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Biomedical subjects

J B Moore

Publications and source records attributed to J B Moore.

At least 91 records · Page 5Linked to original sources
PubMed1982

Superior vena cava syndrome as a cause of pleural effusion.

The development in the postoperative period of the superior vena cava syndrome resulted in a persistent right-sided, transudative pleural effusion. It appears that the increased systemic venous pressure from left innominate thrombosis leading to superior vena cava obstruction in association with chest tube drainage connected to suction (increased intrapleural negative pressure) produced hydrostatic imbalances that resulted in increased pleural fluid formation and collection.

Coronary Artery Bypass↗
PubMed1981

Comparison of penetrating injuries of the right and left colon.

Controversy still exists whether penetrating injuries of the right colon have more favorably than those to the left. The importance of the issue rests in the operative management. This is a review of 50 cases of penetrating injuries of the right colon and 55 of the left treated at our institution from 1975 to 1980. The two patient groups were similar with respect to mechanism of injury, presence of shock at admission, degree of fecal contamination, severity of injury, and the percentage of cases with associated intra-abdominal injuries. The number of patients managed by primary repair or resection (52 vs. 45%), repair or resection with exteriorization (20 vs. 22%), and colostomy (28 vs. 33%) were also comparable in right versus left injuries. The treatment of right colon injuries resulted in 32% morbidity rate and 2% mortality rate, and that of left sided injuries 33% morbidity and rate of 4% mortality rate. These findings indicate that, despite known anatomic and physiologic differences, penetrating trauma to the right and left colon should be managed similarly.

Adolescent↗
PubMed1981

Hydrolysis of soybean trypsin inhibitor by the gamma subunit of 7SNGF and EGF-BP.

Although soybean trypsin inhibitor (STI) does not inhibit the esterase activity of either epidermal growth factor binding protein (EGF BP) or the gamma subunit of 7SNGF, it does behave as a substrate for proteolysis. Cleavage of the active site peptide bond of STI does occur when incubated in the presence of either EGF-BP or the gamma subunit of 7SNGF. The hydrolysis id pH dependent with maximum proteolysis at pH 6.0-7.0. the newly formed C-terminal arginine residue in modified STI can be released by carboxypeptidase B digestion. Both enzymes are inhibited by low concentrations (2-4 microgram/ml) of the microbial protease inhibitors leupeptin and antipain. These inhibitors are specific for trypsin-like proteases. Since both enzymes can be found as part of high molecular weight complexes with growth factors these results confirm the hypothesis that they are involved during a postranslational modification event.

Amino Acids↗
PubMed1981

Effects of variability of practice in a movement-education program on motor skill performance.

The study investigated the effects of the direct and exploration methods of teaching on the overhand throwing performance of kindergarten children. Variable throwing practice was provided in the exploration method by allowing children to throw 5 different types of balls at a variety of targets. Children given the direct method threw only one type of ball and received specific instruction and demonstrations. Throwing for distance and throwing accuracy were measured on pre- and posttests. A novel throwing task was administered on the posttest to measure skill transfer. The experimental groups received instruction three times per week for 4 wk. in throwing while a control group received no instruction. Significant sex differences in throws were found for distance and accuracy. Analysis of data from the novel task gave no significant effects. The two methods of teaching did not produce different levels of throwing skill.

Child, Preschool↗
PubMed1981

Penetrating abdominal trauma index.

A method of quantifying the risk of complication following penetrating abdominal trauma is described. A trauma index score was calculated by assigning a risk factor (1-5) to each organ injured and then multiplying this by a severity of injury estimate (1-5). The sum of the individual organ scores comprised the final penetrating trauma index (P.A.T.I.). A consecutive series from 1975 to 1979 of 108 isolated stab wounds and 114 gunshot wounds to the abdomen requiring laparotomy were analyzed by this scheme. Only patients surviving 24 hours postoperatively were evaluated. Gunshot wounds resulted in P.A.T.I. scores greater than 25 in 39 (34%) of the patients. This was associated with a 46% complication rate and contrasted to a 7% incidence when the P.A.T.I. was equal to or less than 25. Following abdominal stab wounds six (6%) of the patients had P.A.T.I. scores exceeding 25. Complications developed in 50% of this group compared to 5% when the P.A.T.I. was less than 25. Using the P.A.T.I., we conclude that gunshot victims are more likely to need trauma center treatment than those with stab wounds. The P.A.T.I. also might facilitate cost analysis of trauma care. The ability to assess effects of patient age, sex, amount of blood loss, duration of hemodynamic shock, and metabolic response to injury might further enhance the therapeutic implications in both penetrating and blunt abdominal trauma.

Abdominal Injuries↗
PubMed1980

Abdominal injuries associated with penetrating trauma in the lower chest.

A 5 year experience of 248 patients with isolated penetrating lower chest injury was reviewed. Twenty-two (15 percent) of the stab wounds and 46 (46 percent) of the gunshot wounds caused associated intraabdominal injury. Among those taken to the operating room for laparotomy, physical examination proved misleading in 40 percent of the patients with stab wounds and 30 percent of those with gunshot wounds. The diagnostic accuracy of peritoneal lavage, used selectively, was 93 per cent for the patients with stab wounds and 90 percent for those with gunshot wounds. The morbidity was high in patients with combined injuries, with major complications occurring in 27 percent of those with stab wounds and 43 percent of those with gunshot wounds. Two thirds or more of these complications were thoracic. There was one death (4 percent) among the patients with thoracoabdominal stab wounds and six (13 percent) among those with gunshot wounds.

Abdominal Injuries↗
PubMed1980

Mandatory laparotomy for gunshot wounds penetrating the abdomen.

A 4 year experience with 245 patients with isolated lower thoracic or anterior abdominal gunshot wounds was reviewed. Twenty-three (16 percent) of the 144 abdominal injuries were clinically superficial and all were managed successfully nonoperatively. Of the remaining 121 patients, 115 were confirmed to have peritoneal violation at laparotomy and 111 (96 percent) of these had significant visceral injuries. Of the 101 patients with lower chest wounds, 47 had peritoneal violation and 45 (96 percent) had intraabdominal injuries. Twenty-six (17 percent) of the 156 patients with intraperitoneal trauma had unimpressive physical signs on admission. these findings support a policy of routine exploration for gunshot wounds violating the peritoneum. When depth of penetration is uncertain, diagnostic peritoneal lavage should be used. Only those patients with unequivocally superficial injuries warrant observation.

Abdominal Injuries↗
PubMed1980

Peritoneal lavage in abdominal trauma: a prospective study comparing the peritoneal dialysis catheter with the intracatheter.

The accuracy of peritoneal lavage in identifying significant intra-abdominal injury using a peritoneal dialysis catheter approaches 96%. The intracatheter, however, has frequently been substituted in the procedure with expectations of equal reliability. Our randomized prospective study compared the efficacy, accuracy, and safety of these two catheters. Although the complication rate was insignificant in both groups, the intracatheter was associated with technical difficulties in 46% of the patients compared to a rate of only 9% when the dialysis catheter was employed.

Abdominal Injuries↗
PubMed1980

The evolution of abdominal stab wound management.

The results of the selective management of 300 abdominal stab wound victims have been reviewed for a 5-year period. Initially the need for laparotomy was evaluated by sinography, later physical examination, and most recently by local wound exploration combined with peritoneal lavage. The use of sinography resulted in an unnecessary laparotomy rate of 38%. Exploration based upon physical findings eventuated in 36% unnecessary laparotomies, of which 79% were negative, 17% morbidity, and no mortality. Local wound exploration followed by peritoneal lavage when peritoneal violation was suspected resulted in 8% unnecessary laparotomies of which half were negative, 9% morbidity, and no mortality. Based on this experience we have adopted the following approach to abdominal stab wounds. Patients with unexplained blood loss or overt signs of visceral injury undergo prompt exploration. In all other cass with intact peritoneum are discharged from the Emergency Department. If peritoneal violation is evident peri toneal lavage is performed. If the lavage is positive laparotomy is undertaken, and if negative the patient is hospitalized for an additional 24 hours of observation.

Abdominal Injuries↗
PubMed1980

V-Y advancement flap for facial defects.

We have used 107 V-Y advancement flaps in 76 patients with only loss of one flap and loss of hair growth in a second. The versatility of this method of closure and its superior cosmetic result recommend it to the plastic surgeon who must close defects of the face.

Adult↗