RESUMEN
The accidental loss of fingertip soft tissues, which may expose tendons and bones, is a common injury in emergency departments. If these lesions are poorly treated, they can impair fine motor skills and tactile sensitivity of the fingertips. The study was conducted on 30 patients (24 males and 6 females) with 32 soft tissue defects of the fingertip treated in emergency plastic surgery with local pedicled flap at the Plastic Surgery Department of Saint Paul Hospital Hanoi from 01/2016 to 06/2017. The most common cause of injury (21/30) was occupational accidents. At the time of the accident, 12 patients did not have personal protective equipment (PPE). Among 18 patients who had one, eight had incomplete equipment. Of 32 implanted skin flaps, 31 survived completely without necrosis or infection, only one being affected by epidermolysis. Postoperative evaluation showed excellent motor skills for 31/32 fingers and a sensitivity restoration at S4 level for 27/32. Workplace accident is the main cause of fingers soft tissue defects. Covering the fingers soft tissue defects with local pedicled flap in emergency preserves the fine motor function and the delicated tactile sensation of the fingers.
Une étude sur les pertes de substance accidentelles de la pulpe des doigts et leur recouvrement par lambeaux locaux a été réalisée dans le service de chirurgie reconstructive de l'hôpital Saint Paul de Hanoï de janvier 2016 à juin 2017. Elle a concerné 30 patients, 24 hommes et 6 femmes. La cause la plus fréquente était l'accident de travail, soit 21/30 cas. Au moment de l'accident, 12 patients ne disposaient pas d'équipement de protection individuelle (EPI). Sur les 18 patients qui en possédaient, 8 avaient un équipement incomplet. Sur 32 lambeaux mis en place, 31 ont survécu complètement sans nécrose, ni infection, et un a subi une épidermolyse. Trente et un des 32 doigts opérés ont conservé une fonction motrice de bonne qualité et 27 ont récupéré une sensibilité de niveau S4. Le traitement en urgence des pertes de substance de la pulpe des doigts par des lambeaux locaux permet de préserver la fonction motrice fine et la sensibilité des pulpes des doigts.
Asunto(s)
Traumatismos de los Dedos/cirugía , Traumatismos Ocupacionales/cirugía , Procedimientos de Cirugía Plástica , Trasplante de Piel , Colgajos Quirúrgicos/trasplante , Accidentes de Trabajo/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Traumatismos de los Dedos/epidemiología , Traumatismos de los Dedos/rehabilitación , Dedos/patología , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Traumatismos Ocupacionales/epidemiología , Traumatismos Ocupacionales/rehabilitación , Procedimientos de Cirugía Plástica/métodos , Procedimientos de Cirugía Plástica/rehabilitación , Procedimientos de Cirugía Plástica/estadística & datos numéricos , Recuperación de la Función/fisiología , Estudios Retrospectivos , Trasplante de Piel/métodos , Trasplante de Piel/rehabilitación , Trasplante de Piel/estadística & datos numéricos , Traumatismos de los Tejidos Blandos/epidemiología , Traumatismos de los Tejidos Blandos/rehabilitación , Traumatismos de los Tejidos Blandos/cirugía , Tacto/fisiología , Resultado del Tratamiento , Vietnam/epidemiología , Adulto JovenRESUMEN
Semaphorins have an important role in synapse refinement in the mammalian nervous system. The class 3 semaphorin-3F (Sema3F) acting through neuropilin 2/plexin-A3 (Nrp2/PlexA3) holoreceptor complex signals in vivo to restrain apical dendritic spine morphogenesis of cortical pyramidal neurons and hippocampal neurons during postnatal development and mediates excitatory synaptic transmission. Semaphorin signaling has been implicated in the etiology of a number of neurodevelopmental disorders; however, the effects on behavior and mental function of dysregulated Sema3F-Nrp2 signaling have not been fully addressed. The present study is the first behavioral investigation of mice harboring a mutation of the nrp2 gene. Given that loss of Nrp2 signaling alters cortical and hippocampal synaptic organization, we investigated performance of nrp2-deficient mice on learning and sensorimotor function that are known to depend on cortical and hippocampal circuitry. When compared with age-matched controls, nrp2 null mice showed striking impairments in object recognition memory and preference for social novelty. In addition, nrp2(-/-) mice displayed impaired motor function in the rotarod test and in observations of grooming behavior. Exploration of novel olfactory sensory stimuli and nociception were unaffected by the loss of Nrp2. Overall, loss of Nrp2 may induce aberrant processing within hippocampal and corticostriatal networks that may contribute to neurodevelopmental disease mechanisms.
Asunto(s)
Conducta Animal/fisiología , Hipocampo/fisiopatología , Trastornos de la Memoria/fisiopatología , Trastornos Motores/fisiopatología , Neuropilina-2/antagonistas & inhibidores , Animales , Modelos Animales de Enfermedad , Trastornos de la Memoria/complicaciones , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Trastornos Motores/complicaciones , Neuropilina-2/deficienciaRESUMEN
The toxicity of maize containing known doses of fumonisin B1 (FB1) was investigated in mallard ducks during force-feeding. Seventy-five ducks at 12 wk of age were randomly divided into 3 groups of 25, and received control maize, naturally contaminated maize containing 20 mg/kg of FB1, or a mixture of control and contaminated maize (50/50, vol/vol). Force-feeding was performed during 12 d that correspond to a final average feed intake of approximately 10 kg of maize per duck. At the end of the study, 8% mortality was observed in ducks fed 20 mg of FB1/kg of feed, whereas no mortality occurred in the other groups. Liver weight, and plasma concentrations of protein, cholesterol, alanine aminotransferase (ALAT), and lactate dehydrogenase (LDH) were increased by force-feeding, whereas feed conversion ratio appeared decreased by the toxin. Microscopic examination of the liver showed that steatosis was mostly macrovacuolar in control ducks, whereas it was microvacuolar in ducks fed 20 mg of FB1/kg of feed. Free sphingolipid concentrations were measured in liver and plasma. Sphinganine (Sa) and sphinganine to sphingosine (Sa/So) ratio were increased in all treatment groups. These parameters were not affected by force-feeding and all individual values obtained in the treated ducks were higher than those obtained in control ducks. Our results suggest that free Sa level and Sa/So ratio can be used to reveal exposure of ducks to FB1 at doses of 10 mg/kg or greater in feed.
Asunto(s)
Patos , Nutrición Enteral , Fumonisinas/administración & dosificación , Fumonisinas/toxicidad , Esfingosina/análogos & derivados , Zea mays/química , Animales , Hígado Graso/inducido químicamente , Hígado Graso/patología , Hígado Graso/veterinaria , Contaminación de Alimentos , Fumonisinas/análisis , Hígado/química , Enfermedades de las Aves de Corral/inducido químicamente , Enfermedades de las Aves de Corral/patología , Esfingosina/análisis , Esfingosina/sangre , Zea mays/toxicidadRESUMEN
The neural cell adhesion molecule, L1, is thought to play a critical role in the formation and fasciculation of axon tracts during development. In the chick, the L1 cell adhesion molecule is expressed on both ipsi- and contralateral portions of commissural axons and perturbation studies produced a defasciculation of the ipsilateral commissural fibers. Yet in the rat, L1 is reported along commissural axons only after they have reached the contralateral marginal zone. When this species variation was reexamined, L1 was found to be expressed on rat commissural axons in a pattern similar to that observed in the chick. In addition, L1 is detected along commissural axons as early as embryonic day 12 in rats and maintained on both the ipsi- and contralateral surfaces during embryonic development. Other molecular markers that identify commissural axons in rats are TAG-1 (transiently expressed axonal glycoprotein) and DCC (deleted in colorectal cancer), and thus the pattern of L1 staining was compared with that of these other members of the immunoglobulin superfamily. Commissural axons emerging from dorsally located neurons are identified with TAG-1 and DCC, whereas L1 is detected only on ventrally located commissural axons. The pattern of L1 expression overlaps that of the more numerous laterally and ventromedially located GABAergic commissural axons. Furthermore, some of the GABAergic commissural axons express L1 on their surfaces. While commissural axons are often considered as a single population, differences in the combination of adhesion-type molecules on their surfaces and in their neurotransmitter phenotypes may signify distinctive neuronal subgroups.
Asunto(s)
Axones/metabolismo , Moléculas de Adhesión Celular Neuronal , Glutamato Descarboxilasa/biosíntesis , Isoenzimas/biosíntesis , Glicoproteínas de Membrana/biosíntesis , Moléculas de Adhesión de Célula Nerviosa/biosíntesis , Médula Espinal/embriología , Médula Espinal/metabolismo , Animales , Antígenos de Superficie/biosíntesis , Recuento de Células , Contactina 2 , Femenino , Complejo de Antígeno L1 de Leucocito , Masculino , Ratas , Ratas Sprague-Dawley , Médula Espinal/citologíaRESUMEN
OBJECTIVE: To determine postcesarean complications and identify independent risk factors for surgical site infection. METHODS: We studied a cohort of 969 women delivered by cesarean between May and August 1997. Infections were determined by examinations during ward rounds, reviews of laboratory results, and follow-up for 30 days after discharge. Risk factors were identified by multiple logistic regression. RESULTS: Surgical complications were rare. There were febrile morbidity and infection complications in 16.2% and 12.4% of subjects, respectively. Eighty-five subjects had 95 surgical site infections (9.8%), and seven risk factors were independently associated with infection. Risk factors included preoperative remote infection (adjusted odd ratio [OR] 16.5, 95% confidence interval [CI] 2.1, 128.3); chorioamnionitis (OR 10.6, 95% CI 2.1, 54.2); maternal preoperative condition (OR 5.3 for those with severe systemic disease [American Society of Anesthesiologists score > or =31, 95% CI 1.2, 24.0); preeclampsia (OR 2.3, 95% CI 1.1, 4.9); higher body mass index (OR 2.0 for every five-unit increment, 95% CI 1.3, 3.0); nulliparity (OR 1.8, 95% CI 1.1, 3.2); and increased surgical blood loss (OR 1.3 for every 100-mL increment, 95% CI 1.1, 1.5). CONCLUSION: Host susceptibility and existing infections were important predictors of surgical site infection after cesarean delivery. Further intervention should target this high-risk group to reduce the clinical effect of surgical site infection.
Asunto(s)
Cesárea/efectos adversos , Infección de la Herida Quirúrgica/epidemiología , Adulto , Pérdida de Sangre Quirúrgica , Corioamnionitis/epidemiología , Comorbilidad , Susceptibilidad a Enfermedades , Femenino , Humanos , Modelos Logísticos , Oportunidad Relativa , Embarazo , Estudios Prospectivos , Factores de Riesgo , Infección de la Herida Quirúrgica/etiologíaRESUMEN
Early-forming commissural neurons are studied intensively as a model of axonal outgrowth and pathfinding, yet the neurotransmitter phenotype of the majority of these neurons is not known. The present study has determined that a substantial number of commissural neurons express the 65-kDa isoform of glutamic acid decarboxylase (GAD65) as early as embryonic day 12 (E 12). Patterns of GAD65 localization were compared with those of TAG-1, the Transiently expressed Axonal Glycoprotein that is the best known marker of commissural axons. On E13, both GAD65- and TAG-1-labeled commissural axons emanate from similar lateral and ventromedial regions. However, dorsally located TAG-1-positive commissural axons were GAD65-negative. These results suggest that commissural neurons have both gamma-aminobutyric acid (GABA)ergic and non-GABAergic phenotypes. The intensity of GAD65 staining within commissural somata and axons decreased between E14-15 and continued to decline during embryonic development, whereas terminal-like structures in surrounding neuropil increased dramatically. This sudden loss of somatic and axonal GAD65 staining was unexpected and could be interpreted as commissural neurons only transiently expressing the GABAergic phenotype. Further experiments were undertaken to identify commissural neurons with other established GABAergic markers, GAD67 and GABA. When antibody labeling of the two GAD isoforms was compared, GAD67 was detected 1 day later than GAD65, and in a different subcellular distribution. In contrast to GAD65, GAD67 intensely stained somata but labeled few commissural axons. GABA immunoreactivity also was detected in commissural axons 1 day after GAD65, and the labeling pattern between E13 and E16 resembled that of GAD67 rather than GAD65. When GAD and GABA results were compared, it was clear that a number of ventrally located commissural neurons expressed and maintained the GABAergic phenotype during embryonic development. However, the early expression and subcellular redistribution of GAD65 suggests that the GAD isoforms are differentially regulated. The function of the transient GAD65 expression in commissural somata and axons is unknown, but its temporal expression pattern parallels the transient expression of TAG-1, as both are expressed during the early stages of commissural axon outgrowth and pathfinding.
Asunto(s)
Moléculas de Adhesión Celular Neuronal , Neuronas/química , Ratas Sprague-Dawley/fisiología , Médula Espinal/citología , Médula Espinal/embriología , Ácido gamma-Aminobutírico/genética , Animales , Anticuerpos Monoclonales , Axones/química , Axones/enzimología , Contactina 2 , Femenino , Regulación del Desarrollo de la Expresión Génica , Glutamato Descarboxilasa/análisis , Glutamato Descarboxilasa/inmunología , Inmunohistoquímica , Isoenzimas/análisis , Isoenzimas/inmunología , Glicoproteínas de Membrana/análisis , Neuronas/enzimología , Neuronas/ultraestructura , Fenotipo , Embarazo , Ratas , Ácido gamma-Aminobutírico/análisis , Ácido gamma-Aminobutírico/inmunologíaRESUMEN
A prospective study was conducted following 1364 major operations at the 450-bed Hungvuong Obstetric and Gynaecological Hospital in HoChiMinh City, Vietnam, from 1 May to 30 September 1997 to characterize postoperative hospital-acquired infections. These infections were identified by ward rounds, review of laboratory results and patient follow-up until 30 days after discharge. During the study period, 194 infections were identified, yielding a rate of 14.2 infections per 100 operations. The most common sites were surgical wound and urinary tract, contributing together 95.9% of all hospital-acquired infections. The four most common pathogens were Staphylococcus aureus (29.6%), Escherichia coli (20.4%), Enterococci (16.7%) and Staphylococcus epidermidis (14.8%).