Blood Supply to the Human Spinal Cord. I. Anatomy and Hemodynamics

The arterial network that supplies the human spinal cord, which was once thought to be similar to that of the brain, is in fact much different and more extensive. In this article, the authors attempt to provide a comprehensive review of the literature regarding the anatomy and known hemodynamics of the blood supply to the human spinal cord. Additionally, as the medical literature often fails to provide accurate terminology for the arteries that supply the cord, the authors attempt to categorize and clarify this nomenclature. A complete understanding of the morphology of the arterial blood supply to the human spinal cord is important to anatomists and clinicians alike

Blood Supply to the Human Spinal Cord. II. Imaging and Pathology

The blood supply of the spinal cord is a complex system based on multilevel sources and anastomoses. Diseases often affect this vascular supply and imaging has been developed that better investigates these structures. The authors review the literature regarding pathology and imaging modalities for the blood supply of the spinal cord. Knowledge of the disease processes and imaging modalities used to investigate these arterial lesions of the spinal cord will assist the clinician when treating patients with spinal cord lesions

Inflammogenesis of Secondary Spinal Cord Injury

Spinal cord injury (SCI) and spinal infarction lead to neurological complications and eventually to paraplegia or quadriplegia. These extremely debilitating conditions are major contributors to morbidity. Our understanding of SCI has certainly increased during the last decade, but remains far from clear. SCI consists of two defined phases: the initial impact causes primary injury, which is followed by a prolonged secondary injury consisting of evolving sub-phases that may last for years. The underlying pathophysiological mechanisms driving this condition are complex. Derangement of the vasculature is a notable feature of the pathology of SCI. In particular, an important component of SCI is the ischemia-reperfusion injury (IRI) that leads to endothelial dysfunction and changes in vascular permeability. Indeed, together with endothelial cell damage and failure in homeostasis, ischemia reperfusion injury triggers full-blown inflammatory cascades arising from activation of residential innate immune cells (microglia and astrocytes) and infiltrating leukocytes (neutrophils and macrophages). These inflammatory cells release neurotoxins (proinflammatory cytokines and chemokines, free radicals, excitotoxic amino acids, nitric oxide (NO)), all of which partake in axonal and neuronal deficit. Therefore, our review considers the recent advances in SCI mechanisms, whereby it becomes clear that SCI is a heterogeneous condition. Hence, this leads towards evidence of a restorative approach based on monotherapy with multiple targets or combinatorial treatment. Moreover, from evaluation of the existing literature, it appears that there is an urgent requirement for multi-centered, randomized trials for a large patient population. These clinical studies would offer an opportunity in stratifying SCI patients at high risk and selecting appropriate, optimal therapeutic regimens for personalized medicine.Grant #NPRP 4-571-3-171 from the Qatar National Research Fund(a member of Qatar Foundation)

Divisor cordial labeling in the context of join and barycentric subdivision

A divisor cordial labeling of a graph G with vertex set V (G) is a bijection f from V (G) to {1,2,...,|V(G)|} such that an edge e = uv is assigned the label 1 if f(u)|f(v) or f(v)|f(u) and the label 0 otherwise, then |e f (0) - e f (1)| ≤ 1. A graph which admits divisor cordial labeling is called a divisor cordial graph. In this paper we prove that the graphs are divisor cordial graphs. In addition to this we prove that the barycentric subdivision of complete bipartite graphs K 2,n and K 3,n admit divisor cordial labeling.Publisher's Versio

Yubitsume: ritualistic self-amputation of proximal digits among the Yakuza

Abstract: Yubitsume is the ritualistic self-amputation of the proximal digits at the distal interphalangeal joint (DIP) among members of the Japanese mafia, or yakuza. This practice of self-mutilation is done as a sign of apology for making a mistake deemed punishable by higher-ranking members or violating the code of the yakuza. Members of the yakuza may present to emergency departments seeking medical assistance to stop hemorrhage or treat infection at the site of injury following selfamputation or to have the severed portion of the injured finger reattached

Outlaw Motorcycle Gangs: Aspects of the One-Percenter Culture for Emergency Department Personnel to Consider

Outlaw motorcycle gangs (OMGs) are an iconic element of the criminal landscape in the United States, the country of their origin. Members of OMGs may present to the emergency department (ED) as a result of motor vehicle accidents or interpersonal violence. When one member of an OMG is injured, other members and associates are likely to arrive in the ED to support the injured member. The extant literature for ED personnel lacks an overview of the culture of OMGs, a culture that promotes the display of unique symbols and that holds certain paraphernalia as integral to an outlaw biker’s identity and pride. The objective of this manuscript is to discuss various aspects of the culture of OMGs so that ED personnel may better understand the mentality of the outlaw biker. Knowledge of their symbols, values, and hierarchy can be crucial to maintaining order in the ED when an injured outlaw biker presents to the ED. We used standard search engines to obtain reports from law enforcement agencies and studies in academic journals on OMGs. We present the observations of 1 author who has conducted ethnographic research on outlaw bikers since the 1980s. [West J Emerg Med. 2014;15(4):523-528.