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Biomedical subjects

T Seeman

Publications and source records attributed to T Seeman.

At least 73 records · Page 4Linked to original sources
PubMed1984

Hemodynamic and hematologic changes in a standardized trauma-sepsis model in rats.

The aim of this report was to describe an experimental trauma-sepsis model in rats. Trauma consisted of laparotomy and sepsis was induced by intravenous infusion of different amounts (10(8)-10(10)) of live Escherichia coli. Three experimental series were performed. In the first series survival rates were studied up to 7 days after trauma-sepsis. In the second and third series pulse rate, intraarterial blood pressure, cardiac output, liver blood flow and hematologic changes were studied after 24 h. Cardiac output was determined by dye-dilution method and hepatic blood flow by 133Xe wash-out technique. Survival rates were decreased in a dose-related manner when the amount of bacteria administered was increased from 10(8) to 10(10). Twenty-four hours after trauma-sepsis, survival rate was 100% following E. coli 10(8), 69% following E. coli 10(9), and 23% following E. coli 10(10). After 7 days the corresponding figures were 85%, 31%, and 8%. A dose-related decrease was also observed for cardiac output and hepatic blood flow when the amount of bacteria was increased. Mean arterial blood pressure was unchanged. Platelet and white blood cell counts were reduced 24 h following trauma-sepsis, and these changes were also more pronounced when the amount of bacteria infused was increased. Thus, it was possible to demonstrate a graded response following increasing amounts of bacteria regarding survival rate, cardiac output, liver blood flow, and hematologic changes in three subsequent experimental series. A carefully standardized experimental model may be of value for studies of metabolic events following trauma and sepsis.

Animals↗
PubMed1984

Muscular compartment pressure following reconstructive arterial surgery of the lower limbs.

Intramuscular pressure in the anterior tibial compartment and calf circumference were measured daily during six days following reconstructive surgery for lower limb atherosclerosis in 31 patients. Both intramuscular pressure and calf circumference were significantly increased in the operated extremity from the first postoperative day. Maximum intramuscular pressure was found on the second postoperative day. No patient developed a compartment syndrome. Calf circumference increased more slowly and reached maximum on the fifth postoperative day. Following successful reconstructive arterial surgery intramuscular pressure and calf circumference increased most in patients undergoing dissection of the groin and leg, probably reflecting intraoperative damage of lymphatic vessels. In four patients where the reconstructive arterial surgery failed intramuscular pressure and calf circumference remained unchanged postoperatively despite dissection of the groin and leg. Thus, the present study suggests that both impaired lymphatic drainage and increased capillary filtration contribute to the development of increased intramuscular pressure and calf circumference following reconstructive arterial surgery of the leg.

Aged↗
PubMed1984

Effects of hypovolemia on local metabolic changes in skeletal muscle following high velocity missile injury.

The effect of blood loss and reinfusion after 6 h on the tissue damage around a high-velocity missile tract in skeletal muscle has been studied in pigs (n = 13). Hemodynamic variables and blood chemistry were monitored and the levels of ATP, creatine phosphate (CP), glucose, glucose-6-phosphate ( G6 -P), and lactate were repeatedly analyzed in muscle samples from the wound area and from control tissue. In vitro amino acid incorporation into proteins by isolated ribosomes was also studied. The missile injury induced pronounced local metabolic disturbances in the muscle tissue surrounding the missile tract. After 6 h these disturbances were more pronounced and extended further out from the wound channel in bled than in unbled animals. One hour after reinfusion of the shed blood, no remaining difference in the size of the metabolically disturbed tissue area between the two groups of animals could be demonstrated. It is thus concluded that a moderate hypovolemia markedly increases the metabolic deterioration around a high-velocity missile tract in skeletal muscle but that volume restitution, even if given as late as 6 h after the missile injury and the blood loss, will almost completely within 1 h reverse the effects caused by the hypovolemia.

Amino Acids↗
PubMed1983

Increasing incidence of stab wounds.

During the four-year period 1978-1981 74 patients were hospitalized due to stab wounds obtained in criminal trauma. 84% of the patients were submitted to different kinds of surgery. The incidence of stab wounded patients increased each year during the period studied and was doubled the last year as compared to the first year. During the last two years of the study all patients admitted to the emergency unit with stab wounds were registered. Almost 50% of the patients had injuries of a magnitude which did not allow treatment on an out-patient basis. This study showed an increasing trend in the incidence of patients with stab wounds and a need of large resources in the care of these patients.

Adolescent↗
PubMed1982

Local metabolic changes in skeletal muscle following high-energy missile injury.

The extent of cellular deterioration around a high-velocity missile injury was studied in canine skeletal muscle biopsies. The tissue levels of high-energy phosphates and glycolytic metabolites were analyzed in four zones surrounding the bullet tract and in an uninjured extremity. Incorporation of leucine into skeletal muscle proteins in vitro in the different zones was determined. In the tissue adjacent to the bullet tract ATP and phosphocreatine (CP) decreased significantly and remained low. No significant changes of ATP and/or CP occurred in the other zones or in the control muscle. Lactate and glucose levels increased in all zones but G6-P levels decreased in the three zones close to the wound indicating anaerobiosis and disturbed utilization of glucose. Incorporation of leucine decreased in the innermost zone and no restoration took place, but more peripherally a certain reversible decrease was seen. The present results indicate that irreversible cell damage will occur in the tissue adjacent to a high-velocity bullet tract. Reversible cellular dysfunction may occur in tissues without gross changes.

Adenosine Triphosphate↗
PubMed1982

Early local and systemic fibrinolytic response to high energy missile trauma.

In dogs, tissue and blood fibrinolysis was studied after a high velocity missile injury to one hind leg. Plasminogen activator activity in skeletal muscle at different distances from the wound was estimated with a histochemical method. Samples from venous blood draining both the injured and the not injured leg were regularly analysed for fibrinogen, plasminogen, alpha 2-antiplasmin, alpha 2-macroglobulin, fibrinolysis on fibrin plates and fibrin(ogen) degradation products. Tissue close to the bullet track judged as devitalized displayed a significant and persistent reduction of plasminogen activator activity. The same pattern of reaction was observed in muscle without apparent lesions 3 cm from the wound but no uniform pattern could be discerned at a distance of 10 cm. In the blood a very early activation of fibrinolysis took place. There was no difference between the two sides, thus the trauma induced a general activation of fibrinolysis in the organism. Towards the end of the experiments a continuous decrease of fibrinolysis in the euglobulin fraction of plasma on fibrin plates was noted. Concomitantly an increase of plasmin inhibitors took place. It was concluded that a high velocity missile injury to skeletal muscle induced a reduction of plasminogen activator activity in the tissue surrounding the wound. A very early and general activation of systemic fibrinolysis was followed by a decreased fibrinolysis within a few hours.

Animals↗
PubMed1982

A proposed standard methodology for estimating the wounding capacity of small calibre projectiles or other missiles.

A standard methodology for estimating the energy transfer characteristics of small calibre bullets and other fast missiles is proposed, consisting of firings against targets made of soft soap. The target is evaluated by measuring the size of the permanent cavity remaining in it after the shot. The method is very simple to use and does not require access to any sophisticated measuring equipment. It can be applied under all circumstances, even under field conditions. Adequate methods of calibration to ensure good accuracy are suggested. The precision and limitations of the method are discussed.

Biophysical Phenomena↗
PubMed1982

LOcal effects of antibacterial therapy (benzyl-penicillin) on missile wound infection rate and tissue devitalization when debridement is delayed for twelve hours.

Spherical steel bullets (0.88 g, 6.00 mm in diameter, impact velocity around 1000 m/s, smooth-bore rifle) were used for infliction of trauma to the thigh of pigs. The aim was to find out the effect of early antibiotic therapy (benzyl-penicillin) on wound infection rate and on the local progressive tissue devitalization when debridement was delayed until 12 hours after infliction of trauma. The main study on infection and tissue devitalization contained 20 missile wounds; the pilot study on cell metabolism 13 wounds. In the first group 11 pigs, and in the second group 7 pigs were treated with penicillin. Debridement was performed 12 hours after the infliction of trauma. Bacteriological analyses were done on tissue samples from the wound after pc treatment. The contents of adenosine triphosphate, creatine phosphate, glucose, glucose 6-phosphate and lactate were analysed in tissue samples from the wound with and without pc-treatment 12 h after trauma. The usual growth of bacteria when debridement was delayed for 12 h was totally inhibited by the early provision of penicillin. The amount of devitalized tissue-removed in relation to transferred energy was significantly reduced after the treatment as compared to the non-pc-group. The results of the studies on cell metabolism point to a graded tissue damage and possibly reversible injuries in the periphery of the wound, and to less metabolic disturbances after pc-treatment. The results indicated that early general supply of antibiotics may confine the local tissue injury when delayed debridement is anticipated.

Animals↗
PubMed1982

Leucine incorporation into skeletal muscle proteins in vitro and protein synthesis by isolated ribosomes from skeletal muscle around a high velocity missile injury.

Protein synthesis in skeletal muscle around a high velocity missile injury was investigated in two series of experiments. In the first series a shot wound was induced in the hindleg of dogs. Muscle biopsies were taken at various distances from the wound channel and bundles of muscle fibre were incubated in a medium containing 14C-leucine under protein synthetizing conditions. A significant reduction in the rate of leucine incorporation into muscle protein was seen in the adjacent to the wound channel. At a distance of 3 cm from the bullet track no reduction in leucine incorporation into protein occurred. In the second series of experiments a high velocity missile injury was induced in the hindleg of pigs. The capacity of ribosomes to incorporate 14C-phenylalanine into protein was analyzed. Ribosomes were isolated from skeletal muscle around the shot wound. The effect of missile injury alone and that of the combined effect of missile injury and hemorrhage were studied. A marked reduction in ribosomal activity was found in tissue adjacent to and up to 2.4 cm from the wound channel. At a distance of 3 cm from the wound ribosomal activity remained unaffected. Ribosomal activity was significantly more reduced in tissue close to the wound channel after missile injury and hemorrhage than after missile injury alone. The reduced capacity for protein synthesis in muscle around the missile injury found in this study probably reflects a lowered cellular energy level. The local metabolic changes were aggrevated in animals where hemorrhage was also induced indicating that in the clinical situation prevention of hemorrhage and hypovolemia might reduce the amount of tissue that has to be excised following a short wound.

Animals↗
PubMed1982

Postoperative wound infections in patients with long preoperative hospital stay.

In a prospective study of 1243 operations the rate of postoperative wound sepsis was 9.3%. Factors associated with high infection rate were high age, emergency operations, long duration of surgical procedure, potentially contaminated and contaminated operations, diabetes and treatment with steroids. The frequency of wound sepsis was also increased in patients with long preoperative hospital stay or 12.5% as compared to 4.5% in patients with a preoperative stay of one day. Among patients with long preoperative hospitalization, high age, long operative procedures, contaminated operations and treatment with steroids were significantly more common. 85% of the patients with long preoperative hospital stay and wound infection had three or more other factors associated with increased frequency of wound sepsis. No patient had long preoperative hospital stay as the only factor associated with high rate of wound infection. These data indicate that long preoperative hospitalization is not in itself a causative factor in wound infections, but might be related to other factors associated with increased likelihood of wound sepsis.

Age Factors↗
PubMed1981

Optical properties of damaged and undamaged muscle tissue studied in high-energy missile wounds.

Modern surgical treatment of wounds caused by high-energy traumata includes the excision of all non-viable muscle tissue. To judge the transition zone between viable and non-viable tissue correctly, however, it takes a highly qualified surgeon, experienced in high-energy trauma surgery. Less skilled surgeons are tending to leave some non-viable tissue behind in the wound, which often leads to infection and re-operation and causes, among other things, extended suffering and hospitalization for the patient. Among the visible and palpable properties serving as criteria for the surgeon is that the non-viable tissue is dark purple, whereas the viable tissue is of lighter red colours. The perception of colour is depending on the optical properties of a surface and on the composition of the light illuminating it. A pilot study has shown that the colour contrast between viable and non-viable muscle tissue can be enhanced by using colour filters. In this investigation optical properties for muscle tissue in different degrees of viability have been scrutinized. It seems to be possible to find a clinically applicable method to help the surgeon in his work.

Animals↗
PubMed1981

Trauma to the liver during a ten-year period. With special reference to morbidity and mortality after blunt trauma and stab wounds.

The records of 58 patients with hepatic injuries treated between 1969 and 1978 were analyzed in retrospect. The hepatic injury was caused by blunt trauma in 30 cases (52%), stab wounds in 26 cases (45%) and gun shot wounds (GSW) in 2 cases (3%). In 45 patients (78%) the injury could be managed by simple methods such as laparotomy alone or suture and/or drainage. Hepatic lobectomy was performed in 5 patients (9%). When compared with stab wounds, hepatic injuries after blunt trauma were associated with higher frequency of shock, more blood transfusions, more associated injuries, more severe liver injuries and longer hospital stay. Overall mortality rate was 19%. True hepatic injury mortality rate was 5%. After blunt trauma mortality rate was 30% and after stab wounds 4%. The mortality rate was higher in patients with multiple associated injuries and after more severe hepatic injuries.

Adolescent↗
PubMed1981

Bacteriological findings in the first 12 hours following experimental missile trauma.

The purpose of this study was to investigate the rate and magnitude of bacterial growth in gunshot wounds following debridement one, 6 and 12 hours after infliction of a standardized missile trauma (spherical steel bullet, 0.88 g, 6.00 mm in diameter, impact velocity 1 000 m/sec). 39 pigs were shot in one or both thighs (n of wound, 54). The skin was not cleaned before the trauma but was disinfected preoperatively. Before trauma infliction, swab samples were taken from the nose, the rectum and the skin. At the operation, all muscle tissue judged to be devitalized was removed. Samples for bacteriological culturing were taken from the removed tissue and from the margins of the wound cavity. Isolated bacterial strains were classified and a semiquantitative evaluation of the number of, bacteria was performed. Bacterial growth in the devitalized tissue was indicated in about 70% of the wounds. Cultures from tissue judged as viable and left in the wound indicated contamination in 25% of the wounds in the 1-hour group, contamination in 37 and infection in 11% of the 6-hour group, and in the 12-hour group infection in 60 and contamination in 33%. The conclusion is that wound infection can be overcome by adequate surgical treatment within 6 hours but will be out of control after 12 hours' delay. Furthermore, the results indicate that the presence of a sparse mixed flora probably creates the necessary conditions for infection with other pathogenic strains.

Animals↗