Atypical gunshot injury to the neck with an unexpected nonlinear bullet trajectory: a case report and review of the literature

2020 ◽  
Author(s):  
Yuuki Matsui ◽  
Sena Iguchi ◽  
Emiri Sato ◽  
Yoichiro Sato ◽  
Ken Shindo ◽  
...  
Keyword(s):  
Dynamic Properties ◽  
Body Movement ◽  
Neck Region ◽  
Body Awareness ◽  
The Body ◽  
Gunshot Injury ◽  
Retropharyngeal Space ◽  
Related Factors ◽  
Gunshot Injuries ◽  
The Right

Abstract Background Gunshot injuries involving the head and neck region yield profound morbidity and mortality rates because of the region’s dense structure occupied with essential organs. Both projectile- and tissue-related factors determine the disruptive effects of projectiles on living tissues, with the former comprising various physical and dynamic properties of a bullet. Although a bullet generally passes straight through the body, we experienced an unusual case of a gunshot injury to the neck, wherein the bullet penetrated through the deep structures to the contralateral side of the shoulder without damaging any vital organs, allowing us to discuss the diagnostic implications of wound ballistics in managing gunshot wounds with unexpected bullet trajectories. Case presentation A 51-year-old man presented with a gunshot wound to the neck from a point-blank range shooting during a local gang conflict. On admission, a bullet entry hole was observed on the left side of the neck without an exit hole; however, the patient was conscious; vital signs were normal; and no active bleeding, cranial nerve palsy, or aero-digestive tract injury were found. Imaging tests revealed a bullet lying in front of the right humeral head, a comminuted fracture of the right clavicle, and soft tissue edema and small air sacs among the deep neck structures, including the retropharyngeal space. Emergency surgery was performed to extract the bullet, which turned out to be a full metal-jacketed bullet. Five days later, the patient was uneventfully discharged. According to the localization of the damaged tissues and the positional relationship between the bullet’s entrance and its destination, we estimated that the bullet nonlinearly penetrated the neck through the interstructural spaces associated with the least tissue resistance, almost transversely, during its intra-body movement. Conclusion Our experience strongly suggests the importance of realizing the unpredictable nature of a bullet trajectory in a body. Awareness of various ballistic factors and wounding mechanisms, which affect a bullet trajectory and the magnitude of tissue damage, can be of great help in adequate assessment and management of patients with gunshot injuries.

scholarly journals Atypical Gunshot Injury Traversing the Neck with an Unexpected Nonlinear Bullet Trajectory: a Case Report and Review of the Literature

2021 ◽  
Vol 3 (2) ◽  
pp. 765-771
Author(s):  
Yuuki Matsui ◽  
Sena Iguchi ◽  
Emiri Sato ◽  
Yoichiro Sato ◽  
Ken Shindo ◽  
...  
Keyword(s):  
Dynamic Properties ◽  
Vital Signs ◽  
Neck Region ◽  
Contralateral Side ◽  
Gunshot Injury ◽  
Related Factors ◽  
Gunshot Injuries ◽  
Tissue Resistance ◽  
Living Tissues ◽  
The Right

AbstractGunshot injuries involving the head and neck region yield profound morbidity and mortality rates. Projectile-related factors comprising various physical and dynamic properties of a bullet, as well as tissue-related factors, determine the disruptive effects of projectiles on living tissues. We experienced an extremely unusual case of a gunshot injury to the neck, wherein the bullet transversely penetrated across the deep neck structures to the contralateral side of the shoulder without damaging any vital organs. A 51-year-old man presented with a gunshot wound to the neck from a point-blank range. A bullet entry hole was observed on the left side of the neck without an exit hole; however, the patient was conscious, vital signs were normal, and no active bleeding, cranial nerve palsy, or aero-digestive tract injury was found. Imaging tests revealed a bullet lying in front of the right humeral head, which was extracted by emergency surgery. The patient was uneventfully discharged. According to the localization of the damaged tissues and the positional relationship between the bullet’s entrance and its destination, the bullet was estimated to have nonlinearly traversed the neck by traveling through the interstructural spaces associated with the least tissue resistance. Our experience strongly suggests the importance of realizing the unpredictable nature of a bullet trajectory in a body. An appropriate understanding of various ballistic factors and wounding mechanisms can be of great help in the adequate assessment and management of patients with gunshot injuries.

scholarly journals Extremely rare case of retropharyngeal space benign plexiform schwannoma - Excised through Smith- Robinson Approach

2020 ◽  
Vol 11 ◽  
pp. 182
Author(s):  
Rajendra Sakhrekar ◽  
Vishal Peshattiwar ◽  
Ravikant Jadhav ◽  
Bijal Kulkarni ◽  
Sanjiv Badhwar ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Rare Case ◽  
Neck Region ◽  
Retropharyngeal Space ◽  
Case Description ◽  
Head And Neck Region ◽  
Plexiform Schwannoma ◽  
Spine Mr ◽  
The Right ◽  
Slow Growing

Background: Approximately 25–45% of schwannomas are typically slow-growing, encapsulated, and noninvasive tumors that occur in the head-and-neck region where they rarely involve the retropharyngeal space. Here, we report deep-seated benign plexiform schwannoma located in the retropharyngeal C2-C5 region excised utilizing the Smith-Robinson approach. Case Description: A 30-year-old male presented with dysphagia and impaired phonation attributed to an MR documented C2-C5 retropharyngeal schwannomas. On examination, the lesion was soft, deep seated, and extended more toward the right side of the neck. Utilizing a right-sided Smith-Robinson’s approach, it was successfully removed. The histopathology confirmed the diagnosis of a plexiform schwannoma. Conclusion: Retropharyngeal benign plexiform schwannomas are rare causes of dysphagia/impaired phonation in the cervical spine. MR studies best document the size and extent of these tumors which may be readily resected utilizing a Smith-Robinson approach.

scholarly journals Desmoplastic Fibroma and Cemento Ossifying Fibroma of The Anterior Maxilla: A Rare Case Report

2021 ◽  
Vol 24 (1) ◽  
pp. 21-27
Author(s):  
Victor Pakpahan ◽  
Eky Nasuri ◽  
Vera Julia
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Neck Region ◽  
The Body ◽  
Ossifying Fibroma ◽  
Desmoplastic Fibroma ◽  
Anterior Maxilla ◽  
Main Complaint ◽  
Rare Case Report ◽  
The Right

Tumors located in the maxillofacial part of the body were classified by WHO in 2017 and among these are intraosseous form of fibromatosis known as Desmoplastic and Cemento-ossifying fibromas. These tumors usually occur in the head and neck region, especially in the mandible and are relatively rare in the maxilla. Meanwhile, this study aims to discribe a rare case of the cemento ossifying fibroma that had been previously diagnosed as desmoplastic fibroma with a mass tumor in the anterior of the maxilla. A 22 years old female reported to the Cipto Mangkusumo Hospital with the main complaint of a lump in the right side of the upper jaw which appeared 2 years prior to the operation. In April 2017, the patient had a biopsy in Tarakan Hospital and the result was a desmoplastic fibroma. Due to the lump enlargement, the patient was admitted to RSCM in July 2019 and had biopsy incision with a diagnosis of cemento ossifying fibroma which was confirmed by the histopathological examination and histology report. The resection of the right part of maxilla was conducted alongside with reconstruction using the free fibular flap. Moreover, cemento ossifying fibroma and desmoplastic fibroma shared similar features, namely, clinical, histological and radiological features which are important in establishing the diagnosis and treatment of patient. Hence, extensive enucleation or resection is required due to the progressive nature of the tumor to prevent the potential for further recurrences.

scholarly journals Lateral nasal wall haemangioma in a young female: a rare case

2020 ◽  
Vol 6 (11) ◽  
pp. 2139
Author(s):  
Ashfaque Ansari ◽  
Sanjana U. Nair
Keyword(s):  
Nasal Cavity ◽  
Head And Neck ◽  
Neck Region ◽  
Young Female ◽  
The Body ◽  
Lateral Nasal Wall ◽  
Vascular Structures ◽  
Benign Tumours ◽  
The Right ◽  
Mixed Types

<p class="abstract">Hemangiomas are benign tumours originating from vascular structures in the body. Histologically they are divided into capillary, cavernous and mixed types. Although it is very commonly seen in head and neck region, it is very rarely seen in the nasal cavity, nasopharynx and paranasal sinuses and it accounts for only 10% of all head and neck haemangiomas. In this patient the haemangioma was seen arising from the lateral nasal wall, of the right nasal cavity. So far in the literature very few such cases have been reported till date.  </p>

scholarly journals Preliminary study on sleep monitoring system configuration toward an optimal ambient condition setting on the quality of sleep

2021 ◽  
Vol 1 (1) ◽  
pp. 60-72
Author(s):  
Wira Hidayat Mohd Saad
Keyword(s):  
Embedded System ◽  
Monitoring System ◽  
Body Condition ◽  
Body Movement ◽  
Co2 Concentration ◽  
Good Health ◽  
Ambient Condition ◽  
The Body ◽  
Sleep Monitoring ◽  
The Right

Sleep is a form of rest and getting enough sleep at the right times with suitable surrounding conditions is very important to maintain good health throughout life. The study aims to develop the end-user prototyping for a sleep monitoring system that measures the room ambient and body condition by using a wireless device utilizing Bluetooth Low Energy (BLE) embedded system. For the user interface, the Window application is used to display the collected data from separate ambient parameters and body condition embedded systems using Bluno Uno and Bluno Nano respectively. This sleep monitoring system also equipt with a video and audio based recording from the web camera and microphone of the built-in PC based unit. Capturing data from body monitoring and ambient monitoring separate units are then transferred to the Window based application by using the BLE connection and lastly, the captured data are log into the MySQL database with the date and time stamp. The ambient condition system captured the room temperature and humidity, light intensity and rate of CO2 concentration. The body condition system, it is measuring body temperature, heart rate and body movement. Based on the device testing on sleep monitoring, each of the parameters measured is optimized to choose the best possible occurrence of ambience setting selection for optimal sleep quality.

scholarly journals The Effect of Music Therapy in Counseling

2021 ◽  
Author(s):  
Theresia Tri Kinasih Lestari
Keyword(s):  
Music Therapy ◽  
General Public ◽  
Body Movement ◽  
The Body ◽  
Body Movements ◽  
Dance Movements ◽  
The World ◽  
The Right ◽  
A Performance

In general, dance and movement is a performance that is shown in the staging event. Dance is an activitythat uses body movements where muscles throughout the body rub against each other to be able to make abeautiful body movement, and also the need for the right rhythm and beats to make movements in dancedance to be beautiful, but what if motion and dance are used in the world of counseling , through musicalaccompaniment in accordance with dance movements that can make the counselee become more relaxed,both mentally, physically, and mentally. The purpose of writing this paper is to provide newknowledge to the general public about music in counseling sessions.

scholarly journals Study on the Effect of the Ambient Temperature toward the Quality of Sleep

2017 ◽  
Vol 7 (6) ◽  
pp. 2986
Author(s):  
Wira Hidayat bin Mohd Saad ◽  
Khoo Chin Wuen ◽  
Masrullizam bin Mat Ibrahim ◽  
Nor Hashimah Binti Mohd Saad ◽  
Syafeeza Binti Ahmad Radz ◽  
...  
Keyword(s):  
Heart Rate ◽  
Body Temperature ◽  
Ambient Temperature ◽  
Body Condition ◽  
Body Movement ◽  
The Body ◽  
Quality Of Sleep ◽  
Ambient Temperatures ◽  
The Right

Getting enough sleep at the right times can help in improving quality of life and protect mental and physical health. This study proposes a portable sleep monitoring device to determine the relationship between the ambient temperature and quality of sleep. Body condition parameter such as heart rate, body temperature and body movement was used to determine quality of sleep. All readings will be log into database so that users can review back and hence analyze quality of sleep. The functionality of the overall system is designed for a better experience with a very minimal intervention to the user. The simple test on the body condition (body temperature and heart rate) while asleep with several different ambient temperatures are varied and the result shows that someone has a better sleep for the temperature range of 23 to 28 degree Celsius. This can prove by lower body temperature and lower heart rate.

scholarly journals Bullet embolism in a case of homicide: Case report

2013 ◽  
Vol 141 (3-4) ◽  
pp. 242-246
Author(s):  
Vladimir Zivkovic ◽  
Fehim Jukovic ◽  
Slobodan Nikolic
Keyword(s):  
Femoral Artery ◽  
Gunshot Wound ◽  
Imaging Techniques ◽  
Rare Complication ◽  
Gunshot Wounds ◽  
The Body ◽  
Gunshot Injury ◽  
Thoracic Vertebrae ◽  
Injured Part ◽  
The Right

Introduction. Bullet embolism is a special form of embolism, where embolus is either a bullet or its fragment. Bullet penetrates through the injured part of the body into circulation and then travels to a distant part of the body, until it gets blocked in a vessel of the same diameter as the bullet. Case Outline. We are presenting a case of gunshot injury in a 26?year?old male, found unconscious on the passenger seat, with the gunshot injury of the right hand and hemithorax, who died two hours after admission to hospital. Post?mortem X?ray revealed the presence of a metallic foreign body - a bullet, in the level of the left femoral neck. The autopsy revealed entrance and exit gunshot wounds of the upper third of the right upper arm. There was a second entrance gunshot wound, and the bullet passed through the right hemithorax and the right lung, and then through the intervertebral disc between the eighth and ninth thoracic vertebrae, and also making a complete laceration of the wall of the thoracic aorta, in the right posterior semicircumference. The slightly deformed bul? let, caliber 7.65 mm, was found embedded in the lumen of the vessel at the bifurcation of the deep femoral artery from the left femoral artery. Conclusion. Bullet embolism is a rare complication of gunshot wounds. It should be suspected in any gunshot wound victim without an exit wound, or the lack of a missile in the bullet pathway, or if there are premortem signs or symptoms unexpected for the presumed pathway of the bullet, such as distant ischemia or infection. In these cases, some of postmortem imaging techniques should be used to save time in diagnosis, treatment and at autopsy.

scholarly journals Immediate compensation for variations in self-generated Coriolis torques related to body dynamics and carried objects

2013 ◽  
Vol 110 (6) ◽  
pp. 1370-1384 ◽  
Author(s):  
Pascale Pigeon ◽  
Paul DiZio ◽  
James R. Lackner
Keyword(s):  
Dynamic Properties ◽  
Arm Movement ◽  
The Body ◽  
Joint Torque ◽  
Movement Trajectory ◽  
Joint Torques ◽  
Intersegmental Dynamics ◽  
The Right ◽  
Dynamic Dominance ◽  
Interaction Torques

We have previously shown that the Coriolis torques that result when an arm movement is performed during torso rotation do not affect movement trajectory. Our purpose in the present study was to examine whether torso motion-induced Coriolis and other interaction torques are counteracted during a turn and reach (T&R) movement when the effective mass of the hand is augmented, and whether the dominant arm has an advantage in coordinating intersegmental dynamics as predicted by the dynamic dominance hypothesis (Sainburg RL. Exp Brain Res 142: 241–258, 2002). Subjects made slow and fast T&R movements in the dark to just extinguished targets with either arm, while holding or not holding a 454-g object. Movement endpoints were equally accurate at both speeds, with either hand, and in both weight conditions, but subjects tended to angularly undershoot and produce more variable endpoints for targets requiring greater torso rotation. There were no changes in endpoint accuracy or trajectory deviation over repeated movements. The dominant right arm was more stable in its control of trajectory direction across targets, whereas the nondominant left arm had an improved ability to stop accurately on the target for higher levels of interaction torques. The trajectories to more eccentric targets were straighter when performed at higher speeds but slightly more deviated when subjects held the weight. Subjects did not slow their torso velocity or change the timing of the arm and torso velocities when holding the weight, although there was a slight decrease in their hand velocity relative to the torso. The delay between the onsets of torso and finger movements was almost twice as large for the right arm than the left, suggesting the right arm was better able to account for torso rotation in the arm movement. Holding the weight increased the peak Coriolis torque by 40% at the shoulder and 45% at the elbow and, for the most eccentric target, increased the peak net torque by 12% at the shoulder and 34% at the elbow. In accordance with Sainburg's dynamic dominance hypothesis, the right arm exhibited an advantage for coordinating intersegmental dynamics, showing a more stable finger velocity in relation to the torso across targets, decreasing error variability with movement speed, and more synchronized peaks of finger relative and torso angular velocities in conditions with greater joint torque requirements. The arm used had little effect on the movement path and the magnitude of the joint torques in any of the conditions. These results indicate that compensations for forthcoming Coriolis torque variations take into account the dynamic properties of the body and of external objects, as well as the planned velocities of the torso and arm.

scholarly journals Asymmetry of Muscle Mass Distribution and Grip Strength in Professional Handball Players

2021 ◽  
Vol 18 (4) ◽  
pp. 1913
Author(s):  
Marcin Lijewski ◽  
Anna Burdukiewicz ◽  
Jadwiga Pietraszewska ◽  
Justyna Andrzejewska ◽  
Aleksandra Stachoń
Keyword(s):  
Grip Strength ◽  
Muscle Mass ◽  
Body Mass ◽  
Body Movement ◽  
The Body ◽  
Lower Limbs ◽  
Functional Changes ◽  
Morphological Asymmetry ◽  
Risk Of Injury ◽  
The Right

Handball is among the disciplines that impose a significant degree of asymmetry on the body movement. The aim of the study is to assess the influence of physical effort on the occurrence of asymmetry in body musculature and in isometric strength of handball players. The study examined 36 professional handball players. Players’ height and body mass were measured as to calculate their body mass indexes (BMIs). Segmental bioelectrical impedance analysis (SBIA) was used to assess: the percentage of fat mass, total muscle mass (MM), musculature of the right and left side of the body, and body segments (trunk, upper and lower limbs). Moreover, grip strength was also measured. The assessment confirmed the existence of discrepancies in the right and left sides of players’ bodies for the majority of the parameters. Cross-asymmetry and significant bilateral discrepancies in trunk musculature were also observed. Morphological asymmetry may impact performance in sports since it can cause unfavorable functional changes, which in turn increase the risk of injury and conditions caused by overexertion. Therefore, we believe it is important to emphasize the importance of individualized symmetrization during sports practice and consistent monitoring of the asymmetries occurring in different body parts; this should both improve one’s sports results and minimize the risk of injury.

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