WorldWideScience

Sample records for facial blast injury

  1. E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

    Directory of Open Access Journals (Sweden)

    Benjamin A. Archambeau

    2016-11-01

    Full Text Available Electronic cigarettes (also known as e-cigarettes or e-cigs are becoming a popular method of recreational nicotine use over recent years. The growth of new brands and devices has been outpacing the FDA’s ability to regulate them. As a result, some of these devices fail without warning, most likely from malfunction of the lithium-ion batteries that are in close proximity to volatile compounds within the device. Failures have occurred during both use and storage of the devices or their components. The subsequent injuries from several of these events, including full thickness burns requiring grafting and blast injuries, have been observed at Arrowhead Regional Medical Center, a regional trauma and burn center in southern California. One severe case resulted in several maxillofacial fractures, blurred vision, and pneumocephalus after a device failed catastrophically during use. The patient required close monitoring with serial imaging by neurosurgery in the intensive care unit and multiple procedures by oral maxillofacial surgery to reconstruct his facial bones and soft tissue. Ultimately, the patient recovered with minimal permanent damage, but the potential for further injury or even death was apparent. Cases such as this one are becoming more frequent. It is important to increase awareness of this growing problem for both medical professionals and the general public in order to curb this concerning new trend.

  2. E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

    Directory of Open Access Journals (Sweden)

    Benjamin Archambeau

    2016-11-01

    Full Text Available Electronic cigarettes (also known as e-cigarettes or e-cigs are becoming a popular method of recreational nicotine use over recent years. The growth of new brands and devices has been outpacing the FDA’s ability to regulate them. As a result, some of these devices fail without warning, most likely from malfunction of the lithium-ion batteries that are in close proximity to volatile compounds within the device. Failures have occurred during both use and storage of the devices or their components. The subsequent injuries from several of these events, including full thickness burns requiring grafting and blast injuries, have been observed at Arrowhead Regional Medical Center, a regional trauma and burn center in southern California. One severe case resulted in several maxillofacial fractures, blurred vision, and pneumocephalus after a device failed catastrophically during use. The patient required close monitoring with serial imaging by neurosurgery in the intensive care unit and multiple procedures by oral maxillofacial surgery to reconstruct his facial bones and soft tissue. Ultimately, the patient recovered with minimal permanent damage, but the potential for further injury or even death was apparent. Cases such as this one are becoming more frequent. It is important to increase awareness of this growing problem for both medical professionals and the general public in order to curb this concerning new trend.

  3. Application of silver sulfadiazine cream with early surgical intervention in patients suffering from combined burn-blast injury facial tattoos.

    Science.gov (United States)

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

    Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention.

  4. Facial Sports Injuries

    Science.gov (United States)

    ... Find an ENT Doctor Near You Facial Sports Injuries Facial Sports Injuries Patient Health Information News media interested in ... should receive immediate medical attention. Prevention Of Facial Sports Injuries The best way to treat facial sports injuries ...

  5. Penetrating facial injury by a wooden log

    OpenAIRE

    Mohan, Sadanandan; Varghese, George; Kumar, Sanjay; Subramanian, Dinesh Pambungal

    2014-01-01

    Penetrating facial injuries are potentially dangerous and require emergency management because of the presence of vital structures in the face and it may be life threatening especially when the injury involves airway, major blood vessels, spinal cord and cervical spines. Penetrating injuries of facial region can occur due to missile injuries, blast injuries, accidental fall on sharp objects such as sticks or glass and motor vehicle accidents etc., Indications for immediate surgical management...

  6. Facial Injuries and Disorders

    Science.gov (United States)

    Face injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, ... your nose, cheekbone and jaw, are common facial injuries. Certain diseases also lead to facial disorders. For ...

  7. Facial Firework Injury: A Case Series

    Directory of Open Access Journals (Sweden)

    Kashyap Tadisina

    2014-07-01

    Full Text Available Fireworks are used to celebrate a variety of religious, patriotic, and cultural holidays and events around the world. Fireworks are common in the United States, with the most popular holiday for their use being national Independence Day, also known as July Fourth. The use of fireworks within the context of celebrations and holidays presents the ideal environment for accidents that lead to severe and dangerous injuries. Injuries to the face from explosions present a challenging problem in terms of restoring ideal ocular, oral, and facial function. Despite the well documented prevalence of firework use and injury, there is a relatively large deficit in the literature in terms of firework injury that involves the face. We present a unique case series that includes 4 adult male patients all with severe firework injuries to the face that presented at an urban level 1 trauma center. These four patients had an average age of 26.7 years old and presented within 5 hours of each other starting on July Fourth. Two patients died from their injuries and two patients underwent reconstructive surgical management, one of which had two follow up surgeries. We explore in detail their presentation, management, and subsequent outcomes as an attempt to add to the very limited data in the field of facial firework blast injury. In addition, the coincidence of their presentation within the same 5 hours brings into question the availability of the fireworks involved, and the possibility of similar injuries related to this type of firework in the future.

  8. Pediatric facial injuries: It's management

    Science.gov (United States)

    Singh, Geeta; Mohammad, Shadab; Pal, U. S.; Hariram; Malkunje, Laxman R.; Singh, Nimisha

    2011-01-01

    Background: Facial injuries in children always present a challenge in respect of their diagnosis and management. Since these children are of a growing age every care should be taken so that later the overall growth pattern of the facial skeleton in these children is not jeopardized. Purpose: To access the most feasible method for the management of facial injuries in children without hampering the facial growth. Materials and Methods: Sixty child patients with facial trauma were selected randomly for this study. On the basis of examination and investigations a suitable management approach involving rest and observation, open or closed reduction and immobilization, trans-osseous (TO) wiring, mini bone plate fixation, splinting and replantation, elevation and fixation of zygoma, etc. were carried out. Results and Conclusion: In our study fall was the predominant cause for most of the facial injuries in children. There was a 1.09% incidence of facial injuries in children up to 16 years of age amongst the total patients. The age-wise distribution of the fracture amongst groups (I, II and III) was found to be 26.67%, 51.67% and 21.67% respectively. Male to female patient ratio was 3:1. The majority of the cases of facial injuries were seen in Group II patients (6-11 years) i.e. 51.67%. The mandibular fracture was found to be the most common fracture (0.60%) followed by dentoalveolar (0.27%), mandibular + midface (0.07) and midface (0.02%) fractures. Most of the mandibular fractures were found in the parasymphysis region. Simple fracture seems to be commonest in the mandible. Most of the mandibular and midface fractures in children were amenable to conservative therapies except a few which required surgical intervention. PMID:22639504

  9. Shock tubes and blast injury modeling

    Institute of Scientific and Technical Information of China (English)

    Ya-Lei Ning; Yuan-Guo Zhou

    2015-01-01

    Explosive blast injury has become the most prevalent injury in recent military conflicts and terrorist attacks.The magnitude of this kind of polytrauma is complex due to the basic physics of blast and the surrounding environments.Therefore,development of stable,reproducible and controllable animal model using an ideal blast simulation device is the key of blast injury research.The present review addresses the modeling of blast injury and applications of shock tubes.

  10. Facial and Dental Injuries Facial and Dental Injuries in Karate.

    Science.gov (United States)

    Vidovic-Stesevic, Vesna; Verna, Carlalberta; Krastl, Gabriel; Kuhl, Sebastian; Filippi, Andreas

    2015-01-01

    Karate is a martial art that carries a high trauma risk. Trauma-related Swiss and European karate data are currently unavailable. This survey seeks to increase knowledge of the incidence of traumatic facial and dental injuries, their emergency management, awareness of tooth rescue boxes, the use of mouthguards and their modifications. Interviews were conducted with 420 karate fighters from 43 European countries using a standardized questionnaire. All the participants were semi-professionals. The data were evaluated with respect to gender, kumite level (where a karate practitioner trains against an adversary), and country. Of the 420 fighters interviewed, 213 had experienced facial trauma and 44 had already had dental trauma. A total of 192 athletes had hurt their opponent by inflicting a facial or dental injury, and 290 knew about the possibility of tooth replantation following an avulsion. Only 50 interviewees knew about tooth rescue boxes. Nearly all the individuals interviewed wore a mouthguard (n = 412), and 178 of them had made their own modifications to the guard. The results of the present survey suggest that more information and education in wearing protective gear are required to reduce the incidence of dental injuries in karate.

  11. [Fatal explosion injuries from blasting a cigarette machine].

    Science.gov (United States)

    Madea, Burkhard; Ridwan, Hani; Längin, Volker; Doberentz, Elke

    2016-01-01

    In the last few years, a growing number of cases have been reported in Germany in which vending machines have been blasted by criminals to get at the money. Thus, it was only a question of time for the first fatalities to occur as a consequence of such careless explosions. We report on the death of a 16-year-old boy who died after triggering an explosion by spraying a deodorant into the coin slot of a cigarette machine. Death was caused by severe craniocerebral trauma due to tertiary blast-related injuries when the front plate of the machine hit the victim's cerebral and facial skull.

  12. Anatomical considerations to prevent facial nerve injury.

    Science.gov (United States)

    Roostaeian, Jason; Rohrich, Rod J; Stuzin, James M

    2015-05-01

    Injury to the facial nerve during a face lift is a relatively rare but serious complication. A large body of literature has been dedicated toward bettering the understanding of the anatomical course of the facial nerve and the relative danger zones. Most of these prior reports, however, have focused on identifying the location of facial nerve branches based on their trajectory mostly in two dimensions and rarely in three dimensions. Unfortunately, the exact location of the facial nerve relative to palpable or visible facial landmarks is quite variable. Although the precise location of facial nerve branches is variable, its relationship to soft-tissue planes is relatively constant. The focus of this report is to improve understanding of facial soft-tissue anatomy so that safe planes of dissection during surgical undermining may be identified for each branch of the facial nerve. Certain anatomical locations more prone to injury and high-risk patient parameters are further emphasized to help minimize the risk of facial nerve injury during rhytidectomy.

  13. Brain Injury Risk from Primary Blast

    Science.gov (United States)

    2012-02-29

    injury has been studied extensively in air-containing organs such as the lungs , gastrointestinal tract, and ear due to their increased...veterans (Owens, 2008). Primary blast injury has been studied extensively in air-containing organs such as the lungs , gastrointestinal tract, and ear... contusions typically on or around the brainstem though there were no skull fractures for any blast intensity. Risk functions were developed that

  14. Blast Injuries: What Clinicians Need to Know

    Centers for Disease Control (CDC) Podcasts

    2008-11-05

    In this podcast, Dr. Richard C. Hunt, Director of the CDC’s Division of Injury Response, National Center for Injury Prevention and Control provides a brief overview for health care providers on how to respond and care for persons injured by an explosion or blast event.  Created: 11/5/2008 by National Center for Injury Prevention and Control (NCIPC), Division of Injury Response (DIR).   Date Released: 11/6/2008.

  15. Blast-induced traumatic brain injury: a new trend of blast injury research

    Institute of Scientific and Technical Information of China (English)

    Yan Zhao; Zheng-Guo Wang

    2015-01-01

    Blast injury has become the major life-and function-threatening injuries in recent warfares.There is increased research interest in the mental disorders caused by blast-induced traumatic brain injury (bTBI),which has been proved as one of the "signature wounds" in modern battlefield.We reviewed the recent progresses in bTBl-related researches and concluded that the new era of blast injury research has shifted from the traditional physical impairments to cognitive dysfunctional/mental disorders that are proved to be more related to the outcome of combat casualty care.

  16. Analysis of Facial Injuries Caused by Power Tools.

    Science.gov (United States)

    Kim, Jiye; Choi, Jin-Hee; Hyun Kim, Oh; Won Kim, Sug

    2016-06-01

    The number of injuries caused by power tools is steadily increasing as more domestic woodwork is undertaken and more power tools are used recreationally. The injuries caused by the different power tools as a consequence of accidents are an issue, because they can lead to substantial costs for patients and the national insurance system. The increase in hand surgery as a consequence of the use of power tools and its economic impact, and the characteristics of the hand injuries caused by power saws have been described. In recent years, the authors have noticed that, in addition to hand injuries, facial injuries caused by power tools commonly present to the emergency room. This study aimed to review the data in relation to facial injuries caused by power saws that were gathered from patients who visited the trauma center at our hospital over the last 4 years, and to analyze the incidence and epidemiology of the facial injuries caused by power saws. The authors found that facial injuries caused by power tools have risen continually. Facial injuries caused by power tools are accidental, and they cause permanent facial disfigurements and functional disabilities. Accidents are almost inevitable in particular workplaces; however, most facial injuries could be avoided by providing sufficient operator training and by tool operators wearing suitable protective devices. The evaluation of the epidemiology and patterns of facial injuries caused by power tools in this study should provide the information required to reduce the number of accidental injuries.

  17. The radiological management of bomb blast injury.

    Science.gov (United States)

    Hare, S S; Goddard, I; Ward, P; Naraghi, A; Dick, E A

    2007-01-01

    A need to understand the nature and patterns of bomb blast injury, particularly in confined spaces, has come to the fore with the current worldwide threat from terrorism. The purpose of this review article is to familiarize the radiologist with the imaging they might expect to see in a mass casualty terrorist event, illustrated by examples from two of the main institutions receiving patients from the London Underground tube blasts of 7 July 2005. We present examples of injuries that are typical in blast victims, as well as highlighting some blast sequelae that might also be found in other causes of multiple trauma. This should enable the radiologist to seek out typical injuries, including those that may not be initially clinically apparent. Terror-related injuries are often more severe than those seen in other trauma cases, and multi-system trauma at distant anatomical sites should be anticipated. We highlight the value of using a standardized imaging protocol to find clinically undetected traumatic effects and include a discussion on management of multiple human and non-human flying fragments. This review also discusses the role of radiology in the management and planning for a mass casualty terrorist incident and the optimal deployment of radiographic services during such an event.

  18. Blast Injuries: From Improvised Explosive Device Blasts to the Boston Marathon Bombing.

    Science.gov (United States)

    Singh, Ajay K; Ditkofsky, Noah G; York, John D; Abujudeh, Hani H; Avery, Laura A; Brunner, John F; Sodickson, Aaron D; Lev, Michael H

    2016-01-01

    Although most trauma centers have experience with the imaging and management of gunshot wounds, in most regions blast wounds such as the ones encountered in terrorist attacks with the use of improvised explosive devices (IEDs) are infrequently encountered outside the battlefield. As global terrorism becomes a greater concern, it is important that radiologists, particularly those working in urban trauma centers, be aware of the mechanisms of injury and the spectrum of primary, secondary, tertiary, and quaternary blast injury patterns. Primary blast injuries are caused by barotrauma from the initial increased pressure of the explosive detonation and the rarefaction of the atmosphere immediately afterward. Secondary blast injuries are caused by debris carried by the blast wind and most often result in penetrating trauma from small shrapnel. Tertiary blast injuries are caused by the physical displacement of the victim and the wide variety of blunt or penetrating trauma sustained as a result of the patient impacting immovable objects such as surrounding cars, walls, or fences. Quaternary blast injuries include all other injuries, such as burns, crush injuries, and inhalational injuries. Radiography is considered the initial imaging modality for assessment of shrapnel and fractures. Computed tomography is the optimal test to assess penetrating chest, abdominal, and head trauma. The mechanism of blast injuries and the imaging experience of the victims of the Boston Marathon bombing are detailed, as well as musculoskeletal, neurologic, gastrointestinal, and pulmonary injury patterns from blast injuries.

  19. The past and present of blast injury research in China

    Institute of Scientific and Technical Information of China (English)

    Yan Zhao; Yuan-Guo Zhou

    2015-01-01

    With the increasing incidence of blast injury,the research on its mechanisms and protective measures draws more and more attention.Blast injury has many characteristics different from general war injuries or trauma.For example,soldiers often have various degrees of visceral injury without significant surface damage,combined injuries and arterial air embolism.Researchers in China began to investigate blast injury later than the United States and Sweden,but the development is so fast that lots of achievements have been gained,including the development of biological shock tube,the mechanisms and characteristics of blast injury in various organs,as well as protective measures under special environments.This article reviews the past and current situation of blast injury research in China.

  20. Acute Blast Injury Reduces Brain Abeta in Two Rodent Species

    Directory of Open Access Journals (Sweden)

    Rita eDe Gasperi

    2012-12-01

    Full Text Available Blast-induced traumatic brain injury (TBI has been a major cause of morbidity and mortality in the conflicts in Iraq and Afghanistan. How the primary blast wave affects the brain is not well understood. In particular, it is unclear whether blast injures the brain through mechanisms similar to those found in non-blast closed impact injuries (nbTBI. The β-amyloid (Aβ peptide associated with the development of Alzheimer’s disease (AD is elevated acutely following TBI in humans as well as in experimental animal models of nbTBI. We examined levels of brain Aβ following experimental blast injury using enzyme-linked immunosorbent assays for Aβ 40 and 42. In both rat and mouse models of blast injury, rather than being increased, endogenous rodent brain Aβ levels were decreased acutely following injury. Levels of the amyloid precursor protein (APP were increased following blast exposure although there was no evidence of axonal pathology based on APP immunohistochemical staining. Unlike the findings in nbTBI animal models, levels of the β-secretase, BACE-1, and the γ-secretase component presenilin-1 were unchanged following blast exposure. These studies have implications for understanding the nature of blast injury to the brain. They also suggest that strategies aimed at lowering Aβ production may not be effective for treating acute blast injury to the brain.

  1. A Blast Model of Traumatic Brain Injury in Swine

    Science.gov (United States)

    2009-05-01

    public release; distribution unlimited Although blast-induced traumatic brain injury (BI- TBI ) is a significant cause of morbidity and behavioral...survival model of BI- TBI in swine. Traumatic Brain Injury , Swine, Blast, Model Development U U U 7 USAMRMC W81XWH-08-2-0082... Injury , TBI Scientific Advisor, Defense Center of Excellence for Psychological Health and Traumatic Brain Injury ) and Dr. Tamara Crowder at the DoD

  2. Combat Helmets and Blast Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Duncan Wallace

    2012-01-01

    Full Text Available Background: The conflicts in Iraq and Afghanistan and the prominence of traumatic brain injury (TBI, mostly from improvised explosive devices, have focused attention on the effectiveness of combat helmets. Purpose: This paper examines the importance of TBI, the role and history of the development of combat helmets, current helmet designs and effectiveness, helmet design methodology, helmet sensors, future research and recommendations. Method: A literature review was conducted using search terms – combat helmets, traumatic brain injury, concussion, Iraq, Afghanistan and helmet sensors, searching PubMed, MEDLINE, ProQuest and Google Scholar. Conclusions: At present, no existing helmet is able to fully protect against all threats faced on the battlefield. The prominence of traumatic brain injury from improvised explosive devices in the current conflicts in Iraq and Afghanistan has highlighted the limitations in knowledge about blast and how to provide protection from it. As a result, considerable research is currently occurring in how to protect the head from blast over-pressure. Helmet sensors may provide valuable data. Some new combat helmets may be able to protect against rifle rounds, but may result in injuries occurring behind body armour. Optimal combat helmet design requires a balance between the need for protection from trauma and the comfort and practicality of the helmet for the user to ensure the best outcomes.

  3. Hindfoot injuries due to landmine blast accidents.

    Science.gov (United States)

    Khan, M Tahir; Husain, Faisal N; Ahmed, Aftab

    2002-03-01

    Landmines were initially developed as anti-tank weapons. They are still used indiscriminately and in a disorganised fashion, violating the United Nations Treaty on their use [United Nations (1980)]. The injury produced by these devices is variable depending upon the construction and strength of the landmine and body parts coming in contact with the landmine at the time of detonation. The purpose of the present study was to report the type of landmine-blast injuries of the lower limbs and the surgical options available to treat them. Twenty-eight patients, all with lower limb injuries were included in the present study. They had received injuries on the control line of the troubled Jammu and Kashmir regions in the north of Pakistan. All were male patients between the age of 13 and 55 years. A salvage procedure for the forefoot was possible on four patients only and all the rest had a below-knee amputation. Time lapsed between the injury and receiving medical help was the crucial determining factor as to the final outcome of the limb. We believe that the pattern of injury, amount of energy dissipation and part of body in contact with the landmine at the time of explosion are the main determining factors for the final outcome. If skin along with the underlying soft tissue and the neuro-vascular structures on the dorsum of the foot are spared then an attempt can be made at limb salvage.

  4. Mechanisms of hearing loss after blast injury to the ear.

    Directory of Open Access Journals (Sweden)

    Sung-Il Cho

    Full Text Available Given the frequent use of improvised explosive devices (IEDs around the world, the study of traumatic blast injuries is of increasing interest. The ear is the most common organ affected by blast injury because it is the body's most sensitive pressure transducer. We fabricated a blast chamber to re-create blast profiles similar to that of IEDs and used it to develop a reproducible mouse model to study blast-induced hearing loss. The tympanic membrane was perforated in all mice after blast exposure and found to heal spontaneously. Micro-computed tomography demonstrated no evidence for middle ear or otic capsule injuries; however, the healed tympanic membrane was thickened. Auditory brainstem response and distortion product otoacoustic emission threshold shifts were found to be correlated with blast intensity. As well, these threshold shifts were larger than those found in control mice that underwent surgical perforation of their tympanic membranes, indicating cochlear trauma. Histological studies one week and three months after the blast demonstrated no disruption or damage to the intra-cochlear membranes. However, there was loss of outer hair cells (OHCs within the basal turn of the cochlea and decreased spiral ganglion neurons (SGNs and afferent nerve synapses. Using our mouse model that recapitulates human IED exposure, our results identify that the mechanisms underlying blast-induced hearing loss does not include gross membranous rupture as is commonly believed. Instead, there is both OHC and SGN loss that produce auditory dysfunction.

  5. Kevlar Vest Protection Against Blast Overpressure Brain Injury: Systemic Contributions to Injury Etiology

    Science.gov (United States)

    2014-11-01

    Award Number: W81XWH-08-2-0017 TITLE: " Kevlar Vest Protection Against Blast Overpressure Brain Injury: Systemic Contributions to Injury Etiology...TITLE AND SUBTITLE 5a. CONTRACT NUMBER “ Kevlar Vest Protection Against Blast Overpressure Brain Injury: Systemic Contributions to Injury Etiology...traumatic brain injury (bTBI) is largely undefined. Along with reducing mortality, in preliminary experiments Kevlar vests significantly protected

  6. Finite element modeling of blast lung injury in sheep.

    Science.gov (United States)

    Gibbons, Melissa M; Dang, Xinglai; Adkins, Mark; Powell, Brian; Chan, Philemon

    2015-04-01

    A detailed 3D finite element model (FEM) of the sheep thorax was developed to predict heterogeneous and volumetric lung injury due to blast. A shared node mesh of the sheep thorax was constructed from a computed tomography (CT) scan of a sheep cadaver, and while most material properties were taken from literature, an elastic-plastic material model was used for the ribs based on three-point bending experiments performed on sheep rib specimens. Anesthetized sheep were blasted in an enclosure, and blast overpressure data were collected using the blast test device (BTD), while surface lung injury was quantified during necropsy. Matching blasts were simulated using the sheep thorax FEM. Surface lung injury in the FEM was matched to pathology reports by setting a threshold value of the scalar output termed the strain product (maximum value of the dot product of strain and strain-rate vectors over all simulation time) in the surface elements. Volumetric lung injury was quantified by applying the threshold value to all elements in the model lungs, and a correlation was found between predicted volumetric injury and measured postblast lung weights. All predictions are made for the left and right lungs separately. This work represents a significant step toward the prediction of localized and heterogeneous blast lung injury, as well as volumetric injury, which was not recorded during field testing for sheep.

  7. Management of facial soft tissue injuries in children.

    Science.gov (United States)

    Vasconez, Henry C; Buseman, Jason L; Cunningham, Larry L

    2011-07-01

    Pediatric facial trauma can present a challenge to even the more experienced plastic surgeon. Injuries to the head and neck may involve bone and soft tissues with an assortment of specialized organs and tissue elements involved. Because of the active nature of children, facial soft tissue injuries can be diverse and extensive as well as some of the more common injuries a plastic surgeon is asked to treat. In 2007, approximately 800,000 patients younger than 15 years presented to emergency departments around the country with significant open wounds of the head that required treatment.In this review, we present the different types and regions of pediatric soft tissue facial trauma, as well as treatment options and goals of plastic surgery wound management. Special aspects, such as bite wounds, burns, pediatric analgesia, and antibiotic therapy, are also discussed.

  8. Simulation of blast-induced, early-time intracranial wave physics leading to traumatic brain injury.

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Paul Allen; Ford, Corey C. (University of New Mexico, Albuquerque, NM)

    2008-04-01

    U.S. soldiers are surviving blast and impacts due to effective body armor, trauma evacuation and care. Blast injuries are the leading cause of traumatic brain injury (TBI) in military personnel returning from combat. Understanding of Primary Blast Injury may be needed to develop better means of blast mitigation strategies. The objective of this paper is to investigate the effects of blast direction and strength on the resulting mechanical stress and wave energy distributions generated in the brain.

  9. Blast wave injury prediction models for complex scenarios

    NARCIS (Netherlands)

    Teland, J.A.; Doormaal, J.C.A.M. van

    2012-01-01

    Blast waves from explosions can cause lethal injuries to humans. Development of injury criteria has been ongoing for many years, but with the main focus on free field conditions. However, with terrorist actions as a new threat, explosions in urban areas have become of much more interest. Urban areas

  10. Blast wave injury prediction models for complex scenarios

    NARCIS (Netherlands)

    Teland, J.A.; Doormaal, J.C.A.M. van

    2012-01-01

    Blast waves from explosions can cause lethal injuries to humans. Development of injury criteria has been ongoing for many years, but with the main focus on free field conditions. However, with terrorist actions as a new threat, explosions in urban areas have become of much more interest. Urban areas

  11. Lasting retinal injury in a mouse model of blast-induced trauma

    Science.gov (United States)

    Traumatic brain injury (TBI) due to blast exposure is currently the most prevalent of war injuries. While secondary ocular blast injuries due to flying debris are more common, primary ocular blast exposure has been reported among survivors of explosions, but with limited understanding of the resulti...

  12. The Complicated Facial War Injury: Pitfalls and Mismanagement.

    Science.gov (United States)

    Abu-Sittah, Ghassan S; Baroud, Joe; Hakim, Christopher; Wakil, Cynthia

    2017-01-01

    The aim of this paper is to share the authors' experience in the management of complicated facial war injuries using free tissue transfer. A discussion on the most commonly encountered pitfalls in management during the acute and complicated settings is presented in an effort to raise insight on facial war wound complications. Two patients of complicated facial war injuries are presented to exemplify the pitfalls in acute and chronic management of the mandibular region in the first patient and the orbito-maxillary region in the second. The examples demonstrate free tissue transfer for early as well as late definitive reconstructions. A reconstruction algorithm or consensus regarding the optimal management plan of complicated facial war injuries is not attainable. The main principles of treatment, however, remain to decrease bacterial burden by adequate aggressive debridement followed by revisit sessions, remove of all infected hardware followed by replacement with external bony fixation if necessary and reviving the affected area by coverage with well-vascularized tissues and bone. The later is feasible via local, regional, or distant tissue transfer depending on the extent of injury, surgeon's experience, and time and personnel available. Free tissue transfer has revolutionized the management of complicated facial war injuries associated with soft tissue or bone loss as it has allowed the introduction of well-vascularized tissues into a hostile wound environment. The end result is a reduced infection rate, faster recovery time, and better functional outcome compared with when loco-regional soft tissue coverage or bone grafting is used. When soft tissue or bone loss is present, free tissue transfer should be the first management plan if time and personnel are available. The ultimate treatment of a complicated war wound remains prevention by accurate initial management.

  13. Radiologic evaluation of facial injury; Avaliacao radiologica dos traumatismos faciais

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Ricardo Pires de; Volpato, Richard [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil). Servico de Diagnostico por Imagem]. E-mail: richard_volpato@uol.com.br; Nascimento, Lia Paula [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil)

    2003-03-01

    A detailed radiological investigation of the maxillofacial injuries is essential to achieve good treatment results. The images should identify every lesion and guide the treatment, thus improving esthetic and functional results. With the aim of simplifying the diagnostic task, the face may be seen as a five regions structure that may suffer a regional fracture or combined fractures involving the adjacent regions. These regions represent areas of focus for pre surgical planning and are as follows: nasal, orbital, zygomatic, maxillary, and mandibular. In order to understand the injury mechanisms and their consequences it is useful to know the supporting buttresses, which are divided in five sagittal planes, three horizontal planes and two coronal planes. We reviewed the cases of patients with facial trauma treated at Complexo Hospitalar Heliopolis, Sao Paulo, Brazil. A review of the relevant issues concerning radiological investigation of these injuries is presented. This study allowed standardization and ordering of the radiological investigation in patients with facial trauma. (author)

  14. Incidence of Primary Blast Injury in US Military Overseas Contingency Operations: A Retrospective Study

    Science.gov (United States)

    2010-06-01

    blast lung injury,27 codes 860.4 (traumatic pneumothorax, closed) and 861.21 ( pulmonary contusion , closed) were searched in the JTTR. The records of...the explosion-injured patients with closed pneumothoraces and/or closed pulmonary contusions were re- viewed. Patients found to have rib fractures...pressure. The JTTR was searched for these codes with no results. No specific codes for blast lung injury/ pulmonary blast injury or intes- tinal blast

  15. Relationship between Locations of Facial Injury and the Use of Bicycle Helmets: A Systematic Review.

    Science.gov (United States)

    Hwang, Kun; Jeon, Yun Moon; Ko, Yeong Seung; Kim, Yeon Soo

    2015-07-01

    The aim of this study is to review the protective effect of a bicycle helmet on each facial location systematically. PubMed was searched for articles published before December 12, 2014. The data were summarized, and the odds ratio (OR) between the locations of facial injury was calculated. A statistical analysis was performed with Review Manager (The Nordic Cochrane Centre). Bicycle helmets protect the upper and middle face from serious facial injury but do not protect the lower face. Non-wearers had significantly increased risks of upper facial injury (OR, 2.07; Pchin cap might decrease the risk of lower facial injury.

  16. Neuropsychological outcome from blast versus non-blast: mild traumatic brain injury in U.S. military service members.

    Science.gov (United States)

    Lange, Rael T; Pancholi, Sonal; Brickell, Tracey A; Sakura, Sara; Bhagwat, Aditya; Merritt, Victoria; French, Louis M

    2012-05-01

    The purpose of this study was to compare the neuropsychological outcome from blast-related versus non-blast related mild traumatic brain injury (MTBI). Participants were 56 U.S. military service members who sustained an MTBI, divided into two groups based on mechanism of injury: (a) non-blast related (Non-blast; n = 21), and (b) blast plus secondary blunt trauma (Blast Plus; n = 35). All participants had sustained their injury in theatre whilst deployed during Operation Iraqi Freedom or Operation Enduring Freedom. Patients had been seen for neuropsychological evaluation at Walter Reed Army Medical Center on average 4.4 months (SD = 4.1) post-injury. Measures included 14 clinical scales from the Personality Assessment Inventory (PAI) and 12 common neurocognitive measures. For the PAI, there were no significant differences between groups on all scales (p > .05). However, medium effect sizes were found for the Depression (d = .49) and Stress (d = .47) scales (i.e., Blast Plus > Non-blast). On the neurocognitive measures, after controlling for the influence of psychological distress (i.e., Depression, Stress), there were no differences between the Non-blast and Blast Plus groups on all measures. These findings provide little evidence to suggest that blast exposure plus secondary blunt trauma results in worse cognitive or psychological recovery than blunt trauma alone. (JINS, 2012, 18, 595-605).

  17. Facial Injuries and Football Before School

    OpenAIRE

    Ruff, Anne

    2003-01-01

    Sir Alex Ferguson may be grateful that David Beckham did not seek legal redress for the injury caused to his left eyebrow by a flying football boot. In Kearn-Price v. Kent County Council [2002] EWCA Civ.1539, a 14-year-old pupil suffered a serious eye injury when he was struck by a football while standing in the school playground. The Court of Appeal dismissed the local education authority’s appeal against the decision of the county court that the school had been negligent in failing to preve...

  18. Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury.

    Science.gov (United States)

    Capó-Aponte, José E; Jorgensen-Wagers, Kendra L; Sosa, Josue A; Walsh, David V; Goodrich, Gregory L; Temme, Leonard A; Riggs, Daniel W

    2017-01-01

    To assess the prevalence of visual dysfunctions and associated symptoms in war fighters at different stages after non-blast- or blast-induced mild traumatic brain injury (mTBI). A comprehensive retrospective review of the electronic health records of 500 U.S. military personnel with a diagnosis of deployment-related mTBI who received eye care at the Landstuhl Regional Medical Center. For analysis, the data were grouped by mechanism of injury, and each group was further divided in three subgroups based on the number of days between injury and initial eye examination. The data showed a high frequency of visual symptoms and visual dysfunctions. However, the prevalence of visual symptoms and visual dysfunctions did not differ significantly between mechanism of injury and postinjury stage, except for eye pain and diplopia. Among visual symptoms, binocular dysfunctions were more common, including higher near vertical phoria, reduced negative fusional vergence break at near, receded near point of convergence, decreased stereoacuity, and reduced positive relative accommodation. The lack of difference in terms of visual sequelae between subgroups (blast vs. nonblast) suggests that research addressing the assessment and management of mTBI visual sequelae resulting from civilian nonblast events is relevant to military personnel where combat injury results primarily from a blast event.

  19. Acute onset of trigeminal neuralgia, facial paresis and dysphagia after mild head injury.

    Science.gov (United States)

    Gkekas, Nikolaos; Primikiris, Panagiotis; Georgakoulias, Nikolaos

    2014-01-01

    The authors report the rare and first documented case of concomitant microvascular decompression of trigeminal, facial and glossopharyngeal nerves for the management of intractable to medical therapy acute onset of trigeminal neuralgia, facial paresis and dysphagia after mild head injury.

  20. A review of three cases of mobile blast: The new culprit of hand injury

    Directory of Open Access Journals (Sweden)

    Nikunj B Mody

    2016-01-01

    Full Text Available Although blast injuries are common with war; cooking gas; firecracker, mobile phone blast cases are increasing in number in last couple of years. We present 3 cases of mobile blast in 3 children causing injury to dominant hand in them.

  1. FACIAL FRACTURES AND RELATED INJURIES IN DEPARTMENT OF MAXILLO-FACIAL SURGERY, UNIVERSITY HOSPITAL ‘ST. ANNA’, SOFIA, BULGARIA.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-04-01

    Full Text Available Maxillofacial fractures often occur with serious concomitant injury in trauma patients, and knowledge of the type and severity of associated injuries can assist in rapid assessment and treatment. The objective was to identify the most commonly occurring injuries associated with facial fractures in severely injured trauma patients.

  2. Distinguishing Realistic Military Blasts from Firecrackers in Mitigation Studies of Blast Induced Traumatic Brain Injury

    Energy Technology Data Exchange (ETDEWEB)

    Moss, W C; King, M J; Blackman, E G

    2011-01-21

    In their Contributed Article, Nyein et al. (1,2) present numerical simulations of blast waves interacting with a helmeted head and conclude that a face shield may significantly mitigate blast induced traumatic brain injury (TBI). A face shield may indeed be important for future military helmets, but the authors derive their conclusions from a much smaller explosion than typically experienced on the battlefield. The blast from the 3.16 gm TNT charge of (1) has the following approximate peak overpressures, positive phase durations, and incident impulses (3): 10 atm, 0.25 ms, and 3.9 psi-ms at the front of the head (14 cm from charge), and 1.4 atm, 0.32 ms, and 1.7 psi-ms at the back of a typical 20 cm head (34 cm from charge). The peak pressure of the wave decreases by a factor of 7 as it traverses the head. The blast conditions are at the threshold for injury at the front of the head, but well below threshold at the back of the head (4). The blast traverses the head in 0.3 ms, roughly equal to the positive phase duration of the blast. Therefore, when the blast reaches the back of the head, near ambient conditions exist at the front. Because the headform is so close to the charge, it experiences a wave with significant curvature. By contrast, a realistic blast from a 2.2 kg TNT charge ({approx} an uncased 105 mm artillery round) is fatal at an overpressure of 10 atm (4). For an injury level (4) similar to (1), a 2.2 kg charge has the following approximate peak overpressures, positive phase durations, and incident impulses (3): 2.1 atm, 2.3 ms, and 18 psi-ms at the front of the head (250 cm from charge), and 1.8 atm, 2.5 ms, and 16.8 psi-ms at the back of the head (270 cm from charge). The peak pressure decreases by only a factor of 1.2 as it traverses the head. Because the 0.36 ms traversal time is much smaller than the positive phase duration, pressures on the head become relatively uniform when the blast reaches the back of the head. The larger standoff implies

  3. Blast overpressure induced axonal injury changes in rat brainstem and spinal cord

    Directory of Open Access Journals (Sweden)

    Srinivasu Kallakuri

    2015-01-01

    Full Text Available Introduction: Blast induced neurotrauma has been the signature wound in returning soldiers from the ongoing wars in Iraq and Afghanistan. Of importance is understanding the pathomechansim(s of blast overpressure (OP induced axonal injury. Although several recent animal models of blast injury indicate the neuronal and axonal injury in various brain regions, animal studies related to axonal injury in the white matter (WM tracts of cervical spinal cord are limited. Objective: The purpose of this study was to assess the extent of axonal injury in WM tracts of cervical spinal cord in male Sprague Dawley rats subjected to a single insult of blast OP. Materials and Methods: Sagittal brainstem sections and horizontal cervical spinal cord sections from blast and sham animals were stained by neurofilament light (NF-L chain and beta amyloid precursor protein immunocytochemistry and observed for axonal injury changes. Results: Observations from this preliminary study demonstrate axonal injury changes in the form of prominent swellings, retraction bulbs, and putative signs of membrane disruptions in the brainstem and cervical spinal cord WM tracts of rats subjected to blast OP. Conclusions: Prominent axonal injury changes following the blast OP exposure in brainstem and cervical spinal WM tracts underscores the need for careful evaluation of blast induced injury changes and associated symptoms. NF-L immunocytochemistry can be considered as an additional tool to assess the blast OP induced axonal injury.

  4. Face shield design against blast-induced head injuries.

    Science.gov (United States)

    Tan, Long Bin; Tse, Kwong Ming; Tan, Yuan Hong; Sapingi, Mohamad Ali Bin; Tan, Vincent Beng Chye; Lee, Heow Pueh

    2017-03-22

    Blast-induced traumatic brain injury has been on the rise in recent years because of the increasing use of improvised explosive devices in conflict zones. Our study investigates the response of a helmeted human head subjected to a blast of 1 atm peak overpressure, for cases with and without a standard polycarbonate (PC) face shield and for face shields comprising of composite PC and aerogel materials and with lateral edge extension. The novel introduction of aerogel into the laminate face shield is explored and its wave-structure interaction mechanics and performance in blast mitigation is analysed. Our numerical results show that the face shield prevented direct exposure of the blast wave to the face and help delays the transmission of the blast to reduce the intracranial pressures (ICPs) at the parietal lobe. However, the blast wave can diffract and enter the midface region at the bottom and side edges of the face shield, resulting in traumatic brain injury. This suggests that the bottom and sides of the face shield are important regions to focus on to reduce wave ingress. The laminated PC/aerogel/PC face shield yielded higher peak positive and negative ICPs at the frontal lobe, than the original PC one. For the occipital and temporal brain regions, the laminated face shield performed better than the original. The composite face shield with extended edges reduced ICP at the temporal lobe but increases ICP significantly at the parietal lobe, which suggests that a greater coverage may not lead to better mitigating effects. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Development of Experimental Tissue Models for Blast Injury

    Science.gov (United States)

    Butler, Benjamin; Bo, Chiara; Williams, Alun; Jardine, Andy; Brown, Katherine

    2013-06-01

    There is a pressing need to better understand the relationship between the intensity of a blast wave and the clinical consequences for victims of an explosion. In order to quantitatively study how these factors correlate with one another, blast injury tissue models are being developed. Sections of larynx, trachea and pulmonary tissue were excised from a recently sacrificed pig and maintained on ice prior to testing. The samples were subjected to strain rates of between 0.001 s-1 and 1000 s-1 in the laboratory by using a Split Hopkinson Pressure Bar and quasi-static testing apparatus. During high strain rate testing, samples were housed in a polycarbonate chamber which permitted experimentation on tissue held in fluid. Data were analysed using 1, 2 and 3 wave analysis software in Matlab to yield information about the material properties of both undamaged and damaged tissues. In addition, macroscopic changes in tissue organization were also visualized using histopathological techniques. This work is being extended to cellular and animal models to derive more detailed information about the underlying molecular changes relating to blast-induced damage and repair. The Royal British Legion Centre for Blast Injury Studies.

  6. Effects of antioxidant treatment on blast-induced brain injury.

    Directory of Open Access Journals (Sweden)

    Xiaoping Du

    Full Text Available Blast-induced traumatic brain injury has dramatically increased in combat troops in today's military operations. We previously reported that antioxidant treatment can provide protection to the peripheral auditory end organ, the cochlea. In the present study, we examined biomarker expression in the brains of rats at different time points (3 hours to 21 days after three successive 14 psi blast overpressure exposures to evaluate antioxidant treatment effects on blast-induced brain injury. Rats in the treatment groups received a combination of antioxidants (2,4-disulfonyl α-phenyl tertiary butyl nitrone and N-acetylcysteine one hour after blast exposure and then twice a day for the following two days. The biomarkers examined included an oxidative stress marker (4-hydroxy-2-nonenal, 4-HNE, an immediate early gene (c-fos, a neural injury marker (glial fibrillary acidic protein, GFAP and two axonal injury markers [amyloid beta (A4 precursor protein, APP, and 68 kDa neurofilament, NF-68]. The results demonstrate that blast exposure induced or up-regulated the following: 4-HNE production in the dorsal hippocampus commissure and the forceps major corpus callosum near the lateral ventricle; c-fos and GFAP expression in most regions of the brain, including the retrosplenial cortex, the hippocampus, the cochlear nucleus, and the inferior colliculus; and NF-68 and APP expression in the hippocampus, the auditory cortex, and the medial geniculate nucleus (MGN. Antioxidant treatment reduced the following: 4-HNE in the hippocampus and the forceps major corpus callosum, c-fos expression in the retrosplenial cortex, GFAP expression in the dorsal cochlear nucleus (DCN, and APP and NF-68 expression in the hippocampus, auditory cortex, and MGN. This preliminary study indicates that antioxidant treatment may provide therapeutic protection to the central auditory pathway (the DCN and MGN and the non-auditory central nervous system (hippocampus and retrosplenial cortex

  7. Prevention of Blast-Related Injuries

    Science.gov (United States)

    2014-07-01

    curvature changes. Figure 38. Locations with element disconnect issues 2. Modeling air blast wave propagation using a 2-D to 3-D mapping...sagittal sinus, transverse sinus, cerebral spinal fluid (CSF), hemispheres of the cerebrum with distinct white and gray matter, cerebellum, brainstem...brain and cerebral spinal fluid (CSF) were meshed and defined with Lagrangian formulation-based elements. The CSF fills the subarachnoid space

  8. Assessment and Treatment of Blast-Induced Auditory and Vestibular Injuries

    Science.gov (United States)

    2016-06-01

    Collaboration 8. Special Reporting Requirements A Quad Chart is attached . 9. APPENDICES Two abstracts are attached . Assessment and treatment of...characterized shock tube exposures of mice to repetitive blast overpressure Combined functional, morphological, and neurobiological assessments Functional...disorders. Despite the high incidence of auditory dysfunction resulting from blast injuries, the neurobiological mechanisms underlying these blast

  9. Genetic Networks Activated by Blast Injury to the Eye

    Science.gov (United States)

    2014-08-01

    Major Finding: Collected retinas from 40 normal strains with 148 microarrays run. We have collected phenotypic data on corneal thickness, lOP and...pressure ( lOP ), central corneal thickness (CCT) and visual acuity. Task 2) Define the genetic networks activated by blast injury in the eye and in...retina. Accomplishments Under These Goals: Taskl: At the present time we have measured lOP and central corneal thickness on 27 strains of mice

  10. Pulmonary effects of combined blast injury and radiation poisoning.

    Science.gov (United States)

    Johnston, A McD

    2004-09-01

    In situations with relatively small numbers of patients with pulmonary blast injury aggressive modern intensive care treatment may allow a return to normal function. The additional effects of radiation poisoning are more difficult to factor in, but new treatments such as colony stimulating factors may improve the outlook for a group with moderate to severe radiation exposure who would previously have died of infection or haemorrhage.

  11. [The therapy of tinnitus resulting from blast injury (author's transl)].

    Science.gov (United States)

    Jakobs, P; Martin, G

    1978-03-01

    In a prospective study aimed at the cure of tinnitus due to blast injury, oral treatment of 172 patients with the mono-substances Betahistine, Pentoxifyllin and Xantinol-nicotinate were compared with those of control patients who received no medications. Patients treated with Pentoxifyllin and Xantinol-nicotinate improved better than the comparative group without therapy although the differences were not considerable. Betahistine as compared with the other groups produced significantly better therapeutic results.

  12. Reproduction of an animal model of landmine blast injuries

    Directory of Open Access Journals (Sweden)

    Sen ZHANG

    2014-03-01

    Full Text Available Objective To reproduce an animal model of landmine blast injuries for studying its mechanism and characteristics. Methods Fifteen healthy New Zealand white rabbits (body weight 1.9-2.4 kg were prepared as experimental animals. Punctiform burster was used to simulate the landmine, and it was electrically detonated far away to produce landmine blast injuries on unilateral hind limb of rabbits in upright state. The vital signs before and 5min, 15min, 30min, 45min, 1h, 2h, 3h, 6h, 9h and 12h after injuries were recorded. Autopsy of dead animals was performed immediately and the survivors were sacrificed for pathological examination 6h and 12h after the injury. Macroscopic and microscopic changes in the injured limb and distant organs were observed. Fifteen random adult body weights were generated by random number table, and the explosive energy of M14 landmine (about 29g TNT explosive energy was simulated, to compare the ratio of explosive force equivalent to weight calculated between experimental animals and randomly selected adults. Results No significant change in blood pressure was observed at different time points before and after injuries. A broom-like change was found in the injured limb by the general observation. The subareas and pathological changes of injured limb coincided with the typical limb injuries produced by landmine explosion. Damage in different degrees was found in distant organs, and the wound characteristics and injury of major organs were in accordance with the reports of relevant literature. The ratio of explosive equivalent to weight of experimental animals (0.50±0.04g TNT/kg was similar to that of randomly selected adults (0.51±0.05g TNT/kg. Conclusion The present animal model could simulate the landmine explosive injuries, and may be used in research of landmine explosive injuries. DOI: 10.11855/j.issn.0577-7402.2014.01.14

  13. Primary Blast Traumatic Brain Injury in the Rat: Relating Diffusion Tensor Imaging and Behavior

    Directory of Open Access Journals (Sweden)

    Matthew D Budde

    2013-10-01

    Full Text Available The incidence of traumatic brain injury (TBI among military personnel is at its highest point in U.S. history. Experimental animal models of blast have provided a wealth of insight into blast injury. The mechanisms of neurotrauma caused by blast, however, are still under debate. Specifically, it is unclear whether the blast shockwave in the absence of head motion is sufficient to induce brain trauma. In this study, the consequences of blast injury were investigated in a rat model of primary blast TBI. Animals were exposed to blast shockwaves with peak overpressures of either 100 or 450 kPa and subsequently underwent a battery of behavioral tests. Diffusion tensor imaging (DTI, a promising method to detect blast injury in humans, was performed on fixed brains to detect and visualize the spatial dependence of blast injury. Blast TBI caused significant deficits in memory function as evidenced by the Morris Water Maze, but limited emotional deficits as evidenced by the Open Field Test and Elevated Plus Maze. Fractional anisotropy (FA, a metric derived from DTI, revealed significant brain abnormalities in blast-exposed animals. A significant relationship between memory deficits and brain microstructure was evident in the hippocampus, consistent with its role in memory function. The results provide fundamental insight into the neurological consequences of blast TBI, including the evolution of injury during the sub-acute phase and the spatially dependent pattern of injury. The relationship between memory dysfunction and microstructural brain abnormalities may provide insight into the persistent cognitive difficulties experienced by soldiers exposed to blast neurotrauma and may be important to guide therapeutic and rehabilitative efforts.

  14. Assessing Neuro-Systemic & Behavioral Components in the Pathophysiology of Blast-Related Brain Injury

    Directory of Open Access Journals (Sweden)

    Firas H Kobeissy

    2013-11-01

    Full Text Available Among the U.S. military personnel, blast injury is among the leading causes of brain injury. During the past decade, it has become apparent that even blast injury as a form of mild traumatic brain injury (mTBI may lead to multiple different adverse outcomes, such as neuropsychiatric symptoms and long-term cognitive disability. Blast injury is characterized by blast overpressure (BOP, blast duration, and blast impulse. While the blast injuries of a victim close to the explosion will be severe, majority of victims are usually at a distance leading to milder form described as mild blast TBI (mbTBI. A major feature of mbTBI is its complex manifestation occurring in concert at different organ levels involving systemic, cerebral, neuronal and neuropsychiatric responses; some of which are shared with other forms of brain trauma such as acute brain injury and other neuropsychiatric disorders such as PTSD. The pathophysiology of blast injury exposure involves complex cascades of chronic psychological stress, autonomic dysfunction and neuro/systemic inflammation. These factors render blast injury as an arduous challenge in terms of diagnosis and treatment as well as identification of sensitive and specific biomarkers distinguishing mTBI from other non-TBI pathologies and from neuropsychiatric disorders with similar symptoms. This is due to the distinct but shared and partially identified biochemical pathways and neuro-histopathological changes that might be linked to behavioral deficits observed. Taken together, this article aims to provide an overview of the current status of the cellular and pathological mechanisms involved in blast overpressure injury and argues for the urgent need to identify potential biomarkers that can hint at the different mechanisms involved.

  15. Assessment of the Knowledge of Blast Injuries Management among Physicians Working in Tripoli Hospitals (Libya).

    Science.gov (United States)

    Oun, Abdulhakim M; Hadida, Elmokhtar M; Stewart, Charles

    2017-03-08

    Introduction No study on hospital staff preparedness for managing blast injuries has been conducted in Libya. The internal conflict in Libya since 2011 and the difficulties faced by the hospitals has highlighted the need for such studies. Hypothesis Physicians working in Tripoli (capital city Libya) hospitals are inadequately prepared for the management of blast injuries.

  16. Prevention of Blast-Related Injuries

    Science.gov (United States)

    2016-07-01

    to add two procedures to our swine testing protocol. One was to monitor the electroencephalographic ( EEG ) signals from the swine brain pre- and post...brain injury, Open field testing of swine and PMHS, Computer modeling of swine and human brain, brain injury mechanisms 16. SECURITY CLASSIFICATION ...Investigation of the over predicted intracranial pressure 22 ICP) at the frontal lobe 3. Analysis of sensor location sensitivity on model predicted 25 ICP

  17. An animal-to-human scaling law for blast-induced traumatic brain injury risk assessment.

    Science.gov (United States)

    Jean, Aurélie; Nyein, Michelle K; Zheng, James Q; Moore, David F; Joannopoulos, John D; Radovitzky, Raúl

    2014-10-28

    Despite recent efforts to understand blast effects on the human brain, there are still no widely accepted injury criteria for humans. Recent animal studies have resulted in important advances in the understanding of brain injury due to intense dynamic loads. However, the applicability of animal brain injury results to humans remains uncertain. Here, we use advanced computational models to derive a scaling law relating blast wave intensity to the mechanical response of brain tissue across species. Detailed simulations of blast effects on the brain are conducted for different mammals using image-based biofidelic models. The intensity of the stress waves computed for different external blast conditions is compared across species. It is found that mass scaling, which successfully estimates blast tolerance of the thorax, fails to capture the brain mechanical response to blast across mammals. Instead, we show that an appropriate scaling variable must account for the mass of protective tissues relative to the brain, as well as their acoustic impedance. Peak stresses transmitted to the brain tissue by the blast are then shown to be a power function of the scaling parameter for a range of blast conditions relevant to TBI. In particular, it is found that human brain vulnerability to blast is higher than for any other mammalian species, which is in distinct contrast to previously proposed scaling laws based on body or brain mass. An application of the scaling law to recent experiments on rabbits furnishes the first physics-based injury estimate for blast-induced TBI in humans.

  18. Long-term subjective and objective outcome after primary repair of traumatic facial nerve injuries.

    Science.gov (United States)

    Frijters, Erik; Hofer, Stefan O P; Mureau, Marc A M

    2008-08-01

    Although traumatic facial nerve paralysis is a severe handicap, there are no follow-up studies evaluating outcome after primary repair of traumatic facial nerve injuries. From May 1988 to August 2005, 27 patients (mean age, 27 years) were operated for traumatic facial nerve lesions (mean number of affected branches, 2.2). End-to-end facial nerve repair was always performed. All patients were invited to our outpatient clinic for standardized questionnaires (Facial Disability Index, Short Form-36 Health Survey), physical examination (Sunnybrook Facial Grading System), and clinical photographs. Sixteen patients participated in the follow-up study (mean, 9.2 years). Mean Facial Disability Index Physical and Social scores were 86 and 81, respectively, indicating good subjective facial functioning. The mean Sunnybrook Facial Grading System score was 74 indicating adequate facial functioning. Mean physical and mental health scores (Short Form-36 Health Survey) were comparable with normative data. Primary end-to-end repair of traumatic facial nerve injuries results in good long-term objective and subjective functional and emotional outcome.

  19. Nicotine effects on muscarinic receptor-mediated free Ca[Formula: see text] level changes in the facial nucleus following facial nerve injury.

    Science.gov (United States)

    Sun, Dawei; Zhou, Rui; Dong, Anbing; Sun, Wenhai; Zhang, Hongmei; Tang, Limin

    2016-06-01

    It was suggested that muscarinic, and nicotinic receptors increase free Ca[Formula: see text] levels in the facial nerve nucleus via various channels following facial nerve injury. However, intracellular Ca[Formula: see text] overload can trigger either necrotic or apoptotic cell death. It is assumed that, following facial nerve injury, the interactions of nicotinic and muscarinic acetylcholine receptors in facial nerve nucleus may negatively regulate free Ca[Formula: see text] concentrations in the facial nerve nucleus, which provide important information for the repair and regeneration of the facial nerve. The present study investigated the regulatory effects of nicotine on muscarinic receptor-mediated free calcium ion level changes in the facial nucleus in a rat model of facial nerve injury at 7, 30, and 90 days following facial nerve injury using laser confocal microscopy. The dose-dependent regulation of nicotine on muscarinic receptor-mediated free calcium ion level changes in the facial nucleus may decrease the range of free Ca[Formula: see text] increases following facial nerve injury, which is important for nerve cell regeneration. It is concluded that the negative effects of nicotine on muscarinic receptors are related to the [Formula: see text] subtype of nicotinic receptors.

  20. Modeling Blast-Related Brain Injury

    Science.gov (United States)

    2008-12-01

    02139 D. Moore Defense and Veterans Brain Injury Center (WRAMC) 6900 Georgia Ave. NW, Washington, DC 20307 L. Noels University of Liege Chemin des...chevreuils 1, B4000 Liege , Belgium ABSTRACT Recent military conflicts in Iraq and Afghanistan have highlighted the wartime effect of traumatic brain in

  1. Associated injuries in patients with facial fractures: a review of 604 patients.

    Science.gov (United States)

    Béogo, Rasmané; Dakouré, Patrick; Savadogo, Léon Blaise; Coulibaly, Antoine Toua; Ouoba, Kampadilemba

    2013-01-01

    Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention.

  2. Associated injuries in patients with facial fractures: a review of 604 patients

    Science.gov (United States)

    Béogo, Rasmané; Dakouré, Patrick; Savadogo, Léon Blaise; Coulibaly, Antoine Toua; Ouoba, Kampadilemba

    2013-01-01

    Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention. PMID:24778756

  3. Relationship between Locations of Facial Injury and the Use of Bicycle Helmets: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Kun Hwang

    2015-07-01

    Full Text Available The aim of this study is to review the protective effect of a bicycle helmet on each facial location systematically. PubMed was searched for articles published before December 12, 2014. The data were summarized, and the odds ratio (OR between the locations of facial injury was calculated. A statistical analysis was performed with Review Manager (The Nordic Cochrane Centre. Bicycle helmets protect the upper and middle face from serious facial injury but do not protect the lower face. Non-wearers had significantly increased risks of upper facial injury (OR, 2.07; P<0.001 and of middle facial injury (OR, 1.97; P<0.001 as compared to helmet users. In the case of lower facial injury, however, only a slightly increased risk (OR, 1.42; 95% confidence interval (CI, 0.67-3.00, P=0.36 was observed. The abovementioned results can be attributed to the fact that a helmet covers the head and forehead but cannot cover the lower face. However, helmets having a chin cap might decrease the risk of lower facial injury.

  4. Working toward exposure thresholds for blast-induced traumatic brain injury: thoracic and acceleration mechanisms

    CERN Document Server

    Courtney, Michael; 10.1016/j.neuroimage.2010.05.025

    2011-01-01

    Research in blast-induced lung injury resulted in exposure thresholds that are useful in understanding and protecting humans from such injury. Because traumatic brain injury (TBI) due to blast exposure has become a prominent medical and military problem, similar thresholds should be identified that can put available research results in context and guide future research toward protecting warfighters as well as diagnosis and treatment. At least three mechanical mechanisms by which the blast wave may result in brain injury have been proposed - a thoracic mechanism, head acceleration and direct cranial transmission. These mechanisms need not be mutually exclusive. In this study, likely regions of interest for the first two mechanisms based on blast characteristics (positive pulse duration and peak effective overpressure) are developed using available data from blast experiments and related studies, including behind-armor blunt trauma and ballistic pressure wave studies. These related studies are appropriate to in...

  5. Dismounted complex blast injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee.

    Science.gov (United States)

    Fleming, Mark; Waterman, Scott; Dunne, James; D'Alleyrand, Jean-Claude; Andersen, Romney C

    2012-01-01

    The objective of this report is to analyze the resource utilization and injury patterns of complex dismounted blast injuries. A retrospective review of U.S. service members injured in combat between 2007 and 2010 was conducted. Data analyzed included age, injury mechanism, amputated limbs, number and type of associated injuries, blood products utilized, intensive care unit length of stay (ILOS), hospital length of stay (HLOS) and the Injury Severity Score (ISS). Patients were stratified based on the number of amputations. Sixty-three patients comprised the multiple extremity amputation (MEA) group. Ninety-eight percent sustained injuries from an improvised explosive device (IED) and 96% were dismounted. The ISS, number of surgical encounters, blood products utilized and ILOS were all clinically significantly different than controls. Care of multiple extremity amputees involves the utilization of significant resources. This knowledge may better help surgeons and administrators allocate assets at hospitals, both military and civilian, who care for this complex and challenging patient population.

  6. The Role of Posttraumatic Stress in Acute Postconcussive Symptoms following Blast Injury in Combat

    Science.gov (United States)

    2015-02-21

    Hovda DA, Giza CC: The molecular pathophysiology of concussive brain injury . Clin Sports Med 2011; 30: 33–48. 7 World Health Organisation, ICD-10...following blast injury in combat 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Richard Bryant /Monty Baker, Jim...personnel are managed in the acute aftermath of a blast injury . Management of PCS needs to recognize the role of acute posttraumatic stress responses in

  7. A multi-mode shock tube for investigation of blast-induced traumatic brain injury.

    Science.gov (United States)

    Reneer, Dexter V; Hisel, Richard D; Hoffman, Joshua M; Kryscio, Richard J; Lusk, Braden T; Geddes, James W

    2011-01-01

    Blast-induced mild traumatic brain injury (bTBI) has become increasingly common in recent military conflicts. The mechanisms by which non-impact blast exposure results in bTBI are incompletely understood. Current small animal bTBI models predominantly utilize compressed air-driven membrane rupture as their blast wave source, while large animal models use chemical explosives. The pressure-time signature of each blast mode is unique, making it difficult to evaluate the contributions of the different components of the blast wave to bTBI when using a single blast source. We utilized a multi-mode shock tube, the McMillan blast device, capable of utilizing compressed air- and compressed helium-driven membrane rupture, and the explosives oxyhydrogen and cyclotrimethylenetrinitramine (RDX, the primary component of C-4 plastic explosives) as the driving source. At similar maximal blast overpressures, the positive pressure phase of compressed air-driven blasts was longer, and the positive impulse was greater, than those observed for shockwaves produced by other driving sources. Helium-driven shockwaves more closely resembled RDX blasts, but by displacing air created a hypoxic environment within the shock tube. Pressure-time traces from oxyhydrogen-driven shockwaves were very similar those produced by RDX, although they resulted in elevated carbon monoxide levels due to combustion of the polyethylene bag used to contain the gases within the shock tube prior to detonation. Rats exposed to compressed air-driven blasts had more pronounced vascular damage than those exposed to oxyhydrogen-driven blasts of the same peak overpressure, indicating that differences in blast wave characteristics other than peak overpressure may influence the extent of bTBI. Use of this multi-mode shock tube in small animal models will enable comparison of the extent of brain injury with the pressure-time signature produced using each blast mode, facilitating evaluation of the blast wave components

  8. Agmatine promotes expression of brain-derived neurotrophic factor in brainstem facial nucleus in the rat facial nerve injury model

    Institute of Scientific and Technical Information of China (English)

    Li Fang; Wenlong Luo

    2008-01-01

    BACKGROUND: Studies have shown that agmatine can reduce inhibition of neuronal regeneration by increasing cyclic adenosine monophosphate and brain-derived neurotrophic factor (BDNF) in the hippocampus of morphine-dependent rats. The hypothesis that agmatine exerts similar effects on facial nerve injury deserves further analysis.OBJECTIVE: To study the effects of peritoneal agmatine injection on BDNF levels in the rat brainstem after facial nerve injury.DESIGN, TIME AND SETTING: A controlled animal experiment was performed at the Department of Otolaryngology-Head and Neck Surgery at the Second Affiliated Hospital, Chongqing University of Medical Sciences (Chongqing, China), between October and December in 2007.MATERIALS: Twenty-four male Sprague-Dawley rats were randomly divided into a control, a lesion, and an agmatine treatment group, with eight rats in each group. Bilateral facial nerve anastomosis was induced in the lesion and agmatine treatment groups, while the control group remained untreated. A rat BDNF Enzyme-linked immunosorbent assay kit was used to measure BDNF levels in the brainstem facial nucleus.METHODS: Starting on the day of lesion, the agmatine group received a peritoneal injection of 100 mg/kg agmatine, once per day, for a week, whereas rats in the lesion group received saline injections.MAIN OUTCOME MEASURES: BDNF levels in the brainstem containing facial nucleus were measured by ELISA.RESULTS: Twenty-four rats were included in the final analysis without any loss. Two weeks after lesion, BDNF levels were significantly higher in the lesion group than in the control group (P<0.01). A significant increase was noted in the agmatine group compared to the lesion group (P<0.01).CONCLUSION: Agmatine can substantially increase BDNF levels in the rat brainstem after facial nerve injury.

  9. A case study of blast eye injury at work place

    Directory of Open Access Journals (Sweden)

    Prabhakar Srinivasapuram Krishnacharya

    2013-12-01

    Full Text Available This case report aims at investigating whether two consecutive surgical settings would be beneficial in achieving postoperative success for the patient with blast eye injury. A 45-year-old male patient admitted on 17 th October 2011 with history of blast eye injury. Right eye examination revealed central corneal laceration with incarceration of lens matter, multiple foreign bodies also seen embedded in the eyelid margins and in the left cornea. Computed ocular tomography showed a retained intraocular foreign body (IOFB in the right eye. Simultaneous corneal laceration repair and extraction of the ruptured lens performed as primary procedure under general anesthesia. Intraoperative posterior capsule loss was noticed with vitreous presentation. Anterior vitrectomy with removal of the IOFB was done. Foreign bodies were also removed from the left cornea. Penetrating keratoplasty (PK with scleral fixated intraocular lens implantation executed 4 months later as secondary procedure. Visual acuity maintained at 6/24 in 2 years follow-up. In conclusion, two consecutive surgical settings has the advantage of calculating the intra ocular lens power.

  10. Facial Affect Recognition Training Through Telepractice: Two Case Studies of Individuals with Chronic Traumatic Brain Injury.

    Science.gov (United States)

    Williamson, John; Isaki, Emi

    2015-01-01

    The use of a modified Facial Affect Recognition (FAR) training to identify emotions was investigated with two case studies of adults with moderate to severe chronic (> five years) traumatic brain injury (TBI). The modified FAR training was administered via telepractice to target social communication skills. Therapy consisted of identifying emotions through static facial expressions, personally reflecting on those emotions, and identifying sarcasm and emotions within social stories and role-play. Pre- and post-therapy measures included static facial photos to identify emotion and the Prutting and Kirchner Pragmatic Protocol for social communication. Both participants with chronic TBI showed gains on identifying facial emotions on the static photos.

  11. Bryostatin-1 Restores Blood Brain Barrier Integrity following Blast-Induced Traumatic Brain Injury.

    Science.gov (United States)

    Lucke-Wold, Brandon P; Logsdon, Aric F; Smith, Kelly E; Turner, Ryan C; Alkon, Daniel L; Tan, Zhenjun; Naser, Zachary J; Knotts, Chelsea M; Huber, Jason D; Rosen, Charles L

    2015-12-01

    Recent wars in Iraq and Afghanistan have accounted for an estimated 270,000 blast exposures among military personnel. Blast traumatic brain injury (TBI) is the 'signature injury' of modern warfare. Blood brain barrier (BBB) disruption following blast TBI can lead to long-term and diffuse neuroinflammation. In this study, we investigate for the first time the role of bryostatin-1, a specific protein kinase C (PKC) modulator, in ameliorating BBB breakdown. Thirty seven Sprague-Dawley rats were used for this study. We utilized a clinically relevant and validated blast model to expose animals to moderate blast exposure. Groups included: control, single blast exposure, and single blast exposure + bryostatin-1. Bryostatin-1 was administered i.p. 2.5 mg/kg after blast exposure. Evan's blue, immunohistochemistry, and western blot analysis were performed to assess injury. Evan's blue binds to albumin and is a marker for BBB disruption. The single blast exposure caused an increase in permeability compared to control (t = 4.808, p bryostatin-1 was administered (t = 5.113, p Bryostatin-1 administration reduced toxic PKCα levels back toward control levels (t = 4.559, p Bryostatin-1 caused a significant increase in the tight junction proteins VE-cadherin, ZO-1, and occludin through modulation of PKC activity. Bryostatin-1 ultimately decreased BBB breakdown potentially due to modulation of PKC isozymes. Future work will examine the role of bryostatin-1 in preventing chronic neurodegeneration following repetitive neurotrauma.

  12. Effects of gamma-aminobutyric acid receptors on muscarinic receptor-mediated free calcium ion levels in the facial nucleus following facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    Guangfeng Jiang; Dawei Sun; Rui Zhou; Fugao Zhu; Yanqing Wang; Xiuming Wan; Banghua Liu

    2011-01-01

    Muscarinic receptors and nicotine receptors can increase free calcium ion levels in the facial nucleus via different channels following facial nerve injury. In addition, γ-aminobutyric acid A (GABAA) receptors have been shown to negatively regulate free calcium ion levels in the facial nucleus by inhibiting nicotine receptors. The present study investigated the influence of GABAA, γ-aminobutyric acid B (GABAB) and C (GABAC) receptors on muscarinic receptors in rats with facial nerve injury by confocal laser microscopy. GABAA and GABAB receptors exhibited significant dose-dependent inhibitory effects on increased muscarinic receptor-mediated free calcium ion levels following facial nerve injury. Results showed that GABAA and GABAB receptors negatively regulate muscarinic receptor effects and interplay with cholinergic receptors to regulate free calcium ion levels for facial neural regeneration.

  13. Negative regulation of gamma-aminobutyric acid type A receptor on free calcium ion levels following facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    Fugao Zhu; Dawei Sun; Yanqing Wang; Rui Zhou; Junfeng Wen; Xiuming Wan; Yanjun Wang; Banghua Liu

    2010-01-01

    Previous studies have demonstrated that muscarinic, and nicotinic receptors increase free Ca2+ levels in the facial nerve nucleus via various channels following facial nerve injury. However, intracellular Ca2+ overload can trigger either necrotic or apoptotic cell death. Gamma-aminobutyric acid (GABA), an important inhibitory neurotransmitter in the central nervous system, exists in the facial nerve nucleus. It is assumed that GABA negatively regulates free Ca2+ levels in the facial nerve nucleus. The present study investigated GABA type A (GABAA) receptor expression in the facial nerve nucleus in a rat model of facial nerve injury using immunohistochemistry and laser confocal microscopy, as well as the regulatory effects of GABAA receptor on nicotinic receptor response following facial nerve injury. Subunits α1, α3, α5, β1, β2, δ, and γ3 of GABAA receptors were expressed in the facial nerve nucleus following facial nerve injury. In addition, GABAA receptor expression significantly inhibited the increase in nicotinic receptor-mediated free Ca2+ levels in the facial nerve nucleus following facial nerve injury in a concentration-dependent fashion. These results suggest that GABAA receptors exhibit negative effects on nicotinic receptor responses following facial nerve injury.

  14. Non-suicidal self-injury and emotion regulation: a review on facial emotion recognition and facial mimicry

    Science.gov (United States)

    2013-01-01

    Non-suicidal self-injury (NSSI) is an increasingly prevalent, clinically significant behavior in adolescents and can be associated with serious consequences for the afflicted person. Emotion regulation is considered its most frequent function. Because the symptoms of NSSI are common and cause impairment, it will be included in Section 3 disorders as a new disorder in the revised Diagnostic and Statistical Manual of Mental Disorders (DSM-5). So far, research has been conducted mostly with patients with borderline personality disorder (BPD) showing self-injurious behavior. Therefore, for this review the current state of research regarding emotion regulation, NSSI, and BPD in adolescents is presented. In particular, the authors focus on studies on facial emotion recognition and facial mimicry, as social interaction difficulties might be a result of not recognizing emotions in facial expressions and inadequate facial mimicry. Although clinical trials investigating the efficacy of psychological treatments for NSSI among adolescents are lacking, especially those targeting the capacity to cope with emotions, clinical implications of the improvement in implicit and explicit emotion regulation in the treatment of NSSI is discussed. Given the impact of emotion regulation skills on the effectiveness of psychotherapy, neurobiological and psychophysiological outcome variables should be included in clinical trials. PMID:23421964

  15. Novel method to dynamically load cells in 3D-hydrogels culture for blast injury studies

    Science.gov (United States)

    Sory, David R.; Areias, Anabela C.; Overby, Darryl R.; Proud, William G.

    2017-01-01

    For at least a century explosive devices have been one of the most important causes of injuries in military conflicts as well as in terrorist attacks. Although significant experimental and modelling efforts have been focussed on blast injuries at the organ or tissue level, few studies have investigated the mechanisms of blast injuries at the cellular level. This paper introduces an in vitro method compatible with living cells to examine the effects of high stress and short-duration pulses relevant to blast loadings and blunt trauma. The experimental phase involves high strain-rate axial compression of cylindrical specimens within an hermetically sealed chamber made of biocompatible polymer. Numerical simulations were performed in order to verify the experimental loading conditions and to characterize the loading path within the sample. A proof of concept is presented so as to establish a new window to address fundamental questions regarding blast injury at the cellular level.

  16. Compound 49b Reduces Inflammatory Markers and Apoptosis after Ocular Blast Injury

    Science.gov (United States)

    2014-09-01

    few 12 posterior ocular injuries, using high-resolution optical coherence topography , gross pathology, and optokinetics [9]. In this study of...exposure to ocular blast or in closed- globe ocular injuries. For most ocular trauma studies, work has focused on corneal burns or trauma. However...exposure to ocular blast agree with work from corneal burns or other closed globe models. A recent 17 report from British soldiers in Iraq and

  17. A multiscale approach to blast neurotrauma modeling:Part II: Methodology for inducing blast injury to in vitro models

    Directory of Open Access Journals (Sweden)

    Gwen B. Effgen

    2012-02-01

    Full Text Available Due to the prominent role of improvised explosive devices (IEDs in wounding patterns of U.S. war-fighters in Iraq and Afghanistan, blast injury has risen to a new level of importance and is recognized to be a major cause of injuries to the brain. However, an injury risk-function for microscopic, macroscopic, behavioral, and neurological deficits has yet to be defined. While operational blast injuries can be very complex and thus difficult to analyze, a simplified blast injury model would facilitate studies correlating biological outcomes with blast biomechanics to define tolerance criteria. Blast-induced traumatic brain injury (bTBI results from the translation of a shock wave in air, such as that produced by an IED, into a pressure wave within the skull-brain complex. Our blast injury methodology recapitulates this phenomenon in vitro, allowing for control of the injury biomechanics via a compressed-gas shock tube used in conjunction with a custom-designed, fluid-filled receiver that contains the living culture. The receiver converts the air shock wave into a fast-rising pressure transient with minimal reflections, mimicking the intracranial pressure history in blast. We have developed an organotypic hippocampal slice culture model that exhibits cell death when exposed to a 530  17.7 kPa peak overpressure with a 1.026 ± 0.017 ms duration and 190 ± 10.7 kPa-ms impulse in-air. We have also injured a simplified in vitro model of the blood-brain barrier, which exhibits disrupted integrity immediately following exposure to 581  10.0 kPa peak overpressure with a 1.067 ms ± 0.006 ms duration and 222 ± 6.9 kPa-ms impulse in-air. To better prevent and treat bTBI, both the initiating biomechanics and the ensuing pathobiology must be understood in greater detail. A well-characterized, in vitro model of bTBI, in conjunction with animal models, will be a powerful tool for developing strategies to mitigate the risks of bTBI.

  18. Prospects for studying how high-intensity compression waves cause damage in human blast injuries

    Science.gov (United States)

    Brown, Katherine; Bo, Chiara; Ramaswamy, Arul; Masouros, Spiros; Newell, Nicolas; Hill, Adam; Clasper, Jon; Bull, Anthony; Proud, William

    2011-06-01

    Blast injuries arising from improvised explosive devices are often complex leading to long-term disability in survivors. There is an urgent need to mitigate against the effects of blast that lead to these injuries, and to also improve post-traumatic therapeutic treatments related to problems associated with damage and healing processes and infections. We have initiated multidisciplinary studies to develop experimental facilities and strategies for analyzing the effects blast waves upon the human body, from cellular through to skeletal functions. This work is supported by the Atomic Weapons Establishment and the Defence Science and Technology Laboratory, UK.

  19. Study on Remodeling of Astrocytes in Facial Neuclus after Peripheral Injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Pei; WANG Peng; CHEN Guangli; GONG Shusheng

    2005-01-01

    To observe the glial reactions surrounding facial motor neurons following facial nerve anastomosis. At 1,7,21 and 60 d following facial nerve anastomosis, the recovery process of facial movement was observed, the glial fibrillary acidic protein (GFAP) immunoreactivitywas analyzed by a combined method of fluorescent retrograde tracing and immunofluorescent histochemical stai ning, and the ultrastructure of astrocytes were observed under a transmission electron microscope (TEM), respectively. Postoperatively the function of facial muscles could not return to normal, often accompanied with hyperkinetic syndromes such as synkinesis at the late stage. Motor neurons in every facial subnucleus could be retrogradely labeled by fluoro gold (FG), and displayed an evident somatotopic organization. Normally there was a considerable number of GFAP-positive cells in nonnucleus regions but few inside the facial nucleus region. Postoperatively the GFAP immunoreactivity in the anastomotic side increased significantly, but gradually decreased at the late stage. The ultrastructure of astrocytes in our experiment showed that the sheet-like process of astrocytes invested and protected the injured facial motor neurons. The present study shows that reactive astrocytes undergo some characteristic changes during the process of facial nerve injury and regeneration. The plastic change at the late stage may be involved in the mechanism of synkinesis.

  20. Characteristics of maxillofacial injuries and safety of in-theater facial fracture repair in severe combat trauma.

    Science.gov (United States)

    Keller, Matthew W; Han, Peggy P; Galarneau, Michael R; Gaball, Curtis W

    2015-03-01

    The study objectives were to characterize maxillofacial injuries and assess the safety of in-theater facial fracture repair in U.S. military personnel with severe combat trauma from Iraq and Afghanistan. We performed a retrospective chart review of the Expeditionary Medical Encounter Database from 2004 to 2010. 1,345 military personnel with combat-related maxillofacial injuries were identified. Injury severity was quantified with the Abbreviated Injury Scale and Injury Severity Score. Service members with maxillofacial injury and severe combat trauma (Injury Severity Score ≥ 16) were included. The distribution of facial fractures, types, and outcomes of surgical repairs, incidence of traumatic brain injury, concomitant head and neck injuries, burn rate/severity, and rates of Acinetobacter baumannii colonization and surgical site infection were analyzed. The prevalence of maxillofacial injury in the Expeditionary Medical Encounter Database was 22.7%. The most common mechanism of injury was improvised explosive device (65.7%). Midface trauma and facial burns were common. Approximately 64% of the study sample sustained traumatic brain injury. Overall, 45.6% (109/239) had at least one facial bone fracture. Of those with facial fractures, 64.2% (n = 70) underwent surgical repair. None of the service members who underwent in-theater facial fracture repair developed A. baumannii facial wound infection or implant extrusion.

  1. Facial Affect Recognition Training Through Telepractice: Two Case Studies of Individuals with Chronic Traumatic Brain Injury

    OpenAIRE

    John Williamson; Emi Isaki

    2015-01-01

    The use of a modified Facial Affect Recognition (FAR) training to identify emotions was investigated with two case studies of adults with moderate to severe chronic (> five years) traumatic brain injury (TBI).  The modified FAR training was administered via telepractice to target social communication skills.  Therapy consisted of identifying emotions through static facial expressions, personally reflecting on those emotions, and identifying sarcasm and emotions within social stories and ro...

  2. Facial Affect Recognition Training Through Telepractice: Two Case Studies of Individuals with Chronic Traumatic Brain Injury

    OpenAIRE

    Williamson, John; ISAKI, EMI

    2015-01-01

    The use of a modified Facial Affect Recognition (FAR) training to identify emotions was investigated with two case studies of adults with moderate to severe chronic (> five years) traumatic brain injury (TBI). The modified FAR training was administered via telepractice to target social communication skills. Therapy consisted of identifying emotions through static facial expressions, personally reflecting on those emotions, and identifying sarcasm and emotions within social stories and role-pl...

  3. Temporal Progression of Visual Injury from Blast Exposure

    Science.gov (United States)

    2016-09-01

    sample was then separated into three equal tubes. FIGURE 1. PRESSURE-TIME HISTORY AT LOCATION OF ANIMAL PLACEMENT WITHIN BLAST TUBE SB3C2015...exposed to blast between 2007-12  Complete first set of 40 animal blast experiments CY14 Goals – Animal testing, service member studies  Complete data...analysis from retrospective study  Enrollment, interviews, and ocular examination of service members  Complete animal blast experiments  Complete

  4. Postconcussive symptoms after blast and nonblast-related mild traumatic brain injuries in Afghanistan and Iraq war veterans.

    Science.gov (United States)

    Lippa, Sara M; Pastorek, Nicholas J; Benge, Jared F; Thornton, G Matthew

    2010-09-01

    Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories.

  5. Nicotine alpha 4 beta 2 receptor-mediated free calcium in an animal model of facial nucleus injury

    Institute of Scientific and Technical Information of China (English)

    Dawei Sun; Wenhai Sun; Yanqing Wang; Fugao Zhu; Rui Zhou; Yanjun Wang; Banghua Liu; Xiuming Wan; Huamin Liu

    2010-01-01

    Previous studies have demonstrated that the cholinergic system,via nicotinic receptors,regulates intracellular free calcium levels in the facial nucleus under normal physiological conditions.However,the regulation of nicotinic receptors on free calcium levels following facial nerve injury remains unclear.In the present study,an animal model of facial nerve injury was established,and changes in nicotinic receptor expression following facial nerve injury in rats were detected using reverse transcription polymerase chain reaction.Nicotinic receptor-mediated changes of free calcium levels following facial nucleus injury were determined by laser confocal microscopy.Results showed no significant difference in nicotinic receptor expression between the normal group and the affected facial nerve nucleus.The nicotinic receptor α4β2 subtype increased free calcium levels following facial nerve injury by promoting calcium transmembrane influx,and L-type voltage-gated calcium channel-mediated influx of calcium ions played an important role in promoting calcium transmembrane influx.The nicotinic receptor-mediated increase of free calcium levels following facial nerve injury provides an important mechanism for the repair of facial nerve injury.

  6. Blast-Induced Acceleration in a Shock Tube: Distinguishing Primary and Tertiary Blast Injury

    Science.gov (United States)

    2015-10-01

    crushing action (i.e. static pressure) which envelops the head as well as some aerodynamic drag (i.e. dynamic pressure creating blast wind). The use of...with an advanced blast simulator (ABS) yield a higher fidelity, ecologically valid simulation of blast and thereby provide critical insights into

  7. Skull Flexure from Blast Waves: A Mechanism for Brain Injury with Implications for Helmet Design

    Energy Technology Data Exchange (ETDEWEB)

    Moss, W C; King, M J; Blackman, E G

    2009-04-30

    Traumatic brain injury [TBI] has become a signature injury of current military conflicts, with debilitating, costly, and long-lasting effects. Although mechanisms by which head impacts cause TBI have been well-researched, the mechanisms by which blasts cause TBI are not understood. From numerical hydrodynamic simulations, we have discovered that non-lethal blasts can induce sufficient skull flexure to generate potentially damaging loads in the brain, even without a head impact. The possibility that this mechanism may contribute to TBI has implications for injury diagnosis and armor design.

  8. Common femoral vein reconstruction using internal jugular vein after blast injury.

    Science.gov (United States)

    Holt, Andrew M; West, Charles A; Davis, James A; Gilani, Ramyar; Askenasy, Eric

    2014-10-01

    Common femoral vein traumatic injuries are rare. Surgical management is controversial and by nature case specific. In this report, we present an unusual case of an isolated common femoral vein injury from a gunshot blast repaired with an interposition internal jugular vein bypass. To our knowledge, this is the first reported case of an isolated common femoral vein reconstructed in this manner.

  9. Investigation of the relationship between facial injuries and traumatic brain injuries using a realistic subject-specific finite element head model.

    Science.gov (United States)

    Tse, Kwong Ming; Tan, Long Bin; Lee, Shu Jin; Lim, Siak Piang; Lee, Heow Pueh

    2015-06-01

    In spite of anatomic proximity of the facial skeleton and cranium, there is lack of information in the literature regarding the relationship between facial and brain injuries. This study aims to correlate brain injuries with facial injuries using finite element method (FEM). Nine common impact scenarios of facial injuries are simulated with their individual stress wave propagation paths in the facial skeleton and the intracranial brain. Fractures of cranio-facial bones and intracranial injuries are evaluated based on the tolerance limits of the biomechanical parameters. General trend of maximum intracranial biomechanical parameters found in nasal bone and zygomaticomaxillary impacts indicates that severity of brain injury is highly associated with the proximity of location of impact to the brain. It is hypothesized that the midface is capable of absorbing considerable energy and protecting the brain from impact. The nasal cartilages dissipate the impact energy in the form of large scale deformation and fracture, with the vomer-ethmoid diverging stress to the "crumpling zone" of air-filled sphenoid and ethmoidal sinuses; in its most natural manner, the face protects the brain. This numerical study hopes to provide surgeons some insight in what possible brain injuries to be expected in various scenarios of facial trauma and to help in better diagnosis of unsuspected brain injury, thereby resulting in decreasing the morbidity and mortality associated with facial trauma.

  10. Neurobiological mechanisms associated with facial affect recognition deficits after traumatic brain injury.

    Science.gov (United States)

    Neumann, Dawn; McDonald, Brenna C; West, John; Keiski, Michelle A; Wang, Yang

    2016-06-01

    The neurobiological mechanisms that underlie facial affect recognition deficits after traumatic brain injury (TBI) have not yet been identified. Using functional magnetic resonance imaging (fMRI), study aims were to 1) determine if there are differences in brain activation during facial affect processing in people with TBI who have facial affect recognition impairments (TBI-I) relative to people with TBI and healthy controls who do not have facial affect recognition impairments (TBI-N and HC, respectively); and 2) identify relationships between neural activity and facial affect recognition performance. A facial affect recognition screening task performed outside the scanner was used to determine group classification; TBI patients who performed greater than one standard deviation below normal performance scores were classified as TBI-I, while TBI patients with normal scores were classified as TBI-N. An fMRI facial recognition paradigm was then performed within the 3T environment. Results from 35 participants are reported (TBI-I = 11, TBI-N = 12, and HC = 12). For the fMRI task, TBI-I and TBI-N groups scored significantly lower than the HC group. Blood oxygenation level-dependent (BOLD) signals for facial affect recognition compared to a baseline condition of viewing a scrambled face, revealed lower neural activation in the right fusiform gyrus (FG) in the TBI-I group than the HC group. Right fusiform gyrus activity correlated with accuracy on the facial affect recognition tasks (both within and outside the scanner). Decreased FG activity suggests facial affect recognition deficits after TBI may be the result of impaired holistic face processing. Future directions and clinical implications are discussed.

  11. Studies on blast traumatic brain injury using in-vitro model with shock tube.

    Science.gov (United States)

    Arun, Peethambaran; Spadaro, John; John, Jennifer; Gharavi, Robert B; Bentley, Timothy B; Nambiar, Madhusoodana P

    2011-06-11

    One of the major limitations in studying the mechanisms of blast-induced traumatic brain injury (bTBI) or screening therapeutics for protection is the lack of suitable laboratory model systems that can closely mimic the complex blast exposure. Although animal models of bTBI that use shock tubes to mimic blast exposure are available, no high throughput shock tube-based in-vitro models have been reported. Here, we report an in-vitro bTBI model using a compressed air-driven shock tube and mouse neuroblastoma/rat glioblastoma hybrid cells (NG108-15) or SH-SY5Y human neuroblastoma cells in tissue culture plates. Our data showed significant neurobiological effects with decreased adenosine triphosphate levels, increased cellular injury, lactate dehydrogenase release, and reactive oxygen species formation after blast exposure.

  12. Skull Flexure from Blast Waves: A New Mechanism for Brain Injury with Implications for Helmet Design

    CERN Document Server

    Moss, William C; Blackman, Eric G

    2008-01-01

    Traumatic brain injury [TBI] has become the signature injury of current military conflicts. The debilitating effects of TBI on society are long-lasting and costly. Although the mechanisms by which impacts cause TBI have been well researched, the mechanisms by which blasts cause TBI are not understood. Various mechanisms, including impacts caused by the blast, have been investigated, but blast-induced deformation of the skull has been neglected. Through the use of hydrodynamical numerical simulations, we have discovered that non-lethal blasts can induce sufficient flexure of the skull to generate potentially damaging loads in the brain, even if no impact occurs. This mechanism has implications for the diagnosis of TBI in soldiers and the design of protective equipment such as helmets.

  13. Acute pathological changes of facial nucleus and expressions of postsynaptic density protein-95 following facial nerve injury of varying severity A semi-quantitative analysis

    Institute of Scientific and Technical Information of China (English)

    Jingjing Li; Wenlong Luo

    2008-01-01

    BACKGROUND: Previous studies have demonstrated that postsynaptic density protein-95 (PSD-95) is widely distributed in the central nervous system and is related to the development of the CNS and sensory signal transmission as well as acute or chronic nerve cell death following ischemic brain injury.OBJECTIVE: To semi-quantitatively determine the pathological changes of apoptotic facial neurons and the expression of PSD-95 in the facial nucleus following facial nerve injury of varying extents using immunohistochemical staining methods.DESIGN, TIME AND SETTING: Randomized, controlled animal experiments were performed in the Ultrasonic Institute of the Second Affiliated Hospital of Chongqing University of Medical Sciences from September to December 2007.MATERIALS: Sixty-five healthy, adult, Sprague-Dawley (SD) rats, both male and female, were used for this study. Rabbit anti-rat PSD-95 polyclonal antibody was purchased from Beijing Biosynthesis Biotechnology Co., Ltd.METHODS: SD rats were randomly assigned into a control group with five rats and three injured groups with 20 rats per group. Exposure, clamp and cut for bilateral facial nerve trunks were performed in the rats of the injury groups, and no injury was inflicted on the rats of the control group.MAIN OUTCOME MEASURES: The brainstems of all the rats were excised on days 1, 3, 7, and 14 post injury, and then the facial nuclei were stained with hematoxylin-eosin to observe any pathological changes due to apoptosis in facial neurons. PSD-95 expression in facial nuclei was detected by immunohistochemistry, and the number of PSD-95 positive cells was counted under a light microscope.RESULTS: The expression of PSD-95 in the facial nucleus and morphology of the facial neuron within the exposure group had no obvious changes at various points in time tested (P>0.05). However, the expressions of PSD-95 in the facial nucleus of the clamp group and cut group increased on day 1 post injury (Pclamp group>exposure group

  14. In Silico Investigation of Intracranial Blast Mitigation with Relevance to Military Traumatic Brain Injury

    Science.gov (United States)

    2010-09-01

    field overpressure was selected to be above the threshold for unarmored blast lung injury given by the Bowen curves, which estimate the tolerance to a...Explosive blast neurotrauma. J Neurotraum 28:815–825. 11. Murray C, et al. (2005) Spectrum of care provided at an Echelon II medical unit during...Nashville, TN), Vol C2.00001. 23. Bowen I, Fletcher E, Richmond D, Hirsch F, White C (1968) Biophysical mechanisms and scaling procedures applicable in

  15. Facial Affect Recognition Training Through Telepractice: Two Case Studies of Individuals with Chronic Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    John Williamson

    2015-07-01

    Full Text Available The use of a modified Facial Affect Recognition (FAR training to identify emotions was investigated with two case studies of adults with moderate to severe chronic (> five years traumatic brain injury (TBI.  The modified FAR training was administered via telepractice to target social communication skills.  Therapy consisted of identifying emotions through static facial expressions, personally reflecting on those emotions, and identifying sarcasm and emotions within social stories and role-play.  Pre- and post-therapy measures included static facial photos to identify emotion and the Prutting and Kirchner Pragmatic Protocol for social communication.  Both participants with chronic TBI showed gains on identifying facial emotions on the static photos.               

  16. Facial Injuries in Assault Victims in a Growing City in a Developing Country

    Directory of Open Access Journals (Sweden)

    2016-11-01

    Full Text Available Assault causes significant morbidity and mortality the world over. The face is important for both identification and assessment of beauty. Facial injuries from assault are poorly reported in literature especially in developing countries like Nigeria. The aim of this study is to analyse the characteristics of assault-related facial injuries in our environment. This was a prospective study involving the use of interviewer-administered objective structured questionnaire to obtain relevant information from patients attending the Forensic unit of ESUT Teaching Hospital Enugu. A total of 106 patients presented with assault-related facial injuries between March 2012 and February 2013. Male to female ratio was 1.1:1. The age range was 19 months - 68 years; mean age was 33.6 years and modal age range of 21 and ndash; 30 years (N = 49; 46.2%. Most injuries occurred at home (N = 51; 48.1% followed by work/business place (N = 30; 28.3%. There were 2 cases (1.9% of intimate partner violence. A total of 141 injuries (133.1% were recorded with 29 patients (27.4% presenting with multiple injuries. Soft tissue injuries constituted 132 injuries (124.5% while hard tissue injuries were 9 (8.5%.Laceration and incision (N = 75; 70.8% constituted the most common soft tissue injuries followed by contusion (N = 48; 45.3% while dentoalveolar fracture (N = 9; 8.5% was the only encountered hard tissue injury. The face is a common target during assault and people mostly affected are in the active stages of life.

  17. Facial fractures with concomitant open globe injury: mechanisms and fracture patterns associated with blindness.

    Science.gov (United States)

    Vaca, Elbert E; Mundinger, Gerhard S; Kelamis, Joseph A; Dorafshar, Amir H; Christy, Michael R; Manson, Paul N; Rodriguez, Eduardo D

    2013-06-01

    Treatment of facial fractures in the setting of open-globe injuries poses a management dilemma because of the often disparate treatment priorities of multidisciplinary trauma teams and the lack of prognostic data regarding visual outcomes. Patients in the University of Maryland Shock Trauma Registry sustaining facial fractures with concomitant open-globe injuries from January of 1998 to August of 2010 were identified. Odds ratios were calculated to identify demographic and clinical variables associated with blindness, and multivariate regression analysis was performed. A total of 99 patients were identified with 105 open-globe injuries. Seventy-nine percent of injuries were blinding, whereas 4.8 percent of globes achieved a final visual acuity greater than or equal to 20/400. Blindness was associated with penetrating injury, increasing number of facial fractures, zygomaticomaxillary complex fracture, admission Glasgow Coma Scale score less than or equal to 8, and globe injury spanning all three eye zones. Fracture repair was performed more frequently (62.5 percent) and more quickly (average time to fracture repair, 4.5 days) in cases of primary globe enucleation/evisceration when compared with complete (21.2 percent; 8 days; p=0.35) or incomplete (42.9 percent; 11 days; p=0.058) primary globe repair. Penetrating injury mechanism and zone of eye injury appear to be better indicators of visual prognosis than facial fracture patterns. Given the high rates of blindness, secondary enucleation, and delay of fracture repair in patients that were not primarily enucleated, the authors recommend that orbital fracture repair not be delayed in the hopes of eventual visual recovery in cases of high-velocity projectile trauma. Risk, III.

  18. Facial and oral injuries in Brazilian children aged 5-17 years: 5-year review.

    Science.gov (United States)

    Cavalcanti, A L; Melo, T R

    2008-06-01

    This was to assess causes of maxillofacial trauma using a retrospective study in Paraiba, Brazil. Records of 256 patients with maxillofacial injuries aged 5-17 years treated between January 2002 to May 2006 were analyzed according to sex, age, cause of injury, frequency of dentoalveolar trauma, intraoral soft tissue injury, frequency and site of facial fracture. Chi-square and Fisher's Exact Tests were used at a significance level of 5%; odds ratio (OR) with confidence intervals to 95% were calculated (IC95%). Facial injuries were most frequent in males (78.1%) and in 13-17 year olds (60.9%); they tended to be more frequent during weekends (48%). Commonest causes were falls (37.9%) and traffic accidents (21.1%). Nasal fractures were most common (51.3%), followed by the zygomatic-orbital complex (25.4%); dentoalveolar injuries were present in 25.8% of cases. There was a positive association between facial fracture and dentoalveolar trauma, alveolar and tooth fracture, avulsion and intraoral soft tissue injury. Accidental falls were found to be the leading cause of maxillofacial fractures, affecting males 3 times more than females.

  19. Characteristics of and strategies for patients with severe burn-blast combined injury

    Institute of Scientific and Technical Information of China (English)

    CHAI Jia-ke; SHEN Chuan-an; TUO Xiao-ye; LIANG Li-ming; WANG Shu-jun; SHENG Zhi-yong; LU Jiang-yang; WEN Zhong-guang; YANG Hong-ming; JIA Xiao-ming; LI Li-gen; CAO Wei-hong; HAO Dai-feng

    2007-01-01

    Background Severe burn-blast combined injury is a great challenge to medical teams for its high mortality. The aim of this study was to elucidate the clinical characteristics of the injury and to present our clinical experiences on the treatment of such cases.Methods Five patients with severe burn-blast combined injuries were admitted to our hospital 77 hours post-injury on June 7, 2005. The burn extent ranged from 80% to 97% (89.6%±7.2%) of TBSA (full-thickness burns 75%-92%(83.4%±7.3%)). All the patients were diagnosed as having blast injury and moderate or severe inhalation injury. Functions of the heart, liver, kidney, lung, pancreas and coagulation were observed. Autopsy samples of the heart, liver, and lungs were taken from the deceased. Comprehensive measures were taken during the treatment, including protection of organ dys function, use of antibiotics, early anticoagulant treatment, early closure of burn wounds, etc. All the data were analyzed statistically with t test.Results One patient died of septic shock 23 hours after admission (four days after injury), the others survived.Dysfunction of the heart, liver, lungs, pancreas, and coagulation were found in all the patients on admission, and the functions were ameliorated after appropriate treatments.Conclusions Burn-blast combined injury may cause multiple organ dysfunctions, especially coagulopathy. Proper judgment of patients' condition, energetic anticoagulant treatment, early closure of burn wounds, rational use of antibiotics, nutritional support, intensive insulin treatment, timely and effective support and protection of organ function are the most important contributory factors in successful treatment of burn-blast combined injuries.

  20. Changes of IL-8 and IL-8 mRNA after blast-fragment combined injury in dogs

    Institute of Scientific and Technical Information of China (English)

    YAN Jia-chuan; YANG Zhi-huan; DONG Hong; FENG Gong; LI Xiao-yan; YIN You-guo

    2001-01-01

    To explore the characteristics and the mechanism of the blast-fragment combined injury.Methods: After the dogs were inflicted with high-velocity fragment injury on their left hindlimbs after blast injury,the IL-8 in the plasma and lung tissue supernatants were assayed with ELISA, and the expression of IL-8 mRNA in lung tissue was detected with in situ hybridization. Results: The levels of IL-8 in plasma and lung tissues were increased after blast, high velocity fragment and blast-fragment combined injuries respectively. IL-8 mRNA were upregulated after injuries. Conclusion: IL-8 may play a role in the occurrence and development of lung injury.Detecting the plasma levels of IL-8 may be quite helpful to estimate the injury.

  1. Trigeminal Inflammatory Compression (TIC) injury induces chronic facial pain and susceptibility to anxiety-related behaviors.

    Science.gov (United States)

    Lyons, D N; Kniffin, T C; Zhang, L P; Danaher, R J; Miller, C S; Bocanegra, J L; Carlson, C R; Westlund, K N

    2015-06-04

    Our laboratory previously developed a novel neuropathic and inflammatory facial pain model for mice referred to as the Trigeminal Inflammatory Compression (TIC) model. Rather than inducing whole nerve ischemia and neuronal loss, this injury induces only slight peripheral nerve demyelination triggering long-term mechanical allodynia and cold hypersensitivity on the ipsilateral whisker pad. The aim of the present study is to further characterize the phenotype of the TIC injury model using specific behavioral assays (i.e. light-dark box, open field exploratory activity, and elevated plus maze) to explore pain- and anxiety-like behaviors associated with this model. Our findings determined that the TIC injury produces hypersensitivity 100% of the time after surgery that persists at least 21 weeks post injury (until the animals are euthanized). Three receptive field sensitivity pattern variations in mice with TIC injury are specified. Animals with TIC injury begin displaying anxiety-like behavior in the light-dark box preference and open field exploratory tests at week eight post injury as compared to sham and naïve animals. Panic anxiety-like behavior was shown in the elevated plus maze in mice with TIC injury if the test was preceded with acoustic startle. Thus, in addition to mechanical and cold hypersensitivity, the present study identified significant anxiety-like behaviors in mice with TIC injury resembling the clinical symptomatology and psychosocial impairments of patients with chronic facial pain. Overall, the TIC injury model's chronicity, reproducibility, and reliability in producing pain- and anxiety-like behaviors demonstrate its usefulness as a chronic neuropathic facial pain model.

  2. Children and Facial Trauma

    Science.gov (United States)

    ... an ENT Doctor Near You Children and Facial Trauma Children and Facial Trauma Patient Health Information News ... staff at newsroom@entnet.org . What is facial trauma? The term facial trauma means any injury to ...

  3. Treatment of the mangled lower extremity after a terrorist blast injury.

    Science.gov (United States)

    Langworthy, Michael J; Smith, Jeffrey M; Gould, Mark

    2004-05-01

    Terrorist bombings, with resultant blast injuries, have been increasing in frequency during the past 30 years. Injury to the musculoskeletal system is common in victims who survive such attacks. Substantial injury to the limbs may occur through several different mechanisms, each of which may affect prognosis and alter the treatment algorithm. An analysis of the available literature on terrorism and blast events revealed that resource use of the treating medical facility is high during the initial hours after a blast attack, but usually is manageable. A resource management protocol was developed to organize the treatment of limb salvage into four phases. This management protocol may improve the medical facility's ability to manage system resources while treating patients with severe blast injuries. The decision of whether to salvage or proceed with limb amputation is one of the most difficult in orthopaedic trauma. A basic education in the mechanisms of blast damage, a methodical approach to resuscitation, and mangled extremity treatment, likely can improve surgical success.

  4. Human bite injuries in the oro-facial region at the Muhimbili National Hospital, Tanzania

    Directory of Open Access Journals (Sweden)

    Simon Elison NM

    2008-04-01

    Full Text Available Abstract Background Human bites in the maxillofacial region compromise function and aesthetics, resulting in social and psychological effects. There is paucity of information regarding human bite injuries in Tanzania. The aim of the study was to assess the occurrence, treatment modalities and prognosis of human bite injuries in the oro-facial region at the Muhimbili National Hospital Dar es Salaam, Tanzania. Methods In a prospective study the details of patients with human bite injuries in the oro-facial region who attended at the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital between January 2001 and December 2005 were recorded. Data included information on age, sex, site, duration of the injury at the time of reporting to hospital, reasons, details of treatment offered and outcome after treatment. Results A total of 33 patients, 13 males and 20 females aged between 12 and 49 years with human bite injuries in the oro-facial region were treated. Thirty patients presented with clean uninfected wounds while 3 had infected wounds. The most (45.5% frequently affected site was the lower lip. Treatment offered included thorough surgical cleansing with adequate surgical debridement and primary suturing. Tetanus prophylaxis and a course of broad-spectrum antibiotics were given to all the patients. In 90% of the 30 patients who were treated by suturing, the healing was uneventful with only 10% experiencing wound infection or necrosis. Three patients who presented with wounds that had signs of infection were treated by surgical cleansing with debridement, antibiotics and daily dressing followed by delayed primary suturing. Conclusion Most of the human bite injuries in the oro-facial region were due to social conflicts. Although generally considered to be dirty or contaminated they could be successfully treated by surgical cleansing and primary suture with a favourable outcome. Management of such injuries often need

  5. Visual Scanning in the Recognition of Facial Affect in Traumatic Brain Injury

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    Suzane Vassallo

    2011-05-01

    Full Text Available We investigated the visual scanning strategy employed by a group of individuals with a severe traumatic brain injury (TBI during a facial affect recognition task. Four males with a severe TBI were matched for age and gender with 4 healthy controls. Eye movements were recorded while pictures of static emotional faces were viewed (i.e., sad, happy, angry, disgusted, anxious, surprised. Groups were compared with respect to accuracy in labelling the emotional facial expression, reaction time, number and duration of fixations to internal (i.e., eyes + nose + mouth, and external (i.e., all remaining regions of the stimulus. TBI participants demonstrated significantly reduced accuracy and increased latency in facial affect recognition. Further, they demonstrated no significant difference in the number or duration of fixations to internal versus external facial regions. Control participants, however, fixated more frequently and for longer periods of time upon internal facial features. Impaired visual scanning can contribute to inaccurate interpretation of facial expression and this can disrupt interpersonal communication. The scanning strategy demonstrated by our TBI group appears more ‘widespread’ than that employed by their normal counterparts. Further work is required to elucidate the nature of the scanning strategy used and its potential variance in TBI.

  6. Osteopathic manipulative treatment for facial numbness and pain after whiplash injury.

    Science.gov (United States)

    Genese, Josephine Sun

    2013-07-01

    Whiplash injury is often caused by rear-end motor vehicle collisions. Symptoms such as neck pain and stiffness or arm pain or numbness are common with whiplash injury. The author reports a case of right facial numbness and right cheek pain after a whiplash injury. Osteopathic manipulative treatment techniques applied at the level of the cervical spine, suboccipital region, and cranial region alleviated the patient's facial symptoms by treating the right-sided strain of the trigeminal nerve. The strain on the trigeminal nerve likely occurred at the upper cervical spine, at the nerve's cauda, and at the brainstem, the nerve's point of origin. The temporal portion of the cranium played a major role in the strain on the maxillary.

  7. [Capabilities of a Multivox hardware-software system in the radiodiagnosis of facial skeleton injury].

    Science.gov (United States)

    Kuznetsov, A A; Klimova, N V

    2013-01-01

    The authors evaluated the efficiency of a Multivox RIS hardware-software system in optimizing the radiodiagnosis of facial skeleton injury. An attempt was undertaken to systematize an approach to the comprehensive radiographic examination of patients with craniofacial polytrauma. It is shown that an image can be postprocessed using the Multivox RIS hardware-software system, which contributes to the comprehensive analysis of obtained images, by applying different radiographic studies; moreover, digital X-ray study has the most diagnostic value and rationality for isolated maxillofacial trauma and multislice spiral computed tomography has them for mixed, concurrent, and multiple injuries. The developed algorithm for examining the patients with facial skeleton trauma unifies and optimizes the diagnosis of craniofascial injuries at different sites.

  8. A Thoracic Mechanism of Mild Traumatic Brain Injury Due to Blast Pressure Waves

    CERN Document Server

    Courtney, Amy; 10.1016/j.mehy.2008.08.015

    2008-01-01

    The mechanisms by which blast pressure waves cause mild to moderate traumatic brain injury (mTBI) are an open question. Possibilities include acceleration of the head, direct passage of the blast wave via the cranium, and propagation of the blast wave to the brain via a thoracic mechanism. The hypothesis that the blast pressure wave reaches the brain via a thoracic mechanism is considered in light of ballistic and blast pressure wave research. Ballistic pressure waves, caused by penetrating ballistic projectiles or ballistic impacts to body armor, can only reach the brain via an internal mechanism and have been shown to cause cerebral effects. Similar effects have been documented when a blast pressure wave has been applied to the whole body or focused on the thorax in animal models. While vagotomy reduces apnea and bradycardia due to ballistic or blast pressure waves, it does not eliminate neural damage in the brain, suggesting that the pressure wave directly affects the brain cells via a thoracic mechanism. ...

  9. A mouse model of ocular blast injury that induces closed globe anterior and posterior pole damage

    Science.gov (United States)

    Hines-Beard, Jessica; Marchetta, Jeffrey; Gordon, Sarah; Chaum, Edward; Geisert, Eldon E.; Rex, Tonia S.

    2012-01-01

    We developed and characterized a mouse model of primary ocular blast injury. The device consists of: a pressurized air tank attached to a regulated paintball gun with a machined barrel; a chamber that protects the mouse from direct injury and recoil, while exposing the eye; and a secure platform that enables fine, controlled movement of the chamber in relation to the barrel. Expected pressures were calculated and the optimal pressure transducer, based on the predicted pressures, was positioned to measure output pressures at the location where the mouse eye would be placed. Mice were exposed to one of three blast pressures (23.6, 26.4, or 30.4psi). Gross pathology, intraocular pressure, optical coherence tomography, and visual acuity were assessed 0, 3, 7, 14, and 28 days after exposure. Contralateral eyes and non-blast exposed mice were used as controls. We detected increased damage with increased pressures and a shift in the damage profile over time. Gross pathology included corneal edema, corneal abrasions, and optic nerve avulsion. Retinal damage was detected by optical coherence tomography and a deficit in visual acuity was detected by optokinetics. Our findings are comparable to those identified in Veterans of the recent wars with closed eye injuries as a result of blast exposure. In summary, this is a relatively simple system that creates injuries with features similar to those seen in patients with ocular blast trauma. This is an important new model for testing the short-term and long-term spectrum of closed globe blast injuries and potential therapeutic interventions. PMID:22504073

  10. Penetrating facial injury with an "Airsoft" pellet: a case report.

    Science.gov (United States)

    Strong, Ben; Coady, Martin

    2014-11-01

    Airsoft is a recreational combat sport that originated in Japan in the 1970s and is currently increasing in popularity in the UK. Participants use air or electrically powered weapons to fire small plastic pellets at a controlled pressure. UK law strictly regulates the maximum muzzle velocity and the type of ammunition used in these weapons. A search of published papers found several reports of penetrating ocular injuries caused by Airsoft pellets, but no reports of penetrating injuries to other areas of the body. We report the case of a 25-year-old man who sustained a penetrating injury to the cheek after being shot with an Airsoft weapon.

  11. Otologic assessment of blast and nonblast injury in returning Middle East-deployed service members.

    Science.gov (United States)

    Shah, Anil; Ayala, Marco; Capra, Gregory; Fox, David; Hoffer, Michael

    2014-01-01

    To determine if tympanic membrane perforation offers any protection from inner ear damage and determine the incidence and pattern of otologic blast injury in military personnel returning from deployment. Retrospective analysis of US service members injured in Operation Iraqi Freedom and Operation Enduring Freedom from October 2006 to October 2007. One-hundred ten blast-injured patients were compared to 54 nonblast-injured patients returning from deployment. Data captured included audiogram results, presence of tympanic membrane perforation, demographic data, location and nature of injury, loss of consciousness, sleep disturbance, confusion, and symptoms of headache, dizziness, memory loss, and tinnitus. Of 110 blast-injured patients, 18 patients suffered tympanic membrane perforation (16%), of which nine patients suffered bilateral tympanic membrane perforation (8%). Blast patients suffered more hearing loss than controls as measured by pure-tone averages of varying speech reception frequencies and at 6,000 Hz. Of the blast patients who recorded an audiogram, nearly 24% suffered moderate to profound hearing loss. There was no statistically significant difference in hearing outcomes between blast-injured patients with tympanic membrane perforations and those without; however, when comparing patients with unilateral perforations with their contralateral ear, there was a difference in hearing thresholds at 6,000 Hz. There was a significantly increased risk of tinnitus, memory loss, headache, and dizziness between blast-injured patients compared to controls. Due to its violent nature, blast exposure causes greater neuro-otological manifestations and deserves prompt otologic evaluation. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  12. An Investigation of the Mechanism of Traumatic Brain Injury Caused by Blast in the Open Field

    Science.gov (United States)

    Feng, Ke

    Blast-induced traumatic brain injury (bTBI) is a signature wound of modern warfare. The current incomplete understanding of its injury mechanism impedes the development of strategies for effective protection of bTBI. Despite a considerable amount of experimental animal studies focused on the evaluation of brain neurotrauma caused by blast exposure, there is very limited knowledge on the biomechanical responses of the gyrenecephalic brain subjected to primary free-field blast waves imposed in vivo, and the correlation analysis between the biomechanical responses and its injury outcomes. Such information is crucial to the development of injury criteria of bTBI. This study aims to evaluate the external and internal mechanical responses of the brain against different levels of blast loading with Yucatan swine in free field, and to conduct correlational studies with brain tissue damage. To better understand primary bTBI, we have implemented an open field experimental model to apply controlled shock waves on swine head. The applied pressure levels of shock waves were predicted by finite element modeling and verified with calibrated testing. Biomechanical responses of primary blasts such as intracranial pressure (ICP), head kinetics, strain rate of skull, were measured in vivo during the blasts. A positive correlation between incident overpressure (IOP) and its corresponding biomechanical responses of the brain was observed. A parallel group of non-instrumented animals were used to collect injury data 72 hours post experiment. Cellular responses governed by primary blasts, such as neuronal degeneration and apoptosis were studied via immunohistochemistry. Representative fluorescent-stained images were examined under microscope. A positive correlation was found between the amount of degenerative neurons and the blast level. Significant elevation of apoptosis was found in the high-level blast. Comparisons between brains with varies ICP readings demonstrate differences of the

  13. Identical fracture patterns in combat vehicle blast injuries due to improvised explosive devices; a case series

    Directory of Open Access Journals (Sweden)

    Commandeur Joris

    2012-10-01

    Full Text Available Abstract Background In November 2008, a surgical team from the Red Cross Hospital Beverwijk, the Netherlands, was deployed in Afghanistan for three months to attend in the army hospital of Kandahar. During their stay, four incidents of armored personnel carriers encountering an improvised explosive device were assessed. In each incident, two soldiers were involved, whose injuries were strikingly similar. Case presentation The described cases comprise paired thoracic vertebral fractures, radial neck fractures, calcaneal fractures and talar fractures. Moreover, the different types of blast injury are mentioned and related to the injuries described in our series. Acknowledging the different blast mechanisms is important for understanding possible injury patterns. Conclusion From this case series, as well as the existing literature on injury patterns caused by blast injuries, it seems appropriate to pay extra attention to bodily areas that were injured in other occupants of the same vehicle. Obviously, the additional surveillance for specific injuries should be complementary to the regular trauma work-up (e.g., ATLS.

  14. Voluntary Alcohol Intake following Blast Exposure in a Rat Model of Mild Traumatic Brain Injury

    Science.gov (United States)

    Lim, Yi Wei; Meyer, Nathan P.; Shah, Alok S.; Budde, Matthew D.; Stemper, Brian D.; Olsen, Christopher M.

    2015-01-01

    Alcoholism is a frequent comorbidity following mild traumatic brain injury (mTBI), even in patients without a previous history of alcohol dependence. Despite this correlational relationship, the extent to which the neurological effects of mTBI contribute to the development of alcoholism is unknown. In this study, we used a rodent blast exposure model to investigate the relationship between mTBI and voluntary alcohol drinking in alcohol naïve rats. We have previously demonstrated in Sprague Dawley rats that blast exposure leads to microstructural abnormalities in the medial prefrontal cortex (mPFC) and other brain regions that progress from four to thirty days. The mPFC is a brain region implicated in alcoholism and drug addiction, although the impact of mTBI on drug reward and addiction using controlled models remains largely unexplored. Alcohol naïve Sprague Dawley rats were subjected to a blast model of mTBI (or sham conditions) and then tested in several common measures of voluntary alcohol intake. In a seven-week intermittent two-bottle choice alcohol drinking test, sham and blast exposed rats had comparable levels of alcohol intake. In a short access test session at the conclusion of the two-bottle test, blast rats fell into a bimodal distribution, and among high intake rats, blast treated animals had significantly elevated intake compared to shams. We found no effect of blast when rats were tested for an alcohol deprivation effect or compulsive drinking in a quinine adulteration test. Throughout the experiment, alcohol drinking was modest in both groups, consistent with other studies using Sprague Dawley rats. In conclusion, blast exposure had a minimal impact on overall alcohol intake in Sprague Dawley rats, although intake was increased in a subpopulation of blast animals in a short access session following intermittent access exposure. PMID:25910266

  15. Skull flexure from blast waves: a mechanism for brain injury with implications for helmet design

    Energy Technology Data Exchange (ETDEWEB)

    Moss, W C; King, M J; Blackman, E G

    2009-04-14

    Traumatic brain injury [TBI] has become a signature injury of current military conflicts. The debilitating effects of TBI are long-lasting and costly. Although the mechanisms by which impacts cause TBI have been well researched, the mechanisms by which blasts cause TBI are not understood. Various possibilities have been investigated, but blast-induced deformation of the skull has been neglected. From numerical hydrodynamic simulations, we have discovered that nonlethal blasts can induce sufficient flexure of the skull to generate potentially damaging loads in the brain, even if no impact occurs. The possibility that this mechanism may contribute to TBI has implications for the diagnosis of soldiers and the design of protective equipment such as helmets.

  16. Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

    Science.gov (United States)

    Saperi, Bin Sulong; Ramli, Roszalina; Ahmed, Zafar; Muhd Nur, Amrizal; Ibrahim, Mohd Ismail; Rashdi, Muhd Fazlynizam; Nordin, Rifqah; Rahman, Normastura Abd; Yusoff, Azizah; Nazimi, Abd Jabar; Abdul Rahman, Roselinda; Abdul Razak, Noorhayati; Mohamed, Norlen

    2017-01-01

    Objective Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS) were performed. Results A total of 190 patients were enrolled in the study, of whom 83 (43.7%) had FI only, and 107 (56.3%) had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia. PMID:28223831

  17. Primary blast causes mild, moderate, severe and lethal TBI with increasing blast overpressures: Experimental rat injury model

    Science.gov (United States)

    Mishra, Vikas; Skotak, Maciej; Schuetz, Heather; Heller, Abi; Haorah, James; Chandra, Namas

    2016-06-01

    Injury severity in blast induced Traumatic Brain Injury (bTBI) increases with blast overpressure (BOP) and impulse in dose-dependent manner. Pure primary blast waves were simulated in compressed gas shock-tubes in discrete increments. Present work demonstrates 24 hour survival of rats in 0–450 kPa (0–800 Pa•s impulse) range at 10 discrete levels (60, 100, 130, 160, 190, 230, 250, 290, 350 and 420 kPa) and determines the mortality rate as a non-linear function of BOP. Using logistic regression model, predicted mortality rate (PMR) function was calculated, and used to establish TBI severities. We determined a BOP of 145 kPa as upper mild TBI threshold (5% PMR). Also we determined 146–220 kPa and 221–290 kPa levels as moderate and severe TBI based on 35%, and 70% PMR, respectively, while BOP above 290 kPa is lethal. Since there are no standards for animal bTBI injury severity, these thresholds need further refinements using histopathology, immunohistochemistry and behavior. Further, we specifically investigated mild TBI range (0–145 kPa) using physiological (heart rate), pathological (lung injury), immuno-histochemical (oxidative/nitrosative and blood-brain barrier markers) as well as blood borne biomarkers. With these additional data, we conclude that mild bTBI occurs in rats when the BOP is in the range of 85–145 kPa.

  18. Blast injury in children: an analysis from Afghanistan and Iraq, 2002-2010.

    Science.gov (United States)

    Edwards, Mary J; Lustik, Michael; Eichelberger, Martin R; Elster, Eric; Azarow, Kenneth; Coppola, Christopher

    2012-11-01

    Throughout history, children have been victims of armed conflict, including the blast injury complex, however, the pattern of injury, physiologic impact, and treatment needs of children with this injury are not well documented. The Joint Theatre Trauma Registry provides data on all civilians admitted to US military treatment facilities from 2002 to 2010 with injuries from an explosive device. The data were stratified by age and analyzed for differences in anatomic injury patterns, Injury Severity Score (ISS), Revised Trauma Score (RTS), mortality, intensive care unit days, and length of hospitalization. Multivariate logistic regression was done to determine independent predictors of mortality. All operative procedures with a specified site were tabulated and categorized by body region and age. A total of 4,983 civilian patients were admitted, 25% of whom were younger than 15 years. Pediatric patients aged 8 to 14 years had a higher ISS and hospital stay than other age groups, and children younger than 15 years had a longer intensive care unit stay. Injuries in children were more likely to occur in the head and neck and less likely in the bony pelvis and extremities. Children had a lower RTS than the other age groups. Mortality correlated highly with burns, head injury, transfusion, and RTS. Adolescent patients had a lower mortality rate than the other age groups. Improvised explosive devices were the most common cause of injury in all age groups. Children experiencing blast injury complex have an anatomic pattern that is unique and an RTS that reflects more severe physiologic derangement. Injuries requiring transfusion or involving the head and neck and burns were predictive of mortality, and this persisted across all age groups. The mortality rate of children with blast injury is significant (7%), and treatment is resource intensive, requiring many surgical subspecialties. Epidemiologic study, level III.

  19. Blast-Induced Acceleration in a Shock Tube: Distinguishing Primary and Tertiary Blast Injury

    Science.gov (United States)

    2014-10-01

    Annual, Year 2 3. DATES COVERED 4. TITLE AND SUBTITLE Blast-Induced Acceleration in a Shock Tube : Distinguishing Primary and Tertiary 5a...Using a highly characterized shock tube simulation of blast, rats will be exposed to BOP with varied peak amplitudes and impulse in association...understanding of the relation of the former to the latter. As the use of shock tubes has greatly expanded in recent years for biomedical research

  20. Measuring Intracranial Pressure and Correlation with Severity of Blast Traumatic Brain Injury

    Science.gov (United States)

    2013-01-01

    PLoS One, 2012. 7(4): p. e34504. 22. Ansari, M.A., K.N. Roberts, and S.W. Scheff, A time course of contusion -induced oxidative stress and synaptic...response to pulmonary blast injury. J. Trauma 40, 100S–104S. Cernak, I., Wang, Z., Jiang, J., Bian, X., and Savic, J. (2001). Ultrastructural and

  1. Wartime spine injuries: understanding the improvised explosive device and biophysics of blast trauma.

    Science.gov (United States)

    Kang, Daniel G; Lehman, Ronald A; Carragee, Eugene J

    2012-09-01

    The improvised explosive device (IED) has been the most significant threat by terrorists worldwide. Blast trauma has produced a wide pattern of combat spinal column injuries not commonly experienced in the civilian community. Unfortunately, explosion-related injuries have also become a widespread reality of civilian life throughout the world, and civilian medical providers who are involved in emergency trauma care must be prepared to manage casualties from terrorist attacks using high-energy explosive devices. Treatment decisions for complex spine injuries after blast trauma require special planning, taking into consideration many different factors and the complicated multiple organ system injuries not normally experienced at most civilian trauma centers. Therefore, an understanding about the effects of blast trauma by spine surgeons in the community has become imperative, as the battlefield has been brought closer to home in many countries through domestic terrorism and mass casualty situations, with the lines blurred between military and civilian trauma. We set out to provide the spine surgeon with a brief overview on the use of IEDs for terrorism and the current conflicts in Iraq and Afghanistan and also a perspective on the biophysics of blast trauma.

  2. Influence of Combat Blast-Related Mild Traumatic Brain Injury Acute Symptoms on Mental Health and Service Discharge Outcomes

    Science.gov (United States)

    2013-08-15

    is a stronger predictor of outcome in blast related TBI compared with blunt trauma. Further, sports concussions may not be a good model for blast...the multi variate model. Although a history of previous concussions was not predictive of any outcomes, undiagnosed concussions may have oc curred...during these blast events. The cumulative effect of brain in juries has been well documented in repeat concussions occurring in sports related injuries

  3. Blast Exposure Induces Post-Traumatic Stress Disorder-Related Traits in a Rat Model of Mild Traumatic Brain Injury

    OpenAIRE

    Elder, Gregory A; Dorr, Nathan P.; De Gasperi, Rita; Gama Sosa, Miguel A.; Shaughness, Michael C.; Maudlin-Jeronimo, Eric; Hall, Aaron A; McCarron, Richard M.; Ahlers, Stephen T

    2012-01-01

    Blast related traumatic brain injury (TBI) has been a major cause of injury in the wars in Iraq and Afghanistan. A striking feature of the mild TBI (mTBI) cases has been the prominent association with post-traumatic stress disorder (PTSD). However, because of the overlapping symptoms, distinction between the two disorders has been difficult. We studied a rat model of mTBI in which adult male rats were exposed to repetitive blast injury while under anesthesia. Blast exposure induced a variety ...

  4. Experimental study of blast-induced traumatic brain injury using a physical head model.

    Science.gov (United States)

    Zhang, Jiangyue; Pintar, Frank A; Yoganandan, Narayan; Gennarelli, Thomas A; Son, Steven F

    2009-11-01

    This study was conducted to quantify intracranial biomechanical responses and external blast overpressures using physical head model to understand the biomechanics of blast traumatic brain injury and to provide experimental data for computer simulation of blast-induced brain trauma. Ellipsoidal-shaped physical head models, made from 3-mm polycarbonate shell filled with Sylgard 527 silicon gel, were used. Six blast tests were conducted in frontal, side, and 45 degrees oblique orientations. External blast overpressures and internal pressures were quantified with ballistic pressure sensors. Blast overpressures, ranging from 129.5 kPa to 769.3 kPa, were generated using a rigid cannon and 1.3 to 3.0 grams of pentaerythritol tetranitrate (PETN) plastic sheet explosive (explosive yield of 13.24 kJ and TNT equivalent mass of 2.87 grams for 3 grams of material). The PETN plastic sheet explosive consisted of 63% PETN powder, 29% plasticizer, and 8% nitrocellulose with a density of 1.48 g/cm3 and detonation velocity of 6.8 km/s. Propagation and reflection of the shockwave was captured using a shadowgraph technique. Shockwave speeds ranging from 423.3 m/s to 680.3 m/s were recorded. The model demonstrated a two-stage response: a pressure dominant (overpressure) stage followed by kinematic dominant (blast wind) stage. Positive pressures in the brain simulant ranged from 75.1 kPa to 1095 kPa, and negative pressures ranged from -43.6 kPa to -646.0 kPa. High- and normal-speed videos did not reveal observable deformations in the brain simulant from the neutral density markers embedded in the midsagittal plane of the head model. Amplitudes of the internal positive and negative pressures were found to linearly correlate with external overpressure. Results from the current study suggested a pressure-dominant brain injury mechanism instead of strain injury mechanism under the blast severity of the current study. These quantitative results also served as the validation and calibration

  5. Overview of impaired facial affect recognition in persons with traumatic brain injury.

    Science.gov (United States)

    Radice-Neumann, Dawn; Zupan, Barbra; Babbage, Duncan R; Willer, Barry

    2007-07-01

    To review the literature of affect recognition for persons with traumatic brain injury (TBI). It is suggested that impairment of affect recognition could be a significant problem for the TBI population and treatment strategies are recommended based on research for persons with autism. Research demonstrates that persons with TBI often have difficulty determining emotion from facial expressions. Studies show that poor interpersonal skills, which are associated with impaired affect recognition, are linked to a variety of negative outcomes. Theories suggest that facial affect recognition is achieved by interpreting important facial features and processing one's own emotions. These skills are often affected by TBI, depending on the areas damaged. Affect recognition impairments have also been identified in persons with autism. Successful interventions have already been developed for the autism population. Comparable neuroanatomical and behavioural findings between TBI and autism suggest that treatment approaches for autism may also benefit those with TBI. Impaired facial affect recognition appears to be a significant problem for persons with TBI. Theories of affect recognition, strategies used in autism and teaching techniques commonly used in TBI need to be considered when developing treatments to improve affect recognition in persons with brain injury.

  6. Computational modeling of blast wave interaction with a human body and assessment of traumatic brain injury

    Science.gov (United States)

    Tan, X. G.; Przekwas, A. J.; Gupta, R. K.

    2017-07-01

    The modeling of human body biomechanics resulting from blast exposure poses great challenges because of the complex geometry and the substantial material heterogeneity. We developed a detailed human body finite element model representing both the geometry and the materials realistically. The model includes the detailed head (face, skull, brain and spinal cord), the neck, the skeleton, air cavities (lungs) and the tissues. Hence, it can be used to properly model the stress wave propagation in the human body subjected to blast loading. The blast loading on the human was generated from a simulated C4 explosion. We used the highly scalable solvers in the multi-physics code CoBi for both the blast simulation and the human body biomechanics. The meshes generated for these simulations are of good quality so that relatively large time-step sizes can be used without resorting to artificial time scaling treatments. The coupled gas dynamics and biomechanics solutions were validated against the shock tube test data. The human body models were used to conduct parametric simulations to find the biomechanical response and the brain injury mechanism due to blasts impacting the human body. Under the same blast loading condition, we showed the importance of inclusion of the whole body.

  7. No neurochemical evidence of brain injury after blast overpressure by repeated explosions or firing heavy weapons.

    Science.gov (United States)

    Blennow, K; Jonsson, M; Andreasen, N; Rosengren, L; Wallin, A; Hellström, P A; Zetterberg, H

    2011-04-01

    Psychiatric and neurological symptoms are common among soldiers exposed to blast without suffering a direct head injury. It is not known whether such symptoms are direct consequences of blast overpressure. To examine if repeated detonating explosions or firing if of heavy weapons is associated with neurochemical evidence of brain damage. Three controlled experimental studies. In the first, army officers were exposed to repeated firing of a FH77B howitzer or a bazooka. Cerebrospinal fluid (CSF) was taken post-exposure to measure biomarkers for brain damage. In the second, officers were exposed for up to 150 blasts by firing a bazooka, and in the third to 100 charges of detonating explosives of 180 dB. Serial serum samples were taken after exposure. Results were compared with a control group consisting of 19 unexposed age-matched healthy volunteers. The CSF biomarkers for neuronal/axonal damage (tau and neurofilament protein), glial cell injury (GFAP and S-100b), blood-brain barrier damage (CSF/serum albumin ratio) and hemorrhages (hemoglobin and bilirubin) and the serum GFAP and S-100b showed normal and stable levels in all exposed officers. Repeated exposure to high-impact blast does not result in any neurochemical evidence of brain damage. These findings are of importance for soldiers regularly exposed to high-impact blast when firing artillery shells or other types of heavy weapons. © 2010 John Wiley & Sons A/S.

  8. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    OpenAIRE

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a frac...

  9. Functional Status after Blast-Plus-Impact Complex Concussive Traumatic Brain Injury in Evacuated United States Military Personnel

    Science.gov (United States)

    2014-01-01

    vulnerability to PTSD and depression, blast-related hormonal abnormalities,51 and blast-related injuries to specific parts of the brain causing impaired emotional ...Homaifar, B.Y., Gutierrez, P.M., Staves, P.J., Harwood, J.E., Reeves , D., Adler, L.E., Ivins, B.J., Helmick, K., and Warden, D. (2010

  10. Facial nucleus up-regulation of brain-derived neurotrophic factor mRNA following electroacupuncture treatment in a rabbit model of facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    Hong Gao; Bangyu Ju; Guohua Jiang

    2008-01-01

    BACKGROUND: The effect of acupuncture treatment on peripheral facial nerve injury is generally accepted. However, the mechanisms of action remain poorly understood. OBJECTIVE: To validate the effect of acupoint electro-stimulation on brain-derived neurotrophic factor (BDNF) mRNA expression in the facial nucleus of rabbits with facial nerve injury, with the hypothesis that acupuncture treatment efficacy is related to BDNE DESIGN, TIME AND SETTING: Peripheral facial nerve injury, in situ hybridization, and randomized, controlled, animal trial. The experiment was performed at the Laboratory of Anatomy, Heilongjiang University of Chinese Medicine from March to September 2005. MATERIALS: A total of 120 healthy, adult, Japanese rabbits, with an equal number of males and females were selected. Models of peripheral facial nerve injury were established using the facial nerve pressing method. METHODS: The rabbits were randomly divided into five groups (n = 24): sham operation, an incision to the left facial skin, followed by suture; model, no treatment following facial nerve model establishment; western medicine, 10 mg vitamin B1, 50 μg vitamin B12, and dexamethasone (2 mg/d, reduced to half every 7 days) intramuscular injection starting with the first day following lesion, once per day; traditional acupuncture, acupuncture at Yifeng, Quanliao, Dicang, Jiache, Sibai, and Yangbai acupoints using a acupuncture needle with needle twirling every 10 minutes, followed by needle retention for 30 minutes, for successive 5 days; electroacupuncture, similar to the traditional acupuncture group, the Yifeng (negative electrode), Jiache (positive electrode), Dicang (negative electrode), and Sibai (positive electrode) points were connected to an universal pulse electro-therapeutic apparatus for 30 minutes per day, with disperse-dense waves for successive 5 days, and resting for 2 days. MAIN OUTCOME MEASURES: Left hemisphere brain stem tissues were harvested on post-operative days 7, 14

  11. Assessing Quantitative Changes in Intrinsic Thalamic Networks in Blast and Nonblast Mild Traumatic Brain Injury: Implications for Mechanisms of Injury.

    Science.gov (United States)

    Nathan, Dominic E; Bellgowan, Julie F; Oakes, Terrence R; French, Louis M; Nadar, Sreenivasan R; Sham, Elyssa B; Liu, Wei; Riedy, Gerard

    2016-06-01

    In the global war on terror, the increased use of improvised explosive devices has resulted in increased incidence of blast-related mild traumatic brain injury (mTBI). Diagnosing mTBI is both challenging and controversial due to heterogeneity of injury location, trauma intensity, transient symptoms, and absence of focal biomarkers on standard clinical imaging modalities. The goal of this study is to identify a brain biomarker that is sensitive to mTBI injury. Research suggests the thalamus may be sensitive to changes induced by mTBI. A significant number of connections to and from various brain regions converge at the thalamus. In addition, the thalamus is involved in information processing, integration, and regulation of specific behaviors and mood. In this study, changes in task-free thalamic networks as quantified by graph theory measures in mTBI blast (N = 186), mTBI nonblast (N = 80), and controls (N = 21) were compared. Results show that the blast mTBI group had significant hyper-connectivity compared with the controls and nonblast mTBI group. However, after controlling for post-traumatic stress symptoms (PTSS), the blast mTBI group was not different from the controls, but the nonblast mTBI group showed significant hypo-connectivity. The results suggest that there are differences in the mechanisms of injury related to mTBI as reflected in the architecture of the thalamic networks. However, the effect of PTSS and its relationship to mTBI is difficult to distinguish and warrants more research.

  12. Disruption of caudate working memory activation in chronic blast-related traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Mary R. Newsome

    2015-01-01

    Full Text Available Mild to moderate traumatic brain injury (TBI due to blast exposure is frequently diagnosed in veterans returning from the wars in Iraq and Afghanistan. However, it is unclear whether neural damage resulting from blast TBI differs from that found in TBI due to blunt-force trauma (e.g., falls and motor vehicle crashes. Little is also known about the effects of blast TBI on neural networks, particularly over the long term. Because impairment in working memory has been linked to blunt-force TBI, the present functional magnetic resonance imaging (fMRI study sought to investigate whether brain activation in response to a working memory task would discriminate blunt-force from blast TBI. Twenty-five veterans (mean age = 29.8 years, standard deviation = 6.01 years, 1 female who incurred TBI due to blast an average of 4.2 years prior to enrollment and 25 civilians (mean age = 27.4 years, standard deviation = 6.68 years, 4 females with TBI due to blunt-force trauma performed the Sternberg Item Recognition Task while undergoing fMRI. The task involved encoding 1, 3, or 5 items in working memory. A group of 25 veterans (mean age = 29.9 years, standard deviation = 5.53 years, 0 females and a group of 25 civilians (mean age = 27.3 years, standard deviation = 5.81 years, 0 females without history of TBI underwent identical imaging procedures and served as controls. Results indicated that the civilian TBI group and both control groups demonstrated a monotonic relationship between working memory set size and activation in the right caudate during encoding, whereas the blast TBI group did not (p < 0.05, corrected for multiple comparisons using False Discovery Rate. Blast TBI was also associated with worse performance on the Sternberg Item Recognition Task relative to the other groups, although no other group differences were found on neuropsychological measures of episodic memory, inhibition, and general processing speed. These results

  13. A Blast Headform Surrogate for the Assessment of Blast-Induced Traumatic Brain Injury

    Science.gov (United States)

    2012-11-27

    Correct fit of headwear , Representative blast diffraction around headform – Biofidelic wrt internal geometry and material selection: Stress transmission...overpressure histories • With and without protective headwear BI2PED – Recent results Introduction Strategy Facilities Iterations BI2PED & results

  14. Single session of brief electrical stimulation immediately following crush injury enhances functional recovery of rat facial nerve

    Directory of Open Access Journals (Sweden)

    Eileen M. Foecking, PhD

    2012-04-01

    Full Text Available Peripheral nerve injuries lead to a variety of pathological conditions, including paresis or paralysis when the injury involves motor axons. We have been studying ways to enhance the regeneration of peripheral nerves using daily electrical stimulation (ES following a facial nerve crush injury. In our previous studies, ES was not initiated until 24 h after injury. The current experiment tested whether ES administered immediately following the crush injury would further decrease the time for complete recovery from facial paralysis. Rats received a unilateral facial nerve crush injury and an electrode was positioned on the nerve proximal to the crush site. Animals received daily 30 min sessions of ES for 1 d (day of injury only, 2 d, 4 d, 7 d, or daily until complete functional recovery. Untreated animals received no ES. Animals were observed daily for the return of facial function. Our findings demonstrated that one session of ES was as effective as daily stimulation at enhancing the recovery of most functional parameters. Therefore, the use of a single 30 min session of ES as a possible treatment strategy should be studied in human patients with paralysis as a result of acute nerve injuries.

  15. SURGICAL TREATMENT OF UPPER AND MIDDLE FACIAL ZONE TRAUMAS IN PROGRESS OF CONCOMITANT TRAUMATIC CRANIOFACIAL INJURIES.

    Science.gov (United States)

    Lagvilava, G; Gvenetadze, Z; Toradze, G; Devidze, I; Gvenetadze, G

    2015-09-01

    In 2012-2015, 207 patients with concomitant craniofacial injuries, who underwent surgical treatment, were observed; among them 176 were men and 31- women. Age of the patients ranged from 16 to 60 years. According to localization and severity of trauma and a priority of surgical intervention, the patients conventionally were divided into 3 groups by the authors: I group (65 patients) - craniofacial injuries; the skull as well as upper and middle areas of face (subcranial and frontobasal fractures) were affected (fractured). II group (80 patients) - severe traumatic injuries of upper and especially middle zones of the face, accompanied with closed craniocerebral trauma, no need in neurosurgery. III group (62 patients) -on the background of serious head traumas, the injuries of face bones were less severe (injury of one or two anatomic areas with displacement of fractured fragments but without bone tissue defects) According to the obtained results a priority was always given to the neurosurgery (vital testimony).The reconstructive surgeries on face skeleton was conducted in combination involving neurosurgeons (I group patients). Reconstructive surgeries of facial bones were conducted in the patients of II group, immediately or at primary deferred period of time but in the patients of III group the surgical procedures for removal of early secondary or traumatic residual fractures have been performed. Reposition of the fractured facial bone fragments was performed in an open way and fixation was carried out by titanium plates and mesh cage (at bone tissue defect). For prevention and elimination of post-traumatic inflammatory processes, the final stage of surgical intervention was: sanation of nasal accessory sinuses and catheterization (5-7 days) of external carotid arteries for administration of antibiotics and other medical preparations. Early and differentiated approach to face injuries, worsening in the course of craniocephalic trauma was not revealed in any patient

  16. Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

    Directory of Open Access Journals (Sweden)

    Saperi BS

    2017-02-01

    Full Text Available Bin Sulong Saperi,1 Roszalina Ramli,2 Zafar Ahmed,1 Amrizal Muhd Nur,1 Mohd Ismail Ibrahim,3 Muhd Fazlynizam Rashdi,2 Rifqah Nordin,2 Normastura Abd Rahman,4 Azizah Yusoff,4 Abd Jabar Nazimi,2 Roselinda Abdul Rahman,4 Noorhayati Abdul Razak,4 Norlen Mohamed 5 1International Centre for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 2Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 3Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 4School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 5Malaysian Institute of Road Safety Research, Kuala Lumpur, Malaysia Objective: Facial injury (FI may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]. The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS were performed. Results: A total of 190 patients were enrolled in the study, of whom 83 (43.7% had FI only, and 107 (56.3% had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion: Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia. Keywords: facial

  17. VRPI Temporal Progression of Closed Globe Injury from Blast Exposure

    Science.gov (United States)

    2015-09-01

    and visual degradation following blast exposure has not been well characterized . Furthermore, it is unknown if there are early indicators that...be performed using SAS statistical software ( JMP 10.0, Cary,NC). Descriptive and univariate analyses will first be performed to identify the...corneal thickness via OCT and H&E microscopic staining. For OCT image analysis, we developed two MATLAB image processing programs to evaluate the

  18. A Review of the Treatment of Underwater Blast Injuries

    Science.gov (United States)

    1976-09-01

    improving the dismal survival rate of underwater blast victims includes: (1) prevention of air emboli, (2) maintainance of adequate ventilation and...Trendelenberg position (73) has been suggested for cases with severe lung involvement to promote airway drainage and to prevent migration of air emboli to the...accumulation and atelectasis. If the patient cannot contribute to his own physiotherapy , periodic full turning from side-to-side is essential (7, 42

  19. Neural and Behavioral Sequelae of Blast-Related Traumatic Brain Injury

    Science.gov (United States)

    2012-09-01

    concussions , and 8 (38%) reported multiple concussions (range 3-10; data on additional concussions was not available for 2 participants in this group...A chi-square analysis comparing the civTBI and milTBI groups on the proportion with multiple concussions was not significant. Injury relevant...occurred in the context of blast exposure. Finally, although our two TBI groups had a comparable proportion of single vs. multiple concussions , the

  20. Primary Blast Traumatic Brain Injury in the Rat: Relating Diffusion Tensor Imaging and Behavior

    Science.gov (United States)

    2013-10-14

    collegiate football players: the NCAA concussion study. JAMA (2003) 290:2556–63. doi:10.1001/ jama.290.19.2556 6. DePalma RG, Burris DG, Champion HR...Nugent S, et al. Findings of mild traumatic brain injury in combat veterans with PTSD and a history of blast concussion. J Neuropsychiatry Clin Neurosci ...life cognitive impairment in retired professional football players. Neurosurgery (2005) 57:719–26. doi:10.1227/01.NEU.0000175725. 75780.DD discussion

  1. Posttraumatic Stress Disorder in Combat Casualties With Burns Sustaining Primary Blast and Concussive Injuries

    Science.gov (United States)

    2009-04-01

    in close proximity to the blast center, can result in eardrum damage (rupture of the tympanic membrane TM), lung damage (pulmonary or alveolar ...rence of psychologic deficit .12,13 The Defense and Veterans Brain Injury Center reports 22% of soldiers returning from OIF/OEF as having evidence of...psychologic deficit , specifically, posttraumatic stress disorder (PTSD).13 This in- creased risk of altered mental status, concussive symptoms, and PTSD

  2. An Animal-to-Human Scaling Law for Blast-Induced Traumatic Brain Injury Risk Assessment

    Science.gov (United States)

    2014-10-28

    Kleiven S, von Holst H (2002) Consequences of head size following trauma to the human head. J Biomech 35(2):153–160. 55. Alberius P (1987) Cranial suture...neuro- trauma it is imperative to establish a physics-based connection between the intensity of the external threat and the intensity of the internal...injury biomechanics (13–15, 17), the peak intra- cranial pressure was chosen as a characteristic metric of blast intensity transmitted to the brain tissue

  3. Blast Technologies

    Science.gov (United States)

    2011-06-27

    Team Leader Risa Scherer Blast Mitigation Interior and Laboratory Team Leader Blast Technologies POC’s Government Point Of Contacts (POCs): To...to yield injury assessments at higher fidelities and with higher confidence UNCLASSIFIED UNCLASSIFIED Risa Scherer Blast Mitigation Interior and

  4. The role of the health services in the prevention of alcohol-related facial injury.

    LENUS (Irish Health Repository)

    McHugh, E E

    2009-10-01

    This paper outlines the preventive health strategic measures that are currently in place and it endeavours to consider how improvements can be made to our national preventive strategy with the goal of reducing alcohol-related facial injuries. It is based on a review of the literature sourced through PubMed, Ovid Medline and the Cochrane database. The main findings are that increased funding, legislative amendment and media involvement are key to improving the work of the health services in their struggle to limit the ever increasing alcohol-related incidents that are experienced by society today.

  5. Neuronal DNA Methylation Profiling of Blast-Related Traumatic Brain Injury

    Science.gov (United States)

    Ge, Yongchao; Chen, Sean; Xin, Yurong; Umali, Michelle U.; De Gasperi, Rita; Gama Sosa, Miguel A.; Ahlers, Stephen T.; Elder, Gregory A.

    2015-01-01

    Abstract Long-term molecular changes in the brain resulting from blast exposure may be mediated by epigenetic changes, such as deoxyribonucleic acid (DNA) methylation, that regulate gene expression. Aberrant regulation of gene expression is associated with behavioral abnormalities, where DNA methylation bridges environmental signals to sustained changes in gene expression. We assessed DNA methylation changes in the brains of rats exposed to three 74.5 kPa blast overpressure events, conditions that have been associated with long-term anxiogenic manifestations weeks or months following the initial exposures. Rat frontal cortex eight months post-exposure was used for cell sorting of whole brain tissue into neurons and glia. We interrogated DNA methylation profiles in these cells using Expanded Reduced Representation Bisulfite Sequencing. We obtained data for millions of cytosines, showing distinct methylation profiles for neurons and glia and an increase in global methylation in neuronal versus glial cells (p<10−7). We detected DNA methylation perturbations in blast overpressure–exposed animals, compared with sham blast controls, within 458 and 379 genes in neurons and glia, respectively. Differentially methylated neuronal genes showed enrichment in cell death and survival and nervous system development and function, including genes involved in transforming growth factor β and nitric oxide signaling. Functional validation via gene expression analysis of 30 differentially methylated neuronal and glial genes showed a 1.2 fold change in gene expression of the serotonin N-acetyltransferase gene (Aanat) in blast animals (p<0.05). These data provide the first genome-based evidence for changes in DNA methylation induced in response to multiple blast overpressure exposures. In particular, increased methylation and decreased gene expression were observed in the Aanat gene, which is involved in converting serotonin to the circadian hormone melatonin and is implicated in

  6. Time-dependent changes in serum biomarker levels after blast traumatic brain injury.

    Science.gov (United States)

    Gyorgy, Andrea; Ling, Geoffrey; Wingo, Daniel; Walker, John; Tong, Lawrence; Parks, Steve; Januszkiewicz, Adolph; Baumann, Richard; Agoston, Denes V

    2011-06-01

    Neuronal and glial proteins detected in the peripheral circulating blood after injury can reflect the extent of the damage caused by blast traumatic brain injury (bTBI). The temporal pattern of their serum levels can further predict the severity and outcome of the injury. As part of characterizing a large-animal model of bTBI, we determined the changes in the serum levels of S100B, neuron-specific enolase (NSE), myelin basic protein (MBP), and neurofilament heavy chain (NF-H). Blood samples were obtained prior to injury and at 6, 24, 72 h, and 2 weeks post-injury from animals with different severities of bTBI; protein levels were determined using reverse phase protein microarray (RPPM) technology. Serum levels of S100B, MBP, and NF-H, but not NSE, showed a time-dependent increase following injury. The detected changes in S100B and MBP levels showed no correlation with the severity of the injury. However, serum NF-H levels increased in a unique, rapid manner, peaking at 6 h post-injury only in animals exposed to severe blast with poor clinical and pathological outcomes. We conclude that the sudden increase in serum NF-H levels following bTBI may be a useful indicator of injury severity. If additional studies verify our findings, the observed early peak of serum NF-H levels can be developed into a useful diagnostic tool for predicting the extent of damage following bTBI.

  7. Blast exposure induces post-traumatic stress disorder-related traits in a rat model of mild traumatic brain injury.

    Science.gov (United States)

    Elder, Gregory A; Dorr, Nathan P; De Gasperi, Rita; Gama Sosa, Miguel A; Shaughness, Michael C; Maudlin-Jeronimo, Eric; Hall, Aaron A; McCarron, Richard M; Ahlers, Stephen T

    2012-11-01

    Blast related traumatic brain injury (TBI) has been a major cause of injury in the wars in Iraq and Afghanistan. A striking feature of the mild TBI (mTBI) cases has been the prominent association with post-traumatic stress disorder (PTSD). However, because of the overlapping symptoms, distinction between the two disorders has been difficult. We studied a rat model of mTBI in which adult male rats were exposed to repetitive blast injury while under anesthesia. Blast exposure induced a variety of PTSD-related behavioral traits that were present many months after the blast exposure, including increased anxiety, enhanced contextual fear conditioning, and an altered response in a predator scent assay. We also found elevation in the amygdala of the protein stathmin 1, which is known to influence the generation of fear responses. Because the blast overpressure injuries occurred while animals were under general anesthesia, our results suggest that a blast-related mTBI exposure can, in the absence of any psychological stressor, induce PTSD-related traits that are chronic and persistent. These studies have implications for understanding the relationship of PTSD to mTBI in the population of veterans returning from the wars in Iraq and Afghanistan.

  8. Diagnosis and management of evacuated casualties with cervical vascular injuries resulting from combat-related explosive blasts.

    Science.gov (United States)

    Meghoo, Colin A; Dennis, James W; Tuman, Caroline; Fang, Raymond

    2012-05-01

    Explosive blasts are common in the modern military environment. These blasts incorporate a concussive component (primary blast injury) and a penetrating component (secondary blast injury). Penetrating injuries are the leading cause of death and injury in these attacks. This review characterizes the vascular injuries associated with penetrating blast injuries to the neck and provides recommendations on the early management of these casualties for the surgeon unfamiliar with these injuries. The Landstuhl Regional Medical Center Trauma Registry was queried for admissions from January 1, 2006, to June 30, 2010, coded for a penetrating injury to the neck caused by a blast mechanism. Medical records were abstracted from the patient's initial presentation and care through the deployed military medical system. We recorded the vascular injuries, diagnostic studies, operative events, and early postinjury course for all identified patients. Query of the Landstuhl Regional Medical Center Trauma Registry initially identified 252 patients, of which 53 were excluded because their injuries arose from other mechanisms or were only superficial. Among the remaining 199 patients, 38 (19.1%) sustained 44 vascular injuries requiring treatment. Compelling physical examination findings ("hard signs") were present in 15 (7.5%), who underwent immediate neck exploration. Another 12 patients also underwent neck exploration without any prior imaging studies. Computed tomography (CT) or CT angiography (CTA) examinations were done in 172 patients without hard-sign physical examination findings. Of these, the result of the imaging study was negative in 106 patients, and no further investigation or treatment for cervical vascular trauma was initiated. Of 66 patients who underwent CT/CTA before operative neck exploration, CT/CTA identified a vascular injury in 26 that was later confirmed on neck exploration. The combination of physical examination and CT/CTA resulted in a sensitivity of 96.3% and a

  9. Early and continued manual stimulation is required for long-term recovery after facial nerve injury.

    Science.gov (United States)

    Grosheva, Maria; Rink, Svenja; Jansen, Ramona; Bendella, Habib; Pavlov, Stoyan P; Sarikcioglu, Levent; Angelov, Doychin N; Dunlop, Sarah A

    2017-02-18

    We previously have shown that manual stimulation (MS) of vibrissal muscles for 2 months after facial nerve injury in rats improves whisking and reduces motor end plate polyinnervation. Here, we seek to determine whether discontinuing or delaying MS after facial-facial anastomosis (FFA) leads to similar results. Rats were subjected to FFA and received MS for (1) 4 months (early and continued), (2) the first but not the last 2 months (discontinued), or (3) the last 2 months (delayed). Intact animals and those not receiving MS (no MS) were also examined. Early and continued MS restored whisking amplitude to 43°, a value significantly higher compared with the discontinued, delayed, and no MS groups (32°, 24°, and 10°, respectively). Motor end plate polyinnervation occurred in all experimental groups but was significantly higher in the delayed group. Early and continued MS results in better recovery than when it is either discontinued or delayed. Muscle Nerve, 2017. © 2017 Wiley Periodicals, Inc.

  10. Post Mortem Human Surrogate Injury Response of the Pelvis and Lower Extremities to Simulated Underbody Blast.

    Science.gov (United States)

    Bailey, Ann M; Christopher, John J; Brozoski, Frederick; Salzar, Robert S

    2015-08-01

    Military vehicle underbody blast (UBB) is the cause of many serious injuries in theatre today; however, the effects of these chaotic events on the human body are not well understood. The purpose of this research was to replicate both UBB loading conditions and investigate occupant response in a controlled laboratory setting. In addition to better understanding the response of the human to high rate vertical loading, this test series also aimed to identify high rate injury thresholds. Ten whole body post mortem human surrogate (PMHS) tests were completed using the University of Virginia's ODYSSEY simulated blast rig under a range of loading conditions. Seat pan accelerations ranged from 291 to 738 g's over 3 ms of positive phase duration, and foot pan accelerations from 234 to 858 g's over 3 ms of positive phase duration. Post-test computed tomography (CT) scans and necropsies were performed to determine injuries, and revealed a combination of pelvic, lumbar, thoracic, and lower extremity injuries. The research in this paper discusses pelvis and lower extremity injuries under high rate vertical loads.

  11. Iatrogenic facial nerve injuries during chronic otitis media surgery: a multicentre retrospective study.

    Science.gov (United States)

    Linder, T; Mulazimoglu, S; El Hadi, T; Darrouzet, V; Ayache, D; Somers, T; Schmerber, S; Vincent, C; Mondain, M; Lescanne, E; Bonnard, D

    2017-06-01

    To give an insight into why, when and where iatrogenic facial nerve (FN) injuries may occur and to explain how to deal with them in an emergency setting. Multicentre retrospective study in eight tertiary referral hospitals over 17 years. Twenty patients with partial or total FN injury during surgery for chronic otitis media (COM) were revised. Indication and type of surgery, experience of the surgeon, intra- and postoperative findings, value of CT scanning, patient management and final FN outcome were recorded. In 12 cases, the nerve was completely transected, but the surgeon was unaware in 11 cases. A minority of cases occurred in academic teaching hospitals. Tympanic segment, second genu and proximal mastoid segments were the sites involved during injury. The FN was not deliberately identified in 18 patients at the time of injury, and nerve monitoring was only applied in one patient. Before revision surgery, CT scanning correctly identified the lesion site in 11 of 12 cases and depicted additional lesions such as damage to the lateral semicircular canal. A greater auricular nerve graft was interposed in 10 cases of total transection and in one partially lesioned nerve: seven of them resulted in an HB III functional outcome. In two of the transected nerves, rerouting and direct end-to-end anastomosis was applied. A simple FN decompression was used in four cases of superficially traumatised nerves. We suggest checklists for preoperative, intraoperative and postoperative management to prevent and treat iatrogenic FN injury during COM surgery. © 2016 John Wiley & Sons Ltd.

  12. [The use of botulinum toxin type a in the acute phase of facial nerve injury after neurosurgical surgery].

    Science.gov (United States)

    Orlova, O R; Akulov, M A; Usachev, D Iu; Taniashin, S V; Zakharov, V O; Saksonova, E V; Mingazova, L R; Surovykh, S V

    2014-01-01

    To evaluate the role of botulinum toxin type A in the acute phase of facial nerve injury after neurosurgical surgery. The study involved 55 patients with acute facial muscle paresis caused by facial nerve injury during surgery on the posterior cranial fossa and cerebello-pontine angle (CPA). The first group consisted of 35 patients (mean age, 48.14±1.26 years) who were administered botulinum toxin type A (xeomin) at a dose of 2-3 U per point in muscles of the intact side of the face. The control group included 20 patients (mean age, 49.85±1.4 years) who underwent standard rehabilitation treatment of this pathology. The treatment efficacy was evaluated using the House-Brackmann Scale, the Yanagihara facial grading system, the Facial Disability Index (FDI), and the Sunnybrook Facial Grading (SFG) Scale. Before treatment, patients of both groups experienced severe dysfunction according to the House-Brackmann Scale. A month after the botulinium toxin type A therapy had been started, a significant improvement in the group of patients who received botulinum toxin was observed at all scales (p<0.05), whereas improvement in the facial nerve function in the second group was observed only by the 3rd month of rehabilitation treatment (p<0.05). The number of synkineses in the patients who did not receive botulinum toxin was 46% higher than that in the first group (p=0.019) one year after the surgery, and it was higher by 91% after 2 years (p<0.001). The use of botulinum toxin type A is reasonable in acute facial nerve injury and should be mandatory in combined therapy of these patients.

  13. 肝爆震伤的救治%Treatment of liver blast injury

    Institute of Scientific and Technical Information of China (English)

    牟洪超; 周辉; 姜小清; 蔡岩; 孙茂; 董立军

    2015-01-01

    Objective:To investigate the clinical treatment mode of liver blast injury. Methods:The clinical data of 18 patients with liver blast injury who had been treated in our department from May 1998 to December 2013 were studied retrospectively. We summarized the causes of injury, mechanisms,merger injury and compound injury as well as clinical treatment methods and experi-ence to explore the emergency mode of liver blast injury. Results:Wthin 18 cases of liver burst injury, there are pressure cooker ex-plosion (1 case),gas tank explosion (3 cases),fireworks explosion (6 cases), mine gas explosion (8 cases). 14 cases were in hospital-ized immediately within 30minutes-4hours after injury,another 4 cases undergoing initial treatment in other hospital were hospital-ized after the injury within 8 hours. All cases were diagnosed with liver blast injury and merger injury and compound injury.18 cases were variable degrees of shock,there were no single liver blast injury cases . There were 11 cases with varying degrees of burns (5 cases with inhalation injury),2 cases with open fractures,7 cases with lung blast injury,2 cases with spleen rupture,1 case with pan-creatic contusion,3 cases with bowel contusion. All cases were treated by the methods of basical congulation, dressing, fixing ,air ex-haustering of pneumothorax ,oxygen taking and anti shock treatment. 6 cases were cured by non-surgical treatment,the cure rate was 100%(6/6).11 cases were cured by surgical treatment of 12 cases. the cure rate was 91.7%. 1 case died,the mortality rate was 8.3%. Conclusion:The uninterrupted rescue chain model including pre-hospital emergency life-saving,critical evacuation,in-hospi-tal treatment is very important for the patients with liver blast injury. Surgical selection should be differed from conventional surgery for liver blast injury. Treatment of associated injuries should be emphasised.%目的:探讨肝爆震伤的临床救治模式。方法:回顾性分析我科1998年5

  14. Research Advances In Medical Care For Polytrauma Injuries And Blast Injuries

    Science.gov (United States)

    2011-01-25

    skin, including pores and hair follicles . WIRELESS AND TETHERLESS Controlled wirelessly and without tethers. Allows more freedom, versatility...2013 Aims • Identify vital mechanisms of neurodegeneration initiated by blast exposure thus defining novel diagnostic and therapeutic targets Approach

  15. Early Clinical Predictors of 5-Year Outcome After Concussive Blast Traumatic Brain Injury.

    Science.gov (United States)

    Mac Donald, Christine L; Barber, Jason; Jordan, Mary; Johnson, Ann M; Dikmen, Sureyya; Fann, Jesse R; Temkin, Nancy

    2017-07-01

    The long-term clinical effects of wartime traumatic brain injuries (TBIs), most of which are mild, remain incompletely described. Current medical disability cost estimates from world conflicts continually surpass projections. Additional information regarding long-term functional trajectory is needed to reduce this extensive public health burden. To examine 5-year clinical outcomes leveraging existing clinical data collected at 1 year after injury in the same patients and to identify early risk factors for long-term disability. This prospective, longitudinal study enrolled active-duty US military after concussive blast injury (n = 50) in the acute to subacute stage and combat-deployed control individuals (n = 44) in Afghanistan or after medical evacuation to Germany from November 1, 2008, through July 1, 2013. One- and 5-year clinical evaluations were completed in the United States. All concussive blast injuries met the Department of Defense definition of mild, uncomplicated TBI. In-person clinical evaluations included standardized evaluations for neurobehavior, neuropsychological performance, and mental health burden that were essentially identical to the evaluations completed at 1-year follow-up. Data were analyzed from October 1 through November 30, 2016. Changes in the in-person standardized evaluations for neurobehavior, neuropsychological performance, and mental health burden from the 1- to 5-year follow-up. Predictive modeling was used to identify early risk factors for long-term disability. Among the 94 participants (87 men [93%] and 7 women [7%]; mean [SD] age, 34 [8] years), global disability, satisfaction with life, neurobehavioral symptom severity, psychiatric symptom severity, and sleep impairment were significantly worse in patients with concussive blast TBI compared with combat-deployed controls, whereas performance on cognitive measures was no different between groups at the 5-year evaluation. Logistic regression on the dichotomized Extended

  16. Blast and the Consequences on Traumatic Brain Injury-Multiscale Mechanical Modeling of Brain

    Science.gov (United States)

    2011-02-17

    brain and spinal cord injury, is the largest contributor to a poor neurological outcome in survivors of brain and spinal cord trauma. Microscale...anatomical features of a 50th percentile male head, including the brain, falx and tentorium, cerebral spinal fluid (CSF), duramater, piamater, facial...discretized finite elements. (b) Sections of the head model; the right half of the head model is shown with the brain, the meningeal layers (dura

  17. The complexity of biomechanics causing primary blast-induced traumatic brain injury: a review of potential mechanisms.

    Directory of Open Access Journals (Sweden)

    Amy eCourtney

    2015-10-01

    Full Text Available Primary blast induced traumatic brain injury (bTBI is a prevalent battlefield injury in recent conflicts, yet biomechanical mechanisms of bTBI remain unclear. Elucidating specific biomechanical mechanisms is essential to developing animal models for testing candidate therapies and for improving protective equipment. Three hypothetical mechanisms of primary bTBI have received the most attention. Because translational and rotational head accelerations are primary contributors to TBI from non-penetrating blunt force head trauma, the acceleration hypothesis suggests that blast-induced head accelerations may cause bTBI. The hypothesis of direct cranial transmission suggests that a pressure transient traverses the skull into the brain and directly injures brain tissue. The thoracic hypothesis of bTBI suggests that some combination of a pressure transient reaching the brain via the thorax and a vagally mediated reflex result in bTBI. These three mechanisms may not be mutually exclusive, and quantifying exposure thresholds (for blasts of a given duration is essential for determining which mechanisms may be contributing for a level of blast exposure. Progress has been hindered by experimental designs which do not effectively expose animal models to a single mechanism and by over-reliance on poorly validated computational models. The path forward should be predictive validation of computational models by quantitative confirmation with blast experiments in animal models, human cadavers, and biofidelic human surrogates over a range of relevant blast magnitudes and durations coupled with experimental designs which isolate a single injury mechanism.

  18. From the battlefield to the laboratory: the use of clinical data analysis in developing models of lower limb blast injury.

    Science.gov (United States)

    Ramasamy, Arul; Newell, N; Masouros, S

    2014-06-01

    A key weapon in the insurgents' armamentarium against coalition and local security forces in Iraq and Afghanistan has been the use of anti-vehicle mines and improvised explosive devices (IEDs). Often directed against vehicle-borne troops, these devices, once detonated, transfer considerable amounts of energy through the vehicle to the occupants. This results in severe lower limb injuries that are frequently limb threatening. Fundamental to designing novel mitigation strategies is a requirement to understand the injury mechanism by developing appropriate injury modelling tools that are underpinned by the analysis of contemporary battlefield casualty data. This article aims to summarise our understanding of the clinical course of lower limb blast injuries from IEDs and its value in developing unique injury modelling test-beds to evaluate and produce the next generation of protective equipment for reducing the devastating effects of blast injury.

  19. The soft tissue landmarks to avoid injury to the facial artery during filler and neurotoxin injection at the nasolabial region.

    Science.gov (United States)

    Phumyoo, Thirawass; Tansatit, Tanvaa; Rachkeaw, Natthida

    2014-09-01

    The aim of this study was to locate the course of the facial artery and to propose "the danger line" vulnerable to vascular complications following filler injection. The entire facial soft tissues were harvested from 14 Thai soft embalmed cadavers as a facial flap specimen. Measurements of the distance, the depth, and the diameter of the facial artery were done at level of the oral commissure and the nasal ala. The distance between the facial artery and the oral commissure was 15.3 ± 3.7 mm and the depth from the skin was 11.1 ± 3.1 mm. The distance between the facial artery and the nasal ala was 6.7 ± 4.4 mm and the depth was 11.6 ± 3.7 mm. The diameters of the facial artery at level of the oral commissure and the nasal ala were 2.6 ± 0.8 and 1.9 ± 0.5 mm, respectively. Maximum risk of arterial complication from dermal filler injection lateral to the oral commissure is located approximately 15 mm at the depth of 11 mm. High risk of arterial injury at the lateral nasal ala is located at 7 mm with the depth of 12 mm.

  20. The nature of white matter abnormalities in blast-related mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Jasmeet P. Hayes

    2015-01-01

    Full Text Available Blast-related traumatic brain injury (TBI has been a common injury among returning troops due to the widespread use of improvised explosive devices in the Iraq and Afghanistan Wars. As most of the TBIs sustained are in the mild range, brain changes may not be detected by standard clinical imaging techniques such as CT. Furthermore, the functional significance of these types of injuries is currently being debated. However, accumulating evidence suggests that diffusion tensor imaging (DTI is sensitive to subtle white matter abnormalities and may be especially useful in detecting mild TBI (mTBI. The primary aim of this study was to use DTI to characterize the nature of white matter abnormalities following blast-related mTBI, and in particular, examine the extent to which mTBI-related white matter abnormalities are region-specific or spatially heterogeneous. In addition, we examined whether mTBI with loss of consciousness (LOC was associated with more extensive white matter abnormality than mTBI without LOC, as well as the potential moderating effect of number of blast exposures. A second aim was to examine the relationship between white matter integrity and neurocognitive function. Finally, a third aim was to examine the contribution of PTSD symptom severity to observed white matter alterations. One hundred fourteen OEF/OIF veterans underwent DTI and neuropsychological examination and were divided into three groups including a control group, blast-related mTBI without LOC (mTBI - LOC group, and blast-related mTBI with LOC (mTBI + LOC group. Hierarchical regression models were used to examine the extent to which mTBI and PTSD predicted white matter abnormalities using two approaches: 1 a region-specific analysis and 2 a measure of spatial heterogeneity. Neurocognitive composite scores were calculated for executive functions, attention, memory, and psychomotor speed. Results showed that blast-related mTBI + LOC was associated with greater odds of

  1. Pathological Fingerprints, Systems Biology and Biomarkers of Blast Brain Injury

    Science.gov (United States)

    2010-06-01

    895–920. King, N.S. (2008). PTSD and traumatic brain injury: folklore and fact? Brain Inj. 22, 1–5. Kleindienst, A., Hesse , F., Bullock, M.R., and...to traumatic brain injury in nonhuman primates. J. Trauma 62, 199–206. Vinores, S.A., Herman , M.M., Rubinstein, L.J., and Marangos, P.J. (1984...trauma in children. Neurology. 2009;72:609–616. 23. Vinores SA, Herman MM, Rubinstein LJ, Marangos PJ. Electron mi- croscopic localization of neuron

  2. Manganese-Enhanced Magnetic Resonance Imaging as a Diagnostic and Dispositional Tool after Mild-Moderate Blast Traumatic Brain Injury.

    Science.gov (United States)

    Rodriguez, Olga; Schaefer, Michele L; Wester, Brock; Lee, Yi-Chien; Boggs, Nathan; Conner, Howard A; Merkle, Andrew C; Fricke, Stanley T; Albanese, Chris; Koliatsos, Vassilis E

    2016-04-01

    Traumatic brain injury (TBI) caused by explosive munitions, known as blast TBI, is the signature injury in recent military conflicts in Iraq and Afghanistan. Diagnostic evaluation of TBI, including blast TBI, is based on clinical history, symptoms, and neuropsychological testing, all of which can result in misdiagnosis or underdiagnosis of this condition, particularly in the case of TBI of mild-to-moderate severity. Prognosis is currently determined by TBI severity, recurrence, and type of pathology, and also may be influenced by promptness of clinical intervention when more effective treatments become available. An important task is prevention of repetitive TBI, particularly when the patient is still symptomatic. For these reasons, the establishment of quantitative biological markers can serve to improve diagnosis and preventative or therapeutic management. In this study, we used a shock-tube model of blast TBI to determine whether manganese-enhanced magnetic resonance imaging (MEMRI) can serve as a tool to accurately and quantitatively diagnose mild-to-moderate blast TBI. Mice were subjected to a 30 psig blast and administered a single dose of MnCl2 intraperitoneally. Longitudinal T1-magnetic resonance imaging (MRI) performed at 6, 24, 48, and 72 h and at 14 and 28 days revealed a marked signal enhancement in the brain of mice exposed to blast, compared with sham controls, at nearly all time-points. Interestingly, when mice were protected with a polycarbonate body shield during blast exposure, the marked increase in contrast was prevented. We conclude that manganese uptake can serve as a quantitative biomarker for TBI and that MEMRI is a minimally-invasive quantitative approach that can aid in the accurate diagnosis and management of blast TBI. In addition, the prevention of the increased uptake of manganese by body protection strongly suggests that the exposure of an individual to blast risk could benefit from the design of improved body armor.

  3. Accidental hand grenade blast injuries in the Transkei region of ...

    African Journals Online (AJOL)

    Six of the eight children died instantly, while the other two sustained minor injuries. The M26 ... 50% casualty radius of 15 m; however, the fragments can disperse to ... They had perhaps been bending on one knee at the time of the explosion.

  4. Microcavitation as a Neuronal Damage Mechanism in Blast Traumatic Brain Injury

    Science.gov (United States)

    Franck, Christian; Estrada, Jonathan

    2015-11-01

    Blast traumatic brain injury (bTBI) is a leading cause of injury in the armed forces. Diffuse axonal injury, the hallmark feature of blunt TBI, has been investigated in direct mechanical loading conditions. However, recent evidence suggests inertial cavitation as a possible bTBI mechanism, particularly in the case of exposure to blasts. Cavitation damage to free surfaces has been well-studied, but bubble interactions within confined 3D environments, in particular their stress and strain signatures are not well understood. The structural damage due to cavitation in living tissues - particularly at the cellular level - are incompletely understood, in part due to the rapid bubble formation and deformation strain rates of up to ~ 105-106 s-1. This project aims to characterize material damage in 2D and 3D cell culture environments by utilizing a novel high-speed red-blue diffraction assisted image correlation method at speeds of up to 106 frames per second. We gratefully acknowledge funding from the Office of Naval Research (POC: Dr. Tim Bentley).

  5. Neurotransmitter Systems in a Mild Blast Traumatic Brain Injury Model: Catecholamines and Serotonin.

    Science.gov (United States)

    Kawa, Lizan; Arborelius, Ulf P; Yoshitake, Takashi; Kehr, Jan; Hökfelt, Tomas; Risling, Mårten; Agoston, Denes

    2015-08-15

    Exposure to improvised explosive devices can result in a unique form of traumatic brain injury--blast-induced traumatic brain injury (bTBI). At the mild end of the spectrum (mild bTBI [mbTBI]), there are cognitive and mood disturbances. Similar symptoms have been observed in post-traumatic stress disorder caused by exposure to extreme psychological stress without physical injury. A role of the monoaminergic system in mood regulation and stress is well established but its involvement in mbTBI is not well understood. To address this gap, we used a rodent model of mbTBI and detected a decrease in immobility behavior in the forced swim test at 1 d post-exposure, coupled with an increase in climbing behavior, but not after 14 d or later, possibly indicating a transient increase in anxiety-like behavior. Using in situ hybridization, we found elevated messenger ribonucleic acid levels of both tyrosine hydroxylase and tryptophan hydroxylase 2 in the locus coeruleus and the dorsal raphe nucleus, respectively, as early as 2 h post-exposure. High-performance liquid chromatography analysis 1 d post-exposure primarily showed elevated noradrenaline levels in several forebrain regions. Taken together, we report that exposure to mild blast results in transient changes in both anxiety-like behavior and brain region-specific molecular changes, implicating the monoaminergic system in the pathobiology of mbTBI.

  6. Molecular mechanisms of increased cerebral vulnerability after repeated mild blast-induced traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Alaa Kamnaksh

    2014-06-01

    Full Text Available The consequences of a mild traumatic brain injury can be especially severe if it is repeated within the period of increased cerebral vulnerability (ICV that follows the initial insult. To better understand the molecular mechanisms that contribute to ICV, we exposed rats to different levels of mild blast overpressure (5 exposures; total pressure range: 15.54–19.41 psi or 107.14–133.83 kPa at a rate of 1 per 30 min, monitored select physiological parameters, and assessed behavior. Two days post-injury or sham, we determined changes in protein biomarkers related to various pathologies in behaviorally relevant brain regions and in plasma. We found that oxygen saturation and heart rate were transiently depressed following mild blast exposure and that injured rats exhibited significantly increased anxiety- and depression-related behaviors. Proteomic analyses of the selected brain regions showed evidence of substantial oxidative stress and vascular changes, altered cell adhesion, and inflammation predominantly in the prefrontal cortex. Importantly, these pathological changes as well as indications of neuronal and glial cell loss/damage were also detected in the plasma of injured rats. Our findings illustrate some of the complex molecular changes that contribute to the period of ICV in repeated mild blast-induced traumatic brain injury. Further studies are needed to determine the functional and temporal relationship between the various pathomechanisms. The validation of these and other markers can help to diagnose individuals with ICV using a minimally invasive procedure and to develop evidence-based treatments for chronic neuropsychiatric conditions.

  7. Blast Injury: Translating Research Into Operational Medicine (Preprint)

    Science.gov (United States)

    2008-05-20

    JA. Cell damage by lithotripter shock waves at high pressure to preclude cavitation . Ultrasound Med Biol. 1999;25(9):1445–1449. 101. Cernak I, Savic...cellular injury, there is also evidence of cellular damage from direct pressure effects. Cavitation , which has been shown to occur at moderate head...lithotripsy studies.100 Depolymerization of spindle microtubules has been observed at very high static pressures (680 atm) and in ultrasound expo sures

  8. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    Directory of Open Access Journals (Sweden)

    Yeliz Guven

    2015-01-01

    Full Text Available The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

  9. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries.

    Science.gov (United States)

    Guven, Yeliz; Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

  10. Blast-Associated Shock Waves Result in Increased Brain Vascular Leakage and Elevated ROS Levels in a Rat Model of Traumatic Brain Injury.

    Directory of Open Access Journals (Sweden)

    Shushi Kabu

    Full Text Available Blast-associated shock wave-induced traumatic brain injury (bTBI remains a persistent risk for armed forces worldwide, yet its detailed pathophysiology remains to be fully investigated. In this study, we have designed and characterized a laboratory-scale shock tube to develop a rodent model of bTBI. Our blast tube, driven by a mixture of oxygen and acetylene, effectively generates blast overpressures of 20-130 psi, with pressure-time profiles similar to those of free-field blast waves. We tested our shock tube for brain injury response to various blast wave conditions in rats. The results show that blast waves cause diffuse vascular brain damage, as determined using a sensitive optical imaging method based on the fluorescence signal of Evans Blue dye extravasation developed in our laboratory. Vascular leakage increased with increasing blast overpressures and mapping of the brain slices for optical signal intensity indicated nonhomogeneous damage to the cerebral vasculature. We confirmed vascular leakage due to disruption in the blood-brain barrier (BBB integrity following blast exposure. Reactive oxygen species (ROS levels in the brain also increased with increasing blast pressures and with time post-blast wave exposure. Immunohistochemical analysis of the brain sections analyzed at different time points post blast exposure demonstrated astrocytosis and cell apoptosis, confirming sustained neuronal injury response. The main advantages of our shock-tube design are minimal jet effect and no requirement for specialized equipment or facilities, and effectively generate blast-associated shock waves that are relevant to battle-field conditions. Overall data suggest that increased oxidative stress and BBB disruption could be the crucial factors in the propagation and spread of neuronal degeneration following blast injury. Further studies are required to determine the interplay between increased ROS activity and BBB disruption to develop effective

  11. An open air research study of blast-induced traumatic brain injury to goats

    Institute of Scientific and Technical Information of China (English)

    Hui-Jun Chen; Chuan Xu; Yue Li; Zhi-Qiang Chen; Guan-Hua Li; Zhao-Xia Duan; Xiao-Xia Li

    2015-01-01

    Purpose:We once reported blast-induced traumatic brain injury (bTBI) in confined space.Here,bTBI was studied again on goats in the open air using 3.0 kg trinitrotoluene.Methods:The goats were placed at 2,4,6 and 8 m far from explosion center.Trinitrotoluene (TNT) was used as the source of the blast wave and the pressure at each distance was recorded.The systemic physiology,electroencephalogram,serum level of S-100beta,and neuron specific enolase (NSE) were determined pre and post the exposure.Neuroanatomy and neuropathology were observed 4 h after the exposure.Results:Simple blast waveforms were recorded with parameters of 702.8 kPa-0,442 ms,148.4 kPa-2.503 ms,73.9 kPa-3.233 ms,and 41.9 kPa-5.898 ms at 2,4,6 and 8 m respectively.Encephalic blast overpressure was on the first time recorded in the literature by us at 104.2 kPa-0.60 ms at 2 m,where mortality and burn rate were 44% and 44%.Gross examination showed that bTBI was mainly manifested as congestive expansion of blood vessels and subarachnoid hemorrhage,which had a total incidence of 25% and 19% in 36 goats.Microscopical observation found that the main pathohistological changes were enlarged perivascular space (21/36,58%),small hemorrhages (9/36,25%),vascular dilatation and congestion (8/36,22%),and less subarachnoid hemorrhage (2/36,6%).After explosion,serum levels of S100β and NSE were elevated,and EEG changed into slow frequency with declined amplitude.The results indicated that severity and incidence of bTBI is related to the intensity of blast overpressure.Conclusion:Blast wave can pass through the skull to directly injure brain tissue.

  12. Investigation of cavitation as a possible damage mechanism in blast-induced traumatic brain injury.

    Science.gov (United States)

    Goeller, Jacques; Wardlaw, Andrew; Treichler, Derrick; O'Bruba, Joseph; Weiss, Greg

    2012-07-01

    Cavitation was investigated as a possible damage mechanism for war-related traumatic brain injury (TBI) due to an improvised explosive device (IED) blast. When a frontal blast wave encounters the head, a shock wave is transmitted through the skull, cerebrospinal fluid (CSF), and tissue, causing negative pressure at the contrecoup that may result in cavitation. Numerical simulations and shock tube experiments were conducted to determine the possibility of cranial cavitation from realistic IED non-impact blast loading. Simplified surrogate models of the head consisted of a transparent polycarbonate ellipsoid. The first series of tests in the 18-inch-diameter shock tube were conducted on an ellipsoid filled with degassed water to simulate CSF and tissue. In the second series, Sylgard gel, surrounded by a layer of degassed water, was used to represent the tissue and CSF, respectively. Simulated blast overpressure in the shock tube tests ranged from a nominal 10-25 pounds per square inch gauge (psig; 69-170 kPa). Pressure in the simulated CSF was determined by Kulite thin line pressure sensors at the coup, center, and contrecoup positions. Using video taken at 10,000 frames/sec, we verified the presence of cavitation bubbles at the contrecoup in both ellipsoid models. In all tests, cavitation at the contrecoup was observed to coincide temporally with periods of negative pressure. Collapse of the cavitation bubbles caused by the surrounding pressure and elastic rebound of the skull resulted in significant pressure spikes in the simulated CSF. Numerical simulations using the DYSMAS hydrocode to predict onset of cavitation and pressure spikes during cavity collapse were in good agreement with the tests. The numerical simulations and experiments indicate that skull deformation is a significant factor causing cavitation. These results suggest that cavitation may be a damage mechanism contributing to TBI that requires future study.

  13. Acute Blast Injury Reduces Brain Abeta in Two Rodent Species

    Science.gov (United States)

    2012-12-01

    De Gasperi 1,2,3, Miguel A. Gama Sosa1,2,3, Soong Ho Kim4, John W. Steele4,5, Michael C. Shaughness6, Eric Maudlin-Jeronimo6, Aaron A. Hall 6...Wetzlar, Ger- many). Immunohistochemical staining was performed as previ- ously described ( Gama Sosa et al., 2010) using a rabbit anti-APP antibody APP369...Traumatic brain injury: football, warfare, and long- term effects. N. Engl. J. Med. 363, 1293–1296. Elder, G. A., Dorr, N. P., De Gasperi, R., Gama Sosa, M. A

  14. Modeling and simulation of blast-induced, early-time intracranial wave physics leading to traumatic brain injury.

    Energy Technology Data Exchange (ETDEWEB)

    Ford, Corey C. (University of New Mexico, Albuquerque, NM); Taylor, Paul Allen

    2008-02-01

    The objective of this modeling and simulation study was to establish the role of stress wave interactions in the genesis of traumatic brain injury (TBI) from exposure to explosive blast. A high resolution (1 mm{sup 3} voxels), 5 material model of the human head was created by segmentation of color cryosections from the Visible Human Female dataset. Tissue material properties were assigned from literature values. The model was inserted into the shock physics wave code, CTH, and subjected to a simulated blast wave of 1.3 MPa (13 bars) peak pressure from anterior, posterior and lateral directions. Three dimensional plots of maximum pressure, volumetric tension, and deviatoric (shear) stress demonstrated significant differences related to the incident blast geometry. In particular, the calculations revealed focal brain regions of elevated pressure and deviatoric (shear) stress within the first 2 milliseconds of blast exposure. Calculated maximum levels of 15 KPa deviatoric, 3.3 MPa pressure, and 0.8 MPa volumetric tension were observed before the onset of significant head accelerations. Over a 2 msec time course, the head model moved only 1 mm in response to the blast loading. Doubling the blast strength changed the resulting intracranial stress magnitudes but not their distribution. We conclude that stress localization, due to early time wave interactions, may contribute to the development of multifocal axonal injury underlying TBI. We propose that a contribution to traumatic brain injury from blast exposure, and most likely blunt impact, can occur on a time scale shorter than previous model predictions and before the onset of linear or rotational accelerations traditionally associated with the development of TBI.

  15. High-speed imaging and small-scale explosive characterization techniques to understand effects of primary blast-induced injury on nerve cell structure and function

    Science.gov (United States)

    Piehler, T.; Banton, R.; Zander, N.; Duckworth, J.; Benjamin, R.; Sparks, R.

    2017-08-01

    Traumatic brain injury (TBI) is often associated with blast exposure. Even in the absence of penetrating injury or evidence of tissue injury on imaging, blast TBI may trigger a series of neural/glial cellular and functional changes. Unfortunately, the diagnosis and proper treatment of mild traumatic brain injury (mTBI) caused by explosive blast is challenging, as it is not easy to clinically distinguish blast from non-blast TBI on the basis of patient symptoms. Damage to brain tissue, cell, and subcellular structures continues to occur slowly and in a manner undetectable by conventional imaging techniques. The threshold shock impulse levels required to induce damage and the cumulative effects upon multiple exposures are not well characterized. Understanding how functional and structural damage from realistic blast impact at cellular and tissue levels at variable timescales after mTBI events may be vital for understanding this injury phenomenon and for linking mechanically induced structural changes with measurable effects on the nervous system. Our working hypothesis is that there is some transient physiological dysfunction occurring at cellular and subcellular levels within the central nervous system due to primary blast exposure. We have developed a novel in vitro indoor experimental system that uses real military explosive charges to more accurately represent military blast exposure and to probe the effects of primary explosive blast on dissociated neurons. We believe this system offers a controlled experimental method to analyze and characterize primary explosive blast-induced cellular injury and to understand threshold injury phenomenon. This paper will also focus on the modeling aspect of our work and how it relates to the experimental work.

  16. High prevalence of chronic pituitary and target-organ hormone abnormalities after blast-related mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Charles W. Wilkinson

    2012-02-01

    Full Text Available Studies of traumatic brain injury from all causes have found evidence of chronic hypopituitarism, defined by deficient production of one or more pituitary hormones at least one year after injury, in 25-50% of cases. Most studies found the occurrence of posttraumatic hypopituitarism (PTHP to be unrelated to injury severity. Growth hormone deficiency (GHD and hypogonadism were reported most frequently. Hypopituitarism, and in particular adult GHD, is associated with symptoms that resemble those of PTSD, including fatigue, anxiety, depression, irritability, insomnia, sexual dysfunction, cognitive deficiencies, and decreased quality of life. However, the prevalence of PTHP after blast-related mild TBI (mTBI, an extremely common injury in modern military operations, has not been characterized. We measured concentrations of 12 pituitary and target-organ hormones in two groups of male US Veterans of combat in Iraq or Afghanistan. One group consisted of participants with blast-related mTBI whose last blast exposure was at least one year prior to the study. The other consisted of Veterans with similar military deployment histories but without blast exposure. Eleven of 26, or 42% of participants with blast concussions were found to have abnormal hormone levels in one or more pituitary axes, a prevalence similar to that found in other forms of TBI. Five members of the mTBI group were found with markedly low age-adjusted insulin-like growth factor-I (IGF-I levels indicative of probable GHD, and three had testosterone and gonadotropin concentrations consistent with hypogonadism. If symptoms characteristic of both PTHP and PTSD can be linked to pituitary dysfunction, they may be amenable to treatment with hormone replacement. Routine screening for chronic hypopituitarism after blast concussion shows promise for appropriately directing diagnostic and therapeutic decisions that otherwise may remain unconsidered and for markedly facilitating recovery and

  17. The design of a modified lower limb impactor to assess lower limb injury at typical blast loading rates

    CSIR Research Space (South Africa)

    Pandelani, T

    2014-01-01

    Full Text Available in either amputation or long term physical impairment [1]. The injury to the lower extremity is predominantly as a result of direct load transmission from the deforming vehicle floor which is subjected to the blast load [2]. To quantify the effect of high...

  18. Assessment of oral side effects of Antiepileptic drugs and traumatic oro-facial injuries encountered in Epileptic children.

    Science.gov (United States)

    Ghafoor, P A Fazal; Rafeeq, Mohammed; Dubey, Alok

    2014-04-01

    Epilepsy is a chronic disorder with unpredictably recurring seizure. Uncontrolled attacks can put patients at risk of suffering oro-facial trauma. Antiepileptic drugs (AED) provide satisfactory control of seizures in most of the patients with epilepsy. However use of AED has been found to cause many side effects inclusive of side effects in the oral cavity also. This study was conducted on 150 epileptic children, who were on anti epileptic medication for one year. Gingival over growth was seen as common side effect of the AED drugs. Lip and cheek biting were the most common soft tissue injury, while tooth fracture was the most common hard tissue dental injury. General physicians, physicians & dentists should be well aware of the potential side effects of AED. A Dentist should be well versed and trained to manage oro-facial injuries in the emergency department. How to cite the article: Ghafoor PA, Rafeeq M, Dubey A. Assessment of oral side effects of Antiepileptic drugs and traumaticoro-facial injuries encountered in Epileptic children. J Int Oral Health 2014;6(2):126-8.

  19. Comparison of trophic factors' expression between paralyzed and recovering muscles after facial nerve injury. A quantitative analysis in time course.

    Science.gov (United States)

    Grosheva, Maria; Nohroudi, Klaus; Schwarz, Alisa; Rink, Svenja; Bendella, Habib; Sarikcioglu, Levent; Klimaschewski, Lars; Gordon, Tessa; Angelov, Doychin N

    2016-05-01

    After peripheral nerve injury, recovery of motor performance negatively correlates with the poly-innervation of neuromuscular junctions (NMJ) due to excessive sprouting of the terminal Schwann cells. Denervated muscles produce short-range diffusible sprouting stimuli, of which some are neurotrophic factors. Based on recent data that vibrissal whisking is restored perfectly during facial nerve regeneration in blind rats from the Sprague Dawley (SD)/RCS strain, we compared the expression of brain derived neurotrophic factor (BDNF), fibroblast growth factor-2 (FGF2), insulin growth factors 1 and 2 (IGF1, IGF2) and nerve growth factor (NGF) between SD/RCS and SD-rats with normal vision but poor recovery of whisking function after facial nerve injury. To establish which trophic factors might be responsible for proper NMJ-reinnervation, the transected facial nerve was surgically repaired (facial-facial anastomosis, FFA) for subsequent analysis of mRNA and proteins expressed in the levator labii superioris muscle. A complicated time course of expression included (1) a late rise in BDNF protein that followed earlier elevated gene expression, (2) an early increase in FGF2 and IGF2 protein after 2 days with sustained gene expression, (3) reduced IGF1 protein at 28 days coincident with decline of raised mRNA levels to baseline, and (4) reduced NGF protein between 2 and 14 days with maintained gene expression found in blind rats but not the rats with normal vision. These findings suggest that recovery of motor function after peripheral nerve injury is due, at least in part, to a complex regulation of lesion-associated neurotrophic factors and cytokines in denervated muscles. The increase of FGF-2 protein and concomittant decrease of NGF (with no significant changes in BDNF or IGF levels) during the first week following FFA in SD/RCS blind rats possibly prevents the distal branching of regenerating axons resulting in reduced poly-innervation of motor endplates.

  20. Determination of common pathogenic bacteria of blast injury to the limbs in plateau area and related research

    Directory of Open Access Journals (Sweden)

    Zheng-lei WANG

    2015-11-01

    Full Text Available Objective To investigate the common pathogenic bacteria and their drug susceptibility in the wounds in the limbs as a result of blast injury in plateau with a low temperature so as to provide a basis for prevention and treatment of war wound infection in such area. Methods The model of blast injury was reproduced to the hind legs of 800 rabbits in cold and dry plateau. 1, 3, 6, 12, 24, 48, 72 and 96h after injury, the general condition and vital signs of the wounded were observed, and bacterial culture, flora analysis and drug susceptibility test of excretion from wound tract, air, surface of snow, soil and animal fur were performed. Results Micrococciand Bacilliwere found in air and snow. Bacillus subtilis, Escherichia coliand Pseudomonas aeruginosawere found in soil, and Staphylococcus aureus, Acinetobacters, Pseudomonas aeruginosaand Escherichia coliin rabbit fur. The respiration and pulse became faster, and body temperature lowered after injury compared with that before injury. G+ bacteria were found in most wound tract secretions, and the frequency of the bacterial strains in descending order were Bacillus subtilis, coagulase-negative Staphylococci, E. coli, Pseudomonas aeruginosa, Stenotrophomonas maltophiliastrains. The sensitive antibiotics for these G+ bacteria were ofloxacin, ciprofloxacin, erythromycin. Susceptible G– bacteria were susceptible to ceftazidime, minocycline, sulfamethoxazole etc. Conclusions The growth of bacteria in the wounds as a result of blast injury grow slower in cold and dry alpine area. The time of debridement may be delayed for 2-3h. G+ bacteria were main susceptible flora to antibiotics, and it is related to the bacterial flora of the surrounding environment, thus it is suggested that a combination of different antibiotics (ofloxacin, ciprofloxacin or erythromycin alone combined with ceftazidime, minocycline or cotrimoxazole alone are needed to prevent infection after blast injury. DOI: 10.11855/j

  1. Characteristics and mechanisms of cardiopulmonary injury caused by mine blasts in shoals: a randomized controlled study in a rabbit model.

    Directory of Open Access Journals (Sweden)

    Gengfen Han

    Full Text Available BACKGROUND: Because the characteristics of blast waves in water are different from those in air and because kinetic energy is liberated by a pressure wave at the water-air interface, thoracic injuries from mine blasts in shoals may be serious. The aim of the present study was to investigate the characteristics and mechanisms of cardiopulmonary injury caused by mine blasts in shoals. METHODS: To study the characteristics of cardiopulmonary injury, 56 animals were divided randomly into three experimental groups (12 animals in the sham group, 22 animals in the land group and 22 animals in the shoal group. To examine the biomechanics of injury, 20 animals were divided randomly into the land group and the shoal group. In the experimental model, the water surface was at the level of the rabbit's xiphoid process, and paper electric detonators (600 mg RDX were used to simulate mines. Electrocardiography and echocardiography were conducted, and arterial blood gases, serum levels of cardiac troponin I and creatine kinase-MB and other physiologic parameters were measured over a 12-hour period after detonation. Pressures in the thorax and abdomen and the acceleration of the thorax were measured. CONCLUSION: The results indicate that severe cardiopulmonary injury and dysfunction occur following exposure to mine blasts in shoals. Therefore, the mechanisms of cardiopulmonary injury may result from shear waves that produce strain at the water-air interface. Another mechanism of injury includes the propagation of the shock wave from the planta to the thorax, which causes a much higher peak overpressure in the abdomen than in the thorax; as a result, the abdominal organs and diaphragm are thrust into the thorax, damaging the lungs and heart.

  2. [Characteristics and Treatment Strategies for Penetrating Injuries on the Example of Gunshot and Blast Victims without Ballistic Body Armour in Afghanistan (2009 - 2013)].

    Science.gov (United States)

    Güsgen, Christoph; Willms, Arnulf; Richardsen, Ines; Bieler, Dan; Kollig, Erwin; Schwab, Robert

    2017-08-01

    Much like other countries, Germany has recently seen terrorist attacks being planned, executed or prevented at the last minute. This highlights the need for expertise in the treatment of penetrating torso traumas by bullets or explosions. Data on the treatment of firearm injuries and, even more so, blast injuries often stems from crises or war regions. However, it is difficult to compare injuries from such regions with injuries from civilian terrorist attacks due to the ballistic body protection (protective vests, body armour) worn by soldiers. Methods An analysis was performed based on data from patients who were treated in the German Military Hospital Mazar-e Sharif for gunshots or injuries from explosions in the years 2009 to 2013. The data selection was based on patients with penetrating injuries to the thorax and/or abdomen. For better comparability with civilian attack scenarios, this study only included civilian patients without ballistic body protection (body armour, protective vests). Results Out of 117 analysed patients, 58 were affected by firearms and 59 by explosive injuries of the thorax or abdomen. 60% of patients had a thoracic injury, 69% had an abdominal injury, and 25.6% had combined thoracic-abdominal injuries. Blast injury patients were significantly more affected by thoracic trauma. As regards abdominal injuries, liver, intestinal, and colonic lesions were leading in number. Patients with blast injuries had significantly more injured organs and a significantly higher ISS averaging 29. 26% of the shot patients and 41% of the blast wounded patients received Damage Control Surgery (DCS). Despite a lower ISS, gunshot victims did not have a lower total number of operations per patient. Overall mortality was 13.7% (10.3% gunshot wounds, 16.7% blast injury). The highest mortality rate (25.7%) was recorded for patients with combined thoracoabdominal injuries (vs. 8.3% for thoracic and 8.7% for abdominal injuries). The ISS of deceased patients was

  3. A Novel Preclinical Model of Moderate Primary Blast-Induced Traumatic Brain Injury.

    Science.gov (United States)

    Divani, Afshin A; Murphy, Amanda J; Meints, Joyce; Sadeghi-Bazargani, Homayoun; Nordberg, Jessica; Monga, Manoj; Low, Walter C; Bhatia, Prerana M; Beilman, Greg J; SantaCruz, Karen S

    2015-07-15

    Blast-induced traumatic brain injury (bTBI) is the "signature" injury of the recent Iraq and Afghanistan wars. Here, we present a novel method to induce bTBI using shock wave (SW) lithotripsy. Using a lithotripsy machine, Wistar rats (N = 70; 408.3 ± 93 g) received five SW pulses to the right side of the frontal cortex at 24 kV and a frequency of 60 Hz. Animals were then randomly divided into three study endpoints: 24 h (n = 25), 72 h (n = 19) and 168 h (n = 26). Neurological and behavioral assessments (Garcia's test, beam walking, Rotarod, and elevated plus maze) were performed at the baseline, and further assessments followed at 3, 6, 24, 72, and 168 h post-injury, if applicable. We performed digital subtraction angiography (DSA) to assess presence of cerebral vasospasm due to induced bTBI. Damage to brain tissue was assessed by an overall histological severity (OHS) score based on depth of injury, area of hemorrhage, and extent of axonal injury. Except for beam walking, OHS was significantly correlated with the other three outcome measures with at least one of their assessments during the first 6 h after the experiment. OHS manifested the highest absolute correlation coefficients with anxiety at the baseline and 6 h post-injury (r(baseline) = -0.75, r(6hrs) = 0.85; p<0.05). Median hemispheric differences for contrast peak values (obtained from DSA studies) for 24, 72, and 168 h endpoints were 3.45%, 3.05% and 0.2%, respectively, with statistically significant differences at 1 versus 7 d (p<0.05) and 3 versus 7 d (p<0.01). In this study, we successfully established a preclinical rat model of bTBI with characteristics similar to those observed in clinical cases. This new method may be useful for future investigations aimed at understanding bTBI pathophysiology.

  4. An introductory characterization of a combat-casualty-care relevant swine model of closed head injury resulting from exposure to explosive blast.

    Science.gov (United States)

    Bauman, Richard A; Ling, Geoffrey; Tong, Lawrence; Januszkiewicz, Adolph; Agoston, Dennis; Delanerolle, Nihal; Kim, Young; Ritzel, Dave; Bell, Randy; Ecklund, James; Armonda, Rocco; Bandak, Faris; Parks, Steven

    2009-06-01

    Explosive blast has been extensively used as a tactical weapon in Operation Iraqi Freedom (OIF) and more recently in Operation Enduring Freedom(OEF). The polytraumatic nature of blast injuries is evidence of their effectiveness,and brain injury is a frequent and debilitating form of this trauma. In-theater clinical observations of brain-injured casualties have shown that edema, intracranial hemorrhage, and vasospasm are the most salient pathophysiological characteristics of blast injury to the brain. Unfortunately, little is known about exactly how an explosion produces these sequelae as well as others that are less well documented. Consequently, the principal objective of the current report is to present a swine model of explosive blast injury to the brain. This model was developed during Phase I of the DARPA (Defense Advanced Research Projects Agency) PREVENT (Preventing Violent Explosive Neurotrauma) blast research program. A second objective is to present data that illustrate the capabilities of this model to study the proximal biomechanical causes and the resulting pathophysiological, biochemical,neuropathological, and neurological consequences of explosive blast injury to the swine brain. In the concluding section of this article, the advantages and limitations of the model are considered, explosive and air-overpressure models are compared, and the physical properties of an explosion are identified that potentially contributed to the in-theater closed head injuries resulting from explosions of improvised explosive devices (IEDs).

  5. Development of a new biomechanical indicator for primary blast-induced brain injury

    Institute of Scientific and Technical Information of China (English)

    Feng Zhu; Cliff C.Chou; King H.Yang; Albert I.King

    2015-01-01

    Primary blast-induced traumatic brain injury (bTBI) has been observed at the boundary of brain tissue and cerebrospinal fluid (CSF).Such injury can hardly be explained by using the theory of compressive wave propagation,since both the solid and fluid materials have similar compressibility and thus the intracranial pressure (ICP) has a continuous distribution across the boundary.Since they have completely different shear properties,it is hypothesized the injury at the interface is caused by shear wave.In the present study,a preliminary combined numerical and theoretical analysis was conducted based on the theory of shear wave propagation]reflection.Simulation results show that higher lateral acceleration of brain tissue particles is concentrated in the boundary region.Based on this finding,a new biomechanical vector,termed as strain gradient,was suggested for primary bTBI.The subsequent simple theoretical analysis reveals that this parameter is proportional to the value of lateral acceleration.At the boundary of lateral ventricles,high spatial strain gradient implies that the brain tissue in this area (where neuron cells may be contained) undergo significantly different strains and large velocity discontinuity,which may result in mechanical damage of the neuron cells.

  6. Propofol Inhibits NLRP3 Inflammasome and Attenuates Blast-Induced Traumatic Brain Injury in Rats.

    Science.gov (United States)

    Ma, Jie; Xiao, Wenjing; Wang, Junrui; Wu, Juan; Ren, Jiandong; Hou, Jun; Gu, Jianwen; Fan, Kaihua; Yu, Botao

    2016-12-01

    Increasing evidence has demonstrated that inflammatory response plays a crucial role in the pathogenesis of secondary injury following blast-induced traumatic brain injury (bTBI). Propofol, a lipid-soluble intravenous anesthetic, has been shown to possess therapeutic benefit during neuroinflammation on various brain injury models. Recent findings have proved that the NOD-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome involved in the process of the inflammatory response following brain trauma, may probably be a promising target in the treatment of bTBI. Rats were randomly divided into six groups (n = 8): normal group; bTBI-12 and 24 h group; bTBI-12 h and bTBI-24 h group treated with propofol; and bTBI treated with control dimethyl sulfoxide (DMSO) group. The effect of propofol on the expression and activation of NLRP3 inflammasome and the degree of oxidative stress and inflammatory cascades, as well as the brain trauma biomarkers were evaluated in rats suffering from bTBI. The enhanced expressions and activation of NLRP3 inflammasome in the cerebral cortex of bTBI rats were substantially suppressed by the administration of propofol, which was paralleled with the decreased oxidative stress, cytokines production, and the amelioration of cerebral cortex damage. Our results have, for the first time, revealed that over-activation of NLRP3 inflammasome in the cerebral cortex may be involved in the process of neuroinflammation during the secondary injury of bTBI in rats. Propofol might relieve the inflammatory response and attenuate brain injury by inhibiting ROS and reluctant depressing NLRP3 inflammasome activation and pro-inflammatory cytokines maturation.

  7. White Matter Abnormalities are Associated with Chronic Postconcussion Symptoms in Blast-Related Mild Traumatic Brain Injury

    Science.gov (United States)

    Miller, Danielle R.; Hayes, Jasmeet P.; Lafleche, Ginette; Salat, David H.; Verfaellie, Mieke

    2016-01-01

    Blast-related mild traumatic brain injury (mTBI) is a common injury among Iraq and Afghanistan military veterans due to the frequent use of improvised explosive devices. A significant minority of individuals with mTBI report chronic postconcussion symptoms (PCS), which include physical, emotional, and cognitive complaints. However, chronic PCS are non-specific and are also associated with mental health disorders such as posttraumatic stress disorder (PTSD). Identifying the mechanisms that contribute to chronic PCS is particularly challenging in blast-related mTBI, where the incidence of co-morbid PTSD is high. In this study, we examined whether blast-related mTBI is associated with diffuse white matter changes, and whether these neural changes are associated with chronic PCS. Ninety Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans were assigned to one of three groups including a blast-exposed no-TBI group, a blast-related mTBI without loss of consciousness (LOC) group (mTBI−LOC), and a blast-related mTBI with LOC group (mTBI+LOC). PCS were measured with the Rivermead Postconcussion Questionnaire. Results showed that participants in the mTBI+LOC group had more spatially heterogeneous white matter abnormalities than those in the no-TBI group. These white matter abnormalities were significantly associated with physical PCS severity even after accounting for PTSD symptoms, but not with cognitive or emotional PCS severity. A mediation analysis revealed that mTBI+LOC significantly influenced physical PCS severity through its effect on white matter integrity. These results suggest that white matter abnormalities are associated with chronic PCS independent of PTSD symptom severity and that these abnormalities are an important mechanism explaining the relationship between mTBI and chronic physical PCS. PMID:26497829

  8. White matter abnormalities are associated with chronic postconcussion symptoms in blast-related mild traumatic brain injury.

    Science.gov (United States)

    Miller, Danielle R; Hayes, Jasmeet P; Lafleche, Ginette; Salat, David H; Verfaellie, Mieke

    2016-01-01

    Blast-related mild traumatic brain injury (mTBI) is a common injury among Iraq and Afghanistan military veterans due to the frequent use of improvised explosive devices. A significant minority of individuals with mTBI report chronic postconcussion symptoms (PCS), which include physical, emotional, and cognitive complaints. However, chronic PCS are nonspecific and are also associated with mental health disorders such as posttraumatic stress disorder (PTSD). Identifying the mechanisms that contribute to chronic PCS is particularly challenging in blast-related mTBI, where the incidence of comorbid PTSD is high. In this study, we examined whether blast-related mTBI is associated with diffuse white matter changes, and whether these neural changes are associated with chronic PCS. Ninety Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans were assigned to one of three groups including a blast-exposed no--TBI group, a blast-related mTBI without loss of consciousness (LOC) group (mTBI--LOC), and a blast-related mTBI with LOC group (mTBI + LOC). PCS were measured with the Rivermead Postconcussion Questionnaire. Results showed that participants in the mTBI + LOC group had more spatially heterogeneous white matter abnormalities than those in the no--TBI group. These white matter abnormalities were significantly associated with physical PCS severity even after accounting for PTSD symptoms, but not with cognitive or emotional PCS severity. A mediation analysis revealed that mTBI + LOC significantly influenced physical PCS severity through its effect on white matter integrity. These results suggest that white matter abnormalities are associated with chronic PCS independent of PTSD symptom severity and that these abnormalities are an important mechanism explaining the relationship between mTBI and chronic physical PCS.

  9. A Novel Closed-head Model of Mild Traumatic Brain Injury Caused by Primary Overpressure Blast to the Cranium Produces Sustained Emotional Deficits in Mice

    Directory of Open Access Journals (Sweden)

    Scott A Heldt

    2014-01-01

    Full Text Available Emotional disorders are a common outcome from mild traumatic brain injury (TBI in humans, but their pathophysiological basis is poorly understood. We have developed a mouse model of closed-head blast injury using an air pressure wave delivered to a small area on one side of the cranium, which we have used to create mild TBI. We found that 20-psi blasts in 3-month old C57BL/6 male mice yielded no obvious behavioral or histological evidence of brain injury, while 25-40 psi blasts produced transient anxiety in an open field arena but little histological evidence of brain damage. By contrast, 50-60 psi blasts resulted in anxiety-like behavior in an open field arena that became more evident with time after blast. In additional behavioral tests conducted 2-8 weeks after blast, 50-60 psi mice also demonstrated increased acoustic startle, perseverance of learned fear, and enhanced contextual fear, as well as depression-like behavior and diminished prepulse inhibition. We found no evident cerebral pathology, however, and only scattered axonal degeneration in brain sections from 50-60 psi mice 3-8 weeks after blast. Thus, the TBI caused by single 50-60 psi blasts in mice exhibits the minimal neuronal loss coupled to diffuse axonal injury characteristic of human mild TBI. A reduction in the abundance of a subpopulation of excitatory projection neurons in basolateral amygdala enriched in Thy1 was, however, observed. The reported link of this neuronal population to fear suppression suggests their damage by mild TBI may contribute to the heightened anxiety and fearfulness observed after blast in our mice. Our overpressure air blast model of concussion in mice will enable further studies of the mechanisms underlying the diverse emotional deficits seen after mild TBI.

  10. Aeromedical evacuation-relevant hypobaria worsens axonal and neurologic injury in rats after underbody blast-induced hyperacceleration.

    Science.gov (United States)

    Proctor, Julie L; Mello, Kaitlin T; Fang, Raymond; Puche, Adam C; Rosenthal, Robert E; Fourney, William L; Leiste, Ulrich H; Fiskum, Gary

    2017-07-01

    Occupants of military vehicles targeted by explosive devices often suffer from traumatic brain injury (TBI) and are typically transported by the aeromedical evacuation (AE) system to a military medical center within a few days. This study tested the hypothesis that exposure of rats to AE-relevant hypobaria worsens cerebral axonal injury and neurologic impairment caused by underbody blasts. Anesthetized adult male rats were secured within cylinders attached to a metal plate, simulating the hull of an armored vehicle. An explosive located under the plate was detonated, resulting in a peak vertical acceleration force on the plate and occupant rats of 100G. Rats remained under normobaria or were exposed to hypobaria equal to 8,000 feet in an altitude chamber for 6 hours, starting at 6 hours to 6 days after blast. At 7 days, rats were tested for vestibulomotor function using the balance beam walking task and euthanized by perfusion. The brains were then analyzed for axonal fiber injury. The number of internal capsule silver-stained axonal fibers was greater in animals exposed to 100G blast than in shams. Animals exposed to hypobaria starting at 6 hours to 6 days after blast exhibited more silver-stained fibers than those not exposed to hypobaria. Rats exposed to 100% oxygen (O2) during hypobaria at 24 hours postblast displayed greater silver staining and more balance beam foot-faults, in comparison with rats exposed to hypobaria under 21% O2. Exposure of rats to blast-induced acceleration of 100G increases cerebral axonal injury, which is significantly exacerbated by exposure to hypobaria as early as 6 hours and as late as 6 days postblast. Rats exposed to underbody blasts and then to hypobaria under 100% O2 exhibit increased axonal damage and impaired motor function compared to those subjected to blast and hypobaria under 21% O2. These findings raise concern about the effects of AE-related hypobaria on TBI victims, the timing of AE after TBI, and whether these effects

  11. Visible and invisible marks: facial injuries suffered by women as the result of acts of domestic violence.

    Science.gov (United States)

    Dourado, Suzana de Magalhães; Noronha, Ceci Vilar

    2015-09-01

    This article focuses on female facial injuries caused by domestic partners in the light of the cultural assumption that the face is the most valued area of the human body. Through a quantitative/qualitative approach, the study aimed to estimate the prevalence of lesions on the face, head and neck of women abused by their partners. The intention is to comprehend the significance, from the victim's standpoint, of the marks originated in the violent episode and investigate issues concerning healthcare in the treatment of injuries. Statistical data were obtained from reports of the Special Police Department for Women in Salvador, Bahia, and the qualitative phase of research consisted of interviews with women who filed such reports. The results showed that, in 63.2% of studied cases, there were injuries to the face and/or head and/or neck of battered women. Speech analysis revealed that facial injuries, especially permanent ones, tend to result in feelings of low self-esteem, shame and humiliation in the victim, causing severe psychological distress. It was revealed that healthcare was limited to the physical aspects of victimization, without the perception of domestic violence as a health problem and the consequent lack of referral of patients to the centers for women in situations of violence.

  12. Combined Effects of Primary and Tertiary Blast on Rat Brain: Characterization of a Model of Blast-induced Mild Traumatic Brain Injury

    Science.gov (United States)

    2013-03-01

    level primary blast injury in rodent brain, Frontiers in Neurology 2 (2011) 19. 24] E. Ryding, M. Lindstrom , L. Traskman-Bendz, The role of dopamine and...Silva, L. F., Magni, D. V., Ferreira, A. P., Oliveira, M. S., Furian, A. F., Mazzardo- Martins , L., Silva, M. D., Santos, A. R., Ferreira, J., Fighera... Martin , E., J. Neuropsychi- atry Clin. Neurosci. 1997, 9, 18–22. [51] Gu, X., Zhang, J., Brann, D. W., Yu, F. S., Invest. Ophthal- mol. Vis. Sci. 2003, 44

  13. Application of a venous conduit as a stent for repairing rabbit facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND:Recently,many investigators have tried to use natural biomaterials,such as,artery,vein,decalcified bone,etc.,as conduits for nerve repair.However,immunological rejection of conduits made of natural biomaterials limits their application.Therefore,it is essential to identify more suitable types of biomaterials.OBJECTIVE:To observe the characteristics of a bioengineering processing method using venous conduit as a stent for repairing facial nerve injury.DESIGN:A controlled observational experiment.SETTING:Animal Laboratories of the Third Hospital Affiliated to Sun Yat-sen University and the 157 Hospital.MATERIALS:Thirty-three male New Zealand rabbits of pure breed,weighing 1.5 to 2.0 kg,were provided by Medical Experimental Animal Room of Sun Yat-sen University.The protocol was carried out in accordance with animal ethics guidelines for the use and care of animals.Venous conduits and autogenous nerves were transplanted into the left and right cheeks,respectively.Eleven animals were chosen for anatomical observations at 5,10 and 15 weeks after surgery.METHODS:This experiment was carried out in the Animal Laboratories of the Third Hospital Affiliated to Sun Yat-sen University and the 157 Hospital between May and November 2006.After animals were anesthetized,15 mm of retromandibular vein was harvested for preparing a venous conduit.Approximately 3 cm of low buccal branch of facial nerve was exposed.A segment of 1.2 cm nerve was resected from the middle,and a gap of 1.5 cm formed due to bilateral retraction.The prepared venous conduit of 1.5 cm was sutured to the outer membrane of the severed ends of the nerve.Muscle and skin were sutured layer by layer.Using the same above-mentioned method,the low buccal branch of right autogenous facial nerve was resected,and the left facial nerve segment from the same animal was transplanted using end-to-end neurorrhaphy for control.MAIN OUTCOME MEASURES:①Post-operatively,food intake,vibrissae activity and wound healing of

  14. Screening of Biochemical and Molecular Mechanisms of Secondary Injury and Repair in the Brain after Experimental Blast-Induced Traumatic Brain Injury in Rats

    Science.gov (United States)

    2013-01-01

    traumatic encephalopathy . We reported on blast induced mild TBI (mTBI) characterized by fiber- tract degeneration and axonal injury revealed by...genes involved in mitochondrial respiration and electron transport (Cox7b, Ndufa11, Uqcrh) as well as hemoglobin alpha and beta chain genes (Hbb...carrier family 3, mitochondrial membrane ATP synthase, Dncic1, Nsf). However, several other transport function-associated genes (Atp6v0c, Sv2b

  15. A multiscale approach to blast neurotrauma modeling: Part I - Development of novel test devices for in vivo and in vitro blast injury models

    Directory of Open Access Journals (Sweden)

    Matthew B Panzer

    2012-03-01

    Full Text Available The loading conditions used in some current in vivo and in vitro blast-induced neurotrauma models may not be representative of real-world blast conditions. To address these limitations, we developed a compressed-gas driven shock tube with different driven lengths that can generate Friedlander-type blasts. The shock tube can generate overpressures up to 650 kPa with durations between 0.3 and 1.1 ms using compressed helium driver gas, and peak overpressures up to 450 kPa with durations between 0.6 and 3 ms using compressed nitrogen. This device is used for short duration blast overpressure loading for small animal in vivo injury models, and contrasts the more frequently used long duration/high impulse blast overpressures in the literature. We also developed a new apparatus that is used with the shock tube to recreate the in vivo intracranial overpressure response for loading in vitro culture preparations. The receiver device surrounds the culture with materials of similar impedance to facilitate the propagation of a single overpressure pulse through the tissue. This method prevents pressure waves reflecting off the tissue that can cause unrealistic deformation and injury. The receiver performance was characterized using the longest helium-driven shock tube, and produced in-fluid overpressures up to 1500 kPa at the location where a culture would be placed. This response was well correlated with the overpressure conditions from the shock tube (R2 = 0.97. Finite element models of the shock tube and receiver were developed and validated to better elucidate the mechanics of this methodology. A demonstration exposing a culture to the loading conditions created by this system suggest tissue strains less than 5% for all pressure levels simulated, which was well below functional deficit thresholds for strain rates less than 50 s-1. This novel system is not limited to a specific type of culture model and can be modified to reproduce more complex pressure

  16. Epidemiological Study of Mild Traumatic Brain Injury Sequelae Caused by Blast Exposure During Operations Iraqi Freedom and Enduring Freedom

    Science.gov (United States)

    2014-11-01

    features, medical and injury characteristics (e.g., TBI classification), psychosocial history (e.g., trauma exposure), and psychiatric variables. A...persistent postconcussive symptoms within a military sample with blast exposure. J Head Trauma Rehabil. 2014 May 6. [Epub ahead of print] ∑ Walker, W...and it’s relation to post-concussion syndrome. J Head Trauma Rehabil. 2013 Jan;28(1):68-76. b. In-Press publications (accepted in peer

  17. Hyperbaric Oxygen Therapy in the Treatment of Chronic Mild-Moderate Blast-Induced Traumatic Brain Injury PCS and PTSD

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-10-1-0962 TITLE: Hyperbaric Oxygen therapy in the Treatment of Chronic Mild-Moderate Blast-Induced Traumatic Brain Injury...Annual 3. DATES COVERED (From – To) 30Sep2014 - 29Sep2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-10-1-0962 Hyperbaric Oxygen therapy in...post- hyperbaric oxygen treatment. Four additional subjects have been screened in October 2015 and nine are awaiting first appointment for

  18. Occurrence of dental avulsion and associated injuries in patients with facial trauma over a 9-year period.

    Science.gov (United States)

    Marchiori, Erica Cristina; Santos, Saulo Ellery; Asprino, Luciana; de Moraes, Márcio; Moreira, Roger William Fernandes

    2013-06-01

    This retrospective study aimed to assess the occurrence of dental avulsions in patients with facial trauma over a 9-year period. Data was collected from records of patients attended to at the Division of Oral and Maxillofacial Surgery at Piracicaba Dental School-State University of Campinas, Piracicaba (SP), Brazil. Two hundred three patients with 387 avulsed teeth were evaluated, the central incisors being the most common teeth involved (42 % of permanent and 61 % of primary teeth). Thirty-four percent of the cases occurred on weekends, mainly on Saturdays (20 %) and the distribution in relation to the time of year was similar with slight peaks in January. The most prevalent associated dentoalveolar injury was lateral luxation (26 %) and 19 % of the patients presented with an associated facial fracture. The most common sign presented was laceration (23 %), and the main symptoms found were pain (58 %). Associated general trauma was present in 139 patients (68 %), and the most prevalent was the upper limb (41 %). Special emphasis should be given not only to diagnosis and treatment of dental avulsion but for prevention, too. An understanding of the etiology, severity, and distribution of associated traumatic injuries can help for future studies and for an effective prevention of these injuries.

  19. Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell’s palsy:a comparative study

    Institute of Scientific and Technical Information of China (English)

    Bin Huang; Zhang-ling Zhou; Li-li Wang; Cong Zuo; Yan Lu; Yong Chen

    2014-01-01

    OBJECTIVE: There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell’s palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell’s palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell’s palsy. METHODS: The facial nerve function of 68 patients with Bell’s palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to ifnd the relationship between electrical response and therapeutic effects or prognosis. RESULTS: Checking consistency between electrical response grading and House-Brackmann scale: Kappa value 0.028 (P = 0.578). Correlation analysis: the two methods were correlated with the prognosis, and electrical response grading (rER= 0.789) was better than the House-Brackmann scale (rHB= 0.423). CONCLUSION: Electrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.

  20. Vitamin D3 potentiates myelination and recovery after facial nerve injury.

    Science.gov (United States)

    Montava, Marion; Garcia, Stéphane; Mancini, Julien; Jammes, Yves; Courageot, Joël; Lavieille, Jean-Pierre; Feron, François

    2015-10-01

    Roles of vitamin D on the immune and nervous systems are increasingly recognized. Two previous studies demonstrated that ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) induced functional recovery and increased myelination in a rat model of peroneal nerve transection. The current report assessed whether cholecalciferol was efficient in repairing transected rabbit facial nerves. Animals were randomized into two groups of rabbits with an unilateral facial nerve surgery: the vitamin D group included animals receiving a weekly oral bolus of vitamin D3 (200 IU/kg/day), from day 1 post-surgery; the control group included animals receiving a weekly oral bolus of vehicle (triglycerides). Contralateral unsectioned facial nerves from all experimental animals were used as controls for the histological study. The facial functional index was measured every week while the inner diameter of myelin sheath and the G ratio were quantified at the end of the 3 month experiment. The current report indicates that cholecalciferol significantly increases functional recovery and myelination, after 12 weeks of treatment. To the best of our knowledge, this is the first study investigating the therapeutic benefit of vitamin D supplementation in an animal model of facial paralysis. It paves further the way for clinical trials based on the administration of this steroid in individuals with injured facial nerves.

  1. A Systems Science Approach to Understanding Polytrauma and Blast-Related Injury: Bayesian Network Model of Data From a Survey of the Florida National Guard.

    Science.gov (United States)

    Toyinbo, Peter A; Vanderploeg, Rodney D; Belanger, Heather G; Spehar, Andrea M; Lapcevic, William A; Scott, Steven G

    2017-01-15

    We sought to further define the epidemiology of the complex, multiple injuries collectively known as polytrauma/blast-related injury (PT/BRI). Using a systems science approach, we performed Bayesian network modeling to find the most accurate representation of the complex system of PT/BRI and identify key variables for understanding the subsequent effects of blast exposure in a sample of Florida National Guard members (1,443 deployed to Operation Enduring Freedom/Operation Iraqi Freedom and 1,655 not deployed) who completed an online survey during the period from 2009 to 2010. We found that postdeployment symptoms reported as present at the time of the survey were largely independent of deployment per se. Blast exposure, not mild traumatic brain injury (TBI), acted as the primary military deployment-related driver of PT/BRI symptoms. Blast exposure was indirectly linked to mild TBI via other deployment-related traumas and was a significant risk for a high level of posttraumatic stress disorder (PTSD) arousal symptoms. PTSD arousal symptoms and tinnitus were directly dependent upon blast exposure, with both acting as bridge symptoms to other postdeployment mental health and physical symptoms, respectively. Neurobehavioral or postconcussion-like symptoms had no significant dependence relationship with mild TBI, but they were synergistic with blast exposure in influencing PTSD arousal symptoms. A replication of this analysis using a larger PT/BRI database is warranted.

  2. Central nervous system and musculoskeletal medication profile of a veteran cohort with blast-related injuries.

    Science.gov (United States)

    French, Dustin D; Bair, Matthew J; Bass, Elizabeth; Campbell, Robert R; Siddharthan, Kris

    2009-01-01

    Little is known about the utilization of central nervous system (CNS) and musculoskeletal (MS) medications in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans with blast-related injuries (BRIs). We followed prescription drug use among a cohort of 133 OIF/OEF veterans with BRIs by using the Joint Theatre Trauma Registry, the Tampa Polytrauma Registry, and electronic medical records. We extracted 12 months of national medication records from the Veterans Health Administration Decision Support System and analyzed them with descriptive statistics. Over the 12-month period (fiscal year 2007), CNS medications comprised 27.9% (4,225/15,143) of total prescriptions dispensed to 90.2% (120/133) of our cohort. Approximately one-half (48.9%) of the 133 patients were treated with opioid analgesics. Nearly 60% received antidepressants. More than one-half (51.1%) of patients were treated with anticonvulsants. Benzodiazepines and antipsychotics were dispensed to 17.3% and 15.8%, respectively. For MS medicines, 804 were prescribed for 48.1% (64/133) of veterans. Nearly one-fourth (24.8%) were treated with skeletal muscle relaxants. The CNS and MS medications, in general, were continuously prescribed over the 12-month study period. This study provides insight into the complex medical management involved in the care of veterans with BRIs.

  3. Effectiveness of eye armor during blast loading.

    Science.gov (United States)

    Bailoor, Shantanu; Bhardwaj, Rajneesh; Nguyen, Thao D

    2015-11-01

    Ocular trauma is one of the most common types of combat injuries resulting from the interaction of military personnel with improvised explosive devices. Ocular blast injury mechanisms are complex, and trauma may occur through various injury mechanisms. However, primary blast injuries (PBI) are an important cause of ocular trauma that may go unnoticed and result in significant damage to internal ocular tissues and visual impairment. Further, the effectiveness of commonly employed eye armor, designed for ballistic and laser protection, in lessening the severity of adverse blast overpressures (BOP) is unknown. In this paper, we employed a three-dimensional (3D) fluid-structure interaction computational model for assessing effectiveness of the eye armor during blast loading on human eyes and validated results against free field blast measurements by Bentz and Grimm (2013). Numerical simulations show that the blast waves focused on the ocular region because of reflections from surrounding facial features and resulted in considerable increase in BOP. We evaluated the effectiveness of spectacles and goggles in mitigating the pressure loading using the computational model. Our results corroborate experimental measurements showing that the goggles were more effective than spectacles in mitigating BOP loading on the eye. Numerical results confirmed that the goggles significantly reduced blast wave penetration in the space between the armor and the eyes and provided larger clearance space for blast wave expansion after penetration than the spectacles. The spectacles as well as the goggles were more effective in reducing reflected BOP at higher charge mass because of the larger decrease in dynamic pressures after the impact. The goggles provided greater benefit of reducing the peak pressure than the spectacles for lower charge mass. However, the goggles resulted in moderate, sustained elevated pressure loading on the eye, that became 50-100% larger than the pressure loading

  4. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... this condition. Some factors that can cause birth trauma (injury) include: Large baby size (may be seen ...

  5. The Big Bang: Facial Trauma Caused by Recreational Fireworks.

    Science.gov (United States)

    Molendijk, Josher; Vervloet, Bob; Wolvius, Eppo B; Koudstaal, Maarten J

    2016-06-01

    In the Netherlands, it is a tradition of setting off fireworks to celebrate the turn of the year. In our medical facility, each year patients with severe skeletal maxillofacial trauma inflicted by recreational fireworks are encountered. We present two cases of patients with severe blast injury to the face, caused by direct impact of rockets, and thereby try to contribute to the limited literature on facial blast injuries, their treatment, and clinical outcome. These patients require multidisciplinary treatment, involving multiple reconstructive surgeries, and the overall recovery process is long. The severity of these traumas raises questions about the firework traditions and legislations not only in the Netherlands but also worldwide. Therefore, the authors support restrictive laws on personal use of fireworks in the Netherlands.

  6. Restoring GM1 ganglioside expression ameliorates axonal outgrowth inhibition and cognitive impairments induced by blast traumatic brain injury

    Science.gov (United States)

    Rubovitch, Vardit; Zilberstein, Yael; Chapman, Joab; Schreiber, Shaul; Pick, Chaim G.

    2017-01-01

    Blast induced traumatic brain injury (B-TBI) may cause various degrees of cognitive and behavioral disturbances but the exact brain pathophysiology involved is poorly understood. It was previously suggested that ganglioside alteration on the axon surface as well as axonal regenerating inhibitors (ARIs) such as myelin associated glycoprotein (MAG) were involved in axonal outgrowth inhibition (AOI), leading to brain damage. GM1 ganglioside content in the brain was significantly reduced while GD1 ganglioside was not affected. The axonal regeneration was also reduced as seen by the phosphorylated NF-H expression. Moreover, B-TBI induced a significant elevation in MAG expression in the brains of the injured mice. The blast injured mice exhibited a significant decline in spatial memory as seen by the Y-maze test. In addition, the injured mice showed pronounced damage to the visual memory (as evaluated by the Novel object recognition test). A single low dose of GM1 (2 mg/kg; IP), shortly after the injury, prevented both the cognitive and the cellular changes in the brains of the injured mice. These results enlighten part of the complicated mechanism that underlies the damage induced by B-TBI and may also suggest a potential new treatment strategy for brain injuries. PMID:28112258

  7. [Peculiarities of forensic medical reconstruction of the mechanism of injuries in numerous victims of the explosion of a high-capacity blasting device].

    Science.gov (United States)

    Fradkina, N A; Kovalev, A V; Makarov, I Iu

    2013-01-01

    The systemic analysis of forensic medical practice in Moscow during the past 15 years has demonstrated the scientific, practical, and social significance of expertise of peace-time blast injuries resulting from many terrorist attacks with the use of improvised high-capacity explosive devices that caused multiple human victims. The authors emphasize the current lack of objective forensic medical criteria for the reconstruction of the mechanism of injuries in numerous victims of the explosion of a high-capacity blasting device. It dictates the necessity of their development and substantiation of their practical application.

  8. Screening of biochemical and molecular mechanisms of secondary injury and repair in the brain after experimental blast-induced traumatic brain injury in rats.

    Science.gov (United States)

    Kochanek, Patrick M; Dixon, C Edward; Shellington, David K; Shin, Samuel S; Bayır, Hülya; Jackson, Edwin K; Kagan, Valerian E; Yan, Hong Q; Swauger, Peter V; Parks, Steven A; Ritzel, David V; Bauman, Richard; Clark, Robert S B; Garman, Robert H; Bandak, Faris; Ling, Geoffrey; Jenkins, Larry W

    2013-06-01

    Abstract Explosive blast-induced traumatic brain injury (TBI) is the signature insult in modern combat casualty care and has been linked to post-traumatic stress disorder, memory loss, and chronic traumatic encephalopathy. In this article we report on blast-induced mild TBI (mTBI) characterized by fiber-tract degeneration and axonal injury revealed by cupric silver staining in adult male rats after head-only exposure to 35 psi in a helium-driven shock tube with head restraint. We now explore pathways of secondary injury and repair using biochemical/molecular strategies. Injury produced ∼25% mortality from apnea. Shams received identical anesthesia exposure. Rats were sacrificed at 2 or 24 h, and brain was sampled in the hippocampus and prefrontal cortex. Hippocampal samples were used to assess gene array (RatRef-12 Expression BeadChip; Illumina, Inc., San Diego, CA) and oxidative stress (OS; ascorbate, glutathione, low-molecular-weight thiols [LMWT], protein thiols, and 4-hydroxynonenal [HNE]). Cortical samples were used to assess neuroinflammation (cytokines, chemokines, and growth factors; Luminex Corporation, Austin, TX) and purines (adenosine triphosphate [ATP], adenosine diphosphate, adenosine, inosine, 2'-AMP [adenosine monophosphate], and 5'-AMP). Gene array revealed marked increases in astrocyte and neuroinflammatory markers at 24 h (glial fibrillary acidic protein, vimentin, and complement component 1) with expression patterns bioinformatically consistent with those noted in Alzheimer's disease and long-term potentiation. Ascorbate, LMWT, and protein thiols were reduced at 2 and 24 h; by 24 h, HNE was increased. At 2 h, multiple cytokines and chemokines (interleukin [IL]-1α, IL-6, IL-10, and macrophage inflammatory protein 1 alpha [MIP-1α]) were increased; by 24 h, only MIP-1α remained elevated. ATP was not depleted, and adenosine correlated with 2'-cyclic AMP (cAMP), and not 5'-cAMP. Our data reveal (1) gene-array alterations similar to disorders of

  9. FGF-2 is required to prevent astrogliosis in the facial nucleus after facial nerve injury and mechanical stimulation of denervated vibrissal muscles.

    Science.gov (United States)

    Hizay, Arzu; Seitz, Mark; Grosheva, Maria; Sinis, Nektarios; Kaya, Yasemin; Bendella, Habib; Sarikcioglu, Levent; Dunlop, Sarah A; Angelov, Doychin N

    2016-03-01

    Recently, we have shown that manual stimulation of paralyzed vibrissal muscles after facial-facial anastomosis reduced the poly-innervation of neuromuscular junctions and restored vibrissal whisking. Using gene knock outs, we found a differential dependence of manual stimulation effects on growth factors. Thus, insulin-like growth factor-1 and brain-derived neurotrophic factor are required to underpin manual stimulation-mediated improvements, whereas FGF-2 is not. The lack of dependence on FGF-2 in mediating these peripheral effects prompted us to look centrally, i.e. within the facial nucleus where increased astrogliosis after facial-facial anastomosis follows "synaptic stripping". We measured the intensity of Cy3-fluorescence after immunostaining for glial fibrillary acidic protein (GFAP) as an indirect indicator of synaptic coverage of axotomized neurons in the facial nucleus of mice lacking FGF-2 (FGF-2(-/-) mice). There was no difference in GFAP-Cy3-fluorescence (pixel number, gray value range 17-103) between intact wildtype mice (2.12±0.37×10(7)) and their intact FGF-2(-/-) counterparts (2.12±0.27×10(7)) nor after facial-facial anastomosis +handling (wildtype: 4.06±0.32×10(7); FGF-2(-/-): 4.39±0.17×10(7)). However, after facial-facial anastomosis, GFAP-Cy3-fluorescence remained elevated in FGF-2(-/-)-animals (4.54±0.12×10(7)), whereas manual stimulation reduced the intensity of GFAP-immunofluorescence in wild type mice to values that were not significantly different from intact mice (2.63±0.39×10). We conclude that FGF-2 is not required to underpin the beneficial effects of manual stimulation at the neuro-muscular junction, but it is required to minimize astrogliosis in the brainstem and, by implication, restore synaptic coverage of recovering facial motoneurons.

  10. Avoiding Facial Incisions with Midface Free Tissue Transfer

    Science.gov (United States)

    Stalder, Mark W.; Sosin, Michael; Urbinelli, Leo J.; Mayo, James L.; Dorafshar, Amir H.; Hilaire, Hugo St.; Borsuk, Daniel E.

    2017-01-01

    Background: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. Methods: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions. Results: The pathology included palatal defects due to mucoepidermoid carcinoma and ischemic necrosis from cocaine abuse, maxillary defects secondary to fibrous dysplasia and avascular necrosis from traumatic blast injury, and a residual posttraumatic bony deformity of the zygoma. Reconstructions were performed with a free ulnar forearm flap, a free vastus lateralis muscle flap, a deep circumflex iliac artery myoosseous flap, a free fibula flap, and a deep circumflex iliac artery osseous flap, respectively. The facial artery and vein were used as recipient vessels for microvascular anastomosis for all cases. Mean follow-up was 12.2 months. All free tissue transfers were successful, and each patient had a satisfactory aesthetic outcome with no associated facial scars. Conclusion: This technique can be employed during reconstruction of an array of bony or soft-tissue midface deficits with minimal morbidity. This small series effectively demonstrates the varied pathologies and tissue deficiencies that can be successfully reconstructed with free tissue transfer using an entirely intraoral approach to the recipient facial vessels, resulting in no visible scars on the face and an improvement in the overall aesthetic outcome. PMID:28280662

  11. Distinctive response of CNS glial cells in oro-facial pain associated with injury, infection and inflammation

    Directory of Open Access Journals (Sweden)

    Ribeiro-da-Silva Alfredo

    2010-11-01

    Full Text Available Abstract Oro-facial pain following injury and infection is frequently observed in dental clinics. While neuropathic pain evoked by injury associated with nerve lesion has an involvement of glia/immune cells, inflammatory hyperalgesia has an exaggerated sensitization mediated by local and circulating immune mediators. To better understand the contribution of central nervous system (CNS glial cells in these different pathological conditions, in this study we sought to characterize functional phenotypes of glial cells in response to trigeminal nerve injury (loose ligation of the mental branch, infection (subcutaneous injection of lipopolysaccharide-LPS and to sterile inflammation (subcutaneous injection of complete Freund's adjuvant-CFA on the lower lip. Each of the three insults triggered a specific pattern of mechanical allodynia. In parallel with changes in sensory response, CNS glial cells reacted distinctively to the challenges. Following ligation of the mental nerve, both microglia and astrocytes in the trigeminal nuclear complex were highly activated, more prominent in the principal sensory nucleus (Pr5 and subnucleus caudalis (Sp5C area. Microglial response was initiated early (days 3-14, followed by delayed astrocytes activation (days 7-28. Although the temporal profile of microglial and astrocyte reaction corresponded respectively to the initiation and chronic stage of neuropathic pain, these activated glial cells exhibited a low profile of cytokine expression. Local injection of LPS in the lower lip skin also triggered a microglial reaction in the brain, which started in the circumventricular organs (CVOs at 5 hours post-injection and diffused progressively into the brain parenchyma at 48 hours. This LPS-induced microglial reaction was accompanied by a robust induction of IκB-α mRNA and pro-inflammatory cytokines within the CVOs. However, LPS induced microglial activation did not specifically occur along the pain signaling pathway. In

  12. Emotion Recognition following Pediatric Traumatic Brain Injury: Longitudinal Analysis of Emotional Prosody and Facial Emotion Recognition

    Science.gov (United States)

    Schmidt, Adam T.; Hanten, Gerri R.; Li, Xiaoqi; Orsten, Kimberley D.; Levin, Harvey S.

    2010-01-01

    Children with closed head injuries often experience significant and persistent disruptions in their social and behavioral functioning. Studies with adults sustaining a traumatic brain injury (TBI) indicate deficits in emotion recognition and suggest that these difficulties may underlie some of the social deficits. The goal of the current study was…

  13. Neuronal DNA Methylation Profiling of Blast-Related Traumatic Brain Injury

    OpenAIRE

    Haghighi, Fatemeh; Ge, Yongchao; Chen, Sean; Xin, Yurong; Umali, Michelle U.; De Gasperi, Rita; Gama Sosa, Miguel A.; Ahlers, Stephen T.; Elder, Gregory A.

    2015-01-01

    Long-term molecular changes in the brain resulting from blast exposure may be mediated by epigenetic changes, such as deoxyribonucleic acid (DNA) methylation, that regulate gene expression. Aberrant regulation of gene expression is associated with behavioral abnormalities, where DNA methylation bridges environmental signals to sustained changes in gene expression. We assessed DNA methylation changes in the brains of rats exposed to three 74.5 kPa blast overpressure events, conditions that hav...

  14. When Physics Meets Biology: Low and High-Velocity Penetration, Blunt Impact, and Blast Injuries to the Brain

    Science.gov (United States)

    Young, Leanne; Rule, Gregory T.; Bocchieri, Robert T.; Walilko, Timothy J.; Burns, Jennie M.; Ling, Geoffrey

    2015-01-01

    The incidence of traumatic brain injuries (TBI) in the US has reached epidemic proportions with well over 2 million new cases reported each year. TBI can occur in both civilians and warfighters, with head injuries occurring in both combat and non-combat situations from a variety of threats, including ballistic penetration, acceleration, blunt impact, and blast. Most generally, TBI is a condition in which physical loads exceed the capacity of brain tissues to absorb without injury. More specifically, TBI results when sufficient external force is applied to the head and is subsequently converted into stresses that must be absorbed or redirected by protective equipment. If the stresses are not sufficiently absorbed or redirected, they will lead to damage of extracranial soft tissue and the skull. Complex interactions and kinematics of the head, neck and jaw cause strains within the brain tissue, resulting in structural, anatomical damage that is characteristic of the inciting insult. This mechanical trauma then initiates a neuro-chemical cascade that leads to the functional consequences of TBI, such as cognitive impairment. To fully understand the mechanisms by which TBI occurs, it is critically important to understand the effects of the loading environments created by these threats. In the following, a review is made of the pertinent complex loading conditions and how these loads cause injury. Also discussed are injury thresholds and gaps in knowledge, both of which are needed to design improved protective systems. PMID:25999910

  15. The role of multislice spiral computed tomography in the diagnosis and management of acute facial trauma in patients with multiple injuries.

    Science.gov (United States)

    Nemsadze, G; Urushadze, O

    2011-11-01

    Using of mutislice spiral CT as first line examination for the diagnosis of Acute Facial trauma in the setting of Polytrauma reduces both: valuable time and cost of patient treatment. After a brief clinical examination, MDCT was performed depending on the area of injury, using a slice thickness of 0.65 mm. The obtained data were analyzed using 3D, MIP and Standard axial with Bone reconstruction protocols. 64 polytrauma patients were evaluated with both Anterior and Lateral craniography (plain skull X ray: AP and Lateral) and Multi Slice CT. Craniography detected only 18 cases of traumatic injuries of facial bones, but exact range of dislocation and accurate management plan could not be established. In the same 64 cases, Multislice CT revealed localization of all existed fractures, range of fragment dislocation, soft tissue damage and status of Paranasal sinus in 62 cases (96.8%). In two cases MS CT missed the facial fracture, in one case the examination was complicated because of bone thinness and numerous fracture fragments, in another multiple foreign body artifacts complicated the investigation. The study results show that, CT investigation based on our MDCT polytrauma protocol, detects all more or less serious facial bone injuries.

  16. VRP09 Reduction of Corneal Scarring Following Blast and Burn Injuries to Cornea Using siRNAs Targeting TGFb and CTGF

    Science.gov (United States)

    2012-10-01

    collagen gene by 97% and of alpha smooth muscle actin ( aSMA ) by 94% in RCF cultures without compromising the viability of the RCF. We then developed...model that simulates blast injuries. The knockdown of collagen and aSMA was very effective in two of three rabbits. We are optimizing the delivery

  17. Radiological-Pathological Correlations Following Blast-Related Traumatic Brain Injury in the Whole Human Brain Using ex Vivo Diffusion Tensor Imaging

    Science.gov (United States)

    2014-01-01

    injuries caused by non-blast related trauma (e.g. falls, motor vehicle accidents, etc.), post - mortem pathological analyses have revealed that...issues: 1) Selection of control cases: we will select only young, otherwise healthy patients who died from non-head trauma and had a short post - mortem ...20 Oppenheimer, D. R. (1968). "Microscopic lesions in the brain following head injury." J Neurol Neurosurg Psychiatry 31(4): 299-306. http

  18. Dento-alveolar and maxillofacial injuries: a 5-year multi-center study. Part 1: general vs facial and dental trauma.

    Science.gov (United States)

    Lin, Shaul; Levin, Liran; Goldman, Sharon; Peleg, Kobi

    2008-02-01

    Maxillofacial injuries are a significant cause of morbidity and demand meticulously planned treatment. The aim of this present multi-center study was to evaluate the occurrence of dento-alveolar and maxillofacial injuries over a 5-year period. A retrospective cohort study of data from the Israel Trauma Registry was conducted for the years 2000-2004. The registry includes all trauma patients admitted and hospitalized due to an injury. Of the 111,010 hospitalized trauma patients, 5886 (5.3%) were diagnosed with maxillofacial or dental injuries. The main causes of injuries for hospitalized trauma patients were falls (48.1%) and motor vehicle accidents (25.2%), while the major causes of facial and dental injuries were vehicle accidents (39.6%, 56.8%, respectively) and falls (32.1%, 26.7%, respectively). High-risk age groups for dental and facial trauma were 10-18 years and 19-28 years, respectively, while for other trauma, ages for the greatest risk ranged from 0 to 9 years and over 59 years. Males were injured two to three times more frequently than females. A better understanding of the etiology of maxillofacial and dental injuries and identifying the high-risk groups should lead to appropriate prevention programs and treatment methods.

  19. Controlled Low-Pressure Blast-Wave Exposure Causes Distinct Behavioral and Morphological Responses Modelling Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Comorbid Mild Traumatic Brain Injury-Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Zuckerman, Amitai; Ram, Omri; Ifergane, Gal; Matar, Michael A; Sagi, Ram; Ostfeld, Ishay; Hoffman, Jay R; Kaplan, Zeev; Sadot, Oren; Cohen, Hagit

    2017-01-01

    The intense focus in the clinical literature on the mental and neurocognitive sequelae of explosive blast-wave exposure, especially when comorbid with post-traumatic stress-related disorders (PTSD) is justified, and warrants the design of translationally valid animal studies to provide valid complementary basic data. We employed a controlled experimental blast-wave paradigm in which unanesthetized animals were exposed to visual, auditory, olfactory, and tactile effects of an explosive blast-wave produced by exploding a thin copper wire. By combining cognitive-behavioral paradigms and ex vivo brain MRI to assess mild traumatic brain injury (mTBI) phenotype with a validated behavioral model for PTSD, complemented by morphological assessments, this study sought to examine our ability to evaluate the biobehavioral effects of low-intensity blast overpressure on rats, in a translationally valid manner. There were no significant differences between blast- and sham-exposed rats on motor coordination and strength, or sensory function. Whereas most male rats exposed to the blast-wave displayed normal behavioral and cognitive responses, 23.6% of the rats displayed a significant retardation of spatial learning acquisition, fulfilling criteria for mTBI-like responses. In addition, 5.4% of the blast-exposed animals displayed an extreme response in the behavioral tasks used to define PTSD-like criteria, whereas 10.9% of the rats developed both long-lasting and progressively worsening behavioral and cognitive "symptoms," suggesting comorbid PTSD-mTBI-like behavioral and cognitive response patterns. Neither group displayed changes on MRI. Exposure to experimental blast-wave elicited distinct behavioral and morphological responses modelling mTBI-like, PTSD-like, and comorbid mTBI-PTSD-like responses. This experimental animal model can be a useful tool for elucidating neurobiological mechanisms underlying the effects of blast-wave-induced mTBI and PTSD and comorbid mTBI-PTSD.

  20. When Physics Meets Biology: Low and High Velocity Penetration, Blunt Trauma and Blast Injuries to the Brain

    Directory of Open Access Journals (Sweden)

    Leanne eYoung

    2015-05-01

    Full Text Available The incidence of TBI in the US has reached epidemic proportions with well over 2 million new cases reported each year. TBI can occur in both civilians and warfighters, with head injuries occurring in both combat and non-combat situations from a variety of threats, including ballistic penetration, acceleration, blunt impact, and blast. Most generally, TBI is a condition in which physical loads exceed the capacity of brain tissues to absorb without injury. More specifically, TBI results when sufficient external force is applied to the head and is subsequently converted into stresses that must be absorbed or redirected by protective equipment. If the stresses are not sufficiently absorbed or redirected, they will lead to damage of extracranial soft tissue and the skull. Complex interactions and kinematics of the head, neck and jaw cause strains within the brain tissue, resulting in structural, anatomical damage that is characteristic of the inciting insult. This mechanical trauma then initiates a neuro-chemical cascade that leads to the functional consequences of TBI, such as cognitive impairment. To fully understand the mechanisms by which TBI occurs, it is critically important to understand the effects of the loading environments created by these threats. In the following, a review is made of the pertinent complex loading conditions and how these loads cause injury. Also discussed are injury thresholds and gaps in knowledge, both of which are needed to design improved protective systems.

  1. A novel rat model of blast-induced traumatic brain injury simulating different damage degree: implications for morphological, neurological, and biomarker changes

    Directory of Open Access Journals (Sweden)

    Mengdong eLiu

    2015-05-01

    Full Text Available In current military conflicts and civilian terrorism, blast-induced traumatic brain injury (bTBI is the primary cause of neurotrauma. However, the effects and mechanisms of bTBI are poorly understood. Although previous researchers have made significant contributions to establishing animal models for the simulation of bTBI, the precision and controllability of blast-induced injury in animal models must be improved. Therefore, we established a novel rat model to simulate blast-wave injury to the brain. To simulate different extents of bTBI injury, the animals were divided into moderate and severe injury groups. The miniature spherical explosives (PETN used in each group were of different sizes (2.5 mm diameter in the moderate injury group and 3.0 mm diameter in the severe injury group. A specially designed apparatus was able to precisely adjust the positions of the miniature explosives and create eight rats with bTBI simultaneously, using a single electric detonator. Neurological functions, gross pathologies, histopathological changes and the expression levels of various biomarkers were examined after the explosion. Compared with the moderate injury group, there were significantly more neurological dysfunctions, cortical contusions, intraparenchymal hemorrhages, cortical expression of S-100β, MBP, NSE, IL-8, IL-10, iNOS and HIF-1α in the severe injury group. These results demonstrate that we have created a reliable and reproducible bTBI model in rats. This model will be helpful for studying the mechanisms of bTBI and developing strategies for clinical bTBI treatment.

  2. Mechanical Loading of Neurons and Astrocytes with Application to Blast Traumatic Brain Injury

    Science.gov (United States)

    2010-01-01

    traumatic brain injury ( TBI ). Neurons and astrocytes are susceptible to damage mechanisms arising from various...further developments may be pursued to unravel the key mechanical pathways potentially involved in TBI . 1. INTRODUCTION Traumatic brain injury ... injury mechanisms at the cellular level. This is especially important when studying traumatic brain injury ( TBI ). Neurons and astrocytes

  3. Clinical analysis of 182 cases with facial nerve injury%面神经损伤182例临床资料回顾性分析

    Institute of Scientific and Technical Information of China (English)

    于国霞; 蔡志刚; 卢旭光; 施晓健; 彭歆; 俞光岩

    2008-01-01

    目的 分析颌面部外周性面神经损伤后功能恢复的规律和相关影响因素.方法 回顾分析182例面神经损伤患者的病历资料,分析损伤部位、损伤方式、损伤后治疗时间及治疗方式对于面神经功能恢复结果的影响.结果 口腔颌面部面神经损伤以分支损伤为主.神经损伤方式、部位、患者年龄、修复时间等因素均对面神经功能恢复结果有影响.随访至最终有完整记录的解剖性损伤49例中,45例(92%)在6个月内完全恢复;断裂损伤59例中,53例(90%)于6个月内开始恢复;12个月内,神经吻合35例中33例(94%)面神经功能开始恢复;8例神经移植病例中5例(62%)完全恢复.结论 口腔颌面部手术中应尽量降低对神经的损伤,尽早修复受损神经,这样能够更好地保存面神经功能.%Objective To investigate the recovery patterns and the influencing factors of facial nerve injury in maxillofacial surgery by retrospective analysis of a serial clinical data.Methods A total of 182 patients with facial nerve injury were reviewed.The cause of injury,the initial facial nerve function after trauma,the treatment, the initial recovery time of facial nerve function and the total recovery time were recorded.The factors that influenced the outcome of facial nerve function were analyzed.Results The facial nerve branch injury was common in maxillofacial injury.The injury pattern, location,age and reconstruction time all had effects on the function recovery of the facial nerve.Within 6 months,45 of 49(92%) anatomic injured patients completely recovered in 6 months;53 of 59 patients(90%)began to recoverwhen nerve had been ruptured.In 12 months,33 of 35 patients (94%) after nerve anastomosed and 5 of 8 patients (62%)with nerve transplantation got complete recovery.Conclusions Preserving the facial nerve during surgery is very important.If the facial nerve is injured,reconstructive surgery should be applied as soon as possible.

  4. Deficits in facial emotion recognition indicate behavioral changes and impaired self-awareness after moderate to severe traumatic brain injury.

    Directory of Open Access Journals (Sweden)

    Jacoba M Spikman

    Full Text Available Traumatic brain injury (TBI is a leading cause of disability, specifically among younger adults. Behavioral changes are common after moderate to severe TBI and have adverse consequences for social and vocational functioning. It is hypothesized that deficits in social cognition, including facial affect recognition, might underlie these behavioral changes. Measurement of behavioral deficits is complicated, because the rating scales used rely on subjective judgement, often lack specificity and many patients provide unrealistically positive reports of their functioning due to impaired self-awareness. Accordingly, it is important to find performance based tests that allow objective and early identification of these problems. In the present study 51 moderate to severe TBI patients in the sub-acute and chronic stage were assessed with a test for emotion recognition (FEEST and a questionnaire for behavioral problems (DEX with a self and proxy rated version. Patients performed worse on the total score and on the negative emotion subscores of the FEEST than a matched group of 31 healthy controls. Patients also exhibited significantly more behavioral problems on both the DEX self and proxy rated version, but proxy ratings revealed more severe problems. No significant correlation was found between FEEST scores and DEX self ratings. However, impaired emotion recognition in the patients, and in particular of Sadness and Anger, was significantly correlated with behavioral problems as rated by proxies and with impaired self-awareness. This is the first study to find these associations, strengthening the proposed recognition of social signals as a condition for adequate social functioning. Hence, deficits in emotion recognition can be conceived as markers for behavioral problems and lack of insight in TBI patients. This finding is also of clinical importance since, unlike behavioral problems, emotion recognition can be objectively measured early after injury

  5. Deficits in facial emotion recognition indicate behavioral changes and impaired self-awareness after moderate to severe traumatic brain injury.

    Science.gov (United States)

    Spikman, Jacoba M; Milders, Maarten V; Visser-Keizer, Annemarie C; Westerhof-Evers, Herma J; Herben-Dekker, Meike; van der Naalt, Joukje

    2013-01-01

    Traumatic brain injury (TBI) is a leading cause of disability, specifically among younger adults. Behavioral changes are common after moderate to severe TBI and have adverse consequences for social and vocational functioning. It is hypothesized that deficits in social cognition, including facial affect recognition, might underlie these behavioral changes. Measurement of behavioral deficits is complicated, because the rating scales used rely on subjective judgement, often lack specificity and many patients provide unrealistically positive reports of their functioning due to impaired self-awareness. Accordingly, it is important to find performance based tests that allow objective and early identification of these problems. In the present study 51 moderate to severe TBI patients in the sub-acute and chronic stage were assessed with a test for emotion recognition (FEEST) and a questionnaire for behavioral problems (DEX) with a self and proxy rated version. Patients performed worse on the total score and on the negative emotion subscores of the FEEST than a matched group of 31 healthy controls. Patients also exhibited significantly more behavioral problems on both the DEX self and proxy rated version, but proxy ratings revealed more severe problems. No significant correlation was found between FEEST scores and DEX self ratings. However, impaired emotion recognition in the patients, and in particular of Sadness and Anger, was significantly correlated with behavioral problems as rated by proxies and with impaired self-awareness. This is the first study to find these associations, strengthening the proposed recognition of social signals as a condition for adequate social functioning. Hence, deficits in emotion recognition can be conceived as markers for behavioral problems and lack of insight in TBI patients. This finding is also of clinical importance since, unlike behavioral problems, emotion recognition can be objectively measured early after injury, allowing for early

  6. Three-layered osteodural plasty for severe anterior skull base and facial injuries. Report of eleven cases.

    Science.gov (United States)

    Wanyura, Hubert; Kamiński, Artur; Stopa, Zygmunt

    2014-01-01

    The upper cranial trauma of high force and wide area of application leads to fractures of calvaria, the skull base, and the viscerocranium. The aim of the study was to present eleven patients treated for severe anterior skull base and facial defects by means of three-layered osteodural plasty. The operative tactics consisted of bicoronal incision, bifrontal craniotomy, closure of the dura mater damage with a pericranium, reconstruction of bone defects with autologous bone grafts and plasty with anteriorly pedicled pericranial flap on the supratrochlear and supraorbital vessels. During follow-up, which lasted 2-7 years, none of the patients developed any early or late postoperative complications. The three-layer osteodural plasty of severe anterior skull base injuries with the use of autologous bone grafts for the reconstruction of craniofacial skeleton resulted in a good final functional, morphological and aesthetic outcome in all patients. Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  7. Oro-facial injuries in Central American and Caribbean sports games: a 20-year experience.

    Science.gov (United States)

    Amy, Enrique

    2005-06-01

    Dental services in sports competitions in the Games sponsored by the International Olympic Committee are mandatory. In every Central American, Pan American and Olympic Summer Games, as well as Winter Games, the Organizing Committee has to take all the necessary measures to assure dental services to all competitors. In all Olympic villages, as part of the medical services, a dental clinic is set up to treat any dental emergency that may arise during the Games. Almost every participating country in the Games has its own medical team and some may include a dentist. The major responsibilities of the team dentist as a member of the national sports delegation include: (i) education of the sports delegation about different oral and dental diseases and the illustration of possible problems that athletes or other personnel may encounter during the Games, (ii) adequate training and management of orofacial trauma during the competition, (iii) knowledge about the rules and regulations of the specific sport that the dentist is working, (iv) understanding of the anti-doping control regulations and procedures, (v) necessary skills to fabricate a custom-made and properly fitted mouth guard to all participants in contact or collision sports of the delegation. This study illustrates the dental services and occurrence of orofacial injury at the Central American and Caribbean Sports Games of the Puerto Rican Delegation for the past 20 years. A total of 2107 participants made up the six different delegations at these Games. Of these 279 or 13.2% were seen for different dental conditions. The incidence of acute or emergency orofacial conditions was 18 cases or 6% of the total participants. The most frequent injury was lip contusion with four cases and the sport that experienced more injuries was basketball with three cases.

  8. SPECTRUM OF FACIAL BURN INJURIES AND THEIR DIFFERENT MODES OF TREATMENT

    Directory of Open Access Journals (Sweden)

    Satishchandra

    2016-01-01

    Full Text Available INTRODUCTION A major public health problem in India is burns injuries. It is prevalent especially in low and middle income countries, where over 95% of all burn deaths occur. Fire related burns alone account for over 0.3 million deaths per year. But Death is not the only consequence. There are around 80% of the fire victims who become disfigured and permanently disabled. For some this means living with the stigma and rejection that all too often comes with disability and disfigurement.

  9. Oro-facial thermal injury caused by food heated in a microwave oven.

    Science.gov (United States)

    Wakefield, Yasha; Pemberton, Michael N

    2009-01-01

    Burns to the oral mucosa usually result from the accidental ingestion of hot food or beverages. The burns are usually of short duration and little consequence. The widespread use of microwave ovens, however, has added a new dimension to the problem. Microwave ovens heat food much quicker than a conventional oven, but they produce uneven heating within the food and extremely high temperatures can be reached. We describe two cases of patients who suffered inadvertent injury to the oral mucosa from the ingestion of microwave-heated food.

  10. Weapon identification using antemortem CT with 3D reconstruction, is it always possible?--A report in a case of facial blunt and sharp injuries using an ashtray.

    Science.gov (United States)

    Aromatario, Mariarosaria; Cappelletti, Simone; Bottoni, Edoardo; Fiore, Paola Antonella; Ciallella, Costantino

    2016-01-01

    An interesting case of homicide involving the use of a heavy glass ashtray is described. The victim, a 81-years-old woman, has survived for few days and died in hospital. The external examination of the victim showed extensive blunt and sharp facial injuries and defense injuries on both the hands. The autopsy examination showed numerous tears on the face, as well as multiple fractures of the facial bones. Computer tomography scan, with 3D reconstruction, performed in hospital before death, was used to identify the weapon used for the crime. In recent years new diagnostics tools such as computer tomography has been widely used, especially in cases involving sharp and blunt forces. Computer tomography has proven to be very valuable in analyzing fractures of the cranial teca for forensic purpose, in particular antemortem computer tomography with 3D reconstruction is becoming an important tool in the process of weapon identification, thanks to the possibility to identify and make comparison between the shape of the object used to commit the crime, the injury and the objects found during the investigations. No previous reports on the use of this technique, for the weapon identification process, in cases of isolated facial fractures were described. We report a case in which, despite the correct use of this technique, it was not possible for the forensic pathologist to identify the weapon used to commit the crime. Authors wants to highlight the limits encountered in the use of computer tomography with 3D reconstruction as a tool for weapon identification when facial fractures occurred. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Plastic Surgery for Repairing Facial Soft Tissue Injury%面部软组织损伤的整形美容修复

    Institute of Scientific and Technical Information of China (English)

    李咏红

    2014-01-01

    Objective:To investigate the effects and the application of cosmetic repair of patients with injury of facial soft tissue. Method:130 patients for surgery from February,2012 to December,2013 were selected,high-tech means and minimally invasive techniques was used,and plastic repair of facial soft tissue injury was adopted. Result:The repair effect is ideal with good functional recovery,without infection, hematoma and skin flap necrosis. After 1~12 months follow-up,rehabilitation effect was significant. Conclusion:The facial soft tissue injury of the situation is more complicated,and recovery effect is not ideal by using the traditional plastic method. The new technology and minimally invasive technique for facial repair is used with significant effect.%目的:探讨面部软组织损伤患者整形美容修复效果以及应用方法。方法:我所选取2012年2月至2013年12月间进行整容的130例患者,采用高科技手段与微创技术,进行面部软组织损伤的整形美容修复。结果:修复效果理想,功能恢复良好,且未出现感染、皮瓣坏死以及血肿等情况。随访1~12月后,康复效果显著。结论:面部软组织损伤的情况较为复杂,利用传统整形美容方法恢复效果不理想,我们采用新型科技手段与微创技术进行面部修复,效果显著。

  12. Pattern of injury in those dying from traumatic amputation caused by bomb blast.

    Science.gov (United States)

    Hull, J B; Bowyer, G W; Cooper, G J; Crane, J

    1994-08-01

    Traumatic amputation of limbs caused by bomb blast carries a high risk of mortality. This paper describes 73 amputations in 34 deaths from bomb blast in Northern Ireland. The principal aim was to determine the sites of traumatic amputation to provide a biophysical basis for the development of protective measures. Few amputations were through joints; nearly all were through the bone shafts. The most common site in the tibia was the upper third. The distribution of femoral sites resulting from car bombs differed from that characterizing other types of explosion. For car bombs the principal site of amputation was the upper third; for other types of device it was the lower third. It is concluded that flailing is not a notable contributor to limb avulsion. The pattern of amputation is consistent with direct local pressure loads leading to bone fracture; the amputation itself is a secondary event arising from the flow of combustion products.

  13. Central Mechanisms and Treatment of Blast Induced Auditory and Vestibular Injuries

    Science.gov (United States)

    2017-01-01

    animal models for traumatic brain injury” was approved by SoBran ACUC.  We trained two research technicians who are now skilled in the experimental...and results  Methods  Blast-induced neurotrauma: All animal experiments were conducted in accordance with the Animal Welfare Act and other federal...impaired functional connection between FL and Lat Budget Expenditure to Date Projected Expenditure: $492,121.32 Actual Expenditure

  14. Primary Blast Injury Criteria for Animal/Human TBI Models using Field Validated Shock Tubes

    Science.gov (United States)

    2016-09-01

    differential equations for the conservation of momentum, mass and energy along with the material constitutive equations and the equations defining the initial...BOP. Using logistic regression model, predicted mortality rate (PMR) function was calculated, and used to establish TBI severities. We determined a...helped identify loading pathways through which blast overpressure ‘leaks’ into the brain leading to differential loading of the tissue in various

  15. 大鼠面神经损伤后神经元型一氧化氮合酶的表达变化%Expression of Neuronal Nitric Oxide Synthase in the Facial Nucleus after Facial Nerve Injury

    Institute of Scientific and Technical Information of China (English)

    王鹏; 臧晓燕; 张引成

    2014-01-01

    Objective: To observe the variation of neuronal nitric oxide synthase (nNOS) expression in injured facial nerve tissue. Method: 20 adult male SD rats were used in this study, among them , 5 rats were normal controls. In experiment group, a compression injury was applied at one branch of bilateral facial nerve. Every 3 rats in experiment group were sacrified for nNOS immunostaining in a period of 1, 2, 3, 4 and 5 weeks respectively. Results:In normal facial nerve tissue, nNOS expression was not detected. In the injured facial nerve neurons, nNOS immunostaining expression was positive, and lasting up till the fifth weeks. Conclusion: After the nerve injury, the expressing of nNOS was observed in the facial nucleus, which may be related to the death of neuron.%目的:通过观察面神经损伤后神经元型一氧化氮合酶(neuronal NOS, nNOS)在面神经核团中的表达,探讨NO在面神经损伤后的作用。方法:健康成年SD大白鼠20只,其中5只作为正常对照。其余15只为面神经损伤组,在双侧面神经下颊支制作挤压伤。术后1、2、3、4、5周各取3只损伤组大鼠作面神经核团nNOS表达的免疫组化观察。结果:正常情况下面神经元不表达nNOS。面神经损伤后,出现运动神经元变性,其神经元细胞nNOS免疫染色为阳性,并持续至损伤后第5周。结论:面神经损伤后其运动神经元的核团中会出现nNOS的表达。

  16. Mechanism of blood-brain barrier impairment after mild traumatic brain injury caused by blast shock waves and its relationship with delayed nerve dysfunction

    Directory of Open Access Journals (Sweden)

    Zhao-xi XU

    2016-06-01

    Full Text Available Mild traumatic brain injury (mTBI caused by blast shock waves (BSWs is one of the most common injuries among soldiers in the war. Such mTBI can also happen in civilians if exposed to shock waves of accidental explosion disasters, bomb attacks by terrorists and so on. This injury often results in cognitive problems, memory dysfunction and emotional disorder, and these neurological deficits are closely related to the dysfunction or disruption of the blood-brain barrier (BBB. The present paper discusses mainly the relationship between dysfunction or disruption of BBB and inflammatory reaction in mild brain injury associated with explosive shock wave and effects of early intervention of oxidative stress injury, repairing the BBB and blocking inflammation on relieving delayed neurological deficits. DOI: 10.11855/j.issn.0577-7402.2016.05.15

  17. Assessment of the Effects of Acute and Repeated Exposure to Blast Overpressure in Rodents: Towards a Greater Understanding of Blast and the Potential Ramifications for Injury in Humans Exposed to Blast

    Directory of Open Access Journals (Sweden)

    Stephen Thomas Ahlers

    2012-03-01

    Full Text Available Mild traumatic brain injury (mTBI resulting from exposure to improvised explosive devices (IEDs has fueled a requirement to develop animals models that mirror this condition using exposure to blast overpressure (BOP. En route to developing a model of repeated exposure to BOP we sought to initially characterize the effects of acute BOP exposure in rodents, focusing specifically on the levels of BOP exposure that produced clinical mTBI symptoms. We first measured BOP effects on gross motor function on a balance beam. Separate groups of unanesthetized rats were exposed (in different orientations to 40 kPa, 75 kPa and 120 kPa BOP exposure inside a pneumatically driven shock tube. Results demonstrated that rats exposed to 120 kPa demonstrated transient alterations or loss of consciousness indicated by a transient loss of righting and by increased latencies on the balance beam. The 120 kPa exposure was the threshold for overt pathology for acute BOP exposure with approximately 30% of rats presenting with evidence of subdural hemorrhage and cortical contusions. All animals exposed to 120 kPa BOP manifested evidence of significant pulmonary hemorrhage. Anterograde memory deficits were observed in rats exposed to 75 kPa facing the BOP wave and rats exposed to 120 kPa in the lateral (side orientation. We next assessed repeated exposure to either lateral or frontal 40 kPa BOP in anesthetized rats, once per day for 12 days. Results showed that repeated exposure in the frontal, but not side, orientation to the BOP wave produced a transitory learning deficit on a Morris water maze (MWM task as shown by significantly longer latencies to reach the submerged platform in the second and third blocks of a four block session. Implications of these data are discussed in relation to the manifestation of mTBI in military personnel exposed to IEDs. Finally, we suggest that there are multiple types of brain injury from blast.

  18. Mild Traumatic Brain Injury and Conduction Aphasia from a Close Proximity Blast Resulting in Arcuate Fasciculus Damage Diagnosed on DTI Tractography

    Science.gov (United States)

    2009-11-01

    November 2009 issue. 1 The authors present a case demonstrating that a blast injury was associated with both conduction aphasia and an abnormality in...communication which are described below as conduction aphasia and neurogenic stuttering secondary to the aphasia. Also, his family felt that his personality... stuttering , and “mumbling” speech. In continued evaluation, estimated premorbid intellectual ability was at least in the average range. Speech

  19. An Introductory Characterization of a Combat-Casualty-Care Relevant Swine Model of Closed Head Injury Resulting from Exposure to Explosive Blast

    Science.gov (United States)

    2009-07-08

    Richard Bauman, Geoffrey Ling, Lawrence Tong, Adolph Januszkiewicz , Denes Agoston, Nihal Delanerolle, Young Kim, Dave Ritzel, Randy Bell, James Ecklund...of Closed Head Injury Resulting from Exposure to Explosive Blast* Richard A. Bauman,1 Geoffrey Ling,2 Lawrence Tong,3 Adolph Januszkiewicz ,4 Denes...inflammation, and neuronal death cascades. J. Neurotrauma 26, 901-911. Ananiadou, O., Bibou, K ., Drossos, G., Bai, M., Haj-Yahia, S., Charchardi, A., and

  20. Expression of galanin and its receptors are perturbed in a rodent model of mild, blast-induced traumatic brain injury.

    Science.gov (United States)

    Kawa, Lizan; Barde, Swapnali; Arborelius, Ulf P; Theodorsson, Elvar; Agoston, Denes; Risling, Mårten; Hökfelt, Tomas

    2016-05-01

    The symptomatology, mood and cognitive disturbances seen in post-traumatic stress disorder (PTSD) and mild blast-induced traumatic brain injury (mbTBI) overlap considerably. However the pathological mechanisms underlying the two conditions are currently unknown. The neuropeptide galanin has been suggested to play a role in the development of stress and mood disorders. Here we applied bio- and histochemical methods with the aim to elucidate the nature of any changes in the expression of galanin and its receptors in a rodent model of mbTBI. In situ hybridization and quantitative polymerase chain reaction studies revealed significant, injury-induced changes, in some cases lasting at least for one week, in the mRNA levels of galanin and/or its three receptors, galanin receptor 1-3 (GalR1-3). Such changes were seen in several forebrain regions, and the locus coeruleus. In the ventral periaqueductal gray GalR1 mRNA levels were increased, while GalR2 were decreased. Analysis of galanin peptide levels using radioimmunoassay demonstrated an increase in several brain regions including the locus coeruleus, dorsal hippocampal formation and amygdala. These findings suggest a role for the galanin system in the endogenous response to mbTBI, and that pharmacological studies of the effects of activation or inhibition of different galanin receptors in combination with functional assays of behavioral recovery may reveal promising targets for new therapeutic strategies in mbTBI.

  1. Responses of dural mast cells in concussive and blast models of mild traumatic brain injury in mice: Potential implications for post-traumatic headache.

    Science.gov (United States)

    Levy, Dan; Edut, Shahaf; Baraz-Goldstein, Renana; Rubovitch, Vardit; Defrin, Ruth; Bree, Dara; Gariepy, Helaine; Zhao, Jun; Pick, Chaim G

    2016-09-01

    Chronic post-traumatic headache (PTH) is one of the most common symptoms of mild traumatic brain injury (mTBI) but its underlying mechanisms remain unknown. Inflammatory degranulation of dural mast cells (MCs) is thought to promote headache, and may play a role in PTH. Whether mTBI is associated with persistent degranulation of dural MCs is yet to be determined. Histochemistry was used to evaluate time course changes in dural MC density and degranulation level in concussive head trauma and blast mouse models of mTBI. The effects of sumatriptan and the MC stabilizer cromolyn sodium on concussion-evoked dural MC degranulation were also investigated. Concussive head injury evoked persistent MC degranulation for at least 30 days. Blast trauma gave rise to a delayed MC degranulation response commencing at seven days that also persisted for at least 30 days. Neither sumatriptan nor cromolyn treatment reduced concussion-evoked persistent MC degranulation. mTBI evoked by closed head injury or blast exposure is associated with persistent dural MC degranulation. Such a response in mTBI patients may contribute to PTH. Amelioration of PTH by sumatriptan may not involve inhibition of dural MC degranulation. If persistent dural MC degranulation contributes to PTH, then cromolyn treatment may not be effective. © International Headache Society 2015.

  2. British dental surgery and the First World War: the treatment of facial and jaw injuries from the battlefield to the home front.

    Science.gov (United States)

    Hussey, K D

    2014-11-01

    When Britain went to war in 1914, the British Expeditionary Force was deployed without a single dentist. Initially considered combatants, the only dental professionals who could serve at the Front were medically qualified dental surgeons in the Royal Army Medical Corps. In treating the traumatic facial and jaw injuries caused by trench warfare, the dental surgeons of this era earned their place on specialist surgical teams and established the principles of oral and maxillofacial surgery. This article will examine the contribution of specialist dental surgeons to the management of facial and jaw wounds in the First World War along the chain of evacuation from the battlefield to the home front, using illustrative examples from the Hunterian Museum at the Royal College of Surgeons of England.

  3. 16例颜面软组织损伤二期处理的体会%Delayed Treatment of Facial Injuries

    Institute of Scientific and Technical Information of China (English)

    王晓念

    2011-01-01

    目的:探讨颜面软组织损伤的二期处理方法.方法:对16例陈旧性颜面部裂伤的患者,采用快速清创术治疗.结果:全部病例的伤口均一期愈合.结论:快速清创术是治疗颜面部陈旧性裂伤的一种理想方法.%Objective:To summarize clinical expertise on the treatment of dated laceration of facial soft tissues. Methods: 16 patients treated by quick debridment were retrospectively reviewed. Results: All wounds healed with primary intension. Conclusion: Quick debridment is an effective approach in managing old facial injuries.

  4. Glyburide - Novel Prophylaxis and Effective Treatment for Blast-Traumatic Brain Injury

    Science.gov (United States)

    2013-10-01

    the solution as needed using a minimum amount of NaOH to a pH approximately 8 to 8.5. Solutions prepared in this way and stored at 37°C for 48 hours... Sensor Walk, an Pre-train on 24 hr Results Fig. 5 sions. only Blast ficits in no eous Reari truncal sta nt with glib lans test o laxis trea...Simard JM, Woo SK, Bhatta S, Gerzanich V. Drugs acting on SUR1 to treat CNS ischemia and trauma. Curr Opin Pharmacol 2008; 8(1):42-9. PM:18032110

  5. Facial palsy after blunt trauma and without facial bone fracture.

    Science.gov (United States)

    Coltro, Pedro Soler; Goldenberg, Dov Charles; Aldunate, Johnny Leandro Conduta Borda; Alessi, Mariana Sisto; Chang, Alexandre Jin Bok Audi; Alonso, Nivaldo; Ferreira, Marcus Castro

    2010-07-01

    A 14-year-old patient had a low-energy facial blunt trauma that evolved to right facial paralysis caused by parotid hematoma with parotid salivary gland lesion. Computed tomography and angiography demonstrated intraparotid collection without pseudoaneurysm and without radiologic signs of fracture in the face. The patient was treated with serial punctures for hematoma deflation, resolving with regression and complete remission of facial paralysis, with no late sequela. The authors discuss the relationship between facial nerve traumatic injuries associated or not with the presence of facial fractures, emphasizing the importance of early recognition and appropriate treatment of such cases.

  6. Glyburide - Novel Prophylaxis and Effective Treatment for Traumatic Brain Injury

    Science.gov (United States)

    2012-08-01

    ABSTRACT The overall subject of this project is blast- traumatic brain injury (blast- TBI ) and the role of the SUR1-regulated NCCa-ATP channel in blast- TBI ...project is blast- traumatic brain injury (blast- TBI ) and the role of the SUR1-regulated NCCa-ATP channel in secondary injury following blast- TBI . The...effective treatment for traumatic brain injury PRINCIPAL INVESTIGATOR: J. Marc Simard, M.D., Ph.D

  7. Missile injuries in head — neck and maxillo-facial region — an experience in eastern nepal

    OpenAIRE

    2008-01-01

    Ballistic injuries to head-neck and maxillofacial region is quite common problem nowadays. Most of the time the injuries seem to be dreadful but the mechanism of the injuries caused by ballistics and the anatomical conditions of maxillofacial and head-neck region mitigate the severity of the injuries. Proper primary management followed by reconstruction and management of associated injuries decreases the mortality and morbidity of missile injuries in head-neck and maxillofacial region. Eleven...

  8. 面部软组织损伤的整形美容修复分析%Analysis of Plastic Surgery for Repairing Facial Soft Tissue Injury

    Institute of Scientific and Technical Information of China (English)

    牛兴红

    2014-01-01

    目的:探讨整形美容修复面部软组织损伤的效果。方法:选取本院整形科门诊与住院部在2012年3月~2013年1月间收治的100例面部软组织创伤患者,进行整形美容修复,观察治疗后效果。结果:经过修复治疗后,伤口在Ⅰ期的愈合率为90%。结论:整形美容修复对面部创面进行修复,能够有效的达到较佳的修复效果。%Objective:To study the effect of cosmetic surgery to repair facial soft tissue injuries. Methods:Selecting 100 patients with facial soft tissue trauma in plastic outpatient and inpatient deparments from March,2012 to January,doing cosmetic surgery repair,and observing the therapeutic effect after treatment. Results:After repair therapy,the wound in Ⅰ healing rate was 90%. Conclusion:Cosmetic surgery on facial wounds repair can effectively achieve the best effect.

  9. Blood Brain Barrier Dysfunction and Delayed Neurological Deficits in Mild Traumatic Brain Injury Induced by Blast Shock Waves

    Directory of Open Access Journals (Sweden)

    Ashok K Shetty

    2014-08-01

    Full Text Available Mild traumatic brain injury (mTBI resulting from exposure to blast shock waves (BSWs is one of the most predominant causes of illnesses among veterans who served in the recent Iraq and Afghanistan wars. Such mTBI can also happen to civilians if exposed to shock waves of bomb attacks by terrorists. While cognitive problems, memory dysfunction, depression, anxiety and diffuse white matter injury have been observed at both early and/or delayed time-points, an initial brain pathology resulting from exposure to BSWs appears to be the dysfunction or disruption of the blood-brain barrier (BBB. Studies in animal models suggest that exposure to relatively milder BSWs (123 kPa initially induces free radical generating enzymes in and around brain capillaries, which enhances oxidative stress resulting in loss of tight junction proteins, edema formation, and leakiness of BBB with disruption or loss of its components pericytes and astrocyte end-feet. On the other hand, exposure to more intense BSWs (145-323 kPa causes acute disruption of the BBB with vascular lesions in the brain. Both of these scenarios lead to apoptosis of endothelial and neural cells and neuroinflammation in and around capillaries, which may progress into chronic traumatic encephalopathy and/or a variety of neurological impairments, depending on brain regions that are afflicted with such lesions. This review discusses studies that examined alterations in the brain milieu causing dysfunction or disruption of the BBB and neuroinflammation following exposure to different intensities of BSWs. Furthermore, potential of early intervention strategies capable of easing oxidative stress, repairing the BBB or blocking inflammation for minimizing delayed neurological deficits resulting from exposure to BSWs is conferred.

  10. 面神经损伤模型中的半胱氨酸天冬氨酸蛋白酶相关蛋白表达与损伤相关性%Correlation between caspase regulatory gene expression and facial nerve injury in a facial nerve injury model

    Institute of Scientific and Technical Information of China (English)

    魏海刚; 李蜀光; 陈玉婷; 蔡超雄; 许彪

    2014-01-01

    背景:半胱氨酸天冬氨酸蛋白酶在细胞凋亡中发挥着关键作用,但不同形式面神经损伤对半胱氨酸天冬氨酸蛋白酶3和8和cyto-c蛋白表达的影响及其相互关系,目前尚不清楚。  目的:构建大鼠面神经压榨伤及低位切断伤模型,观察面运动神经元的形态学改变和死亡相关基因半胱氨酸天冬氨酸蛋白酶3和8及cyto-c的表达变化并分析其相关性。  方法:制作大鼠右侧面神经的压榨伤和低位切断伤模型,左侧为正常对照侧。用甲苯胺蓝染色及透射电镜观测面运动神经元形态学变化及其死亡情况,免疫组织化学法检测切断伤及压榨伤后半胱氨酸天冬氨酸蛋白酶3和8及cyto-c的表达变化。  结果与结论:面神经切断伤及压榨伤均可引起面运动神经元死亡,死亡形式以凋亡为主。半胱氨酸天冬氨酸蛋白酶3、8,cyto-c蛋白表达阳性神经元分布于正常面神经核各亚核,切断伤组损伤侧细胞染色重于压榨伤组。损伤后3 d时各蛋白表达开始增强,半胱氨酸天冬氨酸蛋白酶3、8表达于伤后14 d而cyto-c则于伤后7 d时达到高峰。相关性分析结果显示:损伤后半胱氨酸天冬氨酸蛋白酶3、8和cyto-c蛋白表达变化与面神经损伤形式、损伤时间有关,半胱氨酸天冬氨酸蛋白酶8、cyto-c表达与半胱氨酸天冬氨酸蛋白酶3表达相关。提示:半胱氨酸天冬氨酸蛋白酶8,cyto-c可能参与了激活半胱氨酸天冬氨酸蛋白酶3的过程。半胱氨酸天冬氨酸蛋白酶级联反应在面运动神经元凋亡过程中有重要作用。%BACKGROUND:Caspase plays a crucial role in the cellapoptosis, but the influence of different facial nerve injury on caspase 1, caspase 8, cyto-c protein expression and their correlation stil remain unclear. OBJECTIVE:To construct facial nerve crush or distal transection injury models, observe the morphological changes of

  11. A Review of Facial Nerve Anatomy

    OpenAIRE

    2004-01-01

    An intimate knowledge of facial nerve anatomy is critical to avoid its inadvertent injury during rhytidectomy, parotidectomy, maxillofacial fracture reduction, and almost any surgery of the head and neck. Injury to the frontal and marginal mandibular branches of the facial nerve in particular can lead to obvious clinical deficits, and areas where these nerves are particularly susceptible to injury have been designated danger zones by previous authors. Assessment of facial nerve function is no...

  12. Amelioration of acute sequelae of blast induced mild traumatic brain injury by N-acetyl cysteine: a double-blind, placebo controlled study.

    Directory of Open Access Journals (Sweden)

    Michael E Hoffer

    Full Text Available BACKGROUND: Mild traumatic brain injury (mTBI secondary to blast exposure is the most common battlefield injury in Southwest Asia. There has been little prospective work in the combat setting to test the efficacy of new countermeasures. The goal of this study was to compare the efficacy of N-acetyl cysteine (NAC versus placebo on the symptoms associated with blast exposure mTBI in a combat setting. METHODS: This study was a randomized double blind, placebo-controlled study that was conducted on active duty service members at a forward deployed field hospital in Iraq. All symptomatic U.S. service members who were exposed to significant ordnance blast and who met the criteria for mTBI were offered participation in the study and 81 individuals agreed to participate. Individuals underwent a baseline evaluation and then were randomly assigned to receive either N-acetyl cysteine (NAC or placebo for seven days. Each subject was re-evaluated at 3 and 7 days. Outcome measures were the presence of the following sequelae of mTBI: dizziness, hearing loss, headache, memory loss, sleep disturbances, and neurocognitive dysfunction. The resolution of these symptoms seven days after the blast exposure was the main outcome measure in this study. Logistic regression on the outcome of 'no day 7 symptoms' indicated that NAC treatment was significantly better than placebo (OR = 3.6, p = 0.006. Secondary analysis revealed subjects receiving NAC within 24 hours of blast had an 86% chance of symptom resolution with no reported side effects versus 42% for those seen early who received placebo. CONCLUSION: This study, conducted in an active theatre of war, demonstrates that NAC, a safe pharmaceutical countermeasure, has beneficial effects on the severity and resolution of sequelae of blast induced mTBI. This is the first demonstration of an effective short term countermeasure for mTBI. Further work on long term outcomes and the potential use of NAC in civilian m

  13. Amelioration of Acute Sequelae of Blast Induced Mild Traumatic Brain Injury by N-Acetyl Cysteine: A Double-Blind, Placebo Controlled Study

    Science.gov (United States)

    Slade, Martin D.; Tsao, Jack W.; Hoffer, Barry

    2013-01-01

    Background Mild traumatic brain injury (mTBI) secondary to blast exposure is the most common battlefield injury in Southwest Asia. There has been little prospective work in the combat setting to test the efficacy of new countermeasures. The goal of this study was to compare the efficacy of N-acetyl cysteine (NAC) versus placebo on the symptoms associated with blast exposure mTBI in a combat setting. Methods This study was a randomized double blind, placebo-controlled study that was conducted on active duty service members at a forward deployed field hospital in Iraq. All symptomatic U.S. service members who were exposed to significant ordnance blast and who met the criteria for mTBI were offered participation in the study and 81 individuals agreed to participate. Individuals underwent a baseline evaluation and then were randomly assigned to receive either N-acetyl cysteine (NAC) or placebo for seven days. Each subject was re-evaluated at 3 and 7 days. Outcome measures were the presence of the following sequelae of mTBI: dizziness, hearing loss, headache, memory loss, sleep disturbances, and neurocognitive dysfunction. The resolution of these symptoms seven days after the blast exposure was the main outcome measure in this study. Logistic regression on the outcome of ‘no day 7 symptoms’ indicated that NAC treatment was significantly better than placebo (OR = 3.6, p = 0.006). Secondary analysis revealed subjects receiving NAC within 24 hours of blast had an 86% chance of symptom resolution with no reported side effects versus 42% for those seen early who received placebo. Conclusion This study, conducted in an active theatre of war, demonstrates that NAC, a safe pharmaceutical countermeasure, has beneficial effects on the severity and resolution of sequelae of blast induced mTBI. This is the first demonstration of an effective short term countermeasure for mTBI. Further work on long term outcomes and the potential use of NAC in civilian mTBI is warranted

  14. Schwann Cells Overexpressing FGF-2 Alone or Combined with Manual Stimulation Do Not Promote Functional Recovery after Facial Nerve Injury

    Directory of Open Access Journals (Sweden)

    Kirsten Haastert

    2009-01-01

    Full Text Available Purpose. To determine whether transplantation of Schwann cells (SCs overexpressing different isoforms of fibroblast growth factor 2 (FGF-2 combined with manual stimulation (MS of vibrissal muscles improves recovery after facial nerve transection in adult rat. Procedures. Transected facial nerves were entubulated with collagen alone or collagen plus naïve SCs or transfected SCs. Half of the rats received daily MS. Collateral branching was quantified from motoneuron counts after retrograde labeling from 3 facial nerve branches. Quality assessment of endplate reinnervation was combined with video-based vibrissal function analysis. Results. There was no difference in the extent of collateral axonal branching. The proportion of polyinnervated motor endplates for either naïve SCs or FGF-2 over-expressing SCs was identical. Postoperative MS also failed to improve recovery. Conclusions. Neither FGF-2 isoform changed the extent of collateral branching or polyinnervation of motor endplates; furthermore, this motoneuron response could not be overridden by MS.

  15. The patient–body relationship and the "lived experience" of a facial burn injury: a phenomenological inquiry of early psychosocial adjustment

    Directory of Open Access Journals (Sweden)

    McLean LM

    2015-08-01

    Full Text Available Loyola M McLean,1–3 Vanessa Rogers,3–4 Rachel Kornhaber,5–7 Marie-Therese Proctor,8 Julia Kwiet,3–4 Jeffrey Streimer,3–4 John Vanderord6 1Brain and Mind Centre and Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; 2Westmead Psychotherapy Program, Discipline of Psychiatry, Sydney Medical School, University of Sydney and Western Sydney Local Health District, Parramatta, NSW, Australia; 3Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia; 4Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; 5School of Health Sciences, Faculty of Health, University of Tasmania, Alexandria, NSW, Australia; 6Severe Burns Injury Unit, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia; 7School of Nursing, University of Adelaide, SA, Australia; 8Graduate School of Counselling, Excelsia College, Sydney, NSW, Australia Background: Throughout development and into adulthood, a person's face is the central focus for interpersonal communication, providing an important insight into one's identity, age, sociocultural background, and emotional state. The face facilitates important social, including nonverbal, communication. Therefore, sustaining a severe burn, and in particular a facial burn, is a devastating and traumatizing injury. Burn survivors may encounter unique psychosocial problems and experience higher rates of psychosocial maladjustment, although there may be a number of potentially mediating factors. Objectives: The purpose of this phenomenological study was to examine the early recovery experience of patients with a facial burn. In particular, this study focused on how the injury impacted on the participants’ relationship with their own body and the challenges of early psychosocial adjustment within the first 4 months of sustaining the injury. Methods: In 2011, six adult participants encompassing two females and four males

  16. A Fluid Helmet Liner for Protection Against Blast Induced Traumatic Brain Injury

    Science.gov (United States)

    2010-05-01

    Induced Traumatic Brain Injury 5a. CONTRACT NUMBER 5b. GRANT NUMBER N00014-08-1-0261 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Young, Laurence , R... Laurence R. Young Steven F. Son George A. Christou Matthew D. Alley Rahul Goel Andrew P. Vechart Benjamin R. Schimizze Table of Contents...Beach, South Carolina, Battelle Press, Columbus, pp. 29-38,1997. 10. Grover ,R., Ree , F. A., and Holmes, N., "Equation of state from Si02 Aerogel

  17. A Neurobehavioral Phenotype of Blast Traumatic Brain Injury and Psychological Stress in Male and Female Rats

    Science.gov (United States)

    2012-02-03

    The weight drop model (also called Marmarou’s weight drop model; Marmarou et al., 1994; Foda & Marmarou, 1994) is frequently used to model...locomotion depend on rat sex and housing condition. Nicotine & Tobacco Research, 1(2), 143-151. Foda , M.A., & Marmarou, A. (1994). A new model of diffuse...of traumatic brain injury. Georgian Med News, 140, 1306. Marmarou, A., Foda , M.A., van den Brink, W., Campbell, J., Kita, H., & Demetriadou

  18. The importance of oral examination facial trauma: recognition of the Guerin sign in Le Fort 1 injuries

    OpenAIRE

    Kassam, Karim; Kumar, Mahesh

    2014-01-01

    Key Clinical Message Facial Trauma is common. The emergency physician should conduct a thorough examination of the oral tissues. A laceration in the palate can be easily missed and should be elicited. Failure to identify a split palate can result in severe dentofacial deformity.

  19. Characterizing effects of mild traumatic brain injury and posttraumatic stress disorder on balance impairments in blast-exposed servicemembers and Veterans using computerized posturography.

    Science.gov (United States)

    Wares, Joanna R; Hoke, Kathy W; Walker, William; Franke, Laura Manning; Cifu, David X; Carne, William; Ford-Smith, Cheryl

    2015-01-01

    The high rate of blast exposures experienced by U.S. servicemembers (SMs) during the recent conflicts in Iraq and Afghanistan has resulted in frequent combat-related mild traumatic brain injuries (mTBIs). Dizziness and postural instability can persist after mTBI as a component of postconcussion syndrome, but also occur among the somatic complaints of posttraumatic stress disorder (PTSD). The goals of this study were to examine the use of computerized posturography (CPT) to objectively characterize chronic balance deficits after mTBI and to explore the utility of CPT in distinguishing between combat and blast-exposed participants with and without mTBI and PTSD. Data were analyzed from a subject pool of 166 combat-exposed SMs and Veterans who had a blast experience within the past 2 yr while deployed. Using nonparametric tests and measures of impairment, we found that balance was deficient in participants diagnosed with mTBI with posttraumatic amnesia (PTA) or PTSD versus those with neither and that deficits were amplified for participants with both diagnoses. In addition, unique deficiencies were found using CPT for individuals having isolated mTBI with PTA and isolated PTSD. Computerized balance assessment offers an objective technique to examine the physiologic effects and provide differentiation between participants with combat-associated mTBI and PTSD.

  20. Glibenclamide pretreatment protects against chronic memory dysfunction and glial activation in rat cranial blast traumatic brain injury.

    Science.gov (United States)

    Stokum, Jesse A; Keledjian, Kaspar; Hayman, Erik; Karimy, Jason K; Pampori, Adam; Imran, Ziyan; Woo, Seung Kyoon; Gerzanich, Volodymyr; Simard, J Marc

    2017-08-30

    Blast traumatic brain injury (bTBI) affects both military and civilian populations, and often results in chronic deficits in cognition and memory. Chronic glial activation after bTBI has been linked with cognitive decline. Pharmacological inhibition of sulfonylurea receptor 1 (SUR1) with glibenclamide was shown previously to reduce glial activation and improve cognition in contusive models of CNS trauma, but has not been examined in bTBI. We postulated that glibenclamide would reduce chronic glial activation and improve long-term memory function after bTBI. Using a rat direct cranial model of bTBI (dc-bTBI), we evaluated the efficacy of two glibenclamide treatment paradigms: glibenclamide prophylaxis (pre-treatment), and treatment with glibenclamide starting after dc-bTBI (post-treatment). Our results show that dc-bTBI caused hippocampal astrocyte and microglial/macrophage activation that was associated with hippocampal memory dysfunction (rapid place learning paradigm) at 28days, and that glibenclamide pre-treatment, but not post-treatment, effectively protected against glial activation and memory dysfunction. We also report that a brief transient time-window of blood-brain barrier (BBB) disruption occurs after dc-bTBI, and we speculate that glibenclamide, which is mostly protein bound and does not normally traverse the intact BBB, can undergo CNS delivery only during this brief transient opening of the BBB. Together, our findings indicate that prophylactic glibenclamide treatment may help to protect against chronic cognitive sequelae of bTBI in warfighters and other at-risk populations. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. INTRA-ARTERIAL INFUSIONS AND DOPLEROGRAPIC CONTROL FOR COMPLEX TREATMENT OF UPPER AND MIDDLE FACIAL ZONES, CONCOMITANT WITH TRAUMATIC CRANIOCEREBRAL INJURIES.

    Science.gov (United States)

    Lagvilava, G; Gvenetadze, Z; Gibradze, E; Danelia, T; Gvenetadze, G

    2016-02-01

    Maxillofacial traumatic injuries concomitant with craniocerebral trauma are still considered as an actual problem in emergency medicine. For this category of patients one of the dangerous and severe complications is development of inflammatory process in the injured areas. Fracture lines of upper and middle facial zones pass through the accessory sinuses of the nose, maxillary/upper dental arch area and are considered to be open and infected fractures. Combination of these fractures with craniocerebral injuries and especially, with open traumas creates predisposition for development of inflammatory processes in CNS that can result in heavy outcome. 29 patients (among them 5-females and 24 -males) with severe and open craniofacial fractures were observed by the authors. For prevention of inflammatory complications in complex treatment of the patients, intra-arterial infusions of therapeutic agents (wide spectrum of antibiotics, Heparin) were used for stimulation of reparative regeneration in fractured fragments of facial bones. After the main surgical interventions (neurosurgery, surgery of facial bones) sanitation of infected centers (accessory sinuses of the nose, oral cavity) and catheterization of external carotid arteries through the temporal arteries were performed. According to the severity of the trauma and its preferential localization, catheterization of carotid arteries was conducted unilaterally (12 cases) or bilaterally (17 cases). Insertion depth through femoral artery was 6-8 cm. Catheter was stayed in the artery for 7-8 days. Intra-arterial infusions were carried out in the morning and evening. Therapeutic agents for arterial infusion included: antibiotic (Rocephin and its analogues), Heparin. To determine the effectiveness of vascular therapy dopplerography of external carotid artery, its branches and supratrochlear artery was performed. Dopplerography of supratrochlear artery, which is the branch of internal carotid artery, was conducted to detect

  2. Intervention of plastic surgery for emergency facial soft tissue injury%急诊面部软组织创伤的整形外科干预

    Institute of Scientific and Technical Information of China (English)

    孙秀锋; 郑妍丽; 姜涛; 王洪燕

    2011-01-01

    [目的]探讨应用整形外科原则和技术,处理急诊面部软组织创伤的方法和经验.[方法]选择急诊面部软组织创伤病例320例,采用整形外科原则和技术行清创及Ⅰ期缝合,观察治疗效果.[结果]伤口Ⅰ期愈合,无明显瘢痕增生,无功能障碍,不需要Ⅱ期修复,美容效果良好.[结论]应用整形外科基本原则和技术处理面部急性软组织创伤,可获得满意的美容效果,值得推广应用.%[Objective] To explore the clinical method of treating emergency facial soft tissue trauma with plastic surgical principles and techniques. [ Methods] The emergency facial soft tissue injuries of 320 patients were selected. They had been debrided and repaired primarily with plastic surgical principles and techniques. Healing effects were observed. [ Results] All cases were primary healing. There were no obvious hyperplasy scars and functional disturbance. Second stage reparation was not required. The cosmetic effect was perfect. [ Conclusion] It is a satisfactory and effective method to treat emergency facial soft tissue trauma with plastic surgical principles and techniques,which can be recommended to all the surgeons.

  3. Facial paralysis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003028.htm Facial paralysis To use the sharing features on this page, please enable JavaScript. Facial paralysis occurs when a person is no longer able ...

  4. [Mountain sports: their role in 2200 facial injuries occurring over 4 years at the University Hospital Center in Grenoble].

    Science.gov (United States)

    Le Bescond, Y; Lebeau, J; Delgove, L; Sadek, H; Raphael, B

    1992-01-01

    Injuries caused by mountain sports account for many of the injuries admitted to the University Hospital of Grenoble. Out of 4,490 traumas, 470 were injuries sustained during the practice of mountain sports. While the frequency of these accidents does not evolve much, the etiological distribution depends on fashion. Thus an increasing number of lesions caused by cross-country biking has been noted during the past two years. We find it urgent to propose protective measures adapted to this new sport.

  5. 腮腺及面神经急性损伤的急诊治疗体会%Treatment Experience for Acute Injuries of Parotid Gland and Facial Nerve

    Institute of Scientific and Technical Information of China (English)

    郝冬月; 刘超华; 何林; 孙峰; 宋保强; 夏文森

    2014-01-01

    Objective To explore the diagnosis and treatment for acute injuries of parotid and facial nerve. Methods From June 2012 to June 2013, 21 cases with parotid and facial nerve injury were performed actively emergency treatment. After sufficient preoperative preparation, the parotid gland and facial nerves were actively treated. Injury in parotid gland, parotid duct, or facial nerve were differently treated. Parotid gland ruptures were repaired instantly, and the parotid duct and facial nerve were anastomosed instantly. Results 93% of the patients with parotid gland and parotid duct injury were completely healed, while the other 7% cases had parotid gland fistula. All of the 7% patients were cured after giving anticholinergics and pressure dressing. 66% of the patients with facial nerve injury were completely cured, the other 24%cases were partly cured, and remained 10% cases were not cured. Conclusion Strict examination should be given to the patients with acute injuries of parotid gland and facial nerve, then the diagnosis and treatment could be given instantly.%目的:探讨腮腺及面神经急性损伤的诊断和治疗。方法2012年6月至2013年6月,对21例腮腺及面神经急性损伤患者进行急诊处理。充分术前准备后,针对腮腺、腮腺导管、面神经主干及各分支损伤,采取不同判断方法,即时行破裂修补及吻合术。术后随访并统计疗效。结果93%腮腺破裂及导管断裂的患者完全治愈,7%患者出现腮腺漏,经换药、抑制腺体分泌药物和加压包扎等治疗后康复;66%面神经吻合的患者基本恢复,24%的患者部分恢复,10%的患者未恢复。结论应对腮腺及面神经急性创伤进行严格检查,并对腮腺及面神经急性损伤进行及时诊断和治疗。

  6. A review of facial nerve anatomy.

    Science.gov (United States)

    Myckatyn, Terence M; Mackinnon, Susan E

    2004-02-01

    An intimate knowledge of facial nerve anatomy is critical to avoid its inadvertent injury during rhytidectomy, parotidectomy, maxillofacial fracture reduction, and almost any surgery of the head and neck. Injury to the frontal and marginal mandibular branches of the facial nerve in particular can lead to obvious clinical deficits, and areas where these nerves are particularly susceptible to injury have been designated danger zones by previous authors. Assessment of facial nerve function is not limited to its extratemporal anatomy, however, as many clinical deficits originate within its intratemporal and intracranial components. Similarly, the facial nerve cannot be considered an exclusively motor nerve given its contributions to taste, auricular sensation, sympathetic input to the middle meningeal artery, and parasympathetic innervation to the lacrimal, submandibular, and sublingual glands. The constellation of deficits resulting from facial nerve injury is correlated with its complex anatomy to help establish the level of injury, predict recovery, and guide surgical management.

  7. Hyperbaric oxygen therapy ameliorates local brain metabolism, brain edema and inflammatory response in a blast-induced traumatic brain injury model in rabbits.

    Science.gov (United States)

    Zhang, Yongming; Yang, Yanyan; Tang, Hong; Sun, Wenjiang; Xiong, Xiaoxing; Smerin, Daniel; Liu, Jiachuan

    2014-05-01

    Many studies suggest that hyperbaric oxygen therapy (HBOT) can provide some clinically curative effects on blast-induced traumatic brain injury (bTBI). The specific mechanism by which this occurs still remains unknown, and no standardized time or course of hyperbaric oxygen treatment is currently used. In this study, bTBI was produced by paper detonators equivalent to 600 mg of TNT exploding at 6.5 cm vertical to the rabbit's head. HBO (100% O2 at 2.0 absolute atmospheres) was used once, 12 h after injury. Magnetic resonance spectroscopy was performed to investigate the impact of HBOT on the metabolism of local injured nerves in brain tissue. We also examined blood-brain barrier (BBB) integrity, brain water content, apoptotic factors, and some inflammatory mediators. Our results demonstrate that hyperbaric oxygen could confer neuroprotection and improve prognosis after explosive injury by promoting the metabolism of local neurons, inhibiting brain edema, protecting BBB integrity, decreasing cell apoptosis, and inhibiting the inflammatory response. Furthermore, timely intervention within 1 week after injury might be more conducive to improving the prognosis of patients with bTBI.

  8. A Table-top Blast Driven Shock Tube

    OpenAIRE

    Courtney, Michael; Courtney, Amy

    2011-01-01

    The prevalence of blast-induced traumatic brain injury in conflicts in Iraq and Afghanistan has motivated laboratory scale experiments on biomedical effects of blast waves and studies of blast wave transmission properties of various materials in hopes of improving armor design to mitigate these injuries. This paper describes the design and performance of a table-top shock tube that is more convenient and widely accessible than traditional compression driven and blast driven shock tubes. The d...

  9. [Facial palsy].

    Science.gov (United States)

    Cavoy, R

    2013-09-01

    Facial palsy is a daily challenge for the clinicians. Determining whether facial nerve palsy is peripheral or central is a key step in the diagnosis. Central nervous lesions can give facial palsy which may be easily differentiated from peripheral palsy. The next question is the peripheral facial paralysis idiopathic or symptomatic. A good knowledge of anatomy of facial nerve is helpful. A structure approach is given to identify additional features that distinguish symptomatic facial palsy from idiopathic one. The main cause of peripheral facial palsies is idiopathic one, or Bell's palsy, which remains a diagnosis of exclusion. The most common cause of symptomatic peripheral facial palsy is Ramsay-Hunt syndrome. Early identification of symptomatic facial palsy is important because of often worst outcome and different management. The prognosis of Bell's palsy is on the whole favorable and is improved with a prompt tapering course of prednisone. In Ramsay-Hunt syndrome, an antiviral therapy is added along with prednisone. We also discussed of current treatment recommendations. We will review short and long term complications of peripheral facial palsy.

  10. 爆竹火药爆炸烧伤伴吸入性损伤的救治%Treatment on the patients of fireworks gunpowder blast injury accompanied with inhalation injury

    Institute of Scientific and Technical Information of China (English)

    郭利刚; 葛礼正; 王凌东; 焦洋; 刘安军; 苏显林

    2012-01-01

    Objective To summarize the experiences of treatment on the patients of fireworks gunpowder blast injury accompanied with inhalation injury. Methods Eighty four cases rescued in this hospital were analyzed in the study. Results Among the 84 cases,59 patients were cured, and 25 patients were died, the mortality was 29.8%. Conclusion Patients injured by the fireworks gunpowder blast have not only high complication rate of inhalation injury but also high mortality. Early diagnosis and treatment, keeping the airway unobstructed are the main measures of treatment. The patients should inhale high concentrations oxygen or pure oxygen immediately after injury. It is necessary to give the patients tracheotomy and to use the moisture mechanical ventilation with positive END-EXPIRATORY PRESSURE (PEEP) and airway lavage early and preventively. It is a key measure to deal with the wounded surface and eliminate or remove scab early in order to avoid visceral complications and improve cure rate.%目的 总结爆竹火药爆炸伤伴吸入性损伤的救治体会.方法对救治的84例患者临床资料进行统计分析.结果 84例中治愈59例,病死率29.8%.结论爆竹火药爆炸伤的吸入性损伤并发率高,病死率亦高.救治应早诊断,早治疗,保持气道通畅.伤后立即吸入高浓度氧或纯氧;预防性、及早地气管切开,应用带湿化的PEEP机械通气和气道灌洗;早期处理创面,切、削痂去除坏死组织,防止内脏并发症,以提高治愈率.

  11. Combined Effects of Primary and Tertiary Blast on Rat Brain: Characterization of a Model of Blast-induced Mild Traumatic Brain Injury

    Science.gov (United States)

    2015-03-01

    changes in protein biomarker levels in functionally -relevant brain regions Two days following injury (or sham), we dissected the PFC, AD, DHC, and VHC and...period. Neuropathological changes are temporally and anatomically closely associated with neuroinflammation, prompting interest in the latter as...known function of TNAP in dephosphorylating pTau, the accumulation of pTau after brain injury could be attributed to the decreased TNAP

  12. Combined Effects of Primary and Tertiary Blast on Rat Brain: Characterization of a Model of Blast-induced Mild Traumatic Brain Injury

    Science.gov (United States)

    2012-03-01

    measurements revealed significant elevations in reactive oxygen species and DNA fragmentation at 24 hrs postinjury. LOC as estimated by prolonged...neurochemical assessments reveal a similar interaction or interplay between insults such that the pathophysiological DNA fragmentation and inflammatory...and combined injuries. Fig 5. DNA fragmentation after BOP, weight drop, and combined injuries. mark, 0.5 for a fall in the middle and 0

  13. Explosive Blast Neuropathology and Seizures

    Directory of Open Access Journals (Sweden)

    S. Krisztian eKovacs

    2014-04-01

    Full Text Available Traumatic brain injury (TBI due to explosive blast exposure is a leading combat casualty. It is also implicated as a key contributor to war related mental health diseases. A clinically important consequence of all types of TBI is a high risk for development of seizures and epilepsy. Seizures have been reported in patients who have suffered blast injuries in the Global War on Terror but the exact prevalence is unknown. The occurrence of seizures supports the contention that explosive blast leads to both cellular and structural brain pathology. Unfortunately, the exact mechanism by which explosions cause brain injury is unclear, which complicates development of meaningful therapies and mitigation strategies. To help improve understanding, detailed neuropathological analysis is needed. For this, histopathological techniques are extremely valuable and indispensable. In the following we will review the pathological results, including those from immunohistochemical and special staining approaches, from recent preclinical explosive blast studies.

  14. The facial skeleton: Armor to the brain?

    OpenAIRE

    Patil, Satishkumar G.; Patil, Bindu S.; Joshi, Udupikrishna; Allurkar, Soumya; Japatti, Sharanabasappa; Munnangi, Ashwini

    2016-01-01

    Background: With the development of urban setting worldwide, the major issue of concern is the increase in the mortality rate in the population due to road traffic accidents. The face, being the most exposed region is susceptible to injuries and maybe associated with injuries to the adjacent neuro-cranium. The literature has conflicting views on the relationship between facial fractures and head injuries with some authors opining that the facial skeleton cushions the brain while some other au...

  15. Demyelination as a Target for Cell-Based Therapy of Chronic Blast-Induced Traumatic Brain Injury

    Science.gov (United States)

    2015-10-01

    remyelination that uses glial restricted progenitors (GRPs) Diffusion tensor imaging, learning and behavior, white matter abnormalities, blast traumatic...the data analysis have been completed for 1 day time point. (b) Reportable outcomes: Diffuson tensor imaging (DTI): Different regions of brain have

  16. Diplegia facial traumatica Traumatic facial diplegia: a case report

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1975-12-01

    Full Text Available É relatado um caso de paralisia facial bilateral, incompleta, associada a hipoacusia esquerda, após traumatismo cranioencefálico, com fraturas evidenciadas radiológicamente. Algumas considerações são formuladas tentando relacionar ditas manifestações com fraturas do osso temporal.A case of traumatic facial diplegia with left partial loss of hearing following head injury is reported. X-rays showed fractures on the occipital and left temporal bones. A review of traumatic facial paralysis is made.

  17. Long-Term Ability to Interpret Facial Expression after Traumatic Brain Injury and Its Relation to Social Integration

    Science.gov (United States)

    Knox, Lucy; Douglas, Jacinta

    2009-01-01

    There is considerable evidence that individuals with traumatic brain injury (TBI) experience problems interpreting the emotional state of others. However, the functional implications of these changes have not been fully investigated. A study of 13 individuals with severe TBI and an equal number of matched controls found that TBI participants had…

  18. Facial swelling

    Science.gov (United States)

    ... help reduce facial swelling. When to Contact a Medical Professional Call your health care provider if you have: Sudden, painful, or severe facial ... or if you have breathing problems. The health care provider will ask about your medical and personal history. This helps determine treatment or ...

  19. Sports injuries of the ear.

    Science.gov (United States)

    Wagner, G A

    1972-07-01

    The author describes common sports injuries involving the ear. Such injuries include hematoma, lacerations, foreign bodies (tattoo), and thermal injuries. Ear canal injuries include swimmer's ear and penetrating injuries. Tympanum injuries include tympanic membrane perforations, ossicular discontinuity, eustachian tube dysfunction, temporal bone fractures and traumatic facial nerve palsy. Inner ear injuries include traumatic sensorineural deafness. The author emphasizes the management of these injuries.

  20. Textbook of Military Medicine. Part 1. Warfare, Weaponry, and the Casualty. Part 5. Conventional Warfare. Ballistic, Blast, and Burn Injuries

    Science.gov (United States)

    1991-01-01

    submunitions are becoming increasingly common in projection that resembles a butterfly’s wings combat (Figure 1-50). around the detonation site (Figure 1...T.; Phillips, Y. Y III. 1988. Computer modelir.g -. thoracic response to blast. J. Trauma 28:S149-$152. 240 Wing , Chapter 7 THE PHYSICS AND...or postmortem sphenoid , and lacrimal bones on the medial surface of examination unless a retrobulbar hemorrhage has re- the orbital wall. In studies

  1. Altering endoplasmic reticulum stress in a model of blast-induced traumatic brain injury controls cellular fate and ameliorates neuropsychiatric symptoms

    Directory of Open Access Journals (Sweden)

    Aric Flint Logsdon

    2014-12-01

    Full Text Available Neuronal injury following blast-induced traumatic brain injury (bTBI increases the risk for neuropsychiatric disorders, yet the pathophysiology remains poorly understood. Blood-brain-barrier (BBB disruption, endoplasmic reticulum (ER stress, and apoptosis have all been implicated in bTBI. Microvessel compromise is a primary effect of bTBI and is postulated to cause subcellular secondary effects such as ER stress. What remains unclear is how these secondary effects progress to personality disorders in humans exposed to head trauma. To investigate this we exposed male rats to a clinically relevant bTBI model we have recently developed. The study examined initial BBB disruption using Evan’s blue, ER stress mechanisms, apoptosis and impulsive-like behavior measured with elevated plus maze (EPM. Large BBB openings were observed immediately following bTBI, and persisted for at least 6 h. Data showed increased mRNA abundance of stress response genes at 3 h, with subsequent increases in the ER stress markers C/EBP homologous protein (CHOP and growth arrest and DNA damage-inducible protein 34 (GADD34 at 24 h. Caspase-12 and Caspase-3 were both cleaved at 24 h following bTBI. The ER stress inhibitor, salubrinal (SAL, was administered (1mg/kg i.p. to investigate its’ effects on neuronal injury and impulsive-like behavior associated with bTBI. SAL reduced CHOP protein expression, and diminished Caspase-3 cleavage, suggesting apoptosis attenuation. Interestingly, SAL also ameliorated impulsive-like behavior indicative of head trauma. These results suggest SAL plays a role in apoptosis regulation and the pathology of chronic disease. These observations provide evidence that bTBI involves ER stress and that the UPR is a promising molecular target for the attenuation of neuronal injury.

  2. 整形外科技术在面部软组织损伤急诊处理中的应用%Clinical application of plastic surgery techniques in emergency treatment of facial soft tissue injuries

    Institute of Scientific and Technical Information of China (English)

    师军涛; 秦宏伟; 王新征

    2013-01-01

    目的 探讨整形外科技术在面部软组织损伤急诊处理中应用的临床效果,以及最大限度地恢复患者面部形态及功能的整形外科方法.方法 回顾性分析2009年6月至2011年6月收治的798例面部软组织创伤患者,采用整形外科技术,根据具体伤情设计不同修复方法,严格遵守无菌无创原则,进行清创、创面修复、皮瓣修复等治疗.结果 790例患者术后Ⅰ期愈合,8例伴有轻微瘢痕,随访6个月至1年,无感染、坏死、明显瘢痕等并发症发生,面部形态及功能恢复良好.结论 在面部软组织损伤急诊处理时,尽早应用整形外科技术进行Ⅰ期修复,避免创面自然愈合后发生畸形及功能障碍,无需Ⅱ期手术整形.%Objective To evaluate the clinical application and effect of plastic surgery in emergency treatment of facial soft tissue injuries,and to explore the better plastic surgery method for facial soft tissue injuries in order to regain the patient facial morphology and function maximally.Methods The clinical data of 798 patients with facial soft tissue injuries from June 2009 to June 2011 were analyzed retrospectively.And plastic surgical techniques were applied to the early treatment of facial soft tissue injuries in this group cases,according to the size of defect and the degree of deformity of the patient,different plastic surgery treatment was chosen,such as skin flap or skin graft to repair wound surfaces.In this process,one must follow sterile noninvasive principle strictly with emphasis on the technique of plastic surgery such as entire debridement,wound healing application of skin flap and so on.Results 790 cases of facial soft tissue injuries were healed by first intention without significant complications,while 8 cases of them had mild scars.During 6 to 12 months of follow-up,neither scar,nor infections and necrosis of the wound region occurred,and the morphology and function of patients' face recovered well without the

  3. Changing characteristics of facial fractures treated at a regional, level 1 trauma center, from 2005 to 2010: an assessment of patient demographics, referral patterns, etiology of injury, anatomic location, and clinical outcomes.

    Science.gov (United States)

    Roden, Katherine S; Tong, Winnie; Surrusco, Matthew; Shockley, William W; Van Aalst, John A; Hultman, Charles S

    2012-05-01

    Despite improvements in automotive safety, motor vehicle collision (MVC)-related facial fractures remain common and represent preventable injuries. This study examines the changing characteristics of facial fractures treated at a regional, level I trauma center, from 2005 to 2010. We identified all patients with facial fractures admitted to our hospital, from 2005 to 2010, by querying the North Carolina Trauma Registry, using International Classification of Diseases, Ninth Revision codes. Prospectively collected data, sorted by year, were descriptively analyzed for demographics, referral patterns, etiology, anatomic location, and clinical outcomes. Number of patients with facial fractures increased from 201 per year to 263 per year (total n = 1508). Although transport distances remained constant at ∼85 miles, standard deviation increased from 37 to 68 miles. Transport time increased from 87 to 119 minutes. Referrals came from 28 surrounding counties in 2005 and 43 counties in 2010. Regarding etiology, MVCs decreased from 40% to 27%, all-terrain vehicle crashes decreased from 6% to 2%, falls increased from 8% to 19%, and bicycle accidents increased from 3% to 6%. Regarding anatomic location, frontal sinus fractures increased from 8% to 37%, zygomaticomaxillary fractures increased from 9% to 18%, nasoethmoid fractures decreased from 12% to 6%, orbital floor fractures decreased from 6% to 3%, and mandible fractures decreased from 28% to 18%. Single-site fractures increased from 75% to 90%. Length of intensive care unit and hospital stay remained stable at 3 and 7 days, respectively. Despite a decrease in MVC-related facial fractures, the overall increase in facial fractures referred to our trauma center is due to a growing number of patient transfers from rural hospitals, where a paucity of qualified surgeons may exist.

  4. Clinical and experimental study on facial paralysis in temporal bone fracture

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To study the main prognostic factors and significanceof facial nerve decompression for facial paralysis in temporal bone fracture.Methods: The main relative prognostic factors of 64 patients with facial paralysis were analyzed. An experimental model of facial paralysis was made. The expansion rates of facial nerve in the facial canal opening group and the facial canal non-opening group were measured and observed under electron microscope.Results: The main factors affecting the prognosis were facial nerve decompression and selection of surgery time. The expansion rate of facial nerve in the facial canal opening group was significantly higher than that of the facial canal non-opening group (t=7.53, P<0.01). The injury degree of the nerve fiber in the facial canal non-opening group was severe.Conclusions: Early facial nerve decompression is beneficial to restoration of the facial nerve function.

  5. Gunshot wounds and blast injuries to the face are associated with significant morbidity and mortality: results of an 11-year multi-institutional study of 720 patients.

    Science.gov (United States)

    Shackford, Steven R; Kahl, Jessica E; Calvo, Richard Y; Kozar, Rosemary A; Haugen, Christine E; Kaups, Krista L; Willey, Marybeth; Tibbs, Brian M; Mutto, Susan M; Rizzo, Anne G; Lormel, Christy S; Shackford, Meghan C; Burlew, Clay Cothren; Moore, Ernest E; Cogbill, Thomas H; Kallies, Kara J; Haan, James M; Ward, Jeanette

    2014-02-01

    Gunshot wounds and blast injuries to the face (GSWBIFs) produce complex wounds requiring management by multiple surgical specialties. Previous work is limited to single institution reports with little information on processes of care or outcome. We sought to determine those factors associated with hospital complications and mortality. We performed an 11-year multicenter retrospective cohort analysis of patients sustaining GSWBIF. The face, defined as the area anterior to the external auditory meatuses from the top of the forehead to the chin, was categorized into three zones: I, the chin to the base of the nose; II, the base of the nose to the eyebrows; III, above the brows. We analyzed the effect of multiple factors on outcome. From January 1, 2000, to December 31, 2010, we treated 720 patients with GSWBIF (539 males, 75%), with a median age of 29 years. The wounding agent was handgun in 41%, explosive (shotgun and blast) in 20%, rifle in 6%, and unknown in 33%. Prehospital or resuscitative phase airway was required in 236 patients (33%). Definitive care was rendered by multiple specialties in 271 patients (38%). Overall, 185 patients died (26%), 146 (79%) within 48 hours. Of the 481 patients hospitalized greater than 48 hours, 184 had at least one complication (38%). Factors significantly associated with any of a total of 207 complications were total number of operations (p < 0.001), Revised Trauma Score (RTS, p < 0.001), and head Abbreviated Injury Scale (AIS) score (p < 0.05). Factors significantly associated with mortality were RTS (p < 0.001), head AIS score (p < 0.001), total number of operations (p < 0.001), and age (p < 0.05). An injury located in Zone III was independently associated with mortality (p < 0.001). GSWBIFs have high mortality and are associated with significant morbidity. The multispecialty involvement required for definitive care necessitates triage to a trauma center and underscores the need for an organized approach and the development of

  6. Pediatric facial burns: Is facial transplantation the new reconstructive psychosurgery?

    Science.gov (United States)

    Hanson, Mark D; Zuker, Ronald M; Shaul, Randi Zlotnik

    2008-01-01

    INTRODUCTION: Current pediatric burn care has resulted in survival being the expectation for most children. Composite tissue allotransplantation in the form of face or hand transplantation may present opportunities for reconstructive surgery of patients with burns. The present paper addresses the question “Could facial transplantation be of therapeutic benefit in the treatment of pediatric burns associated with facial disfigurement?” METHODS: Therapeutic benefit of facial transplantation was defined in terms of psychiatric adjustment and quality of life (QOL). To ascertain therapeutic benefit, studies of pediatric burn injury and associated psychiatric adjustment and QOL in children, adolescents and adults with pediatric burns, were reviewed. RESULTS: Pediatric burn injury is associated with anxiety disorders, including post-traumatic stress disorder and depressive disorders. Many patients with pediatric burns do not routinely access psychiatric care for these disorders, including those for psychiatric assessment of suicidal risk. A range of QOL outcomes were reported; four were predominantly satisfactory and one was predominantly unsatisfactory. DISCUSSION: Facial transplantation may reduce the risk of depressive and anxiety disorders other than post-traumatic stress disorder. Facial transplantation promises to be the new reconstructive psychosurgery, because it may be a surgical intervention with the potential to reduce the psychiatric suffering associated with pediatric burns. Furthermore, patients with pediatric burns may experience the stigma of disfigurement and psychiatric conditions. The potential for improved appearance with facial transplantation may reduce this ‘dual stigmata’. Studies combining surgical and psychiatric research are warranted. PMID:19949498

  7. Three-dimensional finite element simulation and biomechanical analysis of mandible chin blast injury%下颌骨颏部爆炸伤三维有限元仿真及生物力学分析

    Institute of Scientific and Technical Information of China (English)

    雷涛; 郑加军; 王婷婷; 李瑛; 谢良宪

    2015-01-01

    Objective To simulate a finite element model for biomechanical analysis of mandible chin blast injury and analyze the mechanism of maxillofacial blast injury.Methods The three-dimensional element model of human mandible blast injury was established to simulate the dynamic process of injury to the mandible chin.Von Mises stress and effective strain were evaluated in biomechanical study of the simulation results.Results The dynamic damage process of human mandible chin blast injury was simulated successfully.In the condition of 1 000 mg and 3 cm,the Von Mises stress and effective were maximum at condylar neck region (9.1 × 106 Pa,0.62 × 10-3ε),were second at mandibular angle region (6.1 × 106 Pa,0.42 × 10-3ε),and minimum at mental foramen region (6.1 × 106 Pa,0.39 × 10-3ε).Blast distance rather than blast equivalent produced more effect on the mechanical parameters and damage degree.Conclusions Von Mises stress and effective strain can be applied to the evaluation of bone tissue damage.The finite element method is effective in simulating mandible blast injury and can provide a new thought and approach to clinical treatment of oral and maxillofacial blast injury.%目的 利用有限元数字模拟技术动态仿真人下颌骨颏部爆炸伤损伤过程,并进行生物力学分析,探讨颌面部爆炸伤致伤机制. 方法 建立人下颌骨爆炸伤三维有限元模型,动态模拟颏部在不同致伤条件下爆炸动态损伤过程,利用Von Mises应力及有效应变对模拟的结果进行生物力学分析 结果 成功模拟人下颌骨颏部爆炸伤动态损伤过程并进行致伤机制的生物力学分析,在1 000 mg、3 cm条件下,髁状突颈部Von Mises应力及有效应变值最高(9.1×106 Pa及0.62×10-3ε)、下颌角正中次之(6.1×106 Pa及0.42×10-3ε)、下颌骨颏孔区最小(6.1×106 Pa及0.39×10-3ε),距离较爆炸当量对各力学指标及损伤程度影响更为明显. 结论 有限元法可以有效模拟下颌骨爆

  8. Facial anatomy.

    Science.gov (United States)

    Marur, Tania; Tuna, Yakup; Demirci, Selman

    2014-01-01

    Dermatologic problems of the face affect both function and aesthetics, which are based on complex anatomical features. Treating dermatologic problems while preserving the aesthetics and functions of the face requires knowledge of normal anatomy. When performing successfully invasive procedures of the face, it is essential to understand its underlying topographic anatomy. This chapter presents the anatomy of the facial musculature and neurovascular structures in a systematic way with some clinically important aspects. We describe the attachments of the mimetic and masticatory muscles and emphasize their functions and nerve supply. We highlight clinically relevant facial topographic anatomy by explaining the course and location of the sensory and motor nerves of the face and facial vasculature with their relations. Additionally, this chapter reviews the recent nomenclature of the branching pattern of the facial artery.

  9. Facial tics

    Science.gov (United States)

    Tic - facial; Mimic spasm ... Tics may involve repeated, uncontrolled spasm-like muscle movements, such as: Eye blinking Grimacing Mouth twitching Nose wrinkling Squinting Repeated throat clearing or grunting may also be ...

  10. Facial Recognition

    National Research Council Canada - National Science Library

    Mihalache Sergiu; Stoica Mihaela-Zoica

    2014-01-01

    .... From birth, faces are important in the individual's social interaction. Face perceptions are very complex as the recognition of facial expressions involves extensive and diverse areas in the brain...

  11. IED blast postconcussive syncope and autonomic dysregulation.

    Science.gov (United States)

    Sams, Richard; LaBrie, D Walter; Norris, Jacob; Schauer, Judy; Frantz, Earl

    2012-01-01

    Concussions are the most frequent battle injury sustained in Afghanistan. The Concussion Restoration Care Center provides multidisciplinary care to concussed service members in theater. The Concussion Restoration Care Center has managed over 500 concussions, the majority being from improvised explosive device (IED) blasts. Syncope following a concussion without a loss of consciousness is rarely reported in the literature. The pathophysiology of concussion from a blast injury may be distinct from a concussion secondary to blunt trauma. Two cases of syncope following concussions with an alteration of consciousness are presented, and a mechanism of action is proposed. Post-IED blast concussive symptom frequency at initial presentation on a cohort of patients is reported, with 1.3% of patients experiencing postconcussive syncope. Syncope following an IED blast may be related to centrally mediated autonomic dysregulation at the brain stem level. Syncope should be added to the list of possible symptoms that occur following concussions, in particular concussions following a blast injury.

  12. 面神经损伤后面神经核中神经型钙黏附分子及胎盘型钙黏附分子的表达%Expression of neuronal cadherin and placental cadherin in facial motoneurons after facial nerve injury

    Institute of Scientific and Technical Information of China (English)

    李雷激; 徐超然; 覃纲; 刘跃华; 祝琳

    2015-01-01

    背景:面神经周围性损伤后,首先涉及其中枢神经元轴突的逆行性反应,神经能否再生则取决于神经元胞体的存活及功能状态。  目的:检测面神经损伤后,面神经核中神经型钙黏附分子和胎盘型钙黏附分子的表达变化。  方法:将新西兰大白兔随机分为模型组(n=48)和对照组(n=8)。模型组兔建立右侧面神经压榨损伤模型。模型组分别于损伤后1,4,7,14,21,28 d各取8只兔进行检测。运用免疫组织化学SP法及实时定量PCR法检测兔右侧面神经核运动神经元中神经型钙黏附分子和胎盘型钙黏附分子蛋白及mRNA的表达水平。  结果与结论:对照组兔右侧面神经核运动神经元中无神经型钙黏附分子或胎盘型钙黏附分子标记的阳性神经元。模型组兔右侧面神经核运动神经元中存在神经型钙黏附分子和胎盘型钙黏附分子阳性神经元,2种阳性神经元数量均在第14天时达到峰值。与对照组相比,模型组损伤后4-28 d兔面神经核中神经型钙黏附分子mRNA的表达水平明显增加,损伤后1 d时兔面神经核中胎盘型钙黏附分子mRNA的表达水平明显下降,损伤后7-28 d时兔面神经核中胎盘型钙黏附分子mRNA的表达水平明显增加。提示面神经损伤的早期即出现2种分子的阳性表达,其中胎盘型钙黏附分子的表达自神经损伤后一直存在,而神经型钙黏附分子表达时间相对较短。在面神经损伤时,面神经核中神经型钙黏附分子和胎盘型钙黏附分子均表达增加,说明面神经再生可能与黏附分子的高表达有关。%BACKGROUND:Peripheral facial nerve injury first involves the retrograde reactions of central nervous system axons, and nerve regeneration wil depend on the survival and functional status of neuronal cel bodies. OBJECTIVE:To explore the expression of neuronal cadherin and placental cadherin in facial

  13. Autologous platelet rich plasma repair facial nerve injury%自体富血小板血浆修复面神经损伤★

    Institute of Scientific and Technical Information of China (English)

    张兴安; 吴蜀江; 卢海彬; 石修全; 王洪玲; 曹云亮; 李元秀

    2013-01-01

      背景:周围性面神经损伤治疗包括手术、理疗及药物等方法,但有些情况下治疗效果并不十分理想。目的:研究自体富血小板血浆在面神经损伤修复中的作用。方法:将健康大耳白兔10只双侧面神经上颊支横断后置入硅胶神经再生导管,一侧注入富血小板血浆为实验侧,另一侧注入生理盐水为对照侧。术后8周进行面神经大体观察、神经电生理检测、组织学观察、图像分析、评价面神经再生恢复情况。结果与结论:实验侧口轮匝肌动作电位潜伏期明显低于对照侧,复合神经肌肉动作电位振幅(M 波)明显高于对照侧(P <0.01)。实验侧再生神经更显成熟,再生轴突较多,髓鞘分化较好,髓鞘厚度较均匀,再生轴突的直径接近正常,神经轴突较密集,排列较规则,神经纤维外膜较较对照组增厚,胶原纤维、弹力纤维层较对照组增多;对照侧再生轴突数目较少,分布不均匀,轴突发育较差,并见大量纤维结缔组织,空泡变性较实验侧为多。实验侧再生神经在有髓轴突直径、面积、髓鞘厚度及轴突计数等方面均明显优于对照侧,两组差异有显著性(P <0.01)。提示富血小板血浆在面神经损伤修复再生中具有促进作用。%BACKGROUND: Therapeutic methods for of peripheral facial nerve injury include surgery, physical therapy and drug treatment, but the treatment effect is not ideal in some certain cases. OBJECTIVE: To study the effect of autologous platelet rich plasma on repair of facial nerve injury. METHODS: The bilateral destroyed buccal nerve branches of the 10 white rabbits were put in silica gel nerve regeneration chamber, one side injected with platelet rich plasma as experimental group, the other side injected with normal saline as control group. The general observation, neuroelectrophysiology detection, histological observation, image analysis and

  14. The Dehiscent Facial Nerve Canal

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser

    2012-01-01

    Full Text Available Accidental injury to the facial nerve where the bony canal defects are present may result with facial nerve dysfunction during otological surgery. Therefore, it is critical to know the incidence and the type of facial nerve dehiscences in the presence of normal development of the facial canal. The aim of this study is to review the site and the type of such bony defects in 144 patients operated for facial paralysis, myringoplasty, stapedotomy, middle ear exploration for sudden hearing loss, and so forth, other than chronic suppurative otitis media with or without cholesteatoma, middle ear tumors, and anomaly. Correlation of intraoperative findings with preoperative computerized tomography was also analyzed in 35 patients. Conclusively, one out of every 10 surgical cases may have dehiscence of the facial canal which has to be always borne in mind during surgical manipulation of the middle ear. Computerized tomography has some limitations to evaluate the dehiscent facial canal due to high false negative and positive rates.

  15. Is a black eye a useful sign of facial fractures in patients with minor head injuries? A retrospective analysis in a level I trauma centre over 10 years.

    Science.gov (United States)

    Büttner, Michael; Schlittler, Fabian Lukas; Michel, Chantal; Exadaktylos, Aris Konstantinos; Iizuka, Tateyuki

    2014-07-01

    Orbital blunt trauma is common, and the diagnosis of a fracture should be made by computed tomographic (CT) scan. However, this will expose patients to ionising radiation. Our objective was to identify clinical predictors of orbital fracture, in particular the presence of a black eye, to minimise unnecessary exposure to radiation. A 10-year retrospective study was made of the medical records of all patients with minor head trauma who presented with one or two black eyes to our emergency department between May 2000 and April 2010. Each of the patients had a CT scan, was over 16 years old, and had a Glasgow Coma Score (GCS) of 13-15. The primary outcome was whether the black eye was a valuable predictor of a fracture. Accompanying clinical signs were considered as a secondary outcome. A total of 1676 patients (mean (SD) age 51 (22) years) and minor head trauma with either one or two black eyes were included. In 1144 the CT scan showed a fracture of the maxillofacial skeleton, which gave an incidence of 68.3% in whom a black eye was the obvious symptom. Specificity for facial fractures was particularly high for other clinical signs, such as diminished skin sensation (specificity 96.4%), diplopia or occulomotility disorders (89.3%), fracture steps (99.8%), epistaxis (95.5%), subconjunctival haemorrhage (90.4%), and emphysema (99.6%). Sensitivity for the same signs ranged from 10.8% to 22.2%. The most striking fact was that 68.3% of all patients with a black eye had an underlying fracture. We therefore conclude that a CT scan should be recommended for every patient with minor head injury who presents with a black eye.

  16. Facial Cosmetic Surgery

    Science.gov (United States)

    ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  17. Periocular Reconstruction in Patients with Facial Paralysis.

    Science.gov (United States)

    Joseph, Shannon S; Joseph, Andrew W; Douglas, Raymond S; Massry, Guy G

    2016-04-01

    Facial paralysis can result in serious ocular consequences. All patients with orbicularis oculi weakness in the setting of facial nerve injury should undergo a thorough ophthalmologic evaluation. The main goal of management in these patients is to protect the ocular surface and preserve visual function. Patients with expected recovery of facial nerve function may only require temporary and conservative measures to protect the ocular surface. Patients with prolonged or unlikely recovery of facial nerve function benefit from surgical rehabilitation of the periorbital complex. Current reconstructive procedures are most commonly intended to improve coverage of the eye but cannot restore blink.

  18. Facial Scar Revision: Understanding Facial Scar Treatment

    Science.gov (United States)

    ... a facial plastic surgeon Facial Scar Revision Understanding Facial Scar Treatment When the skin is injured from a cut or tear the body heals by forming scar tissue. The appearance of the scar can range from ...

  19. Porcine head response to blast

    Directory of Open Access Journals (Sweden)

    Jay eShridharani

    2012-05-01

    Full Text Available Recent studies have shown an increase in the frequency of traumatic brain injuries related to blast exposure. However, the mechanisms that cause blast neurotrauma are unknown. Blast neurotrauma research using computational models has been one method to elucidate that response of the brain in blast, and to identify possible mechanical correlates of injury. However, model validation against experimental data is required to ensure that the model output is representative of in vivo biomechanical response. This study exposed porcine subjects to primary blast overpressures generated using a compressed-gas shock tube. Shock tube blasts were directed to the unprotected head of each animal while the lungs and thorax were protected using ballistic protective vests similar to those employed in theater. The test conditions ranged from 110-740 kPa peak incident overpressure with scaled durations from 1.3-6.9 ms and correspond approximately with a 50% injury risk for brain bleeding and apnea in a ferret model scaled to porcine exposure. The bulk head acceleration and the pressure at the surface of the head and in the cranial cavity were measured. Immediately after the blast, 5 of the 20 animals tested were apneic. Three subjects recovered without intervention within thirty seconds and the remaining two recovered within 8 minutes following bagging and administration of the respiratory stimulant doxapram. Gross examination of the brain revealed no indication of bleeding. Intracranial pressures ranged from 80-685 kPa as a result of the blast and were notably lower than the shock tube reflected pressures of 300-2830 kPa, indicating pressure attenuation by the skull up to a factor of 8.4. Peak head accelerations were measured from 385-3845 G’s and were well correlated with peak incident overpressure (R2=0.90. One standard deviation corridors for the surface pressure, intracranial pressure, and head acceleration are presented to provide experimental data for

  20. Immunobiology of Facial Nerve Repair and Regeneration

    Institute of Scientific and Technical Information of China (English)

    QUAN Shi-ming; GAO Zhi-qiang

    2006-01-01

    Immunobiological study is a key to revealing the important basis of facial nerve repair and regeneration for both research and development of clinic treatments. The microenvironmental changes around an injuried facial motoneuron, i.e., the aggregation and expression of various types of immune cells and molecules in a dynamic equilibrium, impenetrate from the start to the end of the repair of an injured facial nerve. The concept of "immune microenvironment for facial nerve repair and regeneration", mainly concerns with the dynamic exchange between expression and regulation networks and a variaty of immune cells and immune molecules in the process of facial nerve repair and regeneration for the maintenance of a immune microenvironment favorable for nerve repair.Investigation on microglial activation and recruitment, T cell behavior, cytokine networks, and immunological cellular and molecular signaling pathways in facial nerve repair and regeneration are the current hot spots in the research on immunobiology of facial nerve injury. The current paper provides a comprehensive review of the above mentioned issues. Research of these issues will eventually make immunological interventions practicable treatments for facial nerve injury in the clinic.

  1. Facial blindsight

    Directory of Open Access Journals (Sweden)

    Marco eSolcà

    2015-09-01

    Full Text Available Blindsight denotes unconscious residual visual capacities in the context of an inability to consciously recollect or identify visual information. It has been described for color and shape discrimination, movement or facial emotion recognition. The present study investigates a patient suffering from cortical blindness whilst maintaining select residual abilities in face detection. Our patient presented the capacity to distinguish between jumbled/normal faces, known/unknown faces or famous people’s categories although he failed to explicitly recognize or describe them. Conversely, performance was at chance level when asked to categorize non-facial stimuli. Our results provide clinical evidence for the notion that some aspects of facial processing can occur without perceptual awareness, possibly using direct tracts from the thalamus to associative visual cortex, bypassing the primary visual cortex.

  2. Maxillofacial injuries in the workplace.

    Science.gov (United States)

    Burnham, Richard; Martin, Tim

    2013-04-01

    Over a 2-year period we reviewed patients who presented to a UK maxillofacial unit with facial injuries sustained at work. We looked at links between the mechanism, injury, and characteristics of such injuries.

  3. Investigations of Tissue-Level Mechanisms of Primary Blast Injury Through Modeling, Simulation, Neuroimaging and Neuropathological Studies

    Science.gov (United States)

    2012-07-10

    than abstracts): PaperReceived TOTAL: Books Number of Manuscripts: PaperReceived TOTAL: Patents Submitted Patents Awarded Awards no additional honors... Biomechanics of traumatic brain injury. Computational methods in applied mechanics and engineering 2008;197:4692-4701. [14] Halabieh O, Wan JWL...Simulating Mechanism of Brain Injury During Closed Head Impact. Lecture Notes in Computer Science. Volume 5104/2008. Springer Berlin/Heidelberg; 2008. p 107

  4. 昆山爆炸事故成批烧冲复合伤患者的抢救调配及护理%Rescue, allocation and nursing of multiple- patient burn- blast combined injury in Kunshan explosive accident

    Institute of Scientific and Technical Information of China (English)

    朱利红; 赵朋; 华皎; 袁琴芳; 王芳; 任颖伟; 孙丹; 周竞奋; 吕国忠

    2016-01-01

    目的:探讨突发成批烧冲复合伤患者的护理及各个环节的配合及质量控制情况。方法对35例烧冲复合伤患者在第一时间启动应急预案,其中包括人员调配、物资调配、护理质量控制、病区监控等。结果35例烧冲复合伤患者在第一时间得到了及时有效的烧伤抗休克治疗及护理。成批烧冲复合伤患者抢救成功率达77.14%(27/35),无一例护理并发症。结论护理人员及时调配到位,其数量与结构合理和组织协调有力,物资配备齐全及时,护理应急质量管理控制规范和措施得力,是确保此次突发成批烧冲复合伤危重患者救治成功的关键,是护理质量保障的体现。%Objective To discuss on nursing of patients multiple- patient burn- blast combined injury, the cooperation of processes and quality control. Methods For 35 cases of burn- blast combined injury, emergency plan was initiated immediately, including staffing allocation, supplies allocation, nursing quality control and monitoring the inpatient areas, etc. Results 35 cases of burn- blast combined injury acquired immediate treatment of burn shock and nursing. Rescue rate of multiple- patient burn blast arrived 77.14%(27/35), with no case of nursing complication. Conclusions Timely allocation of nursing staff, rational quantity and structure, forceful organization and coordination, complete and timely supplies, correct quality control of emergence nursing and beneficial solutions are keys to ensure successive nursing of intensive patients of burn-blast combined injury, and also reflection of nursing quality guarantee.

  5. Rejuvenecimiento facial

    Directory of Open Access Journals (Sweden)

    L. Daniel Jacubovsky, Dr.

    2010-01-01

    Full Text Available El envejecimiento facial es un proceso único y particular a cada individuo y está regido en especial por su carga genética. El lifting facial es una compleja técnica desarrollada en nuestra especialidad desde principios de siglo, para revertir los principales signos de este proceso. Los factores secundarios que gravitan en el envejecimiento facial son múltiples y por ello las ritidectomías o lifting cérvico faciales descritas han buscado corregir los cambios fisonómicos del envejecimiento excursionando, como se describe, en todos los planos tisulares involucrados. Esta cirugía por lo tanto, exige conocimiento cabal de la anatomía quirúrgica, pericia y experiencia para reducir las complicaciones, estigmas quirúrgicos y revisiones secundarias. La ridectomía facial ha evolucionado hacia un procedimiento más simple, de incisiones más cortas y disecciones menos extensas. Las suspensiones musculares han variado en su ejecución y los vectores de montaje y resección cutánea son cruciales en los resultados estéticos de la cirugía cérvico facial. Hoy estos vectores son de tracción más vertical. La corrección de la flaccidez va acompañada de un interés en reponer el volumen de la superficie del rostro, en especial el tercio medio. Las técnicas quirúrgicas de rejuvenecimiento, en especial el lifting facial, exigen una planificación para cada paciente. Las técnicas adjuntas al lifting, como blefaroplastias, mentoplastía, lipoaspiración de cuello, implantes faciales y otras, también han tenido una positiva evolución hacia la reducción de riesgos y mejor éxito estético.

  6. Establishment of rabbit models of blast injury to the sacral plexus%兔骶丛爆震伤动物模型的建立

    Institute of Scientific and Technical Information of China (English)

    郭清河; 陈志强; 鹿楠; 杨迪; 朱清华; 陈爱民; 王建民; 李永川; 朱磊; 张志凌; 江曦; 李晓霞; 张良潮

    2012-01-01

    目的 探讨兔骶丛爆震伤动物模型的建立. 方法 取18只日本大耳白兔,致伤物为当量600 mg三硝基甲苯(TNT)炸药的电子雷管,根据雷管与皮肤致伤距离不同分为3组:致伤物与皮肤距离为1 cm(A组)、致伤物与皮肤距离为2 cm(B组)、致伤物与皮肤距离为5 cm(C组),每组6只,以后正中线、右髂后上棘与股骨转子连线及右股骨转子水平连线形成一三角形区域,即骶丛在体表投影区域为致伤点,于距爆炸点10 cm处采集爆震波压力,通过压力公式转换成各组致伤压力,于致伤前、致伤即刻、致伤后1周3个时相点检测下肢短潜伏期体感诱发电位(SLSEP),评估动物的伤情,观察骶丛神经损伤的情况.结果 A、B、C组爆震伤压力平均分别为(413.25±8.09)、(51.34±1.03)、(3.61±7.50) MPa,致伤面积平均分别为(31.47±5.91)、(18.13±8.04)、(4.60±7.16) cm2,以上项目3组间两两比较差异均有统计学意义(P<0.05).A组肉眼下骶丛神经全部断裂,1周存活率为0;B组肉眼下骶丛神经挫伤,骶丛损伤症状明显,伤后即刻SLSEP消失,1周后无恢复,1周存活率为83.3%;C组仅伤及皮肤,未见骶丛损伤症状,伤后即刻、伤后1周SLSEP与伤前比较差异均无统计学意义(P>0.05),1周存活率为100%.结论 600 mg TNT炸药、致伤距离为2 cm,可形成典型的骶丛损伤,稳定性良好,且存活率高,可作为长期实验观察研究.%Objective To establish models of blast injury to the sacral plexus in rabbits.Methods Electronic explosive detonators containing explosion equivalent of 600 mg TNT were used to create explosive injury to 18 rabbits which were divided into 3 even groups at random according to the distance between the detonator and the skin.The distance was 1 cm in group A,2 cm in group B and 5 cm in group C.The hit point was the triangle surface projection of the sacral plexus region formed by the posterior median line,the connection line between the

  7. 超12小时面部软组织创伤Ⅰ期修复临床观察%clinical observation of repairing primarily for over 12-houred facial soft tissue injury

    Institute of Scientific and Technical Information of China (English)

    孙秀锋; 王洪燕; 郑妍丽; 姜涛

    2012-01-01

    目的:探讨Ⅰ期整形修复超12小时面部软组织创伤的方法和经验.方法:选择我院急诊面部软组织创伤超过12h病例17例,采用积极扩创和整形外科技术Ⅰ期修复,观察治疗效果.结果:伤口均甲级愈合,无明显瘢痕增生,无功能障碍,不需要Ⅱ期修复,美容效果良好.结论:超12h面部软组织创伤,采用积极扩创和整形缝合,可获Ⅰ期修复和满意的美容效果,值得临床应用和深入研究.%Objective To explore the clinical method and experience of repairing over 12-houred emergency facial soft tissue trauma primarily with plastic surgical techniques. Methods The over 12-houred emergency facial soft tissue injuries of 17 patients were selected. They had been expanded debrided and repaired primarily with plastic surgical techniques. Healing effects were observed and compared. Results All cases were primary healing.There were no obvious scar formative or function problems.Second stage reconstruction was not needed, the cosmetic effect was perfect. Conclusion The facial soft tissue injury of over 12-hours can require primary healing and- satisfactory cosmetic result with active expanded debride and plastic surgical techniques. It is worth clinical applying and deeply researching.

  8. Transtympanic Facial Nerve Paralysis: A Review of the Literature.

    Science.gov (United States)

    Schaefer, Nathan; O'Donohue, Peter; French, Heath; Griffin, Aaron; Elliott, Devlin; Gochee, Peter

    2015-05-01

    Facial nerve paralysis because of penetrating trauma through the external auditory canal is extremely rare, with a paucity of published literature. The objective of this study is to review the literature on transtympanic facial nerve paralysis and increase physician awareness of this uncommon injury through discussion of its clinical presentation, management and prognosis. We also aim to improve patient outcomes in those that have sustained this type of injury by suggesting an optimal management plan. In this case report, we present the case of a 46-year-old white woman who sustained a unilateral facial nerve paresis because of a garfish penetrating her tympanic membrane and causing direct damage to the tympanic portion of her facial nerve. On follow-up after 12 months, her facial nerve function has largely returned to normal. Transtympanic facial nerve paralysis is a rare injury but can have a favorable prognosis if managed effectively.

  9. Emergency repair of the facial soft tissue injuries with plastic surgery%应用整形美容技术修复面部软组织损伤的临床效果

    Institute of Scientific and Technical Information of China (English)

    徐传岗; 陈艳; 赵静

    2015-01-01

    Objective To investigate the effect of cosmetic surgery on the facial soft tissue injuries.Methods The clinical data of 52 patients with facial soft tissue injuries from June 2013 to June 2014 were analyzed retrospectively.And plastic surgical techniques were applied to the early treatment of facial soft tissue injuries in patients,according to the size of defect and the degree of deformity of the patients,different plastic surgery treatment was chosen,such as skin flap or skin graft to repair wound surfaces.In this process,one must follow sterile noninvasive principle strictly with emphasis on the technique of plastic surgery such as entire debridement,wound healing application of skin flap and so on.Results Total 49 cases of facial soft tissue injuries were healed by first intention without significant complications,while 4 cases of them had mild scars.Absorbable suture exposition appeared in 3 patients after primary healing.Those sutures were romoved after disinfected and no sequelaes were happened.All patients were recovered with good appearances and functions to the most exent.Conclusions The treatment of facial soft tissue injuries,by applying plastic and aesthetic surgery,could reduce scar and postoperative deformity,and secondary corrective procedures can be avoided in most patients.%目的 探讨应用整形美容技术修复面部软组织损伤的方法及临床效果.方法 回顾性分析52例面部软组织创伤患者,采用整形外科技术,根据具体伤情设计不同修复方法,严格遵守无菌、无创原则,进行清创、创面修复、皮瓣修复等治疗.结果 49例患者术后Ⅰ期愈合,4例伴有轻微瘢痕,3例患者Ⅰ期愈合后出现局部皮下可吸收线头外露,予以消毒后拆除,无并发症发生.随访6~12个月,无感染、无坏死、无明显瘢痕等并发症发生.52例患者面部功能及形态均达到了最大限度的修复,患者均较满意.结论 应用整形美容技术修复面部软组织损伤,

  10. Experience with Proctectomy to Manage Combat Casualties Sustaining Catastrophic Perineal Blast Injury Complicated by Invasive Mucor Soft-Tissue Infections

    Science.gov (United States)

    2014-03-01

    traumatic amputations, open pelvic fracture with left sacroiliac joint dissociation, traumatic right orchiectomy, penile burns with membranous...transfused within 24 hours of injury).4 A recent clinical practice guideline addressing IFI has been published by the Department of Defense Joint ...1441 9. 5. Department of Defense Joint Theater Trauma System. http://www.usaisr .amedd.army.mil/assets/cpgs/Invasive Fungal Infection in War Wounds 1

  11. Pulmonary embolism in a wounded with mine blast injury against the background of anticoagulant prophylaxis (case report

    Directory of Open Access Journals (Sweden)

    K. N. Nikolaev

    2015-01-01

    Full Text Available Venous thrombosis and pulmonary embolism in healthy military are rare. Fighting surgical trauma is the trigger of a cascade of defense reactions of the body and the blood coagulation system, leading to stop bleeding. Hemostatic disorders, shifting the equilibrium toward hypercoagulable state, the emergence of the risk factors associated with the injury, lead to uncontrolled thrombosis with subsequent development of venous thromboembolic complications. We present the case of the left pulmonary artery thromboembolism in 41 year old wounded with a gunshot fracture of the right femur, obtained by blowing an unknown explosive device. Medical assistance was provided in three stages of evacuation. In order to stabilize a femur fracture the external fixation device was used. According coagulogram thrombinemia persisted for more than 30 days. Prevention of thrombosis carried LMWH (Clexane, with 9 days after injury. 31 day angiography was performed computer, identified thrombus by 70% ceiling clearance left pulmonary artery; by ultrasound scanning of the veins of the lower limbs was diagnosed asymptomatic thrombosis of the right iliofemoral. Against the background of complex treatment for 67 hours after the injury occurred recanalization. This case shows that the injured limb wound clinical symptoms of the disease symptoms negate venous thrombosis, which becomes the only manifestation of pulmonary embolism. Prevention of venous thromboembolic events, as well as monitoring of its effectiveness, should be carried out at all stages of the evacuation of the wounded and for the entire period of the presence of risk factors for their development.

  12. Protective effects of decay-accelerating factor on blast-induced neurotrauma in rats

    OpenAIRE

    Li, Yansong; Chavko, Mikulas; Slack, Jessica L.; Liu, Bin; McCarron, Richard M.; Ross, James D. (Dalhousie University); Dalle Lucca, Jurandir J

    2013-01-01

    Background Blast-induced neurotrauma (BINT) is the signature life threatening injury of current military casualties. Neuroinflammation is a key pathological occurrence of secondary injury contributing to brain damage after blast injury. We have recently demonstrated that blast-triggered complement activation and cytokine release are associated with BINT. Here, we evaluated if administration of the complement inhibitor recombinant human decay-accelerating factor (rhDAF) is beneficial on neuroi...

  13. Pediatric facial nerve rehabilitation.

    Science.gov (United States)

    Banks, Caroline A; Hadlock, Tessa A

    2014-11-01

    Facial paralysis is a rare but severe condition in the pediatric population. Impaired facial movement has multiple causes and varied presentations, therefore individualized treatment plans are essential for optimal results. Advances in facial reanimation over the past 4 decades have given rise to new treatments designed to restore balance and function in pediatric patients with facial paralysis. This article provides a comprehensive review of pediatric facial rehabilitation and describes a zone-based approach to assessment and treatment of impaired facial movement.

  14. [Scapular/parascapular double skin-paddle free flap for transfixing blast injuries of the hand. A case report].

    Science.gov (United States)

    Colson, T; Pozetto, M; Gibert, N; Dautel, G

    2014-06-01

    Balistic transfixing hand traumas require a complex reconstruction management. Stabilization and reconstruction of the injuried tissues need a double skin-paddle coverage. We present an original case report of a double skin-paddle scapular/parascapular free flap used to cover a through and through gunshot injury of the right hand. A 14-years-old patient presents a severe and extensive wound with full-thickness palmar and dorsal skin defects, dislocation of the carpal bones, median nerve and flexor tendons losses. Distal vascularization is maintained by the deep palmar arch system supplied by the ulnar artery. The radial artery is severed at the level of the first dorsal interosseous space. The measured defect of the dorsal skin was 12×7cm and the palmar one was 6×3cm. After skeletal stabilization, tendinous and nerve preparation, the hand coverage was performed using a double skin-paddle scapular/parascapular free flap. The vascular anastomoses include an end-to-side arterial suture between the circumflex scapular and the radial arteries, and an end-to-end venous suture between the circumflex scapular and the dorsal radial veins. The scapular/parascapular double skin-paddle free flap is a safe and reliable technique to achieve a dorsal and palmar hand coverage in lack of local flaps alternatives. It can be used as a good option prior to bone graft, tendinous and nervous reconstruction. Copyright © 2013. Published by Elsevier Masson SAS.

  15. Facial Scar Revision: Understanding Facial Scar Treatment

    Science.gov (United States)

    ... more to fully heal and achieve maximum improved appearance. Facial plastic surgery makes it possible to correct facial flaws that can undermine self-confidence. Changing how your scar looks can help change ...

  16. Facial attractiveness: General patterns of facial preferences

    National Research Council Canada - National Science Library

    Kościński, Krzysztof

    2007-01-01

    This review covers universal patterns in facial preferences. Facial attractiveness has fascinated thinkers since antiquity, but has been the subject of intense scientific study for only the last quarter of a century...

  17. Blast overpressure waves induce transient anxiety and regional changes in cerebral glucose metabolism and delayed hyperarousal in rats

    Directory of Open Access Journals (Sweden)

    Hibah Omar Awwad

    2015-06-01

    Full Text Available Physiological alterations, anxiety and cognitive disorders are strongly associated with blast-induced traumatic brain injury (blast TBI and are common symptoms in service personnel exposed to blasts. Since 2006, 25-30,000 new TBI cases are diagnosed annually in U.S. Service members; increasing evidence confirms that primary blast exposure causes diffuse axonal injury and is often accompanied by altered behavioral outcomes. Behavioral and acute metabolic effects resulting from blast to the head in the absence of thoracic contributions from the periphery were examined following a single blast wave directed to the head of male Sprague-Dawley rats protected by a lead shield over the torso. An 80 psi head blast produced cognitive deficits that were detected in working memory. Blast TBI rats displayed increased anxiety as determined by elevated plus maze at day 9 post-blast compared to sham rats; blast TBI rats spent significantly more time than the sham controls in the closed arms (p<0.05; n=8-11. Interestingly, anxiety symptoms were absent at days 22 and 48 post-blast. Instead, blast TBI rats displayed hyperactivity and increased rearing behavior at day 48 post-blast compared to sham rats. Blast TBI rats also exhibited suppressed acoustic startle responses, but similar pre-pulse inhibition at day 15 post-blast compared to sham rats. Acute physiological alterations in cerebral glucose metabolism were determined by positron emission tomography 1 and 9 days post-blast using F-18-fluorodeoxyglucose. Global glucose uptake in blast TBI rat brains increased at day 1 post-blast (p<0.05; n=4-6 and returned to sham levels by day 9. Our results indicate a transient increase in cerebral metabolism following a blast injury. Markers for reactive astrogliosis and neuronal damage were noted by immunoblotting motor cortex tissue from day 10 post-blast in blast TBI rats compared to sham controls (p<0.05; n=5-6.

  18. Acceleration-based methodology to assess the blast mitigation performance of explosive ordnance disposal helmets

    Science.gov (United States)

    Dionne, J. P.; Levine, J.; Makris, A.

    2017-07-01

    To design the next generation of blast mitigation helmets that offer increasing levels of protection against explosive devices, manufacturers must be able to rely on appropriate test methodologies and human surrogates that will differentiate the performance level of various helmet solutions and ensure user safety. Ideally, such test methodologies and associated injury thresholds should be based on widely accepted injury criteria relevant within the context of blast. Unfortunately, even though significant research has taken place over the last decade in the area of blast neurotrauma, there currently exists no agreement in terms of injury mechanisms for blast-induced traumatic brain injury. In absence of such widely accepted test methods and injury criteria, the current study presents a specific blast test methodology focusing on explosive ordnance disposal protective equipment, involving the readily available Hybrid III mannequin, initially developed for the automotive industry. The unlikely applicability of the associated brain injury criteria (based on both linear and rotational head acceleration) is discussed in the context of blast. Test results encompassing a large number of blast configurations and personal protective equipment are presented, emphasizing the possibility to develop useful correlations between blast parameters, such as the scaled distance, and mannequin engineering measurements (head acceleration). Suggestions are put forward for a practical standardized blast testing methodology taking into account limitations in the applicability of acceleration-based injury criteria as well as the inherent variability in blast testing results.

  19. [Surgical facial reanimation after persisting facial paralysis].

    Science.gov (United States)

    Pasche, Philippe

    2011-10-01

    Facial reanimation following persistent facial paralysis can be managed with surgical procedures of varying complexity. The choice of the technique is mainly determined by the cause of facial paralysis, the age and desires of the patient. The techniques most commonly used are the nerve grafts (VII-VII, XII-VII, cross facial graft), dynamic muscle transfers (temporal myoplasty, free muscle transfert) and static suspensions. An intensive rehabilitation through specific exercises after all procedures is essential to archieve good results.

  20. Giant sialocele following facial trauma

    OpenAIRE

    Medeiros Júnior,Rui; Rocha Neto,Alípio Miguel da; Queiroz, Isaac Vieira; Cauby,Antônio de Figueiredo; Gueiros,Luiz Alcino Monteiro; Leão,Jair Carneiro

    2012-01-01

    Injuries in the parotid and masseter region can cause serious impairment secondary to damage of important anatomical structures. Sialocele is observed as facial swelling associated with parotid duct rupture due to trauma. The aim of this paper is to report a case of a giant traumatic sialocele in the parotid gland, secondary to a knife lesion in a 40-year-old woman. Conservative measures could not promote clinical resolution and a surgical intervention for the placement of a vacuum drain was ...

  1. Facial porokeratosis.

    Science.gov (United States)

    Carranza, Dafnis C; Haley, Jennifer C; Chiu, Melvin

    2008-01-01

    A 34-year-old man from El Salvador was referred to our clinic with a 10-year history of a pruritic erythematous facial eruption. He reported increased pruritus and scaling of lesions when exposed to the sun. He worked as a construction worker and admitted to frequent sun exposure. Physical examination revealed well-circumscribed erythematous to violaceous papules with raised borders and atrophic centers localized to the nose (Figure 1). He did not have lesions on the arms or legs. He did not report a family history of similar lesions. A biopsy specimen was obtained from the edge of a lesion on the right ala. Histologic examination of the biopsy specimen showed acanthosis of the epidermis with focal invagination of the corneal layer and a homogeneous column of parakeratosis in the center of that layer consistent with a cornoid lamella (Figure 2). Furthermore, the granular layer was absent at the cornoid lamella base. The superficial dermis contained a sparse, perivascular lymphocytic infiltrate. No evidence of dysplasia or malignancy was seen. These findings supported a diagnosis of porokeratosis. The patient underwent a trial of cryotherapy with moderate improvement of the facial lesions.

  2. 汶川地震致颌面部伤员面部功能障碍的情况分析%Investigation and analysis of facial function of patients with maxillofacial injuries in the Wenchuan earthquake

    Institute of Scientific and Technical Information of China (English)

    吴昊; 田卫东; 李锐; 王杭; 郭丽娟; 盛磊; 汤炜; 刘磊; 龙洁; 敬伟

    2012-01-01

    Objective To analyze retrospectively maxillofacial injuries with emphasis on facial function after the Wenchuan earthquake in Sichuan province, so as to provide reference on patients' treatment after earthquake. Methods All the 419 patients with maxillofacial injuries after the earthquake were investigated concerning facial function and a database was used to analyze the results. Results A wide variety of functional disturbances was seen among all the 419 patients, such as nerve injury, occlusal disturbance, limitation of mouth opening, diplopia. Limitation of mouth opening was the most vulnerable. Conclusion Functional disturbances resulting from maxillofacial injuries caused by earthquake did not have obvious differentiation from others, and the ratio varies with the kind injuries.%目的 回顾性分析四川汶川地震中口腔颌面部伤员的面部功能损伤情况,从而为地震中颌面部创伤医学以及救治规范的完善提供依据和参考.方法 回顾性调查分析四川汶川地震中419名口腔颌面伤员的面部功能损伤特点,采用四川大学自主研发设计的颌面部创伤伤员数据库对调查结果进行统计分析.结果 在接受调查的419名颌面部伤员中,出现了不同类型的功能障碍.包括神经损伤症状、咬合错乱、张口受限、复视,其中以张口受限的伤员人数最多.结论 地震导致的颌面部伤所引起的功能障碍的种类和比例与受伤类型有密切关系.

  3. Differences in the Management of Pediatric Facial Trauma.

    Science.gov (United States)

    Braun, Tara L; Xue, Amy S; Maricevich, Renata S

    2017-05-01

    Craniofacial trauma is common in the pediatric population, with most cases limited to soft tissue and dentoalveolar injury. Although facial fractures are relatively rare in children compared with adults, they are often associated with severe injury and cause significant morbidity and disability. Initial evaluation of a child with facial trauma generally involves stabilizing the patient and identifying any severe concomitant injuries before diagnosing and managing facial injuries. The management of pediatric facial fractures is relatively more conservative than that of adults, and nonsurgical management is preferred when possible to prevent the disruption of future growth and development. Outcomes depend on the site of the injury, management plan, and subsequent growth, so children must be followed longitudinally for monitoring and the identification of any complications.

  4. 颜面部软组织创伤的急诊美容修复与护理%Plastic surgery and nursing for repairing of facial soft tissue injury

    Institute of Scientific and Technical Information of China (English)

    朱瑜; 李琳

    2015-01-01

    目的:探讨颜面部外伤的急诊美容修复与护理。方法:根据伤情,细心清创,对创面的处理方法做出正确的设计,采用肿胀麻醉,解剖对位,分层缝合,深层用0/5可吸收线减张缝合,皮肤用0/6单丝尼龙线缝合,缺损创面用带真皮下毛细血管网的皮肤或邻近皮瓣修复。结果:本组197处受伤部位,除了3例因皮肤挫伤缺损严重,待二期行肉芽创面植皮,其余病例均一期愈合。结论:颜面部软组织伤的急诊处理应遵循整形外科原则,术后精心护理,预防感染,减少颜面部的瘢痕、畸形、外伤性灰尘文身等医源性毁容。%Objective To observe the nursing and technique of plastic surgical repair in facial soft tissue trauma. Methods We repaired the wounds of emergency traumaticcases with aesthetic surgery methods and technique. Results The 197 wounds of emergency traumatic cases healed perfectly except the 3 cases with serious bruise were grafted skin on the granulation burn wounds. Conclusion Injury of facial superficial soft tissue might be repaired with cosmetic surgical operation on emergency and intensive perioperative nursing and we applied aesthetic surgery methods to repair the facial trauma can reduce postoperative scar abnormality and iatrogenic disfigure effectively.

  5. Toxicology of blast overpressure.

    Science.gov (United States)

    Elsayed, N M

    1997-07-25

    Blast overpressure (BOP) or high energy impulse noise, is the sharp instantaneous rise in ambient atmospheric pressure resulting from explosive detonation or firing of weapons. Blasts that were once confined to military and to a lesser extent, occupational settings, are becoming more universal as the civilian population is now increasingly at risk of exposure to BOP from terrorist bombings that are occurring worldwide with greater frequency. Exposure to incident BOP waves can cause auditory and non-auditory damage. The primary targets for BOP damage are the hollow organs, ear, lung and gastrointestinal tract. In addition, solid organs such as heart, spleen and brain can also be injured upon exposure. However, the lung is more sensitive to damage and its injury can lead to death. The pathophysiological responses, and mortality have been extensively studied, but little attention, was given to the biochemical manifestations, and molecular mechanism(s) of injury. The injury from BOP has been, generally, attributed to its external physical impact on the body causing internal mechanical damage. However, a new hypothesis has been proposed based on experiments conducted in the Department of Respiratory Research, Walter Reed Army Institute of Research, and later in the Department of Occupational Health, University of Pittsburgh. This hypothesis suggests that subtle biochemical changes namely, free radical-mediated oxidative stress occur and contribute to BOP-induced injury. Understanding the etiology of these changes may shed new light on the molecular mechanism(s) of injury, and can potentially offer new strategies for treatment. In this symposium. BOP research involving auditory, non-auditory, physiological, pathological, behavioral, and biochemical manifestations as well as predictive modeling and current treatment modalities of BOP-induced injury are discussed.

  6. The Effects of Underwater Blast on Divers

    Science.gov (United States)

    2007-11-02

    bladder, including hepatic tear can cause referred right shoulder pain. Transient paralysis in the lower limbs, testicular pain, nausea, vomiting...blast trauma . This is probably because most immersion blast has been studied with heads above the water, 24 sinus injury is unlikely to threaten life and...without impediment. Close to the explosive source, however; there is violent trauma to the rib-cage, chest and abdominal contents, and limb fractures

  7. Measuring Facial Movement

    Science.gov (United States)

    Ekman, Paul; Friesen, Wallace V.

    1976-01-01

    The Facial Action Code (FAC) was derived from an analysis of the anatomical basis of facial movement. The development of the method is explained, contrasting it to other methods of measuring facial behavior. An example of how facial behavior is measured is provided, and ideas about research applications are discussed. (Author)

  8. Facial Recognition

    Directory of Open Access Journals (Sweden)

    Mihalache Sergiu

    2014-05-01

    Full Text Available During their lifetime, people learn to recognize thousands of faces that they interact with. Face perception refers to an individual's understanding and interpretation of the face, particularly the human face, especially in relation to the associated information processing in the brain. The proportions and expressions of the human face are important to identify origin, emotional tendencies, health qualities, and some social information. From birth, faces are important in the individual's social interaction. Face perceptions are very complex as the recognition of facial expressions involves extensive and diverse areas in the brain. Our main goal is to put emphasis on presenting human faces specialized studies, and also to highlight the importance of attractiviness in their retention. We will see that there are many factors that influence face recognition.

  9. [Peripheral facial nerve palsy].

    Science.gov (United States)

    Pons, Y; Ukkola-Pons, E; Ballivet de Régloix, S; Champagne, C; Raynal, M; Lepage, P; Kossowski, M

    2013-06-01

    Facial palsy can be defined as a decrease in function of the facial nerve, the primary motor nerve of the facial muscles. When the facial palsy is peripheral, it affects both the superior and inferior areas of the face as opposed to central palsies, which affect only the inferior portion. The main cause of peripheral facial palsies is Bell's palsy, which remains a diagnosis of exclusion. The prognosis is good in most cases. In cases with significant cosmetic sequelae, a variety of surgical procedures are available (such as hypoglossal-facial anastomosis, temporalis myoplasty and Tenzel external canthopexy) to rehabilitate facial aesthetics and function.

  10. 听神经瘤显微手术面神经损伤的预防%Prevention of facial nerve injury in acoustic neuroma microsurgery

    Institute of Scientific and Technical Information of China (English)

    雷霆; 李龄

    2008-01-01

    目的 总结与分析听神经瘤显微手术中预防面神经损伤的方法.方法 经MRI和(或)CT检查确诊的大型听神经瘤(≥4.0 cm)180例(72%)及中型听神经瘤(2.4~4.0 cm)70例(28%).均采用经患侧枕下乙状窦后入路保留面神经的显微手术.注意三大解剖关系:骨性解剖、蛛网膜解剖、神经与血管的解剖.肿瘤囊内减压后,确认面神经的起始位置、面神经与肿瘤的关系、面神经变形与扭曲、面神经分离的方法、面神经的断裂端-端吻合.随访6个月~1年.结果 肿瘤全切除240例(96.0%);次全切除10例(4.0%),其中死亡1例(0.4%).面神经功能评定:Ⅰ级214例(85.6%);Ⅱ级25例(10.0%);Ⅲ级5例(2.1%);Ⅳ级5例(2.1%).结论 术中注意典型的解剖位置,正确的手术入路和显微手术技术可达到较高的肿瘤全切除率,提高面神经的功能保全率.%Objective To summarize and analyse the techniques of avoiding facial nerve iniury during acoustic neuroma microsurgery.Methods One hundred and eighty patients with large acoustic neuroma(≥4 cm)and 70 patients with medium acoustic neuroma(2.4-4.0 cm)Were diagnosed by MRI/CT scan before operation and confirmed by postoperational pathologic examination.All of patients were treated by sub-occipital retrosigmoid approach for tumor removal and facial nerve reservation during operation.The relationships among the bone,arachnoid,nerve and vascular anatomy were panicularly observed during the operation. After decompression of the tumor,the origination and location of the facial nerve as well as the relationship between the tumor and the facial nerve should be identified.The patients were followed-up from 6 months to 1 year postoperatively and assessed by House-Brackmann facial nerve function grading system.Results Total tumor resection was achieved in 240 of 250 cases (96%)and subtotal in 10 cases including 1 case died because of cerebellar encephalomalacia after operation. According to the House

  11. 胰岛素面部注射对大鼠面神经挤压伤的效果%Effect of Local Insulin Injection on Crushed Injury of Facial Nerve in Rats

    Institute of Scientific and Technical Information of China (English)

    张玉花; 王华明; 尹洁; 景玉宏

    2014-01-01

    Objective To investigate the effect of local insulin injection on neurological function after crushed injury of facial nerve in rats. Methods Facial nerve was crushing injured in 30 Sprague-Dawley rats, from which 20 selected rats were divided into treatment group (n=10) and control group (n=10). The treatment group was injected with insulin 250 ng/kg at innervated muscle, and the control group was injected with normal saline. They were assessed with neurologic deficit score everyday within 7 days after injection, and the regeneration of nerve fiber was observed with retrograde fluorogold labeling. Results Compared with that in the control group, the neurological deficit score was improved more 5~7 days after injection in the treatment group, and the count of fluorogold labeling cells increased more in the treatment group. Conclusion Local injection of insulin can promote the recovery of neurological function after crushed injury of facial nerve.%目的:探讨胰岛素面部注射对大鼠面神经挤压伤神经纤维的再生及神经损伤后功能恢复的效果。方法雄性Sprague-Dawley大鼠30只建立面神经挤压损伤模型,20只纳入实验,随机分为治疗组和对照组各10只。治疗组局部给予胰岛素250 ng/kg注射,对照组局部给予等量生理盐水注射。于损伤后7 d内每天进行神经功能评分;术后7 d利用逆行荧光金标记技术观察神经纤维的再生。结果术后5~7 d,治疗组神经损伤评分均低于对照组(P<0.05)。治疗组损伤侧面神经核内逆行荧光金标记的细胞数量明显增加(P<0.01)。结论胰岛素局部注射治疗可促进面神经挤压伤中后期神经功能恢复及神经纤维再生。

  12. 爆炸冲击波所致轻度颅脑损伤的诊断与处理%Diagnosis and treatment of mild brain injury induced by explosive blast wave

    Institute of Scientific and Technical Information of China (English)

    段朝霞; 张洁元; 陈魁君; 李冠桦; 李兵仓

    2016-01-01

    Blast⁃related traumatic brain injury ( bTBI) induced by explosive blast wave is the most common event on the battlefield.Most of the patients are characterized as mild traumatic brain injury (mTBI). The traditional clinical imaging couldn′t detect the pathological changes in the brain. Also, the functional significance of this type of injury remains controversial.In recent years,some new technology can sensitively detect the minimal abnormality in the injured brain tissues.Thus,it is valuable in the diagnosis of mTBI.In this paper,we summarized the new advancement of diagnosis for mTBI induced by explosive blast wave.%爆炸冲击波引起的创伤性颅脑损伤( bTBI)是战场上最常见的损伤,大多数患者是轻度的颅脑创伤( mTBI)。常规的临床影像技术如CT不能检测出mTBI的脑部变化,并且这类损伤的功能意义目前还有争议,最近几年出现的新技术能敏感地检测出脑组织的细微异常,因此在mTBI的诊断中起非常中的作用。笔者主要综述爆炸冲击波所致mTBI诊断的相关进展。

  13. Evaluation and management of the patient with postoperative facial paralysis.

    Science.gov (United States)

    Hadlock, Tessa

    2012-05-01

    Postoperative facial paralysis comprises a spectrum of injuries ranging from mild, temporary weakness to severe, permanent paralysis, affecting as little as one muscle group to as much as the full hemiface. Herein is presented an introductory review of iatrogenic facial paralysis, from initial evaluation and decision making to the full range of conservative and operative management.

  14. Blast Waves

    CERN Document Server

    Needham, Charles E

    2010-01-01

    The primary purpose of this text is to document many of the lessons that have been learned during the author’s more than forty years in the field of blast and shock. The writing therefore takes on an historical perspective, in some sense, because it follows the author’s experience. The book deals with blast waves propagating in fluids or materials that can be treated as fluids. It begins by distinguishing between blast waves and the more general category of shock waves. It then examines several ways of generating blast waves, considering the propagation of blast waves in one, two and three dimensions as well as through the real atmosphere. One section treats the propagation of shocks in layered gases in a more detailed manner. The book also details the interaction of shock waves with structures in particular reflections, progressing from simple to complex geometries, including planar structures, two-dimensional structures such as ramps or wedges, reflections from heights of burst, and three-dimensional st...

  15. Facial nerve paralysis after cervical traction.

    Science.gov (United States)

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  16. Exacerbation of facial motoneuron loss after facial nerve axotomy in CCR3-deficient mice

    Directory of Open Access Journals (Sweden)

    Derek A Wainwright

    2009-12-01

    Full Text Available We have previously demonstrated a neuroprotective mechanism of FMN (facial motoneuron survival after facial nerve axotomy that is dependent on CD4+ Th2 cell interaction with peripheral antigen-presenting cells, as well as CNS (central nervous system-resident microglia. PACAP (pituitary adenylate cyclase-activating polypeptide is expressed by injured FMN and increases Th2-associated chemokine expression in cultured murine microglia. Collectively, these results suggest a model involving CD4+ Th2 cell migration to the facial motor nucleus after injury via microglial expression of Th2-associated chemokines. However, to respond to Th2-associated chemokines, Th2 cells must express the appropriate Th2-associated chemokine receptors. In the present study, we tested the hypothesis that Th2-associated chemokine receptors increase in the facial motor nucleus after facial nerve axotomy at timepoints consistent with significant T-cell infiltration. Microarray analysis of Th2-associated chemokine receptors was followed up with real-time PCR for CCR3, which indicated that facial nerve injury increases CCR3 mRNA levels in mouse facial motor nucleus. Unexpectedly, quantitative- and co-immunofluorescence revealed increased CCR3 expression localizing to FMN in the facial motor nucleus after facial nerve axotomy. Compared with WT (wild-type, a significant decrease in FMN survival 4 weeks after axotomy was observed in CCR3−/− mice. Additionally, compared with WT, a significant decrease in FMN survival 4 weeks after axotomy was observed in Rag2−/− (recombination activating gene-2-deficient mice adoptively transferred CD4+ T-cells isolated from CCR3−/− mice, but not in CCR3−/− mice adoptively transferred CD4+ T-cells derived from WT mice. These results provide a basis for further investigation into the co-operation between CD4+ T-cell- and CCR3-mediated neuroprotection after FMN injury.

  17. Exacerbation of Facial Motoneuron Loss after Facial Nerve Axotomy in CCR3-Deficient Mice

    Directory of Open Access Journals (Sweden)

    Derek A Wainwright

    2009-11-01

    Full Text Available We have previously demonstrated a neuroprotective mechanism of FMN (facial motoneuron survival after facial nerve axotomy that is dependent on CD4+ Th2 cell interaction with peripheral antigen-presenting cells, as well as CNS (central nervous system-resident microglia. PACAP (pituitary adenylate cyclase-activating polypeptide is expressed by injured FMN and increases Th2-associated chemokine expression in cultured murine microglia. Collectively, these results suggest a model involving CD4+ Th2 cell migration to the facial motor nucleus after injury via microglial expression of Th2-associated chemokines. However, to respond to Th2-associated chemokines, Th2 cells must express the appropriate Th2-associated chemokine receptors. In the present study, we tested the hypothesis that Th2-associated chemokine receptors increase in the facial motor nucleus after facial nerve axotomy at timepoints consistent with significant T-cell infiltration. Microarray analysis of Th2-associated chemokine receptors was followed up with real-time PCR for CCR3, which indicated that facial nerve injury increases CCR3 mRNA levels in mouse facial motor nucleus. Unexpectedly, quantitative- and co-immunofluorescence revealed increased CCR3 expression localizing to FMN in the facial motor nucleus after facial nerve axotomy. Compared with WT (wild-type, a significant decrease in FMN survival 4 weeks after axotomy was observed in CCR3–/– mice. Additionally, compared with WT, a significant decrease in FMN survival 4 weeks after axotomy was observed in Rag2 –/– (recombination activating gene-2-deficient mice adoptively transferred CD4+ T-cells isolated from CCR3–/– mice, but not in CCR3–/– mice adoptively transferred CD4+ T-cells derived from WT mice. These results provide a basis for further investigation into the co-operation between CD4+ T-cell- and CCR3-mediated neuroprotection after FMN injury.

  18. Rapid release of tissue enzymes into blood after blast exposure: potential use as biological dosimeters.

    Directory of Open Access Journals (Sweden)

    Peethambaran Arun

    Full Text Available Explosive blast results in multiple organ injury and polytrauma, the intensity of which varies with the nature of the exposure, orientation, environment and individual resilience. Blast overpressure alone may not precisely indicate the level of body or brain injury after blast exposure. Assessment of the extent of body injury after blast exposure is important, since polytrauma and systemic factors significantly contribute to blast-induced traumatic brain injury. We evaluated the activity of plasma enzymes including aspartate aminotransferase (AST, alanine aminotransferase (ALT, lactate dehydrogenase (LDH and creatine kinase (CK at different time points after blast exposure using a mouse model of single and repeated blast exposures to assess the severity of injury. Our data show that activities of all the enzymes in the plasma were significantly increased as early as 1 h after blast exposure. The elevated enzyme activity remained up to 6 h in an overpressure dose-dependent manner and returned close to normal levels at 24 h. Head-only blast exposure with body protection showed no increase in the enzyme activities suggesting that brain injury alone does not contribute to the systemic increase. In contrast to plasma increase, AST, ALT and LDH activity in the liver and CK in the skeletal muscle showed drastic decrease at 6 h after blast exposures. Histopathology showed mild necrosis at 6 h and severe necrosis at 24 h after blast exposures in liver and no changes in the skeletal muscle suggesting that the enzyme release from the tissue to plasma is probably triggered by transient cell membrane disruption from shockwave and not due to necrosis. Overpressure dependent transient release of tissue enzymes and elevation in the plasma after blast exposure suggest that elevated enzyme activities in the blood can be potentially used as a biological dosimeter to assess the severity of blast injury.

  19. Surgical-Allogeneic Facial Reconstruction: Facial Transplants

    OpenAIRE

    Marcelo Coelho Goiato; Daniela Micheline Dos Santos; Lisiane Cristina Bannwart; Marcela Filié Haddad; Leonardo Viana Pereira; Aljomar José Vechiato Filho

    2014-01-01

    Several factors including cancer, malformations and traumas may cause large facial mutilation. These functional and aesthetic deformities negatively affect the psychological perspectives and quality of life of the mutilated patient. Conventional treatments are prone to fail aesthetically and functionally. The recent introduction of the composite tissue allotransplantation (CTA), which uses transplanted facial tissues of healthy donors to recover the damaged or non-existent facial tissue of mu...

  20. Nerve repair and cable grafting for facial paralysis.

    Science.gov (United States)

    Humphrey, Clinton D; Kriet, J David

    2008-05-01

    Facial nerve injury and facial paralysis are devastating for patients. Although imperfect, primary repair is currently the best option to restore facial nerve function. Cable, or interposition, nerve grafting is an acceptable alternative when primary repair is not possible. Several donor nerves are at the surgeon's disposal. Great auricular, sural, or medial and lateral antebrachial cutaneous nerves are all easily obtained. Both primary repair and interposition grafting typically result in better facial function than do other dynamic and static rehabilitation strategies. Proficient anastomotic technique and, when necessary, selection of an appropriate interposition graft will optimize patient outcomes. Promising research is under way that will enhance future nerve repair and grafting efforts.

  1. Device for Underwater Laboratory Simulation of Unconfined Blast Waves

    CERN Document Server

    Courtney, Elijah; Courtney, Michael

    2015-01-01

    Shock tubes simulate blast waves to study their effects in air under laboratory conditions; however, few experimental models exist for simulating underwater blast waves that are needed for facilitating experiments in underwater blast transmission, determining injury thresholds in marine animals, validating numerical models, and exploring mitigation strategies for explosive well removals. This method incorporates an oxy-acetylene driven underwater blast simulator which creates peak blast pressures of about 1860 kPa. Shot-to-shot consistency was fair, with an average standard deviation near 150 kPa. Results suggest peak blast pressures from 460 kPa to 1860 kPa are available by adjusting the distance from the source.

  2. Note: A table-top blast driven shock tube.

    Science.gov (United States)

    Courtney, Michael W; Courtney, Amy C

    2010-12-01

    The prevalence of blast-induced traumatic brain injury in conflicts in Iraq and Afghanistan has motivated laboratory scale experiments on biomedical effects of blast waves and studies of blast wave transmission properties of various materials in hopes of improving armor design to mitigate these injuries. This paper describes the design and performance of a table-top shock tube that is more convenient and widely accessible than traditional compression driven and blast driven shock tubes. The design is simple: it is an explosive driven shock tube employing a rifle primer that explodes when impacted by the firing pin. The firearm barrel acts as the shock tube, and the shock wave emerges from the muzzle. The small size of this shock tube can facilitate localized application of a blast wave to a subject, tissue, or material under test.

  3. A Table-top Blast Driven Shock Tube

    CERN Document Server

    Courtney, Michael; 10.1063/1.3518970

    2011-01-01

    The prevalence of blast-induced traumatic brain injury in conflicts in Iraq and Afghanistan has motivated laboratory scale experiments on biomedical effects of blast waves and studies of blast wave transmission properties of various materials in hopes of improving armor design to mitigate these injuries. This paper describes the design and performance of a table-top shock tube that is more convenient and widely accessible than traditional compression driven and blast driven shock tubes. The design is simple: it is an explosive driven shock tube employing a rifle primer which explodes when impacted by the firing pin. The firearm barrel acts as the shock tube, and the shock wave emerges from the muzzle. The small size of this shock tube can facilitate localized application of a blast wave to a subject, tissue, or material under test.

  4. Air Medical Evacuations of Soldiers for Oral-facial Disease and Injuries, Operations Enduring Freedom/Iraqi Freedom, January-December 2006

    Science.gov (United States)

    2006-12-01

    of-injury coding in US military hospitals: NATO STANAG 2050. American Journal ofPreventive Medicine. l8(3S): 174-187.) 3. RESULTS. The study found...the Amoroso et al. article in the American Journal of Preventive Medicine(6).) (7) For those cases for which there was only an external cause of injury... Orthodontic Services 3 13.0 210.5 Benign Neoplasms of Tonsil 2 8.7 351.0 Bell’s Palsy 2 8.7 V52.3 V Code- Dental Prosthetic Device 1 4.3 196.0 Secondary

  5. The application of comprehensive physicotherapeutics in the facial soft tissue injury%综合物理治疗在面部软组织挫伤后的应用

    Institute of Scientific and Technical Information of China (English)

    杨青; 刘剑毅; 曹川; 李世荣

    2011-01-01

    目的 探讨综合物理治疗在促进面部软组织挫伤恢复、防治并发症等方面的作用.方法 将56例面部软组织挫伤患者分成综合物理治疗组29例和非物理治疗组27例,综合物理治疗组应用微波、等幅中频正弦电(音频)、超声波、手法按摩等物理治疗并配戴低温热塑板材成型的面部支具进行局部压迫.非物理治疗组伤后不进行任何物理治疗,待其自然恢复.结果 综合物理治疗组面部软组织挫伤处局部淤血、肿痛、感觉障碍、皮下组织粘连4周恢复率为97%,非物理治疗组伤后4周恢复率为74%,显著低于综合物理治疗组.结论 面部软组织挫伤后物理治疗联合低温热塑板材加压的综合治疗能迅速消除面部软组织挫伤后的肿痛、促进淤血吸收、减少面部软组织挫伤引起的感觉障碍、皮下组织粘连引起的面部凹陷或动力性凹陷等并发症,是面部软组织挫伤后良好的治疗手段.%Objective To explore the method of treating the facial soft tissue injury with comprehensive physicotherapeutics and preventing the complication. Methods Altogether 56 facial soft tissue injury outpatients were divided into comprehensive physico therapeutics group(29) and non-comprehensive physicotherapeutics group (27). Micrewave therapy, acoustic frequency therapy, ultrasonic therapy,maneuver massage therapy and hypothermia forming board for pression were used in the comprehensive physico therapeutics group. No therapy were used for non-comprehensive physicotherapeutics group. Results The recovery rate of local haemostasis,pain,sensation disorder and subcutaneous tissue conglutination after 30 days was 97% in the comprehensive physicotherapeutics group. However, the recovery rate of those in non-comprehensive physicotherapeutics group was 74%. Conclusion Comprehensive physicotherapeutics combined with hypothermia forming board for pression can quickly eliminate the local haemostasis, pain

  6. Facial Expression Analysis

    NARCIS (Netherlands)

    Pantic, Maja; Li, S.; Jain, A.

    2009-01-01

    Facial expression recognition is a process performed by humans or computers, which consists of: 1. Locating faces in the scene (e.g., in an image; this step is also referred to as face detection), 2. Extracting facial features from the detected face region (e.g., detecting the shape of facial compon

  7. Facial Expression Recognition

    NARCIS (Netherlands)

    Pantic, Maja; Li, S.; Jain, A.

    2009-01-01

    Facial expression recognition is a process performed by humans or computers, which consists of: 1. Locating faces in the scene (e.g., in an image; this step is also referred to as face detection), 2. Extracting facial features from the detected face region (e.g., detecting the shape of facial

  8. Facial paralysis in children.

    Science.gov (United States)

    Reddy, Sashank; Redett, Richard

    2015-04-01

    Facial paralysis can have devastating physical and psychosocial consequences. These are particularly severe in children in whom loss of emotional expressiveness can impair social development and integration. The etiologies of facial paralysis, prospects for spontaneous recovery, and functions requiring restoration differ in children as compared with adults. Here we review contemporary management of facial paralysis with a focus on special considerations for pediatric patients.

  9. Surgical-allogeneic facial reconstruction: facial transplants.

    Directory of Open Access Journals (Sweden)

    Marcelo Coelho Goiato

    2014-12-01

    Full Text Available Several factors including cancer, malformations and traumas may cause large facial mutilation. These functional and aesthetic deformities negatively affect the psychological perspectives and quality of life of the mutilated patient. Conventional treatments are prone to fail aesthetically and functionally. The recent introduction of the composite tissue allotransplantation (CTA, which uses transplanted facial tissues of healthy donors to recover the damaged or non-existent facial tissue of mutilated patients, resulted in greater clinical results. Therefore, the present study aims to conduct a literature review on the relevance and effectiveness of facial transplants in mutilated subjects. It was observed that the facial transplants recovered both the aesthetics and function of these patients and consequently improved their quality of life.

  10. CLINICAL AND EXPERIMENTAL STUDIES OF LARGE AMPLITUDE ACTION POTENTIAL OF THE SUFFERED FACIAL MUSCLES IN INTRATEMPORAL FACIAL NERVE PARALYSIS

    Institute of Scientific and Technical Information of China (English)

    任重; 惠莲

    1999-01-01

    Objctive. To testify the phenomenon that large amplitude action potential appears at the early stage oil facial paralysis, and to search for the mechanism through clinical and experimental studies. Patients(aninmls) and methods. The action potentials of the orbicular ocular and oral museles were recorded in 34 normal persons by electromyogram instrtiments. The normal range of amplitude percentage was found out according to the normal distribution, One hundred patients with facial paralysis were also studied. The action potentials of facial muscles were recorded ia 17 guinea pigs before and after the facial nerve was comp~ and the facial nerve was examined under electromicroscope before and after the compression.Results. The amplitude percentage of the suffered side to the healthy side was more than 153 percent in 6 of the 100 patients. Large amplitude action potential occured in 35 per cent guinea pigs which were performed the experiment of facial nerve compression. Electromicroscopic examination revealed separation of the lammae of the facial nerve's myelin sheath in the guinea pigs which exhibited large amplitude action potential Conclusion. The facial nerve exhibited a temporary over-excitability at the early stage of facial nerve injury in scane patients and guinea pigs. If the injury was limited in the myelin sheath, the prognods was relatively good.

  11. CLINICAL AND EXPERIMENTAL STUDIES OF LARGE AMPLITUDE ACTION POTENTIAL OF THE SUFFERED FACIAL MUSCLES IN INTRATEMPORAL FACIAL NERVE PARALYSIS

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Ojective. To testify the phenomenon that large amplitude action potential appears at the early stage of facial paralysis, and to search for the mechanism through clinical and experimental studies. Patients(animals) and methods. The action potentials of the orbicular ocular and oral muscles were recorded in 34 normal persons by electromyogram instruments. The normal range of amplitude percentage was found out according to he normal distribution. One hundred patients with facial paralysis were also studied. The action potentials of facial muscles were recorded in 17 guinea pigs before and after the facial nerve was compressed and the facial nerve was examined under electromicroscope before and after the compression.Results. The amplitude percentage of the suffered ide to the healthy side was more than 153 percent in 6 of the 100 patients. Lare amplitude action potential ocured in 35 per cent guinea pigs which were performed the experiment of facial nrve compression. Electromicroscopic examination revealed separation of the lammae of the facial nerve's myelin sheath in the guinea pigs which exhibited large amplitude action potential.Conclusion. The facial nerve exhibited a temporary over-exciability at the early stage of facial nerve injury in some patients and guinea pigs. If the injury waslimited in the myelin sheath, te prognosis was relatively good.

  12. [Early clinical features of severe peripheral facial paralysis and acupuncture strategies].

    Science.gov (United States)

    Wang, Sheng-Qiang; Li, Yun; Bai, Ya-Ping

    2010-05-01

    In order to have a good grasp of rules of acupuncture for severe peripheral facial paralysis, the early clinical features of severe peripheral facial paralysis (Bell's palsy) are studied and analyzed from the aspect of injury level, injury degrees, clinical syndromes and symptoms; consequently, the treatment strategies with acupuncture are proposed. The severe peripheral facial paralysis is an important research area in clinic trials which verifies the effectiveness of acupuncture treatment.

  13. Blast Injuries And Heterotopic Ossification

    Science.gov (United States)

    2012-08-01

    Increased risk of bleeding, delayed fracture healing, impaired renal function and gastritis are all significant rela- tive contraindications. While this...and preventing future surgical excisions while minimising prophylaxis side effects. The views expressed in this article are those of the authors and...declared ©2012 British Editorial Society of Bone and Joint Surgery. This is an open-access article distributed under the terms of the Creative Commons

  14. Facial Emotion Recognition Deficits following Moderate-Severe Traumatic Brain Injury (TBI): Re-examining the Valence Effect and the Role of Emotion Intensity

    NARCIS (Netherlands)

    Rosenberg, H.; McDonald, S.; Dethier, M.; Kessels, R.P.C.; Westbrook, R.F.

    2014-01-01

    Many individuals who sustain moderate-severe traumatic brain injuries (TBI) are poor at recognizing emotional expressions, with a greater impairment in recognizing negative (e.g., fear, disgust, sadness, and anger) than positive emotions (e.g., happiness and surprise). It has been questioned whether

  15. Facial Emotion Recognition Deficits following Moderate-Severe Traumatic Brain Injury (TBI): Re-examining the Valence Effect and the Role of Emotion Intensity

    NARCIS (Netherlands)

    Rosenberg, H.; McDonald, S.; Dethier, M.; Kessels, R.P.C.; Westbrook, R.F.

    2014-01-01

    Many individuals who sustain moderate-severe traumatic brain injuries (TBI) are poor at recognizing emotional expressions, with a greater impairment in recognizing negative (e.g., fear, disgust, sadness, and anger) than positive emotions (e.g., happiness and surprise). It has been questioned whether

  16. Effect of injecting brain cell growth peptide into conduit at the anastomose end of autogenous vein graft conduit on functional rehabilitation of facial nerve injury%自体静脉套吻合端套管内注入脑细胞生长肽对面神经损伤功能恢复的作用

    Institute of Scientific and Technical Information of China (English)

    韩思源; 宋涛; 王玉新

    2004-01-01

    背景:面神经损伤后功能恢复需要较长时间,如何加速面神经的功能恢复是该领域正在研究的课题.目的:比较面神经损伤修复的不同方法,探讨自体静脉套接吻合口及脑细胞生长肽在临床上修复面神经损伤的效果.设计:以诊断为依据的病例对照研究.地点和对象:中国医科大学附属第一医院1999-01/2001-12收治44例面神经损伤患者和1999-01以前收治面神经损伤患者30例.干预:对44例创伤后和腮腺区恶性肿瘤切除造成的面神经损伤患者,在手术显微镜下行神经断端对位吻合,将自体静脉管套入吻合口并在管套内注入脑细胞生长肽.对30例面神经损伤患者采用传统神经端吻合法修复,术后不同时间观察面部表情肌功能恢复及肌电图的动态变化.主要观察指标:观察面部表情肌功能恢复的时间,检测面神经传导速度的动态变化.结果:30例创伤性面神经损伤患者,功能恢复最快9周,最迟13周,平均(11.1±1.1)周,与传统方法(25.8±1.8)周比较有显著性差异(t=34.875,P<0.01);14例肿瘤切除面神经立即修复的患者,功能恢复最快13周,最迟15周,平均(13.8±0.8)周,与传统方法(34.8±2.9)周比较有显著性差异(t=26.336,P<0.01).肌电图检测面神经传导速度的恢复呈递增趋势,表情肌功能恢复时两种方法传导速度比较无显著性差异(P>0.05).结论:自体静脉管套入吻合口并注入脑细胞生长肽的方法均比传统方法效果显著,是一种临床效果比较突出的面神经损伤修复方法.%BACKGROUND: Functional rehabilitation requires longer time after facial nerve injury. How to speed up the functional rehabilitation of facial nerve is a topic in this academic field.OBJECTIVE: To discuss the effect of autogenous vein graft conduit anastomose and brain cell growth peptide(BCGP) on clinical rehabilitation of facial nerve injury by comparing different methods in the rehabilitation of facial

  17. Lesões no complexo maxilofacial em vítimas de violência no ambiente escolar Maxillo facial injuries in victims of violence at school environment

    Directory of Open Access Journals (Sweden)

    Alessandro Leite Cavalcanti

    2009-12-01

    Full Text Available Este estudo investigou a presença de lesões no complexo maxilofacial em crianças e adolescentes vítimas de violência física no ambiente escolar. Foram analisados 42 laudos de exames de corpo de delito envolvendo crianças e adolescentes vítimas de violência física na escola, nos anos de 2003 e 2006. Os dados foram registrados em formulário específico e as variáveis coletadas foram gênero, idade, agente agressor, localização das lesões nas distintas regiões do corpo, tipo e número de lesões presentes, acometimento da cavidade bucal e tipo de envolvimento tecidual. Observou-se que 61,9% das vítimas eram do gênero masculino, sendo a faixa etária de 13 a 17 anos a mais atingida. Os colegas foram os perpetradores mais frequentes (92,9% enquanto os professores foram os agressores em 7,1% dos casos. Lesões nas regiões da cabeça e face estavam presentes em 69,1% da amostra, com 23,8% das vítimas apresentando injúrias na cavidade bucal, sendo que a totalidade das lesões localizadas em tecido mole, principalmente nos lábios. Constatou-se ser elevada a existência de injúrias na cavidade bucal em vítimas de agressão no ambiente escolar, confirmando a importância da odontologia no diagnóstico de lesões nas regiões da cabeça e face em vítimas de violência física.This study investigated the presence of injuries in the maxillofacial complex in children and adolescents victims of physical violence in school environment. Forty-two proofs involved children and adolescents victims of physical violence in school in the years of 2003 and 2006 were analyzed. The data had been registered in specific form collecting the following variables: gender, age, perpetrator agent, localization of the injuries in the distinct regions of the body, type and number of injuries, existence of injuries in oral cavity and tissue involvement. It was observed that 61.9% of the victims were male (61.9%, age-group 13 to 17 years the most reached. In

  18. Blast overpressure after tire explosion: a fatal case.

    Science.gov (United States)

    Pomara, Cristoforo; D'Errico, Stefano; Riezzo, Irene; Perilli, Gabriela; Volpe, Umberto; Fineschi, Vittorio

    2013-12-01

    Fatal blast injuries are generally reported in literature as a consequence of the detonation of explosives in war settings. The pattern of lesion depends on the position of the victim in relation to the explosion, on whether the blast tracks through air or water, and whether it happens in the open air or within an enclosed space and the distance from the explosion. Tire explosion-related injuries are rarely reported in literature. This study presents a fatal case of blast overpressure due to the accidental explosion of a truck tire occurring in a tire repair shop. A multidisciplinary approach to the fatality involving forensic pathologists and engineers revealed that the accidental explosion, which caused a series of primary and tertiary blast wave injuries, was due to tire deterioration.

  19. The effect of application of multiple psychological interventions in the treatment process of patients with facial burn injury%综合心理干预在颜面部烧伤患者治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    周琴; 官浩; 何飞; 折涛; 石雪琴; 邹小梅; 焦晓春

    2012-01-01

    目的:通过对颜面部烧伤患者的综合心理干预,探讨颜面部烧伤患者心理健康状况及对生活能力的影响,评估综合心理干预在颜面部烧伤患者临床疗效中的重要作用.方法:将95例患者随机分为实验组和对照组.实验组在实施常规医学护理的同时给予各类综合心理干预措施.干预前后均采用抑郁自评量表、焦虑自评量表、症状自评量表和Barthe1指数记分法对患者心理状况及生活能力进行评定.结果:综合心理干预后,实验组SDS评分、SAS评分均明显低于对照组,实验组抑郁、焦虑、恐怖、精神病性因子评分等也明显低于对照组.结论:在颜面部烧伤患者的临床治疗中,综合心理干预能够更好的改善患者的焦虑、抑郁、心理健康状况、生活自理能力.对颜面烧伤患者实施综合心理干预,在其整个治疗中非常必要且具有重要意义.%Objective Multiple psychological intervention were applied in the process of facial bum injury treatment. Jo explore the effect of multiple psychological interventions on patients' mental health and living ability. Methods Ninety five patients were divided into experiment group and control group. In the experiment group, patients not only received routine nursing care but also got multiple psychological interventions. Self-rating depression scale (SDS), self-rating anxiety scale (SAS), symptom checklist 90 (SCL-90) and Barthel index of ADL (ADL) were employed to evaluate the mental health and living ability of facial burn patients before and after multiple psychological intervention. Results The scores of SDS and SAS in experiment group were significantly lower than that of in control group. After the intervention, patients in experiment group had lower scores in depression, phobic-anxiety and psychoticism score. Conclusions In facial burn patients treatment process applied multiple psychological interventions can improve depression, phobic

  20. Retained crossbow bolt after penetrating facial trauma.

    Science.gov (United States)

    Shah, Manan U; Sridhara, Shankar K; Wolf, Jeffrey S; Ambro, Bryan T

    2016-01-01

    We present an unusual case of a retained crossbow bolt in the maxillofacial area of a 31-year-old man. While crossbow injuries are rare, this case is of interest because otolaryngologists are often faced with treating retained foreign objects after penetrating facial trauma. These cases are difficult to manage because of the complexity and variety of injuries that can occur during both the initial trauma and the removal. We focus on the management of the bolt's removal and provide a brief discussion of the relevant literature on crossbow injuries to the head and neck.

  1. When to suspect head injury or cervical spine injury in maxillofacial trauma?

    Science.gov (United States)

    Rahman, Sajjad A; Chandrasala, Soumithran

    2014-05-01

    The global status report of the World Health Organization (WHO) on road safety suggested that India is leading in road traffic accidents in the world. According to the report on road accidents in India in 2010 by the Transport Research Wing, Ministry of Road Transport and Highways, New Delhi, Kerala ranked third in accidents per lakh population and second in persons injured per lakh population. As the face, brain, and cervical spine are in close proximity with one another, associated injuries can be suspected. The aim of this study was to determine the relationship between the severity of head, cervical spine, and facial injury and incidence of facial injury in patients with head and/or cervical spine injury. A prospective cohort study was conducted over a period of one year. The study population included all patients having computed tomography (CT)-demonstrable head injury, radiographic evidence of cervical spine injury, and associated head or cervical spine injury with facial injury. Data were analyzed using the chi-square test using statistical package SPSS. A P value less than 0.05 was considered statistically significant. Of 124 patients, 59 (47.6%) had facial injuries. As severity of head injury increased, the number of facial injuries decreased. Statistically, no significant association between facial and head injury was seen. A statistically significant association between dentoalveolar involvement and cervical spine injury was seen (P < 0.001). The proportion of injuries in patients with cervical spine injuries alone was significantly lower in the frontal (P = 0.001) and orbital (P = 0.004) regions and higher in the mandibular region (P = 0.010). Midface injuries were more commonly associated with head injuries. Decreased facial involvement leads to increased severity of head injury. Simple injuries of the cervical spine were more commonly associated with facial injuries.

  2. When to suspect head injury or cervical spine injury in maxillofacial trauma?

    Directory of Open Access Journals (Sweden)

    Sajjad A Rahman

    2014-01-01

    Full Text Available Background: The global status report of the World Health Organization (WHO on road safety suggested that India is leading in road traffic accidents in the world. According to the report on road accidents in India in 2010 by the Transport Research Wing, Ministry of Road Transport and Highways, New Delhi, Kerala ranked third in accidents per lakh population and second in persons injured per lakh population. As the face, brain, and cervical spine are in close proximity with one another, associated injuries can be suspected. The aim of this study was to determine the relationship between the severity of head, cervical spine, and facial injury and incidence of facial injury in patients with head and/or cervical spine injury. Materials and Methods: A prospective cohort study was conducted over a period of one year. The study population included all patients having computed tomography (CT-demonstrable head injury, radiographic evidence of cervical spine injury, and associated head or cervical spine injury with facial injury. Data were analyzed using the chi-square test using statistical package SPSS. A P value less than 0.05 was considered statistically significant. Results: Of 124 patients, 59 (47.6% had facial injuries. As severity of head injury increased, the number of facial injuries decreased. Statistically, no significant association between facial and head injury was seen. A statistically significant association between dentoalveolar involvement and cervical spine injury was seen (P < 0.001. The proportion of injuries in patients with cervical spine injuries alone was significantly lower in the frontal (P = 0.001 and orbital (P = 0.004 regions and higher in the mandibular region (P = 0.010. Conclusion: Midface injuries were more commonly associated with head injuries. Decreased facial involvement leads to increased severity of head injury. Simple injuries of the cervical spine were more commonly associated with facial injuries.

  3. Mechanical and histological characterization of trachea tissue subjected to blast-type pressures

    Science.gov (United States)

    Butler, B. J.; Bo, C.; Tucker, A. W.; Jardine, A. P.; Proud, W. G.; Williams, A.; Brown, K. A.

    2014-05-01

    Injuries to the respiratory system can be a component of polytrauma in blast-loading injuries. Tissues located at air-liquid interfaces, including such tissues in the respiratory system, are particularly vulnerable to damage by blast overpressures. There is a lack of information about the mechanical and cellular responses that contribute to the damage of this class of tissues subjected to the high strain rates associated with blast loading. Here, we describe the results of dynamic blast-like pressure loading tests at high strain rates on freshly harvested ex vivo trachea tissue specimens.

  4. Delayed presentation of traumatic facial nerve (CN VII) paralysis.

    Science.gov (United States)

    Napoli, Anthony M; Panagos, Peter

    2005-11-01

    Facial nerve paralysis (Cranial Nerve VII, CN VII) can be a disfiguring disorder with profound impact upon the patient. The etiology of facial nerve paralysis may be congenital, iatrogenic, or result from neoplasm, infection, trauma, or toxic exposure. In the emergency department, the most common cause of unilateral facial paralysis is Bell's palsy, also known as idiopathic facial paralysis (IFP). We report a case of delayed presentation of unilateral facial nerve paralysis 3 days after sustaining a traumatic head injury. Re-evaluation and imaging of this patient revealed a full facial paralysis and temporal bone fracture extending into the facial canal. Because cranial nerve injuries occur in approximately 5-10% of head-injured patients, a good history and physical examination is important to differentiate IFP from another etiology. Newer generation high-resolution computed tomography (CT) scans are commonly demonstrating these fractures. An understanding of this complication, appropriate patient follow-up, and early involvement of the Otolaryngologist is important in management of these patients. The mechanism as well as the timing of facial nerve paralysis will determine the proper evaluation, consultation, and management for the patient. Patients with total or immediate paralysis as well as those with poorly prognostic audiogram results are good candidates for surgical repair.

  5. Surgical treatment of facial paralysis.

    Science.gov (United States)

    Mehta, Ritvik P

    2009-03-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.

  6. Ritonavir and disulfiram have potential to inhibit caspase-1 mediated inflammation and reduce neurological sequelae after minor blast exposure.

    Science.gov (United States)

    Foley, Kevin; Kast, Richard E; Altschuler, Eric L

    2009-02-01

    Caspase-1 triggers cytokine release following acceleration-induced concussive head injury. Minor blast injury in which no physical tissue injury occurs, results in the release of cytokines in a similar fashion. Ritonavir, a generically available protease inhibitor with a benign short-term side-effect profile, has been shown to inhibit expression of caspase-1. We review the relevant literature and propose that ritonavir may be of benefit in reducing adverse neuropsychiatric outcomes and hastening recovery following mild blast injury. Further research in animal models of blast injury followed by clinical studies would determine whether this therapy is effective.

  7. Advanced trauma life support (ATLS) and facial trauma: can one size fit all? Part 2: ATLS, maxillofacial injuries and airway management dilemmas.

    Science.gov (United States)

    Perry, M; Morris, C

    2008-04-01

    Maxillofacial trauma poses an obvious threat to the patient's airway, which may not be immediately evident. In the multiply injured patient, the co-existence of actual or potential injuries elsewhere may complicate airway management, notably in the presence of full spinal immobilization. Following high-velocity trauma, injuries to the cervical spine must be assumed to be present. They also need to be ruled out in an appropriate and timely manner, as patients may wish to sit up. Assessment and management of the airway in maxillofacial trauma can be difficult, requiring a senior anaesthetist or other individual appropriately trained in emergency airway care. A number of management options may exist to protect the airway, each with advantages and drawbacks. Agitation and vomiting can occur unexpectedly and need to be managed safely with due consideration to the spine. Oral and maxillofacial surgeons need to be aware of these dilemmas and their early warning signs, and be skilled in emergency surgical airway procedures, especially if involved as part of the trauma team. Prolonged immobilization is associated with significant morbidity and mortality. A number of protocols currently exist for 'clearing' the spine. Imaging now plays a greater role, especially in the obtunded, unconscious or intubated patient, and this is discussed.

  8. Increase in Blood-Brain Barrier Perrmeability, Oxidative Stress, and Activated Microglia in a Rat Model of Blast-Induced Traumatic Brain Injury

    Science.gov (United States)

    2010-01-01

    microglimis of Alzheimer ’~ disease . J Nucl Med 36:2207-2210. Grossman R, Shohami E. Ak·xandrovid1 ;\\, Y:1tsiv I, Kloog Y, Bicgon A. 2003. Increase in...unknown. In the present study, we utilized an air-driven shock tube to investigate the effects of blast exposure (120 kPa) on rat brains. Immediately...and exercise per- formance (Bauman et al., 1 ’J97), with similar findings The opinions expres.~ed herein arc those of rhc authors and do nor reflect

  9. Contemporary facial reanimation.

    Science.gov (United States)

    Bhama, Prabhat K; Hadlock, Tessa A

    2014-04-01

    The facial nerve is the most commonly paralyzed nerve in the human body. Facial paralysis affects aesthetic appearance, and it has a profound effect on function and quality of life. Management of patients with facial paralysis requires a multidisciplinary approach, including otolaryngologists, plastic surgeons, ophthalmologists, and physical therapists. Regardless of etiology, patients with facial paralysis should be evaluated systematically, with initial efforts focused upon establishing proper diagnosis. Management should proceed with attention to facial zones, including the brow and periocular region, the midface and oral commissure, the lower lip and chin, and the neck. To effectively compare contemporary facial reanimation strategies, it is essential to employ objective intake assessment methods, and standard reassessment schemas during the entire management period.

  10. Traumatic facial nerve palsy: CT patterns of facial nerve canal fracture and correlation with clinical severity

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jae Cheol; Kim, Sang Joon; Park, Hyun Min; Lee, Young Suk; Lee, Jee Young [College of Medicine, Dankook Univ., Chonan (Korea, Republic of)

    2002-07-01

    To analyse the patterns of facial nerve canal injury seen at temporal bone computed tomography (CT) in patients with traumatic facial nerve palsy and to correlate these with clinical manifestations and outcome. Thirty cases of temporal bone CT in 29 patients with traumatic facial nerve palsy were analyzed with regard to the patterns of facial nerve canal involvement. The patterns were correlated with clinical grade, the electroneurographic (ENoG) findings, and clinical outcome. For clinical grading, the House-Brackmann scale was used, as follows:grade I-IV, partial palsy group; grade V-VI, complete palsy group. The electroneuronographic findings were categorized as mild to moderate (below 90%) or severe (90% and over) degeneration. In 25 cases, the bony wall of the facial nerve canals was involved directly (direct finding): discontinuity of the bony wall was onted in 22 cases, bony spicules in ten, and bony wall displacement in five. Indirect findings were canal widening in nine cases and adjacent bone fracture in two. In one case, there were no direct or indirect findings. All cases in which there was complete palsy (n=8) showed one or more direct findings including spicules in six, while in the incomplete palsy group (n=22), 17 cases showed direct findings. In the severe degeneration group (n=13), on ENog, 12 cases demonstrated direct findings, including spicules in nine cases. In 24 patients, symptoms of facial palsy showed improvement at follow up evaluation. Four of the five patients in whom symptoms did not improve had spicules. Among ten patients with spicules, five underwent surgery and symptoms improved in four of these; among the five patients not operated on , symptoms did not improve in three. In most patients with facial palsy after temporal bone injury, temporal bone CT revealed direct or indirect facial nerve canal involvement, and in complete palsy or severe degeneration groups, there were direct findings in most cases. We believe that meticulous

  11. Tympanic Membrane Perforation and Hearing Loss From Blast Overpressure in Operation Enduring Freedom and Operation Iraqi Freedom Wounded

    Science.gov (United States)

    2007-10-01

    Singh DS, Ahluwalia KJS. Blast injuries of the ear. J Laryngol Otol. 1968;82:1017–1028. 10. Kronenberg J, Ben-Shoshan J, Wolf M. Perforated tympanic...Action Casualty System. Br J Surg. 1989;75:1006–1010. 23. Kronenberg J, Ben-Shoshan J, Modan M, Leventon G. Blast injury and cholesteatoma. Am J Otol

  12. Facial Reconstruction and Rehabilitation.

    Science.gov (United States)

    Guntinas-Lichius, Orlando; Genther, Dane J; Byrne, Patrick J

    2016-01-01

    Extracranial infiltration of the facial nerve by salivary gland tumors is the most frequent cause of facial palsy secondary to malignancy. Nevertheless, facial palsy related to salivary gland cancer is uncommon. Therefore, reconstructive facial reanimation surgery is not a routine undertaking for most head and neck surgeons. The primary aims of facial reanimation are to restore tone, symmetry, and movement to the paralyzed face. Such restoration should improve the patient's objective motor function and subjective quality of life. The surgical procedures for facial reanimation rely heavily on long-established techniques, but many advances and improvements have been made in recent years. In the past, published experiences on strategies for optimizing functional outcomes in facial paralysis patients were primarily based on small case series and described a wide variety of surgical techniques. However, in the recent years, larger series have been published from high-volume centers with significant and specialized experience in surgical and nonsurgical reanimation of the paralyzed face that have informed modern treatment. This chapter reviews the most important diagnostic methods used for the evaluation of facial paralysis to optimize the planning of each individual's treatment and discusses surgical and nonsurgical techniques for facial rehabilitation based on the contemporary literature.

  13. [Facial tics and spasms].

    Science.gov (United States)

    Potgieser, Adriaan R E; van Dijk, J Marc C; Elting, Jan Willem J; de Koning-Tijssen, Marina A J

    2014-01-01

    Facial tics and spasms are socially incapacitating, but effective treatment is often available. The clinical picture is sufficient for distinguishing between the different diseases that cause this affliction.We describe three cases of patients with facial tics or spasms: one case of tics, which are familiar to many physicians; one case of blepharospasms; and one case of hemifacial spasms. We discuss the differential diagnosis and the treatment possibilities for facial tics and spasms. Early diagnosis and treatment is important, because of the associated social incapacitation. Botulin toxin should be considered as a treatment option for facial tics and a curative neurosurgical intervention should be considered for hemifacial spasms.

  14. Computational study of human head response to primary blast waves of five levels from three directions.

    Directory of Open Access Journals (Sweden)

    Chenzhi Wang

    Full Text Available Human exposure to blast waves without any fragment impacts can still result in primary blast-induced traumatic brain injury (bTBI. To investigate the mechanical response of human brain to primary blast waves and to identify the injury mechanisms of bTBI, a three-dimensional finite element head model consisting of the scalp, skull, cerebrospinal fluid, nasal cavity, and brain was developed from the imaging data set of a human female. The finite element head model was partially validated and was subjected to the blast waves of five blast intensities from the anterior, right lateral, and posterior directions at a stand-off distance of one meter from the detonation center. Simulation results show that the blast wave directly transmits into the head and causes a pressure wave propagating through the brain tissue. Intracranial pressure (ICP is predicted to have the highest magnitude from a posterior blast wave in comparison with a blast wave from any of the other two directions with same blast intensity. The brain model predicts higher positive pressure at the site proximal to blast wave than that at the distal site. The intracranial pressure wave invariably travels into the posterior fossa and vertebral column, causing high pressures in these regions. The severities of cerebral contusions at different cerebral locations are estimated using an ICP based injury criterion. Von Mises stress prevails in the cortex with a much higher magnitude than in the internal parenchyma. According to an axonal injury criterion based on von Mises stress, axonal injury is not predicted to be a cause of primary brain injury from blasts.

  15. Working Methods and Experiences of Nursing Groups in Blast Injury External Aid Medical Team%爆炸伤外援医疗队护理组的工作方法与体会

    Institute of Scientific and Technical Information of China (English)

    柏素萍; 蒋玲

    2015-01-01

    目的 探讨爆炸伤外援医疗队护理组的工作方法.方法 迅速组成医疗队护理组,制定外援护理组工作职责和制度.根据患者的病情发展,实施烧伤专科的理论培训及技能训练.同时加强与各方信息沟通,及时做好反馈.严格执行患者安全管理制度,严防不良事件.结果 参与救治患者11例中,1例在48 h内死亡,其余10例危重患者经一个月护理,未发生与护理相关的并发症.结论 外援医疗队护理组能做好医疗点爆炸伤护理工作的支援帮带,对提高护理质量及救治成功率有积极作用.%Objective To explore the working methods and experiences of nursing groups in blast injury external aid medical team.Methods Formulate the working responsibilities and systems of foreign aid medical nursing groups rapidly. Based on patients' disease progression to implement training of burns specialist theory and skill. Meanwhile, reinforce the communication with all aspects and make feedback timely. Execute the system of patient safety management strictly and avoid adverse event. Results In the treatment of 11 patients, 1 patient died in 48 hours and others did not displayed related nursing complications within 1 months' nursing treatment.Conclusion External aid medical team nursing groups can provide blast injury nursing work in the medical post with effective support and help and exert positive role in improving nursing quality and treatment success rate.

  16. History of facial pain diagnosis

    DEFF Research Database (Denmark)

    Zakrzewska, Joanna M; Jensen, Troels S

    2017-01-01

    Premise Facial pain refers to a heterogeneous group of clinically and etiologically different conditions with the common clinical feature of pain in the facial area. Among these conditions, trigeminal neuralgia (TN), persistent idiopathic facial pain, temporomandibular joint pain, and trigeminal...

  17. What Is Expected from a Facial Trauma Caused by Violence?

    Directory of Open Access Journals (Sweden)

    Douglas Rangel Goulart

    2014-12-01

    Full Text Available Objectives: The aim of this retrospective study was to compare the peculiarities of maxillofacial injuries caused by interpersonal violence with other etiologic factors. Material and Methods: Medical records of 3,724 patients with maxillofacial injuries in São Paulo state (Brazil were retrospectively analyzed. The data were submitted to statistical analysis (simple descriptive statistics and Chi-squared test using SPSS 18.0 software. Results: Data of 612 patients with facial injuries caused by violence were analyzed. The majority of the patients were male (81%; n = 496, with a mean age of 31.28 years (standard deviation of 13.33 years. These patients were more affected by mandibular and nose fractures, when compared with all other patients (P < 0.01, although fewer injuries were recorded in other body parts (χ2 = 17.54; P < 0.01; Victims of interpersonal violence exhibited more injuries when the neurocranium was analyzed in isolation (χ2 = 6.85; P < 0.01. Conclusions: Facial trauma due to interpersonal violence seem to be related to a higher rate of facial fractures and lacerations when compared to all patients with facial injuries. Prominent areas of the face and neurocranium were more affected by injuries.

  18. Calculation of driling and blasting parameters in blasting performance

    OpenAIRE

    Dambov, Risto; Karanakova Stefanovska, Radmila; Dambov, Ilija

    2015-01-01

    In all mining technology drilling and blasting parameters and works are one of the main production processes at each mine. The parameters of drilling and blasting and explosives consumption per ton of blasting mass are define economic indicators of any blasting no matter for what purpose and where mining is performed. The calculation of rock blasting should always have in mind that the methodology of calculation of all drilling and blasting parameters in blasting performance are performed for...

  19. Management of facial trauma in children: A case report

    Directory of Open Access Journals (Sweden)

    Das U

    2006-09-01

    Full Text Available Children are uniquely susceptible to cranio facial trauma because of their greater cranial mass to body ratio. Below the age of 5, the incidence of pediatric facial fractures in relation to the total is very low ranging from 0.6-1.2%. Maxillo-facial injuries may be quite dramatic causing parents to panic and the child to cry uncontrollably with blood, tooth and soft tissue debris in the mouth. The facial disfigurement caused by trauma can have a deep psychological impact on the tender minds of young children and their parents. This case report documents the trauma and follow up care of a 4-year-old patient with maxillofacial injuries.

  20. Evolution of blast wave profiles in simulated air blasts: experiment and computational modeling

    Science.gov (United States)

    Chandra, N.; Ganpule, S.; Kleinschmit, N. N.; Feng, R.; Holmberg, A. D.; Sundaramurthy, A.; Selvan, V.; Alai, A.

    2012-09-01

    Shock tubes have been extensively used in the study of blast traumatic brain injury due to increased incidence of blast-induced neurotrauma in Iraq and Afghanistan conflicts. One of the important aspects in these studies is how to best replicate the field conditions in the laboratory which relies on reproducing blast wave profiles. Evolution of the blast wave profiles along the length of the compression-driven air shock tube is studied using experiments and numerical simulations with emphasis on the shape and magnitude of pressure time profiles. In order to measure dynamic pressures of the blast, a series of sensors are mounted on a cylindrical specimen normal to the flow direction. Our results indicate that the blast wave loading is significantly different for locations inside and outside of the shock tube. Pressure profiles inside the shock tube follow the Friedlander waveform fairly well. Upon approaching exit of the shock tube, an expansion wave released from the shock tube edges significantly degrades the pressure profiles. For tests outside the shock tube, peak pressure and total impulse reduce drastically as we move away from the exit and majority of loading is in the form of subsonic jet wind. In addition, the planarity of the blast wave degrades as blast wave evolves three dimensionally. Numerical results visually and quantitatively confirm the presence of vortices, jet wind and three-dimensional expansion of the planar blast wave near the exit. Pressure profiles at 90° orientation show flow separation. When cylinder is placed inside, this flow separation is not sustained, but when placed outside the shock tube this flow separation is sustained which causes tensile loading on the sides of the cylinder. Friedlander waves formed due to field explosives in the intermediate-to far-field ranges are replicated in a narrow test region located deep inside the shock tube.

  1. Blast-Resistant Improvement of Sandwich Armor Structure with Aluminum Foam Composite

    Directory of Open Access Journals (Sweden)

    Shu Yang

    2013-01-01

    Full Text Available Sandwich armor structures with aluminum foam can be utilized to protect a military vehicle from harmful blast load such as a landmine explosion. In this paper, a system-level dynamic finite element model is developed to simulate the blast event and to evaluate the blast-resistant performance of the sandwich armor structure. It is found that a sandwich armor structure with only aluminum foam is capable of mitigating crew injuries under a moderate blast load. However, a severe blast load causes force enhancement and results in much worse crew injury. An isolating layer between the aluminum foam and the vehicle floor is introduced to remediate this drawback. The results show that the blast-resistant capability of the innovative sandwich armor structure with the isolating layer increases remarkably.

  2. Facial Nerve in Foetal Cadavers: An Anatomical Study with Clinical Relevance

    Directory of Open Access Journals (Sweden)

    Kotian SR

    2016-01-01

    Full Text Available Introduction: Facial nerve paralysis is a major complication of parotid surgery and is widely reported. Little attention is paid to the facial nerve trunk in children. The facial nerve trunk in children and infants can be easily injured since they lie close to the surface. The present study therefore intends to describe the variability in the facial nerve trunk and its branching pattern in foetuses. Methods: The study was done bilaterally in 30 formalin-fixed foetuses (15 females, 15 males, age ranging from 21.0 to 35.5 weeks of gestation. The length of the facial nerve trunk was measured and bifurcation and trifurcation of the trunk was examined. Variability in the branching pattern was also noted. Results: The most common facial nerve trunk branching type was bifurcation (53.33%, followed by trifurcation (33.33%. Multiple branching of the facial nerve was also observed in 13.34% of the cases. Other variations related to the facial nerve were also noted. The mean length of the facial nerve trunk was 7.15 ± 2.12 mm. There was no significant difference between the right and left sides and in case of males and female foetuses. Conclusion: Facial nerve injury during parotid surgery is a main cause of paediatric facial paralysis. The length of the facial nerve trunk therefore must be accurately known in any surgical procedure planned in the area. The main furcation of the facial nerve should also receive special attention.

  3. Maxillofacial and dental injuries sustained in hurling.

    LENUS (Irish Health Repository)

    Murphy, C

    2010-06-01

    The incidence of facial injuries in hurling has decreased since the introduction of helmets with facial protection. The aim of this study was to identify the incidence of facial and dental injuries sustained in hurling training or matches and compliance with wearing helmets, with or without modified or unmodified faceguards. This prospective study included all patients who attended the Mid Western Regional Hospital Limerick, with injuries sustained while playing hurling during 2007 and 2008 seasons. The study population included 70 patients. Forty two (60%) injuries occurred during practice and 28(40%) during matches. Fifty two players (75%) sustained facial injuries whilst no helmet was worn. Eighteen injuries (25%) were sustained by players wearing helmets. Th study demonstrates that 60% of injuries occur during training when players do not wear helmets. We support the recent introduction by the GAA making it compulsory to wear helmets with faceguard protection from January 1st 2010.

  4. Low-reactive-level laser treatment in facial paralysis

    Science.gov (United States)

    Brugnera, Aldo, Jr.; Ladalardo, Thereza C.; Bologna, Elisangela; Castanho Garrini, Ana E.; Pinheiro, Antonio L. B.; Campos, Roberto A. d. C.

    2000-03-01

    This study was carried out with a 41-year-old female patient with facial paralysis as a consequence of facial nerve injury during neurosurgery. Low-reactive level laser treatment (LLLT) with a diode laser of 830 nm, 40 mw, continuous wave, spot area 3 mm2, was applied twice a week for 2 weeks, then 1 weekly session following up to 30 sessions, resulting in about 80% improvement of the motor activity.

  5. Facial nerve regeneration after facial allotransplantation: A longitudinal clinical and electromyographic follow-up of lip movements during speech.

    Science.gov (United States)

    De Letter, Miet; Vanhoutte, Sarah; Aerts, Annelies; Santens, Patrick; Vermeersch, Hubert; Roche, Nathalie; Stillaert, Filip; Blondeel, Philip; Van Lierde, Kristiane

    2017-06-01

    Facial allotransplantation constitutes a reconstructive option after extensive damage to facial structures. Functional recovery has been reported but remains an issue. A patient underwent facial allotransplantation after a ballistic injury with extensive facial tissue damage. Speech motor function was sequentially assessed clinically, along with repeated electromyography of lip movements during a follow-up of 3 years. Facial nerve recovery could be demonstrated within the first month, followed by a gradual increase in electromyographic amplitude and decrease in reaction times. These were accompanied by gradual improvement of clinical assessments. Axonal recovery starts early after transplantation. Electromyographic testing is sensitive in demonstrating this early recovery, which ultimately results in clinical improvements. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Rejuvenecimiento facial en "doble sigma" "Double ogee" facial rejuvenation

    Directory of Open Access Journals (Sweden)

    O. M. Ramírez

    2007-03-01

    . Este arco conecta con la convexidad superior del tercio medio facial que se une con la concavidad de la porción inferior del tercio medio (arco inferior. Los paciente con un considerable envejecimiento y ptosis de las estructuras centrales faciales se pueden beneficiar en la mayoría de los casos de nuestro abordaje endoscópico. Las cejas, las comisuras de los párpados, de los tejidos blandos nasoglaberlares, los surcos nasolabiales, la nariz, las mejillas, el ángulo de la boca y los "jowls" (mejillas de bulldog se pueden tratar con eficacia mediante este abordaje. También las ojeras y los hundimientos orbitarios inferiores. Es eficaz también en ritidectomías secundarias o terciarias que requieren rejuvenecimiento cutáneo simultaneo y para cuando se precisa aumento de los tejidos blandos así como en las desproporciones esqueléticas y de los tejidos blandos. Las estructuras óseas expuestas pueden ser aumentadas o reducidas según convenga. Recomendamos este abordaje cuando hay que cambiar o extirpar implantes faciales aloplásticos. Los procedimientos endoscópicos de la frente y del tercio medio facial permiten la reconstrucción del "Doble Sigma" que se asocia a un aspecto juvenil.Subperiosteal techniques describes by Tessier have revolutionized the treatment of the aging face advocating this approach to treat early signs of aging in young and middleage patients. Psillakis refines the technique further and Ramirez describes a safer and more effective method of subperiosteal lifting, so that this technique could be applied across the full spectrum of facial aging. The introduction of the endoscope in the treatment of facial rejuvenation ushered in a new era in Aesthetic Surgery. Today, endoscopically assisted subperiosteal undermining of the upper, middle and lower face can provide a means for repositioning the sagging facial soft tissues in addition to augmentation of the craniofacial skeleton, with a reduced preoperative facial edema, minimal injury to the

  7. Long hair, smoking, and deep facial burns.

    Science.gov (United States)

    Koljonen, Virve

    2008-01-01

    The purpose of this article is to describe deep facial burn injuries by cigarette lighters in longhaired adults and to report our experience in their treatment. Eight consecutive cigarette lighter burn victims are treated in the Helsinki Burn Center in the year 2006. Seven of the patients were women; their mean age was 50 years. All were under the influence of alcohol at the time of injury. The mean burnt area was 3.5% TBSA. The burnt areas were primarily forehead, cheek, and ipsilateral ear. After a conservative treatment, all the patients underwent an operation, whereby the nonhealing burns were excised and covered with autologous split thickness skin grafts. Postoperative period was uneventful in all the patients. Besides having severe detrimental effects on general health status and wound healing, smoking is the leading cause of residential and total fire deaths worldwide. The patients in this article suffered deep facial burns because of cigarette lighters.

  8. Facial expression and sarcasm.

    Science.gov (United States)

    Rockwell, P

    2001-08-01

    This study examined facial expression in the presentation of sarcasm. 60 responses (sarcastic responses = 30, nonsarcastic responses = 30) from 40 different speakers were coded by two trained coders. Expressions in three facial areas--eyebrow, eyes, and mouth--were evaluated. Only movement in the mouth area significantly differentiated ratings of sarcasm from nonsarcasm.

  9. Holistic facial expression classification

    Science.gov (United States)

    Ghent, John; McDonald, J.

    2005-06-01

    This paper details a procedure for classifying facial expressions. This is a growing and relatively new type of problem within computer vision. One of the fundamental problems when classifying facial expressions in previous approaches is the lack of a consistent method of measuring expression. This paper solves this problem by the computation of the Facial Expression Shape Model (FESM). This statistical model of facial expression is based on an anatomical analysis of facial expression called the Facial Action Coding System (FACS). We use the term Action Unit (AU) to describe a movement of one or more muscles of the face and all expressions can be described using the AU's described by FACS. The shape model is calculated by marking the face with 122 landmark points. We use Principal Component Analysis (PCA) to analyse how the landmark points move with respect to each other and to lower the dimensionality of the problem. Using the FESM in conjunction with Support Vector Machines (SVM) we classify facial expressions. SVMs are a powerful machine learning technique based on optimisation theory. This project is largely concerned with statistical models, machine learning techniques and psychological tools used in the classification of facial expression. This holistic approach to expression classification provides a means for a level of interaction with a computer that is a significant step forward in human-computer interaction.

  10. Facial talon cusps.

    LENUS (Irish Health Repository)

    McNamara, T

    1997-12-01

    This is a report of two patients with isolated facial talon cusps. One occurred on a permanent mandibular central incisor; the other on a permanent maxillary canine. The locations of these talon cusps suggests that the definition of a talon cusp include teeth in addition to the incisor group and be extended to include the facial aspect of teeth.

  11. A Preliminary Investigation of Traumatically Induced Axonal Injury in a Three-Dimensional (3-D) Finite Element Model (FEM) of the Human Head During Blast-Loading

    Science.gov (United States)

    2013-07-01

    injury (22). 5 A fixed boundary condition was applied to the entirety of the body below the T1 vertebra , so that the head and neck were free to...protective systems that might alter the inertial response. 13 Although active muscles have an effect on the response of the cervical spine in...although this remains questionable without experimental validation. Also, cervical spine modeling has been extensively studied for automobile injury

  12. Altered prosaposin expression in the rat facial nerve nucleus following facial nerve transection and repair

    Institute of Scientific and Technical Information of China (English)

    Dong Wang; Wenlong Luo; Cuiying Zhou; Jingjing Li

    2009-01-01

    BACKGROUND: Studies have demonstrated that damaged facial nerves synthesize prosaposin to promote repair of facial neurons.OBJECTIVE: To observe time-course changes of prosaposin expression in the facial nerve nucleus of Sprague Dawley rats following facial nerve transection and repair.DESIGN, TIME AND SETTING: A randomized control neuropathological animal experiment was performed in Chongqing Medical University between March 2007 and September 2008.MATERIALS: A total of 48 adult, male, Sprague Dawley rats were selected and randomly divided into transection and transection + end-to-end anastomosis groups (n =24). Rabbit anti-rat prosaposin antibody, instant SABC immunohistochemical kit, and antibody dilution solution were purchased from Wuhan Uscn Science Co., Ltd., China.METHODS: In the transection group, the nerve trunk of the distal retroauricular branch of the left facial nerves was ligated in Sprague Dawley rats, and a 5-mm nerve trunk at the distal end of the ligation site was removed. In the transection + end-to-end anastomosis group, epineurial anastomosis was performed immediately following transection of the left facial nerves. The right facial nerves in the two groups sewed as the normal control group.MAIN OUTCOME MEASURES: The number of prosaposin-positive neurons, as well as intensity of immunostaining in facial nerve nucleus, following transection and end-to-end anastomosis were determined by immunohistochemistry at 1,3, 7, 14, 21, and 35 days after injury.RESULTS: Transection group: transection of facial nerves resulted in increased number of prosaposin-positive neurons and immunoreactivity intensity in the facial nucleus on day 1. These values significantly increased by day 3. Expression was greater than in the control side. The peak of the reduction was reached at 7 days post-surgery. Transection + end-to-end anastomosis group: the number of prosaposin-positive neurons and immunoreactivity intensity was reduced in the facial nerve nucleus following

  13. Blast Loading Experiments of Surrogate Models for Tbi Scenarios

    Science.gov (United States)

    Alley, M. D.; Son, S. F.

    2009-12-01

    This study aims to characterize the interaction of explosive blast waves through simulated anatomical models. We have developed physical models and a systematic approach for testing traumatic brain injury (TBI) mechanisms and occurrences. A simplified series of models consisting of spherical PMMA shells housing synthetic gelatins as brain simulants have been utilized. A series of experiments was conducted to compare the sensitivity of the system response to mechanical properties of the simulants under high strain-rate explosive blasts. Small explosive charges were directed at the models to produce a realistic blast wave in a scaled laboratory test cell setting. Blast profiles were measured and analyzed to compare system response severity. High-speed shadowgraph imaging captured blast wave interaction with the head model while particle tracking captured internal response for displacement and strain correlation. The results suggest amplification of shock waves inside the head near material interfaces due to impedance mismatches. In addition, significant relative displacement was observed between the interacting materials suggesting large strain values of nearly 5%. Further quantitative results were obtained through shadowgraph imaging of the blasts confirming a separation of time scales between blast interaction and bulk movement. These results lead to the conclusion that primary blast effects could cause TBI occurrences.

  14. Spontaneous Facial Mimicry in Response to Dynamic Facial Expressions

    Science.gov (United States)

    Sato, Wataru; Yoshikawa, Sakiko

    2007-01-01

    Based on previous neuroscientific evidence indicating activation of the mirror neuron system in response to dynamic facial actions, we hypothesized that facial mimicry would occur while subjects viewed dynamic facial expressions. To test this hypothesis, dynamic/static facial expressions of anger/happiness were presented using computer-morphing…

  15. Sound-induced facial synkinesis following facial nerve paralysis

    NARCIS (Netherlands)

    Ma, Ming-San; van der Hoeven, Johannes H.; Nicolai, Jean-Philippe A.; Meek, Marcel F.

    2009-01-01

    Facial synkinesis (or synkinesia) (FS) occurs frequently after paresis or paralysis of the facial nerve and is in most cases due to aberrant regeneration of (branches of) the facial nerve. Patients suffer from inappropriate and involuntary synchronous facial muscle contractions. Here we describe two

  16. Live facial feature extraction

    Institute of Scientific and Technical Information of China (English)

    ZHAO JieYu

    2008-01-01

    Precise facial feature extraction is essential to the high-level face recognition and expression analysis. This paper presents a novel method for the real-time geomet-ric facial feature extraction from live video. In this paper, the input image is viewed as a weighted graph. The segmentation of the pixels corresponding to the edges of facial components of the mouth, eyes, brows, and nose is implemented by means of random walks on the weighted graph. The graph has an 8-connected lattice structure and the weight value associated with each edge reflects the likelihood that a random walker will cross that edge. The random walks simulate an anisot-ropic diffusion process that filters out the noise while preserving the facial expres-sion pixels. The seeds for the segmentation are obtained from a color and motion detector. The segmented facial pixels are represented with linked lists in the origi-nal geometric form and grouped into different parts corresponding to facial com-ponents. For the convenience of implementing high-level vision, the geometric description of facial component pixels is further decomposed into shape and reg-istration information. Shape is defined as the geometric information that is invari-ant under the registration transformation, such as translation, rotation, and iso-tropic scale. Statistical shape analysis is carried out to capture global facial fea-tures where the Procrustes shape distance measure is adopted. A Bayesian ap-proach is used to incorporate high-level prior knowledge of face structure. Ex-perimental results show that the proposed method is capable of real-time extraction of precise geometric facial features from live video. The feature extraction is robust against the illumination changes, scale variation, head rotations, and hand inter-ference.

  17. PCA facial expression recognition

    Science.gov (United States)

    El-Hori, Inas H.; El-Momen, Zahraa K.; Ganoun, Ali

    2013-12-01

    This paper explores and compares techniques for automatically recognizing facial actions in sequences of images. The comparative study of Facial Expression Recognition (FER) techniques namely Principal Component's analysis (PCA) and PCA with Gabor filters (GF) is done. The objective of this research is to show that PCA with Gabor filters is superior to the first technique in terms of recognition rate. To test and evaluates their performance, experiments are performed using real database by both techniques. The universally accepted five principal emotions to be recognized are: Happy, Sad, Disgust and Angry along with Neutral. The recognition rates are obtained on all the facial expressions.

  18. Giant sialocele following facial trauma.

    Science.gov (United States)

    Medeiros Júnior, Rui; Rocha Neto, Alípio Miguel da; Queiroz, Isaac Vieira; Cauby, Antônio de Figueiredo; Gueiros, Luiz Alcino Monteiro; Leão, Jair Carneiro

    2012-01-01

    Injuries in the parotid and masseter region can cause serious impairment secondary to damage of important anatomical structures. Sialocele is observed as facial swelling associated with parotid duct rupture due to trauma. The aim of this paper is to report a case of a giant traumatic sialocele in the parotid gland, secondary to a knife lesion in a 40-year-old woman. Conservative measures could not promote clinical resolution and a surgical intervention for the placement of a vacuum drain was selected. Under local anesthesia, a small incision was performed adjacent to parotid duct papilla, followed by muscular divulsion and draining of significant amount of saliva. An active vacuum suction drain was placed for 15 days, aiming to form a new salivary duct. This technique was shown to be a safe, effective and low-cost option, leading to complete resolution and no recurrence after 28 months of follow up.

  19. Effects Of Primary Blast Overpressure On Retina And Optic Tract In Rats

    Directory of Open Access Journals (Sweden)

    James eDemar

    2016-04-01

    Full Text Available Blast has been the leading cause of injury, particularly traumatic brain injury and visual system injury, in combat operations in Iraq and Afghanistan. We determined the effect of shock tube-generated primary blast on retinal electrophysiology and on retinal and brain optic tract histopathology in a rat model.The amplitude of a- and b- waves on the electroretinogram (ERG for both right and left eyes were measured prior to a battlefield-simulation Friedlander-type blast wave and on 1, 7, and 14 days thereafter. Histopathologic findings of the right and left retina and the right and left optic tracts (2.8 mm post-optic chiasm were evaluated 14 days after the blast.For two experiments in which the right eye was oriented to the blast, the amplitude of ERG a- and b-waves at 7 days post-blast on the right side but not on the left side was diminished compared to that of sham animals (P=0.005-0.01 Histopathologic injury scores at 14 days post-blast for the right retina but not the left retina were higher than for sham animals (P=0.01, and histopathologic injury scores at 14 days for both optic tracts were markedly higher than for shams (P < 0.0001. Exposure of one eye to a blast wave, comparable to that causing human injury, produced injury to the retina as determined by ERG and histopathology, and to both post-chiasmatic optic tracts as determined by histopathology. This model may be useful for analyzing the effect of therapeutic interventions on retinal damage due to primary blast waves.

  20. Surgical Treatment of Facial Paralysis

    OpenAIRE

    Mehta, Ritvik P.

    2009-01-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (2 yr). For acute facial paralysis, the main surgi...

  1. Persistent facial pain conditions

    DEFF Research Database (Denmark)

    Forssell, Heli; Alstergren, Per; Bakke, Merete

    2016-01-01

    , clinical features, consequences, central and peripheral mechanisms, diagnostic criteria (DC/TMD), and principles of management. For each of the neuropathic facial pain entities, the definitions, prevalence, clinical features, and diagnostics are described. The current understanding of the pathophysiology......Persistent facial pains, especially temporomandibular disorders (TMD), are common conditions. As dentists are responsible for the treatment of most of these disorders, up-to date knowledge on the latest advances in the field is essential for successful diagnosis and management. The review covers...... TMD, and different neuropathic or putative neuropathic facial pains such as persistent idiopathic facial pain and atypical odontalgia, trigeminal neuralgia and painful posttraumatic trigeminal neuropathy. The article presents an overview of TMD pain as a biopsychosocial condition, its prevalence...

  2. Persistent facial pain conditions

    DEFF Research Database (Denmark)

    Forssell, Heli; Alstergren, Per; Bakke, Merete

    2016-01-01

    TMD, and different neuropathic or putative neuropathic facial pains such as persistent idiopathic facial pain and atypical odontalgia, trigeminal neuralgia and painful posttraumatic trigeminal neuropathy. The article presents an overview of TMD pain as a biopsychosocial condition, its prevalence......Persistent facial pains, especially temporomandibular disorders (TMD), are common conditions. As dentists are responsible for the treatment of most of these disorders, up-to date knowledge on the latest advances in the field is essential for successful diagnosis and management. The review covers......, clinical features, consequences, central and peripheral mechanisms, diagnostic criteria (DC/TMD), and principles of management. For each of the neuropathic facial pain entities, the definitions, prevalence, clinical features, and diagnostics are described. The current understanding of the pathophysiology...

  3. Persistent facial pain conditions

    DEFF Research Database (Denmark)

    Forssell, Heli; Alstergren, Per; Bakke, Merete;

    2016-01-01

    , clinical features, consequences, central and peripheral mechanisms, diagnostic criteria (DC/TMD), and principles of management. For each of the neuropathic facial pain entities, the definitions, prevalence, clinical features, and diagnostics are described. The current understanding of the pathophysiology...

  4. Management of facial blushing

    DEFF Research Database (Denmark)

    Licht, Peter B; Pilegaard, Hans K

    2008-01-01

    people. Side effects are frequent, but most patients are satisfied with the operation. In the short term, the key to success in sympathetic surgery for facial blushing lies in a meticulous and critical patient selection and in ensuring that the patient is thoroughly informed about the high risk of side...... effects. In the long term, the key to success in sympathetic surgery for facial blushing lies in more quality research comparing surgical, pharmacologic, and psychotherapeutic treatments....

  5. Simultaneous facial feature tracking and facial expression recognition.

    Science.gov (United States)

    Li, Yongqiang; Wang, Shangfei; Zhao, Yongping; Ji, Qiang

    2013-07-01

    The tracking and recognition of facial activities from images or videos have attracted great attention in computer vision field. Facial activities are characterized by three levels. First, in the bottom level, facial feature points around each facial component, i.e., eyebrow, mouth, etc., capture the detailed face shape information. Second, in the middle level, facial action units, defined in the facial action coding system, represent the contraction of a specific set of facial muscles, i.e., lid tightener, eyebrow raiser, etc. Finally, in the top level, six prototypical facial expressions represent the global facial muscle movement and are commonly used to describe the human emotion states. In contrast to the mainstream approaches, which usually only focus on one or two levels of facial activities, and track (or recognize) them separately, this paper introduces a unified probabilistic framework based on the dynamic Bayesian network to simultaneously and coherently represent the facial evolvement in different levels, their interactions and their observations. Advanced machine learning methods are introduced to learn the model based on both training data and subjective prior knowledge. Given the model and the measurements of facial motions, all three levels of facial activities are simultaneously recognized through a probabilistic inference. Extensive experiments are performed to illustrate the feasibility and effectiveness of the proposed model on all three level facial activities.

  6. Classifying Facial Actions

    Science.gov (United States)

    Donato, Gianluca; Bartlett, Marian Stewart; Hager, Joseph C.; Ekman, Paul; Sejnowski, Terrence J.

    2010-01-01

    The Facial Action Coding System (FACS) [23] is an objective method for quantifying facial movement in terms of component actions. This system is widely used in behavioral investigations of emotion, cognitive processes, and social interaction. The coding is presently performed by highly trained human experts. This paper explores and compares techniques for automatically recognizing facial actions in sequences of images. These techniques include analysis of facial motion through estimation of optical flow; holistic spatial analysis, such as principal component analysis, independent component analysis, local feature analysis, and linear discriminant analysis; and methods based on the outputs of local filters, such as Gabor wavelet representations and local principal components. Performance of these systems is compared to naive and expert human subjects. Best performances were obtained using the Gabor wavelet representation and the independent component representation, both of which achieved 96 percent accuracy for classifying 12 facial actions of the upper and lower face. The results provide converging evidence for the importance of using local filters, high spatial frequencies, and statistical independence for classifying facial actions. PMID:21188284

  7. Total Facial Nerve Decompression for Severe Traumatic Facial Nerve Paralysis: A Review of 10 Cases

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser

    2012-01-01

    Full Text Available Management of traumatic facial nerve disorders is challenging. Facial nerve decompression is indicated if 90–95% loss of function is seen at the very early period on ENoG or if there is axonal degeneration on EMG lately with no sign of recovery. Middle cranial or translabyrinthine approach is selected depending on hearing. The aim of this study is to present retrospective review of 10 patients with sudden onset complete facial paralysis after trauma who underwent total facial nerve decompression. Operation time after injury is ranging between 16 and105 days. Excitation threshold, supramaximal stimulation, and amplitude on the paralytic side were worse than at least %85 of the healthy side. Six of 11 patients had HBG-II, one patient had HBG-I, 3 patients had HBG-III, and one patient had HBG-IV recovery. Stretch, compression injuries with disruption of the endoneurial tubules undetectable at the time of surgery and lack of timely decompression may be associated with suboptimal results in our series.

  8. Experimental Animal Models for Studies on the Mechanisms of Blast-Induced Neurotrauma

    OpenAIRE

    Risling, Mårten; Davidsson, Johan

    2012-01-01

    A blast injury is a complex type of physical trauma resulting from the detonation of explosive compounds and has become an important issue due to the use of improvised explosive devices (IED) in current military conflicts. Blast-induced neurotrauma (BINT) is a major concern in contemporary military medicine and includes a variety of injuries that range from mild to lethal. Extreme forces and their complex propagation characterize BINT. Modern body protection and the development of armored mil...

  9. [Blasting damage in manmade disasters and terrorist attacks].

    Science.gov (United States)

    Shapovalov, V M; Samokhvalov, I M

    2012-01-01

    In the present case of explosive injuries in peacetime, when suddenly there are usually accidental or intentional explosions methane in mines, tanks with gas or explosives, fuel tanks or gas content, gas tanks, gas pipelines, product pipelines, as well as the explosion of military ordnance--grenades, mines, fuses, shells, and accidentally found child or maliciously used by terrorists. Collected statistical data on manmade disasters in coal mines and explosive injuries in terrorist attacks, the physical parameters of which were able to identify only approximately and type of damage incurred,mostly multiple and combinative combined and presented significant challenges in health care. The reasons and circumstances of the explosion in peacetime, gave a detailed description of the damaging factors, mechanisms, and characteristics arise from injuries suffered in the blast injuries. We describe the pathogenesis of blast injury, basic and clinical manifestations of lesions in the explosions.

  10. Assessment of the Accuracy of Certain Reduced Order Models used in the Prediction of Occupant Injury during Under-Body Blast Events

    Science.gov (United States)

    2014-04-15

    the floor on which the platform is dropped upon. Alternatively, a base excitation can be provided to the sliding platform in the upward vertical...occupant response behavior for the same given pulse. Occupant injuries recorded from both these approaches were compared against those measured...7ms clips of chest resultant acceleration, (7) 7ms clip of pelvic vertical acceleration, (8,9) Peak and 30ms clips of lumbar spine compression, and

  11. Hyperbaric Oxygen Therapy in the Treatment of Chronic Mild-Moderate Blast-Induced Traumatic Brain Injury Post-Concussion Syndrome (PCS) and Post Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    2016-10-01

    secure funding. There are no study results to report at this time and no significant adverse advents. 15. SUBJECT TERMS HBOT: hyperbaric oxygen...therapy; TBI: traumatic brain injury; PPCS: persistent post-concussion syndrome 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18...published 11/2011 in the Journal of Neurotrauma (http://www.liebertonline.com/doi/abs/10.1089/ neu .2011 .1895). The original purpose of the present

  12. Simulation of Blast on Porcine Head

    Science.gov (United States)

    2015-07-01

    S55–S61. Covey DC, Born CT. Blast injuries: mechanics and wounding patterns. J Surgical Orthopaedic Advances. 2010;19(1):8–12. Culbert RW. The vapor...Powell BJ, Baumer TG, Passalacqua NV, Wagner CD, Haut RC, Fenton TW, Yang KH. A forensic pathology tool to predict pediatric skull fracture patterns...microstructural and cerebrovascular changes during normal swine brain development. Pediatric Research, 2011;69(5):418– 424. Winter J. The material properties

  13. Idiopathic facial pain related with dental implantation

    Directory of Open Access Journals (Sweden)

    Tae-Geon Kwon

    2016-06-01

    Full Text Available Chronic pain after dental implantation is rare but difficult issue for the implant practitioner. Patients with chronic pain who had been performed previous implant surgery or related surgical intervention sometimes accompany with psychological problem and difficult to adequately manage. According to the International Classification of Headache Disorders (ICHD 3rd eds, Cepalagia 2013, painful neuropathies and other facial pains are subdivided into the 12 subcategories; 13.1. Trigeminal neuralgia; 13.2 Glossopharyngeal neuralgia; 13.3 Nervus intermedius (facial nerve neuralgia; 13.4 Occipital neuralgia; 13.5 Optic neuritis; 13.6 Headache attributed to ischaemic ocular motor nerve palsy; 13.7 Tolosa-Hunt syndrome; 13.8 Paratrigeminal oculo-sympathetic (Raeder’s syndrome; 13.9 Recurrent painful ophthalmoplegic neuropathy; 13.10 Burning Mouth Syndrome (BMS; 13.11 Persistent Idiopathic Facial Pain (PIFP; 13.12 Central neuropathic pain. Chronic orofacial pain after dental implant surgery can be largely into the two main categories that can be frequently encountered in clinical basis ; 1 Neuropathic pain, 2 Idiopathic pain. If there is no direct evidence of the nerve injury related with the implant surgery, the clinician need to consider the central cause of pain instead of the peripheral cause of the pain. There might be several possibilities; 1 Anaesthesia dolorosa, 2 Central post-stroke pain, 3 Facial pain attributed to multiple sclerosis, 4 Persistent idiopathic facial pain (PIFP, 5 Burning mouth syndrome. In this presentation, Persistent idiopathic facial pain (PIFP, the disease entity that can be frequently encountered in the clinic would be discussed. Persistent idiopathic facial pain (PIFP can be defined as “persistent facial and/or oral pain, with varying presentations but recurring daily for more than 2 hours per day over more than 3 months, in the absence of clinical neurological deficit”. ‘Atypical’ pain is a diagnosis of

  14. Hippocampal vulnerability and subacute response following varied blast magnitudes.

    Science.gov (United States)

    Sajja, Venkata Siva Sai Sujith; Ereifej, Evon S; VandeVord, Pamela J

    2014-06-06

    Clinical outcomes from blast neurotrauma are associated with higher order cognitive functions such as memory, problem solving skills and attention. Current literature is limited to a single overpressure exposure or repeated exposures at the same level of overpressure and is focused on the acute response (magnitudes (low, moderate and high) were used to evaluate molecular injury thresholds. Immunohistochemical analysis demonstrated increased cleaved caspase-3 levels and loss of neuronal population (NeuN+) within the hippocampus of all pressure groups. On the contrary, selective activation of microglia was observed in the low blast group. In addition, increased astrocytes (GFAP), membrane signal transduction protein (Map2k1) and calcium regulator mechanosensitive protein (Piezo 2) were observed in the moderate blast group. Results from gene expression analysis suggested ongoing neuroprotection, as brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF) and Mn and CuZn superoxide dismutases (SOD) all increased in the low and moderate blast groups. Ongoing neuroprotection was further supported by increased SOD levels observed in the moderate group using immunohistochemistry. The gene expression level of glutamate aspartate transporter (GLAST) was upregulated in the low, but downregulated in the high blast group, while no changes were found in the moderate group. Overall, the data shown here provides evidence of a diverse neuroprotective and glial response to various levels of blast exposure. This mechanistic role of neuroprotection is vital in understanding ongoing cellular stress, both at the gene and protein levels, in order to develop interventional studies for the prognosis of injury.

  15. Comparative outcome of bomb explosion injuries versus high-powered gunshot injuries of the upper extremity in a civilian setting.

    Science.gov (United States)

    Luria, Shai; Rivkin, Gurion; Avitzour, Malka; Liebergall, Meir; Mintz, Yoav; Mosheiff, Ram

    2013-03-01

    Explosion injuries to the upper extremity have specific clinical characteristics that differ from injuries due to other mechanisms. To evaluate the upper extremity injury pattern of attacks on civilian targets, comparing bomb explosion injuries to gunshot injuries and their functional recovery using standard outcome measures. Of 157 patients admitted to the hospital between 2000 and 2004, 72 (46%) sustained explosion injuries and 85 (54%) gunshot injuries. The trauma registry files were reviewed and the patients completed the DASH Questionnaire (Disabilities of Arm, Shoulder and Hand) and SF-12 (Short Form-12) after a minimum period of 1 year. Of the 157 patients, 72 (46%) had blast injuries and 85 (54%) had shooting injuries. The blast casualties had higher Injury Severity Scores (47% vs. 22% with a score of > 16, P = 0.02) and higher percent of patients treated in intensive care units (47% vs. 28%, P = 0.02). Although the Abbreviated Injury Scale score of the upper extremity injury was similar in the two groups, the blast casualties were found to have more bilateral and complex soft tissue injuries and were treated surgically more often. No difference was found in the SF-12 or DASH scores between the groups at follow up. The casualties with upper extremity blast injuries were more severely injured and sustained more bilateral and complex soft tissue injuries to the upper extremity. However, the rating of the local injury to the isolated limb is similar, as was the subjective functional recovery.

  16. Penetrating trauma to the facial skeleton by pickaxe – case report

    OpenAIRE

    Neskoromna-Jędrzejczak Aneta; Bogusiak Katarzyna; Przygoński Aleksander; Timler Dariusz

    2016-01-01

    Number of deaths related with injuries suffered as a result of experienced traumas is increasing. Penetrating traumas of the facial skeleton occur relatively rarely and much more often concern rather children than adults. Epidemiology relating this kind of trauma differs depending on the region of the world. In Poland, gunshot injuries as well as traumas caused by explosions of firecrackers or fireworks amount only to a slight percentage among all facial skeleton traumas, and the most common ...

  17. Comparison of Medical Adhesive Tapes in Patients at Risk of Facial Skin Trauma under Anesthesia

    OpenAIRE

    Ling Antonia Zeng; Sui An Lie; Shin Yuet Chong

    2016-01-01

    Introduction. Adhesive tapes are used for taping eyelids closed and securing endotracheal tubes during general anesthesia. These tapes can cause facial skin injury. We compared the incidence of facial skin injury and patient satisfaction with different tapes used. Methods. A total of 60 adult patients at risk of skin trauma were randomized to use 3M™ Kind Removal Silicone Tape or standard acrylate tapes: 3M Durapore (endotracheal tube) and Medipore (eyelids). Patients were blinded to tape use...

  18. Dry ice blasting

    Science.gov (United States)

    Lonergan, Jeffrey M.

    1992-04-01

    As legal and societal pressures against the use of hazardous waste generating materials has increased, so has the motivation to find safe, effective, and permanent replacements. Dry ice blasting is a technology which uses CO2 pellets as a blasting medium. The use of CO2 for cleaning and stripping operations offers potential for significant environmental, safety, and productivity improvements over grit blasting, plastic media blasting, and chemical solvent cleaning. Because CO2 pellets break up and sublime upon impact, there is no expended media to dispose of. Unlike grit or plastic media blasting which produce large quantities of expended media, the only waste produced by CO2 blasting is the material removed. The quantity of hazardous waste produced, and thus the cost of hazardous waste disposal is significantly reduced.

  19. Equine-associated maxillofacial injuries: retrospective 5-year analysis.

    Science.gov (United States)

    Islam, Shofiq; Gupta, Benjamin; Taylor, Christopher J; Chow, Jeffrey; Hoffman, Gary R

    2014-02-01

    We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management.

  20. Facial trauma: how dangerous are skiing and snowboarding?

    Science.gov (United States)

    Tuli, Tarkan; Haechl, Oliver; Berger, Natalie; Laimer, Klaus; Jank, Siegfried; Kloss, Frank; Brandstätter, Anita; Gassner, Robert

    2010-02-01

    The aim of this study was to investigate maxillofacial injuries sustained in both skiing and snowboarding accidents and correlate injury mechanisms and patterns evaluating a large population. Between 1991 and 2003, all patients with maxillofacial injuries due to skiing and snowboarding accidents (1,393 cases) were reviewed and statistically analyzed according to age, gender, type of injury, cause of accident, location of trauma, and associated injuries. Skiing accidents resulted in a total of 1,250 injuries, and snowboarding resulted in 143. In this study 686 skiers presented with 1,452 facial bone fractures and 80 snowboarders sustained 160 fractures of the face. Skiers had dentoalveolar trauma in 810 cases and 1,295 soft tissue injuries, whereas snowboarders had 88 dental injuries and 187 soft tissue lesions. Mechanisms of injury included 542 cases due to skiing and 85 falls due to snowboarding (a 1.79-fold higher risk for snowboarders). The gender distribution showed a male-female ratio of 3:1 in skiers and 5.5:1 in snowboarders. In both groups male patients were more prone to have a facial bone fracture than female patients. Snowboarders aged between 10 and 29 years had a 2.14-fold higher risk of sustaining a maxillofacial injury than skiers. In both groups facial bone fractures occurred more often in male patients, and they were more likely to result from falls and collisions with other persons. Young snowboarders had a higher risk of maxillofacial injuries (especially soft tissue lesions) than skiers, whereas for children and old persons, skiing posed a much higher risk. Wearing a helmet while skiing and snowboarding should be mandatory to prevent serious trauma to the head. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. The effect of the anisodaminum and dexamethasone on the changes of blood gas of the rats following the blast-toxicosis combined injury by the explosion of the nitrogen tetroxide%山莨菪碱联用地塞米松对四氧化二氮爆炸致冲毒复合伤大鼠血气的影响

    Institute of Scientific and Technical Information of China (English)

    岳茂兴; 杨鹤鸣; 王正国; 王德文; 夏亚东; 杨志焕; 李建忠; 彭瑞云; 徐世全

    2001-01-01

    Objectve To investigate the effects of anisodaminum and dexamethasone on the changes of blood gas of the N2O4 blast-toxicosis combined injury model. Methods Two hundred and twenty-four male Wistar rats were divided randomly into 4 groups: ①N2O4 blast-toxicosis combined injury model group; ②Anisodaminum treated group; anisodaminum (3 mg/kg) was given ip right after, 15 min after and 2 h after the injury; ③Dexamethasone treated group; dexamethasone (10 mg/kg) was given ip right after the injury, 15 min after and 2 h after the injury; ④Anisodaminum and dexamethasone combine-treated group; anisodaminum (3 mg/kg) and dexamethasone (10 mg/kg) were given ip right after, 15 min after and 2 h after the injury. Each group was subdivided into control group and 6 treatment groups which were killed 3, 6, 12, 24, 48, 72 hours after the injury for blood gas analysis.  Results In N2O4 blast-toxicosis model group PaO2 and pH of the plasma were significantly decreased, while PaCO2 was increased . Combined use of anisodaminum and dexamethasone in the early stage significantly ameliorated the disorders of the blood gas of the combined injury. Conclusion It is suggested that the combined use of anisodaminum and dexamethasone in the early stage is effective in the treatment of blast-toxicosis combined injury caused by the explosion of the nitrogen tetroxide.%目的通过复制N2O4爆炸致冲毒复合伤模型,研究山莨菪碱联用地塞米松对实验动物血气的影响。方法采用健康雄性Wistar大鼠224只,随机分组:①模型组:冲击伤加N2O4染毒复合致伤;②山莨菪碱组:伤后即刻、伤后15 min、伤后2 h分别腹腔注射山莨菪碱3 mg/kg,共3次;③地塞米松组:伤后即刻、15 min、2 h分别腹腔注射地塞米松10 mg/kg,共3次。④山莨菪碱联用地塞米松组:伤后分3次注射山莨菪碱3 mg/kg及地塞米松10 mg/kg。结果模型组血氧分压明显下降,二氧化碳分压上升,血

  2. Reconstruction of improvised explosive device blast loading to personnel in the open

    Science.gov (United States)

    Wiri, Suthee; Needham, Charles

    2016-05-01

    Significant advances in reconstructing attacks by improvised explosive devices (IEDs) and other blast events are reported. A high-fidelity three-dimensional computational fluid dynamics tool, called Second-order Hydrodynamic Automatic Mesh Refinement Code, was used for the analysis. Computer-aided design models for subjects or vehicles in the scene accurately represent geometries of objects in the blast field. A wide range of scenario types and blast exposure levels were reconstructed including free field blast, enclosed space of vehicle cabin, IED attack on a vehicle, buried charges, recoilless rifle operation, rocket-propelled grenade attack and missile attack with single subject or multiple subject exposure to pressure levels from ˜ 27.6 kPa (˜ 4 psi) to greater than 690 kPa (>100 psi). To create a full 3D pressure time-resolved reconstruction of a blast event for injury and blast exposure analysis, a combination of intelligence data and Blast Gauge data can be used to reconstruct an actual in-theatre blast event. The methodology to reconstruct an event and the "lessons learned" from multiple reconstructions in open space are presented. The analysis uses records of blast pressure at discrete points, and the output is a spatial and temporal blast load distribution for all personnel involved.

  3. Blunt Facial Trauma Causing Isolated Optic Nerve Hematoma

    Directory of Open Access Journals (Sweden)

    R. Parab

    2013-01-01

    Full Text Available Traumatic optic neuropathy is an uncommon, yet serious, result of facial trauma. The authors present a novel case of a 59-year-old gentleman who presented with an isolated blunt traumatic left optic nerve hematoma causing vision loss. There were no other injuries or fractures to report. This case highlights the importance of early recognition of this rare injury and reviews the current literature and management of traumatic optic neuropathy.

  4. Adolescents with HIV and facial lipoatrophy: response to facial stimulation

    OpenAIRE

    Jesus Claudio Gabana-Silveira; Laura Davison Mangilli; Sassi, Fernanda C.; Arnaldo Feitosa Braga; Claudia Regina Furquim de Andrade

    2014-01-01

    OBJECTIVES: This study evaluated the effects of facial stimulation over the superficial muscles of the face in individuals with facial lipoatrophy associated with human immunodeficiency virus (HIV) and with no indication for treatment with polymethyl methacrylate. METHOD: The study sample comprised four adolescents of both genders ranging from 13 to 17 years in age. To participate in the study, the participants had to score six or less points on the Facial Lipoatrophy Index. The facial stim...

  5. Assessing Pain by Facial Expression: Facial Expression as Nexus

    OpenAIRE

    Prkachin, Kenneth M.

    2009-01-01

    The experience of pain is often represented by changes in facial expression. Evidence of pain that is available from facial expression has been the subject of considerable scientific investigation. The present paper reviews the history of pain assessment via facial expression in the context of a model of pain expression as a nexus connecting internal experience with social influence. Evidence about the structure of facial expressions of pain across the lifespan is reviewed. Applications of fa...

  6. Lesiones pigmentadas buco-faciales más frecuentes: Estudio clínico y correlación histopatológica The most frequent buccofacial pigmented injuries: Clinical study and histopathological correlation

    Directory of Open Access Journals (Sweden)

    Rafael Delgado Fernández

    2005-08-01

    Full Text Available Las lesiones pigmentadas de la piel y la mucosa bucal constituyen alteraciones que aparecen frecuentemente en la clínica estomatológica; por sus características y las diferentes formas de presentarse, su diagnóstico clínico con frecuencia discrepa del estudio morfológico. Por la importancia clínica de algunas de estas lesiones, nos propusimos hacer un estudio retrospectivo desde el punto de vista clínico y morfológico en 6 años (1998-2003, en los archivos de biopsias del Departamento de Patología de la Facultad de Estomatología. La búsqueda estuvo dirigida a aquellas solicitudes de biopsias sobre lesiones pigmentadas buco-faciales con su correspondiente informe histopatológico, con el propósito de determinar algunos parámetros clínicos como edad, sexo, localización y la correlación de diagnóstico clínico histopatológico. Se seleccionó un total de 155 biopsias de pacientes afectados. Los resultados indicaron que las lesiones que predominaron en los diagnósticos fueron las siguientes: los nevus (de localización cutánea, la pigmentación exógena, el léntigo y el melanoma, con una distribución del 65,2 %, 29 %, 4,5 % y 1,3 %, respectivamente. El sexo femenino fue el más afectado en cada una de las entidades. La presentación según grupos de edades fue variable, se observó que los nevus y el léntigo fueron más frecuentes en los jóvenes, entre los 30 y 39 años de edad (25,7 y 28,6 %, respectivamente, mientras que las pigmentaciones exógenas fueron más frecuentes en pacientes mayores de 60 años (26,7% en la cavidad bucal. Se estableció una correlación clínico-histopatológica, y de esta forma se comprobó el diagnóstico clínico o se rectificó este en cada uno de los casos estudiados.The pigmented injuries of the skin and oral mucosa are alterations that appear commonly at the dental clinic Due to their characteristics and different forms of presentation, their clinical diagnosis usually differs from the

  7. Neuromuscular retraining for facial paralysis.

    Science.gov (United States)

    Diels, H J; Combs, D

    1997-10-01

    Neuromuscular retraining is an effective method for rehabilitating facial musculature in patients with facial paralysis. This nonsurgical therapy has demonstrated improved functional outcomes and is an important adjunct to surgical treatment for restoring facial movement. Treatment begins with an intensive clinical evaluation and incorporates appropriate sensory feedback techniques into a patient-specific, comprehensive, home therapy program. This article discusses appropriate patients, timelines for referral, and basic treatment practices of facial neuromuscular retraining for restoring function and expression to the highest level possible.

  8. Computer facial animation

    CERN Document Server

    Parke, Frederic I

    2008-01-01

    This comprehensive work provides the fundamentals of computer facial animation and brings into sharper focus techniques that are becoming mainstream in the industry. Over the past decade, since the publication of the first edition, there have been significant developments by academic research groups and in the film and games industries leading to the development of morphable face models, performance driven animation, as well as increasingly detailed lip-synchronization and hair modeling techniques. These topics are described in the context of existing facial animation principles. The second ed

  9. Facial Data Field

    Institute of Scientific and Technical Information of China (English)

    WANG Shuliang; YUAN Hanning; CAO Baohua; WANG Dakui

    2015-01-01

    Expressional face recognition is a challenge in computer vision for complex expressions. Facial data field is proposed to recognize expression. Fundamentals are presented in the methodology of face recognition upon data field and subsequently, technical algorithms including normalizing faces, generating facial data field, extracting feature points in partitions, assigning weights and recog-nizing faces. A case is studied with JAFFE database for its verification. Result indicates that the proposed method is suitable and eff ective in expressional face recognition con-sidering the whole average recognition rate is up to 94.3%. In conclusion, data field is considered as a valuable alter-native to pattern recognition.

  10. An investigation of a reticulated foam - perforated steel sheet combination as a blast mitigation structure

    Science.gov (United States)

    Nguyen, Thuy-Tien N.; Proud, William G.

    2017-01-01

    Explosions are one of the main causes of injuries during battles and conflicts, with improvised explosive devices (IEDs) becoming increasingly common. Blast waves produced from such explosions can inflict very complex injuries on human and serious damage to structures. Here, the interaction between blast waves and sandwich structures of reticulated foam and perforated sheets is studied using a shock tube. The level of mitigation for primary blast injuries of these structures are discussed in terms of pulse shape, pressure magnitude and impulse. Schlieren photography and other high-speed imaging were used to capture the form of the blast wave. The results show up to 95% mitigation in both pressure and impulse with the structures studied. The behaviors of these mitigating sandwich panels under two loadings, Mach 2.0 and Mach 2.6, are also discussed.

  11. Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

    Directory of Open Access Journals (Sweden)

    Sultan Şevik Eliçora

    2015-01-01

    Full Text Available Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.

  12. Mathematical models of blast induced TBI: current status, challenges and prospects

    Directory of Open Access Journals (Sweden)

    Raj K Gupta

    2013-05-01

    Full Text Available Blast induced traumatic brain injury (TBI has become a signature wound of recent military activities and is the leading cause of death and long-term disability among U.S. soldiers. The current limited understanding of brain injury mechanisms impedes the development of protection, diagnostic and treatment strategies. We believe mathematical models of blast wave brain injury biomechanics and neurobiology, complemented with in vitro and in vivo experimental studies, will enable a better understanding of injury mechanisms and accelerate the development of both protective and treatment strategies. The goal of this paper is to review the current state of the art in mathematical and computational modeling of blast induced TBI, identify research gaps and recommend future developments. A brief overview of blast wave physics, injury biomechanics and the neurobiology of brain injury is used as a foundation for a more detailed discussion of multiscale mathematical models of primary biomechanics and secondary injury and repair mechanisms. The paper also presents a discussion of model development strategies, experimental approaches to generate benchmark data for model validation and potential applications of the model for prevention and protection against blast wave TBI.

  13. Effects of low-level blast exposure on the nervous system: Is there really a controversy?

    Directory of Open Access Journals (Sweden)

    Gregory A Elder

    2014-12-01

    Full Text Available High-pressure blast waves can cause extensive CNS injury in humans. However, in combat settings such as Iraq and Afghanistan, lower level exposures associated with mild TBI (mTBI or subclinical exposure have been much more common. Yet controversy exists concerning what traits can be attributed to low-level blast, in large part due to the difficulty of distinguishing blast-related mTBI from post-traumatic stress disorder (PTSD. We describe how TBI is defined in humans and the problems posed in using current definitions to recognize blast-related mTBI. We next consider the problem of applying definitions of human mTBI to animal models, in particular that TBI severity in humans is defined in relation to alteration of consciousness at the time of injury, which typically cannot be assessed in animals. However, based on outcome assessments a condition of low-level blast exposure can be defined in animals that likely approximates human mTBI or subclinical exposure. We review blast injury modeling in animals noting that inconsistencies in experimental approach have contributed to uncertainty over the effects of low-level blast. Yet animal studies show that low-level blast pressure waves are transmitted to the brain. In brain low-level blast exposures cause behavioral, biochemical, pathological and physiological effects on the nervous system including the induction of PTSD-related behavioral traits in the absence of a psychological stressor. We review the relationship of blast exposure to chronic neurodegenerative diseases noting the paradoxical lowering of Abeta by blast, which along with other observations suggest that blast-related TBI is pathophysiologically distinct from non-blast TBI. Human neuroimaging studies show that blast-related mTBI is associated with a variety of chronic effects that are unlikely to be explained by co-morbid PTSD. We conclude that abundant evidence supports low-level blast as having long-term effects on the nervous system.

  14. Exposure of the thorax to a sublethal blast wave causes a hydrodynamic pulse that leads to perivenular inflammation in the brain.

    Science.gov (United States)

    Simard, J Marc; Pampori, Adam; Keledjian, Kaspar; Tosun, Cigdem; Schwartzbauer, Gary; Ivanova, Svetlana; Gerzanich, Volodymyr

    2014-07-15

    Traumatic brain injury (TBI) caused by an explosive blast (blast-TBI) is postulated to result, in part, from transvascular transmission to the brain of a hydrodynamic pulse (a.k.a., volumetric blood surge, ballistic pressure wave, hydrostatic shock, or hydraulic shock) induced in major intrathoracic blood vessels. This mechanism of blast-TBI has not been demonstrated directly. We tested the hypothesis that a blast wave impacting the thorax would induce a hydrodynamic pulse that would cause pathological changes in the brain. We constructed a Thorax-Only Blast Injury Apparatus (TOBIA) and a Jugular-Only Blast Injury Apparatus (JOBIA). TOBIA delivered a collimated blast wave to the right lateral thorax of a rat, precluding direct impact on the cranium. JOBIA delivered a blast wave to the fluid-filled port of an extracorporeal intravenous infusion device whose catheter was inserted retrograde into the jugular vein, precluding lung injury. Long Evans rats were subjected to sublethal injury by TOBIA or JOBIA. Blast injury induced by TOBIA was characterized by apnea and diffuse bilateral hemorrhagic injury to the lungs associated with a transient reduction in pulse oximetry signals. Immunolabeling 24 h after injury by TOBIA showed up-regulation of tumor necrosis factor alpha, ED-1, sulfonylurea receptor 1 (Sur1), and glial fibrillary acidic protein in veins or perivenular tissues and microvessels throughout the brain. The perivenular inflammatory effects induced by TOBIA were prevented by ligating the jugular vein and were reproduced using JOBIA. We conclude that blast injury to the thorax leads to perivenular inflammation, Sur1 up-regulation, and reactive astrocytosis resulting from the induction of a hydrodynamic pulse in the vasculature.

  15. Etiology, diagnosis, and characteristics of facial fracture at a midwestern level I trauma center.

    Science.gov (United States)

    Smith, Hayden; Peek-Asa, Corinne; Nesheim, Dustin; Nish, Andrew; Normandin, Pamela; Sahr, Sheryl

    2012-01-01

    Study purpose was to describe facial fracture frequency, demography, injury characteristics, and diagnostic modalities at a Midwestern level I trauma center. A retrospective review was conducted on a Midwestern trauma center registry for years 2008 and 2009. Patient and injury data were collected along with diagnostic modality for facial fracture patients. Comparative statistics were conducted on the basis of the number of facial fractures, route of admission, presence of traumatic brain injury, and gender. There were 154 patients diagnosed with 443 facial fractures, representing 5% of the trauma population. Median patient age was 45 years. Median number of fractures was 2. Fractures were frequently present in orbit (32%), malar bone and maxilla (26%), and the nasal bones (19%). Motor vehicle crash was the most common mechanism (47%). Most fractures were diagnosed with maxillofacial computed tomography (78%). Males had an odds ratio of 2.5 (95% confidence interval, 1.15-5.43) for multiple facial fractures and composed 67% of the sample. Traumatic brain injury was diagnosed in 71% of patients. This study of a medium-sized city and its surrounding rural areas revealed differences from studies in large urban centers. Differences included lower gender ratio, older average age, and mechanism of injury. While urban trauma centers report assault as a leading cause of facial fracture, this study noted higher frequencies of motor vehicle crash and falls and fewer assaults.

  16. Using an end-to-side interposed sural nerve graft for facial nerve reinforcement after vestibular schwannoma resection. Technical note.

    Science.gov (United States)

    Samii, Madjid; Koerbel, Andrei; Safavi-Abbasi, Sam; Di Rocco, Federico; Samii, Amir; Gharabaghi, Alireza

    2006-12-01

    Increasing rates of facial and cochlear nerve preservation after vestibular schwannoma surgery have been achieved in the last 30 years. However, the management of a partially or completely damaged facial nerve remains an important issue. In such a case, several immediate or delayed repair techniques have been used. On the basis of recent studies of successful end-to-side neurorrhaphy, the authors applied this technique in a patient with an anatomically preserved but partially injured facial nerve during vestibular schwannoma surgery. The authors interposed a sural nerve graft to reinforce the facial nerve whose partial anatomical continuity had been preserved. On follow-up examinations 18 months after surgery, satisfactory cosmetic results for facial nerve function were observed. The end-to-side interposed nerve graft appears to be a reasonable alternative in cases of partial facial nerve injury, and might be a future therapeutic option for other cranial nerve injuries.

  17. Multiracial Facial Golden Ratio and Evaluation of Facial Appearance.

    Science.gov (United States)

    Alam, Mohammad Khursheed; Mohd Noor, Nor Farid; Basri, Rehana; Yew, Tan Fo; Wen, Tay Hui

    2015-01-01

    This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM) Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian), with the mean age of 21.54 ± 1.56 (Age range, 18-25). Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects' evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI), Malaysian Chinese (MC) and Malaysian Malay (MM) were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; Pmean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts. 1) Only 17.1% of Malaysian facial proportion conformed to the golden ratio, with majority of the population having short face (54.5%); 2) Facial index did not depend significantly on races; 3) Significant sexual dimorphism was shown among Malaysian Chinese; 4) All three races are generally satisfied with their own facial appearance; 5) No significant association was found between golden ratio and facial evaluation score among Malaysian population.

  18. Diplegia facial traumatica

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1975-12-01

    Full Text Available É relatado um caso de paralisia facial bilateral, incompleta, associada a hipoacusia esquerda, após traumatismo cranioencefálico, com fraturas evidenciadas radiológicamente. Algumas considerações são formuladas tentando relacionar ditas manifestações com fraturas do osso temporal.

  19. Management of facial blushing

    DEFF Research Database (Denmark)

    Licht, Peter B; Pilegaard, Hans K

    2008-01-01

    an indication for treatment, facial blushing may be treated effectively by thoracoscopic sympathectomy. The type of blushing likely to benefit from sympathectomy is mediated by the sympathetic nerves and is the uncontrollable, rapidly developing blush typically elicited when one receives attention from other...

  20. Facial Paralysis Reconstruction.

    Science.gov (United States)

    Razfar, Ali; Lee, Matthew K; Massry, Guy G; Azizzadeh, Babak

    2016-04-01

    Facial nerve paralysis is a devastating condition arising from several causes with severe functional and psychological consequences. Given the complexity of the disease process, management involves a multispecialty, team-oriented approach. This article provides a systematic approach in addressing each specific sequela of this complex problem.

  1. Paralisia facial bilateral

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1976-03-01

    Full Text Available É apresentado um caso de diplegia facial surgida após meningite meningocócica e infecção por herpes simples. Depois de discutir as diversas condições que o fenômeno pode apresentar-se, o autor inclina-se por uma etiologia herpética.

  2. Novel Facial Features Segmentation Algorithm

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    An efficient algorithm for facial features extractions is proposed. The facial features we segment are the two eyes, nose and mouth. The algorithm is based on an improved Gabor wavelets edge detector, morphological approach to detect the face region and facial features regions, and an improved T-shape face mask to locate the extract location of facial features. The experimental results show that the proposed method is robust against facial expression, illumination, and can be also effective if the person wearing glasses, and so on.

  3. Comparison of hemihypoglossal- and accessory-facial neurorrhaphy for treating facial paralysis in rats.

    Science.gov (United States)

    Li, Dezhi; Wan, Hong; Feng, Jie; Wang, Shiwei; Su, Diya; Hao, Shuyu; Schumacher, Michael; Liu, Song

    2014-12-15

    The aim of this study was to determine the effectiveness of hypoglossal-facial nerve "side"-to-end (HemiHN-FN) and accessory-facial nerve end-to-end (AN-FN) neurorrhaphy using a predegenerated nerve graft (PNG) for reanimating facial paralysis in a rat FN injury model. A total of 25 rats with complete unilateral facial paralysis resulting from section of the right FN were divided into 5 groups (n=5 each) that were submitted to immediate, delayed (3 months after FN injury) or no (control) FN reconstruction procedures involving HemiHN-FN or AN-FN neurorrhaphy. Approximately 3 months after FN reconstruction, cholera toxin subunit B conjugate Alexa 555 (CTB-Alexa 555) was injected into the ipsilateral whisker pad muscle and CTB-Alexa 555-labeled neurons were observed in the hypoglossal or accessory nuclei of all the FN reconstruction rats, but none of these neurons were found in the controls. There were numerous myelinated and nonmyelinated axons in both PNG and repaired FN of the FN reconstruction rats. No differences were found for these numbers between the two neurorrhaphy methods for each of the treatment time points, indicating the equal effectiveness of axon regeneration. However, a significantly higher number of CTB-Alexa 555-labeled neurons was observed in the hypoglossal nucleus of the immediate HemiHN-FN neurorrhaphy-treated rats when compared to that in the accessory nucleus of the immediate AN-FN neurorrhaphy-treated rats, consistent with the surface values of the recorded MAPs at the whisker pad muscle while electro-stimulating the FN. These results suggest that HemiHN-FN neurorrhaphy produces more efficient innervation of the paralyzed facial muscles than AN-FN neurorrhaphy without sacrificing ipsilateral hypoglossal function. Taking into consideration the clinical relevance of these findings for postoperative complications and functional reanimation in relation to the central plasticity, we suggest that HemiHN-FN neurorrhaphy may be the preferable facial

  4. Patterns of Pediatric Maxillofacial Injuries.

    Science.gov (United States)

    Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha

    2016-05-01

    Facial trauma in children and adolescents is reported to range from 1% to 30%. Because of many anatomical, physiological, and psychological characteristics of the pediatric population, maxillofacial injuries in children should be treated with special consideration that is attributable to certain features inherent in facial growth patterns of children. This study evaluated maxillofacial injuries in 726 children in terms of incidence, patterns of injury, causes, and treatment modalities and compared these parameters among 3 pediatric age groups. Intergroup differences were analyzed using Z test for 2 populations' proportion. The results showed that the incidence of pediatric maxillofacial injuries and fractures is higher than that reported elsewhere with male predominance. Soft tissue injuries are more frequently encountered in younger individuals, whereas the incidence of skeletal injuries increases with age. This study also revealed that certain etiologies, namely road traffic accidents, violence, bicycle, missiles, and industrial injures, increase with age; on the other hand, falls and puncture wounds are more common in younger children.

  5. Comparative study of psychologtcal health conditions between elderly and young adult patients with facial soft tissue injury and analysis of the mode for the diagnosis and treatment%中青年与老年面部创伤患者心理状态比较及诊疗模式分析

    Institute of Scientific and Technical Information of China (English)

    杨震; 亓发芝; 顾建英; 曹小曼

    2009-01-01

    Objective To compare the difference of psychological health conditions between eldedy and young adult patients with facial soft tissue injury.Methods The SDS,SAS and UCLA loneliness scale were applied to 88 patients with facial soft tissue injury.Results The score of anxiety and depression index in young adult patients were significantly higher than that in elderly adult patients[(50.96±6.21)vs(40.45±5.29),P<0.01;(0.58±0.06)vs(0.44±0.04),P<0.01].However,the loneliness score was notably lower than that in elderly adult patients[(60.62±5.43)vs(38.22±6.64)](P<0.01).Conclusion The facial injury patients of different ages suffered from different psychological symptoms and they should be treated differently.%目的 比较中青年与老年面部创伤患者心理状态.方法 采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、UCLA孤独量表等心理学量表对88例面部创伤患者的心理健康状况进行测量.结果 中青年患者焦虑评分[(50.96±6.21)分]、抑郁指数[(0.58±0.06)]明显高于老年患者[(40.45±5.29)分,(0.44±0.04)](P<0.01),老年患者的孤独评分[(60.62±5.43)分]明显高于中青年患者[(38.22±6.64)分](P<0.01).结论 不同年龄层次的面部创伤患者心理障碍情况有很大不同,在临床处理上应区别对待.

  6. Facial nerve palsy: Evaluation by contrast-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, T.; Ishii, K.; Okitsu, T.; Okudera, T.; Ogawa, T

    2001-11-01

    AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy. MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve palsy, using a 1.0 T unit. All of 147 patients were evaluated by contrast-enhanced MR imaging and the pattern of enhancement was compared with that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS: The intrameatal and labyrinthine segments of the normal facial nerve did not show enhancement, whereas enhancement of the distal intrameatal segment and the labyrinthine segment was respectively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intrameatal and labyrinthine segments is specific for facial nerve palsy. Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and traumatic nerve injury, including clinically silent damage in trauma. Kinoshita T. et al. (2001)

  7. Analysis of Traffic Accident-Related Facial Trauma.

    Science.gov (United States)

    Choi, Su Hyun; Gu, Ja Hea; Kang, Dong Hee

    2016-10-01

    The consequences of facial trauma remain of great significance both functionally and esthetically. Traffic accident-related facial trauma is a frequent and significant cause of maxillofacial injury. The purpose of this study was to determine the natural history of traffic accident-related facial injuries in 846 patients over a 10-year period at a regional emergency center. The authors report a retrospective study of 846 patients with facial trauma from traffic accidents. The medical records of these patients were reviewed and analyzed to determine clinical characteristics, treatments, and outcomes of traffic accident-related facial trauma. In total, 687 of the 846 patients (81.2%) had fractures of the face, and nasal bone fractures were the most common followed by zygomatic complex fractures, blow-out fractures, and maxilla fractures. About 51.2% patients had open wounds on the face, such as lacerations, abrasions, skin or soft tissue defects, and friction burns. Only 7.4% of patients were treated conservatively and the others underwent repair or closed and open reduction. The complication rate was 46.3%, and scars were the most common followed by nose-related complication, hypoesthesia, and eyelid deformities. In addition, 47.6% of complication patients underwent secondary operations. Almost 15% of drivers were drunk, and about 8.7% were confessed drowsy during drive. Almost 30% of pedestrians were hit when they jaywalked across the street. Epidemiological data regarding traffic accident-related facial trauma are important and useful not only for decisions about patient care and developing optimal treatment regimens but to develop new methods to prevent injuries.

  8. Combinación de colgajos locales y libre microvascularizado para reconstrucción del tercio facial inferior tras traumatismo por arma de fuego Combination of local and free microvascularized flaps for reconstruction of the lower third of the face after gunshot injury

    Directory of Open Access Journals (Sweden)

    Laura Villanueva-Alcojol

    2011-12-01

    Full Text Available El traumatismo por arma de fuego en el territorio maxilofacial constituye uno de los mayores retos a los que se enfrenta el cirujano a la hora de la reconstrucción. La diferencia esencial con otro tipo de traumatismos es la severidad de la lesión y la pérdida de tejidos óseos y blandos. Podemos encontrar en la literatura numerosos artículos sobre reconstrucción facial tras extirpación oncológica; sin embargo, hay pocos documentos que discutan la utilización de colgajos locales y libres microvascularizados para reconstrucción de defectos tras traumatismos de alta energía, y los algoritmos terapéuticos para reconstrucción postraumática. En este trabajo se presenta un caso de reconstrucción del tercio inferior facial tras intento de autolisis y se hace una revisión de los principios de tratamiento de este tipo de pacientes.Gunshot wounds to the maxillofacial region are a challenging problem for the surgeon responsible for reconstruction. The essential difference with respect to other injuries is the severity of the lesion and soft and hard tissue loss. Extensive literature exists on facial reconstruction following tumor extirpation, but there are few reports on the use of local flaps and free tissue transfer for the post-traumatic reconstruction of high-energy defects and therapeutic algorithms for post-traumatic reconstruction. The authors report the case of a patient with reconstruction of the lower third of the face after a suicide attempt and review the principles of treatment of these patients.

  9. Interaction between facial expression and color

    OpenAIRE

    Kae Nakajima; Tetsuto Minami; Shigeki Nakauchi

    2017-01-01

    Facial color varies depending on emotional state, and emotions are often described in relation to facial color. In this study, we investigated whether the recognition of facial expressions was affected by facial color and vice versa. In the facial expression task, expression morph continua were employed: fear-anger and sadness-happiness. The morphed faces were presented in three different facial colors (bluish, neutral, and reddish color). Participants identified a facial expression between t...

  10. Maximal exercise performance-impairing effects of simulated blast overpressure in sheep.

    Science.gov (United States)

    Januszkiewicz, A J; Mundie, T G; Dodd, K T

    1997-07-25

    Lung contusion has been identified as a primary blast injury. These experiments addressed a fundamental and overt endpoint of primary blast injury, incapacitation (performance decrement). Respiration, hemodynamics, and blood gases were measured in sheep undergoing incremental exercise challenge before and 1 h after simulated blast exposure of the thorax. Pathologic examination of lung tissue was performed after exposure and exercise testing. Blast overpressure was simulated in the laboratory using a compressed air-driven shock tube. Three levels of lung injury (Levels 1-3, 'Trivial', 'Slight', and 'Moderate' injury, respectively) were examined for effects on maximal oxygen consumption (VO[2max]), an index of cardiorespiratory fitness. Resting hemodynamics and blood gases were relatively normal an hour after exposure, immediately before exercise. However, Levels 1-3 lung injury were associated with average 4.8, 29.9 and 49.3% VO(2max). decreases, respectively. These performance decrements for Levels 2 and 3 were significantly different from respective controls (non-exposed). Exercise caused significant hemoconcentration in sheep under control conditions, before exposure (resting 9.5 +/- 0.9, end-exercise 11.8 +/- 0.9 g/100 ml). Blast exposure resulted in average decreases of 4.9 +/- 3.4, 12.8 +/- 4.0, and 12.6 +/- 3.3% in exercise-induced hemoconcentration for Levels 1-3 injury, respectively. Normal exercise-induced hemodynamic increases were also attenuated after exposure. Levels 2 and 3 injury resulted in average 22.6 +/- 2.9 and 18.5 +/- 11.2% stroke volume decreases, and also 22.3 +/- 8.4 and 29.0 +/- 14.2% cardiac output decreases, respectively, during exercise. While blast lung pathology and pulmonary function changes could account for post-blast performance decrements, these experiments suggest that in sheep, early after exposure, diminished hemoconcentration and cardiac disfunction may also contribute to decreased exercise performance.

  11. Retinotopy of facial expression adaptation.

    Science.gov (United States)

    Matsumiya, Kazumichi

    2014-01-01

    The face aftereffect (FAE; the illusion of faces after adaptation to a face) has been reported to occur without retinal overlap between adaptor and test, but recent studies revealed that the FAE is not constant across all test locations, which suggests that the FAE is also retinotopic. However, it remains unclear whether the characteristic of the retinotopy of the FAE for one facial aspect is the same as that of the FAE for another facial aspect. In the research reported here, an examination of the retinotopy of the FAE for facial expression indicated that the facial expression aftereffect occurs without retinal overlap between adaptor and test, and depends on the retinal distance between them. Furthermore, the results indicate that, although dependence of the FAE on adaptation-test distance is similar between facial expression and facial identity, the FAE for facial identity is larger than that for facial expression when a test face is presented in the opposite hemifield. On the basis of these results, I discuss adaptation mechanisms underlying facial expression processing and facial identity processing for the retinotopy of the FAE.

  12. Realistic facial animation generation based on facial expression mapping

    Science.gov (United States)

    Yu, Hui; Garrod, Oliver; Jack, Rachael; Schyns, Philippe

    2014-01-01

    Facial expressions reflect internal emotional states of a character or in response to social communications. Though much effort has been taken to generate realistic facial expressions, it still remains a challenging topic due to human being's sensitivity to subtle facial movements. In this paper, we present a method for facial animation generation, which reflects true facial muscle movements with high fidelity. An intermediate model space is introduced to transfer captured static AU peak frames based on FACS to the conformed target face. And then dynamic parameters derived using a psychophysics method is integrated to generate facial animation, which is assumed to represent natural correlation of multiple AUs. Finally, the animation sequence in the intermediate model space is mapped to the target face to produce final animation.

  13. Other facial neuralgias.

    Science.gov (United States)

    O'Neill, Francis; Nurmikko, Turo; Sommer, Claudia

    2017-01-01

    Premise In this article we review some lesser known cranial neuralgias that are distinct from trigeminal neuralgia, trigeminal autonomic cephalalgias, or trigeminal neuropathies. Included are occipital neuralgia, superior laryngeal neuralgia, auriculotemporal neuralgia, glossopharyngeal and nervus intermedius neuralgia, and pain from acute herpes zoster and postherpetic neuralgia of the trigeminal and intermedius nerves. Problem Facial neuralgias are rare and many physicians do not see such cases in their lifetime, so patients with a suspected diagnosis within this group should be referred to a specialized center where multidisciplinary team diagnosis may be available. Potential solution Each facial neuralgia can be identified on the basis of clinical presentation, allowing for precision diagnosis and planning of treatment. Treatment remains conservative with oral or topical medication recommended for neuropathic pain to be tried before more invasive procedures are undertaken. However, evidence for efficacy of current treatments remains weak.

  14. Facial resemblance enhances trust.

    Science.gov (United States)

    DeBruine, Lisa M

    2002-07-07

    Organisms are expected to be sensitive to cues of genetic relatedness when making decisions about social behaviour. Relatedness can be assessed in several ways, one of which is phenotype matching: the assessment of similarity between others' traits and either one's own traits or those of known relatives. One candidate cue of relatedness in humans is facial resemblance. Here, I report the effects of an experimental manipulation of facial resemblance in a two-person sequential trust game. Subjects were shown faces of ostensible playing partners manipulated to resemble either themselves or an unknown person. Resemblance to the subject's own face raised the incidence of trusting a partner, but had no effect on the incidence of selfish betrayals of the partner's trust. Control subjects playing with identical pictures failed to show such an effect. In a second experiment, resemblance of the playing partner to a familiar (famous) person had no effect on either trusting or betrayals of trust.

  15. Field experiment for blasting crater

    Institute of Scientific and Technical Information of China (English)

    YE Tu-qiang

    2008-01-01

    A series of single hole blasting crater experiments and a variable distance multi-hole simultaneous blasting experiment was carded in the Yunfu Troilite Mine, according to the Livingston blasting crater theory. We introduce in detail, our methodology of data collection and processing from our experiments. Based on the burying depth of the explosives, the blasting crater volume was fitted by the method of least squares and the characteristic curve of the blasting crater was obtained using the MATLAB software. From this third degree polynomial, we have derived the optimal burying depth, the critical burying depth and the optimal explosive specific charge of the blasting crater.

  16. Injury Prevention and Performance Enhancement in 101st Airborne Soldiers

    Science.gov (United States)

    2009-10-01

    comprehensive health promotion and nutrition plan to prevent co-morbidities secondary to blast injuries FY 08 CDMRP: A Comprehensive Health Promotion...AD_________________ AWARD NUMBER: W81XWH-06-2-0070 TITLE: Injury Prevention and Performance...2. REPORT TYPE Final 3. DATES COVERED 29 Sep 2006 – 28 Sep 2009 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Injury Prevention and Performance

  17. Alcohol abusive use increases facial trauma?

    Science.gov (United States)

    Soares-Carneiro, Suzana-Célia-de-Aguiar; Matos da-Silva, Gessyca-Suielly-Melo; de-Barros-Caldas, Luciano-Cruz; Porto, Gabriela-Granja; Leal, Jefferson-Figueiredo; Catunda, Ivson

    2016-01-01

    Background Trauma is among the main death causes and morbidity in the world and is often related to the use of alcohol and its abuse has reached massive proportions, no matter if the country is developed or not, being considered as public health problem. Since there are very few randomized and prospective studies in literature about the association of facial trauma and the use of alcohol, this study aims to investigate the impact of alcohol use in facial trauma. Material and Methods This was a prospective and cross sectional study, involving facial trauma patients attended at Oral Maxillofacial Surgery Division of a State Hospital. Variables included patient´s profile, trauma etiology, facial region involved, type of injury and treatment and days of hospitalization. AUDIT test was applied to identify risks and damages of alcohol use and chemical dependence. Absolute distribution, uni and mutilvaried percentages were made for data evaluation. Pearson´s qui-squared and Fisher´s Exact tests were also used. Results One hundred patients were evaluated. The patient´s mean age was 33.50 years-old, 48% had between 17 and 29 years old, 28% had 30 to 39, and 24% 40 or more. Most of them were male (86%). The most frequent etiology was traffic accident (57%), the extraoral area was most committed (62%), the most frequent type of injury was fractures (78%) and the most affected bone was the mandible (36%). More than half of the patients (53%) had surgical treatment. 38% had their discharge from hospital right after the first attendance. The AUDIT most frequent answer was “moderate use” (46%) and use at risk (39%). There was significant difference between the use of alcohol (AUDIT) and hematoma (0.003) and number of days of hospitalization (p=0.005). Conclusions In this study it was not observed association between alcohol consumption using the AUDIT and trauma etiology, but patient victims of traffic accidents were classified as with risk in the scale. Most of the

  18. Congenital Facial Teratoma

    OpenAIRE

    Rai, Manjunath; Hegde, Padmaraj; Devaraju, Umesh M.

    2011-01-01

    Teratomas are neoplasm composed of three germinal layers of the embryo that form tissues not normally found in the organ in which they arise. These are most common in the sacrococcygeal region and are rare in the head and neck, which account for less than 6%. An unusual case of facial teratoma in a new born, managed successfully is described here with postoperative follow up of 2 years without any recurrence.

  19. Multiracial Facial Golden Ratio and Evaluation of Facial Appearance.

    Directory of Open Access Journals (Sweden)

    Mohammad Khursheed Alam

    Full Text Available This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian, with the mean age of 21.54 ± 1.56 (Age range, 18-25. Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects' evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI, Malaysian Chinese (MC and Malaysian Malay (MM were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; P<0.05 but no significant difference was found between races. Out of the 286 subjects, 49 (17.1% were of ideal facial shape, 156 (54.5% short and 81 (28.3% long. The facial evaluation questionnaire showed that MC had the lowest satisfaction with mean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts.1 Only 17.1% of Malaysian facial proportion conformed to the golden ratio, with majority of the population having short face (54.5%; 2 Facial index did not depend significantly on races; 3 Significant sexual dimorphism was shown among Malaysian Chinese; 4 All three races are generally satisfied with their own facial appearance; 5 No significant association was found between golden ratio and facial evaluation score among Malaysian population.

  20. Integrated Care for Multisensory Injury

    Science.gov (United States)

    2013-07-01

    neurosensory injury. Multiple sensory system injuries and chronic effects may also alter a patient’s general appearance and behavior (eg, mo- tor...persistent central processing dysfunction, and/or cognitive deficits). Central compensation for multiple neurosensory impairments can be mental...For example, an upper extremity amputee who also suffers from blast-related vision and hearing dysfunction and mTBI may not have the manual

  1. Glyburide - Novel Prophylaxis and Effective Treatment for Traumatic Brain Injury

    Science.gov (United States)

    2010-08-01

    hemorrhagic shock. 15. SUBJECT TERMS blast, traumatic brain injury, neurogenic pulmonary edema, mortality, caspase-3, beta- amylase precursor... function and on pat hophysiological mani festations (IgG, caspase-3 and β-APP immunolabeling), ind ependent of transthoracic mechani sms of blast injury...Glendale Heights, IL). The tool was modified by removing the piston that normally drives the fastener, making the tool function like a firearm and

  2. DARPA challenge: developing new technologies for brain and spinal injuries

    Science.gov (United States)

    Macedonia, Christian; Zamisch, Monica; Judy, Jack; Ling, Geoffrey

    2012-06-01

    The repair of traumatic injuries to the central nervous system remains among the most challenging and exciting frontiers in medicine. In both traumatic brain injury and spinal cord injuries, the ultimate goals are to minimize damage and foster recovery. Numerous DARPA initiatives are in progress to meet these goals. The PREventing Violent Explosive Neurologic Trauma program focuses on the characterization of non-penetrating brain injuries resulting from explosive blast, devising predictive models and test platforms, and creating strategies for mitigation and treatment. To this end, animal models of blast induced brain injury are being established, including swine and non-human primates. Assessment of brain injury in blast injured humans will provide invaluable information on brain injury associated motor and cognitive dysfunctions. The Blast Gauge effort provided a device to measure warfighter's blast exposures which will contribute to diagnosing the level of brain injury. The program Cavitation as a Damage Mechanism for Traumatic Brain Injury from Explosive Blast developed mathematical models that predict stresses, strains, and cavitation induced from blast exposures, and is devising mitigation technologies to eliminate injuries resulting from cavitation. The Revolutionizing Prosthetics program is developing an avant-garde prosthetic arm that responds to direct neural control and provides sensory feedback through electrical stimulation. The Reliable Neural-Interface Technology effort will devise technologies to optimally extract information from the nervous system to control next generation prosthetic devices with high fidelity. The emerging knowledge and technologies arising from these DARPA programs will significantly improve the treatment of brain and spinal cord injured patients.

  3. Experience With Esthetic Reconstruction of Complex Facial Soft Tissue Trauma; Application of the Pulsed Dye Laser

    Directory of Open Access Journals (Sweden)

    Ebrahimi

    2014-08-01

    Full Text Available Background Facial soft tissue injury can be one of the most challenging cases presenting to the plastic surgeon. The life quality and self-esteem of the patients with facial injury may be compromised temporarily or permanently. Immediate reconstruction of most defects leads to better restoration of form and function as well as early rehabilitation. Objectives The aim of this study was to present our experience in management of facial soft tissue injuries from different causes. Patients and Methods We prospectively studied patients treated by plastic surgeons from 2010 to 2012 suffering from different types of blunt or sharp (penetrating facial soft tissue injuries to the different areas of the face. All soft tissue injuries were treated primarily. Photography from all patients before, during, and after surgical reconstruction was performed and the results were collected. We used early pulsed dye laser (PDL post-operatively. Results In our study, 63 patients including 18 (28.5% women and 45 (71.5% men aged 8-70 years (mean 47 years underwent facial reconstruction due to soft tissue trauma in different parts of the face. Sharp wounds were seen in 15 (23% patients and blunt trauma lacerations were seen in 52 (77% patients. Overall, 65% of facial injuries were repaired primary and the remainder were reconstructed with local flaps or skin graft from adjacent tissues. Postoperative PDL therapy done two weeks following surgery for all scars yielded good results in our cases. Conclusions Analysis of the injury including location, size, and depth of penetration as well as presence of associated injuries can aid in the formulation of a proper surgical plan. We recommend PDL in the early post operation period (two weeks after suture removal for better aesthetic results.

  4. Facial pain and temporomandibular disorders

    OpenAIRE

    2002-01-01

    Abstract The study was undertaken to determine the prevalence of facial pain and the association of facial pain with temporomandibular disorders (TMD) as well as with other factors, in a geographically defined population-based sample consisting of subjects born in 1966 in northern Finland, and in a case-control study including subjects with facial pain and their healthy controls. In addition, the influence of conservative stomatognathic and necessary prosthetic treatme...

  5. Secondary Insults of Traumatic Brain Injury in CCATT Patients Returning from Iraq/Afghanistan: 2001-2006

    Science.gov (United States)

    2010-08-31

    matrix. Tolerance values above 0.1 and VIF values below 10 are desired to further support a lack of multicollinearity (Pallant, 2007). The Chi...Variables Tolerance VIF Injury Severity Score .966 1.035 Blast vs. Non-Blast .980 1.021 Year of Injury .566 1.768 AOR to LRMC Aircraft .608 1.645 LRMC

  6. The importance of systemic response in the pathobiology of blast-induced neurotrauma

    Directory of Open Access Journals (Sweden)

    Ibolja eCernak

    2010-12-01

    Full Text Available Due to complex injurious environment where multiple blast effects interact with the body, parallel blast-induced neurotrauma is a unique clinical entity induced by systemic, local, and cerebral responses. Activation of autonomous nervous system; sudden pressure-increase in vital organs such as lungs and liver; and activation of neuroendocrine-immune system are among the most important mechanisms that contribute significantly to molecular changes and cascading injury mechanisms in the brain. It has been hypothesized that vagally mediated cerebral effects play a vital role in the early response to blast: this assumption has been supported by experiments where bilateral vagotomy mitigated bradycardia, hypotension, and apnea, and also prevented excessive metabolic alterations in the brain of animals exposed to blast. Clinical experience suggests specific blast-body-nervous system interactions such as 1 direct interaction with the head either through direct passage of the blast wave through the skull or by causing acceleration and/or rotation of the head; and 2 via hydraulic interaction, when the blast overpressure compresses the abdomen and chest, and transfers its kinetic energy to the body’s fluid phase, initiating oscillating waves that traverse the body and reach the brain. Accumulating evidence suggests that inflammation plays important role in the pathogenesis of long-term neurological deficits due to blast. These include memory decline, motor function and balance impairments, and behavioral alterations, among others. Experiments using rigid body- or head protection in animals subjected to blast showed that head protection failed to prevent inflammation in the brain or reduce neurological deficits, whereas body protection was successful in alleviating the blast-induced functional and morphological impairments in the brain.

  7. [Prosopagnosia and facial expression recognition].

    Science.gov (United States)

    Koyama, Shinichi

    2014-04-01

    This paper reviews clinical neuropsychological studies that have indicated that the recognition of a person's identity and the recognition of facial expressions are processed by different cortical and subcortical areas of the brain. The fusiform gyrus, especially the right fusiform gyrus, plays an important role in the recognition of identity. The superior temporal sulcus, amygdala, and medial frontal cortex play important roles in facial-expression recognition. Both facial recognition and facial-expression recognition are highly intellectual processes that involve several regions of the brain.

  8. Virtual 3-D Facial Reconstruction

    Directory of Open Access Journals (Sweden)

    Martin Paul Evison

    2000-06-01

    Full Text Available Facial reconstructions in archaeology allow empathy with people who lived in the past and enjoy considerable popularity with the public. It is a common misconception that facial reconstruction will produce an exact likeness; a resemblance is the best that can be hoped for. Research at Sheffield University is aimed at the development of a computer system for facial reconstruction that will be accurate, rapid, repeatable, accessible and flexible. This research is described and prototypical 3-D facial reconstructions are presented. Interpolation models simulating obesity, ageing and ethnic affiliation are also described. Some strengths and weaknesses in the models, and their potential for application in archaeology are discussed.

  9. History of facial pain diagnosis

    Science.gov (United States)

    Jensen, Troels S

    2017-01-01

    Premise Facial pain refers to a heterogeneous group of clinically and etiologically different conditions with the common clinical feature of pain in the facial area. Among these conditions, trigeminal neuralgia (TN), persistent idiopathic facial pain, temporomandibular joint pain, and trigeminal autonomic cephalalgias (TAC) are the most well described conditions. Conclusion TN has been known for centuries, and is recognised by its characteristic and almost pathognomonic clinical features. The other facial pain conditions are less well defined, and over the years there has been confusion about their classification. PMID:28181442

  10. ESF BLAST DESIGN ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    E.F. fitch

    1995-03-13

    The purpose and objective of this design analysis are to develop controls considered necessary and sufficient to implement the requirements for the controlled drilling and blasting excavation of operations support alcoves and test support alcoves in the Exploratory Studies Facility (ESF). The conclusions reached in this analysis will flow down into a construction specification ensuring controlled drilling and blasting excavation will be performed within the bounds established here.

  11. Blast Overpressure Studies.

    Science.gov (United States)

    1998-05-01

    USAARL Contract Report No. CR-98-Ö3 Blast Overpressure Studies By Daniel L. Johnson EG&G Management Systems, Inc. Albuquerque, New Mexico May...Both studies were done at the Blast Overpressure-Kirtland Test Site (BOP-KTS) in New Mexico . Under a contract conducted for the USAMRMC, EG&G was... TDH -4 9 elements mounted in a David Clark 9AN/2 ear muff for added noise isolation. The calibration of the earphones was accomplished using a Bruel

  12. Promising Technique for Facial Nerve Reconstruction in Extended Parotidectomy

    Directory of Open Access Journals (Sweden)

    Ithzel Maria Villarreal

    2015-11-01

    Full Text Available Introduction: Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons.   Case Report: A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended.   Conclusion:  It is of critical importance to restore function to patients with facial nerve injury.  Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site.  Donor–site morbidity is low and additional surgical time is minimal

  13. Promising Technique for Facial Nerve Reconstruction in Extended Parotidectomy

    Science.gov (United States)

    Villarreal, Ithzel Maria; Rodríguez-Valiente, Antonio; Castelló, Jose Ramon; Górriz, Carmen; Montero, Oscar Alvarez; García-Berrocal, Jose Ramon

    2015-01-01

    Introduction: Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons. Case Report: A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended. Conclusion: It is of critical importance to restore function to patients with facial nerve injury. Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh) flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site. Donor–site morbidity is low and additional surgical time is minimal compared with the time of a single

  14. Botulinum Toxin (Botox) for Facial Wrinkles

    Science.gov (United States)

    ... Stories Español Eye Health / Eye Health A-Z Botulinum Toxin (Botox) for Facial Wrinkles Sections Botulinum Toxin (Botox) ... Facial Wrinkles How Does Botulinum Toxin (Botox) Work? Botulinum Toxin (Botox) for Facial Wrinkles Written by: Kierstan Boyd ...

  15. Mild blast events alter anxiety, memory, and neural activity patterns in the anterior cingulate cortex.

    Science.gov (United States)

    Xie, Kun; Kuang, Hui; Tsien, Joe Z

    2013-01-01

    There is a general interest in understanding of whether and how exposure to emotionally traumatizing events can alter memory function and anxiety behaviors. Here we have developed a novel laboratory-version of mild blast exposure comprised of high decibel bomb explosion sound coupled with strong air blast to mice. This model allows us to isolate the effects of emotionally fearful components from those of traumatic brain injury or bodily injury typical associated with bomb blasts. We demonstrate that this mild blast exposure is capable of impairing object recognition memory, increasing anxiety in elevated O-maze test, and resulting contextual generalization. Our in vivo neural ensemble recording reveal that such mild blast exposures produced diverse firing changes in the anterior cingulate cortex, a region processing emotional memory and inhibitory control. Moreover, we show that these real-time neural ensemble patterns underwent post-event reverberations, indicating rapid consolidation of those fearful experiences. Identification of blast-induced neural activity changes in the frontal brain may allow us to better understand how mild blast experiences result in abnormal changes in memory functions and excessive fear generalization related to post-traumatic stress disorder.

  16. Mild blast events alter anxiety, memory, and neural activity patterns in the anterior cingulate cortex.

    Directory of Open Access Journals (Sweden)

    Kun Xie

    Full Text Available There is a general interest in understanding of whether and how exposure to emotionally traumatizing events can alter memory function and anxiety behaviors. Here we have developed a novel laboratory-version of mild blast exposure comprised of high decibel bomb explosion sound coupled with strong air blast to mice. This model allows us to isolate the effects of emotionally fearful components from those of traumatic brain injury or bodily injury typical associated with bomb blasts. We demonstrate that this mild blast exposure is capable of impairing object recognition memory, increasing anxiety in elevated O-maze test, and resulting contextual generalization. Our in vivo neural ensemble recording reveal that such mild blast exposures produced diverse firing changes in the anterior cingulate cortex, a region processing emotional memory and inhibitory control. Moreover, we show that these real-time neural ensemble patterns underwent post-event reverberations, indicating rapid consolidation of those fearful experiences. Identification of blast-induced neural activity changes in the frontal brain may allow us to better understand how mild blast experiences result in abnormal changes in memory functions and excessive fear generalization related to post-traumatic stress disorder.

  17. Bilateral Facial Paralysis Caused by Temporal Bone Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Ghiasi

    2016-02-01

    Full Text Available Introduction Although bilateral facial nerve palsy is a rare condition, its etiology is more detectable than the unilateral type. A temporal bone fracture is one cause of bilateral facial nerve palsy, contributing in 3% of the cases. Case Presentation Here, we report the case of a 35-year-old man complaining of bilateral incomplete eye closure, two weeks after a closed head injury caused by a motor vehicle accident. Conclusions The high resolution computed tomography findings revealed a bilateral temporal bone fracture line, which extended to the fallopian canal. With regard to treatment, near complete recovery was obvious after two weeks of treatment with oral corticosteroids. Overall, bilateral facial palsy is hard to diagnose; therefore, clinical suspicion and the early detection of facial nerve injuries is necessary for good nerve recovery in temporal bone fractures.

  18. Branch facial nerve trauma after superficial temporal artery biopsy: a case report

    Directory of Open Access Journals (Sweden)

    Rison Richard A

    2011-01-01

    Full Text Available Abstract Introduction Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy. Case presentation A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia. Conclusion Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.

  19. iFace: Facial Expression Training System

    OpenAIRE

    Ito, Kyoko; Kurose, Hiroyuki; Takami, Ai; Nishida, Shogo

    2008-01-01

    In this study, a target facial expression selection interface for a facial expression training system and a facial expression training system were both proposed and developed. Twelve female dentists used the facial expression training system, and evaluations and opinions about the facial expression training system were obtained from these participants. In the future, we will attempt to improve both the target facial expression selection interface and the comparison of a current and a target f...

  20. Cephalometric soft tissue facial analysis.

    Science.gov (United States)

    Bergman, R T

    1999-10-01

    My objective is to present a cephalometric-based facial analysis to correlate with an article that was published previously in the American Journal of Orthodontic and Dentofacial Orthopedics. Eighteen facial or soft tissue traits are discussed in this article. All of them are significant in successful orthodontic outcome, and none of them depend on skeletal landmarks for measurement. Orthodontic analysis most commonly relies on skeletal and dental measurement, placing far less emphasis on facial feature measurement, particularly their relationship to each other. Yet, a thorough examination of the face is critical for understanding the changes in facial appearance that result from orthodontic treatment. A cephalometric approach to facial examination can also benefit the diagnosis and treatment plan. Individual facial traits and their balance with one another should be identified before treatment. Relying solely on skeletal analysis, assuming that the face will balance if the skeletal/dental cephalometric values are normalized, may not yield the desired outcome. Good occlusion does not necessarily mean good facial balance. Orthodontic norms for facial traits can permit their measurement. Further, with a knowledge of standard facial traits and the patient's soft tissue features, an individualized norm can be established for each patient to optimize facial attractiveness. Four questions should be asked regarding each facial trait before treatment: (1) What is the quality and quantity of the trait? (2) How will future growth affect the trait? (3) How will orthodontic tooth movement affect the existing trait (positively or negatively)? (4) How will surgical bone movement to correct the bite affect the trait (positively or negatively)?

  1. Plastic Changes of Synapses and Excitatory Neurotransmitter Receptors in Facial Nucleus Following Facial-facial Anastomosis

    Institute of Scientific and Technical Information of China (English)

    Pei CHEN; Jun SONG; Linghui LUO; Shusheng GONG

    2008-01-01

    The remodeling process of synapses and eurotransmitter receptors of facial nucleus were observed. Models were set up by facial-facial anastomosis in rat. At post-surgery day (PSD) 0, 7, 21 and 60, synaptophysin (p38), NMDA receptor subunit 2A and AMPA receptor subunit 2 (GIuR2) were observed by immunohistochemical method and emi-quantitative RT-PCR, respectively. Meanwhile, the synaptic structure of the facial motorneurons was observed under a transmission electron microscope (TEM). The intensity of p38 immunoreactivity was decreased, reaching the lowest value at PSD day 7, and then increased slightly at PSD 21. Ultrastructurally, the number of synapses in nucleus of the operational side decreased, which was consistent with the change in P38 immhnoreactivity. NMDAR2A mRNA was down-regulated significantly in facial nucleus after the operation (P000.05). The synapses innervation and the expression of NMDAR2A and AMPAR2 mRNA in facial nucleus might be modified to suit for the new motor tasks following facial-facial anastomosis, and influenced facial nerve regeneration and recovery.

  2. Laser facial nerve welding in a rabbit model.

    Science.gov (United States)

    Bloom, Jason D; Bleier, Benjamin S; Goldstein, Stephen A; Carniol, Paul J; Palmer, James N; Cohen, Noam A

    2012-01-01

    To assess the feasibility of laser tissue welding for repair of facial nerve injury. In a prospective in vivo animal survival surgery model, rabbit facial nerve injury was followed by either standard suture neurorrhaphy or laser tissue welding using a diode laser (808 ± 1 nm) to weld biological solder. Rabbits were evaluated at 4, 8, 12, and 16 weeks by facial videography and electromyography. Histopathological analysis of the repair was performed at 4 and 16 weeks. Videographic analysis demonstrated the laser tissue welding repair trended toward superior outcomes compared with suture neurorrhaphy at all 4 time points. Electrophysiological analysis demonstrated similar or better results, with statistically significant improvement at week 16 (P laser nerve repair created a greater initial inflammatory reaction. An analysis of operative time demonstrated significantly decreased time and ease of use for laser tissue welding. This pilot study demonstrates that laser nerve welding may be an expedient, feasible, and safe method for facial nerve repair in a rabbit model. Further experiments with larger numbers are needed to provide additional evidence that laser tissue welding produces a neurorrhaphy that has functional, electrophysiological, and histological results that could rival traditional suture neurorrhaphy.

  3. Children's Facial Trustworthiness Judgments: Agreement and Relationship with Facial Attractiveness.

    Science.gov (United States)

    Ma, Fengling; Xu, Fen; Luo, Xianming

    2016-01-01

    This study examined developmental changes in children's abilities to make trustworthiness judgments based on faces and the relationship between a child's perception of trustworthiness and facial attractiveness. One hundred and one 8-, 10-, and 12-year-olds, along with 37 undergraduates, were asked to judge the trustworthiness of 200 faces. Next, they issued facial attractiveness judgments. The results indicated that children made consistent trustworthiness and attractiveness judgments based on facial appearance, but with-adult and within-age agreement levels of facial judgments increased with age. Additionally, the agreement levels of judgments made by girls were higher than those by boys. Furthermore, the relationship between trustworthiness and attractiveness judgments increased with age, and the relationship between two judgments made by girls was closer than those by boys. These findings suggest that face-based trait judgment ability develops throughout childhood and that, like adults, children may use facial attractiveness as a heuristic cue that signals a stranger's trustworthiness.

  4. Mole gun injury.

    Science.gov (United States)

    Pistré, V; Rezzouk, J

    2013-09-01

    A mole gun is a weapon, which is used to trap and kill moles. This report provides an overview of the state of knowledge of mole gun injuries, comparable to blast injuries caused by fireworks, explosive or gunshot. Over a 2-year period, the authors reported their experience with ten hand injuries caused by mole gun. Radial side of the hand was often concerned, particularly the thumb. The authors explain their choices in the management of such lesions. Surgery was performed primarily and a large debridement currently seemed to offer the best outcome for the patient. Blast, crush, burns and lacerations may explain the higher rate of amputation to the digits. A long period of physiotherapy, specifically of the hand, was needed before the patient could return to work. This ballistic hand trauma encountered by surgeons requires knowledge and understanding of these injuries. It should be in accordance with firearms law because of severe injuries encountered and possible lethal wounds. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  5. [Rehabilitation of facial paralysis].

    Science.gov (United States)

    Martin, F

    2015-10-01

    Rehabilitation takes an important part in the treatment of facial paralysis, especially when these are severe. It aims to lead the recovery of motor activity and prevent or reduce sequelae like synkinesis or spasms. It is preferable that it be proposed early in order to set up a treatment plan based on the results of the assessment, sometimes coupled with an electromyography. In case of surgery, preoperative work is recommended, especially in case of hypoglossofacial anastomosis or lengthening temporalis myoplasty (LTM). Our proposal is to present an original technique to enhance the sensorimotor loop and the cortical control of movement, especially when using botulinum toxin and after surgery.

  6. Post-traumatic acute bilateral facial nerve palsy - a management dilemma

    Directory of Open Access Journals (Sweden)

    Kumar Rakesh

    2015-03-01

    Full Text Available Acute bilateral facial nerve paralysis is a rare clinical entity, and its management remains very controversial (operative or conservative. Here we are presenting a case of acute onset bilateral facial nerve palsy following head injury with bilateral temporal bone fracture with clinico-radiographic contrary. Patient was managed conservatively with complete recovery. By this article, authors want to stress on combining clinical examination and radiological findings for decision making of this rare entity and tried to evaluate the management.

  7. An up-to-date view on persistent idiopathic facial pain.

    Science.gov (United States)

    Sardella, A; Demarosi, F; Barbieri, C; Lodi, G

    2009-06-01

    Previously called atypical facial pain, persistent idiopathic facial pain (PIFP) is a common, but poorly defined entity. The cause of PIFP is unknown, but surgery or injury in the distribution of the trigeminal nerve could be reported as early event. Treatment is often unsatisfactory and quality research relating management of this condition is missing. Psychologi-cal distress is frequently observed in patients suffering from persistent idiopathic facial pain. The present review aims at presenting the available knowledge of this elusive orofacial pain condition.

  8. Post Traumatic Delayed Bilateral Facial Nerve Palsy (FNP): Diagnostic Dilemma of Expressionless Face.

    Science.gov (United States)

    Kumar, Rakesh; Mittal, Radhey Shyam

    2015-04-01

    Bilateral facial nerve palsy [FNP] is a rare condition. Mostly it is idiopathic. Post traumatic bilateral FNP is even more rare and having unique neurosurgical considerations. Post traumatic delayed presentation of bilateral FNP is socially debilitating and also having diagnostic challenge. Due to lack of facial asymmetry as present in unilateral facial paralysis, it is difficult to recognize. We are presenting a case of delayed onset bilateral FNP who developed FNP after 12 days of head injury with a brief discussion of its diagnostic dilemma and management along with literature review.

  9. Experimental animal models for studies on the mechanisms of blast induced neurotrauma

    Directory of Open Access Journals (Sweden)

    Mårten eRisling

    2012-04-01

    Full Text Available A blast injury is a complex type of physical trauma resulting from the detonation of explosive compounds and has become an important issue due to the use of improvised explosive devices (IED in current military conflicts. Blast induced neurotrauma (BINT is a major concern in contemporary military medicine and includes a variety of injuries that range from mild to lethal. BINT is characterized by extreme forces and their complex propagation. Modern body protection and the development of armored military vehicles can be assumed to have changed the outcome of BINT. Primary blast injuries are caused by overpressure waves whereas secondary, tertiary and quaternary blast injuries can have more varied origins such as the impact of fragments, abnormal movements or heat. The characteristics of the blast wave can be assumed to be significantly different in open field detonations compared to explosions in a confined space, such an armored vehicle. Important parameters include peak pressure, duration and shape of the pulse. Reflections from walls and armor can make the prediction of effects in individual cases very complex. Epidemiological data do not contain information of the relative importance of the different blast mechanisms. It is therefore important to generate data in carefully designed animal models. Such models can be selective reproductions of a primary blast, penetrating injuries from fragments, acceleration movements or combinations of such mechanisms. It is of crucial importance that the physical parameters of the employed models are well characterized so that the experiments can be reproduced in different laboratory settings. Ideally, pressure recordings should be calibrated by using the same equipment in several laboratories. With carefully designed models and thoroughly evaluated animal data it should be possible to achieve a translation of data between animal and clinical data. Imaging and computer simulation represent a possible link

  10. Iatrogenic facial nerve palsy "Prevention is better than cure": Analysis of four cases

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar

    2011-01-01

    Full Text Available Iatrogenic facial nerve palsy in mastoid surgery is considered a crime or a taboo in the present scenario of medical science. But one has to accept the fact that every otologist encounters this entity at some point in his/her career. Hence it is of prime importance to be equipped to detect and to manage these cases. The obvious and disfiguring facial deformity it causes makes this a dreaded complication. Our article here discusses our experience in managing four cases of iatrogenic facial palsy. The etiology in all the cases was mastoidectomy for cholesteatoma. The detection of the site and repair was performed by the same surgeon in all cases. The facial nerve was transected completely in three cases, and in one case there was partial loss (>50% of fibers. Cable nerve grafting was utilized in three patients. There was grade 4 improvement in three patients who underwent cable nerve grafting, and one patient had grade 2 recovery after end-to-end anastomosis. A good anatomical knowledge and experience with temporal bone dissection is of great importance in preventing facial nerve injury. If facial nerve injury is detected, it should be managed as early as possible. An end-to-end anastomosis provides better results in final recovery as opposed to cable nerve grafting for facial nerve repair.

  11. Reduced Order Modeling for Rapid Simulations of Blast and Rollover Events of a Ground Vehicle and its Occupants Using Rigid Body Dynamic Models

    Science.gov (United States)

    2013-03-11

    IED, SimBRS, PSM , blastoff, slamdown, UBM, facet, pressure, ROM, injury, lsDYNA 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18...Prescribed accelerative vertical motion / PSM ....................................................................................... 25 Blast pressure...33 Figure 5.4 Kinematics at 50 msec for LS-Dyna output with ConWep blast force, and MADYMO output with PSM for all nodes

  12. Processing faces and facial expressions.

    Science.gov (United States)

    Posamentier, Mette T; Abdi, Hervé

    2003-09-01

    This paper reviews processing of facial identity and expressions. The issue of independence of these two systems for these tasks has been addressed from different approaches over the past 25 years. More recently, neuroimaging techniques have provided researchers with new tools to investigate how facial information is processed in the brain. First, findings from "traditional" approaches to identity and expression processing are summarized. The review then covers findings from neuroimaging studies on face perception, recognition, and encoding. Processing of the basic facial expressions is detailed in light of behavioral and neuroimaging data. Whereas data from experimental and neuropsychological studies support the existence of two systems, the neuroimaging literature yields a less clear picture because it shows considerable overlap in activation patterns in response to the different face-processing tasks. Further, activation patterns in response to facial expressions support the notion of involved neural substrates for processing different facial expressions.

  13. Tracking facial features with occlusions

    Institute of Scientific and Technical Information of China (English)

    MARKIN Evgeny; PRAKASH Edmond C.

    2006-01-01

    Facial expression recognition consists of determining what kind of emotional content is presented in a human face.The problem presents a complex area for exploration, since it encompasses face acquisition, facial feature tracking, facial expression classification. Facial feature tracking is of the most interest. Active Appearance Model (AAM) enables accurate tracking of facial features in real-time, but lacks occlusions and self-occlusions. In this paper we propose a solution to improve the accuracy of fitting technique. The idea is to include occluded images into AAM training data. We demonstrate the results by running ex periments using gradient descent algorithm for fitting the AAM. Our experiments show that using fitting algorithm with occluded training data improves the fitting quality of the algorithm.

  14. Facial Asymmetry and Emotional Expression

    CERN Document Server

    Pickin, Andrew

    2011-01-01

    This report is about facial asymmetry, its connection to emotional expression, and methods of measuring facial asymmetry in videos of faces. The research was motivated by two factors: firstly, there was a real opportunity to develop a novel measure of asymmetry that required minimal human involvement and that improved on earlier measures in the literature; and secondly, the study of the relationship between facial asymmetry and emotional expression is both interesting in its own right, and important because it can inform neuropsychological theory and answer open questions concerning emotional processing in the brain. The two aims of the research were: first, to develop an automatic frame-by-frame measure of facial asymmetry in videos of faces that improved on previous measures; and second, to use the measure to analyse the relationship between facial asymmetry and emotional expression, and connect our findings with previous research of the relationship.

  15. Vascularization of the facial bones by facial artery: implications for full face allotransplantation

    OpenAIRE

    Rampazzo, Antonio

    2014-01-01

    Background-The maxillary artery is recognized as the main vascular supply of the facial bones; nonetheless clinical evidence supports a co-dominant role for the facial artery. This study explores the extent of the facial skeleton within a facial allograft that can be harvested based on the facial artery. Methods-Twenty-three cadaver heads were used in this study. In 12 heads, the right facial, superficial temporal and maxillary arteries were injected. In 1 head, facial artery angiography w...

  16. Odontogenic Facial Cellulitis

    Directory of Open Access Journals (Sweden)

    Yordany Boza Mejias

    2012-11-01

    Full Text Available Background: odontogenic facial cellulitis is an acute inflammatory process manifested in very different ways, with a variable scale in clinical presentation ranging from harmless well defined processes, to diffuse and progressive that may develop complications leading the patient to a critical condition, even risking their lives. Objective: To characterize the behavior of odontogenic facial cellulitis. Methods: A descriptive case series study was conducted at the dental clinic of Aguada de Pasajeros, Cienfuegos, from September 2010 to March 2011. It included 56 patients who met the inclusion criteria. Variables analyzed included: sex, age, teeth and regions affected, causes of cellulite and prescribed treatment. Results: no sex predilection was observed, lower molars and submandibular anatomical region were the most affected (50% and 30 4% respectively being tooth decay the main cause for this condition (51, 7%. The opening access was not performed to all the patients in the emergency service. The causal tooth extraction was not commonly done early, according to the prescribed antibiotic group. Thermotherapy with warm fomentation and saline mouthwash was the most prescribed and the most widely used group of antibiotics was the penicillin. Conclusions: dental caries were the major cause of odontogenic cellulite. There are still difficulties with the implementation of opening access.

  17. Human Injury Criteria for Underwater Blasts

    Science.gov (United States)

    2014-09-08

    marine mammals, USDI/MMA/OCS study 90-0093, (Bryan, Texas, LGL Ecological Research Assoc, 1991). 17.  Richmond, D., Underwater shock facility and...Martin, P., The Lancet, 242(1943), pp. 336. 50.  Moore, T., British medical journal, 2(1944), pp. 626. 51.  Palma , J., and Uldall, U.S. Naval Medical

  18. Prevention of Blast-Related Injuries

    Science.gov (United States)

    2013-07-01

    2010).A three-dimensional digital segmented and deformable brain atlas of the domestic pig.J Neurosci Methods. 192(1):102-109. Sajja VS, Galloway...Ophthalmol, 83(10):1106-1111. Viano, D. C., Casson, I. R., Pellman, E. J., Zhang, L., King, A. I., Yang, K. H., (2005) Concussion in professional football

  19. Blast-induced Mild Traumatic Brain Injury

    Science.gov (United States)

    2010-01-01

    may worsen TBI-related cognitive complaints, and agents that improve cognitive function, such as methylphenidate , may exacerbate PTSD symptoms. It is...for management of depression, PTSD, and anxiety; (7) referrals to substance abuse treatment specialists as needed; (8) teaching of sleep manage- ment

  20. Prevention of Blast-Related Injuries

    Science.gov (United States)

    2015-07-14

    incubation in an appropriate secondary antibody followed by routine avidin biotin peroxidase technique. These trials are ongoing. We also undertook dual ...study. Finally, an implantable telemetry technique can be used to measure qEEG in subacute and chronically awake swine models in the future