Apparent Injuries Research Articles

Protective effect of butyrate against ethanol-induced gastric ulcers in mice by promoting the anti-inflammatory, anti-oxidant and mucosal defense mechanisms

Gastric ulcers (GUs) are a common type of peptic ulcer. Alcohol overdose is one of the main causes of GU, which is difficult to prevent. Although the protective effect of butyrate on inflammation-related diseases is well understood, its effect on GUs has not been reported. We investigated the protective effects of butyrate against ethanol-induced lesions to the gastric mucosa in mice and the underlying mechanisms. BALB/c mice were orally pretreated with butyrate for 30min prior to the establishment of the GU model by challenge with absolute ethanol. Ethanol administration produced apparent mucosal injuries with morphological and histological damage, whereas butyrate pretreatment reduced the gastric mucosal injuries in a dose-dependent manner. Butyrate pretreatment also significantly ameliorated contents of malondialdehyde (MDA) and carbonyl proteins, and decreased levels of IL-1β, TNF-α and IL-6. The Western blot results consistently demonstrated that butyrate pretreatment attenuated the phosphorylation of NF-κB p65, p38 MAPK and ERKs in the gastric tissues. Additionally, gastric wall mucus (GWM), a parameter reflecting mucosal defense, was clearly increased by butyrate pretreatment. Butyrate pretreatment protects the gastric mucosa against ethanol-induced lesions by strengthening the mucosal defense and anti-oxidant and anti-inflammatory activities. As a necessary substance for the body, butyrate may be applied to the prevention and treatment of GUs.

Identification and quantitation of mifepristone and its N-demethyl metabolite in the plasma of an aborted fetus by liquid chromatography–quadrupole–time-of-flight–mass spectrometry (LC–Q–TOFMS) and ultra-performance liquid chromatography–tandem mass spectrometry (UPLC–MS–MS)

Mifepristone, also known as RU 486, is a derivative of norethindrone, a synthetic 19-nor-steroid; it acts as an antagonist to progestational and glucocorticoid functions by its binding to progesterone as well as glucocorticoid receptors [1]. Mifepristone is useful for terminating early pregnancy and for emergency contraception [1–4]. Mifepristone is approved in the US, EU countries, Israel, and China, but is not approved in Japan. In Japan, mifepristone has been ‘privately’ or secretly imported; the Ministry of Health, Labour and Welfare warned about its private import in 2004 because of possible complications, e.g., massive hemorrhaging [5]. Despite the warning, it has still been imported and used. It is, thus, important to detect mifepristone and its metabolites with high sensitivity. Several analytical methods have been reported for the measurement of mifepristone, such as the radioimmunoassay [6, 7], the radioreceptor assay [8, 9], voltammetry [10] and high performance liquid chromatography (LC) with an ultraviolet detector [11–17]. Recently, LC– tandem mass spectrometry (MS/MS) [18, 19] has been applied to detect and identify mifepristone and its metabolites from body fluids. In this Letter, we describe the determination of mifepristone and its metabolite in a plasma sample of an aborted fetus using a novel LC–quadrupole–time-of-flight– mass spectrometer (Q–TOFMS) with high sensitivity and specificity and an ultra-performance liquid chromatography–tandem mass spectrometer (UPLC–MS–MS). A woman in her twenties consulted an ER due to her poor health conditions; she then confessed her delivery and that she discarded the dead fetus. She also admitted that she had administered mifepristone and misoprostol prior to her delivery, although the time of administration and the amounts of the compounds were not clear. Around one day after delivery, autopsy of the fetus was performed. Autopsy findings were as follows: a male fetus whose height and weight were 30 cm and 505 g, respectively. No apparent injuries or malformations were observed. A cephalic hematoma-like finding was obtained. The lungs seemed liver-like, although histopathological observations detected some alveolar enlargement. Based on the above findings, the possibility that the fetus had been alive at the delivery was not fully excluded. The fetus was estimated to be at approximately 20–24 weeks gestation. Mifepristone and misoprostol were purchased from Sigma (St. Louis, MO, USA); N-demethyl mifepristone and alfaxalone were from Toronto Research Chemicals (Ontario, Canada) and Tocris (Bristol, UK), respectively. Drug free plasma was purchased from Tennessee Blood Services (Memphis, TN, USA). Other chemicals used were of the highest purity commercially available. A plasma specimen was collected from the femoral blood of the fetus. Mifepristone and its metabolites were analyzed based on the method by Homer et al. [19] with appropriate modifications. Screening of mifepristone and quantitation of the drug and its metabolites by UPLC–MS–MS were employed on an ACQUITY UPLC-TQD system (Waters, & Akira Ishii akishii@med.nagoya-u.ac.jp

The ABCs of caring for sexual assault patients

The ABCs of caring for sexual assault patients

Estimation of Injury Simulation in International Women's Football

This study attempted to determine the frequency of apparent injury incidents in women's international football and estimate what proportion was authentic. Broadcast recordings of 47 games from 2 tournaments were reviewed to identify incidents in which a player behaved as if injured. Apparent injuries were considered definite if a player withdrew from participation within 5 minutes or if bleeding was visible. Remaining incidents were considered questionable. A total of 270 apparent injuries were observed at a rate of 5.74/game compared with 11.26/game previously reported in men's football. The definite injury rate was only 0.78/game vs. 4.96/game for questionable injuries. Definite injuries were associated with on-field treatment (P < 0.010), stretcher (P < 0.010), and second half (P = 0.022), while questionable injuries were associated with fouls (P = 0.036), contact (P < 0.010), and being tackled (P = 0.025). Questionable injuries were not associated with the final third of a half or with team success.

A new genus,Adventacarusand newAbacarusspecies from Hungary (Acari: Prostigmata: Eriophyoidea)

Partial results of 19 years of mite collecting on ornamental trees and shrubs, on streets, in parks, in greenery, in botanical gardens and private gardens, in various localities of Hungary are included here. During this survey a new genus, Adventacarus n. gen. and two new species were collected: Adventacarus turulae n. sp. and Abacarus korosicsomai n. sp. are described and illustrated from Phyllostachys viridiglaucescens. Both species appeared to be vagrant without causing apparent injuries to the host. The importance of gnathosomal chaetotaxy in the systematics of the eriophyoid mites is emphasized. A new tribe, Adventacarini n. tr. is proposed.

Estimation of Injury Simulation in International Men's Soccer

The aim of this study was to determine the frequency of apparent injury incidents in men's international soccer and attempt to estimate what proportion of these incidents are authentic. Broadcast recordings of 89 group stage games from 4 tournaments were reviewed to identify incidents in which a player behaved as if injured. Apparent injuries were considered definite if a player withdrew from participation within 5 min or if bleeding was visible. The remaining incidents were considered questionable. A total of 980 apparent injuries were observed at a rate of 5.63/team game. The definite injury rate was only 0.41/team game vs. 5.22/team game for questionable injuries. Definite injuries were associated with on-field treatment (P<0.001) and stretcher (P<0.001) while questionable injuries were associated with fouls (P<0.001), yellow cards (P=0.013), and the first half (P=0.001). Questionable injuries were more associated with the final 1/3 of the second half than the initial 2/3 (P=0.039). For the 24 games of the 2007 AFC Asian Cup there was an association between questionable injuries and a contact mechanism (P<0.001). The range of the rate of questionable injury was 4.17-5.4 by confederation. This information may assist soccer governing bodies in developing plans to prevent injury simulation behavior.

Povrede vratne kicme kod korisnika dvotockasa povredjenih u saobracajnim nezgodama

Due to the vehicle characteristics neck injuries are common in motorcycle and moped users involved in traffic accidents. We are reporting on neck injuries amongst 502 fatalities of drivers and passengers of motorcycles and mopeds, and cyclists. Cervical spine injuries were found in 124 cases (24.7%). Cervical spine injury was statistically significantly more frequently in passengers (61.9%) compared to the drivers (20.7%) of motorcycle and moped (chi2 = 13.384; p < 0.01), the lesions are usually localized in the upper cervical spine (52.4%), the most frequently at atlantoocciptal region (F = 25.835; p); these injuries were most frequently caused by frontal (31.45%) or rear (50.81%) axial collisions. Almost all cases of cervical spine injuries were present without apparent external injuries; they were associated with lesions of neck muscles, blood vessels and/or neck organs, and in 79 cases (63.7%) there was a lesion of the cervical spinal cord. The research results indicate a large incidence of neck injuries in traffic accidents especially in motorcycle, moped and bicycle axial collision with the possible absence of external injuries, which may represent a clinical and forensic problem.

Car Versus Bicycle: Conclusion

A 58-year-old man was riding his bicycle and was struck by a car. He was ejected and landed on his back on the pavement of the roadway. He complained of severe pain in his lower back and sacral area. Ground emergency medical services (EMS) arrived to find a pale, diaphoretic man who was alert but in distress. His medical history was negative, and he was taking no medications. The initial heart rate was 130 beats/minute, and the blood pressure was 70 mmHg by palpation. A helicopter air ambulance was requested from the rural scene location to transport the patient to a trauma center. The physical examination by the flight crew demonstrated the patient had not changed from the original EMS assessment, despite the administration of 1 L normal saline intravenously. There were no apparent injuries to his head, neck, chest, or extremities.

Evaluation of an Electric Gradient to Deter Seal Predation on Salmon Caught in Gill‐Net Test Fisheries

AbstractAn electric deterrent system was tested as an effective and safe method of deterring predation by Pacific harbor seals Phoca vitulina richardsi on sockeye salmon Oncorhynchus nerka and pink salmon Oncorhynchus gorbuscha caught in a Fraser River gill‐net test fishery. Seals were deterred from foraging in a test fishing gill net in the Fraser River by using a pulsed, low‐voltage DC electric gradient. Salmon catch per unit effort (CPUE) was significantly greater for the treated (electric) section of the gill net than for the nontreated section (marginal mean CPUE = 4.0/1,000 m · min versus 1.0/1,000 m · min), and there was no overlap in the 95% confidence intervals for the two treatments. There were no apparent injuries to any animals during the study. This previously undocumented nonlethal technology demonstrates the potential to reduce pinniped predation on salmon, with meaningful implications for fisheries management agencies that rely on gill‐net test fisheries in freshwater rivers frequented by pinnipeds.

Stress in Salminus brasiliensis fingerlings due to different densities and times of transportation

The stress in dorado fingerlings (Salminus brasiliensis) caused by transportation at densities of 5, 10, and 15g/l after 4, 8, and 12h was evaluated by the concentration of tissue cortisol measured by ELISA. The conditions of transportation were simulated on an orbital table shaker with horizontal movements, inside 15 litres plastic bags filled with 4 litres of water and pure oxygen. Cortisol concentrations increased in all densities after 4h of transportation converging to a common concentration at the end of the tested times. Electrical conductivity of water increased with density and transportation time. The transportation caused stress on fish, but the increase on density and in times of transportation did not cause mortality to fingerlings. The transportation of S. brasiliensis fingerlings can be done without mortality or apparent injuries to animals until the maximum analyzed density of 15g/l and up to 12h.

Detecting Traumatic Brain Injury Among Veterans of Operations Enduring and Iraqi Freedom

N C Med J January/February 2008, Volume 69, Number 1 dvances in battlefield medicine and protective devices used in Operation Enduring Freedom-Afghanistan (OEF), beginning in October 2001, and Operation Iraqi Freedom (OIF), beginning in March 2003, are saving the lives of many service members who would have died in other wars. While the mortality rate for injures was 30% in World War II and 24% in Vietnam, the rate in these recent wars has been constantly close to 10%. The result is that many veterans who previously would have died are living with very serious injuries, and those who formerly would have had serious and apparent injuries now have conditions that significantly impact their lives but are not always obvious. One of these conditions, traumatic brain injury (TBI), is considered the signature wound of the current conflicts. It is estimated that almost 50% of soldiers injured in combat return with some form of TBI (mild, moderate, or severe). This compares with 14% to 18% of combat casualties having a brain injury during the Vietnam War.

Skeletal pathology in Pan troglodytes schweinfurthii in Kibale National Park, Uganda

The ecological pressures shaping chimpanzee anatomy and behavior are the subject of much discussion in primatology and paleoanthropology, yet empirical data on fundamental parameters including body size, morbidity, and mortality are rare for wild chimpanzees. Here, we present skeletal pathology and body size data for 20 (19 crania, 12 postcrania) chimpanzees (Pan troglodytes schweinfurthii) from Kibale National Park, Uganda. We compare these data with other East African populations, especially Gombe National Park. Estimated body size for Kibale chimpanzees was similar to other East African populations and significantly larger than Gombe chimpanzees. The high rates of trauma and other skeletal pathology evident in the Kibale chimpanzee skeletons were similar to those in the Gombe skeletal sample. Much of the major skeletal trauma in the Kibale skeletons was attributable to falls, although other pathologies were noted as well, including apparent injuries from snares, degenerative arthritis, and minor congenital abnormalities.

HEALED FRACTURES AND OTHER ABNORMALITIES IN BONES OF SMALL MAMMALS

Accidental falls are fairly common in arboreal and scansorial mammals. In many, if not most cases, such mishaps do not result in serious injuries. For example, Steele and Koprowski (2001) reported that in 20,000 h of observation of eastern gray squirrels (Sciurus carolinensis) and eastern fox squirrels (Sciurus niger), they witnessed 56 major falls (>10 m) and many minor slips with no apparent injuries. Occasionally, however, such falls do result in serious injuries or death (Thompson 1976; Brandwood and others 1986; Wolkomir and Wolkomir 1994). Of 65 eastern gray squirrels examined by Thorington (1972), 3 (4.6%) had healed fractures of the long bones of the legs. The incidence of healed fractures is even higher in large arboreal primates and marsupials. For example, Schultz (1969:194) reported that 33% of gibbons (Hylobates spp.), 34% of orangutans (Pongo spp.), and 28% of adult capuchin monkeys (Cebus spp.) and proboscis monkeys (Nasalis larvatus) had at least 1 healed fracture. J Mckee (pers. comm. 2002) estimated that about 2% of the koalas (Phascolarctos cinereus) examined at his veterinary lab at the University of Queensland, Australia, had healed fractures. In comparison, Schultz (1969) reported that healed fractures were less common in terres-

Lightning Fatalities on the South African Highveld

A review of the Southern Africa medical literature shows a paucity of published data regarding lightning fatalities. The South African Highveld has a lightning ground flash density of 6 to 9 flashes/km/year, with a high incidence of thunderstorm days per year (some 40-70). The Highveld has a largely urban population, many of whom have low socioeconomic status and poor education, housing, and other infrastructures and hence (possibly) are at greater exposure risk. Thirty-eight victims of lightning-related death were identified from the records of the 6 large medicolegal mortuaries on the South African Highveld, serving a population of approximately 7 million, for the period 1997 to 2000. Analysis of the records revealed that 95% of all victims were black, 79% were male, and the average age was 36 years. Lightning strikes occurred from September through to April (normal summer rainfall period), and the most strikes took place in the late afternoon (3:00 pm to 6:00 pm). All except 1 case occurred outdoors. In the autopsy reports, mention was made of singeing of hair in 68% of cases, and mention of damage to clothing was made in 26% of cases. Cutaneous thermal injuries were noted in 34 of the 38 cases, with apparent electrothermal injuries of the feet noted in 4 cases. Fifty-two percent of victims sustained some form of associated blunt-force injury (including abrasions, contusions, etc). Specific keraunopathologic injuries were described in only 2 of the cases. Twenty-one cases had some form of internal organ injury. This study serves to illustrate the relatively high incidence of lightning strikes in the region and calls for a more systematic and detailed investigative protocol in lightning-related deaths.

Isolated zone III vertical fracture of first sacral vertebra—a case report

A 20-year-old woman was hit by a rolling rock. She was rescued immediately without any other apparent injuries. Radiographs showed a central fracture of the first sacral vertebra and pubic symphysi...

Does the angle of mediolateral episiotomy incision affect the incidence of anal sphincter injury?

OF ANAL SPHINCTER INJURY? MAEVE EOGAN, RONAN O’CONNELL, COLM O’HERLIHY, University College Dublin, Obstetrics and Gynaecology, Dublin, Ireland, University College Dubin, Surgery, Dublin, Ireland, Ireland OBJECTIVE: Midline episiotomy, when compared with mediolateral incisions, predisposes to higher rates of obstetric anal sphincter injury. It is not known what angle of proximity to the midline becomes critical in terms of third degree perineal tear. Our aim was to assess the influence of the angle of episiotomy incision on anal sphincter trauma. STUDY DESIGN: A prospective observational study was conducted at 3 months postpartum in two cohorts of primiparous women who had undergone right mediolateral episiotomy during vaginal childbirth. One group, who had sustained clinically apparent anal sphincter injuries during delivery, were compared with controls, who had not. The episiotomy scar angle and perineal midline were measured using superimposed transparent plastic film and a protractor. Data were recorded and analysed using SPSS, Student’s t and c tests. RESULTS: A total of 100 patients, 54 cases and 46 controls, were assessed. Women who sustained anal sphincter injury were more likely to have undergone assisted delivery and, thus, to have been delivered by an obstetrician rather than a midwife. The mean angle of episiotomy was significantly more acute in cases (30.0(, 95% CI: 13-47) than in controls (38.0(, 95% CI: 20-56, P ! .0001). CONCLUSION: These results indicate that episiotomy angle is an additional risk factor for obstetric anal sphincter injury and suggest that mediolateral episiotomy should be cut close to 45( to minimise the risk of anal sphincter disruption.

Understanding the molecular responses to hypoxia using Drosophila as a genetic model.

We have previously discovered that Drosophila melanogaster could recover from extended periods of anoxia (0% oxygen) with no apparent consequential injuries. We have since employed forward and reverse genetic approaches to decipher the molecular basis for anoxia tolerance. In so doing, we have identified several independent mutant lines that demonstrated increased sensitivity to anoxia. Characterization of one of these mutants resulted in the identification of a dADAR gene that plays a role in the sensitivity to low levels of oxygen. We have also used microarrays to study all known Drosophila genes, the expression of which may be altered by hyoxia. Microarrays experiments have generated a large body of information that is being currently analyzed. We believe that these undertakings will provide insight into the genetic mechanisms of hypoxia tolerance and ischemic injuries.

Secondary extremity compartment syndrome.

Abdominal compartment syndrome has been reported to occur after fluid resuscitation in injured patients, even in the absence of intra-abdominal injuries. This report describes a set of patients who developed the secondary extremity compartment syndrome (SECS) in uninjured extremities after resuscitation for other injuries. This study was a retrospective chart review of all trauma patients developing SECS at a Level I trauma center. Data are mean +/- SD. From 1996 to 2001, 10 patients (8 men, age 31 +/- 13 years, Injury Severity Score of 29 +/- 17, and 3 with penetrating trauma) from a series of 11,996 trauma admissions developed SECS after resuscitation for other injuries. The mean number of extremities developing the SECS per patient was 3.1. This included compartment syndromes in 10 upper extremities and in 12 lower extremities that did not have any apparent injuries (i.e., contusions, fractures, or vascular injuries). After evaluation by the trauma team, abdominal silos were needed in 7 of the 10 patients also, and the mortality in patients with the SECS was 70%. SECS is a rare complication of the postresuscitation systemic inflammatory response syndrome, is associated with significant morbidity, and may be a marker for mortality. SECS should be ruled out by measurement of compartment pressures in uninjured and injured extremities in patients with severe diffuse edema after resuscitation for injury.

A methodology for inferring the causes of observed impairments in aquatic ecosystems

Biological surveys have become a common technique for determining whether aquatic communities have been injured. However, their results are not useful for identifying management options until the causes of apparent injuries have been identified. Techniques for determining causation have been largely informal and ad hoc. This paper presents a logical system for causal inference. It begins by analyzing the available information to generate causal evidence; available information may include spatial or temporal associations of potential cause and effect, field or laboratory experimental results, and diagnostic evidence from the affected organisms. It then uses a series of three alternative methods to infer the cause: Elimination of causes, diagnostic protocols, and analysis of the strength of evidence. If the cause cannot be identified with sufficient confidence, the reality of the effects is examined, and if the effects are determined to be real, more information is obtained to reiterate the process.

A METHODOLOGY FOR INFERRING THE CAUSES OF OBSERVED IMPAIRMENTS IN AQUATIC ECOSYSTEMS

Biological surveys have become a common technique for determining whether aquatic communities have been injured. However, their results are not useful for identifying management options until the causes of apparent injuries have been identified. Techniques for determining causation have been largely informal and ad hoc. This paper presents a logical system for causal inference. It begins by analyzing the available information to generate causal evidence; available information may include spatial or temporal associations of potential cause and effect, field or laboratory experimental results, and diagnostic evidence from the affected organisms. It then uses a series of three alternative methods to infer the cause: Elimination of causes, diagnostic protocols, and analysis of the strength of evidence. If the cause cannot be identified with sufficient confidence, the reality of the effects is examined, and if the effects are determined to be real, more information is obtained to reiterate the process.