PURPOSETo evaluate the usefulness and information collecting ability of speckle tracking imaging techniques in the assessment of myocardial regional ventricular contractility in a rabbit model with blunt cardiac injury.

METHODSFifteen healthy New Zealand rabbits weighing (2.70 ±0.28) kg were anesthetized (3% pentobarbital sodium/i.v) and impacted using the BIM-II biological impact machine to induce myocardial contusion (MC). Hemodynamic parameters, such as heart rate, systolic pressure, mean arterial pressure, diastolic pressure and central venous pressure, were determined before and after MC. Further, parameters reflecting left ventricular functions, such as left ventricular end systolic pressure, left ventricular end diastolic pressure, isovolumic pressure (IP) and the maximal increasing/decreasing rate of left intraventricular pressure (±dp/dtmax), were also determined before and after MC. Left ventricular functions were determined either by two dimensional transthoracic echocardiography or by speckle tracking imaging for segmental abnormal ventricular wall motions.

RESULTSHeart rate, systolic pressure, diastolic pressure and mean arterial pressure decreased significantly but transiently, while central venous pressure markedly increased after MC. In contrast to significant changes in diastolic functions, there was no significant change in cardiac systolic functions after MC. The speckle tracking imaging demonstrated that strain values of different myocardial segment significantly decreased post impact, and that of the ventricular segment decreased from segment to segment.

CONCLUSIONSpeckle tracking imaging is useful and informative to assess myocardial regional dysfunctions post MC.

Animals ; Echocardiography ; Female ; Heart Injuries ; diagnostic imaging ; physiopathology ; Hemodynamics ; Male ; Myocardial Contraction ; Rabbits ; Ventricular Function ; Wounds, Nonpenetrating ; diagnostic imaging ; physiopathology

Although nitric oxide (NO) plays an important role in the pathophysiological process of cerebral ischemia or severe traumatic brain injury, its contribution to the pathogenesis of moderate diffuse axonal injury (mDAI) remains to be clarified. The alterations in nitric oxide synthase (NOS) activity and the histopathological response after mDAI was investigated. Forty anesthetized Sprague-Dawley adult rats were injured with a Marmarou's weight-drop device through a Plexiglas guide tube. These rats were divided into 8 groups (control, 1 hr, 2 hr, 3 hr, 6 hr, 12 hr, 24 hr, 48 hr after trauma). The temporal pattern of apoptosis in the adult rat brain after mDAI was characterized using TUNEL histochemistry. In addition, the cDNA for NOS activity was amplified using RT-PCR. The PCR products were electrophoresed on a 2% agarose gel. eNOS activity was not detected, but nNOS activity was expressed after 3 hr and continuously 48 hr after impact, which was approximately double that of the control group at 12 and 24 hr. Subsequently, there was a decrease in activity after 48 hr. The iNOS activity increased dramatically after 12 hr and was constant for a further 12 hr followed by a dramatic decrease below the level of the control group. Significant apoptotic changes occurred 12 and 24 hr. after insult. nNOS and iNOS activity were affected after moderate diffuse axonal injury in a time-dependent manner and there was a close relation between the apoptotic changes and NOS activity. Although the nNOS activity was expressed early, its activity was not stronger th an iNOS, which was expressed later.
Animal ; *Apoptosis ; Craniocerebral Trauma/enzymology/*physiopathology ; Diffuse Axonal Injury/enzymology/*physiopathology ; Nitric-Oxide Synthase/*metabolism ; Rats ; Rats, Sprague-Dawley ; Wounds, Nonpenetrating/enzymology/*physiopathology

OBJECTIVE: To explore MSCT optimal examination time for patients with unconspicuous rib fracture. METHODS: Sixty-three patients with thoracic trauma from January 2009 to June 2011 were collected. They were examined by MSCT in the first week after trauma and re-examined during eighth weeks after trauma. The number of rib which had been found fractured in the first examination was compared to that in re-examinations. RESULTS: Patients with fine rib fracture often have different diagnostic results at different examination time after trauma. There was statistical difference between the number in the first week and the third week to the fifth week. CONCLUSION MSCT could show the pathophysiological changes of rib fracture objectively in the stage between the third week and the fifth week after trauma, which is optimal examination time for the fine rib fracture.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; Pleura/pathology* ; Radiography, Thoracic/methods* ; Rib Fractures/physiopathology* ; Thoracic Injuries/physiopathology* ; Time Factors ; Wounds, Nonpenetrating/physiopathology* ; Young Adult

OBJECTIVE: To analyze and summarize the characteristics of traumatic macular hole and to discuss the key points and matters need attention in forensic identification. METHODS: Sixteen cases of traumatic macular hole were collected from Forensic Science Identification Center of China Medical University from 2004 to 2009 and analyzed. RESULTS: All of the 16 cases resulted from closed ocular contusion. Traumatic macular hole was more common in young men and may occur immediately after injury or after a certain interval. Six months after injury, there was a spontaneous closure of macular hole in 2 cases and the vision of the injured in 12 cases improved to different degrees. According to the degree of vision dysfunction, 12 cases were identified as slight injury, 4 cases were identified as severe injury. CONCLUSION Traumatic macular hole has its characteristics. Its injury degree is all slight or severe injury. The time of identification should be within 3-6 months.
Adolescent ; Adult ; Expert Testimony ; Eye/physiopathology* ; Eye Injuries/physiopathology* ; Female ; Forensic Medicine ; Fundus Oculi ; Humans ; Injury Severity Score ; Male ; Remission, Spontaneous ; Retinal Perforations/physiopathology* ; Retrospective Studies ; Time Factors ; Tomography, Optical Coherence ; Visual Acuity ; Wounds, Nonpenetrating/physiopathology* ; Young Adult

OBJECTIVE: To establish a 3D finite element model of the complete human thoracic cage, and to perform a biomechanical analysis. METHODS: The multislice computed tomography (MSCT) images of human thorax were obtained and used to develop a 3D reconstruction and a finite element model of the thoracic cage by finite element modeling software. The right hypochondrium area of the model was simulated to sustain the frontal impacts by a blunt impactor with velocities of 4, 6 and 8 m/s, and the distribution of stress and strain after the impact of the model was analyzed. RESULTS: A highly anatomically simulated finite element model of human thoracic cage was successfully developed with a fine element mean quality which was above 0.7. The biomechanical analysis showed that the thoracic cage revealed both local bending and overall deformation after the impact. Stress and strain arose from the initial impact area of the ribs, and then spread along the ribs to both sides, at last concentrated in the posterior side of the ribs and near the sternum. Impacts with velocities of 6 m/s and 8 m/s were predicted to cause rib fractures when the strain of the ribs were beyond the threshold values. CONCLUSION The finite element modeling software is capable of establishing a highly simulated 3D finite element model of human thoracic cage. And the established model could be applicable to analyze stress and strain distribution of the thoracic cage under forces and to provide a new method for the forensic identification of chest injury.
Adult ; Cadaver ; Computer Simulation ; Finite Element Analysis ; Forensic Medicine ; Humans ; Imaging, Three-Dimensional ; Male ; Models, Biological ; Multidetector Computed Tomography ; Stress, Mechanical ; Thoracic Injuries/physiopathology* ; Thorax/physiology* ; Wounds, Nonpenetrating/physiopathology*

OBJECTIVE: To study the characteristics of forensic identification cases involved with peripheral nerve injury, and to discuss how to apply the clinical information, forensic examination and neurophysiological testing. METHODS: One hundred and fifty-eight cases which were diagnosed peripheral nerve injury in clinic, were collected. Then the individual characteristics, injuries, identification results, exaggeration or camouflage were analysed. RESULTS: The male, the unemployed, and the young and middle-aged were common in our cases. The main reasons of "peripheral nerve injury" were traffic accidents and sharp injuries. Most wounded parts were in limbs. Also the exaggeration and camouflage accounted for a considerable proportion in our cases. CONCLUSION The forensic identification of "peripheral nerve injury" cases should be evaluated with clinical information, forensic examination and electrophysiological testing comprehensively.
Accidents, Traffic ; Adolescent ; Adult ; Age Distribution ; Disability Evaluation ; Electromyography ; Electrophysiology ; Female ; Forensic Medicine ; Humans ; Male ; Middle Aged ; Neural Conduction/physiology* ; Peripheral Nerve Injuries ; Peripheral Nerves/physiopathology* ; Peripheral Nervous System Diseases/physiopathology* ; Retrospective Studies ; Trauma Severity Indices ; Wounds, Nonpenetrating/physiopathology* ; Young Adult