Trauma dental y lesiones faciales por armas de aire comprimido: reporte de un caso / Dental trauma and facial injuries by airguns: a case report

Las armas de aire comprimido son utilizadas desde hace muchos años con distintos usos que van desde el tiro recreativo hasta el control de plagas. Las más comunes son aquellas que disparan ''balines" o esferas metálicas que pueden llegar a tener capacidad de penetrar tejidos dependiendo del tipo de carga y de la longitud del cañón. Se presenta un caso clínico de un masculino que fue agredido con un arma tipo pistola con carga de CO2 que recibió un impacto a nivel facial y sufrió laceración en piel de labio y fractura dental complicada.

Air guns have been used for many years for a variety of purposes ranging from recreational shooting to pest control. The most common are those that shoot "pellets" or metallic spheres that can penetrate tissues depending on the type of load and the length of the barrel. A clinical case is presented of a male who was assaulted with a CO2-loaded pistol-type weapon, hit at facial level, and suffered laceration of the lip's skin and complicated dental fracture.

Doble mecanismo de estrangulación. A propósito de un caso / Double mechanism of strangulation. Apropos of a case

RESUMEN Las asfixias mecánicas son aquellas que resultan del impedimento mecánico a la penetración del aire en las vías respiratorias, suelen clasificarse atendiendo a la naturaleza del medio mecánico que las origina y a su modo de actuar. La estrangulación puede definirse como la constricción del cuello mediante la aplicación de una fuerza activa, ajena al peso del cuerpo, que actúa por intermedio de un lazo, las manos, el antebrazo o cualquier otra estructura rígida. En la estrangulación antebraquial, la constricción del cuello se lleva a cabo normalmente rodeando al individuo con el brazo y el antebrazo. Cuando el mecanismo de la compresión del cuello es lateral, no se afectan las vías aéreas, la compresión de las arterias carótidas hace que se produzca una isquemia cerebral y pérdida de conocimiento en 10-15 segundos. El mecanismo de muerte en estos casos será la anoxia cefálica. Si la compresión del cuello es anterior, actúa ocluyendo las vías aéreas, la presión sobre los cartílagos tiroides y cricoides puede producir fracturas y el mecanismo de muerte será la obstrucción respiratoria. El presente trabajo constituyó un caso poco común de estrangulación, donde se utilizó un mecanismo combinado que llevó al occiso al deceso final. Para la realización de la discusión del caso se tuvo en cuenta los elementos del lugar del hecho, el examen del exterior y el interior del cadáver (AU).

ABSTRACT Mechanical asphyxias are those resulting from the mechanical obstruction of the air penetration in the airways. They are usually classified according to the nature of the mechanical mean producing it and the way it performs. Strangulation may be defined as neck constriction through the application of an active force not proper to the body weight, acting by means of a knot, hands, forearm or any stiff structure. In ante brachial strangulation, neck constriction is normally performed surrounding the individual with the arm and forearm. When the neck constriction mechanism is lateral, the airways are not affected: carotid arteries constriction produces a brain stroke and loss of consciousness in 10-15 s. The death mechanism in these cases will be cephalic anoxia. If the neck compression is anterior, it occludes the airways; the pressure on thyroidal and cricoid cartilages may produce fractures and death mechanism will be respiratory obstruction. The current work deals with an uncommon strangulation case, where a combined mechanism led the person to the final decease. For the case discussion the authors took into account the elements of the place, and the examination of the exterior and the inside of the corpse (AU).

Pneumatic Colorectal Injury Caused by High Pressure Compressed Air

The pneumatic colorectal injury caused by high pressure compressed air are rare and can be fatal. Herein, we present a case of 45-year-old male who developed sudden onset of severe abdominal pain after cleaning the dust on his pants with high pressure compressed air gun dust cleaner. Emergent exploratory laparotomy was done which findings are a huge rectal perforation with multiple serosal and subserosal tear in sigmoid to splenic flexure of colon. Anterior resection with left hemicolectomy, and temporary transverse colostomy was performed. Postoperative course was uneventful. Recently, prognosis is generally favorable because of prompt diagnosis and emergent surgical management.

Orbital Cellulitis from an Orbital Compressed Air and Diesel Explosion Injury

No abstract available.

Colorectal injury by compressed air: the rule of conservative therapy / Lesão colorretal por ar comprimido: a regra da terapia conservadora

ABSTRACT We are reporting a case of colorectal injury caused by a jet of compressed air directed from a distance towards the anus. The patient mentioned that it happened accidentally while his colleague was cleaning his clothes using compressed air. The patient presented with acute abdominal pain and distension. A contrast CT study did not show any free air or leakage. The patient was treated conservatively, progressed well and was discharged from the hospital on the fourth day.

RESUMO Descrevemos um caso de lesão colorretal causada por um jato de ar comprimido direcionado para o ânus, a certa distância. O paciente mencionou que o ocorrido foi acidental, enquanto um colega estava limpando suas roupas com ar comprimido. O paciente se apresentou com dores abdominais agudas e distensão. Um estudo de TC contrastado não demonstrou ar livre, nem vazamento. O paciente foi tratado conservadoramente, teve boa evolução e recebeu alta hospitalar no quarto dia.

Rectal Perforation with Pneumoperitoneum Caused by Compressed Air

Compressed air can cause serious damage to internal organs. The stomach is an organ that is rarely perforated due to its elasticity. However, intestines are weaker and thinner compared to the stomach. A 40-year-old male came to the emergency room with severe abdominal pain due to dyspnea. The patient experienced abdominal pain right after his coworker shot compressed air into the patient's pants. The patient suffered from a rigid abdomen, and bed-side ultrasonography was carried out as soon as possible. Pneumoperitoneum was diagnosed by portable X-ray. After computed tomography, emergency paracentesis was carried out for decompression. After emergency paracentesis, the patient's symptoms and vital signs were stabilized. After the procedure, the patient had an emergency laparotomy.

Remineralization ability of fluoride varnish containing tricalcium phosphate by time / 대한구강보건학회지

OBJECTIVES: The aim of this study was to evaluate the degree of remineralization over time after application of fluoride varnish with and without tricalcium phosphate (TCP). METHODS: This in vitro study used extracted bovine lateral incisors without dental caries. Artificial lesions were created in the enamel specimens. The amount of mineral loss (ΔF(before)) was measured using quantitative light-induced fluorescence (QLF). Test fluoride varnishes (10 mg) were applied to the enamel surface of the specimen and dried for 4 min. No fluoride varnish was applied to the specimens in the control group. Each group was randomly assigned 12 specimens, and remineralization was allowed to occur to different time points (0.5, 1, 3, 6, 12, and 24 h) in each group. Specimens were washed with distilled water and dried with compressed air for 3 s. ΔF(after) was determined using QLF. RESULTS: When fluoride varnish containing TCP was applied for up to 6 h, the amount of mineral loss significantly increased, and when non-TCP fluoride varnish was applied for up to 12 hours, the amount of mineral loss significantly increased (P<0.05). However, the amount of mineral loss was higher in the control group. The difference between ΔF(before) and ΔF(after) (ΔΔF) increased over time. There was a significant difference between the TCP group and the control group after 6 h. The non-TCP group showed a significant difference after 24 h compared to the control group. After 12 h, significant differences were observed in the TCP group compared to both the non-TCP and control groups. CONCLUSIONS: This study showed that the degree of remineralization increased gradually over time after fluoride varnish application compared to the control group. In particular, fluoride varnish containing TCP showed better remineralization capability than varnish without TCP.

Large Steel Tank Fails and Rockets to Height of 30 meters - Rupture Disc Installed Incorrectly

At a brewery, the base plate-to-shell weld seam of a 90-m3 vertical cylindrical steel tank failed catastrophically. The 4 ton tank "took off" like a rocket leaving its contents behind, and landed on a van, crushing it. The top of the tank reached a height of 30 m. The internal overpressure responsible for the failure was an estimated 60 kPa. A rupture disc rated at < 50 kPa provided overpressure protection and thus prevented the tank from being covered by the European Pressure Equipment Directive. This safeguard failed and it was later discovered that the rupture disc had been installed upside down. The organizational root cause of this incident may be a fundamental lack of appreciation of the hazards of large volumes of low-pressure compressed air or gas. A contributing factor may be that the standard piping and instrumentation diagram (P&ID) symbol for a rupture disc may confuse and lead to incorrect installation. Compressed air systems are ubiquitous. The medium is not toxic or flammable. Such systems however, when operated at "slight overpressure" can store a great deal of energy and thus constitute a hazard that ought to be addressed by safety managers.

Near-complete optic nerve transection by high-pressure air

The use of high-pressure air instruments has become more common. Consequently, there have been a number of cases of orbital emphysema caused by contact with high-pressure air. In this case, a 62-year-old male patient visited an emergency medical center after his left eye was shot by an air compressor gun that was used to wash cars. Lacerations were observed in the upper and lower eyelids of his left eye. Radiological examinations revealed orbital emphysema, optic nerve transection, pneumocephalus, and subcutaneous emphysema in the face, neck, shoulder, and mediastinum. Canalicular injury repair was performed, and the emphysema resolved. However, there was near-complete vision loss in the patient's left eye. Because most optic nerve transections occur after a severe disruption in bone structure, pure optic nerve transections without any injury of the bone structure, as in the present case, is extremely rare.

Subcutaneous emphysema after treatment through airabrasivedevice: case report / Enfisema subcutâneo gerado após tratamento com equipamento de ar comprimido: relato de caso

Subcutaneous emphysema is an event often generated by iatrogenic reason, caused by improper dissection of air into soft tissues and/ or anatomical structures, causing edema and visually noticeable volumetric change in the area of the incident. The main etiological factor for this is the use of equipment such as air syringe or high-speed handpieces in surgical procedures of greater magnitude; however, subcutaneous emphysema may also occur in simple procedures, such that presented in this case report, through using air-abrasive device usually proper for dental prophylaxis. This case report aimed to describe the care measurements to avoid such event, describing proper procedures for the correct solution of the case, as well as to alert the professionals about the risks and necessary precautions.

O enfisema subcutâneo é um evento muitas vezes de origem iatrogênica, causado pela infusão indevida de ar nos tecidos e/ou estruturas anatômicas, causando edemaciamento e alteração volumétrica visualmente perceptível na área do ocorrido. O principal fator etiológico para tal é o uso de equipamentos como seringa tríplice ou caneta de alta rotação durante procedimentos cirúrgicos de maior magnitude; no entanto, o enfisema subcutâneo também pode ocorrer diante de procedimentos mais simples, tal como o ocorrido no presente relato de caso, em que houve sua ocorrência pelo uso de equipamento de ar comprimido usualmente utilizado para execução de profilaxia. O objetivo do presente artigo foi relatar o caso, assim como descrever os cuidados para se evitar tal evento, e descrever procedimentos adequados para o correto prosseguimento e resolução adequada do caso.

Orbital Emphysema Causing Eye Movement Restriction Without Orbital Fractures Due to Compressed Air Injury

PURPOSE: The authors experienced a case of orbital emphysema causing eye movement disorder following conjunctival tear without any orbital wall fractures after exposure to compressed air. CASE SUMMARY: A 28-year-old man's left periorbital area was injured while working with compressed air. There was marked lid swelling on the left side with palpable crepitus. The patient had an exotropia and hypertropia of the left eye. In addition, the extraocular movement of the left eye was restricted on upgaze without nausea and vomiting. On slit-lamp examination, conjunctival partial laceration and subconjunctival air bubbles adjacent to the conjunctival laceration could be seen. Orbital computed tomography showed air in the periorbital and retrobulbar region of the left eye and no evidence of orbital fracture. On examination 4 days after the primary repair of the conjunctival laceration, the patient completely recovered without any complication. CONCLUSIONS: Orbital emphysema following a conjunctival laceration caused by compressed air without any orbital wall fractures can cause restriction of eye movement.

Colon Barotrauma Caused by Compressed Air

Colon barotrauma can be mostly caused by elevated intraluminal pressure. Air insufflation during colonoscopy procedure is the most common cause of iatrogenic colon barotrauma. Cat scratch colon can usually be seen in the mild type of colon barotrauma, and colon perforation can be seen in the severe type. We presently report a case of non-iatrogenic colon barotrauma caused by industrial compressed air. Multiple linear mucosal ulcers were noted in the recto-sigmoid colon, but the colon was not perforated. The patient was discharged without any further complications after conservative treatments.

An introduction to diving medicine and decompression sickness

Diving is a perilous activity. Long exposure to the subaquatic environment results in many troubles to divers. In Korea, the number of divers, especially recreational ones, is soaring up and the incidence of diving related accidents and illnesses is also increasing rapidly. Consequently, diving medicine which approaches underwater medical problems is getting more important to doctors as well as divers. Decompression sickness (DCS) is one of the most typical diseases in diving medicine, and divers who breathe compressed air or mixed gas always have a risk of suffering from it. DCS is caused by bubbles from dissolved inert gas as a result of decompression. The diagnosis of DCS is based completely on clinical manifestations, but it is not easy to make a correct diagnosis due to various symptoms. In general, DCS needs prompt recompression chamber treatment with trained medical and paramedical staff, but few doctors are trained to handle diving related diseases like DCS and most people in Korea are not aware of diving medicine. Additionally, lack of recompression facilities hinders DCS patients from taking treatment timely. To deal with these problems, Korean government as well as doctors needs to show deep concern at this field.

Efficacy of gluma desensitizer[TM] and duraphat[TM] in relieving dentinal hypersensitivity in non-carious cervical lesions

The objective of this study was to compare the efficacy of Gluma Desensitizer[TM] and Duraphat[TM] in relieving dentinal hypersensitivity in non-carious cervical lesions by a randomized control trial. 196 patients having hypersensitive non-carious cervical lesions were divided into two groups. Gluma Desensitizer[TM] was applied to patients in Group A and Duraphat[TM] to patients ingroup B. Patient's pain response to compressed air was recorded on the visual analogue scale at baseline, 5 minutes, 7 days and 30 days after treatment. Data were analyzed using SPSS version 12. Comparison of sensitivity between the two treatment groups on application of compressed air showed a statistically significant difference. The results of this study showed that Gluma Desensitizer[TM] showed better results in relieving dentinal hypersensitivity than Duraphat[TM] in non-carious cervical lesions

A Case Study of a Patient with Penetrating Neck Injuries caused by a Nail Gun

Powered by compressed air, a nail gun is an essential alternative tool to a hammer on any construction site. This useful machine launches nails at high speed, automatically embedding them in a piece of wood in only a fraction of a second. In spite of its convenience, life-threatening and fatal nail gun injuries can occur when a nail gun is misused, such as in a suicide attempt, or when the operator has insufficient training because combustion nail guns are capable of firing projectiles at velocities higher than 150 m per second. Although injuries by nail guns are rarely reported, there have been reports of nail gun injuries to the head and the trachea in Korea. In the emergency room, the authors experienced a patient injured by an accidental shooting of a nail gun while working in construction. In that accident, a nail penetrated the patient's cervical vertebra through the left cheek. This report is aimed at studying medical treatment for patients with penetrating injuries caused by nail guns.

Colorectal Trauma by Compressed Air / 대한법의학회지

A seaman died after a jet of compressed air directed to his anus while working with his colleagues in deck of the ship. He suffered from abdominal pain and distension, and died 5 hours later in the ship. Autopsy was performed and revealed rupture of the splenic flexure of the colon and partial seromuscular tearing in the rectosigmoidal region. We concluded that the cause of death was tension pneumoperitoneum by the pneumatic colonic rupture. The need for education of the workers handling compressed air appliances is emphasized.

A Fatal Case of Methylene Chloride Poisoning

A 52-year-old man was found dead in the driver's seat of his tank lorry. The tank lorry was used to transport industrial wastewater to a disposal plant; the material was transferred into a storage tank with the help of compressed air. The wastewater contained methylene chloride and 2-chloropyridine. No respiratory protective equipment was used while working under these conditions. The autopsy report showed extensive edema and congestion of the brain, lung, and intraperitoneal organs. The concentrations of methylene chloride in lung and brain were reported at 398 and 67 mg/kg, respectively.

The Effect of Compressed Air Jet Cleaning on the Elimination of Postoperative Residual Protein from a ProSeal(TM) Laryngeal Mask Airway / 대한마취과학회지

BACKGROUND: The reusable ProSeal(TM) laryngeal mask airways (PLMA's) have the potential to act as a vector for the transmission of prion diseases such as variant Creutzveldt-Jacob disease. This study tested the hypothesis that supplementary compressed air jet cleaning facilitates the removal of protein deposits on PLMA's after surgery. METHODS: After clinical use, thirty PLMA's were randomly allocated to be washed by hand and with an autoclave (134 degrees C for 40 min) (group 1, n = 15), or by hand, autoclave and compressed air jet cleaning (1 min) (group 2, n = 15). In both groups, protein deposits were detected on PLMA's by erythrosine staining. A staining score designated as nil, mild, moderate, and severe was given to each site (outer, inner surface and edges of the cuff, airway and drain tube, finger strap) according to the percentage of stained surface area. The severity of staining was compared for masks prior to use and after cleaning the mask. RESULTS: Despite the cleaning of masks, the staining score worsened on the outer, inner surface and edge of PLMA's in both groups (P < 0.05); however, a similar pattern was observed on each part of a cleaned PLMA for both groups. CONCLUSIONS: We conclude that compressed air jet cleaning for 1 min did not improve the removal of protein deposits on PLMA's after surgery.

Clinical Experience and Efficacy of Lipomatic(R) Liposuction(The Vibroliposuction)

The liposculpting has become one of the most popular aesthetic operations. Lipomatic(R) technique was recently developed for solving several problems. The principle of operation is the prepagation of oscillation wave energy created by compressed air to the cannula, so that it can dislodge only the fat globules. So they can be more easily extracted from the body through the tube in shorter time. In this study, 48 cases of liposuction using Lipomatic(R) were performed from March, 2001 to March, 2003 in Bundang CHA hospital. We compared the preoperative amount of hemoglobin, circumference of each area and weights with postoperative results. Furthermore, we measured the amount of infiltration solution and aspirated fat. The average of infiltrated and aspirated volume were 2241 ml and 1935 ml, respectively. The average decrease in hemoglobin value was 0.8 mg/dl. The mean weight loss was 0.9 kg. The average decrease in circumference was 9.6 cm in abdomen, 4.6 cm in thigh, 3.6 cm in upper arm and 3.5 cm in calf, respectively. There were no serious side effects; the patients were nearly all satisfied with the result of good body contouring. The patients were benefited from the shorter operation time, less bleeding, less hematoma, less ecchymosis, less swelling and less pain compared with those who took the other methods in our experience. In addition, the operator was benefited from the shorter operation time, less physical effort and more accuracy. We conclude that Lipomatic(R) liposuction is effective, reliable and safe method compare with conventional liposuction methods.

The Distribution of Medical Personnel and Medical Equipments in the Intensive Care Units in Korea / 대한구급학회지

BACKGROUND: Not much of the fund is invested in the intensive care unit (ICU) in Korean hospitals since the cost of ICU care is set too low compared to the other medical fields as well as to the other part of the world. This study is designed to support the base of an ICU standard guideline in Korea. METHODS: The questionnaire were sent to 73 ICUs and 24 neonatal ICUs (NICU) of 30 hospitals. Twenty-two of them were teaching hospitals and 8 of them were general hospitals. RESULTS: The ratios of ICU bed number to total bed number were 5.0% and 6.0% in teaching hospital and general hospital respectively. The ratios of NICU bed to total bed were 3.4% and 2.0% in teaching hospital and general hospital respectively. Intensivists were kept in 24.6% of ICU and 36.4% of NICU. Residents were kept in 43.1% of ICU and 45.5% of NICU. The utilization of ICU service was 90% for teaching hospital and 86% for general hospital. The utilization of NICU was 89% for teaching hospital and 3% of general hospital. Nurse to patient ratios varied widely. Most ICUs in teaching hospital showed the nurse to patients ratio of 1 : 4 which was about 32% of total ICU. Most NICUs in teaching hospital showed the nurse to patients ratio of 1 : 5 which was around 20% of total NICU. Most of the ICUs were equipped with central piping system for oxygen and compressed air supply, vacuum system and all the necessary medical gadgets such as mechanical ventilators, ECG monitors, defibrillators, pulse oximeters and infusion pumps. CONCLUSIONS: The distribution of medical personnel as well as medical equipments were varied widely. The variation existed between teaching hospital and general hospital as well as within the teaching hospitals. We need to establish a standard, which grades the level of ICU according to the number of keeping physician, nurse-patients ratio, and the types of medical equipments they have.