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Sample records for penetrating injuries miscellanea

  1. Liver trauma from penetrating injuries. Miscellanea, personal series, clinical and CT findings

    International Nuclear Information System (INIS)

    Salzano, A.; Nocera, V.; De Rosa, A.; Vigliotti, A.; Rossi, E.; Carbone, M.; Gatta, G.

    2000-01-01

    Penetrating liver wounds are related to many causes and rank second after blunt abdominal and liver trauma. In this report are examined the clinical and radiological findings of personal series of patients with penetrating trauma, especially by firearms and stab and cut wounds. It will also tried to define the diagnostic workup of these traumas, which is especially based on CT signs of liver damage and associated changes and which is of basic importance for following treatment, both surgical or conservative. In the last seven years it was retrospectively reviewed 31 cases of penetrating liver trauma. The patients were 19 men and 12 women, ranging in age 18 to 73 (mean 42), with penetrating liver injuries from firearms (16 patients) and stab (9 cases) wounds; 6 patients had injuries from different cases. Abdominal CT was carried out in emergency with the CT Angiography (CTA) technique in all patients. In the patients with suspected chest and abdomen involvement CT was performed from the mid-chest for accurate assessment of diaphragm and lung bases and to exclude associated pleuropulmonary damage. Penetrating liver wounds were caused by firearms in 70% of cases, by stabbing in 12% and, in the extant 18%, by other cases such as home accidents, road and work traumas, and liver biopsy. In this series, the liver was most frequently involved, especially by firearms wounds; in the 16 cases the most frequent injuries were hemorrhagic tears. It was found bullets in the liver in 6 cases. In one case of home accident the patient wounded himself while slicing bread with a long knife, which cut into the anterior abdominal wall and tore the anterior liver capsule, as seen at CTA. Penetrating wounds to liver and abdomen are less frequent than those to the chest. In the past decade the use of CT has changed the diagnostic and therapeutic approach to such injuries completely, decreasing the resort to explorative laparotomy and hepatorrhaphy. Indeed, CT provides a clear picture of

  2. Liver trauma from penetrating injuries. Miscellanea, personal series, clinical and CT findings; Traumi epatici da lesioni penetranti. Miscellanea, casistica personale, aspetti clinici e con Tomografia Computerizzata

    Energy Technology Data Exchange (ETDEWEB)

    Salzano, A.; Nocera, V. [Ospedale San Giovanni di Dio di Frattamaggiore, Servizio di Radiologia, Frattamaggiore, NA (Italy); De Rosa, A.; Vigliotti, A. [Azienda Sanitaria Locale NA1, Radiologia, Naples (Italy); Rossi, E.; Carbone, M.; Gatta, G. [Naples Univ. Federico 2., Naples (Italy). Ist. di Scienze Radiologiche; Vitale, L. [Ospedale di Sorrento, Servizio di Radiologia, Sorrento, NA (Italy)

    2000-12-01

    Penetrating liver wounds are related to many causes and rank second after blunt abdominal and liver trauma. In this report are examined the clinical and radiological findings of personal series of patients with penetrating trauma, especially by firearms and stab and cut wounds. It will also tried to define the diagnostic workup of these traumas, which is especially based on CT signs of liver damage and associated changes and which is of basic importance for following treatment, both surgical or conservative. In the last seven years it was retrospectively reviewed 31 cases of penetrating liver trauma. The patients were 19 men and 12 women, ranging in age 18 to 73 (mean 42), with penetrating liver injuries from firearms (16 patients) and stab (9 cases) wounds; 6 patients had injuries from different cases. Abdominal CT was carried out in emergency with the CT Angiography (CTA) technique in all patients. In the patients with suspected chest and abdomen involvement CT was performed from the mid-chest for accurate assessment of diaphragm and lung bases and to exclude associated pleuropulmonary damage. Penetrating liver wounds were caused by firearms in 70% of cases, by stabbing in 12% and, in the extant 18%, by other cases such as home accidents, road and work traumas, and liver biopsy. In this series, the liver was most frequently involved, especially by firearms wounds; in the 16 cases the most frequent injuries were hemorrhagic tears. It was found bullets in the liver in 6 cases. In one case of home accident the patient wounded himself while slicing bread with a long knife, which cut into the anterior abdominal wall and tore the anterior liver capsule, as seen at CTA. Penetrating wounds to liver and abdomen are less frequent than those to the chest. In the past decade the use of CT has changed the diagnostic and therapeutic approach to such injuries completely, decreasing the resort to explorative laparotomy and hepatorrhaphy. Indeed, CT provides a clear picture of

  3. [Liver trauma due to penetrating lesions: miscellanea, personal case series, clinical and CT findings].

    Science.gov (United States)

    Salzano, A; Nocera, V; De Rosa, A; Rossi, E; Carbone, M; Gatta, G; Vitale, L; Vigliotti, A

    2000-12-01

    Penetrating liver wounds are related to many causes and rank second after blunt abdominal and liver trauma. We will report the clinical and radiological findings of our personal series of patients with penetrating trauma, especially by firearms and stab and cut wounds. We will also try to define the diagnostic workup of these traumas, which is especially based on CT signs of liver damage and associated changes and which is of basic importance for following treatment, both surgical or conservative. In the last seven years we retrospectively reviewed 31 cases of penetrating liver trauma. The patients were 19 men and 12 women, ranging in age 18 to 73 (mean 42), with penetrating liver injuries from firearms (16 patients) and stab (9 cases) wounds; 6 patients had injuries from different causes. Abdominal CT was carried out in emergency with the CT Angiography (CTA) technique in all patients. In the patients with suspected chest and abdomen involvement CT was performed from the mid-chest for accurate assessment of diaphragm and lung bases and to exclude associated pleuropulmonary damage. Penetrating liver wounds were caused by firearms in 70% of cases, by stabbing in 12% and, in the extant 18%, by other causes such as home accidents, road and work traumas, and liver biopsy. In our series, the liver was most frequently involved, especially by firearms wounds; in our 16 cases the most frequent injuries were hemorrhagic tears. We found bullets in the liver in 6 cases. In one case of home accident the patient wounded himself while slicing bread with a long knife, which cut into the anterior abdominal wall and tore the anterior liver capsule, as seen at CTA. Penetrating wounds to liver and abdomen are less frequent than those to the chest. In the past decade the use of CT has changed the diagnostic and therapeutic approach to such injuries completely, decreasing the resort to explorative laparotomy and hepatorrhaphy. Indeed, CT provides a clear picture of the extent and

  4. Penetrating eye injury in war.

    Science.gov (United States)

    Biehl, J W; Valdez, J; Hemady, R K; Steidl, S M; Bourke, D L

    1999-11-01

    The percentage of penetrating eye injuries in war has increased significantly in this century compared with the total number of combat injuries. With the increasing use of fragmentation weapons and possibly laser weapons on the battle-field in the future, the rate of eye injuries may exceed the 13% of the total military injuries found in Operations Desert Storm/Shield. During the Iran-Iraq War (1980-1988), eye injuries revealed that retained foreign bodies and posterior segment injuries have an improved prognosis in future military ophthalmic surgery as a result of modern diagnostic and treatment modalities. Compared with the increasing penetrating eye injuries on the battlefield, advances in ophthalmic surgery are insignificant. Eye armor, such as visors that flip up and down and protect the eyes from laser injury, needs to be developed. Similar eye protection is being developed in civilian sportswear. Penetrating eye injury in the civilian sector is becoming much closer to the military model and is now comparable for several reasons.

  5. Penetrating abdominal injuries: management controversies

    Science.gov (United States)

    Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C

    2009-01-01

    Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761

  6. Penetrating abdominal injuries: management controversies

    Directory of Open Access Journals (Sweden)

    Velmahos George C

    2009-04-01

    Full Text Available Abstract Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries.

  7. MDCT diagnosis of penetrating diaphragm injury

    Energy Technology Data Exchange (ETDEWEB)

    Bodanapally, Uttam K.; Shanmuganathan, Kathirkamanathan; Mirvis, Stuart E.; Sliker, Clint W.; Fleiter, Thorsten R.; Sarada, Kamal; Miller, Lisa A. [University of Maryland School of Medicine, Department of Diagnostic Radiology, Baltimore, MD (United States); Stein, Deborah M. [University of Maryland, Department of Surgery, Shock Trauma Center, Baltimore, MD (United States); Alexander, Melvin [National Study Center for Trauma and Emergency Medical Systems, Baltimore, MD (United States)

    2009-08-15

    The purpose of the study was to determine the diagnostic sensitivity and specificity of multidetector CT (MDCT) in detection of diaphragmatic injury following penetrating trauma. Chest and abdominal CT examinations performed preoperatively in 136 patients after penetrating trauma to the torso with injury trajectory in close proximity to the diaphragm were reviewed by radiologists unaware of surgical findings. Signs associated with diaphragmatic injuries in penetrating trauma were noted. These signs were correlated with surgical diagnoses, and their sensitivity and specificity in assisting the diagnosis were calculated. CT confirmed diaphragmatic injury in 41 of 47 injuries (sensitivity, 87.2%), and an intact diaphragm in 71 of 98 patients (specificity, 72.4%). The overall accuracy of MDCT was 77%. The most accurate sign helping the diagnosis was contiguous injury on either side of the diaphragm in single-entry penetrating trauma (sensitivity, 88%; specificity, 82%). Thus MDCT has high sensitivity and good specificity in detecting penetrating diaphragmatic injuries. (orig.)

  8. MDCT diagnosis of penetrating diaphragm injury

    International Nuclear Information System (INIS)

    Bodanapally, Uttam K.; Shanmuganathan, Kathirkamanathan; Mirvis, Stuart E.; Sliker, Clint W.; Fleiter, Thorsten R.; Sarada, Kamal; Miller, Lisa A.; Stein, Deborah M.; Alexander, Melvin

    2009-01-01

    The purpose of the study was to determine the diagnostic sensitivity and specificity of multidetector CT (MDCT) in detection of diaphragmatic injury following penetrating trauma. Chest and abdominal CT examinations performed preoperatively in 136 patients after penetrating trauma to the torso with injury trajectory in close proximity to the diaphragm were reviewed by radiologists unaware of surgical findings. Signs associated with diaphragmatic injuries in penetrating trauma were noted. These signs were correlated with surgical diagnoses, and their sensitivity and specificity in assisting the diagnosis were calculated. CT confirmed diaphragmatic injury in 41 of 47 injuries (sensitivity, 87.2%), and an intact diaphragm in 71 of 98 patients (specificity, 72.4%). The overall accuracy of MDCT was 77%. The most accurate sign helping the diagnosis was contiguous injury on either side of the diaphragm in single-entry penetrating trauma (sensitivity, 88%; specificity, 82%). Thus MDCT has high sensitivity and good specificity in detecting penetrating diaphragmatic injuries. (orig.)

  9. Penetrating eye injuries from writing instruments

    Directory of Open Access Journals (Sweden)

    Kelly SP

    2011-12-01

    Full Text Available Simon P Kelly, Graham MB ReevesThe Royal Bolton Hospital, Bolton, UKPurpose: To consider the potential for ocular injury from writing implements by presenting four such cases, and to consider the incidence of such eye injuries from analysis of a national trauma database.Methods: The Home and Leisure Accident Surveillance System was searched for records of eye injuries from writing instruments to provide UK estimates of such injuries. Four patients with ocular penetrating injury from pens or pencils (especially when caused by children, and examined by the authors, are described which illustrate mechanisms of injury.Results: It is estimated that around 748 ocular pen injuries and 892 ocular pencil injuries of undetermined severity occurred annually in the UK during the database surveillance period 2000–2002. No eye injuries from swords, including toy swords and fencing foils, were reported.Conclusion: Ocular perforation sometimes occur from writing instruments that are thrown in the community, especially by children. Implications for policy and prevention are discussed. Non-specialists should have a low threshold for referring patients with eye injuries if suspicious of ocular penetration, even where caused by everyday objects, such as writing instruments.Keywords: eye injury, eye, children, mechanism, writing instruments, prevention

  10. Penetrating chest injury: A miraculous life salvage

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    Santosh B Dalavi

    2013-01-01

    Full Text Available An unusual penetrating chest injury was caused by high velocity road traffic accident. An 18-year-old had a four wheeler accident and was brought in emergency department with a ′bamboo′ stick on the left side chest exiting through back. After the stabilization of vital parameters, an inter-costal tube drainage was done on the left side. Except the minor brochopleural fistula which healed by 10 th day, his recovery was uneventful. The outcome was consistent with current aggressive management of penetrating chest injuries. Management of penetrating chest injury involving pulmonary trauma is based on three principles. One is stabilization of hemodynamics of patient with proper clinical evaluation. Second, a mere intercostal tube drainage sufficient for majority of the cases. Third, post-operative active as well as passive physiotherapy is necessary for speedy recovery.

  11. Suicide bomb attack causing penetrating craniocerebral injury

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    Hussain Manzar

    2013-02-01

    Full Text Available 【Abstract】Penetrating cerebral injuries caused by foreign bodies are rare in civilian neurosurgical trauma, al-though there are various reports of blast or gunshot inju-ries in warfare due to multiple foreign bodies like pellets and nails. In our case, a 30-year-old man presented to neurosur-gery clinic with signs and symptoms of right-sided weak-ness after suicide bomb attack. The skull X-ray showed a single intracranial nail. Small craniotomy was done and the nail was removed with caution to avoid injury to surround-ing normal brain tissue. At 6 months’ follow-up his right-sided power improved to against gravity. Key words: Head injury, penetrating; Bombs; Nails

  12. The contemporary management of penetrating splenic injury.

    Science.gov (United States)

    Berg, Regan J; Inaba, Kenji; Okoye, Obi; Pasley, Jason; Teixeira, Pedro G; Esparza, Michael; Demetriades, Demetrios

    2014-09-01

    Selective non-operative management (NOM) is standard of care for clinically stable patients with blunt splenic trauma and expectant management approaches are increasingly utilised in penetrating abdominal trauma, including in the setting of solid organ injury. Despite this evolution of clinical practice, little is known about the safety and efficacy of NOM in penetrating splenic injury. Trauma registry and medical record review identified all consecutive patients presenting to LAC+USC Medical Center with penetrating splenic injury between January 2001 and December 2011. Associated injuries, incidence and nature of operative intervention, local and systemic complications and mortality were determined. During the study period, 225 patients experienced penetrating splenic trauma. The majority (187/225, 83%) underwent emergent laparotomy. Thirty-eight clinically stable patients underwent a deliberate trial of NOM and 24/38 (63%) were ultimately managed without laparotomy. Amongst patients failing NOM, 3/14 (21%) underwent splenectomy while an additional 6/14 (42%) had splenorrhaphy. Hollow viscus injury (HVI) occurred in 21% of all patients failing NOM. Forty percent of all NOM patients had diaphragmatic injury (DI). All patients undergoing delayed laparotomy for HVI or a splenic procedure presented symptomatically within 24h of the initial injury. No deaths occurred in patients undergoing NOM. Although the vast majority of penetrating splenic trauma requires urgent operative management, a group of patients does present without haemodynamic instability, peritonitis or radiologic evidence of hollow viscus injury. Management of these patients is complicated as over half may remain clinically stable and can avoid laparotomy, making them potential candidates for a trial of NOM. HVI is responsible for NOM failure in up to a fifth of these cases and typically presents within 24h of injury. Delayed laparotomy, within this limited time period, did not appear to increase

  13. Penetrating spinal injuries and their management

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    A Kumar

    2011-01-01

    Full Text Available Penetrating spinal trauma due to missile/gunshot injuries has been well reported in the literature and has remained the domain of military warfare more often. Civic society′s recent upsurge in gunshot injuries has created a dilemma for the treating neurosurgeon in many ways as their management has always involved certain debatable and controversial issues. Both conservative and surgical management of penetrating spinal injuries (PSI have been practiced widely. The chief neurosurgical concern in these types of firearm injuries is the degree of damage sustained during the bullet traversing through the neural tissue and the after-effects of the same in long term. We had an interesting case of a penetrating bullet injury to cervical spine at C2 vertebral level. He was operated and the bullets were removed from posterior midline approach. Usually, the management of such cases differs from region to region depending on the preference of the surgeon but still certain common principles are followed world over. Thus, we realized the need to review the literature regarding spinal injuries with special emphasis on PSI and to study the recent guidelines for their treatment in light of our case.

  14. LAPAROSCOPIC MANAGEMENT OF RETROPERITONEAL INJURIES IN PENETRATING ABDOMINAL INJURIES.

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    Mosai, F

    2017-09-01

    Laparoscopy in penetrating abdominal injuries is now accepted and practiced in many modern trauma centres. However its role in evaluating and managing retroperitoneal injuries is not yet well established. The aim of this study was to document our experience in using laparoscopy in a setting of penetrating abdominal injuries with suspected retroperitoneal injury in haemodynamically stable patients. A retrospective descriptive study of prospectively collected data from a trauma unit at Dr George Mukhari Academic Hospital (DGMAH) was done. All haemodynamically stable patients with penetrating abdominal injury who were offered laparoscopy from January 2012 to December 2015 were reviewed and those who met the inclusion criteria were analysed. A total of 284 patients with penetrating abdominal injuries were reviewed and 56 met the inclusion criteria and were analysed. The median age was 30.8 years (15-60 years) and males constituted 87.5% of the study population. The most common mechanism of injury was penetrating stab wounds (62.5%). Forty-five patients (80.3%) were managed laparoscopically, of these n=16 (28.5%) had retroperitoneal injuries that required surgical intervention. The most commonly injured organ was the colon (19.6%). The conversion rate was 19.6% with most common indication for conversion been active bleeding (14%). The complication rate was 7.14% (N=4) and were all Clavien-Dindo grade 3. There were no recorded missed injuries and no mortality. The positive outcomes documented in this study with no missed injuries and absence of mortality suggests that laparoscopy is a feasible option in managing stable patients with suspected retroperitoneal injuries.

  15. Ureteric transection secondary to penetrating handlebar injury

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    K.P. Debbink

    2017-08-01

    Full Text Available Ureteric trauma is rare, occurring in <1% of all traumas. We present a unique case of a 13 year old female who sustained a penetrating abdominal injury from a bicycle handlebar. Upon initial examination there was herniation of bowel through the abdominal wound, so exploratory laparotomy was performed. A serosal injury of the colon and bleeding mesenteric veins were encountered; the retroperitoneum was not explored at that time. Postoperative course was remarkable for a doubling of the serum creatinine, increasing abdominal distention and pain. Computed tomography on postoperative day five demonstrated a large amount of intra-abdominal fluid. The patient was taken for re-exploration. The left ureter was found to be completely transected. It was repaired over a double-J stent. This case demonstrates the need for a high index of suspicion in the diagnosis of ureteric injury. Keywords: Ureter, Bicycle, Handlebar, Penetrating

  16. Penetrating abdominal injury cases admitted in University of Benin ...

    African Journals Online (AJOL)

    The incidence of penetrating abdominal injuries especially through gunshot injuries is on the increase and is a major cause of morbidity and mortality in our community. Control measures and ways of reducing morbidity and mortality are suggested. Keywords: penetrating abdominal injuries, gun shot injuries. Annals of ...

  17. Management of Penetrating Spinal Cord Injuries in a Non Spinal ...

    African Journals Online (AJOL)

    Management of Penetrating Spinal Cord Injuries in a Non Spinal Centre: Experience at Enugu, Nigeria. ... The thoracic spine{9(41%)}was most often involved. ... Five (23%) patients with injury at cervical level died from respiratory failure.

  18. Analysis of 178 penetrating stomach and small bowel injuries.

    Science.gov (United States)

    Salim, Ali; Teixeira, Pedro G R; Inaba, Kenji; Brown, Carlos; Browder, Timothy; Demetriades, Demetrios

    2008-03-01

    Surgical site infections (SSIs), such as wound infection, fascial dehiscence, and intraabdominal abscess, commonly occur following penetrating abdominal trauma. However, most of the literature involves penetrating colon injuries. There are few reports describing complications following penetrating stomach and small bowel injuries. Based on the hypothesis that SSIs are commonly found following penetrating stomach and small bowel trauma, a prospective observational study was performed at an academic Level I trauma center from March 1, 2004 until August 31, 2006. The subjects were patients who had sustained a penetrating injury to the stomach or small bowel. Patients were followed for the development of an SSI, defined as wound infection, fascial dehiscence, or intraabdominal abscess. A total of 178 patients were admitted with penetrating stomach or small bowel injuries over the 29-month period. There were 121 (68%) gunshot injuries and 57 (32%) stab wounds. Associated intraabdominal injuries occurred in 74% of patients. Overall, SSIs occurred in 20% of cases. Risk factors for SSI included associated duodenal or colon injury, whereas time to operating room, blood loss, and type and duration of antibiotic use were not. When associated colon injuries were excluded, SSIs occurred in 16% of patients with gastric injuries and 13% of those with small bowel injuries. SSIs commonly follow penetrating stomach and small bowel trauma. Risk factors for SSI include associated duodenal or colon injury. Delay to operating room, blood loss, and type and length of antibiotic prophylaxis were not associated with an increased risk of SSI.

  19. Penetrating abdominal injuries in adults seen at two teaching ...

    African Journals Online (AJOL)

    Objective: To determine the pattern and management outcome of penetrating abdominal injuries (PAI) in the two main teaching hospitals in Ghana. Study Design: A prospective ... Conclusion: Stab wounds are the main penetrating abdominal injuries seen mostly among young male adults in Ghana. Management was by a ...

  20. Impact of location on outcome after penetrating colon injuries.

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    Sharpe, John P; Magnotti, Louis J; Weinberg, Jordan A; Zarzaur, Ben L; Shahan, Charles P; Parks, Nancy A; Fabian, Timothy C; Croce, Martin A

    2012-12-01

    Most studies examining suture line failure after penetrating colon injuries have focused on right- versus left-sided injuries. In our institution, operative decisions (resection plus anastomosis vs. diversion) are based on a defined management algorithm regardless of injury location. The purpose of this study was to evaluate the effect of injury location on outcomes after penetrating colon injuries. Consecutive patients with full thickness penetrating colon injuries for 13 years were stratified by age, injury location and mechanism, and severity of shock. According to the algorithm, patients with nondestructive injuries underwent primary repair. Destructive wounds underwent resection plus anastomosis in the absence of comorbidities or large preoperative or intraoperative transfusion requirements (>6 U of packed red blood cells); otherwise, they were diverted. Injury location was defined as ascending, transverse, descending (including splenic flexure), and sigmoid. Multivariable logistic regression was performed to determine whether injury location was an independent predictor of either morbidity or mortality. Four hundred sixty-nine patients were identified: 314 (67%) underwent primary repair and 155 (33%) underwent resection. Most injuries involved the transverse colon (39%), followed by the ascending colon (26%), the descending colon (21%), and the sigmoid colon (14%). Overall, there were 13 suture line failures (3%) and 72 abscesses (15%). Most suture line failures involved injuries to the descending colon (p = 0.06), whereas most abscesses followed injuries to the ascending colon (p = 0.37). Multivariable logistic regression failed to identify injury location as an independent predictor of either morbidity or mortality after adjusting for 24-hour transfusions, base excess, shock index, injury mechanism, and operative management. Injury location did not affect morbidity or mortality after penetrating colon injuries. Nondestructive injuries should be primarily

  1. Civilian Penetrating Gunshot Injury to the Neurocranium in Enugu

    African Journals Online (AJOL)

    This is an open access article distributed under the terms of the Creative Commons ... Table 1: Clinicodemographic profile of civilian penetrating gunshot neurocranial injuries ... (*Armed robbery, cultists, terrorism). [Downloaded free from ...

  2. Selective Nonoperative Management of Penetrating Abdominal Solid Organ Injuries

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    Demetriades, Demetrios; Hadjizacharia, Pantelis; Constantinou, Costas; Brown, Carlos; Inaba, Kenji; Rhee, Peter; Salim, Ali

    2006-01-01

    Objective: To assess the feasibility and safety of selective nonoperative management in penetrating abdominal solid organ injuries. Background: Nonoperative management of blunt abdominal solid organ injuries has become the standard of care. However, routine surgical exploration remains the standard practice for all penetrating solid organ injuries. The present study examines the role of nonoperative management in selected patients with penetrating injuries to abdominal solid organs. Patients and Methods: Prospective, protocol-driven study, which included all penetrating abdominal solid organ (liver, spleen, kidney) injuries admitted to a level I trauma center, over a 20-month period. Patients with hemodynamic instability, peritonitis, or an unevaluable abdomen underwent an immediate laparotomy. Patients who were hemodynamically stable and had no signs of peritonitis were selected for further CT scan evaluation. In the absence of CT scan findings suggestive of hollow viscus injury, the patients were observed with serial clinical examinations, hemoglobin levels, and white cell counts. Patients with left thoracoabdominal injuries underwent elective laparoscopy to rule out diaphragmatic injury. Outcome parameters included survival, complications, need for delayed laparotomy in observed patients, and length of hospital stay. Results: During the study period, there were 152 patients with 185 penetrating solid organ injuries. Gunshot wounds accounted for 70.4% and stab wounds for 29.6% of injuries. Ninety-one patients (59.9%) met the criteria for immediate operation. The remaining 61 (40.1%) patients were selected for CT scan evaluation. Forty-three patients (28.3% of all patients) with 47 solid organ injuries who had no CT scan findings suspicious of hollow viscus injury were selected for clinical observation and additional laparoscopy in 2. Four patients with a “blush” on CT scan underwent angiographic embolization of the liver. Overall, 41 patients (27

  3. Management of penetrating heart and accompanying lung injuries

    International Nuclear Information System (INIS)

    Ekim, H.; Basel, H.; Odabasi, D.; Tuncer, M.; Gumrukcuoglu, H.A.

    2010-01-01

    Objective: Penetrating heart injury is potentially a life threatening condition due to cardiac tamponade or exsanguinating hemorrhage. The aim of this study was to evaluate victims who were referred to our hospital with penetrating heart and accompanying lung injuries and to review our overall outcome with this type of combined injuries. Methodology: Twenty patients with combined penetrating heart and lung injuries were operated at Yuzuncu Yil University Research Hospital, between May 1999 and January 2010. The diagnosis of combined heart and lung injuries was proved by surgical exploration in all cases. The surgical procedures mainly included the relief of cardiac tamponade, control of bleeding, repair of cardiac and pulmonary lacerations, and coronary artery bypass grafting if required. Results: In this series of 20 patients; there were 18 males and two females between the age of 14 to 60 years, with a mean age of 34.8+-13.5 years. Seventeen victims sustained stab wounds, and the remaining three were injured by a gunshot wounds. In 20 patients there were 22 cardiac chamber injuries. The most commonly injured cardiac chamber was the right ventricle followed by the left ventricle. In addition to the injuries to heart muscle, injuries to the coronary arteries were found in two patients. The most commonly injured lung lobe was the left upper lobe. Conclusion: Our experience shows that early diagnosis and immediate surgical intervention are the main factors affecting patient survival after penetrating heart and lung injuries. Therefore, heart injury should always be kept in mind in victims with penetrating thoracic injuries. (author)

  4. Penetrating abdominal war injuries among the war victims at Lacor ...

    African Journals Online (AJOL)

    hospital for prompt and appropriate treatment. All cases of such injuries should have exploratory laparotomy as soon as possible. Introduction. Penetrating abdominal injuries among the war wounded present a challenge in its management especially in a situation with limited human and financial resources such as ours.

  5. Penetrating Brain Injury after Suicide Attempt with Speargun

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    John Ross Williams

    2014-07-01

    Full Text Available Penetrating cranial injury by mechanisms other than are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here we present a case of penetrating brain injury by the low velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of lower-velocity penetrating brain injury (LVPBI, including benefit in delaying foreign body removal to allow for tamponade; the importance of history taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using DECT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher velocity forms of intracranial injury.

  6. Ultrasonographic demonstration of intraneural neovascularization after penetrating nerve injury.

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    Arányi, Zsuzsanna; Csillik, Anita; Dévay, Katalin; Rosero, Maja

    2018-06-01

    Hypervascularization of nerves has been shown to be a pathological sign in some peripheral nerve disorders, but has not been investigated in nerve trauma. An observational cohort study was performed of the intraneural blood flow of 30 patients (34 nerves) with penetrating nerve injuries, before or after nerve reconstruction. All patients underwent electrophysiological assessment, and B-mode and color Doppler ultrasonography. Intraneural hypervascularization proximal to the site of injury was found in all nerves, which was typically marked and had a longitudinal extension of several centimeters. In 6 nerves, some blood flow was also present within the injury site or immediately distal to the injury. No correlation was found between the degree of vascularization and age, size of the scar / neuroma, or degree of reinnervation. Neovascularization of nerves proximal to injury sites appears to be an essential element of nerve regeneration after penetrating nerve injuries. Muscle Nerve 57: 994-999, 2018. © 2018 Wiley Periodicals, Inc.

  7. Primary repair of penetrating colon injuries: a systematic review.

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    Singer, Marc A; Nelson, Richard L

    2002-12-01

    Primary repair of penetrating colon injuries is an appealing management option; however, uncertainty about its safety persists. This study was conducted to compare the morbidity and mortality of primary repair with fecal diversion in the management of penetrating colon injuries by use of a meta-analysis of randomized, prospective trials. We searched for prospective, randomized trials in MEDLINE (1966 to November 2001), the Cochrane Library, and EMBase using the terms colon, penetrating, injury, colostomy, prospective, and randomized. Studies were included if they were randomized, controlled trials that compared the outcomes of primary repair with fecal diversion in the management of penetrating colon injuries. Five studies were included. Reviewers performed data extraction independently. Outcomes evaluated from each trial included mortality, total complications, infectious complications, intra-abdominal infections, wound complications, penetrating abdominal trauma index, and length of stay. Peto odds ratios for combined effect were calculated with a 95 percent confidence interval for each outcome. Heterogeneity was also assessed for each outcome. The penetrating abdominal trauma index of included subjects did not differ significantly between studies. Mortality was not significantly different between groups (odds ratio, 1.70; 95 percent confidence interval, 0.51-5.66). However, total complications (odds ratio, 0.28; 95 percent confidence interval, 0.18-0.42), total infectious complications (odds ratio, 0.41; 95 percent confidence interval, 0.27-0.63), abdominal infections including dehiscence (odds ratio, 0.59; 95 percent confidence interval, 0.38-0.94), abdominal infections excluding dehiscence (odds ratio, 0.52; 95 percent confidence interval, 0.31-0.86), wound complications including dehiscence (odds ratio, 0.55; 95 percent confidence interval, 0.34-0.89), and wound complications excluding dehiscence (odds ratio, 0.43; 95 percent confidence interval, 0

  8. Contemporary management of civilian penetrating cervicothoracic arterial injuries.

    Science.gov (United States)

    Weinberg, Jordan A; Moore, Andrew H; Magnotti, Louis J; Teague, Rebecca J; Ward, Tyler A; Wasmund, Joshua B; Lamb, Elena M P; Schroeppel, Thomas J; Savage, Stephanie A; Minard, Gayle; Maish, George O; Croce, Martin A; Fabian, Timothy C

    2016-08-01

    The management of arterial injury at the thoracic outlet has long hinged on the fundamental principles of extensile exposure and vascular anastomosis. Nonetheless, treatment options for such injuries have evolved to include both endovascular stent placement and temporary vascular shunts. The purpose of this study was to evaluate our recent experience with penetrating cervicothoracic arterial injuries in light of these developments in trauma care. Patients with penetrating injuries to the innominate, carotid, subclavian, or axillary arteries managed at a single civilian trauma center between 2000 and 2013 were categorized as the modern era (ME) cohort. The management strategies and outcomes pertaining to the ME group were compared to those of previously reported experience (PE) concerning injuries to the innominate, carotid, subclavian, or axillary arteries at the same institution from 1974 to 1988. Over the two eras, there were 202 patients: 110 in the ME group and 92 in the PE group. Most of the injuries in both groups were managed with primary repair (45% vs. 46%; p = 0.89). A similar proportion of injuries in each group was managed with anticoagulation alone (14% vs. 10%; p = 0.40). In the ME group, two cases were managed with temporary shunt placement, and endovascular stent placement was performed in 12 patients. Outcomes were similar between the groups (bivariate comparison): mortality (ME, 15% vs. PE, 14%; p = 0.76), amputation following subclavian or axillary artery injury (ME, 5% vs. PE, 4%; p = 0.58), and posttreatment stroke following carotid injury (ME, 2% vs. PE, 6%; p = 0.57). Experience with penetrating arterial cervicothoracic injuries at a high-volume urban trauma center remained remarkably similar with respect to both anatomic distribution of injury and treatment. Conventional operative exposure and repair remain the cornerstone of treatment for most civilian cervicothoracic arterial injuries. Therapeutic study, level V.

  9. Independent risk factors of morbidity in penetrating colon injuries.

    Science.gov (United States)

    Girgin, Sadullah; Gedik, Ercan; Uysal, Ersin; Taçyildiz, Ibrahim Halil

    2009-05-01

    The present study explored the factors effective on colon-related morbidity in patients with penetrating injury of the colon. The medical records of 196 patients were reviewed for variables including age, gender, factor of trauma, time between injury and operation, shock, duration of operation, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), site of colon injury, Colon Injury Score, fecal contamination, number of associated intra- and extraabdominal organ injuries, units of transfused blood within the first 24 hours, and type of surgery. In order to determine the independent risk factors, multivariate logistic regression analysis was performed. Gunshot wounds, interval between injury and operation > or =6 hours, shock, duration of the operation > or =6 hours, PATI > or =25, ISS > or =20, Colon Injury Score > or = grade 3, major fecal contamination, number of associated intraabdominal organ injuries >2, number of associated extraabdominal organ injuries >2, multiple blood transfusions, and diversion were significantly associated with morbidity. Multivariate logistic regression analysis showed diversion and transfusion of > or =4 units in the first 24 hours as independent risk factors affecting colon-related morbidity. Diversion and transfusion of > or =4 units in the first 24 hours were determined to be independent risk factors for colon-related morbidity.

  10. Operative management of penetrating carotid artery injuries.

    Science.gov (United States)

    Reva, V A; Pronchenko, A A; Samokhvalov, I M

    2011-07-01

    To analyse management and outcomes of carotid artery (CA) injuries. Retrospective study of the patients in the combat operations in Chechnya (1999-2002) and in peacetime (2003-2009). A total of 46 patients with missile (27) and stab (19) wounds, who had common and internal CA injury, underwent an open surgery. Temporary shunts (TSs) were placed in eight patients with more severe injuries. Retrospective analysis of patients' data. CA ligation and CA repair were performed in 9 and 37 patients, respectively. Of the nine patients with CA ligation, five developed neurologic deficit; the remaining four patients died (100% of poor outcomes). Of the 37 patients with blood flow restoration, nine patients died and neurologic deficit persisted in two patients (30% of poor outcomes) (p < 0.05). Among patients with TS, three patients died and two had stable neurologic deficit (63% of poor results). Of the patients without TS, 10 patients died and five had neurologic disorders (56% of poor outcomes) (p = 0.53). CA repair is the method of choice in CA injury. TS use does not result in a decreased mortality rate or neurologic deficit reduction in patients with severe injuries. Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  11. The role of diagnostic VATS in penetrating thoracic injuries

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    Guasti Guido

    2006-10-01

    Full Text Available Abstract Background Penetrating chest injuries account for 1–13% of thoracic trauma hospital admissions and most of these are managed with a conservative approach. Nevertheless, 18–30% of cases managed only with tube thoracostomy have residual clotted blood, considered the major risk factor for the development of fibrothorax and empyema. In addition, 4–23% of chest injury patients present persistent pneumothorax and 15–59% present an injury to the diaphragm, which is missed in 30% of cases. In order to make a correct diagnosis, reduce the number of missed injuries, chronic sequelae and late mortality we propose performing surgical exploration of all patients with a penetrating injury of the pleural cavity. Methods 1270 patients who sustained thoracic trauma were admitted to our hospital between 1994 and 2004. Of these, 16 patients had penetrating injuries: thirteen were surgically explored by means of Video Assisted Thoracic Surgery (VATS, and 3 with thoracotomy due to hemodynamic instability or suspected lesion of the heart or great vessels. Results In the 13 patients who underwent VATS, 5 injuries to the diaphragm, 3 lesions to an intercostal artery, and 1 lesion to the diaphragmatic artery were detected. In 12 of these patients a laceration of the pulmonary parenchyma was also present. A conversion to thoracotomy was necessary due to a broad laceration of the diaphragm and due to hemostasis of an intercostal artery. In all but one case, which was later converted, diagnostic imaging missed the diagnosis of laceration of the diaphragm. There was no intra- or postoperative mortality, and average hospital stay was five days. Conclusion VATS is a safe and effective way to diagnose and manage penetrating thoracic injuries, and its extensive use leads to a reduction in the number of missed, potentially fatal lesions as well as in chronic sequelae.

  12. [Penetrant injuries of colon--our experience].

    Science.gov (United States)

    Lazović, R; Krivokapić, Z; Dobricanin, V

    2010-01-01

    In attemption to determine the place of primary repair in management of colon injuries, an open, non randomized clinical study was performed. Retrospective (RS) group of 62 patients according to exclusion criteria by Stone (S/F) and Flint (F1) was managed by one or two stage surgical procedure. Prospective (PR) group of 34 patients was managed using one stage repair non-selectively: two stage procedures were performed in 3 cases of advanced peritonitis and multi-segmental lacerations with impaired circulation of colon. In RS group 36 patients were managed by primary repair and in PR group, 31 were managed by primary repair. Both groups were of similar age/sex. Indexes of trauma severity were similar (TS, ISS, PATI). The latent time was shorter in PR group. Associated injuries to other body regions and abdominal organs were similar in both groups. S/F criteria and Flint grading in both (RS vs. PR) groups were similar. Comparison of attempted and successful primary repairs justifies the more liberal use of primary repair in early management of colon injuries.

  13. [Our experience in the cases with penetrating colonic injuries].

    Science.gov (United States)

    Kahya, Mehmet Cemal; Derici, Hayrullah; Cin, Necat; Tatar, Fatma; Peker, Yasin; Genç, Hüdai; Deniz, Vedat; Reyhan, Enver

    2006-07-01

    In this study, the factors that effect the morbidity and mortality in patients with penetrating colonic injuries were evaluated. Fourty-two patients (37 males, 5 females; mean age 30,1; range 14 to 63 years) with penetrating colonic trauma were evaluated according to age, gender, type of penetrating trauma, location and severity of the colonic injury, associated injury, interval between the trauma and the definitive operation, hemodynamic status, blood transfusion requirement, fecal contamination, surgical procedure, postoperative complication and mortality. Type of the penetrating trauma was stab injury in twenty-eight (67%) patients, and gunshot injury in fourteen (33%) patients. The mean Colon Injury Severity Score was 2,1. The mean Abdominal Trauma Index (ATI) was 17,2 and it was over than 25 in eight (19%) patients. The symptoms of shock were present in eleven (26%) patients at admission. Blood transfusions were applied in sixteen (38%) patients. In twenty-one patients intraabdominal bleeding was observed and it was more than 500 mL in eleven (26%) patients. Primary repair was performed in 36 (86%) of the 42 patients and colostomy was performed in six (14%) patients. Morbidity and mortality rates were 41% and 10% respectively. It was found that morbidity rates were increased in patients with ATI score higher than 25, and mortality rates were increased in patients presenting shock at admission, with the amount of intraabdominal blood more than 500 mL, and who needed three or more units of blood transfusion. The primary repair of the penetrating colon trauma can be performed confidently in the hemodynamically stable patients with ATI score less than 25.

  14. Selective observational management of penetrating neck injury in ...

    African Journals Online (AJOL)

    Background. The most appropriate management of penetrating neck injury (PNI) remains controversial. This study was conducted to determine the accuracy and safety of physical examination as the basis of selective observational management of PNI at our institution. Methods. The study was conducted between 1991 and ...

  15. Laparoscopic repair of penetrating injury of the diaphragm: an ...

    African Journals Online (AJOL)

    In this study we review our experience in using laparoscopy as a diagnostic and therapeutic tool in dealing with penetrating diaphragmatic injuries due to stab wounds and look at the feasibility of using this procedure in other similar institutions. Thirty patients, all of whom were males 20-30 years of age, presented to the ...

  16. Nonoperative management of penetrating kidney injuries: a prospective audit.

    Science.gov (United States)

    Moolman, C; Navsaria, P H; Lazarus, J; Pontin, A; Nicol, A J

    2012-07-01

    The role of nonoperative management for penetrating kidney injuries is unknown. Therefore, we review the management and outcome of penetrating kidney injuries at a center with a high incidence of penetrating trauma. Data from all patients presenting with hematuria and/or kidney injury discovered on imaging or at surgery admitted to the trauma center at Groote Schuur Hospital in Cape Town, South Africa during a 19-month period (January 2007 to July 2008) were prospectively collected and reviewed. These data were analyzed for demographics, injury mechanism, perioperative management, nephrectomy rate and nonoperative success. Patients presenting with hematuria and with an acute abdomen underwent a single shot excretory urogram. Those presenting with hematuria without an indication for laparotomy underwent computerized tomography with contrast material. A total of 92 patients presented with hematuria following penetrating abdominal trauma. There were 75 (80.4%) proven renal injuries. Of the patients 84 were men and the median age was 26 years (range 14 to 51). There were 50 stab wounds and 42 gunshot renal injuries. Imaging modalities included computerized tomography in 60 cases and single shot excretory urography in 18. There were 9 patients brought directly to the operating room without further imaging. A total of 47 patients with 49 proven renal injuries were treated nonoperatively. In this group 4 patients presented with delayed hematuria, of whom 1 had a normal angiogram and 3 underwent successful angioembolization of arteriovenous fistula (2) and false aneurysm (1). All nonoperatively managed renal injuries were successfully treated without surgery. There were 18 nephrectomies performed for uncontrollable bleeding (11), hilar injuries (2) and shattered kidney (3). Post-nephrectomy complications included 1 infected renal bed hematoma requiring percutaneous drainage. Of the injuries found at laparotomy 12 were not explored, 2 were drained and 5 were treated with

  17. Penetrating cardiac injury by wire thrown from a lawn mower.

    Science.gov (United States)

    Rubio, P A; Reul, G J

    1979-01-01

    The first successful surgically treated case of penetrating heart injury, specifically the right ventricle, caused by a fragment of coat hanger wire thrown by a lawn mower, is reported. Though traumatic heart injuries are rare, this case represents accurate surgical management and judgment, especially in the preoperative phase which resulted in early operating and excellent postoperative results. It is our feeling that if the patient can be transferred safely to the operating room the mortality rate is considerably lowered; however, emergency room thoracotomy, which will undoubtedly result in a greater survival rate from these spectacular injuries, should be performed in the emergency center if cardiac activity ceases or the patient's condition deteriorates considerably.

  18. "Thunderstruck": penetrating thoracic injury from lightning strike.

    Science.gov (United States)

    van Waes, Oscar J F; van de Woestijne, Pieter C; Halm, Jens A

    2014-04-01

    Lightning strike victims are rarely presented at an emergency department. Burns are often the primary focus. This case report describes the improvised explosive device like-injury to the thorax due to lightning strike and its treatment, which has not been described prior in (kerauno)medicine. Penetrating injury due to blast from lightning strike is extremely rare. These "shrapnel" injuries should however be ruled out in all patients struck by lightning. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  19. Penetrating Cardiac and Hepatic Injury; Polytrauma of a Child After Bombing

    Directory of Open Access Journals (Sweden)

    Baris Akca

    2013-10-01

    Full Text Available After a bombing attack, patients were brought into hospital suffering from a combination of injuries caused by the blast, penetrating injuries and burns which as a case of polytrauma. In penetrating thoracoabdominal injuries due to bombing possibility of cardiac injury should be kept in mind. Penetrating cardiac injuries in children are rare but has a high mortality and morbidity. In some cases there may be difficulty in diagnosis of penetrating cardiac injury. In this case we want to share the diagnosis, treatment and follow-up processes of penetrating cardiac and hepatic injury with burns of a politrauma child due to bombing.

  20. A Case of Undesired Bleb Developed After Penetrating Injury

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    Cem Ozgonul

    2014-03-01

    Full Text Available Eighty-year-old male patient was admitted to our policlinic with stinging, burning and itching in both eyes. Ophthalmological examination revealed avascular undesired bleb that releated with anterior chamber at 2-3 hour quadrant nasal limbus with the surrounding corneal and conjunctival epithelium was vascularized and the dimension was 3x3x3 mm. Towards these findings, we questioned the patient again and we found that, 40 years ago, a broken part of the shaving razor had injured his eye. After penetrating injury of the eye, because of the sutured wound leakage, undesired bleb formations can be seen. We suggest that kind of patient shold be followed up to prevent late complications of penetrating injury.

  1. Swordfish Attack—Death by Penetrating Head Injury

    Directory of Open Access Journals (Sweden)

    Boon Hui Gooi

    2007-04-01

    Full Text Available There have been very few reports of swordfish attacks on humans and none have resulted in death. Although there are no reports of unprovoked attacks on humans, swordfish can be very dangerous when provoked and they can jump and use their swords to pierce their target. We describe here an unusual case of death that resulted from intracranial penetrating injury caused by a swordfish.

  2. Penetrating cardiac injuries in blunt chest wall trauma.

    Science.gov (United States)

    Kanchan, Tanuj; Menezes, Ritesh G; Sirohi, Parmendra

    2012-08-01

    The present photocase illustrates the possible mechanism of direct cardiac injuries from broken sharp jagged fractured ends of ribs in blunt force trauma to the chest in run over traffic mishaps. We propose that the projecting fractured ends of the ribs penetrate the underlying thoracic organs due to the transient phenomenon of deformation of chest cavity under pressure in run over traffic mishaps. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  3. Assessment and outcome of 496 penetrating gastrointestinal warfare injuries.

    Science.gov (United States)

    Saghafinia, M; Nafissi, N; Motamedi, M R K; Motamedi, M H K; Hashemzade, M; Hayati, Z; Panahi, F

    2010-03-01

    The abdominal viscera are among the most vulnerable organs of the body to penetrating trauma. Proper management of such trauma in war victims at the first-line hospital where these victims are first seen is of paramount importance. We reviewed medical records of war victims suffering small bowel and colorectal injuries treated at first, second and third-line hospitals during the Iraq-Iran War (1980-88) to assess surgical outcomes. The medical records of 496 Iranian war victims suffering penetrating gastrointestinal (GI) injuries treated at first, second and third-line (tertiary) hospitals, a total of 19 centres, were reviewed. Laparotomy had been performed at the 1st line hospitals for all patients who had an acute abdomen, whose wounds violated the peritoneum or whose abdominal radiographs showed air or shrapnel in the abdominal cavity. Stable patients were transferred from first-line to second-line or from second line to tertiary hospitals postoperatively. The treatments, complications and patient outcomes were documented and analyzed. There were 496 patients; 145, 220 and 131 victims underwent laparotomy for GI injuries at first, second and third-line hospitals respectively. The small intestine and colon respectively were the most prevalent abdominal organs damaged. Those first treated for GI injuries at front-line hospitals (145 victims) had more serious conditions and could not be transferred prior to surgery and presented a higher prevalence of complications and mortality. Overall mortality from GI surgery was 3.6% (18 patients). Eleven patients (7.5%) whose first GI operation was performed at frontline hospitals and 7 patients (3.2%) who underwent their first surgical operation at second-line hospitals died. The most common reason for these deaths was complications relating to the gastrointestinal operation such as anastomotic leak. Six missed injuries were seen at the frontline and one at second line hospitals. There were no deaths at the 3rd line hospitals

  4. Neuroimaging in adult penetrating brain injury: a guide for radiographers

    Energy Technology Data Exchange (ETDEWEB)

    Temple, Nikki; Donald, Cortny; Skora, Amanda [Discipline of Medical Radiation Sciences, The University of Sydney, Lidcombe, New South Wales (Australia); Reed, Warren, E-mail: warren.reed@sydney.edu.au [Medical Image Optimisation and Perception Group, Discipline of Medical Radiation Sciences, The University of Sydney, Lidcombe, New South Wales (Australia)

    2015-06-15

    Penetrating brain injuries (PBI) are a medical emergency, often resulting in complex damage and high mortality rates. Neuroimaging is essential to evaluate the location and extent of injuries, and to manage them accordingly. Currently, a myriad of imaging modalities are included in the diagnostic workup for adult PBI, including skull radiography, computed tomography (CT), magnetic resonance imaging (MRI) and angiography, with each modality providing their own particular benefits. This literature review explores the current modalities available for investigating PBI and aims to assist in decision making for the appropriate use of diagnostic imaging when presented with an adult PBI. Based on the current literature, the authors have developed an imaging pathway for adult penetrating brain injury that functions as both a learning tool and reference guide for radiographers and other health professionals. Currently, CT is recommended as the imaging modality of choice for the initial assessment of PBI patients, while MRI is important in the sub-acute setting where it aids prognosis prediction and rehabilitation planning, Additional follow-up imaging, such as angiography, should be dependent upon clinical findings.

  5. Neuroimaging in adult penetrating brain injury: a guide for radiographers

    International Nuclear Information System (INIS)

    Temple, Nikki; Donald, Cortny; Skora, Amanda; Reed, Warren

    2015-01-01

    Penetrating brain injuries (PBI) are a medical emergency, often resulting in complex damage and high mortality rates. Neuroimaging is essential to evaluate the location and extent of injuries, and to manage them accordingly. Currently, a myriad of imaging modalities are included in the diagnostic workup for adult PBI, including skull radiography, computed tomography (CT), magnetic resonance imaging (MRI) and angiography, with each modality providing their own particular benefits. This literature review explores the current modalities available for investigating PBI and aims to assist in decision making for the appropriate use of diagnostic imaging when presented with an adult PBI. Based on the current literature, the authors have developed an imaging pathway for adult penetrating brain injury that functions as both a learning tool and reference guide for radiographers and other health professionals. Currently, CT is recommended as the imaging modality of choice for the initial assessment of PBI patients, while MRI is important in the sub-acute setting where it aids prognosis prediction and rehabilitation planning, Additional follow-up imaging, such as angiography, should be dependent upon clinical findings

  6. Microglial Inflammasome Activation in Penetrating Ballistic-Like Brain Injury.

    Science.gov (United States)

    Lee, Stephanie W; Gajavelli, Shyam; Spurlock, Markus S; Andreoni, Cody; de Rivero Vaccari, Juan Pablo; Bullock, M Ross; Keane, Robert W; Dietrich, W Dalton

    2018-04-02

    Penetrating traumatic brain injury (PTBI) is a significant cause of death and disability in the United States. Inflammasomes are one of the key regulators of the interleukin (IL)-1β mediated inflammatory responses after traumatic brain injury. However, the contribution of inflammasome signaling after PTBI has not been determined. In this study, adult male Sprague-Dawley rats were subjected to sham procedures or penetrating ballistic-like brain injury (PBBI) and sacrificed at various time-points. Tissues were assessed by immunoblot analysis for expression of IL-1β, IL-18, and components of the inflammasome: apoptosis-associated speck-like protein containing a caspase-activation and recruitment domain (ASC), caspase-1, X-linked inhibitor of apoptosis protein (XIAP), nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3), and gasdermin-D (GSDMD). Specific cell types expressing inflammasome proteins also were evaluated immunohistochemically and assessed quantitatively. After PBBI, expression of IL-1β, IL-18, caspase-1, ASC, XIAP, and NLRP3 peaked around 48 h. Brain protein lysates from PTBI animals showed pyroptosome formation evidenced by ASC laddering, and also contained increased expression of GSDMD at 48 h after injury. ASC-positive immunoreactive neurons within the perilesional cortex were observed at 24 h. At 48 h, ASC expression was concentrated in morphologically activated cortical microglia. This expression of ASC in activated microglia persisted until 12 weeks following PBBI. This is the first report of inflammasome activation after PBBI. Our results demonstrate cell-specific patterns of inflammasome activation and pyroptosis predominantly in microglia, suggesting a sustained pro-inflammatory state following PBBI, thus offering a therapeutic target for this type of brain injury.

  7. Civilian Penetrating Gunshot Injury to the Neurocranium in Enugu.

    Science.gov (United States)

    Onyia, Ephraim Eziechina; Chikani, Mark C; Mezue, Wilfred C; Uche, Enoch O; Iloabachie, Izuchukwu; Mesi, Matthew; Ejembi, Sunday; Agunwa, Chuka

    2017-01-01

    Civilian penetrating gunshot injuries to the neurocranium are no longer uncommon in Nigeria. Such injuries are however poorly reported. They are associated with poor outcome and, at close range, are frequently fatal, especially when inflicted by high-velocity weapons. Prompt transfer to neurosurgical service and urgent intervention may improve outcome in those that are not mortally wounded. Fifty-two patients with civilian penetrating gunshot wounds seen over a 10-year period (2004-2014) at the University of Nigeria Teaching Hospital and Memfys Hospital for Neurosurgery Enugu were reviewed retrospectively, and their data were analyzed to evaluate factors that impacted on outcome. Only patients with clinical and imaging evidence of cranial gunshot injuries who reached hospital alive were included in the study. The overall mortality and Glasgow outcome score were analyzed. Fifty-two patients with isolated civilian penetrating gunshot wounds were identified (M:F = 7.7:1); mean (standard deviation) age was 32.8 (11.9) years. There was a high correlation (0.983) between the sex of the patients and the outcome. The overall mortality was 30.8%, whereas the mortality for patients with postresuscitation Glasgow coma scale (GCS) score ≤8 was 57%, as against 12.9% in those in whom postresuscitation GCS was >8; meaning that 87.1% of patients in whom postresuscitation GCS was >8 survived. Thirty-one patients (59.6%) had papillary abnormalities. Majority of patients with monohemispheric lesions survived while all those with diencephalic, transventricular, and posterior fossa involvement had 100% mortality. Admitting GCS and bullet trajectory were predictive of outcome.

  8. Civilian penetrating gunshot injury to the neurocranium in Enugu

    Directory of Open Access Journals (Sweden)

    Ephraim Eziechina Onyia

    2017-01-01

    Full Text Available Introduction: Civilian penetrating gunshot injuries to the neurocranium are no longer uncommon in Nigeria. Such injuries are however poorly reported. They are associated with poor outcome and, at close range, are frequently fatal, especially when inflicted by high-velocity weapons. Prompt transfer to neurosurgical service and urgent intervention may improve outcome in those that are not mortally wounded. Materials and Methods: Fifty-two patients with civilian penetrating gunshot wounds seen over a 10-year period (2004–2014 at the University of Nigeria Teaching Hospital and Memfys Hospital for Neurosurgery Enugu were reviewed retrospectively, and their data were analyzed to evaluate factors that impacted on outcome. Only patients with clinical and imaging evidence of cranial gunshot injuries who reached hospital alive were included in the study. The overall mortality and Glasgow outcome score were analyzed. Results: Fifty-two patients with isolated civilian penetrating gunshot wounds were identified (M:F = 7.7:1; mean (standard deviation age was 32.8 (11.9 years. There was a high correlation (0.983 between the sex of the patients and the outcome. The overall mortality was 30.8%, whereas the mortality for patients with postresuscitation Glasgow coma scale (GCS score ≤8 was 57%, as against 12.9% in those in whom postresuscitation GCS was> 8; meaning that 87.1% of patients in whom postresuscitation GCS was> 8 survived. Thirty-one patients (59.6% had papillary abnormalities. Majority of patients with monohemispheric lesions survived while all those with diencephalic, transventricular, and posterior fossa involvement had 100% mortality. Conclusions: Admitting GCS and bullet trajectory were predictive of outcome.

  9. Management of penetrating ocular injuries and endophthalmitis in thirteen-year follow-up period

    Directory of Open Access Journals (Sweden)

    Vukosavljević Miroslav

    2006-01-01

    Full Text Available Introduction: Ocular trauma is one of the most common causes of unilateral morbidity and blindness in the world today. Objective: Frequency of penetrating ocular injuries and endophthalmitis after injuries caused by explosive weapons during the war in former Yugoslavia in the period 1991-1999 as well as eye injuries in the period 2000-2004 was examined. Method: During 1991-1999, 647 patients with eye injuries were hospitalized at Eye Clinic, MMA, out of whom 500 cases with penetrating eye injuries. In 2000-2004 period, 601 patients with eye injuries were treated, out of whom 297 had penetrating eye injuries (including patients from Montenegro and Republica Srpska. All patients underwent thorough ophthalmological examination, antibiotic treatment and VPP or other required surgical interventions. Results: All 500 patients from the first period had severe penetrating eye injuries. Intrabulbar foreign bodies (IFB were detected in 286 cases, while 214 cases with penetrating eye injuries had no intrabulbar foreign bodies. Almost all patients had multiple head and body injuries as well. Endophthalmitis was observed in 29 eyes (5.2% upon admission to hospital. In the second observed period (2000-2004, 196 (66% out of 297 penetrating eye injuries had IOFB, and 101 (34% was without IOFB. Endophthalmitis was observed in 34 eyes (8.4%. Conclusion: War eye injuries are a special group of injuries. Relatively low percent of posttraumatic endophthalmitis is definitely worth attention, especially in comparison with peacetime eye penetrating injuries.

  10. [Management of penetrating ocular injuries and endophthalmitis in thirteen-year follow-up period].

    Science.gov (United States)

    Vukosavljević, Miroslav

    2006-01-01

    Ocular trauma is one of the most common causes of unilateral morbidity and blindness in the world today. Frequency of penetrating ocular injuries and endophthalmitis after injuries caused by explosive weapons during the war in former Yugoslavia in the period 1991-1999 as well as eye injuries in the period 2000-2004 was examined. During 1991-1999, 647 patients with eye injuries were hospitalized at Eye Clinic, MMA, out of whom 500 cases with penetrating eye injuries. In 2000-2004 period, 601 patients with eye injuries were treated, out of whom 297 had penetrating eye injuries (including patients from Montenegro and Republica Srpska). All patients underwent thorough ophthalmological examination, antibiotic treatment and VPP or other required surgical interventions. All 500 patients from the first period had severe penetrating eye injuries. Intrabulbar foreign bodies (IFB) were detected in 286 cases, while 214 cases with penetrating eye injuries had no intrabulbar foreign bodies. Almost all patients had multiple head and body injuries as well. Endophthalmitis was observed in 29 eyes (5.2%) upon admission to hospital. In the second observed period (2000-2004), 196 (66%) out of 297 penetrating eye injuries had IOFB, and 101 (34%) was without IOFB. Endophthalmitis was observed in 34 eyes (8.4%). War eye injuries are a special group of injuries. Relatively low percent of posttraumatic endophthalmitis is definitely worth attention, especially in comparison with peacetime eye penetrating injuries.

  11. Penetrating abdominal injury and peritonitis: A rare case of birth Injury

    Directory of Open Access Journals (Sweden)

    Patankar Shreeprasad

    2008-01-01

    Full Text Available The incidence of birth injuries has decreased considerably because of the identification of risk factors at an earlier stage and taking the decision for caesarian section (LSCS at proper time. Fractures, nerve palsies and central nervous system injuries comprise the majority of "birth injuries." In this study, we report a newborn that had a birth injury during LSCS. The baby sustained a penetrating abdominal injury by the knife of the surgeon, while performing LSCS. The bowel was injured at two sites, proximal jejunum and descending colon. The baby developed meconeum spillage and peritonitis. Exploratory laprotomy was done and the injuries were identified. The injured portions were resected and bowel continuity was reestablished. The baby had an uneventful recovery.

  12. Trans-orbital orbitocranial penetrating injury by pointed iron rod

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    Vinod Kumar Tewari

    2015-01-01

    Full Text Available Trans-orbital orbitocranial penetrating injury (TOPI by a foreign body is an extremely rare compound head injury having a potential to cause major morbidity and mortality. Preoperative radiological imaging by CT scan is very important for operative guidance, but in remote area where CT scan is not available, the patient is generally referred to tertiary level. Here we present a case which was dealt successfully without CT scan, only on the basis of stable clinical status and X-rays. We present a case of a 35-year-old man who had an accidental injury (fall from height by rod. Immediate X-ray (anteroposterior and lateral views revealed that the pointed end of the foreign body (rod was inside the ipsilateral anterior fossa via basifrontal bone up to frontal vertex, not crossing the midline. CT scan was not available and his vitals with GCS were normal (15/15. He was operated with the help of an ophthalmic surgeon by right frontotemporal craniotomy. The patient was discharged on 10 th day without any neurological deficit except restricted right eyeball movement to superolateral and ptosis. The restricted eyeball movements recovered after third month of follow up with remnant ptosis for 2 years. This case highlights an unusual case, direct visualization and repair of brain structures with higher antibiotics can save the life even in remote areas where CT scan is still not available only on the basis of stable GCS and X-rays.

  13. http://www.bioline.org.br/js 104 Penetrating Tracheal Injuries – A ...

    African Journals Online (AJOL)

    jen

    airway and prompt repair is the mainstay of management of penetrating tracheal injuries. Introduction ... tracheal injury was made in the 16th century ... Pearson 7 Harrington8 Sheely9 and Hood10 ..... Ed Am Col Surg (Chicago) .p.391. 12.

  14. Prognostic analysis of 216 cases with penetrating ocular injury

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    Yong Guo

    2013-08-01

    Full Text Available AIM: To analyze the factors of penetrating ocular injury, and to investigate the prognostic factors and treatment strategies. METHODS: A retrospective analysis of 216 ocular trauma patients(221 eyes, in our hospital from November 2009 to November 2011, was completed. RESULTS: The eyeball atrophy inevitably occurred in 13 eye wounds more than 30mm. Retinal prolapse of the eyes, 78%(35/45completed vitrectomy, 33%(15/45were eyeball atrophy. The 51%(20/39of subchoroidal hemorrhage eyes were eyeball atrophy. Retinal prolapse and subchoroidal hemorrhage increased the risk of ocular atrophy(PPCONCLUSION: Serious ocular trauma prognosis related to many factors. The retina prolapse and the subchoroidal hemorrhage were important prognosis testify. A scleral buckling condensation surgery and vitrectomy have a therapeutic effect, and can improve visual function.

  15. Penetrating Colorectal Injuries: Diagnostic Performance of Multidetector CT with Trajectography.

    Science.gov (United States)

    Dreizin, David; Boscak, Alexis R; Anstadt, Michael J; Tirada, Nikki; Chiu, William C; Munera, Felipe; Bodanapally, Uttam K; Hornick, Michael; Stein, Deborah M

    2016-12-01

    Purpose To determine the diagnostic performance of multidetector computed tomography (CT) with trajectography for penetrating colorectal injuries. Materials and Methods This institutional review board-approved and HIPAA-compliant study was a 6-year blinded retrospective review by two independent readers of 182 consecutive patients who preoperatively underwent 40- or 64-row multidetector CT for penetrating torso trauma below the diaphragm and had surgically confirmed findings. Colorectal perforation was present in 42 patients. Trajectory analysis with postprocessing software was used for all studies. Additional signs evaluated were rectal contrast agent leak, collections of extruded fecal material, mural defect, wall thickening, abnormal enhancement, free fluid or stranding, and free air. The quality of the colorectal contrast agent administration was recorded. Sensitivity, specificity, predictive values, areas under the receiver operating characteristic curves (AUCs), and Cohen κ were determined. Results In patients with rectal contrast agent administration (n = 151), AUCs were 0.90-0.91, which indicated excellent accuracy. Trajectory was sensitive (88%-91%). For single wounds (n = 104), sensitivity of trajectory was 96% for both readers, but was only 80% for multiple wounds (n = 47). Contrast agent leak was highly specific (96%-98%), but insensitive (42%-46%). Improved diagnostic performance was observed in patients with poor colonic distension or opacification. Accuracy remained high (AUC, 0.86-0.99) in the group without rectal contrast agent administration (n = 31). Conclusion Trajectory had excellent sensitivity, while rectal contrast agent leak was specific but insensitive. Sensitivity of trajectory was lower for multiple wounds. Accuracy remained high in patients without rectal contrast agent administration. © RSNA, 2016.

  16. Injuries to the colon from blast effect of penetrating extra-peritoneal thoraco-abdominal trauma.

    Science.gov (United States)

    Sharma, Om P; Oswanski, Michael F; White, Patrick W

    2004-03-01

    Although rare, blast injury to the intestine can result from penetrating thoraco-abdominal extra-peritoneal gunshot (and shotgun) wounds despite the absence of injury to the diaphragm or to the peritoneum. Injuries of the spleen, small intestine and the mesentery by this mechanism have been previously reported in the world literature. This paper reports the first two cases of non-penetrating ballistic trauma to the colon.

  17. Deep penetrating brain injury with 20 years asymptomatic survival. Case report

    International Nuclear Information System (INIS)

    Buczek, M.; Pieninski, A.

    1993-01-01

    Authors report the case of penetrating injury of the head with large metallic fragment embedded to the brain with 20 years asymptomatic survival. Patient sustained head injury during work, 20 years ago and for these period of time was not aware of having foreign body intracranially with excellent general condition and no signs of neurological deficit. Metal nail was detected incidentally by plain skull X-ray films( and subsequent CT scan) during routine procedures when patient was admitted for surgical procedure. In our opinion presented case is uncommon because of asymptomatic course. Most of penetrating head injuries are considered as life threatening due to sudden onset, severe general patient condition and possible deterioration according to the type of injury and extent of cerebral destruction. For those reasons earliest possible neurosurgical treatment is recommended. We emphasize the role of debridement for most of brain penetration injuries. (author)

  18. Penetrating abdominal injuries in children: a study of 33 cases

    African Journals Online (AJOL)

    etiology, principles of management and outcome of children with ... injury, time of presentation to the Accident and Emergency ... accidents, sports and occupational and recreational ..... of severe firearm injury among children and youth.

  19. Penetrating bladder trauma: a high risk factor for associated rectal injury.

    Science.gov (United States)

    Pereira, B M; Reis, L O; Calderan, T R; de Campos, C C; Fraga, G P

    2014-01-01

    Demographics and mechanisms were analyzed in prospectively maintained level one trauma center database 1990-2012. Among 2,693 trauma laparotomies, 113 (4.1%) presented bladder lesions; 51.3% with penetrating injuries (n = 58); 41.3% (n = 24) with rectal injuries, males corresponding to 95.8%, mean age 29.8 years; 79.1% with gunshot wounds and 20.9% with impalement; 91.6% arriving the emergence room awake (Glasgow 14-15), hemodynamically stable (average systolic blood pressure 119.5 mmHg); 95.8% with macroscopic hematuria; and 100% with penetrating stigmata. Physical exam was not sensitive for rectal injuries, showing only 25% positivity in patients. While 60% of intraperitoneal bladder injuries were surgically repaired, extraperitoneal ones were mainly repaired using Foley catheter alone (87.6%). Rectal injuries, intraperitoneal in 66.6% of the cases and AAST-OIS grade II in 45.8%, were treated with primary suture plus protective colostomy; 8.3% were sigmoid injuries, and 70.8% of all injuries had a minimum stool spillage. Mean injury severity score was 19; mean length of stay 10 days; 20% of complications with no death. Concomitant rectal injuries were not a determinant prognosis factor. Penetrating bladder injuries are highly associated with rectal injuries (41.3%). Heme-negative rectal examination should not preclude proctoscopy and eventually rectal surgical exploration (only 25% sensitivity).

  20. Perioperative Care for Pediatric Patients With Penetrating Brain Injury: A Review.

    Science.gov (United States)

    Mikhael, Marco; Frost, Elizabeth; Cristancho, Maria

    2017-05-19

    Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury. PBI was one of the exclusion criteria in the second edition of guidelines for the acute medical management of severe TBI in infants, children, and adolescents that was published in 2012 (it is referred to as "pediatric guidelines" in this review). Many reviews of TBI do not differentiate between the mechanisms of injury. We present an overview of PBI, its presenting features, epidemiology, and causes as well as an analysis of case series and the conclusions that may be drawn from those and other studies. More clinical trials specific to penetrating head injuries in children, focusing mainly on pathophysiology and management, are needed. The term PBI is specific to penetrating injury only, whereas TBI, a more inclusive term, describes mainly, but not only, blunt injury.

  1. Disabling Orthostatic Headache after Penetrating Stonemason Pencil Injury to the Sacral Region

    Directory of Open Access Journals (Sweden)

    Carlo Brembilla

    2015-01-01

    Full Text Available Penetrating injuries to the spine, although less common than motor vehicle accidents and falls, are important causes of injury to the spinal cord. They are essentially of two varieties: gunshot or stab wounds. Gunshot injuries to the spine are more commonly described. Stab wounds are usually inflicted by knife or other sharp objects. Rarer objects causing incidental spinal injuries include glass fragments, wood pieces, chopsticks, nailguns, and injection needles. Just few cases of penetrating vertebral injuries caused by pencil are described. The current case concerns a 42-year-old man with an accidental penetrating stonemason pencil injury into the vertebral canal without neurological deficit. After the self-removal of the foreign object the patient complained of a disabling orthostatic headache. The early identification and treatment of the intracranial hypotension due to the posttraumatic cerebrospinal fluid (CSF sacral fistulae were mandatory to avoid further neurological complications. In the current literature acute pattern of intracranial hypotension immediately after a penetrating injury of the vertebral column has never been reported.

  2. Penetrating abdomino-thoracic injury with an iron rod: An anaesthetic challenge

    Directory of Open Access Journals (Sweden)

    Kiranpreet Kaur

    2014-01-01

    Full Text Available Penetrating abdomino-thoracic injuries are potentially life-threatening due to the associated haemorrhagic shock and visceral injury. The management of these injuries poses specific challenges in pre-hospital care, transport, and management strategies. We report a 35-year-old male having impalement injury of the left thorax and left upper arm with a metallic rod used for construction of the house after a fall from height. One rod penetrated thorax from left shoulder and exit point was present just above the iliac crest and second rod was seen piercing left upper arm. Patient was successfully managed without any intraoperative, post-operative surgical complications, neurological damage or permanent injuries.

  3. Management of penetrating colon and rectal injuries in the pediatric patient.

    Science.gov (United States)

    Haut, Elliott R; Nance, Michael L; Keller, Martin S; Groner, Jonathan I; Ford, Henri R; Kuhn, Ann; Tuchfarber, Barbara; Garcia, Victor; Schwab, C William; Stafford, Perry W

    2004-09-01

    Management of civilian penetrating colon injuries in the adult has evolved from the universal use of fecal diversion to the highly selective use of colostomy. We hypothesized that a similar management approach was appropriate for the pediatric population. A retrospective review of pediatric patients (age trauma centers for the period January 1990 through June 2001. For the period of review, 53 children with a penetrating colorectal injury were identified. Firearms caused 89 percent of the injuries. The colon was injured in 83 percent (n = 44) of patients and the rectum in 17 percent (n = 9) of patients. The colorectal injury was managed without colostomy in 62 percent (n = 33) and with colostomy in 38 percent (colon = 11, rectum = 9). All rectal injuries were treated with colostomy. The hospital length of stay was longer in the colostomy group (17.6 days vs. 11.4 days). The complication rate was higher in the colostomy group (55 percent vs. 27 percent), which included two patients with stoma-related complications. There was no mortality in this series. Primary repair was used safely in most cases of civilian penetrating colon injuries in the pediatric population. All rectal injuries were treated with colostomy in this series. Fecal diversion was used selectively. Colostomy was performed for selected cases of colon wounds associated with shock, multiple blood transfusions, multiple other injuries, extensive contamination, and high-velocity weapons. In the absence of these associated factors, primary repair appears justified.

  4. Outcome of penetrating chest injuries in an urban level I trauma center in the Netherlands.

    Science.gov (United States)

    Heus, C; Mellema, J J; Giannakopoulos, G F; Zuidema, W P

    2015-04-25

    Most patients with penetrating chest injuries benefit from early treatment with chest tube drainage or surgery. Although penetrating chest injury is not uncommon, few descriptive studies are published, especially in Europe. The aim of this study was to review our experience and further improve our management of penetrating chest injuries in a level I trauma center in the Netherlands. All patients with penetrating chest injury between August 2004 and December 2012 were included. Demographics, mechanism of injury, physiological parameters, Injury Severity Scores (ISS), surgical and non-surgical treatment, length of intensive care unit (ICU) stay, length of hospital stay (LOS), complications and rate of mortality were collected. A total of 159 patients were analyzed. Patients included 116 (73 %) stab wounds and 34 (21 %) gunshot wounds. In 27 patients (17 %), cardiac injury was seen. The mean ISS was 12. Almost half of all patients (49 %) were treated with only chest tube drainage. Alternatively, surgical treatment was performed in 24 % of all cases. Anterolateral incision was most frequently used to gain access to the thoracic cavity. The mean LOS was 9 days. Among all patients, 17 % were admitted to the ICU with a mean stay of 3 days. In 18 (11 %) patients, one or more complications occurred. The 30-day mortality was 7.5 %. Patients presenting with penetrating chest injury are not uncommon in the Netherlands and can mostly be treated conservatively. In one-fourth of the patients, surgical treatment is performed. A structural and vigorous approach is needed for good clinical outcome.

  5. Subcutaneous emphysema of the upper extremity following penetrating blackthorn injury to the wrist.

    LENUS (Irish Health Repository)

    Tiong, W H C

    2009-02-01

    SUMMARY: Noninfective subcutaneous emphysema of the upper extremity, albeit rare, has to be borne in mind when treating patients with subcutaneous emphysema. The misdiagnosis of this condition as its serious infective counterpart often leads to unnecessary aggressive treatment. Noninfective subcutaneous emphysema often accompanies a patient who has no systemic symptoms of illness. Unfortunately, the distinction is not always easy especially when history of injury suggests involvement of an infective or reactive element. Penetrating blackthorn injury is common, especially in rural communities, and often occurs from farming or gardening activities. Blackthorn penetration can cause numerous tissue reactions once embedded under the skin and they are often contaminated with soil. Here we present, for the first time, a case where penetrating blackthorn injury to the wrist resulted in noninfective subcutaneous emphysema involving the whole upper limb and neck, and its subsequent management.

  6. Pediatric gunshot penetrating head injury: a case report with 2-year follow-up

    OpenAIRE

    Steven Tandean; Marsal Risfandi; Iskandar Japardi

    2018-01-01

    Gunshot is a rare subset of penetrating head injury, and generally the victim dies before arriving at the hospital. This paper reported a case of an intracranial gunshot injury in a 12 year-old boy that was shot by his friend, whose primary intention was to play around, using a revolver. A missile projectile penetrated from mid frontal and came out from right occipital. Vital signs were stable with GCS 8 from physical examination. A rational management strategy should permit a good outcome. T...

  7. Illustrating Pathologies in the First Years of the Miscellanea Curiosa, 1670-1687.

    Science.gov (United States)

    Conforti, Maria

    2015-01-01

    The Miscellanea Curiosa, sive Ephemeridum Medico-Physicarum Germanicarum, the learned periodical published in different German cities under the aegis of the Academia Leopoldina Naturae Curiosorum, contained many cases of an anatomical nature. The Miscellanea Curiosa in its first years actively participated in the development of anatomia practica, the anatomical practice of observing the signs of diseases in cadavers and connecting them to what had been observed at the bedside. The illustrations that accompanied the post-mortem reports published in the Miscellanea Curiosa allow one to assess the evolution of the pathological illustration itself. This article is thus intended to serve as a contribution to the rediscovery of the origins of this visual genre. A learned journal like the Miscellanea Curiosa, which appeared regularly, provided an ideal venue for the process of accumulating, cross-referencing and--in the final analysis--selecting, serializing and systematizing the knowledge that would form the foundations of modern pathology, by providing a wealth of evidence and images observed at the dissection table.

  8. Tea Cup in the brain, a rare case of penetrating brain injury in pediatric patient

    Directory of Open Access Journals (Sweden)

    Sharma Arvind

    2016-03-01

    Full Text Available Head injuries are very common in children. All over the world, the most common mechanism is fall. These injuries are more prevalent in developing countries due to lack of education, poverty, lack of standard and scientific ways to child upbringing. Penetrating injuries in pediatric patients is extremely uncommon and usually occur due to sharp objects like knife, screw driver, drills, nails. We are reporting a rare case of a child with penetrating head injury due to tea cup, very commonly used crockery in every house hold. To the best of our knowledge, no similar case has ever been reported in world literature. Our case also emphasized the need for educating people about child care.

  9. Penetrating injury caused by the gear pedal of a motor-cycle ...

    African Journals Online (AJOL)

    This is a case of a penetrating injury to the left lower extremity caused by the gear pedal of a motor-cycle that pierced through the foot of one of the 3 passengers on a motor-cycle involved in a road traffic accident. He had no neurovascular injury but was found radiologically to have an ipsilateral tibia fracture. The object was ...

  10. Characterization and Application of a Large Animal Model of Penetrating Ballistic Brain Injury (PBBI)

    Science.gov (United States)

    2012-03-01

    Jump, South American Track and Field Grand Prix. Cuenca, Ecuador , 2004. - Goodwill Ambassador, Ministry of Tourism of Ecuador . Quito, Ecuador , 2000...they only comprise 11.5% of all-cause injury deaths and have a case fatality rate (CFR) of less than 1% [33]. In contrast, penetrating TBIs due to...because many cases of mild closed TBI are not detected post-injury and because the bodily distribution of wounds for all combat casualties (e.g. Wounded In

  11. Syringe needle skull penetration reduces brain injuries and secondary inflammation following intracerebral neural stem cell transplantation

    OpenAIRE

    Gao, Mou; Dong, Qin; Zhang, Hongtian; Yang, Yang; Zhu, Jianwei; Yang, Zhijun; Xu, Minhui; Xu, Ruxiang

    2017-01-01

    Intracerebral neural stem cell (NSC) transplantation is beneficial for delivering stem cell grafts effectively, however, this approach may subsequently result in brain injury and secondary inflammation. To reduce the risk of promoting brain injury and secondary inflammation, two methods were compared in the present study. Murine skulls were penetrated using a drill on the left side and a syringe needle on the right. Mice were randomly divided into three groups (n=84/group): Group A, receiving...

  12. Penetrating pancreatico-duodenal injuries: a 2-year experience at cmh peshawar

    International Nuclear Information System (INIS)

    Bashir, R.A.; Qasmi, S.A.; Waqas, A.

    2012-01-01

    Objective: To outline the various treatment options and outcomes in penetrating pancreatico-duodenal injuries with emphasis on the operative decision making strategies. Study Design: Descriptive study. Place and Duration of Study: Department of Surgery at Combined Military Hospital Peshawar, from 1st June 2008 to 30th May 2010. Patients and Methods: All combat casualties with penetrating pancreaticoduodenal injuries (PPDI) received in 'Emergency reception' of Combined Military Hospital, Peshawar were included. Data was taken from the patients medical charts and by personal evaluation and entered in a proforma. The variables used were age, sex, cause of the injury, haemo-dynamic status, conscious level, intensive care treatment duration, time to initial exploration, associated injury, grade of pancreatic injury according to Penetrating Abdominal Trauma Index (PATI) scoring system, grade of duodenal injury (according to PATI scoring system), total PATI score, operative repair, total hospital stay, morbidity, and mortality. Results: Twenty three patients having either or both of PPDI were included in the study out of 196 combat casualities. No case was excluded on basis of presence of associated injury. Mean age was 29.26 years (SD+-6.489) with only one (4.3%) case of female gender, the rest were male patients or soldiers. Nineteen (82.6%) cases had primary mechanism/cause of injury being splinters from Improvised Explosive Devices (IEDs) or bomb blasts; while 4 (17.4%) cases had Gunshot Wounds. Eighteen (78.3%) patients were haemo-dynamically stable on arrival while 5 (21.7%) patients were unstable. Mean duration of stay in hospital was 10.6 days, with a range of 1-19 days (cases with high PATI score and un-stable haemodynamic status died with-in 24 hrs). Most cases of pancreatico-duodenal injury were of mild severity i.e. grade-1 or 2 and we encountered no case of grade-5 PPDI. Most commonly occurring associated injury was to small gut. Overall mortality was 6 (26

  13. Penetrating Ocular Injuries in Pediatric Age Group in a Rural Area of ...

    African Journals Online (AJOL)

    Penetrating injury is defined as a single full thickness laceration of the eyeball usually caused by a sharp object. ... common cause of mono-ocular preventable blindness in pediatric age group. The three ... the eye was done using the torch light, slit lamp, direct, and indirect ... All patients were given tetanus toxoid 0.5 mL.

  14. Penetrating Maxillary Sinus Injury With Loss Of Vision Caused By An ...

    African Journals Online (AJOL)

    Good visual outcome following ocular emergencies will depend on prompt presentation, recognition and assessment as well as initial management. Penetrating injury of the orbit involving paranasal sinuses with retained foreign body in the orbito-maxillary region are uncommon.Thirty to fifty percent of all ocular traumas are ...

  15. Management of a Low-Energy Penetrating Brain Injury Caused by a Nail

    Directory of Open Access Journals (Sweden)

    V. R. Ferraz

    2016-01-01

    Full Text Available Low-energy penetrating nail injury to the brain is an extremely rare neurosurgical emergency. The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal hemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision. We report a rarely described neurosurgical approach for removal of a penetrating nail from the brain and skull without evidence of associated hematoma and other brain lesions.

  16. Dealing with the Surgical and Medical Challenges of Penetrating Brain Injuries

    Directory of Open Access Journals (Sweden)

    Nikolaos Syrmos

    2013-01-01

    Full Text Available Peacetime has reduced the overall incidence of penetrating brain injuries (PBI, and those related to missile penetration are not common anymore at least in western countries. Nevertheless, PBI still occur, and car crashes or work accidents are their main causes. The management of such cases is characterized by many challenges, not only from a surgical and medical point of view, but also for the different and sometimes bizarre dynamics by which they present. Herein we report an unusual deep penetrating brain injury, due to a high-energy crash against a metallic rod in a construction site, with a good surgical outcome despite dramatic clinical conditions on admission. A discussion of the surgical results and functional outcome related to PBI, as found in the English medical literature, is provided. Moreover the most common postoperative complications along with the diagnostic flow charts and therapeutic options useful to prevent inappropriate treatment are highlighted.

  17. Usefulness of routine computed tomography in the evaluation of penetrating war injuries to the chest.

    Science.gov (United States)

    Darwish, Bassam; Mahfouz, Mohammad Z; Izzat, Mohammad Bashar

    2018-05-02

    This review was conducted to compare the contributions of chest X-ray (CXR) and computed tomography (CT) towards detecting intrathoracic damage in patients with penetrating war injuries to the chest and to determine whether identification of additional injuries by chest CT will have an impact on the choice of therapeutic interventions and clinical outcomes. We reviewed records of 449 patients (374 men, mean age 29.3 ± 14.8 years) who were admitted to our hospital with penetrating war injuries to the chest over a 7-year period. Collected data included mechanisms of injury, associated injuries, results of CXRs and chest CTs, methods of management, in-hospital stays, complications and mortalities. Immediate screening CXRs were obtained in all patients not requiring emergent thoracotomies, of which 91.4% showed positive signs of injury. Chest CTs were performed at the discretion of the physicians in 49.4% of patients, and CXR-positive findings were confirmed in all cases, while revealing additional injuries in 11% of patients. Chest CT findings led to additional closed chest drainage in 5.6% of patients but had no impact on treatment strategy in 94.4% of scanned patients. Follow-up CXRs showed new positive findings in 22 patients, leading to additional closed chest drainage in 3 patients and delayed open thoracotomies in 7 other patients. CXRs continue as the primary diagnostic modality in the assessment of patients with penetrating war injuries to the chest. Chest CTs can be omitted in most patients, thus reducing CT imaging case-load substantially, while most clinically significant chest injuries remain sufficiently recognized.

  18. Use of Sengstaken-Blakemore intrahepatic balloon: an alternative for liver-penetrating injuries.

    Science.gov (United States)

    Fraga, Gustavo Pereira; Zago, Thiago Messias; Pereira, Bruno Monteiro; Calderan, Thiago Rodrigues Araujo; Silveira, Henrique Jose Virgili

    2012-09-01

    Severe lesions in the liver are associated with a high mortality rate. Alternative surgical techniques such as the use of an intrahepatic balloon may be effective and reduce mortality in severe hepatic lesions. This study aimed to demonstrate the experience of a university hospital in the use of the Sengstaken-Blakemore balloon in patients with transfixing penetrating hepatic injury as an alternative way to treat these challenging injuries. A retrospective study based on the trauma registry of a university hospital was performed. All patients admitted with hepatic penetrating injuries and treated with the Sengstaken-Blakemore balloon within the period 1990-2010 were reviewed. Forty-six patients with transfixing hepatic injuries were treated with the Sengstaken-Blakemore balloon in the study period. The most frequent cause of injury was gunshot wound (87 % of the patients). The mean trauma scores on admission were Revised Trauma Score (RTS) = 7.12 ± 1.46, Injury Severity Score (ISS) = 22.4 ± 9.7, and Abdominal Trauma Index (ATI) = 19.5 ± 11. According to the severity of the hepatic trauma, 71.8 % of patients had grade III, 23.9 % grade IV, and 4.3 % grade V injuries. Associated abdominal injuries were found in 89.1 % of the patients. The most frequent liver-related complications were hepatic abscess postoperative bleeding (8.6 %), biliary fistula (8.6 %), (4.3 %), and biliary peritonitis (2.1 %). Surgical reintervention was necessary in 14 patients (31.1 %). From those 14, only 3 had the balloon removed. The overall morbidity and mortality rates were 56.5 % and 23.9 % (11 patients), respectively. The knowledge of alternative surgical techniques is essential in improving survival in patients with severe penetrating hepatic injuries. The use of intrahepatic balloon is a viable surgical strategy.

  19. Roentgenologic findings of non-penetrating extracardiac chest injuries

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Duck; Ra, Woo Youn [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    1975-06-15

    Of the conventional P-A and A-P chest films which have been studied, many roentgenologic signs suggested for chest trauma. In the present study, an effort was designated to further clarify the x-ray findings of the nonpenetrating extracardiac chest injuries and to observe the x-ray findings being a leading maneuver of surgical procedure. Fat embolism and shock lung must be kept in mind on follow up films. The results thus obtained are summarized as follows; 1. Most of cases are visualized between the age of 10 and 50 and more common in male. 2. The denoting rib fracture, hemopneumothorax, and lung contusion are direct roentgenologic signs. 3. In case of serious result which showed pulmonary edema pattern on conventional chest films, we thought fat embolism or shock lung to be the cause of death.

  20. Penetrating Bihemispheric Traumatic Brain Injury: A Collective Review of Gunshot Wounds to the Head.

    Science.gov (United States)

    Turco, Lauren; Cornell, David L; Phillips, Bradley

    2017-08-01

    Head injuries that cross midline structures of the brain are bihemispheric. Other terms have been used to describe such injuries, but bihemispheric is the most accurate and should be standard nomenclature. Bihemispheric head injuries are associated with greater mortality and morbidity than other penetrating traumatic brain injuries (TBIs). Currently, there is a tendency to manage severe gunshot wounds (GSWs) to the head nonoperatively, despite reports of improved outcome in military patients treated aggressively. Thus, controversy exists in the management of civilian TBI. PubMed was searched for query terms, and PRISMA guidelines were used. Studies were selected by relevance and inclusion of data regarding etiology, diagnosis, and management of bihemispheric TBI. Case reports, studies not in English, and records lacking information on mechanism or bihemispheric injuries were excluded. Thirteen studies were included and most contained level IV evidence. The mean mortality rate of all head GSWs was 62% in adults and 32% in children. Bihemispheric GSWs had greater mortality rates of 82% in adults and 60% in children. There was a larger proportion of self-inflicted injury in studies with greater rates of bihemispheric injuries. Bihemispheric injuries have greater mortality rates than other penetrating TBI. Violation of midline brain structures such as the diencephalon and mesencephalon, increased rate of self-inflicted wounds, and lack of a standard management algorithm may increase the lethality of these injuries. Although bihemispheric injuries historically have been considered nonsalvageable, an aggressive surgical approach has been shown to improve outcomes, particularly in the military population. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. A ten-year study of penetrating injuries of the colon.

    Science.gov (United States)

    Adesanya, Adedoyin A; Ekanem, Ekanem E

    2004-12-01

    Colon injury has been associated with a high risk of septic complications and mortality. We prospectively studied the pattern, management, outcome, and prognostic factors in patients who sustained penetrating colon injuries. Sixty patients who presented to our hospital with penetrating colon injuries over a ten-year period (1992 to 2001) were studied. Colon wounds were caused by gunshots in 55 (91.7 percent) patients and knife stabs in 5 (8.3 percent). There was a delay of more than 12 hours before laparotomy in 30 (50 percent) patients. Moderate or major fecal contamination of the peritoneal cavity occurred in 58 (96.7 percent) patients. The average penetrating abdominal trauma index score was 25.9 and 20 (33.3 percent) patients sustained Flint Grade 3 colon injury. Associated intra-abdominal injuries occurred in the small bowel (73.3 percent), liver (25 percent), stomach (23.3 percent), and mesentery (16.7 percent). Right colon wounds (35) were managed by primary repair in 24 (68.6 percent) patients and proximal diverting colostomy in 11 (31.4 percent), whereas left colon wounds (25) were managed by diverting colostomy in 22 (88.0 percent) patients and primary repair in 3 (12.0 percent) patients. Common complications included wound infection (56.7 percent), septicemia (31.7 percent), and enterocutaneous fistula (16.7 percent). The overall mortality rate was 33.3 percent and colon injury-related mortality was 21.7 percent. Presence of destructive colon injury was associated with a greater than fourfold increased incidence of death. Other significant risk factors included shock on admission, major fecal contamination, duration of operation more than four hours, penetrating abdominal trauma index score >25, and more than two postoperative complications. There was no difference in outcome between patients who had primary repair and those undergoing diverting colostomy. Colostomy closure-related morbidity was 21 percent and mortality was 5.3 percent. A more liberal

  2. Glucose and oxygen metabolism after penetrating ballistic-like brain injury

    Science.gov (United States)

    Gajavelli, Shyam; Kentaro, Shimoda; Diaz, Julio; Yokobori, Shoji; Spurlock, Markus; Diaz, Daniel; Jackson, Clayton; Wick, Alexandra; Zhao, Weizhao; Leung, Lai Y; Shear, Deborah; Tortella, Frank; Bullock, M Ross

    2015-01-01

    Traumatic brain injury (TBI) is a major cause of death and disability in all age groups. Among TBI, penetrating traumatic brain injuries (PTBI) have the worst prognosis and represent the leading cause of TBI-related morbidity and death. However, there are no specific drugs/interventions due to unclear pathophysiology. To gain insights we looked at cerebral metabolism in a PTBI rat model: penetrating ballistic-like brain injury (PBBI). Early after injury, regional cerebral oxygen tension and consumption significantly decreased in the ipsilateral cortex in the PBBI group compared with the control group. At the same time point, glucose uptake was significantly reduced globally in the PBBI group compared with the control group. Examination of Fluorojade B-stained brain sections at 24 hours after PBBI revealed an incomplete overlap of metabolic impairment and neurodegeneration. As expected, the injury core had the most severe metabolic impairment and highest neurodegeneration. However, in the peri-lesional area, despite similar metabolic impairment, there was lesser neurodegeneration. Given our findings, the data suggest the presence of two distinct zones of primary injury, of which only one recovers. We anticipate the peri-lesional area encompassing the PBBI ischemic penumbra, could be salvaged by acute therapies. PMID:25669903

  3. Laparoscopic repair of penetrating injury of the diaphragm: an experience from a district hospital

    Directory of Open Access Journals (Sweden)

    Ali Yahya

    2008-01-01

    Full Text Available In this study we review our experience in using laparoscopy as a diagnostic and therapeutic tool in dealing with penetrating diaphragmatic injuries due to stab wounds and look at the feasibility of using this procedure in other similar institutions.Thirty patients, all of whom were males 20-30 years of age, presented to the surgical emergency unit of our hospital with upper abdominal and lower chest wall stab wounds between 01-05-1998 and 30-11-2006. Diagnosis of the diaphragm injury was either obvious with omentum herniating through the chest wall, or occult with confirmation of the injury at laparoscopy.All patients underwent diagnostic laparoscopy, which resulted in identification and efficient treatment of eight patients with diaphragmatic injury, and thereby laparotomy was avoided. The procedure converted to open surgery in one patient because of a small left-sided colonic tear. Laparoscopy is an efficient tool for the diagnosis and management of diaphragmatic injuries. It should be used routinely instead of exploratory laparotomy in haemodynamically stable patients with penetrating lower chest injuries.

  4. Penetrating Obturator Artery Injury after Gunshot Wounds: A Successful Multidisciplinary Trauma Team Approach to a Potentially Lethal Injury.

    Science.gov (United States)

    Maraqa, Tareq I; Shin, Ji-Sun J; Diallo, Ismael; Sachwani-Daswani, Gul R; Mercer, Leo C

    2017-11-17

    Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A  23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries. The patient underwent a successful coil-embolization of the right OA. Given the density of structures within the pelvis, patients who sustain gunshot wounds to the pelvic region are at high risk for injury to the small bowel, sigmoid colon, rectum, bladder, and/or vascular structures. While bleeding is the major cause of early mortality in PT, rectal injuries carry the highest mortality due to visceral injuries. A high clinical index of suspicion is needed to diagnose an iliac artery injury or injury to its branches. Prompt computed tomographic angiogram (CTA) and embolization of the OA is the best method to control and stop the bleeding and improve the mortality outcome. Clinicians caring for patients presenting with pelvic gunshot wounds should pay attention to the delayed presentation of internal hemorrhage from the OAs. A multidisciplinary team approach is crucial in the successful management of penetrating injuries to the obturator artery.

  5. Treatment of penetrating hepatic injuries: a retrospective analysis of 50 patients.

    Science.gov (United States)

    Gonullu, D; Koksoy, F N; Ilgun, S; Demiray, O; Yucel, O; Yucel, T

    2009-01-01

    The aim of this study was to determine the possibility of non-operative treatment via retrospective analysis of our patients. Fifty patients with penetrating hepatic injuries were examined retrospectively with respect to trauma scores, associated injuries, complications, and mortality parameters. Thirteen injuries were caused by firearms, whereas 37 injuries were caused by stab wounds. Forty-three patients (86%) underwent laparotomy and 7 patients (14%) were monitored by CT and clinical findings (nonoperative group, NO group). The laparotomies were evaluated as non-therapeutic in 11 patients (22%) (NTL group) and therapeutic in 32 patients (64%) (TL group). The morbidity and mortality rates were 40 and 10%, respectively. RTS and ISS scores of the nonsurviving and the surviving patients were significantly different. The rates of major venous, grade IV-V hepatic injuries, and gunshot wounds were significantly higher in the nonsurviving patients when compared to the surviving patients. Major venous and grade IV-V hepatic injuries were the primary factors determining mortality and these injuries generally occurred as a result of firearm injuries. NTL occurring at a rate of 22% would decrease to 2% if 'RTS <7' criteria was added to the hemodynamic instability and/or peritoneal irritation findings determining surgical candidacy. Copyright 2009 S. Karger AG, Basel.

  6. Early surgical managment of penetrating ocular injuries involving the posterior segment.

    Science.gov (United States)

    Michels, R G

    1976-09-01

    Pars plana vitrectomy technic can be used in the early management of certain penetrating ocular injuries involving the posterior segment, including selected intraocular foreign bodies. This study reports the results of ten consecutive cases of intraocular foreign bodies in the posterior segment treated by a combination of vitrectomy (including lensectomy when necessary) and foreign-body extraction with forceps. The foreign body was successfully removed in nine of ten eyes, and nine of ten eyes were salvaged. This favorable experience using early vitreous surgery suggests that the vitrectomy technic can be used in other penetrating injuries involving the posterior segment that are not associated with intraocular foreign bodies. Possible indications for early vitrectomy are presented, including cases with a poor prognosis when managed by conventional methods.

  7. Multiple-Projectile Penetrating Neck Injury from a Modified Nail-Containing Gas Pistol

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    Dimitar Dimitrov Pazardzhikliev

    2014-09-01

    Full Text Available Background: Penetrating neck injuries result from missiles and stab wounds. A gas pistol is a non-lethal weapon for self-defence. Case Report: We present a case where the use of a modified gun led to multiple injuries in a single shot. Four projectiles were embedded in the neck, one in the larynx and three in the cervical spine. The first was removed via a combined external and endoscopic approach, while the rest were put on follow-up. Conclusion: The reported case shows that damage from modified gas pistols, although rarely life threatening, may cause long term discomfort and diminished quality of life.

  8. Penetrating head injury with bilateral eye avulsion due to Himalayan bear bite.

    Science.gov (United States)

    Roka, Yam B; Roka, Narayani; Shrestha, Manzil; Puri, Puspa R; Adhikari, Hari B

    2012-12-01

    The Himalayan black bear (Ursus thibetanus or Selenarctos thibetanus), although an omnivore, is more carnivorous than its American counterpart. It is also more aggressive towards humans and is a threatened species because of the deforestation in the Himalayas. Furthermore, poverty, encroachment of the forest, extensive deforestation, lack of education and living near the forest are factors that increase the probability of such animal injuries. We report the case of a 35-year-old woman who suffered a severe penetrating head injury with scalp and bilateral eye avulsion, which was managed successfully. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  9. Is non-operative approach applicable for penetrating injuries of the left thoraco-abdominal region?

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    Osman Kones

    2016-03-01

    Full Text Available Objectives: Currently, diagnostic laparoscopy (DL is recommended for the left thoraco-abdominal region penetrating injuries (LTARP. However, organ and diaphragmatic injury may not be detected in all of these patients. Our aim is to focus on this LTARP patient group without any operative findings and to highlight the evaluation of diagnostic tools in the high-tech era for a possible selected conservative treatment. Material and methods: The patients who were admitted to ED due to LTARP, and who underwent routine DL were evaluated retrospectively in terms of demographic, clinical, radiological, and operative findings of the patients. Results: The current study included 79 patients with LTARP. In 44 of 79 patients, abdominal injury was not detected. In 30 patients an isolated diaphragmatic injury was revealed and in 4 patients a visceral injury was accompanying to diaphragmatic injury. Surgical findings revealed that the diaphragm was the organ most likely to sustain injury. In patients with more than one positive diagnostic findings need for surgery rate was 61.5%, however; in patients with one positive diagnostic finding (n = 53, positive surgical finding rate was only 35.8%, (p = 0.03. Regarding the combined use of all diagnostic tools in these patients; such as physical examination, plain chest X-ray, and computed tomography, when this method was used for pre-operative diagnosis, sensitivity was measured as 82.7%, specificity 84.1%, PPV 77.4% and NPV 88.1%. Conclusion: Although DL is reliable for diagnosis of diaphragmatic and visceral injury in patients with LTARP. However, individual decision making for laparoscopic intervention is needed to prevent morbidity of an unnecessary operation under emergent setting due to high rates of negative intraabdominal findings. Keywords: Wounds penetrating, Physical examination, Diagnostic imaging, Treatment outcome

  10. Intraocular eyelashes and iris cyst in anterior chamber following penetrating eye injury: a case report

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    Sahu S

    2017-03-01

    Full Text Available Sabin Sahu,1 Lila Raj Puri,1 Sanjay Kumar Singh2 1Department of Ophthalmology, Sagarmatha Choudhary Eye Hospital, Lahan, Siraha, 2Department of Ophthalmology, Biratnagar Eye Hospital, Biratnagar, Nepal Background: The presence of intraocular eyelashes following penetrating eye injury or ocular surgery is relatively uncommon. The response of the eye to intraocular eyelashes is variable. The eyelash may be symptomatic or may remain asymptomatic for long periods. Objective: We report a case with two intraocular eyelashes and an iris cyst after 2 years of asymptomatic period following penetrating eye injury. Case presentation: A 24-year-old male presented with decreased vision in the left eye which he had noticed for the previous 2 weeks. His visual acuity was 6/6 in the right eye and 6/18 in the left eye, improving to 6/9 with -2.5 DC × 140° correction. The intraocular pressure was 12 mmHg in both eyes. On slit-lamp examination, the left eye showed 8 mm linear peripheral corneal opacity nasally, two eyelashes in the superior anterior chamber, and an iris cyst measuring 4 mm × 4 mm in the superior iris. The right eye was normal. Dilated fundus examination of both eyes was normal. The eyelashes and cyst were removed surgically. There were no complications during the 3-month follow-up period. Conclusion: Intraocular implantation of eyelashes following penetrating eye injury can remain asymptomatic for long periods; however, late development of iris cyst may occur. Keywords: intraocular eyelashes, iris cyst, penetrating eye injury

  11. [Neuropsychological evaluation of a case of organic personality disorder due to penetrating brain injury].

    Science.gov (United States)

    Sanz de la Torre, J C; Pérez-Ríos, M

    1996-06-01

    In this paper, an organic personality disorder case by penetrating brain injury, predominantly localized in the right frontal lobe, is presented. Neuropsychological and neuroimaging (CT scan studies) were performed. We assessed the main cognitive aspect: orientation, attention, memory, intelligence, language, visual-spatial functioning, motor functioning, executive functioning and personality. The results obtained, point out disorders in the patient's behavior and in the executive functions. Likewise, other cognitive functions as: attention, memory, language and visual-spatial functioning, show specific deficits.

  12. Complications following blunt and penetrating injuries in 216 victims of chest trauma requiring tube thoracostomy.

    Science.gov (United States)

    Helling, T S; Gyles, N R; Eisenstein, C L; Soracco, C A

    1989-10-01

    Tube thoracostomy (TT) is required in the treatment of many blunt and penetrating injuries of the chest. In addition to complications from the injuries, TT may contribute to morbidity by introducing microorganisms into the pleural space or by incomplete lung expansion and evacuation of pleural blood. We have attempted to assess the impact of TT following penetrating and blunt thoracic trauma by examining a consecutive series of 216 patients seen at two urban trauma centers with such injuries who required TT over a 30-month period. Ninety-four patients suffered blunt chest trauma; 122 patients were victims of penetrating wounds. Patients with blunt injuries had longer ventilator requirements (12.6 +/- 14 days vs. 3.7 +/- 7.1 days, p = 0.003), longer intensive care stays (12.2 +/- 12.5 days vs. 4.1 +/- 7.5 days, p = 0.001), and longer periods of TT, (6.5 +/- 4.9 days vs. 5.2 +/- 4.5 days, p = 0.018). Empyema occurred in six patients (3%). Residual hemothorax was found in 39 patients (18%), seven of whom required decortication. Recurrent pneumothorax developed in 51 patients (24%) and ten required repeat TT. Complications occurred in 78 patients (36%). Patients with blunt trauma experienced more complications (44%) than those with penetrating wounds (30%) (p = 0.04). However, only seven of 13 patients developing empyema or requiring decortication had blunt trauma. Despite longer requirements for mechanical ventilation, intensive care, and intubation, victims of blunt trauma seemed to have effective drainage of their pleural space by TT without increased risk of infectious complications.

  13. Longitudinal Evaluation of Wound Healing after Penetrating Corneal Injury: Anterior Segment Optical Coherence Tomography Study.

    Science.gov (United States)

    Zheng, Kang Keng; Cai, Jianhao; Rong, Shi Song; Peng, Kun; Xia, Honghe; Jin, Chuan; Lu, Xuehui; Liu, Xinyu; Chen, Haoyu; Jhanji, Vishal

    2017-07-01

    Ocular imaging can enhance our understanding of wound healing. We report anterior segment optical coherence tomography (ASOCT) findings in penetrating corneal injury. Serial ASOCT was performed after repair of penetrating corneal injury. Internal aberrations of wound edges were labeled as "steps" or "gaps" on ASOCT images. The wound type was characterized as: type 1: continuous inner wound edge or step height ≤ 80 µm; type 2: step height > 80 µm; type 3: gap between wound edges; and type 4: intraocular tissue adherent to wound. Surgical outcomes of different wound types were compared. 50 consecutive patients were included (6 females, 44 males; mean age 33 ± 12 years). The average size of wound was 4.2 ± 2.6 mm (type 1, 8 eyes; type 2, 27 eyes; type 3, 12 eyes; type 4, 3 eyes). At the end of 3 months, 70% (n = 35) of the wounds were type 1. At the end of 6 months, all type 1 wounds had healed completely, whereas about half of type 2 (48.1%) and type 3 (50%) wounds had recovered to type 1 configuration. The wound type at baseline affected the height of step (p = 0.047) and corneal thickness at 6 months (p = 0.035). ASOCT is a useful tool for monitoring wound healing in cases with penetrating corneal injury. Majority of the wound edges appose between 3 and 6 months after trauma. In our study, baseline wound configuration affected the healing pattern.

  14. Syringe needle skull penetration reduces brain injuries and secondary inflammation following intracerebral neural stem cell transplantation.

    Science.gov (United States)

    Gao, Mou; Dong, Qin; Zhang, Hongtian; Yang, Yang; Zhu, Jianwei; Yang, Zhijun; Xu, Minhui; Xu, Ruxiang

    2017-03-01

    Intracerebral neural stem cell (NSC) transplantation is beneficial for delivering stem cell grafts effectively, however, this approach may subsequently result in brain injury and secondary inflammation. To reduce the risk of promoting brain injury and secondary inflammation, two methods were compared in the present study. Murine skulls were penetrated using a drill on the left side and a syringe needle on the right. Mice were randomly divided into three groups (n=84/group): Group A, receiving NSCs in the left hemisphere and PBS in the right; group B, receiving NSCs in the right hemisphere and PBS in the left; and group C, receiving equal NSCs in both hemispheres. Murine brains were stained for morphological analysis and subsequent evaluation of infiltrated immune cells. ELISA was performed to detect neurotrophic and immunomodulatory factors in the brain. The findings indicated that brain injury and secondary inflammation in the left hemisphere were more severe than those in the right hemisphere, following NSC transplantation. In contrast to the left hemisphere, more neurotrophic factors but less pro-inflammatory cytokines were detected in the right hemisphere. In addition, increased levels of neurotrophic factors and interleukin (IL)-10 were observed in the NSC transplantation side when compared with the PBS-treated hemispheres, although lower levels of IL-6 and tumor necrosis factor-α were detected. In conclusion, the present study indicated that syringe needle skull penetration vs. drill penetration is an improved method that reduces the risk of brain injury and secondary inflammation following intracerebral NSC transplantation. Furthermore, NSCs have the potential to modulate inflammation secondary to brain injuries.

  15. Tube pancreatico-duodenostomy for management of a severe penetrating pancreaticoduodenal injury.

    Science.gov (United States)

    Hatzigeorgiadis, Anestis; Boulas, Konstantinos A; Barettas, Nikolaos; Papageorgiou, Irene; Blouhos, Konstantinos

    2014-05-27

    Optimal management of penetrating pancreaticoduodenal injuries and better outcomes are associated with simple, fast damage control surgery and shorter operative time. The performance of pyloric exclusion and tube duodenostomy has markedly decreased. However, there is still a trend toward their performance in cases of delay duodenal repair or severe pancreaticoduodenal injury. The present report describes a case of a hemodynamically stable patient with a single penetrating gunshot trauma causing an AAST-OIS grade III pancreatic head injury and grade IV injury of the second portion of the duodenum. The patient was treated in our Level IV rural trauma center and submitted to primary closure of the posterolateral duodenal wall (the laceration of the contralateral inner medial duodenal wall could not be repaired), external duodenal and pancreatic drainage, and duodenal decompression by tube pancreatico-duodenostomy (insertion of a 18 Fr Foley catheter through the laceration of the pancreatic head toward the duodenal lumen), tube cholangiostomy, and pyloric exclusion accompanied with a feeding jejunostomy. Tube pancreatico-duodenostomy, which is described for the first time in the literature, turned out to be effective and can be considered as an option in pancreaticoduodenal trauma when the inner medial duodenal wall cannot be repaired.

  16. Factors affecting mortality after penetrating cardiac injuries: 10-year experience at urban level I trauma center.

    Science.gov (United States)

    Mina, Michael J; Jhunjhunwala, Rashi; Gelbard, Rondi B; Dougherty, Stacy D; Carr, Jacquelyn S; Dente, Christopher J; Nicholas, Jeffrey M; Wyrzykowski, Amy D; Salomone, Jeffrey P; Vercruysse, Gary A; Feliciano, David V; Morse, Bryan C

    2017-06-01

    Despite the lethality of injuries to the heart, optimizing factors that impact mortality for victims that do survive to reach the hospital is critical. From 2003 to 2012, prehospital data, injury characteristics, and clinical patient factors were analyzed for victims with penetrating cardiac injuries (PCIs) at an urban, level I trauma center. Over the 10-year study, 80 PCI patients survived to reach the hospital. Of the 21 factors analyzed, prehospital cardiopulmonary resuscitation (odds ratio [OR] = 30), scene time greater than 10 minutes (OR = 58), resuscitative thoracotomy (OR = 19), and massive left hemothorax (OR = 15) had the greatest impact on mortality. Cardiac tamponade physiology demonstrated a "protective" effect for survivors to the hospital (OR = .08). Trauma surgeons can improve mortality after PCI by minimizing time to the operating room for early control of hemorrhage. In PCI patients, tamponade may provide a physiologic advantage (lower mortality) compared to exsanguination. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Laparoscopic management of retroperitoneal injuries from penetrating abdominal trauma in haemodynamically stable patients.

    Science.gov (United States)

    Koto, Modise Zacharia; Matsevych, Oleh Y; Mosai, Fusi; Balabyeki, Moses; Aldous, Colleen

    2018-02-27

    Laparoscopy is increasingly utilised in the trauma setting. However, its safety and reliability in evaluating and managing retroperitoneal injuries are not known. The aim of this study was to analyse our experience with laparoscopic management of retroperitoneal injuries due to penetrating abdominal trauma (PAT) and to investigate its feasibility, safety and accuracy in haemodynamically stable patients. Over a 4-year period, patients approached laparoscopically with retroperitoneal injuries were analysed. Mechanism, location and severity of injuries were recorded. Surgical procedures, conversion rate and reasons for conversion and outcomes were described. Of the 284 patients with PAT, 56 patients had involvement of retroperitoneum. Stab wounds accounted 62.5% of patients. The mean Injury Severity Score was 7.4 (4-20). Among retroperitoneal injuries, the colon (27%) was the most commonly involved hollow viscera followed by duodenum (5%). The kidney (5%) and the pancreas (4%) were the injured solid organs. The conversion rate was 19.6% and was mainly due to active bleeding (73%). Significantly more patients with gunshot wound were converted to laparotomy (38% vs. 9%). Therapeutic laparoscopy was performed in 36% of patients. There were no recorded missed injuries or mortality. Five (9%) patients developed the Clavien-Dindo Grade 3 complications, three were managed with reoperation, one with drainage/debridement and one with endovascular technique. Laparoscopic management of retroperitoneal injuries is safe and feasible in haemodynamically stable patients with PAT. However, a high conversion rate indicates difficulties in managing these injuries. The requirements are the dexterity in laparoscopy and readiness to convert in the event of bleeding.

  18. Comparison of the effects of intravitreal bevacizumab and dexamethasone in experimental posterior penetrating eye injury

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    Ayse Oner

    2018-04-01

    Full Text Available AIM: To compare the effects of intravitreal anti-vascular endothelial growth factor (VEGF and dexamethasone in an experimental rabbit model of posterior penetrating ocular injury. METHODS: Thirty white New Zealand rabbits were included in the study. A posterior penetrating ocular injury was performed at the superotemporal quadrant. They were randomly divided into three groups. The rabbits in group 1 received intravitreal dexamethasone, in group 2 they received intravitreal bevacizumab and those in group 3 received intravitreal physiological saline solution in both eyes. All eyes were examined ophthalmologically on the 1st, 3rd, 7th, 14th and 28th days following the injury and the clinical findings were scored. On the day 28, the eyes were enucleated, evaluated and scored macroscopically, histopathologically and scanning electron microscopically. RESULTS: The median clinical score on the 14th and 28th days and the median macroscopic score of the dexamethasone group was significantly better than that of control (P=0.004, 0.018. Dexamethasone group was also better than that of bevacizumab group but the differences did not reach statistical significance. Retinal detachment rate was 8.3%, 16.6% and 12.5% in the dexamethasone group, bevacizumab group and control group, respectively (P=0.476. More extensive fibrocelluler proliferations were observed in controls compared with dexamethasone and bevacizumab groups. But these differences did not reach the statistical significance (P=0.538. In scanning electron microscopy all groups showed fibreous stalk and dense collagen fibrils in vitreous. CONCLUSION: This study shows that intravitreal injection of both dexamethasone and bevacizumab may reduce the intraocular fibrous proliferation after an experimental posterior penetrating ocular injury in rabbits.

  19. Management and outcome of low velocity penetrating head injury caused by impacted foreign bodies.

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    Moussa, Wael Mohamed Mohamed; Abbas, Mohamed

    2016-05-01

    Penetrating head injuries with impacted foreign bodies are rare, associated with a high incidence of morbidity and potentially life-threatening. In this study, we aimed at investigating the outcome of these cases as well as analyzing the factors affecting the prognosis. A retrospective study in which the records of 16 patients who had penetrating head injuries caused by low-velocity impacted foreign bodies were revised. All patients were males with a mean age of 28.9 years (range, 18 to 50 years). The follow-up period ranged from 4 to 13 months with a mean of 8.1 months. Causes of injury were construction accidents in 6 (37.5 %) patients, assault in 6 (37.5 %) and road traffic accidents in 4 (25 %). The impacted objects included a bar of iron, a piece of wood, a nail, a sickle and a piece of glass. Diagnostic computerized tomography (CT) of the brain was carried out on admission in all patients. Thirteen (81.3 %) patients were submitted to surgery, and all had the appropriate management in the form of antibiotics and dehydrating measures as required. The primary outcome measure was the Glasgow Outcome Scale (GOS) at the end of follow-up. At the end of follow-up, ten (62.5 %) patients had a GOS score of 5, two (12.5 %) patients had a score of 4, and four (25 %) patients had a score of 1. Low-velocity penetrating head injuries are most common in young adult males. With the appropriate management, a majority of even the most severe cases can have a favorable outcome.

  20. [Penetrating orbitocranial injury: a review of the literature and a case report of injury by a watercolor brush in a 3-year-old child].

    Science.gov (United States)

    Rzaev, D A; Danilin, V E; Letyagin, G V; Istomina, T K; Chishchina, N V

    We present a rare case of orbitocranial penetrating injury by a watercolor brush in a 3-year-old child. Injuries of this localization can affect important orbital structures (eyeball, blood vessels, nerves, muscles) and cause severe intracranial damages. In some cases, diagnosis of these injuries in children may be difficult due to the lack of marked clinical manifestations. The presented clinical case illustrates the approaches for choosing methods for diagnosis of injury in childhood and subsequent treatment options.

  1. Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body.

    Science.gov (United States)

    Nagpal, Manish; Chaudhary, Pranita; Jain, Ashish

    2018-01-01

    Intraocular foreign body (IOFB) in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.

  2. Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body

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    Manish Nagpal

    2018-01-01

    Full Text Available Intraocular foreign body (IOFB in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.

  3. Diagnostic accuracy of triple-contrast multi-detector computed tomography for detection of penetrating gastrointestinal injury: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Saksobhavivat, Nitima [Faculty of Medicine Ramathibodi Hospital, Mahidol University, Department of Diagnostic and Therapeutic Radiology, Ratchathewi, Bangkok (Thailand); Shanmuganathan, Kathirkamanathan; Boscak, Alexis R.; Sliker, Clint W.; Bodanapally, Uttam K.; Archer-Arroyo, Krystal; Miller, Lisa A.; Fleiter, Thorsten R.; Alexander, Melvin T.; Mirvis, Stuart E. [University of Maryland School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Baltimore, MD (United States); Stein, Deborah M.; Scalea, Thomas M. [University of Maryland School of Medicine, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States)

    2016-11-15

    Neither the performance of CT in diagnosing penetrating gastrointestinal injury nor its ability to discriminate patients requiring either observation or surgery has been determined. This was a prospective, single-institutional observational study of patients with penetrating injury to the torso who underwent CT. Based on CT signs, reviewers determined the presence of a gastrointestinal injury and the need for surgery or observation. The primary outcome measures were operative findings and clinical follow-up. CT results were compared with the primary outcome measures. Of one hundred and seventy-one patients (72 gunshot wounds, 99 stab wounds; age range, 18-57 years; median age, 28 years) with penetrating torso trauma who underwent CT, 45 % were followed by an operation and 55 % by clinical follow up. Thirty-five patients had a gastrointestinal injury at surgery. The sensitivity, specificity, and accuracy of CT for diagnosing a gastrointestinal injury for all patients were each 91 %, and for predicting the need for surgery, they were 94 %, 93 %, 93 %, respectively. Among the 3 % of patients who failed observation, 1 % had a gastrointestinal injury. CT is a useful technique to diagnose gastrointestinal injury following penetrating torso injury. CT can help discriminate patients requiring observation or surgery. (orig.)

  4. Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons

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    Melo, Alessandro Severo Alves de; Moreira, Luiza Beatriz Melo; Pessoa, Fernanda Miraldi Clement; Saint-Martin, Nara; Ancilotti Filho, Roger [Universidade Federal Fluminense (UFF), Niterói, RJ (Brazil); Souza Junior, Arthur Soares [Faculdade de Medicina de São José do Rio Preto (FAMERP), SP (Brazil); Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2017-11-15

    Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). Conclusion: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach. (author)

  5. Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons

    Directory of Open Access Journals (Sweden)

    Alessandro Severo Alves de Melo

    2017-10-01

    Full Text Available Abstract Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8% were gunshot wounds and 5 (14.2% were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%, manifesting as contusions in 34 cases (85%, atelectasis in 8 (20%, lacerations in 1 (2.5% and hematomas in 1 (2.5%. Hemothorax was seen in 31 cases (77.5%, and pneumothorax was seen in 22 cases (55%. Mediastinal lesions were observed in 8 cases (20%, including mediastinal hematoma in 3 cases (7.5%, hemopericardium in 3 (7.5%, and pneumomediastinum in 2 (5%. Diaphragmatic rupture was seen in 2 cases (5%. Conclusion: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach.

  6. Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons.

    Science.gov (United States)

    de Melo, Alessandro Severo Alves; Moreira, Luiza Beatriz Melo; Pessoa, Fernanda Miraldi Clemente; Saint-Martin, Nara; Ancilotti Filho, Roger; Souza, Arthur Soares; Marchiori, Edson

    2017-01-01

    The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach.

  7. Tomographic aspects of penetrating thoracic trauma: injuries from firearms and other weapons

    International Nuclear Information System (INIS)

    Melo, Alessandro Severo Alves de; Moreira, Luiza Beatriz Melo; Pessoa, Fernanda Miraldi Clement; Saint-Martin, Nara; Ancilotti Filho, Roger; Souza Junior, Arthur Soares; Marchiori, Edson

    2017-01-01

    Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). Conclusion: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach. (author)

  8. Non-operative management of right side thoracoabdominal penetrating injuries--the value of testing chest tube effluent for bile.

    Science.gov (United States)

    De Rezende Neto, João Baptista; Guimarães, Tiago Nunes; Madureira, João Lopo; Drumond, Domingos André Fernandes; Leal, Juliana Campos; Rocha, Aroldo; Oliveira, Rodrigo Guimarães; Rizoli, Sandro B

    2009-05-01

    While mandatory surgery for all thoracoabdominal penetrating injuries is advocated by some, the high rate of unnecessary operations challenges this approach. However, the consequences of intrathoracic bile remains poorly investigated. We sought to evaluate the outcome of patients who underwent non-operative management of right side thoracoabdominal (RST) penetrating trauma, and the levels of bilirubin obtained from those patients' chest tube effluent. We managed non-operatively all stable patients with a single RST penetrating injury. Chest tube effluent samples were obtained six times within (4-8 h; 12-16 h; 20-24 h; 28-32 h; 36-40 h; 48 h and 72 h) of admission for bilirubin measurement and blood for complete blood count, bilirubin, alanine (ALT) and aspartate aminotransferases (AST) assays. For comparison we studied patients with single left thoracic penetrating injury. Forty-two patients with RST injuries were included. All had liver and lung injuries confirmed by CT scans. Only one patient failed non-operative management. Chest tube bilirubin peaked at 48 h post-trauma (mean 3.3+/-4.1 mg/dL) and was always higher than both serum bilirubin (pchest tube effluent from control group (27 patients with left side thoracic trauma). Serum ALT and AST were higher in RST injury patients (ptrauma appears to be safe. Bile originating from the liver injury reaches the right thoracic cavity but does not reflect the severity of that injury. The highest concentration was found in the patient failing non-operative management. The presence of intrathoracic bile in selected patients who sustain RST penetrating trauma, with liver injury, does not preclude non-operative management. Our study suggests that monitoring chest tube effluent bilirubin may provide helpful information when managing a patient non-operatively.

  9. Endoscopy-guided vitreoretinal surgery following penetrating corneal injury: a case report

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    Motoko Kawashima

    2010-08-01

    Full Text Available Motoko Kawashima1, Shinichi Kawashima2, Murat Dogru1,3, Makoto Inoue4, Jun Shimazaki1,51Department of Ophthalmology, Tokyo Dental College, Chiba, Japan; 2Department of Ophthalmology, International University of Health and Welfare, Tokyo, Japan; 3Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan; 4Kyorin Eye Center, Tokyo, Japan; 5Department of Ophthalmology, Keio University School of Medicine, Tokyo, JapanIntroduction: Severe ocular trauma requires emergency surgery, and a fresh corneal graft may not always be available. We describe a case of perforating eye injury with corneal ­opacity, suspected endophthalmitis, and an intraocular foreign body. The patient was successfully treated with a two-step procedure comprising endoscopy-guided vitrectomy followed by corneal transplantation. This surgical technique offers a good option to vitrectomy with simultaneous keratoplasty in emergency cases where no graft is immediately available and there is the ­possibility of infection due to the presence of a foreign body.Case presentation: A 55-year-old Japanese woman was referred to our hospital with a ­perforating corneal and lens injury sustained with a muddy ferrous rod. Primary corneal sutures and lensectomy were performed immediately. Vitreoretinal surgery was required due to ­suspected endophthalmitis, vitreous hemorrhage, retinal detachment, dialysis and necrosis of the peripheral retina. Instead of conventional vitrectomy, endoscopy-guided vitreous surgery was performed with the Solid Fiber Catheter AS-611 (FiberTech, Tokyo, Japan due to the presence of corneal opacity and the unavailability of a donor cornea. The retina was successfully attached with the aid of a silicon oil tamponade. Following removal of the silicon oil at 3 months after surgery, penetrating keratoplasty and intraocular lens implantation with ciliary sulcus suture fixation were performed. At 6 months after penetrating

  10. Penetrating injury of the lungs and multiple injuries of lower extremities caused by aircraft bombs splinters

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    Golubović Zoran

    2010-01-01

    Full Text Available Introduction. Injuries caused by aircraft bombs cause severe damages to the human body. They are characterized by massive destruction of injured tissues and organs, primary contamination by polymorph bacterial flora and modified reactivity of the body. Upon being wounded by aircraft bombs projectiles a victim simultaneously sustains severe damages of many organs and organ systems due to the fact that a large number of projectiles at the same time injure the chest, stomach, head and extremities. Case report. We presented a patient, 41 years of age, injured by aircraft bomb with hemo-pneumothorax and destruction of the bone and soft tissue structures of the foot, as well as the treatment result of such heavy injuries. After receiving thoracocentesis and short reanimation, the patient underwent surgical procedure. The team performed thoracotomy, primary treatment of the wound and atypical resection of the left lung. Thoracic drains were placed. The wounds on the lower leg and feet were treated primarily. Due to massive destruction of bone tissue of the right foot by cluster bomb splinters, and impossibility of reconstruction of the foot, guillotine amputation of the right lower leg was performed. Twelve days after the wounding caused by cluster bomb splinters, soft tissue of the left lower leg was covered by Tirsch free transplantant and the defect in the area of the left foot was covered by dorsalis pedis flap. The transplant and flap were accepted and the donor sites were epithelized. Twenty-six days following the wounding reamputation was performed and amputation stump of the right lower leg was closed. The patient was given a lower leg prosthesis with which he could move. Conclusion. Upon being wounded by aircraft bomb splinters, the injured person sustains severe wounds of multiple organs and organ systems due to simultaneous injuries caused by a large number of projectiles. It is necessary to take care of the vital organs first because they

  11. Penetrating injuries to the duodenum: An analysis of 879 patients from the National Trauma Data Bank, 2010 to 2014.

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    Phillips, Bradley; Turco, Lauren; McDonald, Dan; Mause, Alison; Walters, Ryan W

    2017-11-01

    Despite wide belief that the duodenal Organ Injury Scale has been validated, this has not been reported in the published literature. Based on clinical experience, we hypothesize that the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) for duodenal injuries can independently predict mortality. Our objectives were threefold: (1) describe the national profile of penetrating duodenal injuries, (2) identify predictors of morbidity and mortality, and (3) validate the duodenum AAST-OIS as a statistically significant predictor of mortality. Using the Abbreviated Injury Scale 2005 and International Classification of Diseases-9th Rev.-Clinical Modification (ICD-9-CM) E-codes, we identified 879 penetrating duodenal trauma patients from the National Trauma Data Bank between 2010 and 2014. We controlled patient-level covariates of age, biological sex, systolic blood pressure (SBP), Glasgow Coma Scale (GCS) score, pulse, Injury Severity Score (ISS), and Organ Injury Scale (OIS) grade. We estimated multivariable generalized linear mixed models to account for the nesting of patients within trauma centers. Our results indicated an overall mortality rate of 14.4%. Approximately 10% of patients died within 24 hours of admission, of whom 76% died in the first 6 hours. Patients averaged approximately five associated injuries, 45% of which involved the liver and colon. Statistically significant independent predictors of mortality were firearm mechanism, SBP, GCS, pulse, ISS, and AAST-OIS grade. Specifically, odds of death were decreased with 10 mm Hg higher admission SBP (13% decreased odds), one point higher GCS (14.4%), 10-beat lower pulse (8.2%), and 10-point lower ISS (51.0%). This study is the first to report the national profile of penetrating duodenal injuries. Using the National Trauma Data Bank, we identified patterns of injury, predictors of outcome, and validated the AAST-OIS for duodenal injuries as a statistically significant predictor of morbidity

  12. Inferior vena cava filter penetration following Whipple surgical procedure causing ureteral injury.

    Science.gov (United States)

    Abdel-Aal, Ahmed Kamel; Ezzeldin, Islam B; Moustafa, Amr Soliman; Ertel, Nathan; Oser, Rachel

    2015-12-01

    We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple's pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction. Our case highlights the importance of careful inferior vena cava manipulation during abdominal surgery in the presence of an inferior vena cava filter, and the option of temporary removal of the filter to be placed again after surgery in order to avoid this complication, unless protection is required against clot migration during the surgical procedure.

  13. The utility of presacral drainage in penetrating rectal injuries in adult and pediatric patients.

    Science.gov (United States)

    Savoie, Kate B; Beazley, Thomas M; Cleveland, Brent; Khaneki, Sina; Markel, Troy A; Hammer, Peter M; Savage, Stephanie; Williams, Regan F

    2017-11-01

    With changing weaponry associated with injuries in civilian trauma, there is no clinical census on the utility of presacral drainage (PSD) in penetrating rectal injuries (PRIs), particularly in pediatric patients. Patients with PRI from July 2004-June 2014 treated at two free-standing children's hospitals and two adult level 1 trauma centers were compared by age (pediatric patients ≤16 years) and PSD. A stratified analysis was performed based on age. The primary outcome was pelvic/presacral abscess. We identified 81 patients with PRI; 19 pediatric, 62 adult. Forty patients had PSD; only three pediatric patients had a drain. Adult patients were more likely to have sustained gunshot wounds (84%), whereas pediatric patients were more likely to sustain impalement injuries (59%). Pediatric patients were more likely to have distal extraperitoneal injuries (56% versus 27% in adults, P = 0.03). PSD was more common in adult patients (59% versus 14%, P = 0.0004), African-Americans (71% versus 11% Caucasian, P adult and pediatric patients. There were three cases of pelvic/presacral abscess, all in the adult patients (P = 0.31); one patient with PSD and two without PSD (P = 0.58). In stratified analysis, there were no differences in any infectious complication between those with and without PSD. Pelvic/presacral abscess is a rare complication of PRI, especially in pediatric patients. PSD is not associated with decreased rates of infectious complications and may not be necessary in the treatment of PRI. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. A subgroup analysis of penetrating injuries to the pancreas: 777 patients from the National Trauma Data Bank, 2010-2014.

    Science.gov (United States)

    Phillips, Bradley; Turco, Lauren; McDonald, Dan; Mause, Elizabeth; Walters, Ryan W

    2018-05-01

    This study is the first to analyze penetrating injuries to the pancreas within subgroups of severe traumatic brain injury (TBI), early deaths, and potential survivors. Our objectives were to identify national patterns of injury, predictors of mortality, and to validate the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) pancreas injury grades by mortality. Secondary outcomes included hospital and intensive care unit length of stay and days on mechanical ventilation. Using the Abbreviated Injury Scale 2005 and ICD-9-CM E-codes, we identified 777 penetrating pancreatic trauma patients from the National Trauma Data Bank that occurred between 2010 and 2014. Severe TBI was identified by ICD-9-CM diagnosis codes and Glasgow Coma Score (GCS; n = 7), early deaths were those that occurred within 24 h of admission (n = 82), and potential survivors included patients without severe TBI who survived longer than 24 h following admission (n = 690). We estimated multivariable generalized linear mixed models to predict mortality to account for the nesting of potential survivors within trauma centers. Our results indicated that overall mortality decreased from 16.9% to 6.8% after excluding severe TBI and early deaths. Approximately, 11% of patients died within 24 h of admission, of whom 78% died in the first 6 h. Associated injuries to the stomach, liver, and major vasculature occurred in approximately 50% of patients; rates of associated injuries were highest in patients who died within 6 h of admission. In potential survivors, mortality increased by AAST-OIS grade: 3.5% I/II; 8.3% III; 9.6% IV; and 13.8% V. Predictors of mortality with significantly increased odds of death were patients with increasing age, lower admission GCS, higher admission pulse rate, and more severe injuries as indicated by Organ Injury Scale grade. From 777 patients, we identified national patterns of injury, predictors of outcome, and mortality by AAST-OIS grade within

  15. More than just a urinary catheter — Haemorrhage control by using a Foley catheter in a penetrating aortic root injury

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    Adel Elmoghrabi

    2016-08-01

    Full Text Available The prevalence of great vessel injuries in thoracic trauma is reported at 0.3–10%, predominantly due to a penetrating mechanism. Thoracic aortic injuries, more specifically those within proximity of the aortic root are challenging to manage and unceasing bleeding hampers adequate visualisation for performing repair. We report a case of a 31-year-old male that presented to the emergency department 1 h after sustaining a stab wound injury within proximity of the left upper sternal border. Vital signs were stable on presentation. Physical examination revealed a 1.5 cm laceration in the 3rd intercostal space. Chest X-ray revealed a small left pneumothorax, FAST scan was negative, and CT of the chest revealed left sided haemopneumothorax and haemopericardium. The patient was emergently transferred to the operating room where median thoracotomy was performed. A significant amount of bleeding was observed originating from a 1 cm laceration of the aortic root. Bleeding was controlled using a Foley catheter after unsuccessful attempts of digital compression, and the laceration was repaired using pledgeted sutures. Postoperative echocardiography and CT scan of the chest revealed normal cardiac functions with resolution of haemopericardium and haemopneumothorax, and the patient was discharged in a stable condition. High index of suspicion should be maintained for injury to the great vessels in patients with penetrating chest injuries, despite apparent haemodynamic stability. In this case, balloon tamponade using a Foley catheter served as a quick and simple technique that resulted in an almost bloodless field, facilitating adequate visualisation for definitive repair. Although the use of this technique has been previously described, this report serves as a reminder that a Foley catheter can be successfully used for balloon catheter tamponade in injuries to the aortic root. Keywords: Aortic root, Injury, Foley's catheter, Balloon catheter, Aorta

  16. Penetrating injury to the chest by an attenuated energy projectile: a case report and literature review of thoracic injuries caused by "less-lethal" munitions

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    Porto Leonardo BO

    2009-06-01

    Full Text Available Abstract We present the case of a patient who sustained a penetrating injury to the chest caused by an attenuated energy rubber bullet and review the literature on thoracic injuries caused by plastic and rubber "less-lethal" munitions. The patient of this report underwent a right thoracotomy to extract the projectile as well as a wedge resection of the injured lung parenchyma. This case demonstrates that even supposedly safe riot control munition fired at close range, at the torso, can provoke serious injury. Therefore a thorough investigation and close clinical supervision are justified.

  17. Penetrating injury to the chest by an attenuated energy projectile: a case report and literature review of thoracic injuries caused by "less-lethal" munitions.

    Science.gov (United States)

    Rezende-Neto, Joao; Silva, Fabriccio Df; Porto, Leonardo Bo; Teixeira, Luiz C; Tien, Homer; Rizoli, Sandro B

    2009-06-26

    We present the case of a patient who sustained a penetrating injury to the chest caused by an attenuated energy rubber bullet and review the literature on thoracic injuries caused by plastic and rubber "less-lethal" munitions. The patient of this report underwent a right thoracotomy to extract the projectile as well as a wedge resection of the injured lung parenchyma. This case demonstrates that even supposedly safe riot control munition fired at close range, at the torso, can provoke serious injury. Therefore a thorough investigation and close clinical supervision are justified.

  18. Imaging characteristics and treatment of a penetrating brain injury caused by an oropharyngeal foreign body in a dog.

    Science.gov (United States)

    McKenzie, Jennifer; Cooper Murphy, Megan; Broome, Cameron; Tayari, Hamaseh; Gutierrez-Quintana, Rodrigo

    2017-07-20

    A 4-year-old Border collie was presented with one episode of collapse, altered mentation, and a suspected pharyngeal stick injury. Magnetic resonance imaging (MRI) and computed tomography showed a linear foreign body penetrating the right oropharynx, through the foramen ovale and the brain parenchyma. The foreign body was surgically removed and medical treatment initiated. Complete resolution of clinical signs was noted at recheck 8 weeks later. Repeat MRI showed chronic secondary changes in the brain parenchyma. To the authors' knowledge, this is the first report of the advanced imaging findings and successful treatment of a penetrating oropharyngeal intracranial foreign body in a dog. © 2017 American College of Veterinary Radiology.

  19. Neural signatures of third-party punishment: evidence from penetrating traumatic brain injury.

    Science.gov (United States)

    Glass, Leila; Moody, Lara; Grafman, Jordan; Krueger, Frank

    2016-02-01

    The ability to survive within a cooperative society depends on impartial third-party punishment (TPP) of social norm violations. Two cognitive mechanisms have been postulated as necessary for the successful completion of TPP: evaluation of legal responsibility and selection of a suitable punishment given the magnitude of the crime. Converging neuroimaging research suggests two supporting domain-general networks; a mentalizing network for evaluation of legal responsibility and a central-executive network for determination of punishment. A whole-brain voxel-based lesion-symptom mapping approach was used in conjunction with a rank-order TPP task to identify brain regions necessary for TPP in a large sample of patients with penetrating traumatic brain injury. Patients who demonstrated atypical TPP had specific lesions in core regions of the mentalizing (dorsomedial prefrontal cortex [PFC], ventromedial PFC) and central-executive (bilateral dorsolateral PFC, right intraparietal sulcus) networks. Altruism and executive functioning (concept formation skills) were significant predictors of TPP: altruism was uniquely associated with TPP in patients with lesions in right dorsolateral PFC and executive functioning was uniquely associated with TPP in individuals with lesions in left PFC. Our findings contribute to the extant literature to support underlying neural networks associated with TPP, with specific brain-behavior causal relationships confirming recent functional neuroimaging research. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  20. IMMUNOMODULATORY ACTION OF MYELOPIDUM UNDER ITS INCLUSION IN COMPLEX THERAPY OF PATIENTS WITH PENETRATING OCULAR INJURIES

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    T. V. Gavrilova

    2008-01-01

    Full Text Available Abstract. Examination of immunomodulatory actions and clinical efficiency of myelopidum when included into complex therapy that was carried out in 24 male patients with severe (stage 3 penetrating eye injury in the course of trauma treatment. The levels of C-reactive protein, lactoferrin, interleukin (IL-1β, IL-6, and activity of complement system were measured in peripheral blood, and concentrations of lactoferrin and IL-8 were determined in tears. An increase in lactoferrin, C-reactive protein, IL-1β, IL-8, and C5 complement component levels was detected during early post-traumatic period, as compared with data from the control group. As compared to effects of steroid and non-steroid anti-inflammatory drugs included into standard therapy, treatment with myelopidum has led to a more favorable clinical course of traumatic process, and resulted into more pronounced anti-inflammatory effect that was manifested by decrease in lactoferrin and C-reactive protein levels, reduction of IL-1β concentration, and C5 complement component activity. (Med. Immunol., 2008, vol. 10, N 2-3, pp 239-244.

  1. An Unusual Case of Cerebral Penetrating Injury by a Driven Bone Fragment Secondary to Blunt Head Trauma

    OpenAIRE

    Lee, Jae Il; Ko, Jun Kyeung; Cha, Seung Heon; Han, In Ho

    2011-01-01

    Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right t...

  2. Vascular geometry as a risk factor for non-penetrating traumatic injuries of the aortic arch.

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    Andreas Schicho

    Full Text Available To assess biomechanical factors in aortic arch geometry contributing to the development of non-penetrating aortic arch injury (NAAI in multiply injured patients with an Injury Severity Score (ISS ≥ 16.230 consecutive multiply injured trauma patients with an ISS ≥ 16 admitted to our Level-I trauma center during a consecutive 24-month period were prospectively included of whom 13 presented with NAAI (5.7%. Standardized whole-body CT in a 2x128-detector-row scanner included a head-and-neck CTA. Aortic arch diameters, width, height, angles and thoracic width and height were measured in individuals with NAAI and ISS-, sex-, age-, and trauma mechanism-matched controls.There was no difference between groups regarding sex, age, ISS, and aortic diameters. The aortic arch angle in individuals with NAAI (71.3° ± 14.9° was larger than in healthy control (60.7° ± 8.6°; p*<0.05. In patients with NAAI, the distance between ascendent and descendent aorta was larger (5.2 cm ± 1.9 cm than in control (2.8 ± 0.5 cm; ***p<0.001. The aortic arch is higher above tracheal bifurcation in NAAI (3.6 cm ± 0.6 cm than in matched control (2.4 cm ± 0.3 cm; ***p<0.001. Accordingly, the area under the aortic arch, calculated as half of an eliptic shape, is significantly larger in patients with NAAI (15.0 cm2 ± 6.5 cm2 when compared to age- and sex-matched controls without NAAI (5.5 cm2 ± 1.3 cm2; ***p<0.001.Besides the magnitude of deceleration and direction of impact, width and height of the aortic arch are the 3rd and 4th factor directly contributing to the risk of developing traumatic NAAI in severely injured patients.

  3. Analysis of 162 colon injuries in patients with penetrating abdominal trauma: concomitant stomach injury results in a higher rate of infection.

    Science.gov (United States)

    O'Neill, Patricia A; Kirton, Orlando C; Dresner, Lisa S; Tortella, Bartholomew; Kestner, Mark M

    2004-02-01

    Fecal contamination from colon injury has been thought to be the most significant factor for the development of surgical site infection (SSI) after trauma. However, there are increasing data to suggest that other factors may play a role in the development of postinjury infection in patients after colon injury. The purpose of this study was to determine the impact of gastric wounding on the development of SSI and nonsurgical site infection (NSSI) in patients with colon injury. Post hoc analysis was performed on data prospectively collected for 317 patients presenting with penetrating hollow viscus injury. One hundred sixty-two patients with colon injury were subdivided into one of three groups: patients with isolated colon wounds (C), patients with colon and stomach wounds with or without other organ injury (C+S), and patients with colon and other organ injury but no stomach injury (C-S) and assessed for the development of SSI and NSSI. Infection rates were also determined for patients who sustained isolated gastric injury (S) and gastric injury in combination with other injuries other than colon (S-C). Penetrating Abdominal Trauma Index, operative times, and transfusion were assessed. Discrete variables were analyzed by Cochran-Mantel-Haenszel chi2 test and Fisher's exact test. Risk factor analysis was performed by multivariate logistic regression. C+S patients had a higher rate of SSI infection (31%) than C patients (3.6%) (p=0.008) and C-S patients (13%) (p=0.021). Similarly, the incidence of NSSI was also significantly greater in the C+S group (37%) compared with the C patients (7.5%) (p=0.07) and the C-S patients (17%) (p=0.019). There was no difference in the rate of SSI or NSSI between the C and C-S groups (p=0.3 and p=0.24, respectively). The rate of SSI was significantly greater in the C+S patients when compared with the S-C patients (31% vs. 10%, p=0.008), but there was no statistical difference in the rate of NSSI in the C+S group and the S-C group (37

  4. Penetrating missile-type head injury from a defective badminton racquet.

    Science.gov (United States)

    Pappano, Dante; Murray, Elizabeth; Cimpello, Lynn Babcock; Conners, Gregory

    2009-06-01

    Injuries occurring during badminton are rarely serious and primarily involve the lower extremities. We report an instance wherein a patient suffered serious brain injury related to playing with a defective badminton racquet. The possibility of similar injuries following the separation of the racquet head and shaft from the handle needs to be disseminated.

  5. Management of penetrating extraperitoneal rectal injuries: An Eastern Association for the Surgery of Trauma practice management guideline.

    Science.gov (United States)

    Bosarge, Patrick L; Como, John J; Fox, Nicole; Falck-Ytter, Yngve; Haut, Elliott R; Dorion, Heath A; Patel, Nimitt J; Rushing, Amy; Raff, Lauren A; McDonald, Amy A; Robinson, Bryce R H; McGwin, Gerald; Gonzalez, Richard P

    2016-03-01

    The management of penetrating rectal trauma invokes a complex decision tree that advocates the principles of proximal diversion (diversion) of the fecal stream, irrigation of stool from the distal rectum, and presacral drainage based on data from World War II and the Vietnam War. This guideline seeks to define the initial operative management principles for nondestructive extraperitoneal rectal injuries. A systematic review of the MEDLINE database using PubMed was performed. The search retrieved English language articles regarding penetrating rectal trauma from January 1900 to July 2014. Letters to the editor, case reports, book chapters, and review articles were excluded. Topics of investigation included the management principles of diversion, irrigation of stool from the distal rectum, and presacral drainage using the GRADE methodology. A total of 306 articles were screened leading to a full-text review of 56 articles. Eighteen articles were used to formulate the recommendations of this guideline. This guideline consists of three conditional evidence-based recommendations. First, we conditionally recommend proximal diversion for management of these injuries. Second, we conditionally recommend the avoidance of routine presacral drains and distal rectal washout in the management of these injuries.

  6. A heuristic approach and heretic view on the technical issues and pitfalls in the management of penetrating abdominal injuries.

    Science.gov (United States)

    Yilmaz, Tugba H; Ndofor, Brown C; Smith, Martin D; Degiannis, Elias

    2010-07-14

    There is a general decline in penetrating abdominal trauma throughout the western world. As a result of that, there is a significant loss of expertise in dealing with this type of injury particularly when the patient presents to theatre with physiological instability. A significant percentage of these patients will not be operated by a trauma surgeon but, by the "occasional trauma surgeon", who is usually trained as a general surgeon. Most general surgeons have a general knowledge of operating penetrating trauma, knowledge originating from their training years and possibly enhanced by reading operative surgery textbooks. Unfortunately, the details included in most of these books are not extensive enough to provide them with enough armamentaria to tackle the difficult case. In this scenario, their operative dexterity and knowledge cannot be compared to that of their trauma surgeon colleagues, something that is taken for granted in the trauma textbooks. Techniques that are considered basic and easy by the trauma surgeons can be unfamiliar and difficult to general surgeons. Knowing the danger points and pitfalls that will be encountered in penetrating trauma to the abdomen, will help the occasional trauma surgeons to avoid intraoperative errors and improve patient care. This manuscript provides a heuristic approach from surgeons working in a high volume penetrating trauma centers in South African. Some of the statements could be considered heretic by the "accepted" trauma literature. We believe that this heuristic ("rule of thumb" approach, that originating from "try and error" experience) can help surgical trainees or less experienced in penetrating trauma surgeons to improve their surgical decision making and technique, resulting in better patient outcome.

  7. A heuristic approach and heretic view on the technical issues and pitfalls in the management of penetrating abdominal injuries

    Directory of Open Access Journals (Sweden)

    Smith Martin D

    2010-07-01

    Full Text Available Abstract There is a general decline in penetrating abdominal trauma throughout the western world. As a result of that, there is a significant loss of expertise in dealing with this type of injury particularly when the patient presents to theatre with physiological instability. A significant percentage of these patients will not be operated by a trauma surgeon but, by the "occasional trauma surgeon", who is usually trained as a general surgeon. Most general surgeons have a general knowledge of operating penetrating trauma, knowledge originating from their training years and possibly enhanced by reading operative surgery textbooks. Unfortunately, the details included in most of these books are not extensive enough to provide them with enough armamentaria to tackle the difficult case. In this scenario, their operative dexterity and knowledge cannot be compared to that of their trauma surgeon colleagues, something that is taken for granted in the trauma textbooks. Techniques that are considered basic and easy by the trauma surgeons can be unfamiliar and difficult to general surgeons. Knowing the danger points and pitfalls that will be encountered in penetrating trauma to the abdomen, will help the occasional trauma surgeons to avoid intraoperative errors and improve patient care. This manuscript provides a heuristic approach from surgeons working in a high volume penetrating trauma centers in South African. Some of the statements could be considered heretic by the "accepted" trauma literature. We believe that this heuristic ("rule of thumb" approach, that originating from "try and error" experience can help surgical trainees or less experienced in penetrating trauma surgeons to improve their surgical decision making and technique, resulting in better patient outcome.

  8. Emergency department thoracotomy for penetrating injuries of the heart and great vessels: an appraisal of 283 consecutive cases from two urban trauma centers.

    Science.gov (United States)

    Seamon, Mark J; Shiroff, Adam M; Franco, Michael; Stawicki, S Peter; Molina, Ezequiel J; Gaughan, John P; Reilly, Patrick M; Schwab, C William; Pryor, John P; Goldberg, Amy J

    2009-12-01

    Historically, patients with penetrating cardiac injuries have enjoyed the best survival after emergency department thoracotomy (EDT), but further examination of these series reveals a preponderance of cardiac stab wound (SW) survivors with only sporadic cardiac gunshot wound (GSW) survivors. Our primary study objective was to determine which patients requiring EDT for penetrating cardiac or great vessel (CGV) injury are salvageable. All patients who underwent EDT for penetrating CGV injuries in two urban, level I trauma centers during 2000 to 2007 were retrospectively reviewed. Demographics, injury (mechanism, anatomic injury), prehospital care, and physiology (signs of life [SOL], vital signs, and cardiac rhythm) were analyzed with respect to hospital survival. The study population (n = 283) comprised young (mean age, 27.1 years +/- 10.1 years) men (96.1%) injured by gunshot (GSW, 88.3%) or SWs (11.7%). Patients were compared by injury mechanism and number of CGV wounds with respect to survival (SW, 24.2%; GSW, 2.8%; p cumulative impact of penetrating injury mechanism, ED SOL, and number of CGV wounds was analyzed together, we established that those sustaining multiple CGV GSWs (regardless of ED SOL) were nearly unsalvageable. These results indicate that when multiple CGV GSWs are encountered after EDT, further resuscitative efforts may be terminated without limiting the opportunity for survival.

  9. 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.

  10. Traumatismos raquimedulares penetrantes em adolescentes Traumatismos raquimedulares penetrantes en adolescentes Penetrating spinal cord injuries in adolescents

    Directory of Open Access Journals (Sweden)

    Marcelo Campos Moraes Amato

    2009-09-01

    ó entre cirugía o tratamiento conservador. RESULTADOS: el promedio de edad fue de 16 años (13 a 18 años. La media de hospitalización inicial fue de 11 días (4 a 180 días. Cuatro pacientes fueron sometidos al tratamiento conservador. Solo un paciente sometido a laminectomía migró para Frankel E. Ningún paciente presentó infección de la herida o inestabilidad tardía de la columna vertebral. CONCLUSIÓN: las lesiones medulares secundarias desempeñan poca importancia en el resultado neurológico, lo cual lleva a la definición clínica del cuadro en la admisión hospitalar de la mayoría de los casos. Hubo una nítida predominancia de TRMp en adolescentes del sexo masculino. No ocurrió diferencia significativa entre las conductas realizadas en relación al resultado neurológico, infección e inestabilidad. El tratamiento debe ser individualizado, sin negligencia en el tratamiento clínico y considerando la cirugía sólo para casos específicos.OBJECTIVE: to analyze the management of a series of adolescents with penetrating spinal cord injuries (pSCI and comparing to literature, provide the best therapeutic strategy to these patients. METHODS: retrospective evaluation of medical reports of ten consecutive cases of pSCI, nine from the male sex and one from the female. All the patients were under 18 years old. The clinical history, neurologic evaluation and the images exams were analyzed. The therapeutic management varied between surgery and conservative. RESULTS: the average age was 16 years old (form 13 to 18 years. The median time spent at the first hospitalization was 11 days (from 4 to 180 days. Four patients were submitted to laminectomy, one to wound debridement and five to conservative treatment. Only one patient submitted to laminectomy had neurological improvement. No patients presented in this series showed, in the follow-up, wound infection or spinal instability. CONCLUSION: secondary spinal cord injuries are less relevant to the neurological status

  11. Selective Nonoperative Management of Penetrating Torso Injury From Combat Fragmentation Wounds

    Science.gov (United States)

    2008-02-01

    outlines the paradigm of care: “Penetrating inju- ries below the nipples , above the symphysis pubis, and between the posterior axillary lines must be...abdo- men and were hemodynamically stable and without abdom- inal pain or tenderness. CT scan of some of these casualties revealed fragments in the lumen

  12. Accuracy of conventional imaging of penetrating torso injuries in the trauma resuscitation room

    NARCIS (Netherlands)

    D.S.E. Varin (Dorien); A.N. Ringburg (Akkie); E.M.M. van Lieshout (Esther); P. Patka (Peter); I.B. Schipper (Inger)

    2009-01-01

    textabstractChest X-ray (CXR), abdominal ultrasound, cardiac ultrasound, and abdominal X-ray are the most frequently used imaging modalities to radiologically evaluate patients with penetrating torso trauma. The aim of this study was to evaluate the accuracy of these imaging modalities. From January

  13. Penetrating abdomino-thoracic injuries: report of four impressive, spectacular and representative cases as well as their challenging surgical management.

    Science.gov (United States)

    Eder, Frank; Meyer, Frank; Huth, Christof; Halloul, Zuhir; Lippert, Hans

    2011-03-01

    Gunshot wounds are rare events in European countries, but stab and impalement injuries occur more frequently and are often spectacular. The aim of the study was to describe several types of penetrating abdomino-thoracic injuries as well as the appropriate surgical interventions, including complex wound management. The representative case series includes four patients with abdomino-thoracic penetrating trauma (two impalements and two stabbings), who were treated in a surgical university hospital (tertiary) centre during a 12-month period. 1. A man was impaled on a steel pipe, which entered the body above the right kidney and behind the liver through the mediastinum via the right thorax, passing the heart and aortic arch up to the left clavicle. The rod was removed via sternotomy and median laparotomy. Only the left subclavian vein required repair. Postoperatively, a residual lesion of the left brachial plexus caused temporary pneumonia. 2. A leg of a collapsing chair drilled into a woman's left foramen obturatorium and exited the body at the right anterior iliac spine. At a regional hospital, the chair leg was removed and the canal caused by gluteal penetration was excised. Exploratory laparotomy revealed peritonitis resulting from a perforated ileum. The injury was repaired with segmental resection and anastomosis. Postoperative right inguinal wound necrosis necessitated excision and vacuum-assisted closure sealing. The patient has residual paresthesia in her left leg resulting from a sacral plexus lesion. 3. During an altercation, a man was stabbed twice in the right thorax. The right pulmonary lobe, the diaphragm, and the liver dome between segment VIII and V were injured. The patient also had a large scalp avulsion at the left and right parietooccipital site and transection of the biceps muscle at the middle third of the right humerus. The chest injuries, approached via right subcostal incision and right anterior thoracotomy were managed with liver packing (two

  14. Patterns of injury in penetrating sharp trauma in a Provincial KwaZulu-Natal Hospital

    Directory of Open Access Journals (Sweden)

    Andrew Lockyer

    2013-06-01

    Discussion: Most patients suffered multiple wounds over multiple sites but these did not frequently require admission to hospital and caused no deaths. As long as clinicians remain vigilant for more severe injuries, these patients can generally be treated in low resourced environments. The majority of patients were discharged directly from the Emergency Centre making it the best place for these people to receive health education to prevent further injuries.

  15. Patterns of injury in penetrating sharp trauma in a Provincial KwaZulu-Natal Hospital

    Directory of Open Access Journals (Sweden)

    A. Lockyer*

    2013-12-01

    Discussion: Most patients suffered multiple wounds over multiple sites but these did not frequently require admission to hospital and caused no deaths. As long as clinicians remain vigilant for more severe injuries, these patients can generally be treated in low resourced environments. The majority of patients were discharged directly from the Emergency Centre making it the best place for these people to receive health education to prevent further injuries.

  16. EVALUATION OF THORACOSCOPY IN THE DIAGNOSIS OF DIAPHRAGMATIC INJURIES IN PENETRATING THORACOABDOMINAL TRAUMA WITHOUT LUNG DEFLATION AT DR GEORGE MUKHARI ACADEMIC HOSPITAL.

    Science.gov (United States)

    Nsakala, L

    2017-06-01

    With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87.5%. This was a prospective study; all stable trauma patients with penetrating thoracoabdominal injury aged 18 years and above admitted to the trauma unit at Dr George Mukhari Academic Hospital during the period of the study were included. All patients with penetrating thoracoabdominal trauma who were unstable, or necessitating prompt management and all paediatric patients were excluded from the study. In theatre, under general anaesthesia, we first performed thoracoscopy without single lung ventilation followed by laparoscopy as control on each patient. Data was collected using a standard proforma by the attending surgeon and was analysed by a statistician using IBM SPSS 22 software. A total of 32 patients met the inclusion criteria of which 4 were female (12.5%) and 28 male (87.5%) with the median age of 29 years. Of the 32 patients, 27 had thoracoabdominal stab wounds (84.3%) and 5 had gunshot wounds (15.6%). Fourteen patients (43.75%) had left sided injury and 18 patients (56.25%) had injury to the right side. The incidence of diaphragmatic injury was 37.5% (n = 12). No injuries were missed on thoracoscopy; there was no mortality or morbidity. Thoracoscopy without single lung ventilation is safe and comparable to thoracoscopy with single lung ventilation as a diagnostic tool for diaphragmatic injuries in stable patients with penetrating thoracoabdominal trauma.

  17. The use of laparoscopy in the diagnosis and treatment of blunt and penetrating abdominal injuries: 10-year experience at a level 1 trauma center.

    Science.gov (United States)

    Johnson, Jeremy J; Garwe, Tabitha; Raines, Alexander R; Thurman, Joseph B; Carter, Sandra; Bender, Jeffrey S; Albrecht, Roxie M

    2013-03-01

    Diagnostic laparoscopy (DL) has decreased the rate of nontherapeutic laparotomy for patients suffering from penetrating injuries. We evaluated whether DL similarly lowers the rate of nontherapeutic laparotomy for patients with blunt injuries. All patients undergoing DL over a 10-year period (ie, 2001-2010) in a single level 1 trauma center were classified by the mechanism of injury. Demographic and perioperative data were compared using the Student t and Fisher exact tests. There were 131 patients included, 22 of whom sustained blunt injuries. Patients suffering from blunt injuries were more severely injured (Injury Severity Score 18.0 vs 7.3, P = .0001). The most common indication for DL after blunt injury was a computed tomographic scan concerning for bowel injury (59.1%). The rate of nontherapeutic laparotomy for patients sustaining penetrating vs blunt injury was 1.8% and nil, respectively. DL, when coupled with computed tomographic findings, is an effective tool for the initial management of patients with blunt injuries. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Coagulopathy and transfusion requirements in war related penetrating traumatic brain injury. A single centre study in a French role 3 medical treatment facility in Afghanistan.

    Science.gov (United States)

    Bordes, J; Joubert, C; Esnault, P; Montcriol, A; Nguyen, C; Meaudre, E; Dulou, R; Dagain, A

    2017-05-01

    Traumatic brain injury associated coagulopathy is frequent, either in isolated traumatic brain injury in civilian practice and in combat traumatic brain injury. In war zone, it is a matter of concern because head and neck are the second most frequent site of wartime casualty burden. Data focusing on transfusion requirements in patients with war related TBI coagulopathy are limited. A descriptive analysis was conducted of 77 penetrating traumatic brain injuries referred to a French role 3 medical treatment facility in Kabul, Afghanistan, deployed on the Kabul International Airport (KaIA), over a 30 months period. On 77 patients, 23 died during the prehospital phase and were not included in the study. Severe traumatic brain injury represented 50% of patients. Explosions were the most common injury mechanism. Extracranial injuries were present in 72% of patients. Traumatic brain injury coagulopathy was diagnosed in 67% of patients at role 3 admission. Red blood cell units (RBCu) were transfused in 39 (72%) patients, French lyophilized plasma (FLYP) in 41 (76%), and fresh whole blood (FWB) in 17 (31%). The results of this study support previous observations of coagulopathy as a frequent complication of traumatic brain injury. The majority of patients with war related penetrating traumatic brain injury presented with extracranial lesions. Most of them required a high level of transfusion capacity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. penetrating abdominal trauma

    African Journals Online (AJOL)

    gender, mechanism of injury, injury severity scores (ISS), penetrating ... ileus, reduced pulmonary function and loss of muscle mass and function, all of .... pathophysiology and rehabilitation. ... quality of life after surgery for colorectal cancer.

  20. Multiple growing fractures and cerebral venous anomaly after penetrating injuries: delayed diagnosis in a battered child

    International Nuclear Information System (INIS)

    Makkat, S.; Vandevenne, J.E.; Parizel, P.M.; Schepper, A.M. de

    2001-01-01

    A growing fracture usually results from a skull fracture with dural tear after blunt head trauma during infancy. We present a case of child abuse with multiple growing fractures resulting from penetrating head trauma by scissors. MR imaging confirmed the presence of growing fractures and revealed a presumably post-traumatic venous anomaly (occluded left cavernous sinus and aberrant posterior venous drainage via the internal cerebral veins). Diagnosis of the growing fractures and venous anomaly was delayed until the age of 15 years. Medical expertise should be more readily available to battered children, and MR imaging is advocated in growing skull fracture to exclude associated post-traumatic brain lesions. (orig.)

  1. Multiple growing fractures and cerebral venous anomaly after penetrating injuries: delayed diagnosis in a battered child

    Energy Technology Data Exchange (ETDEWEB)

    Makkat, S.; Vandevenne, J.E.; Parizel, P.M.; Schepper, A.M. de [Dept. of Radiology, Universitair Ziekenhuis Antwerpen, Edegem (Belgium)

    2001-05-01

    A growing fracture usually results from a skull fracture with dural tear after blunt head trauma during infancy. We present a case of child abuse with multiple growing fractures resulting from penetrating head trauma by scissors. MR imaging confirmed the presence of growing fractures and revealed a presumably post-traumatic venous anomaly (occluded left cavernous sinus and aberrant posterior venous drainage via the internal cerebral veins). Diagnosis of the growing fractures and venous anomaly was delayed until the age of 15 years. Medical expertise should be more readily available to battered children, and MR imaging is advocated in growing skull fracture to exclude associated post-traumatic brain lesions. (orig.)

  2. Antifungal Wound Penetration of Amphotericin and Voriconazole in Combat-related Injuries: Case Report

    Science.gov (United States)

    2015-04-15

    invasive fungal infection in accord- ance with the LRMC “blast protocol” [8], demonstrating angioinvasive non-septate branching hyphae diagnostic of...different occasions between post-injury days 12 and 46, with non-septate branching hyphae observed but not cultured on 5 additional soft tissue specimens

  3. Penetrating injury caused by the gear pedal of a motor-cycle

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    He had no neurovascular injury but was found radiologically to have an ipsilateral tibia fracture. ... radiologiquement d'avoir une fracture du tibia ipsilatéral. ... the ankle joint. It passed out from the lateral aspect approximately 6 cm distal to the lateral malleolus. He also sustained a laceration measuring about 10cm on the ...

  4. Early-onset Infectious Complications among Penetrating and Severe Closed Traumatic Brain Injury in Active Duty Deployed during OIF and OEF, 2008-2013

    Science.gov (United States)

    2015-02-01

    seizures, hydrocephalus, cerebral spinal fluid (CSF) leaks, infections inside the skull, vascular injuries, and cranial nerve injuries. 9-11 The...the form of early in-theater cranial decompression, followed by aggressive critical care management. 8 Medical advances, in addition to improved body...p = 0.66). However, closed TBI patients were significantly more likely than penetrating TBI patients to have anoxic brain damage (coma, stupor

  5. Stiletto stabbing: penetrating injury to the hypothalamus with hyperacute diabetes insipidus.

    Science.gov (United States)

    Itshayek, Eyal; Gomori, John Moshe; Spektor, Sergey; Cohen, José E

    2010-12-01

    Diabetes insipidus (DI) is a well documented complication observed after traumatic head injuries. We report a case of hyperacute onset DI in a 19-year-old male who sustained a hypothalamic-pituitary injury when he was stabbed in the head with a 30-cm long thin-bladed knife. At CT, our patient showed significant hemorrhagic contusions of the lower hypothalamus. He developed polydipsia, polyuria, and mild hypernatremia in the Emergency Department. Diagnostic digital subtraction angiography showed a hypervascular congestive pituitary gland with prominent draining veins. On the third day his hypernatremia became severe (183mEq/L). He was managed with parenteral fluids and a regimen of intranasal DDAVP (1-desamino 8-d-arginine vasopressin), leading to improved plasmatic sodium levels, urine output, and urinary specific gravity. In patients presenting with hyperacute posttraumatic DI, emergency room physicians and neurosurgeons should rule out direct injury to the hypothalamus and/or the posterior lobe of the pituitary, and initiate early pharmacological treatment. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Development of a guinea pig cutaneous radiation injury model using low penetrating X-rays.

    Science.gov (United States)

    Rodgers, Kathleen E; Tan, Alick; Kim, Lila; Espinoza, Theresa; Meeks, Christopher; Johnston, William; Maulhardt, Holly; Donald, Melissa; Hill, Colin; diZerega, Gere S

    2016-08-01

    A guinea pig skin model was developed to determine the dose-dependent response to soft X-ray radiation into the dermis. X-ray exposure (50 kVp) was defined to a 4.0 × 4.0 cm area on the lateral surface of a guinea pig using lead shielding. Guinea pigs were exposed to a single fraction of X-ray irradiation ranging from 25-79 Gy via an XRAD320ix Biological Irradiator with the collimator removed. Gross skin changes were measured using clinical assessments defined by the Kumar scale. Skin contracture was assessed, as well as histological evaluations. Loss of dermal integrity was shown after a single dose of soft X-ray radiation at or above 32 Gy with the central 2.0 × 2.0 cm of the exposed site being the most affected. Hallmarks of the skin injury included moist desquamation, ulceration and wound contracture, as well as alterations in epithelium, dermis, muscle and adipose. Changes in the skin were time- and radiation dose-dependent. Full-thickness injury occurred without animal mortality or gross changes in the underlying organs. The guinea pig is an appropriate small animal model for the short-term screening of countermeasures for cutaneous radiation injury (CRI).

  7. [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

  8. Selective Estrogen Receptor Modulators regulate reactive microglia after penetrating brain injury

    Directory of Open Access Journals (Sweden)

    George E. Barreto

    2014-06-01

    Full Text Available Following brain injury, microglia assume a reactive-like state and secrete pro-inflammatory molecules that can potentiate damage. A therapeutic strategy that may limit microgliosis is of potential interest. In this context, selective estrogen receptor modulators, such as raloxifene and tamoxifen, are known to reduce microglia activation induced by neuroinflammatory stimuli in young animals. In the present study, we have assessed whether raloxifene and tamoxifen are able to affect microglia activation after brain injury in young and aged animals in time points relevant to clinics, which is hours after brain trauma. Volume fraction of MHC-II+ microglia was estimated according to the point-counting method of Weibel within a distance of 350 μm from the lateral border of the wound, and cellular morphology was measured by fractal analysis. Two groups of animals were studied: 1 young rats, ovariectomized at 2 months of age; and 2 aged rats, ovariectomized at 18 months of age. Fifteen days after ovariectomy animals received a stab wound brain injury and the treatment with estrogenic compounds. Our findings indicate that raloxifene and tamoxifen reduced microglia activation in both young and aged animals. Although the volume fraction of reactive microglia was found lower in aged animals, this was accompanied by important changes in cell morphology, where aged microglia assume a bushier and hyperplasic aspect when compared to young microglia. These data suggest that early regulation of microglia activation provides a mechanism by which SERMs may exert a neuroprotective effect in the setting of a brain trauma.

  9. Lesiones penetrantes maxilofaciales: Presentación de 4 casos Penetrating maxillofacial injuries: Report of 4 cases

    Directory of Open Access Journals (Sweden)

    José Manuel Díaz Fernández

    2006-09-01

    Full Text Available Una historia y examen físico detallado deben ser imperativos en todos los pacientes con sospechas de lesiones penetrantes de la región maxilofacial por parte del cirujano maxilofacial, con participación activa y frecuente de oftalmólogos, otorrinolaringólogos y neurocirujanos, incluso ante lesiones aparentemente triviales. La exploración por radiografías simples, ultrasonidos y especialmente la tomografía axial computadorizada de reconstrucción tridimensional, constituye la mejor vía para detectar lesiones oculares y/ u orbitarias, fracturas del complejo craneofacial, precisar localización, naturaleza y relación del objeto hiriente con órganos y estructuras anatómicas importantes. Se presentan 4 pacientes con este tipo de lesiones proporcionadas por 3 tipos de objetos de naturaleza y características diferentes. Se enfatiza en los aspectos terapéuticos y se ilustra el trabajo con imágenes por rayos X simples y TAC. Se emiten consideraciones a tener presentes en este tipo de lesiones resaltando aquellas con extensión intracraneal.A medical history and a detailed physical examination should be imperative in all the patients with suspicion of penetrating injuries of the maxillofacial region, on the part of the maxillofacial surgeon with an active and frequent participation of ophthalmologists, otorhinolaryngologists and neurosurgeons, even in the case of apparently trivial injuries. The exploration by simple X rays, ultrasounds and, specially, computerized axial tomography of tridimensional reconstruction is the best way to detect ocular and/or orbital injuries, fractures of the craniofacial complex , and to determine the localization, nature and relation of the wounding object to organs and important anatomical structures. 4 patients with this type of injuries produced by three types of objects of different nature and characteristics are presented. Emphasis is made on the therapeutic aspects and the paper is illustrated with

  10. Reprodaetion of an animal model of multiple intestinal injuries mimicking "lethal triad" caused by severe penetrating abdominal trauma

    Directory of Open Access Journals (Sweden)

    Peng-fei WANG

    2011-03-01

    Full Text Available Objective To reproduce an animal model of multi-intestinal injuries with "lethal triad" characterized by low body temperature,acidosis and coagulopathy.Methods Six female domestic outbred pigs were anesthetized,and the carotid artery and jugular vein were cannulated for monitoring the blood pressure and heart rate and for infusion of fluid.The animals were shot with a gun to create a severe penetrating abdominal trauma.Immediately after the shooting,50% of total blood volume(35ml/kg hemorrhage was drawn from the carotid artery in 20min.After a 40min shock period,4h of pre-hospital phase was mimicked by normal saline(NS resuscitation to maintain systolic blood pressure(SBP > 80mmHg or mean arterial pressure(MAP > 60mmHg.When SBP > 80mmHg or MAP > 60mmHg,no fluid infusion or additional bleeding was given.Hemodynamic parameters were recorded,and pathology of myocardium,lung,small intestine and liver was observed.Results There were multiple intestinal perforations(8-10 site injuries/pig leading to intra-abdominal contamination,mesenteric injury(1-2 site injuries/pig resulted in partial intestinal ischemia and intra-abdominal hemorrhage,and no large colon and mesenteric vascular injury.One pig died before the completion of the model establishment(at the end of pre-hospital resuscitation.The typical symptoms of trauma-induced hemorrhagic shock were observed in survival animals.Low temperature(33.3±0.5℃,acidosis(pH=7.242±0.064,and coagulopathy(protrombin time and activated partial thromboplasting time prolonged were observed after pre-hospital resuscitation.Pathology showed that myocardium,lung,small intestine and liver were severely injured.Conclusions A new model,simulating three stages of "traumatic hemorrhagic shock,pre-hospital recovery and hospital treatment" and inducing the "lethal triad" accompanied with abdominal pollution,has been successfully established.This model has good stability and high reproducibility.The survival animals can be

  11. Experimental Evaluation of Ileal Patch in Delayed Primary Repair of Penetrating Colon Injuries: An Animal Study

    Directory of Open Access Journals (Sweden)

    Hamid Reza Abbasi

    2006-10-01

    Full Text Available Primary repair of traumatic colonic perforation is progressively gaining acceptance as the best method of management. However, when delayed, the risk of infection-related complications may increase. Here, we present a new method of repairing colon perforation in the presence of peritonitis. Acute colon injury was simulated in 22 German shepherd dogs. The dogs were randomly divided into two groups of 11 and after 24 hours they were operated on. The perforations were repaired by subserosal suture technique. In the first group (group A, ileal patch was used. In the other group (group B, the colon was closed by debridement and anastomosis. After 6 weeks, the repairs were assessed on the basis of survival, gross and histological assessments. Nine (82% dogs in group A and six (56% in group B survived. Ileal patch utilization significantly decreased the mortality rate (p < 0.05. The cause of death in two group A dogs and five group B dogs was peritonitis and intra-abdominal abscess formation. None of the surviving dogs showed evidence of anastomotic leakage or breakdown. Small bowel patch used in primary repair of colon injury in the presence of peritonitis may decrease the risk of postoperative infection-related complications and the mortality rate.

  12. A Political Case of Penetrating Cranial Trauma: The Injury of James Scott Brady.

    Science.gov (United States)

    Menger, Richard; Kalakoti, Piyush; Hanif, Rimal; Ahmed, Osama; Nanda, Anil; Guthikonda, Bharat

    2017-09-01

    James Brady, the White House press secretary during President Ronald Reagan's first term in office, was 1 of 4 people (including the President) wounded during an attempted assassination attempt on President Reagan's life on March 30, 1981. John Hinckley, Jr. was found not guilty of this attempt by reason of insanity. The assassination attempt was a ploy by Hinckley, Jr. to impress the actress Jodie Foster. Brady was the most seriously injured of the 4 who were wounded. He suffered a gunshot wound to the left forehead that traveled through the left frontal lobe, corpus callosum, and then into the right frontal and temporal lobes. He initially required a bifrontal craniotomy for evacuation of a right frontotemporal intraparenchymal hemorrhage and debridement of tract. His postoperative course was complicated by seizures, cerebrospinal fluid leakage (necessitating multiple reparative procedures), aspiration pneumonia, and pulmonary emboli. Despite the severity of his injury and perioperative morbidities, Mr. Brady made good recovery. Although permanently left with residual weakness on the left side of his body, making a wheelchair necessary, Brady maintained cognitive and personality traits that were very close to his preinjury baseline. As a result, James Brady and his wife, Sarah, led a call to create legislative reform subsequently known as the "Brady Bill." This bill controversially made mandatory background checks for the purchase of firearms from licensed dealers. Our work aims to describe the assassination attempt, the neurosurgical injury and management of Mr. Brady's case, and the brief historical sequel that followed. Copyright © 2017 by the Congress of Neurological Surgeons.

  13. Complication following primary repair of a penetrating bull horn injury to the trachea

    Directory of Open Access Journals (Sweden)

    Khan Mozaffar

    2008-01-01

    Full Text Available A 22-year-old male patient was admitted to the casualty with a bull horn injury in the lower zone of the neck in the midline. The patient was conscious and distressed but hemodynamically stable. Local examination revealed a lacerated wound. He underwent emergency primary repair of the wound under halothane anesthesia; intubation was done keeping in readiness all preparations for difficult airway management. Postoperatively, elective controlled ventilation was performed with continuous infusion of muscle relaxant. After approximately 8 hours of controlled ventilation, the syringe pump failed; this initially went unnoticed and made the patient cough and buck on the tube. Infusion was restarted after a bolus dose of vecuronium bromide intravenously but, meanwhile, the patient developed subcutaneous emphysema in the neck. He was immediately transferred to the operating room, where exploration of the surgical site revealed dehiscence of the tracheal wound; this had led to the subcutaneous emphysema. Repair of the tracheal wound dehiscence was not possible due to both lack of space and lack of tissue for apposition. Hence, a tracheostomy tube was inserted through the tracheal wound and the patient was transferred to the intensive care unit for elective controlled ventilation. The patient was weaned off the ventilator within 24 h and transferred to the surgical ward on spontaneous ventilation with the tracheostomy tube in situ. The size of the patient′s tracheostomy tube was reduced gradually by the serial exchange method. The wound ultimately healed with minimal scarring.

  14. An unusual case of cerebral penetrating injury by a driven bone fragment secondary to blunt head trauma.

    Science.gov (United States)

    Lee, Jae Il; Ko, Jun Kyeung; Cha, Seung Heon; Han, In Ho

    2011-12-01

    Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right temple while cutting the rod. Initial brain computed tomography (CT) and magnetic resonance imaging demonstrated scanty subdural hematoma at right temporal lobe and left falx and intracerebral hematoma at both frontal lobes. Facial CT with 3-D reconstruction images showed a small bony defect at the right sphenoid bone's greater wing and a small bone fragment at the left frontal lobe, crossing the falx. We present the unusual case of a temple trauma patient in whom a sphenoid bone fragment migrated from its origin upward, to the contralateral frontal lobe, producing hematoma along its trajectory.

  15. Colon diversion versus primary colonic repair in gunshot abdomen with penetrating colon injury in Libyan revolution conflict 2011 (a single center experience).

    Science.gov (United States)

    Mansor, Salah; Bendardaf, Rashed; Bougrara, Muftah; Hagam, Mohamed

    2014-09-01

    The objective of this study is comparing colon diversion versus primary repair in penetrating colon gunshot injuries. A retrospective study of 63 cases of gunshot abdomen with penetrating colon injury were admitted to Al-jalla Hospital in 2011 in Benghazi, Libya. After surgical intervention, these patients were observed for any postoperative complications. During the study period, 63 eligible patients included, 62 (98.4%) were males and 1 (1.6%) was female. And the mean age was 29.24 years. Eighteen patients had an injury on the right side of the colon, while 16, 6, 11, 6, 2, 3, and 1 patients had an injury on the transverse, left, sigmoid, rectum, right transverse, left transverse, and total colonic injury, respectively. In the first group, 23 patients (36.5%) was treated with colon diversion, (2 with Hartmann's operation, 21 with loop colostomy). In the second group, 40 patients (63.4 %) was treated with primary repair. Eighteen (28.5%) with right hemicolectomy, 5 (7.9%) with transverse colon resection and anastomosis, and 17 (26.9%) with simple repair. We evaluate the rate of postoperative complication and compare the postoperative morbidity between both groups. In our study, there was no significant statistical difference between types of operations and rate of complications (P = 0.18). We could not see any advantage of the diversion over the primary repair. To reduce risk of the psychological trauma, complications of colostomy, unnecessary repeated hospitalization, decrease of economic cost, and complications of stoma revision operation, we should consider that the primary repair of penetrating colon injuries is an acceptable alternative method of treatment over the colostomy.

  16. Pleural Drainage and its Role in Management of the Isolated Penetrating Chest Injuries During the War Time in Sarajevo, 1992.-1995.

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    Ademir Hadžismajlović

    2007-05-01

    Full Text Available Penetrating chest injuries are the most frequent causes of serious demage and death in wounded indivisuals. In reports from the last wars where wounds caused by high velocity projectiles predominated, thoracotomies were perfomed in about 15% of the wounded individuals, mostly encompassing injuries of the heart and great vessels, accomanied by massive bleeding that could not be resolved by chest tube insertion. This retrospective analysis was performed on the medical records of 477 patients tretaed for isolated penetrating chest injuries in Department of Thoracic Surgery Clinical Center of the University in Sarajevo between april 1992 - june 1995. We analised the ways of their menagement with special view on pleural drainage, indication for this method and results of treatment. 398 (83,4% wounded individuals have been treated with pleural tube inserting as definitive mesaure and for the urgent thoracotomy there were 79 (16,6% patients left. Average hospital treatment in wounded drained patients was 7,68 days. With shrapnels there were 357 (74,84% wounded individuals, and with bullet 120 (25,16% wounded individuals. The complications of plaural tube inserting were - empyema in 34 (7,13% patients and there were no other complications. Chest tube inserting as definitive mesaure was used in 398 (83,44% patients. Chest tube inserting as preoperative measure (urgent thoracotomy was used in 79 (16,56% patients. There were 460 (96,44% healed patients. Death occurred in 17 (3,56% patients.

  17. Pleural drainage and its role in management of the isolated penetrating chest injuries during the war time in Sarajevo, 1992.-1995.

    Science.gov (United States)

    Hadzismajlović, Ademir; Pilav, Alen

    2007-05-01

    Penetrating chest injuries are the most frequent causes of serious demage and death in wounded indivisuals. In reports from the last wars where wounds caused by high velocity projectiles predominated, thoracotomies were perfomed in about 15% of the wounded individuals, mostly encompassing injuries of the heart and great vessels, accomanied by massive bleeding that could not be resolved by chest tube insertion. This retrospective analysis was performed on the medical records of 477 patients tretaed for isolated penetrating chest injuries in Department of Thoracic Surgery Clinical Center of the University in Sarajevo between april 1992 - june 1995. We analised the ways of their menagement with special view on pleural drainage, indication for this method and results of treatment. 398 (83,4%) wounded individuals have been treated with pleural tube inserting as definitive mesaure and for the urgent thoracotomy there were 79 (16,6%) patients left. Average hospital treatment in wounded drained patients was 7,68 days. With shrapnels there were 357 (74,84%) wounded individuals, and with bullet 120 (25,16%) wounded individuals. The complications of plaural tube inserting were - empyema in 34 (7,13%) patients and there were no other complications. Chest tube inserting as definitive mesaure was used in 398 (83,44%) patients. Chest tube inserting as preoperative measure (urgent thoracotomy) was used in 79 (16,56%) patients. There were 460 (96,44%) healed patients. Death occurred in 17 (3,56%) patients.

  18. The role of performing life support courses in rural areas in improving pre-hospital physiologic condition of patients with penetrating injuries

    International Nuclear Information System (INIS)

    Naffisi, N.; Mohebbi, H.A.; Moharamzadeh, Y.

    2008-01-01

    To evaluate the impact of animal model based medical training courses for village healthcare workers on prehospital physiologic condition and prognosis of patients with penetrating injuries. Seventy-six village healthcare workers were trained and equipped to deliver in-field medical first cares. First group (226 patients) consisted of those who received this cares by the trained group and second group (245 patients) were those who received no in-field cares and were transported directly to the trauma center in provincial capital, Ilam. Physiologic Severity Score (PSS) was calculated to determine the physiologic condition of patients in both groups. Results: The most prevalent cause of trauma in both groups was car accidents (61.6%). Controlling of hemorrhage was the most frequent provided initial medical care (40.6%). A significant improvement regarding the PSS score was observed in the first group of patients compared to the second group (7.505 vs. 6.799, 95% CI for difference: 0.3 to 0.9). The mortality rates of the first and second group of patients were 3% and 7.3%, respectively (p=0.051). Performing life support courses in rural areas of low-income countries where there is no pre-hospital triage and emergency medical system and provision of classic resuscitative measures are limited, has a significant impact on improvement of pre-hospital physiologic condition and prognosis of patients with penetrating injuries. (author)

  19. NNZ-2566 treatment inhibits neuroinflammation and pro-inflammatory cytokine expression induced by experimental penetrating ballistic-like brain injury in rats

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    Tortella Frank C

    2009-08-01

    Full Text Available Abstract Background Inflammatory cytokines play a crucial role in the pathophysiology of traumatic brain injury (TBI, exerting either deleterious effects on the progression of tissue damage or beneficial roles during recovery and repair. NNZ-2566, a synthetic analogue of the neuroprotective tripeptide Glypromate®, has been shown to be neuroprotective in animal models of brain injury. The goal of this study was to determine the effects of NNZ-2566 on inflammatory cytokine expression and neuroinflammation induced by penetrating ballistic-like brain injury (PBBI in rats. Methods NNZ-2566 or vehicle (saline was administered intravenously as a bolus injection (10 mg/kg at 30 min post-injury, immediately followed by a continuous infusion of NNZ-2566 (3 mg/kg/h, or equal volume of vehicle, for various durations. Inflammatory cytokine gene expression from the brain tissue of rats exposed to PBBI was evaluated using microarray, quantitative real time PCR (QRT-PCR, and enzyme-linked immunosorbent assay (ELISA array. Histopathology of the injured brains was examined using hematoxylin and eosin (H&E and immunocytochemistry of inflammatory cytokine IL-1β. Results NNZ-2566 treatment significantly reduced injury-mediated up-regulation of IL-1β, TNF-α, E-selectin and IL-6 mRNA during the acute injury phase. ELISA cytokine array showed that NZ-2566 treatment significantly reduced levels of the pro-inflammatory cytokines IL-1β, TNF-α and IFN-γ in the injured brain, but did not affect anti-inflammatory cytokine IL-6 levels. Conclusion Collectively, these results suggest that the neuroprotective effects of NNZ-2566 may, in part, be functionally attributed to the compound's ability to modulate expression of multiple neuroinflammatory mediators in the injured brain.

  20. Surgical management of cutaneous infection caused by atypical mycobacteria after penetrating injury: the hidden dangers of horticulture.

    Science.gov (United States)

    Holland, J; Smith, C; Childs, P A; Holland, A J

    1997-02-01

    We identified two patients in a 12-month period who presented with cutaneous infection and secondary lymph node involvement from atypical mycobacterial infection after minor gardening injuries. One patient had a coinfection with Nocardia asteroides. Both patients required multiple surgical interventions, despite appropriate antibiotic therapy, before resolution of the disease. The course of the infection was characterized by chronic relapses with complete healing at 12 to 18 months after the original injury. The identification and management of this clinical problem are reviewed.

  1. Penetrating ureteral trauma

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    Gustavo P. Fraga

    2007-04-01

    Full Text Available OBJECTIVE: The purpose of this series is to report our experience in managing ureteral trauma, focusing on the importance of early diagnosis, correct treatment, and the impact of associated injuries on the management and morbid-mortality. MATERIALS AND METHODS: From January 1994 to December 2002, 1487 laparotomies for abdominal trauma were performed and 20 patients with ureteral lesions were identified, all of them secondary to penetrating injury. Medical charts were analyzed as well as information about trauma mechanisms, diagnostic routine, treatment and outcome. RESULTS: All patients were men. Mean age was 27 years. The mechanisms of injury were gunshot wounds in 18 cases (90% and stab wounds in two (10%. All penetrating abdominal injuries had primary indication of laparotomy, and neither excretory urography nor computed tomography were used in any case before surgery. The diagnosis of ureteric injury was made intra-operatively in 17 cases (85%. Two ureteral injuries (10% were initially missed. All patients had associated injuries. The treatment was dictated by the location, extension and time necessary to identify the injury. The overall incidence of complications was 55%. The presence of shock on admission, delayed diagnosis, Abdominal Trauma Index > 25, Injury Severity Score > 25 and colon injuries were associated to a high complication rate, however, there was no statistically significant difference. There were no mortalities in this group. CONCLUSIONS: A high index of suspicion is required for diagnosis of ureteral injuries. A thorough exploration of all retroperitoneal hematoma after penetrating trauma should be an accurate method of diagnosis; even though it failed in 10% of our cases.

  2. A Close Cut: A Technical Report of Endovascular Removal of a Penetrating Intravascular Foreign Body after a Lawn Mowing Injury

    Energy Technology Data Exchange (ETDEWEB)

    Tapping, C. R. [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom); Gallo, A.; Silva, R. J. De [Oxford University Hospitals, John Radcliffe Hospital, Department of Cardiothoracic Surgery (United Kingdom); Uberoi, R., E-mail: raman.uberoi@orh.nhs.uk [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom)

    2012-12-15

    We present a case of endovascular retrieval of a penetrating foreign body that was originally lodged in the mediastinum and then migrated to the hepatic vein. The steel nail entered the thorax and traversed the left lung causing a pneumothorax. The patient underwent a thoracotomy, but the foreign body had migrated from its original mediastinal position. A postsurgical CT showed that the object was below the right hemidiaphragm. Diagnostic venogram demonstrated that the object was in the main hepatic vein. Using a double-snare technique, the object was safely and successfully removed from the hepatic vein via the right common femoral vein.

  3. The role of performing life support courses in rural areas in improving pre-hospital physiologic conditions of patients with penetrating injuries.

    Science.gov (United States)

    Nia, Masoud Saghafi; Naffisi, Nahid; Mohebbi, Hassan Ali; Moharamzadeh, Yashar

    2008-09-01

    To evaluate the impact of animal model based medical training courses for village healthcare workers on prehospital physiologic condition and prognosis of patients with penetrating injuries. Experimental study. This study was carried out in Mehran city and its neighbouring rural districts in western part of Iran from 2002 to 2004. Seventy-six village healthcare workers were trained and equipped to deliver in-field medical first cares. First group (226 patients) consisted of those who received this cares by the trained group and second group (245 patients) were those who received no in-field cares and were transported directly to the trauma center in provincial capital, Ilam. Physiologic Severity Score (PSS) was calculated to determine the physiologic condition of patients in both groups. The most prevalent cause of trauma in both groups was car accidents (61.6%). Controlling of hemorrhage was the most frequent provided initial medical care (40.6%). A significant improvement regarding the PSS score was observed in the first group of patients compared to the second group (7.505 vs. 6.799, 95% CI for difference: 0.3 to 0.9). The mortality rates of the first and second group of patients were 3% and 7.3%, respectively (p=0.051). Performing life support courses in rural areas of low-income countries where there is no pre-hospital triage and emergency medical system and provision of classic resuscitative measures are limited, has a significant impact on improvement of pre-hospital physiologic condition and prognosis of patients with penetrating injuries.

  4. Comprehensive Evaluation of Neuroprotection Achieved by Extended Selective Brain Cooling Therapy in a Rat Model of Penetrating Ballistic-Like Brain Injury

    Science.gov (United States)

    Shear, Deborah A.; Deng-Bryant, Ying; Leung, Lai Yee; Wei, Guo; Chen, Zhiyong; Tortella, Frank C.

    2016-01-01

    Brain hypothermia has been considered as a promising alternative to whole-body hypothermia in treating acute neurological disease, for example, traumatic brain injury. Previously, we demonstrated that 2-hours selective brain cooling (SBC) effectively mitigated acute (≤24 hours postinjury) neurophysiological dysfunction induced by a penetrating ballistic-like brain injury (PBBI) in rats. This study evaluated neuroprotective effects of extended SBC (4 or 8 hours in duration) on sub-acute secondary injuries between 3 and 21 days postinjury (DPI). SBC (34°C) was achieved via extraluminal cooling of rats' bilateral common carotid arteries (CCA). Depending on the experimental design, SBC was introduced either immediately or with a 2- or 4-hour delay after PBBI and maintained for 4 or 8 hours. Neuroprotective effects of SBC were evaluated by measuring brain lesion volume, axonal injury, neuroinflammation, motor and cognitive functions, and post-traumatic seizures. Compared to untreated PBBI animals, 4 or 8 hours SBC treatment initiated immediately following PBBI produced comparable neuroprotective benefits against PBBI-induced early histopathology at 3 DPI as evidenced by significant reductions in brain lesion volume, axonal pathology (beta-amyloid precursor protein staining), neuroinflammation (glial fibrillary acetic protein stained-activated astrocytes and rat major histocompatibility complex class I stained activated microglial cell), and post-traumatic nonconvulsive seizures. In the later phase of the injury (7–21 DPI), significant improvement on motor function (rotarod test) was observed under most SBC protocols, including the 2-hour delay in SBC initiation. However, SBC treatment failed to improve cognitive performance (Morris water maze test) measured 13–17 DPI. The protective effects of SBC on delayed axonal injury (silver staining) were evident out to 14 DPI. In conclusion, the CCA cooling method of SBC produced neuroprotection measured across multiple

  5. Can surgery improve neurological function in penetrating spinal injury? A review of the military and civilian literature and treatment recommendations for military neurosurgeons.

    Science.gov (United States)

    Klimo, Paul; Ragel, Brian T; Rosner, Michael; Gluf, Wayne; McCafferty, Randall

    2010-05-01

    Penetrating spinal injury (PSI), although an infrequent injury in the civilian population, is not an infrequent injury in military conflicts. Throughout military history, the role of surgery in the treatment of PSI has been controversial. The US is currently involved in 2 military campaigns, the hallmark of both being the widespread use of various explosive devices. The authors reviewed the evidence for or against the use of decompressive laminectomy to treat PSI to provide a triservice (US Army, Navy, and Air Force) consensus and treatment recommendations for military neurosurgeons and spine surgeons. A US National Library of Medicine PubMed database search that identified all literature dealing with acute management of PSI from military conflicts and civilian urban trauma centers in the post-Vietnam War period was undertaken. Nineteen retrospective case series (11 military and 8 civilian) met the study criteria. Eleven military articles covered a 20-year time span that included 782 patients who suffered either gunshot or blast-related projectile wounds. Four papers included sufficient data that analyzed the effectiveness of surgery compared with nonoperative management, 6 papers concluded that surgery was of no benefit, 2 papers indicated that surgery did have a role, and 3 papers made no comment. Eight civilian articles covered a 9-year time span that included 653 patients with spinal gunshot wounds. Two articles lacked any comparative data because of treatment bias. Two papers concluded that decompressive laminectomy had a beneficial role, 1 paper favored the removal of intracanal bullets between T-12 and L-4, and 5 papers indicated that surgery was of no benefit. Based on the authors' military and civilian PubMed literature search, most of the evidence suggests that decompressive laminectomy does not improve neurological function in patients with PSI. However, there are serious methodological shortcomings in both literature groups. For this and other reasons

  6. The challenges in developing a finite element injury model of the neck to predict the penetration of explosively propelled projectiles.

    Science.gov (United States)

    Breeze, Johno; Newbery, T; Pope, D; Midwinter, M J

    2014-09-01

    Neck injuries sustained by UK service personnel serving on current operations from explosively propelled fragments result in significant mortality and long-term morbidity. Many of these injuries could potentially have been prevented had the soldiers been wearing their issued neck collars at the time of injury. The aim of this research is to develop an accurate method of predicting the resultant damage to cervical neurovascular structures from explosively propelled fragments. A finite element numerical model has been developed based on an anatomically accurate, anthropometrically representative 3D mathematical mesh of cervical neurovascular structures. Currently, the model simulates the passage of a fragment simulating projectile through all anatomical components of the neck using material models based upon 20% ballistic gelatin on the simplification that all tissue types act like homogenous muscle. The material models used to define the properties of each element within the model will be sequentially replaced by ones specific to each individual tissue within an anatomical structure. However, the cumulative effect of so many additional variables will necessitate experimental validation against both animal models and post-mortem human subjects to improve the credibility of any predictions made by the model. We believe this approach will in the future have the potential to enable objective comparisons between the mitigative effects of different body armour systems to be made with resultant time and financial savings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. [HIGH VELOCITY PENETRATING HEAD AND NECK INJURIES OF SYRIAN CIVIL WAR CASUALTIES TREATED IN THE GALILEE MEDICAL CENTER].

    Science.gov (United States)

    Ronen, Ohad; Assadi, Nidal; Sela, Eyal

    2017-05-01

    For two years the State of Israel has been treating casualties from the Syrian civil war. The Galilee Medical Center in Nahariya is the main hospital for this humanitarian mission. Objectives: To evaluate the demographic and clinical characteristics of the casualties that were treated in our department. Information from medical records of all Syrian casualties evacuated to the Galilee Medical Center were evaluated. Between March 2013 and December 2014, 450 casualties were evacuated to the Galilee Medical Center. Of those, 45 were treated in the Department of Otolaryngology - Head and Neck Surgery. Of the 45 cases, 43 were male (95.5%) and the mean age was 30.4 years (range 1-79 years). There was a significant difference in terms of gender (p Syria, and 12 died. Of all Syrian injured treated in the ENT department, the vast majority were young men. The main cause of injury was gunshot wounds. It is likely that the lack of protective gear that exist in western armies is a factor in the complex injuries treated at the Galilee Medical Center.

  8. Anthropometric assessment of cervical neurovascular structures using CTA to determine zone-specific vulnerability to penetrating fragmentation injuries

    International Nuclear Information System (INIS)

    Breeze, J.; West, A.; Clasper, J.

    2013-01-01

    Aim: To determine military-specific cervical neurovascular and external anthropometric data to scale future numerical injury models of the neck and improve body armour design with a view to prevention or mitigation of combat neck injury. Materials and methods: Contrast-enhanced computed tomography (CT) angiograms of 50 UK servicemen were analysed. Mean diameters and distances from the skin surface were determined for the carotid artery (CA), internal jugular vein (IJV), vertebral artery (VA) and spinal cord (SC) at the three surgical neck zones. Horizontal neck circumference at C6 and three potential vertical cervical anthropometric measurements were analysed to determine which had the least variability between subjects. Results: The diameters of cervical vascular structures are greater and the vessels more superficial as the anatomical plane moves caudally. The SC and VA are better protected than the IJV and CA due to their greater depth and bony coverage, except for the VA in zone 1. Conclusion: Future cervical anthropometric assessments should use the vertical angle of mandible to mid-claviclular distance in combination with the horizontal neck circumference as these demonstrated the least variability. Cervical neurovascular structures are least vulnerable posterosuperiorly and therefore extending the posterior aspect of a ballistic helmet inferiorly or adding a nape protector would appear to be less justified. Cervical vessels are most vulnerable in zone 1 and a circumferential collar of ballistic material at least 75 mm high would cover this area in 95% of this population.

  9. Dual Therapeutic Effects of C-10068, a Dextromethorphan Derivative, Against Post-Traumatic Nonconvulsive Seizures and Neuroinflammation in a Rat Model of Penetrating Ballistic-Like Brain Injury

    Science.gov (United States)

    Shear, Deborah A.; Graham, Philip B.; Bridson, Gary W.; Uttamsingh, Vinita; Chen, Zhiyong; Leung, Lai Yee; Tortella, Frank C.

    2015-01-01

    Abstract Post-traumatic seizures can exacerbate injurious outcomes of severe brain trauma, yet effective treatments are limited owing to the complexity of the pathology underlying the concomitant occurrence of both events. In this study, we tested C‐10068, a novel deuterium-containing analog of (+)-N-methyl-3-ethoxymorphinan, in a rat model of penetrating ballistic-like brain injury (PBBI) and evaluated the effects of C-10068 on PBBI-induced nonconvulsive seizures (NCS), acute neuroinflammation, and neurofunctional outcomes. NCS were detected by electroencephalographic monitoring. Neuroinflammation was evaluated by immunohistochemical markers, for example, glial fibrillary acidic protein and major histocompatibility complex class I, for activation of astrocytes and microglia, respectively. Neurofunction was tested using rotarod and Morris water maze tasks. Three infusion doses of C-10068 (1.0, 2.5, and 5.0 mg/kg/h×72 h) were tested in the antiseizure study. Neuroinflammation and neurofunction were evaluated in animals treated with 5.0 mg/kg/h×72 h C-10068. Compared to vehicle treatment, C-10068 dose dependently reduced PBBI-induced NCS incidence (40–50%), frequency (20–70%), and duration (30–82%). The most effective antiseizure dose of C-10068 (5.0 mg/kg/h×72 h) also significantly attenuated hippocampal astrocyte activation and perilesional microglial reactivity post-PBBI. Within C-10068-treated animals, a positive correlation was observed in reduction in NCS frequency and reduction in hippocampal astrocyte activation. Further, C-10068 treatment significantly attenuated astrocyte activation in seizure-free animals. However, C-10068 failed to improve PBBI-induced motor and cognitive functions with the dosing regimen used in this study. Overall, the results indicating that C-10068 exerts both potent antiseizure and antiinflammatory effects are promising and warrant further investigation. PMID:25794265

  10. Dual Therapeutic Effects of C-10068, a Dextromethorphan Derivative, Against Post-Traumatic Nonconvulsive Seizures and Neuroinflammation in a Rat Model of Penetrating Ballistic-Like Brain Injury.

    Science.gov (United States)

    Lu, Xi-Chun May; Shear, Deborah A; Graham, Philip B; Bridson, Gary W; Uttamsingh, Vinita; Chen, Zhiyong; Leung, Lai Yee; Tortella, Frank C

    2015-10-15

    Post-traumatic seizures can exacerbate injurious outcomes of severe brain trauma, yet effective treatments are limited owing to the complexity of the pathology underlying the concomitant occurrence of both events. In this study, we tested C-10068, a novel deuterium-containing analog of (+)-N-methyl-3-ethoxymorphinan, in a rat model of penetrating ballistic-like brain injury (PBBI) and evaluated the effects of C-10068 on PBBI-induced nonconvulsive seizures (NCS), acute neuroinflammation, and neurofunctional outcomes. NCS were detected by electroencephalographic monitoring. Neuroinflammation was evaluated by immunohistochemical markers, for example, glial fibrillary acidic protein and major histocompatibility complex class I, for activation of astrocytes and microglia, respectively. Neurofunction was tested using rotarod and Morris water maze tasks. Three infusion doses of C-10068 (1.0, 2.5, and 5.0 mg/kg/h × 72 h) were tested in the antiseizure study. Neuroinflammation and neurofunction were evaluated in animals treated with 5.0 mg/kg/h × 72 h C-10068. Compared to vehicle treatment, C-10068 dose dependently reduced PBBI-induced NCS incidence (40-50%), frequency (20-70%), and duration (30-82%). The most effective antiseizure dose of C-10068 (5.0 mg/kg/h × 72 h) also significantly attenuated hippocampal astrocyte activation and perilesional microglial reactivity post-PBBI. Within C-10068-treated animals, a positive correlation was observed in reduction in NCS frequency and reduction in hippocampal astrocyte activation. Further, C-10068 treatment significantly attenuated astrocyte activation in seizure-free animals. However, C-10068 failed to improve PBBI-induced motor and cognitive functions with the dosing regimen used in this study. Overall, the results indicating that C-10068 exerts both potent antiseizure and antiinflammatory effects are promising and warrant further investigation.

  11. Penetrating cardiothoracic war wounds.

    Science.gov (United States)

    Biocina, B; Sutlić, Z; Husedzinović, I; Rudez, I; Ugljen, R; Letica, D; Slobodnjak, Z; Karadza, J; Brida, V; Vladović-Relja, T; Jelić, I

    1997-03-01

    Penetrating cardiothoracic war wounds are very common among war casualties. Those injuries require prompt and specific treatment in an aim to decrease mortality and late morbidity. There are a few controversies about the best modality of treatment for such injuries, and there are not many large series of such patients in recent literature. We analysed a group of 259 patients with penetrating cardiothoracic war wounds admitted to our institutions between May 1991 and October 1992. There were 235 (90.7%) patients with thoracic wounds, 14 (5.4%) patients with cardiac, wounds and in 10 (3.7%) patients both heart and lungs were injured. The cause of injury was shrapnel in 174 patients (67%), bullets in 25 patients (9.7%), cluster bomb particles in 45 patients (17.3%) and other (blast etc.) in 15 patients (6%). Patients, 69, had concomitant injuries of various organs. The initial treatment in 164 operated patients was chest drainage in 76 (46.3%) patients, thoracotomy and suture of the lung in 71 (43.2%) patients, lobectomy in 12 (7.3%) patients and pneumonectomy in 5 (3%) patients. Complications include pleural empyema and/or lung abscess in 20 patients (8.4%), incomplete reexpansion of the lung in 10 patients (4.2%), osteomyelitis of the rib in 5 patients (2.1%) and bronchopleural fistula in 1 patient (0.4%). Secondary procedures were decortication in 12 patients, rib resection in 5 patients, lobectomy in 2 patients, pneumonectomy in 4 patients, reconstruction of the chest wall in 2 patients and closure of the bronchopleural fistula in 1 patient. The cardiac chamber involved was right ventricle in 12 patients, left ventricular in 6 patients, right atrium in 7 patients, left atrium in 3 patients, ascending aorta in 2 patients and 1 patient which involved descending aorta, right ventricle and coronary artery (left anterior descending) and inferior vena cava, respectively. The primary procedure was suture in 17 patients (in 10 patients with the additional suture of the

  12. Lesão cerebral penetrante por grande fragmento de fibra de amianto tratada por craniectomia descompressiva: relato de caso Penetrating brain injury due to a large asbestos fragment treated by decompressive craniectomy: case report

    Directory of Open Access Journals (Sweden)

    Gustavo Cardoso de Andrade

    2004-12-01

    Full Text Available Relata-se caso de paciente de 22 anos vítima de traumatismo cranioencefálico penetrante por fragmento de fibra de amianto medindo 15 x 12 cm, e seu tratamento bem sucedido por craniectomia descompressiva. Ao contrário da lesão encefálica por projétil de arma de fogo, lesão encefálica penetrante por objeto de baixa energia é incomum. A maioria dos casos relatados na literatura envolve lesões cranio-orbitárias ou autoflagelação em pacientes psiquiátricos. O caso relatado torna-se especial em virtude das grandes dimensões do objeto penetrante, do tratamento por craniectomia descompressiva e do bom resultado funcional alcançado.We report the case of a 22-year-old man victim of penetrating brain injury due to a 15 x 12 asbestos fragment and a successfully treatment via decompressive craniectomy. Unlike gunshot wounds to the head, penetrating brain injury from low energy objects are unusual. Most cases reported involve cranio-orbitary injuries as well as self inflicted lesions in mentally ill patients. The reported case is noteworthy due to the large dimensions of the foreign body, the treatment via decompressive craniectomy and the good patient functional outcome.

  13. colour-flow ultrasound in the detection of penetrating vascular

    African Journals Online (AJOL)

    VASCULAR INJURIES OF THE NECK. Peter Corr ... in patients with penetrating neck injuries. 5 IIfr Mal ... study of the aortic arch, carotid and vertebral artery was performed as .... that may require endovascular treatment, for example vertebral.

  14. Thyroid Emphysema Following Penetrating Neck Trauma

    Directory of Open Access Journals (Sweden)

    Demet Karadağ

    2011-03-01

    Full Text Available Although traumatic thyroid gland rupture or hemorrhage is usually seen in goitrous glands, injuries of the normal thyroid gland after neck trauma have rarely been described in the literature. We describe a 44-year-old man who presented with thyroid emphysema and subcutaneous emphysema (SCE that occurred after penetrating neck trauma. CT images showed complete resolution of thyroid emphysema and subcutaneous emphysema at follow-up examination. Neck injuries can be life threatening. After penetrating neck traumas, physicians should consider subtle esophageal or tracheal laceration. Thyroid emphysema can occur as the result of penetrating neck trauma. The mechanism of emphysema of the thyroid parenchyma can be explained by the thyroid gland’s presence in a single visceral compartment that encompasses the larynx, trachea and thyroid gland. We describe an unusual case of thyroid emphysema of a normal thyroid gland following a penetrating neck injury.

  15. Experience With The Management Of unusual Penetrating Chest ...

    African Journals Online (AJOL)

    The presentation shows how a victim of fall from height in the bush can sustain a penetrating chest injury on a dry stick of a shrub. Applications on the principles of management of penetrating chest injury is needed despite the grotesque clinical appearance. [Jnl College of Medicine Vol.7(1) 2002: 40-42] ...

  16. Accuracy of Physical Examination, Ankle-Brachial Index, and Ultrasonography in the Diagnosis of Arterial Injury in Patients With Penetrating Extremity Trauma: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    deSouza, Ian S; Benabbas, Roshanak; McKee, Sean; Zangbar, Bardiya; Jain, Ashika; Paladino, Lorenzo; Boudourakis, Leon; Sinert, Richard

    2017-08-01

    Penetrating Extremity Trauma (PET) may result in arterial injury, a rare but limb- and life-threatening surgical emergency. Timely, accurate diagnosis is essential for potential intervention in order to prevent significant morbidity. Using a systematic review/meta-analytic approach, we determined the utility of physical examination, Ankle-Brachial Index (ABI), and Ultrasonography (US) in the diagnosis of arterial injury in emergency department (ED) patients who have sustained PET. We applied a test-treatment threshold model to determine which evaluations may obviate CT Angiography (CTA). We searched PubMed, Embase, and Scopus from inception to November 2016 for studies of ED patients with PET. We included studies on adult and pediatric subjects. We defined the reference standard to include CTA, catheter angiography, or surgical exploration. When low-risk patients did not undergo the reference standard, trials must have specified that patients were observed for at least 24 hours. We used the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) to evaluate bias and applicability of the included studies. We calculated positive and negative likelihood ratios (LR+ and LR-) of physical examination ("hard signs" of vascular injury), US, and ABI. Using established CTA test characteristics (sensitivity = 96.2%, specificity = 99.2%) and applying the Pauker-Kassirer method, we developed a test-treatment threshold model (testing threshold = 0.14%, treatment threshold = 72.9%). We included eight studies (n = 2,161, arterial injury prevalence = 15.5%). Studies had variable quality with most at high risk for partial and double verification bias. Some studies investigated multiple index tests: physical examination (hard signs) in three studies (n = 1,170), ABI in five studies (n = 1,040), and US in four studies (n = 173). Due to high heterogeneity (I 2  > 75%) of the results, we could not calculate LR+ or LR- for hard signs or LR+ for ABI. The weighted

  17. Penetrating abdominal trauma.

    Science.gov (United States)

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  18. [Heterogeneity of costs and performance for penetrating eye injuries and suturing amniotic membranes under DRG conditions : Analysis of case constellations of the G-DRG C01B of the Regensburg University eye clinic].

    Science.gov (United States)

    Franz, D; Mrosek, M; Mrosek, S; Helbig, H; Framme, C

    2012-01-01

    Patients with penetrating eye injuries are a very heterogeneous group both medically and economically. Since 2009, treatment involving sutures for open eye injuries and cases requiring amniotic membrane transplantation (AMT) were allocated to DRG C01B of the German diagnosis-related group system. However, given the significant clinical differences between these treatments, an inhomogeneity of costs to performance is postulated. This analysis describes case allocation problems within the G-DRG C01B category and presents solutions. A retrospective analysis was conducted from the standardized G-DRG data of 277 patients with open eye injuries and AMT between 2007 and 2008, grouped under the 2008 G-DRG system version to the G-DRG C01Z category. This data was provided by the Department of Ophthalmology at the University Hospital Regensburg. Additionally case-based data of the following were supplemented: length of surgery, time of anesthesia and intensity of patient care. Fixed and variable costs were determined for surgery and other inpatient treatment. Finally, an analysis of the heterogeneity of costs within the G-DRG C01B of the G-DRG system 2009 was implemented. Inhomogeneity was evident within the G-DRG C01B of the G-DRG system 2009 for the two groups suture of open eye injuries and AMT concerning the parameters length of stay, proportion of high outliers and cost per case. Multiple surgeries during an inpatient stay lead to an extended length of stay and increasing costs, especially within the AMT group. Intensity of patient care and the consideration of patient comorbidity did not yield relevant differences. The quality of the G-DRG system is measured by its ability to obtain adequate funding for highly complex and heterogeneous cases. Specific modifications of the G-DRG structures could increase the appropriateness of case allocation for patients with open eye injuries within the G-DRG C01B of the German DRG system 2009. As a result of the present study, cases

  19. Penetrating ocular trauma from trampoline spring.

    Science.gov (United States)

    Spokes, David; Siddiqui, Salina; Vize, Colin

    2010-02-01

    The case is presented of a 12-year old boy who sustained severe penetrating ocular trauma while playing on a domestic trampoline. A main spring broke under tension and the hook had struck the eye at high velocity and penetrated the sclera. Primary repair was undertaken but on review it became apparent the eye could not be salvaged. Evisceration was carried out and an orbital implant was placed. Post-operative cosmesis is acceptable. This type of injury has not been reported before. Adult supervision of children on trampolines is recommended to minimise the chance of serious injury.

  20. colour-flow ultrasound in the detection of penetrating vascular

    African Journals Online (AJOL)

    To determine the sensitivity of colour-flow ultrasound in the detection of penetrating vascular injuries of ... Colour-flow ultrasound is sensitive in detecting vascular injuries and is suitable as a screening .... injury, ultrasound appears to be sensitive in detecting these lesions. However there is a risk of missing more central.

  1. Thyroid Emphysema Following Penetrating Neck Trauma

    OpenAIRE

    Karadağ, Demet; Doner, Egemen; Adapınar, Baki

    2014-01-01

    Although traumatic thyroid gland rupture or hemorrhage is usually seen in goitrous glands, injuries of the normal thyroid gland after neck trauma have rarely been described in the literature. We describe a 44-year-old man who presented with thyroid emphysema and subcutaneous emphysema (SCE) that occurred after penetrating neck trauma. CT images showed complete resolution of thyroid emphysema and subcutaneous emphysema at follow-up examination. Neck injuries can be life threatening. After pene...

  2. The neuroprotective efficacy of cell-penetrating peptides TAT, penetratin, Arg-9, and Pep-1 in glutamic acid, kainic acid, and in vitro ischemia injury models using primary cortical neuronal cultures.

    Science.gov (United States)

    Meloni, Bruno P; Craig, Amanda J; Milech, Nadia; Hopkins, Richard M; Watt, Paul M; Knuckey, Neville W

    2014-03-01

    Cell-penetrating peptides (CPPs) are small peptides (typically 5-25 amino acids), which are used to facilitate the delivery of normally non-permeable cargos such as other peptides, proteins, nucleic acids, or drugs into cells. However, several recent studies have demonstrated that the TAT CPP has neuroprotective properties. Therefore, in this study, we assessed the TAT and three other CPPs (penetratin, Arg-9, Pep-1) for their neuroprotective properties in cortical neuronal cultures following exposure to glutamic acid, kainic acid, or in vitro ischemia (oxygen-glucose deprivation). Arg-9, penetratin, and TAT-D displayed consistent and high level neuroprotective activity in both the glutamic acid (IC50: 0.78, 3.4, 13.9 μM) and kainic acid (IC50: 0.81, 2.0, 6.2 μM) injury models, while Pep-1 was ineffective. The TAT-D isoform displayed similar efficacy to the TAT-L isoform in the glutamic acid model. Interestingly, Arg-9 was the only CPP that displayed efficacy when washed-out prior to glutamic acid exposure. Neuroprotection following in vitro ischemia was more variable with all peptides providing some level of neuroprotection (IC50; Arg-9: 6.0 μM, TAT-D: 7.1 μM, penetratin/Pep-1: >10 μM). The positive control peptides JNKI-1D-TAT (JNK inhibitory peptide) and/or PYC36L-TAT (AP-1 inhibitory peptide) were neuroprotective in all models. Finally, in a post-glutamic acid treatment experiment, Arg-9 was highly effective when added immediately after, and mildly effective when added 15 min post-insult, while the JNKI-1D-TAT control peptide was ineffective when added post-insult. These findings demonstrate that different CPPs have the ability to inhibit neurodamaging events/pathways associated with excitotoxic and ischemic injuries. More importantly, they highlight the need to interpret neuroprotection studies when using CPPs as delivery agents with caution. On a positive note, the cytoprotective properties of CPPs suggests they are ideal carrier molecules to

  3. Analytical review of 664 cases of penetrating buttock trauma

    Science.gov (United States)

    2011-01-01

    A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries. The aim of the study is to provide the as yet lacking analytical review of the literature on penetrating trauma to the buttock, with appraisal of characteristics, features, outcomes, and patterns of major injuries. Based on these results we will provide an algorithm. Using a set of terms we searched the databases Pub Med, EMBASE, Cochran, and CINAHL for articles published in English between 1970 and 2010. We analysed cumulative data from prospective and retrospective studies, and case reports. The literature search revealed 36 relevant articles containing data on 664 patients. There was no grade A evidence found. The injury population mostly consists of young males (95.4%) with a high proportion missile injury (75.9%). Bleeding was found to be the key problem which mostly occurs from internal injury and results in shock in 10%. Overall mortality is 2.9% with significant adverse impact of visceral or vascular injury and shock (P colon, or rectum injuries leading in shot wounds, whilst vascular injury leads in stab wounds (P trauma. In conclusion, penetrating buttock trauma should be regarded as a life-threatening injury with impact beyond the pelvis until proven otherwise. PMID:21995834

  4. Complete upper urinary tract obstruction caused by penetrating ...

    African Journals Online (AJOL)

    Complete upper urinary tract obstruction caused by penetrating pellet injury of the ureter. M.T. Gulpinar, S.K. Keskin, A Yildirim, T Caskurlu. Abstract. Ureteral injuries due to gunshots are tend to be misdiagnosed because of concomitant vascular and intraabdominal organ wounds. Our case is a 23-year old man who was ...

  5. Metasploit penetration testing cookbook

    CERN Document Server

    Agarwal, Monika

    2013-01-01

    This book follows a Cookbook style with recipes explaining the steps for penetration testing with WLAN, VOIP, and even cloud computing. There is plenty of code and commands used to make your learning curve easy and quick.This book targets both professional penetration testers as well as new users of Metasploit, who wish to gain expertise over the framework and learn an additional skill of penetration testing, not limited to a particular OS. The book requires basic knowledge of scanning, exploitation, and the Ruby language.

  6. Penetration testing with Perl

    CERN Document Server

    Berdeaux, Douglas

    2014-01-01

    If you are an expert Perl programmer interested in penetration testing or information security, this guide is designed for you. However, it will also be helpful for you even if you have little or no Linux shell experience.

  7. Barrier penetration database

    International Nuclear Information System (INIS)

    Fainberg, A.; Bieber, A.M. Jr.

    1978-11-01

    This document is intended to supply the NRC and nuclear power plant licensees with basic data on the times required to penetrate forcibly the types of barriers commonly found in nuclear plants. These times are necessary for design and evaluation of the physical protection system required under 10CFR73.55. Each barrier listed is described in detail. Minor variations in basic barrier construction that result in the same penetration time, are also described

  8. Study on Penetration Characteristics of Tungsten Cylindrical Penetrator

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Jong Hyun; Lee, Young Shin; Kim, Jae Hoon [Chungnam Nat' l Univ., Daejeon (Korea, Republic of); Bae, Yong Woon [Agency for Defense Development, Daejeon (Korea, Republic of)

    2013-09-15

    The design of missile require extremely small warheads that must be highly efficient and lethal. The penetration characteristics of each penetrator and the total number of penetrators on the warhead are obvious key factors that influence warhead lethality. The design of the penetrator shape and size are directly related to the space and weight of the warhead. The design of the penetrator L/D was directly related to the space and weight of the warhead. L and D are the length and the diameter of the projectile, respectively. The AUTODYN-3a code was used to study the effect of penetrator penetration. The objective of numerical analysis was to determine the penetration characteristics of penetrator produced by hypervelocity impacts under different initial conditions such as initial velocity, obliquity angle and L/D of penetrator. The residual velocity and residual mass were decreased with increasing initial impact velocity under L/D{<=}4.

  9. Penetration portion shielding structure

    International Nuclear Information System (INIS)

    Hayashi, Katsumi; Narita, Hitoshi; Handa, Hiroyuki; Takeuchi, Jun; Tozuka, Fumio.

    1994-01-01

    Openings of a plurality of shieldings for penetration members are aligned to each other, and penetration members are inserted from the openings. Then, the openings of the plurality of shielding members are slightly displaced with each other to make the penetration portions into a helical configuration, so that leakage of radiation is reduced. Upon removal of the members, reverse operation is conducted. When a flowable shielding material is used, the penetration portions are constituted with two plates having previously formed openings and pipes for connecting the openings with each other and a vessel covering the entire of them. After passing the penetration members such as a cable, the relative position of the two plates is changed by twisting, to form a helical configuration which reduces radiation leakage. Since they are bent into the helical configuration, shielding performance is extremely improved compared with a case that radiation leakage is caused from an opening of a straight pipe. In addition, since they can be returned to straight pipes, attachment, detachment and maintenance can be conducted easily. (N.H.)

  10. Prophylactic antibiotics for penetrating abdominal trauma.

    Science.gov (United States)

    Brand, Martin; Grieve, Andrew

    2013-11-18

    Penetrating abdominal trauma occurs when the peritoneal cavity is breached. Routine laparotomy for penetrating abdominal injuries began in the 1800s, with antibiotics first being used in World War II to combat septic complications associated with these injuries. This practice was marked with a reduction in sepsis-related mortality and morbidity. Whether prophylactic antibiotics are required in the prevention of infective complications following penetrating abdominal trauma is controversial, however, as no randomised placebo controlled trials have been published to date. There has also been debate about the timing of antibiotic prophylaxis. In 1972 Fullen noted a 7% to 11% post-surgical infection rate with pre-operative antibiotics, a 33% to 57% infection rate with intra-operative antibiotic administration and 30% to 70% infection rate with only post-operative antibiotic administration. Current guidelines state there is sufficient class I evidence to support the use of a single pre-operative broad spectrum antibiotic dose, with aerobic and anaerobic cover, and continuation (up to 24 hours) only in the event of a hollow viscus perforation found at exploratory laparotomy. To assess the benefits and harms of prophylactic antibiotics administered for penetrating abdominal injuries for the reduction of the incidence of septic complications, such as septicaemia, intra-abdominal abscesses and wound infections. Searches were not restricted by date, language or publication status. We searched the following electronic databases: the Cochrane Injuries Group Specialised Register, CENTRAL (The Cochrane Library 2013, issue 12 of 12), MEDLINE (OvidSP), Embase (OvidSP), ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED), ISI Web of Science: Conference Proceedings Citation Index- Science (CPCI-S) and PubMed. Searches were last conducted in January 2013. All randomised controlled trials of antibiotic prophylaxis in patients with penetrating abdominal trauma versus no

  11. Ground penetrating radar

    CERN Document Server

    Daniels, David J

    2004-01-01

    Ground-penetrating radar has come to public attention in recent criminal investigations, but has actually been a developing and maturing remote sensing field for some time. In the light of recent expansion of the technique to a wide range of applications, the need for an up-to-date reference has become pressing. This fully revised and expanded edition of the best-selling Surface-Penetrating Radar (IEE, 1996) presents, for the non-specialist user or engineer, all the key elements of this technique, which span several disciplines including electromagnetics, geophysics and signal processing. The

  12. Skull penetrating wound

    International Nuclear Information System (INIS)

    Gonzalez Orlandi, Yvei; Junco Martin, Reinel; Rojas Manresa, Jorge; Duboy Limonta, Victor; Matos Herrera, Omar; Saez Corvo, Yunet

    2011-01-01

    The cranioencephalic trauma is common in the emergence centers to care for patients with multiple traumata and it becames in a health problem in many countries. Skull penetrating trauma is located in a special place due to its low frequency. In present paper a case of male patient aged 52 severely skull-injured with penetrating wound caused by a cold steel that remained introduced into the left frontotemporal region. After an imaging study the emergence surgical treatment was applied and patient evolves adequately after 25 days of hospitalization. Nowadays, she is under rehabilitation treatment due to a residual right hemiparesis.(author)

  13. Tumor penetrating peptides

    Directory of Open Access Journals (Sweden)

    Tambet eTeesalu

    2013-08-01

    Full Text Available Tumor-homing peptides can be used to deliver drugs into tumors. Phage library screening in live mice has recently identified homing peptides that specifically recognize the endothelium of tumor vessels, extravasate, and penetrate deep into the extravascular tumor tissue. The prototypic peptide of this class, iRGD (CRGDKGPDC, contains the integrin-binding RGD motif. RGD mediates tumor homing through binding to αv integrins, which are selectively expressed on various cells in tumors, including tumor endothelial cells. The tumor-penetrating properties of iRGD are mediated by a second sequence motif, R/KXXR/K. This C-end Rule (or CendR motif is active only when the second basic residue is exposed at the C-terminus of the peptide. Proteolytic processing of iRGD in tumors activates the cryptic CendR motif, which then binds to neuropilin-1 activating an endocytic bulk transport pathway through tumor tissue. Phage screening has also yielded tumor-penetrating peptides that function like iRGD in activating the CendR pathway, but bind to a different primary receptor. Moreover, novel tumor-homing peptides can be constructed from tumor-homing motifs, CendR elements and protease cleavage sites. Pathologies other than tumors can be targeted with tissue-penetrating peptides, and the primary receptor can also be a vascular zip code of a normal tissue. The CendR technology provides a solution to a major problem in tumor therapy, poor penetration of drugs into tumors. The tumor-penetrating peptides are capable of taking a payload deep into tumor tissue in mice, and they also penetrate into human tumors ex vivo. Targeting with these peptides specifically increases the accumulation in tumors of a variety of drugs and contrast agents, such as doxorubicin, antibodies and nanoparticle-based compounds. Remarkably the drug to be targeted does not have to be coupled to the peptide; the bulk transport system activated by the peptide sweeps along any compound that is

  14. Analytical review of 664 cases of penetrating buttock trauma

    Directory of Open Access Journals (Sweden)

    Schulte Klaus-Martin

    2011-10-01

    Full Text Available Abstract A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries. The aim of the study is to provide the as yet lacking analytical review of the literature on penetrating trauma to the buttock, with appraisal of characteristics, features, outcomes, and patterns of major injuries. Based on these results we will provide an algorithm. Using a set of terms we searched the databases Pub Med, EMBASE, Cochran, and CINAHL for articles published in English between 1970 and 2010. We analysed cumulative data from prospective and retrospective studies, and case reports. The literature search revealed 36 relevant articles containing data on 664 patients. There was no grade A evidence found. The injury population mostly consists of young males (95.4% with a high proportion missile injury (75.9%. Bleeding was found to be the key problem which mostly occurs from internal injury and results in shock in 10%. Overall mortality is 2.9% with significant adverse impact of visceral or vascular injury and shock (P P

  15. Penetrating and blunt trauma to the neck: clinical presentation, assessment and emergency management.

    Science.gov (United States)

    Perdonck, P; de Schoutheets, J C; Monsieurs, K G; Van Laer, C; Vander Poorten, V; Vanderveken, O

    Penetrating and blunt trauma to the neck: clinical presentation, assessment ana emergency management. In Belgium, and even in Western Europe, penetrating and blunt injury to the neck is relatively uncommon in both the civilian and military populations. Pre-hospital and emergency assessment and management will therefore always prove challenging, as individual exposure to this specific type of injury remains low. Historically, the neck has been divided into three anatomical zones with specific landmarks to guide the diagnostic and therapeutic approach to penetrating neck injuries. Most penetrating injuries need to be explored surgically, although with the advent of multi-detector computed tomographic angiography (MDCTA), which yields high diagnostic sensitivity, this inflexible approach has recently changed to a more targeted management, based on clinical, radiographic and, if deemed necessary, endoscopic findings. However, some authors have addressed their concern about this novel, 'no-zone' approach, since the risk of missing less apparent aerodigestive tract injuries may increase. It is recommended, therefore, that all patients with penetrating neck injuries be closely observed, irrespective of the initial findings. The incidence of blunt neck injury is much lower, and this makes risk assessment and management even more difficult in comparison with penetrating injuries. Again, MDCTA is most often the first diagnostic tool if a blunt neck injury is suspected, due to its good sensitivity for blunt cerebrovascular injuries (BCVI) as well as for aerodigestive tract injuries. Specific patterns of injury and unexpected neurological and neuro-radiological findings in trauma patients should always warrant further investigation. Despite ongoing debate, systemic anticoagulation is recommended for most BCVI, sometimes combined with endovascular treatment. Aerodigestive tract injuries may present dramatically, but are often more subtle, making the diagnosis more difficult

  16. Antibody tumor penetration

    Science.gov (United States)

    Thurber, Greg M.; Schmidt, Michael M.; Wittrup, K. Dane

    2009-01-01

    Antibodies have proven to be effective agents in cancer imaging and therapy. One of the major challenges still facing the field is the heterogeneous distribution of these agents in tumors when administered systemically. Large regions of untargeted cells can therefore escape therapy and potentially select for more resistant cells. We present here a summary of theoretical and experimental approaches to analyze and improve antibody penetration in tumor tissue. PMID:18541331

  17. Python penetration testing essentials

    CERN Document Server

    Mohit

    2015-01-01

    If you are a Python programmer or a security researcher who has basic knowledge of Python programming and want to learn about penetration testing with the help of Python, this book is ideal for you. Even if you are new to the field of ethical hacking, this book can help you find the vulnerabilities in your system so that you are ready to tackle any kind of attack or intrusion.

  18. Improving Outcomes Following Penetrating Colon Wounds

    Science.gov (United States)

    Miller, Preston R.; Fabian, Timothy C.; Croce, Martin A.; Magnotti, Louis J.; Elizabeth Pritchard, F.; Minard, Gayle; Stewart, Ronald M.

    2002-01-01

    Introduction During World War II, failure to treat penetrating colon injuries with diversion could result in court martial. Based on this wartime experience, colostomy for civilian colon wounds became the standard of care for the next 4 decades. Previous work from our institution demonstrated that primary repair was the optimal management for nondestructive colon wounds. Optimal management of destructive wounds requiring resection remains controversial. To address this issue, we performed a study that demonstrated risk factors (pre or intraoperative transfusion requirement of more than 6 units of packed red blood cells, significant comorbid diseases) that were associated with a suture line failure rate of 14%, and of whom 33% died. Based on these outcomes, a clinical pathway for management of destructive colon wounds was developed. The results of the implementation of this pathway are the focus of this report. Methods Patients with penetrating colon injury were identified from the registry of a level I trauma center over a 5-year period. Records were reviewed for demographics, injury characteristics, and outcome. Patients with nondestructive injuries underwent primary repair. Patients with destructive wounds but no comorbidities or large transfusion requirement underwent resection and anastomosis, while patients with destructive wounds and significant medical illness or transfusion requirements of more than 6 units/blood received end colostomy. The current patients (CP) were compared to the previous study (PS) to determine the impact of the clinical pathway. Outcomes examined included colon related mortality and morbidity (suture line leak and abscess). Results Over a 5.5-year period, 231 patients had penetrating colon wounds. 209 survived more 24 hours and comprise the study population. Primary repair was performed on 153 (73%) patients, and 56 patients had destructive injuries (27%). Of these, 40 (71%) had resection and anastomosis and 16 (29%) had diversion

  19. Market penetration of ethanol

    International Nuclear Information System (INIS)

    Szulczyk, Kenneth R.; McCarl, Bruce A.; Cornforth, Gerald

    2010-01-01

    This research examines in detail the technology and economics of substituting ethanol for gasoline. This endeavor examines three issues. First, the benefits of ethanol/gasoline blends are examined, and then the technical problems of large-scale implementation of ethanol. Second, ethanol production possibilities are examined in detail from a variety of feedstocks and technologies. The feedstocks are the starch/sugar crops and crop residues, while the technologies are corn wet mill, dry grind, and lignocellulosic fermentation. Examining in detail the production possibilities allows the researchers to identity the extent of technological change, production costs, byproducts, and GHG emissions. Finally, a U.S. agricultural model, FASOMGHG, is updated which predicts the market penetration of ethanol given technological progress, variety of technologies and feedstocks, market interactions, energy prices, and GHG prices. FASOMGHG has several interesting results. First, gasoline prices have a small expansionary impact on the U.S. ethanol industry. Both agricultural producers' income and cost both increase with higher energy prices. If wholesale gasoline is $4 per gallon, the predicted ethanol market penetration attains 53% of U.S. gasoline consumption in 2030. Second, the corn wet mill remains an important industry for ethanol production, because this industry also produces corn oil, which could be converted to biodiesel. Third, GHG prices expand the ethanol industry. However, the GHG price expands the corn wet mill, but has an ambiguous impact on lignocellulosic ethanol. Feedstocks for lignocellulosic fermentation can also be burned with coal to generate electricity. Both industries are quite GHG efficient. Finally, U.S. government subsidies on biofuels have an expansionary impact on ethanol production, but may only increase market penetration by an additional 1% in 2030, which is approximately 6 billion gallons. (author)

  20. Study of Penetration Technology

    Science.gov (United States)

    1976-11-01

    srecimens fabricated at the AFATL, AISI-01 oil quenched bar stock was used. Three of the projectiles used in the Eglin penetration experiments are shown...in the Mathema- tical Laboratory at Eglin AFB, is essencially a fourth order Runge-Kutta numerical method for solving simultaneous differential...C9G. VEL. X-COMPo (M4/5): d!10. I oil 140. 107. 82. RmCC~kr’ED TIME OF MAXIftjM/MINIM94U COIL VOLTAGE tSI MAX 0040 A 55 *.03J04A 0 0 05ji6 .000634 MIN

  1. Deep penetration calculations

    International Nuclear Information System (INIS)

    Thompson, W.L.; Deutsch, O.L.; Booth, T.E.

    1980-04-01

    Several Monte Carlo techniques are compared in the transport of neutrons of different source energies through two different deep-penetration problems each with two parts. The first problem involves transmission through a 200-cm concrete slab. The second problem is a 90 0 bent pipe jacketed by concrete. In one case the pipe is void, and in the other it is filled with liquid sodium. Calculations are made with two different Los Alamos Monte Carlo codes: the continuous-energy code MCNP and the multigroup code MCMG

  2. Penetrating chest wound of the foetus

    Directory of Open Access Journals (Sweden)

    Albert Wandaogo

    2016-01-01

    Full Text Available Traumas of the foetus caused by stabbings are rare but actually life-threatening for both the foetus and the mother. We report a case of penetrating chest wound on a baby taken from the obstetrics unit to the paediatric surgical department. His mother was assaulted by his father, a mentally sick person with no appropriate follow-up. The foetus did not show any sign of vital distress. Surgical exploration of the wound has revealed a section of the 10 th rib, a laceration of the pleura and a tearing of the diaphragm. A phrenorraphy and a pleural drainage were performed. The new-born and its mother were released from hospital after 5 days and the clinical control and X-ray checks 6 months later showed nothing abnormal. We insisted a medical, psychiatric follow-up be initiated for the father. As regards pregnant women with penetrating wounds, the mortality rate of the foetus is 80%. The odds are good for our newborn due to the mild injuries and good professional collaboration of the medical staff. Penetrating transuterine wounds of the foetus can be very serious. The health care needed should include many fields due to the mother and the foetus′ lesions extreme polymorphism. In our case, it could have prevented by a good psychiatric followed up of the offender.

  3. Penetration Tester's Open Source Toolkit

    CERN Document Server

    Faircloth, Jeremy

    2011-01-01

    Great commercial penetration testing tools can be very expensive and sometimes hard to use or of questionable accuracy. This book helps solve both of these problems. The open source, no-cost penetration testing tools presented do a great job and can be modified by the user for each situation. Many tools, even ones that cost thousands of dollars, do not come with any type of instruction on how and in which situations the penetration tester can best use them. Penetration Tester's Open Source Toolkit, Third Edition, expands upon existing instructions so that a professional can get the most accura

  4. Physical Penetration Testing: A Whole New Story in Penetration Testing

    NARCIS (Netherlands)

    Dimkov, T.; Pieters, Wolter

    2011-01-01

    Physical penetration testing plays an important role in assuring a company that the security policies are properly enforced and that the security awareness of the employees is on the appropriate level. In physical penetration tests the tester physically enters restricted locations and directly

  5. Management of blunt and penetrating biliary tract trauma.

    Science.gov (United States)

    Thomson, Benjamin N J; Nardino, Benson; Gumm, Kellie; Robertson, Amanda J; Knowles, Brett P; Collier, Neil A; Judson, Rodney

    2012-06-01

    Penetrating or blunt injury to the biliary tree remains a rare complication of trauma occurring in 0.1% of trauma admissions. Because of the different presentations, sites of biliary tract injury, and associated organ injury, there are many possible management pathways to be considered. A retrospective analysis of prospectively gathered data was performed for all gallbladder and biliary tract injuries presenting to the trauma service or hepatobiliary unit of the Royal Melbourne Hospital between January 1, 1999, and March 30, 2011. There were 33 biliary injuries in 30 patients (0.1%) among 26,014 trauma admissions. Three of the 30 patients (10%) died. Of 10 gallbladder injuries, 8 were managed with cholecystectomy. There were 23 injuries to the biliary tree. Fourteen patients had injuries to the intrahepatic biliary tree of which seven involved segmental ducts. Of these, four segmental duct injuries required hepatic resection or debridement. Nine patients had injury to the extrahepatic biliary tree of which five required T-tube placement ± bilioenteric anastomosis and one a pancreaticoduodenectomy. Biliary injury is a rare but important consequence of abdominal trauma, and good outcomes are possible when a major trauma center and hepatopancreaticobiliary service coexist. Cholecystectomy remains the gold standard for gallbladder injury. Drainage with or without endoscopic stenting will resolve the majority of intrahepatic and partial biliary injuries. Hepaticojejunostomy remains the gold standard for complete extrahepatic biliary disruption. Hepatic and pancreatic resection are only required in the circumstances of unreconstructable biliary injury. Therapeutic study, level V. Copyright © 2012 by Lippincott Williams & Wilkins.

  6. Neurosurgical Management of Nonmissile Penetrating Cranial Lesions.

    Science.gov (United States)

    de Holanda, Luciano Ferreira; Pereira, Benedito Jamilson A; Holanda, Rafael Rodrigues; Neto, José Targino; de Holanda, Carlos Vanderlei M; Giudicissi Filho, Miguel; de Oliveira, Nathalia Ribeiro Cunha; de Oliveira, Jean G

    2016-06-01

    The objective of this study is to present a case series of nonmissile penetrating (NMP) injuries and to establish a workflow for an uncommon mechanism of traumatic head injury through the analysis of each case, classification of the type of lesion, management, and outcome score at follow-up. From January 1991 to December 2008, 36,000 patients presenting with traumatic brain injury (TBI) were admitted in the Department of Neurosurgery, Hospital Antônio Targino, Campina Grande-PB, Brazil. From these patients, 11 presenting with lesions caused by NMP objects were selected. Among the 11 patients, 9 were men and 2 were women. Their ages ranged from 7 to 74 years old (mean age ± SD, 29.1 ± 22.99 years). All patients underwent neuroradiologic evaluation. The entry point was classified as natural (orbit) or artificial (skull transfixation), and we also divided the patients presenting with secondary parenchymal or vascular damage from those presenting with only lesions caused by the primary penetration into the cranium and meninges. All patients were neurosurgically treated with removal of the foreign body through craniotomy, except the patient whose object (pen) was removed without craniotomy with local anesthesia. Glasgow Coma Scale (GCS) score on admission was a statistically significant factor on prognosis, and any patient who presented with a GCS score of 15 evolved satisfactorily, and there were no deaths in this group of patients (P = 0.04). TBIs caused by NMP objects are unusual and caused by aggression, self-inflicted harm (in the case of psychiatric patients), and accident. The foreign body may enter into the skull through a natural hole (orbit, nose, mouth, or ear) or crosses the skull, causing a fracture and creating an artificial hole. Preoperative neuroradiologic assessment is paramount for the correct neurosurgical approach. The main prognostic factor for these patients is the GCS score at admission. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Penetration of Photovoltaics in Greece

    Directory of Open Access Journals (Sweden)

    Eugenia Giannini

    2015-06-01

    Full Text Available Recently, an interesting experiment was completed in Greece concerning photovoltaic penetration into the electricity production sector. Based on the relevant laws and in accordance to the related European directives, an explosive penetration process was completed in less than three years, resulting in a 7% share of photovoltaics in electricity production instead of the previous negligible share. The legislation was based on licensing simplification and generous feed-in-tariffs. This approach transformed photovoltaic technology from a prohibitively expensive to a competitive one. This work aims to summarize the relevant legislation and illustrate its effect on the resulting penetration. A sigmoid-shape penetration was observed which was explained by a pulse-type driving force. The return on investment indicator was proposed as an appropriate driving force, which incorporates feed-in-tariffs and turnkey-cost. Furthermore, the resulting surcharge on the electricity price due to photovoltaic penetration was also analyzed.

  8. Urgent thoracotomy for penetrating chest trauma: analysis of 158 patients of a single center.

    Science.gov (United States)

    Onat, Serdar; Ulku, Refik; Avci, Alper; Ates, Gungor; Ozcelik, Cemal

    2011-09-01

    Penetrating injuries to the chest present a frequent and challenging problem, but the majority of these injuries can be managed non-\\operatively. The aim of this study was to describe the incidence of penetrating chest trauma and the ultimate techniques used for operative management, as well as the diagnosis, complications, morbidity and mortality. A retrospective 9-year review of patients who underwent an operative procedure following penetrating chest trauma was performed. The mechanism of injury, gender, age, physiological and outcome parameters, including injury severity score (ISS), chest abbreviated injury scale (AIS) score, lung injury scale score, concomitant injuries, time from admission to operating room, transfusion requirement, indications for thoracotomy, intra-operative findings, operative procedures, length of hospital stay (LOS) and rate of mortality were recorded. A total of 1123 patients who were admitted with penetrating thoracic trauma were investigated. Of these, 158 patients (93 stabbings, 65 gunshots) underwent a thoracotomy within 24 h after the penetrating trauma. There were 146 (92.4%) male and 12 (7.6%) female patients, and their mean age was 25.72 9.33 (range, 15–54) years. The mean LOS was 10.65 8.30 (range, 5–65) days. Patients admitted after a gunshot had a significantly longer LOS than those admitted with a stab wound (gunshot, 13.53 9.92 days; stab wound, 8.76 6.42 days, p chest AIS score (p chest requiring a thoracotomy are uncommon, and lung-sparing techniques have become the most frequently used procedures for lung injuries. The presence of associated abdominal injuries increased the mortality five-fold. Factors that affected mortality were ISS, chest AIS score, SBP, ongoing chest output, blood transfusion volume, diaphragmatic injury and associated abdominal injury.

  9. Current management of penetrating torso trauma: nontherapeutic is not good enough anymore.

    Science.gov (United States)

    Ball, Chad G

    2014-04-01

    A highly organized approach to the evaluation and treatment of penetrating torso injuries based on regional anatomy provides rapid diagnostic and therapeutic consistency. It also minimizes delays in diagnosis, missed injuries and nontherapeutic laparotomies. This review discusses an optimal sequence of structured rapid assessments that allow the clinician to rapidly proceed to gold standard therapies with a minimal risk of associated morbidity.

  10. Gastrointestinal Traumatic Injuries: Gastrointestinal Perforation.

    Science.gov (United States)

    Revell, Maria A; Pugh, Marcia A; McGhee, Melanie

    2018-03-01

    The abdomen is a big place even in a small person. Gastrointestinal trauma can result in injury to the stomach, small bowel, colon, or rectum. Traumatic causes include blunt or penetrating trauma, such as gunshot wounds, stabbings, motor vehicle collisions, and crush injuries. Nontraumatic causes include appendicitis, Crohn disease, cancer, diverticulitis, ulcerative colitis, blockage of the bowel, and chemotherapy. The mechanism of injury will affect both the nature and severity of any resulting injuries. Treatment must address the critical and emergent nature of these injuries as well as issues that affect all trauma situations, which include management of hemodynamic instability. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Deep ocean model penetrator experiments

    International Nuclear Information System (INIS)

    Freeman, T.J.; Burdett, J.R.F.

    1986-01-01

    Preliminary trials of experimental model penetrators in the deep ocean have been conducted as an international collaborative exercise by participating members (national bodies and the CEC) of the Engineering Studies Task Group of the Nuclear Energy Agency's Seabed Working Group. This report describes and gives the results of these experiments, which were conducted at two deep ocean study areas in the Atlantic: Great Meteor East and the Nares Abyssal Plain. Velocity profiles of penetrators of differing dimensions and weights have been determined as they free-fell through the water column and impacted the sediment. These velocity profiles are used to determine the final embedment depth of the penetrators and the resistance to penetration offered by the sediment. The results are compared with predictions of embedment depth derived from elementary models of a penetrator impacting with a sediment. It is tentatively concluded that once the resistance to penetration offered by a sediment at a particular site has been determined, this quantity can be used to sucessfully predict the embedment that penetrators of differing sizes and weights would achieve at the same site

  12. Europa Kinetic Ice Penetrator (EKIP)

    Data.gov (United States)

    National Aeronautics and Space Administration — The goal of the proposed work is to validate an initial design for a Europa penetrator that can withstand the high g load associated with the expected hypervelocity...

  13. Imaging assessment of penetrating craniocerebral and spinal trauma

    International Nuclear Information System (INIS)

    Offiah, C.; Twigg, S.

    2009-01-01

    Craniocerebral and spinal penetrating trauma, which may be either missile (most typically gun-related) or non-missile (most typically knife-related), is becoming an increasingly common presentation to the urban general and specialized radiology service in the UK. These injuries carry significant morbidity and mortality with a number of criteria for prognosis identifiable on cross-sectional imaging. Potential complications can also be pre-empted by awareness of certain neuroradiological features. Not all of these injuries are criminal in origin, however, a significant proportion will be, requiring, on occasion, provision of both ante-mortem and post-mortem radiological opinion to the criminal investigative procedure. This review aims to highlight certain imaging features of penetrating craniocerebral and spinal trauma including important prognostic, therapeutic, and forensic considerations.

  14. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot

    Directory of Open Access Journals (Sweden)

    Christos Stefanou

    2016-01-01

    Full Text Available Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically.

  15. Penetration of Photovoltaics in Greece

    OpenAIRE

    Eugenia Giannini; Antonia Moropoulou; Zacharias Maroulis; Glykeria Siouti

    2015-01-01

    Recently, an interesting experiment was completed in Greece concerning photovoltaic penetration into the electricity production sector. Based on the relevant laws and in accordance to the related European directives, an explosive penetration process was completed in less than three years, resulting in a 7% share of photovoltaics in electricity production instead of the previous negligible share. The legislation was based on licensing simplification and generous feed-in-tariffs. This approach ...

  16. Projectile penetration into ballistic gelatin.

    Science.gov (United States)

    Swain, M V; Kieser, D C; Shah, S; Kieser, J A

    2014-01-01

    Ballistic gelatin is frequently used as a model for soft biological tissues that experience projectile impact. In this paper we investigate the response of a number of gelatin materials to the penetration of spherical steel projectiles (7 to 11mm diameter) with a range of lower impacting velocities (projectile velocity are found to be linear for all systems above a certain threshold velocity required for initiating penetration. The data for a specific material impacted with different diameter spheres were able to be condensed to a single curve when the penetration depth was normalised by the projectile diameter. When the results are compared with a number of predictive relationships available in the literature, it is found that over the range of projectiles and compositions used, the results fit a simple relationship that takes into account the projectile diameter, the threshold velocity for penetration into the gelatin and a value of the shear modulus of the gelatin estimated from the threshold velocity for penetration. The normalised depth is found to fit the elastic Froude number when this is modified to allow for a threshold impact velocity. The normalised penetration data are found to best fit this modified elastic Froude number with a slope of 1/2 instead of 1/3 as suggested by Akers and Belmonte (2006). Possible explanations for this difference are discussed. © 2013 Published by Elsevier Ltd.

  17. Abdominal penetrating trauma and organ damage and its prognosis

    Directory of Open Access Journals (Sweden)

    Babak Abri

    2016-12-01

    Full Text Available Introduction: Abdominal penetrating trauma is still a serious problem in the world, due to its high prevalence in young people that impose a heavy economic burden on our country, we decided to evaluate the epidemiologic and demographic status and patient’s prognosis. Methods: This is a descriptive cross-sectional study; all patients with abdominal penetrating trauma referred to the emergency department of Imam Reza Hospital between March 2012 and March 2014 were enrolled to study. Age, sex, injured organs, mechanism of trauma and the prognosis was documented in the checklist. Data was analyzed by SPSS 15.0, and descriptive analysis was run. Results: In this study, 137 patients were enrolled; 103 patients (75.20% did not have visceral damage. In visceral injury, the spleen was most commonly injured abdominal organs (8.03%. the damage to small intestine seen in 8 patients (5.84%, kidney and liver damage seen in 6 patients (4.38% and 5 patients, respectively, and finally diaphragm and colon injury was seen in 2 patients (1.46%. Conclusion: According to a recent study, abdominal penetrating trauma mostly occurred in men. The most common cause of abdominal penetrating trauma was related to knife damage; spleen was commonly damaged organ caused by knives and other sharp objects.

  18. The imaging of stab injuries

    Energy Technology Data Exchange (ETDEWEB)

    Vries, Coert S. de; Africa, Mogoeemang; Gebremariam, Fekade A.; Rensburg, J. Janse van; Otto, Susan F.; Potgieter, Henrik F. (Dept. of Diagnostic Radiology, Faculty of Health Sciences, Univ. of the Free State and Academic Health Complex, Free State Province Dept. of Health, Bloemfontein (South Africa)), e-mail: devriesc.md@ufs.ac.za

    2010-01-15

    In the trauma unit of the Bloemfontein Academic Complex, the total number of stab wounds seen represents approximately 70.5% of penetrating injuries, which is 6.4% of 5004 trauma cases seen in a period of 1 year. The other cases are gunshot wounds and pedestrian or motor vehicle accidents. Specific guidelines and protocols are followed for penetrating trauma management. All imaging modalities are utilized, with chest radiography the mainstay of thoracic imaging in patients having sustained sharp penetrating chest injuries. Computed tomography (CT) is being used more frequently as the primary imaging modality in the evaluation of hemodynamically stable patients with penetrating injuries. The improved speed of data acquisition and superior image reconstruction of multidetector CT (MDCT) has further driven this change in imaging approach. Although digital subtraction angiography (DSA) has been the reference standard for the diagnosis of traumatic vascular injuries, it is giving way to faster, less invasive, and less personnel-intensive imaging techniques, e.g., MDCT angiography. Given the fact that we work in an academic environment and that we have a dedicated interventional unit, arteriography is still frequently performed and still has its place as the 'gold standard' in the diagnosis of vascular injuries. Penetrating chest injuries suspected of traversing the mediastinum or extending near the posterior mediastinal structures dictate esophageal and tracheal evaluation. Although radiology has a role to play, direct visualization (esophagoscopy, bronchoscopy) remains the most reliable method of excluding injuries to these structures. Transthoracic ultrasound (echocardiography) has become indispensable in helping to evaluate injuries to the heart and the ascending and descending aortas. More recent work has demonstrated that ultrasonography can also be used to detect hemothoraces and pneumothoraces with accuracy

  19. Plutonium in depleted uranium penetrators

    International Nuclear Information System (INIS)

    McLaughlin, J.P.; Leon-Vintro, L.; Smith, K.; Mitchell, P.I.; Zunic, Z.S.

    2002-01-01

    Depleted Uranium (DU) penetrators used in the recent Balkan conflicts have been found to be contaminated with trace amounts of transuranic materials such as plutonium. This contamination is usually a consequence of DU fabrication being carried out in facilities also using uranium recycled from spent military and civilian nuclear reactor fuel. Specific activities of 239+240 Plutonium generally in the range 1 to 12 Bq/kg have been found to be present in DU penetrators recovered from the attack sites of the 1999 NATO bombardment of Kosovo. A DU penetrator recovered from a May 1999 attack site at Bratoselce in southern Serbia and analysed by University College Dublin was found to contain 43.7 +/- 1.9 Bq/kg of 239+240 Plutonium. This analysis is described. An account is also given of the general population radiation dose implications arising from both the DU itself and from the presence of plutonium in the penetrators. According to current dosimetric models, in all scenarios considered likely ,the dose from the plutonium is estimated to be much smaller than that due to the uranium isotopes present in the penetrators. (author)

  20. Penetration shielding applications of CYLSEC

    International Nuclear Information System (INIS)

    Dexheimer, D.T.; Hathaway, J.M.

    1985-01-01

    Evaluation of penetration and discontinuity shielding is necessary to meet 10CFR20 regulations for ensuring personnel exposures are as low as reasonably achievable (ALARA). Historically, those shielding evaluations have been done to some degree on all projects. However, many early plants used conservative methods due to lack of an economical computer code, resulting in costly penetration shielding programs. With the increased industry interest in cost effectively reducing personnel exposures to meet ALARA regulations and with the development of the CYLSEC gamma transport computer code at Bechtel, a comprehensive effort was initiated to reduce penetration and discontinuity shielding but still provide a prudent degree of protection for plant personnel from radiation streaming. This effort was more comprehensive than previous programs due to advances in shielding analysis technology and increased interest in controlling project costs while maintaining personnel exposures ALARA. Methodology and resulting cost savings are discussed

  1. The impact of mechanism on the management and outcome of penetrating colonic trauma.

    Science.gov (United States)

    Oosthuizen, G V; Kong, V Y; Estherhuizen, T; Bruce, J L; Laing, G L; Odendaal, J J; Clarke, D L

    2018-02-01

    Introduction In light of continuing controversy surrounding the management of penetrating colonic injuries, we set out to compare the outcome of penetrating colonic trauma according to whether the mechanism of injury was a stab wound or a gunshot wound. Methods Our trauma registry was interrogated for the 5-year period from January 2012 to December 2016. All patients over the age of 18 years with penetrating trauma (stab or gunshot) and with intraoperatively proven colonic injury were reviewed. Details of the colonic and concurrent abdominal injuries were recorded, together with the operative management strategy. In-hospital morbidities were divided into colon-related and non-colon related morbidities. The length of hospital stay and mortality were recorded. Direct comparison was made between patients with stab wounds and gunshot wounds to the colon. Results During the 5-year study period, 257 patients sustained a colonic injury secondary to penetrating trauma; 95% (244/257) were male and the mean age was 30 years. A total of 113 (44%) sustained a gunshot wound and the remaining 56% (144/257) sustained a stab wound. Some 88% (226/257) of all patients sustained a single colonic injury, while 12% (31/257) sustained more than one colonic injury. A total of 294 colonic injuries were found at laparotomy. Multiple colonic injuries were less commonly encountered in stab wounds (6%, 9/144 vs. 19%, 22/113, P colonic stab wounds and colonic gunshot wounds are different in terms of severity of the injury and in terms of outcome. While primary repair is almost always applicable to the management of colonic stab wounds, the same cannot be said for colonic gunshot wounds. The management of colonic gunshot wounds should be examined separately from that of stab wounds.

  2. Prediction of electric vehicle penetration.

    Science.gov (United States)

    2017-05-01

    The object of this report is to present the current market status of plug-in-electric : vehicles (PEVs) and to predict their future penetration within the world and U.S. : markets. The sales values for 2016 show a strong year of PEV sales both in the...

  3. FAA Fluorescent Penetrant Laboratory Inspections

    Energy Technology Data Exchange (ETDEWEB)

    WINDES,CONNOR L.; MOORE,DAVID G.

    2000-08-02

    The Federal Aviation Administration Airworthiness Assurance NDI Validation Center currently assesses the capability of various non-destructive inspection (NDI) methods used for analyzing aircraft components. The focus of one such exercise is to evaluate the sensitivity of fluorescent liquid penetrant inspection. A baseline procedure using the water-washable fluorescent penetrant method defines a foundation for comparing the brightness of low cycle fatigue cracks in titanium test panels. The analysis of deviations in the baseline procedure will determine an acceptable range of operation for the steps in the inspection process. The data also gives insight into the depth of each crack and which step(s) of the inspection process most affect penetrant sensitivities. A set of six low cycle fatigue cracks produced in 6.35-mm thick Ti-6Al-4V specimens was used to conduct the experiments to produce sensitivity data. The results will document the consistency of the crack readings and compare previous experiments to find the best parameters for water-washable penetrant.

  4. Industrial Penetration and Internet Intensity

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); M.J. McAleer (Michael); Y-C. Wu (Yu-Chieh)

    2016-01-01

    textabstractThis paper investigates the effect of industrial penetration and internet intensity for Taiwan manufacturing firms, and analyses whether the relationships are substitutes or complements. The sample observations are based on 153,081 manufacturing plants, and covers 26 two-digit industry

  5. Import market penetration in services

    OpenAIRE

    Langhammer, Rolf J.

    1991-01-01

    The EC-1992 programme foresees the complete liberalization of trade in services among member countries. To what extent has import market penetration in the Community already begun in selected service industries? Which EC member countries have been the forerunners to date? The following paper uses a new data base released recently by EUROSTAT in an attempt to answer these and other related questions.

  6. Nonprojectile penetrating iron rod from the oral cavity to the posterior cranial fossa: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Lan ZG

    2018-03-01

    Full Text Available Zhi Gang Lan,1 Seidu A Richard,1–3 Jin Li,1 Chaohua Yang1 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Immunology, Jiangsu University, Zhenjiang, Jiangsu, People’s Republic of China; 3Department of Surgery, Volta Regional Hospital, Ho, Ghana, West Africa Introduction: Nonprojectile penetrating skull base injuries as a result of falls have rarely been confronted in normal neurosurgery although a few nonmissile injuries have been reported. These kinds of injuries represent a life-threatening emergency. Case presentation: We present an unusual case of a 25-year-old male construction worker who suffered an accidental penetrating skull base injury when he fell on a metal rod while he was walking on a 2-meter-high platform. He was clinically stable at presentation. Skull radiograph showed a solid metallic bar, 30 cm long, that penetrated through the right anguli oris eminence and was lodged low in the right occipital bone. Conclusion: Penetrating injury to the head is considered a form of severe traumatic brain injury. Although case of penetrating head injuries as a result of fall from heights are very rare, we anticipate the construction works on high-rise buildings are at maximum risk. We advise that removal of this kind of foreign bodies be done in the theater and not outside because of risk of involvement of larger vessels leading to fatal hemorrhage. We further suggest that patients with nonprojectile injuries should undergo a preoperative computed tomography-angiography to rule out any vascular injury. Keywords: nonprojectile, fall, hemorrhage, skull, penetrating injury, construction

  7. [Professor WU Zhongchao's experience of penetration needling].

    Science.gov (United States)

    Zhang, Ning; Wang, Bing; Zhou, Yu

    2016-08-12

    Professor WU Zhongchao has unique application of penetration needling in clinical treatment. Professor WU applies penetration needling along meridians, and the methods of penetration needling include self-meridian penetration, exterior-interior meridian penetration, identical-name meridian penetration, different meridian penetration. The meridian differentiation is performed according to different TCM syndromes, locations and natures of diseases and acupoint nature, so as to make a comprehensive assessment. The qi movement during acupuncture is focused. In addition, attention is paid on anatomy and long-needle penetration; the sequence and direction of acupuncture is essential, and the reinforcing and reducing methods have great originality, presented with holding, waiting, pressing and vibrating. Based on classical acupoint, the acupoint of penetration needling is flexible, forming unique combination of acupoints.

  8. Control of penetration zone GMAW

    Directory of Open Access Journals (Sweden)

    Віталій Петрович Iванов

    2016-11-01

    Full Text Available Thermal properties of the base metal, shielding medium and the nature of the electrode metal transfer to a great extent determine the penetration area formation in gas-arc welding. It is not always possible to take into account the influence of these factors on penetration front forming within the existing models. The aim of the work was to research the penetration area forming in gas-arc welding. The research of the penetration area forming in gas-arc welding of CrNi austenitic steels was made. The parameters of the regime as well as the kind of the gaseous medium influence on the formation of the penetration zone were studied. The article shows a linear proportional relationship between the electrode feed rate and the size of the base metal plate. The penetration area formation mode for welding in argon and carbon dioxide have been worked out. Diameter, feed rate and the speed of the electrode movement have been chosen as the main input parameters. Multiple regression analysis method was used to make up the modes. The relations of the third order that make it possible to take into account the electrode metal transfer and thermal properties change of the materials to be welded were used. These relationships show quite good agreement with the experimental measurements in the calculation of the fusion zone shape with consumable electrode in argon and carbon dioxide. It was determined that the shape of the melting front curve can be shown as a generalized function in which the front motion parameters depend on feed rate and the diameter of the electrode. Penetration zone growth time is determined by the welding speed and is calculated as a discrete function of the distance from the electrode with the spacing along the movement coordinate. The influence of the mode parameters on the formation of the fusion zone has been investigated and the ways to manage and stabilize the weld pool formation have been identified. The modes can be used to develop

  9. An unusual case of foreign body pulmonary embolus: case report and review of penetrating trauma at a pediatric trauma center.

    Science.gov (United States)

    Boomer, Laura A; Watkins, Daniel J; O'Donovan, Julie; Kenney, Brian D; Yates, Andrew R; Besner, Gail E

    2015-03-01

    Penetrating thoracic trauma is relatively rare in the pediatric population. Embolization of foreign bodies from penetrating trauma is very uncommon. We present a case of a 6-year-old boy with a penetrating foreign body from a projectile dislodged from a lawn mower. Imaging demonstrated a foreign body that embolized to the left pulmonary artery, which was successfully treated non-operatively. We reviewed the penetrating thoracic trauma patients in the trauma registry at our institution between 1/1/03 and 12/31/12. Data collected included demographic data, procedures performed, complications and outcome. Sixty-five patients were identified with a diagnosis of penetrating thoracic trauma. Fourteen of the patients had low velocity penetrating trauma and 51 had high velocity injuries. Patients with high velocity injuries were more likely to be older and less likely to be Caucasian. There were no statistically significant differences between patients with low vs. high velocity injuries regarding severity scores or length of stay. There were no statistically significant differences in procedures required between patients with low and high velocity injuries. Penetrating thoracic trauma is rare in children. The case presented here represents the only report of cardiac foreign body embolus we could identify in a pediatric patient.

  10. Akon - A Penetrator for Europa

    Science.gov (United States)

    Jones, Geraint

    2016-04-01

    Jupiter's moon Europa is one of the most intriguing objects in our Solar System. This 2000km-wide body has a geologically young solid water ice crust that is believed to cover a global ocean of liquid water. The presence of this ocean, together with a source of heating through tidal forces, make Europa a conceivable location for extraterrestrial life. The science case for exploring all aspects of this icy world is compelling. NASA has selected the Europa Mission (formerly Europa Clipper) to study Europa in detail in the 2020s through multiple flybys, and ESA's JUICE mission will perform two flybys of the body in the 2030s. The US agency has extended to the European Space Agency an invitation to provide a contribution to their mission. European scientists interested in Europa science and exploration are currently organizing themselves, in the framework of a coordinated Europa M5 Inititative to study concurrently the main options for this ESA contribution, from a simple addition of individual instruments to the NASA spacecraft, to a lander to investigate Europa's surface in situ. A high speed lander - a penetrator - is by far the most promising technology to achieve this latter option within the anticipated mass constraints, and studies of such a hard lander, many funded by ESA, are now at an advanced level. An international team to formally propose an Europa penetrator to ESA in response to the anticipated ESA M5 call is growing. The working title of this proposal is Akon (Άκων), named after the highly accurate javelin gifted to Europa by Zeus in ancient Greek mythology. We present plans for the Akon penetrator, which would impact Europa's surface at several hundred metres per second, and travel up to several metres into the moon's subsurface. To achieve this, the penetrator would be delivered to the surface by a dedicated descent module, to be destroyed on impact following release of the penetrator above the surface. It is planned that the instruments to be

  11. Assessing high wind energy penetration

    DEFF Research Database (Denmark)

    Tande, J.O.

    1995-01-01

    In order to convincingly promote installing wind power capacity as a substantial part of the energy supply system, a set of careful analyses must be undertaken. This paper applies a case study concentrated on assessing the cost/benefit of high wind energy penetration. The case study considers...... expanding the grid connected wind power capacity in Praia, the capital of Cape Verde. The currently installed 1 MW of wind power is estimated to supply close to 10% of the electric energy consumption in 1996. Increasing the wind energy penetration to a higher level is considered viable as the project...... with the existing wind power, supply over 30% of the electric consumption in 1996. Applying the recommended practices for estimating the cost of wind energy, the life-cycle cost of this 2.4 MW investment is estimated at a 7% discount rate and a 20 year lifetime to 0.26 DKK/kW h....

  12. Mobile Termination and Mobile Penetration

    OpenAIRE

    Hurkens, Sjaak; Jeon, Doh-Shin

    2009-01-01

    In this paper, we study how access pricing affects network competition when subscription demand is elastic and each network uses non-linear prices and can apply termination-based price discrimination. In the case of a fixed per minute termination charge, we find that a reduction of the termination charge below cost has two oppos- ing effects: it softens competition but helps to internalize network externalities. The former reduces mobile penetration while the latter boosts it. We find that fi...

  13. Mobile termination and mobile penetration

    OpenAIRE

    Hurkens, Sjaak

    2009-01-01

    In this paper, we study how access pricing affects network competition when subscription demand is elastic and each network uses non-linear prices and can apply termination-based price discrimination. In the case of a fixed per minute termination charge, we find that a reduction of the termination charge below cost has two opposing effects: it softens competition but helps to internalize network externalities. The former reduces mobile penetration while the latter boosts it. We find that firm...

  14. Fluorescent penetration crack testing method

    International Nuclear Information System (INIS)

    Roth, A.

    1979-01-01

    The same cleaning, penetration, washing, development and evaluation agents are used in this method as for known methods. In order to accelerate or shorten the testing, the drying process is performed only to optical dryness of the material surface by blowing on it with pressurized air, the development by simple pressing into or dusting of the material with the developer and the temperature of the washing water is selected within room temperature range. (RW) [de

  15. HMO penetration and physicians' earnings.

    Science.gov (United States)

    Hadley, J; Mitchell, J M

    1999-11-01

    The goal of this study is to estimate whether cross-sectional variations in enrollment in health maintenance organizations (HMOs) affected physicians' earnings and hourly income in 1990. Using data from a nationally representative sample of 4,577 younger physicians (penetration is endogenous and used the instrumental variables approach to obtain unbiased estimates. HMO penetration had a negative and statistically significant impact on physicians earnings in 1990. A doubling of the average level of HMO penetration in the market is estimated to reduce annual earnings by 7% to 10.7%, and hourly earnings by approximately 6% to 9%. It appears that HMOs were successful in reducing physicians' annual and per hour earnings in 1990, presumably through a combination of fewer visits and lower payment rates for people covered by HMOs. Although these results cannot be generalized to all physicians, the experience of a younger cohort of physicians may still be a good indicator of the future effects of HMOs because younger physicians may be more susceptible to market forces than older and more established physicians. Moreover, these results may be somewhat conservative because they reflect market behavior in 1990, several years before the rapid growth and more aggressive market behavior of HMOs in recent years.

  16. Development of Medical Adjunctive Treatment for Acute Penetrating Head Injury

    Science.gov (United States)

    1988-04-01

    a bird) 22. Pyramid .................................................. (found in Egypt) 23. Unicorn ...Eat 2. Care 2. Mile 2. Rose 3. Rice 3. Cake 3. Meat 4. Storm 4. Skate 4. Cream 5. Market 5. Almost 5. Relate 6. Closet 6. Sailor 6. Strike 7. Mistake 7

  17. Penetrating abdominal injuries in children: a study of 33 cases ...

    African Journals Online (AJOL)

    Background: Trauma is gradually becoming a major cause of disability and it can be of any form, physical or emotional. For the surgeon the physical form is of major interest, especially its causes and incidence, which can be influenced by environmental or social factors. Aim: The aim of this work was to study the incidence, ...

  18. Real-Time Penetrating Particle Analyzer (PAN)

    Science.gov (United States)

    Wu, X.; Ambrosi, G.; Bertucci, B.

    2018-02-01

    The PAN can measure penetrating particles with great precision to study energetic particles, solar activities, and the origin and propagation of cosmic rays. The real-time monitoring of penetrating particles is crucial for deep space human travel.

  19. Occupational Cow Horn Eye Injuries in Ibadan, Nigeria

    African Journals Online (AJOL)

    Cow horn injury is an uncommon cause of penetrating eye injury with grave ... cattle‑related jobs, and they all had unilateral open‑globe injuries with corneoscleral lacerations. ... likely to be because men are at increased risk as cattle rearers.

  20. Network Penetration Testing and Research

    Science.gov (United States)

    Murphy, Brandon F.

    2013-01-01

    This paper will focus the on research and testing done on penetrating a network for security purposes. This research will provide the IT security office new methods of attacks across and against a company's network as well as introduce them to new platforms and software that can be used to better assist with protecting against such attacks. Throughout this paper testing and research has been done on two different Linux based operating systems, for attacking and compromising a Windows based host computer. Backtrack 5 and BlackBuntu (Linux based penetration testing operating systems) are two different "attacker'' computers that will attempt to plant viruses and or NASA USRP - Internship Final Report exploits on a host Windows 7 operating system, as well as try to retrieve information from the host. On each Linux OS (Backtrack 5 and BlackBuntu) there is penetration testing software which provides the necessary tools to create exploits that can compromise a windows system as well as other operating systems. This paper will focus on two main methods of deploying exploits 1 onto a host computer in order to retrieve information from a compromised system. One method of deployment for an exploit that was tested is known as a "social engineering" exploit. This type of method requires interaction from unsuspecting user. With this user interaction, a deployed exploit may allow a malicious user to gain access to the unsuspecting user's computer as well as the network that such computer is connected to. Due to more advance security setting and antivirus protection and detection, this method is easily identified and defended against. The second method of exploit deployment is the method mainly focused upon within this paper. This method required extensive research on the best way to compromise a security enabled protected network. Once a network has been compromised, then any and all devices connected to such network has the potential to be compromised as well. With a compromised

  1. Ethical Dilemmas and Dimensions in Penetration Testing

    OpenAIRE

    Faily, Shamal; McAlaney, John; Iacob, C.

    2015-01-01

    Penetration testers are required to attack systems to evaluate their security, but without engaging in unethical behaviour while doing so. Despite work on hacker values and studies into security practice, there is little literature devoted to the ethical pressures associated with penetration testing. This paper presents several ethical dilemmas and dimensions associated with penetration testing;\\ud these shed light on the ethical positions taken by Penetration testers, and help identify poten...

  2. Kali Linux wireless penetration testing essentials

    CERN Document Server

    Alamanni, Marco

    2015-01-01

    This book is targeted at information security professionals, penetration testers and network/system administrators who want to get started with wireless penetration testing. No prior experience with Kali Linux and wireless penetration testing is required, but familiarity with Linux and basic networking concepts is recommended.

  3. Effect of compressibility on the hypervelocity penetration

    Science.gov (United States)

    Song, W. J.; Chen, X. W.; Chen, P.

    2018-02-01

    We further consider the effect of rod strength by employing the compressible penetration model to study the effect of compressibility on hypervelocity penetration. Meanwhile, we define different instances of penetration efficiency in various modified models and compare these penetration efficiencies to identify the effects of different factors in the compressible model. To systematically discuss the effect of compressibility in different metallic rod-target combinations, we construct three cases, i.e., the penetrations by the more compressible rod into the less compressible target, rod into the analogously compressible target, and the less compressible rod into the more compressible target. The effects of volumetric strain, internal energy, and strength on the penetration efficiency are analyzed simultaneously. It indicates that the compressibility of the rod and target increases the pressure at the rod/target interface. The more compressible rod/target has larger volumetric strain and higher internal energy. Both the larger volumetric strain and higher strength enhance the penetration or anti-penetration ability. On the other hand, the higher internal energy weakens the penetration or anti-penetration ability. The two trends conflict, but the volumetric strain dominates in the variation of the penetration efficiency, which would not approach the hydrodynamic limit if the rod and target are not analogously compressible. However, if the compressibility of the rod and target is analogous, it has little effect on the penetration efficiency.

  4. Development of penetrant materials from used oil

    International Nuclear Information System (INIS)

    Mohamad Pauzi Ismail; Azhar Azmi

    2014-01-01

    This paper described the results of experiment to produce penetrant for nondestructive testing using used engine oil. The used engine oil was obtained from motor vehicle. It was mixed with kerosene at several mix proportion. The penetrability of these mixing were measured and compared with the penetrant available on the market. The results of measurement were explained and discussed. (author)

  5. Vena caval impalement: an unusual lawn mower injury in a child.

    Science.gov (United States)

    Muńoz-Juárez, M; Drugas, G T; Hallett, J W; Zietlow, S P

    1998-06-01

    Penetrating injury to the vena cava is a potentially life threatening condition that necessitates prompt recognition and immediate treatment. Herein we describe a unique lawn mower-related injury in a 4-year-old boy, resulting in the impalement of the inferior vena cava by a foreign body projectile. Relevant concepts in the management of children with lawn mower injuries are discussed, with emphasis on penetrating injury to the inferior vena cava.

  6. Penetrating trauma; experience from Southwest Finland between 1997 and 2011, a retrospective descriptive study.

    Science.gov (United States)

    Inkinen, J; Kirjasuo, K; Gunn, J; Kuttila, K

    2015-08-01

    (1) There is lack of epidemiological data on penetrating trauma in European countries. (2) In Finland most acts of violence are performed under the influence of alcohol. The aim of this study was to determine the incidence and types of injury, treatment and survival of patients with penetrating injuries to the thorax and abdomen. This study includes two trauma centers with combined catchment area of approximately 720,000 patients. Patients were identified from patient records using ICD-10 codes. Patients were predominantly young males and they were stab victims. The average yearly incidence for penetrating trauma was 0.9/100,000 inhabitants. Thirteen percent of patients admitted gave a negative toxicology screen or breathalyzer test for alcohol. Twenty two percent of wounds were self-inflicted. Fifty five percent of patients received a chest tube and 30 patients (23%) underwent emergent thoracotomy after sustaining critical injury to the thorax. A considerable proportion (12%) of the study group also later died due to alcohol and/or violence, highlighting the psychosocial co-morbidity among penetrating trauma victims. Chest tube insertion is a skill to be mastered by any on-call physician. This simple procedure can be potentially life-saving. There is also a call for assessment of psychosocial well-being among penetrating trauma victims.

  7. FAA Fluorescent Penetrant Activities - An Update

    Energy Technology Data Exchange (ETDEWEB)

    Moore, D.G.

    1998-10-20

    The Federal Aviation Administration's Airworthiness Assurance NDI Validation Center (AANC) is currently characterizing low cycle fatigue specimens that will support the needs of penetrant manufacturers, commercial airline industry and the Federal Aviation Administration. The main focus of this characterization is to maintain and enhance the evaluation of penetrant inspection materials and apply resources to support the aircraft community needs. This paper discusses efforts to-date to document the Wright Laboratory penetrant evaluation process and characterize penetrant brightness readings in the initial set of sample calibration panels using Type 1 penetrant.

  8. Web penetration testing with Kali Linux

    CERN Document Server

    Muniz, Joseph

    2013-01-01

    Web Penetration Testing with Kali Linux contains various penetration testing methods using BackTrack that will be used by the reader. It contains clear step-by-step instructions with lot of screenshots. It is written in an easy to understand language which will further simplify the understanding for the user.""Web Penetration Testing with Kali Linux"" is ideal for anyone who is interested in learning how to become a penetration tester. It will also help the users who are new to Kali Linux and want to learn the features and differences in Kali versus Backtrack, and seasoned penetration testers

  9. Penetration through the Skin Barrier

    DEFF Research Database (Denmark)

    Nielsen, Jesper Bo; Benfeldt, Eva; Holmgaard, Rikke

    2016-01-01

    The skin is a strong and flexible organ with barrier properties essential for maintaining homeostasis and thereby human life. Characterizing this barrier is the ability to prevent some chemicals from crossing the barrier while allowing others, including medicinal products, to pass at varying rates......-through diffusion cells) as well as in vivo methods (microdialysis and microperfusion). Then follows a discussion with examples of how different characteristics of the skin (age, site and integrity) and of the penetrants (size, solubility, ionization, logPow and vehicles) affect the kinetics of percutaneous...

  10. Penetration testing with Raspberry Pi

    CERN Document Server

    Muniz, Joseph

    2015-01-01

    If you are looking for a low budget, small form-factor remotely accessible hacking tool, then the concepts in this book are ideal for you. If you are a penetration tester who wants to save on travel costs by placing a low-cost node on a target network, you will save thousands by using the methods covered in this book. You do not have to be a skilled hacker or programmer to use this book. It will be beneficial to have some networking experience; however, it is not required to follow the concepts covered in this book.

  11. Correlation Between Cone Penetration Rate And Measured Cone Penetration Parameters In Silty Soils

    DEFF Research Database (Denmark)

    Poulsen, Rikke; Nielsen, Benjaminn Nordahl; Ibsen, Lars Bo

    2013-01-01

    This paper shows, how a change in cone penetration rate affects the cone penetration measurements, hence the cone resistance, pore pressure, and sleeve friction in silty soil. The standard rate of penetration is 20 mm/s, and it is generally accepted that undrained penetration occurs in clay while...... drained penetration occurs in sand. When lowering the penetration rate, the soil pore water starts to dissipate and a change in the drainage condition is seen. In intermediate soils such as silty soils, the standard cone penetration rate may result in a drainage condition that could be undrained......, partially or fully drained. However, lowering the penetration rate in silty soils has a great significance because of the soil permeability, and only a small change in penetration rate will result in changed cone penetration measurements. In this paper, analyses will be done on data from 15 field cone...

  12. Chylous ascites associated with chylothorax; a rare sequela of penetrating abdominal trauma: a case report

    Directory of Open Access Journals (Sweden)

    Plummer Joseph M

    2007-11-01

    Full Text Available Abstract We present the case of a patient with the rare combination of chylous ascites and chylothorax resulting from penetrating abdominal injury. This patient was successfully managed with total parenteral nutrition. This case report is used to highlight the clinical features and management options of this uncommon but challenging clinical problem.

  13. Surgical management of penetrating pelvic trauma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    ZHANG Peng

    2012-12-01

    Full Text Available 【Abstract】 High-velocity penetrating pelvic injury is one of the most difficult challenges to trauma surgeons. The injury sites frequently include soft tissue, pelvis, geni-tourinary tract, vascular structures and intraabdominal viscera. We present an unusual case of a male patient suf-fering a collision at night with a deformed steel bar penetrat-ing into his right groin. Careful planning of the surgical approach is important before extracting the foreign body. The possibility of multiorgan damage to intrapelvic struc-tures such as colon, urinary bladder, vessels and nerves, frequently necessitates a multidisciplinary involvement and systematic approach. Besides, limited incision as well as modification should be considered, and debridement and perioperative antibiotics can be used to reduce the risk of serious wound infection. Key words: Pelvis; Debridement; Wounds, penetrating

  14. Linguistic Intuitions and Cognitive Penetrability

    Directory of Open Access Journals (Sweden)

    Michael Devitt

    2014-12-01

    Full Text Available Metalinguistic intuitions play a very large evidential role in both linguistics and philosophy. Linguists think that these intuitions are products of underlying linguistic competence. I call this view “the voice of competence” (“VoC”. Although many philosophers seem to think that metalinguistic intuitions are a priori many may implicitly hold the more scientifically respectable VoC. According to VoC, I argue, these intuitions can be cognitively penetrated by the central processor. But, I have argued elsewhere, VoC is false. Instead, we should hold “the modest explanation” (“ME” according to which these intuitions are fairly unreflective empirical theory-laden central-processor responses to phenomena. On ME, no question of cognitive penetration arises. ME has great methodological significance for the study of language. Insofar as we rely on intuitions as evidence we should prefer those of linguists and philosophers because they are more expert. But, more importantly, we should be seeking other evidence in linguistic usage.

  15. Endovascular treatment of penetrating arterial trauma with stent grafts.

    Science.gov (United States)

    Biagioni, Rodrigo Bruno; Burihan, Marcelo Calil; Nasser, Felipe; Biagioni, Luisa Ciucci; Ingrund, José Carlos

    2018-02-01

    The endovascular management of arterial injuries has resulted in reduced operating time, blood loss, hospital mortality, lower incidence of sepsis, and decrease in mortality rates. For penetrating trauma, however, the benefits of endovascular therapy are questionable. Data were obtained by retrospective analysis of electronic medical records. All patients with vascular trauma seeking care at our institution from January 2010 to December 2015 were reviewed. A total of 223 vascular trauma patients were enrolled. Of these, 18 patients (8 %) were treated with endovascular techniques. The data related to clinical presentation, patient characteristics, technical aspects of the treatment, and follow-up were analysed. The mean patient age was 35.4 ± 17.8 years, 94 % were male. The mean injury severity score was 10.4 ± 2.5. The most commonly observed trauma mechanism was a gunshot in 10 cases (55 %), followed by lesions provoked by arterial catheter misplacement in five cases (27 %), and stab wounds in three cases (16.6 %). The main injury site was the subclavian artery, accounting for eight cases (44 %), followed by the superficial femoral artery and the tibiofibular trunk in two cases, respectively (18 %). The anterior tibial, fibular artery, axillary, common carotid, superior mesenteric, and profunda femoris were each affected once. Arteriovenous fistula was detected in nine cases (50 %), pseudoaneurysms in nine cases (50 %), and short occlusion in two cases (11 %). The mean follow-up duration was 753 days. The primary patency rate was 92.3 and 61.5 % after one and two years, respectively. The survival rate was 94.4 % after one and two years. Infection of the stents or limb amputations were not identified at follow-up. The endovascular treatment of penetrating arterial injuries with covered stents is feasible. However, the criteria used to choose the best method must be individualized.

  16. Minimal debridement or simple wound closure as the only surgical treatment in war victims with low-velocity penetrating head injuries. Indications and management protocol based upon more than 8 years follow-up of 99 cases from Iran-Iraq conflict.

    Science.gov (United States)

    Amirjamshidi, Abbass; Abbassioun, Kazem; Rahmat, Hamid

    2003-08-01

    During military conflicts, surviving victims traditionally underwent large enough craniectomy or craniotomy to achieve extensive debridement of the in-driven bone, shell fragments, and debris. Meanwhile, the completely as well as the partially devitalized adjacent brain tissue would also be debrided. This might have led to additional neurologic deficit or lesser degree of recovery of functions. We studied the efficacy and safety of much more limited or even absence of surgical intervention in a selected group of wartime head-wounded patients. Among 1,150 war victims with penetrating head wounds referred to two major centers affiliated with Tehran University of Medical Sciences during the 8-year period spanning the Iran-Iraq conflict, there were 191 head-wounded patients who underwent either no surgical intervention or a very limited debridement. We have attempted to follow up as closely as possible for more than 8 years. Ninety-nine of them fulfilled the criteria to be included in this series. Close follow-up for development of cerebral infections, functional recovery, or development of new neurologic deficits and epilepsy were performed. At least 3 contrast-enhanced CT scans were taken for each patient. All patients were victims of the battle-field areas with low- to moderate-velocity missile or shell fragment injury. The Glasgow Coma Scale (GCS) scores of the patients were between 8-14 when visited by the first attending neurosurgery staff. The factors considered to be effective in the outcome analysis were the entry point, the number of the in-driven bone fragments, the retained shell fragments, the brain compartments affected, and the paranasal sinus or skull base involvement with or without cerebrospinal fluid (CSF) fistula. There were 13 unilobar, 44 bilobar, 4 trilobar, 38 transventricular, and 3 skull base lesions. The number of retained metal fragments varied between 1 to 6. The number of retained bone fragments varied between 1 to 5 in 73 victims and more

  17. [Traumatic rupture of the pancreas and duodenum in pre-existing penetrating duodenal ulcer].

    Science.gov (United States)

    Schröder, W; Krüger, I; Mönig, S P; Hölscher, A H

    2000-01-01

    Pancreatic injuries are rare complications after blunt abdominal trauma and usually the result of a direct force separating the pancreatic body in front of the vertebral column. This case report describes the uncommon event of a severe pancreatic and duodenal injury (stage IV b of Lukas) in which the combination of a direct force and the setting of a preexisting penetrating ulcer of the duodenum caused the extent of the pancreatic and duodenal injury [9]. Because of the preexisting lesion a Whipple procedure had to be performed. This case report demonstrates the influence of chronic abdominal diseases on the outcome of blunt abdominal trauma.

  18. Endovascular management of a gunshot wound injury to the innominate artery and brachiocephalic vein.

    NARCIS (Netherlands)

    Werre, A.J.; Vliet, J.A. van der; Biert, J.; Blankensteijn, J.D.; Schultze Kool, L.J.

    2005-01-01

    Surgical repair of penetrating injuries of the thoracic outlet with combined arterial and venous involvement is associated with considerable morbidity and mortality. A 37-year-old man presented to the emergency room with a left-sided penetrating zone I neck injury caused by a close-range handgun

  19. Cable Braid Electromagnetic Penetration Model.

    Energy Technology Data Exchange (ETDEWEB)

    Warne, Larry K. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Langston, William L. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Basilio, Lorena I. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Johnson, W. A. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

    2015-06-01

    The model for penetration of a wire braid is rigorously formulated. Integral formulas are developed from energy principles and reciprocity for both self and transfer immittances in terms of potentials for the fields. The detailed boundary value problem for the wire braid is also setup in a very efficient manner; the braid wires act as sources for the potentials in the form of a sequence of line multipoles with unknown coefficients that are determined by means of conditions arising from the wire surface boundary conditions. Approximations are introduced to relate the local properties of the braid wires to a simplified infinite periodic planar geometry. This is used in a simplified application of reciprocity to be able to treat nonuniform coaxial geometries including eccentric interior coaxial arrangements and an exterior ground plane.

  20. Emergency operation for penetrating thoracic trauma in a metropolitan surgical service in South Africa.

    Science.gov (United States)

    Clarke, Damian Luiz; Quazi, Muhammed A; Reddy, Kriban; Thomson, Sandie Rutherford

    2011-09-01

    This audit examines our total experience with penetrating thoracic trauma. It reviews all the patients who were brought alive to our surgical service and all who were taken directly to the mortuary. The group of patients who underwent emergency operation for penetrating thoracic trauma is examined in detail. A prospective trauma registry is maintained by the Pietermaritzburg Metropolitan Complex. This database was retrospectively interrogated for all patients requiring an emergency thoracic operation for penetrating injury from July 2006 till July 2009. A retrospective review of mortuary data for the same period was undertaken to identify patients with penetrating thoracic trauma who had been taken to the forensic mortuary. Over the 3-year period July 2006 to July 2009, a total of 1186 patients, 77 of whom were female, were admitted to the surgical services in Pietermaritzburg with penetrating thoracic trauma. There were 124 gunshot wounds and 1062 stab wounds. A total of 108 (9%) patients required emergency operation during the period under review. The mechanism of trauma in the operative group was stab wounds (n = 102), gunshot wound (n = 4), stab with compass (n = 1), and impalement by falling on an arrow (n = 1). Over the same period 676 persons with penetrating thoracic trauma were taken to the mortuary. There were 135 (20%) gunshot wounds of the chest in the mortuary cohort. The overall mortality for penetrating thoracic trauma was 541 (33%) of 1603 for stab wounds and 135 (52%) of 259 for gunshot wounds of the chest. Among the 541 subjects with stab wounds from the mortuary cohort, there were 206 (38%) with cardiac injuries. In the emergency operation group there were 11 (10%) deaths. In 76 patients a cardiac injury was identified. The other injuries identified were lung parenchyma bleeding (n = 12) intercostal vessels (n = 10), great vessels of the chest (n = 6), internal thoracic vessel (n = 2), and pericardial injury with no myocardial injury (n = 2

  1. Bodily action penetrates affective perception

    Science.gov (United States)

    Rigutti, Sara; Gerbino, Walter

    2016-01-01

    Fantoni & Gerbino (2014) showed that subtle postural shifts associated with reaching can have a strong hedonic impact and affect how actors experience facial expressions of emotion. Using a novel Motor Action Mood Induction Procedure (MAMIP), they found consistent congruency effects in participants who performed a facial emotion identification task after a sequence of visually-guided reaches: a face perceived as neutral in a baseline condition appeared slightly happy after comfortable actions and slightly angry after uncomfortable actions. However, skeptics about the penetrability of perception (Zeimbekis & Raftopoulos, 2015) would consider such evidence insufficient to demonstrate that observer’s internal states induced by action comfort/discomfort affect perception in a top-down fashion. The action-modulated mood might have produced a back-end memory effect capable of affecting post-perceptual and decision processing, but not front-end perception. Here, we present evidence that performing a facial emotion detection (not identification) task after MAMIP exhibits systematic mood-congruent sensitivity changes, rather than response bias changes attributable to cognitive set shifts; i.e., we show that observer’s internal states induced by bodily action can modulate affective perception. The detection threshold for happiness was lower after fifty comfortable than uncomfortable reaches; while the detection threshold for anger was lower after fifty uncomfortable than comfortable reaches. Action valence induced an overall sensitivity improvement in detecting subtle variations of congruent facial expressions (happiness after positive comfortable actions, anger after negative uncomfortable actions), in the absence of significant response bias shifts. Notably, both comfortable and uncomfortable reaches impact sensitivity in an approximately symmetric way relative to a baseline inaction condition. All of these constitute compelling evidence of a genuine top-down effect on

  2. Bodily action penetrates affective perception

    Directory of Open Access Journals (Sweden)

    Carlo Fantoni

    2016-02-01

    Full Text Available Fantoni & Gerbino (2014 showed that subtle postural shifts associated with reaching can have a strong hedonic impact and affect how actors experience facial expressions of emotion. Using a novel Motor Action Mood Induction Procedure (MAMIP, they found consistent congruency effects in participants who performed a facial emotion identification task after a sequence of visually-guided reaches: a face perceived as neutral in a baseline condition appeared slightly happy after comfortable actions and slightly angry after uncomfortable actions. However, skeptics about the penetrability of perception (Zeimbekis & Raftopoulos, 2015 would consider such evidence insufficient to demonstrate that observer’s internal states induced by action comfort/discomfort affect perception in a top-down fashion. The action-modulated mood might have produced a back-end memory effect capable of affecting post-perceptual and decision processing, but not front-end perception. Here, we present evidence that performing a facial emotion detection (not identification task after MAMIP exhibits systematic mood-congruent sensitivity changes, rather than response bias changes attributable to cognitive set shifts; i.e., we show that observer’s internal states induced by bodily action can modulate affective perception. The detection threshold for happiness was lower after fifty comfortable than uncomfortable reaches; while the detection threshold for anger was lower after fifty uncomfortable than comfortable reaches. Action valence induced an overall sensitivity improvement in detecting subtle variations of congruent facial expressions (happiness after positive comfortable actions, anger after negative uncomfortable actions, in the absence of significant response bias shifts. Notably, both comfortable and uncomfortable reaches impact sensitivity in an approximately symmetric way relative to a baseline inaction condition. All of these constitute compelling evidence of a genuine top

  3. Assessing high wind energy penetration

    International Nuclear Information System (INIS)

    Tande, J.O.

    1995-01-01

    In order to convincingly promote installing wind power capacity as a substantial part of the energy supply system, a set of careful analyses must be undertaken. This paper applies a case study concentrated on assessing the cost/benefit of high wind energy penetration. The case study considers expanding the grid connected wind power capacity in Praia, the capital of Cape Verde. The currently installed 1 MW of wind power is estimated to supply close to 10% of the electric energy consumption in 1996. Increasing the wind energy penetration to a higher level is considered viable as the project settings are close to ideal, including a very capable national utility company, Electra, a conventional power supply system based on imported heavy fuel and gas oil, and favourable wind conditions with an estimated annual average of 9.3 m/s at the hub height of the wind turbines. With the applied case study assumptions, simulations with WINSYS over the lifetime of the assessed wind power investment show that investments up to 4.2 MW are economically viable. The economic optimum is found at 2.4 MW reaching an internal rate of return of almost 8% p.a. This 2.4 MW of wind power would, together with the existing wind power, supply over 30% of the electric consumption in 1996. Applying the recommended practices for estimating the cost of wind energy, the life-cycle cost of this 2.4 MW investment is estimated at a 7% discount rate and a 20 year lifetime to 0.26 DKK/kW h. (Author)

  4. Market penetration of intersection AEB: Characterizing avoided and residual straight crossing path accidents.

    Science.gov (United States)

    Sander, Ulrich; Lubbe, Nils

    2018-06-01

    Car occupants account for one third of all junction fatalities in the European Union. Driver warning can reduce intersection accidents by up to 50 percent; adding Autonomous Emergency Braking (AEB) delivers a reduction of up to 70 percent. However, these findings are based on an assumed 100 percent equipment rate, which may take decades to achieve. Our study investigates the relationship between intersection AEB market penetration rates and avoidance of accidents and injuries in order to guide implementation strategies. Additionally, residual accident characteristics (impact configurations and severity) are analyzed to provide a basis for future in-crash protection requirements. We determined which accidents would have been avoided through the use of an Intersection AEB system with different sensor field-of-views (180° and 120°) by means of re-simulating the pre-crash phase of 792 straight crossing path (SCP) car-to-car accidents recorded in the German In-Depth Accident Study (GIDAS) and the associated Pre-Crash Matrix (PCM). Intersection AEB was activated when neither of the conflict opponents could avoid the crash through reasonable braking or steering reactions. For not-avoided accidents, we used the Kudlich-Slibar rigid body impulse model to calculate the change of velocity during the impact as a measure of impact severity and the principal direction of force. Accident avoidance over market penetration is not linear but exponential, with higher gains at low penetration rates and lower gains at higher rates. A wide field-of-view sensor (180°) substantially increased accident avoidance and injury mitigation rates compared to a 120° field-of-view sensor. For a 180° field-of-view sensor at 100 percent market penetration, about 80 percent of the accidents and 90 percent of the MAIS2 + F injuries could be avoided. For the remaining accidents, AEB intervention rarely affected side of impact. The median change of velocity (delta-V) of the remaining crashes

  5. Varieties of cognitive penetration in visual perception.

    Science.gov (United States)

    Vetter, Petra; Newen, Albert

    2014-07-01

    Is our perceptual experience a veridical representation of the world or is it a product of our beliefs and past experiences? Cognitive penetration describes the influence of higher level cognitive factors on perceptual experience and has been a debated topic in philosophy of mind and cognitive science. Here, we focus on visual perception, particularly early vision, and how it is affected by contextual expectations and memorized cognitive contents. We argue for cognitive penetration based on recent empirical evidence demonstrating contextual and top-down influences on early visual processes. On the basis of a perceptual model, we propose different types of cognitive penetration depending on the processing level on which the penetration happens and depending on where the penetrating influence comes from. Our proposal has two consequences: (1) the traditional controversy on whether cognitive penetration occurs or not is ill posed, and (2) a clear-cut perception-cognition boundary cannot be maintained. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Percutaneous penetration studies for risk assessment

    DEFF Research Database (Denmark)

    Sartorelli, Vittorio; Andersen, Helle Raun; Angerer, Jürgen

    2000-01-01

    . In order to predict the systemic risk of dermally absorbed chemicals and to enable agencies to set safety standards, data is needed on the rates of percutaneous penetration of important chemicals. Standardization of in vitro tests and comparison of their results with the in vivo data could produce...... internationally accepted penetration rates and/or absorption percentages very useful for regulatory toxicology. The work of the Percutaneous Penetration Subgroup of EC Dermal Exposure Network has been focussed on the standardization and validation of in vitro experiments, necessary to obtain internationally...... accepted penetration rates for regulatory purposes. The members of the Subgroup analyzed the guidelines on percutaneous penetration in vitro studies presented by various organizations and suggested a standardization of in vitro models for percutaneous penetration taking into account their individual...

  7. Ethical hacking and penetration testing guide

    CERN Document Server

    Baloch, Rafay

    2014-01-01

    Requiring no prior hacking experience, Ethical Hacking and Penetration Testing Guide supplies a complete introduction to the steps required to complete a penetration test, or ethical hack, from beginning to end. You will learn how to properly utilize and interpret the results of modern-day hacking tools, which are required to complete a penetration test. The book covers a wide range of tools, including Backtrack Linux, Google reconnaissance, MetaGooFil, dig, Nmap, Nessus, Metasploit, Fast Track Autopwn, Netcat, and Hacker Defender rootkit. Supplying a simple and clean explanation of how to effectively utilize these tools, it details a four-step methodology for conducting an effective penetration test or hack.Providing an accessible introduction to penetration testing and hacking, the book supplies you with a fundamental understanding of offensive security. After completing the book you will be prepared to take on in-depth and advanced topics in hacking and penetration testing. The book walks you through each ...

  8. Evaluation of the use of tomography in penetrating neck trauma

    Directory of Open Access Journals (Sweden)

    ADONIS NASR

    Full Text Available ABSTRACTObjective:the study has the intention of evaluate the accuracy of computed tomography for the diagnosis of cervical lesions on penetrating neck trauma and also identify the most frequent mechanisms of trauma. Most injured structures, determine the age range and the most prevalent sex.Methods: observational descriptive retrospective study executed by the systematic retrospective review of medical records of all patients victims of penetrating neck trauma that went through surgery and CT scans, admitted into Hospital do Trabalhador, between January 2009 and December 2013.Results:the final sample was of 30 patients, 96.7% of the male sex, the median age was of 28 years old. Most patients suffered injuries by gun (56.7% and 33,3% suffered stab wounds. The most stricken area of the neck was Zone II (77.8% and the left side (55.2%. Regarding the structures injured, the CT showed 6.7% lesions on airways but the surgery showed 40% of damaged, with a value of p=0.002. As to damages of the esophagus and pharynx the CT detected 10% of lesions, while surgery found 30% of lesions, therefore with a significant value of p=0.013. As for the analysis the CT showed reliable. As for the analysis of vascular damage, the CT showed to be, in most cases, reliable to the findings during the surgical act.Conclusion:besides the great use of CT for the diagnosis of penetrating neck injuries we can say that this is an exam with low accuracy for the diagnosis of lesions of aerodigestive tract, therefore it is important a clinical correlation for a good diagnosis.as for the vascular lesions and of other structures, the CT had high sensibility and specificity, thus a good exam to be used in overall.

  9. Initial response of a rock penetrator

    International Nuclear Information System (INIS)

    Longcope, D.B.; Grady, D.E.

    1977-12-01

    An analysis based on elastic rod theory is given for the early-time axisymmetric response of pointed penetrators. Results of measurements by laser interferometry of the back surface particle velocity of laboratory scale penetrators impacted by sandstone targets are presented. Values of the initial pressure on the penetrator tip are determined which give good agreement between the analytical and experimental results. These initial tip pressures are found to be approximated by the stress-particle velocity Hugoniot for the target material

  10. Traumatic Aortic Injury

    Directory of Open Access Journals (Sweden)

    Brianna Miner

    2016-09-01

    Full Text Available History of present illness: A 48-year-old male with unknown past medical history presents as a trauma after being hit by a car traveling approximately 25 miles per hour. On initial presentation, the patient is confused, combative, and not answering questions appropriately. The patient is hypotensive with a blood pressure of 68/40 and a heart rate of 50 beats per minute, with oxygen saturation at 96% on room air. FAST scan is positive for fluid in Morrison’s pouch, splenorenal space, and pericardial space. Significant findings: The initial chest x-ray showed an abnormal superior mediastinal contour (blue line, suggestive of a possible aortic injury. The CT angiogram showed extensive circumferential irregularity and outpouching of the distal aortic arch (red arrows compatible with aortic transection. In addition, there was a circumferential intramural hematoma, which extended through the descending aorta to the proximal infrarenal abdominal aorta (green arrow. There was also an extensive surrounding mediastinal hematoma extending around the descending aorta and supraaortic branches (purple arrows. Discussion: Traumatic aortic injury is a life-threatening event. The incidence of blunt thoracic aortic injury is low, between 1 to 2 percent of those patients with blunt thoracic trauma.1 However, approximately 80% of patients with traumatic aortic injury die at the scene.2 Therefore it is imperative to diagnose traumatic aortic injury in a timely fashion. The diagnosis can be difficult due to the non-specific signs and symptoms and other distracting injuries. Clinical suspicion should be based on the mechanism of the injury and the hemodynamic status of the patient. In any patient with blunt or penetrating trauma to the chest that is hemodynamically unstable, traumatic aortic injury should be on the differential. Chest x-ray can be used as a screening tool. A normal chest x-ray has a negative predictive value of approximately 97%. CTA chest is the

  11. Injury: necropsy studies

    Directory of Open Access Journals (Sweden)

    Roberto Almeida Rêgo de Souza

    2015-12-01

    Full Text Available Objective: to carry out an epidemiological research of trauma related deaths subjected to autopsy. Methods: a retrospective research was held through the analysis of 412 medical records related to traumatic deaths in 2014, subjected to autopsy at the Forensics Department of Itabuna, evaluating the following variables: gender, age, marital status, race, education, pre- hospital care, consequence of death, type of trauma, mechanism of injury, lesion topography, cause of death, day, time and city the incident took place. Data was divided into two groups: I penetrating trauma and II blunt injury. Results: The vast majority was male (93%, brown (95%, single (83%, with education up to elementary school (42% prevailing age group between 25 and 29 years of age (67 %, and death caused by homicide (62%. The most frequent type was penetrating trauma (61%, being the skull the most affected body region (65%. Intracranial hemorrhages were the main causes of death (30.8%. Injuries by firearms projectiles prevailed in group I, and automobile accidents in group II. Conclusion: the population most affected by deaths due to external causes in the city of Itabuna, Bahia, consists of young, brown, single men.

  12. In-place HEPA filter penetration test

    International Nuclear Information System (INIS)

    Bergman, W.; Wilson, K.; Elliott, J.; Bettencourt, B.; Slawski, J.W.

    1997-01-01

    We have demonstrated the feasibility of conducting penetration tests on high efficiency particulate air (HEPA) filters as installed in nuclear ventilation systems. The in-place penetration test, which is designed to yield equivalent penetration measurements as the standard DOP efficiency test, is based on measuring the aerosol penetration of the filter installation as a function of particle size using a portable laser particle counter. This in-place penetration test is compared to the current in-place leak test using light scattering photometers for single HEPA filter installations and for HEPA filter plenums using the shroud method. Test results show the in-place penetration test is more sensitive than the in-place leak test, has a similar operating procedure, but takes longer to conduct. Additional tests are required to confirm that the in-place penetration test yields identical results as the standard dioctyl phthalate (DOP) penetration test for HEPA filters with controlled leaks in the filter and gasket and duct by-pass leaks. Further development of the procedure is also required to reduce the test time before the in- place penetration test is practical

  13. Market penetration rates of new energy technologies

    International Nuclear Information System (INIS)

    Lund, Peter

    2006-01-01

    The market penetration rates of 11 different new energy technologies were studied covering energy production and end-use technologies. The penetration rates were determined by fitting observed market data to an epidemical diffusion model. The analyses show that the exponential penetration rates of new energy technologies may vary from 4 up to over 40%/yr. The corresponding take-over times from a 1% to 50% share of the estimated market potential may vary from less than 10 to 70 years. The lower rate is often associated with larger energy impacts. Short take-over times less than 25 years seem to be mainly associated with end-use technologies. Public policies and subsides have an important effect on the penetration. Some technologies penetrate fast without major support explained by technology maturity and competitive prices, e.g. compact fluorescent lamps show a 24.2%/yr growth rate globally. The penetration rates determined exhibit some uncertainty as penetration has not always proceeded close to saturation. The study indicates a decreasing penetration rate with increasing time or market share. If the market history is short, a temporally decreasing functional form for the penetration rate coefficient could be used to anticipate the probable behavior

  14. In-place HEPA filter penetration test

    Energy Technology Data Exchange (ETDEWEB)

    Bergman, W.; Wilson, K.; Elliott, J. [Lawrence Livermore National Lab., CA (United States)] [and others

    1997-08-01

    We have demonstrated the feasibility of conducting penetration tests on high efficiency particulate air (HEPA) filters as installed in nuclear ventilation systems. The in-place penetration test, which is designed to yield equivalent penetration measurements as the standard DOP efficiency test, is based on measuring the aerosol penetration of the filter installation as a function of particle size using a portable laser particle counter. This in-place penetration test is compared to the current in-place leak test using light scattering photometers for single HEPA filter installations and for HEPA filter plenums using the shroud method. Test results show the in-place penetration test is more sensitive than the in-place leak test, has a similar operating procedure, but takes longer to conduct. Additional tests are required to confirm that the in-place penetration test yields identical results as the standard dioctyl phthalate (DOP) penetration test for HEPA filters with controlled leaks in the filter and gasket and duct by-pass leaks. Further development of the procedure is also required to reduce the test time before the in-place penetration test is practical. 14 refs., 14 figs., 3 tabs.

  15. Chirurgica Taurina: a 10-year experience of bullfight injuries.

    Science.gov (United States)

    Rudloff, Udo; Gonzalez, Victor; Fernandez, Eduardo; Holguin, Esteban; Rubio, Gustavo; Lomelin, Jorge; Dittmar, Michael; Barrera, Rafael

    2006-10-01

    Despite recent efforts to improve medical treatment for injured bullfighters, including the foundation of a scientific society for bullfight injuries, serious injuries, in particular in villages and smaller arenas, still do occur. We are not aware of any series in the English literature that aimed to study the specific mechanisms, types, and outcomes of these injuries. A review of the trauma registry of injured bullfighters who suffered any type of trauma during bullfighting and received emergency therapy by the Surgical Trauma Services between 1994 and 2004 at the Plaza de Toros Nuevo Progreso, Guadalajara, Mexico. In all, 68 out of 750 bullfighters (9.06%) required emergency assistance during bullfighting. Trauma to the upper and lower extremity was most common (66%), followed by injuries to the inguinal (8%) and perineal area (7%). Extremity injuries included penetrating wounds requiring operative debridement in 64% of cases, articular dislocations in 4%, closed fractures in 4%, and open fractures in 1% of cases. Major vascular injuries occurred in 5% of the cases. Penetrating inguinal and penetrating perineal injuries were associated with major vascular injuries to the femoral vessels, necessitating operative repair in 33% of the cases. A considerable risk of serious, life-threatening injuries is inherent to bullfighting. Penetrating inguinal and perineal trauma with injury to the femoral vessels represents a specific, potentially fatal injury. A low threshold for exploration of these penetrating injuries in injured bullfighters is associated with a favorable outcome. Appreciation of the unique mechanisms and types of injuries related to bullfighting should lead to target intervention and help the evolvement of improved emergency treatment in organized bullfighting.

  16. Sports Injuries

    Science.gov (United States)

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper ... can also lead to injuries. The most common sports injuries are Sprains and strains Knee injuries Swollen ...

  17. Golf Injuries

    Science.gov (United States)

    ... Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Golf Injuries Golf looks like an easy game to ... WHAT TYPES OF INJURIES ARE MOST COMMON IN GOLF? Acute injuries are usually the result of a ...

  18. Influence of jet thrust on penetrator penetration when studying the structure of space object blanket

    Directory of Open Access Journals (Sweden)

    N. A. Fedorova

    2014-01-01

    Full Text Available The article presents the calculation-and-theory-based research results to examine the possibility for using the jet thrust impulse to increase a penetration depth of high-velocity penetrator modules. Such devices can be used for studies of Earth surface layer composition, and in the nearest future for other Solar system bodies too. Research equipment (sensors and different instruments is housed inside a metal body of the penetrator with a sharpened nose that decreases drag force in soil. It was assumed, that this penetrator is additionally equipped with the pulse jet engine, which is fired at a certain stage of penetrator motion into target.The penetrator is considered as a rigid body of variable mass, which is subjected to drag force and reactive force applied at the moment the engine fires. A drag force was represented with a binomial empirical law, and penetrator nose part was considered to be conical. The jet thrust force was supposed to be constant during its application time. It was in accordance with assumption that mass flow and flow rate of solid propellant combustion products were constant. The amount of propellant in the penetrator was characterized by Tsiolkovsky number Z, which specifies the ratio between the fuel mass and the penetrator structure mass with no fuel.The system of equations to describe the penetrator dynamics was given in dimensionless form using the values aligned with penetration of an equivalent inert penetrator as the time and penetration depth scales. Penetration dynamics of penetrator represented in this form allowed to eliminate the influence of penetrator initial mass and its cross-section diameter on the solution results. The lack of such dependency is convenient for comparing the calculation results since they hold for penetrators of various initial masses and cross-sections.To calculate the penetration a lunar regolith was taken as a soil material. Calculations were carried out for initial velocities of

  19. Lawn mower-related projectile injury.

    Science.gov (United States)

    McNamara, William F; Yamout, Sani Z; Escobar, Mauricio A; Glick, Philip L

    2009-07-01

    Lawn mower injuries are a potentially devastating, yet preventable cause of morbidity and mortality in the pediatric population. The sequelae to these injuries can become even worse if the initial presentation goes unsuspected by medical staff, leading to a delay in treatment. The authors report the case of a lawn mower-related penetrating missile injury, where the extent of injury was not appreciated by the patient until signs and symptoms of a soft-tissue infection developed, prompting the patient to seek medical attention the next day.

  20. Evolving colon injury management: a review.

    Science.gov (United States)

    Greer, Lauren T; Gillern, Suzanne M; Vertrees, Amy E

    2013-02-01

    The colon is the second most commonly injured intra-abdominal organ in penetrating trauma. Management of traumatic colon injuries has evolved significantly over the past 200 years. Traumatic colon injuries can have a wide spectrum of severity, presentation, and management options. There is strong evidence that most non-destructive colon injuries can be successfully managed with primary repair or primary anastomosis. The management of destructive colon injuries remains controversial with most favoring resection with primary anastomosis and others favor colonic diversion in specific circumstances. The historical management of traumatic colon injuries, common mechanisms of injury, demographics, presentation, assessment, diagnosis, management, and complications of traumatic colon injuries both in civilian and military practice are reviewed. The damage control revolution has added another layer of complexity to management with continued controversy.

  1. Pre-hospital transport times and survival for Hypotensive patients with penetrating thoracic trauma

    Directory of Open Access Journals (Sweden)

    Mamta Swaroop

    2013-01-01

    Full Text Available Background: Achieving definitive care within the "Golden Hour" by minimizing response times is a consistent goal of regional trauma systems . This study hypothesizes that in urban Level I Trauma Centers, shorter pre-hospital times would predict outcomes in penetrating thoracic injuries. Materials and Methods: A retrospective cohort study was performed using a statewide trauma registry for the years 1999-2003 . Total pre-hospital times were measured for urban victims of penetrating thoracic trauma. Crude and adjusted mortality rates were compared by pre-hospital time using STATA statistical software. Results: During the study period, 908 patients presented to the hospital after penetrating thoracic trauma, with 79% surviving . Patients with higher injury severity scores (ISS were transported more quickly. Injury severity scores (ISS ≥16 and emergency department (ED hypotension (systolic blood pressure, SBP <90 strongly predicted mortality (P < 0.05 for each . In a logistic regression model including age, race, and ISS, longer transport times for hypotensive patients were associated with higher mortality rates (all P values <0.05. This was seen most significantly when comparing patient transport times 0-15 min and 46-60 min (P < 0.001. Conclusion: In victims of penetrating thoracic trauma, more severely injured patients arrive at urban trauma centers sooner . Mortality is strongly predicted by injury severity, although shorter pre-hospital times are associated with improved survival . These results suggest that careful planning to optimize transport time-encompassing hospital capacity and existing resources, traffic patterns, and trauma incident densities may be beneficial in areas with a high burden of penetrating trauma.

  2. A review of penetration mechanisms and dynamic properties of tungsten and depleted uranium penetrators

    International Nuclear Information System (INIS)

    Andrew, S.P.; Caligiuri, R.D.; Eiselstein, L.E.

    1991-01-01

    Kinetic energy penetrators must posses the best possible combination of hardness, stiffness, strength, and fracture toughness characteristics to be effective against modern armor systems. Over the last decade, depleted uranium (DU) and tungsten alloys have been the materials of choice for kinetic energy penetrators. Du and tungsten perform abut the same against semi-infinite targets, and DU outperforms tungsten penetrators in oblique, spaced array targets, but because of environmental and subsequent cost concerns, effort has focused on improving the performance of tungsten penetrators over the last few years. However, despite recent improvements in material properties, the penetration performance of tungsten still lags behind that of DU. One possible reason is the difference in deformation mechanisms at the leading edge of the penetrator during the penetration process-DU alloys tend to shear band and sharpen as they penetrate the target material, whereas tungsten penetrators tend to mushroom and blunt. As a first step to determine whether shear banding is truly the reason for superior DU performance, a review of the fabrication, high strain-rate properties, and penetration phenomena of penetrators manufactured from both tungsten and DU alloys. Specifically, the effects of composition, processing, and heat treatment on material properties and penetration mechanisms of these alloys are discussed

  3. Quantitative penetration testing with item response theory

    NARCIS (Netherlands)

    Pieters, W.; Arnold, F.; Stoelinga, M.I.A.

    2013-01-01

    Existing penetration testing approaches assess the vulnerability of a system by determining whether certain attack paths are possible in practice. Therefore, penetration testing has thus far been used as a qualitative research method. To enable quantitative approaches to security risk management,

  4. Generic penetration in the retail antidepressant market.

    Science.gov (United States)

    Ventimiglia, Jeffrey; Kalali, Amir H

    2010-06-01

    In this article, we explore the accelerated penetration of generic antidepressants in the United States market following the availability of generic citalopram and sertraline. Analysis suggests that overall, generic penetration into the antidepressant market has grown from approximately 41 percent in January 2004 to over 73 percent in January 2010. Similar trends are uncovered when branded and generic prescriptions are analyzed by specialty.

  5. Quantitative Penetration Testing with Item Response Theory

    NARCIS (Netherlands)

    Arnold, Florian; Pieters, Wolter; Stoelinga, Mariëlle Ida Antoinette

    2014-01-01

    Existing penetration testing approaches assess the vulnerability of a system by determining whether certain attack paths are possible in practice. Thus, penetration testing has so far been used as a qualitative research method. To enable quantitative approaches to security risk management, including

  6. Quantitative penetration testing with item response theory

    NARCIS (Netherlands)

    Arnold, Florian; Pieters, Wolter; Stoelinga, Mariëlle

    2013-01-01

    Existing penetration testing approaches assess the vulnerability of a system by determining whether certain attack paths are possible in practice. Thus, penetration testing has so far been used as a qualitative research method. To enable quantitative approaches to security risk management, including

  7. Chemical Penetration Enhancers for Transdermal Drug Delivery ...

    African Journals Online (AJOL)

    for transdermal administration. The permeation of drug through skin can be enhanced by both chemical penetration enhancement and physical methods. In this review, we have discussed the chemical penetration enhancement technology for transdermal drug delivery as well as the probable mechanisms of action.

  8. Self-Inflicted Orbito-Cranial Injury Secondary to Gunshot: Case Report

    Directory of Open Access Journals (Sweden)

    Yam Bahadur Roka

    2017-10-01

    Full Text Available The eye may be injured by various penetrating and non-penetrating injuries like sticks, pencils, rods, gunshot and chopsticks. Self-inflicted gunshot injuries have been rarely reported in literature. This case is interesting in multiple aspects which include poverty, lack of education and the failure of government to ensure control of the use of firearms in Nepal. We report a case of self-inflicted gun injury which was managed successfully.

  9. Transconjunctival penetration of mitomycin C

    Directory of Open Access Journals (Sweden)

    Velpandian T

    2008-01-01

    Full Text Available Aims: The study was performed to estimate transconjunctival penetration of mitomycin C (MMC to Tenon′s tissue following application over the intact conjunctiva before routine trabeculectomy. Settings and Design: Institution-based case series. Materials and Methods: In 41 eyes of 41 patients, MMC (0.4 mg/ml for 3 min was applied over the intact conjunctiva before beginning trabeculectomy. Tenon′s capsule directly beneath the site of application was excised during trabeculectomy and was homogenized, centrifuged and MMC concentrations were analyzed using high-performance liquid chromatography (HPLC. Statistical Analysis Used: Statistical analysis was performed using stata0 8.0 version software (STATA Corporation, Houston, TX, USA. In this study, P -values less than 0.05 were considered as statistically significant. Results: The average weight of the sample of Tenon′s tissue excised was 5.51 ± 4.42 mg (range: 0.9-17.1 and the average estimated MMC concentration found to be present in Tenon′s tissue using HPLC was 18.67 ± 32.36 x 10−6 moles/kg of the tissue (range: 0.38-197.05 x 10−6 . In 36 of the 41 patients (87.80%, the MMC concentration reached above 2 x 10−6 moles/kg of the tissue concentration required to inhibit human conjunctival fibroblasts. Conclusions: Mitomycin C does permeate into the subconjunctival tissue after supraconjunctival application for 3 min. Application of MMC over the conjunctiva may be a useful alternative to subconjunctival or subscleral application during routine trabeculectomy and as an adjunct for failing blebs.

  10. Missile injuries of the brain

    International Nuclear Information System (INIS)

    Kazmi, S.A.M.; Ashraf, A.T.; Qureshi, N.A.

    2001-01-01

    Data was analyzed relating to a consecutive series of 16 patients of penetrating brain injuries received at forward defense lines. Characteristics studied were the cause of injury, level of consciousness and various neurological deficits presented on initial examination, CT scan findings, the surgical procedures performed and the final outcome after one year of follow-up. One out of 16 patients, died due to severe associated injuries to abdominal viscera and major vessels. Meningitis occurred in one patient during the immediate postoperative period. All patients with motor weakness speech deficits and incontinence showed significant improvement. Hearing loss of one ear persisted in one patient. Two patients developed delayed onset seizures. It is concluded that, patients with penetrating brain injuries should be evacuated to the tertiary care neurosurgical centres as soon as possible. In operation only obviously necrotic brain and easily accessible metal and bone pieces should be removed. There is no need to explore the normal brain as it would only result in increased neurological deficits. The patients with such injuries should receive broad-spectrum antibiotics to prevent the infective complications. (author)

  11. Miniature Ground Penetrating Radar, CRUX GPR

    Science.gov (United States)

    Kim, Soon Sam; Carnes, Steven R.; Haldemann, Albert F.; Ulmer, Christopher T.; Ng, Eddie; Arcone, Steven A.

    2006-01-01

    Under NASA instrument development programs (PIDDP 2000-2002, MIPD 2003-2005, ESR and T, 2005) we have been developing miniature ground penetrating radars (GPR) for use in mapping subsurface stratigraphy from planetary rovers for Mars and lunar applications. The Mars GPR is for deeper penetration (up to 50 m depth) into the Martian subsurface at moderate resolution (0.5 m) for a geological characterization. As a part of the CRUX (Construction and Resource Utilization Explorer) instrument suite, the CRUX GPR is optimized for a lunar prospecting application. It will have shallower penetration (5 m depth) with higher resolution (10 cm) for construction operations including ISRU (in-situ resource utilization).

  12. Development of coring, consolidating, subterrene penetrators

    International Nuclear Information System (INIS)

    Murphy, H.D.; Neudecker, J.W.; Cort, G.E.; Turner, W.C.; McFarland, R.D.; Griggs, J.E.

    1976-02-01

    Coring penetrators offer two advantages over full face-melting penetrators, i.e., formation of larger boreholes with no increase in power and the production of glass-lined, structurally undisturbed cores which can be recovered with conventional core-retrieval systems. These cores are of significant value in geological exploratory drilling programs. The initial design details and fabrication features of a 114-mm-diam coring penetrator are discussed; significant factors for design optimization are also presented. Results of laboratory testing are reported and compared with performance predictions, and an initial field trial is described

  13. Sphere impact and penetration into wet sand

    KAUST Repository

    Marston, J. O.

    2012-08-07

    We present experimental results for the penetration of a solid sphere when released onto wet sand. We show, by measuring the final penetration depth, that the cohesion induced by the water can result in either a deeper or shallower penetration for a given release height compared to dry granular material. Thus the presence of water can either lubricate or stiffen the granular material. By assuming the shear rate is proportional to the impact velocity and using the depth-averaged stopping force in calculating the shear stress, we derive effective viscosities for the wet granular materials.

  14. Sphere impact and penetration into wet sand

    KAUST Repository

    Marston, J. O.; Vakarelski, Ivan Uriev; Thoroddsen, Sigurdur T

    2012-01-01

    We present experimental results for the penetration of a solid sphere when released onto wet sand. We show, by measuring the final penetration depth, that the cohesion induced by the water can result in either a deeper or shallower penetration for a given release height compared to dry granular material. Thus the presence of water can either lubricate or stiffen the granular material. By assuming the shear rate is proportional to the impact velocity and using the depth-averaged stopping force in calculating the shear stress, we derive effective viscosities for the wet granular materials.

  15. A Mass Loss Penetration Model to Investigate the Dynamic Response of a Projectile Penetrating Concrete considering Mass Abrasion

    Directory of Open Access Journals (Sweden)

    NianSong Zhang

    2015-01-01

    Full Text Available A study on the dynamic response of a projectile penetrating concrete is conducted. The evolutional process of projectile mass loss and the effect of mass loss on penetration resistance are investigated using theoretical methods. A projectile penetration model considering projectile mass loss is established in three stages, namely, cratering phase, mass loss penetration phase, and remainder rigid projectile penetration phase.

  16. The penetration of aerosols through fine orifices

    International Nuclear Information System (INIS)

    Marshall, I.A.; Latham, L.J.; Ball, M.H.E.; Mitchell, J.P.

    1991-07-01

    A novel experimental technique has been extended to study the migration of gas-borne glass microspheres in the size range from about 1 to 15 μm volume equivalent diameter through orifices with bores and thicknesses in the range from 2 to 100 μm and 12.7 to 509 μm respectively. The penetration of these particles was significant with all orifices greater than 10 μm bore at a constant driving pressure of 100 kPa. However, few particles penetrated the 5 μm bore orifice, while virtually no particles penetrated the 2 μm bore orifice. Particle size distributions determined after penetration through the orifices were very similar to that of the upstream aerosol except when significant attenuation occurred. (author)

  17. Temporary fire sealing of penetrations on TFTR

    International Nuclear Information System (INIS)

    Hondorp, H.L.

    1981-02-01

    The radiation shielding provided for TFTR for D-D and D-T operation will be penetrated by numerous electrical and mechanical services. Eventually, these penetrations will have to be sealed to provide the required fire resistance, tritium sealability, pressure integrity and radiation attenuation. For the initial hydrogen operation, however, fire sealing of the penetrations in the walls and floor is the primary concern. This report provides a discussion of the required and desirable properties of a temporary seal which can be used to seal these penetrations for the hydrogen operation and then subsequently be removed and replaced as required for the D-D and D-T operations. Several candidate designs are discussed and evaluated and recommendations are made for specific applications

  18. Identifying structural damage with ground penetrating radar

    CSIR Research Space (South Africa)

    Van Schoor, Abraham M

    2008-07-01

    Full Text Available Ground penetrating radar (GPR) and electrical resistance tomography (ERT) surveys were conducted in an urban environment in an attempt to identify the cause of severe structural damage to a historically significant residential property...

  19. Kali Linux wireless penetration testing beginner's guide

    CERN Document Server

    Ramachandran, Vivek

    2015-01-01

    If you are a security professional, pentester, or anyone interested in getting to grips with wireless penetration testing, this is the book for you. Some familiarity with Kali Linux and wireless concepts is beneficial.

  20. Penetration testing protecting networks and systems

    CERN Document Server

    Henry, Kevin M

    2012-01-01

    This book is a preparation guide for the CPTE examination, yet is also a general reference for experienced penetration testers, ethical hackers, auditors, security personnel and anyone else involved in the security of an organization's computer systems.

  1. The penetration of aerosols through fine capillaries

    International Nuclear Information System (INIS)

    Mitchell, J.P.; Edwards, R.T.; Ball, M.H.E.

    1989-10-01

    A novel experimental technique has been developed to study the penetration of aerosol particles ranging from about 1 to 15 μm aerodynamic diameter through capillaries varying from 20 to 80 μm bore and from 10 to 50 mm in length. When the driving pressure was 100 kPa, the penetration of the airborne particles was considerably smaller than expected from a simple comparison of particle diameter with the bore of the capillary. Particle size distributions determined after penetration through the capillaries were in almost all cases similar to the particle size distribution of the aerosol at the capillary entrance. This lack of size-selectivity can be explained in terms of the capillary behaving as a conventional suction-based sampler from a near still (calm) air environment. The resulting particle penetration data are important in assessing the potential for the leakage of aerosols through seals in containers used to transport radioactive materials. (author)

  2. Femoral vessel injury by a nonlethal weapon projectile

    Directory of Open Access Journals (Sweden)

    Rodrigo Bruno Biagioni, MD

    2018-06-01

    Full Text Available Rubber projectiles are used as an alternative to metal bullets owing to their lower morbidity and mortality rate. There are few reports of vascular lesions of extremities caused by rubber projectiles in the literature. The authors report the case of a 37-year-old man who was the victim of a penetrating injury to the left thigh with a rubber projectile. He reported only pain at the site of the injury; pulses were decreased in the affected limb. After arteriography confirmed an injury to the superficial femoral artery, he underwent an arterial and venous femorofemoral bypass using a reversed contralateral saphenous vein. Keywords: Vascular trauma, Nonlethal projectile, Penetrating trauma

  3. Low Force Penetration of Icy Regolith

    Science.gov (United States)

    Mantovani, J. G.; Galloway, G. M.; Zacny, K.

    2016-01-01

    A percussive cone penetrometer measures the strength of granular material by using percussion to deliver mechanical energy into the material. A percussive cone penetrometer was used in this study to penetrate a regolith ice mixture by breaking up ice and decompacting the regolith. As compared to a static cone penetrometer, percussion allows low reaction forces to push a penetrometer probe tip more easily into dry regolith in a low gravity environment from a planetary surface rover or a landed spacecraft. A percussive cone penetrates icy regolith at ice concentrations that a static cone cannot penetrate. In this study, the percussive penetrator was able to penetrate material under 65 N of down-force which could not be penetrated using a static cone under full body weight. This paper discusses using a percussive cone penetrometer to discern changes in the concentration of water-ice in a mixture of lunar regolith simulant and ice to a depth of one meter. The rate of penetration was found to be a function of the ice content and was not significantly affected by the down-force. The test results demonstrate that this method may be ideal for a small platform in a reduced gravity environment. However, there are some cases where the system may not be able to penetrate the icy regolith, and there is some risk of the probe tip becoming stuck so that it cannot be retracted. It is also shown that a percussive cone penetrometer could be used to prospect for water ice in regolith at concentrations as high as 8 by weight.

  4. Crossbow injury to the neck | Omura | South African Journal of Surgery

    African Journals Online (AJOL)

    Crossbow injuries are uncommon among penetrating trauma. The tendency for a crossbow bolt to remain in situ appears to limit catastrophic haemorrhage despite the involvement of major vessels.1 Here we report our experience with an injury to the left internal jugular vein by a crossbow bolt. The injury was successfully ...

  5. In vitro penetration of bleaching agents into the pulp chamber

    DEFF Research Database (Denmark)

    Benetti, Ana Raquel; Valera, M C; Mancini, M N G

    2004-01-01

    To investigate pulp chamber penetration of bleaching agents in teeth following restorative procedures.......To investigate pulp chamber penetration of bleaching agents in teeth following restorative procedures....

  6. Non-operative management for penetrating splenic trauma : how far can we go to save splenic function?

    NARCIS (Netherlands)

    Spijkerman, Roy; Teuben, Michel Paul Johan; Hoosain, Fatima; Taylor, Liezel Phyllis; Hardcastle, Timothy Craig; Blokhuis, Taco Johan; Warren, Brian Leigh; Leenen, Luke Petrus Hendrikus

    2017-01-01

    BACKGROUND: Selective non-operative management (NOM) for the treatment of blunt splenic trauma is safe. Currently, the feasibility of selective NOM for penetrating splenic injury (PSI) is unclear. Unfortunately, little is known about the success rate of spleen-preserving surgical procedures. The aim

  7. Eye Injuries

    Science.gov (United States)

    ... that you could lose your vision. Most eye injuries are preventable. If you play sports or work in certain jobs, you may need protection. The most common type of injury happens when something irritates the ...

  8. Ocular Injuries

    African Journals Online (AJOL)

    GB

    2015-04-02

    Apr 2, 2015 ... KEYWORDS: Bangers, eye injuries, holidays, Nigeria ... antibiotic and cycloplegic eye drops, antibiotic ointment at night and .... Adeoti C. O, Bello T. O., Ashaye A. O. Blinding ... Can fireworks-related injuries to children during ...

  9. ACL Injuries

    Science.gov (United States)

    ... while doing things like skiing, playing soccer or football, and jumping on a trampoline. When you injure ... severity of the injury, age, physical condition, medical history, and other injuries or illnesses. People who are ...

  10. Knee Injuries

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Knee Injuries KidsHealth / For Teens / Knee Injuries What's in ... can do to protect them. What's in a Knee? The knee is a joint , actually the largest ...

  11. A review of penetration mechanisms and dynamic properties of tungsten and depleted uranium penetrators

    International Nuclear Information System (INIS)

    Andrew, S.P.; Caligiuri, R.D.; Eiselstein, L.E.

    1991-01-01

    Over the last decade, depleted uranium (DU) and tungsten alloys have been the materials of choice for kinetic energy penetrators. However, despite improvements in mechanical properties in recent years, the penetration performance of tungsten still lags behind that of DU. One possible reason is the difference in deformation mechanisms- DU alloys tend to shear band as they penetrate the target material, whereas tungsten penetrators tend to mushroom. As a first step to determining whether shear banding is truly the reason for superior DU performance, a review and summary of the available information was performed. This paper presents a state-of-the-art review of the formulation, high strain- rate properties, and penetration phenomena of penetrators manufactured from both tungsten and DU alloys. Specifically, the effects of composition, processing, and heat treatment on mechanical properties and penetration mechanisms of these alloys are discussed. Penetration data and models for penetration mechanisms (in particular shear banding) are also presented, as well as the applicability of these models and their salient features

  12. Rapid penetration into granular media visualizing the fundamental physics of rapid earth penetration

    CERN Document Server

    Iskander, Magued

    2015-01-01

    Rapid Penetration into Granular Media: Visualizing the Fundamental Physics of Rapid Earth Penetration introduces readers to the variety of methods and techniques used to visualize, observe, and model the rapid penetration of natural and man-made projectiles into earth materials. It provides seasoned practitioners with a standard reference that showcases the topic's most recent developments in research and application. The text compiles the findings of new research developments on the subject, outlines the fundamental physics of rapid penetration into granular media, and assembles a com

  13. Hamstring Injury

    Science.gov (United States)

    Hamstring injury Overview A hamstring injury occurs when you strain or pull one of your hamstring muscles — the group of three muscles that run along ... You may be more likely to get a hamstring injury if you play soccer, basketball, football, tennis ...

  14. Orienteering injuries

    OpenAIRE

    Folan, Jean M.

    1982-01-01

    At the Irish National Orienteering Championships in 1981 a survey of the injuries occurring over the two days of competition was carried out. Of 285 individual competitors there was a percentage injury rate of 5.26%. The article discusses the injuries and aspects of safety in orienteering.

  15. Deformation analysis of shallow penetration in clay

    Science.gov (United States)

    Sagaseta, C.; Whittle, A. J.; Santagata, M.

    1997-10-01

    A new method of analysis is described for estimating the deformations and strains caused by shallow undrained penetration of piles and caissons in clay. The formulation combines previous analyses for steady, deep penetration, with methods used to compute soil deformations due to near-surface ground loss, and is referred to as the Shallow Strain Path Method (SSPM). Complete analytical solutions for the velocity and strain rates are given for a planar wall, an axisymmetric, closed-ended pile and unplugged, open-ended pile geometries. In these examples, the analyses consider a single source penetrating through the soil at a constant rate, generating a family of penetrometers with rounded tips, referred to as simple wall, pile and tube geometries. Soil deformations and strains are obtained by integrating the velocity and strain rates along the particle paths.The transition from shallow to deep penetration is analysed in detail. Shallow penetration causes heave at the ground surface, while settlements occur only in a thin veneer of material adjacent to the shaft and in a bulb-shaped region around the tip. The size of this region increases with the embedment depth. Deformations inside an open-ended pile/caisson are affected significantly by details of the simple tube wall geometry.

  16. Forty hours with a traumatic carotid transection: A diagnostic caveat and review of the contemporary management of penetrating neck trauma.

    Science.gov (United States)

    Ng, Eugene; Campbell, Ian; Choong, Andrew; Kruger, Allan; Walker, Philip J

    2018-02-20

    Although penetrating neck trauma (PNT) is uncommon, it is associated with the significant morbidity and mortality. The management of PNT has changed significantly over the past 50 years. A radiological assessment now is a vital part of the management with a traditional surgical exploration. A 22 years old male was assaulted by a screwdriver and sustained multiple penetrating neck injuries. A contrast CT scan revealed a focal pseudoaneurysm in the left common carotid artery bulb. There was no active bleeding or any other vascular injuries and the patient remained haemodynamically stable. In view of these findings, he was initially managed conservatively without an open surgical exploration. However, the patient was noted to have an acute drop in his hemoglobin count overnight post injury and the catheter directed angiography showed active bleeding from the pseudoaneurysm. Surgical exploration 40 hours following the initial injury revealed a penetrating injury through both arterial walls of the left carotid bulb which was repaired with a great saphenous vein patch. A percutaneous drain was inserted in the carotid triangle and a course of intravenous antibiotics for five days was commenced. The patient recovered well with no complications and remained asymptomatic at five months followup. Copyright © 2018 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. All rights reserved.

  17. Two methodologies for physical penetration testing using social engineering

    NARCIS (Netherlands)

    Dimkov, T.; van Cleeff, A.; Pieters, Wolter; Hartel, Pieter H.

    2010-01-01

    Penetration tests on IT systems are sometimes coupled with physical penetration tests and social engineering. In physical penetration tests where social engineering is allowed, the penetration tester directly interacts with the employees. These interactions are usually based on deception and if not

  18. Opportunities for high wind energy penetration

    DEFF Research Database (Denmark)

    Tande, J.O.; Hansen, J.C.

    1997-01-01

    Wind power is today a mature technology, which at windy locations, is economically competitive to conventional power generation technologies. This and growing global environmental concerns have led governments to encourage and plan for wind energy development, a typical aim being 10% of electricity...... consumption. The successful operation of the three major power systems of Cape Verde, with a total wind energy penetration of about 15% since December 1994, demonstrates that power systems can be operated with high penetration of wind energy by adding simple control and monitoring systems only. Thorough...... analyses conclude that expanding to even above 15% wind energy penetration in the Cape Verde power systems is economical. Worldwide, numerous locations with favorable wind conditions and power systems similar to the Capeverdean provide good opportunities for installing wind farms and achieving high wind...

  19. WAPTT - Web Application Penetration Testing Tool

    Directory of Open Access Journals (Sweden)

    DURIC, Z.

    2014-02-01

    Full Text Available Web applications vulnerabilities allow attackers to perform malicious actions that range from gaining unauthorized account access to obtaining sensitive data. The number of reported web application vulnerabilities in last decade is increasing dramatically. The most of vulnerabilities result from improper input validation and sanitization. The most important of these vulnerabilities based on improper input validation and sanitization are: SQL injection (SQLI, Cross-Site Scripting (XSS and Buffer Overflow (BOF. In order to address these vulnerabilities we designed and developed the WAPTT (Web Application Penetration Testing Tool tool - web application penetration testing tool. Unlike other web application penetration testing tools, this tool is modular, and can be easily extended by end-user. In order to improve efficiency of SQLI vulnerability detection, WAPTT uses an efficient algorithm for page similarity detection. The proposed tool showed promising results as compared to six well-known web application scanners in detecting various web application vulnerabilities.

  20. Penetrating power of resonant electromagnetic induction imaging

    Directory of Open Access Journals (Sweden)

    Roberta Guilizzoni

    2016-09-01

    Full Text Available The possibility of revealing the presence and identifying the nature of conductive targets is of central interest in many fields, including security, medicine, industry, archaeology and geophysics. In many applications, these targets are shielded by external materials and thus cannot be directly accessed. Hence, interrogation techniques are required that allow penetration through the shielding materials, in order for the target to be identified. Electromagnetic interrogation techniques represent a powerful solution to this challenge, as they enable penetration through conductive shields. In this work, we demonstrate the power of resonant electromagnetic induction imaging to penetrate through metallic shields (1.5-mm-thick and image targets (having conductivities σ ranging from 0.54 to 59.77 MSm−1 concealed behind them.

  1. Wireless Network Penetration Testing and Security Auditing

    Directory of Open Access Journals (Sweden)

    Wang Shao-Long

    2016-01-01

    Full Text Available IEEE802.11 wireless wireless networks have security issues that are vulnerable to a variety of attacks. Due to using radio to transport data, attackers can bypass firewalls, sniff sensitive information, intercept packets and send malicious packets. Security auditing and penetration testing is expected to ensure wireless networks security. The contributions of this work are analyzed the vulnerability and types of attacks pertaining to IEEE 802.11 WLAN, performed well known attacks in a laboratory environment to conduct penetration tests to confirm whether our wireless network is hackable or not. WAIDPS is configured as auditing tool to view wireless attacks, such as WEP/WPA/WPA2 cracking, rouge access points, denial of service attack. WAIDPS is designed to detect wireless intrusion with additional features. Penetration testing and auditing will mitigate the risk and threatening to protect WALN.

  2. Development Of The Nuclear Optical Penetration

    Science.gov (United States)

    Inoue, K.; Koike, K.; Imada, Y.

    1984-10-01

    We have developed the nuclear optical penetration to be incorporated in the wall penetration of the shell to introduce a data transmission system using optical fibers into a nuclear power plant with a pressurized water reactor. Radiation-induced coloration in optical glass seriously affects transmission characteristics of optical fibers, whereas it has been revealed that the pure-silica core optical fiber without any dopant in the core has wide applicability in radiation fields thanks to its very low radiation-induced attenuation. The wall penetration of the shell should have airtightness and resistivity to heat, vibration, and pressure, let alone radiation, excellent enough to be invariable in data transmission efficiency even when subjected to severe environmental tests. The sealing modules of this newly developed nuclear optical penetration are hermetically sealed. The gap between the optical fiber rod (100 pm in core diameter and 5 mm in rod diameter) and stainless steel tube is sealed with lamingted glass layer. As the result of He gas leakage test, high airtightness of less than 10 cc/sec was achieved. No thermal deformation of the core was caused by sealing with laminated glass layer, nor was observed transmission loss. Then the sealiing modules were subjected to the irradiation test using 60 Co gamma ray exposure of 2 x 10 rads. Though silica glass layer supporting the fiber rod and sealing glass portion turned blackish purple, transparency of the fiber was not affected. Only less than 0.5 dB of connecting loss was observed at the connecting point with the optical fiber cable. The sealing modules were also found to have resistivity to vibration and pressure as excellent as that of existing nuclear electric penetrations. We expect the nuclear optical fiber penetration will be much effective in improving reliability of data transmission systems using optical fibers in radiation fields.

  3. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ...

  4. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ...

  5. HMO penetration: has it hurt public hospitals?

    Science.gov (United States)

    Clement, J P; Grazier, K L

    2001-01-01

    The purpose of this study is to determine the extent to which health maintenance organization (HMO) penetration within the public hospitals' market area affects the financial performance and viability of these institutions, relative to private hospitals. Hospital- and market-specific measures are examined in a fully interacted model of over 2,300 hospitals in 321 metropolitan statistical areas (MSAs) in 1995. Although hospitals located in markets with higher HMO penetration have lower financial performance as reflected in revenues, expenses and operating margin, public hospitals are not more disadvantaged than other hospitals by managed care.

  6. Operational experience of extreme wind penetrations

    Energy Technology Data Exchange (ETDEWEB)

    Estanqueiro, Ana [INETI/LNEG - National Laboratory for Energy and Geology, Lisbon (Portugal); Mateus, Carlos B. [Instituto de Meteorologia, Lisboa (Portugal); Pestana, Rui [Redes Energeticas Nacionais (REN), Lisboa (Portugal)

    2010-07-01

    This paper reports the operational experience from the Portuguese Power System during the 2009/2010 winter months when record wind penerations were observed: the instantaneous wind power penetration peaked at 70% of consumption during no-load periods and the wind energy accounted for more than 50% of the energy consumed for a large period. The regulation measures taken by the TSO are presented in the paper, together with the additional reserves operated for added system security. Information on the overall power system behavior under such extreme long-term wind power penetrations will also be addressed. (org.)

  7. Hybrid treatment of penetrating aortic ulcer

    International Nuclear Information System (INIS)

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi; Vazquez, Rosa Maria Lepe

    2015-01-01

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  8. Hybrid treatment of penetrating aortic ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi, E-mail: jaherrero5@hotmail.com [Unidade de Gestao Clinica (UGC) de Diagnostico por Imagem - Hosppital Universitario Virgen Macarena, Sevilha (Spain); Vazquez, Rosa Maria Lepe [Unit of Radiodiagnosis - Hospital Nuestra Senora de la Merced, Osuna, Sevilha (Spain)

    2015-05-15

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  9. Roentgenologic image of penetrating duodenal bulb ulcer

    International Nuclear Information System (INIS)

    Strunin, A.E.

    1986-01-01

    When studying a series of aimed roentgenograms in patients with peptic ulcer a gas bubble of irregular spherical configuration or two-layer niche were determined near the bulb medial contour. Gas bubble was from 0.5-0.7 to 3.5 cm in diameter. In such cases penetrating ulcers were determined in operations. Along with other signs gas bubble symptom, sometimes two-layer signs may be used for timely and exact roentgenological diagnosis of penetrating duodenal bulb ulcer in peptic ulcer disease

  10. Fractal measures in a deep penetration problem

    International Nuclear Information System (INIS)

    Murthy, K.P.N.; Indira, R.; John, T.M.

    1993-01-01

    In the Monte Carlo simulation of a deep penetration problem the parameter, say b in the importance function must be assigned a value b' such that variance is minimum. If b b' the sample mean is still not reliable; but the sample fluctuations would be small and misleading, though the actual fluctuations are quite large. This is because the distribution of transmission has a tail which becomes prominent when b > b'. Considering a model deep penetration problem, and employing exact enumeration techniques, it is shown that in the limit of large biasing the long tailed distribution to the transmission is multifractal. (author). 5 refs., 3 figs

  11. Generic Penetration of the SSRI Market.

    Science.gov (United States)

    Cascade, Elisa F; Kalali, Amir H

    2008-04-01

    In this article, we investigate the penetration of generic selective serotonin reuptake inhibitors (SSRIs) in the US market and the implications for patient out-of-pocket expense. The data suggest that generic penetration into the SSRI market has grown from approximately nine percent in 2000, the year that the patent for Prozac((R)) expired, to 72 percent in 2007. For December, 2007, the difference in patient out-of-pocket expense for branded vs. generic agents was, on average, $55.42 for patients paying by cash (i.e., they had no prescription drug insurance) and $22.39 for patients with insurance coverage.

  12. Sternotomy or drainage for a hemopericardium after penetrating trauma: a randomized controlled trial.

    Science.gov (United States)

    Nicol, Andrew J; Navsaria, Pradeep H; Hommes, Martijn; Ball, Chad G; Edu, Sorin; Kahn, Delawir

    2014-03-01

    To determine if stable patients with a hemopericardium detected after penetrating chest trauma can be safely managed with pericardial drainage alone. The current international practice is to perform a sternotomy and cardiac repair if a hemopericardium is detected after penetrating chest trauma. The experience in Cape Town, South Africa, on performing a mandatory sternotomy in hemodynamically stable patients was that a sternotomy was unnecessary and the cardiac injury, if present, had sealed. A single-center parallel-group randomized controlled study was completed. All hemodynamically stable patients with a hemopericardium confirmed at subxiphoid pericardial window (SPW), and no active bleeding, were randomized. The primary outcome measure was survival to discharge from hospital. Secondary outcomes were complications and postoperative hospital stay. Fifty-five patients were randomized to sternotomy and 56 to pericardial drainage and wash-out only. Fifty-one of the 55 patients (93%) randomized to sternotomy had either no cardiac injury or a tangential injury. There were only 4 patients with penetrating wounds to the endocardium and all had sealed. There was 1 death postoperatively among the 111 patients (0.9%) and this was in the sternotomy group. The mean intensive care unit (ICU) stay for a sternotomy was 2.04 days (range, 0-25 days) compared with 0.25 days (range, 0-2) for the drainage (P drainage group (95% CI: 0.8-2.7). Total hospital stay was significantly shorter in the SPW group (P drainage is effective and safe in the stable patient with a hemopericardium after penetrating chest trauma, with no increase in mortality and a shorter ICU and hospital stay. (ClinicalTrials.gov Identifier: NCT00823160).

  13. Penetrating gunshot wound to the head: transotic approach to remove the bullet and masseteric-facial nerve anastomosis for early facial reanimation.

    Science.gov (United States)

    Donnarumma, Pasquale; Tarantino, Roberto; Gennaro, Paolo; Mitro, Valeria; Valentini, Valentino; Magliulo, Giuseppe; Delfini, Roberto

    2014-01-01

    Gunshot wounds to the head (GSWH) account for the majority of penetrating brain injuries, and are the most lethal. Since they are rare in Europe, the number of neurosurgeons who have experienced this type of traumatic injury is decreasing, and fewer cases are reported in the literature. We describe a case of gunshot to the temporal bone in which the bullet penetrated the skull resulting in the facial nerve paralysis. It was excised with the transotic approach. Microsurgical anastomosis among the masseteric nerve and the facial nerve was performed. GSWH are often devastating. The in-hospital mortality for civilians with penetrating craniocerebral injury is very high. Survivors often have high rate of complications. When facial paralysis is present, masseteric-facial direct neurorraphy represent a good treatment.

  14. Paragliding injuries.

    OpenAIRE

    Krüger-Franke, M; Siebert, C H; Pförringer, W

    1991-01-01

    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during st...

  15. Formed Due to Traumatic Diaphragmatic Injury, A Case of Gastric Perforation

    Directory of Open Access Journals (Sweden)

    Ceren Sen Tanrikulu

    2014-03-01

    Full Text Available Diaphragmatic hernia may be congenital or traumatic in origin. Diaphragmatic hernias are more common in adult and occur as a result of penetrating injuries are more common than from blunt injuries. Traumatic diaphragmatic hernia may manifest immediately or without any findings that several months/years after the incident. Early diagnosis is difficult, and it is usually made intraoperatively. Frequently during the early phase of traumatic diaphragmatic hernias, abdominal organ injury can be seen, such as stomach, colon and liver. In this study, we presented a case with acute gastric strangulation and perforation in the diaphragmatic injury occurred as a result of penetrating thoracic trauma.

  16. Tree root mapping with ground penetrating radar

    CSIR Research Space (South Africa)

    Van Schoor, Abraham M

    2009-09-01

    Full Text Available In this paper, the application of ground penetrating radar (GPR) for the mapping of near surface tree roots is demonstrated. GPR enables tree roots to be mapped in a non-destructive and cost-effective manner and is therefore a useful prospecting...

  17. Penetration and haptenation of p-phenylenediamine

    NARCIS (Netherlands)

    Pot, Laura M.; Scheitza, Simone M.; Coenraads, Pieter-Jan; Bloemeke, Brunhilde; Blomeke, B.

    Although p-phenylenediamine (PPD) has been recognized as an extreme sensitizer for many years, the exact mechanism of sensitization has not been elucidated yet. Penetration and the ability to bind to proteins are the first two hurdles that an allergen has to overcome to be able to sensitize. This

  18. Mechanical behaviour of pressure vessel head penetrations

    International Nuclear Information System (INIS)

    Faidy, C.; Ternon, F.; Vagner, J.; Vaindirlis, M.

    1994-01-01

    After leaks on Bugey 3 penetrations EdF and Framatome have started a study on the stress corrosion phenomenon of Inconel 600. In this paper, limited to the mechanical aspect, we present an estimation of in service stresses, the experimental program on mockup for visualize the surface stress and the noxiousness of potential cracks. 5 figs., 6 tabs., 5 refs

  19. Standard Penetration Test and Relative Density

    Science.gov (United States)

    1971-02-01

    Se OPSeS Debido a que el agua subterranea granclemente influve la resistencia a suelo, se establecio una relacion empirica entre el nurmero de golpes...de laboratorio ejecutados con un penetr6metro est’tico pequeno. INTRODUCTION One of the main problems encountered in subsoil e’xploration is in situ

  20. Penetration of electronic beams in ionizing media

    International Nuclear Information System (INIS)

    Martiarena, M.L.; Zanete, D.H.; Garibotti, C.R.

    1988-01-01

    It is studied the penetration of an electron beam in an ionizable medium by means of a generalized kinetic equation. This equation is related to elastic collisions, processes of creation and destruction of particles. By integrating numerically the transport equation, it can be evaluated the relative effects of all the processes involved in the evolution of the system. (A.C.A.S.) [pt

  1. Penetration of amalgam constituents into dentine

    NARCIS (Netherlands)

    Scholtanus, Johannes D.; Ozcan, Mutlu; Huysmans, Marie-Charlotte D. N. J. M.

    Objectives: Amalgam restorations are replaced by adhesively placed composite resin restorations at an increasing rate. After the removal of amalgam dentine often shows marked dark discoloration that is attributed to the penetration of corrosion products from overlying amalgams. it is questioned

  2. Penetration of amalgam constituents into dentine.

    NARCIS (Netherlands)

    Scholtanus, J.D.; Ozcan, M.; Huysmans, M.C.D.N.J.M.

    2009-01-01

    OBJECTIVES: Amalgam restorations are replaced by adhesively placed composite resin restorations at an increasing rate. After the removal of amalgam dentine often shows marked dark discoloration that is attributed to the penetration of corrosion products from overlying amalgams. It is questioned

  3. Computed tomographic findings in penetrating peptic ulcer

    International Nuclear Information System (INIS)

    Madrazo, B.L.; Halpert, R.D.; Sandler, M.A.; Pearlberg, J.L.

    1984-01-01

    Four cases of peptic ulcer penetrating the head of the pancreas were diagnosed by computed tomography (CT). Findings common to 3 cases included (a) an ulcer crater, (b) a sinus tract, and (c) enlargement of the head of the pancreas. Unlike other modalities, the inherent spatial resolution of CT allows a convenient diagnosis of this important complication of peptic ulcer disease

  4. Reduced penetrance in human inherited disease

    African Journals Online (AJOL)

    Rabah M. Shawky

    2014-01-31

    Jan 31, 2014 ... tant role in cellular senescence, tumorigenesis and in several diseases including type ... between epigenetic DNA modifications and human life span has also been shown .... penetrance mutation that is age dependent especially when compared with the ..... on healthy aging and longevity. Immunity Aging ...

  5. An Experimental Model for Market Penetration.

    Science.gov (United States)

    Caren, William L.

    1987-01-01

    A plan for college market penetration that has been successful in increasing the applicant pool for one institution is outlined and discussed. It includes development of performance objectives, a schedule, a promotional plan, market survey, and promotional activities including alumni, media, and other community resources. (MSE)

  6. STYLET PENETRATION BEHAVIOURS OF FOUR Cicadulina ...

    African Journals Online (AJOL)

    ACSS

    Feeding from phloem cells, overall probing and probe mean (the average time per probe) were higher ... Key Words: Cicadulina spp., electrical penetration graph, MSV, Zea mays .... wire and alligator clip clamped to the stem of the .... á All measures are in minutes except for frequency of probing; - Main effect not significant.

  7. Percutaneous penetration studies for risk assessment

    DEFF Research Database (Denmark)

    Sartorelli, Vittorio; Andersen, Helle Raun; Angerer, Jürgen

    2000-01-01

    experiences, literature data and guidelines already in existence. During the meetings of Percutaneous Penetration Subgroup they presented a number of short papers of up to date information on the key issues. The objective was to focus the existing knowledge and the gaps in the knowledge in the field...

  8. Penetration of albendazole sulphoxide into hydatid cysts.

    OpenAIRE

    Morris, D L; Chinnery, J B; Georgiou, G; Stamatakis, G; Golematis, B

    1987-01-01

    The penetration of albendazole sulphoxide, the principal metabolite of albendazole into hydatid cysts (E granulosus) was measured by means of in vitro animal and clinical studies. The drug freely diffuses across the parasitic membranes. Cyst/serum concentrations of 22% were achieved in patients, longer pre-operative therapy produced higher concentrations.

  9. Selective recurrent laryngeal nerve stimulation using a penetrating electrode array in the feline model.

    Science.gov (United States)

    Haidar, Yarah M; Sahyouni, Ronald; Moshtaghi, Omid; Wang, Beverly Y; Djalilian, Hamid R; Middlebrooks, John C; Verma, Sunil P; Lin, Harrison W

    2017-10-31

    Laryngeal muscles (LMs) are controlled by the recurrent laryngeal nerve (RLN), injury of which can result in vocal fold (VF) paralysis (VFP). We aimed to introduce a bioelectric approach to selective stimulation of LMs and graded muscle contraction responses. Acute experiments in cats. The study included six anesthetized cats. In four cats, a multichannel penetrating microelectrode array (MEA) was placed into an uninjured RLN. For RLN injury experiments, one cat received a standardized hemostat-crush injury, and one cat received a transection-reapproximation injury 4 months prior to testing. In each experiment, three LMs (thyroarytenoid, posterior cricoarytenoid, and cricothyroid muscles) were monitored with an electromyographic (EMG) nerve integrity monitoring system. Electrical current pulses were delivered to each stimulating channel individually. Elicited EMG voltage outputs were recorded for each muscle. Direct videolaryngoscopy was performed for visualization of VF movement. Stimulation through individual channels led to selective activation of restricted nerve populations, resulting in selective contraction of individual LMs. Increasing current levels resulted in rising EMG voltage responses. Typically, activation of individual muscles was successfully achieved via single placement of the MEA by selection of appropriate stimulation channels. VF abduction was predominantly observed on videolaryngoscopy. Nerve histology confirmed injury in cases of RLN crush and transection experiments. We demonstrated the ability of a penetrating MEA to selectively stimulate restricted fiber populations within the feline RLN and selectively elicit contractions of discrete LMs in both acute and injury-model experiments, suggesting a potential role for intraneural MEA implantation in VFP management. NA Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  10. Paragliding injuries.

    Science.gov (United States)

    Krüger-Franke, M; Siebert, C H; Pförringer, W

    1991-06-01

    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries.

  11. The Basics of Hacking and Penetration Testing Ethical Hacking and Penetration Testing Made Easy

    CERN Document Server

    Engebretson, Patrick

    2011-01-01

    The Basics of Hacking and Penetration Testing serves as an introduction to the steps required to complete a penetration test or perform an ethical hack. You learn how to properly utilize and interpret the results of modern day hacking tools; which are required to complete a penetration test. Tool coverage will include, Backtrack Linux, Google, Whois, Nmap, Nessus, Metasploit, Netcat, Netbus, and more. A simple and clean explanation of how to utilize these tools will allow you  to gain a solid understanding of each of the four phases and prepare them to take on more in-depth texts and topi

  12. Radon penetration of concrete slab cracks, joints, pipe penetrations, and sealants

    NARCIS (Netherlands)

    Nielson, KK; Rogers, VC; Holt, RB; Pugh, TD; Grondzik, WA; deMeijer, RJ

    1997-01-01

    Radon movement through 12 test slabs with different cracks, pipe penetrations, cold joints, masonry blocks, sealants, and tensile stresses characterized the importance of these anomalous structural domains, Diffusive and advective radon transport were measured with steady-state air pressure

  13. Whiplash injuries.

    Science.gov (United States)

    Malanga, Gerard; Peter, Jason

    2005-10-01

    Whiplash injuries are very common and usually are associated with rear-end collisions. However, a whiplash injury can be caused by any event that results in hyperextension and flexion of the cervical spine. These injuries are of serious concern to all consumers due to escalating cost of diagnosis, treatment, insurance, and litigation. Most acute whiplash injury cases respond well to conservative treatments, which result in resolution of symptoms usually within weeks to a few months after the injury occurred. Chronic whiplash injuries often are harder to diagnose and treat and often result in poor outcomes. Current research shows that various structures in the cervical spine receive nociceptive innervation and potentially may be the cause of chronic pain symptoms. One potential pain generator showing promise is the facet or zygapophyseal joints. Various researchers have proven that these joints are injured during whiplash injuries and that diagnosis and temporary pain relief can be obtained with facet joint injections. The initial evaluation of any patient should follow an organized and stepwise approach, and more serious causes of neck pain must first be ruled out through the history, physical examination, and diagnostic testing. Treatment regimens should be evidence-based, focusing on treatments that have proven to be effective in treating acute and chronic whiplash injuries.

  14. Ocular Injury

    Science.gov (United States)

    ... trauma can happen at home, school, play or sports. Most common injuries are scratches to the cornea or blunt trauma. Approved and tested eye and face protection is essential to prevent injuries. Sports such as hockey, baseball, racquet ball, squash, and ...

  15. Rowing Injuries

    DEFF Research Database (Denmark)

    Thornton, Jane S; Vinther, Anders; Wilson, Fiona

    2017-01-01

    understanding in pre-participation screening, training load, emerging concepts surrounding back and rib injury, and relative energy deficiency in sport. Through a better understanding of the nature of the sport and mechanisms of injury, physicians and other healthcare providers will be better equipped to treat...

  16. Trampoline injuries.

    Science.gov (United States)

    Nysted, M; Drogset, J O

    2006-12-01

    To describe the mechanism, location and types of injury for all patients treated for trampoline-associated injuries at St Olav's University Hospital, Trondheim, Norway, from March 2001to October 2004. Patients were identified from a National Injury Surveillance System. All patients were asked to complete a standard questionnaire at their first visit at the hospital. Most data were recorded prospectively, but data on the mechanism of injury, the number of participants on the trampoline at the time of injury, adult supervision and whether the activity occurred at school or in another organised setting were collected retrospectively. A total of 556 patients, 56% male and 44% female, were included. The mean age of patients was 11 (range 1-62) years. 77% of the injuries occurred on the body of the trampoline, including falls on to the mat, collisions with another jumper, falls on to the frame or the springs, and performing a somersault, whereas 22% of the people fell off the trampoline. In 74% of the cases, more than two people were on the trampoline, with as many as nine trampolinists noted at the time of injury. For children Trampolining can cause serious injuries, especially in the neck and elbow areas of young children. The use of a trampoline is a high-risk activity. However, a ban is not supported. The importance of having safety guidelines for the use of trampolines is emphasised.

  17. A Direct Carotid-Cavernous Fistula due to Penetrating Trauma by a Knitting Needle to the Temporal Region

    Directory of Open Access Journals (Sweden)

    Selcuk Gocmen

    2012-08-01

    Full Text Available Traumatic carotid-cavernous and #64257;stulas (CCF usually occur after closed head injuries. In addition, CCFs can also be caused by penetrating injuries with stab or gunshot injuries. We present the case of traumatic CCF that was caused with a knitting needle directly penetrating through the temporal region. A 46-year-old man consulted with a progressive left swollen eye. His head computed tomography (CT revealed a left temporal lobe contusion and fracture of the left temporal bone. Digital subtraction angiography (DSA showed a direct high-flow fistula (Type-A lesion. After the balloon occlusion test, which was well tolerated by the patient, the internal carotid artery was occluded by the interventional radiologist. A review of the literature demonstrated that all of the traumatic CCFs occurred due to penetrating stab injuries through the orbita. To our knowledge, such a case has not been previously reported. [Arch Clin Exp Surg 2012; 1(4.000: 261-264

  18. The penetrating depth analysis of Lunar Penetrating Radar onboard Chang’e-3 rover

    Science.gov (United States)

    Xing, Shu-Guo; Su, Yan; Feng, Jian-Qing; Dai, Shun; Xiao, Yuan; Ding, Chun-Yu; Li, Chun-Lai

    2017-04-01

    Lunar Penetrating Radar (LPR) has successfully been used to acquire a large amount of scientific data during its in-situ detection. The analysis of penetrating depth can help to determine whether the target is within the effective detection range and contribute to distinguishing useful echoes from noise. First, this study introduces two traditional methods, both based on a radar transmission equation, to calculate the penetrating depth. The only difference between the two methods is that the first method adopts system calibration parameters given in the calibration report and the second one uses high-voltage-off radar data. However, some prior knowledge and assumptions are needed in the radar equation and the accuracy of assumptions will directly influence the final results. Therefore, a new method termed the Correlation Coefficient Method (CCM) is provided in this study, which is only based on radar data without any a priori assumptions. The CCM can obtain the penetrating depth according to the different correlation between reflected echoes and noise. To be exact, there is a strong correlation in the useful reflected echoes and a random correlation in the noise between adjacent data traces. In addition, this method can acquire a variable penetrating depth along the profile of the rover, but only one single depth value can be obtained from traditional methods. Through a simulation, the CCM has been verified as an effective method to obtain penetration depth. The comparisons and analysis of the calculation results of these three methods are also implemented in this study. Finally, results show that the ultimate penetrating depth of Channel 1 and the estimated penetrating depth of Channel 2 range from 136.9 m to 165.5 m ({\\varepsilon }r=6.6) and from 13.0 m to 17.5 m ({\\varepsilon }r=2.3), respectively.

  19. Age-associated impact on presentation and outcome for penetrating thoracic trauma in the adult and pediatric patient populations.

    Science.gov (United States)

    Mollberg, Nathan M; Tabachnick, Deborah; Lin, Fang-Ju; Merlotti, Gary J; Varghese, Thomas K; Arensman, Robert M; Massad, Malek G

    2014-02-01

    Studies reporting on penetrating thoracic trauma in the pediatric population have been limited by small numbers and implied differences with the adult population. Our objectives were to report on a large cohort of pediatric patients presenting with penetrating thoracic trauma and to determine age-related impacts on management and outcome through comparison with an adult cohort. A Level I trauma center registry was queried between 2006 and 2012. All patients presenting with penetrating thoracic trauma were identified. Patient demographics, injury mechanism, injury severity, admission physiology, and outcome were recorded. Patients were compared, and outcomes were analyzed based on age at presentation, with patients 17 years or younger defining our pediatric cohort. A total of 1,423 patients with penetrating thoracic trauma were admitted during the study period. Two hundred twenty patients (15.5%) were pediatric, with 205 being adolescents (13-17 years) and 15 being children (≤ 12 years). In terms of management for the pediatric population, tube thoracostomy alone was needed in 32.7% (72 of 220), whereas operative thoracic exploration was performed in 20.0% (44 of 220). Overall mortality was 13.6% (30 of 220). There was no significant difference between the pediatric and adult population with regard to injury mechanism or severity, need for therapeutic intervention, operative approach, use of emergency department thoracotomy, or outcome. Stepwise logistic regression failed to identify age as a predictor for the need for either therapeutic intervention or mortality between the two age groups as a whole. However, subgroup analysis revealed that being 12 years or younger (odds ratio, 3.84; 95% confidence interval, 1.29-11.4) was an independent predictor of mortality. Management of traumatic penetrating thoracic injuries in terms of the need for therapeutic intervention and operative approach was similar between the adult and pediatric populations. Mortality from

  20. The epidemiology, evaluation, and management of stingray injuries.

    Science.gov (United States)

    Diaz, James H

    2007-01-01

    A descriptive analysis and review of the world's salient scientific literature on stingray injuries was conducted in light of recent high-profile cases of fatal and near-fatal thoracic stingray injuries to guide clinicians in evaluating and managing stingray injuries. Data was extracted from observational and longitudinal studies over the period, 1950-2006, to permit (1) a stratification of stingray injuries as bites, penetrating lacerations with and without envenoming, and combinations of deeply penetrating and envenoming wounds; and (2) an assessment of new management strategies for thoracoabdominal penetrating trauma and non-healing, necrotic stingray wounds. Unlike their Chondrichthyes classmates, the sharks, stingrays are docile and non-aggressive; and will not attack with their spined tails, unless provoked. Although some occupations are predisposed to stingray injuries, most stingray injuries can be avoided by observing seafloors and adopting simple practices when wading, swimming, diving, or fishing in temperate oceans and some tropical freshwater river systems. All stingray injuries should be managed initially with wound irrigation to dislodge retained spine fragments and envenoming tissues and warm water immersion to inactivate heat-labile toxins.

  1. Containment penetration design criteria and implementation

    International Nuclear Information System (INIS)

    Perry, R.F.; Rigamonti, G.; Dainora, J.

    1975-01-01

    A rational design criteria is presented which serves as a basis for the design and analysis of containment piping penetrations. The criteria includes the effect of temperature as well as mechanical loads for the full range of plant conditions. With this criteria various penetration flued head designs have been compared and optimization achieved. Sleeve wall dimensions and containment loads have been determined without reference to piping configuration. An interaction theory which allows the implementation of the criteria for the determination of design loads and minimum sleeve wall thickness. The interaction theory developed applies to elastic-perfectly plastic cylinders (pipes and sleeves) and accounts for the simultaneous load resultants of transverse shear force, bending moment, torsional moment, and axial force in addition to internal pipe pressure. Application of the theory developed to the determination of sleeve thickness and containment design loads is presented in detail. (Auth.)

  2. Corrosion and protection of uranium alloy penetrators

    International Nuclear Information System (INIS)

    Weirick, L.J.; Johnson, H.R.; Dini, J.W.

    1975-06-01

    Penetrators made from either a U--3/4 percent Ti alloy or a U--3/4 percent Mo--3/4 percent Zr--3/4 percent Nb--1/2 percent Ti alloy (''Quad'') corrode mildly in moist air, significantly in moist nitrogen, and severely in salt fog. Adequate protection was provided in moist air and nitrogen by coating with electroplated nickel, electroplated nickel and zinc with a chromate finish, and galvanized zinc with a chromate finish. In salt fog, electroplated nickel offered only temporary protection whereas galvanized zinc and electroplated nickel-zinc provided long-lasting protection. The resistance of uncoated penetrators was affected variously by dissimilar metal couplings. Aluminum protected the Quad alloy and adversely affected the U--3/4 percent Ti alloy, whereas steel enhanced localized corrosion in both. (U.S.)

  3. Eddy current testing with high penetration

    International Nuclear Information System (INIS)

    Becker, R.; Kroening, M.

    1999-01-01

    The low-frequency eddy current testing method is used when penetration into very deep layers is required. The achievable penetration depth is determined among other parameters by the lowest testing frequency that can be realised together with the eddy current sensor. When using inductive sensors, the measuring effect declines proportional to the lowering frequency (induction effect). Further reduction of testing frequency requires other types of sensors, as e.g. the GMR (Giant Magnetic Resistance), which achieves a constant measuring sensitivity down to the steady field. The multi-frequency eddy current testing method MFEC 3 of IZFP described here can be operated using three different scanning frequencies at a time. Two variants of eddy current probes are used in this case. Both have an inductive winding at their emitters, of the type of a measuring probe. The receiver end is either also an inductive winding, or a magnetic field-responsive resistance (GMR). (orig./CB) [de

  4. Large scale wind power penetration in Denmark

    DEFF Research Database (Denmark)

    Karnøe, Peter

    2013-01-01

    he Danish electricity generating system prepared to adopt nuclear power in the 1970s, yet has become the world's front runner in wind power with a national plan for 50% wind power penetration by 2020. This paper deploys a sociotechnical perspective to explain the historical transformation...... of "networks of power" via the interactions of politics, the techno-physics of electrons, and the market setting. The Danish case is about how an assemblage of new agencies has reorganized and reshaped society by building a new sociotechnical network. This has rendered developments highly unpredictable...... and highly experimental. The transformation process can be followed through the way successive technical engineering reports have represented the challenges associated with the penetration of wind power. The iteration shows how novel technical phenomena emerge and are assimilated, and how new engineering...

  5. Standardization of penetrating radiation testing system

    International Nuclear Information System (INIS)

    Wiley, P.A.; Aronson, H.L.

    1979-01-01

    Standardization is provided to control system gain of a penetrating radiation testing system by periodically inspecting a reference object in the same manner as the product samples so as to generate a stabilization signal which is compared to a reference signal. The difference, if any, between the stabilization signal and the reference signal is integrated and the integrated signal is used to correct the gain of the system

  6. Market penetration of new energy technologies

    Energy Technology Data Exchange (ETDEWEB)

    Packey, D.J.

    1993-02-01

    This report examines the characteristics, advantages, disadvantages, and, for some, the mathematical formulas of forecasting methods that can be used to forecast the market penetration of renewable energy technologies. Among the methods studied are subjective estimation, market surveys, historical analogy models, cost models, diffusion models, time-series models, and econometric models. Some of these forecasting methods are more effective than others at different developmental stages of new technologies.

  7. Intrauterine Devices Penetrated and Migrated: CT Findings

    International Nuclear Information System (INIS)

    Mejia Restrepo, Jorge; Lopez, Juan Esteban; Aldana Sepulveda, Natalia; Ruiz Zabaleta, Tania; Mazzaro Mauricio

    2011-01-01

    Intrauterine devices have been used for over 40 years, and they constitute the most widely accepted method of contraception among women because of the low rates of complications and low cost. Although uncommon, with the growing use of multidetector CT penetrated and migrated intrauterine devices have become a more common incidental finding. In some cases, intrauterine devices migrate to adjacent viscera, in particular the bladder and bowel and may give rise to symptoms. Consequently tomographic localization and characterization are essential for treatment planning.

  8. Models of fast-electron penetration

    International Nuclear Information System (INIS)

    Perry, D.J.; Raisis, S.K.

    1994-01-01

    We introduce multiple scattering models of charged-particle penetration which are based on the previous analyses of Yang and Perry. Our development removes the main limitations of the Fermi-Eyges approach while retaining its considerable potential as a theory which is useful for applied work. We illustrate key predictions with sample calculations that are of particular interest in therapeutic applications, 5-20 MeV electrons incident on water. 8 refs., 5 figs

  9. Injury - kidney and ureter

    Science.gov (United States)

    ... kidney; Ureteral injury; Pre-renal failure - injury, Post-renal failure - injury; Kidney obstruction - injury Images Kidney anatomy Kidney - blood and urine flow References Molitoris BA. Acute kidney injury. In: Goldman ...

  10. Spinal Cord Injury 101

    Medline Plus

    Full Text Available menu Understanding Spinal Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ...

  11. Repetitive Stress Injuries

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Repetitive Stress Injuries KidsHealth / For Teens / Repetitive Stress Injuries What's ... t had any problems since. What Are Repetitive Stress Injuries? Repetitive stress injuries (RSIs) are injuries that ...

  12. Spanish RPV head penetrations. Regulatory status

    International Nuclear Information System (INIS)

    Figueras, J.M.; Colino, J.R.

    1995-01-01

    The paper presents the actual status of inspection results on the Spanish PWR RPV CRD head penetrations (CRDH's), after two years of a whole program of inspections in all affected plants. Actual situation of penetrations pertaining to ALMARAZ 1 and 2, ASCO 1 and 2 and VANDELLOS 2 NPP's show any damage in those CRDH's inspected in 1993 and 1994 (roughly 20 out of 65 CRDH's at each unit). The paper presents a summary of CRDH characteristics, inspection methods and results obtained in each plant. TRILLO NPP has a different CRDH design (KWU-SIEMENS type) and for that reason is not considered an affected plant nor has conducted any inspection up to now. JOSE CABRERA (ZORITA) NPP has shown extensive damage, both in the lower side (weldment to the vessel) and in the upper free span area, near bimetallic weldment to SS 304, in active and nonactive penetrations and also in the vent nozzle. The paper comments extensively on the CRDH materials general data, root-cause analysis and structural analysis of degraded zones, inspection results, repair actions and other additional actions applied up to now. Finally, the paper deals with the regulatory actions taken by CSN on this topic, both for those NPP's actually non affected by the IGSCC phenomenon in the RPV CRDH's and for the specific safety case of ZORITA NPP. (author)

  13. Cutaneous mucormycosis secondary to penetrative trauma.

    Science.gov (United States)

    Zahoor, Bilal; Kent, Stephen; Wall, Daryl

    2016-07-01

    Mucormycosis is a rare but serious sequelae of penetrating trauma [1-5]. In spite of aggressive management, mortality remains high due to dissemination of infection. We completed a review of literature to determine the most optimal treatment of cutaneous mucormycosis which occurs secondary to penetrating trauma. We completed a review regarding the management of mucormycosis in trauma patients. We selected a total of 36 reports, of which 18 were case-based, for review. Surgical debridement is a primary predictor of improved outcomes in the treatment of mucormycosis [3,6,7]. Anti-fungal therapy, especially lipid soluble formulation of Amphotericin B, is helpful as an adjunct or when surgical debridement has been maximally achieved. Further research is needed to fully evaluate the impact of topical dressings; negative pressure wound therapy is helpful. An aggressive and early surgical approach, even at the expense of disfigurement, is necessary to reduce mortality in the setting of cutaneous mucormycosis that results from penetrating trauma [4,8,9]. Anti-fungal therapy and negative pressure wound therapy are formidable adjuncts. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Deep penetration of light into biotissue

    Science.gov (United States)

    Bearden, Edward D.; Wilson, James D.; Zharov, Vladimir P.; Lowery, Curtis L.

    2001-07-01

    The results of a study of deep (several centimeters) light penetration into biological tissue are presented in order to estimate its significance to potentially photosensitive structures and processes including the fetal eyes. In order to accomplish this goal, samples of various tissues (fat, muscle, and uterus) from surgical patients and autopsies were examined with a double integrating sphere arrangement to determine their optical properties. The results were implemented in a Monte Carlo modeling program. Next, optical fiber probes were inserted into the uterus and abdominal wall of patients undergoing laparoscopic procedures. The fibers were couples to a photomultiplier tube with intervening filters allowing measurements of light penetration at various wavelengths. To determine the feasibility of stimulation in utero, a xenon lamp and waveguide were used to transilluminate the abdomen of several labor patients. Light in the range of 630 to 670 nm where the eye sensitivity and penetration depth are well matched, will likely provide the best chance of visual stimulation. Fetal heart rate, fetal movement, and fetal magnetoencephalography (SQUID) and electroencephalography (EEG) were observed in different studies to determine if stimulation has occurred. Since internal organs and the fetus are completely dark adapted, the amount of light required to simulate in our opinion could be on the order of 10(superscript -8 Watts.

  15. Penetration in bimodal, polydisperse granular material

    KAUST Repository

    Kouraytem, Nadia; Thoroddsen, Sigurdur T; Marston, J. O.

    2016-01-01

    We investigate the impact penetration of spheres into granular media which are compositions of two discrete size ranges, thus creating a polydisperse bimodal material. We examine the penetration depth as a function of the composition (volume fractions of the respective sizes) and impact speed. Penetration depths were found to vary between delta = 0.5D(0) and delta = 7D(0), which, for mono-modal media only, could be correlated in terms of the total drop height, H = h + delta, as in previous studies, by incorporating correction factors for the packing fraction. Bimodal data can only be collapsed by deriving a critical packing fraction for each mass fraction. The data for the mixed grains exhibit a surprising lubricating effect, which was most significant when the finest grains [d(s) similar to O(30) mu m] were added to the larger particles [d(l) similar to O(200 - 500) mu m], with a size ratio, epsilon = d(l)/d(s), larger than 3 and mass fractions over 25%, despite the increased packing fraction. We postulate that the small grains get between the large grains and reduce their intergrain friction, only when their mass fraction is sufficiently large to prevent them from simply rattling in the voids between the large particles. This is supported by our experimental observations of the largest lubrication effect produced by adding small glass beads to a bed of large sand particles with rough surfaces.

  16. Penetration in bimodal, polydisperse granular material

    KAUST Repository

    Kouraytem, N.

    2016-11-07

    We investigate the impact penetration of spheres into granular media which are compositions of two discrete size ranges, thus creating a polydisperse bimodal material. We examine the penetration depth as a function of the composition (volume fractions of the respective sizes) and impact speed. Penetration depths were found to vary between delta = 0.5D(0) and delta = 7D(0), which, for mono-modal media only, could be correlated in terms of the total drop height, H = h + delta, as in previous studies, by incorporating correction factors for the packing fraction. Bimodal data can only be collapsed by deriving a critical packing fraction for each mass fraction. The data for the mixed grains exhibit a surprising lubricating effect, which was most significant when the finest grains [d(s) similar to O(30) mu m] were added to the larger particles [d(l) similar to O(200 - 500) mu m], with a size ratio, epsilon = d(l)/d(s), larger than 3 and mass fractions over 25%, despite the increased packing fraction. We postulate that the small grains get between the large grains and reduce their intergrain friction, only when their mass fraction is sufficiently large to prevent them from simply rattling in the voids between the large particles. This is supported by our experimental observations of the largest lubrication effect produced by adding small glass beads to a bed of large sand particles with rough surfaces.

  17. Badminton injuries.

    Science.gov (United States)

    Krøner, K; Schmidt, S A; Nielsen, A B; Yde, J; Jakobsen, B W; Møller-Madsen, B; Jensen, J

    1990-01-01

    In a one year period, from 1 January 1986 to 31 December 1986, 4303 patients with sports injuries were treated at Aarhus Amtssygehus and Aarhus Kommunehospital. The mean age was 21.6 years (range 7-72 years) and 2830 were men. Two hundred and seventeen badminton injuries occurred in 208 patients (136 men) with a mean age of 29.6 years (range 7-57 years), constituting 4.1 percent of all sport injuries in Aarhus. Joints and ligaments were injured in 58.5 percent of the patients, most frequently located in the lower limb and significantly more often among patients younger than 30 years of age. Muscle injury occurred in 19.8 percent of the patients. This type of injury was significantly more frequent among patients older than 30 years of age. Most injuries were minor. However, 6.8 percent of the patients were hospitalized and 30.9 percent received additional treatment by a physician. As the risk of injury varies with age, attempts to plan training individually and to institute prophylactic measures should be made. PMID:2078802

  18. CNS penetration of ART in HIV-infected children

    NARCIS (Netherlands)

    van den Hof, Malon; Blokhuis, Charlotte; Cohen, Sophie; Scherpbier, Henriette J.; Wit, Ferdinand W. N. M.; Pistorius, M. C. M.; Kootstra, Neeltje A.; Teunissen, Charlotte E.; Mathot, Ron A. A.; Pajkrt, Dasja

    2018-01-01

    Background: Paediatric data on CNS penetration of antiretroviral drugs are scarce. Objectives: To evaluate CNS penetration of antiretroviral drugs in HIV-infected children and explore associations with neurocognitive function. Patients and methods: Antiretroviral drug levels were measured in paired

  19. Miscellanea to the relation between notions of "organization" and "institution"

    Directory of Open Access Journals (Sweden)

    Julian Daszkowski

    2009-04-01

    Full Text Available Historycy gospodarki bardzo wyraźnie podkreślają, że od połowy XIX wieku organizowanie komercyjnych przedsiębiorstw i zarządzanie nimi stało się nowym1 i specyficzny m2 obszarem powszechnego działania w gospodarce, przynosząc sukcesy nie jednokrotnie większe od tych, ktre wynikały z postępw techniki3. Z te go powodu oprcz pojawienia się nowych nazw i pojęć, nastąpiły także liczne zmiany i modyfikacje w sposobach oraz okolicznościach używania słw na oznaczenie nowych zjawisk lub relacji między nimi. Tak na przykład nazwa organizacja\\" w znaczeniu rzeczowo-atrybutowym4 zaczęła być używana zamiennie z nazwami przedsiębiorstwo\\", osoba prawna\\", korporacja\\", spłka\\", a nawet firma\\". Jest to istniejący do dziś językowy zwyczaj, w ktrym rżne nazwy są traktowane jako stylistyczne warianty symbolizujące tą samą treść.

  20. Update on ultrasound elastography: Miscellanea. Prostate, testicle, musculo-skeletal

    International Nuclear Information System (INIS)

    Correas, J.M.; Drakonakis, E.; Isidori, A.M.; Hélénon, O.; Pozza, C.; Cantisani, V.; Di Leo, N.; Maghella, F.; Rubini, A.; Drudi, F.M.; D’ambrosio, F.

    2013-01-01

    Nowadays ultrasound elastosonography is an established technique, although with limited clinical application, used to assess tissue stiffness, which is a parameter that in most cases is associated with malignancy. However, although a consistent number of articles have been published about several applications of elastosonography, its use in certain human body districts is still not well defined. In this paper we write on the use of elastosonography in prostate, testicle and musculo-skeletal apparatus. We report and compare the work of several authors, different type of elastosonography (shear wave, strain elastography, etc.) and instrumental data obtained in the study of both benign and malignant lesions

  1. Update on ultrasound elastography: Miscellanea. Prostate, testicle, musculo-skeletal

    Energy Technology Data Exchange (ETDEWEB)

    Correas, J.M. [Descartes University and Necker University Hospital, Department of Adult Radiology, Paris (France); Drakonakis, E. [Nuffield Orthopaedic Centre, Oxford (United Kingdom); Isidori, A.M. [Sapienza University of Rome, Department of Experimental Medicine, Rome (Italy); Hélénon, O. [Descartes University and Necker University Hospital, Department of Adult Radiology, Paris (France); Pozza, C. [Sapienza University of Rome, Department of Experimental Medicine, Rome (Italy); Cantisani, V., E-mail: vito.cantisani@uniroma1.it [Sapienza University of Rome, Department of Radiology, Rome (Italy); Di Leo, N.; Maghella, F.; Rubini, A.; Drudi, F.M.; D’ambrosio, F. [Sapienza University of Rome, Department of Radiology, Rome (Italy)

    2013-11-01

    Nowadays ultrasound elastosonography is an established technique, although with limited clinical application, used to assess tissue stiffness, which is a parameter that in most cases is associated with malignancy. However, although a consistent number of articles have been published about several applications of elastosonography, its use in certain human body districts is still not well defined. In this paper we write on the use of elastosonography in prostate, testicle and musculo-skeletal apparatus. We report and compare the work of several authors, different type of elastosonography (shear wave, strain elastography, etc.) and instrumental data obtained in the study of both benign and malignant lesions.

  2. Penetration Testing Curriculum Development in Practice

    Directory of Open Access Journals (Sweden)

    Chengcheng Li

    2015-04-01

    Full Text Available As both the frequency and the severity of network breaches have increased in recent years, it is essential that cybersecurity is incorporated into the core of business operations. Evidence from the U.S. Bureau of Labor Statistics (Bureau of Labor Statistics, 2012 indicates that there is, and will continue to be, a severe shortage of cybersecurity professionals nationwide throughout the next decade. To fill this job shortage we need a workforce with strong hands-on experience in the latest technologies and software tools to catch up with the rapid evolution of network technologies. It is vital that the IT professionals possess up-to-date technical skills and think and act one step ahead of the cyber criminals who are constantly probing and exploring system vulnerabilities. There is no perfect security mechanism that can defeat all the cyber-attacks; the traditional defensive security mechanism will eventually fail to the pervasive zero-day attacks. However, there are steps to follow to reduce an organization’s vulnerability to cyber-attacks and to mitigate damages. Active security tests of the network from a cyber-criminal’s perspective can identify system vulnerabilities that may lead to future breaches. “If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. But if you know the enemy and know yourself, you need not fear the result of hundred battles” (Sun, 2013. Penetration testing is a discipline within cybersecurity that focuses on identifying and exploiting the vulnerabilities of a network, eventually obtaining access to the critical business information. The pentesters, the security professionals who perform penetration testing, or ethical hackers, break the triad of information security - Confidentiality, Integrity, and Accountability (CIA - as if they were a cyber-criminal. The purpose of ethical hacking or penetration testing is to know what the “enemy” can do and then generate a

  3. Changing pattern and outcome of pediatric chest injuries in urban Syria.

    Science.gov (United States)

    Darwish, Bassam; Mahfouz, Mohammad Z; Al-Nosairat, Saeed; Izzat, Mohammad Bashar

    2018-01-01

    Background Pediatric chest injuries were infrequent in our practice, but the outbreak of the Syrian crisis resulted in an increase in number and a change in the pattern of thoracic trauma incidents. We compared our experience of pediatric chest injuries before and during the crisis. Methods We reviewed the records of 256 children aged 12.8 ± 5 years who were admitted to our hospital with the diagnosis of chest trauma over a 12-year period. Collected data included mechanism of injury, associated injuries, method of management, length of hospital stay, complications, and mortality. Results The incidence of pediatric chest injuries increased significantly following the outbreak of the crisis, and penetrating injuries prevailed, mainly due to shrapnel, bullets, and stab wounds. Forty percent of patients with blunt injuries and 20% of those with penetrating injuries were managed conservatively, whereas urgent thoracotomies were indicated in 10%, mostly in patients with penetrating injuries. Associated injuries were more frequent in patients with blunt injuries and resulted in a longer hospital stay and an increased mortality rate. The overall mortality rate was 7.8% and it was higher in children younger than 7 years of age and in patients who had been subjected to blunt injuries. Conclusions There has been a recent substantial upsurge in the incidence of pediatric thoracic trauma, with a predominance of penetrating injuries. Most patients could be managed nonoperatively, but a small subset required an open thoracotomy. The presence of associated injuries constitutes the main determinant of prognosis in this group of patients.

  4. Improving outcomes following penetrating colon wounds: application of a clinical pathway.

    Science.gov (United States)

    Miller, Preston R; Fabian, Timothy C; Croce, Martin A; Magnotti, Louis J; Elizabeth Pritchard, F; Minard, Gayle; Stewart, Ronald M

    2002-06-01

    During World War II, failure to treat penetrating colon injuries with diversion could result in court martial. Based on this wartime experience, colostomy for civilian colon wounds became the standard of care for the next 4 decades. Previous work from our institution demonstrated that primary repair was the optimal management for nondestructive colon wounds. Optimal management of destructive wounds requiring resection remains controversial. To address this issue, we performed a study that demonstrated risk factors (pre or intraoperative transfusion requirement of more than 6 units of packed red blood cells, significant comorbid diseases) that were associated with a suture line failure rate of 14%, and of whom 33% died. Based on these outcomes, a clinical pathway for management of destructive colon wounds was developed. The results of the implementation of this pathway are the focus of this report. Patients with penetrating colon injury were identified from the registry of a level I trauma center over a 5-year period. Records were reviewed for demographics, injury characteristics, and outcome. Patients with nondestructive injuries underwent primary repair. Patients with destructive wounds but no comorbidities or large transfusion requirement underwent resection and anastomosis, while patients with destructive wounds and significant medical illness or transfusion requirements of more than 6 units/blood received end colostomy. The current patients (CP) were compared to the previous study (PS) to determine the impact of the clinical pathway. Outcomes examined included colon related mortality and morbidity (suture line leak and abscess). Over a 5.5-year period, 231 patients had penetrating colon wounds. 209 survived more 24 hours and comprise the study population. Primary repair was performed on 153 (73%) patients, and 56 patients had destructive injuries (27%). Of these, 40 (71%) had resection and anastomosis and 16 (29%) had diversion. More destructive injuries were

  5. Impacted thoracic foreign bodies after penetrating chest trauma.

    Science.gov (United States)

    Sersar, Sameh I; Albohiri, Khalid A; Abdelmohty, Hysam

    2016-10-01

    Retained foreign bodies in the chest may include shell fragments, bullets, shrapnel, pieces of clothing, bones, and rib fragments. The risks of removal of foreign bodies must be weighed against the complications of leaving them inside the chest. We treated 90 cases of retained intrathoracic foreign bodies in patients admitted to 3 tertiary centers in Saudi Arabia between March 2015 and March 2016. Sixty patients were injured by shrapnel, 26 had one or more bullets, 3 had broken rib fragments, and one had a metal screw. The chest wall was site of impaction in 48 cases, the lungs in 24, pleura in 14, and mediastinum in 4. Removal of the retained foreign body was carried out in 12 patients only: bullets in 9 cases, bone fragments in 2, and a metal screw in one. The predictors for removal were bullets, female sex, and mediastinal position with bilateral chest injury, especially with fracture ribs. Retained intrathoracic foreign bodies due to penetrating chest trauma are treated mainly conservatively unless there is another indication for chest exploration. © The Author(s) 2016.

  6. 40 CFR 1065.365 - Nonmethane cutter penetration fractions.

    Science.gov (United States)

    2010-07-01

    ... fractions. 1065.365 Section 1065.365 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Measurements § 1065.365 Nonmethane cutter penetration fractions. (a) Scope and frequency. If you use a FID... penetration fractions of methane, PFCH4, and ethane, PF C2H6. As detailed in this section, these penetration...

  7. Spinal injury

    Science.gov (United States)

    ... Dallas, TX: American Red Cross; 2016. Kaji AH, Newton EJ, Hockberger RS. Spinal injuries. In: Marx JA, ... member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www. ...

  8. Chilling injury

    African Journals Online (AJOL)

    ahar

    2013-12-18

    Dec 18, 2013 ... ROS avoidance genes play pivotal role in defense mechanism against chilling injury derived oxidative stress. ... Low temperature storage is a postharvest technology ..... crops is highly dependent on ethylene production and.

  9. Injury Statistics

    Science.gov (United States)

    ... Power Saws for 2001 05/15/2002 Nail Gun Related Injuries and Deaths Home Maintenance & Construction 05/ ... Information (FOIA) Inspector General No Fear Act Data USA.gov Report an Unsafe Product Contact Us: 800- ...

  10. Electrical injury

    Science.gov (United States)

    ... RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 134. Price LA, Loiacono LA. Electrical and lightning injury. In: Cameron JL, Cameron AM, eds. Current Surgical ...

  11. Ear Injury

    Science.gov (United States)

    ... of different injuries can affect the outer ear. Cauliflower ear (subperichondrial hematoma) A blunt blow to the ... to a deformed ear. This deformity, called a cauliflower ear, is common among wrestlers, boxers, and rugby ...

  12. Diffusion of radioactively tagged penetrants through rubbery polymers. II. Dependence on molecular length of penetrant

    International Nuclear Information System (INIS)

    Rhee, C.K.; Ferry, J.D.; Fetters, L.J.

    1977-01-01

    The diffusion of radioactively tagged n-hexadecane, n-dotriacontane, and a polybutadiene oligomer with molecular weight 1600 has been studied in 12 rubbery polymers. Diffusion coefficients were obtained from the theory for the thin smear method: for n-hexadecane and for n-dotriacontane (with one exception), in the form appropriate for a completely miscible polymer-penetrant pair, and for the oligomer in the form appropriate for slow entry of the pentrant across the penetrant-polymer interface. For the four flexible linear penetrants, n-dodecane, n-hexadecane, n-dotriacontane, and oligomer, the ratios of diffusion coefficients (or translational friction coefficients) are nearly the same in every polymer. It is concluded that these penetrants travel with similar segmentwise motions, although that is not the case with bulkier, more rigid penetrants. For the three normal paraffins, the friction coefficient is approximately proportional to molecular weight, but that for the oligomer is smaller than would be predicted on this basis

  13. Injuries caused by firewood splitting machines.

    Science.gov (United States)

    Hellstrand, P H

    1989-01-01

    The aim of this paper is to present the types of injury caused by firewood splitting machines and also to elucidate the accident mechanism. The study is based on 15 cases. The machine has a rotating spiral cone, and usually the victims' gloved fingertips were caught by the point of the cone. This led to either amputations, usually of radial fingers and/or penetrating wounds through the middle of the hand. In most cases the accidents could not be blamed on bad working techniques. The study of the mechanisms of injury points to insufficient protective devices in a machine construction which has a potentially dangerous working principle.

  14. CT analysis of missile head injury

    International Nuclear Information System (INIS)

    Besenski, N.; Jadro-Santel, D.; Jelavic-Koic, F.; Pavic, D.; Mikulic, D.; Glavina, K.; Maskovic, J.

    1995-01-01

    Between August 1991 and December 1992, CT was performed in 154 patients who had suffered missile head injury during the war in the Republic of Croatia. In 54% CT was performed 1-24 h after injury, and in 27% follow-up CT was also obtained. The wounds were penetrating, tangential or perforating (45%, 34% and 21%, respectively). Haemorrhage was the most frequent lesion in the brain (84%). Follow-up CT evolution of haemorrhage, oedema, cerebritis, abscess, secondary vascular lesions, necrosis, encephalomalacia and hydrocephalus. The most dynamic changes occurred 7-14 days after injury. In 14% of cases, deep cerebral lesions were found in the corpus callosum, septum pellucidum periventricular region and pons, although bone and shell fragments were in a different part of the brain parenchyma. Such lesions were found in penetrating injuries only. CT proved very useful for assessing the extent and type of lesions. Although different mechanisms of brain damage in missile head injury are known, here they are, to the best of our knowledge, shown for the first time by CT. (orig.)

  15. Cold injuries.

    Science.gov (United States)

    Kruse, R J

    1995-01-01

    There are two categories of cold injury. The first is hypothermia, which is a systemic injury to cold, and the second is frostbite, which is a local injury. Throughout history, entire armies, from George Washington to the Germans on the Russian Front in World War II, have fallen prey to prolonged cold exposure. Cold injury is common and can occur in all seasons if ambient temperature is lower than the core body temperature. In the 1985 Boston Marathon, even though it was 76 degrees and sunny, there were 75 runners treated for hypothermia. In general, humans adapt poorly to cold exposure. Children are at particular risk because of their relatively greater surface area/body mass ratio, causing them to cool even more rapidly than adults. Because of this, the human's best defense against cold injury is to limit his/her exposure to cold and to dress appropriately. If cold injury has occurred and is mild, often simple passive rewarming such as dry blankets and a warm room are sufficient treatment.

  16. A RETROSPECTIVE STUDY ON BLUNT INJURY ABDOMEN

    OpenAIRE

    Kopperundevi; Jagadeesan; Kiruthiga

    2016-01-01

    Blunt injury abdomen is the leading cause of morbidity and mortality in all age groups. Blunt trauma differs from penetrating trauma as different organs are characteristically injured by compression from blunt straining. A total of 53 cases of blunt trauma were studied in this study for the period of 1 year. In this study, commonest cause for blunt abdominal trauma was road traffic accident. The maximum incidence was noted in 20-40 middle age group of which 90% male patients were ...

  17. Penetration Testing Professional Ethics: a conceptual model and taxonomy

    Directory of Open Access Journals (Sweden)

    Justin Pierce

    2006-05-01

    Full Text Available In an environment where commercial software is continually patched to correct security flaws, penetration testing can provide organisations with a realistic assessment of their security posture. Penetration testing uses the same principles as criminal hackers to penetrate corporate networks and thereby verify the presence of software vulnerabilities. Network administrators can use the results of a penetration test to correct flaws and improve overall security. The use of hacking techniques, however, raises several ethical questions that centre on the integrity of the tester to maintain professional distance and uphold the profession. This paper discusses the ethics of penetration testing and presents our conceptual model and revised taxonomy.

  18. Assessing the credibility of diverting through containment penetrations

    International Nuclear Information System (INIS)

    Cooley, J.N.; Swindle, D.W. Jr.

    1980-01-01

    A viable approach has been developed for identifying those containment penetrations in a nuclear fuel reprocessing plant which are credible diversion routes. The approach is based upon systematic engineering and design analyses and is applied to each type of penetration to determine which penetrations could be utilized to divert nuclear material from a reprocessing facility. The approach is described and the results of an application are discussed. In addition, the concept of credibility is developed and discussed. For a typical reprocessing plant design, the number of penetrations determined to be credible without process or piping modifications was approx. 16% of the penetrations originally identified

  19. Surgical management of colorectal injuries: colostomy or primary repair?

    Science.gov (United States)

    Papadopoulos, V N; Michalopoulos, A; Apostolidis, S; Paramythiotis, D; Ioannidis, A; Mekras, A; Panidis, S; Stavrou, G; Basdanis, G

    2011-10-01

    Several factors have been considered important for the decision between diversion and primary repair in the surgical management of colorectal injuries. The aim of this study is to clarify whether patients with colorectal injuries need diversion or not. From 2008 to 2010, ten patients with colorectal injuries were surgically treated by primary repair or by a staged repair. The patients were five men and five women, with median age 40 years (20-55). Two men and two women had rectal injuries, while 6 patients had colon injuries. The mechanism of trauma in two patients was firearm injuries, in two patients was a stab injury, in four patients was a motor vehicle accident, in one woman was iatrogenic injury during vaginal delivery, and one case was the transanal foreign body insertion. Primary repair was possible in six patients, while diversion was necessary in four patients. Primary repair should be attempted in the initial surgical management of all penetrating colon and intraperitoneal rectal injuries. Diversion of colonic injuries should only be considered if the colon tissue itself is inappropriate for repair due to severe edema or ischemia. The role of diversion in the management of unrepaired extraperitoneal rectal injuries and in cases with anal sphincter injuries is mandatory.

  20. Market penetration scenarios for fuel cell vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, C.E.; James, B.D.; Lomax, F.D. Jr. [Directed Technologies, Inc., Arlington, VA (United States)

    1997-12-31

    Fuel cell vehicles may create the first mass market for hydrogen as an energy carrier. Directed Technologies, Inc., working with the US Department of Energy hydrogen systems analysis team, has developed a time-dependent computer market penetration model. This model estimates the number of fuel cell vehicles that would be purchased over time as a function of their cost and the cost of hydrogen relative to the costs of competing vehicles and fuels. The model then calculates the return on investment for fuel cell vehicle manufacturers and hydrogen fuel suppliers. The model also projects the benefit/cost ratio for government--the ratio of societal benefits such as reduced oil consumption, reduced urban air pollution and reduced greenhouse gas emissions to the government cost for assisting the development of hydrogen energy and fuel cell vehicle technologies. The purpose of this model is to assist industry and government in choosing the best investment strategies to achieve significant return on investment and to maximize benefit/cost ratios. The model can illustrate trends and highlight the sensitivity of market penetration to various parameters such as fuel cell efficiency, cost, weight, and hydrogen cost. It can also illustrate the potential benefits of successful R and D and early demonstration projects. Results will be shown comparing the market penetration and return on investment estimates for direct hydrogen fuel cell vehicles compared to fuel cell vehicles with onboard fuel processors including methanol steam reformers and gasoline partial oxidation systems. Other alternative fueled vehicles including natural gas hybrids, direct injection diesels and hydrogen-powered internal combustion hybrid vehicles will also be analyzed.

  1. High-velocity penetrating thoracic trauma with suspected cardiac involvement in a combat support hospital

    International Nuclear Information System (INIS)

    Dominguez, F.; Gentlesk, P.J.; Eckart, R.E.; Beekley, A.C.; Huffer, L.L.

    2011-01-01

    The most common cardiac injuries in the United States are blunt trauma from motor vehicle accidents or low-velocity trauma from stabbings. During military conflict, high-velocity injuries, including gunshot wounds (GSW) and fragment injury from improvised explosive devices (IED), are relatively more common. This is a retrospective review of cases with high-velocity penetrating injury and suspected myocardial involvement during a 6-month period in Baghdad, Iraq, at a United States Army hospital during Operation Iraqi Freedom. Eleven cases survived to admission (GSW in 5, IED in 6). The mean age of the all-male cohort was 27 years (range, 3-54 years). Eight of the 11 patients (73%) were victims of polytrauma. The entrance involved the right ventricle (n=3), right atrium (n=2), left ventricle (n=1), or mediastinum and pericardial reflections (n=5). Echocardiography was performed in all 11 patients. In 7 patients, no foreign body was identifiable, and in 2 patients the foreign body was identified within the pericardial fat pad. Three patients were identified as having a suspected ventricular septal defect, ranging in size from 2 to 8 mm. The most common electrocardiographic abnormality was atrioventricular block and right bundle branch block. In 4 patients, the management of the chest injury was nonsurgical, and in 1 patient the treatment was a chest tube only. Four of the patients underwent median sternotomy, 1 underwent emergent lateral thoracotomy, and 1 underwent an infradiaphragmatic approach. This case series is too small to draw definitive conclusions; however, a multidisciplinary approach to high-velocity injuries with potential for cardiac involvement augments preoperative assessment for myocardial injury and may allow selective nonoperative management. (author)

  2. Getting My Bearings, Returning to School: Issues Facing Adolescents with Traumatic Brain Injury

    Science.gov (United States)

    Schilling, Ethan J.; Getch, Yvette Q.

    2012-01-01

    Traumatic brain injury (TBI) is characterized by a blow to the head or other penetrating head injury resulting in impairment of the brain's functioning. Despite the high incidence of TBI in adolescents, many educators still consider TBI to be a low-incidence disability. In addition, school personnel often report receiving little to no pre-service…

  3. Radiation injuries of plasmatic membrane and lethal action of radiation on cells

    Energy Technology Data Exchange (ETDEWEB)

    Fomenko, B S; Akoev, I G [AN SSSR, Pushchino-na-Oke. Inst. Biologicheskoj Fiziki

    1984-01-01

    Data on modification of procaryotes and eukaryotes cell injuries using preparations not penetrating into cells and also membrane-specific drugs localized in cells in a lipid phase are generalized. A conclusion is drawn that radiation injuries of plasmatic membrane of prokaryotes and eukaryotes contribute considerably to lethal action of radiation on cells.

  4. Occupational exposure to sharps injury among healthcare providers in Ethiopia regional hospitals

    NARCIS (Netherlands)

    Sharew, Nigussie Tadesse; Mulu, Getaneh Baye; Habtewold, Tesfa Dejenie; Gizachew, Kefyalew Dagne

    2017-01-01

    BACKGROUND: Sharps injury is a penetrating stab wound from a needle, scalpel, or another sharp object that may result in exposure to blood or other body fluids. According to World Health Organization pooled estimate, the annual incidence of sharps injury in Africa was ranged from 2.10 to 4.68 per

  5. Radiation injuries of plasmatic membrane and lethal action of radiation on cells

    International Nuclear Information System (INIS)

    Fomenko, B.S.; Akoev, I.G.

    1984-01-01

    Data on modification of procaryotes and eukaryotes cell injuries using preparations not penetrating into cells and also membrane-specific drugs localized in cells in a lipid phase are generalized. A conclusion is drawn that radiation injuries of plasmatic membrane of prokaryotes and eukaryotes contribute considerably to lethal action of radiation on cells

  6. Simulating barrier penetration during combat. Technical report

    International Nuclear Information System (INIS)

    De Laquil, P. III.

    1980-04-01

    A computer program, BARS, simulates combat between an adversary group attempting to hijack special nuclear material and escort personnel attempting to protect it. BARS is designed to investigate how various combat strategies and levels of performance affect the time required to penetrate barriers (armor, deterrent systems, etc.) against forcible entry. A Monte Carlo code, BARS uses a game theoretic approach to allocate the attacking and defending forces. Combat suppression is simulated using a stochastic state-transition model for the behavior of individuals under combat stress. The BARS program was developed as part of the overall combat modelling effort of the transportation safeguards program

  7. A medium energy neutron deep penetration experiment

    International Nuclear Information System (INIS)

    Amian, W.; Cloth, P.; Druecke, V.; Filges, D.; Paul, N.; Schaal, H.

    1986-11-01

    A deep penetration experiment conducted at the Los Alamos WNR facility's Spallation Neutron Target is compared with calculations using intra-nuclear-cascade and S N -transport codes installed at KFA-IRE. In the experiment medium energy reactions induced by neutrons between 15 MeV and about 150 MeV inside a quasi infinite slab of iron have been measured using copper foil monitors. Details of the experimental procedure and the theoretical methods are described. A comparison of absolute reaction rates for both experimentally and theoretically derived reactions is given. The present knowledge of the corresponding monitor reaction cross sections is discussed. (orig.)

  8. Income Inequality and Transnational Corporate Penetration

    Directory of Open Access Journals (Sweden)

    Linda Beer

    2015-08-01

    Full Text Available This study examines whether the positive association between national income inequality and transnational corporate penetration found previously by Bornschier and Chase-Dunn (1985 and others circa the late 1960s still holds for the mid-l980s. Both methodological and theoretical problems of earlier studies are discussed and solutions are offered. Economic development, political-institutional and regional variables are also included inthe analyses. While further research is warranted, the results provide support for a World-System/Dependency perspective in understanding income inequality cross-nationally.

  9. Premium Efficiency Motors And Market Penetration Policy

    Energy Technology Data Exchange (ETDEWEB)

    Benhaddadi, Mohamed; Olivier, Guy

    2010-09-15

    This paper illustrates the induced enormous energy saving potential, permitted by using high-efficiency motors. Furthermore, the most important barriers to larger high-efficiency motors utilization are identified, and some incentives recommendations are given to overcome identified impediments. The authors consider that there is a strong case to enhance incentives policies for larger market penetration. The US Energy Policy Act and the Canadian Energy Efficient Act have lead to North American leadership on motor efficiency implementation. North America is not on the leading edge for energy saving and conservation. Motor efficiency is an exception that should be at least maintained.

  10. Hacking with Kali practical penetration testing techniques

    CERN Document Server

    Broad, James

    2013-01-01

    Hacking with Kali introduces you the most current distribution of the de facto standard tool for Linux pen testing. Starting with use of the Kali live CD and progressing through installation on hard drives, thumb drives and SD cards, author James Broad walks you through creating a custom version of the Kali live distribution. You'll learn how to configure networking components, storage devices and system services such as DHCP and web services. Once you're familiar with the basic components of the software, you'll learn how to use Kali through the phases of the penetration testing lifecycle

  11. Penetration of relativistic heavy ions through matter

    International Nuclear Information System (INIS)

    Scheidenberger, C.; Geissel, H.

    1997-07-01

    New heavy-ion accelerators covering the relativistic and ultra-relativistic energy regime allow to study atomic collisions with bare and few-electron projectiles. High-resolution magnetic spectrometers are used for precise stopping-power and energy-loss straggling measurements. Refined theories beyond the Born approximation have been developed and are confirmed by experiments. This paper summarizes the large progress in the understanding of relativistic heavy-ion penetration through matter, which has been achieved in the last few years. (orig.)

  12. Penetrating the markets: biomass and commercial distribution

    International Nuclear Information System (INIS)

    Schmidl, J.

    1999-01-01

    Although biomass accounts for a significant proportion of renewable energy in Europe, its market penetration could be increased if certain barriers can be surmounted. Some of those barriers are identified and suggestions made as to how they may be overcome through improved 'distribution' in various sectors. To integrate biomass into the electricity distribution system, the commercial distribution of liquid biofuels, and in the commercial distribution of biomass in the heat sector, certain rewards and penalties could be introduced and these are discussed. The low temperature heat market is seen as very important for the further development of bioenergy in Europe. (UK)

  13. Neutron streaming studies along JET shielding penetrations

    Science.gov (United States)

    Stamatelatos, Ion E.; Vasilopoulou, Theodora; Batistoni, Paola; Obryk, Barbara; Popovichev, Sergey; Naish, Jonathan

    2017-09-01

    Neutronic benchmark experiments are carried out at JET aiming to assess the neutronic codes and data used in ITER analysis. Among other activities, experiments are performed in order to validate neutron streaming simulations along long penetrations in the JET shielding configuration. In this work, neutron streaming calculations along the JET personnel entrance maze are presented. Simulations were performed using the MCNP code for Deuterium-Deuterium and Deuterium- Tritium plasma sources. The results of the simulations were compared against experimental data obtained using thermoluminescence detectors and activation foils.

  14. Mastering Kali Linux for advanced penetration testing

    CERN Document Server

    Beggs, Robert W

    2014-01-01

    This book provides an overview of the kill chain approach to penetration testing, and then focuses on using Kali Linux to provide examples of how this methodology is applied in the real world. After describing the underlying concepts, step-by-step examples are provided that use selected tools to demonstrate the techniques. If you are an IT professional or a security consultant who wants to maximize the success of your network testing using some of the advanced features of Kali Linux, then this book is for you. This book will teach you how to become an expert in the pre-engagement, management,

  15. Market penetration of natural gas in Europe

    International Nuclear Information System (INIS)

    Haas, R.; Wirl, F.

    1992-01-01

    The strategy of restricting natural gas to noble uses (directive of EEC and endorsed by the IEA) impeded gas expansion despite substantial upward revisions in the assessment of available resources. However, increasing environmental concern slowly but gradually undermines this strategy because natural gas serves as a substitute for costly abatement. This article discusses the prospect of future natural gas consumption considering economic and ecological facts as well as strategic and political considerations. In fact, we argue that inconsistent political interventions first seriously lowered gas penetration but now favor its use

  16. Kali Linux assuring security by penetration testing

    CERN Document Server

    Ali, Shakeel; Allen, Lee

    2014-01-01

    Written as an interactive tutorial, this book covers the core of Kali Linux with real-world examples and step-by-step instructions to provide professional guidelines and recommendations for you. The book is designed in a simple and intuitive manner that allows you to explore the whole Kali Linux testing process or study parts of it individually.If you are an IT security professional who has a basic knowledge of Unix/Linux operating systems, including an awareness of information security factors, and want to use Kali Linux for penetration testing, then this book is for you.

  17. Imaging of abdominal and pelvic injuries from the Boston Marathon bombing.

    Science.gov (United States)

    Singh, Ajay K; Sodickson, Aaron; Abujudeh, Hani

    2016-02-01

    The aim of this study is to describe the imaging findings of abdominal and pelvic injuries in victims of the Boston Marathon bombing. A retrospective review of 87 patients following the Boston Marathon bombing was performed to evaluate for abdominal and pelvic injuries on plain radiography or CT scans of the abdomen and pelvis. Imaging exams were evaluated for shrapnel, soft tissue injury, visceral damage, vascular disruption, and fractures. The injuries were classified as primary, secondary, tertiary, and quaternary blast injuries. Eleven of the 87 patients had positive findings in the abdomen or pelvis (M:F = 7:4, average age 34.6 years). There were 22 ball bearings, two nails, one screw, and two irregular metal fragments in the 11 patients with secondary blast (shrapnel) injuries. There was no peritoneal penetration or visceral injury seen in any of the patients. One patient had multiple transverse process fractures, representing tertiary blast injury. All but one patient had superficial penetrating abdominal or pelvic injuries secondary to shrapnel. There were no cases of bowel or solid visceral organ injuries due to the lack of peritoneal violation from the relatively low-powered explosions. Absence of peritoneal penetration by shrapnel indicates no need for laparotomy following low-powered explosions.

  18. The role of eye protection in work-related eye injuries.

    Science.gov (United States)

    Fong, L P; Taouk, Y

    1995-05-01

    A recent survey of general hospitals by the Victorian Injury Surveillance System found that ocular trauma represented 15% of work-related injuries. As circumstances surrounding occupational eye injuries have been poorly documented previously, their associations to occupation, industry and work-safety practices, including safety eyewear use, need to be identified to develop appropriate preventive strategies for high-risk groups. From a prospective cross-sectional survey of all eye injuries treated at the Royal Victorian Eye and Ear Hospital, work-related cases were analysed for demographic, occupational and safety eye-wear information. Hospital-based data were supplemented by information from WorkCover Authorities and Labour Force statistics to derive incidence and cost estimates. There were 9390 eye injuries during the 18-month survey period; 42% (n=3923) of total and 29% (n=52) of penetrating ocular injuries occurred at work. The most frequently injured were metal, automotive and building trades workers grinding and drilling (41% of outpatients) and hammering (53% of penetrating eye injuries). Automotive workers had the highest frequency for penetrating injuries, and most were exposed to hammering and were also the least likely to wear safety eye-wear. Eye injuries are frequent (10% of work-related injuries) and highly preventable by the correct use of safety eye-wear, a cost-effective intervention that may result in cost savings of $59 million for work-type activities in the occupational and domestic settings in Australia each year.

  19. Chest Injuries Associated with Head Injury

    African Journals Online (AJOL)

    Traumatic brain injury (TBI) is a common cause of mortality and severe morbidity. Although there have been significant advances in management, associated severe injuries, in particular chest injuries, remain a major challenge. Extracranial injuries, especially chest injuries increase mortality in patients with TBI in both short.

  20. Ultraviolet and visible light penetration of epidermis

    International Nuclear Information System (INIS)

    Eggset, G.; Kavli, G.; Volden, G.; Krokan, H.

    1984-01-01

    Light penetration in untanned skin and skin tanned with UVB (middlewave ultraviolet light) or PUVA (Psoralen photochemotherapy) was compared. Transmission at different wavelengths was measured through sheets of intact epidermis isolated by a suction blister technique. Thick epidermis was collected from a newly formed palmar friction bulla. For these studies a monochromator was used and the range of wavelengths examined was 280-700 nm. The transmission was considerably lower in tanned skin and the difference was most pronounced in the UV range. In the UVB range (290-320 nm), transmission was 13-43% for untanned epidermis, 8-12% for UVB tanned and slightly lower for PUVA tanned epidermis. At wavelengths below 325 nm only a few per cent of light penetrate through thick palmar epidermis. Both UVB and PUVA induce increased melanin content and thickening of the epidermis. Our results indicate that melanin is the most efficient protection against UVA while thickening of epidermis may be as important as the increased melanin content for the protection of living basal cells against the harmful UVB rays. (Auth)

  1. High-Penetration Photovoltaic Planning Methodologies

    Energy Technology Data Exchange (ETDEWEB)

    Gao, David Wenzhong [Alternative Power Innovations, LLC, Broomfield, CO (United States); Muljadi, Eduard [National Renewable Energy Lab. (NREL), Golden, CO (United States); Tian, Tian [National Renewable Energy Lab. (NREL), Golden, CO (United States); Miller, Mackay [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-02-24

    The main objective of this report is to provide an overview of select U.S. utility methodologies for performing high-penetration photovoltaic (HPPV) system planning and impact studies. This report covers the Federal Energy Regulatory Commission's orders related to photovoltaic (PV) power system interconnection, particularly the interconnection processes for the Large Generation Interconnection Procedures and Small Generation Interconnection Procedures. In addition, it includes U.S. state interconnection standards and procedures. The procedures used by these regulatory bodies consider the impacts of HPPV power plants on the networks. Technical interconnection requirements for HPPV voltage regulation include aspects of power monitoring, grounding, synchronization, connection to the overall distribution system, back-feeds, disconnecting means, abnormal operating conditions, and power quality. This report provides a summary of mitigation strategies to minimize the impact of HPPV. Recommendations and revisions to the standards may take place as the penetration level of renewables on the grid increases and new technologies develop in future years.

  2. Coulomb explosion of large penetrating molecular clusters

    International Nuclear Information System (INIS)

    Wegner, H.E.; Thieberger, P.

    1981-01-01

    The main purpose of these Coulomb explosion measurements is to determine what kind of structure these and other complex molecules may have and also to determine what other special phenomena may come into play as these complex molecules pass through matter. Although the first preliminary measurements involving the Coulomb explosion of these molecules was reported at this workshop last year, the results are briefly summarized before going on to the more recent measurements obtained with a completely new kind of detector system. This new image intensifier detector system, coupled with a microcomputer, has proven to be a valuable tool in the study of the Coulomb explosion of complex molecules that penetrate matter. In the future, with some additional improvements in the system, and much better statistics for most of the molecules studied to date, it is expected that much new information will be gained about the structure of many kinds of complex molecular ions including the special effects that may be encountered when these fast molecular ions penetrate matter

  3. Penetration of magnetic fields into plasmas

    International Nuclear Information System (INIS)

    Bengtson, R.D.

    1976-01-01

    A pulsed plasma experiment was constructed to study the penetration of a fast-rising magnetic pulse into an initially unmagnetized, weakly ionized plasma of density 10 11 to 10 13 cm -3 . Magnetic probe data was analyzed using a magnetohydrodynamic approach to obtain detailed information about the dynamics of the penetration mechanism. In particular it is possible to obtain the local resistivity and thus the collision frequency from this data. These collision frequencies compare favorably with theoretical estimates of turbulent collision frequencies. The data indicates that sufficient energy is absorbed to heat the bulk of the plasma to temeratures in excess of 1 keV. A differential rotation of a collisionless theta-pinch column during implosion has been observed and explained by a model in which the driving mechanism is the off-diagonal element p/sub r theta/ of the pressure tensor. Rotational motion was detected by directional probes and spectroscopic techniques. Experimental data were modeled by a one-dimensional hybrid code which included ionization and charge exchange of protons with neutral H atoms

  4. Mass transfer from penetrations in waste containers

    International Nuclear Information System (INIS)

    Pescatore, C.; Sastre, C.

    1987-01-01

    Recent studies have indicated that localized corrosion of a relatively small area of a waste container may impair the containment function to such an extent that larger releases may be possible than from the bare waste form. This would take place when a large number of holes coexist on the container while their concentration fields do not interact significantly with each other. After performing a steady state analysis of the release from a hole, it is shown that much fewer independent holes can coexist on a container surface than previously estimated. The calculated radionuclide release from multiple independent holes must be changed accordingly. Previous analyses did not proceed to a correct application of the linear superposition principle. This resulted in unacceptable physical conclusions and undue strain on the performance assessment necessary for a container licensing procedure. The paper also analyzes the steady state release from penetrations of finite length and whose concentration fields interact with one another. The predicted release from these penetrations is lower than the previously calculated release from holes of zero thickness. It is concluded here that the steady-state release from multiple holes on a waste container can not exceed the release from the bare waste form and that multiple perforations need not be a serious liability to container performance. 8 refs., 3 figs., 1 tab

  5. An unusual case of a serious blunt injury of the eye

    Directory of Open Access Journals (Sweden)

    Jovanović Miloš

    2009-01-01

    Full Text Available Introduction. Optic nerve avulsion is a serious injury of the eye. The objective of the paper was to present the peculiarity of the eye injury caused by a penetrating orbital wound with foreign body being retained in the orbit. Case report. A 15-year-old boy who sustained injury by chain link is presented. While he was turning the chain round in his hand, the last link broke off, piercing the lower lid, penetrated the left orbital cavity and remained behind the eyeball at the top of orbit. While passing towards the top of the orbit, the foreign body caused a blunt injury of the eyeball and avulsion of the ocular nerve. The accurate localization of the foreign body was verified by X-ray and CT imaging. The foreign body was removed through the entry wound. The eye injury resulted in amaurosis. Conclusion. This injury was one of those that could have been prevented.

  6. Pattern of Ocular Injuries in Owo, Nigeria

    Directory of Open Access Journals (Sweden)

    Charles Oluwole Omolase

    2011-01-01

    Full Text Available Purpose: To determine the pattern of ocular injuries in patients presenting to the eye clinic and the accident and emergency department of Federal Medical Center, Owo, Ondo State, Nigeria. Methods: This prospective study was conducted between January and December 2009. Federal Medical Center, Owo is the only tertiary hospital in Ondo State, Nigeria. The eye center located at this medical center was the only eye care facility in the community at the time of this study. All patients were interviewed with the aid of an interviewer-administered questionnaire and underwent a detailed ocular examination. Results: Of 132 patients included in the study, most (84.1% sustained blunt eye injury while (12.1% had penetrating eye injury. A considerable proportion of patients (37.9% presented within 24 hours of injury. Vegetative materials were the most common (42.4% offending agent, a minority of patients (22% was admitted and none of the patients had used eye protection at the time of injury. Conclusion: In the current series, blunt eye injury was the most common type of ocular trauma. The community should be educated and informed about the importance of preventive measures including protective eye devices during high risk activities. Patients should be encouraged to present early following ocular injury.

  7. Stylet penetration of Cacopsylla pyri; an electrical penetration graph (EPG) study

    NARCIS (Netherlands)

    Civolani, S.; Leis, M.; Grandi, G.; Garzo, E.; Pasqualini, E.; Musacchi, S.; Chicca, M.; Castaldelli, G.; Rossie, M.; Tjallingii, W.F.

    2011-01-01

    Detailed information on plant penetration activities by pear psylla Cacopsylla pyri L. (Hemiptera Psyllidae) is essential to study phytoplasma transmission of “Candidatus Phytoplasma pyri” responsible of pear decline disease (PD) and to trace and evaluate resistant traits in new pear tree selections

  8. Long-rod penetration: the transition zone between rigid and hydrodynamic penetration modes

    Directory of Open Access Journals (Sweden)

    Jian-feng Lou

    2014-06-01

    Full Text Available Long-rod penetration in a wide range of velocity means that the initial impact velocity varies in a range from tens of meters per second to several kilometers per second. The long rods maintain rigid state when the impact velocity is low, the nose of rod deforms and even is blunted when the velocity gets higher, and the nose erodes and fails to lead to the consumption of long projectile when the velocity is very high due to instantaneous high pressure. That is, from low velocity to high velocity, the projectile undergoes rigid rods, deforming non-erosive rods, and erosive rods. Because of the complicated changes of the projectile, no well-established theoretical model and numerical simulation have been used to study the transition zone. Based on the analysis of penetration behavior in the transition zone, a phenomenological model to describe target resistance and a formula to calculate penetration depth in transition zone are proposed, and a method to obtain the boundary velocity of transition zone is determined. A combined theoretical analysis model for three response regions is built by analyzing the characteristics in these regions. The penetration depth predicted by this combined model is in good agreement with experimental result.

  9. Medicaid HMO penetration and its mix: did increased penetration affect physician participation in urban markets?

    Science.gov (United States)

    Adams, E Kathleen; Herring, Bradley

    2008-02-01

    To use changes in Medicaid health maintenance organization (HMO) penetration across markets over time to test for effects on the extent of Medicaid participation among physicians and to test for differences in the effects of increased use of commercial versus Medicaid-dominant plans within the market. The nationally representative Community Tracking Study's Physician Survey for three periods (1996-1997, 1998-1999, and 2000-2001) on 29,866 physicians combined with Centers for Medicare and Medicaid Services (CMS) and InterStudy data. Market-level estimates of Medicaid HMO penetration are used to test for (1) any participation in Medicaid and (2) the degree to which physicians have an "open" (i.e., nonlimited) practice accepting new Medicaid patients. Models account for physician, firm, and local characteristics, Medicaid relative payment levels adjusted for geographic variation in practice costs, and market-level fixed effects. There is a positive effect of increases in commercial Medicaid HMO penetration on the odds of accepting new Medicaid patients among all physicians, and in particular, among office-based physicians. In contrast, there is no effect, positive or negative, from expanding the penetration of Medicaid-dominant HMO plans within the market. Increases in cost-adjusted Medicaid fees, relative to Medicare levels, were associated with increases in the odds of participation and of physicians having an "open" Medicaid practice. Provider characteristics that consistently lower participation among all physicians include being older, board certified, a U.S. graduate and a solo practitioner. The effects of Medicaid HMO penetration on physician participation vary by the type of plan. If states are able to attract and retain commercial plans, participation by office-based physicians is likely to increase in a way that opens existing practices to more new Medicaid patients. Other policy variables that affect participation include the presence of a federally

  10. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ...

  11. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ...

  12. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, ... Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW ...

  13. Dealing with Sports Injuries

    Science.gov (United States)

    ... Videos for Educators Search English Español Dealing With Sports Injuries KidsHealth / For Teens / Dealing With Sports Injuries ... a long way toward preventing injuries. Types of Sports Injuries Common reasons why teens get injured playing ...

  14. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ... Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ...

  15. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult Injuries Spinal Cord Injury 101 David ...

  16. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult Injuries Spinal Cord Injury 101 ...

  17. Traumatic diaphragmatic injuries in infants and children: imaging findings

    International Nuclear Information System (INIS)

    Koplewitz, B.Z.; Manson, D.E.; Babyn, P.S.; Ramos, C.; Ein, S.H.

    2000-01-01

    Objectives. Traumatic diaphragmatic injuries (DI) in infants and children are uncommon and are often associated with multiple severe injuries. Delayed presentation can be life threatening due to organ herniation and strangulation. We present the imaging findings in a relatively large population of children who experienced this rare injury. Methods. Medical records of all patients admitted to our Trauma Service from 1977 to 1998 with DI were retrospectively reviewed recording imaging, clinical and surgical or autopsy findings. Results. Of sixteen patients with DI (7 females, 9 males; age 3 weeks to 15 years), 14 suffered from blunt trauma secondary to high-energy impact, and 2 from penetrating injuries. Unilateral DI occurred equally on each side, with one bilateral injury. Associated injuries, present in 81%, included severe head injuries, visceral, mesenteric and vascular injuries and multiple fractures. Six patients died from multiple organ failure (3), head injury (2), and shock (1). Findings in the initial chest X-ray suggested the diagnosis in 13 (81%) of 16 injuries, and CT demonstrated irregularity and thickening of the diaphragm in 4 out of 7. Conclusions. Plain film findings suggested the diagnosis in most; CT and MR were useful adjuncts. High index of suspicion and awareness of the mechanism of injury can lead to prompt diagnosis, early repair, and decreased morbidity and mortality. (orig.)

  18. Delayed Cerebral Ischemia following to Repair of Penetrating Trauma to External Carotid artery Introduction

    Directory of Open Access Journals (Sweden)

    M. Eskandarlou

    2016-01-01

    Full Text Available Introduction: Penetrating trauma to anterior neck can induce cerebral ischemia due to carotid artery injury. Brain ischemia also can present after surgical carotid repairs. Early diagnosis and suitable treatment modality prevent from permanent neurologic deficit post operatively. Case Report: A 30 years old man with stab wound to zone two left side of neck underwent exploration and penrose insertion. Due to excessive bleeding through drain tube, patient was transferred to Besat Hospital of Hamadan. Surgical repair of external carotid artery successfully was done. Four days later patient developed right hemiparesis suddenly. According to MRI and color Doppler sonography finding of thrombosis of left common and internal carotid artery, reoperation was done. After thrombectomy cerebral ischemia and hemi-paralysis improved. Conclusions: Surgical approach to symptomatic penetrating neck trauma is oblique cervical incision, control of bleeding, repair of internal carotid, repair or ligature of external carotid artery base on some factors and preferential repair of internal jugular vein. Meticulous and fine surgical technique for both vascular repair and protection of adjacent normal vessels for avoiding to blunt trauma or compression with retractors is noticeable. Exact postoperative care as repeated clinical examination with goal of early diagnosis of internal carotid artery thrombosis and rapid diagnostic and treatment planning of this complication are important factors for taking of good result in treatment of penetrating trauma to carotid. Sci J Hamadan Univ Med Sci . 2016; 22 (4 :353-357

  19. Emergency treatment of violent trauma: clinical cases and surgical treatment of penetrating thoracoabdominal, perineal and anorectal trauma.

    Science.gov (United States)

    Zuccon, William; Paternollo, Roberto; Del Re, Luca; Cordovana, Andrea; De Murtas, Giovanni; Gaverini, Giacomo; Baffa, Giulia; Lunghi, Claudio

    2013-01-01

    The authors analyse clinical cases of penetrating thoracic, abdominal, perineal and anorectal injury and describe the traumatic event and type of lesion, the principles of surgical treatment, the complication rate and follow up. In the last 24 months, we analyzed 10 consecutive cases of penetrating thoracic and abdominal wounds [stab wound (n=7), with evisceration (n=4), gunshot wound (n=1)], and penetrating perineal and anorectal wounds (impalement n=4). In addition, we report an unusual case of neck injury from a stab wound. All the patients underwent emergency surgery for the lesions reported. In 7 cases of perforating vulnerant thoracoabdominal trauma from stab wounds there was hemoperitoneum due to bleeding from the abdominal wall (n=3), the omentum (n=1), the vena cava (n=1) and the liver (n=2). Evisceration of the omentum was observed in 4 cases. In 2 cases laparoscopy was performed. In one case laparotomy and thoracoscopy was performed. In a patient with an abdominoperineal gunshot wound, exploration was extraperitoneal. The 4 cases of perineal and anorectal impalement were treated with primary reconstruction, while in one case a laparotomy was needed to suture the rectum and fashion a temporary colostomy. In one case of anorectal injury rehabilitation resulted in a gradual improvement of fecal continence, while in the patient with the colostomy follow up at 2 months was scheduled to plan colostomy closure. Based on the our clinical experience and the literature, in penetrating abdominal trauma laparotomy may be required if patients are hemodynamically unstable (or in hemorrhagic shock), in patients with evisceration and peritonitis, or for exploration of penetrating thoracoabdominal and epigastric lesions. In anterior injuries of the abdominal wall from gunshot or stab wounds, laparotomy is indicated when there is peritoneal violation and significant intraperitoneal damage. In patients with actively bleeding wounds of the abdominal wall muscles minimal

  20. Blunt traumatic pericardial rupture and cardiac herniation with a penetrating twist: two case reports

    Directory of Open Access Journals (Sweden)

    Galloway Robert

    2009-12-01

    Full Text Available Abstract Background Blunt Traumatic Pericardial Rupture (BTPR with resulting cardiac herniation following chest trauma is an unusual and often fatal condition. Although there has been a multitude of case reports of this condition in past literature, the recurring theme is that of a missed injury. Its occurrence in severe blunt trauma is in the order of 0.4%. It is an injury that frequently results in pre/early hospital death and diagnosis at autopsy, probably owing to a combination of diagnostic difficulties, lack of familiarity and associated polytrauma. Of the patients who survive to hospital attendance, the mortality rate is in the order of 57-64%. Methods We present two survivors of BTPR and cardiac herniation, one with a delayed penetrating cardiac injury secondary to rib fractures. With these two cases and literature review, we hope to provide a greater awareness of this injury Conclusion BTPR and cardiac herniation is a complex and often fatal injury that usually presents under the umbrella of polytrauma. Clinicians must maintain a high index of suspicion for BTPR but, even then, the diagnosis is fraught with difficulty. In blunt chest trauma, patients should be considered high risk for BTPR when presenting with: Cardiovascular instability with no obvious cause Prominent or displaced cardiac silhouette and asymmetrical large volume pneumopericardium Potentially, with increasing awareness of the injury and improved use and availability of imaging modalities, the survival rates will improve and cardiac Herniation could even be considered the 5th H of reversible causes of blunt traumatic PEA arrest.

  1. EPIDEMIOLOGY, AETIOLOGY AND PATTERN OF PENETRATING OCULAR TRAUMA IN KOLKATA AND SURROUNDINGS

    Directory of Open Access Journals (Sweden)

    Parthapratim Mandal

    2016-10-01

    Full Text Available BACKGROUND The purpose of the study was to determine the epidemiology, aetiology and pattern of penetrating ocular trauma in Kolkata and surroundings. MATERIALS AND METHODS It was a retrospective study of patients with open globe injuries who underwent surgery from July 2015 to June 2016 at Regional Institute of Ophthalmology, Calcutta Medical College, West Bengal. We examined and classified the injuries based on BETTS (Birmingham eye trauma terminology system. We included 192 eyes from 192 patients. The majority of injuries occurred in young (48% patients were <16 years. 54.17% patients were male and 45.83% were female. Most common mode of trauma was Stone (52, Followed by Iron Rod or Piece (44 and Wood (32. Other causes were Cow’s horn (14, Needle (12 Knife (8, Arrow (6, Sickle (6, Rubber Tube (4, Glass (2, Crackers (4, Metal Instrument (2, Bird Beak (2 and Pencil (2. RESULTS The highest proportion of injuries occurred at home followed by outside. According to BETTS, 61 patients had zone 1, 29 patients - zone 2, 6 patients - Zone 3 injury. Associated features were iris prolapse, hyphaema, anterior capsular rupture, lid tear and impacted foreign body. Mean period of presenting at hospital was 2.72 days. Most common visual acuity at presentation was less than 6/60 to perception of light. CONCLUSION In our study, serious ocular trauma frequently occurred at home followed by outside and the young were particularly at risk. Most common mode of trauma was stone. Most of the injuries were limited to cornea up to limbus. More adequate adult supervision and educational measures are necessary in order to reduce the prevalence of these accidents.

  2. Civil engineering applications of ground penetrating radar

    CERN Document Server

    Pajewski, Lara

    2015-01-01

    This book, based on Transport and Urban Development COST Action TU1208, presents the most advanced applications of ground penetrating radar (GPR) in a civil engineering context, with documentation of instrumentation, methods, and results. It explains clearly how GPR can be employed for the surveying of critical transport infrastructure, such as roads, pavements, bridges, and tunnels, and for the sensing and mapping of underground utilities and voids. Detailed attention is also devoted to use of GPR in the inspection of geological structures and of construction materials and structures, including reinforced concrete, steel reinforcing bars, and pre/post-tensioned stressing ducts. Advanced methods for solution of electromagnetic scattering problems and new data processing techniques are also presented. Readers will come to appreciate that GPR is a safe, advanced, nondestructive, and noninvasive imaging technique that can be effectively used for the inspection of composite structures and the performance of diagn...

  3. Cephalic Tetanus from Penetrating Orbital Wound

    Directory of Open Access Journals (Sweden)

    Eloïse Guyennet

    2009-01-01

    Full Text Available Tetanus is a neurologic disorder caused by tetanospasmin, a protein toxin elaborated by Clostridium tetani. Cephalic tetanus is a localized form of the disease causing trismus and dysfunction of cranial nerves. We report the case of a man who presented with facial trauma, complete ophthalmoplegia, exophthalmos, areactive mydriasis, and periorbital hematoma. An orbital CT revealed air bubbles in the right orbital apex. The patient was given a tetanus toxoid booster and antibiotherapy. After extraction of a wooden foreign body, the patient developed right facial nerve palsy, disorders of swallowing, contralateral III cranial nerve palsy, and trismus. Only one case of cephalic tetanus from penetrating orbital wound has been reported in literature 20 years ago. When a patient presents with an orbital wound with ophthalmoplegia and signs of anaerobic infection, cephalic tetanus should be ruled out.

  4. Penetration enhancer: monoethylether of diethylene glycol

    International Nuclear Information System (INIS)

    Koprda, V.; Kassai, Z.; Bohacik, L.; Bezek, S.; Hadcrafft, J.; Falson-Rieg, F.

    1999-01-01

    The monoethylether of diethylene glycol (Transcutol), an excellent solubilising agent, has been suggested as a penetration enhancer compatible with trans-dermal drug delivery systems. Using the abdominal skin of 5 day old rats and Franz-type diffusion cells the following topics were studied in this contribution: (1) Flux of Transcutol, labelled with [Ethyl- 14 C]-ether, across an intact skin model, (2) Changes in properties of the skin barrier after stripping with adhesive tape, and (3) Changes in flux of Transcutol when mixed with different co-solvents. The flux from pure solvent in donor compartment reached around 50 μg cm -2 hr -1 across the intact skin horny layer, whilst after 12 strips the flux increased about 200 times. In the presence of propylene glycol dipelargonate, the flux over 2 mg cm -2 hr -1 across non stripped skin was achieved. (authors)

  5. Penetrating Stab Wound of the Right Ventricle

    Directory of Open Access Journals (Sweden)

    Onursal Buğra

    2010-04-01

    Full Text Available 18 years old male patient was admitted to our emergency unit with a penetrating stab wound to the right ventricle. A stab wound to the right ventricle was found to be 3 cm in diameter. The bleeding was controlled by insertion of a Foley catheter and inflation of the balloon. The stab wound had transected distal acute marginal side ofthe right coronary artery. A successful repair was performed with the use of a foley catheter and application of the Medtronic Octopus Tissue Stabilization System. The wound was closed with pledgeted mattress sutures. The distal acute marginal side of the right coronary artery was ligated. In this presentation, the surgical intervention method was reported and followed by a discussion of emergency surgical procedures of the heart.

  6. Automatic control of oscillatory penetration apparatus

    Science.gov (United States)

    Lucon, Peter A

    2015-01-06

    A system and method for controlling an oscillatory penetration apparatus. An embodiment is a system and method for controlling a sonic drill having a displacement and an operating range and operating at a phase difference, said sonic drill comprising a push-pull piston and eccentrics, said method comprising: operating the push-pull piston at an initial push-pull force while the eccentrics are operated at a plurality of different operating frequencies within the operating range of the sonic drill and measuring the displacement at each operating frequency; determining an efficient operating frequency for the material being drilled and operating the eccentrics at said efficient operating frequency; determining the phase difference at which the sonic drill is operating; and if the phase difference is not substantially equal to minus ninety degrees, operating the push-pull piston at another push-pull force.

  7. Fluorescent Penetrant INSPECTION—CLEANING Study Update

    Science.gov (United States)

    Eisenmann, D.; Brasche, L.

    2009-03-01

    Fluorescent penetrant inspection (FPI) is widely used in the aviation industry and other industries for surface-breaking crack detection. As with all inspection methods, adherence to the process parameters is critical to the successful detection of defects. There is variety of lubricants and surface coatings used in the aviation industry which must be removed prior to FPI. Before the FPI process begins, components are cleaned using a variety of cleaning methods which are selected based on the alloy and the soil types which must be removed. It is also important that the cleaning process not adversely affect the FPI process. From the first three phases of this project it has been found that a hot water rinse can aid in the detection process when using this nondestructive method.

  8. Market penetration of energy supply technologies

    Science.gov (United States)

    Condap, R. J.

    1980-03-01

    Techniques to incorporate the concepts of profit-induced growth and risk aversion into policy-oriented optimization models of the domestic energy sector are examined. After reviewing the pertinent market penetration literature, simple mathematical programs in which the introduction of new energy technologies is constrained primarily by the reinvestment of profits are formulated. The main results involve the convergence behavior of technology production levels under various assumptions about the form of the energy demand function. Next, profitability growth constraints are embedded in a full-scale model of U.S. energy-economy interactions. A rapidly convergent algorithm is developed to utilize optimal shadow prices in the computation of profitability for individual technologies. Allowance is made for additional policy variables such as government funding and taxation. The result is an optimal deployment schedule for current and future energy technologies which is consistent with the sector's ability to finance capacity expansion.

  9. Convective penetration in a young sun

    Science.gov (United States)

    Pratt, Jane; Baraffe, Isabelle; Goffrey, Tom; MUSIC developers group

    2018-01-01

    To interpret the high-quality data produced from recent space-missions it is necessary to study convection under realistic stellar conditions. We describe the multi-dimensional, time implicit, fully compressible, hydrodynamic, implicit large eddy simulation code MUSIC. We use MUSIC to study convection during an early stage in the evolution of our sun where the convection zone covers approximately half of the solar radius. This model of the young sun possesses a realistic stratification in density, temperature, and luminosity. We approach convection in a stellar context using extreme value theory and derive a new model for convective penetration, targeted for one-dimensional stellar evolution calculations. This model provides a scenario that can explain the observed lithium abundance in the sun and in solar-like stars at a range of ages.

  10. Fingertip Injuries

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Fingertip Injury Email to a friend * required fields ...

  11. Musculoskeletal injuries

    International Nuclear Information System (INIS)

    Gigirey, V

    2012-01-01

    This presentation is about musculoskeletal injuries and the diagnosis of osseous tumors. The use of the radiology, bone scintigraphy, computed tomography and magnetic resonance contribute to detect the localization of the osseous lesions as well as the density (lytic, sclerotic, mixed) and the benign and malignant tumors.

  12. Modeling of Oblique Penetration into Geologic Targets Using Cavity Expansion Penetrator Loading with Target free-Surface Effects

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Joe; Longcope, Donald B.; Tabbara, Mazen R.

    1999-05-03

    A procedure has been developed to represent the loading on a penetrator and its motion during oblique penetration into geologic media. The penetrator is modeled with the explicit dynamics, finite element computer program PRONTO 3D and the coupled pressure on the penetrator is given in a new loading option based on a separate cavity expansion (CE) solution that accounts for the pressure-reduction from a nearby target free surface. The free-surface influ- ence distance is selected in a predictive manner by considering the pressure to expand a spherical cavity in a finite radius sphere of the target material. The CE/PRONTO 3D procedure allows a detailed description of the penetrator for predicting shock environments or structural failure dur- ing the entire penetration event and is sufficiently rapid to be used in design optimization. It has been evaluated by comparing its results with data from two field tests of a full-scale penetrator into frozen soil at an impact angles of 49.6 and 52.5 degrees from the horizontal. The measured penetrator rotations were 24 and 22 degrees, respectively. In the simulation, the rotation was21 degrees and predominately resulted from the pressure reduction of the free surface. Good agree- ment was also found for the penetration depth and axial and lateral acceleration at two locations in the penetrator.

  13. Femoral vessel injury by a nonlethal weapon projectile.

    Science.gov (United States)

    Biagioni, Rodrigo Bruno; Miranda, Gustavo Cunha; Mota de Moraes, Leonardo; Nasser, Felipe; Burihan, Marcelo Calil; Ingrund, José Carlos

    2018-06-01

    Rubber projectiles are used as an alternative to metal bullets owing to their lower morbidity and mortality rate. There are few reports of vascular lesions of extremities caused by rubber projectiles in the literature. The authors report the case of a 37-year-old man who was the victim of a penetrating injury to the left thigh with a rubber projectile. He reported only pain at the site of the injury; pulses were decreased in the affected limb. After arteriography confirmed an injury to the superficial femoral artery, he underwent an arterial and venous femorofemoral bypass using a reversed contralateral saphenous vein.

  14. Forestry applications of ground-penetrating radar

    Energy Technology Data Exchange (ETDEWEB)

    Lorenzo, H.; Perez-Gracia, V.; Novo, A.; Armesto, J.

    2010-07-01

    Ground-penetrating radar (GPR) is a geophysical and close-range remote sensing technique based on the use of radar pulses to obtain cross-section images of underground features. This method is characterized by the transmission of an electromagnetic short length pulse (1-2 ns), presenting a centre frequency ranging from 10 MHz to 2.5 GHz. The principles of GPR operation are based on the ability of low frequency radar waves to penetrate into a non-conductive medium, usually subsoil, but also walls, concrete or wood. Those waves are detected after suffering a reflection in electromagnetic discontinuities of the propagation medium. Therefore, this is a suitable method to study changes in those physical properties, and also to characterize different mediums and the reflective targets providing information about their physical properties. The aim of this work is to describe and demonstrate different applications of GPR in forestry, showing the obtained results together with their interpretation. Firstly, in this paper, it is illustrated how GPR is able to map shallow bedrock, subsoil stratigraphy and also to estimate shallow water table depth. Secondly, different tree trunks as well as dry timber are analyzed, evaluating the different radar data obtained in each particular case, and observing differences in their electromagnetic properties related to the GPR response. Finally, several measurements were taken in order to analyze the use of GPR to detect tree root systems using polarimetric techniques, being possible to detect medium and big size roots, together with groups of small roots. (Author) 39 refs.

  15. Topological properties of the limited penetrable horizontal visibility graph family

    Science.gov (United States)

    Wang, Minggang; Vilela, André L. M.; Du, Ruijin; Zhao, Longfeng; Dong, Gaogao; Tian, Lixin; Stanley, H. Eugene

    2018-05-01

    The limited penetrable horizontal visibility graph algorithm was recently introduced to map time series in complex networks. In this work, we extend this algorithm to create a directed-limited penetrable horizontal visibility graph and an image-limited penetrable horizontal visibility graph. We define two algorithms and provide theoretical results on the topological properties of these graphs associated with different types of real-value series. We perform several numerical simulations to check the accuracy of our theoretical results. Finally, we present an application of the directed-limited penetrable horizontal visibility graph to measure real-value time series irreversibility and an application of the image-limited penetrable horizontal visibility graph that discriminates noise from chaos. We also propose a method to measure the systematic risk using the image-limited penetrable horizontal visibility graph, and the empirical results show the effectiveness of our proposed algorithms.

  16. Crack growth rates in vessel head penetration materials

    International Nuclear Information System (INIS)

    Gomez Briceno, D.; Lapena, J.; Blazquez, F.

    1994-01-01

    The cracks detected in reactor vessel head penetrations in certain European plants have been attributed to Primary Water Stress Corrosion Cracking (PWSCC). The penetrations in question are made from Inconel 600. The susceptibility of this alloy to PWSCC has been widely studied in relation to use of this material for steam generator tubes. When the first reactor vessel head penetration cracks were detected, most of the available data on crack propagation rates were from test specimens made from steam generator tubes and tested under conditions that questioned the validity of these data for assessment of the evolution of cracks in penetrations. For this reason, the scope of the Spanish Research Project on the Inspection and Repair of PWR reactor vessel head penetrations included the acquisition of data on crack propagation rates in Inconel 600, representative of the materials used for vessel head penetrations. (authors). 1 fig., 2 tabs., 6 refs

  17. Primary intraocular lens implantation for penetrating lens trauma in Africa.

    Science.gov (United States)

    Bowman, R J; Yorston, D; Wood, M; Gilbert, C; Foster, A

    1998-09-01

    This study aimed to audit the surgical strategy of primary posterior chamber intraocular lens implantation for cases of recent penetrating trauma involving the lens in an African population. Retrospective, noncomparative case series. Seventy-two cases are reported, including all patients who underwent primary intraocular lens implantation for traumatic cataract extraction performed within 1 month of injury between 1988 and 1996. Demographic characteristics and follow-up attendance rates are analyzed. Surgical technique and the occurrence of intraoperative and postoperative complications are reported. Visual outcomes are reported with detailed analysis for cases of poor visual outcome. Mean age was 14.3 years (standard deviation = 11.1), 57 (79%) were male and 15 (21%) were female (chi-square = 23.66, P capsule had been breached by the trauma in 27 (38%) cases, and 15 of these required anterior vitrectomy. Capsular fixation of the implant was achieved in 49% of patients, the remainder having sulcus fixation. Intraoperative rupture of the posterior capsule occurred in four cases. The only common postoperative complication was acute fibrinous anterior uveitis, which occurred in 29 (40%) patients, and 32% of patients followed up for at least 6 months required secondary posterior capsulotomy. This was more common in younger patients (chi-square = 4.2, P < 0.05). Corrected postoperative visual acuities were available for 51 patients, of which 71% achieved 20/60 or better visual acuity. Patients 6 years of age or younger were less likely to achieve 20/60 (chi-square = 6.61, P = 0.01). This surgical strategy has proved successful, producing good visual results and causing no sight-threatening complications. Primary posterior capsulotomy may be appropriate for younger patients.

  18. Vehicle effects on human stratum corneum absorption and skin penetration.

    Science.gov (United States)

    Zhang, Alissa; Jung, Eui-Chang; Zhu, Hanjiang; Zou, Ying; Hui, Xiaoying; Maibach, Howard

    2017-05-01

    This study evaluated the effects of three vehicles-ethanol (EtOH), isopropyl alcohol (IPA), and isopropyl myristate (IPM)-on stratum corneum (SC) absorption and diffusion of the [ 14 C]-model compounds benzoic acid and butenafine hydrochloride to better understand the transport pathways of chemicals passing through and resident in SC. Following application of topical formulations to human dermatomed skin for 30 min, penetration flux was observed for 24 h post dosing, using an in vitro flow-through skin diffusion system. Skin absorption and penetration was compared to the chemical-SC (intact, delipidized, or SC lipid film) binding levels. A significant vehicle effect was observed for chemical skin penetration and SC absorption. IPA resulted in the greatest levels of intact SC/SC lipid absorption, skin penetration, and total skin absorption/penetration of benzoic acid, followed by IPM and EtOH, respectively. For intact SC absorption and total skin absorption/penetration of butenafine, the vehicle that demonstrated the highest level of sorption/penetration was EtOH, followed by IPA and IPM, respectively. The percent doses of butenafine that were absorbed in SC lipid film and penetrated through skin in 24 h were greatest for IPA, followed by EtOH and IPM, respectively. The vehicle effect was consistent between intact SC absorption and total chemical skin absorption and penetration, as well as SC lipid absorption and chemical penetration through skin, suggesting intercellular transport as a main pathway of skin penetration for model chemicals. These results suggest the potential to predict vehicle effects on skin permeability with simple SC absorption assays. As decontamination was applied 30 min after chemical exposure, significant vehicle effects on chemical SC partitioning and percutaneous penetration also suggest that skin decontamination efficiency is vehicle dependent, and an effective decontamination method should act on chemical solutes in the lipid domain.

  19. Effects of magnetic shear on current penetration in a tokamak

    International Nuclear Information System (INIS)

    Zhang Pengyun; Wang Long

    2001-01-01

    The penetrations of the parallel and perpendicular components of plasma currents are interrelated to each other due to the existence of magnetic shear in a tokamak configuration. Effects of the shear on the penetration of Fourier components of toroidal plasma current are analysed in a cylindrical column model. The current penetration is obviously strengthened by the shear for a bell-bike conductivity profile and low safety factor and low aspect ratio

  20. Microstructural observations on the terminal penetration of long rod projectile

    OpenAIRE

    Krushna Kumbhar; P. Ponguru Senthil; A.K. Gogia

    2017-01-01

    Present study focuses on the terminal penetration of tungsten heavy alloy (WHA) long rod penetrator impacted against armour steel at an impact velocity of 1600 m/s. The residual penetrator and armour steel target recovered after the ballistic test have been characterized using optical microscope, scanning electron microscope (SEM) and electron probe micro analyzer (EPMA). Metallurgical changes in target steel and WHA remnant have been analysed. Large shear stresses and shear localization have...

  1. Penetration Testing dan Analisis Kemanan Web Paud Dikmas

    OpenAIRE

    Giffari, Abizar

    2018-01-01

    Sebuah instansi atau perusahaan tentunya mempunyai data penting yang tersimpan dalam sebuah sistem database yang kuat dan aman untuk menghindari ancaman pencurian data dari pihak luar. Untuk mengukur sejauh mana tingkat keamanan yang dibuat, diperlukan sebuah metode pengetesan yang disebut Penetration Testing. Penetration Testing memungkinkan kita untuk dapat menentukan sejauh mana tingkat keamanan sistem yang di test. Penetration Testing juga memungkinkan kita menyerang sistem layaknya attac...

  2. Quantitative analysis of transcranial and intraparenchymal light penetration in human cadaver brain tissue.

    Science.gov (United States)

    Tedford, Clark E; DeLapp, Scott; Jacques, Steven; Anders, Juanita

    2015-04-01

    Photobiomodulation (PBM) also known as low-level light therapy has been used successfully for the treatment of injury and disease of the nervous system. The use of PBM to treat injury and diseases of the brain requires an in-depth understanding of light propagation through tissues including scalp, skull, meninges, and brain. This study investigated the light penetration gradients in the human cadaver brain using a Transcranial Laser System with a 30 mm diameter beam of 808 nm wavelength light. In addition, the wavelength-dependence of light scatter and absorbance in intraparenchymal brain tissue using 660, 808, and 940 nm wavelengths was investigated. Intact human cadaver heads (n = 8) were obtained for measurement of light propagation through the scalp/skull/meninges and into brain tissue. The cadaver heads were sectioned in either the transverse or mid-sagittal. The sectioned head was mounted into a cranial fixture with an 808 nm wavelength laser system illuminating the head from beneath with either pulsed-wave (PW) or continuous-wave (CW) laser light. A linear array of nine isotropic optical fibers on a 5 mm pitch was inserted into the brain tissue along the optical axis of the beam. Light collected from each fiber was delivered to a multichannel power meter. As the array was lowered into the tissue, the power from each probe was recorded at 5 mm increments until the inner aspect of the dura mater was reached. Intraparenchymal light penetration measurements were made by delivering a series of wavelengths (660, 808, and 940 nm) through a separate optical fiber within the array, which was offset from the array line by 5 mm. Local light penetration was determined and compared across the selected wavelengths. Unfixed cadaver brains provide good anatomical localization and reliable measurements of light scatter and penetration in the CNS tissues. Transcranial application of 808 nm wavelength light penetrated the scalp, skull, meninges, and brain

  3. Building virtual pentesting labs for advanced penetration testing

    CERN Document Server

    Cardwell, Kevin

    2014-01-01

    Written in an easy-to-follow approach using hands-on examples, this book helps you create virtual environments for advanced penetration testing, enabling you to build a multi-layered architecture to include firewalls, IDS/IPS, web application firewalls, and endpoint protection, which is essential in the penetration testing world. If you are a penetration tester, security consultant, security test engineer, or analyst who wants to practice and perfect penetration testing skills by building virtual pen testing labs in varying industry scenarios, this is the book for you. This book is ideal if yo

  4. The market penetration of energy-efficiency programs

    Energy Technology Data Exchange (ETDEWEB)

    Berry, L.

    1990-04-01

    The focus of this report is on one source of resource planning uncertainty: the expected market penetration of DSM (Demand Site Management) programs. Its purpose is to help refine planning assumptions and reduce uncertainty about the market penetration of utility DSM programs by: (1) investigating concepts and definitions of market penetration, (2) reviewing data that characterize patterns of variation (including ranges, averages and maximum levels) in program participation rates, (3) identifying the factors that affect participation, and (4) reviewing the structure and data requirements of models that forecast market penetration. 84 refs., 14 figs., 16 tabs.

  5. Hacking and penetration testing with low power devices

    CERN Document Server

    Polstra, Philip

    2014-01-01

    Hacking and Penetration Testing with Low Power Devices shows you how to perform penetration tests using small, low-powered devices that are easily hidden and may be battery-powered. It shows how to use an army of devices, costing less than you might spend on a laptop, from distances of a mile or more. Hacking and Penetration Testing with Low Power Devices shows how to use devices running a version of The Deck, a full-featured penetration testing and forensics Linux distribution, and can run for days or weeks on batteries due to their low power consumption. Author Philip Polstra shows how to

  6. Characterization of nuclear reactor containment penetrations. Preliminary report

    International Nuclear Information System (INIS)

    Bump, T.R.; Seidensticker, R.W.; Shackelford, M.A.; Gambhir, V.K.; McLennan, G.L.

    1984-06-01

    This report summarizes the survey work conducted by Argonne National Laboratory on the design and details of major penetrations in 22 nuclear power plants. The survey includes all containment types and materials in current use. It also includes details of all types of penetrations (except for electrical penetration assemblies and valves) and the seals and gaskets used in them. The report provides a test matrix for testing major penetrations and for testing seals and gaskets in order to evaluate their leakage potential under severe accident conditions

  7. Prevention of serious impurity penetration into water-steam circuits

    International Nuclear Information System (INIS)

    Burgmann, F.; Bursik, A.; Flunkert, F.; Nieder, R.

    1977-01-01

    In consequence of reports from several power Plants concerning heavy damages due to penetrations of impurities into the water-steam circuit, the VGB Sub-Committee 'Water Chemistry in Thermal Power Plants' has established a working group to check-up how serious impurity penetration can be avoided. The lecture describes possible danger points. Suitable technical arrangements for the avoidance of penetrations, and possibilities for monitoring will be discussed. Penetration of impurities cannot be avoided with absolute reliability, even when the recommended arrangements and usual monitoring are realized. Additional measures for the protection of water steam circuits will be suggested. (orig.) [de

  8. Quasi-relativistic effects in barrier-penetration processes

    International Nuclear Information System (INIS)

    Anchishkin, D.V.

    1991-01-01

    The problem of a particle tunneling through the potential barrier is solved within quasi-relativistic Schroedinger equation. It is shown that the subbarrier relativistic effects give a significant addition to penetration coefficient when some relations between parameters of the barrier and mass of a tunneling particle are satisfied. For instance an account of these effects for penetration of low energy π + -mesons through Coulomb barrier of the 298 U nuclei would give the increasing of penetration coefficient to 30 percent as compared to the nonrelativistic one. Also we give the criteria under which the contribution of the ''under barrier relativism'' to penetration coefficient becomes essential. 3 refs.; 6 figs. (author)

  9. Operating methods to remove the excess of penetrant in surface. Preponderant and characteristic part of water for water washable penetrants

    International Nuclear Information System (INIS)

    Dubosc, P.

    1985-01-01

    Penetrant use for quality control, although very well known (nuclear, space industries, offshore platforms) is often poorly practiced. This is largely due to a lack of understanding by the users the way that the different components of the system (penetrants, solvents, emulsifiers, and developers) function. In this talk, we shall explain a particular characteristic that the manufacturers of reputable penetrant seek to build into their water washable penetrants. It is a viscosity curve which has the function of keeping water in a well defined form. We show why the form of the curve is crucial, which reaction between water and penetrant it corresponds to, and we deduce the practical consequences of bringing into play procedures for removing excess penetrant with or without water [fr

  10. Double ionization chamber survey meter for the separate measurement of penetrating and non-penetrating dose

    International Nuclear Information System (INIS)

    Lucas, A.C.

    1987-01-01

    The full capabilities of an advanced 8-bit microprocessor have been utilized in construction of a wide range, multiplexing survey meter based on dual electrometers and ionization chambers. The ionization chambers are constructed of modular conducting and non-conducting parts in such a way that the angular dependence for measurement of beta radiation is controlled by design. Display functions for the high range instrument include logarithmic or linear analog display, digital display of rate or dose, SI or English units, optionally for either total, penetrating, or non-penetrating dose. The instrument is presently configured to operate in the range 0.1 R/hr to 50,000 R/hr in support of the requirements of Regulatory Guide 19.7

  11. Comparison of isolated and concomitant liver injuries: is hepatic trauma entirely responsible for the outcome?

    Science.gov (United States)

    Yazici, P; Aydin, U; Sozbilen, M

    2010-01-01

    This study was undertaken to examine both isolated and concomitant liver injuries to clarify the role of liver trauma on outcome. This retrospective study was a review of all abdominal trauma patients who presented with liver injuries, with or without concomitant injury at Ege University School of Medicine over a 3-year period. Presentation, injury grade, management, and outcomes were analyzed. Patients with isolated hepatic injury (Group A) were compared with patients who had concomitant hepatic injury (liver and spleen/small bowel) (Group B). Significance was set at 95% confidence intervals. Of 368 patients, 80 (21%) presented with liver injury. Of these, the aetiology was as follows: 53 (66.2%) blunt injury, 19 (23%) penetrating injury, and 8 (10%) gun shot trauma. There were 38 patients in Group A and 42 in Group B. Of these 42 patients, 19 were diagnosed with serious types of injury ; eight thoracic, three open long bone fracture, one intra-cardiac, one intracranial. Six additional patients were observed with injuries to large abdominal vessels. Eleven patients (28.9%) with isolated hepatic injury were managed non-operatively. Mortality, intensive care unit and hospital length of stay, and transfusion requirements were significantly higher in Group B. Only the number of transfused blood units and the grade of liver injury were found to be effective on outcome whereas stepwise regression analysis revealed that injury type (penetrating) and blood transfusion were predictive for mortality. This study highlighted that although isolated liver injury results in good outcome with non-operative management, concomitant injuries to the liver lead to a higher failure and mortality rate. However, liver injury itself is rarely responsible for death.

  12. Penetration, Post-penetration Development, and Reproduction of Meloidogyne incognita on Cucumis melo var. texanus.

    Science.gov (United States)

    Faske, T R

    2013-03-01

    Cucumis melo var. texanus, a wild melon commonly found in the southern United States and two accessions, Burleson Co. and MX 1230, expressed resistance to Meloidogyne incognita in preliminary experiments. To characterize the mechanism of resistance, we evaluated root penetration, post-penetration development, reproduction, and emigration of M. incognita on these two accessions of C. melo var. texanus. Additionally, we evaluated 22 accessions of C. melo var. texanus for their reaction against M. incognita in a greenhouse experiment. Fewer (P ≤ 0.05) J2 penetrated the root system of C. melo var. texanus accessions (Burleson Co. and MX 1230) and C. metuliferus (PI 482452) (resistant control), 7 days after inoculation (DAI) than in C. melo 'Hales Best Jumbo' (susceptible control). A delayed (P ≤ 0.05) rate of nematode development was observed at 7, 14, and 21 DAI that contributed to lower (P ≤ 0.05) egg production on both accessions and C. metuliferus compared with C. melo. Though J2 emigration was observed on all Cucumis genotypes a higher (P ≤ 0.05) rate of J2 emigration was observed from 3 to 6 DAI on accession Burleson Co. and C. metuliferus than on C. melo. The 22 accessions of C. melo var. texanus varied relative to their reaction to M. incognita with eight supporting similar levels of nematode reproduction to that of C. metuliferus. Cucumis melo var. texanus may be a useful source of resistance against root-knot nematode in melon.

  13. Suicide bombers form a new injury profile.

    Science.gov (United States)

    Aharonson-Daniel, Limor; Klein, Yoram; Peleg, Kobi

    2006-12-01

    Recent explosions of suicide bombers introduced new and unique profiles of injury. Explosives frequently included small metal parts, increasing severity of injuries, challenging both physicians and healthcare systems. Timely detonation in crowded and confined spaces further increased explosion effect. Israel National Trauma Registry data on hospitalized terror casualties between October 1, 2000 and December 31, 2004 were analyzed. A total of 1155 patients injured by explosion were studied. Nearly 30% suffered severe to critical injuries (ISS > or = 16); severe injuries (AIS > or = 3) were more prevalent than in other trauma. Triage has changed as metal parts contained in bombs penetrate the human body with great force and may result in tiny entry wounds easily concealed by hair, clothes etc. A total of 36.6% had a computed tomography (CT), 26.8% had ultrasound scanning, and 53.2% had an x-ray in the emergency department. From the emergency department, 28.3% went directly to the operating room, 10.1% to the intensive care unit, and 58.4% directly to the ward. Injuries were mostly internal, open wounds, and burns, with an excess of injuries to nerves and to blood vessels compared with other trauma mechanisms. A high rate of surgical procedures was recorded, including thoracotomies, laparotomies, craniotomies, and vascular surgery. In certain cases, there were simultaneous multiple injuries that required competing forms of treatment, such as burns and blast lung. Bombs containing metal fragments detonated by suicide bombers in crowded locations change patterns and severity of injury in a civil population. Specific injuries will require tailored approaches, an open mind, and close collaboration and cooperation between trauma surgeons to share experience, opinions, and ideas. Findings presented have implications for triage, diagnosis, treatment, hospital organization, and the definition of surge capacity.

  14. Craniomaxillofacial falling bullet injuries and management.

    Science.gov (United States)

    Shuker, Sabri T; Sadda, Raid

    2010-07-01

    The purpose of this study was to bring attention to craniocerebral maxillofacial perforating/penetrating injuries due to AK-47 Kalashnikov falling bullets (FBs); these dangerous injuries to both civilians and soldiers are rare. A review of the literature shows no reports on AK-47 FBs leading to double craniocerebral perforation and settling into the maxillofacial region. The number of victims, the AK-47's availability, the associated morbidity and mortality rates, and the rarity of cases prompted this article. The treatment of injuries to the craniocerebral facial clinical profile due to FBs is challenging, and an understanding of the neurosurgical and maxillofacial management of these low-velocity FB injuries is required. We treated 11 cases due to AK-47 rifle FBs and 1 due to anti-aircraft Dashka 12.7-mm FBs. Craniocerebral facial injuries were treated and lodged bullets removed from different challenging locations in the base of the skull, without increasing morbidity and with avoidance of unnecessary surgical trauma to the affected area by the bullets. The required identification of such injuries can be difficult, and the removal of the lodged bullet to prevent secondary complications and reduce the chance of secondary infection can be graver than in other parts of the body. AK-47 FBs are a major public health concern internationally and require serious attention in terms of protection and management for civilians and soldiers in uniform. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Ground Penetrating Radar Technologies in Ukraine

    Science.gov (United States)

    Pochanin, Gennadiy P.; Masalov, Sergey A.

    2014-05-01

    Transient electromagnetic fields are of great interest in Ukraine. The following topics are studied by research teams, with high-level achievements all over the world: (i) Ultra-Wide Band/Short-pulse radar techniques (IRE and LLC "Transient Technologies", for more information please visit http://applied.ire.kharkov.ua/radar%20systems_their%20components%20and%20relevant%20technologies_e.html and http://viy.ua); (ii) Ground Penetrating Radar (GPR) with stepped frequency sounding signals (IRE); (iii) Continuous-Wave (CW) radar with phase-shift keying signals (IRE); and (iv) Radio-wave interference investigation (Scientific and Technical Centre of The Subsurface Investigation, http://geophysics.ua). GPR applications are mainly in search works, for example GPR is often used to search for treasures. It is also used to identify leaks and diffusion of petroleum in soil, in storage areas, as well as for fault location of pipelines. Furthermore, GPR is used for the localization of underground utilities and for diagnostics of the technical state of hydro dams. Deeper GPR probing was performed to identify landslides in Crimea. Rescue radar with CW signal was designed in IRE to search for living people trapped under the rubble of collapsed buildings. The fourth version of this radar has been recently created, showing higher stability and noise immunity. Radio-wave interference investigation allows studying the soil down to tens of meters. It is possible to identify areas with increased conductivity (moisture) of the soil. LLC "Transient Technologies" is currently working with Shevchenko Kyiv University on a cooperation program in which the construction of a test site is one of the planned tasks. In the framework of this program, a GPR with a 300 MHz antenna was handed to the geological Faculty of the University. Employees of "Transient Technologies" held introductory lectures with a practical demonstration for students majoring in geophysics. The authors participated to GPR

  16. Modeling of Oblique Penetration into Geologic Targets Using Cavity Expansion Penetrator Loading with Target free-Surface Effects

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Joe; Longcope, Donald B.; Tabbara, Mazen R.

    1999-06-01

    A procedure has been developed to represent the loading on a penetrator and its motion during oblique penetration into geologic media. The penetrator is modeled with the explicit dynamics, finite element computer program PRONTO 3D and the coupled pressure on the penetrator is given in a new loading option based on a separate cavity expansion (CE) solution that accounts for the pressure reduction from a nearby target free surface. The free-surface influence distance is selected in a predictive manner by considering the pressure to expand a spherical cavity in a finite radius sphere of the target material. The CE/PRONTO 3D procedure allows a detailed description of the penetrator for predicting shock environments or structural failure during the entire penetra- tion event and is sufficiently rapid to be used in design optimization. It has been evaluated by comparing its results with data from two field tests of a full-scale penetrator into frozen soil at an impact angles of 49.6 and 52.5 degrees from the horizontal. The measured penetrator rotations were 24 and 22 degrees, respectively. In the simulation, the rotation was 21 degrees and predom- inately resulted from the pressure reduction of the free surface. Good agreement was also found for the penetration depth and axial and lateral acceleration at two locations in the penetrator.

  17. Traumatic colon injuries -- factors that influence surgical management.

    Science.gov (United States)

    Jinescu, G; Lica, I; Beuran, M

    2013-01-01

    This study sought to evaluate current trends in surgical management of colon injuries in a level I urban trauma centre, in the light of our increasing confidence in primary repair. Our retrospective study evaluates the results of 116 patients with colon injuries operated at Bucharest Clinical Emergency Hospital, in the light of some of the most commonly cited factors which could influence the surgeon decision-making process towards primary repair or colostomy. Blunt injuries were more common than penetrating injuries (65% vs. 31%). Significant other injuries occurred in 85 (73%) patients. Primary repair was performed in 95 patients (82%). Fecal diversion was used in 21 patients(18%). Multiple factors influence the decision-making process: shock, fecal contamination, associated injuries and higher scores on the Abdominal Trauma Index (ATI) and Colon Injury Scale (CIS). Colon related intra-abdominal complications occurred in 7% of patients in whom the colon injury was closed primarily and in 14% of patients in whom a stoma was created, ATI having a predictive role in their occurrence. The overall mortality rate was 19%. Primary repair of colon injuries, either by primary suture or resection and anastomosis, is a safe method in the management of the majority of colonic injuries. Colostomy is preferred for patients with ATI ≥ 30 and CIS ≥ 4. Surgical judgment remains the final arbiter in decision making. Celsius.

  18. Postmortem ventilation in cases of penetrating gunshot and stab wounds to the chest.

    Science.gov (United States)

    Germerott, Tanja; Preiss, Ulrich S; Ross, Steffen G; Thali, Michael J; Flach, Patricia M

    2013-11-01

    We sought to determine the effect of postmortem ventilation in combination with a suction pump in cases showing penetrating trauma to the chest with haemo- and/or pneumothorax, for better evaluation of the lungs in postmortem computed tomography (PMCT). The study included 6 subjects (1 female, 5 male; age 32-67years) with a penetrating gunshot or stab wound to the chest and consecutive pneumo- and/or haemothorax. The pneumo- and haemothorax were evacuated by a suction pump, and postmortem ventilation was applied using a home care ventilator. PMCT images with and without postmortem ventilation were compared, as well as the autopsy results. In three cases haemo- and pneumothorax was clearly reduced. Postmortem ventilation led to distinct re-expansion of the lungs in two cases, and to re-expansion of single lung lobes in two cases with shotgun injuries. No visible effect was seen in the remaining two cases, because of extensive destruction of lung tissue and blood aspiration. In two cases the injuries sustained in the individual lung lobes were successfully located during postmortem ventilation. The bullet channel was apparent in one case; in another case, injury of the pericardium became visible by generating pneumopericardium. The present method is capable of improving evaluation of the postmortem lung in the presence of single stab or gunshot wounds and if there is no severe destruction of the respiratory system and aspiration. Forensic autopsy should still be considered as the gold standard, although in some cases the present method might be helpful, especially where no autopsy is required. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. The Role of Intraoperative Cerebral Angiography in Transorbital Intracranial Penetrating Trauma: A Case Report and Literature Review.

    Science.gov (United States)

    Riley, Jonathan P; Boucher, Andrew B; Kim, Denise S; Barrow, Daniel L; Reynolds, Matthew R

    2017-01-01

    Transorbital intracranial penetrating trauma with a retained intracranial foreign body is a rare event lacking a widely accepted diagnostic and therapeutic algorithm. Intraoperative catheter angiography (IOA) has been advocated by some authorities to rule out cerebrovascular injury before and/or after removal of the object, but no standard of care currently exists. A 19-year-old man was involved in a construction site accident whereby a framing nail penetrated the left globe, traversed the lateral bony orbit, and terminated in the midtemporal lobe. No hematoma or injury to the middle cerebral arteries (MCAs) was apparent on noncontrast head computed tomography (CT) or CT angiography, respectively. The foreign body was removed in the operating room under direct visualization after a frontotemporal craniotomy without incident. No significant venous or arterial bleeding was encountered. All visualized MCA branches appeared intact. Indocyanine green videoangiography performed immediately after object removal showed adequate filling of the MCA branches. Given these uneventful clinical and radiographic findings, IOA was not performed. Postoperative head CT and CT angiography showed no obvious neurovascular injury. On postoperative day 2, the patient was noted to have an expressive aphasia. Cerebral angiography showed absent antegrade filling of the angular artery with some retrograde perfusion. Magnetic resonance imaging confirmed an ischemic infarction in the midtemporal lobe. The patient's expressive aphasia improved to near baseline during his hospitalization and he made an excellent clinical recovery. In transorbital intracranial penetrating trauma with a retained intracranial object, we advocate microsurgical removal of the object under direct visualization followed immediately by IOA. IOA should be strongly considered even in the setting of minimal intraoperative bleeding and normal findings on videoangiography (a course of action that was not followed in the

  20. Synergistic Effect of Combined Hollow Viscus Injuries on Intra-Abdominal Abscess Formation.

    Science.gov (United States)

    Paulus, Elena M; Croce, Martin A; Shahan, Charles P; Zarzaur, Ben L; Sharpe, John P; Dileepan, Amirtha; Boyd, Brandon S; Fabian, Timothy C

    2015-07-01

    The strong association between penetrating colon injuries and intra-abdominal abscess (IAA) formation is well established and attributed to high colon bacterial counts. Since trauma patients are rarely fasting at injury, stomach and small bowel colony counts are also elevated. We hypothesized that there is a synergistic effect of increased IAA formation with concomitant stomach and/or colon injuries when compared to small bowel injuries alone. Consecutive patients at a level one trauma center with penetrating small bowel (SB), stomach (S), and/or colon (C) injuries from 1996 to 2012 were reviewed. Logistic regression determined associations with IAA, adjusting for age, gender, Injury Severity Score (ISS), admission Glasgow Coma Score, transfusions, and concurrent pancreas or liver injury. A total of 1518 patients (91% male, ISS = 15.9 ± 8.4) were identified: 496 (33%) SB, 231 (15%) S, 288 (19%) C, 40 (3%) S + SB, 69 (5%) S + C, 338 (22%) C + SB, and 56 (4%) S + C + SB. 148 (10%) patients developed IAA: 4 per cent SB, 9 per cent S, 10 per cent C, 5 per cent S + SB, 22 per cent S + C, 13 per cent C + SB, and 25 per cent S + C + SB. Multiple logistic regression demonstrated that ISS, 24 hour blood transfusions, and concomitant pancreatic or liver injuries were associated with IAA. Compared with reference SB, S or S + SB injuries were no more likely to develop IAA. However, S + C, SB + C, and S + C + SB injuries were significantly more likely to have IAA. In conclusion, combined stomach + colon, small bowel + colon, and stomach, colon, + small bowel injuries have a synergistic effect leading to increased IAA formation after penetrating injuries. Heightened clinical suspicion for IAA formation is necessary in these combined hollow viscus injury patients.

  1. Skin Penetration Enhancement by Natural Oils for Dihydroquercetin Delivery.

    Science.gov (United States)

    Čižinauskas, Vytis; Elie, Nicolas; Brunelle, Alain; Briedis, Vitalis

    2017-09-12

    Natural oils are commonly used in topical pharmaceutical formulations as emulsifiers, stabilizers or solubility enhancers. They are presented as safe and inert components, mainly used for formulation purposes. It is confirmed that natural oils can affect the skin penetration of various substances. Fatty acids are mainly responsible for this effect. Current understanding lacks reliable scientific data on penetration of natural oils into the skin and their skin penetration enhancement potential. In the current study, fatty acid content analysis was used to determine the principal fatty acids in soybean, olive, avocado, sea-buckthorn pulp, raspberry seed and coconut oils. Time of flight secondary ion mass spectrometry bioimaging was used to determine the distribution of these fatty acids in human skin ex vivo after application of the oils. Skin penetration enhancement ratios were determined for a perspective antioxidant compound dihydroquercetin. The results demonstrated skin penetration of fatty acids from all oils tested. Only soybean and olive oils significantly increased the skin distribution of dihydroquercetin and can be used as skin penetration enhancers. However, no correlation can be determined between the fatty acids' composition and skin penetration enhancement using currently available methodological approaches. This indicates that potential chemical penetration enhancement should be evaluated during formulation of topically applied products containing natural oils.

  2. Penetration of varnishes into demineralized root dentine in vitro

    NARCIS (Netherlands)

    Arends, J; Duschner, H; Ruben, JL

    1997-01-01

    In this paper the penetration of three different varnishes employed in caries prevention (Duraphat(R), Fluor Protector(R) and Cervitec(R)) into demineralized dentine is quantified using confocal laser scanning microscopy. The results show that the varnish penetration into lesions about 85 mu m in

  3. HMO penetration and the geographic mobility of practicing physicians.

    Science.gov (United States)

    Polsky, D; Kletke, P R; Wozniak, G D; Escarce, J J

    2000-09-01

    In this study, we assessed the influence of changes in health maintenance organization (HMO) penetration on the probability that established patient care physicians relocated their practices or left patient care altogether. For physicians who relocated their practices, we also assessed the impact of HMO penetration on their destination choices. We found that larger increases in HMO penetration decreased the probability that medical/surgical specialists in early career stayed in patient care in the same market, but had no impact on generalists, hospital-based specialists, or mid career medical/surgical specialists. We also found that physicians who relocated their practices were much more likely to choose destination markets with the same level of HMO penetration or lower HMO penetration compared with their origin markets than they were to choose destination markets with higher HMO penetration. The largely negligible impact of changes in HMO penetration on established physicians' decisions to relocate their practices or leave patient care is consistent with high relocation and switching costs. Relocating physicians' attraction to destination markets with the same level of HMO penetration as their origin markets suggests that, while physicians' styles of medical practice may adapt to changes in market conditions, learning new practice styles is costly.

  4. 46 CFR 174.225 - Hull penetrations and shell connections.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Hull penetrations and shell connections. 174.225 Section 174.225 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SUBDIVISION AND STABILITY... § 174.225 Hull penetrations and shell connections. Each overboard discharge and shell connection except...

  5. Two methodologies for physical penetration testing using social engineering

    NARCIS (Netherlands)

    Dimkov, T.; Pieters, Wolter; Hartel, Pieter H.

    2009-01-01

    During a penetration test on the physical security of an organization, if social engineering is used, the penetration tester directly interacts with the employees. These interactions are usually based on deception and if not done properly can upset the employees, violate their privacy or damage

  6. Gastroscopic treatment of gastric band penetrating the gastric wall

    DEFF Research Database (Denmark)

    Jess, Per; Fonnest, G

    1999-01-01

    Gastric wall penetration of a gastric band after operation for morbid obesity is a well known late complication. The treatment is usually reoperation. In this case report we show that a band penetrating the gastric wall can be successfully treated by gastroscopic operation. This technique is more...

  7. A Study on Factors Affecting Airborne LiDAR Penetration

    Directory of Open Access Journals (Sweden)

    Wei-Chen Hsu

    2015-01-01

    Full Text Available This study uses data from different periods, areas and parameters of airborne LiDAR (light detection and ranging surveys to understand the factors that influence airborne LiDAR penetration rate. A discussion is presented on the relationships between these factors and LiDAR penetration rate. The results show that the flight height above ground level (AGL does not have any relationship with the penetration rate. There are some factors that should have larger influence. For example, the laser is affected by a wet ground surface by reducing the number of return echoes. The field of view (FOV has a slightly negative correlation with the penetration rate, which indicates that the laser incidence angle close to zero should achieve the best penetration. The vegetation cover rate also shows a negative correlation with the penetration rate, thus bare ground and reduced vegetation in the aftermath of a typhoon also cause high penetration rate. More return echoes could be extracted from the full-waveform system, thereby effectively improving the penetration rate. This study shows that full-waveform LiDAR is an effective method for increasing the number of surface reflected echoes. This study suggests avoiding LiDAR survey employment directly following precipitation to prevent laser echo reduction.

  8. Replica scale modelling of long rod tank penetrators

    NARCIS (Netherlands)

    Diederen, A.M.; Hoeneveld, J.C.

    2001-01-01

    Experiments and simulations have been conducted using scale size tungsten alloy penetrators at ordnance velocity against an oblique plate array consisting of an inert sandwich and a base armour. The penetrators are made from 2 types of tungsten alloy with different tensile strength. Two scale sizes

  9. The Impact of IPv6 on Penetration Testing

    NARCIS (Netherlands)

    Ottow, Christiaan; van Vliet, Frank; de Boer, Pieter-Tjerk; Pras, Aiko

    In this paper we discuss the impact the use of IPv6 has on remote penetration testing of servers and web applications. Several modifications to the penetration testing process are proposed to accommodate IPv6. Among these modifications are ways of performing fragmentation attacks, host discovery and

  10. Quantitative penetration testing with item response theory (extended version)

    NARCIS (Netherlands)

    Arnold, Florian; Pieters, Wolter; Stoelinga, Mariëlle Ida Antoinette

    2013-01-01

    Existing penetration testing approaches assess the vulnerability of a system by determining whether certain attack paths are possible in practice. Therefore, penetration testing has thus far been used as a qualitative research method. To enable quantitative approaches to security risk management,

  11. An explosive acoustic telemetry system for seabed penetrators

    Energy Technology Data Exchange (ETDEWEB)

    Hauser, G.C.; Hickerson, J.

    1988-04-01

    This report discusses the design and past applications of an explosive acoustic telemetry system (EATS) for gathering and transmitting data from seabed penetrators. The system was first fielded in 1982 and has since been used to measure penetrator performance on three other occasions. Descriptions are given of the mechanical hardware, system electronics, and software.

  12. Impact of adult atopic dermatitis on topical drug penetration

    DEFF Research Database (Denmark)

    Garcia Ortiz, Patricia; Hansen, Steen H; Shah, Vinod P

    2009-01-01

    Appropriate methodologies for the determination of drug penetration in diseased skin have not yet been established. The aim of this study was to determine the cutaneous penetration of a metronidazole cream formulation in atopic dermatitis, employing dermal microdialysis and tape strip sampling...

  13. Penetration of asbestos fibers in respirator filters

    International Nuclear Information System (INIS)

    Cheng, Yung-Sung; Pearson, S.D.; Rohrbacher, K.D.; Yeh, Hsu-Chi.

    1994-01-01

    Currently, the health risks associated with asbestos have restricted its use and created a growing asbestos abatement industry with a need for respirator filters that are effective for worker protection. The main purpose of this project is to determine the influence of fiber size, electrostatic charge, and flow rate on the penetration of asbestos fibers in respirator filter cartridges. The study includes four types of filters each tested at two flow rates: the AO-R57A, a dual cartridge HEPA filter tested at 16 and 42.5 L/min; the MSA-S, a dust and mist filter tested at 16 and 42.5 L/min; the MSA-A power filter tested at 32 and 85 L/min; and the 3M-8710, a low-efficiency disposable face mask filter tested at 32 and 85 L/min. The three types of asbestos fibers used (amosite, crocidolite, and chrysotile) ranged in length from 0.04-0.5 μm and in aspect ratio (ratio of length to diameter) from 3 to 60. The fibers were used in both charged and neutralized forms. The results from amosite fibers are reported here

  14. Investigating hydrocarbon contamination using ground penetrating radar

    International Nuclear Information System (INIS)

    Roest, P.B. van der; Brasser, D.J.S.; Wagebaert, A.P.J.; Stam, P.H.

    1996-01-01

    The increasing costs of remediating contaminated sites has stimulated research for cost reducing techniques in soil investigation and clean-up techniques. Under the traditional approach soil borings and groundwater wells are used to investigate contaminated soil. These are useful tools to determine the amount and characteristics of the contamination, but they are inefficient and costly in providing information on the location and extent of contamination as they only give information on one point. This often leads to uncertainty in estimating clean-up costs or, even worse, to unsuccessful clean-ups. MAP Environmental Research has developed a technology using Ground Penetrating Radar (GPR) in combination with in-house developed software to locate and define the extent of hydrocarbon contamination. With this technology, the quality of site investigation is increased while costs are reduced. Since 1994 MAP has been improving its technology and has applied it to over 100 projects, which all have been checked afterwards by conventional drilling. This paper gives some general characteristics of the method and presents a case study. The emphasis of this paper lies on the practical application of GPR to hydrocarbon contamination detection

  15. Penetrative convection at high Rayleigh numbers

    Science.gov (United States)

    Toppaladoddi, Srikanth; Wettlaufer, John S.

    2018-04-01

    We study penetrative convection of a fluid confined between two horizontal plates, the temperatures of which are such that a temperature of maximum density lies between them. The range of Rayleigh numbers studied is Ra=[0.01 ,4 ]106,108 and the Prandtl numbers are Pr=1 and 11.6. An evolution equation for the growth of the convecting region is obtained through an integral energy balance. We identify a new nondimensional parameter, Λ , which is the ratio of temperature difference between the stable and unstable regions of the flow; larger values of Λ denote increased stability of the upper stable layer. We study the effects of Λ on the flow field using well-resolved lattice Boltzmann simulations and show that the characteristics of the flow depend sensitively upon it. For the range Λ = , we find that for a fixed Ra the Nusselt number, Nu, increases with decreasing Λ . We also investigate the effects of Λ on the vertical variation of convective heat flux and the Brunt-Väisälä frequency. Our results clearly indicate that in the limit Λ →0 the problem reduces to that of the classical Rayleigh-Bénard convection.

  16. Spontaneous wound dehiscence after penetrating keratoplasty

    Directory of Open Access Journals (Sweden)

    Alireza Foroutan

    2014-10-01

    Full Text Available Spontaneous wound separation may be developed even months after suture removal especially in the context of long-term corticosteroid therapy. A 68-year-old Caucasian woman presented to our cornea clinic with spontaneous wound dehiscence after her third penetrating keratoplasty (PKP which was performed three years ago. An Ahmed glaucoma valve (New World Medical, Ranchos Cucamonga, CA was inserted ten months after the third PKP, which successfully controlled intraocular pressure (IOP. At the examination, the last sutures were removed eight months ago and she was using flourometholone 0.1 % (Sina Darou, Tehran, Iran with a dose of once a day. There was one quadrant of wound dehiscence from 8 to 11 o`clock associated with anterior wound gape and severe corneal edema. Resuturing was performed for the patient. At the one month examination, the corneal edema was resolved and best corrected visual acuity was 20/200 mainly due to previous glaucomatous optic neuropathy. Caution about the prolonged use of corticosteroids is necessary. Topical immunosuppressives could be a promising choice in this field.

  17. Adsorption of polymer chains at penetrable interfaces

    International Nuclear Information System (INIS)

    Gerasimchuk, I. V.; Sommer, J.-U.; Gerasimchuk, V. S.

    2011-01-01

    We investigate the problem of adsorption (localization) of polymer chains in the system of two penetrable interfaces within the mean-field approximation. The saturation of the polymer system in the limit case of zero bulk concentration is studied. We find the exact solution of this mean-field polymer adsorption problem that opens the possibility to treat various localization problems for polymer chains in such environments using appropriate boundary conditions. The exact solution is controlled by a single scaling variable that describes the coupling between the interfaces due to the polymer chains. We obtain a nonmonotonic behavior of the amount of adsorbed polymers as a function of the distance between the interfaces. This leads to a high-energy and a low-energy phase for the double layer with respect to the amount of polymers localized. At the saturation point, we find the total energy of the system and determine the force acting between the interfaces to be strictly attractive and to monotonically decay to zero when the interface distance increases.

  18. Interpretation of the lime column penetration test

    International Nuclear Information System (INIS)

    Liyanapathirana, D S; Kelly, R B

    2010-01-01

    Dry soil mix (DSM) columns are used to reduce the settlement and to improve the stability of embankments constructed on soft clays. During construction the shear strength of the columns needs to be confirmed for compliance with technical assumptions. A specialized blade shaped penetrometer known as the lime column probe, has been developed for testing DSM columns. This test can be carried out as a pull out resistance test (PORT) or a push in resistance test (PIRT). The test is considered to be more representative of average column shear strength than methods that test only a limited area of the column. Both PORT and PIRT tests require empirical correlations of measured resistance to an absolute measure of shear strength, in a similar manner to the cone penetration test. In this paper, finite element method is used to assess the probe factor, N, for the PORT test. Due to the large soil deformations around the probe, an Arbitrary Lagrangian Eulerian (ALE) based finite element formulation has been used. Variation of N with rigidity index and the friction at the probe-soil interface are investigated to establish a range for the probe factor.

  19. Penetration of tritium into the Tropical Pacific

    International Nuclear Information System (INIS)

    Fine, R.A.; Peterson, W.H.; Ostlund, H.G.

    1987-01-01

    The persistence of subsurface tritium maxima coincident with the Equatorial Currents is used to show that advection along isopycnals by the mean wind-driven circulation is the dominant process in the at most 14-year time scale for the penetration of high northern latitude water to the equator (above 26.2 sigma-theta). Ventilation of the equatorial Pacific thermocline from the north contrasts sharply with the equatorial Atlantic thermocline which is ventilated from the south. The most striking manifestation of the North Pacific circulation is evidenced by a tritium maximum and salinity minimum at the equator between 145 0 and 125 0 W located above 25.6 sigma-theta. It shows that regardless of time of sampling the easter/central equator has received the highest latitude water, probably as a consequence of recirculation by the Equatorial Currents. Between the same meridians there is a tritium maximum on and north of the equator at the surface, which is interpreted as an expression of upwelling. Its coincidence with the cool tongue (Wyrtki) provides direct evidence that the upwelling process plays a dominant role in its maintenance on a decadal time scale

  20. "No zone" approach in penetrating neck trauma reduces unnecessary computed tomography angiography and negative explorations.

    Science.gov (United States)

    Ibraheem, Kareem; Khan, Muhammad; Rhee, Peter; Azim, Asad; O'Keeffe, Terence; Tang, Andrew; Kulvatunyou, Narong; Joseph, Bellal

    2018-01-01

    The most recent management guidelines advocate computed tomography angiography (CTA) for any suspected vascular or aero-digestive injuries in all zones and give zone II injuries special consideration. We hypothesized that physical examination can safely guide CTA use in a "no zone" approach. An 8-year retrospective analysis of all adult trauma patients with penetrating neck trauma (PNT) was performed. We included all patients in whom the platysma was violated. Patients were classified into three groups as follows: hard signs, soft signs, and asymptomatic. CTA use, positive CTA (contrast extravasation, dissection, or intimal flap) and operative details were reported. Primary outcomes were positive CTA and therapeutic neck exploration (TNE) (defined by repair of major vascular or aero-digestive injuries). A total of 337 patients with PNT met the inclusion criteria. Eighty-two patients had hard signs and all of them went to the operating room, of which 59 (72%) had TNE. One hundred fifty-six patients had soft signs, of which CTA was performed in 121 (78%), with positive findings in 12 (10%) patients. The remaining 35 (22%) underwent initial neck exploration, of which 14 (40%) were therapeutic yielding a high rate of negative exploration. Ninty-nine patients were asymptomatic, of which CTA was performed in 79 (80%), with positive findings in 3 (4%), however, none of these patients required TNE. On sub analysis based on symptoms, there was no difference in the rate of TNE between the neck zones in patients with hard signs (P = 0.23) or soft signs (P = 0.51). Regardless of the zone of injury, asymptomatic patients did not require a TNE. Physical examination regardless of the zone of injury should be the primary guide to CTA or TNE in patients with PNT. Following traditional zone-based guidelines can result in unnecessary negative explorations in patients with soft signs and may need rethinking. Copyright © 2017 Elsevier Inc. All rights reserved.