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At least 109 records · Page 6Linked to original sources
PubMed1997

Effect of prior receptor antagonism on behavioral morbidity produced by combined fluid percussion injury and entorhinal cortical lesion.

We have used an animal model of traumatic brain injury (TBI) that incorporates both the neurotransmitter toxicity of fluid percussion TBI and deafferentation of bilateral entorhinal cortical (BEC) lesion to explore whether administration of muscarinic cholinergic or N-methyl-D-aspartate glutamatergic antagonists prior to injury ameliorates cognitive morbidity. Fifteen minutes prior to moderate central fluid percussion TBI, rats were given intraperitoneal injections of either scopolamine (1.0 mg/kg) or MK-801 (0.3 mg/kg) and 24 hr later underwent BEC lesion. Body weight was followed for 5 days postinjury, as was beam balance and beam walk performance to assure motor recovery prior to spatial memory testing. Each group was assessed for spatial memory deficits with the Morris water maze at short term (days 11-15) and long-term (60-64 days) postinjury intervals and then compared with untreated combined insult and sham-injured controls. Results showed that each drug significantly elevated body weight relative to untreated injured cases. Both scopolamine and MK-801 reduced beam balance deficits, whereas neither drug had a significant effect on beam walk deficits. Interestingly, short-term cognitive deficits assessed on days 11-15 were differentially affected by the two drugs: MK-801 pretreatment enhanced the recovery of spatial memory performance, whereas scopolamine pretreatment did not. Long-term (days 60-64) deficits in spatial memory were not altered by pretreatment with either drug. Our results suggest that, unlike fluid percussion TBI alone, behavioral impairment may require more select intervention when deafferentation is part of the head trauma pathology.

Animals↗
PubMed1976

Fluid-percussion model of mechanical brain injury in the cat.

Mechanical brain injury was produced in 36 cats with a fluid-percussion model in which brain damage or dysfunction is produced by a single, brief, hydraulically-induced pressure transient that is conducted through the brain. Fluid-percussion injury induce elastic deformation of the brain resembling the brain deformation known to occur following head impact. Physiological responses and pahtological changes following injury were expressed as a function of peak pressure. Macroscopic central nervous system lesions concentrated at the pontomesencephalic junction, cervicomedullary junction, and in the cerebellar tonsils were consistently observed at and above 2.6 atmospheres (atm). At higher levels of injury (greater than or equal to 3.2 atm) there was extensive basal subarachnoid hemorrhage. At very high levels of injury (greater than 4.0 atm) hemorrhagic contusions were noted at the cerebral hemisphere impact site. A spectrum of neuronal alterations was identified in the damaged areas. Computer analysis showed correlation of electroencephalographic (EEG) changes with the neuropathological changes, since EEG recovery became severely impaired above 2.6 atm. No EEG changes were noted below 1.5 atm. From 1.5 to 2.2 atm there was a physiological response to injury but no significant changes were seen on neuropathological examination. This range of injury should permit further studies of the more subtle changes following mechanical brain injury without intraparenchymal hemorrhage or subarachnoid hemorrhage. The fluid-percussion model relates brain deformation following mechanical loading to a single pressure transient that is easily measured and controlled. Further quantitative investigation into the pathobiology of mechanical brain injury following graded brain deformation is thus made possible.

Animals↗
PubMed1994

Auscultatory percussion: a simple method to detect pleural effusion.

OBJECTIVE: To assess a new technique for the detection of free pleural fluid. DESIGN: 118 consecutive inpatients with radiologic evidence of free pleural fluid and a control group of 175 randomly selected inpatients were examined over a three-year period in a prospective blind study by auscultatory percussion (AP) for evidence of pleural effusion. The cutoff in the percussion note by AP is strikingly loud and sharp at the fluid level and allows precise delineation of even minimal amounts of pleural fluid. The fluid level was measured in reference to the last rib. The criterion for detection of pleural effusion by AP was a demonstrable horizontal fluid level at the sound cutoff across the posterior hemithorax above the last rib that shifted with lateral tilt. SETTING: A general medical and surgical university-affiliated teaching Veterans Affairs hospital. PATIENTS/PARTICIPANTS: All inpatients were eligible. Ready availability of examiners was essential. Rotating third- and fourth-year medical students, residents, and senior staff members participated. INTERVENTIONS: None. MAJOR RESULTS: 113 of the 118 patients with radiologic evidence of pleural effusion had a distinct horizontal fluid level above the last rib that shifted with lateral tilt (sensitivity = 95.8%). None of the 175 control patients examined at random showed evidence of pleural effusion by AP examination, which was confirmed by chest radiography (specificity = 100%). Nine of the 175 patients without radiologic evidence of pleural effusion had elevated diaphragms that simulated a fluid level in the examination by AP. Each of the nine patients, however, had no shift in the level with lateral tilt. Subpulmonic effusions were readily displaced and identified by this method of AP. CONCLUSIONS: Examination by AP is highly sensitive and specific for the detection of free pleural fluid, even in the presence of obesity, thickened pleura, lung masses, pneumonia, and associated lung disease. The examination correlates closely with standard and lateral decubitus chest radiography. Pleural effusion unsuspected by conventional means of physical examination and undetectable by standard chest radiography can readily be detected by the method of AP. The examination is easy to do and is particularly suited to enhance detection of pleural effusion. As little as 50 mL of free pleural fluid can be detected.

Adult↗
PubMed1991

Fluid percussion barotrauma chamber: a new in vitro model for traumatic brain injury.

Advances in the understanding of the pathophysiology of traumatic brain injury have implicated a number of cellular events as fundamental to the evolution of neurologic dysfunction in this process. Following the primary biomechanical insult, a highly complex series of biochemical changes occur, some of which are reversible. The development of fluid percussion injury as an in vivo model for traumatic brain injury has greatly improved our ability to study this disease. However, a comparable in vitro model of biomechanical injury which would enable investigators to study the response to injury in isolated cell types has not been described. We have developed a model of transient barotrauma in cell culture to examine the effects of this form of injury on cell metabolism. This model employs the same fluid percussion device commonly used in in vivo brain injury studies. The effect of this injury was evaluated in monolayers of human glial cells. Cell viability by trypan blue exclusion and the production of leukotrienes following increasing barotrauma was investigated. This model provided a reproducible method of subjecting cells in culture to forces similar to those currently used in animal experimental head injury.

Barotrauma↗
PubMed2005

A persistent change in subcellular distribution of calcineurin following fluid percussion injury in the rat.

Calcineurin, a neuronally enriched, calcium-stimulated phosphatase, is an important modulator of many neuronal processes, including several that are physiologically related to the pathology of traumatic brain injury. The effect of moderate, central fluid percussion injury on the subcellular distribution of this important neuronal enzyme was examined. Animals were sacrificed at several time points post-injury and calcineurin distribution in subcellular fractions was assayed by Western blot analysis and immunohistochemistry. A persistent increase in calcineurin concentration was observed in crude synaptoplasmic membrane-containing fractions. In cortical fractions, calcineurin immunoreactivity remained persistently increased for 2 weeks post-injury. In hippocampal homogenates, calcineurin immunoreactivity remained increased for up to 4 weeks. Finally, immunohistochemical analysis of hippocampal slices revealed increased staining in the apical dendrites of CA1 neurons. The increased staining was greatest in magnitude 24 h post-injury; however, staining was still more intense than control 4 weeks post-injury. The data support the conclusion that fluid percussion injury results in redistribution of the enzyme in the rat forebrain. These changes have broad physiological implications, possibly resulting in altered cellular excitability or a greater likelihood of neuronal cell death.

Animals↗
PubMed2005

Randomized controlled study of mechanical percussion, diuresis, and inversion therapy to assist passage of lower pole renal calculi after shock wave lithotripsy.

OBJECTIVES: To determine whether mechanical percussion, diuresis, and inversion (PDI) therapy after shock wave lithotripsy (SWL) improves the clearance rates of lower pole renal stones. METHODS: In this single-blind study, 108 patients who underwent SWL treatment for lower pole renal stones with a total diameter of 2 cm or less were prospectively randomized into two groups. One group (n = 49) received SWL only and the other group (n = 59) received a median of four sessions of PDI therapy (range 1 to 12), 1 to 2 weeks after each SWL session. PDI therapy was performed as follows. Patients drank 500 mL of water 30 minutes before therapy; they then lay in a prone Trendelenburg position on a 45 degrees -angle couch, and received continuous 10-minute manual mechanical percussion applied over the flank. Stone clearance was documented with plain abdominal radiography, with additional imaging, if indicated, 1 and 3 months after initial SWL therapy. RESULTS: The patients from both groups were comparable in terms of total stone diameter, infundibular neck diameter, infundibular length, caliceal height, infundibular-pelvic angles, infundibular-ureteral angles, infundibular-vertebral angles, lower pole cortical thickness, and caliceal number. All patients underwent a maximum of four SWL treatments. For all assessable patients, the radiologically documented complete stone clearance rate at 3 months for the SWL-alone group was 35.4% and for the SWL plus PDI group was 62.5% (chi-square test, P = 0.006). CONCLUSIONS: PDI therapy is a valuable adjunct in assisting passage of lower pole renal stone fragments after SWL therapy.

Adolescent↗
PubMed1998

Impaired expression of long-term potentiation in hippocampal slices 4 and 48 h following mild fluid-percussion brain injury in vivo.

The effect of fluid percussion brain injury on hippocampal long-term potentiation (LTP) was investigated in hippocampal slices in vitro. Mild to moderate (1.7-2.1 atm) lateral fluid percussion head injury or sham operation was produced in rats 4 or 48 h prior to harvesting brain slices from the ipsilateral hippocampus. Field excitatory post-synaptic potentials (fEPSPs) were recorded in stratum radiatum of hippocampal subfield CA1 in response to electrical stimulation of the Schaffer collaterals. The initial slope of fEPSPs was used to investigate changes in synaptic strength prior to and following 100 or 200 Hz (1 s) tetanic stimulation. TBI significantly inhibited expression of LTP in hippocampal slices in vitro. Post-tetanus fEPSP slopes increased more than 100% in hippocampal slices from sham-operated animals but less than 50% in slices from rats following TBI. The data suggest that changes in functional synaptic plasticity in the hippocampus may contribute to cognitive disorders associated with TBI (traumatic brain injury). The data also indicate that TBI-induced effects on hippocampal LTP are robust and may be investigated in the hippocampal slice preparation in vitro.

Animals↗
PubMed2000

Mechanical percussion inversion can result in relocation of lower pole stone fragments after shock wave lithotripsy.

OBJECTIVES: To determine whether mechanical percussion combined with inversion (MPI) therapy and forced diuresis can move stone fragments out of the lower pole of the kidney. METHODS: Twelve patients with lower pole residual stone fragments at least 2 weeks after shock wave lithotripsy were treated using the following protocol. Eleven patients received 20 mg of furosemide before MPI therapy. Patients were treated in the prone Trendelenberg position on a pivoting stretcher and given 10 minutes of percussion over the flank using a mechanical chest physiotherapy percussor. Stone location was documented with plain abdominal radiographs before, immediately after, and 2 weeks following MPI therapy. Voided urine was strained immediately after MPI therapy and throughout the study period. RESULTS: Abdominal radiographs before and after treatment demonstrated movement of fragments out of the lower pole in 11 patients. In 8 patients, the lower pole appeared entirely clear of fragments on the immediate post-treatment film. Four patients passed stone fragments in their first voided urine. Ten patients passed stone fragments during the 2-week follow-up period. CONCLUSIONS: MPI therapy combined with diuresis can effectively mobilize stone fragments out of the lower pole calyces and appears to aid in the passage of fragments.

Diuretics↗
PubMed1980

Auscultatory percussion of the chest.

In a controlled blind study 28 patients with prominent chest disease by chest X-ray each had normal or equivocal findings by conventional methods of percussion. In each case the lung abnormality was readily detected by auscultatory percussion. Lesions less than 2 cm in diameter were detected.

Adult↗
PubMed1988

Clinical use of the olecranon-manubrium percussion sign in shoulder trauma.

We conducted a study to assess the efficacy of the use of osteophony in the evaluation of shoulder trauma. Evaluation of the shoulder includes the physical examination and often a radiographic series. We studied the usefulness of the olecranon-manubrium percussion (OMP) test, a physical diagnostic procedure performed in shoulder trauma. The bell of the stethoscope is placed over the manubrium, both elbows are flexed at 90 degrees, and the olecranon is percussed. In the normal examination with no disruption of bony conduction, both sides should produce a crisp equal sound. In the event of a dislocation or fracture with disruption of bony conduction, the affected side should be duller in pitch and intensity. We evaluated the utilization of the OMP test to assess its accuracy when used as a screening test for radiographs in conjunction with the physical examination and radiographic examination. Ninety-six patients were prospectively evaluated by the OMP test and also received radiographs. In those patients who had radiographic abnormalities, 40 of 47 (85.1%) had an abnormal OMP sign. In those patients without radiographic abnormalities, none had an abnormal OMP sign. In assessing anterior shoulder dislocations, 11 of 13 (84.6%) had an abnormal OMP sign (P less than .02). After relocation, 100% had a normal OMP sign. Of those with clavicular fractures, nine of nine (100%) had abnormal OMP signs (P less than .005). Of those with a fracture of the humerus, 16 of 20 (80%) revealed an abnormal OMP test (P less than .01). The test was not significant in assessing acromio-clavicular joint abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergencies↗
PubMed1993

Immunolocalization of heat shock protein after fluid percussive brain injury and relationship to breakdown of the blood-brain barrier.

We have previously developed a model of mild, lateral fluid percussive head injury in the rat and demonstrated that although this injury produced minimal hemorrhage, breakdown of the blood-brain barrier was a prominent feature. The relationship between posttraumatic blood-brain barrier disruption and cellular injury is unclear. In the present study we examined the distribution and time course of expression of the stress protein HSP72 after brain injury and compared these findings with the known pattern of breakdown of the blood-brain barrier after a similar injury. Rats were subjected to a lateral fluid percussive brain injury (4.8-5.2 atm, 20 ms) and killed at 1, 3, and 6 h and 1, 3, and 7 days after injury. HSP72-like immunoreactivity was evaluated in sections of brain at the light-microscopic level. The earliest expression of HSP72 occurred at 3 h postinjury and was restricted to neurons and glia in the cortex surrounding a necrotic area at the impact site. By 6 h, light immunostaining was also noted in the pia-arachnoid adjacent to the impact site and in certain blood vessels that coursed through the area of necrosis. Maximal immunostaining was observed by 24 h postinjury, and was primarily associated with the cortex immediately adjacent to the region of necrosis at the impact site. This region consisted of darkly immunostained neurons, glia, and blood vessels. Immunostaining within the region of necrosis was restricted to blood vessels. HSP72-like immunoreactivity was also noted in a limited number of neurons and glia in other brain regions, including the parasagittal cortex, deep cortical layer VI, and CA3 in the posterior hippocampus.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

[Intrapulmonary percussion. A new method of respiratory therapy].

Intrapulmonary percussion with a high-frequency jet system is a new method in the treatment of respiratory impairment. It imitates the conventional percussion massage of the thorax by introducing high-frequency gas oscillations (300 impulses per minute) into the tracheobronchial system. In 14 patients with abnormal alveolo-arterial oxygen differences due to bronchial mucostasis ventilation was satisfactorily improved by its application.

Humans↗
PubMed1991

Immediate hypertensive response to fluid percussion brain injury may be related to intracerebral hemorrhage and hypothalamic damage.

Fluid percussion brain injury is associated with an immediate rise in mean arterial pressure (MAP). However, the cerebral morphologic basis for this response is still not clear. Thirty-four anesthetized rats were injured using a lateral craniotomy preparation. In 19 rats, impact level was set at 1.73 +/- 0.04 atm, and impact duration was kept at 25 msec to examine the relationship between postinjury hypertensive response and cerebral lesions. MAP was monitored for 1 hour after impact. Fluid percussion produced an increase in MAP from 99 +/- 3 to 134 +/- 4 mm Hg (p less than 0.001), with an increment range of -2 to 87 mm Hg (36 +/- 5 mm Hg) or 0 to 96% increase. The MAP peak occurred at 15 +/- 2 seconds and then rapidly returned to the preimpact level. Histopathological findings, principally hemorrhage, were graded and ranked from 1 to 19 according to relative severity and hypothalamic involvement. There was a significant correlation between MAP rise and the injury ranking (r = 0.52, p = 0.02). No appreciable damage was observed in the brainstem caudal to the diencephalon. Fifteen rats were subjected to higher injury levels. The overall impact magnitude ranged from 1.3 to 3.5 atm. A linear relationship was found between impact magnitude (X, atm) and increment in MAP (Y, mm Hg) (Y = 28.1*X - 14.0, r = 0.62, p less than 0.001). Our study indicates that the immediate postinjury hypertensive response is closely correlated with the impact magnitude and may be related to intracerebral hemorrhage and hypothalamic damage but not necessarily to caudal brainstem damage.

Animals↗
PubMed1992

Expression of c-fos in the hippocampus following mild and moderate fluid percussion brain injury.

An oncoprotein mediator of gene expression, c-fos, was evaluated in the central fluid percussion model of traumatic brain injury (TBI). Since hippocampal CA1 neurons are particularly vulnerable to TBI, we hypothesized that TBI may produce pathobiologic changes in CA1, in part, by alterations in gene expression through c-fos. Sprague-Dawley rats were subjected to mild (1.0 atm) or moderate (2.1 atm) fluid percussion TBI or sham injury. At 15 min, 1 h, and 24 h after injury (or sham injury), sections from middorsal hippocampus were immunostained with antibodies to c-fos, and c-fos-positive CA1 neurons were counted. As predicted, c-fos was localized in the nuclei of CA1 pyramidal neurons. However, the intensity of label was not equal over all CA1 neurons. Cells with high-intensity c-fos label were more prevalent after mild TBI. The number of c-fos-labeled CA1 neurons was increased at 15 min after both mild and moderate TBI relative to paired sham controls. Counts of c-fos-positive neurons remained significantly elevated at 1 h postinjury only after mild TBI. By 24 h postinjury, the number of c-fos-positive cells at both injury levels was not different from sham controls. No difference was observed between the number of c-fos-positive cells in naive and sham controls. However, label intensity was slightly less in the naive cases. These results suggest that the pathobiologic changes at early intervals following mild or moderate TBI may involve c-fos alteration of gene expression and that c-fos expression may be differentially regulated as a function of injury level.

Animals↗
PubMed2000

Microdialysis-based long-term measurements of energy-related metabolites in the rat brain following a fluid percussion trauma.

The aim of the study was to evaluate an experimental approach based on a fluid percussion rat trauma model in combination with the microdialysis technique for the analysis of cerebral interstitial biochemical alterations following head trauma, and to test the hypothesis that the previously observed acute accumulation of lactate and increase in the lactate pyruvate ratio may persist for several days following trauma. We analyzed how lactate, pyruvate, and glucose were altered in the cortex adjacent to the contusion and in the contralateral side of the brain following a traumatic brain injury. The results were compared with those from sham-operated animals. The lactate concentration in the cortex adjacent to the contusion was 0.73 +/- 0.13 mmol/L and 0.71 +/- 0.08 mmol/L 24 and 48 h posttrauma, respectively, and 0.42 +/- 0.07 mmol/L in the sham group (p < 0.05). The lactate/pyruvate ratio of 18.3 +/- 2.3 in the cortex adjacent to the contusion 24 h posttrauma was higher than corresponding value of 10.3 +/- 1.5 in the sham group (p < 0.05). The lactate/pyruvate ratio 48 h posttrauma did not differ from that in the sham group. Interstitial glucose in the cortex adjacent to the contusion and the sham group were similar. Microdialysis measurements from the contralateral side did not differ from those in the sham group. We conclude that the previously observed acute alterations in brain metabolism persist for at least 48 h posttrauma. Further, the measured parameters from the contralateral side can be used as controls since they did not differ from the sham group. Combining microdialysis with a fluid percussion trauma model may be a tool to explore secondary brain injury mechanisms and evaluate new therapies for the treatment of traumatic brain injury.

Animals↗
PubMed1976

The influence of percussion, occlusion and mastication on the occurrence of silent periods in masseter muscle activity.

The occurrence of silent periods in masseter muscle activity was investigated during percussion of the bony structures of the head and neck, during occlusion of the teeth on surfaces of varying hardness, and during chewing of different food-stuffs. Silent periods were demonstrated on percussion during isometric and isotonic contraction of the masseter muscles and the occurrence of silent periods was influenced by the force of occlusion and by the nature of the surface contacted. Mandibular velocity was investigated during tapping and chewing sequences by ultra-high-speed cinematography, but it was not found possible to identify a critical change in mandibular velocity associated with the occurrence of silent periods. More silent periods were observed during the chewing of hard foods than of soft foods and there were more silent periods near the beginning of chewing sequences than towards the end. Differences in latency and duration of silent periods were observed in relation to artificial changes in the occlusion.

Dental Occlusion↗
PubMed1979

Pierre Adolphe Piorry (1794-1879): pioneer of percussion and pleximetry.

Piorry was born in Poitiers on 31 December 1794. As a medical student he served in the Napoleonic war in Spain. His teachers in medicine included Corvisart, Bayle, Broussais, and Magendie; he qualified in 1816 with an MD thesis: "On the danger of reading medical text books by the laity"! Laënnec's invention of the stethoscope (1816) and De l' Auscultation Médiate (1819) inspired Piorry to make an analogous contribution to the technique of percussion (which had been originally described by Auenbrugger in his Inventum Novum in 1761 and translated from the Latin into French by Corvisart in 1808). This led to Piorry's invention in 1826 of the pleximeter (le plessimétre) to help outline the internal organs (l'organographisme), which he described inDe la Percussion Médiate (1828). Piorry became renowned as a professor of medicine in many of the great Parisian hospitals (Charité, Pitié, and Hôtel Dieux). In 1832 he was appointed to L'Hospice de la Salpétrière, where he held a famous course of clinical lectures. He wrote prolificly on many aspects of medicine and published more than twenty books. He was, in addition, a poet of some distinction, and wrote a remarkable long poem Dieu, L'Ame et la Nature (1853). Piorry held his neologisms-for example, toxin, toxaemia, septicaemia, etc.-are still in use. This, together with the mixed reception that his advocacy of pleximetry received from his medical contemporaries, made him a controversial figure. He died on 29 May 1879.

Auscultation↗
PubMed1996

Contraction response to muscle percussion is increased in peripheral nerve conduction block.

We studied the contraction of skeletal muscle upon direct percussion in 119 patients presenting with palsies related to focal peripheral nerve disorders. We compared the response of the paralyzed muscles with the response obtained on the contralateral normal side. The cause of the palsy was subsequently assessed by electrophysiological testing which disclosed: conduction block (CB), axonal, or mixed lesions (when both CB and denervation existed in similar proportions). Most of the time, the muscle response to percussion was increased in patients with CB (37/47), decreased in axonal lesions (44/53), and symmetric in mixed lesions (12/19). We conclude that distinction between CB and denervation is often possible on the basis of this simple bedside test.

Adult↗