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Biomedical subjects

F A Moore

Publications and source records attributed to F A Moore.

190 records · Page 11Linked to original sources

Primary tracheomalacia.

Tracheomalacia is a rare congenital malformation of the tracheobronchial cartilages in which the supporting cartilaginous rings permit expiratory collapse of the airway. The condition is usually mild and self-limited. There is a severe variant, however, that is life-threatening and warrants separate categorization. Four children with severe primary tracheomalacia were treated recently. The clinical symptoms, diagnostic findings, and eventual treatment of these patients were highly distinctive and almost identical in all 4, permitting us to make the following observations: (1) primary severe tracheomalacia must be suspected in infants with unexplained respiratory distress manifested by stridor and cyanosis; (2) symptoms are not present at birth but appear insidiously after the first weeks of life, are markedly aggravated by respiratory tract infections, and are made worse by agitation; (3) bronchoscopy is essential for definitive diagnosis and should be employed early in the diagnostic process; (4) tracheostomy is probably essential in most instances; and (5) resolution, although spontaneous, does not occur until after 2 years of age.

Cartilage Diseases↗

T1 relaxation times in vivo of human normal pelvic tissues and gynecologic malignancies.

The spin-lattice relaxation time (T1) of the water protons of intrapelvic tissues was determined in vivo in women using an NMR imager. T1's of squamous cell carcinoma of the cervix are significantly longer than those of the normal cervix. A similar trend occurs in carcinomas of the endometrium and ovary. The results suggest that direct determination of T1 in vivo may be useful in the diagnosis and management of gynecologic malignancies.

Adenocarcinoma↗

An alternative phototherapy light combination.

Combinations of fluorescent lamps for phototherapy were evaluated in order to select one that maximizes blue light content (400 to 500 nanometers) for most effective photodegradation of bilirubin, maintains acceptable color balance for observing infant skin color, and requires minimal lamp replacement for low maintenance cost. The combination that best achieves these objectives consists of four special blue (Westinghouse F20T12-BB) and four broad spectrum (Verd-A-Ray F20T12-CC) lamps that produce blue radiation in excess of an array of eight conventional blue lamps, a spectrum closely approximating that of natural light, and at least 80% of the original blue radiation after 2,100 hours of use.

Biomedical Engineering↗

Penetrating wounds to the posterior chest: analysis of exigent thoracotomy and laparotomy.

Most reports of penetrating chest wounds include all regions of the thoracic wall. Recent studies of abdominal wounds stratified by entrance site have demonstrated significant differences in injury pattern that influence initial assessment and management. This is an analysis of 135 consecutive patients admitted to the Denver General Hospital with penetrating injuries to the posterior chest, done in an effort to elucidate operative indications. Fifteen of these patients required emergency department (ED) thoracotomy and were excluded from the study. In the remaining 120 patients, mechanism was gunshot (GSW) in 20% and stab wound (SW) in 80%; 89% were men, and the mean age was 26 years. For analysis, the posterior chest was further divided into upper and lower at the inferior tip of the scapula line. Overall, 28 patients (23%) with posterior penetrating chest wounds required early surgical intervention; 38% following a GSW compared to 20% due to a SW. Only 9 patients (8%) required thoracotomy while 19 (15%) underwent laparotomy. The most frequent indication for thoracotomy was persistent chest hemorrhage, and for laparotomy, positive diagnostic peritoneal lavage.

Abdominal Injuries↗

Ischemia/reperfusion-induced disruption of rat small intestine transit is reversed by total enteral nutrition.

OBJECTIVES: A reduced blood flow to the gut is a consistent event after traumatic shock. Enteral nutrition support has been shown to reduce the septic morbidity after major trauma. We evaluated the effects of a transient ischemia followed by reperfusion (I/R) and an enteral nutrition support regimen on the motility of the small intestine of the rat. METHODS: A catheter was placed in the upper duodenum and the small intestine was then made ischemic by clamping the superior mesenteric artery for 45 min; the arteries of sham rats were isolated but not clamped. Intestinal transit was evaluated by measuring the amount of fluorescein isothiocyanate-dextran (12 000 MW) in each of 10 intestinal sections at 30 min after injection through the duodenal catheter. The mean geometric center of marker distribution (MGC) was calculated for each group and compared. In a second study, I/R was followed by infusion of saline or a complete nutrient solution overnight, and transit was determined. RESULTS: Intestinal transit (as the MGC) of I/R rats at 24 h after the beginning of reperfusion (3.5 +/- 0.2) and 48 h after the beginning of reperfusion (4.5 +/- 1.1) was significantly lower than that in the respective sham controls (5.1 +/- 0.3 and 5.9 +/- 0.5). The MGC for rats receiving a nutrient solution overnight during the reperfusion phase (6.0 +/- 1.1) was significantly increased compared with the MGC of 4.8 +/- 0.3 for rats receiving saline during the same period. CONCLUSIONS: These results demonstrate a long-term deleterious effect of a non-lethal ischemia on intestinal transit and may be one explanation for many of the sequelae occurring after ischemia. In addition, these results demonstrate that a nutrient infusion will prevent the delayed transit. This may provide a partial explanation for the beneficial effects of total enteral nutrition in the clinical situation of posttraumatic injury.

Animals↗

Net protein catabolic rate after kidney transplantation: impact of corticosteroid immunosuppression.

Protein catabolic rate (PCR) was measured during the first 3 to 7 weeks after kidney transplantation in nine nondiabetic patients (16-52 yr old) who were receiving azathioprine and corticosteroid immunosuppression. Five of the patients received additional amounts of corticosteroids to treat rejection episodes. The PCR paralleled the amounts of corticosteroids administered initially as prophylactic immunosuppression and later as treatment for rejection episodes. In spite of a diet containing 1.2 g of protein per kg ideal body weight, net urea generation reflected severe lean body mass breakdown, roughly equivalent in magnitude to a 50% body surface area full-thickness burn. This catabolism was accompanied by a fall in serum albumin without significant weight loss. Hypercatabolism in the early posttransplant period is severe. After transplantation diet should be modified to try to satisfy these nitrogen demands.

Adolescent↗

Gut-derived mediators of multiple organ failure: platelet-activating factor and interleukin-6.

Laboratory studies suggest that the postischaemic gut serves as a priming bed for circulating neutrophils that provoke multiple organ failure. Platelet-activating factor, generated by phospholipase A2, appears to be active in priming neutrophils in the gut. Interleukin-6 also appears to be elaborated by the postischaemic gut, but may be even more important in distant organs via promoting neutrophil-mediated organ dysfunction.

Animals↗