Mark A J Newman

Sir Charles Gairdner Hospital, Perth City, Western Australia, Australia

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Publications (68)131.36 Total impact

  • Heart, Lung and Circulation 01/2014; 23(1):e46. DOI:10.1016/j.hlc.2013.10.042 · 1.17 Impact Factor
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    ABSTRACT: OBJECTIVES Remote ischaemic preconditioning (RIPC) may protect distant organs against ischaemia-reperfusion injury. We investigated the impact of RIPC on kinin receptor expression in neutrophils following RIPC in patients undergoing coronary artery bypass grafting (CABG).METHODS Patients undergoing elective CABG with cardiopulmonary bypass (CPB) were randomized to RIPC (n = 15) or control (n = 15) groups. The study group underwent RIPC by inflation of a blood pressure cuff on the arm. Expression of kinin receptors, plasma concentrations of IL-6, IL-8, IL-10, TNF-α and neutrophil elastase were determined at baseline (before RIPC/sham), immediately before surgery (after RIPC/sham) and 30 min and 24 h after surgery. Plasma bradykinin levels were assessed before and after RIPC/sham, and at 30 min, 6, 12 and 24 h after surgery. Serum creatine kinase (CK), troponin I, C-reactive protein (CRP) and lactate levels were measured immediately prior to surgery and 30 min, 6, 12, 24 and 48 h after surgery.RESULTSKinin B2 receptor expression did not differ between the groups at baseline (pre-RIPC), but was significantly lower in the RIPC group than in the control group after RIPC/sham (P < 0.05). Expressions of both kinin B1 and B2 receptors were significantly down-regulated in the RIPC group, and this persisted to 24 h after surgery (P < 0.001). Neutrophil elastase levels were significantly increased after surgery. There were no differences in CK, CRP, cytokine, lactate or troponin I levels between the groups.CONCLUSIONSRIPC down-regulated the expression of kinin B1 and B2 receptors in neutrophils of patients undergoing CABG.
    Interactive Cardiovascular and Thoracic Surgery 06/2013; 17(4). DOI:10.1093/icvts/ivt279 · 1.11 Impact Factor
  • Lucas H A Sanders · Weiwen Chen · Steve E Cindric · Mark A J Newman
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    ABSTRACT: The use of crutches following a sternotomy raises the concern of sternal dehiscence. We discuss secure reinforced sternal closure, classify sternal distractional forces and discuss the postoperative mobilization process.
    Interactive Cardiovascular and Thoracic Surgery 05/2011; 13(2):237-9. DOI:10.1510/icvts.2010.258509 · 1.11 Impact Factor
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    ABSTRACT: Immature mediastinal teratomas refractory to chemotherapy are very rare and require management by an aggressive surgical approach. We describe resection of a large mediastinal teratoma in a 23-year-old man, with a satisfactory early result.
    Asian cardiovascular & thoracic annals 04/2011; 19(2):160-2. DOI:10.1177/0218492311398060
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    ABSTRACT: Serosal pathologies including malignant mesothelioma (MM) can show features of osseous and/or cartilaginous differentiation although the mechanism for its formation is unknown. Mesothelial cells have the capacity to differentiate into cells with myofibroblast, smooth muscle and endothelial cell characteristics. Whether they can differentiate into other cell types is unclear. This study tests the hypothesis that mesothelial cells can differentiate into cell lineages of the embryonic mesoderm including osteoblasts and adipocytes. To examine this, a functional assay of bone formation and an adipogenic assay were performed in vitro with primary rat and human mesothelial cells maintained in osteogenic or adipogenic medium (AM) for 0-26 days. Mesothelial cells expressed increasing levels of alkaline phosphatase, an early marker of the osteoblast phenotype, and formed mineralized bone-like nodules. Mesothelial cells also accumulated lipid indicative of a mature adipocyte phenotype when cultured in AM. All cells expressed several key osteoblast and adipocyte markers, including osteoblast-specific runt-related transcription factor 2, and demonstrated changes in mRNA expression consistent with epithelial-to-mesenchymal transition. In conclusion, these studies confirm that mesothelial cells have the capacity to differentiate into osteoblast- and adipocyte-like cells, providing definitive evidence of their multipotential nature. These data strongly support mesothelial cell differentiation as the potential source of different tissue types in MM tumours and other serosal pathologies, and add support for the use of mesothelial cells in regenerative therapies.
    Journal of Cellular and Molecular Medicine 11/2010; 15(10):2095-105. DOI:10.1111/j.1582-4934.2010.01212.x · 3.70 Impact Factor
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Anesthesiology 03/2010; 112(3):762-3. DOI:10.1097/ALN.0b013e3181cdec09 · 6.17 Impact Factor
  • Heart, Lung and Circulation 03/2010; 19(9):573. DOI:10.1016/j.hlc.2009.12.002 · 1.17 Impact Factor
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    ABSTRACT: Papillary fibroelastomas are benign cardiac tumors that involve cardiac valves. These tumors are usually asymptomatic and are found incidentally during cardiac surgery or during echocardiographic evaluation in a patient who exhibits cardiac symptoms. However, these tumors may cause major thromboembolic complications. Herein, we describe the surgical management of a patient who had an unusual appearance and location of a papillary fibroelastoma that was attached to the interventricular septum.
    Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 01/2010; 37(1):119-20. · 0.63 Impact Factor
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    ABSTRACT: Access through the right superior pulmonary vein is a commonly used route for left ventricular vent insertion. Complex reshaping of the stylet and vent into a certain position or external guidance do not guarantee successful placement. In this article we describe a modified technique where the stylet sets up the position to allow consistent atraumatic advancement of the catheter across the mitral valve.
    The Annals of thoracic surgery 12/2009; 88(6):2050-1. DOI:10.1016/j.athoracsur.2009.03.063 · 3.65 Impact Factor
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    ABSTRACT: Remote ischemic preconditioning (RIPC) has been shown to reduce ischemic-reperfusion injury and is induced by brief forearm ischemia. Kinins are known to be involved in RIPC and act via the G protein coupled B1 and B2 receptors. Interaction of the kinins with their respective receptors causes receptor internalization, thereby reducing the potential for further activation. This may be critical for the protective effect of RIPC and if so, we hypothesized, would significantly decrease the expression of kinin receptors on the surface of neutrophils. The study was performed on five healthy human volunteers. The left forearm was rendered ischemic for three 5-min periods, each separated by 5 min of reperfusion. Three venous blood samples were taken from the right arm, one before and two after RIPC. Neutrophil isolation, immunofluorescence labeling, and confocal microscopy were performed. Mean pixel intensity data were generated using a fixed circular area of interest (AOI, 40×40 μm). For every image, the AOI was placed over a cell and the mean pixel intensity was recorded. The mean intensity was expressed as pixel×10(2)/μm(2) and presented as mean±SEM. Immunofluorescence at the different time points was compared by one way analysis of variance with Bonferroni's post-hoc test. A P value<0.05 was considered significant. The mean pixel intensity for kinin B1 receptors was decreased at 24 h after RIPC compared with both baseline and 15 min after RIPC (P<0.001). Similarly, the intensity for B2 receptor labeling on neutrophils was significantly decreased 24 h after RIPC compared with the baseline value (P<0.001). RIPC decreases expression of kinin receptors on circulating human neutrophils. Reduction in kinin surface receptors suggests internalization of receptors and is consistent with the concepts of kinin receptor activation and their role in RIPC.
    Journal of Surgical Research 11/2009; 171(1):311-6. DOI:10.1016/j.jss.2009.11.011 · 2.12 Impact Factor
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    ABSTRACT: It has been suggested that blood transfusion has an adverse effect on long-term health, mainly through immune modulation and tumor promotion. To further assess this concern, the authors have performed a prospective observational study with the hypothesis that after taking perioperative risk factors relevant to long-term survival into account, patients undergoing coronary artery surgery who receive a perioperative allogeneic blood transfusion have worse long-term survival than those who do not. The health outcomes of 1,841 consecutive subjects who had isolated nonemergency first-time coronary artery surgery and who survived more than 60 days after surgery were determined by record linkage. The association between length of survival, blood products transfused, and risk factors for long-term survival at entry to the study were determined by Cox proportional hazards regression. A total of 1,062 subjects were transfused. Of these, 266 subjects died during a mean follow-up of 8.1 yr. Of subjects who were transfused, 27% had a new malignant condition recorded on the death certificate, compared with 43% who were not transfused. Older age, cerebrovascular disease, use of a mammary graft, chronic pulmonary disease, renal dysfunction, reduced left ventricular function, and preoperative anemia were predictive of reduced long-term survival. There was no association between transfusion of blood products and long-term survival. Patients who have undergone coronary artery surgery and who have received moderate amounts of blood as part of responsible and conservative management should be reassured that they are unlikely to experience a reduction in long-term survival.
    Anesthesiology 09/2009; 111(2):327-33. DOI:10.1097/ALN.0b013e3181ab6743 · 6.17 Impact Factor
  • Lucas H.A. Sanders · Mark A.J. Newman
    The Annals of thoracic surgery 07/2009; 87(6):2003. DOI:10.1016/j.athoracsur.2008.12.015 · 3.65 Impact Factor
  • The Journal of thoracic and cardiovascular surgery 05/2009; 139(3):777-8. DOI:10.1016/j.jtcvs.2009.01.016 · 3.99 Impact Factor
  • Heart, Lung and Circulation 03/2009; 18(1):50-1. DOI:10.1016/j.hlc.2007.06.525 · 1.17 Impact Factor
  • Pankaj Saxena · Adam Boyt · Mark Newman
    Heart, Lung and Circulation 02/2009; 18(1):87-87. DOI:10.1016/j.hlc.2008.11.054 · 1.17 Impact Factor
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    ABSTRACT: Advanced prosthetic valve endocarditis is often associated with substantial destruction of the tissues adjacent to the prosthesis. Removal of the infected prosthesis and débridement of the infected tissues make implantation of a new prosthesis challenging. Herein, we discuss successful surgical aortic valve translocation in a 50-year-old man who had advanced acute prosthetic valve endocarditis with destruction of the aortic annulus. One year after being discharged from the hospital, the patient was asymptomatic with good exercise tolerance.
    Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 01/2009; 36(6):604-6. · 0.63 Impact Factor
  • Mark A J Newman
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    ABSTRACT: Background: We hypothesized that lung volume reduction surgery for pulmonary emphysema would improve body mass index (BMI), airflow obstruction, dyspnoea and exercise capacity (BODE) index, a multidimensional predictor of survival in chronic obstructive pulmonary disease. We also aimed to identify preoperative predictors of improvement in the BODE index. Methods: In a prospective cohort study of patients undergoing king-volume reduction surgery at our centre, with the method of the National Emphysema Treatment Trial, we compared clinical characteristics before and 1 year after surgery with the Wilcoxon signed rank test. Changes in the BODE index were correlated to preoperative variables with the Spearman correlation coefficient. Results: Twenty-three patients with predominantly upper-lobe pulmonary emphysema underwent lung-volume reduction surgery (14 by video-assisted thoracoscopic surgery, 9 by median sternotomy). There were no postoperative or follow-up deaths. The BODE index improved from a median of 5 (interquartile range 4-5) before surgery to 3 (interquartile range 2-4) 1 year after Surgery (P < 0.0001). Improvements were seen in the lung function and dyspnoea components of the BODE index. Lower preoperative 6-min-walk distance and lower post-walk Borg fatigue scores were each associated with greater improvement in the BODE index after 1 year. Conclusion: Lung-volume reduction for pulmonary emphysema improved the BODE index in patients with predominantly upper-lobe disease. Lower preoperative 6-min-walk distance correlated to greater improvement in the BODE index.
    ANZ Journal of Surgery 10/2008; 78(9):819-820. DOI:10.1111/j.1445-2197.2008.04660.x · 1.12 Impact Factor
  • Pankaj Saxena · Andrew Lee · Igor E Konstantinov · Mark A J Newman
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    ABSTRACT: Papillary fibroelastoma (PFE) is a rare and benign cardiac tumour that mainly affects the valves. This tumour has the potential to cause serious life threatening thromboembolic complications. Herein, we describe successful excision of an aortic valve papillary fibroelastoma. The importance of valve sparing tumour resection is emphasised.
    Heart, Lung and Circulation 09/2008; 17(4):349-51. DOI:10.1016/j.hlc.2006.10.016 · 1.17 Impact Factor
  • Heart, Lung and Circulation 07/2008; 17(3):241-2. DOI:10.1016/j.hlc.2006.12.003 · 1.17 Impact Factor
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    ABSTRACT: Deep hypothermia leading to cardiac arrest requires aggressive management for resuscitation. Various methods are available to rewarm the patient. We hereby present a case report where active resuscitation was carried out using cardiopulmonary bypass in a young female who was found unconscious with a core temperature of 26 degrees C. The relevant literature is also reviewed.
    Heart, Lung and Circulation 07/2008; 18(6):416-8. DOI:10.1016/j.hlc.2008.04.005 · 1.17 Impact Factor