This editorial aims to refine the severe polytrauma management principles. While keeping ABCDE priorities, the termination of futile resuscitation and the early use of tourniquet to stop exsanguinating limb bleeding are crucial. Difficult-airway-management (DAM) is by a structured 5-level approach. The computerised tomography (CT) scanner is the tunnel to death for hemodynamically unstable patients. Focused Abdominal Sonography for Trauma–Ultrasonography (FAST USG) has replaced diagnostic peritoneal lavage (DPL) and is expanding to USG life support. Direct whole-body multidetector-row computed tomography (MDCT) expedites diagnosis & treatment. Non-operative management is a viable option in rapid responders in shock. Damage control resuscitation comprising of permissive hypotension, hemostatic resuscitation & damage control surgery (DCS) help prevent the lethal triad of trauma. Massive transfusion protocol reduces mortality and decreases the blood requirement. DCS attains rapid correction of the deranged physiology. Mortality reduction in major pelvic disruption requires a multi-disciplinary protocol, the novel pre-peritoneal pelvic packing and the angio-embolization. When operation is the definitive treatment for injury, prevention is best therapy.

Adult ; Bundle-Branch Block ; physiopathology ; Electrocardiography ; Humans ; Male ; Myocardial Infarction ; complications ; Syndrome ; Ventricular Fibrillation ; etiology ; physiopathology

As obesity is known to be related to hyperlipidemia, insulin and leptin resistance, and other chronic diseases, much recent research has focused on functional food materials and their anti-obesity activity. This study was performed to study the effects of Artemisia Iwayomogi oligosaccharide AIPI on the anti-obesity function in normal rats and diet-induced obese (DIO) rats. F344 male rats were divided into four groups: Normal-control (CONT), normal-AIPI, DIO-CONT and DIO-AIPI. The groups were provided with water (in the CONT groups) or another drink for 4 weeks. The final body weights of rats in the DIO-AIPI group were lower than those in the CONT group. Abdominal adipose tissue weight per kg of body weight in the DIO-AIPI group was significantly lower than that in the DIO-CONT group. Also, the final levels of serum-triglyceride, serum-total cholesterol and serum-low density lipoprotein cholesterol in the DIO-AIPI group were lower than those in the DIO-CONT group. Moreover, the serum-high density lipoprotein cholesterol level in the normal-AIPI group was significantly higher than that in the normal-CONT group. Finally, the serum-leptin concentration was significantly lower in the DIO-AIPI group. Total lipid, triglyceride, and total cholesterol contents in the feces of the DIO-AIPI group were as high as 142%, 199%, and 165% of the respective values of the DIO-CONT GROUP. These results indicate that orally administered Artemisia Iwayomogi oligosaccharide not only has hypotriglycemic and hypocholesterolemic effects, but also has the effect of reducing the body weight and the abdominal adipose tissue weights obese rats. Therefore, we expect that Artemisia Iwayomogi oligosaccharide AIPI may have an anti-obesity function in F344 diet-induced obese rats.
Abdominal Fat ; Animals ; Artemisia* ; Body Weight ; Cholesterol ; Chronic Disease ; Feces ; Functional Food ; Humans ; Hyperlipidemias ; Insulin ; Leptin* ; Lipoproteins ; Male ; Obesity ; Rats* ; Triglycerides ; Water ; Weights and Measures

OBJECTIVE: To investigate the effects of bisphenol A (BPA) on cell death pattern in neuronal development of chick embryos. MATERIALS AND METHODS: We planned to compare the cytokinetic features in the normal chick embryo and those with BPA. Fifteen eggs were divided into three GROUPS: the control group, BPA 50 microgram/g egg group and BPA 200 microgram/g egg group. Embryos were incubated for 56 hours (Hamburger & Hamilton stage 16) and then we injected BPA into embryos. The embryos were sectioned by 3 micrometer thickness at the level of wing buds and stained at 72 hours after incubation (HH stage 18). We observed cell death in the spinal cord using terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method. RESULTS: The TUNEL-positivity markedly increased in proportion to the doses of BPA. The number of TUNEL-positive cells per section was 15.2+/-2.14 in the control group, 34.6+/-3.44 in the BPA 50 microgram/g egg group, 87.6+/-4.32 in the BPA 200 g/g egg group. Furthermore the contour of spinal cord was deformed as the doses of BPA raised. CONCLUSION: BPA causes neuronal cell death and exerts cytotoxic effect on early chick embryos. It suggests that BPA might have an effect on cytogenesis during neural tube development.
Animals ; Apoptosis ; Benzhydryl Compounds ; Cell Death ; Chick Embryo ; Eggs ; Embryonic Structures ; Neural Tube ; Neurons ; Ovum ; Phenols ; Spinal Cord ; Wings, Animal

BACKGROUNDCardiac resynchronization therapy (CRT) is an effective electrical therapy for patients with moderate to severe heart failure and cardiac dyssynchrony. This study aimed to investigate the degree of acute left ventricular (LV) resynchronization with biventricular pacing (BVP) at different LV sites and to examine the feasibility of performing transthoracic echocardiography (TTE) to quantify acute LV resynchronization during CRT procedure.

METHODSFourteen patients with NYHA Class III-IV heart failure, LV ejection fraction < or = 35%, QRS duration > or = 120 ms and septal-lateral delay (SLD) > or = 60 ms on tissue Doppler imaging (TDI), underwent CRT implant. TDI was obtained from three apical views during BVP at each accessible LV site and SLD during BVP was derived. Synchronicity gain index (Sg) by SLD was defined as (1 + (SLD at baseline--SLD at BVP)/SLD at baseline).

RESULTSSeventy-two sites were studied. Positive resynchronization (R+, Sg > 1) was found in 42 (58%) sites. R+ was more likely in posterior or lateral than anterior LV sites (66% vs. 36%, P < 0.001). Concordance of empirical LV lead implantation sites and sites with R+ was 50% (7/14).

CONCLUSIONSThe degree of acute LV resynchronization by BVP depends on LV lead location and empirical implantation of LV lead results in only 50% concordance with R+. Performing TTE during CRT implantation is feasible to identify LV sites with positive resynchronization.

Aged ; Cardiac Resynchronization Therapy ; methods ; Echocardiography ; methods ; Female ; Heart Failure ; therapy ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; therapy

Adolescent ; Death, Sudden, Cardiac ; etiology ; Female ; Humans ; Ion Channels ; physiology ; Mutation ; Ryanodine Receptor Calcium Release Channel ; genetics ; Syncope ; etiology ; Tachycardia, Ventricular ; genetics

Multiple carcinoid tumors in stomach are very rare tumors and associated with pernicious anemia, chronic atrophic gastritis and Zollinger-Ellison syndrome. These are believed to be due to hypergastrinemia, resulting in chronic stimulation of enterochromaffine-like (ECL) cells, leading to hyperplasia, metaplasia and ultimately neoplasia. The carcinoid tumor is potentially malignant, even though it may grow slowly, so the treatment of choice must be endoscopic lumpectomy or surgical gastrectomy. The prognosis depends on the site of the tumor and its size. Most carcinoid tumors are less than 1 cm in size and metastasis is uncommon but metastasis in tumors with size over 2 cm is common. A case of multiple carcinoid tumors in stomach, which was successfully removed by endoscopy, is herein reported.
Anemia, Pernicious ; Carcinoid Tumor* ; Endoscopy ; Gastrectomy ; Gastrins ; Gastritis, Atrophic ; Hyperplasia ; Mastectomy, Segmental ; Metaplasia ; Neoplasm Metastasis ; Prognosis ; Stomach* ; Zollinger-Ellison Syndrome