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Biomedical subjects

J H Moore

Publications and source records attributed to J H Moore.

134 records · Page 8Linked to original sources
PubMedDate not supplied

Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine.

The results of transplantation of free autologous fat obtained by blunt syringe suction lipectomy are unpredictable. We examined if adipose tissue viability is compromised by using syringe suction lipectomy and by infiltration of the tissue with local anesthetics. As reference, we used adipose tissue samples excised during elective surgery. Fat obtained intraoperatively and by lipectomy was digested with collagenase to isolate adipocytes. The mechanical damage associated with sample handling and cell isolation in both procedures was similar and did not exceed 6% of the total cell mass. In addition, cells isolated from intraoperative and lipectomy samples did not differ functionally, responded similarly to insulin stimulation of glucose transport and epinephrine-stimulated lipolysis, and retained the same growth pattern in culture. Since during fat transplantation the graft is exposed to local anesthetics at both the donor and the recipient sites, we reexamined adipocyte function in the presence of lidocaine. Lidocaine potently inhibited glucose transport and lipolysis in adipocytes and their growth in culture. That effect, however, persisted only as long as lidocaine was present; after washing, the cells were able to fully regain their function and growth regardless of whether the exposure was as short as 30 minutes or as long as 10 days. These results indicate that adipose tissue obtained by syringe lipectomy consists of fully viable and functional adipocytes, but local anesthetics may halt their metabolism and growth.

Adipocytes↗
PubMedDate not supplied

Epidural analgesia compared with intravenous morphine patient-controlled analgesia: postoperative outcome measures after mastectomy with immediate TRAM flap breast reconstruction.

BACKGROUND AND OBJECTIVES: Epidural analgesia has been shown to provide superior pain control compared with intravenous (IV) opioids after major surgical procedures. In this study, we compared the effect of epidural analgesia and IV morphine patient-controlled analgesia (PCA) on pain relief, duration of hospitalization, oral nutrition, ambulation, and side effects in patients undergoing a major surgical procedure (i.e., unilateral mastectomy with immediate transverse rectus abdominis musculocutaneous flap reconstruction). METHODS: Eighteen patients were prospectively randomized to receive either epidural analgesia or PCA during the postoperative period. The intensity of pain was assessed daily by a 100-mm visual analog scale. The total length of hospital stay, time to ambulation, and time to oral nutrition were recorded. RESULTS: The epidural group had significantly lower pain scores at 3 evaluation times through postoperative day number 4 (P < .05). The total length of hospitalization for the epidural group (median, 101 hours) was significantly less than the PCA group (median, 126 hours; P = .0498). The time to first ambulation, time to first bowel sounds, time to tolerating oral nutrition, incidence of nausea/vomiting or pruritus, and time to first flatus were not statistically different between the groups. CONCLUSIONS: These results show that epidural analgesia compared with PCA offered improved pain control after breast reconstruction with immediate transverse rectus abdominis musculocutaneous flap reconstruction. It also resulted in a 25-hour reduction in time of hospitalization.

Adolescent↗
PubMedDate not supplied

The biophysical effects of ultrasound on median nerve distal latencies.

PURPOSE: Previous studies have documented the lack of ultrasound's non-thermal effects on nerve conduction using frequencies of 1 MHz and 870 kHz. The analyses and conclusions were reached, despite only one study incorporating pulsed ultrasound. The purpose of this study was to determine the biophysical effects of continuous wave (CW) and pulsed wave (PW) ultrasound on median nerve motor and sensory latencies using common frequencies of 1.0 and 3.0 MHz. SUBJECTS: Fifteen healthy subjects (8 males, 7 females, age = 23.5 + 4.44 yrs, height = 171.2 + 10.7 cm, weight = 67.5 + 7.9 kg) without a history of neurological or musculoskeletal injury to their non-dominant arm volunteered for testing. METHODS AND MATERIALS: Subjects were exposed in counterbalanced order to five ultrasound treatment conditions: (1) 1 MHz, 1.0 W/cm2, 8 min., (2) 1 MHz, 1.0 W/cm2, 50% PW, 8 min., (3) 3.0 MHz, 1.0 W/cm2, CW, 8 min., (4) 3.0 MHz, 1.0 W/cm2, 50% PW, 8 min., (5) placebo, 0.0 W/cm2, 8 min. Dependent measures for motor and sensory latencies, and subcutaneous temperatures were taken pretreatment, at 2, 4 and 6 minutes during treatment, and immediately post-treatment. Separate two within repeated measures ANOVA were used for each dependent measure. RESULTS: Analysis revealed significant interactions for motor latencies [F (16,224) = 52.77, p < .001], sensory latencies [F (16,224) = 41.10, p < .001], and subcutaneous temperatures [F (16,224) = 52.77, p < .001]. Tukey's HSD post hoc analyses confirmed that nerve latencies responded similarly to subcutaneous temperature changes during and after ultrasound treatment. CONCLUSIONS: Alterations in nerve latencies from ultrasound on healthy nerves appeared to be related to temperature changes induced by ultrasound's thermal effects, and not by non-thermal or mechanical effects.

Adult↗
PubMedDate not supplied

The effect of the median nerve compression test on median nerve conduction across the carpal tunnel.

INTRODUCTION: We conducted an experimental, single-blind research study to determine the efficacy of using the median nerve compression test (MNCT) to improve the sensitivity and specificity of median nerve motor and sensory latencies for the diagnosis of carpal tunnel syndrome (CTS). We expected post-MNCT latencies to be prolonged in the CTS group. METHODS: A convenience sample of 18 subjects aged 18-65 was enrolled in this study. The CTS group consisted of 9 subjects with 14 hands tested having clinical signs and symptoms of CTS and normal baseline latency measures. The control group consisted of 9 gender- and age-matched (+/- 3 years) subjects with 14 hands tested. Three standard distal sensory latencies (DSL) and one distal motor latency (DML) were obtained, then repeated after application of the MNCT. RESULTS: No significant differences in latencies were found between groups (p = 0.76) or within subjects (p = 0.74) after application of the MNCT. There was less than 10% increase in sensitivities of post-MNCT latencies. DISCUSSION AND CONCLUSION: We found that the MNCT did not cause a meaningful increase in sensitivity or specificity of latencies for the diagnosis of CTS. The use of the MNCT as a method to prolong standard latencies is not recommended.

Adolescent↗