26
|
Neymark E, LaBerge JM, Hirose R, Melzer JS, Kerlan RK, Wilson MW, Gordon RL. Arteriographic detection of renovascular disease in potential renal donors: incidence and effect on donor surgery. Radiology 2000; 214:755-60. [PMID: 10715042 DOI: 10.1148/radiology.214.3.r00mr18755] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the arteriographic incidence and severity of renal arterial disease in potential renal donors and to evaluate the effect of identifying vascular abnormalities on subsequent donor surgery. MATERIALS AND METHODS The records of 716 potential living renal donors who underwent conventional arteriography were reviewed. Abnormal arteriograms were reexamined to characterize vascular disease, and the effect of identifying renovascular disease on subsequent donor surgery was ascertained with chart review. RESULTS Renovascular abnormalities were noted in the dictated reports in 78 patients (10.9%). The most common causes were fibromuscular dysplasia and atherosclerosis. The arteriograms of 64 patients were available for retrospective review. Abnormalities were characterized as minimal stenosis (<30% narrowing) in 42 patients and mild stenosis (30%-50% narrowing) in 19 of 61 patients with arteriographic abnormalities at retrospective review. In three patients, no significant abnormality was seen at retrospective review. The effect of detecting renovascular disease on donor selection was determined in 74 of the 78 patients. In 73 of these 74 patients (99%), detection of an abnormality directly affected donor surgery. CONCLUSION In this population of potential renal donors, the arteriographic incidence of renovascular disease (10.9%) was higher than previously reported. Although renovascular abnormalities were mild, their detection influenced the plan for donor surgery in almost all patients.
Collapse
|
27
|
Wilson MW, Gordon RL, LaBerge JM, Saavedra J, Kerlan RK. Intravascular occluding device using a modified Gianturco stent as a coil cage. J Vasc Interv Radiol 2000; 11:221-4. [PMID: 10716394 DOI: 10.1016/s1051-0443(07)61469-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
28
|
Chuter TA, Reilly LM, Faruqi RM, Kerlan RB, Sawhney R, Canto CJ, LaBerge JM, Wilson MW, Gordon RL, Wall SD, Rapp J, Messina LM. Endovascular aneurysm repair in high-risk patients. J Vasc Surg 2000; 31:122-33. [PMID: 10642715 DOI: 10.1016/s0741-5214(00)70074-7] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the role of endovascular aneurysm repair in high-risk patients. METHODS The elective endovascular repair of infrarenal aortic aneurysm was performed in 116 high-risk patients with either custom-made or commercial stent grafts. The routine follow-up examination included contrast-enhanced computed tomography (CT) before discharge, at 3, 6, and 12 months, and annually thereafter. Patients with endoleak on the initial CT underwent re-evaluation at 2 weeks. Those patients with positive CT results at 2 weeks underwent endovascular treatment. RESULTS Endovascular repair was considered feasible in 67% of the patients. The mean age was 75 years, and the mean aneurysm diameter was 6.3 cm. The American Society of Anesthesiologists grade was II in 3.4%, III in 65.5%, IV in 30.1%, and V in 0.9%. There were no conversions to open repair. Custom-made aortomonoiliac stent grafts were implanted in 77.6% of the cases, custom-made aortoaotic stent grafts in 11.2%, and commercial bifurcated stent grafts in 11.2%. The 30-day rates of mortality, major morbidity, and minor morbidity were 3.4%, 20.7%, and 12%, respectively, in the first 58 patients and 0%, 3.4%, and 3.4%, respectively, in the last 58. The late complications included five cases of stent graft kinking, two cases of femorofemoral graft occlusion, and three cases of proximal stent migration, one of which led to aneurysm rupture. At 2 weeks after repair, endoleak was present in 10.3% of the cases. All the type I (direct perigraft) endoleaks underwent successful endovascular treatment, whereas only one type II (collateral) endoleak responded to treatment. The technical success rate at 2 weeks was 86.2%, and the clinical success rate was 96.6%. The continuing success rate was 87.9%. Seventeen patients died late, unrelated deaths. CONCLUSION Endovascular aneurysm repair is safe and effective in patients at high risk, for whom it may be the preferred method of treatment.
Collapse
|
29
|
LaBerge JM, Sawhney R, Wall SD, Chuter TA, Canto CJ, Wilson MW, Kerlan RK, Gordon RL. Retrograde catheterization of the inferior mesenteric artery to treat endoleaks: anatomic and technical considerations. J Vasc Interv Radiol 2000; 11:55-9. [PMID: 10693714 DOI: 10.1016/s1051-0443(07)61281-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
30
|
Bloom AI, Wilson MW, Kerlan RK, Gordon RL, LaBerge JM. Talc pleurodesis through small-bore percutaneous tubes. Cardiovasc Intervent Radiol 1999; 22:433-6. [PMID: 10501900 DOI: 10.1007/s002709900422] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pleurodesis using talc as the sclerosing agent is an effective procedure for preventing reaccumulation of malignant pleural effusions. Because of its thickness, the talc slurry is usually instilled through large bore (20-28 Fr), surgically placed thorocostomy tubes. However, these tubes often cause considerable patient discomfort. Herein we report a series of eight patients in whom the talc slurry was inserted through 10 and 12 Fr percutaneous chest tubes. Six of the eight patients (75%) had a successful pleurodesis without a reaccumulation of fluid. We conclude that this is an acceptable method for treating patients with malignant pleural effusions.
Collapse
|
31
|
Wilson MW, Hungerford JL. Comparison of episcleral plaque and proton beam radiation therapy for the treatment of choroidal melanoma. Ophthalmology 1999; 106:1579-87. [PMID: 10442907 DOI: 10.1016/s0161-6420(99)90456-6] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To compare the efficacy of iodine-125 (125I) and ruthenium-106 (106Ru) episcleral plaque radiation therapy and proton beam radiation therapy (PBRT) in the treatment of choroidal melanoma. DESIGN A retrospective, nonrandomized comparative study. METHODS Charts of patients treated with 125I, 106Ru, and PBRT for choroidal melanoma between January 1988 and June 1996 at St. Bartholomew's Hospital and Moorfields Eye Hospitals were reviewed. MAIN OUTCOME MEASURE Local control of choroidal melanomas after 125I, 106Ru, or PBRT. RESULTS A total of 597 patients were identified (125I = 190, 106Ru = 140, PBRT = 267). Patients treated with 106Ru had a significantly greater risk of local tumor recurrence than did patients treated with either 125I (P = 0.0133; confidence interval [CI], 1.26-7.02; risk ratio, 2.97) or PBRT (P = 0.0097; CI, 1.30-6.66; risk ratio, 2.94). A stepwise Cox proportional hazard model found maximal basal diameter to be a significant covariate (P = 0.0033). CONCLUSION Patients treated with 106Ru had a significantly greater risk of local tumor recurrence than did those patients treated with either 125I or PBRT.
Collapse
|
32
|
Bloom AI, Gordon RL, Ahl KH, Kerlan RK, LaBerge JM, Wilson MW, Venook AP, Warren R. Transcatheter embolization for the treatment of misperfusion after hepatic artery chemoinfusion pump implantation. Ann Surg Oncol 1999; 6:350-8. [PMID: 10379855 DOI: 10.1007/s10434-999-0350-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The use of surgically implanted chemoinfusion pumps for the treatment of hepatic metastases from colorectal carcinoma can be complicated by intra- or extrahepatic misperfusion. This may result in suboptimal tumor exposure to the chemotherapeutic agent and injury to other gastrointestinal organs. Misperfusion can be managed by selective arterial transcatheter embolization. METHODS Between 1989 and 1996, 16 patients with liver metastases from colorectal carcinoma and with hepatic artery chemoinfusion pump misperfusion were treated using transcatheter coil embolization. Six female and 10 male patients (age range, 34-84 years; median, 51.5 years) were identified by retrospective review of the records of the Department of Interventional Radiology. After pump placement, abnormal liver perfusion scan or methylene blue endoscopy study results prompted angiography with coil embolization. After embolization, the imaging studies were repeated and patients were monitored in the Oncology Clinic. RESULTS Eight patients exhibited intrahepatic misperfusion (group 1) and eight extrahepatic misperfusion (group 2). Coil embolization was immediately successful in 100% of patients in group 1, with restoration of normal hepatic perfusion, and in 75% in group 2. There were no immediate procedure-related complications. Follow-up periods ranged from 1 to 23 months (median, 13.5 months). Embolization was unsuccessful for two patients (in group 2), who tolerated a modified chemotherapeutic regimen, with follow-up periods of 18.5 and 22 months. CONCLUSIONS Transcatheter coil embolization is the therapy of choice for the management of hepatic artery chemoinfusion pump misperfusion. It is rapid, effective, and well tolerated by patients and obviates the need for additional surgical intervention.
Collapse
|
33
|
Ault-Justus SE, Hodges JC, Wilson MW. Generation of a library of 4-thiazolidinones utilizing polymer supported quench (PSQ) reagent methodology. Biotechnol Bioeng 1999; 61:17-22. [PMID: 10099492 DOI: 10.1002/(sici)1097-0290(199824)61:1<17::aid-bit6>3.0.co;2-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A one-pot, three-component, solution-phase synthesis of 2, 3-disubstituted and 2,3,5-trisubstituted 4-thiazolidinones is described. Poly(styrene-co-divinylbenzene)-supports functionalized with tris(2-aminoethyl)amine and 2-amino-ethanethiol are used to remove excess reagents from the desired product upon completion of the reaction. Simple filtration followed by concentration provides products of sufficient purity for biological evaluation. This approach has been used for a parallel combinatorial generation of a library of multi-substituted 4-thiazolidinones. Copyright 1998 John Wiley & Sons, Inc.
Collapse
|
34
|
Bhagat VJ, Wilson MW, Sudilovsky D, LaBerge JM, Gordon RL, Kerlan RK. Percutaneous biopsy of a posterior mediastinal mass through an extrapleural window created with dilute contrast. J Thorac Imaging 1999; 14:99-100. [PMID: 10210480 DOI: 10.1097/00005382-199904000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Extrapleural administration of dilute contrast was used to facilitate biopsy of a posterior mediastinal mass.
Collapse
|
35
|
Lauer AK, Wobig JL, Shults WT, Neuwelt EA, Wilson MW. Severe ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy. Am J Ophthalmol 1999; 127:230-3. [PMID: 10030580 DOI: 10.1016/s0002-9394(98)00346-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To report severe ocular and orbital toxicity after administration of intracarotid etoposide phosphate and carboplatin. METHOD Case report. RESULTS A 52-year-old man with glioblastoma multiforme underwent left intracarotid administration of eto poside phosphate and carboplatin inferior to the ophthalmic artery. Within 7 hours, a nonpupillary block angle-closure glaucoma developed secondary to uveal effusion in the ipsilateral eye, which was relieved by cycloplegia. Four days later, severe orbital inflammation resulted in a visual acuity of counting fingers, proptosis, optic neuropathy, and total external ophthalmoplegia in the eye. The patient's condition improved after a lateral cantholysis and administration of high-dose intravenous corticosteroids. Two weeks later, an anterior uveitis occurred in the left eye, which responded to topical corticosteroids. During a 2-month period, the patient recovered to a visual acuity of 20/70, near normal motility, and normal intraocular pressure, and the ocular and orbital inflammation resolved. Preexisting ipsilateral chemotherapy-induced maculopathy became more pronounced. CONCLUSION Ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy is infrequently reported.
Collapse
|
36
|
Perini S, Gordon RL, Golden JA, LaBerge JM, Wilson MW, Kerlan RK. Deformation and migration of Palmaz stents after placement in the tracheobronchial tree. J Vasc Interv Radiol 1999; 10:209-15. [PMID: 10082110 DOI: 10.1016/s1051-0443(99)70466-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
37
|
AAssar OS, LaBerge JM, Gordon RL, Wilson MW, Mulvihill SJ, Way LW, Kerlan RK. Percutaneous management of abscess and fistula following pancreaticoduodenectomy. Cardiovasc Intervent Radiol 1999; 22:25-8. [PMID: 9929541 DOI: 10.1007/s002709900324] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the efficacy of percutaneous drainage of fluid collections following pancreaticoduodenectomy (Whipple's procedure). METHODS We performed a retrospective review of 19 patients referred to our service with fluid collections following pancreaticoduodenectomy. The presence of associated enteric or biliary fistulas, the route(s) of access for image-guided drainage, the incidence of positive bacterial cultures, and the duration and success of percutaneous management were recorded. RESULTS Fistulous communication to the jejunum in the region of the pancreatico-jejunal anastomosis was demonstrable in all 19 patients by gentle contrast injection into drainage tubes. Three patients had concurrent biliary fistulas. In 18 of 19 patients, fluid samples yielded positive bacterial cultures. Successful percutaneous evacuation of fluid was achieved in 17 of 19 patients (89%). The mean duration of drainage was 31 days. CONCLUSION Percutaneous drainage of abscess following pancreaticoduodenectomy is effective in virtually all patients despite the coexistence of enteric and biliary fistulas.
Collapse
|
38
|
Wilson MW, Wobig JL, Dailey RA. Infection of a porous polyethylene orbital implant with Capnocytophaga. Ophthalmic Plast Reconstr Surg 1998; 14:398-402. [PMID: 9842559 DOI: 10.1097/00002341-199811000-00003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 68-year-old woman experienced an infection of a porous polyethylene orbital implant caused by Capnocytophaga after a dental procedure. The infection was unresponsive to both topical and oral antibiotics and required removal of the porous polyethylene orbital implant. Capnocytophaga is a capnophilic, gram-negative bacillus. Capnocytophaga is a normal commensal of the mouth and is responsible for both gingivitis and periodontal disease. Capnocytophaga is a rare cause of ocular infections. This is the first reported patient with an infection of a porous polyethylene orbital implant caused by Capnocytophaga. The authors believe infected integrated orbital implants must be removed because neither topical or systemic therapy provide effective treatment.
Collapse
|
39
|
Perini S, Gordon RL, LaBerge JM, Kerlan RK, Wilson MW, Feng S, Ring EJ. Transcatheter embolization of biopsy-related vascular injury in the transplant kidney: immediate and long-term outcome. J Vasc Interv Radiol 1998; 9:1011-9. [PMID: 9840051 DOI: 10.1016/s1051-0443(98)70442-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
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.
Collapse
|
40
|
Bhagat VJ, Gordon RL, Osorio RW, LaBerge JM, Kerlan RK, Melzer JS, Bretan PN, Wilson MW, Ring EJ. Ureteral obstructions and leaks after renal transplantation: outcome of percutaneous antegrade ureteral stent placement in 44 patients. Radiology 1998; 209:159-67. [PMID: 9769827 DOI: 10.1148/radiology.209.1.9769827] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To analyze the outcome of percutaneous antegrade ureteral stent placement for treatment of ureteral stenoses and leaks after renal transplantation. MATERIALS AND METHODS Antegrade pyelography and percutaneous ureteral stent placement were performed in 45 patients with ureteral obstruction (n = 40), leak (n = 3), or both (n = 2). Obstructions were graded as mild, moderate, or complete, and as early (< or = 3 months after transplantation) or late (> 3 months). RESULTS The outcome of stent placement was successful in 25 (57%) patients (average follow-up, 30 months). The ureteroneocystostomy (UNC) was the most common site of obstructions (22 of 41), leaks (four of five), and successful outcomes (16 of 22). Moderate obstructions were most common (29 of 41) and responded best to treatment (17 of 29). Eighteen (69%) of 26 early obstructions and five (33%) of 15 late obstructions were successfully managed percutaneously. All complications (12 of 45 patients) were minor, with infections the most common (n = 7). No mortality or allograft loss was attributable to stent placement. CONCLUSION Ureteral stents are safe and effective for the treatment of obstructions and leaks and are particularly effective for early and UNC obstructions. These stents may also be useful for temporary drainage.
Collapse
|
41
|
LaBerge JM, Kerlan RK, Wilson MW, Gordon RL. Use of a new percutaneous thrombolytic device for percutaneous removal of biliary stones. AJR Am J Roentgenol 1998; 171:1048-50. [PMID: 9762994 DOI: 10.2214/ajr.171.4.9762994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
42
|
Wilson MW, Hamilton BH, Dong Q, Stafford-Johnson DB, Kazanjian SN, Williams DM, Marx MV, Cho KJ, Prince MR. Gadolinium-enhanced magnetic resonance venography of the portal venous system prior to transjugular intrahepatic portosystemic shunts and liver transplantation. Original investigation. Invest Radiol 1998; 33:644-52. [PMID: 9766049 DOI: 10.1097/00004424-199809000-00020] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES The accuracy of gadolinium-enhanced magnetic resonance venography (GdMRV) in identifying visceral venous abnormalities was assessed in patients before they underwent transjugular intrahepatic portosystemic shunt (TIPS) or orthotopic liver transplantation (OLT). METHODS Twenty-seven patients with portal hypertension underwent GdMRV and transcatheter venography prior to OLT or TIPS. The gadolinium dose was 0.5 mL/kg (0.25 mmol/kg), administered by rapid hand injection. Coronal 3D spoiled gradient-echo GdMRV was performed in a single breath-hold. Four blinded reviewers retrospectively evaluated coronal maximum intensity projection (MIP) images, while two reviewers evaluated the MIPs and multiplanar reconstructions. Abnormalities that could affect transjugular intrahepatic portosystemic shunt or transplantation were noted and compared with the results of corresponding catheter venograms read by a separate blinded reviewer. RESULTS Abnormalities were identified by GdMRV with a sensitivity and specificity of 83% and 97% for the right hepatic vein, 86% and 100% for the main portal vein (MPV), 42% and 99% for the right portal vein, 54% and 94% for the left portal vein, 61% and 96% for the superior mesenteric vein, and 74% and 91% for the splenic vein. Varices and shunts were correctly identified with a sensitivity of 96%. Multiplanar reconstruction increased MPV sensitivity to 100%. CONCLUSION Vascular abnormalities that affect TIPS and OLT can be identified by GdMRV. Multiplanar reconstruction increased the accuracy to 100% for the MPV.
Collapse
|
43
|
Wilson MW, Hernández AS, Calvet AP, Hodges JC. Solid-supported syntheses of 3-thio-1,2,4-triazoles. Mol Divers 1998; 3:95-112. [PMID: 9593179 DOI: 10.1023/a:1009696119443] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
Collapse
|
44
|
Wilson MW, Leung LK, Hong JT, Glauert HP. Effect of the peroxisome proliferators ciprofibrate and perfluorodecanoic acid on eicosanoid concentrations in rat liver. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1998; 400A:439-45. [PMID: 9547588 DOI: 10.1007/978-1-4615-5325-0_59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
45
|
Lehman JD, Gordon RL, Kerlan RK, Laberge JM, Wilson MW, Golden JA, Webb WR. Expandable metallic stents in benign tracheobronchial obstruction. J Thorac Imaging 1998; 13:105-15. [PMID: 9556287 DOI: 10.1097/00005382-199804000-00005] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Expandable metallic stents offer advantages over previously available techniques for treating benign tracheobronchial stenosis or obstruction. Endoluminal stent placement offers a rapid and effective means of opening up narrowed airways, and results in excellent relief of symptoms and improvement in pulmonary function. Because they are delivered in a nonexpanded state using flexible over-wire systems, they can be placed using a flexible bronchoscope and can be located in second-order bronchial branches. Metallic stents have been used to treat benign airway obstruction caused by anastomotic narrowing after lung transplantation, infection, congenital lesions, tracheobronchial malacia, inflammatory conditions including relapsing polychondritis, Wegener granulomatosis, and acquired immunodeficiency syndrome, and external compression from benign mediastinal masses or fibrosis. The stents become epithelialized, which prevents migration and permits ciliary activity to continue. Significant complications can occur, including airway inflammation, stent migration, airway erosion, and stent fracture and collapse, but more serious complications are uncommon. Computed tomography is essential in imaging patients being considered for stent placement, as it allows 1) accurate representation of airway anatomy in three dimensions. 2) measurement of airway diameter, 3) evaluation of airway anatomy distal to a narrowed segment and invisible to bronchoscopy, 4) demonstration of dynamic changes in airway morphologic features during forced exhalation in patients with airway malacia, and 5) demonstration of focal or diffuse air trapping in lung peripheral to the abnormal airway. In patients who have had stent placement, computed tomography is valuable in assessing airway morphologic features and dynamics distal to the stent, and can be valuable in assessing stent dysfunction.
Collapse
|
46
|
Grossniklaus HE, Wojno TH, Wilson MW, Someren AO. Myoepithelioma of the lacrimal gland. ARCHIVES OF OPHTHALMOLOGY (CHICAGO, ILL. : 1960) 1997; 115:1588-90. [PMID: 9400797 DOI: 10.1001/archopht.1997.01100160758017] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A right orbital tumor was excised from a 76-year-old woman. Pathological examination showed that the tumor was composed of spindle to cuboidal cells arranged in a solid to trabecular pattern. Immunohistochemical stains were positive for S-100 protein, muscle-specific actin, cytokeratins MAK6 and AE1,3, and glial fibrillary acid protein and negative for CD34 in tumor cells. Ultrastructural features of tumor cells included microvillous processes, intercellular junctions, and intracytoplasmic filaments with electron densities. To our knowledge, this is the first non-spindle cell myoepithelioma noted to arise in the lacrimal gland. This tumor likely has a similar biological behavior to pleomorphic adenoma (benign mixed tumor).
Collapse
|
47
|
Wilson MW, Hungerford JL, George SM, Madreperla SA. Topical mitomycin C for the treatment of conjunctival and corneal epithelial dysplasia and neoplasia. Am J Ophthalmol 1997; 124:303-11. [PMID: 9439356 DOI: 10.1016/s0002-9394(14)70822-0] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To evaluate the efficacy of topical mitomycin C in treating conjunctival and corneal epithelial dysplasia and neoplasia. METHODS Seven eyes of seven patients with conjunctival and corneal epithelial dysplasia and neoplasia were treated with one drop of topical mitomycin C 0.04% four times a day for 7 days in alternate weeks. The patients' charts were reviewed retrospectively. Patients with either multiple recurrences or extensive ocular surface involvement were treated. In all eyes, the diagnosis of epithelial dysplasia or neoplasia was confirmed by histopathology before the onset of therapy. Patients were examined at least every 14 days during treatment and examined at intervals after completion of treatment. RESULTS With topical mitomycin C, six eyes of seven patients had complete clinical regression of their conjunctival and corneal epithelial dysplasia and neoplasia. One eye of one patient had partial clinical regression of conjunctival and corneal epithelial dysplasia. Follow-up after completion of topical mitomycin C therapy and excision of residual disease ranged from 2 to 16 months (mean, 9 months; SD, 4.3 months) and was without clinical sign of recurrence. Topical mitomycin C therapy was associated with transitory ocular discomfort, conjunctival injection, tearing, photophobia, and punctate epithelial keratopathy. CONCLUSION In this small series of eyes, topical mitomycin C was effective as a treatment for conjunctival and corneal epithelial dysplasia and neoplasia.
Collapse
|
48
|
Gordon RL, Ahl KL, Kerlan RK, Wilson MW, LaBerge JM, Sandhu JS, Ring EJ, Welton ML. Selective arterial embolization for the control of lower gastrointestinal bleeding. Am J Surg 1997; 174:24-8. [PMID: 9240947 DOI: 10.1016/s0002-9610(97)00044-5] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Transcatheter embolization is accepted as a safe method for treating acute bleeding from the upper gastrointestinal (GI) tract. Hesitancy persists using this technique below the ligament of Treitz, based on the belief that the risk of intestinal infarction is unacceptably high, despite mounting clinical evidence to the contrary. METHODS A series of 17 consecutive patients with angiographically demonstrated small intestinal or colonic bleeding was retrospectively reviewed. The success and complication rate of subselective embolization was assessed. RESULTS Bleeding was stopped in 13 of 14 patients (93%) in whom embolization was possible, and in 13 of 17 patients (76%) where there was an intention to treat. Sufficiently selective catheterization to permit embolization could not be achieved in 3 patients. No clinically apparent bowel infarctions were caused. CONCLUSION Subselective embolization is a safe treatment option for lower GI bleeding, suitable for many patients and effective in most. Careful technique and a readiness to abandon embolization when a suitable catheter position cannot be achieved are important.
Collapse
|
49
|
Glauert HP, Hong JT, Leung LK, Wilson MW. Role of eicosanoid metabolism in carcinogenesis by peroxisome proliferators. Ann N Y Acad Sci 1996; 804:719-21. [PMID: 8993604 DOI: 10.1111/j.1749-6632.1996.tb18679.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
50
|
White AD, Creswell MW, Chucholowski AW, Blankley CJ, Wilson MW, Bousley RF, Essenburg AD, Hamelehle KL, Krause BR, Stanfield RL, Dominick MA, Neub M. Heterocyclic ureas: inhibitors of acyl-CoA:cholesterol O-acyltransferase as hypocholesterolemic agents. J Med Chem 1996; 39:4382-95. [PMID: 8893833 DOI: 10.1021/jm960404v] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A series of diaryl-substituted heterocyclic ureas was prepared, and their ability to inhibit acyl-CoA: cholesterol O-acyltransferase (ACAT) in vitro and to lower plasma total cholesterol in cholesterol-fed animal models in vivo was examined. N-(2,6-Diisopropylphenyl)-N'-tetrazole or isoxazole-substituted heterocyclic ureas proved optimal. A carbon chain of 11-14 carbons substituted 1,3 with respect to the amine provided the optimal side chain. Substitution of the alkyl chain generally lowered activity. Tetrazole urea 2i dosed at 3 mg/kg lowered plasma total cholesterol (TC) 67% in an acute, cholesterol-fed (C-fed) rat model of hypercholesterolemia and 47% in C-fed dogs. Tetrazole 2i, dosed at 10 mg/kg, also lowered TC 52% and raised HDL cholesterol 113% in rats with pre-established hypercholesterolemia.
Collapse
|