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Biomedical subjects

W E DeMuth

Publications and source records attributed to W E DeMuth.

At least 19 recordsLinked to original sources
PubMed1984

Treatment of renal artery embolism.

Renal artery embolectomy was performed on four patients. There was no operative mortality. Four of the five affected kidneys were salvaged. The most common initial symptom was flank pain. The literature from 1970 to 1982 was reviewed to determine the current operative mortality (11%) and frequency of kidney salvage (67% to 90%) with surgery or anticoagulation. Newer treatment modalities, including intraarterially injected low-dose streptokinase and percutaneous transluminal angioplasty, have also proved useful. The addition of these newer methods, combined with the fact that kidneys can frequently be salvaged after prolonged periods of acute renal artery occlusion, led to the development of a clinical algorithm for treatment. With this algorithm, surgical embolectomy was reserved for patients with total renal parenchymal compromise caused by emboli, whose conditions failed to respond to less invasive treatment modes.

Adult↗
PubMed1982

Evaluation of adjuvant postoperative radiotherapy for lung cancer.

One hundred eighteen patients with lung cancer were retrospectively analyzed to determine whether postoperative radiotherapy (RT) improves survival. Patterns of treatment failure and three year NED (no evidence of disease) survival rates were assessed according to extent of tumor spread, histology, and treatment method. Patients with hilar or mediastinal node metastases were at higher risk of local failure compared to those with negative nodes. Postoperative RT reduced local recurrence and improved 3 year survival among patients with positive nodes. However, postoperative RT did not improve survival among those with negative nodes. Our data indicated that patients with positive hilar or mediastinal nodes may require postoperative RT to improve survival.

Adenocarcinoma↗
PubMed1982

Carcinoma of the lung: evaluation of histological grade and factors influencing prognosis.

The results in 96 patients with lung cancer who underwent lobectomy or pneumonectomy were analyzed. In reviewing the case histories of these patients, it became apparent that those with poorly differentiated tumor (grade 3) have an increased likelihood of positive lymph node metastases compared with those with well-differentiated (grade 1) or moderately differentiated (grade 2) tumor. Poor differentiation of the tumor, vascular invasion, and lymph node metastases appear to represent poor prognostic indices in patients undergoing operation. Compared with patients with grade 1 and grade 2 tumors, patients with a grade 3 adenocarcinoma had more local recurrences, while those with grade 3 squamous cell carcinoma had more distant metastases. The findings suggest that histological grading is an important adjunct to the clinical evaluation of and planning of treatment for patients with lung cancer.

Adenocarcinoma↗
PubMed1982

The role of vascular laboratory criteria in the selection of patients for lower extremity amputation.

We evaluated clinical and vascular laboratory data on 126 patients with below-knee or forefoot amputation. Vascular laboratory examination included Doppler systolic blood pressure and arterial wave form analysis using the segmental plethysmograph. Fifty-four patients had below-knee amputation. A calf systolic pressure greater than 70 torr was associated with 97% (33/34) success (p less than 0.005), an ankle systolic pressure greater than 30 torr yielded 91% (39/43) success (p less than 0.025), and an ankle systolic pressure greater than zero yielded an 87% success (p less than 0.005). In the absence of each of the above criteria, the predictive value of a negative test was only 32%, 40%, and 52%, respectively. The presence of a popliteal pulse was associated with 97% success (p less than 0.025); however, 88% of those with an absent popliteal pulse also achieved successful healing of below-the-knee amputations. Prior vascular reconstructive surgery was detrimental to healing of below-knee amputations. with 33% failure rate (p less than 0.025). For the 72 forefoot amputations, an ankle systolic pressure greater than 70 torr yielded a 65% success (p less than 0.025). The sensitivity of an ankle systolic pressure greater than 70 torr was 80% (32/40) and an ankle systolic greater than 35 yielded a sensitivity of 95% (38/40). The specificity was low for both of these reference values. Clinical and vascular laboratory criteria can identify patients who will have a successful below-knee amputation; however, because of the high false negative rate, patients should not be denied below-knee amputation solely on the basis of Doppler systolic pressure. Vascular laboratory criteria for predicting healing of forefoot amputations are also limited by the high rate of false positive and false negative results.

Aged↗
PubMed1982

Avulsion of the innominate artery from the aortic arch associated with a posterior tracheal tear.

The management of a patient with avulsion of the innominate artery from the aortic arch associated with a longitudinal tear on the posterior aspect of the trachea is discussed. It is obviously important to make both diagnoses preoperatively to determine priorities in the surgical management. If the airway injury can be managed by tracheal intubation, then it is recommended that the vascular injury be repaired first. If there is a persistent air leak with respiratory distress, then it is necessary to repair the tracheal injury before performing the vascular procedure. In some patients it may be appropriate to treat the tracheal injury nonoperatively.

Accidents, Traffic↗
PubMed1980

Blunt cardiac trauma: the effect of alcohol on survival and metabolic function.

Cardiac mitochondria showed significant uncoupling of oxidative phosphorylation after rats were given intraperitoneal alcohol. The rate of oxygen utilization in the absence of ADP was increased while there was no significant change in oxygen utilization in the presence of ADP. These in vivo results were confirmed with in vitro experiments. Also, intraperitoneal alcohol increased the mortality of blunt cardiac trauma. The alterations in cardiac energy metabolism demonstrated may explain the increased mortality in alcohol-pretreated animals subjected to cardiac contusion.

Animals↗
PubMed1979

Traumatic renal arteriovenous fistula: case report and useful operative technique.

A patient with a traumatic extrarenal arteriovenous fistula underwent successful repair of the lesion. The reconstruction utilized a portion of renal vein to allow lateral repair of the renal artery. The patient's postoperative course was complicated by paradoxical hypertension and severe abdominal pain like that in the "post-coarctectomy syndrome." Satisfactory recovery has occurred and the patient remains normotensive.

Abdominal Injuries↗
PubMed1978

Buckshot wounds.

The differences between wounds due to conventional shotgun (shot) injuries and those inflicted by buckshot are inadequately appreciated by most clinicians. Cadaver extremities were used as targets for 12-gauge loads of No. 6 shot and 00 Buckshot to portray some of the "wounding" characteristics of these popular shotgun loads. "Wounds" so produced were consistent with expected ballistic performance of these projectiles. The lethality of buckshot wounds is discussed, four clinical cases are described, and the wounding mechanisms are briefly outlined.

Adolescent↗
PubMed1976

Lymphangioma of the stomach in a child.

A case of cystic lymphangioma arising from the stomach wall in a child is reported. This is a rare site of origin for the tumor and its manner of presentation, traumatic rupture, is also unusual. These tumors have not been associated with malignant degeneration. Treatment for these lesions is surgical.

Child, Preschool↗
PubMed1976

Long-term results of brachial thrombectomy following cardiac catheterization.

The late results of brachial thrombectomy following cardiac catheterization were evaluated in 20 patients. All patients had a radial pulse present and no symptoms or signs of ischemia of the hand at the time of discharge from the hospital. Late evaluation of these 20 patients revealed 8 in whom the long-term results were classified as failure of the thrombectomy. Four of these had intermittent claudication of the involved arm and hand. None had any tissue loss and four had no symptoms referable to the failed thrombectomy. The one patient who refused surgery had claudication of the affected arm. The mean period of followup was 20.8 months. The rate of failed thrombectomies was twice as high in females than in males. Prolonged time of cardiac catheterization (over 4 hours), delay in diagnosis of more than 24 hours, and omitting the use of systemic heparinization at the time of diagnosis are three factors that appear to increase the likelihood of late failures.

Arm↗
PubMed1976

Evaluation of use of the rigid dressing in amputation of the lower extremity.

Twenty-seven arteriosclerotic amputees were evaluated to determine the value of the rigid dressing technique for amputation wound management. Results were compared with those for patients having conventional stump wound management. The two groups were similar in number, age and incidence of diabetes. All the patients treated with the rigid dressing had primary healing of the amputation wound, while 13 patients treated with the conventional dressing had primary healing. Long term rehabilitation to the use of a prosthesis was not improved by the application of a rigid dressing on the amputation wound. Our current preference is use of the rigid dressing applied in the operating room at the time of amputation. If the wound is satisfactory and the general condition of the patient is such that he can use a temporary pylon, it is attached to the cast at the first change, about two weeks after operation.

Aged↗
PubMed1975

Effects of alcohol on cardiovascular performance after experimental nonpenetrating chest trauma.

Electrocardiographic and hemodynamic correlates were recorded before and after a standardized nonpenetrating blow to the chest in 9 anesthetized control dogs (Group I), 5 dogs, pretreated with alcohol, 0.4 g/kg intravenously (Group II), and 12 dogs undergoing chest trauma after alcohol infusions (Group III). In animals in Group I, transient major arrhythmias, including complete heart block and ventricular tachycardia, occurred immediately after impact. One animal died with ventricular fibrillation. In the eight survivors these disturbances were accompanied by acute reductions in aortic pressure and cardiac index; values for both variables gradually increased after restoration of sinus mechanism. Alcohol alone (Group II) produced no significant alterations in either hemodynamic performance or electrical activity, but when combined with nonpenetrating chest injury (Group III) it caused a mortality rate of 92 percent, the majority of animals dying with electromechanical dissociation. Mean survival time in Group III was 23.1 plus and minus 6.5 (standard error of the mean) minutes compared with 80.3 plus and minus 9.6 minutes in Group I. At autopsy, minor cardiac lesions of either the pericardium or myocardium were observed in all animals in Groups I and III, but none were considered lethal. It is concluded that administration of alcohol, even in small doses, can effect catastrophic reductions in mechanical performance in the presence of otherwise nonfatal cardiac injury secondary to nonpenetrating chest trauma. The clinical implications of this association are discussed.

Animals↗
PubMed1975

Wounding capacity of rotary lawn mowers.

The rotary lawn mower possesses a powerful wounding mechanism. A typical 26-inch rotary mower blade rotating at 3,000 revolutions per minute develops a kinetic energy of 2,100 ft lb. Wounds may be inflicted by direct strike or by missile action due to a broken blade or other mass. Other serious injuries due to crushing or upset are commonly seen with self-propelled mowers. Ways of reducing these risks are enumerated.

Accidents, Home↗