OBJECTIVETo explore the acting mechanism of electrical field in electrical injury.

METHODSThirty-six New Zealand white rabbits were employed in the study and were randomly divided into 7 groups. There were 12 rabbits in group 1 and 4 in each group of other 6 groups. The animal model of nonthermal electrical injury previously replicated was employed in the study. Experiment with paralleled muscular fibers in electrical field was carried out in groups 2 approximately 4, while that of vertical muscular fibers in electrical field in groups 5-7. Anatomical examination was done to determine the index of deep burn injury (IDBI) in all groups of rabbits at 0, 2 and 24 postburn hour (PBH). Histological and ultrastructural examination, gamma picturing and isotope scanning with 99mTc were done in group 1 at 2 PBH.

RESULTSThere was no obvious skin injury in the white rabbits in group 1. Deep tissue necrosis was identified under the small electrode. Constant muscular spasm was observed in the inner side of the thigh. The muscles in paralleled electrical field suffered more severe injury than those in vertical one. Tissue injury was more severe in those areas with higher current density, less soft tissue, and also in the central area of the axis of the electric field. There were obvious changes in the perfusion and blood pool phases in these areas as observed with the aid of 99mTc. Light microscopic examination revealed swelling and necrosis of muscular fibers. Under electron microscopy, it was found that there were edema and dissolution with separation of lipid molecular layers of cell membrane, Shortened nucleus with partial dissolution of nuclear membrane, increased heparin granules within nucleus, swelling of mitochondria and endoplasmic reticulum, myofilament dissolution, expanded gap between myofilament and decreased number of heparin granules.

CONCLUSIONNon-thermal tissue injury in the electrical field, in terms of cell, ultrastructural and molecular levels, was induced and aggravated by all the factors constituting high voltage electrical field.

As the technologic sophistication of generation and distribution of electrical energy has grown, so has the general concern about the effects of electric fields on human health. There can be no doubt that the significance of electrical trauma will continue to grow with our increasing use of power. It is apparent that our understanding of the various forms of electric trauma must increase, while we continue to promote safety near electrical hazards and develop effective medical therapies. Tissue damage as a result of electrical injury occurs by two mechanisms which are summative in action and have a variable degree of contribute to the ultimate damage produced. Thermal tissue damage occurs as a result of heat generated within the tissue (which offer an electrical resistance) secondary to the passage of the electrical current. High temperatures can also lead to cell membrane components, e.g., phospholipids, to dissolve. Electroportation damage is the tissue damage induced secondary to the strong electric field. Transmembrane potentials caused by electrical current result in the formation of pore in the phospholipid component of the cell membrane resulting in loss of function of the cell membrane with consequent cell death.
Animals ; Electric Injuries/physiopathology* ; Heart Injuries/physiopathology* ; Hemodynamics ; Humans ; Muscle, Skeletal/injuries*

Electrical injuries can cause cardiac abnormalities, ranging from dysrhythmias to myocardial infarction. Atrial fibrillation after electrical injury is extremely rare. The mechanisms underlying electrical current-induced arrhythmias are unclear. However, due to differences in electrical resistance, current travels preferentially along blood vessels and nerves, making the heart the most susceptible organ to electrical injury. Cardiac arrhythmias may occur at the time of electrical injury or later, but most occur within the first day of injury. Almost all patients described in previous reports with atrial fibrillation developed the condition after high voltage injuries (> 1,000 V). In our case, however, atrial fibrillation developed after a low voltage injury (220 V). Atrial fibrillation was detected and the rate was controlled with intravenous digoxin infusion. A normal sinus rhythm was restored 21 h after the electrical injury.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Blood Vessels ; Digoxin ; Electric Impedance ; Electric Injuries ; Heart ; Humans ; Myocardial Infarction

Electrical injury may lead to a conduction disorder of the heart. We report here on a 36-year-old man, who was treated with a permanent pacemaker, after an electrical injury induced high-degree atrioventricular block and clinical manifestations (dizziness and dyspnea).
Adult ; Atrioventricular Block* ; Electric Injuries ; Heart ; Heart Conduction System ; Humans

We, herein, present a patient with no history of trauma who developed shoulder pain after undergoing low-voltage electric shock. According to the computed tomography, there was a multi-segmental fracture that extended into the glenoid cavity of the left scapula. A good outcome was obtained after open reduction and internal fixation. Emergency physicians should be aware of the possibility of scapular fracture extending into the glenoid cavity, especially in patients with shoulder pain after electrical injury.
Electric Injuries ; Emergencies ; Glenoid Cavity* ; Humans ; Scapula ; Shock* ; Shoulder Pain

Adolescent ; Drugs, Chinese Herbal ; therapeutic use ; Electric Injuries ; therapy ; Humans ; Male ; Wrist Injuries ; therapy

To evaluate the various factors related to the development of electric cataract in electric burn patients, we reviewed medical charts of 663 electric burn patients who were admitted to the department of General Surgery in Hanil General Hospital between 1981 and 1993. Eleven patients(1.7%) had electric cataract in both eyes. All of them were injured by contact with 22,900 voltage current, and developed third degree burns. Fifty-eight electric burn patients had their electric inputs through their head and eight (13.8%) among them developed cataracts. Only three(0.5%) among 567 electric burn patients who had their electric inputs through upper extremities developed cataracts. The interval between the electric injury and the diagnosis was 2 to 18 months. Anterior subcapsular opacity was the most common type of lenticular opacity. Other associated ocular complications included uveitis, macular edema, macular degeneration, and macular hole.
Burns ; Burns, Electric ; Cataract* ; Diagnosis ; Electric Injuries ; Head ; Hospitals, General ; Humans ; Macular Degeneration ; Macular Edema ; Retinal Perforations ; Upper Extremity ; Uveitis

OBJECTIVE: To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). METHODS: Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated. RESULTS: There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks. CONCLUSION: The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.
Acoustics ; Asthenia ; Brain Injuries* ; Deglutition ; Deglutition Disorders* ; Dysphonia* ; Electric Stimulation Therapy ; Electric Stimulation* ; Humans ; Phonation ; Pilot Projects* ; Stroke

OBJECTIVE: To evaluate effects of short stretch bandage and electrical stimulation therapy (EST) for the complex regional pain syndrome (CRPS) in hemiplegic patients METHOD: 10 hemiplegic CRPS patients after stroke or traumatic brain injury were included in the study. We established CRPS from clinical symptoms and triphasic bone scan. Short stretch bandage was applied on affected limb and changed every 24 hours for 2 weeks. EST was tried for 10 minutes twice per day. It was applied at finger and wrist flexor muscles. We measured hand volume of pre-and posttreatment using hand volumeter. Also compared pre-and posttreatment pain-free range of motion (ROM) of metacarpophalangeal (MCP) joint and third proximal interphalangeal (PIP) joint circumference. RESULTS: Mean difference of hand volume between the affected and the unaffected prior to treatment was 20.5+/-4.9 ml (7.9+/-2.3%). After treatment, mean volume change was 15.5+/-4.9 ml (5.5+/-1.8%) (p<0.05). Mean change of pain-free ROM was 8.0+/-4.8 degree (10.9+/-7.1%), mean change of PIP joint circumference was 3.1+/-1.4 mm (5.9+/-2.4%) (p<0.05). CONCLUSION: Short stretch bandage and EST complex therapy is effective for the reduction of paralyzed hand edema and pain in hemiplegic CRPS patients. However further control study is required.
Bandages* ; Brain Injuries ; Edema ; Electric Stimulation Therapy* ; Electric Stimulation* ; Extremities ; Fingers ; Hand ; Humans ; Joints ; Muscles ; Range of Motion, Articular ; Stroke ; Wrist

Objective: To evaluate the baseline colon transit time and rectoanal manometry and the effects of the electrical stimulation to the sacral dermatomes for the neurogenic bowel according to the level of spinal cord injury. METHOD: To determine the baseline differences, thirty three patients were classified into two groups: cord injured level above T9 and from T9 to L2. And thirteen patients were included in follow-up study to evaluate the effects of 4 weeks electrical stimulation. RESULTS: There was no significant difference in the baseline colon transit time on two groups. After electrical stimulation, the left and rectosigmoid transit time was more improved in lower level injured group comparing with upper level injured group. In the rectoanal manometry the mean resting anal pressure, mean squeezing pressure, high pressure zone, and threshold of rectoanal inhibitory reflex were increased after the electrical stimulation on two groups. And the mean squeezing pressure on T9-L2 injured patients was significantly increased (p<0.05). CONCLUSION: The elecrical stimulation to the sacral dermatomes increased the mean squeezing pressure of rectoanal manometry more significantly on the T9-L2 injured patients than the group of spinal cord injured level above T9. However, there was no statistically significant difference in the colon transit time before and after the electrical stimulation between two groups
Colon ; Electric Stimulation Therapy ; Electric Stimulation* ; Follow-Up Studies ; Humans ; Manometry ; Neurogenic Bowel* ; Reflex ; Spinal Cord Injuries* ; Spinal Cord*