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Biomedical subjects

A W Fleming

Publications and source records attributed to A W Fleming.

47 records · Page 3Linked to original sources
PubMed1981

An analysis of the isoenzymes of creatine phosphokinase and lactic dehydrogenase in the esophagus.

Surgical manipulation of muscular organs can cause alterations of the serum isoenzymes of creatine phosphokinase (CPK) and lactic dehydrogenase (LDH), which are frequently used to confirm the diagnosis of myocardial infarction (MI). Since the content of these enzymes and their isoenzymes has not been established for the esophagus, an experiment was conducted to evaluate and compare the enzymes in postmortem specimens from humans and fresh canine specimens. One gram transmural esophageal sections were taken from specimens having no demonstrable disease. All samples were homogenized individually in Ringer's lactate solution and centrifuged, and the supernatants were analysed for the respective isoenzyme distributions by agarose gel electrophoresis. From the study we drew the following conclusions: (1) all three isoenzymes of CPK (including CPK-MB, the myocardialisoenzyme) are present in the esophagus; (2) LDH, the isoenzyme of LDH most prevalent in myocardium, is the least common of the five isoenzymes of LDH in the esophagus; (3) the dog is an appropriate model for studying changes of these isoenzymes after operation; and (4) any potential confusion in diagnosing postoperative MI due to esophageal CPK-MB in the serum can be resolved, theoretically, by analyzing LDH serum isoenzymes. In myocardial infarction, LDH becomes the predominant isoenzyme, whereas esophageal injury should be associated, theoretically, with a serum LDH isoenzyme pattern in which LDH is the least prevalent isoenzyme.

Adult↗
PubMed1977

Overactive inferior oblique muscle.

The most common type of overactive inferior oblique muscle is secondary to a delay in the development of superior oblique muscle function. Operative intervention is not indicated because as a child matures the overactivity of the inferior oblique muscle will gradually disappear. In those cases where surgery is performed, the desired effect of elimination of excess elevation is achieved indirectly. The theory that the inferior oblique muscle is not primarily an elevator is supported by this explanation involving an indirect surgical effect. An explanation of a common postoperative finding after unilateral recession of an inferior oblique muscle is presented.

Age Factors↗
PubMed1975

Total coronary blood flow measurements and myocardial metabolism during cardiopulmonary bypass in a canine model.

Myocardial respiratory function and total coronary blood flow were evaluated during cardiopulmonary bypass in 18 dogs. The fibrillating heart was found to be associated with an increase in myocardial oxygen utilization and metabolic rate which was compensated for by a corresponding increase in total coronary blood flow. Following anoxic arrest of the heart, there appears to be an initial impairment to oxygen utilization. Oxygen consumption does not return to normal after 15 minutes of restoring coronary blood flow. The stability of the experimental model as outlined in this study is thought to be related to the use of autologous blood in priming the extracorporeal circuit.

Animals↗
PubMedDate not supplied

Use of concentrated fibrinogen in experimental splenic trauma.

This study evaluated Fibrin Sealant (FS), a two-component biologic adhesive that is effective in establishing hemostasis, in 27 experimentally produced splenic injuries in five adult mongrel dogs. Ten small superficial lacerations (2.0 cm in length), six large superficial lacerations (3.0-6.0 cm in length), three small wedge resections, and eight stab wounds extending into the splenic hilum were effectively repaired with FS without suture splenorrhaphy or temporary splenic hilar occlusion. Complete hemostasis was achieved in all animals prior to skin closure. Dogs were reexplored postoperatively at intervals varying from 4 h to 6 weeks. When animals were killed, there was no gross evidence of splenic disruption or recurrent bleeding; the spleens all had developed well-healed capsules. Histologic examination demonstrated a regenerated fibrous capsule extending over the injuries without significant inflammatory response. We conclude that FS provides adequate hemostatic control of superficial and deep splenic injuries; has good systemic and local compatibility; can be applied to bleeding parenchymal wounds; organ ischemia is generally not required; avoids the use of parenchymal sutures, which may be traumatic; and may promote splenic wound healing. Thus, use of FS is an effective technique for splenic preservation after trauma.

Animals↗
PubMedDate not supplied

Use of concentrated fibrinogen in experimental tracheal repair.

Tracheal stenosis is a devastating complication of tracheal resection that may be related to improper suture selection and technique, as well as extensive surgical devascularization. This study evaluated Fibrin Sealant (FS) (Immuno AG, Vienna, Austria), a two-component biologic adhesive, as a method for reducing the need for sutures in tracheal surgery. This adhesive has been found to be effective in face-to-face sealing of tissues, wound healing, and in establishing hemostasis. Six adult mongrel dogs underwent tracheal repair with FS. Three had tracheal hemitransections (approximately three quarters of the circumference) and were repaired using one absorbable suture and FS, and three had complete transections (with resection of two tracheal rings each) repaired using five absorbable sutures and FS. The animals were killed at varying intervals ranging from 6 h to 6 weeks. No animal had gross evidence of significant tracheal stenosis, and the endotracheal mucosa appeared well healed. We conclude that the use of FS in tracheal reconstruction results in a stable, leakless trachea, and that it significantly reduces the number of sutures needed; this may lead to a decreased potential for anastomotic ischemia and tracheal stenosis.

Animals↗