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Biomedical subjects

J E Moran

Publications and source records attributed to J E Moran.

32 records · Page 2Linked to original sources
PubMed1990

Magnetoencephalographic studies of migraine.

We report for the first time the detection by magnetoencephalography (MEG) of signals observable in migraine patients during headache, but not in controls. These signals consisted of three features: suppression of spontaneous cortical activity, long duration field changes, and large amplitude waves (LAW) of several seconds duration. LAW were also seen during the interictal period. We discuss the possible relationship of these signals to spreading depression (SD), and why the LAW have not been observed in previous studies of SD.

Adolescent↗
PubMed1990

Antineutrophil cytoplasm antibody (ANCA) associated vasculitis.

In 1982 we first reported the presence of antineutrophil cytoplasm antibodies (ANCA) in 8 patients with systemic vasculitis and segmental necrotizing glomerulonephritis. The results of long-term follow-up are described. Screening of 7,500 serum samples revealed positive ANCA in 9 additional patients with vasculitis. Eighty-eight other patients with vasculitis were ANCA negative, including 7 with microscopic polyarteritis nodosa (MPAN) and 8 with Wegener's granulomatosis (WG). Conversely, ANCA were never detected in the absence of vasculitis. Fourteen patients presenting with glomerulonephritis and ANCA were followed for a median of 6.3 years. Eleven patients had MPAN and 3 WG. Remissions were obtained with immunosuppressive therapy in all patients. Clinical relapse was associated with the reappearance of ANCA. Five-year survival was 89% and 5-year dialysis free survival was 77%. ANCA are specific markers for a sub-group of patients with vasculitis and are sensitive markers of disease activity. Glomerulonephritis associated with ANCA positive vasculitis has a favorable outcome with immunosuppressive therapy.

Antibodies, Antinuclear↗
PubMed1989

Mixed-mode therapy: kinetic analysis and acute clinical evaluation.

A mixed therapeutic modality was devised in which patients with chronic renal failure were treated with a combination of continuous ambulatory peritoneal dialysis (CAPD; two daily 4-hour exchanges per day; 16 h dry belly) and hemodialysis (1 session per week). Kinetic modeling analysis indicated that a time-averaged urea concentration equivalent to CAPD could be obtained with a Kt/V value of 1.2-1.6, depending on patient parameters, for the single-weekly hemodialysis. The therapy format was acutely evaluated in a 2-week clinical trial on 4 patients. Excursions in small-solute concentration were virtually equivalent to those predicted from theory. Adequate fluid removal was obtained in the 2 CAPD exchanges and blood pressure was well controlled. As a result of the success of the acute trials, and since this format may offer potential lifestyle advantages to patients who possess dual access, a chronic trial of mixed-mode therapy seems advised.

Aged↗
PubMed1989

Beta-2 microglobulin removal during continuous ambulatory peritoneal dialysis (CAPD).

Beta-2 microglobulin (B2M) handling in continuous ambulatory peritoneal dialysis (CAPD) was characterized in acute and chronic clinical studies. Average clearance rate was 0.7 mL/min and mean mass transfer coefficient, KoA, was calculated to be 0.95 cm2/min; these values are in the range expected from extrapolation of published data for other large solutes. In chronic studies with both anuric and oliguric populations, CAPD was shown to be much more effective than conventional hemodialysis in removing B2M and, in fact, CAPD removal rates were equivalent to those reported for high flux dialysis therapies. However, this greater extraction was not associated with any clinically significant reduction in circulating plasma concentrations. These trends remained valid in both the anuric and oliguric subsets of the study population.

Dialysis Solutions↗
PubMed1985

Vascular access for extracorporeal therapy in the rabbit.

A technique allowing short-term blood access for extracorporeal therapy in rabbits is described. The technique utilizes silicone rubber cannulae and teflon vessel tips to construct an externalized carotid-jugular arteriovenous shunt. The insertion procedure takes 1 h and extracorporeal blood flows in excess of 10 ml/min are obtainable for up to 7 days. Blood flow may still be obtained following shunt clotting by insertion of smaller diameter catheters through the arterial cannula. This technique has been successfully used for extracorporeal therapy in rabbit disease models.

Animals↗
PubMedDate not supplied

Subcutaneous vascular access devices.

Tunneled dialysis catheters have played an important role in providing vascular access for hemodialysis for over 20 years, yet limitations associated with poor flow, thrombosis, and infections due to the transcutaneous nature of catheters have led to the development of alternative vascular access devices. This article reviews two historical devices-the Hemasite and the Bentley DiaTAP button-and provides an overview of two new fully subcutaneous vascular access devices-the LifeSite Hemodialysis Access System (Vasca, Inc., Tewksbury, MA) and the Dialock Hemodialysis System (Biolink Corp., Norwell, MA). These new subcutaneous devices differ significantly from currently available tunneled dialysis catheters in their design and method of use and may result in improved outcomes in hemodialysis patients. Indeed, initial clinical experiences with this new class of fully implanted access devices validate a subcutaneous approach to hemodialysis access and suggest that their high flow rates and low complication rates may make subcutaneous devices an attractive alternative to dialysis catheters for hemodialysis patients.

Catheterization, Central Venous↗