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Biomedical subjects

C A Moore

Publications and source records attributed to C A Moore.

At least 109 records · Page 6Linked to original sources
PubMed1988

Neural tube defects and omphalocele in trisomy 18.

A trisomy 18 fetus with severe congenital anomalies including craniorachischisis, large omphalocele, and bilateral cleft lip and palate is reported. The occurrence of neural tube defects and/or omphalocele in reported cases of trisomy 18 is discussed and the frequency of these anomalies in 85 trisomy 18 patients evaluated at Indiana University School of Medicine from 1963 to 1986 is reviewed. In this series of patients the frequency of neural tube defects was 7.0% and the frequency of omphaloceles was 5.9%. The percentage of these findings in our cases supports the premise that neural tube defects and omphaloceles are part of the trisomy 18 phenotype. Since fetuses with trisomy 18 are subject to early fetal loss or premature birth, the more subtle physical features of this condition may not be apparent. Thus, karyotyping of fetuses and premature infants with either neural tube defect or omphalocele should be considered.

Abnormalities, Multiple↗
PubMed1987

Acephalus-acardia in twins with aneuploidy.

Since 1963, 11 cases have been reported in which both the acardiac twin and the "normal" co-twin were studied cytogenetically. Aneuploidy or polyploidy was clearly identified in the acardiac twin in 7 cases and in the co-twin in 1 case. We report on 2 additional twin pairs in which aneuploidy was associated with acephalus-acardia. In both cases the "normal" co-twin had a Klinefelter (47,XXY) karyotype. Chromosome analysis in the 2 acardiac twins documented a 47,XXY constitution in one and 94,XXXXYY anomaly in the other. One of the "normal" co-twins also had the VATER association. Given these data we would recommend chromosome analysis of both members of a twin pair when one has acephalus-acardia.

Abnormalities, Severe Teratoid↗
PubMed1987

Spatial organization of human perioral reflexes.

Reflex responses recorded from the upper and lower divisions of the human orbicularis oris muscle were studied as a function of the site of stimulation. Stimuli were applied to 11 sites, ranging from the glabrous skin of the upper and lower lip vermilion borders to the hairy skin of the cheek. Highly localized, innocuous mechanical stimuli were created by displacing a servo-controlled probe over the surface of the perioral skin. Reflex response amplitude was strongly dependent on the site of stimulation. Stimulation of some sites, for example the ipsilateral corner of the mouth, the chin, and cheek, produced no responses, whereas stimulation of other sites, particularly the ipsilateral vermilion borders, produced large reflex responses. Changes in response amplitude as a function of stimulation site were the same for the upper lip and lower lip muscle recordings, with the largest responses at both recording sites produced by stimulation of the ipsilateral upper lip vermilion border. These results suggest that the upper and lower divisions of orbicularis oris share common synaptic drive, at least from inputs generated via reflex pathways, and that the upper vermilion border may be more densely innervated with mechanoreceptors than the lower. The latter hypothesis was supported by an additional experiment examining two-point discrimination thresholds for the glabrous skin of the upper and lower lips. Two-point thresholds were significantly smaller for the upper compared with the lower lip vermilion border.

Adult↗
PubMed1986

Relationship between amplitude of tremor and reflex responses of the human jaw-closing system.

Jaw-closing force was transduced while subjects maintained a biting force of 9.8 N. To estimate the amplitude of tremor in each subject's force record, the average spectrum of the force was computed, and the definite integral of the averaged spectrum in the frequency range from 3.5 to 10 Hz was calculated. For the same subjects, the amplitude of reflex responses to innocuous mechanical stimuli delivered to intraoral and perioral sites was measured as the peak-to-peak change in jaw-closing force following application of the stimulus. Force responses produced by stimulation at each site were used to compute an average reflex response measure for each subject. Large intersubject variability was observed in the amplitudes of jaw tremor and reflex responses. A correlation coefficient computed between the tremor and reflex measures revealed that subjects with large amplitude tremor tended also to have large reflex force responses. This correlation is consistent with the suggestion that activity in cutaneous reflex pathways contributes to tremor of the human mandible.

Electromyography↗
PubMed1986

Myocardial contrast echocardiography in humans: I. Safety--a comparison with routine coronary arteriography.

Myocardial contrast echocardiography is a new diagnostic cardiovascular imaging technique capable of defining perfusion zones of coronary vessels in vivo; ultimately, it may be used to measure absolute regional myocardial blood flow. However, before it can be used in humans, its safety must be clearly established. Accordingly, the electrocardiographic and hemodynamic effects of intracoronary injections of 2 cc of sonicated Renografin-76 were compared with 5 to 10 cc of non-sonicated Renografin-76 in 10 subjects with normal coronary arteries. Two cubic centimeters of sonicated Renografin provides optimal myocardial opacification during echocardiography, while 5 to 10 cc of Renografin is required for an adequate coronary arteriogram. During coronary arteriography, heart rate decreased while PR and QT intervals and QRS duration increased as compared with baseline and myocardial contrast echocardiography (p less than 0.01). Similarly, the decrease in aortic pressure and first derivative of left ventricular pressure (dP/dt) was significantly (p less than 0.01) greater during routine coronary arteriography than during myocardial contrast echocardiography. Changes in left ventricular end-diastolic or pulmonary capillary wedge pressure were similar during myocardial contrast echocardiography and coronary angiography. There were no significant differences in the duration of electrocardiographic and hemodynamic changes between myocardial contrast echocardiography and coronary arteriography. It is concluded that intracoronary injection of 2 cc of sonicated Renografin-76 provides optimal myocardial opacification. It is safe in humans, producing transient electrocardiographic and hemodynamic alterations that are less pronounced than those seen during routine coronary angiography.

Adult↗
PubMed1986

Uterine activity during sleep.

REM-related increases in uterine activity were found in 10 healthy young adult volunteer subjects. Contraction baseline pressures were elevated compared with NREM sleep, stage 2 sleep, stages 3 and 4 slow wave sleep (SWS), and stage 0. Contraction amplitudes during REM sleep were greater than those during SWS and stage 0, while contraction rates differed only between REM sleep and SWS. The results strongly indicated a cycle of genital activity in women that parallels the penile erection cycle in men. The implications of this finding and suggestions for future research are discussed.

Adult↗
PubMed1986

Postinfarction ventricular septal rupture: the importance of location of infarction and right ventricular function in determining survival.

Over a 5.5 year period, 1264 consecutive patients with acute myocardial infarction as confirmed by enzyme levels were prospectively identified. Of these, 25 (2%) suffered ventricular septal rupture (pulmonary/systemic flow range 1.5 to 6) 7 +/- 7 days after onset of myocardial infarction. Death occurred in 14 patients (56%) and was more common after inferior than anterior myocardial infarction (11 of 15 [73%] vs three of 10 [30%], p less than .05). Among 133 variables analyzed, survivors and nonsurvivors were similar with respect to all premorbid clinical characteristics, infarct size as assessed by peak creatine kinase values, shunt size, two-dimensional echocardiographic and hemodynamic indexes of left ventricular function, and extent of coronary disease. Compared with survivors, the nonsurvivors had greater impairment of right ventricular function as determined by a higher two-dimensional echocardiographically derived right ventricular wall motion index (RVWMI) (0.55 +/- 0.87 vs 1.70 +/- 0.45, p less than .001), greater elevation of right ventricular end-diastolic pressure (11 +/- 6 vs 17 +/- 6, p less than .02), and greater mean right atrial pressure (10 +/- 6 vs 16 +/- 3, p less than .01). Of interest, two of the three patients who presented with anterior myocardial infarction and who died had inferiorly extended infarcts and all had abnormal RVWMIs (greater than or equal to 1.0). As expected, cardiogenic shock shortly after onset of ventricular septal rupture was associated with a 91% mortality, but was more common after inferior than anterior myocardial infarction (60% vs 20%, p less than .05). The mean effective cardiac index was also higher in survivors than nonsurvivors (2.1 +/- 0.5 vs 1.2 +/- 0.5, p less than .001). Finally, multivariate analysis indicated that all nonsurvivors could be identified based on: an effective cardiac index of 1.75 liters/min/m2 or less, the presence of extensive right ventricular and septal dysfunction on the two-dimensional echocardiogram, a mean right atrial pressure of 12 mm Hg or more, and early onset of ventricular septal rupture. Thus, our data demonstrate that: mortality is higher when ventricular septal rupture complicates inferior than when it complicates anterior myocardial infarction, survivors can be distinguished from nonsurvivors and the prediction of outcome is highly accurate, and combined right ventricular and septal dysfunction has a substantial impact on prognosis.

Adult↗
PubMed1985

Distribution of the human jaw stretch reflex response elicited by percutaneous, localized stretch of jaw-closing muscles.

In the present study homonymous and heteronymous projections of muscle spindle afferent fibers in the human jaw-closing system were investigated. Stretch reflex responses were elicited with percutaneous displacement stimuli applied to the belly of the anterior superficial divisions of temporalis and masseter muscles. The distribution of reflex responses in jaw-closing muscles was assessed. Reflex responses to this stimulus were observed in all jaw-closing muscles ipsilateral to the stimulated muscle, suggesting that the projection of spindle afferent fibers to jaw-closing muscles in humans is diffuse. Comparisons of homonymous and heteronymous reflex response amplitudes indicated that homonymous response amplitudes tended to be larger. However, the relative strength of heteronymous inputs to masseter motoneurons appeared to be stronger than those to temporalis motoneurons.

Adult↗
PubMed1985

Reflex responses of the human jaw-closing system depend on the locus of intraoral mechanical stimulation.

Innocuous mechanical stimuli were applied to eight sites on the tongue dorsum and palate while subjects used feedback to maintain a constant isometric biting force. Reflex responses of the jaw-closing system were measured as changes in force and in EMGs recorded from right and left masseter muscles. Stimulation at each of the eight sites produced reflex force and EMG responses in most subjects tested. The nature of the reflex responses strongly depended on the site of stimulation. Stimulation of the palate tended to produce suppression of ongoing EMG activity and decreases in background biting force. In contrast, stimulation of sites on the tongue posterior to the tip, most often resulted in excitatory EMG responses and increases in jaw-closing force. Unilateral, early excitatory responses were observed in the right masseter with stimulation of the right side of the tongue. The existence of spatially organized responses of the human jaw-closing system to innocuous intraoral stimulation is not consistent with the view that these cutaneous reflexes are primarily of protective significance.

Adolescent↗
PubMed1985

Reflex responses of human lip muscles to mechanical stimulation during speech.

The role played by reflex pathways in the production of movement has been a significant issue for motor control theorists interested in a wide variety of motor behaviors. From studies of locomotion and chewing, it appears that gains in reflex pathways can be altered so that activity in these pathways does not produce destabilizing responses during movement. In speech production, recent experimental evidence has been interpreted to suggest that autogenetic lip reflexes (perioral reflexes) are suppressed during sustained phonation or speech production. The present study was conducted to assess the effects of phonation, direction of movement, and ongoing speech production on reflex responses of lip muscles. The present results suggest, in contrast to earlier work, that this reflex pathway is not suppressed or absent because the amplitude of the observed response depends upon the activation levels of the various muscles of the lower lip and, therefore, indirectly on the nature of the gesture the subject is instructed to produce.

Journal Article↗
PubMed1985

Anaesthesia for suction termination of pregnancy.

The effect of three anaesthetic techniques on blood loss and intra-uterine pressure changes in response to Syntocinon were studied in patients undergoing routine first trimester suction termination of pregnancy. All patients received a standard premedication, a bolus dose of fentanyl, intravenous induction of anaesthesia and maintenance with nitrous oxide and oxygen plus either intravenous supplementation or 0.5% halothane. Intra-uterine pressure was related to the anaesthetic technique used although blood loss was unrelated either to anaesthetic technique or to intra-uterine pressure changes.

Abortion, Induced↗
PubMed1985

Development and evaluation of a new kinetic assay for the quantitation of fibronectin gelatin-binding activity.

A new rapid and sensitive kinetic assay that measures the gelatin-binding activity of fibronectin has been developed. This assay is based on the rate of fibronectin-mediated aggregation of covalently coupled latex-gelatin particles. The addition of human plasma and serum resulted in aggregation rates proportional to the concentration of fibronectin in the test sample. This assay was inhibited by the addition of gelatin, demonstrating substrate specificity. This new assay requires 50 microliter of sample and can be performed within 5 minutes. Particle aggregation rates were affected by pH, heparin, and coupled gelatin concentration per milligram of latex. Maximum aggregation rates were observed at pH 8.0. Heparin was not an absolute requirement for particle aggregation but enhanced rates up to 1 U heparin/ml with little additive effect at greater concentrations. Heparin had a relatively greater effect on assays performed in acidic buffers. The concentration of gelatin per milligram of latex was rate limiting up to approximately 50 micrograms gelatin/mg latex with little change in aggregation rates at higher concentrations. Good correlation between total antigenic fibronectin (electroimmunoassay) and fibronectin gelatin-binding activity (latex-gelatin kinetic aggregation assay) was demonstrated in plasma from normal blood donors. This new assay will allow further definition of the relationship between fibronectin gelatin-binding activity and antigenic fibronectin in normal and pathophysiologic states.

Electrophoresis, Polyacrylamide Gel↗
PubMed1984

Human neutrophil N-acetyl-beta-D-glucosaminidase: granule localization. Further evidence for two azurophil granules.

The heterogeneity of human neutrophil granules, particularly of azurophil granules, defined as peroxidase containing, was examined by measuring N-acetyl-beta-D-glucosaminidase in fractions of isopycnic sucrose gradients of such granules. Neutrophil granules were prepared from normal human blood, monodispersed in heparinized sucrose, and centrifuged by established methods. N-Acetyl-beta-D-glucosaminidase was previously shown to be exquisitely sensitive to small amounts of heparin; paradoxically, larger amounts restore activity. The inhibition is reversed with protamine. N-Acetyl-beta-D-glucosaminidase activity had its peak at density 1.20 gm/ml (band B) and a lesser peak at density 1.22 gm/ml (band A). Mean specific enzyme activity was 899 +/- 217 nmol p-nitrophenol released per minute per milligram protein in gradient fraction 12 (band B), and 507 +/- 149 nmol p-nitrophenol released per minute per milligram protein in fraction 8 (band A) (p less than 0.01), which correlated in part to the significantly higher protein content in band A. These specific activities are 31-fold and 17-fold greater, respectively, then mean neutrophil lysate specific activity of 28.8 +/- 7.0 nmol p-nitrophenol released per minute per milligram protein, indicating a considerable concentration of granule enzyme activity in these gradient bands. The gradient distribution of N-acetyl-beta-D-glucosaminidase is nearly identical to that of myeloperoxidase and beta-glucuronidase, thus providing another enzyme marking the existence of two populations of azurophil granules, separable by density. Of total gradient enzyme activity, the mean percentage distribution of N-acetyl-beta-D-glucosaminidase in the pellet was 0.3%. Because the mean percentage of total gradient activity in the pellet was on an order of magnitude higher for myeloperoxidase (4.7%), beta-glucuronidase (3.7%), lysozyme (3.9%), and protein (2.8%), our data suggest that N-acetyl-beta-D-glucosaminidase has a possibly unique site within or an affinity to one or both of the two populations of azurophilic granules that is distinct from that for myeloperoxidase and beta-glucuronidase.

Acetylglucosaminidase↗
PubMed1983

Human neutrophil N-acetyl-beta-D-glucosaminidase: heparin inhibition.

To determine N-acetyl-beta-D-glucosaminidase (EC 3.2.1.30) in human neutrophil granules separated by a method requiring heparin, the inhibition of this enzyme by heparin was studied. Neutrophils were purified from blood of five donors by modifications of the Hypaque-Ficoll and dextran separation methods resulting in a suspension which was 96% neutrophils. Neutrophil lysates were assayed for N-acetyl-beta-D-glucosaminidase by measuring the amount of p-nitrophenol released from p-nitrophenyl-N-acetyl-beta-D-glucosaminide. The reaction showed first-order kinetics with regard to enzyme concentration. Triton X-100, 0.1% v/v, enhanced enzyme activity. Heparin was shown to reduce neutrophil lysate N-acetyl-beta-D-glucosaminidase to a specific activity of 46% at a heparin concentration of 2 units per assay and to 43% (maximal inhibition) at 17 and 50 units of heparin per assay. Substantially higher heparin concentrations partially restored the inhibited activity, the maximal restoration being a return to 80% of the original activity at 1700 units of heparin per assay. Protamine sulfate was assessed for its ability to restore N-acetyl-beta-D-glucosaminidase activity in the presence of heparin. At 1.0 mg/10 units of heparin, protamine restores enzyme activity to its heparin-free activity. These studies of human neutrophil N-acetyl-beta-D-glucosaminidase demonstrate: (1) specific enzyme activity is 28.8 +/- 7.0 nmole p-nitrophenol released per minute per milligram of protein or 1.7 +/- 0.5 nmole p-nitrophenol released per minute per 10(6) neutrophils; (2) heparin rapidly but finitely inhibits enzyme activity at very low concentrations and paradoxically restores it toward normal at high concentrations; and (3) protamine sulfate restores enzyme activity inhibited by heparin.

Acetylglucosaminidase↗