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Biomedical subjects

H T Williams

Publications and source records attributed to H T Williams.

7 recordsLinked to original sources

Elastin and granulation tissue.

The contraction of granulation tissue is an important factor in wound healing. The tract of an abdominal drainage tube closes at the rate of 1 mm/h once the tube is removed. Specialized myofibroblasts are generally believed to be responsible for this process and the presence of elastin in granulation tissue has been debated for many years. A 3-mm polyethylene tube was inserted through the left lobe of the liver in 41 rats. A tube of granulation tissue formed around the plastic. This granulation tissue was isolated, after periods ranging from 8 to 20 days, by removing the left lobe of the liver and scraping away the surrounding liver tissue. Biochemical assay for elastin revealed that normal hepatic tissue does not contain any detectable amount of elastin. All 41 samples of granulation tissue contained elastin with a mean value of 8.5 X 10(-6) g of elastin per milligram of tissue. Normal rat aorta contains 31.4 X 10(-6) g of elastin per milligram of tissue. These tubes of granulation tissue were histologically normal and the presence of elastin was recognized using elastin stains. The exact role of elastin in granulation tissue is uncertain but this experiment clearly demonstrates its generation and presence there.

Animals

Surgical treatment of the thoracic outlet compression syndrome.

Narrowing of the thoracic outlet may give rises to symptoms in the arm from compression of the nerves, the subclavian artery, and the subclavian vein. Anatomic studies show that nerve compression may affect fibers from T-1, C-8, and not infrequently C-7, providing an explanation for the diffuse nature of the nerve symptoms in the arm. Relief from this compression at the thoracic outlet is readily accomplished by transaxillary resection of the first rib together with any associated cervical rib, fibrous cervical rib analogues, or other fibrous bands encroaching on the neurovascular structures. A study of 40 patients with the syndrome who were treated in this way and followed up after an interval of three to ten years shows that those with nerve and vein symptoms can expect a good result but the results of treatment in those with arterial symptoms is less satisfactory.

Adult

Calf blood flow and ankle systolic blood pressure in intermittent claudication monitored over five years.

The response of calf blood flow and ankle blood pressure to 2 minutes of ischemic exercise were recorded every 6 months over a 5-year period in 9 patients with intermittent claudication who were treated conservatively on a regime including alpha tocopherol. No statistically significant change was noted in the pattern of the calf blood flow response over this period. Statistically significant (P less than 0.05) increases in resting and minimal postexercise ankle systolic pressures were partially attributable to a concomitant increase in central arterial pressure as indicated by brachial systolic pressure. Results from 18 patients over 1 year and from 14 patients over 2 years are consistent with these findings. The evidence presented suggests that the arterial disease process was stable over this period.

Ankle

A morphologic study on the effect of suturing the submucosa of the large intestine.

Five suture materials, chromic catgut, braided silk, Prolene, Teflon coated braided Dacron and Dexon have been examined morphologically for their effect on the submucosal collagen structure of the large intestine. The rougher surfaced materials, such as catgut, braided silk and Dexon, cause considerable damage to the submucosa on either side of an intestinal anastomosis. Because of this damage, it would appear that these sutures are more likely to jeopardize the integrity of an intestinal anastomosis.

Animals

Normal processes and restraints in wound healing.

Wound healing normally follows an uninterrupted course but, for the purposes of description, it can be considered in four phases -- hemostasis, acute inflammation, repair and consolidation. Arrest of healing may occur at any phase and lead to a number of clinical problems. Repair cannot begin until the phase of acute inflammation has begun to subside; this fact is of special importance in clinical surgery. Wound healing in gastrointestinal tract and abdominal incisions is emphasized because healing problems are common in these areas and failure to heal results in morbidity and a regrettable mortality.

Collagen

Bacterial peritonitis and the bursting strength of intestinal anastomoses.

In order to study the bursting strength of intestinal anastomoses, resection of a wedge of ileum and creation of an anastomosis were performed, and peritonitis was induced in five groups of rats. Peritonitis was induced by intraperitoneal injection of bacterial suspensions of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Clostridium welchii, and the exteriorized ileal loop in each rat was regularly inspected for peritoneal exudation, adhesions, hyperemia, obstruction, leakage and bursting strength. All bowel anastomoses performed in the presence of peritonitis were weaker than those done in a sterile field (control group) and the type of organism influenced the strength of the anastomosis and the histopathologic changes; in this study the weakest anastomoses were associated with E. coli infection.

Animals