Examination of metal mobilization from a gunshot by scanning acoustic microscopy, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and inductively coupled plasma optical emission spectroscopy: A case report

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dc.contributor.authorBilen B.
dc.contributor.authorAtes Alkan F.
dc.contributor.authorBarutcu U.B.
dc.contributor.authorSezen M.
dc.contributor.authorUnlu M.B.
dc.contributor.authorAghayev K.
dc.date.accessioned2024-03-13T10:01:13Z
dc.date.available2024-03-13T10:01:13Z
dc.date.issued2018
dc.departmentİstanbul Beykent Üniversitesien_US
dc.description.abstractBackground: Projectile foreign bodies are known to cause chronic heavy metal toxicity due to the release of metal into the bloodstream. However, the local effect around the metallic object has not been investigated and the main goal of our study is to examine the influence of the object in close proximity of the object. Case presentation: A 36-year-old Caucasian woman with one metallic pellet close to her sciatic nerve due to a previous shotgun injury at the gluteal area presented with a diagnosis of recurrent lumbar disk herniation at L4-5 level. A physical examination confirmed chronic neuropathy and she underwent a two-stage surgery. The surgery included removal of the foreign body, followed by discectomy and fusion at the involved level. During the removal of the metallic foreign body, a tissue sample around the pellet and another tissue sample from a remote area were obtained. The samples were analyzed by scanning acoustic microscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. Lead, chromium, copper, cadmium, iron, manganese, selenium, and zinc elements in tissue, blood, and serum specimens were detected by inductively coupled plasma optical emission spectroscopy. Conclusions: An acoustic impedance map of the tissue closer to the metallic body showed higher values indicating further accumulation of elements. Energy-dispersive X-ray spectroscopy results confirmed scanning acoustic microscopy results by measuring a higher concentration of elements closer to the metallic body. Scanning electron microscopy images showed that original structure was not disturbed far away; however, deformation of the structure existed in the tissue closer to the foreign body. Element analysis showed that element levels within blood and serum were more or less within acceptable ranges; on the other hand, element levels within the tissues showed pronounced differences indicating primarily lead intoxication in the proximity of the metallic body. We can state that residues of metallic foreign bodies of gunshot injuries cause chronic metal infiltration to the surrounding tissue and induce significant damage to nearby neural elements; this is supported by the results of scanning acoustic microscopy, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and inductively coupled plasma optical emission spectroscopy. © 2018 The Author(s).en_US
dc.description.sponsorshipWe are thankful to the patient, who gave us permission to study her tissues, and to the Ministry of Development of Turkey, who supported the scanning acoustic microscopy studies in this research.en_US
dc.identifier.doi10.1186/s13256-018-1905-7
dc.identifier.issn1752-1947
dc.identifier.issue1en_US
dc.identifier.pmid30593288en_US
dc.identifier.scopus2-s2.0-85059244185en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.urihttps://doi.org/10.1186/s13256-018-1905-7
dc.identifier.urihttps://hdl.handle.net/20.500.12662/3046
dc.identifier.volume12en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherBioMed Central Ltd.en_US
dc.relation.ispartofJournal of Medical Case Reportsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectGunshot injuryen_US
dc.subjectLead toxicityen_US
dc.subjectMetal infiltrationen_US
dc.subjectScanning acoustic microscopyen_US
dc.titleExamination of metal mobilization from a gunshot by scanning acoustic microscopy, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and inductively coupled plasma optical emission spectroscopy: A case reporten_US
dc.typeArticleen_US

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