Project description:C. elegans exhibit an age-dependent mechanical stress response to blunt force injury. Stress responses are often defined in part by an elicited cellular transcriptional response. We find in C. elegans that mechanical stress by blunt trauma induces a distinct and age-dependent transcriptional program.
Project description:The selective vulnerability of dopaminergic neurons to trauma-induced neurodegeneration is a conserved phenomenon across species, extending from nematodes to humans. However, the molecular mechanisms contributing to this hypersensitivity to blunt force injury remain poorly understood. We find that dopamine oxidation, a key driver of Parkinson’s Disease, extends its toxic role to the acute challenges of blunt force trauma. Ectopic synthesis of dopamine in serotonergic neurons alone proves sufficient in determining neuronal subtype sensitivity to trauma-induced death. While dopaminergic neurons maintain this neurotransmitter in a functional and benign state, trauma-induced subcellular redox imbalances elicit dopamine-dependent cytotoxicity. Perturbing dopamine synthesis and its packaging into synaptic vesicles further demonstrate how cytosolic dopamine is both necessary and sufficient to drive cell loss upon mechanical stress and during aging. Additionally, trauma activates the B-Zip transcription factor, fos-1, which exacerbates this toxic cascade by transcriptionally upregulating the rate-limiting enzyme in dopamine synthesis, cat-2. In summary, our study unravels the molecular intricacies that render dopaminergic neurons uniquely prone to physical perturbation, highlighting a shared vulnerability across different evolutionary lines.
Project description:Testicular rupture after blunt scrotal trauma is characterized by rupture of the tunica albuginea and extrusion of seminiferous tubules. This is a serious injury and appropriate evaluation and management are necessary both for symptom control, but also for preservation of the testicle. Clinical examination of the scrotum following trauma is difficult and may result in incorrect triage of patients for surgical exploration. This case study describes the assessment and management of blunt testicular trauma in an adolescent lacrosse player.
Project description:The majority of cardiac left ventricular aneurysms involve the anterior and/or apical wall. We present a case of a 50-year-old man with heart failure caused by a large inferolateral left ventricular aneurysm and associated mitral regurgitation, managed by aneurysmectomy, mitral valvuloplasty, and surgical revascularization.
Project description:We report the case of a 67-year-old patient who presented with anginal symptoms to the hospital. Computed tomographic angiography, to rule out a pulmonary embolism, showed a left ventricular apical outpouching. The patient underwent further imaging modalities, including contrast echocardiography (TTE) and cardiovascular magnetic resonance imaging (CMR), which were suggestive of a true left ventricular aneurysm (LVA). The absence of obstructive coronary artery disease on coronary angiography, absence of late enhancement on the CMR, and ultimately the intraoperative findings during surgical resection of the aneurysm, were strong indicators of a non-ischemic etiology of the patient's LVA. Additionally, the patient denied any previous history of cardiac instrumentation to rule out iatrogenic causes of LVA and congenital causes were excluded by a previous echocardiogram. Finally, history and presenting electrocardiogram did not reveal any other underlying obvious causes for the LVA. Excluding all common causes for the LVA an idiopathic cause seemed most likely.
Project description:True ventricular aneurysm is a scarred wall that most commonly results after an unrevascularized ST elevation myocardial infarction. Patients usually present with heart failure, angina, ventricular arrhythmia, systemic embolization, or ventricular rupture. Diagnosis can be achieved via echocardiography, left ventricle angiogram, cardiac computed tomography, or cardiac magnetic resonance.
Project description:Blunt trauma to the chest resulting in coronary thrombosis and ST elevation myocardial infarction (STEMI) is a rare but well-described occurrence in adults. Angiography in such cases has generally disclosed complete epicardial coronary occlusion with thrombus, indistinguishable from the findings commonly found in spontaneous plaque rupture due to atherosclerotic disease. In all previously reported cases in which coronary interrogation with intravascular ultrasound (IVUS) was performed in association with acute revascularization, coronary artery dissection was implicated as the etiology of coronary thrombosis. We present the first case report of blunt trauma-associated coronary thrombosis without underlying atherosclerosis or coronary dissection, as documented by IVUS imaging.