scholarly journals Spontaneous migration of a falling bullet in the cerebellum reveals the importance of intraoperative skull X-ray

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
Ali Hammed ◽  
Moufid Mahfoud ◽  
Alaa Sulaiman
Keyword(s):  
Gunshot Wounds ◽  
Neurological Status ◽  
Surgical Removal ◽  
X Ray ◽  
Clinical Challenge ◽  
Close Proximity ◽  
Bullet Wound ◽  
Spontaneous Migration ◽  
The Military ◽  
Bullet Injury

Abstract Cranial gunshot wounds (CGSWs) are the most lethal types of the cranial traumas and they are usually mortal. Falling bullets or gravitational bullets are the ones that move under the effect of the gravity force after the muzzle force diminished. CGSWs constitute a major clinical challenge for neurosurgeons dealing with trauma in both the military and civil experience. We report the case of a 21-year-old man with a falling bullet wound to the head. The decision of surgical treatment of a bullet injury is difficult if it is in close proximity to vital structures; removal of the bullet may cause significant neurological damage; however, migration can lead to a worsening of the neurological status of the patient. Before surgical removal of any intracranial bullet, as valuable information, it is recommended that a plain skull X-ray be obtained after final positioning of the head.

Spontaneous Migration of a Bullet in the Spinal Subarachnoid Space Causing Delayed Radicular Symptoms

Neurosurgery ◽  
1986 ◽  
Vol 18 (1) ◽  
pp. 97-100 ◽  
Author(s):  
Najmaldin O. Karim ◽  
Michael W. Nabors ◽  
Mario Golocovsky ◽  
Donald F. Cooney
Keyword(s):  
Gunshot Wounds ◽  
Exploratory Laparotomy ◽  
Low Back ◽  
Lower Quadrant ◽  
X Ray ◽  
Left Lower Extremity ◽  
Spinal Subarachnoid Space ◽  
Spontaneous Migration ◽  
Radicular Symptoms ◽  
Neurologically Intact

Abstract The authors report a case of a gunshot wound to the left lower quadrant of the abdomen in a patient who initially was neurologically intact. The bullet had lodged at the T-11, T-12 level in the spinal canal. After an exploratory laparotomy, the patient developed severe low back pain radiating to his left lower extremity and an incomplete footdrop. Repeat x-ray films and a myelogram showed that the bullet had migrated to the L-4, L-5 level on the left. Bullet emboli and delayed sequelae of gunshot wounds to the spine are discussed.

scholarly journals Surgical removal of a migrating intraspinal bullet: illustrative case

2021 ◽  
Vol 1 (22) ◽  
Author(s):  
Daniel de los Cobos ◽  
Alexa Powers ◽  
Jonathan P. Behrens ◽  
Tobias A. Mattei ◽  
Pooria Salari
Keyword(s):  
Cauda Equina ◽  
Lead Toxicity ◽  
Gunshot Wounds ◽  
Neurological Status ◽  
Neurological Deficits ◽  
Spinal Instability ◽  
Surgical Removal ◽  
Illustrative Case ◽  
Cord Injury ◽  
Patient Reported

BACKGROUND Management of gunshot wounds to the spine with subsequent spinal cord injury is a controversial topic among spine surgeons. Possible complications of retained intradural bullets include delayed neurological deficits, spinal instability, and lead toxicity. The authors’ purpose is to review the potential complications of retained intraspinal bullets and the surgical indications for intraspinal bullet removal. OBSERVATIONS The authors describe a case of a patient who developed cauda equina symptoms following a gunshot wound to the lumbar spine with a migrating retained intraspinal bullet. Because of neurological changes, the patient underwent surgical removal of the bullet. At the postoperative clinic visit 2 weeks following bullet removal, the patient reported resolution of her symptoms. LESSONS Gunshot wounds to the spine are challenging cases. The decision to proceed with surgical management in the event of retained bullet fragments is multifactorial and relies heavily on the patient’s neurological status. A current review of the literature suggests that, in cases of cauda equina injuries and the development of neurological deficits in patients with retained intraspinal fragments, there is benefit from surgical decompression and bullet removal. Careful preoperative planning is required, and consideration of spinal alignment with positional changes is crucial.

scholarly journals Unbinding of Hyaluronan Accelerates the Enzymatic Activity of Bee Hyaluronidase

2011 ◽  
Vol 286 (41) ◽  
pp. 35699-35707 ◽  
Author(s):  
Attila Iliás ◽  
Károly Liliom ◽  
Brigitte Greiderer-Kleinlercher ◽  
Stephan Reitinger ◽  
Günter Lepperdinger
Keyword(s):  
Experimental Data ◽  
Quartz Crystal ◽  
Surface Loop ◽  
X Ray ◽  
Site Model ◽  
Substrate Interaction ◽  
Close Proximity ◽  
Binding Groove ◽  
The One ◽  
Best Fit

Hyaluronan (HA), a polymeric glycosaminoglycan ubiquitously present in higher animals, is hydrolyzed by hyaluronidases (HAases). Here, we used bee HAase as a model enzyme to study the HA-HAase interaction. Located in close proximity to the active center, a bulky surface loop, which appears to obstruct one end of the substrate binding groove, was found to be functionally involved in HA turnover. To better understand kinetic changes in substrate interaction, binding of high molecular weight HA to catalytically inactive HAase was monitored by means of quartz crystal microbalance technology. Replacement of the delimiting loop by a tetrapeptide interconnection increased the affinity for HA up to 100-fold, with a KD below 1 nm being the highest affinity among HA-binding proteins surveyed so far. The experimental data of HA-HAase interaction were further validated showing best fit to the theoretically proposed sequential two-site model. Besides the one, which had been shown previously in course of x-ray structure determination, a previously unrecognized binding site works in conjunction with an unbinding loop that facilitates liberation of hydrolyzed HA.

NEUROBLASTOMA SYMPATHETICUM

PEDIATRICS ◽  
1959 ◽  
Vol 23 (6) ◽  
pp. 1179-1191
Author(s):  
Robert E. Gross ◽  
Sidney Farber ◽  
Lester W. Martin
Keyword(s):  
Surgical Removal ◽  
Total Excision ◽  
Cure Rate ◽  
X Ray ◽  
Progressive Improvement ◽  
Infancy And Childhood ◽  
Bony Metastases ◽  
The Many ◽  
Aggressive Attack ◽  
Cure Rates

The treatment of patients with neuroblastoma does not lie solely in the province of a single specialty; it requires cooperation of pediatrician, surgeon, radiologist and tumor therapist. It is essential that they all be aware of the unique characteristics of this particular tumor if optimum results are to be obtained. The many factors found to influence the prognosis for a child with neuroblastoma are discussed. In those cases wherein there are no demonstrable metastases, the treatment of choice consists of total excision, followed by local x-ray irradiation; this has resulted in a cure rate of 88%. In those cases wherein total excision is not possible, partial surgical removal followed by x-ray irradiation and tumor chemotherapy has given a cure rate of 64%. In those cases where only biopsy has been performed, x-ray irradiation and chemotherapy has still given a salvage, with a cure rate of 38%. When there are metastases to the liver alone, about two-thirds of babies can be cured by x-ray therapy. Whenever bony metastases have appeared in any case, the prognosis is extremely poor, and it is rare for such an individual to survive, regardless of the form of therapy. An aggressive attack on neuroblastoma in infancy and childhood, combining sungeny, x-ray irradiation and tumor chemotherapy, has shown a progressive improvement in results. During the period 1950-1957, cure rates have risen to 36.7% for all patients entering the hospital, regardless of age of the patient on extent of the neoplasm. For babies under a year of age, cures have occurred in 56%, and if there were no demonstrable metastases to bone at the time of hospitalization, the cures have been 70%.

scholarly journals Intraosseous Odontoma

2011 ◽  
Vol 2 (3) ◽  
pp. 277-279
Author(s):  
Shadab Mohammad ◽  
Laxman R Malkunje ◽  
Nimisha Singh
Keyword(s):  
Clinical Manifestations ◽  
Surgical Removal ◽  
Tumor Treatment ◽  
Mandibular Angle ◽  
Impacted Teeth ◽  
X Ray ◽  
Patient Gender ◽  
Large Compound

ABSTRACT Odontomes show no gender predilection, and are most often diagnosed in the second decade of life. They are preferentially located in the upper maxilla, particularly in the anterior sector. Compound odontome are more prevalent than complex odontome, and show no predilection in terms of patient gender, age or location. We hereby report a case of large compound odontome in the mandibular angle region of a 55- year-old woman. Most such lesions are asymptomatic and constitute casual findings in X-ray studies indicated for other reasons. The most common clinical manifestations are absence of impacted teeth and the presence of a tumor. Treatment consists of surgical removal of the lesion. The prognosis is very good, with a scant tendency towards relapse.

Ancient Cultivations at Housesteads, Northumberland

Antiquity ◽  
1931 ◽  
Vol 5 (19) ◽  
pp. 351-354
Author(s):  
W. Percy Hedley
Keyword(s):  
The South ◽  
The West ◽  
South Side ◽  
Close Proximity ◽  
Hadrian's Wall ◽  
The Military ◽  
The Hill ◽  
North And South

The Roman Fort of Borcovicium at Housesteads in Northumberland should need no introduction to anyone interested in archaeology. During the last year it has been brought into great prominence by being presented to the Nation by Mr John Maurice Clayton, and through its close proximity to the portion of Hadrian’s Wall recently threatened by quarrying operations.The fort at Housesteads was one of the earliest to be examined by British antiquaries, but although it has received so much attention its environs have been almost entirely disregarded. On both sides of the Military Way leading out of the west gateway was an extensive civil settlement, and traces of buildings can be seen on the south side of the fort. The hillside sloping to the southward is covered with the remains of early cultivations. These have generally been accepted as of Romano-British age. There are, however, two distinct systems of early cultivation. To the southwest of the fort there is a series of terraces running along the hillside, but on the southeast of the fort there are lynchets running north and south at regular interva up and down the hillside. From the hill to the south of Housesteads it can be clearly seen that where there is terrace cultivation it has been superimposed on the earlier system of lynchets, and this is also shown in air photographs.

scholarly journals Secondary lead poisoning a projectile housed in the human body

2012 ◽  
pp. 230-234 ◽  
Author(s):  
Juan Bernardo Gerstner Garcés
Keyword(s):  
Lead Poisoning ◽  
Human Body ◽  
Management Strategies ◽  
Signs And Symptoms ◽  
Gunshot Wounds ◽  
Neurological Status ◽  
Patient Knowledge ◽  
Unexplained Death ◽  
History Of

With the increase of violence and use of firearms in Colombia, we may see more cases of lead poisoning in our environment, and must be prepared to diagnose and treat them. Subtle signs and symptoms as unexplained anemia, gastro-intestinal discomfort and abdominal cramps, and severe as changes in behavior and neurological status, nephropathy, and unexplained death, may be associated with a history of gunshot wounds and projectiles in the human body, and must offer the patient knowledge and management strategies of pathology.

Investigation of the structure and phase transitions of the polymeric inorganic–organic hybrids: [M(Im)4V2O6]∞; M = Mn, Co, Ni, Im = imidazole

2010 ◽  
Vol 67 (1) ◽  
pp. 41-52 ◽  
Author(s):  
Kittipong Chainok ◽  
Kenneth J. Haller ◽  
A. David Rae ◽  
Anthony C. Willis ◽  
Ian D. Williams
Keyword(s):  
Phase Transition ◽  
Low Temperatures ◽  
Stacking Faults ◽  
Local Geometry ◽  
X Ray Diffraction ◽  
Space Group ◽  
X Ray ◽  
Disordered Phase ◽  
Large Hysteresis ◽  
Close Proximity

The polymeric isomorphous hybrid inorganic–organic vanadium oxide compounds [M(Im)4V2O6]∞, M = Mn, Co, Ni, Im = imidazole, were investigated at various temperatures between 100 and 295 K by single-crystal X-ray diffraction. The crystals all contain two-dimensional polymeric sheets packed perpendicular to c* and are 1:1 disordered in the space group P42/n (Z = 8) at 295 K. The disordered phase is reversibly transformed to an I41/a ordered phase (Z = 32) below 281 K for the Mn compound and below 175 K for the Co compound. Within a localized region of the I41/a phase eight imidazoles are in close proximity and seven of these are hydrogen bonded to framework O atoms. The hydrogen-bond connectivity of six of these ligands is unchanged by the phase transition that allows an inversion of the local geometry using an inversion operator that is a symmetry element of P42/n, but not I41/a. The Mn structure has a well defined phase transition but the Co structure shows a large hysteresis and it was necessary to include stacking faults in the modelling of the Co structure at low temperatures. The Ni structure was shown to be partially twinned, but ordered in the space group P2/n (Z = 8) at 100 K, with two different localized regions each containing four pairs of inversion-related imidazoles, hydrogen bonding to framework O atoms involving eight imidazoles in one region and six imidazoles in the other. Models for the phase transition mechanisms are considered.

Possible effects of land use on the clay mineralogy of a brown forest soil

Clay Minerals ◽  
2002 ◽  
Vol 37 (4) ◽  
pp. 663-670 ◽  
Author(s):  
D. C. Bain ◽  
D. T. Griffen
Keyword(s):  
Land Use ◽  
Clay Mineralogy ◽  
Parent Material ◽  
X Ray Diffraction ◽  
Brown Forest Soil ◽  
X Ray ◽  
Close Proximity ◽  
Diffraction Patterns ◽  
Effects Of Land Use ◽  
Brown Forest Soils

AbstractThree soil profiles classed as brown forest soils on schistose parent material, in close proximity but under different land uses, have been studied. The profile under 50 year-old Sitka spruce trees is the most acidic, the second profile under rough grassland is less acidic, and the third profile in an arable field which has been fertilized is the least acidic. The clay fractions (ς μm) of all three profiles are very similar. However, computer simulations of the X-ray diffraction patterns of clay phases using a modified version of NEWMOD revealed two possible weathering trends: (1) an increasing proportion of vermiculite in interstratified mica-vermiculite in the upper horizons of the arable and forested soils; (2) formation of high-charge corrensite by weathering of chlorite in all three profiles but least pronounced in the arable soil. The differences in clay mineralogy amongst the profiles are minor, but these two different weathering trends may be due to the effects of different land use.

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