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At least 127 records · Page 7Linked to original sources
PubMed2004

Perfluorocarbon emulsion improves cerebral oxygenation and mitochondrial function after fluid percussion brain injury in rats.

OBJECTIVE: Cerebral ischemia is a common secondary sequela of traumatic brain injury (TBI). Experimental models of stroke have demonstrated reductions in ischemia after perfluorocarbon (PFC) administration; however, there are no published reports of PFC efficacy after TBI. The current study analyzed the effect of the PFC emulsion Oxygent (AF0144; Alliance Pharmaceutical Corp., San Diego, CA) on cerebral oxygenation, mitochondrial redox potential, and free radical formation after lateral fluid percussion injury. METHODS: After fluid percussion injury, five 2.25 ml/kg doses of PFC or saline were administered to rats breathing 100% O(2), and oxygen tension was recorded. In a second experiment, a single bolus (11.25 ml/kg) of PFC or saline was given after injury, and redox potential and free radical formation were measured at 1 or 4 hours with Alamar blue dye and dihydrorhodamine 123, respectively. RESULTS: Cerebral oxygen tension was significantly increased in both injured and sham animals treated with 11.25 ml/kg of PFC as compared with saline (P < 0.05). Likewise, PFC significantly increased mitochondrial redox potential as compared with saline at 4 hours after injury (P < 0.01). Mitochondrial peroxynitrite and peroxide production also increased with the administration of PFC (P < 0.05). CONCLUSION: The current study demonstrates that a PFC emulsion can significantly increase cerebral oxygenation after TBI and enhance mitochondrial function at 4 hours after injury as compared with saline. This study demonstrates a new therapeutic potential for PFC to enhance cerebral oxygenation and aerobic metabolism after TBI. However, the increased free radical formation with high-dose PFCs suggests the need for further studies combining PFCs with free radical scavengers.

Animals↗
PubMed2000

[Physical diagnosis--percussion and palpation of the spleen].

The accuracy of physical examination of the spleen was investigated in the literature. Ultrasonography or scintigraphy was used to test the findings at physical examination. Physical examination has a low sensitivity, but a reasonably good specificity. The interobserver variability is rather high. In general, palpation is more sensitive and specific than percussion. The findings of percussion improve the accuracy of palpation and the combination has a high specificity, of approximately 90%. The two should therefore be used in conjunction. The sensitivity is much lower although it is greatly influenced by the degree of splenic enlargement and the leanness of the patient.

Humans↗
PubMed2001

[Physical diagnosis--pain elicited by percussion in the kidney area].

Percussion of the kidney as a diagnostic method was first described by John Benjamin Murphy (1857-1916). The test is rapidly elicited, but can cause severe pain. Considering acute pyelonephritis or acute renal colic, it is common practice to perform fist percussion of the kidney, yet its diagnostic value is unknown. Finnish study results in 1998 suggest that in acute renal colic loin tenderness and erythrocyturia are more significant signs than renal tenderness. There is no scientific evidence for determining renal tenderness in diagnosing urinary tract infections and urolithiasis.

Contraindications↗
PubMed2002

Use of percussion as a screening tool in the diagnosis of occult hip fractures.

Traumatic hip pain is a common clinical problem in the emergency department. There is significant morbidity in discharging a patient with an undiagnosed undisplaced hip fracture. The auscultatory percussion technique is a useful method to risk stratify patients who present with traumatic hip pain and with normal radiographs. We sought to study the sensitivity and specificity of the auscultatory percussion technique in a prospective study.

Aged↗
PubMed1991

[Early clinical diagnosis of osteoporosis using auscultatory percussion. Therapeutic monitoring].

The authors describe the auscultatory percussion method, easy to perform and reliable in early bed-side diagnosis of osteoporosis, even if asymptomatic. In addition, the great importance of early diagnosis in preventing fractures complicating osteoporosis is underlined. The results obtained with prompt administration of current therapy in 25 cases, diagnosed with the aid of auscultatory percussion, are reported. Finally, practical use of this method for both therapeutic monitoring and individual prescription of drugs, is emphasized.

Adult↗
PubMed1985

Assessment of percussion, vibratory-shaking and breathing exercises in chest physiotherapy.

While gravity-assisted positions (postural drainage) and the forced expiratory technique are known to promote sputum clearance, the additional value of percussion, vibratory-shaking and breathing exercises individually in chest physiotherapy is uncertain. These modalities have been evaluated in 8 patients with copious sputum production (mean: 44 g/day), using an inhaled radioaerosol technique. Tracheobronchial clearance was unaffected by the addition of either vibratory-shaking or percussion with and without breathing exercises to postural drainage. There was however a significant (p less than 0.01) increase in the dry weight of sputum produced during each of these treatments. The combination of postural drainage used in conjunction with the forced expiration technique is responsible for the majority of mucus mobilisation and should form the basis of routine chest physiotherapy programmes; the other modes appear to be of lesser value.

Breathing Exercises↗
PubMed1985

Auscultatory percussion of the urinary bladder.

A volumetric study of the bladder was done in 170 adult male patients examined by auscultatory percussion. The upper border of the urinary bladder was defined and measured in reference to the symphysis pubis to gauge urinary volume. The findings were correlated with the urinary volumes obtained after the bladder had been emptied by voiding in 90 patients without urinary tract disease and in 42 patients who required catheterization. With a bladder level less than 2 cm, none of the patients had a full bladder or a urinary volume of 250 mL. Of the 55 patients with bladder levels of 3 cm or more, 53 patients had full bladders. Catheterizations were timely and avoided frequent and unnecessary catheterization. Residual urinary volumes estimated by auscultatory percussion in 12 patients with obstructive uropathy and 26 patients studied with indwelling catheters correlated closely with the catheterized urinary volumes. Full bladders, obstructive uropathy, and malfunctioning indwelling catheters were readily detected.

Adult↗
PubMed1979

The arts of percussion and auscultation of the chest re-examined.

Clinical teaching of percussion and auscultation is examined critically, and it is suggested that there is confusion on the subject both in textbooks and in the minds of clinicians and students. Percussion should be viewed more in terms of 'feel' than 'sound', and thus a classification of 'hard', 'intermediate' and 'soft' dullness is introduced. As regards auscultation, a plea is made for differentiation between obstructed and non-obstructed consolidation of lobes, a point recognized by some clinicians, but not enunciated with clarity by teachers. The differences between the clinical findings in obstructive consolidation of the upper and lower lobes are discussed. The importance of distinguishing between tracheal and bronchial breathing is emphasized.

Auscultation↗
PubMed1997

Tinel's sign or percussion test? Developing a better method of evoking a Tinel's sign.

Clinicians elicit a Tinel's sign by tapping over a nerve site with their fingertips. No standard force has been established, and overzealous tapping can produce a false-positive "Tinel's sign" that is actually a positive percussion test. The purpose of our study was to determine a threshold force that produces a positive percussion test in each of seven nerve locations in the upper extremities of subjects with no known nerve injuries and in subjects with nerve injuries. These data suggest limits for the amount of force necessary to elicit a Tinel's sign. If these limits are adhered to, the incidence of false-positive responses may be kept low.

Adolescent↗
PubMedDate not supplied

Theoretical percussion force of the periotest diagnosis.

The Periotest percussion force acting on a dental implant was estimated by assuming a mass-spring-dashpot model of the implant-bone system constructed on the basis of a clinical experiment. A theoretical value of about 10 N, comparable to hitherto reported experimental values, was obtained for an osseointegrated implant of about 1 g. The percussion force would probably be smaller for a heavier implant.

Acceleration↗
PubMed2005

Intrapulmonary percussive ventilation vs incentive spirometry for children with neuromuscular disease.

BACKGROUND: Pulmonary infections can be life threatening for children with neuromuscular diseases who have impaired ability to clear secretions. Intrapulmonary percussive ventilation (IPV) is a pneumatic device that delivers air and aerosol to the lungs at frequencies of 200 to 300 cycles per minute at peak pressures from 20 to 40 cm H(2)O. Anecdotal reports and pilot studies show its safety and effectiveness in mobilizing secretions in patients with cystic fibrosis. OBJECTIVE: To test the hypothesis that IPV used in a pulmonary program for adolescents with neuromuscular disease would reduce the number of days of antibiotic use for pulmonary infection. METHODS: A randomized, controlled study was conducted to compare efficacy of IPV with incentive spirometry (IS) in reducing number of days of antibiotic use in adolescents with neuromuscular disease. The secondary endpoints were the number of respiratory infections, hospitalizations, and school days missed. RESULTS: A total of 18 patients were enrolled (9 IPV, 9 IS). Antibiotic use was significantly higher with IS (24/1000 patient-days) compared with IPV (0/1000 patient-days), (incidence rate ratio, 43; 95% confidence interval, 6-333). The IS group spent more days hospitalized (4.4/1000 patient-days vs 0/1000 patient-days) than the IPV group (incidence rate ratio, 8.5; 95% confidence interval, 1.1-67). The IPV group had 0 episodes of pneumonia or bacterial bronchitis compared with 3 events in the IS group, although this did not meet statistical significance. CONCLUSION: Intrapulmonary percussive ventilation as part of a preventive pulmonary regimen reduced days of antibiotic use and hospitalization for respiratory illness in adolescents with neuromuscular disease.

Absenteeism↗
PubMed1996

Persistent pulmonary consolidation treated with intrapulmonary percussive ventilation: a preliminary report.

Intrapulmonary percussive ventilation (IPV) is a novel form of chest physiotherapy delivered by a percussive pneumatic device (IPV, Percussionaire, Sand Point, ID). There are few published reports about the use of IPV for diseases other than cystic fibrosis. We report our experience with three pediatric patients and one adult patient with persistent pulmonary consolidation refractory to conventional therapies. Three of the four patients had neuromuscular disease; one patient had segmental atelectasis due to aspiration. Three of the four patients showed clinical and radiographic improvement within 48 hours of starting IPV. The fourth patient experienced brief episodes of third-degree atrioventricular block, hypoxemia, and bradycardia during two IPV treatments. IPV was safely restarted and he slowly improved. We conclude that while IPV requires further clinical evaluation, it appears to be a safe and effective therapy for selected patients. However, close observation is essential during and after IPV treatments, especially in patients who have difficulty mobilizing or expectorating sputum.

Adolescent↗
PubMed1990

The increase in local cerebral glucose utilization following fluid percussion brain injury is prevented with kynurenic acid and is associated with an increase in calcium.

Immediately following a lateral fluid percussion brain injury, the cerebral cortex and hippocampus ipsilateral to the percussion show a marked accumulation of calcium and a pronounced increase in glucose metabolism. To determine if this increase in glucose metabolism was related to the indiscriminate release of the excitatory amino acid (EAA) glutamate, kynurenic acid (an EAA antagonist) was perfused into the cerebral cortex through a microdialysis probe for 30 min prior to injury. The results show that adding kynurenic acid to the extracellular space prior to trauma prevents the injury-induced increase in glucose utilization. These results indicate that calcium contributes to the ionic fluxes that are typically seen following brain injury and supports the concept of an increased energy demand upon cells to drive pumping mechanisms in order to restore membrane ionic balance.

Animals↗
PubMed2004

Characterization of the alteration of nutritional state in brain injury induced by fluid percussion in rats.

OBJECTIVE: Patients suffering from traumatic brain injury (TBI) undergo rapid weight loss with negative nitrogen balance and enhanced whole-body protein breakdown, with protein wasting causing morbidity and increased mortality. Many experimental models of TBI have been used to evaluate strategies to improve the outcome of these patients, but nutritional status has not been considered in experiments published to date, although this may have great importance and influence the results obtained with TBI models. This study characterized the hypercatabolism level and nutritional status of TBI rats. DESIGN: Twenty-four male Wistar rats were randomized into three groups. Rats from the TBI group were anesthetized and fluid percussion was applied. The pair-fed (PF) group was healthy but was pair-fed to the TBI group. The ad libitum (AL) group was healthy and fed ad libitum. The study was performed over 10 days post-TBI. MEASUREMENTS AND RESULTS: TBI in rats was characterized by remarkable long-lasting anorexia, renal failure (creatinine clearance: AL 1.8+/-0.2 and PF 1.5+/-0.1 vs. TBI 0.9+/-0.1 l/24 hour), anorexia (appetite depressed throughout the study), increased myofibrillar proteolysis (3-methylhistidine/creatinine ratio (day 2: AL 36+/-1 and PF 38+/-2 vs. TBI 54+/-5 micromol/mmol), and intestinal atrophy (ileum: AL 29.3+/-2.5 and PF 28.7+/-1.1 vs. TBI 22.5+/-1.4 mg/cm). In addition, anorexia led to muscular atrophy and decreased nitrogen balance. The metabolic alterations described above can increase morbidity and mortality. CONCLUSIONS: TBI by fluid percussion in rats is a model reproducing the metabolic and nutritional alterations observed in clinical practice and is suitable for further studies exploring the efficacy of optimized nutritional support.

Analysis of Variance↗
PubMed1997

Chronic histopathological consequences of fluid-percussion brain injury in rats: effects of post-traumatic hypothermia.

Early outcome measures of experimental traumatic brain injury (TBI) are useful for characterizing the traumatic severity as well as for clarifying the pathomechanisms underlying patterns of neuronal vulnerability. However, it is increasingly apparent that acute outcome measures may not always be accurate predictors of chronic outcome, particularly when assessing the efficacy of potential therapeutic regimens. This study examined the chronic histopathological outcome in rats 8 weeks following fluid-percussive TBI coupled with moderate post-traumatic brain hypothermia, a protocol that provides acute neuronal protection. Animals received a moderate parasagittal percussive head injury (2.01-2.38 atm) or sham procedure followed immediately by 3 h of brain hypothermia (30 degrees C) or normothermia (37 degrees C). Eight weeks following TBI, serial tissue sections were stained with hematoxylin and eosin or immunostained for glial fibrillary acidic protein. Tissue damage, gliosis and immunoreactive astrocytes were observed in the ipsilateral thalamus, hippocampus, and in the neocortex lateral to the injury site. Within the thalamus, focal necrosis was restricted to selective thalamic nuclei. Significant hippocampal cell loss was found in the ipsilateral dentate hilar region of both TBI groups. Quantitative volume measurements revealed significant decreases in cortical, thalamic and hippocampal volume ipsilateral to the impact in both TBI groups. Lateral ventricles were substantially enlarged in the TBI-normothermia group, an effect which was significantly attenuated by post-TBI hypothermia. The attenuation of lateral ventricular dilation by post-traumatic hypothermia is indicative of chronic neuroprotection in this TBI model. These data provide new information concerning the chronic histopathological consequence of experimental TBI and the relevance of this trauma model to chronic human head injury.

Animals↗
PubMed1997

The expression of tumor necrosis factor-alpha in the rat brain after fluid percussive injury.

To investigate the role of tumor necrosis factor-alpha (TNF alpha) after traumatic head injury in rats, moderate brain injury of 1000 mmHg was generated by an original fluid percussion injury device. TNF alpha levels in cerebrospinal fluid (CSF) gradually increased during the first 1 h, rose to a maximal elevation at 3 h and 6 h and returned to basal values by 24 h. Horseradish peroxidase tracer experiments revealed that primary microvascular damage appeared as early as 15 min after impact, but rapidly recovered and 1 h after impact secondary microvascular damage occurred in the hippocampus and parasagittal cortex. By immunoelectron microscopy, TNF alpha reactions were detected in the lysosomes of microglia accumulated at the impact site of the cortex 30 min after impact, and 1 h after impact these reactions were mainly detected at the glial cells (such as microglia and astrocytes) in the hippocampus and parasagittal cortex. Therefore the delayed microvascular damage observed in sites remote from the impact may be induced by TNF alpha which is synthesized mainly by glial cells. The present study suggests that TNF alpha conveyed from the microglial cells is one co-factor contributing to the fluid percussive brain edema formation after moderate brain injury.

Animals↗
PubMed2000

The role of tumor necrosis factor-alpha in diffuse axonal injury following fluid-percussive brain injury in rats.

The immunolocalization of tumor necrosis factor-alpha (TNF alpha) after diffuse axonal injury (DAI) is demonstrated using a midline fluid percussion rat model (moderate brain injury of 1000 mm Hg was generated) and the effects of TNF alpha on the axolemmal permeability using horseradish peroxidase as a tracer. In addition, the accumulation of beta-amyloid precursor protein (beta-APP) was investigated, which has recently been shown to be a reliable marker for the diagnosis of DAI in cases with fatal head injury. TNF alpha levels in brain tissues from the impact site and the cortex including the corpus callosum, gradually increased during the first 1 h, rose to a maximal elevation at 3 h, gradually decreased at 6 h and decreased further at 24 h. Horseradish peroxidase (HRP) tracer experiments revealed that primary axonal damage appeared as early as 15 min after impact but rapidly recovered and that 1 h after impact, secondary axonal damage occurred in the corpus callosum and the brain stem. By immunoelectron microscopy it was seen that beta-APP accumulated in the axon from 1 h after impact demonstrating that there was functional axonal damage. TNF alpha reactions were detected in the lysosomes of microglia 30 min after impact and 1 h after impact these reactions were mainly detected in the glial cells (such as microglia, astrocytes and oligodendrocytes) in the corpus callosum and the brain stem. It is generally accepted that TNF alpha directly induces primary demyelination and oligodendrocyte apoptosis. Therefore, TNF alpha conveyed from the microglial cells is one cofactor contributing to the formation of the delayed axonal damage observed at these sites. The present study suggests that TNF alpha conveyed from the glial cells may contribute to the pathogenic mechanism of DAI formation following fluid percussive brain injury.

Amyloid beta-Protein Precursor↗
PubMed1996

Indeloxazine hydrochloride improves impairment of passive avoidance performance after fluid percussion brain injury in rats.

We studied behavioral and histological changes after fluid percussion brain injury and the effects of indeloxazine hydrochloride, a cerebral activator, on these post-traumatic changes in rats. An acquisition trial in passive avoidance task was conducted on the 3rd day after injury. The latency of step-through in injured rats was significantly (p < 0.05) shorter than that in sham-operated rats on the 4th, 10th and 14th days after the operation. There were injury-induced neurological deficits on days 1-4 post-injury. Histological changes were observed in the peripheral area of the cortical lesion at the impact site and in the thalamus but not in the hippocampus on the 14th day. Indeloxazine (10 and 20 mg/kg, p.o.) administered once a day from the 3rd (30 min prior to the acquisition trial) to the 9th day after injury significantly (p < 0.05) improved the impairment of the passive avoidance performance without affecting locomotor activity. Indeloxazine showed no significant effects on either neurological deficits or the cortical lesion area. These results suggest that impairment of passive avoidance performance occurs without apparent histological damage in the hippocampus after fluid percussion brain injury and is attenuated by post-traumatic treatment with indeloxazine.

Animals↗