Health-care providers are increasingly faced with the possibility of needing to care for people injured in explosions, but can often, however, feel undertrained for the unique aspects of the patient's presentation and management. Although most blast-related injuries (eg, fragmentation injuries from improvised explosive devices and standard military explosives) can be managed in a similar manner to typical penetrating or blunt traumatic injuries, injuries caused by the blast pressure wave itself cannot. The blast pressure wave exerts forces mainly at air-tissue interfaces within the body, and the pulmonary, gastrointestinal, and auditory systems are at greatest risk. Arterial air emboli arising from severe pulmonary injury can cause ischaemic complications-especially in the brain, heart, and intestinal tract. Attributable, in part, to the scene chaos that undoubtedly exists, poor triage and missed diagnosis of blast injuries are substantial concerns because injuries can be subtle or their presentation can be delayed. Management of these injuries can be a challenge, compounded by potentially conflicting treatment goals. This Seminar aims to provide a thorough overview of these unique primary blast injuries and their management.
Adenophostin A possesses the highest known affinity for the inositol 1,4,5-trisphosphate (Ins(1,4,5)P 3 ) receptor (InsP 3 R). The compound shares with Ins(1,4,5)P 3 those structural elements essential for binding to the InsP 3 R. However, its adenosine 2-phosphate moiety has no counterpart in the Ins(1,4,5)P 3 molecule. To determine whether its unique structure conferred a distinctive biological activity, we characterized the adenophos- Stimulation of many plasma membrane receptors increases the intracellular concentration of the second messenger inositol 1,4,5-trisphosphate (Ins(1,4,5)P 3 ).
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