Maxillofacial fractures in the elderly: a comparative study

Previous maxillofacial trauma research has dealt primarily with facial bone fractures in the general population. Very few studies have specifically addressed maxillofacial fractures in the elderly. We compared 45 elderly (65 years of age or older) and 201 younger adult (16 to 64 years of age) patients admitted to our hospital with maxillofacial fractures. The percentage of patients admitted with nasal bone fractures was much greater in the elderly population, while mandibular fractures were more common in the adult group. Motor vehicle accidents accounted for over half the injuries in both groups, while falls were more prevalent in the elderly. Management of the elderly patient may be complicated by their associated injuries or underlying medical problems, perhaps partially accounting for their longer median length of hospital stay. The elderly are a unique subpopulation of maxillofacial fracture patients and deserve further study regarding their injuries and optimal methods for treatment.     

口腔颌面部爆炸伤的研究现状

口腔颌面部爆炸伤是指由致伤物爆炸所造成的口腔颌面部组织损伤,两种主要致伤因素是冲击波和高速破片,较一般火器伤而言,爆炸伤的致伤机制及致伤特点都有不同之处。对爆炸伤害的物理机制和病理生理反应方面研究有助于改进防护及改善治疗策略。本文在简述口腔颌面部爆炸伤的致伤因素和损伤特点的基础上,着重综述了动物模型和有限元模型的研究方法及结果,旨在为以后的模型研究提供思路和参考。     

Cortisol response of wild ungulates to trauma situations: hunting is not necessarily the worst stressor

Animal welfare concerns are becoming a central issue in wildlife management and conservation. Thus, we investigated stress response of wild ungulates to potentially traumatic situations (shooting injuries, vehicle collisions, entanglement, injuries or diseases) and hunting methods (stalking, battues and hunts with dogs) by means of serum cortisol concentrations from blood collected from killed animals. Cortisol levels in roe deer ranged below and in wild boar above levels for moose, red deer and fallow deer (hence, pooled as a group “deer”). Apart from species, cortisol concentration in trauma situations was mainly explained by trauma type and presence of disturbance after the trauma event. Effect of trauma type differed significantly for “deer”, with animals caught in fences and suffering vehicle collisions experiencing higher cortisol levels than animals injured by shooting. Differences between hunting methods were observed in the cervids (“deer” and roe deer), with stalking leading to lower cortisol levels than hunts with dogs (both groups) and battues (roe deer). Events both before and after the shot, such as duration of pursuit prior to shooting, location of injury, trauma length and presence of disturbance after the shot were relevant for cortisol levels in hunted cervids. Our results indicate that search teams tracking and euthanising wounded animals should behave in a calm way to minimise disturbance. Still, it is important to acknowledge that many situations described in the literature, i.e. reindeer handling, roe deer captures and red deer yarding, seem even more stressful, beside vehicle collisions, than most hunting methods.     

Common injuries of the athlete's hand.

Hand injuries are among the most frequent accidents seen in sports medicine. All too commonly they are considered trivial since the athlete may continue to participate actively and neglect his injury. The consequent delay in diagnosis and proper treatment may result in long-standing or even permanent disability. This paper describes the more commonly encountered hand injuries, their diagnosis and their optimal treatment. Included are soft-tissue injuries, ligamentous injuries, fractures and tendon avulsions. The basic principles applicable to skeletal and soft-tissue trauma of the hand, which physicians at all levels of sports medicine may encounter, are stressed.     

Current concepts in the immediate management of acute spinal cord injuries.

The management of acute spinal cord injuries has changed considerably during the past 10 years owing to new information about the pathophysiology of cord trauma and new diagnostic and treatment methods. It is now known that the cord suffers not only from the immediate physical effects of trauma, but also from secondary pathologic processes, such as ischemia and edema, which are treatable in the first few hours after injury. New neuroradiologic and neurophysiological techniques, such as the recording of the somatosensory evoked potential, increase the accuracy of diagnosis and prognosis in the acute phase. Current immediate treatment includes the administration of steroids and mannitol, with careful attention to respiratory and cardiovascular homeostasis, to overcome post-traumatic ischemia and edema, and immobilization of the spine with devices such as the halo. New surgical procedures are used in selected cases to improve neurologic recovery, to provide rigid immobilization of the spine or to allow earlier mobilization of the patient. The care of spinal cord injuries in the acute phase is facilitated by multidisciplinary units.     

Seed pretreatment with magnetic field alters the storage proteins and lipid profiles in harvested soybean seeds

The increase in crop productivity is an urgent need of the time to reduce scarcity of food in underdeveloped countries. Several biological, chemical and physical methods have been applied to promote crop yield. Application of magnetic field (MF) is an emerging physical method used to increase plant growth and yield. The reports on MF pretreatment-induced nutritional changes in harvested seeds are scarce. We previously identified the optimal frequency of MF to improve plant growth and yield as 1500 nT at 10.0 Hz. This study was aimed to investigate the effect of MF treatment on storage proteins and fatty acids in harvested soybean seeds. The results showed that MF triggered globulin production and suppressed prolamin production. However, lipid content in seeds increased, because MF exposure caused an elevation of several fatty acids including caprylic acid, palmitic acid, heptadecanoic acid, linoleic acid, lignoceric acid and eicosapentaenoic acid. This is the first report to reveal the seed pretreated MF on nutritional values of harvested seeds. This study suggests that MF treatment improves seed quality by regulating the metabolism of storage proteins and fatty acids.     

Total coliform detection in drinking water: comparison of membrane filtration with Colilert and Coliquik

The Colilert (CL) and Coliquik (CQ) systems were compared in a presence-absence format against the Standard Methods membrane filtration (MF) technique to determine whether differences existed in total coliform detection. Approximately 750 water samples were collected from distribution systems, covered and uncovered storage reservoirs, well sites, and the influent to drinking water treatment plants. Samples were analyzed for total coliforms and heterotrophic bacteria with MF, CL, and CQ. The agreements between CL and MF and between CQ and MF were both greater than 94.8%, which indicates that both may be acceptable methods for total coliform detection. Disagreement between the CL and CQ methods was primarily due to false-negative results. Furthermore, laboratory and field inoculation methods were compared for CL, more than 98% agreement was obtained. This finding indicates that sampling and immediate field inoculation may be an alternative to the traditional laboratory inoculation.     

Which place for stem cell therapy in the treatment of acute radiation syndrome?

Radiation-induced (RI) tissue injuries can be caused by radiation therapy, nuclear accidents or radiological terrorism. Notwithstanding the complexity of RI pathophysiology, there are some effective approaches to treatment of both acute and chronic radiation damages. Cytokine therapy is the main strategy capable of preventing or reducing the acute radiation syndrome (ARS), and hematopoietic growth factors (GF) are particularly effective in mitigating bone marrow (BM) aplasia and stimulating hematopoietic recovery. However, first, as a consequence of RI stem and progenitor cell death, use of cytokines should be restricted to a range of intermediate radiation doses (3 to 7 Gy total body irradiation). Second, ARS is a global illness that requires treatment of damages to other tissues (epithelial, endothelial, glial, etc.), which could be achieved using pleiotropic or tissue-specific cytokines. Stem cell therapy (SCT) is a promising approach developed in the laboratory that could expand the ability to treat severe radiation injuries. Allogeneic hematopoietic stem cell transplantation (BM, mobilized peripheral blood and cord blood) transplantation has been used in radiation casualties with variable success due to limiting toxicity related to the degree of graft histocompatibility and combined injuries. Ex vivo expansion should be used to augment cord blood graft size and/or promote very immature stem cells. Autologous SCT might also be applied to radiation casualties from residual hematopoietic stem and progenitor cells (HSPC). Stem cell plasticity of different tissues such as liver or skeletal muscle, may also be used as a source of hematopoietic stem cells. Finally, other types of stem cells such as mesenchymal, endothelial stem cells or other tissue committed stem cells (TCSC), could be used for treating damages to nonhematopoietic organs.     

Total coliform detection in drinking water: comparison of membrane filtration with Colilert and Coliquik.

The Colilert (CL) and Coliquik (CQ) systems were compared in a presence-absence format against the Standard Methods membrane filtration (MF) technique to determine whether differences existed in total coliform detection. Approximately 750 water samples were collected from distribution systems, covered and uncovered storage reservoirs, well sites, and the influent to drinking water treatment plants. Samples were analyzed for total coliforms and heterotrophic bacteria with MF, CL, and CQ. The agreements between CL and MF and between CQ and MF were both greater than 94.8%, which indicates that both may be acceptable methods for total coliform detection. Disagreement between the CL and CQ methods was primarily due to false-negative results. Furthermore, laboratory and field inoculation methods were compared for CL, more than 98% agreement was obtained. This finding indicates that sampling and immediate field inoculation may be an alternative to the traditional laboratory inoculation.     

Management of the Acute Radiation Syndrome

Classification of radiation injury on a clinical basis is useful for determining priorities of evacuation and treatment in a mass casualty situation. Victims of nuclear attack would probably also suffer traumatic and thermal injuries. Four categories of surgical injury have therefore been combined with three categories of radiation injury to yield 12 classes of patients whose disposition is described. The treatment of the acute radiation syndrome is briefly discussed and concurrent injuries from trauma and burns and their possible implications are considered.     

Inhibition of ovarian development by methyl farnesoate in the tadpole shrimp, Triops longicaudatus

Methyl farnesoate (MF), a putative crustacean hormone, is the immediate precursor of insect juvenile hormone III (JHIII) in the biosynthetic pathway. We examined whether MF, shown to inhibit adult metamorphosis in several crustacean species, is a juvenilizing factor in the tadpole shrimp, Triops longicaudatus. Oocyte production was chosen as a parameter for measuring reproductive development. MF was administered to juveniles by ingestion via biological vector (Artemia nauplii), MF-coated food pellets, and MF liposome food pellets. Artemia were incubated in 30 microl of 5 microg/ml MF. The MF-coated and MF liposome pellets were prepared with MF concentrations ranging between 0.1 microg/g and 10 microg/g MF by weight. Groups of tadpole shrimp were treated with these vectors from the time of hatching for 5 or 10 days in laboratory and field studies. The treatment groups of all the MF vectors showed reductions in oocyte production. Lower concentrations of MF (0.75 microg/g-3.8 microg/g MF) appeared to have a physiological effect on fecundity, but higher concentrations (10 microg/g MF) reduced somatic growth. MF-coated pellets (1 microg/g MF) administered to adults (after 5 days) caused no difference in oocyte production. The observed reductions of fecundity and the disparity of results between MF treatment on juveniles and adults suggest that MF may regulate ovarian development.     

Comparison of nine brands of membrane filter and the most-probable-number methods for total coliform enumeration in sewage-contaminated drinking water.

Nine different brands of membrane filter were compared in the membrane filtration (MF) method, and those with the highest yields were compared against the most-probable-number (MPN) multiple-tube method for total coliform enumeration in simulated sewage-contaminated tap water. The water was chlorinated for 30 min to subject the organisms to stresses similar to those encountered during treatment and distribution of drinking water. Significant differences were observed among membranes in four of the six experiments, with two- to four-times-higher recoveries between the membranes at each extreme of recovery. When results from the membranes with the highest total coliform recovery rate were compared with the MPN results, the MF results were found significantly higher in one experiment and equivalent to the MPN results in the other five experiments. A comparison was made of the species enumerated by these methods; in general the two methods enumerated a similar spectrum of organisms, with some indication that the MF method was subject to greater interference by Aeromonas.     

Pediatric trauma: differences in pathophysiology,injury patterns and treatment compared with adult trauma.

Although multiple trauma remains the leading cause of death among children, fewer resources and less attention have been directed to treatment of the injured child than to treatment of the injured adult. Insufficient training of medical personnel and hence lack of expertise in the management of injured children are factors contributing to disability and death in such children. Although the principles of resuscitation of injured children are similar to those for adults, appreciation of the differences in cardiorespiratory variables, airway anatomy, response to blood loss, thermoregulation and equipment required is essential for successful initial resuscitation. Cerebral, abdominal and thoracic injuries account for most of the disability and death among injured children. Cerebral damage may be due to secondary injuries to the brain and is potentially preventable. The need to preserve the spleen in children complicates the management of abdominal trauma. Although children usually have large cardiorespiratory reserves, they are likely to need airway control and ventilation with thoracic injuries. The psychologic effect of trauma may pose long-term problems and needs close follow-up.     

Massive and recurrent hernias; use of dermal grafts in carrying out repair

Nonpenetrating abdominal injuries are commonly seen in a general hospital. High speed traffic accidents are responsible for the majority of these injuries. The mortality rate is high. Deaths were from associated injuries, failure to recognize abdominal trauma, hemorrhage and from acute renal insufficiency. Careful observation of every severely injured person, vigorous treatment of hemorrhagic shock with whole blood, and prompt surgical intervention when indicated will improve the mortality figures.     

腺苷A2A受体在小鼠颅脑创伤与外周组织损伤模型中的作用差异

本文旨在探索腺苷A2A受体在颅脑创伤、皮肤创伤及放射损伤复合创伤中的作用差异.分别观察和检测野生型小鼠、A2A受体基因敲除小鼠以及给予A2A受体激动剂CGS21680治疗的小鼠在皮肤创伤、放射损伤复合创伤后的伤口愈合时间以及颅脑创伤后的神经功能缺损情况、伤侧皮层脑含水量、脑脊液中谷氨酸浓度.结果表明,CGS21680促进外周组织伤口愈合,却加重颅脑创伤模型的神经功能损害,这与其促进谷氨酸释放有关.相反,A2A受体基因敲除显著延迟小鼠皮肤创伤及放射损伤复合创伤模型的伤口愈合,而在颅脑创伤模型中通过抑制谷氨酸释放产生保护效应.本研究初步证实,A2A受体激活促进谷氨酸大量释放可能是其在中枢损伤与外周损伤产生作用差异的机理之一,这为将来临床应用A2A受体激动剂减轻外周损伤,而用A2A受体拈抗剂减轻颅脑损伤提供了一定的实验依据.     

Raptors rehabilitated in Iowa during 1986 and 1987: a retrospective study

A retrospective study was conducted on 60 raptors representing 13 species treated at the Iowa State University College of Veterinary Medicine during 1986-1987. Eight species (31 individuals) were Falconiformes and five species (29 individuals) were Strigiformes. Seventy-five percent of all injuries were due to trauma and 65% of these were injuries arising from human activity, including car collisions (28%), shooting (17%) and trapping (11%). Thirty-four percent of all raptors admitted were treated and released, 25% were permanently crippled and 41% died during treatment or were euthanized. Data from this study implicate trauma resulting from human activity as a major reason for injury in free-ranging raptors presented for treatment in Iowa.     

Stem-cell transplantation for autoimmune diseases

The use of intensive immunosuppressive treatment coupled with BM stem-cell transplantation (SCT) to treat human autoimmune diseases (AID) follows anecdotal observations of responses of AID to allogeneic SCT and an extensive background of experience with SCT in animals with AID. In the last decade, numerous clinical trials have been initiated to explore a potential benefit of (mainly autologous) SCT in advanced and debilitating cases of rheumatoid arthritis, scleroderma, systemic lupus erythematosis and multiple sclerosis. In this review the etiology of AID and the experimental basis of SCT is presented, together with recent clinical results of SCT for AID. While much has been learned about the risks and benefits of SCT in AID, the underlying mechanisms regulating remission and relapse of AID after treatment remain largely unknown.     

损伤控制外科在严重胸外伤为主的全身多发伤救治中的应用

目的:探讨损伤控制外科(DCS)在严重胸外伤为主的全身多发伤救治中应用的临床效果。方法:2010年1月至2012年6月收治的57例患者采用早期全面治疗(ETC组),2012年7月至2013年12月收治的57例患者采用DCS理论救治(DCS组)。比较两组相关生理指标恢复情况及并发症的发生情况。结果:与ETC组比较,DCS组乳酸清除时间、体温恢复时间、PT和APTT恢复时间、住院时间、ICU治疗时间明显缩短,出血量明显减少(P0.05);DCS组腹腔感染、ARDS、应激性溃疡的发生率及死亡率均较ETC组明显降低(P0.05)。结论:严重胸外伤为主的全身多发伤救治中应用DCS理论可明显改善患者生理指标恢复,减少并发症,提高救治成功率。     

Evaluation of four methods for enumeration of Vibrio parahaemolyticus.

Two membrane filter (MF) and two most-probable-number methods for enumerating Vibrio parahaemolyticus were compared. The MF methods used elevated-temperature incubations (41 and 42 degrees C) and were more specific than the most-probable-number methods (conducted at 35 degrees C). The MF method with a hydrophobic grid and a repair step was most effective.