William A. Neely

Aortic and other arterial injuries.

Three hundred sixty arterial injuries in 353 patients are reviewed. They covered a wide spectrum of injuries and included 36 aortic injuries and 19 cases of carotid truama. The mortality rate of 12% was in large part due to aortic injuries. Shock was the predominant cause of death. Infection was the most frequent non-fatal complication. Pulmonary complications were surprisingly uncommon. With methods and techniques discussed in the paper, 90% satisfactory end results were achieved. The amputation rate was 6% where extremity injuries were involved.

Researches on the cause of burn hypermetabolism.

Researches on the Cause of Burn Hypermetabolism WILLIAM NEELY;ANTHONY PETRO;GARLAND HOLLOMAN;FRED RUSHTON;M. TURNER;JAMES HARDY; Annals of Surgery

Lung carcinoma: survey of 2286 cases with emphasis on small cell type.

Lung carcinoma is the commonest major malignancy in men in the United States and its incidence is increasing rapidly in women. It is estimated that there will have been 117,000 new cases and 101,300 deaths in 1980. The 2286 patients with lung carcinoma admitted to the Hospital of the University of Mississippi from 1955 to 1980 were reviewed by decades of chronology and of life, with respect to age, cell type, sex and racial incidence. The greatest age incidence was in the sixth and seventh decades; cell types overall were epidermoid (45% of the patients), adenocarcinoma (12% of the patients), small (oat) cell (21% of the patients), and others (22% of the patients). There was a steady increase in the incidence of disease in females, adjusted for total hospital admissions, and a less certain increase among black patients. Twenty-eight per cent of 250 patients with small cell carcinoma so studied exhibited some feature of the paraneoplastic or paraendocrine syndromes. In 41 patients with small cell carcinoma treated with multiple drug chemotherapy, there was an overall response rate of 50% and an additional “stable disease” rate of 28%. Mean survival period in this group was 52 weeks, compared with 12 weeks in patients whose diseases went untreated. Clearly, definite progress is being made, not only in our knowledge of the biology of lung carcinoma, in general, but in the treatment of small cell carcinoma in particular.

Evisceration secondary to blunt trauma: occurrence through an incisional hernia.

We present a case of evisceration of the stomach, small bowel, and colon through an old incisional hernia in a 75-year old woman following blunt automobile trauma to the abdomen. Following routine surgical closure and debridement of excess skin the patient recovered uneventfully with no recurrence of the hernia.

A micromethod for the determination of deuterium oxide in biological fluids

Abstract A simple micromethod for the analysis of deuterium oxide content of plasma has been described. Other fluids of low protein content may be distilled directly without precipitation. This procedure can be carried out on as little as 0.3 ml of plasma and is therefore suitable for measuring D 2 O in body fluids of experimental animals as small as mice.

Bidirectional movement of water through the skin of a nonsweating animal

Abstract Exchange of water between body fluids and a saturated atmosphere was measured in dogs using D 2 O as the tracer. Bidirectional transfer rates were calculated from a series of eight experiments in which the tracer was placed first in the chamber. Outward diffusion of D 2 O averaged 32.5 ± 5.9 (S.D.) gm. per square meter per hour and inward 26 ± 13.4 gm. per square meter per hour. Outward transfer was calculated from a second series of nine experiments in which the D 2 O was injected intravenously into the dog and averaged in this series 34.5 ± 15.5 gm. per square meter per hour. Mean water loss through the skin of these nonsweating animals was greater than absorption even in a saturated atmosphere.

Canine heartworms in experimental cardiac and pulmonary surgery.

Summary Upon receiving an intravenous extract of Dirofilaria immitis , 75% of dogs with microfilaria of Dirofilaria immitis and 21% of dogs without demonstrable microfilaria had an anaphylactoid reaction. This response is typical of the “homologous blood reaction.” Of available dogs in the Jackson area 55% had microfilaria antibodies in the blood stream. Dogs susceptible to the “homologous blood reaction” were desensitized by treatment with increasing doses of heartworm extract on 3 successive days. This prevented the frequently fatal liver reaction with splanchnic congestion and impaired venous return seen in susceptible dogs when transfused with blood obtained from dogs containing heartworms. This desensitization procedure is recommended for use in all dogs to be used in surgical procedures involving homologous blood transfusion or exchange.

The cells as osmometers: A critical reappraisal using the sodium and chloride space

technics, the average erythrocyte survival is about 120 days. By performing simultaneous Ashby and rBdiochromium51 survival times in normal persons, it has been found that the chromiumsl results can be made to approximate the Ashby data by correcting for a 1 per cent per day elution of the chromium. This correction factor for elution is open to question in the hemolytic anemias. In this study simultaneous determinations of erythrocyte survival were made in six patients with stable hemolytic states using N16-glycine and radiochromium5r. The diagnoses were: sickle cell anemia (four), symptomatic hemolytic anemia (one) and idiopathic hemolytic anemia (one). Since destruction of red cells is a random process in these states, N16 data can be handled in the same way as the Cr51 data. Five patients had erythrocyte radiochromium51 half-lives of 5.5, 6.0, 10.5, 11.2 and 15 days, respectively. The corresponding N l5 half-lives were 15, 22, 7.3, 15, and 21.5 days. (The data on the other patient required special analysis.) In these patients shortened radiochromium half-time represented a shortened erythrocyte survival but did not correlate with N16 survival data.