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junctional hemorrhage

Jean-Guillaume Meusnier, Charles Dewar, Erti Mavrovi, Frederic Caremil, Pierre-Francois Wey, Jean-Yves Martinez
BACKGROUND: Junctional hemorrhage (i.e., between the trunk and limbs) are too proximal for a tourniquet and difficult to compress. These hemorrhages are responsible for 20% of preventable deaths by bleeding on the battlefield. The majority of these involve the groin area. Devices allowing a proximal compression for arterial axes have been recently developed. OBJECTIVE: The purpose of this study was to compare the use of two junctional- tourniquet models, the Combat Ready Clamp (CRoC®) and the SAM® Junctional Tourniquet (SJT), in simulated out-of-hospital trauma care when tourniquets were ineffective to stop the arterial flow...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Ronak Dholakia, Chandramouli Sadasivan, David Fiorella, Henry Woo, B Barry Lieber
Cerebral aneurysms are pathological focal evaginations of the arterial wall at and around the junctions of the circle of Willis. Their tenuous walls predispose aneurysms to leak or rupture leading to hemorrhagic strokes with high morbidity and mortality rates. The endovascular treatment of cerebral aneurysms currently includes the implantation of fine-mesh stents, called flow diverters, within the parent artery bearing the aneurysm. By mitigating flow velocities within the aneurysmal sac, the devices preferentially induce thrombus formation in the aneurysm within hours to days...
October 11, 2016: Journal of Biomechanical Engineering
Mary Catherine Furness, Emile Setlakwe, John Sallaway, Darren Wood, Jordan Fromstein, Luis G Arroyo
A 3-year-old Standardbred gelding with a history of pyrexia, persistent hemorrhage from the oral cavity, and a large, soft swelling at the junction of the caudal aspect of the mandibular rami and proximal neck was evaluated. The horse had neutropenia and anemia, with atypical granulated cells in a blood smear. Additional tests confirmed acute myeloid leukemia with basophilic differentiation, which has been reported in humans, cats, dogs, and cattle but not horses.
October 2016: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Susan M Hastings, Shriprasad Deshpande, Scott Wagoner, Kevin O Maher, David N Ku
Extracorporeal membrane oxygenation (ECMO) for cardiopulmonary support of critically ill patients is used frequently in the pediatric population. ECMO is burdened by complications, including thrombosis and hemorrhage. Here we demonstrate the focused location of clots, their histological composition, and the relationship of in situ thrombus to local hemodynamics in ECMO circuits.Pediatric ECMO circuits from Children's Healthcare of Atlanta, Emory University (Atlanta, GA) were obtained following removal from extracorporeal support over a 2...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Julio Gallego-Delgado, Upal Basu-Roy, Maureen Ty, Matilde Alique, Cristina Fernandez-Arias, Alexandru Movila, Pollyanna Gomes, Ada Weinstock, Wenyue Xu, Innocent Edagha, Samuel C Wassmer, Thomas Walther, Marta Ruiz-Ortega, Ana Rodriguez
Cerebral malaria is characterized by cytoadhesion of Plasmodium falciparum-infected red blood cells (Pf-iRBCs) to endothelial cells in the brain, disruption of the blood-brain barrier, and cerebral microhemorrhages. No available antimalarial drugs specifically target the endothelial disruptions underlying this complication, which is responsible for the majority of malaria-associated deaths. Here, we have demonstrated that ruptured Pf-iRBCs induce activation of β-catenin, leading to disruption of inter-endothelial cell junctions in human brain microvascular endothelial cells (HBMECs)...
October 3, 2016: Journal of Clinical Investigation
S E van Oostendorp, E C T H Tan, L M G Geeraedts
INTRODUCTION: Exsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area's remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Keshavamurthy Vinay, Chougule Abhijit, Sunil Dogra
Mucosal plasmacytoses constitute a group of idiopathic inflammatory disorders, characterized by a dense infiltrate of plasma cells at the mucocutaneous junction without any recognizable dermatosis or neoplasm. We report an unusual clinical presentation of mucosal plasmacytosis presenting with hemorrhagic crusting of the lips, mimicking erythema multiforme.
2016: Dermatology Online Journal
Sivaporn Inyoo, Aroonroong Suttitheptumrong, Sa-Nga Pattanakitsakul
Dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) is a severe pathological manifestation of dengue virus (DENV) infection. Enhanced production of cytokines in dengue patients is proposed to induce endothelial barrier instability resulting in increased vascular leakage. Tumor necrosis factor (TNF)-α is an inflammatory cytokine that activates endothelial cells and enhances vascular permeability and plasma leakage in DHF/DSS. The present study investigated the in vitro effect of TNF-α and DENV infection on the expression of adherence junction proteins, tight junction proteins and membrane integrity of human endothelial cell lines...
August 31, 2016: Japanese Journal of Infectious Diseases
Toshinari Kawasaki, Hitoshi Fukuda, Yoshitaka Kurosaki, Akira Handa, Masaki Chin, Sen Yamagata
BACKGROUND: The patient with SAH by hemorrhagic AVFs usually presents with meningeal signs including headache and nausea, and focal neurological deficit is found in rare cases. In this article, we report a case of acute compressive cervical myelopathy caused by hemorrhagic AVF at the craniocervical junction. CLINICAL DESCRIPTION: A 73-year-old woman was transferred to our hospital for sudden headache and subsequent left hemiparesis. Head CT showed subarachnoid hemorrhage (SAH) exclusively in the posterior fossa, and catheter angiography revealed a perimedullary arteriovenous fistula at the craniocervical junction as a source of the SAH...
August 24, 2016: World Neurosurgery
Mingtao Chang, Hao Tang, Dong Liu, Yang Li, Lianyang Zhang
A variety of agents may have a beneficial effect in reducing injury-induced intestinal edema of fluid, but studies confirming the efficacy and mechanisms of these agents in secondary intra-abdominal hypertension (IAH) are lacking. This study was to compare the effectiveness of melatonin, 7.5% hypertonic saline (HS), and hydroxyethyl starch 130/0.4 (HES) on the resuscitation of secondary IAH in a rat model. Female SD rats were divided into: sham group, shock group, lactated Ringer solution (LR) group, melatonin group, HS group, and HES group...
2016: PloS One
Marc J Dinkin, Athos Patsalides
BACKGROUND: Our goal was to evaluate the safety and efficacy of stenting of venous sinus stenosis (VSS) in patients with medically-refractory, medically-intolerant or fulminant idiopathic intracranial hypertension (IIH) in a prospective, observational study. METHODS: Thirteen patients with IIH who were refractory or intolerant to medical therapy or who presented with fulminant visual field (VF) loss underwent stenting of VSS at the transverse-sinus sigmoid sinus junction, using a Precise Pro carotid stent system (Cordis)...
August 23, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Huanjiao Jenny Zhou, Lingfeng Qin, Haifeng Zhang, Wenwen Tang, Weidong Ji, Yun He, Xiaoling Liang, Zongren Wang, Qianying Yuan, Alexander Vortmeyer, Derek Toomre, Germaine Fuh, Minghong Yan, Martin S Kluger, Dianqing Wu, Wang Min
Cerebral cavernous malformations (CCMs) are vascular malformations that affect the central nervous system and result in cerebral hemorrhage, seizure and stroke. CCMs arise from loss-of-function mutations in one of three genes: KRIT1 (also known as CCM1), CCM2 or PDCD10 (also known as CCM3). PDCD10 mutations in humans often result in a more severe form of the disease relative to mutations in the other two CCM genes, and PDCD10-knockout mice show severe defects, the mechanistic basis for which is unclear. We have recently reported that CCM3 regulates exocytosis mediated by the UNC13 family of exocytic regulatory proteins...
September 2016: Nature Medicine
Jinwei Pang, Yue Wu, Jianhua Peng, Ping Yang, Li Kuai, Xinghu Qin, Fang Cao, Xiaochuan Sun, Ligang Chen, Michael P Vitek, Yong Jiang
Apolipoprotein E (Apoe) genetic polymorphisms have been implicated in the long term outcome of subarachnoid haemorrhage (SAH), but little is known about the effect of Apoe on the early brain injury (EBI) after SAH. This study investigated the potential role of APOE in EBI post-SAH. Multiple techniques were used to determine the early BBB disruption in EBI post-SAH in a murine model using wild-type (WT) and Apoe-/- (KO) mice. Progressive BBB disruption (Evans blue extravasation and T2 hyperintensity in magnetic resonance imaging) was observed before the peak of endogenous APOE expression elevation at 48h after SAH...
July 24, 2016: Oncotarget
Natsuki Tanaka, Takeshi Izawa, Shigeo Takenaka, Hideo Akiyoshi, Jyoji Yamate, Mitsuru Kuwamura
Coiled-coil domain containing 85c (Ccdc85c) is a causative gene for hemorrhagic hydrocephalus mouse which shows hydrocephalus with frequent brain hemorrhage and formation of subcortical band heterotopia. A previous study revealed that Ccdc85C protein is expressed in the systemic simple epithelial cells with proliferative activity in rats and suggested that Ccdc85C expression may be related to the cell proliferation of simple epithelial cells. To reveal the roles of Ccdc85C in the proliferative lesion, we examined the expression patterns of Ccdc85C in the mammary gland tumor of dogs, a common representative tumor derived from simple epithelial cells...
July 26, 2016: Histology and Histopathology
John F Kragh, James K Aden, Stacy Shackelford, Michael A Dubick
BACKGROUND: The objective of the present study was to assess the effect of instructor learning on student performance in use of junctional tourniquets. METHODS: From a convenience sample of data available after another study, we used a manikin for assessment of control of bleeding from a right groin gunshot wound. Blood loss was measured by the instructor while training users. The data set represented a group of 30 persons taught one at a time. The first measure was a plot of mean blood loss volumes for the sequential users...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Jee Y Lee, Won H Na, Hae Y Choi, Kwang H Lee, Bong G Ju, Tae Y Yune
The disruption of the blood-spinal cord barrier (BSCB) by matrix metalloprotease (MMP) activation is a detrimental event that leads to blood cell infiltration, inflammation, and apoptosis, thereby contributing to permanent neurological disability after spinal cord injury (SCI). However, the molecular mechanisms underlying Mmp gene regulation have not been fully elucidated. Here, we demonstrated the critical role of histone H3K27 demethylase Jmjd3 in the regulation of Mmp gene expression and BSCB disruption using in vitro cellular and in vivo animal models...
November 2016: Neurobiology of Disease
Fei-Yu Pan, Lin Feng, Wei-Dan Jiang, Jun Jiang, Pei Wu, Sheng-Yao Kuang, Ling Tang, Wu-Neng Tang, Yong-An Zhang, Xiao-Qiu Zhou, Yang Liu
Our study investigated the effect of dietary methionine hydroxy analogue (MHA) on growth and immunity (head kidney, spleen and skin) of young grass carp (Ctenopharyngodon idella). A total of 630 grass carp (259.70 ± 0.47 g) were fed graded levels of MHA (0, 2.4, 4.4, 6.4, 8.5 and 10.5 g/kg diet) and one dl-methionine (DLM) group (6.4 g/kg diet) for 8 weeks. At the end of the feeding trial, fish were challenged with Aeromonas hydrophila for 14 days. The results indicated that optimal MHA increased lysozyme (LZ) and acid phosphatase (ACP) activities, complement 3 (C3), C4 and immunoglobulin M (IgM) contents and up-regulated mRNA levels of liver expressed antimicrobial peptide 2, hepcidin (head kidney), β-defensin-1 in the immune organs (P < 0...
September 2016: Fish & Shellfish Immunology
Melissa A Kottke, Thomas J Walters
Edema is typically presented as a secondary effect from injury, illness, disease, or medication, and its impact on patient wellness is nested within the underlying etiology. Therefore, it is often thought of more as an amplifier to current preexisting conditions. Edema, however, can be an independent risk factor for patient deterioration. Improper management of edema is costly not only to the patient, but also to treatment and care facilities, as mismanagement of edema results in increased lengths of hospital stay...
September 2016: Shock
Mark Calayag, Reid Hoshide, David D Gonda, Hal S Meltzer, Takanori Fukushima, Michael L Levy
INTRODUCTION: Hemorrhagic cavernous malformations involving the lateral pontine region require complex surgical considerations to maximize complete resection of the cavernoma and associated hemorrhage while minimizing morbidity. We describe our experience through the middle fossa rhomboid approach in 8 children with cavernomas involving the pons, with lateralized hemorrhages extending through the pontine parenchyma. METHODS: Eight children underwent this approach over a 10-year period at Rady Children's Hospital of San Diego...
August 2016: Neurosurgery
Guilherme Dabus, Jonathan A Grossberg, C Michael Cawley, Jacques E Dion, Ajit S Puri, Ajay K Wakhloo, Douglas Gonsales, Pedro Aguilar-Salinas, Eric Sauvageau, Italo Linfante, Ricardo A Hanel
BACKGROUND: The off-label use of flow diverters in the treatment of distal aneurysms continues to be debated. OBJECTIVE: To report our multicenter experience in the treatment of complex anterior cerebral artery aneurysms with the Pipeline embolization device (PED). METHODS: The neurointerventional databases of the four participating institutions were retrospectively reviewed for aneurysms treated with PED between October 2011 and January of 2016...
July 5, 2016: Journal of Neurointerventional Surgery
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