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Biomedical subjects

J R Moore

Publications and source records attributed to J R Moore.

At least 73 records · Page 4Linked to original sources
PubMed1986

Free vascularized bone and muscle flaps for osteomyelitis.

Chronic, post-traumatic osteomyelitis remains an unsolved problem for orthopedists. With improved knowledge of skin and muscle flap circulation, surgeons are now capable of covering wide defects left by debridement. Early clinical experience with muscle and skin flaps to improve vascularity and achieve a stable, closed wound have been encouraging. Management of wounds with infected bone is primarily aimed at resection of infected or nonviable tissue. Antibiotics are of value, however are of secondary importance to a thorough debridement. It is uncertain as to whether osteomyelitis is a curable entity. However, free tissue transfer affords the surgeon the opportunity to perform a thorough debridement and achieve a stable closed wound.

Adult↗
PubMed1986

Prevalence of DSM-III conduct and adjustment disorders for adolescent psychiatric inpatients.

The prevalence of DSM-III conduct and adjustment disorders in two adolescent psychiatric facilities, both located near large U.S. cities, was investigated. Overall, 31.6% of the adolescent inpatients were conduct disordered while 12.5% were adjustment disordered. The conduct disorders were primarily "aggressive" subtypes suggesting that this characteristic may influence hospitalization and diagnostic decisions. Such data on prevalence assists future treatment planning, allowing anticipation of case loads.

Adjustment Disorders↗
PubMed1986

Vascularized tissue transfer in the treatment of osteomyelitis.

In conclusion, the efficacy of free tissue transfer in the treatment of osteomyelitis is geared mainly at enabling the surgeon to perform a wide radical debridement of infected and nonviable soft tissue and bone. Definitive bony management does not have to be performed concurrently with the soft-tissue coverage procedure and may be effectively staged. The type of free tissue transfer employed will depend upon the size and location of the defect, the condition of the contiguous structures, and the experience of the surgeon. Free tissue transfer that is used judiciously after the eradication of all infected bone and soft tissue appears to be a useful technique for controlling osteomyelitis.

Adult↗
PubMed1986

Gastric carcinoma: 30-year review.

The records of 1030 patients with gastric carcinoma seen between 1941 and 1970 were analysed. A 10-year follow-up was available for 1024. The overall operability and resectability rates were 80.9% and 53.5% respectively, and in the two decades 1951 to 1960 and 1961 to 1970, the rates increased significantly, as did the subtotal gastrectomy rate of 46.9%. Subtotal resection for cure was done in 59.5%, and for palliation in 40.5%. Fifty-six patients underwent a total gastrectomy. There was no significant increase in consecutive decades in either overall 5-year survival or survival following subtotal gastrectomy. The 5- and 10-year survival rates of 15.1% and 6.6%. Of the 5-year survivors, 54% had no lymphnode involvement and 35.2% had nodes positive for tumour spread. Gastroesophagectomy was associated with a high morbidity and extremely low survival. Of 56 patients having a total gastrectomy, 37 lived 1 year or more while only 5 survived 5 or more years. Linitis plastica occurred with equal frequency in men and women. Operability and resectability rates were lower and there was a 90.6% 1-year death rate.

Adult↗
PubMed1985

Toe-to-hand transfer based on the medial plantar artery.

Two patients had toe-to-hand transfers based on the medial plantar artery system. The dorsalis pedis and first dorsal metatarsal arteries were absent in both cases. Although the procedure is slightly more complicated than currently described techniques for toe-to-hand transfers based on the dorsal system, the procedure was performed in both cases without complication.

Adult↗
PubMed1985

Gouty tenosynovitis in the hand.

Gouty tenosynovitis can present as an infection, tendon rupture, nerve compression, or digital stiffness. In ten patients, extensive urate deposition was encountered in the extensor tendons at both the wrist and digital levels in addition to involvement of the flexor tendons in the carpal canal and digital theca. Direct nerve or muscle involvement was not observed in the hand. Medical therapy, which is now the cornerstone of treatment for most aspects of gout, may not be the best treatment for tophaceous deposits in the hand. Operative treatment may be required to debulk tophaceous deposits, improve tendon gliding, decompress nerves, allow increased range of motion of joints, and ameliorate pain.

Adult↗
PubMed1985

Embolotherapy in the treatment of congenital arteriovenous malformations of the hand: a case report.

This article describes the treatment of a painful ulcerating congenital arteriovenous malformation in the hand of a 39-year-old woman. Preoperative transcatheter embolotherapy was used to diminish vascularity and engorgement. Operative treatment consisted of a resection of angiomatous material and coverage with a pedicle flap. Preoperative transcatheter embolization of small feeder vessels may offer some advantage over the operative approach alone in treating congenital arteriovenous malformations of the hand.

Adult↗
PubMed1985

Blood vessel implantation into ischemic bone.

Blood vessel implantation, core decompression, and core decompression plus cancellous bone grafting were compared in 36 adult mongrel dogs to evaluate their relative effectiveness in revascularizing an ischemic femoral head. Each of the methods resulted in a reversal of the ischemic changes to varying degrees. Blood vessel implantation resulted in increased new bone formation at the site of vessel implantation but no significant revascularization in the peripheral portion of the femoral head. The method of creating avascular necrosis of the femoral head of the canine, as described by Hori, was studied in a controlled fashion. Although ischemic changes were noted in our hands, the model failed to produced findings consistent with avascular necrosis.

Angiography↗
PubMed1985

Agenesis of the corpus callosum and macrocephaly in siblings.

A brother and sister with developmental delay, relative macrocephaly and agenesis of the corpus callosum are described. The brother also had unilateral cerebellar hypoplasia and malrotation of the large bowel. Published cases of familial agenesis of the corpus callosum are reviewed and the value of ultrasonography in demonstrating agenesis of the corpus callosum in the neonate is emphasised.

Abnormalities, Multiple↗
PubMed1985

Severe pseudoachondroplasia with parental consanguinity.

A boy who showed features of the severe form of pseudoachondroplasia, whose parents were first cousins, is reported. Published reports supporting the existence of an autosomal recessive form of this disorder are reviewed.

Achondroplasia↗
PubMed1984

Colorectal cancer. Risk factors and screening strategies.

Colorectal cancer is common in the United States and frequently discovered too late for cure. Epidemiologic studies suggest a complex relationship between animal fat intake, fecal flora, and risk of development of colorectal cancer, but the actual mechanism of carcinogenesis is still unknown. Early detection might increase the proportion of patients who could be cured of the disease. Screening of asymptomatic subjects over the age of 40 years for fecal occult blood seems to detect cancers before they become invasive. Efforts are needed to ensure that all subjects with positive tests for occult blood are completely examined. We prefer colonoscopy as a single test in that it is both diagnostic and curative early in the disease. The cost-effectiveness of mass screening and its ability to reduce colorectal cancer mortality in our society require further prospective study.

Adenoma↗
PubMed1984

Allogenic transplants of bone revascularized by microvascular anastomoses: a preliminary study.

An area of experimental bone grafting that needs further study is the use of free vascularized allografts of bone. In 35 outbred mongrel dogs, the viability of vascularized bone allografts with and without azathioprine immunosuppression was compared to vascularized autogenous bone grafts. Viability was assessed by histologic techniques, fluorochrome bone labeling, and electron microscopy. Autogenous vascularized bone grafts remained viable, and it was concluded that microvascular technique was not the limiting factor in attaining survival of the grafts. The behavior of autogenous vascularized bone grafts with and without the influence of azathioprine was similar. Allogenic vascularized bone transplants uniformly failed at a period between 2 and 3 weeks. Immunosuppression with azathioprine did not appreciably affect survival of the osteocytes. However, the host response to the foreign tissue was slightly modified. The clinical ramifications of bone transplantations in humans are not analogous to the clinical situation of transplantation of other organs. If vascularized bone transplants are performed in humans, a relatively safe form of immunosuppression is necessary. This study suggests that azathioprine alone does not offer sufficient immunosuppression to insure viability of the vascularized transplant.

Animals↗
PubMed1984

Localized nodular tenosynovitis: experience with 115 cases.

One hundred fifteen cases of localized nodular synovitis (giant cell tumor of the tendon sheath) were reviewed. The optimal treatment for these lesions is unknown, and a high recurrence rate exists. Growths arose from most of the synovial sites of the hand, including joints, capsular ligaments, and tendon sheaths. Deformation of the bone surface was commonly seen; however, bone invasion was uncommon. The histologic features may vary, but the lesions are always benign and do not metastasize. Treatment consisted of thorough local excision and adjacent joint exploration when appropriate. Recurrence occurred in 10 cases (9%) with one to five additional surgical procedures needed to eradicate the lesion.

Adolescent↗