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Biomedical subjects

M K Wilson

Publications and source records attributed to M K Wilson.

13 recordsLinked to original sources
PubMed2003

Reconstruction of the trachea with a tubed radial forearm free flap.

BACKGROUND: We present the case of a patient with adenoid cystic carcinoma of the trachea who had 60 mm of the trachea excised and reconstructed with a stented radial forearm free flap. The patient was well in the immediate postoperative period with good function of the neotrachea. Problems developing after the reconstruction included proximal stricture, sputum retention, and recurrent pneumonia. RESULT: The patient died of malignant hypercalcemia 16 months after the reconstruction. To our knowledge this is the first reported case of a total tracheal resection and reconstruction with a combination of free tissue transfer and internal stenting. CONCLUSION: We conclude that tracheal reconstruction has the potential to provide a reliable airway in patients not able to be reconstructed with a primary anastomosis.

Adult↗
PubMed2000

A brain dead donor model of porcine orthotopic cardiac transplantation for assessment of cardiac allograft preservation.

BACKGROUND: We aimed to develop a large animal model of orthotopic cardiac transplantation, incorporating donor brain death, to assess new methods of preservation of the donor heart. METHODS: Brain death was achieved in the donor pig by inflation of a 20 cc subdural balloon 1 h prior to harvest. The donor heart was stored for 6 h with conventional hypothermic ischaemic preservation. It was then transplanted orthotopically into the recipient pig using the Lower and Shumway technique. One hour after reperfusion, the transplanted heart was weaned from cardiopulmonary bypass with dobutamine support. Dobutamine support was continued for up to 4 h, if required. After 6 h of physiological and biochemical evaluation, the recipient was euthanased and the heart excised for histological assessment. RESULTS: All pigs experienced the classical haemodynamic changes associated with brain death. This resulted in the release of Troponin I, consistent with myocardial injury. The donor operation was successfully completed in 11 out of 13 pigs. Six out of 11 transplanted hearts were successfully weaned from cardiopulmonary bypass, but required ongoing dobutamine support. CONCLUSIONS: This porcine model of orthotopic cardiac transplantation is a relevant and practical large animal model for the assessment of new methods of preservation of the donor heart.

Journal Article↗
PubMed1998

Combined heart and single-lung transplantation in complex congenital heart disease.

We present a patient with a history of tricuspid and pulmonary atresia who underwent a classic Glenn shunt and a Potts shunt during childhood, resulting in different right and left pulmonary physiology. Because of progression of cardiopulmonary disease and the fact that the right lung was "protected," the patient underwent combined heart-left single-lung transplantation. The postoperative course was uneventful. Potential early and late advantages of this approach include simplifying of the operative procedure and mitigating the potential effects of obliterative bronchiolitis.

Adult↗
PubMed1996

Recurrent pyogenic cholangitis or "oriental cholangiohepatitis' in occidentals: case reports of four patients.

The first description of recurrent pyogenic cholangitis occurring in four occidentals is presented. While recurrent pyogenic cholangitis is a common syndrome of uncertain aetiology among orientals (also known as oriental cholangiohepatitis), it has not previously been described in occidentals. Four such patients are described. They presented with recurrent attacks of ascending cholangitis and associated hepatolithiasis, biliary stricturing and dilation. Focal hepatic involvement was treated by segmental liver resection and recurrent disease by interventional endoscopy or radiology.

Adult↗
PubMed1988

An optimized quality control procedure for hematology analyzers with the use of retained patient specimens.

The authors propose guidelines for the use of retained patient specimens for the quality control of multichannel hematology analyzers. They demonstrate that control limits for patient specimen replicates may be derived from the long-term standard deviations (s) of commercial whole blood controls. They then use computer stimulation of the Coulter multichannel hematology instrument to determine power functions of various procedures using retained specimens. These power functions show that the use of three patient specimens and +/- 2 s limits are optimal for the detection of systematic error. They recommend that three different, previously analyzed normal range specimens be periodically analyzed, e.g., at eight-hour intervals. The differences between the current and original measurements should then be calculated and compared with their +/- 2 s limits. If at least two of the three differences for any directly measured parameter exceed the +/- 2 s limits, there will be a high probability of significant analytic error. Because the power functions of the derived red blood cell parameters, hematocrit, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration demonstrate relatively low error detection capabilities, the authors recommend that these parameters not be monitored with the retained patient specimen procedure.

Hematology↗
PubMed1983

Evaluation of the accuracy of the diff3/50 with a cell by cell comparison.

The traditional approach to the evaluation of accuracy of discrete differential counters uses a graphic comparison of automated and manual counts. This type of comparison introduces so much sampling variation that significant differences often are obscured. To exclude this sampling variability, one of three technologists, a reference technologist and the Coulter diff3/50, each performed a differential count on exactly the same 100 cells of 47 normal and 56 abnormal blood smears. Linear regression analysis demonstrated excellent agreement between the technologists for all cell types with the exception of band neutrophils. Comparison of the instrument results with the technologists' results showed very good agreement for segmented neutrophils, lymphocytes, monocytes, and eosinophils. The identification of band neutrophils, basophils, immature granulocytes and atypical lymphocytes requires improvement. The overall performance is acceptable, with only 11 leukocytes, on the average normal smear, misclassified out of 100 normal leukocytes (four bands called segs, four segs called bands, and three non-neutrophils incorrectly classified). We recommend similar evaluations for all discrete differential counters.

Basophils↗
PubMed1982

Con-A-stimulated superoxide production by granulocytes: reversible activation of NADPH oxidase.

Stimulation of granulocyte (PMN) superoxide (O2-) production by concanavalin-A (Con-A) can be monitored continuously in the spectrophotometer. Both the rate of activation and final activity of the O2--generating system is dependent on the concentration of Con-A. Alpha methylmannoside (alpha MM) can prevent Con-A, but not phorbol myristate acetate (PMA) or zymosan, induced O2- production. Alpha MM inhibits both the rate of activation and the final rate of O2- production. When alpha MM is added after the attainment of a maximal rate of O2- production with Con-A, O2- production continues for another minute before it ceases. When PMA is added to such treated cells, it restores O2- production. Although the inhibition of O2- production by alpha MM on previously activated cells requires time, most of the bound concanavalin-A is removed immediately after the addition of alpha MM. Treatment of cells with L-1-tosylamido-2-phenylethyl-chloromethyl ketone (TPCK) prevents activation of PMN by Con-A to a greater extent than it does for either PMA or zymosan. TPCK has no effect on the binding of Con-A. TPCK, when added after Con-A, will inactivate O2- production by the cells. The addition of PMA after TPCK treatment restores O2--generating activity. Membrane-enriched particles from PMN activated with Con-A, alpha MM, and PMA demonstrate that the change in O2- production seen by whole cells is due to an alteration of the activity of the NADPH oxidase. Thus, Con-A stimulation of human PMN O2- production can be prevented and reversed by the addition of either alpha MM or TPCK and that PMA can reactivate Con-A and either alpha MM- or TPCK-treated cells. The activation, inactivation, and reactivation occur as a result of changes in the plasma membrane NADPH-dependent O2--generating enzyme.

Concanavalin A↗
PubMed1982

Split peroneus brevis transfer: nonosseous ankle stabilization procedure.

There have been numerous articles written on surgical reconstruction of the lateral collateral ligaments. This paper discusses a different type of lateral ankles stabilization procedure performed on 19 patients at Doctors General Hospital, with mean follow-up of 14 months. The procedure is done entirely with soft tissue; no osseous structures are involved. The authors have utilized tendon, particularly part of the peroneous brevis tendon, to reinforce the lateral capsule and collateral ligaments. It is this technique and some modifications that are presented.

Adolescent↗
PubMedDate not supplied

Aging of human segmental oligosynaptic reflexes for control of leg movement.

A heteronymous group I oligosynaptic reflex from the common peroneal nerve to vastus medialis muscle was compared with a group I homonymous monosynaptic reflex to soleus, using electrical stimulation of peripheral nerve trunks in two groups of healthy men, mean ages 22 and 65 years. The oligosynaptic reflex was still elicitable with age, its magnitude decreasing similarly to the monosynaptic reflex. A further group of older subjects, mean age 75 years, showed similar results. Clearly, the oligosynaptic reflex is not lost with healthy aging. The motor interneuronal pool may at least partially avoid the age-related cell loss of motoneuronal pools, with consequent maintenance of segmental participation for movements such as gait. The slowing of conduction velocities, for these proprioceptive reflex arcs, may reduce the effectiveness of autoregulation of the gait.

Adult↗