Sequelae of carbide-related thermo-chemical injury: A retrospective analysis

Purpose: To describe the outcomes of eyes with calcium carbide (CaC2)?related thermo?chemical injury. Methods: This study included 28 eyes of 23 patients who presented with calcium carbide?related ocular burns. Only patients with more than three months of follow?up were included. Group A included 16 eyes with Dua抯 Grade I朓II burns, while Group B included 12 eyes with Grade IV朧I burns. Electronic medical records were reviewed to provide data on the etiology of burn, presenting clinical signs and visual acuity, sequelae, and surgical interventions performed, both in the acute and chronic phases. Results: The overall mean age was 28.48 � 11.8 years. Fifteen patients were injured while using carbide to create an explosion to scare away animals on farms. The median presenting BCVA (best?corrected visual acuity) in Group A (20/160) was significantly better than in Group B [(20/2000) (P = 0.002)]. Five eyes in Group A and one eye in Group B underwent medical management. There was no difference in the duration of follow?up for both groups (P = 0.24). The median final BCVA in Group A (20/32) was significantly better than in Group B [(20/200) (P = 0.02)]. Two eyes in Group A and nine eyes in Group B developed LSCD. Two eyes in Group B were phthisical at the last visit. Conclusion: Calcium carbide?related ocular injuries can result in significant visual morbidity in young adults. Early presentation and management may improve outcomes. Prevention of these injuries by increasing awareness and increasing advocacy efforts is necessary.

Self-drilling screws for the prevention of dental and skeletal injuries during open reduction and internal fixation of pediatric mandibular fractures

Facial trauma in pediatric population predisposes the child to injury of both the developing skeleton and dentition. This article aims to highlight the experience of the authors through a case report, in using self-drilling screws for fixation of mandibular fractures in pediatric age group. The use of self-drilling screws minimizes the complications such as thermal and/or mechanical damage to the developing dentition and the bone. They also provide significant advantages including ease of availability and technique, superior anchorage with primary stability, and minimizing or avoiding permanent damage to the developing tooth germs in the site of fracture. The use of self-drilling screws for mandibular open reduction and internal fixation in children is an easy, reliable, and safe technique which may have significant value addition in preventing inadvertent injury to the developing tooth germs.

Effect of cooling water temperature on the temperature changes in pulp chamber and at handpiece head during high-speed tooth preparation

OBJECTIVES: It was the aim of this study to evaluate the effect of cooling water temperature on the temperature changes in the pulp chamber and at the handpiece head during high-speed tooth preparation using an electric handpiece. MATERIALS AND METHODS: Twenty-eight intact human molars received a standardized occlusal preparation for 60 seconds using a diamond bur in an electric handpiece, and one of four treatments were applied that varied in the temperature of cooling water applied (control, with no cooling water, 10°C, 23°C, and 35°C). The temperature changes in the pulp chamber and at the handpiece head were recorded using K-type thermocouples connected to a digital thermometer. RESULTS: The average temperature changes within the pulp chamber and at the handpiece head during preparation increased substantially when no cooling water was applied (6.8°C and 11.0°C, respectively), but decreased significantly when cooling water was added. The most substantial drop in temperature occurred with 10°C water (−16.3°C and −10.2ºC), but reductions were also seen at 23°C (−8.6°C and −4.9°C). With 35°C cooling water, temperatures increased slightly, but still remained lower than the no cooling water group (1.6°C and 6.7ºC). CONCLUSIONS: The temperature changes in the pulp chamber and at the handpiece head were above harmful thresholds when tooth preparation was performed without cooling water. However, cooling water of all temperatures prevented harmful critical temperature changes even though water at 35°C raised temperatures slightly above baseline.

LncRNA XIST promotes extracellular matrix synthesis, proliferation and migration by targeting miR-29b-3p/COL1A1 in human skin fibroblasts after thermal injury

Background: Long noncoding RNAs (lncRNAs) have been reported to be associated with dermis process during burn wound healing. This study aimed to investigate the role of lncRNA X-inactive specific transcript (XIST) in human skin fibroblasts (HSF) and extracellular matrix (ECM) as well as the regulatory network of XIST/microRNA-29b-3p (miR-29b-3p)/collagen 1 alpha 1 (COL1A1). Methods: The wound samples were collected from 25 patients with deep partial thickness burn at day 5 after burn. The thermal injured model was established using HSF cells. The expressions of XIST, miR-29b-3p and COL1A1 were measured by quantitative real-time polymerase chain reaction and western blot. ECM synthesis, cell proliferation and migration were detected by western blot, cell counting kit-8 and trans-well assays, respectively. The interaction between miR-29b-3p and XIST or COL1A1 was explored by bioinformatics analysis and luciferase reporter assay. Results: The expressions of XIST and COL1A1 were enhanced but miR-29b-3p expression was decreased after thermal injury. XIST overexpression promoted ECM synthesis, cell proliferation and migration in thermal injured HSF cells. However, XIST knockdown played an opposite effect. miR-29b-3p overexpression inhibited ECM synthesis, cell proliferation and migration, which was reversed by XIST. COL1A1 silence suppressed ECM synthesis, cell proliferation and migration by miR-29b-3p targeting. Moreover, COL1A1 up-regulation weakened the effect of XIST silence on ECM synthesis and HSF cell function. Conclusion: XIST promoted ECM synthesis, cell proliferation and migration by sponging miR-29b-3p and targeting COL1A1 in HSF cells after thermal injury, indicating the promoting role of XIST in wound healing.

A New Model of Extraocular Muscle Fibrosis by Thermal Cauterization in the Rats

PURPOSE: To evaluate the effect of cauterization on extraocular muscle (EOM) fibrosis in rats, and to develop a novel EOM fibrosis model. METHODS: Twenty-four eyes of 12 Sprague Dawley rats were assigned randomly to two groups. We exposed the superior rectus muscle (SRM) and performed thermal injury 2 mm behind the insertion site of the SRM using a cautery device in the experimental group. The thermal injuries were performed twice for 1 second, for a total of 2 seconds. In the control group, the same procedures except the thermal injury were performed. Two weeks after surgery, all eyes were enucleated and stained with hematoxylin and eosin (H&E) and Masson's trichrome (MT). RESULTS: Staining with H&E and MT showed that thermal injury significantly increased inflammation and fibrosis in the experimental group (p=0.002, p < 0.001, respectively). CONCLUSIONS: Thermal injury using cauterization effectively induced fibrosis of EOM in the rat model. This simple model was effective in inducing fibrosis of SRM and will be useful for studying postoperative fibrosis after strabismus surgery.

Various Upper Endoscopic Findings of Acute Esophageal Thermal Injury Induced by Diverse Food: A Case Series

Esophageal thermal injury caused by food has been reported to occur mostly after drinking hot liquid food, and is known to produce alternating white and red linear mucosal bands. In addition, thermal injury caused by ingestion of hot solid foods is documented to be a cause of esophageal ulcers or pseudomembranes. From January 2006 to August 2012, five patients with suspected esophageal thermal injury underwent esophagogastroduodenoscopy with biopsy. A "candy-cane" appearance was observed in one case, pseudomembrane was observed in two cases, an esophageal ulcer was observed in one case, and a friable and edematous mucosa was noted in one case. We believe that the endoscopic findings of esophageal thermal injury depend on the following factors: causative materials, amount of food consumed, exposure period, and time to endoscopy after the incident. Therefore, physicians who encounter patients with suspected esophageal thermal injury should carefully take the patient's history considering these factors.

A Case of PICOLIGHT Powder Induced Thermal Injury of the Gastric Mucosa

There are many reports about causes of corrosive agents such as acids and alkaline and occasionally hot food in either liquid or solid forms as causes of upper gastrointestinal mucosal injury. However, there have been no reports on bowel preparation solutions as a cause of upper gastrointestinal injury. We describe a case of bowel preparation solution (PICOLIGHT powder) induced thermal injury of the gastric mucosa with a review of the literature.

The Expression of Human Beta Defensins by Thermal Injury

PURPOSE: Defensins are important components of innate immune system. These peptides have antimicrobial activity against a wise variety of pathogens that associated with burn wound infection. In particular, human beta-defensins are expressed in normal epidermal region and showed differential expression of some skin disease. We investigated that expression of human beta-defensin by in vitro and ex-vivo by thermal condition. METHODS: To investigate the expression of human beta-defensins in acute burn condition, we cultured keratinocytes and used to rat's skin at this experiment. After thermal condition, we showed the expression of beta-defensins-2 (hBD-2), -3 (hBD-3), keratins, keratinocyte differentiation and junction protein levels by RT-PCR and immunohistochemistry (IHC). RESULTS: HBD-2 & involucrin were down-regulated from 1 hr to 8 hrs in mRNA level. But others were not changed in mRNA level. In protein level, hBD-3 was decreased but pan-cytokeratin and beta-catenin were not changed. CONCLUSION: HBD-2 was down-regulated in thermal injury. Because thermal injury could induce the influence of keratinocyte differentiation and the decrease of skin protection ability. Our results suggested that human beta-defensins plays an important role in protection by several injury.

A Large Symmetrical Esophageal Ulcer Caused by Thermal and Compressive Injury from a Solid Foodstuff Known as 'Song-Pyen' / 대한내과학회지

There are many possible causes of esophageal ulcer, such as reflux esophagitis, pill-induced esophagitis, infectious esophagitis, tuberculosis, syphilis, Behcet's disease, radiation injury, caustic injury, foreign body-induced injury, esophageal cancer, and so on. However, there are only a few cases of esophageal ulcer by thermal injury from food, and most of these were caused by liquids; few are related to ingestion of solid food. We experienced a case of a large symmetrical esophageal ulcer caused by thermal and compressive injury from a hot solid foodstuff known as 'Song-pyen', a traditional Korean food, and report the natural course of healing by conservative treatment, with a review of the few available reports regarding such injuries.

An unusual case of intraorbital foreign body and its management.

Intraorbital foreign bodies are usually the result of accidental trauma and can lead to considerable morbidity. We report an unusual case of an industrial injury in a plastic manufacuring unit wherein hot molten plastic splashed and solidified inside the orbit. The resultant increased intraorbital pressure led to loss of vision in that eye. The extreme temperature of the foreign body caused extensive thermal damage to the surrounding adnexal structures. Staged reconstructive surgery was undertaken to repair the damage, with an acceptable final cosmetic outcome. Employment of protective eye wear to prevent such accidents in high-risk occupations should be made mandatory.

Rapid Chondrolysis of Knee Joint after Arthroscopy Using Radiofrequency Device / 대한정형외과학회잡지

We report the cases of 3 young individuals, each of whom presented to our hospital for the evaluation and treatment of sudden onset chondrolysis. Previously, all 3 individuals had undergone arthroscopic knee procedures over a similar time at another hospital. In this paper, we review the possible problems that cause chondrolysis during or after arthroscopic procedures, such as the followings: use of thermal treatment, occult infection with Propionibacterium acnes, idiopathic or iatrogenic osteochondral injury, high temperature of fluid during arthroscopic irrigation, improperly placed implants, and the use of an intra-articular pain pump. We can exclude other causes of chondrolysis through the clinical course of the patients and surgical records and progress records. We conclude that the possible cause of chondrolysis in all cases was due to thermal injury caused by high temperatures, which decreased or blocked the irrigation fluid flow generated during arthroscopy.

Burns during pregnancy: a socio-cultural disease.

Burns during pregnancy poses a serious threat to the life of baby, as well as to the mother. More severely it is associated with various social and economical problems, as well as associated with illiteracy and poverty which many cases complicate its prevention. Burns during pregnancy influence maternal as well as foetal outcome. Keeping this in view a comprehensive task was undertaken to assess the maternal and foetal outcome in relation to burn extent and gestational age of foetus. A total of thirty two cases of burn females with pregnancy were analyzed. There were 23 maternal and 26 foetal deaths. Percentage of abortion during the third trimester was highest. Rate of maternal mortality increased with percentage of Total Body Surface Area (TBSA) burnt. Maximum incidence of maternal mortality rate was with cases of burns involving more than 50% TBSA.

Acute Thermal Injury of the Esophagus from Solid Food: Clinical Course and Endoscopic Findings

A 53-yr-old man presented with a two-day history of odynophagia and a foreign body sensation. Two days before admission, the patient began to experience odynophagia and a foreign body sensation in the chest after swallowing several extremely hot pieces of solid food (prawn) in haste. Endoscopy revealed a huge longitudinal ulcer, typical of friable hyperemic mucosa with necrotic debris along the full length of the esophagus in the posterolateral region. Here we present the clinical course of serial endoscopy of an acute thermal injury of the esophagus caused by solid food.

Lesiones traumáticas: conducta odontológica / Injury: dental behavior

En la cavidad bucal se pueden producir una variedad de lesiones de diferente etiología, por ello es muy importante que el odontólogo las identifique y conozca las consecuencias que ocasiona si no se previenen o tratan a tiempo. Se funda como premisa que el cuidado periodontal es, en esencia, labor del odontólogo general y que éste no puede pasar por alto la responsabilidad de proveer atención a todos los pacientes. La incidencia excesivamente elevada de los problemas periodontales entre la población, dificulta que un número reducido de especialistas los pueda enfrentar. Asimismo, el estrecho vínculo entre los tratamientos dentales restaurativos y los regímenes periodontales hace muy importante que el odontólogo general disponga de conocimientos a fondo sobre periodoncia. En la cavidad bucal se producen variedades de lesiones de origen traumático ya sea por injurias químicas, físicas y térmicas estás representan una urgencia en Odontología. El propósito de este reporte es describir las diferentes presentaciones clínicas de dicha patología, su etiología, diagnósticos diferenciales y diferentes métodos de tratamiento, para valorar sus complicaciones y cuidados postoperatorios. Para ello se realizó basado en los lineamientos de la investigación descriptiva documental, una revisión de la literatura nacional e internacional

A variety of different etiologies pathologies can affect the oral cavity, due to this reason, dentists must be able to identify them and their consequences if they are not treated on time. It is primordial for the general practitioner dentists the periodontal care of their patients. Among the population the periodontal diseases are very common and only a reduced number of specialists can treat them. The close relation between restorative dental treatments and periodontal treatment procedures lead to the tendency that de general practitioner has enough knowledge in the periodontal field. Among the variety of pathologic entities that affect the oral mucosa, that presents as ulcer and are really Traumatic lesions in its different types chemical injury, physical injury, thermal injury It is considered one of the emergencies in dentistry. Dentist must be able to recognize and treat them. The purpose of this research is to describe the possible etiologic agents, clinical features and treatment of this disease and also to recommend the multidisciplinary attention to these patient. For this paper was made a study based on the lineaments of the descriptive documental research, mainly with scientific bibliographic references literature national and international

Esophageal Thermal Injury by Hot Adlay Tea

Reversible thermal injury to the esophagus as the result of drinking hot liquids has been reported to generate alternating white and red linear mucosal bands, somewhat reminiscent of a candy cane. This phenomenon is associated with chest pain, dysphagia, odynophagia, and epigastric pain. Here, we report a case of thermal injury to the esophageal and oral cavity due to the drinking of hot tea, including odynophagia and dysphagia. A 69-year-old man was referred due to a difficulty in swallowing which had begun a week prior to referral. The patient, at the time of admission, was unable to swallow even liquids. He had recently suffered from hiccups, and had consumed five cups of hot adlay tea one week prior to admission, as a folk remedy for the hiccups. Upon physical examination, the patient's oral cavity evidenced mucosal erosion, hyperemia, and mucosa covered by a whitish pseudomembrane. Nonspecific findings were detected on the laboratory and radiological exams. Upper endoscopy revealed diffuse hyperemia, and erosions with thick and whitish pseudomembraneous mucosa on the entire esophagus. The stomach and duodenum appeared normal. We diagnosed the patient with thermal esophageal injury inflicted by the hot tea. He was treated with pantoprazole, 40 mg/day, for 14 days, and evidenced significant clinical and endoscopic improvement.

Esophageal Ulcer by Thermal Injury from Steamed Egg / 대한소화기내시경학회지

The common causes of esophageal ulcers include severe reflux esophagitis, carcinomas, pill-induced esophagitis, viral diseases, caustic injury, foreign bodies and radiation injury. In rare cases, they can also be caused by Crohn's disease, Behcet's disease, syphilis and idiopathic causes. A thermal injury caused by the ingestion of hot food has not been reported to be a cause of esophageal ulcers. We report an alcoholic who developed an esophageal ulcer and odynophagia after ingesting part of an extremely hot steamed egg with a review of the few available reports regarding such injuries. We suggest that the ingestion of extremely hot food should also be considered a cause of esophageal ulcers.

The Limited Immune Modulatory Effect of Early Escharectomy on Adhesion Molecules in Major Burn Patients / 대한마취과학회지

BACKGROUND: Early escharectomy has been shown to improve the survival rates and the treatment outcomes of major burn patients. However, its exact mechanism, especially in terms of the human immune system, has not been fully elucidated. This observational study, which placed a focus on adhesion molecules, was conducted to assess changes of soluble intercelluar adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin in major burn patients undergoing early eschar excision. METHODS: Seventeen ASA physical status II or III adult major burn patients, admitted for plastic and reconstructive surgery for burn wound care, were initially recruited. When early escharectomy was scheduled, a series of blood samples were obtained four times at 72 and 24 hours preop and 24 and 72 hours postop, respectively. Changing levels of sICAM-1, sVCAM-1, and E-selectin were measured using quantitative sandwich immunoassay techniques. RESULTS: All patients suffered from major burns. Early escharectomy does not appear to have any significant impact on the levels of sICAM-1 and sVCAM-1. On the other hand, E-selectin levels showed a significant decrease after escharectomy. CONCLUSIONS: Major burn injury certainly induces a systemic inflammatory response. Adhesion molecules behave in such a way that escharectomy has a limited immunomodulatory effect in major burns. This is probably related to the timing and extent of surgery, and the complex nature of burn related inflammation.

A Case of Epoxy Resin Induced Thermal Injury in Upper Gastrointestinal Tract / 대한소화기내시경학회지

Epoxy resins has been used as a adhesive material in industry. Toxic effects for epoxy resin are known as respiratory, dermatologic, ophthalmologic and allergic symptoms. Ingestion of epoxy resin has been known to induce moderate toxic effect, but reports are very rare. Toxic injury due to ingestion in gastrointestinal tract is usually caused by suicidal attempt or incidental ingestion in young ages and alcoholics. Herein, we report a case of diffuse mucosal injury in upper gastrointestinal tract caused by thermal injury from epoxy resin with a review of relevant literatures.

Concurrent Impairment of Th1 and Th2 Response in Thermal Injury

Large numbers of reports have shown that thermal injury (TI) causes a wide spectrum of defects in immune response that lead to a high susceptibility to various opportunistic infections. However, it is still a matter of debate whether TI induces Th2 polarization or global impairment in Th1/Th2 response. In this study, TI in a mouse model was induced by exposing shaved dorsal skin to boiling water and cytokine production was analyzed. At day 2 of injury, whole spleen cells and T cells were collected and then stimulated with an anti-CD3 antibody. The levels of cytokine secretion were determined by cytokine ELISA. Production of IFNgamma and IL 4 by whole spleen cells from injured mice were concurrently decreased when compared to those from sham-injured controls. Proportional changes in T, B, and T-subset cells were not accompanied. Using purified T cells devoid of accessory cells (AC), it was shown that those defects resulted primarily from lowered T cell potentials. By using mixed cultures of sham T and TI-AC and vice versa, it was revealed that AC also acted as inhibitor cells in IFNgamma and IL 4 production in less extent. Blockade of glucocorticoid signals rendered the T cells partially resistant to TI-induced inhibition in IFNgamma and but not IL 4 production. These results clearly demonstrate that TI induces overall suppression in Th1 and Th2 response through T cell dysfunction together with the inhibition of AC activity, and that reduction in only IFNgamma but not IL 4, production may be caused, in part, by corticosteroid hormone that is secreted prominently during trauma.

Skin Tissue Changes Following Thermal Injury in the Paralysed Lower Limb of Spinal Injured Rats

OBJECTIVE: To prove that the skin of paralysed limb of spinal injured rat is more susceptible to a thermal injury than control, and to find out that the possible relating factors for explaining the increased susceptibility of skin. METHOD: Of total 69 male Sprague-Dawley rats, 50 were randomly divided into two groups, the spinal injured of which cords were transected at T10-13 level and the control. They were subdivided into 5 subgroups according to the duration of thermal injury. Infrared ray was used for thermal injury. Arterial cannulation was done in the femoral artery for blood gas analysis. Temperature was measured with a digital thermometer. Biopsy samples were stained with HE, and also immunohistochemical staining for heat shock protein 70 (HSP-70) was done. RESULTS: After thermal injury, the spinal injured group showed more severe tissue damage and a higher temperature elevation than the control. There was a tendency of decreased blood pH and pO2, and increased pCO2. Contrary to the control, the immunoreactivity of HSP-70 was very tiny or rarely present in the spinal injured group. CONCLUSION: This study suggest that the increased susceptibility of skin to the thermal injury in spinal injured rats may be related to the vasomotor instability. And, the poor expression of HSP-70 from the skin of spinal injured rat can be a factor for the explanation of the defective cellular protective response in spinal cord injury.