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Biomedical subjects

W D Newton

Publications and source records attributed to W D Newton.

7 recordsLinked to original sources
PubMed1991

Atheroembolism.

Atheroembolism is an underdiagnosed and often preventable cause of acute arterial insufficiency. The patients suffering from atheroembolism require aggressive evaluation for a source of emboli and frequently surgical excision or exclusion of the source. The Keesler Air Force Base experience with atheroembolism over the past four years was reviewed. Fifteen patients representing 0.03 per cent of hospital admissions were diagnosed with atheroembolism. The embolic source as confirmed by arteriography was aortoiliac in eight patients (57%), femoropopliteal in six patients (43%), and unknown in one patient. Nine patients (60%) were treated surgically or with angioplasty. Three patients had toe amputations and one required a below-the-knee amputation. Only one death occurred that was secondary to unrelated disease.

Adult↗
PubMed1989

Pulmonary embolism: improvement in hemodynamic function with amrinone therapy.

We have described a 57-year-old man who had had lower extremity vascular surgery complicated by PE. Dyspnea, hypotension, hypoxemia, and CHF developed, but thrombolytic therapy was not started because of the recent surgical procedure; instead, he had plication of the inferior vena cava. Because of persistent pulmonary artery hypertension and decreasing cardiac indices, amrinone therapy was begun, and resulted in marked hemodynamic improvement.

Amrinone↗
PubMed1987

Necrotizing fasciitis from invasive Phycomycetes.

Invasive phycomycotic fungal infections are life-threatening complications in patients with impaired immune response. A successful outcome usually depends on early aggressive treatment. Hyperbaric oxygen (HBO) therapy has been suggested as adjuvant therapy based on theoretical considerations and in vitro evidence of fungal growth retardation. A standard gas gangrene HBO protocol was used to treat a progressive necrotizing polymicrobial soft-tissue infection of the lower extremity in a patient with normal host defenses. Progression of the fungal infection was stopped only after radical surgical debridement. This Phycomycetes (Apophycomyces elegans) has not been previously reported as a pathogen in man.

Adult↗
PubMed1986

Use of the splenic and hepatic arteries for renal revascularization.

During a 16-year period at the Massachusetts General Hospital 77 patients underwent 79 procedures (29 hepatorenal bypasses, 50 splenorenal arterial anastomoses) for treatment of renovascular hypertension, renal preservation, or both. The procedure was chosen primarily to avoid a diseased or scarred aorta in 41, to allow a staged approach to bilateral renal artery stenoses or multiple vascular lesions in 17, as a "lesser operation" for five poor-risk patients, for complex problems including trauma, mycotic aneurysm, aortic dissection, thoracoabdominal aneurysm, and renal artery aneurysm in five, and as the procedure of choice in 11 patients. The perioperative mortality rate was 6% for the 77 patients studied. No hepatic dysfunction was seen. Deterioration of renal function occurred on three occasions but only in patients with bilateral simultaneous repair. Cure or improvement of hypertension was achieved in 52 of 63 patients and renal function preserved or improved in 67 of 77 patients. Long-term functional results remain good during follow-up periods up to 14 years. Our experience indicates that use of the hepatic or splenic artery may provide a safe and largely successful alternative for renal revascularization in selected circumstances.

Follow-Up Studies↗
PubMed1986

Mural degeneration in the glutaraldehyde-tanned umbilical vein graft: incidence and implications.

After discovering an aneurysm in a glutaraldehyde-tanned umbilical vein (GTUV) graft that resulted in graft thrombosis, we reevaluated all patients from our institution who had GTUV grafts implanted for more than 2 years. Of 60 patients identified, 14 of 15 patients with patent grafts were recalled and had either digital subtraction or standard angiographic studies. Angiographic changes in the grafts were graded on a scale of 0 to 3, from normal (grade 0) to frank aneurysmal degeneration (grade 3). Eight grafts (57%) had frank aneurysmal (grade 3) changes, and three other grafts (21%) had preaneurysmal (grade 2) changes. Only one graft was angiographically normal. GTUV grafts undergo aneurysmal degeneration in a significant percentage of implants. Symptomatic aneurysms have presented with thrombosis and limb-threatening ischemia as well as rupture. GTUV aneurysms should be treated by complete graft resection, as segmental resection of diseased portions of grafts resulted in metachronous aneurysm recurrence. Because of the high incidence of GTUV degeneration, the clinical indications for the use of GTUV grafts should be seriously reevaluated, and we recommend that all patients with patent GTUV grafts for more than 2 years be evaluated for the presence of aneurysmal degeneration.

Aldehydes↗
PubMed1969

The "9+1" pattern of microtubules in spermatozoa of Mesostoma (Platyhelminthes, Turbellaria).

The living spermatozoa of the flatworm Mesostoma georgianum have a sperm body about 100 mu long and 0.5 mu wide, and two motile free flagella, ca. 200 mu long. In sections examined with the electron microscope, these flagella have the usual nine pairs of peripheral doublet microtubules and have a single central core unit which is connected to the A members of the doublets by spokelike structures. There are also short connections between the doublets and the flagellar membrane. In material negatively stained with phosphotungstic acid, the doublet microtubules seem to have very different elastic properties than the core; they tend to fall on the copper grids in coils of rather uniform diameter (2-4 mu), while the core is much more rigid and is often found extending alone, along a relatively straight course, for very long distances (up to 73 mu). After negative staining, the core has a striking appearance with a dense center around which are wound two hollow structures in a double helix of 45 degrees pitch. The center-to-center distance of each gyre is approximately 650 A, and the hollow structures are ca. 180 A in diameter.

Animals↗