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Biomedical subjects

M D Tilson

Publications and source records attributed to M D Tilson.

At least 91 records · Page 5Linked to original sources
PubMed1982

Decreased hepatic copper levels. A possible chemical marker for the pathogenesis of aortic aneurysms in man.

The spontaneously aneurysm-prone Blotchy mouse has a mutation on the X chromosome resulting in low hepatic copper levels; and copper is an essential cofactor for lysyl oxidase, which catalyzes reactions leading to the cross-linking of collagen and elastin. Population characteristics and family histories of patients with aneurysms suggest that aneurysmal disease may also be sex linked in man. Hepatic copper levels were determined in 13 patients who died with abdominal aortic aneurysms and in 13 control patients selected on the criterion of severe atherosclerotic occlusive disease of the abdominal aorta. Excluding two patients with severe liver disease, the tissue copper level in the patients with aneurysms was only 26% of the control level. The results suggest that additional studies of the biologic markers for aneurysm formation in the Blotchy mouse should be carried out prospectively in human subjects.

Animals↗
PubMed1981

Generalized arteriomegaly. A possible predisposition to the formation of abdominal aortic aneurysms.

Studies of patients with arteriomegaly have suggested that an increased incidence of aneurysms occurs in patients with unusually large arteries. However, as far as we know, a study of comparative arterial sites in consecutive patients with aneurysms has not been reported previously. We have compared the diameters of the suprarenal abdominal aortas and iliac arteries in concurrent consecutive series of 12 male patients with aneurysms and 12 male patients with atherosclerotic occlusive disease. These vessels remote from the aneurysms were 40% to 48% larger in diameter in the aneurysmal group by both angiography and direct measurement. In addition, the patients with aneurysms were found to be taller and to have a greater mean body surface area. Possible implications of these findings relevant to the pathogenesis of aneurysms are suggested.

Aorta, Abdominal↗
PubMed1980

Differences in results for aneurysm vs occlusive disease after bifurcation grafts: results of 100 elective grafts.

To compare abdomonal aortic surgery for aneurysmal (AAA) vs occlusive (OCC) disease, 50 consecutive cases of elective bifurcation grafts for AAA and 50 consecutive cases for OCC disease were analyzed. The mean age of the AAA patients was a decade greater than the OCC patients, and they had more associated diseases. Only six AAA patients were women, while women predominated in the OCC group. Only three AAA patients were claudicants and none had rest pain. About one third of the OCC group had distal disease, and 14 had rest pain. Operative mortality was 4% (two deaths in each group). The survival of the grafted AAA patients was almost equal to normal expectancy. There were no late thromboses of grafts in the AAA group, while there were five late failures in the OCC group. The OCC group underwent significantly more frequent reoperative surgery during the follow-up period. The numerous differences in the two population groups apparent in this study provide a basis for questioning the concept that aneurysms are caused by atherosclerosis.

Adult↗
PubMed1980

Early proliferative activity: its occurrence in the crypts of small bowel and colon after partial small-bowel resection.

Crypt population kinetics in both small bowel and colon were determined in the early postoperative period in the rat after either sham resection or resection of 50% of the midportion of the small bowel. A proliferative response was evident in the colon within 24 hours. This response of the labeling index was statistically significant in the left colon by comparison with the sham-resected animals, whereas in the right colon it was significant by comparison not only with the sham-resected but also with the intact animals. A proliferative response was documented in the remnants of the small bowel on the third postoperative day by comparison with those of the sham-resected animals. These findings indicate that adaptive hyperplasia begins very promptly in the intestinal remnants after partial resection.

Animals↗
PubMed1979

Obturator canal bypass grafts for septic lesions of the femoral artery.

Infection of the femoral artery results in false aneurysm formation and hemorrhage unless appropriate reconstructive measures are taken. We reviewed ten such cases managed by obturator canal bypass with autogenous saphenous vein. The graft maintained viability of the extremity in every case in the early postoperative period. One death occurred related to cardiac disease, and there was one late failure. This experience confirms the usefulness of the obturator canal as a method for bypass of the infected femoral artery.

Adolescent↗
PubMed1979

Surgical principles and polytetrafluoroethylene.

This report describes a 24-month follow-up in 100 consecutive polytetrafluoroethylene (PTFE) arterial grafts. Although initial results were superb, a continued follow-up has showed extremely high closure rates for femoropopliteal and femorotibial grafts. The primary reason for this high attrition rate is thought to be stasis. We believe that PTFE is clearly the best synthetic arterial replacement available, but the material does not approach the autogenous saphenous vein in terms of long-term patency. Therefore, in spite of its many advantages, we do not recommend the elective use of PTFE for peripheral small-vessel bypass.

Bioprosthesis↗
PubMed1979

Retroperitoneal cross pelvic bypass grafts.

An extraperitoneal retropubic cross iliac artery bypass graft is a safe alternative to an intra-abdominal aortoiliac bypass, axillofemoral bypass or subcutaneous femorofemoral bypass in the patient considered to be at high risk. This procedure may prove to be superior to subcutaneously placed grafts because the graft is less prone to trauma and infection. The circulation of the donor limb must be adequate to produce a significant increase in the rate of flow through the recipient limb. There was an early patency of the graft in 58 of 61 patients. There was patency of the graft at three years in 40 of 61 patients.

Blood Vessel Prosthesis↗
PubMed1978

Abdominal angina.

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Aorta, Abdominal↗
PubMed1977

Quantitative bacteriology and pathology of the lung in experimental Pseudomonas pneumonia treated with positive end-expiratory pressure (PEEP).

Mechanical ventilation with positive end-expiratory pre-sure (PEEP) is widely used to treat ventilatory failure complicating pulmonary infection. The present experiment was carried out to test the hypothesis that PEEP is beneficial in an experimental model of canine pneumonia studied for 24 hours. Sixteen mongrel dogs were assigned to ventilation with either zero end-expiratory pressure (ZEEP) or 10 cm H2O PEEP. Pneumonia was induced in half of each group by intratracheal inoculation with Pseudomonas. Tissues for quantitative bacteriology and pathology were obtained at the time of death at 24 hours. Three of four infected-ZEEP dogs died before 24 hours. The geometrical mean of quantitative bacterial counts from infected-ZEEP lobes was 2.0 X 10(6) (+/-3.9) (organisms/gm of tissue), while the mean of the infected-PEEP lobes was 1.7 X 10(4) (+/-3.6) (p less than 0.05). Semiquantitative pathology scores indicated greater injury to the ZEEP-infected than to the PEEP-infected lungs. Quantitative bacteriology and microscopic evidence of parenchymal injury were positively correlated. Thus PEEP-treated animals had lower quantitative bacterial counts, less microscopic pulmonary damage, and improved survival. The advantage conferred by PEEP may be due to facilitation of local mechanisms of pulmonary defense against infection, to increased systemic resistance to sepsis, or to both.

Animals↗