Search PubMed⌕ Search

Biomedical subjects

M W Wilson

Publications and source records attributed to M W Wilson.

78 records · Page 5Linked to original sources
PubMedDate not supplied

Liver transplantation complicated by malpositioned transjugular intrahepatic portosystemic shunts.

PURPOSE: To report the surgical problems encountered during orthotopic liver transplantation as a result of a malpositioned transjugular intrahepatic portosystemic shunt (TIPS). PATIENTS AND METHODS: Three patients are described in whom TIPS stents were malpositioned in the following locations: extending into the main portal vein, extending into the suprahepatic inferior vena cava, and extending into the right atrium. RESULTS: Malpositioning of TIPS stents altered and prolonged the operation in all of these patients by interfering with cross-clamping at the usual vascular sites during liver transplantation. Incorporation of the stents into the vascular wall prevented transcatheter retrieval and increased the difficulty of intraoperative removal. CONCLUSION: Awareness of hepatic vascular anatomy is necessary in avoiding stent malpositioning. If malpositioning is identified, transcatheter approaches may be helpful in repositioning the stent. Otherwise, the transplant surgery team must be made aware of the problem for proper surgical planning prior to liver transplantation.

Adult↗
PubMedDate not supplied

Percutaneous transhepatic hepatic venography in the delineation and treatment of Budd-Chiari syndrome.

PURPOSE: To assess the usefulness of percutaneous transhepatic hepatic venography (PTHV) in planning interventional radiologic treatment of Budd-Chiari syndrome (BCS). MATERIALS AND METHODS: Six patients aged 14-56 years underwent examination for BCS. After preliminary transfemoral inferior vena cavography and selective hepatic venography failed in determining the extent of venous obstruction, PTHV was performed. RESULTS: PTHV completely depicted the proximal and distal extent of hepatic venous occlusion. Intraluminal thrombus in the right and middle hepatic veins shown in one patient was treated with fibrinolytic infusion and balloon thrombectomy. Central obstruction of the right hepatic vein shown in two patients was treated with venoplasty or venoplasty and stent placement. In three patients. PTHV showed a "spider web" appearance of diffuse obliteration of the normal intrahepatic venous architecture; a transjugular intrahepatic portosystemic shunt was placed in two of these patients. CONCLUSION: PTHV provides information not available with conventional venography that is useful in planning the treatment of BCS.

Adolescent↗
PubMedDate not supplied

Transcatheter embolization of biopsy-related vascular injury in the transplant kidney: immediate and long-term outcome.

PURPOSE: To assess the effect of transcatheter embolization for treatment of biopsy-related vascular injury in renal allografts, specifically evaluating technical success, clinical benefit, and long-term effect on renal function. MATERIALS AND METHODS: A retrospective review was performed of all postbiopsy renal allograft vascular injuries referred for embolization during a 113-month period. The likelihood of a prolonged detrimental effect on allograft function was estimated from observed variation in serum creatinine levels before and after the procedure. RESULTS: Embolic therapy with use of metallic coils and superselective technique was performed in 21 renal transplant patients. Technical success was achieved in 95% of cases. There were no serious complications. Eradication of the clinical sign or symptom prompting referral was seen in 15 of 17 (88%) patients. Eleven of 19 (58%) patients analyzed demonstrated no evidence of a long-term detrimental effect on allograft function. A detrimental effect was possibly present in six of 19 (32%) patients, and probable in only two of 19 (10%) patients. CONCLUSIONS: Transcatheter embolization can be an appropriate and effective therapeutic choice for biopsy-related renal allograft vascular injury.

Adolescent↗
PubMedDate not supplied

Solid-supported syntheses of 3-thio-1,2,4-triazoles.

Two solid-supported synthesis strategies for the preparation of 3-thio-1,2,4-triazoles are described. In the first, Rink amide resin is combined with Fmoc-protected omega-amino acids, acid hydrazides, and alkyl halides to provide diverse sets of starting materials from which numerous triazoles may be prepared. The second employs t-alkylcarbamate resin (Boc resin) which permits the use of additional pools of starting materials, including isothiocyanates and alpha- and omega-amino esters, resulting in triazoles with patterns of functional groups that are not possible from the initial route. The combination of multiple resins and resin attachment sites allows the preparation of a diverse library based upon the 3-thio-1,2,4-triazole scaffold and avoids the pitfall of having a single linker functionality present at the same position in all library members. General synthetic procedures and representative products from each route are presented. A similarity analysis of representative sublibraries from each synthesis strategy concludes that variation of the solid-phase linker chemistry and attachment site can enhance molecular diversity of the combined triazole library.

Amino Acids↗
PubMedDate not supplied

A reference system for neuroanatomical localization on functional reconstructed cerebral images.

The correlation of anatomical with functional brain images is of critical importance for data analysis. We have designed and tested a reference system method that provides accurate localization of neuroanatomy on functional brain images. The method differs from prior techniques using headholding devices in that it does not require head fixation and is noninvasive. The reference system can be quickly, accurately, and reproducibly applied to the patient's head with respect to the surface anatomy of the head. The reference system is easily adaptable to multiple imaging modalities. The reference system is implemented with the aid of a computer algorithm that reconstructs the anatomic images into a new image matching a selected functional image. Accuracy and reproducibility of placement of the reference system was demonstrated by the application of the system on multiple subjects by two independent observers. The use of this method provides accurate correlation between functional and anatomical brain images.

Brain Mapping↗