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At least 19 recordsLinked to original sources
PubMed2004

Transplantation of dermal multipotent cells promotes survival and wound healing in rats with combined radiation and wound injury.

Combined radiation and wound injury occurs after severe nuclear accidents that accompany explosions or nuclear attacks. High doses of ionizing radiation can cause bone marrow aplasia and delay wound healing. Combined radiation and wound injury is very complex and is more difficult to deal with than single injuries. Multipotent stem cells that have self-renewal potential and multilineage differentiation capacity are the relevant cells in regenerative medicine. To determine whether multipotent stem cells can have multiple therapeutic effects in vivo, systemic transplantation of cultured dermal multipotent cells was performed in rats with combined radiation and wound injury. The results showed that dermal multipotent cell transplantation promoted survival and accelerated both hematopoietic recovery and wound healing in rats with combined radiation and wound injury. FISH analysis using a Y-chromosome-specific probe indicated that donor dermal multipotent cells could engraft into recipient skin and bone marrow after transplantation. FACS analysis of the proportions of CD2- and CD25-positive peripheral lymphocytes indicated that dermal multipotent cell transplantation did not induce an obvious activation of allogeneic lymphocytes in vivo in 3 weeks. These data indicate that dermal multipotent cell transplantation may provide a new tool for the treatment of combined radiation and wound injuries.

Animals↗
PubMed1996

Visceral injuries, wound infection and sepsis following electrical injuries.

Visceral injuries, wound infection and sepsis were investigated in 226 inpatients who sustained electrical burns over a period of 15 years. Four patients who sustained thoracic and abdominal organ injuries were noted in this series. The patients had injuries of the small intestine, stomach, colon and the lung. All the patients received operative treatment. Two of them died of sepsis. Injuries to the internal organs should always be considered following high-voltage injuries, and they should be managed as early as possible. The data concerning wound infection and sepsis following electrical injuries were evaluated in three consecutive 5-year periods. Over this period of 15 years, different antibiotic regimens were used for prophylaxis and treatment. Most patients in the current series had been contaminated or infected by various pathogens prior to admission. Long-lasting administration of prophylactic antibiotics in these patients showed no improvement in controlling the sepsis. After 1987, most of the microorganisms were eliminated following more effective antimicrobial therapy. The progressive decrease in infection frequency of species such as Pseudomonas aeruginosa, Proteus mirabilis and Enterobacter cloacae, appeared to be causally related to the changes in the general therapeutic protocol which included new antibiotics. The infections caused by E. coli and Staphylococcus aureus showed a rather steady state. A marked increase in frequency of negative wound cultures was also noted between the years 1989 and 1993. A gradual decrease in mortality rates was observed from the first to the last 5-year period, whereas mortality rates due to sepsis showed a gradual but slower decline. Sepsis (142 patients comprising 62.8 per cent of the total mortality rate) was the most frequent complication resulting in death.

Adolescent↗
PubMed2004

Penetrating stab wound injuries to the face.

Penetrating knife blade injuries to the maxillofacial region are quite rare, with retained knife blades even rarer. Associated vascular, ocular, ductal, neurosurgical injuries should be identified and treated accordingly. Appropriate special investigations included plain radiographs and angiograms, which were used in establishing the proximity of the foreign object to the arterial supply to the head and neck. The impacted blade should be removed in theatre. Ten patients with this injury are discussed.

Adolescent↗
PubMed2003

TGF-alpha overexpression induces astrocytic hypertrophy after cortical stab wound injury.

To determine the exact role of TGF-alpha in glial activation after traumatic brain injury, we investigated the astroglial and microglial responses after cortical stab wound injury in TGF-alpha overexpressing mice. Adult male B6D2-TgN (MMTVTGFA) 29RjC transgenic mice were used for the subjects. This transgenic line carries a TGF-alpha cDNA under the control of the dexamethasone-inducible MMTV promoter. Thus, exogenous administration of dexamethasone induces TGF-alpha overexpression. Male B6D2F1/J mice at the same age served as wild-type animals. After the cortical stab wound injury, expression of glial fibrillary acidic protein, CD-11b and interleukine-6 were investigated immunohistochemically. The results indicate that TGF-alpha might affect astrocytic hypertrophy without affecting microgliosis not only in the normal condition, but also in the pathological condition. Moreover, overexpression of TGF-alpha induced obvious expression of IL-6 around the lesion. This fact might indicate possible role of TGF-alpha in affecting neuronal function.

Animals↗
PubMed2005

Fascial ultrasound for evaluation of anterior abdominal stab wound injury.

BACKGROUND: Local stab wound (SW) exploration to assess abdominal fascial integrity is a highly invasive procedure frequently performed under demanding circumstances in the Emergency Department (ED). We hypothesized ultrasound (U/S) may be useful in the detection of fascial defects resulting from anterior abdominal stab injury, eliminating the need for local wound exploration METHODS: Thirty-five hemodynamically normal patients evaluated at a Level I trauma center for anterior abdominal stab wounds were examined by U/S (8 mHz probe) for evidence of fascial violation. All patients were subsequently evaluated by local wound exploration RESULTS: Fascial U/S had an overall sensitivity of 59% and specificity of 100%, (PPV 100%, NPV 59%) for detection of fascial SW defects compared with local wound exploration. The sensitivity of fascial U/S for stab wound evaluation varied directly with experience of the sonographer CONCLUSIONS: A positive fascial U/S obviates the need for invasive SW exploration; however, a negative fascial U/S does not preclude the need for local wound exploration. Resident U/S training for specific penetrating injuries may reduce the need for abdominal SW fascial exploration in the ED.

Abdominal Injuries↗
PubMed2003

Effects of the nerve growth factor on the survival and wound healing in mice with combined radiation and wound injury.

High dose of ionizing radiation could cause bone-marrow aplasia and delay wound healing. Nerve growth factor (NGF) has been demonstrated to play roles in wound healing and to affect the functional activities of mature immune and hematopoietic cells. In this study, we investigated the effects of NGF on survival and wound healing in mice with combined radiation and wound injury. Immunohistochemical analysis indicated that the expression of NGF decreased significantly at postwounding days 3, 5, 7, 10 and 14 in wounded tissues combined with total body irradiation of 5 Gy. NGF significantly increased the survival and migration of skin fibroblasts with the irradiation of 15 Gy in in vitro experiments. Intraperitoneal and topical applications of NGF increased the survival rate, peripheral white blood cells and bone-marrow nucleated cells; they also promoted wound healing and increased the cell number of fibroblasts and blood capillaries in granulation tissues. These results showed evidence that NGF could increase wound healing and promote survival in irradiated animals. This dual effect of NGF may provide a new tool for the treatment of radiation-combined injuries.

Animals↗
PubMed2005

Three dimensional electromechanical model of porcine heart with penetrating wound injury.

The aim of this study is development a prototype computational model of the pig heart that can be used to predict physiological responses to a penetrating wound injury. The pig has been chosen for this model studies because it shares many anatomical similarities with humans. Three-dimensional cubic Hermite finite element meshes based on detailed measurements of porcine anatomy combined into an integrated anatomic model. The pig ventricular model includes detailed left and right ventricular geometry and myofiber and laminar sheet orientations throughout the mesh. The cardiac mesh was refined and monodomain equations for action potential propagation solved using well-established collocation-Galerkin finite element methods. The membrane kinetic equations for the action potential model was based on detailed cellular models of transmembrane ionic fluxes and intracellular calcium fluxes in canine ventricular myocytes and human atrial myocytes. We modified the anisotropic myocardial conductivity tensor on the endocardial surface of the ventricles by making use of a surface model fitted to measured of Purkinje fiber network anatomy. The mechanical model compute regional three-dimensional stress and strain distributions using anisotropic constitutive laws referred to local material coordinate axes defined by local myofiber and laminar sheet orientations. Passive myocardial mechanics modeled using exponential orthotropic strain energy functions. Active systolic myocardial stresses computed from a multi-scale model that uses crossbridge theory to predict calcium-activated sarcomere length- and velocity-dependent tension filament tension. Since the electrical and mechanical models use a common finite element mesh as the parent parametric framework and both models are solved within our custom finite element package, it is straightforward to couple these models, as we have recently done for a model of coupled ventricular electromechanics. We apply the coupled electromechanical model to predict alterations in regional diastolic and systolic wall mechanics associated with rhythm disturbances and possible arrhythmias with decreased blood volume, tamponade, myocardial injury, and regional ischemia caused by a penetrating wound.

Animals↗
PubMed2001

Phacoemulsification conditions resulting in thermal wound injury.

PURPOSE: To determine and model the relationships between phacoemulsification conditions and viscoelastic agents that result in thermal wound injury. SETTING: Animal laboratory, Irvine, California, USA. METHODS: Mechanical and animal models, various wound sizes, phacoemulsification tips, and dispersive and cohesive viscoelastic agents were evaluated. Settings for phaco power, vacuum, and irrigation levels were controlled within a surgically relevant range. In the mechanical and animal models, incision temperature was assessed as a function of phacoemulsification parameters and time. In the animal model, wound damage was evaluated at the time of surgery. RESULTS: Induced time delays from the onset of phaco power to the onset of irrigation flow caused a thermal rise at the incision site. In these experiments, lack of irrigation and aspiration resulted in the greatest thermal rise and caused wound damage. Both the cohesive and dispersive viscoelastic agents were associated with a delay in the start of irrigation and aspiration, which resulted in similar maximum temperatures. Mathematical models were developed to estimate the maximum incision temperature from the phacoemulsification power, the duration (seconds) of occlusion, the tip gauge and type, and other phacoemulsification parameters. The models predict that under comparable conditions, occlusion with a viscoelastic agent will result in higher incision temperatures than occlusion with a balanced salt solution. CONCLUSION: Under comparable phacoemulsification conditions, both the cohesive and dispersive viscoelastic agents were associated with elevated temperatures that would be preventable by ensuring irrigation and aspiration flow before the onset of phacoemulsification power.

Acetates↗
PubMed1995

Gunshot wound injuries. Frequency and cost analyses in south central Los Angeles.

Nine hundred fifty-two patients with gunshot wound injuries admitted between July 1, 1989 and June 30, 1990 in a level one trauma center in South Central Los Angeles were studied retrospectively. The authors attempted to define those periods that gunshot injuries were most likely to occur, to characterize the involved high-risk populations, and to estimate direct and indirect cost of care to society.

Adult↗
PubMed1996

Transient induction of heme oxygenase after cortical stab wound injury.

Heme oxygenase (HO) exists as two isoenzymes designated heme oxygenase-1 (HO-1) and heme oxygenase-2 (HO-2). HO-1 has been identified as a heat shock or stress protein and is inducible whereas HO-2 is largely refractory to induction. HO-2 is the predominant isoenzyme in normal brain and appears to have a predominantly neuronal distribution in cerebral cortex. Cortical stab wound injury resulted in HO-1 induction as determined by Western blot analysis. Immunohistochemical analysis suggested that induced HO-1 was largely restricted to reactive astrocytes and macrophage-like cells. Enhanced HO-1 immunoreactivity was observed in hypertrophied, GFAP+ reactive astrocytes near the wound margin as early as 12 h after injury. Very rarely were HO-1+ neurons observed and then only up to 6 h after stabbing. Maximal numbers of HO-1+ astrocytes were found 3 days after stabbing. Their numbers declined thereafter. By 5 days after stab injury few HO-1+ reactive astrocytes were observed although GFAP+ reactive astrocytes were still prominent near the wound margin. HO-1+ macrophage-like cells were initially observed between 1 and 3 days after injury and they persisted in the margin of the wound for at least 14 days. The proximity of HO-1+ cells to the wound margin suggests that factors associated with injury contribute to the regulation of HO-1 in injured cortex.

Animals↗
PubMed2003

[Abdominal stab wound injury with omentum evisceration].

INTRODUCTION: The abdominal stab wound with omentum evisceration, represent 4 to 20% of abdominal injuries. It causes a problem of therapeutic indication between selective and mandatory laparotomy. The goal of this work is to give some answers to this dilemma. MATERIAL AND METHODS: A retrospective study from 1992 to 2000, concerning 75 patients presenting an omentum evisceration. Where there were 71 men et four women, the mean age was 25 years old. All the abdominal injuries are exclusively by the stab wound. These 75 patients were divided into three groups: group I: 24 patients (32) were immediately operated ahead of the existence of severity elements; group II: 18 (24%) patients had an isolated omentum evisceration without any elements of severity were operated immediately; group III: 33 (44%) were placed under clinical, radiological and ultrasound control. RESULTS: We have found four cases of negative laparotomy (16,7%) in group I, and 14 (77,8%) in group II. Five secondary laparotomies (15%) were performed in group III. Among the 51 patients (Group II and Group III) nine (17%) had visceral injuries... In all of the three groups, there was a high frequency of intestinal organs injuries, there was no mortality and 12% of morbidity. CONCLUSION: The isolated omentum evisceration is a penetrating injury of the abdominal wall but not synonym with visceral injuries, the interventionists authors had a high rate of negative laparotomy. However the selective authors in the asymptomatic patients under clinic examination appears logical: we believe that the laparoscopic diagnostic and therapeutic in doubtful cases can resolve this problem.

Adult↗
PubMed1999

Evaluation of clinician accuracy in describing gunshot wound injuries.

A large series of gunshot wounds is analyzed to determine, first, whether the wounds were described with enough detail to estimate the distance and direction of fire; and second, to utilize the autopsy description to determine accuracy. All of the University of Miami-Jackson Medical Center (UM-JMC) records coded as gunshot wounds and treated during calendar year 1995 were included in this study. The analysis is of 566 shootings from bullets in which 1259 wounds were described in the hospital records. Of the 1259 bullet wounds, the size and/or shape was described in only 63 (5%) and only four wounds (0.3%) had any indication of distance of fire. The location of the wound could be determined to within 3 cm in 655 (52%) and only 39 (3%) of the wounds were measured from some landmark. Directionality was neither indicated nor determinable in 897 (71%) of the wounds examined. Fifty-five (9%) cases resulted in death and were compared with medical examiner autopsies. Clinical information was inadequate for comparison in three (6%) of these cases. In 22 cases that were said to have one wound, only 14 (64%) of these were correctly documented. Of 16 cases with 2 wounds, 9 (56%) were correctly identified by the clinicians. When greater than 2 wounds were present (14), the clinicians were wrong 93% of the time. This study demonstrates that clinicians responsible for treating gunshot-wounded persons do not adequately document or interpret these wounds.

Adolescent↗
PubMed2004

[Abdominal wound injuries: diagnosis and treatment. Report of 79 cases].

INTRODUCTION: - Traditionally, penetrating abdominal wounds justify routine laparotomy. However, this policy can be adapted to mechanism of injury (stab or firearm) and accuracy of imaging procedures if they eliminate visceral injury thus allowing close follow up. PATIENTS AND METHODS: Retrospective study of 79 patients (May 1995-May 2002) with a penetrating abdominal wound: (47 (59%) stab wounds and 32 (41 %) firearm wounds). Correlation between imaging and surgical findings, treatment, post-operative course were studied. RESULTS: Sixty-eight patients were operated on from the outset, and 11 underwent close follow-up. Of the 11 patients who had follow-up, (9 after stab wound and 2 after firearm wound), two had to be operated (1 in each group). Correlation between imaging and surgical findings was good in 34 (72%) patients after stab wound and in 21 (80%) after firearm wound; the mean number of visceral injuries was 1 and 3 respectively. Six patients (8%) died (mortality: 2% and 16% respectively), 12 (15%) had postoperative complications. CONCLUSION: Penetrating abdominal stab wounds can be treated by close follow-up if imaging excludes visceral injury. Firearm wounds still justify routine laparotomy due to both multiplicity of visceral injuries and bad prognosis.

Abdominal Injuries↗
PubMed1995

Migration of bovine aortic smooth muscle cells after wounding injury. The role of hyaluronan and RHAMM.

The migration of smooth muscle cells is a critical event in the pathogenesis of vascular diseases. We have investigated the role of hyaluronan (HA) and the hyaluronan receptor RHAMM in the migration of adult bovine aortic smooth muscle cells (BASMC). Cultured BASMC migrated from the leading edge of a single scratch wound with increased velocity between 1 and 24 h. Polyclonal anti-RHAMM antisera that block HA binding with this receptor abolished smooth muscle cell migration following injury. HA stimulated the random locomotion of BASMC and its association with the cell monolayer increased following wounding injury. Immunoblot analysis of wounded monolayers demonstrated a novel RHAMM protein isoform that appeared within one hour after injury. At the time of increased cell motility after wounding, FACS analysis demonstrated an increase in the membrane localization in approximately 25% of the cell population. Confocal microscopy of injured monolayers confirmed that membrane expression of this receptor was limited to cells at the wound edge. Collectively, these data demonstrate that RHAMM is necessary for the migration of smooth muscle cells and that expression and distribution of this receptor is tightly regulated following wounding of BASMC monolayers.

Animals↗