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Biomedical subjects

D R Kopaniky

Publications and source records attributed to D R Kopaniky.

9 recordsLinked to original sources
PubMed1990

The results of treatment of gunshot wounds to the brain in children.

Thirty-three children ranging in age from 8 months to 15 years were treated for gunshot wounds to the brain. Half of the children were less than 10 years old. Fifty-eight percent died. Mortality was influenced by the trajectory of the bullet, intent to commit suicide, and the neurological status immediately after injury. The age and sex of the child and the caliber of the bullet did not influence survival. Three-fourths of the deaths occurred within 24 hours of injury, suggesting these patients had a mortal wound from the onset. Eleven of the children were attempting suicide, 9 of whom died; 13 were playing with a gun, 5 of whom died; 2 were shot as innocent bystanders to crimes in progress; 1 was shot while involved in a criminal act; 1 was shot in a hunting accident; and in 2 who died within minutes of arrival, the circumstances of the shooting were not documented. Of the survivors, none was left vegetative after 6 months, 3 had severe disabilities, 9 were moderately disabled, and 2 had a good outcome. The mortality rate is strikingly similar to that of adults with similar injuries; however, the morbidity appears to be less. On the other hand, with simple preventative measures, virtually each injury would have been avoided.

Accidents↗
PubMed1988

Massive posterior epistaxis. A manifestation of internal carotid injury at the skull base.

Severe crushing head injuries can produce massive posterior epistaxis as a result of injury to the internal carotid artery at the skull base. We describe two such cases with traumatic pseudoaneurysm of the internal carotid therapy. They were managed with detachable balloon embolization. The anatomy of the internal carotid artery is reviewed. The diagnosis of pseudoaneurysms and their incidence, clinical presentation, and management are discussed.

Accidents, Traffic↗
PubMed1987

Pseudomonas cervical osteomyelitis in a polytrauma patient.

Cervical osteomyelitis, an uncommon disease, is rarely associated with Pseudomonas organisms in non-drug-users. This report describes a case of cervical vertebral osteomyelitis associated with Pseudomonas aeruginosa pneumonia following panfacial trauma and closed head injury. Delays in diagnosing vertebral osteomyelitis are common because of the nonspecific nature of the history and the initial absence of clinical evidence, both of which may help to foster a generally low index of suspicion.

Adult↗
PubMed1986

A practical classification of acute cervical spine injuries.

This article presents a practical classification of acute cervical spine injuries based on terminology with generally accepted and understood definitions, published results of experimentally produced acute injuries of the cervical spine, and the correlation of the radiographic and pathologic characteristics of the laboratory models with acute clinical injuries.

Acute Disease↗
PubMed1985

General metabolism in patients with acute paraplegia and quadriplegia.

This study measured the nutritional status of eight spine-injured patients during their first 10 to 14 days in the hospital. Initial and follow-up nutritional assessment showed that their nutritional status deteriorated at least partly due to an inadequate supply of protein and calories. Infective complications and prolonged respiratory support were common and may have been caused in part by impaired nutrition. This suggests that a prospective study of aggressive nutritional support for patients with spinal cord transection should be initiated to determine whether this acquired malnutrition and its associated complications can be prevented.

Adolescent↗
PubMed1985

Infection about the spine associated with low-velocity-missile injury to the abdomen.

We reviewed the cases of twenty patients who had a fracture or disruption of the disc space of a lower thoracic or lumbar vertebra that was associated with a low-velocity-missile wound to the abdomen. All of the patients underwent an exploratory laparotomy at the time of admission and all received broad-spectrum antibiotics for a minimum of two days. None of the patients had an immediate laminectomy or an immediate debridement of the paraspinal area. In eight patients the gastrointestinal tract was not perforated, and none of them had evidence of infection. In four patients the stomach and small bowel were perforated by the bullet before it struck the vertebral column, and none of them had meningitis, paraspinal infection, or osteomyelitis. In contrast, meningitis, paraspinal infection, or osteomyelitis did develop in seven of eight patients in whom the bullet perforated the colon before it hit the vertebra. Perforation of the colon by a low-velocity missile before the missile fractured the thoracic or lumbar vertebra was associated with a high incidence of infection. The appropriate management may require early operative intervention. This is in contrast to the non-operative approach that has been advocated for low-velocity gunshot wounds to the spine. We agree that a non-operative approach is indicated for gunshot wounds of the abdomen that do not involve the colon.

Abdominal Injuries↗
PubMed1980

Alternative superficial temporal artery to middle cerebral artery revascularization procedure.

The intact superficial temporal artery was sutured to the cortical arachnoid in a patient in whom no adequate cortical recipient vessel could be found. Subsequent arteriography demonstrated good revascularization of the middle cerebral distribution fed through the superficial temporal artery. The patient was relieved of this symptoms and remained neurologically intact postoperatively. In the rare instance where an adequate recipient middle cerebral artery is not available, this method may be an alternative means of providing cortical revascularization.

Adult↗
PubMed1975

Anterior pituitary vasodilation after hemorrhage in the dog.

A miniature thermoelectric probe was used to record continuously tissue blood flow in the anterior pituitary gland of anesthetized dogs. The output of the flow probe is linear in the range of tissue blood flow encountered in the pituitary. Probe placement required minimal tissue trauma, and zero blood flow was recorded at the end of each experiment. Little or no change in flow followed hemorrhage of 10 ml/kg body weight. However, hemorrhages of 20 or 30 ml/kg were followed by a biphasic deviation from control level, with an initial transient decrease in flow, followed by recovery to control at about 19 min and a rise above control to 90% of maximum at about 32 min. Hypothalamohypophysial vascular resistance was found to decrease significantly following hemorrhages of 20 or 30 ml/kg, and this was shown to be independent of resistance changes in the femoral vascular bed. It is concluded that anterior pituitary blood flow is well maintained following moderate hemorrhage as a result of intrinsic vasodilation in the hypothalamo-hypophysial vascular bed.

Adrenocorticotropic Hormone↗