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Biomedical subjects

J H Moore

Publications and source records attributed to J H Moore.

At least 37 records · Page 2Linked to original sources
PubMed1998

Soft-tissue complications of intra-arterial chemotherapy for extremity sarcomas.

High-grade sarcomas have a high rate of local recurrence as well as distant metastases. This has led to the development of intra-arterial chemotherapy (IAC) as part of a multimodal approach to control local disease and/or reduce the extent of surgical resection. Intra-arterial catheters are positioned by an interventional radiologist into the feeding vessels of the tumor. Adriamycin and 5-fluorodeoxyuridine are infused intra-arterially. Cisplatinum, with or without granulocyte colony stimulating factor, is given systemically. Patients usually experience acute self-limited soft-tissue inflammation in the treated area. In our experience of 118 patients, 3 patients experienced soft-tissue necrosis that required excision and reconstruction. The first was treated for synovial sarcoma of a metatarsal. After IAC with Adriamycin, she sloughed the skin, subcutaneous tissue, and some of the posterior compartment musculature of her calf. This tissue was debrided. A gastrocnemius flap and skin graft were used for coverage. She is free of disease and ambulatory. The second patient was treated with IAC Adriamycin for a radial head chondrosarcoma. She developed soft-tissue slough, which became infected with Pseudomonas. She required extensive debridement of the skin, subcutaneous tissue, and muscle, and was subsequently reconstructed with a latissimus flap and a split-thickness skin graft (STSG). She later developed a local recurrence requiring amputation. The latissimus was elevated and used to cover the distal stump. She also is free of disease. The third patient was treated with IAC Adriamycin for Ewing's sarcoma of the right femur. This was complicated by fat necrosis and persistent pain. Subsequent radiotherapy only worsened her symptoms. She underwent wide excision and muscle flap/STSG repair, which relieved her pain. She is currently ambulatory and free of disease. In conclusion, as the use of IAC continues, its complications may become more common. Our experience with this previously unknown entity is illustrated and therapeutic options are discussed.

Adult↗
PubMed1998

Diabetes research in an American Indian community.

PURPOSE: To describe field experiences of a nurse-led team conducting collaborative research on diabetes with an American Indian community. Diabetes is of epidemic proportions among Indians. Methodological reports can assist nurse researchers to make important contributions to Indian health and diabetes care. ORGANIZING FRAMEWORK: Wax's stages of fieldwork: Initiation, fieldwork, post-field work. SCOPE AND METHOD: Report of key research experiences from all phases of a study with an Indian community (1988-1996). Based on review of classic literature, field notes, and team meetings. FINDINGS: Methodological literature on research with Indians and cultural tutelage by Indians were helpful but neither sufficient nor infallible. A long period of investigator presence in the community before beginning the research was extremely useful. The need for researchers to explain their presence and the contribution of research to the community was ongoing. CONCLUSIONS: Wax's conception of field work as a dialectic process was supported. A collaborative, community focus and willingness to spend much time acquiring cultural knowledge can facilitate successful research on Indian health.

Cultural Diversity↗
PubMed1998

Effects of strength training on strength development and joint position sense in functionally unstable ankles.

OBJECTIVE: To examine the effects of ankle-strengthening exercises on joint position sense and strength development in subjects with functionally unstable ankles. DESIGN AND SETTING: Subjects were randomly assigned to a training or control group. The training group participated in a 6-week strength-training protocol using rubber tubing 3 times a week throughout the training period. The control group did not participate in the strength-training protocol. SUBJECTS: Twenty healthy college students (10 females, 10 males, age = 20.6 +/- 2.23 years; ht = 176.40 +/- 7.14 cm; wt = 74.18 +/- 10.17 kg) with a history of functional ankle instability volunteered to participate in this study. MEASUREMENTS: We pretested and posttested dorsiflexor and evertor isometric strength with a handheld dynamometer and collected joint position sense (JPS) data at 20 degrees for inversion and plantar flexion and at 10 degrees for eversion and dorsiflexion. RESULTS: Statistical tests for strength and JPS revealed significant group-by-time interactions for dorsiflexion strength, eversion strength, inversion JPS, and plantar flexion JPS. Simple main-effects testing revealed improvements in training group strength and JPS at posttesting. There were no significant effects for eversion JPS, but the group main effect for dorsiflexion JPS was significant, with the experimental group having better scores than the control group. CONCLUSIONS: Ankle-strengthening exercises improved strength, inversion JPS, dorsiflexion JPS, and plantar flexion JPS in subjects with functionally unstable ankles.

Journal Article↗
PubMed1997

Dexamethasone stimulates leptin release from human adipocytes: unexpected inhibition by insulin.

In the present study we have examined the effect of dexamethasone on ob gene mRNA expression and leptin release from isolated human subcutaneous adipocytes. Dexamethasone stimulated leptin release from cultured adipocytes in a time- and dose-dependent manner. A two-fold increase in leptin release was detectable by 36 h of treatment with 10(-7) M dexamethasone. Leptin release was preceded by a significant 83 +/- 30% increase in ob mRNA after 24 h exposure to the compound. Co-incubation of cells with dexamethasone (10(-7) M) and insulin (10(-7) or 10(-9) M) completely blocked the dexamethasone-stimulated increase in ob mRNA and leptin release. These data demonstrate that insulin and glucocorticoids regulate leptin synthesis and release from human adipocytes in vitro.

Adipocytes↗
PubMed1997

The role of the apolipoprotein E polymorphism in the prediction of coronary artery disease age of onset.

We investigated the role of the apolipoprotein (Apo) E polymorphism in the prediction of CAD age of onset in a sample of unrelated living male (n = 65) and female (n = 54) Caucasian subjects diagnosed with CAD. Cumulative distributions of age at the first diagnosis of CAD were estimated for each Apo E genotype and tested for homogeneity using the log-rank test. The Apo epsilon 33 genotype was used as a reference group for all hypothesis tests. Analyses were performed separately in males and females. We found evidence suggesting that the presence of the Apo epsilon 32 genotype in males is associated with a significantly earlier CAD age of onset. These results suggest that the Apo E polymorphism may be a gender-specific predictor of CAD age of onset.

Adult↗
PubMed1996

Mutation screening and identification of a sequence variation in the human ob gene coding region.

In the present study mRNA from the subcutaneous adipose tissue of 68 obese (defined as a body mass index > or = 27.3 for men and > or = 27.8 for women) and 38 lean subjects was screened for mutations in the ob gene coding region. No mutations in the coding region of the human ob gene were detected using Conformation Sensitive Gel Electrophoresis in 105 subjects. A first base substitution (G to A) was detected in one individual, which changed a valine to a methionine at position 94. The mRNA of all subjects contained the codon for glutamine-49, ruling out the possibility of a splice defect occurring during the removal of intron 2. These observations suggest that defects in the ob gene sequence itself are not the primary cause of obesity in humans.

Adipose Tissue↗
PubMed1996

Quantitative ultrasonic diagnosis of silicone breast implant rupture: an in vitro feasibility study.

Ultrasound is useful in evaluating the integrity of silicone breast implants. However, extensive operator experience is required. A system for computer-assisted diagnosis is being developed to reduce operator dependence. Feasibility was examined by measuring the ultrasonic properties of breast implants in vitro. Silicone gels from 45 explanted implants (26 intact and 19 ruptured) were placed in sealed acoustic test chambers and 60 RF A-lines were acquired from each. Velocity of sound, attenuation and integrated backscatter (IB) were estimated. Receiver operating characteristic (ROC) analysis was performed. The mean speed of sound was 1060 m/s +/- 50.1 m/s in intact implants and 1115 m/s +/- 74.3 m/s in ruptured ones (p < 0.003). Differences in attenuation were not statistically significant. The mean IB was -83.9 dB +/- 7.94 dB in intact and -77.2 dB +/- 9.07 dB in ruptured implants (p < 0.006). The area under the ROC curve (Az) was 0.70 and 0.73 for IB and velocity, respectively, while combining the two yielded Az = 0.81. Changes in speed of sound and IB, with changes in integrity of breast implants, have been demonstrated in vitro. The results indicate the potential for quantitative assessment of silicone breast implants performed in vivo.

Breast Implants↗
PubMed1996

Sliding myofascial flap of the rectus abdominus muscles for the closure of recurrent ventral hernias.

Despite a reported incidence of up to 11 percent of incisional/ventral hernias following celiotomies, there is no universally applicable preventive or reconstructive technique in practice. Among patients undergoing repair of ventral incisional herniation, the reported recurrence rates are typically in the 30- to 50-percent range. This study concentrates on the patient with a large, recurrent abdominal incisional hernia in whom conventional surgical repair has failed. We report our recent 4-year experience with the use of "components separation" of the myofascial layers of the abdominal wall for repair of these recurrent herniations. During 4-year period, 35 patients with large, recurrent ventral hernias underwent repair by the same surgeon (J. H. M.) using the method described below. Abdominal defects as large as 875 cm2 were repaired, with a median defect size of 255 cm2. The repair was based on the compound flap of the rectus muscle with its attached internal oblique-transversus abdominus muscle with advancement to the midline to recreate the linea alba. Any repairs that were attenuated were supported with either ePTFE (8.6 percent) or Vicryl mesh (34 percent). The study group consisted of 35 patients, 34 percent male and 66 percent female; mean age was 55 years. Length of follow-up ranged from 1 to 43 months, with a mean follow-up of 22 months. Overall recurrence rate for herniation was 8.5 percent (3/35). Additional complications, namely seroma, wound infection, and hematoma, occurred at rates of 2.8, 5.7, and 5.7 percent, respectively. There were no mortalities. The compound flap of the rectus and internal oblique-transversus can be advanced medially to recreate the linea alba to provide dynamic, stable support for defects as large as 875 cm2. A recurrence rate of 8.5 percent was achieved in a relatively high-risk population with acceptable morbidity and no mortalities. In our 4-year experience, the sliding rectus abdominus myofascial flap has proved to be a safe and effective tool for dealing with patients in whom conventional means of repair have failed.

Abdominal Muscles↗
PubMed1995

Platelet-derived growth factors-AA and -BB regulate collagen and collagenase gene expression differentially in human fibroblasts.

Platelet-derived growth factor (PDGF) is a mitogen associated with tissue repair, a process involving collagen synthesis and remodelling by interstitial collagenase. This study examines and compares the regulation of interstitial collagenase and collagen gene expression by PDGF-AA and -BB in human fibroblasts. Time-course analysis showed that neither PDGF-AA or -BB had a consistent effect on the expression of pro-alpha 1(I) or pro-alpha 2(I) type-I collagen genes. In contrast, interstitial collagenase gene expression was found to be consistently up-regulated severalfold by PDGF-BB. Enhanced expression of the collagenase gene was not apparently due to up-regulation of its promoter activity in human dermal fibroblasts, as indicated by transient and stable transfection experiments. Unlike PDGF-BB, PDGF-AA did not alter collagenase mRNA levels under low-serum culture conditions. Thus, the biological activities of the PDGF homodimers are different, with PDGF-BB being clearly more potent than PDGF-AA in its regulation of collagenase gene expression.

Becaplermin↗
PubMed1995

Artificial intelligence programming with LabVIEW: genetic algorithms for instrumentation control and optimization.

A genetic algorithm for instrumentation control and optimization was developed using the LabVIEW graphical programming environment. The usefulness of this methodology for the optimization of a closed loop control instrument is demonstrated with minimal complexity and the programming is presented in detail to facilitate its adaptation to other LabVIEW applications. Closed loop control instruments have variety of applications in the biomedical sciences including the regulation of physiological processes such as blood pressure. The program presented here should provide a useful starting point for those wishing to incorporate genetic algorithm approaches to LabVIEW mediated optimization of closed loop control instruments.

Algorithms↗
PubMed1995

E-cadherin expression in primary and metastatic thoracic neoplasms and in Barrett's oesophagus.

Reduced expression of E-cadherin, a Ca(2+)-dependent cell adhesion molecule present in normal epithelium, has been associated with invasive and metastatic cancer. Immunohistochemistry was used in examining the relationship between E-cadherin expression and stage in 59 oesophageal and 52 lung cancers. Advanced-stage oesophageal cancers were associated with both reduced and disorganised E-cadherin expression (P < 0.01). Advanced-stage lung adenocarcinomas generally exhibited disorganised or reduced E-cadherin expression, but no statistical association between expression pattern and stage was found (P > 0.05). No differences in stage were seen between tumours with reduced or disorganised E-cadherin expression. Altered E-cadherin expression was detected in dysplastic, non-invasive Barrett's oesophagus. Importantly, high-level E-cadherin expression was detected in 17 of 17 lymph nodes containing metastatic cancer. E-cadherin mRNA expression was decreased in tumours with reduced protein expression, but not in tumours with disorganised expression. Expression of alpha-catenin mRNA, an E-cadherin-associated protein, was detected in tissues with altered E-cadherin protein expression. Reduced and disorganised expression of E-cadherin appear to be related to transcriptional and post-translational events respectively, and both appear to represent altered cell adhesion associated with invasion and metastasis in thoracic neoplasms.

Adenocarcinoma↗
PubMed1995

Plantar fibromatosis: a review of primary and recurrent surgical treatment.

Plantar fibromatosis can be quite disabling to the patient, as well as a technical challenge to the surgeon. Patients who undergo previous local excisions and in whom aggressive recurrences develop are difficult to manage successfully. We present a consecutive series of five primary procedures on patients with painful plantar fibroma and seven revision operations on patients with recurrent plantar fibroma. The average follow-up was 47 months (range, 22-66 months) in the primary group and 40 months (range, 21-78 months) in the revision group. The overall results were satisfactory in four of the five primary operations, with only one recurrence. In the revision group, five of seven results were satisfactory with no recurrences. The major complication that led to unsatisfactory results was the development of a postoperative neuroma. In this article, we outline our present surgical techniques of wide primary excision and a staged revision procedure with delayed split-thickness skin graft closure. These techniques can be used successfully to manage this disabling, progressive disease.

Adult↗
PubMed1995

Blood quantum and ethnic intermarriage in the Boas data set.

The data collected by Boas is biased toward employees of Indian agencies and school populations. The data show that intermarried Amerindians in the last century tended to marry back into the Amerindian population rather than into the general population, as in this century. Distributions of blood quantum within tribes show the intensity and duration of contact with the dominant society and other tribes. Amerindians who married into other tribes tended to choose spouses from contiguous tribes, but over one-fourth of spouses represented different language families. General hypotheses should be tested in the Boas data only with great caution and after correcting for historical factors if possible.

Adolescent↗
PubMed1994

Intestinal differentiation and p53 gene alterations in Barrett's esophagus and esophageal adenocarcinoma.

The development of esophageal adenocarcinoma is frequently associated with intestinal-type Barrett's metaplasia. Barrett's metaplasia and esophageal adenocarcinomas were examined for expression of the intestinal brush-border-associated hydrolase aminopeptidase N (APN). APN mRNA was detected by utilizing the reverse transcription polymerase chain reaction (RT-PCR) in 50% of Barrett's metaplasia specimens and in 26% of esophageal adenocarcinomas. APN protein was detected by utilizing immunohistochemistry in 84% of Barrett's metaplasia specimens and in 71% of adenocarcinomas, although a decrease or loss of APN protein was sometimes observed in dysplastic Barrett's metaplasia and adenocarcinomas. Alterations in the p53 tumor-suppressor gene have previously been found in both dysplastic Barrett's mucosa and esophageal adenocarcinomas. The same specimens analyzed for APN were examined for the nuclear accumulation of the p53 protein. Utilizing immunohistochemistry, p53 staining was detected in 42% of Barrett's metaplasia specimens, most of which were dysplastic, and in 58% of adenocarcinomas. In the samples positive for p53 protein, gene mutations in exons 5, 7 and 8 were detected by utilizing single-strand conformation polymorphism analysis (SSCP) in 1 Barrett's metaplasia specimen and 6 adenocarcinomas. In Barrett's metaplasia, there was an inverse correlation between APN protein expression and p53 protein accumulation (p < 0.05) suggesting a link between genetic alterations and loss of this marker. The analysis of markers of intestinal differentiation with markers of disease progression may prove to be a useful approach for studying carcinogenesis in Barrett's metaplasia.

Adenocarcinoma↗
PubMed1994

Plasma lipids and diet of the Mvskoke Indians.

Plasma lipids, lipoproteins, and apolipoproteins were measured in 123 female and 57 male Mvskoke Indians, a population of American Indians with a high prevalence of non-insulin-dependent diabetes mellitus (NIDDM). Dietary patterns were assessed with a food-frequency questionnaire. There were no differences in total cholesterol, low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), apolipoproteins A-I or B in female Indians with and without diabetes. In males with diabetes, however, LDL-C was lower. Triglyceride and fasting plasma glucose were higher in subjects with diabetes. Total cholesterol and LDL-C were lower and HDL-C was higher than age and sex-matched Lipid Research Clinics values, especially for subjects with diabetes. This is surprising given that the diet of Mvskoke Indians contains foods high in total fat, saturated fatty acids, and cholesterol. We may explain, in part, the low incidence of coronary heart disease in this population.

Adult↗
PubMed1994

Alterations of K-ras, p53, and erbB-2/neu in human lung adenocarcinomas.

The development of human adenocarcinoma of the lung involves multiple genetic changes including activation of oncogenes and loss of tumor suppressor genes. Patients whose lung tumors contain K-ras oncogene mutation, accumulation of the protein product of the tumor suppressor gene p53, or erbB-2/neu oncoprotein overexpression have been shown to have a worse prognosis. We examined these three genetic indicators in 29 lung adenocarcinomas to determine whether these markers are present in the same tumors or if they represent molecular changes that define different subsets of patients. P53 nuclear protein accumulation and erbB-2/neu protein overexpression were determined by immunohistochemical analysis of cryostat sections of tumor specimens and corresponding normal lung tissue. K-ras mutations were detected by radiolabeled oligonucleotide probes, specific for the various twelfth codon mutations, hybridized to exon 1 of K-ras, which was amplified by the polymerase chain reaction. Increased nuclear accumulation of p53 protein was found in 11 adenocarcinomas (38%). All of the p53 positive tumors were found to show high level staining and homogeneous expression of erbB-2/neu protein. K-ras mutations were detected in seven tumors (24%), all of which overexpressed erbB-2/neu. The presence of a K-ras mutation did not correlate with p53 accumulation. In total, 93% of the tumors were found to overexpress erbB-2/neu, the highest being in one tumor with erbB-2/neu gene amplification. The presence of K-ras twelfth codon mutation was associated with increased cigarette smoking. In conclusion, erbB-2/neu overexpression is a common event in lung adenocarcinomas. Furthermore, the presence of K-ras mutation and p53 protein accumulation define separate groups of patients. The mechanisms by which these genetic alterations interact or adversely affect prognosis is unknown.

Adenocarcinoma↗
PubMed1994

A new technique for biopsy of human abdominal fat under local anaesthesia with Lidocaine.

The objectives of this study were to develop a new technique to safety, reliably, and in a cosmetically acceptable way, obtain more than 5.0 g of abdominal subcutaneous fat in out-patients, and to investigate whether inhibitory effects of a local anaesthetic on adipose tissue function in vitro are sufficient argument against the use of infiltrative local anaesthesia during fat biopsy to obtain samples for metabolic studies. Measurements were obtained to compare glucose transport and lipolysis response to insulin in adipocytes isolated from subcutaneous abdominal fat obtained: (i) during elective surgery in eight women and four men (BMI 25.8 +/- 3.1 kg/m2); and (ii) from five male and three female out-patients (BMI 25.8 +/- 3.1 kg/m2) by the described novel technique performed under local anaesthesia with Lidocaine. The effects of acute and 11-day exposure to Lidocaine in vitro on adipocyte lipolysis and glucose transport response to insulin, and the growth potential were determined. In vivo exposure of the tissue samples to local anaesthetic by the novel technique had no apparent effect on isolated adipocyte responses to insulin by stimulation of glucose transport or by inhibitor- or adrenaline-stimulated lipolysis; the results were not different to those for adipocytes isolated from fat obtained during elective abdominal surgeries. Lidocaine added in vitro potently inhibited glucose transport and lipolysis in adipocytes, and cell attachment and growth in primary 'ceiling' culture; this effect persisted only as long as Lidocaine was present. After washing, adipocytes fully regained their function and growth regardless of the exposure period, as short as 30 min or as long as 11 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗