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2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Aykut Colakerol ◽  
Mustafa Zafer Temiz ◽  
Mubarek Bargicho Adem ◽  
Kamil Ozdogan ◽  
Fatih Celebi ◽  
...  

Herein, we reported a duodenal perforation case as an intestinal injury during a percutaneous nephrostomy procedure. A 73-year-old woman with bilateral nephrostomy catheters was applied to the emergency service with right flank pain. Early in the day, her bilateral nephrostomy catheters had been changed. On physical examination, she had a defense and rebound at her right quadrant, and costovertebral angle tenderness was also positive. In the contrast-enhanced abdominal computed tomography scan, the right nephrostomy catheter was located in the second part of the duodenum, and the contrast agent did not leak into the peritoneum from the injury area. We decided on conservative management of the case with active surveillance using daily blood tests and physical examinations. The nephrostomy catheter in the duodenum was left to prevent fistula between the duodenum and the skin, and a new one was placed in the right kidney. The broad spectrum antibiotherapy regime was applied, and the patient was followed up closely. The catheter in the duodenum was removed on the 20th day, uneventfully, and the patient was discharged successfully on the 24th day with her permanent bilateral nephrostomy tubes. On the first follow-up, one month later, the patient had no active medical complaint.


2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zhong Di ◽  
Xin Wu ◽  
Wei Xie ◽  
Xianming Lin

Pericyte, as an important component of the blood-brain barrier, has received increasing attention in the study of cerebrovascular diseases. However, the mechanism of pericytes after the occurrence of cerebral ischemia is controversial. On the one hand, the expression of pericytes increases after cerebral ischemia, constricting the blood vessels to restrict blood supply and aggravating the damage caused by ischemia; on the other hand, pericytes participate in capillary angiogenesis in the ischemic area, which facilitates the repair of the ischemic injury area. The multifunctionality of pericytes is an important reason for this phenomenon, but the different time points of observation for the outcome indicators in each study are also an important factor that leads to the controversy of pericytes. Based on the review of a large database of original studies, the authors’ team summarized the effects of pericytes on cerebral microvasculature at different time points after stroke, searched the possible markers, and explored possible therapeutic.


2021 ◽  
Vol 66 (4) ◽  
pp. 556-566
Author(s):  
A. P. Momot ◽  
V. M. Vdovin ◽  
D. A. Orekhov ◽  
I. P. Bobrov ◽  
I. I. Shakhmatov ◽  
...  

Introduction. Earlier studies of low-dose fibrin monomer (FM) demonstrated that low-dose FM has unique hemostatic properties in vivo.Aim — to compare the morphological consequences of intravenous administration of tranexamic acid (TXA) and FM with the hemostatic and hemostasiological effects in hypofibrinogenemia caused by the use of streptokinase after controlled liver injury.Materials and methods. The morphological pattern of fibrin formation in the liver injury area after spontaneous arrest of bleeding in the animals treated with streptokinase or placebo was studied in 73 male rabbits of the Chinchilla breed, split into four groups. In three groups, the study was performed under the conditions of intravenous administration of placebo, TXA, or FM against the background of fibrinolysis activation by streptokinase. Platelet count in the blood, the concentration of fibrinogen, as well as the results of calibrated thrombography, were taken into account.Results. Sequential administration of streptokinase and TXA was accompanied by decreased fibrinogen concentration (by 29.6 %) and, at the same time, a reduction in blood loss (by 15.4 times) in comparison with animals where placebo was used instead of TXA. A decrease in blood loss was associated with increased thickness of thrombotic deposits at the edge of the wound, mainly consisting of red blood cells. These observations were combined with data on the acceleration of thrombin formation in venous blood plasma in a calibrated thrombography test (Peak thrombin 65.4 nmol/L to 109.6 nmol/L in the placebo group). Compared to the observations where placebo was administered instead of FM, however, the sequential use of streptokinase and FM also led to a decrease in blood loss (by 11.0 times) despite decreased fibrinogen concentration (by 23.3 %). A decrease in blood loss was also associated with platelet consumption in venous blood and with increased thickness of thrombotic deposits on the injury surface, where, in addition to red blood cells, the accumulation of fibrin masses was determined by the morphological pattern.Conclusion. The mechanisms of the systemic hemostatic effect of TXA and FM are different, despite the similarity of the achieved hemostatic effects in the conditions of stimulation of blood fibrinolytic activity. These findings expand the understanding of new therapeutic possibilities for reducing post-traumatic blood loss.


2021 ◽  
Vol 102 (5) ◽  
pp. 642-653
Author(s):  
V M Vdovin ◽  
A P Momot ◽  
I I Shakhmatov ◽  
I P Bobrov ◽  
D A Orekhov ◽  
...  

Aim. To identify and compare the morphological, hemostatic and hemostasiological consequences of intravenous administration of tranexamic acid and fibrin monomer in controlled liver injury against drug-induced thrombocytopathy. Methods. The morphological features of fibrin formation in the area of liver injury after spontaneous bleeding arrest combined with the indicators of blood loss in the animals treated with intravenous placebo, tranexamic acid or fibrin monomer was studied in 69 male rabbits. The effects of these drugs were assessed against thrombocytopathy associated with the combined use of acetylsalicylic acid and clopidogrel. Platelet number and function (adnosine diphosphate-induced aggregation), the data of thromboelastometry and calibrated automated thrombogram, fibrinogen concentration and D-dimer level were considered in the blood test. The feature distribution in the samples was assessed using the ShapiroWilk test. Depending on the distribution, Student's t-test, MannWhitney U test or Wilcoxon signed-rank test were used to test for a significant difference between the features. Differences in mortality rate were established by using Fisher's exact test. The differences were considered statistically significant at p 0.05. Results. A model of thrombocytopathy which showed decreased platelet aggregation function (by 4.5 times), increased blood loss (by 40%), and high mortality (53.9%) was reproduced. Only a small accumulation of thrombotic material was noted on the injured surface of such animals. The use of tranexamic acid led to decreased post-traumatic bleeding (2.5 times) and animal mortality (20%). The latter was provided on the wound surface by increasing the thickness of both thrombotic deposits and fibrin strands. When fibrin monomer was used, the phenomenon of an overcompensated decrease in blood loss (by 6.7 times) accompanied by zero mortality was noted despite a pronounced decrease in platelet aggregation. The maximum increase in the thickness of thrombotic material and fibrin strands was morphologically determined in the injury area compared with other animal groups. Conclusion. Morphological features of traumatic hemostatic effect at the injured area when using tranexamic acid and fibrin monomer have a number of differences despite the similarity of the achieved results in minimizing blood loss.


Processes ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1545
Author(s):  
Siyan Chen ◽  
Zhengqing Zhou ◽  
Yong Ma ◽  
Li Zhang ◽  
Tianyi Wang ◽  
...  

Hydrogen fluoride (HF) is a typical dangerous gas in the fluorine chemical industry. Its leakage is one of the most common types of accidents in this industry, and it poses a serious threat to personnel safety and health, environmental sanitation, and social stability. In this paper, the process and consequences of an HF leakage accident in a fluorine chemical plant were simulated by using computational fluid dynamics (CFD) simulation software, and hazardous areas (lethal area, severe injury area, light injury area, and maximum allowable concentration area) of HF diffusion were determined according to the HF concentration corresponding to the degree of personal injury. Moreover, the effects of wind speed and height on hazardous areas were analyzed. The research results of this paper provide model support for similar enterprises to predict the consequences of harmful gas leakage accidents, and give suggestions on emergency evacuation and rescue work, which have practical application significance.


2021 ◽  
Vol 12 ◽  
pp. 146
Author(s):  
Anil K. Roy ◽  
Nefize Turan ◽  
Pasang Wangmo ◽  
Louis Nkrumah ◽  
Stewart G. Neill ◽  
...  

Background: Bipolar electrocautery systems used during neurosurgical procedures have been shown to induce thermal injury to surrounding tissue. The goal of this study was to compare the thermal injury induced by two different systems commonly used in neurosurgical procedures (Silverglide by Stryker Corporation and SpetzlerMalis by Codman Neuro), with that of a newly introduced device (TRIOwand by NICO Corporation). Methods: A farm swine underwent craniectomy and durotomy with subsequent exposure of cortical brain tissue. Electrocoagulation for the duration of 3 s was conducted with three different bipolar systems under comparable power settings. The maximal depth of thermal injury and mean area of injury in Hematoxylin and Eosin stained slides were quantified using Image J. The tissues were evaluated for vacuolization and ischemic damage. One-way ANOVA followed by post hoc Tukey test was utilized for statistical analysis. Alpha level was set at 0.05. Results: TRIOwand lesions showed less depth of injury when compared to both Spetzler-Malis (P < 0.001) and Silverglide lesions (P = 0.048). Silverglide lesions showed significantly less depth of injury when compared to SpetzlerMalis lesions (P < 0.001). The injury area induced by the TRIOwand was significantly less than that of Spetzler-Malis (P < 0.001) and Silverglide systems (P < 0.001). Ischemic changes and vacuolization were seen in all three groups. Conclusion: Thermal damage is induced to varying extents by all bipolar systems. In this porcine model and under the conditions tested, bipolar cauterization with the TRIOwand resulted in less depth and decreased mean area of injury. Further studies are needed to characterize the injury caused by different bipolar systems with other settings and under surgical conditions in humans.


Author(s):  
Laura N. Zamproni ◽  
Mayara T. V. V. Mundim ◽  
Marimelia A. Porcionatto

Graphical AbstractBioscaffolds potential applications in tissue engineering. Bioscaffolds can be used to grow stem cells and target their differentiation in vitro(upper, left) or be used as stem cell delivery route in a brain injury (upper, right). Bioscaffolds can also contain si/miRNAs that will modify locally neural cells gene expression (lower, left) or contain exosomes/growth factors for paracrine signaling such as stimulating neurogenesis and increase neural stem migration to injury area (lower, right). This cover has been designed using resources created by Vitaly Gorbachev from Flaticon.com.


Author(s):  
MARUFZHON KH. KADYROV ◽  
ALEXANDER N. KAZULIN ◽  
MAKSUDZHON M. KADYROV ◽  
ARTUR A. SIDAKOV ◽  
PAVEL V. KHLYSTOV

During the period 2017-2021, 112 patients with fractures of the zygomaticomaxillary and zygomatic-orbito-maxillary complexes were diagnosed and surgically treated. The patients were divided into 2 groups. In the first group, after a comprehensive study of the clinical and radiological picture of the injury area, 86 patients were treated in the traditional way. The essence of the method was to create access through a small puncture-incision along the lower edge of the zygomatic bone and perform the reposition of fragments using the hook of A.A. Limberg. The remaining 26 patients were treated with open reposition and rigid fixation of bone fragments with transconjunctival, intraoral, and sometimes blepharoplastic incisions using titanium microplates and micro-screws. The results of the “traction test” were checked to identify the infringement of the lower oblique muscle of the eyeball. A computed tomography scan revealed a symptom of a “hanging drop” in combination with damage to the bottom of the eye socket. Despite such disadvantages as the need for a longer intervention, high financial costs and additional skills of the operating surgeon, after the treatment of the second group of patients, there was a decrease in postoperative complications and thus an improvement in the results of surgical treatment.


2021 ◽  
Vol 64 (1) ◽  
pp. 13-22
Author(s):  
Zhenfen Dong ◽  
Yuheng Men ◽  
Zhengming Li ◽  
Zhenzhen Liu ◽  
Jianwei Ji

HighlightsChlorophyll fluorescence imaging can be used to evaluate chilling injury.Chilling injury area heterogeneity in the L*a*b* color space is significant.Improved k-means++ clustering has a good segmentation effect on chilling injury.Abstract. The application of fluorescence imaging in the detection of tomato chilling injury was investigated. With the segmentation of the chilling injury area serving as the experimental target, an algorithm based on chlorophyll fluorescence image analysis and improved k-means++ clustering was proposed. First, the extraction of lateral heterogeneity values algorithm was used to analyze the horizontal heterogeneity in five color spaces of the fluorescence images of tomato seedling leaves, and it was found that the chilling injury area was significant in the L*a*b* color space. Second, the fluorescence image was converted from the RGB color space to the L*a*b* color space, and the k-means++ algorithm was used to cluster the two-dimensional data of the a*b* space. Third, insertion sorting was used to reorder the different label regions obtained by the k-means++ clustering algorithm, and the region with the largest value was used as the target region. Finally, the binary image of the target region was filtered using a morphological noise filter, and the cold-damaged area was outputted by the mask operation. The results showed that the cold-damaged area was well segmented when the fluorescence imaging contained yellow cold traces. The mean match rate of the proposed algorithm was 37.08%, 13.52%, and 0.96% higher than that based on the HSV model and watershed algorithm, the fuzzy C-means clustering method, and the k-means clustering method, respectively. Similarly, the mean error rate was 13.69%, 5.56%, and 0.16% lower than that based on the HSV model and watershed algorithm, the fuzzy C-means clustering method, and the k-means clustering method, respectively. These findings provide a foundation for research on early warning of chilling injury by identifying the chilling injury status of tomato leaves using a computer vision method. Keywords: Chlorophyll fluorescence, Fluorescence image, Image segmentation, k-Means++.


2020 ◽  
Author(s):  
Lina Simonyte ◽  
Lina Matukynaite ◽  
Algirdas Dagys ◽  
Lina Jankauskaite

Abstract Background: Paediatric minor traumas/wounds are one of the most common reasons to visit paediatric emergency department (PED). In this study we evaluated how different specialty physicians in PED treat wounds and what methodologies they used before developing a unified wound care SOP.Methods: A prospective Questionnaire based one centre study was conducted in PED of Hospital of Lithuanian University of Health Sciences Kauno Klinikos. All the physicians/fellows working in PED were asked to voluntarily fill anonymous questionnaire after each patient who required wound management.Results: In total, 166 questionnaires were collected and 148 were analysed. Mean age of the patients was 5.91 [3.13-8.13] years. Average laceration length was 1.75 [1.0-2.0] cm. The main injury area was forehead (28.4%), hairy part of the head composed 22.3% of all the wounds. Wounds did not differ in length treated by EM and surgical physicians; GP and paediatricians managed smaller wounds. Most wounds were cleaned with chlorhexidine gluconate or combination with hydrogen peroxide. 33.8% of wounds were sutured. In 12.8% suturing was combined with Steri-Strips™. In 43.2% of the cases no needle methods were used. Suturing was most often chosen by the surgical specialty clinician/fellow (66.7%). 48% of the patients were given anaesthesia (mostly locally). 8.7% of suturing cases received no anaesthesia at all. 4 children were prescribed antibiotics for aftercare. The check-up date for sutures removal was associated with location of the wound. Conclusion: this study revealed differences between various specialty physicians and fellows working in PED with regard to wound management starting with wound cleaning to laceration aftercare and recommendations. Thus, it led to a wound care SOP development seeking unified and evidence-based methodology of wound management and aftercare in PED.


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