Penetrating Stab Wounds of the Spine: Two Cases and Review of the Literature

Penetrating wounds of the spine caused by edged weapons are on the increase due to the growing insecurity, violence, availability and accessibility of these weapons, which are generally objects of everyday use (knife, axe, machete, screwdriver, bicycle spoke, scissors, garden fork, sickle and sharpened broom handle, etc.). These objects may be the cause of penetrating wounds responsible for neurological deficits with breaches of the dura mater, or they may be without neurological deficits due to the level of the weapon in the spine. We present two clinical cases of patients with penetrating knife wounds of the spine. One at cervical level with pneumorrhagic emphysema, spinal cord compression and pneunemoencephaly, with neurological deficit who had a surgicalintervention followed by physiotherapy and a progressive recovery, the other with a penetrating wound at L5 crossing the blade to the vertebral body without neurological deficit in whom the knife was extracted at the emergency department without secondarydeficit. Penetrating wounds of the spine are caused by stab wounds, including knives. In particular, emphysema, diffuse pneumorrhagia and pneumoencephalus are extremely rare in the same patient, this being due to the knife extraction technique. These lesions, associated with neurological deficit and cerebrospinal fluid (CSF) leakage, constitute a neurosurgical emergency.

Caracterización de adolescentes lesionados por armas blancas en región tóraco-abdominal / Adolescents' characterization injured by steels in tóraco-abdominal region

Introducción: El trauma intencional por arma blanca, que ocasiona lesiones potencialmente fatales, constituye una de las causas de atención médica frecuente en el Servicio de Urgencias. Objetivo: Caracterizar a adolescentes con lesiones por armas blancas en región tóraco-abdominal. Métodos: Se realizó un estudio observacional, descriptivo, de corte transversal en 94 pacientes con lesiones tóraco-abdominales por arma blanca ingresados en el Hospital Pediátrico Juan Manuel Márquez en el período comprendido desde enero del 2016 hasta diciembre del 2020. Las variables estudiadas fueron: edad, sexo, tipo de heridas y localización, lesiones ocasionadas, procedimientos quirúrgicos realizados, complicaciones y casuística según los años estudiados. Resultados: El sexo masculino fue el más frecuente (92,6 por ciento) y las edades entre 15 y 18 años (87,2 por ciento). Predominaron las heridas de tipo no penetrantes (60,7 por ciento) y la localización torácica (59,8 por ciento). En las lesiones penetrantes predominó el neumotórax abierto (31 por ciento). Los procedimientos quirúrgicos más realizados fueron la sutura de herida traumática (100 por ciento) y la pleurostomía (44,8 por ciento). Entre las complicaciones presentadas prevalecieron la neumonía (35,2 por ciento) y la infección de la herida traumática (17,6 por ciento). El 2019 fue el año con mayor número de casos (25,5 por ciento). Conclusiones: Los adolescentes con lesiones tóraco-abdominales por arma blanca se caracterizan, en general, por ser varones entre 15 y 18 años. Las heridas de tipo no penetrante en tórax constituyen la lesión fundamental y la sutura de heridas es el procedimiento quirúrgico más empleado. La complicación más frecuente es la neumonía(AU)

Introduction: Intentional stab wound trauma, which causes potentially fatal injuries, is one of the causes for frequent medical attention in the emergency department. Objective: To characterize adolescents with stab wounds in the thoracoabdominal region. Methods: An observational, descriptive and cross-sectional study was conducted in 94 patients with thoracoabdominal stab wounds admitted to Hospital Pediátrico Juan Manuel Márquez from January 2016 to December 2020. The variables studied were age, sex, wound type and location, caused injuries, performed surgical procedures, complications and casuistry according to the studied years. Results: The male sex was the most frequent (92.6 percent), together with ages between 15 and 18 years (87.2 percent). Nonpenetrating injuries (60.7 percent) and the thoracic location (59.8 percent) predominated. Among penetrating injuries, open pneumothorax (31 percent) dominated. The most frequently performed surgical procedures were traumatic wound suturing (100 percent) and pleurostomy (44.8 percent). Among the complications, pneumonia (35.2 percent) and traumatic wound infection (17.6 percent) prevailed. 2019 was the year with the highest number of cases (25.5 percent). Conclusions: Adolescents with thoracoabdominal stab wounds were generally characterized as males at ages between 15 and 18 years. Nonpenetrating thoracic wounds are the main injuries and wound suturing is the most frequently used surgical procedure. The most frequent complication is pneumonia(AU)

Development and thinking of Chinese radiation medicine / 中华疾病控制杂志

In this paper, we reviewed the initiation and development of radiation medicine in China, field researches on the health effects of nuclear test and the great leap from the final reports, advance in clinical diagnosis and treatment of radiation injury, and research of radiation combined injuries. Nowadays, China makes great efforts to move up further in development and peaceful use of nuclear energy as one nuclear power. So, nuclear development and nuclear safety have ushered in new opportunities and challenges. To this end, we must maintain a clear understanding, grasp new opportunities, meet new challenges, and be prepared for danger. Thus, a bright future for research in radiation medicine will come.

Injury effect of navy new concept weaponry on combatants and its medical prevention / 第二军医大学学报

New concept weaponry have much greater damage effects than traditional weaponry, not only destroying military equipment and communication systems, but also severely injurying combatants. Typical new concept weaponry, including shipborne laser weapons, electromagnetic pulse weapons and infrasonic weapons, holds destructive power by special light, sound, or electromagnetic wave. This paper expounds the injury effects of new concept weapons on combatants and its medical protection measures, so as to provide reference for the health service support under the condition of new concept weapons.

The presence of sharp-edged weapon related cut mark in Joseon skull discovered at the 16th century market district of Old Seoul City ruins in South Korea / 대한해부학회지

A human skull was discovered at the 16th-century drainage channel of market district ruins, one of the busiest streets in the capital of Joseon kingdom. By anthropological examination, we noticed the cut mark at the right occipital part of the cranium. Judging from the wound property, it might have been caused by a strong strike using a sharp-edged weapon. As no periosteal reaction or healing signs were observed at the cut mark, he might have died shortly after the skull wound was made. We speculated that this might have been of a civilian or soldier victim who died in a battle or the decapitated head of prisoner. This is the first report about the discovery of the skull damaged by sharp-edged weapon at the archaeological sites in the capital city of Joseon Kingdom.

Psychological markers underlying murder weapon profile: a quantitative study

The horrific nature of murder using different types of weapons has been an important focal point ofmany criminological studies. Weapons that are used in murders seem to play dominant roles in murderinvestigations as they may provide information leading to arrest. The established factors for weaponusage include environmental context, demography and availability of weapons. However, there isinsufficient research attention on the psychological functioning of murderers for particular weaponusage. In light of this, the current study seeks to narrow this gap of information by identifying theinfluences of psychological traits on weapon usage among a sample of male murderers. The presentcross-sectional study was conducted among 71 male murderers incarcerated in 11 prisons withinPeninsular Malaysia. The selection of the sample was based on predetermined selection criteriausing a purposive sampling method. A guided self-administered questionnaire comprising sociodemographyvariables and four Malay validated psychometric instruments: Zuckerman-KuhlmanPersonality Questionnaire-40-Cross-Culture, Self-control Scale, “How I Think” Questionnaire andAggression Questionnaire; was used. Independent sample t-test was performed to establish themean score differences of psychological traits between the murderers who used single and multipleweapons while Kruskal-Wallis tests were carried out to ascertain the differences between the specifictypes of weapons used among the murderers. Following this, one-way ANOVA was carried out toascertain the psychological trait differences among the murderers according to the different sourcesof weapon. Results indicated specific psychological traits influenced the number(s), source(s) andtype(s) of weapon used in committing murder. The findings have implications for the psychologicalprofiling of unknown murderers within the Malaysian context.

Cutaneous Manifestations of Potential Chemical, Biological, and Radiological Agents and Their Clinical Management / 대한피부과학회지

The level of terrorist threats using chemical, biological, and radiological agents has been continuously increasing, and it is an undeniable truth that these agents are actually in use today. The fact that most chemical, biological, and radiological agents cause skin-related symptoms, and that the skin symptoms are observed at a relatively early stage of the condition, leads to the conclusion that dermatologists could be the first point of contact for potential victims of these agents. It is highly important that first responders are able to recognize symptoms caused by these agents early and react quickly. Therefore, dermatologists do have a responsibility to take on a role in dealing with chemical, biological, and radiological attacks, and pre-equip themselves with professional knowledge in this field. Among the various types of chemical agents, typical examples of agents causing skin-related symptoms are blistering agents, which lead to bullae and necrosis on the skin. Biological agents are classified from Category A to C according to their respective risk factors. The most dangerous Category A agents include anthrax, smallpox, plague, tularemia, and viral hemorrhagic fever, all of which are known to show characteristic skin-related symptoms. Upon exposure to a certain level of radiation, radiological agents can also lead to erythema on the skin. In this article, we will discuss various characteristics and up-to-date treatment methods of potential chemical, biological, and radiological agents to help dermatologists advance their knowledge in this field.

Cutaneous Manifestations of Potential Chemical, Biological, and Radiological Agents and Their Clinical Management / 대한피부과학회지

The level of terrorist threats using chemical, biological, and radiological agents has been continuously increasing, and it is an undeniable truth that these agents are actually in use today. The fact that most chemical, biological, and radiological agents cause skin-related symptoms, and that the skin symptoms are observed at a relatively early stage of the condition, leads to the conclusion that dermatologists could be the first point of contact for potential victims of these agents. It is highly important that first responders are able to recognize symptoms caused by these agents early and react quickly. Therefore, dermatologists do have a responsibility to take on a role in dealing with chemical, biological, and radiological attacks, and pre-equip themselves with professional knowledge in this field. Among the various types of chemical agents, typical examples of agents causing skin-related symptoms are blistering agents, which lead to bullae and necrosis on the skin. Biological agents are classified from Category A to C according to their respective risk factors. The most dangerous Category A agents include anthrax, smallpox, plague, tularemia, and viral hemorrhagic fever, all of which are known to show characteristic skin-related symptoms. Upon exposure to a certain level of radiation, radiological agents can also lead to erythema on the skin. In this article, we will discuss various characteristics and up-to-date treatment methods of potential chemical, biological, and radiological agents to help dermatologists advance their knowledge in this field.

Detection of anthrax toxin genetic sequences by the solid phase oligo-probes.

Purpose: There is an urgent need to detect a rapid field-based test to detect anthrax. We have developed a rapid, highly sensitive DNA-based method to detect the anthrax toxin lethal factor gene located in pXO1, which is necessary for the pathogenicity of Bacillus anthracis. Materials and Methods: We have adopted the enzyme-linked immunosorbent assay (ELISA) so that instead of capturing antibodies we capture the DNA of the target sequence by a rapid oligo-based hybridization and then detect the captured DNA with another oligoprobe that binds to a different motif of the captured DNA sequences at a dissimilar location. We chose anthrax lethal factor endopeptidase sequences located in pXO1 and used complementary oligoprobe, conjugated with biotin, to detect the captured anthrax specific sequence by the streptavidin-peroxidase-based colorimetric assay. Result: Our system can detect picomoles (pMoles) of anthrax (approximately 33 spores of anthrax) and is >1000 times more sensitive than the current ELISA, which has a detection range of 0.1 to 1.0 ng/mL. False positive results can be minimized when various parameters and the colour development steps are optimized. Conclusion: Our results suggest that this assay can be adapted for the rapid detection of minuscule amounts of the anthrax spores that are aerosolized in the case of a bioterrorism attack. This detection system does not require polymerase chain reaction (PCR) step and can be more specific than the antibody method. This method can also detect genetically engineered anthrax. Since, the antibody method is so specific to the protein epitope that bioengineered versions of anthrax may not be detected.

Pattern of injuries in homicidal cases in Greater Mumbai a three year study.

The present study was carried out in the City of Greater Mumbai’s all post mortem centres during the calendar year of 2004 to 2006 with aims and objective to determine the pattern of injuries in cases of homicides during this period with special reference to injuries sustained during these homicidal incidences. Total 371 cases of homicidal deaths were collected from post mortem reports, panchnama, police requisition and statements of relatives. The injuries present on the particular body area were noted with due consideration of kind of weapon used, internal organs injured and cause of death. Male victim’s preponderance was noted over female victims with male age group of 21-30 years being most commonly affected. The head face and neck region of the body was most often targeted. Internal organs most commonly affected were neck structures followed by brain while least involved organ was heart. Hard and blunt weapons were most commonly used followed by sharp edged and pointed weapons. Infanticide was most common in female infants. The most common cause of death in male victims was shock and haemorrhages and in female victims was mechanical asphyxia.

Trauma Analysis of Cranial Fractures and Estimation of Its Related Weapon for Reference to Forensic Anthropological Decisions / 체질인류학회지

The role of forensic anthropology is to reconstruct the process of individual death by predicting the cause and manner of death as well as to find out biological profiles of unknown skeletal remains based on the data of physical anthropology. The purpose of this study is to suggest the data of decision-making process for cranial fractures and its related weapons of skeletal remains from the forensic fields. A hammer (31.7%) and baseball bat (16.7%) represented almost half of the blunt type of weapon used in the cranial fracture. The linear fracture was caused by most of weapons, the spider's web and depressed fracture by the hammer, and the comminuted fracture by the heavy tools such as maul, wrench, etc as well as the hammer. By the chi-square test, there were significant differences between fracture patterns and types of weapon that it was helpful to estimate the weapon of cranial fracture for forensic anthropological decisions. Conclusively, we could prepare the priority order of estimating cause and manner of death in the case of cranial fracture for the forensic context and suggest research design of physical anthropology about osteological biomechanics and taphonomy relating cranial fractures.

Taser technology: medical, legal, ethical & social implications of introduction of taser gun in India.

A person struck by a taser gun experiences stimulation of his sensory and motor nerves, resulting in strong involuntary muscle contractions. This may lead to physiological changes similar to a moderate intensity exercise. The mechanism of action of Taser gun is Electro-Muscular Disruption (EMD) technology. Though Tasers are considerably safe, some incidents of injury and deaths have been reported. The primary cause of such deaths is found to be influenced by some underlying pathology or some external factor, rather than Taser itself. Recent introduction Taser gun as weapon in Indian police has raised various medico legal, social and ethical issues regarding the safety of using taser guns. In this article we have reviewed all the medical, Legal, Ethical and Social aspects of introduction of taser gun in India as weapon. It has been concluded that Taser is a proportionate, low risk weapon can be used to resolving incidents where the public or officers face severe violence or the threat of such violence which cannot safely be dealt with by other means.

Medico legal diagnosis & pattern of injuries with sharp weapons.

Out of one hundred cases examined in GGS Medical College Faridkot during the period from July 2006 to September 2007 who sustained injuries with sharp weapons, majority (58%) were in the age group of 21-40 years, males (92%) with simple injuries (80%) and with light sharp weapons. Upper limbs were the parts of body with injuries in majority (47%) of cases followed by head (17%) and mixed type (14%).Nature of injury was homicidal in 60% cases followed by 34% cases with fabricated or strongly suspected fabricated injuries. This is a retrospective study to document pattern of injuries with medico-legal diagnosis to ascertain the type of injuries in the disbursement of justice.

Homicides by sharp weapons.

In the present society, which is gradually becoming over democratic it is natural that old values of sanctity of life changes and personality problems develop due to consequent stress of life. This ultimately results in violence. Killing of a human being is one of the most serious or major crimes. Since very long time, different judicial authority to prevent crime and its further occurrence framed laws. The laws were made according to the religious make up of the society but later the laws were according to the emperor’s own convenience. In spite of all these, there has been a phenomenal rise in the incidence of homicide all over the world and also in India. The study was conducted on 200 alleged cases of homicides. The incidence of homicidal deaths was observed as 13.03% with male preponderance and the commonest age affected was 21 to 40 yrs. Out of different weapons used to inflict the injuries on dead bodies of homicides, 31(10.88%) sharp cutting weapons were used. Incised wounds were present maximum 38(29.69%) on head and face. Defence wounds were present in 72(36%) of homicide deaths.

Effects of atomic explosion on the human body

In conclusion, the following facts should be emphasized: a. Thermal and mechanical injuries account for the majority of the casualties from an atomic bomb explosionb. From experiences in Japan, 90% of all persons requiring medical attention in the first week will have burns and 60-85% of all patients will be burnedc. The burns are of the "flash" type, produced by a source of high intensity and brief duration. They are of all degrees of severity; and while some may heal speedily with little treatment, this is by no means a general condition. Sequelae and overall mortality will vary with the treatmentd. Every effort should be made to evacuate the thermal and traumatic casualties early, and treat them vigorously, to reduce the incidence of complications from delaye. Radiation injury comprises 20% of the total casualties. Most of those who receive the supralethal and lethal dose will die even if given treatmentf. Hospitals surviving will be at the outskirts of the unfortunate city, with functional capacity crippled by the disruption of power, water, and disposal systemg. The fire storm, the wreckage and rubble, would make approaches to most of the hospitals impossible - certainly from within two miles from ground zeroIn any atomic disaster, 80% of the work will be borne by the medical profession and all the services allied to it. Our aim must be to reduce the number of casualties by providing prompt, efficient rescue and aid to the injured. Here action must be taken in a welter of chaos, with the greatest need of co-ordination in the face of the greatest hindrance. Yet on the day when the emergency medical services must be brought into action, there will live - or there will die - hundreds of thousands of people according to its effectiveness. (Conclusion)

Experimental study on ocular trauma of animals inside the tank / 第三军医大学学报

Objective To study the characteristics of ocular trauma inside of the tank after being bit by the antitank bombs to provide experimental evidences for defense- and-treatment of ocular trauma. Methods A total of 48 health sheep were divided into 3 groups and put into a tank separately. The three different caliber antitank bombs were used to shot the tank forearmor: large high-energy bomb for Group I, intermediate armor-piercing explosive fire bomb for Group Ⅱ, small armor-piercing fire bomb for Group Ⅲ. After the hit, the harmful gases, temperature, blast overpressure within the cabin and the injury situations of eyes were checked. Results After fire, harmful gases and blast overpressure were increased, but the temperature was not obviously changed. Each bomb explosion caused obvious reaction in blood vessel of uvea and retina, edema and degeneration as well as the changes of ultrastructure in retina. Conclusion The ocular trauma inside of the tank are complex and serious and related to the weapon calibre, class, and wounding effect. Closed ocular trauma has the characteristics of slight wound outside and serious wound inside as well as obvious reaction in blood vessels of uvea and retina.

Study on development strategy of medical and biological techniques correlating with medical protection against New Concept Weapons / 第三军医大学学报

Objective To evaluate the key role of development of medical and biological techniques correlating with medical protection against New Concept Weapons(NCWs) and put forward a development strategy in medical protection against NCWs. Methods Data on the present medical techniques protecting against NCWs were obtained by tracing references. On the basis of analyzing and studying the obtained data, an evaluation was made by consulting experts, system analysis, scientific selection, clustering analysis and policy analysis. Results The correlation coefficients correlation, indexes and scores in the present progress of 36 techniques were determined. Furthermore, the evaluation was made. Conclusion Different developing strategy should be taken in accordance with the important and the present research on medical and biological techniques correlating with medical protection against NCWs. This study will give us some advice on protecting against NCWs in medicine.

A BRIEF INQUIRY INTO HIGHTECH WEAPON INJURIES / 解放军医学杂志

Solving the problem of weapon injuries is of primary importance in military medical research. This article aims at presenting an inquiry into hightech weapon injuries in terms of the following: (1)classify hightech weapons into special, hightech conventional and new concept weapons, and expound their characteristics; (2)demonstrate from different angles the pressing necessity to step up researches on special (nuclear, chemical and biological) weapons; (3)discuss the types and injurious effects (high speed projectiles, war heads with numerous shrapnels and cluster bomb, multiple killing factors and high casualty inflicting power) of the everlastingly emerging hightech conventional weapons, and multiple injuries, and combined injuries produced thereby; (4)probe into new concept weapons, mainly the beamed (laser, microwave and infrasound) and non lethal weapon injuries; (5)bring up the question of confrontation of hightech weapons′ in the space in the future; (6)explore the tactics in four levels to confront hightech weapons, and research on medical protection against hightech weapon injuries in terms of basic sciences, medical logistics, and medical equipments.