The Management of Abdominal Injuries in the Presence of Head Injury

When head and blunt abdominal injuries are combined, the head injury is often afforded too much attention and the abdominal injury too little, especially when the patient is unconscious. If mismanaged, the abdominal injury is often the more serious threat to life. Except for extradural hemorrhage, neurosurgical intervention, when indicated, can be delayed until the patient has been thoroughly evaluated for the presence of extra cranial injuries with higher therapeutic priority.Abdominal examination of the unconscious or uncooperative patient is difficult. Tenderness as a sign of abdominal injury cannot be elicited. Abdominal rigidity (in the absence of rigid extremities), a silent abdomen, shock, and extreme restlessness may indicate intra-abdominal changes. Abdominal paracentesis is a valuable diagnostic aid, and the finding of blood, bile-stained fluid, intestinal contents or air is an indication for immediate laparotomy. Once all injuries are known, priorities for treatment can be assigned. Often head and abdominal injuries can be treated concomitantly.     

Configurations resulting from iso-chromatid and iso-subchromatid unions after meiotic and mitotic prophase irradiation

Summary By making use of the chromosomes of Trillium erectum as a model, potential and actual configurations arising from presumed iso-chromatid and iso-subchromatid unions after irradiation of meiotic or mitotic prophase have been studied and analyzed. Diagrams and photographs of various recognizable types of chromatid or subchromatid rearrangements are presented. A minimum of two iso-chromatid unions within an arm of a single chromosome in meiotic prophase, if separated by a single chiasma, can give rise to a monocentric chromosome with a triplicated segment, the middle portion of which is an inversion. A minimum of two iso-subchromatid breaks within an arm at either meiotic or mitotic prophase also can result in the production of a monocentric chromosome containing a triplicated segment. The stage of appearance of dicentrics or bridges arising from chromatid or subchromatid unions in meiotic prophase is influenced by chiasma number and pattern and by the number of strands per chromosome or chromatid. Some of the rearrangements described may have genetic and evolutionary implication of considerable potential importance which has not been recognized previously.Research carried out at Brookhaven National Laboratory under the auspices of the U.S. Atomic Energy Commission.