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Biomedical subjects

J M Moran

Publications and source records attributed to J M Moran.

At least 91 records · Page 5Linked to original sources
PubMed1979

Effect of gentamicin on shear and interface strengths of bone cement.

Antibiotic impregnated cement offers a potential method for salvage of infected total joint replacements. The addition of gentamicin in concentrations of .5, 1.0, and 2.0 per 40 significantly affects the shear strength of Palacos acrylic bone cement. The clinical significance of this strnegth drop is not clear. Large grained antibiotic additives have deleterious effect on shear strength. Measurements were made to determine the effect of gentamicin concentration on the bone-cement interface strength but no trend could be determined. The interface strength was much less than the strength of Palacos alone and suggested that bone strength is the limiting factor.

Acrylic Resins↗
PubMed1978

Vena cava interruption after pulmonary embolectomy.

Interruption of the inferior vena cava for thromboembolism is occasionally apppropriate following either pulmonary embolectomy or other cardiac operation performed through a median sternotomy. Experience has shown that simple extension of the sternotomy incision to the umbilicus is a quick and practical means of obtaining good exposure for caval interruption.

Abdominal Muscles↗
PubMed1977

Staged intracranial and extracranial revascularization.

Twenty patients with a combination of intracranial and extracranial cerebrovascular lesions were identified in a series comprised of 118 candidates for superficial temporal artery to middle cerebral artery (STA-MCA) bypass. Ten patients had internal carotid (ICA) occlusion and contralateral ICA stenosis, seven patients had combinations of ipsilateral lesions, usually ICA occlusion and external carotid (ECA) stenosis, and three patients had multiple lesions. Eighteen patients had a STA-MCA bypass performed; 11 of these had contralateral reconstruction for ICA stenosis, and seven had ECA stenosis corrected. Two additional patients became asymptomatic after ECA endarterectomy only and their proposed STA-MCA bypass has been postponed. There were two deaths, one early and one late. Eleven patients are asymptomatic, five are improved, one is unchanged, and one is neurologically worse.

Adult↗
PubMed1977

Treatment of cardiogenic shock in myocardial infarction by intraaortic balloon counterpulsation surgery.

Thirty-seven patients in cardiogenic shock due to acute myocardial infarction were treated with intraaortic balloon counterpulsation and/or surgery. Eighteen of these patients were treated with counterpulsation alone; eight survived and five were in functional class I or II at the time of follow-up; two were in functional class III, and one was in functional class IV. Nineteen patients were treated surgically, eight survived and seven were in functional class I or II at the time of follow-up; one was in functional class III. Good functional recovery with counterpulsation alone is most common with inferior infarction. With surgery, functional recovery depends not only on the extent of the infarction and the coronary anatomy, but also on the ability to perform surgery within 12 hours of infarction or to support the patient with mechanical means for 10 to 14 days after the infarction and then perform surgery.

Adult↗
PubMed1977

Refractory ventricular arrhythmia: the role of intraoperative electrophysiological study.

Thirty patients with drug refractory ventricular tachycardia (RVT) were studied between 1 week and 5 years after myocardial infarction with coronary agniography and left ventriculography. They were divided into four groups: (1) inoperable, five patients; (2, a) operated, with primary left ventricular failure, five patients; (2, b) operated with primary RVT, not mapped, 15 patients; (2, c) operated, with mapping, five patients. The mortality rate in group 1 was 100%, and in group 2, a it was 80%. In group 2, b, despite aggressive drug therapy and operation, including aneurysmectomy, coronary revascularization, and intra-aortic balloon pumping when appropriate, the mortality rate wad intraoperative mapping in group 2, c. Arrhythmogenic foci were identified and removed in four. There was one operative death (20%) and four patients are alive from 12 to 27 months after operation, three of whom are asymptomatic. Intraoperative epicardial mapping is an important adjunct to surgery for RVT.

Aged↗
PubMed1976

Definition of myocardial perfusion by continuous infusion of krypton-81m.

Krypton-81m, a radionuclide emitting a 190 kev gamma ray, has a half-life of 13 seconds. It is a radioisotope of an inert water-soluble noble gas and is produced at a constant rate by spontaneous decay of rubidium-81 in an 81Rb-81mKr generator-delivery system. Delivery is through a minibore Teflon catheter that can be threaded through a standard no. 7 or 8F angiographic catheter. The generator is eluted by 5 percent dextrose-in-water, delivered by infusion pump at 1.5 ml/min, and the eluate is infused intraarterially directly into any organ. Delivery and decay reach equilibrium within 2 minutes, producing a heterogeneous distribution that is proportional to the perfusibility of the tissue concerned and the time required to reach it. The ultrashort halflife of the radionuclide rapidly eliminates activity when delivery ceases; thus, experiments can be sequentially repeated at brief intervals. The radiation hazard for easily imaged doses is negligible. Preliminary studies in open chest dogs were visualized by scintillation camera, stored on digital data disk, processed, and displayed in dual channel, dual color mode on a video system. Images of myocardial perfusion defined relative levels of perfusion, collateral circulation between coronary arterial branches, equilibrium time of diffusible perfusion of the myocardium, focal defects in induced occlusion, collateral circulation to occlusion, and reactive hyperemia after release of induced coronary occlusion. The system and technique appear applicable to human subjects.

Animals↗
PubMed1976

Surgical treatment of postinfarction ventricular aneurysm.

We have operated on 62 consecutive patients for postinfarction ventricular aneurysm since coronary bypass grafting became available. Analysis of hemodynamic and angiographic data reveals that the prognosis of operation is favorable if mean pulmonary artery pressure is less than 45 mm Hg and cardiac index is greater than 2.0 L/min/m2; such factors as the preoperative New York Heart Association Functional Class, number of coronary grafts, aneurysm size, left ventricular end-diastolic pressure, and coronary score were not closely related to the outcome of operation. Hospital mortality was 6.5% (4 patients) and late mortality, with a mean follow-up of two years, was 11% (7 patients). The prognosis among survivors was good: 82% (46) achieved NYHA Class I or II status, whereas 87% (54) had been in Class III or IV preoperatively. Concomitant vein grafting with aneurysmectomy did not significantly enhance operative or late survival, nor did it add appreciably to the risk of operation. Long-term benefits of revascularization in addition to aneurysmectomy are expected but not yet proved.

Adult↗
PubMed1976

Balloon counterpulsation following surgery for ischemic heart disease.

Intraaortic balloon counterpulsation (IABC) was used in 40 patients who developed left ventricular pump failure following surgery for ischemic heart disease. The IABC was inserted in the operating room in 32 patients, and within 36 hours of surgery in eight patients. Four patients could not be weaned from cardiopulmonary bypass and died in the operating room. Of the other 36 patients, eight died while on IABC. Twenty-eight patients (70%) were successfully weaned from IABC, although six died later in hospital. Twenty-two patients (55%) survived hospitalization. No late deaths have occurred at 5-33 months of follow-up (mean 16-4 months). Twenty (91%) of 22 survivors are Class I or II at time of this report. Postoperative pump failure occurs because of perioperative acute myocardial infarction and/or major preoperative left ventricular dysfunction. Patients with perioperative infarction who have no prior left ventricular dysfunction have a significantly lower mortality (14%) than do those patients with preoperative left ventricular dysfunction who have subsequent acute perioperative infarction (mortality 67%) P less than 0.05.

Adult↗