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At least 703 records · Page 39Linked to original sources
PubMed1980

Haemodynamic and metabolic consequences of lung contusion following blunt chest trauma.

Haemodynamic and metabolic pulmonary functional data were recorded in 18 patients suffering from lung contusion following blunt chest trauma. Similar qualitative results were obtained whether the patients were given oxygen via a mask (Group 1, 8 patients) or needed assisted ventilation (Group 2, 10 patients). Cardiac index rose 25% during the first five days and remained elevated for three to six weeks. Pulmonary vascular resistance (PVR) and intrapulmonary shunting were elevated on admission and showed peaks on the second and fifth days. After three weeks there was still a shunt fraction of 21%, while PVR had become normal. Bronchial infections, sepsis and hyper-coagulability occurred more frequently in the respirator-treated group. Hospitalization was in average more than three times longer for these patients. It is concluded that respirator treatment should be restricted to patients in urgent need of artificial ventilation. The haemodynamic and metabolic findings were well correlated to the delayed clinical recovery.

Adult↗
PubMed1980

Methylprednisolone in the treatment of lung contusion following blunt chest trauma.

The effects of large doses of methylprednisolone (MP) (30 mg per kg. b.w.) in patients with lung contusion following blunt chest trauma were studied in 10 patients selected at random and compared with 10 chest trauma patients receiving no steroids, but otherwise treated in the same way. All patients survived. Serious post-traumatic complications were reduced in the steroid group. All patients were followed with haemodynamic and metabolic observations for 6 weeks using Swan-Ganz flow directed thermodilution catheters. The most pronounced effect of MP was a significant reduction of pulmonary vascular resistance which may prevent right heart failure. The study demonstrates that MP should be given in sufficient doses in patients with respiratory insufficiency following blunt chest trauma.

Adult↗
PubMed1979

Pressor response resulting from experimental contusion injury to the spinal cord.

Experimental contusion paraplegic injury to the posterior spinal cord in cats results in a sudden increase of systemic blood pressure to between 200 and 250 mm Hg, and an increase in pulse pressure and a slowing of pulse rate. This initial hypertensive phase lasts approximately 3 to 4 minutes, and then is followed by a hypotensive phase. This pressor response is mediated by the alpha adrenergic receptor sites of the peripheral sympathetic nervous system and can be blocked by intravenous phenoxybenzamine, an alpha adrenergic blocking agent. The hypotensive phase is the result of an overall reduction in alpha adrenergic vascular tone and can be reversed by the infusion of metaraminol or intravenous fluids. The alterations in blood pressure that follow impact injury are most likely related to alterations of peripheral arteriolar resistance and venous return of blood to the heart.

Adrenalectomy↗
PubMed1983

Uptake and elimination of methylprednisolone from contused cat spinal cord following intravenous injection of the sodium succinate ester.

The uptake and elimination of methylprednisolone by the injured cat lumbar spinal cord were examined following a single 30-mg/kg intravenous bolus injection of the sodium succinate ester. The findings were considerably different from those previously reported for normal lumbar cord. When the glucocorticoid was administered 30 minutes after a 400 gm-cm contusion injury, peak tissue concentrations in both injured and uninjured segments of traumatized spinal cord were not achieved until 30 minutes following drug administration. The elimination of methylprednisolone from injured spinal cord tissue was biphasic in nature, with a rapid elimination phase occurring between 1 and 2 hours after drug administration. This rapid elimination phase was followed by a slower phase which paralleled the constant elimination rate from uninjured tissue of traumatized cord (approximate half-time = 6 hours). Significantly more methylprednisolone accumulated in the injured segment of traumatized spinal cord than in an uninjured segment adjacent to the injury site. This was only true, however, if the drug was administered at times up to 1 hour after injury. If injected after 1 hour, uptake by the injured segment decreased significantly with time after trauma and was no different from that observed for the uninjured segment in the same animal, which showed no significant variation with time after trauma. The probable basis for these differences and the possible clinical implications of these pharmacokinetic characteristics are discussed.

Animals↗
PubMed2000

Beneficial effects of modest systemic hypothermia on locomotor function and histopathological damage following contusion-induced spinal cord injury in rats.

OBJECT: Local spinal cord cooling (LSCC) is associated with beneficial effects when applied following ischemic or traumatic spinal cord injury (SCI). However, the clinical application of LSCC is associated with many technical difficulties such as the requirement of special cooling devices, emergency surgery, and complicated postoperative management. If hypothermia is to be considered for future application in the treatment of SCI, alternative approaches must be developed. The objectives of the present study were to evaluate 1) the relationship between systemic and epidural temperature after SCI; 2) the effects of modest systemic hypothermia on histopathological damage at 7 and 44 days post-SCI; and 3) the effects of modest systemic hypothermia on locomotor outcome at 44 days post-SCI. METHODS: A spinal cord contusion (12.5 mm at T-10) was produced in adult rats that had been randomly divided into two groups. Group 1 rats (seven in Experiment 1; 12 in Experiment 2) received hypothermic treatment (epidural temperature 32-33 degrees C) 30 minutes postinjury for 4 hours; Group 2 rats (nine in Experiment 1; eight in Experiment 2) received normothermic treatment (epidural temperature 37 degrees C) 30 minutes postinjury for 4 hours. Blood pressure, blood gas levels, and temperatures (epidural and rectal) were monitored throughout the 4-hour treatment period. Twice weekly assessment of locomotor function was performed over a 6-week survival period by using the Basso-Beattie-Bresnahan locomotor rating scale. Seven (Experiment 1) and 44 (Experiment 2) days after injury, animals were killed, perfused, and their spinal cords were serially sectioned. The area of tissue damage was quantitatively analyzed from 16 longitudinal sections selected from the central core of the spinal cord. CONCLUSIONS: The results showed that 1) modest changes in the epidural temperature of the spinal cord can be produced using systemic hypothermia; 2) modest systemic hypothermia (32-33 degrees C) significantly protects against locomotor deficits following traumatic SCI; and 3) modest systemic hypothermia (32-33 degrees C) reduces the area of tissue damage at both 7 and 44 days postinjury. Although additional research is needed to study the therapeutic window and long-term benefits of systemic hypothermia, these data support the possible use of modest systemic hypothermia in the treatment of acute SCI.

Analysis of Variance↗
PubMed1983

[Electron microscopic study of an experimental contusion cataract of a Japanese monkey].

The traumatic cataract was experimentally induced in the lens of a Japanese monkey and observed with the electron microscope. The purpose of this study was to shed some light on the origin of the cataract caused by various factors. The clinical examinations of the experimental animal showed the opacity of the posterior subcapsular cortex. Electronmicroscopic investigations revealed that lens fibers within the opaque region increased in number of mitochondrion, rough surfaced endoplasmic reticulum and other organelles when compared with those in the clinically normal region of the lens. Furthermore, the intercellular space in the opaque region increased to such an extent that large extracellular vacuoles were formed. Many of these lens fibers became swollen and decreased the interdigitation. Some swollen cells showed sparse arrangement of their cytoplasmic filaments. These morphological changes showed an acceleration of water absorption of the lens fibers from a relatively early stage of the traumatic contusion cataract. The increase in number of mitochondrion in such swollen (hydropic) fibers may play an important role in this process. The present experiment suggests that the appearance of so-called hydropic cells is an initial change in the cataractous lens.

Animals↗
PubMed1999

Alterations in AMPA receptor subunit expression after experimental spinal cord contusion injury.

The AMPA-preferring subtype of ionotropic glutamate receptors (GluRs) is a hetero-oligomeric ion channel assembled from various combinations of four subunits: GluR1, GluR2, GluR3, and GluR4. Antagonists of these receptors can mitigate the effects of experimental spinal cord injury (SCI), indicating that these receptors play a significant role in pathophysiology after spinal trauma. We tested the hypothesis that SCI alters expression of AMPA receptors using a standardized thoracic weight-drop model of rat contusive spinal cord injury. AMPA receptor subunit expression was measured at 24 hr and at 1 month after SCI with quantitative Western blot analysis and in situ hybridization. GluR2 protein levels were preferentially reduced near the injury site 24 hr after SCI. This reduction persisted at 1 month. At a cellular level, a significant decrease in both GluR2 and GluR4 mRNA was found in spared ventral motor neurons adjacent to the injury site and distal to it, with other AMPA subunit mRNAs maintained at control levels. In contrast, only GluR1 mRNA was decreased in the sympathetic preganglionic neurons of the intermediolateral horn. These results suggest population-specific and long-lasting changes in neuronal AMPA receptor composition, which may alter response to glutamate after SCI. These alterations may contribute not only to acute neuropathological consequences of injury, but they may also be partially responsible for the altered functional state of preserved tissue seen chronically after SCI.

Animals↗
PubMed1999

Effects of the sodium channel blocker tetrodotoxin on acute white matter pathology after experimental contusive spinal cord injury.

Focal microinjection of tetrodotoxin (TTX), a potent voltage-gated sodium channel blocker, reduces neurological deficits and tissue loss after spinal cord injury (SCI). Significant sparing of white matter (WM) is seen at 8 weeks after injury and is correlated to a reduction in functional deficits. To determine whether TTX exerts an acute effect on WM pathology, Sprague Dawley rats were subjected to a standardized weight-drop contusion at T8 (10 gm x 2.5 cm). TTX (0. 15 nmol) or vehicle solution was injected into the injury site 5 or 15 min later. At 4 and 24 hr, ventromedial WM from the injury epicenter was compared by light and electron microscopy and immunohistochemistry. By 4 hr after SCI, axonal counts revealed reduced numbers of axons and significant loss of large (>/=5 micrometer)-diameter axons. TTX treatment significantly reduced the loss of large-diameter axons. In addition, TTX significantly attenuated axoplasmic pathology at both 4 and 24 hr after injury. In particular, the development of extensive periaxonal spaces in the large-diameter axons was reduced with TTX treatment. In contrast, there was no significant effect of TTX on the loss of WM glia after SCI. Thus, the long-term effects of TTX in reducing WM loss after spinal cord injury appear to be caused by the reduction of acute axonal pathology. These results support the hypothesis that TTX-sensitive sodium channels at axonal nodes of Ranvier play a significant role in the secondary injury of WM after SCI.

Animals↗
PubMed1999

Contusion of lungs.

A 16 years old male with history of beating by army personnel was admitted in the hospital with the complaints of chest pain and breathlessness. After about 5 hours of admission, the patient died in spite of treatment with analgesics, antibiotics, fluids and oxygen inhalation. The autopsy report showed multiple bruises on different body parts and there were contusions on the lungs showing impression of rib patterns. Histological examination showed alveoli filled with blood and cellular infiltrate in interalveolar and interstitial spaces.

Adolescent↗
PubMed2001

[A frequent fiber-scopic bronchial lavege for the case of bilateral sever pulmonary contusion with flail chest].

A 26-year-old man was injured in the traffic accident. He had complicated chest trauma. He came to our hospital by ambulance immediately after rescued from crashed his automobile. He had severe pulmonary contusion with frail chest, pulmonary laceration, tension hemopneumothorax, and hypovolemic shock, and air embolism of the brain. He was managed with fiber-optic bronchoscopy under mechanical ventilation and chest drainage. Frequent broncho-scopic bronchial lavage of respiratory tract with thrombin and adrenaline solution was helpful to prevent anoxia due to complicated chest injury. He developed acute bacterial empyema and multiple organ failure due to septic shock during intensive care for trauma. However, he underwent surgical treatment for empyema and fully returned to his work after 6 months after his critical accident.

Accidents, Traffic↗
PubMed2001

[Unexplained right ventricle dilatation clarified by a cardiac contusion many years ago].

In a 52-year-old man with new onset atrial fibrillation, transthoracic echocardiography showed an isolated, considerably dilated right ventricle. Frequent causes of right ventricular dilatation were ruled out. The image-forming investigation showed an isolated dilation of the ventral part of the heart, which, in combination with a blunt chest trauma 30 years previously, led to a previous cardiac contusion being suspected. In accordance with this hypothesis myocardial scintigraphy showed asymmetric hypertrophy of the right ventricular wall, which is consistent with the remodeling that occurs in response to injured cardiac tissue. After electrical cardioversion sinus rhythm was obtained; the patient remained symptom free.

Atrial Fibrillation↗
PubMedDate not supplied

[Defined contusion marks caused by the knife handle].

If in inflicting a stab wound the knife is vigorously pushed in up to the end of the blade, this does not only cause cutting of the tissue, but also a blunt traumatization. The resulting abrasions can correspond with the respective construction parts (handle, handguard, devices for fixing the open blade) as to position, shape and size, thus allowing conclusions as to the shape of the instrument used. Incomplete, one-sided marks of the handle suggest an oblique-angled stab. The presence of a contusion mark shows that the blade penetrated completely, which makes it easier to draw conclusions as to the length of the blade from the depth of penetration. The reconstruction possibilities are demonstrated on the basis of three autopsies (homicide cases with different types of knives).

Adult↗
PubMed2004

[Multiple cerebral white matter lesions following head trauma with eyeball contusion].

We reported a 36-year-old man with multiple cerebral white matter lesions following head trauma with eyeball contusion. He had suffered from optic neuritis on non-injured side after one and half months from the head trauma. Brain MRI revealed multiple cerebral white matter lesions and lumbar puncture disclosed an elevated level of protein of the cerebrospinal fluid after two and half months from the head trauma. He was treated with steroid pulse therapy and resulted in an improvement of his visual acuity and a remarkable decrease of multiple cerebral white matter lesions. There has been a controversy concerning the causal relationship between trauma and multiple sclerosis (MS). In this case, MS-like multiple cerebral white matter lesions are considered to be relevant to the head trauma.

Adult↗
PubMed2005

The diagnosis of cardiac dysfunction in critically III trauma patients with blunt chest trauma and presumed myocardial contusion: the critical nature of end diastolic volume.

BACKGROUND: To evaluate prospectively the effectiveness of monitoring end-diastolic volume (EDV) vs pulmonary artery occlusion pressure (PAO) as an estimate of cardiac preload in hemodynamically unstable critically ill 23 myocardial contusion patients with blunt chest trauma admitted to a university trauma center.. METHODS: Patients were resuscitated (ATLS guidelines) with intubation and volume replacement for altered consciousness, hypoxemia or hemodynamic instability. Volume resuscitation and pulmonary artery catheterization were started to measure PAO, EDV, and oxygen utilization parameters. Myocardial performance was determined in both static (0., 24., 48., 72. hours) and dynamic condition after 500cc fluid bolus. RESULTS: A moderate injury severity (GCS 9, TS 11, ISS 34) with MVA mechanism (91%), an average ICU stay of 14 days and a 39% mortality were revealed. Correlation of PAO, EDV with CO, CI demonstrated that EDV is more reliable than PAO However, factoring heart rate into CO determination was more reliable than single preload estimates of EDV-PAO-HR, HR-EDV, and HR-PAO. EDV-PAO-HR were correlated more strongly with cardiac output from 24 to 96 hours. A higher AV02 decrease was associated with improved survival, and a nearly significant decrease in EDV. Dynamic comparison found no change in cardiac performance with a small volume challenge. CONCLUSION: Simultaneous consideration of PAO, EDV, HR allowed the most accurate determination of cardiac output.

Arterial Pressure↗
PubMedDate not supplied

[Forensic-medical assessment of pathomorphological changes in the myocardium in blunt chest trauma with an isolated heart contusion].

A total of 37 autopsy cases were divided into two groups. Group 1 consisted of 17 victims who had died of closed blunt trauma of the chest with isolated heart contusion made by fists, feet in shoes. Group 2 (control) consisted of 20 cases of sudden death of ischemic heart disease because of atherosclerotic cardiosclerosis. Fragments of the heart containing endocardium were studied on the microscope JEIL-SM200 (Japan). Endocardium pathomorphology was represented by relief changes of the endocardium, structural arrangement of separate groups of muscular fibers above the endocardium surface, hemorrhages and blood clots, endotheliocyte desquamation, prelacerations, lacerations and destruction of the endocardium.

Adult↗
PubMedDate not supplied

[The effect of carnosine on inflammatory processes during contusion of the eyeball].

The effect of dipeptide carnosine on proteolytic processes accompanying inflammation was investigated in lacrimal fluid of patients with eyeball contusion. Eye drops containing 5% carnosine in combination with traditional treatment reduced elastase-like activity in lacrimal fluid and increased effectiveness of therapy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1991

[Post-traumatic alveolar changes in lung contusion].

Bronchoalveolar lavage (BAL) specimens taken from nine patients with lung contusion following multiple trauma were compared with specimens from different control groups. Early interstitial and intra-alveolar reactions are PMN degranulation, mediator release and high protein leakage. The alveolar reactions are similar in extent to the reaction found in post-traumatic ARDS.

Acute-Phase Proteins↗