United States Department of the Army

About: United States Department of the Army is a government organization based out in Arlington, Virginia, United States. It is known for research contribution in the topics: Poison control & Population. The organization has 32668 authors who have published 42453 publications receiving 947075 citations. The organization is also known as: DA & U.S. Department of the Army.

Loss of the insular ribbon: another early CT sign of acute middle cerebral artery infarction.

Abstract: Although computed tomography (CT) remains the most frequently used imaging examination in acute cerebral infarction, its sensitivity for early detection of strokes remains limited. In middle cerebral artery (MCA) strokes less than 6 hours old, loss of definition of the gray-white interface in the lateral margins of the insula ("insular ribbon") was observed. The acute and subacute CT findings in 11 retrospective and 16 prospective patients are presented. Loss of the insular ribbon was detected in 12 of the prospective cases and in all 11 retrospective cases. The insular ribbon is supplied by the insular segment of the MCA and its claustral branches. With cessation of MCA flow, the insular ribbon becomes the region most distal from the anterior and posterior cerebral collateral circulations. Consequently, the insular ribbon effectively becomes a watershed arterial zone. Loss of the insular ribbon is thus a reflection of acute edema due to infarction. Loss of the insular ribbon appears to be another frequen...

Regulation of Ethylene Evolution and Leaf Abscission by Auxin.

Abstract: : It is shown that auxin enhanced ethylene evolution occurs in a variety of plant material, and that ethylene evolution can be constrolled by endogenous as well as exogenous levels of auxin The importance of auxin regulated ethylene evolution on a physiological process is demonstrated by investigating the abscission of bean petiole explants

Coagulopathy: Its pathophysiology and treatment in the injured patient

Abstract: Hemorrhage continues to be one of the leading causes of death following trauma Trauma patients are susceptible to the early development of coagulopathy and the most severely injured patients are coagulopathic on hospital admission Hypothermia, acidosis, and dilution from standard resuscitation can worsen the presenting coagulopathy and perpetuate bleeding Early identification of coagulopathy is dependent on clinical awareness and point of care laboratory values Routinely used laboratory coagulation parameters fail to adequately describe this state Thrombelastography is a test that can be done at the bedside and uses whole blood to provide a functional evaluation of coagulation Rapid diagnosis of coagulopathy, followed by prevention or correction of hypothermia and acidosis should be a priority during the initial evaluation and resuscitation Judicious use of resuscitation fluids and early replacement of coagulation factors will help prevent iatrogenic hemodilution This review covers the pathophysiology as well as the clinical and laboratory diagnosis of coagulopathy Prevention and treatment strategies are discussed, including early transfusion of coagulation factors during massive transfusion and the use of recombinant factor VIIa Damage control resuscitation is briefly discussed, and it involves the combination of hypotensive resuscitation and hemostatic resuscitation Finally, a description of the use of fresh whole blood in the military setting is included Its use has been proven to be safe and beneficial in this setting and warrants further investigation as an adjunct to the management of civilian trauma patients

Clinical application of an acellular biologic scaffold for surgical repair of a large, traumatic quadriceps femoris muscle defect.

Abstract: Many battlefield injuries involve penetrating soft tissue trauma often accompanied by skeletal muscle defects, known as volumetric muscle loss. This article presents the first known case of a surgical technique involving an innovative tissue engineering approach for the repair of a large volumetric muscle loss. A 19-year-old Marine presented with large volumentric muscle loss of the right thigh as a result of an explosion. The patient reported muscle weakness with right knee extension, secondary to volumentric muscle loss, primarily involving the vastus medialis muscle. This persisted 3 years postinjury, despite extensive physical therapy. With all existing management options exhausted, restoration of a portion of the lost vastus medialis muscle was attempted by surgical implantation of a multi-layered scaffold composed of extracellular matrix derived from porcine intestinal submucossa. The patient had no complications, was discharged home on postoperative day 5, and resumed physical therapy after 4 weeks. Four months postoperatively, the patient demonstrated marked gains in isokinetic performance. Computer tomography indicated new tissue at the implant site. This approach offers a treatment option to a heretofore untreatable injury and will allow us to improve future surgical treatments for volumetric muscle loss.