Context-Dependent Effects of Inflammation On Retina Regeneration

Inflammation is required for the proliferation of Müller glia (MG) into multipotent progenitors (MGPCs) in the injured fish and avian retinas. However, its function in retina regeneration has not been fully understood. Here we investigated the role of inflammation in three different retinal regeneration paradigms in zebrafish (stab-injury, NMDA-injury and insulin treatment). We first show that different types of immune cells and levels of inflammatory cytokines were found in the retinas of these paradigms. Though zymosan injection alone was insufficient to induce MG proliferation in the uninjured retina, immune suppression significantly inhibited MGPC formation in all three paradigms. Enhancing inflammation promoted MGPC formation after stab-injury, while exhibiting a context-dependent role in the NMDA or insulin models. Furthermore, proper levels of inflammation promoted MG reprogramming and cell cycle re-entry after stab- or NMDA-injury, but excessive inflammation also suppressed MG proliferation in the latter model. Finally, while inflammation promoted retinal neuron regeneration after stab-injury, immune suppression surprisingly achieved the best regeneration in the NMDA model. Our study reveals the complex and context-dependent role of inflammation during retinal repair in fish, and suggests accurate inflammation management may be crucial for successful retina regeneration in mammals.

Tricuspid chordal rupture following stab injury: a case of successful repair

We report a case of a 32-year-old male patient who sustained an isolated stab injury to the left chest wall. He was initially treated with emergency surgery for right ventricular free wall rupture, with an uneventful postoperative course. During follow-up, the patient complained of exercise intolerance and dyspnea on effort. Transthoracic echocardiography (TTE) demonstrated a previously undiagnosed severe tricuspid regurgitation due to flail of the anterior leaflet and a ruptured chorda. A redo operation was scheduled, and the valve was successfully repaired, with different techniques employed. This case highlights the importance of careful clinical evaluation of victims of chest penetrating trauma and how early diagnosis of hidden valvular lesions might increase the odds of valve repair. It also demonstrates the clover technique as a valuable technique in the correction of traumatic tricuspid regurgitation.

Microsurgical Repair of Severed Thoracic Spinal Cord and Clinical Outcome: Technical Case Report

This report describes a case of successful repair of severed thoracic spine in a young man who presented with a penetrating stab injury to spine resulting in Brown-Séquard syndrome. Surgical technique and post-operative management is discussed.A 34-year-old fit and well healthy man was admitted with a history of stab injury to the thoracic spine at thoracic T2/3 level with ASIA impairment score (AIS) score D with an incomplete spinal cord affecting his left lower limb with complete paralysis and right lower limb paresis with impaired sensation below T6 level to L5. Neuroimaging confirmed a penetrating knife injury traversing the T2/3 level causing hemi-section of the spinal cord confirmed intraoperatively. He underwent an urgent exploratory surgery of his spine and a T2/3 laminectomy was performed to aid removal of the knife. The dura was noted to be contused and severed spinal cord was noted to be severed with associated cord oedema. A microsurgical repair of the severed cord was performed with duroplasty followed by intense neuro-rehabilitation. On a three month follow up his AIS score is E with lower limb power is 5/5 bilaterally and he is able to mobilise independently up to 8-10 steps without any supportive aid and with crutches he is independently functional and mobile.This is the first documented case of microsurgical repair of severed thoracic spinal cord secondary to traumatic knife injury. In the management of such scenario, apart from the removal of foreign body, repair of the cord with duroplasty should be carefully considered. The role of spinal neuroplasticity in healing following timely repair of the spinal cord along with intense rehabilitation remains the key. This had resulted in a good clinical and functional outcome with in a 12 month period.

A Dire Emergency Case of Stab Injury with Impending Ischemia of Eviscerated Bowel with Colonic Perforation - A Case Report

Penetrating abdominal trauma is mostly caused by gunshots or stab wounds.1 Management of penetrating abdominal trauma is often challenging and time between the injury and surgical intervention play a pivotal role in such cases depending upon the clinical presentation of the patient.The success rate depends so much on early surgical intervention that one cannot wait for pre-operative work up before taking the patient to operation theatre2. We present a case of stab injury presented with eviscerated ischemic bowel and perforation in transverse colon with mesenteric arterial spurter.

Induction of Oxidative Stress and Apoptosis in the Injured Brain: Potential Relevance to Brain Regeneration in Zebrafish.

In the recent years, zebrafish, owing to its tremendous adult neurogenic capacity, has emerged as a useful vertebrate model to study brain regeneration. Recent findings suggest a significant role of the BDNF/TrkB signaling as a mediator of brain regeneration following a stab injury in the adult zebrafish brain. Since BDNF has been implicated in a plethora of physiological processes, we hypothesized that these processes are affected in the injured zebrafish brain. In this small study, we examined the indicators of oxidative stress and of apoptosis using biochemical assays, RT-PCR and IHC to reflect upon the impact of stab injury on oxidative stress levels and apoptosis in the injured adult zebafish brain. Our results indicate induction of oxidative stress in the injured adult zebrafish brain. Also, apoptosis was induced in the injured brain as indicated by increased protein levels of cleaved caspase3 as well as enhanced mRNA levels of both pro-apoptotic and anti-apoptotic genes. This knowledge contributes to the overall understanding of adult neurogenesis in the zebrafish model and raises new questions pertaining to the compensatory physiological mechanisms in response to traumatic brain injury in the adult zebrafish brain.

Pattern of Abdominal Stab Injury in a Tertiary Hospital in Nigeria

Background: Abdominal stab injury is a type of penetrating abdominal injury. The management may be operative or non-operative. Objectives: To determine the pattern, treatment options and outcome in abdominal stab injuries. Methods: This was a retrospective study carried out over 4 years between January 2014 and December 2017, at the University of Benin Teaching Hospital, Benin City, Nigeria. Patients aged 18 years and above formed the study population. The case files of the patients were retrieved from the medical record. The information obtained included age, gender, injury to arrival time (IAT), type of weapon, the abdominal injury sustained, clinical symptoms and signs, surgical intervention time (SIT), type of surgery carried out, operative findings and complications. Results: Overall, there were 34 patients made up of 30 (88.2%) males and 4 (11.8%) females with a male to female ratio of 7.5:1. The mean age of the patients was 30±8.9 years with the age range of 17-50 years. The mean injury to arrival time (IAT) was 2.0±1.6 hours; surgery intervention time (SIT) was 5.9±5.6 hours. Twenty (58.8%) patients had laparotomy while 14 (41.2%) were successfully managed non-operatively. Post-operative complications included surgical site infection (SSI), entrance wound infection, intra-peritoneal abscess and intestinal obstruction. There was no mortality. Conclusion: Abdominal stab injury was predominant among males and can be managed by the operative method or non-operative method in the absence of significant visceral injury. Selective non-operative management was effective in avoiding unnecessary laparotomy in more than one-third of the cases.

A Case of Pericardial Tamponade Caused by Abdominal Knife Stab Injury

This paper reported a case of pericardial tamponade, caused by the blood from abdominal organ injury, which flowed through the diaphragm and pericardial holes into the pericardium. Liver injury, gastric injury, pancreatic injury, diaphragmatic break were found by the following laparotomy exploration.