843 resultados para CRASH INJURY


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The objective of this work was to visualize the association between microcracking and other epidermal chilling injury symptoms, and to identify rots in cucumber fruit (Cucumis sativus L.) by scanning electron microscopy (SEM). Depressed epidermal areas and surface cracking due to damages of subepidermal cells characterized the onset of pitting in cucumber fruit. The germination of conidia of Alternaria alternata, with some of them evident on the fractures in the cultivar Trópico, occurred after damaging on the epidermis. Before, the chilling injury symptoms became visible, Stemphylium herbarum conidia germinated, and mycelium penetrated through the hypodermis using the microcracks as pathway. In the cultivar Perichán 121 the fungus was identified as Botrytis cinerea.

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Bridge rail and approach guardrails provide safety to drivers by shielding more hazardous objects and redirecting vehicles to the roadway. However, guardrail can increase both the initial cost and maintenance cost of a bridge, while adding another object that may be struck by vehicles. Most existing low volume road (LVR) bridges in the state of Iowa are currently indicated to not possess bridge rail meeting “current acceptable standards”. The primary objective of the research summarized in this report was to provide the nations bridge and approach rail state of practice and perform a state wide crash analysis on bridge rails and approach guardrails on LVR bridges in Iowa. In support of this objective, the criteria and guidelines used by other bridge owners were investigated, non-standard and innovative bridge and approach guardrails for LVR’s were investigated, and descriptive, statistical and economical analyses were performed on a state wide crash analysis. The state wide crash analysis found the overall number of crashes at/on the more than 17,000+ inventoried and non-inventoried LVR bridges in Iowa was fewer than 350 crashes over an eight year period, representing less than 0.1% of the statewide reportable crashes. In other words, LVR bridge crashes are fairly rare events. The majority of these crashes occurred on bridges with a traffic volume less than 100 vpd and width less than 24 ft. Similarly, the majority of the LVR bridges possess similar characteristics. Crash rates were highest for bridges with lower traffic volumes, narrower widths, and negative relative bridge widths (relative bridge width is defined as: bridge width minus roadway width). Crash rate did not appear to be effected by bridge length. Statistical analysis confirmed that the frequency of vehicle crashes was higher on bridges with a lower width compared to the roadway width. The frequency of crashes appeared to not be impacted by weather conditions, but crashes may be over represented at night or in dark conditions. Statistical analysis revealed that crashes that occurred on dark roadways were more likely to result in major injury or fatality. These findings potentially highlight the importance of appropriate delineation and signing. System wide, benefit-cost (B/C) analyses yielded very low B/C ratios for statewide bridge rail improvements. This finding is consistent with the aforementioned recommendation to address specific sites where safety concerns exist.

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The pattern of thyroid function changes following severe trauma was assessed prospectively in 35 patients during the first 5 days after injury. Patients were divided into 2 groups to evaluate the effect of head injury: group I, patients with severe head injury; group II, patients with multiple injuries without head injury. The results demonstrate a low T3 and low T4 syndrome throughout the study, with decreases in both total and free levels of T3 and T4, normal or increased rT3 levels, and normal TSH levels. The presence of severe head injury was associated with lower levels of TSH and free T3. Mortality was 37%. Survival was associated with higher TSH and T3 levels, but not with higher T4 levels. TSH levels exceeding 1 mU/l on the first day were only observed in survivors. These findings show that a typical low T3 and low T4 syndrome is present after severe trauma in patients with multiple injury as well as with head injury. Primary hypothyroidism can be excluded, pituitary or hypothalamic hypothyroidism is likely in these patients.

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CD1d is a major histocompatibility complex class 1-like molecule that regulates the function and development of natural killer T (NKT) cells. Previously, we identified a critical role for the CD1d-NKT cell arm of innate immunity in promoting the development of UVB-induced p53 mutations, immune suppression, and skin tumors. Sunburn, an acute inflammatory response to UVB-induced cutaneous tissue injury, represents a clinical marker for non-melanoma skin cancer (NMSC) risk. However, the innate immune mechanisms controlling sunburn development are not considered relevant in NMSC etiology, and remain poorly investigated. Here we found that CD1d knockout (CD1d(-/-)) mice resist UVB-induced cutaneous tissue injury and inflammation compared with wild-type (WT) mice. This resistance was coupled with a faster epithelial tissue healing response. In contrast, the skins of UVB-irradiated invariant NKT cell-knockout (Jα18(-/-)) and NKT cell-deficient (TCRα(-/-)) mice, which express CD1d but are deficient in CD1d-dependent NKT cells, exhibited as much cutaneous tissue injury and inflammation as WT mice. In the absence of NKT cells, CD1d-deficient keratinocytes, dendritic cells, and macrophages exhibited diminished basal and stress-induced levels of pro-inflammatory mediators. Thus, our findings identify an essential role for CD1d in promoting UVB-induced cutaneous tissue injury and inflammation. They also suggest sunburn and NMSC etiologies are immunologically linked.

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This report presents a national synthesis of rural expressway, two-way stop -controlled (TWSC) intersection safety strategies and intersection designs and an analysis of Iowa expressway TWSC intersection crash characteristics. A rural expressway is a multi-lane highway with a divided median and with mostly at -grade intersections, although some intersections may be grade separated. The synthesis of intersection strategies is conducted in two parts. The first is a literature review and the second part is a national survey of strategies currently being applied by state transportation agencies. The characterization of crash patterns at TWSC expressway intersections is examined through the analysis of 5 years of crash data at 644 intersections.

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In April 2008 a preliminary investigation of fatal and major injury crashes on Iowa’s primary road system from 2001 through 2007 was conducted by the Iowa Department of Transportation, Office of Traffic and Safety. A mapping of these data revealed an apparent concentration of these serious crashes on a section of Iowa 25 north of Creston. Based on this information, a road safety audit of this roadway section was requested by the Office of Traffic and Safety. Iowa 25 is a two-lane asphaltic concrete pavement roadway, 22 ft in width with approximately 6 ft wide granular shoulders. Originally constructed in 1939, the roadway was last rehabilitated in 1996 with a 4-in. asphalt overlay. Except for shoulder paving through a curve area, no additional work beyond routine maintenance has been accomplished in the section. The 2004 traffic map indicates that IA 25 has a traffic volume of approximately 2070 vehicles per day with 160 commercial vehicles. The posted speed is 55 mph. This report contains a discussion of audit team findings, crash and roadway data, and recommendations for possible mitigation of safety concerns for this roadway section.

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A road safety audit was conducted for a seven-mile section of County Road W-55 in Washington County, Iowa. In 2006, the average annual daily traffic on this roadway was found to be 1,290 vehicles per day. Using crash data from 2001 to 2007, the Iowa Department of Transportation (Iowa DOT) has identified this roadway as being in the top 5% of Iowa secondary rural roads with the highest density of serious (fatal and major injury) crashes for single-vehicle run-off-road incidents. Considering these safety data, the Washington County Engineer requested that a road safety audit be conducted to identify areas with safety concerns and to recommend low-cost mitigation to address those concerns. Staff and officials from the Iowa DOT, Iowa State Patrol, Governor’s Traffic Safety Bureau, Federal Highway Administration, Institute for Transportation, and local law enforcement and transportation agencies met to review crash data and discuss potential safety improvements to this segment of W-55. This report outlines the findings and recommendations of the road safety audit team to address the safety concerns on this W-55 corridor and explain several selected mitigation strategies.

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This project analyzes the characteristics and spatial distributions of motor vehicle crash types in order to evaluate the degree and scale of their spatial clustering. Crashes occur as the result of a variety of vehicle, roadway, and human factors and thus vary in their clustering behavior. Clustering can occur at a variety of scales, from the intersection level, to the corridor level, to the area level. Conversely, other crash types are less linked to geographic factors and are more spatially “random.” The degree and scale of clustering have implications for the use of strategies to promote transportation safety. In this project, Iowa's crash database, geographic information systems, and recent advances in spatial statistics methodologies and software tools were used to analyze the degree and spatial scale of clustering for several crash types within the counties of the Iowa Northland Regional Council of Governments. A statistical measure called the K function was used to analyze the clustering behavior of crashes. Several methodological issues, related to the application of this spatial statistical technique in the context of motor vehicle crashes on a road network, were identified and addressed. These methods facilitated the identification of crash clusters at appropriate scales of analysis for each crash type. This clustering information is useful for improving transportation safety through focused countermeasures directly linked to crash causes and the spatial extent of identified problem locations, as well as through the identification of less location-based crash types better suited to non-spatial countermeasures. The results of the K function analysis point to the usefulness of the procedure in identifying the degree and scale at which crashes cluster, or do not cluster, relative to each other. Moreover, for many individual crash types, different patterns and processes and potentially different countermeasures appeared at different scales of analysis. This finding highlights the importance of scale considerations in problem identification and countermeasure formulation.

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Iowa features an extensive surface transportation system, with more than 110,000 miles of roadway, most of which is under the jurisdiction of local agencies. Given that Iowa is a lower-population state, most of this mileage is located in rural areas that exhibit low traffic volumes of less than 400 vehicles per day. However, these low-volume rural roads also account for about half of all recorded traffic crashes in Iowa, including a high percentage of fatal and major injury crashes. This study was undertaken to examine these crashes, identify major contributing causes, and develop low-cost strategies for reducing the incidence of these crashes. Iowa’s extensive crash and roadway system databases were utilized to obtain needed data. Using descriptive statistics, a test of proportions, and crash modeling, various classes of rural secondary roads were compared to similar state of Iowa controlled roads in crash frequency, severity, density, and rate for numerous selected factors that could contribute to crashes. The results of this study allowed the drawing of conclusions as to common contributing factors for crashes on low-volume rural roads, both paved and unpaved. Due to identified higher crash statistics, particular interest was drawn to unpaved rural roads with traffic volumes greater than 100 vehicles per day. Recommendations for addressing these crashes with low-cost mitigation are also included. Because of the isolated nature of traffic crashes on low-volume roads, a systemic or mass action approach to safety mitigation was recommended for an identified subset of the entire system. In addition, future development of a reliable crash prediction model is described.

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Résumé Les canaux ioniques ASICs (acid-sensing ion channels) appartiennent à la famille des canaux ENaC/Degenerin. Pour l'instant, quatre gènes (1 à 4) ont été clonés dont certains présentent des variants d'épissage. Leur activation par une acidification rapide du milieu extracellulaire génère un courant entrant transitoire essentiellement sodique accompagné pour certains types d'ASICs d'une phase soutenue. Les ASICs sont exprimés dans le système nerveux, central (SNC) et périphérique (SNP). On leur attribue un rôle dans l'apprentissage, la mémoire et l'ischémie cérébrale au niveau central ainsi que dans la nociception (douleur aiguë et inflammatoire) et la méchanotransduction au niveau périphérique. Toutefois, les données sont parfois contradictoires. Certaines études suggèrent qu'ils sont des senseurs primordiaux impliqués dans la détection de l'acidification et la douleur. D'autres études suggèrent plutôt qu'ils ont un rôle modulateur inhibiteur dans la douleur. De plus, le fait que leur activation génère majoritairement un courant transitoire alors que les fibres nerveuses impliquées dans la douleur répondent à un stimulus nocif avec une adaptation lente suggère que leurs propriétés doivent être modulés par des molécules endogènes. Dans une première partie de ma thèse, nous avons abordé la question de l'expression fonctionnelle des ASICs dans les neurones sensoriels primaires afférents du rat adulte pour clarifier le rôle des ASICs dans les neurones sensoriels. Nous avons caractérisé leurs propriétés biophysiques et pharmacologiques par la technique du patch-clamp en configuration « whole-cell ». Nous avons pu démontrer que près de 60% des neurones sensoriels de petit diamètre expriment des courants ASICs. Nous avons mis en évidence trois types de courant ASIC dans ces neurones. Les types 1 et 3 ont des propriétés compatibles avec un rôle de senseur du pH alors que le type 2 est majoritairement activé par des pH inférieurs à pH6. Le type 1 est médié par des homomers de la sous-unité ASIC1 a qui sont perméables aux Ca2+. Nous avons étudié leur co-expression avec des marqueurs des nocicepteurs ainsi que la possibilité d'induire une activité neuronale suite à une acidification qui soit dépendante des ASICs. Le but était d'associer un type de courant ASIC avec une fonction potentielle dans les neurones sensoriels. Une majorité des neurones exprimant les courants ASIC co-expriment des marqueurs des nocicepteurs. Toutefois, une plus grande proportion des neurones exprimant le type 1 n'est pas associée à la nociception par rapport aux types 2 et 3. Nous avons montré qu'il est possible d'induire des potentiels d'actions suite à une acidification. La probabilité d'induction est proportionnelle à la densité des courants ASIC et à l'acidité de la stimulation. Puis, nous avons utilisé cette classification comme un outil pour appréhender les potentielles modulations fonctionnelles des ASICs dans un model de neuropathie (spared nerve injury). Cette approche fut complétée par des expériences de «quantitative RT-PCR ». En situation de neuropathie, les courants ASIC sont dramatiquement changés au niveau de leur expression fonctionnelle et transcriptionnelle dans les neurones lésés ainsi que non-lésés. Dans une deuxième partie de ma thèse, suite au test de différentes substances sécrétées lors de l'inflammation et l'ischémie sur les propriétés des ASICs, nous avons caractérisé en détail la modulation des propriétés des courants ASICs notamment ASIC1 par les sérines protéases dans des systèmes d'expression recombinants ainsi que dans des neurones d'hippocampe. Nous avons montré que l'exposition aux sérine-protéases décale la dépendance au pH de l'activation ainsi que la « steady-state inactivation »des ASICs -1a et -1b vers des valeurs plus acidiques. Ainsi, l'exposition aux serine protéases conduit à une diminution du courant quand l'acidification a lieu à partir d'un pH7.4 et conduit à une augmentation du courant quand l'acidification alleu à partir d'un pH7. Nous avons aussi montré que cette régulation a lieu des les neurones d'hippocampe. Nos résultats dans les neurones sensoriels suggèrent que certains courants ASICs sont impliqués dans la transduction de l'acidification et de la douleur ainsi que dans une des phases du processus conduisant à la neuropathie. Une partie des courants de type 1 perméables au Ca 2+ peuvent être impliqués dans la neurosécrétion. La modulation par les sérines protéases pourrait expliquer qu'en situation d'acidose les canaux ASICs soient toujours activables. Résumé grand publique Les neurones sont les principales cellules du système nerveux. Le système nerveux est formé par le système nerveux central - principalement le cerveau, le cervelet et la moelle épinière - et le système nerveux périphérique -principalement les nerfs et les neurones sensoriels. Grâce à leur nombreux "bras" (les neurites), les neurones sont connectés entre eux, formant un véritable réseau de communication qui s'étend dans tout le corps. L'information se propage sous forme d'un phénomène électrique, l'influx nerveux (ou potentiels d'actions). A la base des phénomènes électriques dans les neurones il y a ce que l'on appelle les canaux ioniques. Un canal ionique est une sorte de tunnel qui traverse l'enveloppe qui entoure les cellules (la membrane) et par lequel passent les ions. La plupart de ces canaux sont normalement fermés et nécessitent d'être activés pour s'ouvrire et générer un influx nerveux. Les canaux ASICs sont activés par l'acidification et sont exprimés dans tout le système nerveux. Cette acidification a lieu notamment lors d'une attaque cérébrale (ischémie cérébrale) ou lors de l'inflammation. Les expériences sur les animaux ont montré que les canaux ASICs avaient entre autre un rôle dans la mort des neurones lors d'une attaque cérébrale et dans la douleur inflammatoire. Lors de ma thèse je me suis intéressé au rôle des ASICs dans la douleur et à l'influence des substances produites pendant l'inflammation sur leur activation par l'acidification. J'ai ainsi pu montrer chez le rat que la majorité des neurones sensoriels impliqués dans la douleur ont des canaux ASICs et que l'activation de ces canaux induit des potentiels d'action. Nous avons opéré des rats pour qu'ils présentent les symptômes d'une maladie chronique appelée neuropathie. La neuropathie se caractérise par une plus grande sensibilité à la douleur. Les rats neuropathiques présentent des changements de leurs canaux ASICs suggérant que ces canaux ont une peut-être un rôle dans la genèse ou les symptômes de cette maladie. J'ai aussi montré in vitro qu'un type d'enryme produit lors de l'inflammation et l'ischémie change les propriétés des ASICs. Ces résultats confirment un rôle des ASICs dans la douleur suggérant notamment un rôle jusque là encore non étudié dans la douleur neuropathique. De plus, ces résultats mettent en évidence une régulation des ASICs qui pourrait être importante si elle se confirmait in vivo de part les différents rôles des ASICs. Abstract Acid-sensing ion channels (ASICs) are members of the ENaC/Degenerin superfamily of ion channels. Their activation by a rapid extracellular acidification generates a transient and for some ASIC types also a sustained current mainly mediated by Na+. ASICs are expressed in the central (CNS) and in the peripheral (PNS) nervous system. In the CNS, ASICs have a putative role in learning, memory and in neuronal death after cerebral ischemia. In the PNS, ASICs have a putative role in nociception (acute and inflammatory pain) and in mechanotransduction. However, studies on ASIC function are somewhat controversial. Some studies suggest a crucial role of ASICs in transduction of acidification and in pain whereas other studies suggest rather a modulatory inhibitory role of ASICs in pain. Moreover, the basic property of ASICs, that they are activated only transiently is irreconcilable with the well-known property of nociception that the firing of nociceptive fibers demonstrated very little adaptation. Endogenous molecules may exist that can modulate ASIC properties. In a first part of my thesis, we addressed the question of the functional expression of ASICs in adult rat dorsal root ganglion (DRG) neurons. Our goal was to elucidate ASIC roles in DRG neurons. We characterized biophysical and pharmacological properties of ASIC currents using the patch-clamp technique in the whole-cell configuration. We observed that around 60% of small-diameter sensory neurons express ASICs currents. We described in these neurons three ASIC current types. Types 1 and 3 have properties compatible with a role of pH-sensor whereas type 2 is mainly activated by pH lower than pH6. Type 1 is mediated by ASIC1a homomultimers which are permeable to Ca 2+. We studied ASIC co-expression with nociceptor markers. The goal was to associate an ASIC current type with a potential function in sensory neurons. Most neurons expressing ASIC currents co-expressed nociceptor markers. However, a higher proportion of the neurons expressing type 1 was not associated with nociception compared to type 2 and -3. We completed this approach with current-clamp measurements of acidification-induced action potentials (APs). We showed that activation of ASICs in small-diameter neurons can induce APs. The probability of AP induction is positively correlated with the ASIC current density and the acidity of stimulation. Then, we used this classification as a tool to characterize the potential functional modulation of ASICs in the spared nerve injury model of neuropathy. This approach was completed by quantitative RT-PCR experiments. ASICs current expression was dramatically changed at the functional and transcriptional level in injured and non-injured small-diameter DRG neurons. In a second part of my thesis, following an initial screening of the effect of various substances secreted during inflammation and ischemia on ASIC current properties, we characterized in detail the modulation of ASICs, in particular of ASIC1 by serine proteases in a recombinant expression system as well as in hippocampal neurons. We showed that protease exposure shifts the pH dependence of ASIC1 activation and steady-state inactivation to more acidic pH. As a consequence, protease exposure leads to a decrease in the current response if ASIC1 is activated by a pH drop from pH 7.4. If, however, acidification occurs from a basal pH of 7, protease-exposed ASIC1a shows higher activity than untreated ASIC1a. We provided evidence that this bi-directional regulation of ASIC1a function also occurs in hippocampal neurons. Our results in DRG neurons suggest that some ASIC currents are involved in the transduction of peripheral acidification and pain. Furthermore, ASICs may participate to the processes leading to neuropathy. Some Ca 2+-permeable type 1 currents may be involved in neurosecretion. ASIC modulation by serine proteases may be physiologically relevant, allowing ASIC activation under sustained slightly acidic conditions.

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The calcaneus gives shape to the heel. Its special position places it in direct contact with the floor, upon which rests the weight of the body. It assures the transition between the vertical skeleton and horizontal surface of the foot, thus permitting ambulation. The calcaneus is subjected to high physical stress, yet at the same time its complex articulating surfaces permit fine adaptation to the ground. Fractures of the calcaneus result from a high energy injury, usually a fall from a height. The treatment of such fractures poses difficult problems. The functional sequelae of the injury may be severe, prolonged, and frequently results in a permanent disability. This is due not only to the type of fracture, but the orthopaedic management as well. Careful evaluation of the patient, fracture pattern, soft tissue condition, and treatment modalities is obligatory to achieve the optimal result.

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The objective of this study was to assess the efficiency of spiral CT (SCT) aortography for diagnosing acute aortic lesions in blunt thoracic trauma patients. Between October 1992 and June 1997, 487 SCT scans of the chest were performed on blunt thoracic trauma patients. To assess aortic injury, the following SCT criteria were considered: hemomediastinum, peri-aortic hematoma, irregular aspect of the aortic wall, aortic pseudodiverticulum, intimal flap and traumatic dissection. Aortic injury was diagnosed on 14 SCT examinations (2.9 %), five of the patients having had an additional digital aortography that confirmed the aortic trauma. Twelve subjects underwent surgical repair of the thoracic aorta, which in all but one case confirmed the aortic injury. Two patients died before surgery from severe brain lesions. The aortic blunt lesions were confirmed at autopsy. According to the follow-up of the other 473 patients, we are aware of no false-negative SCT examination. Our limited series shows a sensitivity of 100 % and specificity of 99.8 % of SCT aortography in the diagnosis of aortic injury. It is concluded that SCT aortagraphy is an accurate diagnostic method for the assessment of aortic injury in blunt thoracic trauma patients.