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D Hurlbut

Publications and source records attributed to D Hurlbut.

12 recordsLinked to original sources
PubMed2005

Sonographic pitfalls in the diagnosis of enteric duplication cysts.

OBJECTIVE: The sonographic double wall sign has been well described in the literature and is often the cornerstone in suggesting the diagnosis of an enteric duplication cyst. We report two cases with this sign that were erroneously diagnosed as enteric cysts and a third case without this sonographic feature that proved to be a duplication cyst. Histologic analysis of the specimens helps explain the cause of the sonographic pitfalls. CONCLUSION: The potential sonographic visualization of the split hypoechoic muscularis propria layer or identification of all five layers will increase the specificity in making the sonographic diagnosis of duplication cyst.

Adolescent↗
PubMed2000

Anterior rectal duplication: a diagnostic challenge.

The authors present an anterior rectal cyst in a 14-month-old girl. This rare variant of rectal duplications presented with recurrent urinary infections. The diagnosis was challenging in view of the multiple differential diagnoses to be considered. Magnetic resonance imaging appeared to be the most accurate preoperative investigation. The cyst was removed uneventfully by partial excision and mucosal ablation. An awareness of this variant can lead to early diagnosis and curative resection.

Failure to Thrive↗
PubMed1999

Muscle quality. II. Effects Of strength training in 65- to 75-yr-old men and women.

To determine the effects of strength training (ST) on muscle quality (MQ, strength/muscle volume of the trained muscle group), 12 healthy older men (69 +/- 3 yr, range 65-75 yr) and 11 healthy older women (68 +/- 3 yr, range 65-73 yr) were studied before and after a unilateral leg ST program. After a warm-up set, four sets of heavy-resistance knee extensor ST exercise were performed 3 days/wk for 9 wk on the Keiser K-300 leg extension machine. The men exhibited greater absolute increases in the knee extension one-repetition maximum (1-RM) strength test (75 +/- 2 and 94 +/- 3 kg before and after training, respectively) and in quadriceps muscle volume measured by magnetic resonance imaging (1,753 +/- 44 and 1, 955 +/- 43 cm3) than the women (42 +/- 2 and 55 +/- 3 kg for the 1-RM test and 1,125 +/- 53 vs. 1,261 +/- 65 cm3 for quadriceps muscle volume before and after training, respectively, in women; both P < 0.05). However, percent increases were similar for men and women in the 1-RM test (27 and 29% for men and women, respectively), muscle volume (12% for both), and MQ (14 and 16% for men and women, respectively). Significant increases in MQ were observed in both groups in the trained leg (both P < 0.05) and in the 1-RM test for the untrained leg (both P < 0.05), but no significant differences were observed between groups, suggesting neuromuscular adaptations in both gender groups. Thus, although older men appear to have a greater capacity for absolute strength and muscle mass gains than older women in response to ST, the relative contribution of neuromuscular and hypertrophic factors to the increase in strength appears to be similar between genders.

Aged↗
PubMed1995

Multiorgan microsporidiosis: report of five cases and review.

We describe five cases and review 34 reported cases of multiorgan microsporidiosis. Most of the patients with multiorgan involvement have been adults with AIDS. Organs most commonly infected include the small intestine, urinary tract, biliary tree, and eye; involvement of the respiratory tract, nasal sinuses, and central nervous system is also described but appears to be less frequent. Although patients with multiorgan disease may be asymptomatic, clinical presentation usually relates to the involved organs. Enterocytozoon bieneusi and Septata intestinalis are the most frequently identified species of pathogens. An affinity for certain tissues is observed among different microsporidial species. In all but one case of E. bieneusi infection, infection was limited to intestinal and hepatobiliary tracts, a finding suggestive of local extension. In contrast, the patients infected with S. intestinalis had widespread involvement, suggesting true hematogenous or lymphatic dissemination. Treatment may have to be based on findings regarding which organs and specific microsporidial species are involved. Further investigation of the pathogenic tendencies and route of acquisition of these organisms and the therapeutic agents active against them is needed.

AIDS-Related Opportunistic Infections↗
PubMed1991

A comparison of heterotopic and orthotopic intestinal transplantation in rats.

Two surgical techniques are commonly used for small intestinal transplantation: heterotopic (accessory) intestinal grafting (HIT), where the small bowel is initially defunctioned with restoration of intestinal continuity at a later date, and orthotopic (in continuity) intestinal grafting (OIT), where the small bowel is immediately anastomosed to the native intestine. The present experiments were undertaken to compare the advantages and disadvantages of these two surgical models. Graft barrier function (intestinal permeability), intestinal histology, and graft survival were evaluated after heterotopic and orthotopic intestinal transplantation in the following groups of rats: group 1: isografts, group 2: untreated allografts, group 3: low-dose cyclosporine-treated allografts (subcutaneous CsA 2 mg/kg/day), and group 4: high-dose CsA-treated allografts (subcutaneous CsA 4 mg/kg/day). Intestinal permeability was consistently higher after HIT than OIT in all of the groups (ANOVA; P less than 0.01). Histological evidence of rejection appeared earlier after HIT than OIT (HIT 5th postoperative day (POD); OIT 7th POD; P less than 0.05). The mean survival of untreated allografts was longer after HIT than OIT (HIT 15.7 +/- 6 days, OIT 9.2 +/- 1 days, P less than 0.05). The rats treated with low-dose CsA after OIT lost weight and died of rejection after a mean survival time of 17.7 +/- 2 days, while the rats treated with low-dose CsA after HIT remained well until sacrifice on POD 28 (P less than 0.01). The rats with isografts and rats with allografts treated with high-dose CsA remained well after HIT and OIT until sacrifice on the 28th POD. These data suggest that nutrients and other factors in the succus entericus may improve gut barrier function and delay the onset of rejection after OIT. However, rejection of the orthotopic intestinal graft is usually fatal, while rejection of the heterotopic graft is often surprisingly well tolerated. These factors must be taken into consideration when choosing a surgical technique for intestinal transplantation in humans.

Animals↗
PubMed1991

Intestinal permeability and bacterial translocation following small bowel transplantation in the rat.

In addition to its role in absorbing nutrients, the intestinal mucosa provides an important barrier against toxins and bacteria in the bowel lumen. The present study evaluated gut barrier function following orthotopic (in continuity) intestinal grafting in rats. Graft histology, intestinal permeability, and bacterial translocation to the grafted mesenteric lymph nodes, the host's liver, and the host's spleen were assessed on the 3rd, 5th, and 7th postoperative days. The study group received no immunosuppression after allotransplantation. The two control groups included rats with isografts and rats with cyclosporine-treated allografts. On the 7th POD, the study animals had moderate transmural inflammation due to rejection, with normal histology in the isografts and CsA-treated allografts; increased intestinal permeability, measured by urinary excretion of oral 51Cr-EDTA (P less than 0.01); and increased number of bacteria in the MLN and spleen (P less than 0.05). The number of bacteria in the MLN and spleen of the study group positively correlated with the changes in intestinal permeability (P less than 0.05). Rejection of the orthotopic intestinal graft leads to increased intestinal permeability and bacterial translocation from the lumen of the graft to the host's reticuloendothelial system. Measures to improve gut barrier function and antibiotic therapy during rejection episodes may help reduce the incidence of septic complications after intestinal grafting.

Animals↗
PubMed1990

Pleuropulmonary morbidity: internal thoracic artery versus saphenous vein graft.

Although use of the internal thoracic artery (ITA) for coronary artery bypass grafting results in superior graft patency and improved patient survival, our initial clinical observations suggested an increased incidence of pleuropulmonary morbidity with its use. One hundred consecutive patients with left ITA grafts were studied prospectively and compared with a consecutive retrospective group of 100 patients undergoing coronary artery bypass grafting with saphenous vein grafts only. Preoperative, postoperative day (POD) 2, POD 6, and postoperative week 8 chest roentgenograms were analyzed for atelectasis and effusion. Postoperative left lower lobe atelectasis was common in both groups on both POD 2 (saphenous vein, 43%, versus ITA, 53%; not significant) and POD 6 (saphenous vein, 40%, versus ITA, 41%; not significant). There was a significantly higher incidence of pleural effusion on POD 6 in the ITA group (84% versus 47%; p less than 0.05) but most of these were small. There was more chest tube drainage (1,413 versus 1,028 mL; p less than 0.01) and a greater need for secondary thoracostomy or thoracentesis (4% versus 0%) in the ITA group. The left pleural space was opened in 67 of the 100 ITA patients but pleurotomy did not appear to influence postoperative morbidity. We conclude that use of the internal thoracic artery for coronary artery bypass grafting results in a small but significant increase in pleuropulmonary morbidity.

Chest Tubes↗