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Biomedical subjects

M C Hutton

Publications and source records attributed to M C Hutton.

5 recordsLinked to original sources

Three-dimensional time-of-flight MR angiography using selective inversion recovery RAGE with fat saturation and ECG-triggering: application to renal arteries.

A three-dimensional (3D), ECG-triggered, selective inversion recovery (SIR) rapid gradient-echo (RAGE) technique is proposed to obtain MR angiograms of the main renal arteries. By using the selective inversion recovery and fat saturation, the background is significantly suppressed while blood maintains a high signal intensity as compared with conventional 3D time-of-flight (TOF) MR angiography. The sequence is ECG-triggered so that blood in-flow is maximized during systole, and intravoxel dephasing and pulsatile flow artifacts are minimized by collecting data during diastole. As a result, vessel boundary blurring and ghosting artifacts due to background motion are dramatically reduced, and the conspicuity and lumen definition of the arteries are significantly improved. High-quality MR angiograms of the main renal arteries with excellent blood/tissue contrast and suppression of motion artifacts have been consistently obtained for normal volunteers, with the length of visualization being 51 +/- 07 mm for the left, and 57 +/- 06 mm for the right renal arteries, significantly greater than using conventional 3D TOF pulse sequences. Statistical analysis was performed by using a one-sided Student's t test.

Angiography↗

Peripheral vascular surgery.

Patients may present with a wide range of manifestations of arterial occlusive disease. The clinician must be able to assess the magnitude of the arterial flow diminution and thereby determine the appropriate treatment regimen. A careful history, physical examination, and pertinent noninvasive vascular laboratory tests should provide adequate information for the clinician to establish the severity of disease and the need to pursue a medical or surgical treatment plan. Patient evaluation must be carried out expeditiously, especially when limb-threatening conditions such as infection or gangrene exist, because these problems may progress rapidly and result in major lower extremity amputation.

Arterial Occlusive Diseases↗

Splenic injury: nonoperative management in three patients with infectious mononucleosis.

Three patients with infectious mononucleosis and splenic injury were managed nonoperatively. Mechanisms of injury included significant left upper quadrant trauma during a football game in a 17-year-old boy, a minor fall in a 16-year-old girl, and no apparent trauma in the remaining patient, a 28-year-old man. All had significant abdominal pain and two were hypotensive upon admission. All had computerized tomographic scan documentation of splenic enlargement, significant injury, and free peritoneal blood. Paracentesis was not performed. Only the first patient received transfused blood. The hospitalization period ranged from nine to 14 days. Gradual and finally complete healing (return to normal size) was documented in all three patients. Follow-up is 66, 14, and 10 months. Although clearly controversial and not free from danger, successful nonoperative management of the injured enlarged spleen in select patients with mononucleosis is possible in an appropriate setting.

Adolescent↗

Thrombosis of the aorta caused by mucormycosis.

We have reported the case of a 57-year-old man with a myelodysplastic syndrome who had sudden paraplegia and paresthesias of both legs. Myelogram was normal, but an aortogram showed thrombosis of the abdominal aorta. Thrombectomy disclosed a clot composed of nonseptate hyphae with right angle branching, characteristic of the family Mucoraceae. Though angioinvasion and septic thrombosis are characteristic features of mucormycosis, aortic thrombosis has not previously been reported with this infection.

Aorta, Abdominal↗

Young Investigator Award. In vivo treatment of infected prosthetic graft material with urokinase: an animal model.

PURPOSE: Pyogenic infection of vascular grafts represents a serious complication that may necessitate graft removal. If better treatment methods could be developed, perhaps some infected grafts could be salvaged and not removed. This study reports an animal model that evaluates the sterilization of contaminated vascular graft material implants with urokinase and antibiotics. MATERIALS AND METHODS: Polytetrafluoroethylene (PTFE) implants were incubated overnight in a known concentration of bacteria (Staphylococcus epidermidis) and were then implanted subcutaneously into four groups of anesthetized hamsters. The first group (control) received no treatment. The second group received urokinase injections twice daily into each abscess. The third group received intraabscess urokinase and systemic gentamicin twice daily. The fourth group received only systemic gentamicin. The hamsters were killed after 1 week. The graft implants and surrounding tissues were excised and submitted for quantitative cultures. RESULTS: With use of a cutoff value of 100 organisms per milliliter, below which the abscesses were considered noninfected, the following rates of noninfectivity were observed: group 1 (control), 5% noninfected; group 2 (urokinase only), 19.4%; group 3 (urokinase and gentamicin), 63.2%; and group 4 (gentamicin only), 32.5%. The noninfectivity rate of group 3 was significantly higher than that of all other groups combined (P < .001) and was significantly better than that of group 4 alone (P = .013). CONCLUSION: The combination of intraabscess urokinase and systemic gentamicin is very synergistic in graft sterilization. Urokinase may assist in the degradation of both fibrin and the biofilm produced by S epidermidis, thus improving penetration of antibiotics and local host defense mechanisms.

Abscess↗