Search PubMed⌕ Search

Biomedical subjects

I Cernak

Publications and source records attributed to I Cernak.

At least 37 records · Page 2Linked to original sources
PubMed1996

Glucose as an adjunct triage tool to the Red Cross Wound Classification.

The plasma concentrations of glucose, adrenaline, noradrenaline, insulin, and cortisol were measured in 59 patients within 18 hours of military gunshot/missile (MG/M) wound. The wounds were categorized by the Red Cross Wound Classification (RCWC) and assessed by the Injury Severity Score (ISS) method. The majority of the measured biochemical parameters, except insulin, were significantly increased after MG/M wounds, compared with control values. Plasma glucose concentration in wounded patients was positively related to ISS over the whole severity range. Plasma insulin concentration increased with glucose. Noradrenaline and cortisol were positively related to glucose. Because hemorrhage is the most common cause of general response to MG/M wound, we concluded that glucose measurement could be a useful adjunct tool to the RCWC in rapid and accurate assessment of severely wounded patients, especially those with occult thoraco-abdominal wounds.

Adolescent↗
PubMed1996

Leukotrienes in the pathogenesis of pulmonary blast injury.

Our previous studies demonstrate a significant increase of sulfidopeptide leukotriene concentrations in animals exposed to a free air blast. The aim of this study was to analyze the role of leukotrienes in the local response of lung tissue as well as in the general response of organisms to blast overpressure. The study was conducted on adult rabbits exposed to moderate blast overpressure (four pulmonary contusions characterized as confluent ecchymoses involving 30 to 60% of the lungs), generated in laboratory conditions. One group of experimental animals was treated with 5-lipoxygenase (5-LO) inhibitor, diethylcarbamazine (DEC, Sigma, St. Louis, Missouri) (50 mg/kg, i.v.), immediately before blast. The early posttraumatic period was observed (30 minutes after blast). Hemodynamic parameters (mean arterial pressure, heart rate, blood gases) as well as arterial plasma levels of conjugated dienes were observed. The myeloperoxidase activity, lipid peroxidation products levels, and water contents were measured in the lung tissue of injured rabbits. We observed that 5-LO inhibition reduced edema formation, accumulation of neutrophils, and generation of lipid peroxidation products in injured lungs. In this study, we demonstrated that treatment with DEC inhibits the increased systemic generation of conjugated dienes after blast injury. Although DEC exerts local antioxidant activity with beneficial effects on lung tissue, this 5-LO inhibitor intensifies the blast overpressure caused hemodynamic insufficiency.

Animals↗
PubMed1995

Experimental magnesium depletion in adult rabbits caused by blast overpressure.

The complex pressure wave (blast) generated by some explosions causes pulmonary pathological changes which resemble the histological findings of the adult respiratory distress syndrome (ARDS). The development of indirect neurotrauma following experimental pulmonary blast injury has been shown previously. The purpose of this study was to evaluate lung and brainstem total tissue magnesium concentrations in adult rabbits following pulmonary blast injury. In order to assess the interrelationship between magnesium and other secondary injury factors, total calcium and high energy phosphate (phosphocreatine, PCr; adenosine triphosphate, ATP) contents were simultaneously measured. Twenty adult male rabbits were divided into two groups. Group C (n = 10) served as control, while group B (n = 10) was subjected to a focused blast wave, generated in laboratory conditions using an air-driven shock tube. Moderate pulmonary blast injury was verified by histological examination in group B. Total tissue magnesium and calcium contents were measured by atomic absorption spectrophotometry in the lungs and brainstem of adult rabbits 30 min following blast overpressure and in their uninjured controls. Simultaneously, PCr and ATP contents were measured by fluorimetric enzymatic analyses in same structures. Lung and brainstem water contents were determined by wet weight to dry weight ratio. Blast overpressure to the lungs induced significant magnesium depletion, increased calcium and decreased the Mg/Ca ratio in lung tissue of injured animals. Increases in water content and PCr/ATP ratio were also observed. Significant correlations between these Mg/Ca and PCr/ATP and between Mg and ATP parameters confirmed the functional relationship between magnesium depletion and impaired bioenergetic state in indirect neurotrauma in adult rabbits through blast overpressure.

Animals↗
PubMedDate not supplied

Relations among plasma prolactin, testosterone, and injury severity in war casualties.

Tissue trauma leads to a complex hormonal response of pituitary end-organ axis. This response can be recorded by determining parameters that represent the functional integrity of these systems. The concentrations of serum prolactin (PRL), serum testosterone, and plasma adrenocorticotropin (ACTH) were measured in 62 adult male casualties from the recent war in former Yugoslavia. Patients with brain injury were not included. Venous blood samples were taken as soon as possible (2-18 hours) after admission and at 1, 2, 5, and 14 days after injury. The severity of gunshot/missile wounds was assessed by the Injury Severity Score (ISS). The control group consisted of healthy blood donors. Uninjured subjects who had undergone great stress on the battlefield (explosion in the vicinity without injury) served as the sham-control group. Tissue trauma leads to a severity-dependent decrease in serum testosterone concentrations during the first 5 days following injury. Significant correlations were observed between ACTH, prolactin, and ISS during the first 18 hours after injury. A strong negative correlation between testosterone and prolactin serum concentrations was found during the first 18 hours. In patients with additional complications or unsatisfactory outcome, the prolactin concentrations remained elevated, whereas testosterone concentrations were reduced. Our results support the usefulness of recording hormonal changes for determining trauma severity and monitoring the clinical course. Such monitoring also helps assess the efficacy of therapeutic strategies. The relation between testosterone and prolactin might be helpful for predicting the clinical course and trauma outcome.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

[Experimental study of the pathogenesis of frostbite. Part I. Pathohistologic and ultrastructural changes in tissues immediately after thawing].

Histopathologic and ultrastructural changes in the tissues of frozen extremities of Wistar rats were investigated immediately after thawing. Three experimental groups were formed: two were exposed to cryoinjuries of different intensity, while the third was the control one. Cryoinjury was caused by experimental model of local, controlled freezing of hind, right extremities. Immediately after thawing the tissue samples were taken from frozen right and unfrozen left extremities, in which histopathologic and ultrastructural changes were compared mutually and with control group, respectively. It was observed that the freezing directly caused ultrastructural and histopathologic damage of the tissues that were manifested immediately after thawing and were proportional to the intensity of freezing. Simultaneously, in the tissues existed complex circulatory disorders manifested in open arteriovenous shunts, venous congestion and microcirculatory insufficiency caused by evident spasm of arteriolae that could be considered to be very significant pathogenetic factor in ischemic damage of unfreezed tissues.

Animals↗
PubMedDate not supplied

Inhibition of leukotriene formation by diethylcarbamazine modifies the acid-base balance in the rabbits with blast injuries of the lungs.

Our previous investigations have shown that leukotrienes are important mediators/modulators in local response of the lungs to the blast injury. The aim of the present study was to investigate the effects of diethylcarbamazine (DEC), an 5-lipoxygenase inhibitor, on the acid-base balance following pulmonary blast injury. The experiments were performed on rabbits (n = 16) subjected to focused blast over-pressure on the middle thoracic region. Immediately prior to blast injury one group was treated with DEC (50 mg/kg, i.v.), and the other with the same volume of saline. Parameters of acid-base balance were measured in arterial and venous blood before and 30 minutes after injury. Obtained results indicated that DEC treatment reduced some disturbances induced by blast injury (prevents edema formation in the lungs, permits respiratory compensation of metabolic acidosis in general circulation, normalization of respirations and slightly improves the oxygen saturation of hemoglobin), in spite of intensified hemodynamic insufficiencies associated with increased hypotension and acidosis in the peripheral circulation.

Acid-Base Equilibrium↗
PubMedDate not supplied

[Experimental study of the pathogenesis of frostbite. Part II. Role of the sympathetic-adrenergic system in tissue reperfusion immediately after thawing].

The authors have investigated the role of sympathetic-adrenergic system in reperfusion of muscular tissue of the feet of Wistar rats immediately after thawing using alpha adrenergic blocker phentolamine methanesulfonate (Regitin). Cryoinjury was applied over an experimental model of local, controlled freezing of different intensity for certain experimental groups. Blood flow through microcirculation was measured by scintigraphy, following Tc-99m-pertechnetate clearance that was given in muscular mass of frozen right, as well as unfrozen left feet of rats. Results obtained in some experimental groups were compared mutually, as well as with the control group that was not exposed to cryoinjury. The investigations have revealed that immediately after thawing existed significant reduction, non-dependent of the intensity of freezing, in blood flow in microcirculation of both frozen and unfrozen feet of rats compared to the control group. Significant increase of microcirculatory blood flow in unfrozen feet was caused by blockade of sympathetic-adrenergic system, while the blood flow remained unchanged in the frozen ones. The reduction of blood flow in microcirculation of frozen tissues immediately after thawing was not associated with sympathetic-adrenergic factor.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

[Experimental study of the pathogenesis of frostbite. Part III. Significance of energy status of muscle tissue in the pathogenesis of frostbite].

The authors have investigated energy status of muscle tissue of the lower legs of Wistar rats subjected to freezing, as well as the dependence of ultrastructure changes in muscle tissue mitochondria on the intensity of freezing. The animals were divided into three experimental groups: two groups were exposed to cryoinjury of different intensity, while the third was the control one. Cryoinjury was applied over an experimental after thawing were taken samples of muscle tissue for the analysis of content of energy phosphates and carbohydrates' metabolites, respectively, as well as for morphometric analysis of mitochondria volume out of frozen right and unfrozen left lower legs. Results obtained from different experimental groups were compared mutually and with control group that was not exposed to cryoinjury, respectively. It was found that the freezing in muscle tissue caused hydrops degeneration of mitochondria, depletion of energy reserves, reduction of energy status and the activation of mechanism of anaerobic metabolism. All these alterations were proportional to the intensity of freezing and considerably influenced contractility function of muscle cells, causing prolonged spasm of arterioles in thawed tissue, i.e., rigor congelationis that was primarily defined as an important factor in the pathogenesis of ischemic impairment of thawed tissues.

Animals↗
PubMedDate not supplied

[Intra-arterial administration of prostaglandin E1 in occlusive arterial diseases].

The authors present their result of a two-year follow-up of 106 patients to whom an intra-arterial perfusion of prostaglandin E1 was administered, as limb salvage procedure. The patients were in the IIIrd and IVth stage of occlusive diseases by Fountain, and surgical reconstructions were not possible. All patients were divided into five groups: A--diabetic angiopathy (5), B--distal form of atherosclerosis (40), C--diabetic angiopathy and atherosclerosis (45), D--Burger disease (10) and E--adjuvant therapy in reconstruction with poor run-off (6). The Doppler sonographic and angiographic measurements were performed. After transcutaneous (16 cases), or intraoperative (90 cases) introduction of the catheter into superficial of profunda femoral artery, a continuous intraarterial administration of prostaglandin E1 was carried out in a dose of 10 nanograms/kg body weight/minute (total dosage 3000 nanograms). The patients were controlled immediately after the treatment, as well as 1, 3, 6, 12, 24 and 36 months after the treatment. In efficiency of the treatment was estimated on the following basis: elimination of rest pain, healing of trophic ulceration and demarcation of gangrenous processes. Our late results of intra-arterial administration of prostaglandin E1 proved to be a very successful limb salvage procedure. The treatment was more successful in a connections between the upper knee arterial net and pedal arterial arches were preserved.

Adult↗
PubMedDate not supplied

[Pathophysiologic reactions in sheep to blast waves from detonation of aerosol explosives].

In the controlled field experiments 18 sheep were exposed to the detonation of the aerosol explosive generating the blast wave necessary to produce death in 50% of cases. The time of death and characteristic damages on the predilection sites of some organs are interpreted as blast type injuries. General response of the body to blast wave was similar to the one produced by other etiological factors. A special characteristic of the experiment was the frequency and severity of pathologic changes on the internal organs of the chest and abdomen. According to the authors' opinion the severity and type of pathologic changes could be explained by effects of the complex blast wave generated by detonation of the aerosol explosives.

Animals↗
PubMedDate not supplied

[Pathogenesis of pulmonary edema caused by blast waves].

In the study of pathogenetic mechanisms of pulmonary edema to blast wave generated by detonation of the aerosol explosive in the open air, the dynamics of changes of the eicosanoid contents, the products of the energy metabolism as well as the glucose metabolism in the lung tissue of sheep have been examined. On the basis of data from the literature as well as own results the authors have given the original scheme of possible mechanisms of pulmonary edema caused by effects of the blast wave.

Animals↗
PubMedDate not supplied

[Metabolic changes as part of the general response of the body to the effect of blast waves].

Aiming to understand general response of the body to effects of blast wave there have been examined products of carbo-hydrates metabolism (glycogen, glucose, pyruvate, malate, oxalacetate) and of energy metabolism (ATP, ADP, AMP, inorganic phosphorus, energy state, potential of phosphorylation) in tissues of the liver and heart of sheep exposed to blast wave generated by detonation of the aerosol explosive. The authors have concluded that changes in the metabolism of carbo-hydrates and energy occurred in the tissue of the liver and heart after effects of blast wave are nonspecific and that they developed in the scope of general response of the body to trauma. It is possible that lung damages, as a local reaction to blast wave modify/modulate (aggrevate) the found changes.

Animals↗
PubMedDate not supplied

[Changes in serum enzyme values as possible indicators of the severity of blast injuries].

In order to detect biochemical parameters in the peripheral blood which would serve as an indicator of severity of blast injuries, the enzyme dynamics (creatine kinase, aspartat transaminase, alanin transaminase, lactic dehydrogenase, alkaline phosphatase, angiotensin convertase) has been followed up in the serum of sheep. The significant increase was found in the values of creatine kinase, aspartat transaminase and alanine transaminase in the serum of the experimental animals an hour after effects of the blast wave. The authors have concluded that changes of the mentioned enzymes can serve as one of signs of damages of the lungs and gastrointestinal tract caused by blast wave in the early posttraumatic period.

Animals↗
PubMedDate not supplied

[Eicosanoids in septic shock in rats].

In order to evaluate the role of eicosanoids in pathogenesis of septic shock, the dynamics of TxA2, PGE2 and peptidoleukotriene contents has been measured in the liver of rats with surgically induced septic shock (sesum resection). In the same time the general parameters have been followed up: survival, body temperature, hematocrit and glucose contents in the plasma of experimental animals. Aiming to differentiate the importance of some eicosanoids, immediately after surgery methyl prednisolone (phospholipase A2 inhibitor) or indomethacin (cyclooxigenase enzyme inhibitor) have been given. Based on own results the authors have concluded that in pathogenetic mechanisms of septic shock the main role have peptidoleukotrienes, lipooxygenase products of degradation of arachidonic acid.

Animals↗
PubMedDate not supplied

[Mechanisms of the beneficial effect of indomethacin and nimodipine in the treatment of traumatic shock in rats].

Aiming to study the pathogenetic mechanisms of the disturbed function of the central nervous system in traumatic shock we have determined the dynamics of changes of eicosanoids (PGF2 alpha, TxB2, 6-keto-PGF1 alpha, peptidoleukotrienes) in the brain structures (medulla oblongata, hypothalamus) of the experimental animals subjected to bilateral trauma of the hind legs (tourniquet trauma, LD50). Considering that our previous data have shown the importance of eicosanoid mediatory system in the pathogenetic mechanisms of shock, we have studied possible use of prostaglandin synthesis inhibitors (indomethacin) and calcium channel antagonists (nimidipine) in traumatic shock. The authors have concluded that in the pathogenetic mechanism of the disturbed function of the CNS in traumatic shock the important role has peptidoleukotrienes as well as that the combined use of prostaglandin synthesis inhibitors and antagonists of voltage-dependent calcium channel would be useful in the therapy of the injured patients.

6-Ketoprostaglandin F1 alpha↗
PubMedDate not supplied

[Mechanisms of the favorable effect of spinal anesthesia in traumatic shock].

Changes in the level of total peptidoleukotriens-pLT (LTC4 + LTD4 + LTE4) and inositol triphosphates (IP3) were analyzed in the thalamus of rats subjected to "tourniquet" trauma of both hind extremities (LD50) depending on the power of afferent nociceptive nerve impulses. Prevention of spreading, i.e., reduction of painful impulses from the damaged regions was achieved by the spinal anesthesia with bupivacain-chloride immediately after removal of the rubber bandage. Together with pLT and IP3 levels determined by radio immunoassay, physiologic parameters (mean arterial pressure, blood-brain barrier permeability) were also analyzed. Morphologic changes in the thalamus of rats were analyzed by electron microscopy. Extreme increase of the thalamic pLT and IP3 levels in traumatized animals together with increased blood-brain barrier permeability were found. Spinal anesthesia prevented, i.e., reduced these pathologic changes. Authors conclude that afferent painful impulses cause pLT increase in the thalamus and could modify CNS response to the trauma.

Anesthesia, Spinal↗