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Biomedical subjects

W C Boyd

Publications and source records attributed to W C Boyd.

At least 19 recordsLinked to original sources
PubMed1987

Thrombolytic therapy of axillary-subclavian venous thrombosis.

Patients with axillary-subclavian vein thrombosis often have a poor outcome when treated with intravenous heparin sodium and oral warfarin sodium. Four patients were therefore treated with thrombolytic therapy. Good initial and excellent long-term results were achieved. In follow-up that has ranged up to four years, these patients do not have the common complaints of edema, fatigue, cramping, or weakness seen after traditional anticoagulation. Patients have returned to their previous occupations and have normal arm function. Noninvasive Doppler vascular laboratory studies suggest continued patency of axillary veins. Thrombolytic therapy should be considered in the treatment of spontaneous axillary-subclavian vein thrombosis.

Adult↗
PubMed1977

Sequential circulatory changes in the circumferentially burned limb.

To assess the hemodynamic alterations in the circumferentially burned extremity, Doppler arterial examinations and Xenon-133 washout determinations of muscle blood flow (MBF) were obtained in 27 limbs. In this laboratory normal resting MBF was 2.82+/-0.86 cc/min/100 gm (mean +/- S.E.M., N=26) with no value less than 1.60 cc/min/100 gm. In 27 circumferentially burned limbs, the maximum decrement in MBF occurred by 36 hours following thermal injury. The lowest MBF value in the 11 extremities not requiring escharotomy was 1.50cc/min/100gm. Escharotomy was done in 16 extremities. Mean MBF immediately prior to escharotomy was 1.30+/-0.26cc/min/100gm and improved to 4.43+/-0.52cc/min/100gm following escharotomy (p less than 0.01). Correlation between MBF and Doppler examinations was present in 63% of all studies and in 88% of studies performed immediately before or after escharotomy. The diagnostic sensitivity of Doppler examination required audible recognition of abnormal velocity signals as well as absent velocity signals. Because the intial MBF determination or Doppler examination is not helpful in predicting which extremities will eventually require escharotomy, sequential studies should be done during the first 36-48 hours following thermal injury.

Adolescent↗
PubMed1977

Xenon-133 determination of muscle blood flow in electrical injury.

Xe-133 washout determination of muscle blood flow (MBF) was used to detect muscle ischemia in electrical injury of an experimental animal model and three patients. The control MBF of rabbit hindlimbs, which averaged 11.29 +/- 1.07 cc/min/100 gm, was significantly reduced by electrical injury, to 5.82 +/- 1.49 cc/min/100 gm (p less than 0.001). An electrical injury of 4,000 watt-seconds or greater was associated with uniform MBF less than 1.00 cc/min/100 gm and with histopathologic alterations of muscle necrosis. Thenar MBF less than 1.00 cc/min/100 gm in two patients was associated with muscle necrosis requiring distal arm amputation. The remaining patient with sequential muscle blood flows above this level had uneventful healing of hand electrical injuries. Xe-133 determination of MBF may be a useful objective technique to determine the extent of electrical injury in muscle.

Adult↗
PubMed1977

Use of Marlex mesh in acute loss of the abdominal wall due to infection.

Closure of wounds of the abdomen with a minimal amount of foreign material is still the preferred method. However, in those instances in which loss of tissue is too great to effect closure or in which closure will place the suture line under tension, the use of a synthetic plastic mesh is an effective alternative. As described, the technique avoids the risks of further necrosis of the tissue, infection and dehiscence. In those instances of extensive loss of tissue, it is frequently the only practical method available to reconstruct the abdominal wall.

Abdominal Muscles↗
PubMed1976

Subtotal colectomy for refractory pseudomembranous enterocolitis.

Pseudomembranous enterocolitis resulting from therapy with antibiotics such as clindamycin and lincomycin hydrochloride monohydrate does not always respond to drug and vigorous medical support. We describe two seriously ill patients who recovered after subtotal colectomy with ileostomy.

Adult↗
PubMed1975

Optimizing results of gastric bypass.

Gastric bypass is an extensive gastric exclusion operation used in patients who are more than twice their ideal weight. Most of the early postoperative deaths observed in 3% of 442 patients during the initial 9 years, could have been prevented by more attention to operative technique and early recognition and correction of leaks when they occurred. The best weight loss can be produced by adherence to three components of the operation: 1) Bypass of stomach and duodenum, 2) a small fundic segment and 3) a small (12 mm diameter) gastroenterostomy stoma. The average patient of 142 kg can expect to have a weight of around 107 kg at 1 year 103 kg at 5 years. Revision of a large stoma to a smaller (9 mm) diameter can induce further weight loss in some patients whose loss has been inadequate. The 1.8% incidence of stoma ulceration may be lowered with the present emphasis on a smaller fundic pouch, but could increase with longer observation. Presently stoma ulcers occur once in every 140 patient years at risk.

Adolescent↗