Correlation Between Intra-Abdominal Free Fluid and Solid Organ Injury in Blunt Abdominal Trauma

Background: In previous studies, the diagnostic value of Focused Assessment with Sonography for Trauma (FAST) has been evaluated but few studies have been performed on the relationship between the amount of free intra-abdominal fluid and organ injury in blunt abdominal trauma. To select patients with a higher probability of intra-abdominal injuries, several scoring systems have been proposed based on the results of FAST. Objectives: The aim of this study was to determine the prognostic value of FAST according to the Huang scoring system and to propose a cut-off point for predicting the presence of intra-abdominal injuries on the Computed Tomography (CT) scan. The correlation between age and Glasgow Coma Scale (GCS) and the presence of intra-abdominal injuries on the CT scan was also assessed. Patients and Methods: This study was performed on 200 patients with severe blunt abdominal trauma who had stable vital signs. For all patients, FAST-ultrasound was performed by a radiologist and the free fluid score in the abdomen was calculated according to the Huang score. Immediately, an intravenous contrast-enhanced abdominal CT scan was performed in all patients and abdominal solid organ injuries were assessed. Results were analyzed using Kruskal-Wallis test, Mann-Whitney test and ROC curves. The correlation between age and GCS and the presence of intra-abdominal injuries on CT-scan was also evaluated. Results: The mean age of the patients was 29.6 ± 18.3 years and FAST was positive in 67% of the subjects. A significant correlation was seen between the FAST score and the presence of organ injury on CT scan (P < 0.001). Considering the cut-off point of 3 for the free fluid score (with a range of 0-8), sensitivity, specificity, positive predictive value and negative predictive value were calculated to be 0.83, 0.98, 0.93, and 0.95, respectively. Age and GCS showed no significant correlation with intra-abdominal injuries. Conclusions: It seems that FAST examination for intra-abdominal fluid in blunt trauma patients can predict intra-abdominal injuries with very high sensitivity and specificity. Using the scoring system can more accurately determine the probability of the presence of abdominal injuries with a cut-off point of three

Routine Chest Computed Tomography and Patient Outcome in Blunt Trauma

Background: Computerized Tomography (CT) scan is gaining more importance in the initial evaluation of patients with multiple trauma, but its effect on the outcome is still unclear. Until now, no prospective randomized trial has been performed to define the role of routine chest CT in patients with blunt trauma. Objectives: In view of the considerable radiation exposure and the high costs of CT scan, the aim of this study was to assess the effects of performing the routine chest CT on the outcome as well as complications in patients with blunt trauma. Patients and Methods: After approval by the ethics board committee, 100 hemodynamically stable patients with high-energy blunt trauma were randomly divided into two groups. For group one (control group), only chest X-ray was requested and further diagnostic work-up was performed by the decision of the trauma team. For group two, a chest X-ray was ordered followed by a chest CT, even if the chest X-ray was normal. Injury severity, total hospitalization time, Intensive Care Unit (ICU) admission time, duration of mechanical ventilation and complications were recorded. Data were evaluated using t-test, Man-Whitney and chi-squared test. Results: No significant differences were found regarding the demographic data such as age, injury severity and Glasgow Coma Scale (GCS). Thirty-eight percent additional findings were seen in chest CT in 26% of the patients of the group undergoing routine chest CT, leading to 8% change in management. The mean of in-hospital stay showed no significant difference in both groups with a P value of 0.098. In addition, the mean ICU stay and ventilation time revealed no significant differences (P values = 0.102 and 0.576, respectively). Mortality rate and complications were similar in both groups. Conclusions: Performing the routine chest CT in high-energy blunt trauma patients (with a mean injury severity of 9), although leading to the diagnosis of some occult injuries, has no impact on the outcome and does not decrease the in-hospital stay and ICU admission time. It seems that performing the routine chest CT in these patients may lead to overtreatment of nonsignificant injuries. The decision about performing routine CT scan in a trauma center should be made cautiously, considering the detriments and benefits

ON n-FOLD FILTERS IN BL-ALGEBRAS

Abstract The notions of n-fold fantastic basic logic and the related algebras, n-fold fantastic BL-algebras, are introduced. We also define n-fold fantastic filters and prove some relations between these filters and construct quotient algebras via these filters

Effects of whole body vibration on outer hair cells' hearing response to distortion product otoacoustic emissions

Whole body vibration (WBV) is one of the most vexing problems in industries. There is a debate about the effect of WBV exposure on hearing system as vibration-induced hearing loss. The purpose of this study was to investigate outer hair cells' (OHCs') hearing response hearing response to distortion product otoacoustic emissions (DPOAEs) in rabbits exposed to WBV. It was hypothesized that the DPOAE response amplitudes (A dp) in rabbits exposed to WBV would be lower than those in control rabbits not exposed to WBV. New Zealand white (NZW) rabbits as vibration group (n�=�6, exposed to WBV in the z-axis at 4-8 Hz and 1.0 ms-2 root mean square for 8 h per day during five consecutive days) and NZW rabbits as control group (n�=�6, not exposed to any WBV) were participated. A dp and noise floor levels (L nf) were examined on three occasions: day 0 (i.e., baseline), day 8 (i.e., immediately 1 h after exposure), and day 11 (i.e., 72 h following exposure) with f 2 frequencies ranging from 500 to 10,000 Hz and primaries L 1 and L 2 levels of 65 and 55 dB sound pressure level, respectively. Main effects were statistically found to be significant for group, time, and frequency (p�&lt;�0.05). DPOAE amplitudes were significantly larger for rabbits exposed to WBV, larger on day 8 and larger for mid to high f 2 frequencies (at and above 5,888.50 Hz). Main effects were not statistically found to be significant for ear (p�&gt;�0.05). Also, four statistically significant interactions including time by ear, time by frequency, group by frequency, and group by time were detected (p�&lt;�0.05). Contrary to the main hypothesis, DPOAE amplitudes were significantly larger for rabbits exposed to WBV. WBV exposure significantly led to enhanced mean A dp at mid to high frequencies rather than at low ones. © 2012 The Society for In Vitro Biology

Assessment of the influence of whole body vibration on Cochlear function

Background: Whole body vibration (WBV) is a potentially harmful consequence resulting from the dissipation of energy by industrial machineries. The result of WBV exposure on the auditory system remains unknown. The objective of the present research was to evaluate the influence of WBV on cochlear function, in particular outer hair cell function. It is hypothesized that WBV impairs cochlear function resulting in decreased Distortion Product Otoacoustic Emission (DPOAE) levels (Ldp) in rabbits subjected to WBV. Methods. Twelve rabbits were equally divided into vibration and control groups. Animals in vibration group were exposed to 1.0ms-2 r.m.s vertical WBV at 4-8Hz for 8h/day during 5 consecutive days. Outer hair cell function was assessed by comparing repeated-measurements of DPOAE levels (Ldp) across a range of f2 frequencies in rabbits both exposed and unexposed to WBV. DPOAE level shifts (LSdp) were compared across ears, frequencies, groups, and times. Results: No differences were seen over time in DPOAE levels in the non-exposed rabbits (p=0.082). Post-exposure Ldp in rabbits exposed to WBV were significantly increased at all test frequencies in both ears compared to baseline measures (p=0.021). The greatest increase in Ldp following exposure was seen at 5888.5Hz (mean shift=13.25dB). Post-exposure Ldp in rabbits exposed to WBV were not significantly different between the right and left ears (p=0.083). Conclusion: WBV impairs cochlear function resulting in increased DPOAE responses in rabbits exposed to WBV. DPOAE level shifts occurred over a wide range of frequencies following prolonged WBV in rabbits. © 2012 Moussavi-Najarkola et al.; licensee BioMed Central Ltd

Noise-induced outer hair cells' dysfunction and cochlear damage in rabbits

Background: Outer hair cells' (OHCs') dysfunctions as the extent of temporary and permanent threshold shifts (TTS and PTS) and cochlear damage were assessed in rabbits exposed to continuous noise. Methods: Twelve New Zealand white rabbits were studied in noise (N) (n=6; exposed to continuous noise; 95 dB SPL, 500-8000 Hz for 8 h per day during 5 consecutive days) and control (C) (n=6; not exposed to noise). OHCs' functions were assessed by distortion product otoacoustic emission (DPOAE) level (Ldp) measurements in different periods and comparing TTS and PTS. Animals were anaesthetized by CO2; cochleae were extracted, fixed in 10 formaldehyde for 48 hours, decalcified by 10 nitric acid for 24 hours, and dehydrated, embedded, sectioned 5 \am thickness and stained by Hematoxylin and Eosin for light microscopy. Results: The most and least Ldp or TTS or PTS were related to 5888.50 Hz and 588.00 Hz respectively in noise subjected rabbits (P0.05). Severely vacuolated OHCs, pyknotic IHCs, swollen SC, and slightly thickened BM were found. Conclusion: Continuous noise extensively led to OHCs' dysfunctions as decreased Ldp (both TTS and PTS) and highly damage to cochlea. © Iranian Red Crescent Medical Journal

Manufacturing and Installation of the Compound Cryogenic Distribution Line for the Large Hadron Collider

The Large Hadron Collider (LHC) [1] currently under construction at CERN will make use of superconducting magnets operating in superfluid helium below 2 K. A compound cryogenic distribution line (QRL) will feed with helium at different temperatures and pressures the local elementary cooling loops in the cryomagnet strings. Low heat inleak to all temperature levels is essential for the overall LHC cryogenic performance. Following a competitive tendering, CERN adjudicated in 2001 the contract for the series line to Air Liquide (France). This paper recalls the main features of the technical specification and shows the project status. The basic choices and achievements for the industrialization phase of the series production are also presented, as well as the installation issues and status

Inducing sterile pyramidal neuronal death in mice to model distinct aspects of gray matter encephalitis

Up to one person in a population of 10,000 is diagnosed once in lifetime with an encephalitis, in 50–70% of unknown origin. Recognized causes amount to 20–50% viral infections. Approximately one third of affected subjects develops moderate and severe subsequent damage. Several neurotropic viruses can directly infect pyramidal neurons and induce neuronal death in cortex and hippocampus. The resulting encephalitic syndromes are frequently associated with cognitive deterioration and dementia, but involve numerous parallel and downstream cellular and molecular events that make the interpretation of direct consequences of sudden pyramidal neuronal loss difficult. This, however, would be pivotal for understanding how neuroinflammatory processes initiate the development of neurodegeneration, and thus for targeted prophylactic and therapeutic interventions. Here we utilized adult male NexCre‑ ERT2xRosa26-eGFP-DTA (= ‘DTA’) mice for the induction of a sterile encephalitis by diphtheria toxin-mediated ablation of cortical and hippocampal pyramidal neurons which also recruits immune cells into gray matter. We report multifaceted aftereffects of this defined process, including the expected pathology of classical hippocampal behaviors, evaluated in Morris water maze, but also of (pre)frontal circuit function, assessed by prepulse inhibition. Importantly, we modelled in encephalitis mice novel translationally relevant sequelae, namely altered social interaction/cognition, accompanied by compromised thermoreaction to social stimuli as convenient readout of parallel autonomic nervous system (dys)function. High resolution magnetic resonance imaging disclosed distinct abnormalities in brain dimensions, including cortical and hippocampal layering, as well as of cerebral blood flow and volume. Fluorescent tracer injection, immunohistochemistry and brain flow cytometry revealed persistent blood–brain-barrier perturbance and chronic brain inflammation. Surprisingly, blood flow cytometry showed no abnormalities in circulating major immune cell subsets and plasma high-mobility group box 1 (HMGB1) as proinflammatory marker remained unchanged. The present experimental work, analyzing multidimensional outcomes of direct pyramidal neuronal loss, will open new avenues for urgently needed encephalitis research