Kazuistika prezentuje případ mladé ženy, která utrpěla poranění jater při úrazu elektrickým proudem a následném pádu ze stožáru vysokého napětí. Vzniklý jaterní hematom se při negativním vstupním CT vyšetření prezentoval s 48hodinovým časovým odstupem.

Our report presents the case of a young woman who suffered liver trauma after electrical current injury and ensuing fall from an electricity pylon. The resulting intrahepatic hematoma manifested after a time interval of 48 hours following the injury, with initially negative CT scan.

• Keywords
• jaterní hematom,
• MeSH
• Whole Body Imaging methods   MeSH
• Adult MeSH
• False Negative Reactions MeSH
• Hematoma * diagnosis   etiology   MeSH
• Liver * injuries   MeSH
• Contrast Media diagnostic use   MeSH
• Humans MeSH
• Delayed Diagnosis * MeSH
• Tomography, X-Ray Computed MeSH
• Multiple Trauma MeSH
• Burns, Electric MeSH
• Electric Injuries * MeSH
• Injury Severity Score MeSH
• Accidental Falls MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Renal artery thrombosis is a rare complication of blunt abdominal injury. It occurs most frequently in car accidents in which sudden deceleration results in multiple internal injuries. Renal artery occlusion occurs rarely as an isolated blunt trauma. This report presents a case of traumatic occlusion of the left renal artery with complete ischaemia of the left kidney in a haemodynamically stable girl who suffered multiple seat-belt injuries in a car crash. Ambiguous findings on a CT scan of the abdominal cavity indicated surgical inspection of the abdomen and, since the injury-to-surgery interval was short, an attempt at revascularisation of the left kidney was made. This was performed using laparotomy through a lateral left-side incision, as an uncommon approach to the injured organs. A seat-belt fracture of the L2/3 spine was stabilised at secondstage surgery. Key words: renal artery thrombosis, seat-belt fracture of the lumbar spine.

• MeSH
• Renal Artery injuries   surgery   MeSH
• Seat Belts adverse effects   MeSH
• Accidents, Traffic MeSH
• Laparotomy MeSH
• Kidney blood supply   MeSH
• Humans MeSH
• Kidney Diseases MeSH
• Multiple Trauma complications   MeSH
• Thrombosis etiology   surgery   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

OBJECTIVES: This retrospective study aimed to analyze the trend of mortality due to thoracic aortic ruptures caused by deceleration injuries that occurred within the catchment area of Hradec Kralove University Hospital. MATERIALS AND METHODS: The study sample comprised 175 patients who had sustained thoracic aortic ruptures caused by deceleration injuries and were transported to Hradec Kralove University Hospital in 2009-2014. The small proportion of patients enrolled in this retrospective study were diagnosed and treated at the emergency department (ED). However, the overwhelming majority of the sample comprised of patients who died at the accident scene and later underwent an autopsy at the Institute of Forensic Medicine in our hospital. RESULTS: Of 175 patients, 150 underwent an autopsy. Of these, 139 individuals (79%) died at the incident scene, and 11 (6%) were transported to the ED and later died of their injuries. A total of 36 patients were admitted to the hospital; 29 were admitted primary (11 later died), and 7 were transferred. No deaths occurred in the group of secondary admissions. Thus, 31% of all patients hospitalized died following transport to the hospital. Of 175 patients, 15% (or 69% of all hospitalized patients) survived their injuries. Among patients who died as a result of thoracic aortic injury, no unexpected deaths were recorded (i.e., no deaths among patients with survival probability more than 50% = PS > 0.5). CONCLUSION: Our results suggested that the lethality of thoracic aortic injuries might be minimized by transporting triage-positive patients directly to trauma centers. Accurate diagnoses and treatments were supported by admission chest X-rays, a massive transfusion protocol, and particularly, CT angiography, which is not routinely included in primary surveys. An additional prognostic parameter was clinical collaboration between an experienced trauma surgeon, an interventional radiologist, and a vascular or thoracic surgeon.

• MeSH
• Aorta, Thoracic diagnostic imaging   injuries   MeSH
• Accidents, Traffic mortality   statistics & numerical data   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Radiography MeSH
• Retrospective Studies MeSH
• Aortic Rupture diagnostic imaging   epidemiology   etiology   mortality   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Trauma Centers statistics & numerical data   MeSH
• Deceleration adverse effects   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Hong Kong MeSH

• Keywords
• chiropraxe - páteř krční - úrazy - příručky,

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• traumatologie
• ortopedie
• radiologie, nukleární medicína a zobrazovací metody
• neurochirurgie

• MeSH
• Haplorhini MeSH
• Craniocerebral Trauma physiopathology   MeSH
• Macaca MeSH
• Temporal Bone injuries   MeSH
• Vibration MeSH
• Deceleration MeSH
• Acceleration MeSH
• Animals MeSH
• Check Tag
• Animals MeSH

Cíl: Cílem této studie bylo vytvořit reprodukovatelný model zavřeného poranění hlavy potkanů akceleračně-deceleračním mechanizmem. Model by měl vést ke zvýšenému nitrolebnímu tlaku (ICP), neurologickému postižení zvířat a umožnit nastavení různé tíže kraniotraumat. Soubor a metodika: Pro vytváření kraniotraumat jsme sestrojili impaktor s volitelným závažím a pohyblivou dopadovou plochou. V první pilotní skupině 40 potkanů jsme testovali pouze jeho základní nastavení. Následně, v druhé skupině u 21 potkanů, jsme provedli experimentální kraniotrauma závažím 400 gramů z výšky 30 až 100 centimetrů při konstantní pružnosti podložky. V třetí kontrolní skupině 15 potkanů jsme změřili fyziologické parametry včetně ICP. Výsledky: Podle výšky pádu impaktoru vznikly čtyři typy poranění mozku - letální, těžké, střední a lehké. Při letálním poranění (45-100 cm) byla u všech potkanů okamžitá křečová aktivita s následným úmrtím. Těžké poranění (40 cm) mělo 50% mortalitu. U přeživších zvířat jsme zaznamenali neurologický deficit a průměrný ICP 9,3 +/- 3,76 mmHg. Střední poranění mozku (35 cm) vedlo k menší mortalitě, neurologický deficit byl u poloviny přeživších a ICP dosáhl 7,6 +/- 3,54 mmHg. Ve skupině lehkého poranění mozku (30 cm) přežila všechna zvířata bez neurologického nálezu s ICP 5,5 +/- 0,74 mmHg. Kontrolní skupina bez úrazu měla ICP 2,9 +/- 0,81 mmHg. Závěr: Popsaný model zavřeného poranění hlavy u potkanů s pomocí modifikovaného impaktoru s volitelným závažím je vhodný pro jednodobé i dvoudobé experimenty zkoumající kraniocerebrální poranění. Pouhou změnou výšky shozu závaží impaktoru je možno vytvářet buď reprodukovatelné těžké, střední nebo lehké kraniotrauma. Vzestup ICP a neurologické postižení odpovídá jednotlivým stupňům poranění.

Objective: The objective of this study is to create a reproducible model of closed head injury in rats using the acceleration-deceleration mechanism. The model should result in increased intracranial pressure (ICP) and neurological deterioration animals, and generate graded brain injury. Material and method: In order to provoke cranial traumas we constructed an impactor with selectable weights and a mobile impact surface. Within the first pilot group of 40 rats, we tested only its basic setup. Afterwards, within the second group of 21 rats, we provoked an experimental cranial trauma using a weight of 400 grams dropped from a height ranging from 30 to 100 centimetres at a constant surface elasticity. Within the third control group of 15 rats, we measured physiological parameters including ICP. Results: According to the height of fall, four types of brain injuries were established +/- lethal, severe, moderate, and mild. With the lethal injury (45+/-100 cm), an immediate convulsions with subsequent death occurred in all the rats. A severe injury (40 cm) showed 50% mortality. Neurological deterioration and an average ICP of 9.3 +/- 3.76 mmHg was recorded in the surviving animals. A moderate brain injury (35 cm) resulted in lower mortality, the neurological deficit occurred in half of the survivors and ICP achieved 7.6 +/- 3.54 mmHg. Within the group of mild brain injury (30 cm), all animals survived without any neurological and behavioral deterioration with an ICP of 5.5 +/- 0.74 mmHg. The control group without any injury had an ICP of 2.9 +/- 0.81 mmHg. Conclusion: The described model of closed head injury in rats using a modified impactor with adjustable weights is suitable for both single-stage and two-stage experiments examining craniocerebral injuries. By simply changing the fall height of the impactor, reproducible severe, moderate, or mild brain injury can be created. The intracranial pressure elevation and the neurological deterioration correlate with these grades of brain injury.

• MeSH
• Animal Experimentation MeSH
• Financing, Organized MeSH
• Intracranial Pressure MeSH
• Craniocerebral Trauma MeSH
• Models, Animal MeSH
• Neurologic Manifestations MeSH
• Pilot Projects MeSH
• Rats, Sprague-Dawley injuries   MeSH
• Rats, Wistar injuries   MeSH
• Statistics as Topic MeSH
• Head Injuries, Closed diagnosis   MeSH
• Animals MeSH
• Check Tag
• Male MeSH
• Animals MeSH

Cíl: Difuzní axonální poranění je traumatické postižení mozku vznikající jako následek střižného pohybu při náhlém zrychlení či zpomalení mozku výrazněji vůči zbytku těla. Za cíl jsme si dali porovnat možnosti dnešních zobrazovacích metod v diagnostice difuzního axonálního postižení (DAP). Dále jsme se snažili v retrospektivní studii zjistit senzitivitu výpočetní tomografie (CT) a magnetické rezonance (MR) v diagnostice DAP a zhodnotit korelaci nálezu na zobrazovacích metodách s tíži klinického stavu. Metodika: Vyšetření CT probíhalo na přístroji Philips Brilliance 64-řadý helikální, nativně, s provedením měkkotkáňového a kostního přepočtu. MR vyšetření bylo provedeno na přístroji Philips Achieva 1,5T s použitím hlavové cívky, nativně v T2, T1 a GRE sekvenci v rovině transverzální, FLAIR sekvence v rovině koronální či sagitální a difuzně vážená sekvence (DWI) a ADC mapy v transverzální rovině. Celkem bylo vyšetřeno 60 pacientů. Výsledky: Mezi roky 2010-2014 byl DAP popsán celkem u 60 pacientů, 38 na CT, a dalších 22 na MR. Dvacet pacientů mělo následně trvalou poruchu vědomí či zemřelo, 36 mělo trvalé následky, osm se plně uzdravilo a u šesti nevíme konečný klinický stav. Senzitivita CT je v našem souboru 63 %, specificita 97 %. Závěr: V dnešní době je zlatým standardem v diagnostice kraniotraumatu nativní CT vyšetření, které má v případě DAP v našem souboru relativně nízkou senzitivitu a vysokou specificitu. MR je vzhledem k dostupnosti i časové náročnosti vyšetření vhodnou metodou až u pacientů, u nichž nález na CT neodpovídá jejich klinickému stavu. Pacienti s diagnostikovaným DAP mají obecně špatnou prognózu, až Ms zemře nebo má trvalou poruchu vědomí a další cca Ví pacientů má trvalé následky.

Aim: Diffuse axonal injury is traumatic brain injury arising as a result of shear movement during sudden acceleration or deceleration of the brain strongly against the rest of the body. We want to compare the capabilities of todays imaging modalities in diagnostics of diffuse axonal injury (DAI). Next, we tried in retrospective study to determine the sensitivity of computed tomography (CT) and magnetic resonance (MR) in the diagnostic of DAI and to evaluate the clinical status of patients diagnosed for DAI. Method: We used 64-row helical CT (Philips Brilliance 64), we made native scans with soft-tissue and bone conversion. MR examination was performed on a Philips Achieva 1.5T machine using a head coil, natively in T2, Tl and GRE sequence in the transverse plane, FLAIR in coronal or sagittal plane and diffusion-weighted sequences (DWI) and ADC maps in the transversal plane. A total of 60 patients were examined. Results: 60 patients with DAI were examined in time period from 2010-2014, 38 with diagnoses of DAI on CT and 22 on MR. 20 patients had a subsequent permanent impairment of consciousness or died, 36 had lasting consequences, 8 fully healed and in 6 patients we do not know how they ended. Conclusion: Today native CT is the gold standard in the diagnosis of brain injury. In our group of DAI patients CT, unlike MR, had low relatively sensitivity of 63% (high specificity 97%). However, MR is not method of first choice due to its insufficient availability and time-consuming examination. MR is a useful approach for those patients whose findings on CT do not match the clinical condition. Patients diagnosed for DAP have generally a poor prognosis, Ms in our group of patients die or have permanent impairment of consciousness, and another M has long lasting consequences.

• MeSH
• Diffuse Axonal Injury * radiography   MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   instrumentation   statistics & numerical data   MeSH
• Tomography, X-Ray Computed * methods   instrumentation   statistics & numerical data   MeSH
• Brain Injuries radiography   MeSH
• Retrospective Studies MeSH
• Sensitivity and Specificity * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Vyšetrovanie smrteľných prípadov pádov z výšky ako aj skokov z výšky v samovražednom úmysle tvorí neodmysliteľnú súčasť súdnolekárskej praxe. Základným mechanizmom vzniku poranení je náhla decelerácia. Vo väčšine prípadov ide o poranenia spôsobené tupými predmetmi. Autori demonštrujú prípad neobvyklého mechanizmu vzniku poranení v prípade samovražedného skoku 55-ročného muža zo siedmeho poschodia, kedy došlo k amputácii predkolení pri stupňovitom páde z výšky na zábradlí terasy panelového domu.

Investigation of fatal cases of falls from height as well as jumps from height in suicidal ideation makes up an integral part of forensic practice. In Slovakia, a method of suicide by jumping from height is after hanging the second most chosen method of ending life. In about one third of the cases, the influence of addictive substances is determined. The basic mechanism of injury is a sudden deceleration of body movement when hitting a solid surface. Several factors influence the nature, localization, severity, and frequency of injuries. In most cases, there occur multiple injuries to the skeleton and internal organs caused by blunt objects. The authors demonstrate the case of an unusual mechanism of injury in a 55-year-old man who committed suicide by jumping from the seventh floor of a block of flats. A stepped fall from height resulted in the through knee amputation of both legs by hitting posterior thigh area and knee joints on the railing of the terrace of the block of flats on the ground floor level. The body was found in the basement. In contact with the railing, the man´s trousers and pants were pulled off. The autopsy determined the immediate cause of death as polytrauma. Additional toxicological-chemical examination of blood and urine samples collected at autopsy revealed ethanol at the concentration within the extent of laboratory error, caffeine, and nicotine in toxicologically insignificant concentrations and traces of acetone. Motivation of man´s suicide remains unknown.

• MeSH
• Lower Extremity pathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Autopsy MeSH
• Suicide * MeSH
• Amputation, Traumatic etiology   MeSH
• Accidental Falls MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

BACKGROUND AND AIMS: Senescence is the process of losing fitness when growing old, and is shaped by the trade-off between maintenance and reproduction that makes reproduction more unsure and maintenance more costly with age. In repeatedly reproducing plants, reductions in growth and fertility are signs of senescence. Disturbance, however, provides an opportunity to reset the ageing clock and consequently potentially ameliorate senescence. METHODS: To test the effects of disturbance on traits closely related to fitness and thus to senescence, a long-term garden experiment was established with two short-lived perennial congeners,Barbarea vulgaris and Barbarea stricta, that differ in their ability to resprout after injury. In the experiment, five damage treatments were applied to plants in four different phenophases. KEY RESULTS: It was found that damage to the plant body significantly prolonged life span in B. vulgaris but decreased whole-life seed production in both species. High concentration of seed production in one growing season characterized short life spans. Both more severe damage and a more advanced phenological phase at the time of damage caused reproduction to be spread over more than one growing season and equalized per-season seed production. In terms of seed quality, average weight of a single seed decreased and seed germination rate increased with age regardless of damage. CONCLUSIONS: Although disturbance is able to reset the ageing clock of plants, it is so harmful to plant fitness that resprouting serves, at best, only to alleviate slightly the signs of senescence. Thus, in terms of whole-life seed production, injured plants were not more successful than uninjured ones in the two studied species. Indeed, in these species, injury only slightly postponed or decelerated senescence and did not cause effective rejuvenation.

• MeSH
• Barbarea growth & development   MeSH
• Models, Biological MeSH
• Time Factors MeSH
• Species Specificity MeSH
• Germination * MeSH
• Plant Roots growth & development   MeSH
• Reproduction MeSH
• Seeds growth & development   MeSH
• Models, Statistical MeSH
• Body Size MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Seat Belts standards   utilization   MeSH
• Accidents, Traffic MeSH
• Humans MeSH
• Multiple Trauma classification   therapy   MeSH
• Pregnancy MeSH
• Deceleration adverse effects   MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH