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In this study, GGOs and consolidation were the predominant abnormalities of the lung inhalation injury induced by smoke bombs. Image findings were based on histological characteristics, which included pulmonary edema, alveolitis, interstitial fibrosis, intra-alveolar fibrosis and diffuse alveolar damage (1,28,29). The number of pediatric patients with GGOs was highest in the 1st week (10 out of 11 pediatric patients), which decreased in the following one week and had a moderate upsurge trend in the 3rd week. The upsurge trend was due to the appearance of subpleural ground glass opacity and irregular linear opacities. Another predominant pattern of consolidation was common in the 1st week (8 out of 11 pediatric patients), which decreased in the following two weeks and disappeared in the 4th week. The consolidation areas totally resolved or reduced to small areas of fine reticulation. The reticular pattern associated with subpleural parenchymal bands and septal lines was detected to increase progressively from the 3rd week. Apart from these findings, the final scans of all pediatric patients in the 4th week showed residual abnormalities, including reticular pattern or GGOs with a superimposed reticular pattern and septal lines. The image characteristics of the CT scans obtained from the 3rd to the 4th week were clarified as interstitial fibrosis. The parenchymal bands indicated subsegmental atelectasis, which would be reversed as a result of resolution of inflammation with re-expansion of alveoli. Similarly, the resolution of interstitial edema and cellular infiltration could also explain the resolution of subpleural irregular linear opacities and septal lines. In one patient, the initial scan showed patterns like layered cake, consolidation with air bronchus signs in the accumulation area, GGOs in the aforementioned area and normal lung in the top area. The final scan showed that consolidation and GGOs resolved completely, and that there were only a few residual fibrotic lesions. Therefore, it was speculated that large and obvious consolidation accompanied with air bronchus signs was more easily resolved. The finding was similar to the CT images and prognosis of lobar pneumonia. Pneumomediastinum, subcutaneous emphysema or pneumothorax were found in five patients in the 4th day after the accident, which aggravated in the early stage and gradually resolved in the later stage. These findings were consistent with some former studies on adults (1,26,29,30). These conditions may be followed by severe cough caused by exposure to toxic materials such as chlorine (31) and nitrogen oxide (32). The mechanism of pneumothorax and pneumomediastinum may be the result of alveolar rupture caused by the direct injury of the alveoli (31).
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Put the smoke bomb inside a prop. There are several examples online of photographers putting smoke bombs inside objects that a model can hold, like birdcages, lanterns, or umbrellas. It makes for some interesting smoke bomb pictures as the smoke billows out from a seemingly ordinary object.