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Biomedical subjects

E Kukovetz

Publications and source records attributed to E Kukovetz.

6 recordsLinked to original sources
PubMed1995

Released PMN elastase: an indicator of postsurgical uneventful wound healing and early inflammatory complications. A contribution to the search for objective criteria in wound healing monitoring.

Monitoring of postoperative wound healing is important for the early diagnosis of postoperative infective complications in order to decrease morbidity. The purpose of this study was to search for a discriminatory time point between uneventful wound healing and early wound infections after operations for orthopaedic trauma using PMN elastase. This proteolytic enzyme is a biochemical marker for pathological granulocyte stimulation. The two groups of injured patients comprised persons with 'per priman' (pp) wound healing without complications--group 1 (N = 31)--and the early manifestation of a bacterial wound infection 'per secundam' (ps) during the healing phase--group 2 (N = 4). In group 1, surgical trauma was accompanied by an increase in PMN elastase levels reaching the maximum within the first 3 postoperative days; values returned to normal on day 10. In group 2 PMN elastase median levels showed recurring increases throughout. No normal values were observed. There was a highly significant difference (P < 0.01) on days 4 and 5 in group 2 compared with the control group 1. Since PMN elastase can be determined on an autoanalyser, and the enzyme is of proven discriminatory value, it is suggested that this marker should become part of the daily diagnostic routine in the care of the injured.

Adult↗
PubMed1994

Polymorphonuclear leucocyte migration response in uneventful wound healing following trauma surgery. A contribution to the search for objectifiable criteria in wound healing monitoring.

In a study of the clinical importance of polymorphonuclear granulocytes (PMN) for the monitoring of wound healing we investigated the postsurgical course of nine patients all of whom had undergone trauma surgery and had no wound complications. The "stimulated random PMN locomotion" was evaluated by a new migration filter device which preserves the cells in their genuine priming state, simulating in vivo conditions. The percentage of all activated PMN, expressed by the total migration index (TMI) reflected the highest median immediately after surgery (Zmax = 30.1%) and dropped to the lowest value on day 13 (Zmin = 13.9%). The mean invasion depth (T/2) of the cells along the migration distance into the filter showed only slight variations over time. The neutrophil migration activity (NMA), described by T/2 and TMI, behaved in a similar way to TMI. In studying physiological healing, preliminary results indicate that TMI, which expresses PMN activation, is an efficient tool in the postoperative monitoring of patients, and might in the future serve as a basis for an early warning system for wound healing complications.

Adult↗
PubMed1994

The lipid peroxidation product 4-hydroxynonenal is formed by--and is able to attract--rat neutrophils in vivo.

4-Hydroxynonenal (HNE), a major aldehydic product of lipid peroxidation, is a chemoattractant for neutrophilic polymorphonuclear granulocytes in vitro. The question was studied, whether HNE is formed during the ingress of neutrophils in the Sephadex model of inflammation. The polydextrane Sephadex G-200, which causes an acute aseptic traumatic inflammation, was injected subcutaneously into rats. The implants were excised 6-36 hours later, and the neutrophils separated from the exsudate by centrifugation. After extraction with dichloromethane HNE was identified in the exsudate by non-derivative reversed phase HPLC in combination with on-line uv-spectroscopy. The concentration of HNE in the inflammatory focus did not correlate with the number of neutrophils present. While the peak of HNE coincided with the time point of the highest turnover rate of neutrophils (0.13 microM at 6 hrs after implantation), the highest number of neutrophils (about 100 million cells) occurred not earlier than 18 hrs later (24 hrs after onset of inflammation). When neutrophils were isolated from the inflammatory focus and stimulated with Zymosan, they were able to produce HNE in vitro depending on the time of isolation. The highest production of HNE (0.17 microM) by phagocyting neutrophils was observed at the shortest inflammation time studied (3 hrs). In order to compare these results with the oxidative burst of neutrophils the formation of superoxide was also measured by the cytochrome c reduction assay in vitro. The maximum of the production rate of superoxide anion was observed at the same inflammation time (6 hrs), when the HNE maximum occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldehydes↗
PubMed1993

[Biochemical wound monitoring. PMN elastase in different healing stages after trauma surgery-orthopedic interventions].

Laboratory parameters are of proven value in the diagnosis of early postsurgical infections, since clinical aspects cannot always be clearly defined. Neutrophil granulocytes (PMN) are major inflammatory cells taking effect following ingestion and degradation of foreign material, such as bacteria and cell debris, for example after mechanical trauma. In patients who had undergone surgery we monitored the course of plasma PMN elastase in uncomplicated wound healing (n = 22), in uncomplicated wound healing associated with secondary infections (n = 6), and in defective wound healing (manifestation of a bacterial wound infection: n = 3; wound infection already manifest at the time of entry on study: n = 11). Surgical trauma was accompanied by an increase in PMN elastase and C-reactive protein (CRP) in all patients studied, reaching a maximum within the first 3 postsurgical days. When a bacterial wound infection became manifest during the course of healing there was a highly significant difference on the 4th postsurgical day (p < 0.01) compared with the group with uncomplicated healing. Since PMN elastase can now be determined automatically with an autoanalyser and a commercial kit and its discriminatory time point is as soon as 4-5 days after surgery, it is suggested that this marker should be determined routinely together with CRP in traumatology.

Adult↗
PubMed1992

Possible involvement of myeloperoxidase in lipid peroxidation.

1. Exposure of liposomes to the MPO-H2O2-Cl- system results in oxidation of lipids. Malondialdehyde and 4-hydroxynonenal are formed. 2. Oxidation of liposomes by stimulated rat neutrophils, assessed by malondialdehyde formation, is inhibited by KCN. This indicates involvement of MPO in the process. 3. The MPO-H2O2 system oxidizes mildly LDL but in the presence of chloride a propagation phase, with a rapid increase of conjugated diene formation, was observed.

Animals↗