Facial Skin-Mucosal Biodynamic Blast Injuries and Management

Shuker, Sabri T.

doi:10.1016/j.joms.2010.03.003

Cited by 19 publications

(14 citation statements)

References 18 publications

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“…A number of rodent models involving FMOD gene knockouts have shown accelerated osteoarthritis in the temporomandibular joint (40), as compared to wildtype animals. Temporomandibular joint disorder has been reported by service members and veterans with exposure to IEDs and blast injury (98) and posttraumatic stress disorder (PTSD) (99). Of relevance to the data presented, headaches are the most commonly reported condition associated with temporomandibular joint disorders (100).…”

Section: Headache and Chronic Painmentioning

confidence: 99%

DNA Methylation Patterns of Chronic Explosive Breaching in U.S. Military Warfighters

Wang

Wilson

et al. 2020

Front. Neurol.

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Background: Injuries from exposure to explosions rose dramatically during the Iraq and Afghanistan wars, which motivated investigation of blast-related neurotrauma. We have undertaken human studies involving military "breachers"-exposed to controlled, low-level blast during a 3-days explosive breaching course. Methods: We screened epigenetic profiles in peripheral blood samples from 59 subjects (in two separate U.S. Military training sessions) using Infinium MethylationEPIC BeadChips. Participants had varying numbers of exposures to blast over their military careers (empirically defined as high ≥ 40, and conversely, low < 39 breaching exposures). Daily self-reported physiological symptoms were recorded. Tinnitus, memory problems, headaches, and sleep disturbances are most frequently reported. Results: We identified 14 significantly differentially methylated regions (DMRs) within genes associated with cumulative blast exposure in participants with high relative to low cumulative blast exposure. Notably, NTSR1 and SPON1 were significantly differentially methylated in high relative to low blast exposed groups, suggesting that sleep dysregulation may be altered in response to chronic cumulative blast exposure. In comparing lifetime blast exposure at baseline (prior to exposure in current training), and top associated symptoms, we identified significant DMRs associated with tinnitus, sleep difficulties, and headache. Notably, we identified KCNN3, SOD3, MUC4, GALR1, and WDR45B, which are implicated in auditory function, as differentially methylated associated with self-reported tinnitus. These findings suggest neurobiological mechanisms behind auditory injuries in our military warfighters and are particularly relevant given tinnitus is not only a primary disability among veterans, but has also been demonstrated in active duty medical records for populations exposed to blast in training. Additionally, we found that differentially methylated regions associated with the genes CCDC68 and COMT track with sleep difficulties, and those within FMOD and TNXB track with pain and headache. Conclusion: Sleep disturbances, as well as tinnitus and chronic pain, are widely reported in U.S. military service members and veterans. As we have previously demonstrated, DNA methylation encapsulates lifetime exposure to blast. The current Wang et al. Methylation Pattern of Cumulative Blast data support previous findings and recapitulate transcriptional regulatory alterations in genes involved in sleep, auditory function, and pain. These data uncovered novel epigenetic and transcriptional regulatory mechanism underlying the etiological basis of these symptoms.

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Section: Headache and Chronic Painmentioning

confidence: 99%

DNA Methylation Patterns of Chronic Explosive Breaching in U.S. Military Warfighters

Wang

Wilson

et al. 2020

Front. Neurol.

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“…Dermal burns occur because of direct or indirect exposure of an individual to a heat source that can cause damage to facial skin, the eyelids, and the lips and burning of facial hair (Shuker, 2010). Different aspects of the environment might influence the severity of blast burns.…”

Section: Facial Dermal Burn Traumamentioning

confidence: 99%

“…Different aspects of the environment might influence the severity of blast burns. For example, in a review of facial burns, Shuker noted that burns related to blasts were more severe in closed settings, where the blast wave was less likely to dissipate (Shuker, 2010). A mathematical model coupled with a live, controlled experiment of a bus explosion revealed that burns related to blasts were more severe in closed settings, where the blast wave was less likely to dissipate (Antanovskii, Remennikov, and Winter, 2010).…”

Section: Facial Dermal Burn Traumamentioning

confidence: 99%

“…Although burns are particularly common in cases in which the victim is close to the blast site (Shuker, 2010), computational modeling of burn in humans is almost nonexistent. Using multiscale computational models to understand the mechanisms and progression of injury and the subsequent use of protective equipment and treatment could be quite valuable.…”

Section: What Does Computational Modeling Elucidate About Skin Trauma...mentioning

confidence: 99%

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Toward a Unified Multiscale Computational Model of the Human Body's Immediate Responses to Blast-Related Trauma: A Review of the Scientific Literature

Sousa¹,

McBirney²,

Hoch³

et al. 2021

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A Review of the Scientific Literature I n the early 2000s, during the first several years of Operation Enduring Freedom and Operation Iraqi Freedom, improvised explosive devices (IEDs) accounted for a growing proportion of U.S. combat casualties and blast-related injuries. As incidence rates quickly rose, further research into the prevention, diagnosis, and treatment of blast-related injury was needed to identify those in need of care, how to determine their level of impairment, and the efficacy of various treatments and rehabilitation methods (Tanielian and Jaycox, 2008). Advancements in boundary conditions, material properties, the computational modeling of shock tubes that replicate blast waves, the use of animal models and cadavers for data, and validation have all contributed to enhance research about the human body's responses to blast exposure.Developing comprehensive blast-related injury mechanisms remains an active area of research and exploration. Computational modeling has investigated some of the human body's responses to blast-induced injuries in various body parts, from the cellular level to the tissue system level. Such modeling grants researchers the ability to assess the vulnerability of organs exposed to blast and correlations with clinically measurable injury levels. However, despite significant progress, there are several important factors that remain difficult to measure directly in real time, including the fluid mechanics of the human body (especially the brain), electrochemical and electromechanical components, and the brain's mechanobiology, such as intracranial pressure (ICP), deformations, stretch, shear stress, shear strain, and maximum principal strain (MPS).It is also important to note that, as critical as computational models highly focused on one body part or tissue system are to deepening our understanding, it is infrequent that service mem-

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“…[1][2][3] Burn injury alone, even in the absence of smoke inhalation, often causes damage to the lung tissue. [4] In recent years, increasing evidence has suggested that neutrophils play an important role in the pathophysiology of burn-induced lung injury.…”

Section: Introductionmentioning

confidence: 99%

The evaluation of different treatment protocols for combined injury-induced lung injury in rabbits

Li¹

2017

Ulus Travma Acil Cerrahi Derg

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Facial Skin-Mucosal Biodynamic Blast Injuries and Management

Cited by 19 publications

References 18 publications

DNA Methylation Patterns of Chronic Explosive Breaching in U.S. Military Warfighters

DNA Methylation Patterns of Chronic Explosive Breaching in U.S. Military Warfighters

Toward a Unified Multiscale Computational Model of the Human Body's Immediate Responses to Blast-Related Trauma: A Review of the Scientific Literature

The evaluation of different treatment protocols for combined injury-induced lung injury in rabbits

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