1/6. Improving ischaemic skin revascularisation by nerve growth factor in a child with crush syndrome.nerve growth factor (NGF) is the first described neurotrophin that stimulates the growth and differentiation of nerve cells and promotes skin and peripheral tissue regeneration. Recent studies suggest that NGF influences endothelial cell proliferation and angiogenic activity. In view of these proposed regenerative effects, we evaluated the efficacy of subcutaneous administration of highly purified murine NGF in a child with severe crush syndrome of the lower left limb. NGF 10 micro g was administered subcutaneously every eight hours for seven days to the extensive ischaemic skin lesion of the calcaneal area. After treatment we observed gradual improvement of the ischaemic area; no side effects were noted. The child was discharged in good clinical condition to await a limited calcaneal escharotomy.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/6. Tyre tread marks on the body without internal injuries.Two cases are presented involving a 5-year-old boy with tyre tread impressions on the back and right arm and a 4-year-old girl with tread marks on the head but both had no internal injuries. These cases suggest that injuries to internal organs do not always occur when the trunk or head is run over by the wheels of a vehicle.- - - - - - - - - - ranking = 0.18428304916563keywords = organ (Clic here for more details about this article) |
3/6. Gluteal compartment and crush syndromes. Report of three cases and review of the literature.Gluteal compartment syndromes are rare. The pathophysiology and the principles of diagnosis and treatment, however, are the same as those for leg and forearm compartment syndromes. Trauma may not be a salient feature of gluteal compartment syndromes where substance abuse and a prolonged period of unconsciousness, recumbency, or both are more typical. Because of this and the large muscle mass involved, systemic manifestations of a crush syndrome are usually present. Altered mental status and metabolic abnormalities may distract from the primary problem, resulting in delayed diagnosis and treatment. The proximity of the sciatic nerve can result in compression induced neuropathy. Measurement of an elevated compartment pressure confirms the diagnosis. In three patients, aged 37, 31, and 37 years, prompt fasciotomy relieved muscle ischemia, preserved neurologic function, and produced a satisfactory functional result.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
4/6. Acute compartment syndrome of the upper arm: a report of 2 cases.compartment syndromes of the upper arm are rare clinical entities but can be a serious problem, especially in unconscious patients or those presenting with altered mental status. A high index of suspicion is needed to make an accurate diagnosis. Measuring compartment pressures is helpful, but the role of pressure measurement in the diagnosis and treatment may be secondary to the clinical examination. In patients presenting without histories of trauma, who have sustained long periods of immobilization, a suspicion of a crush syndrome should also be included during the workup of a compartment syndrome. Fasciotomy and debridement of necrotic and nonviable tissue are the treatments of choice for a patient with a compartment syndrome, but initiating medical management and providing medical stability for systemic complications resulting from a crush syndrome may be necessary prior to surgical intervention to prevent organ failure and death. overall, prognosis is improved by early diagnosis and treatment.- - - - - - - - - - ranking = 0.18428304916563keywords = organ (Clic here for more details about this article) |
5/6. Posttraumatic childhood lumbosacral plexus neuropathy.A 13-month-old male received crush injury to the abdomen resulting in paraparesis due to lumbosacral plexus neuropathy. The child was monitored with serial clinical examinations and electromyography/nerve conduction studies. He had complete clinical recovery. lumbosacral plexus neuropathy is unusual in childhood and has not been previously reported as a result of abdominal trauma. This patient is presented with details of the clinical course, electrodiagnostic studies, discussion, and literature review.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
6/6. A case of crush syndrome with giant negative T waves and reversible left ventricular dysfunction.A 54-year-old male experienced the Hanshin earthquake at 5:46 am on Jan. 17, 1995. He was rescued after being buried under his house for 20 h. After being treated at two hospitals, he was admitted to our hospital with acute renal failure caused by crush syndrome. The maximal serum creatinine kinase level was 35,000 IU/L (CK-MM: 100%), and the maximal myoglobin level was 12,600 ng/ml. An electrocardiogram showed inverted T waves in V5,6 which later became giant negative T waves, and a QS pattern in a VL and V1-6. Two-dimensional echocardiography showed a hypokinetic left ventricle. He was treated with hemodialysis 13 times. Cardiac contraction gradually improved to the normal level. coronary angiography revealed normal coronary arteries and acetylcholine did not induce coronary spasm. biopsy specimens from the right ventricular septum showed slight degeneration. 201Tl imaging showed hypoperfusion except in the anterior wall and 123I-MIBG imaging showed a perfusion defect except in the anterior wall. After about 1 month, only 201Tl imaging showed improvement. We believe that myocardial ischemia, cardiac sympathetic nerve damage and/or cardiac contusion caused giant negative T waves and left ventricular dysfunction. This is a rare case which showed significant myocardial damage with crush syndrome.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |