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Biomedical subjects

J T Moore

Publications and source records attributed to J T Moore.

At least 55 records · Page 3Linked to original sources
PubMed1990

Surgical complications of continuous ambulatory peritoneal dialysis.

Surgical experience with 260 consecutive patients with chronic renal failure receiving continuous ambulatory peritoneal dialysis (CAPD) at one medical center from 1980 to 1989 is reviewed. Patients received CAPD for a mean of 24.2 months (range: 3 days to 91 months). Catheter longevity consistently improved in all but 1 year from 1984 to 1989, as did exit-site and tunnel infections. Of 311 catheters inserted, 151 (49%) required removal, of which 111 (74%) were attributed to peritonitis. Cumulative patient survival was 80%, 60%, and 53% at 1, 2, and 3 years, respectively. Diabetic patients had statistically significant lower survival rates. Additional complications including catheter leakage, catheter malposition, catheter obstruction, and abdominal wall hernias were negligible. Although CAPD is not free from serious complications, our data show remarkable improvement since 1980 in catheter longevity, hospital stay, and infection rates.

Catheters, Indwelling↗
PubMed1989

Magnetic resonance findings in REM sleep behavior disorder.

Rapid eye movement (REM) sleep behavior disorder is characterized by bizarre acts during nocturnal sleep that may lead to physical injuries. Dream content suggests that motor overactivity is an attempted dream enactment and polygraphic studies reveal REM stage without atonia, an alteration of REM sleep generation that facilitates excessive motor activity. In 6 patients with REM sleep behavior disorder. MRI of the brain showed multifocal signal intensity lesions suggestive of lacunar infarcts in periventricular regions (5 patients) and in dorsal pontomesencephalic areas (3 patients). REM sleep behavior disorder may be the result of injury to the midrostral tegmentum nuclei, the tegmentoreticular tracts, or both. This condition is easily controlled with clonazepam.

Aged↗
PubMed1989

An ambulatory geriatric evaluation unit in a family geriatric curriculum.

Training in Geriatric Medicine has become increasingly important in the education of family physicians. This paper describes the experience of a community-based Family Medicine residency in developing an ambulatory Geriatric Evaluation Unit (GEU) as part of a comprehensive geriatric curriculum. The experience demonstrates the value of a multidisciplinary team approach, systematic development and integration of additional education activities as effective techniques for training family physicians and ancillary health care providers.

Allied Health Personnel↗
PubMed1988

Processing of two protein precursors yields four mature guinea pig seminal vesicle secretory proteins.

The translation of the two most abundant guinea pig seminal vesicle epithelium mRNAs (1800 nucleotides and 950 nucleotides) and the subsequent processing of their protein products were studied in an effort to elucidate the mechanism by which the four mature guinea pig seminal vesicle epithelium (GPSVE) secretory proteins are produced. The primary translation products of the 1800 nt and 950 nt mRNAs are two secretory protein precursors of 45 kDa and 20 kDa, respectively. Removal of signal peptides from these two precursors produces proteins of 43 kDa and 18.5 kDa, which are recognized by polyclonal antisera directed against the four mature secretory proteins. The existence of further processing intermediates in the production of the secretory proteins is suggested by the appearance of other immunoreactive polypeptides following incubation of GPSVE in nutrient medium containing [3H] leucine. Immunological and pulse-chase analysis strongly suggests that the 43-kDa protein gives rise to SVP-1, -3, and -4 and that SVP-2 is derived from the 18.5-kDa protein.

Animals↗
PubMed1988

Significance of premorbid adjustment and psychotherapy in selected case studies.

Although psychiatric symptoms are common among elderly individuals, these symptoms are seldom treated by psychotherapy. This article proposes a model to help explain genesis of psychiatric symptoms in late life. The model, which is illustrated by case examples, suggests psychotherapeutic strategies and helps define methods of assessing therapeutic outcomes. The model emphasizes the importance of losses, premorbid adjustment, and mediating factors in determining whether stresses result in adaptation or symptom formation.

Aged↗
PubMed1987

Malignant pneumomediastinum: successful tube mediastinostomy in the neonate.

Five critically ill neonates underwent tube mediastinostomy in the neonatal intensive care nursery for tension pneumomediastinum. All of the neonates showed immediate clinical improvement, with a decrease in peak airway pressure and elevation of arterial oxygen pressure levels. There were no complications directly attributable to the procedure. We believe that pneumomediastinum in association with severe hypoxia, metabolic acidosis, and high ventilation pressures indicates clinically significant tension in the mediastinum. This results in a decrease in systemic blood pressure and pulmonary venous return that is not amenable to conservative management. Needle aspiration is inadequate because of the dynamic nature of the air leak. Tube decompression of the mediastinum is the treatment of choice in these circumstances.

Humans↗
PubMed1987

The major clotting protein from guinea pig seminal vesicle contains eight repeats of a 24-amino acid domain.

The complete amino acid sequence of the major clotting protein from the guinea pig seminal vesicle (SVP-1) has been determined by nucleotide sequencing of cDNA clones corresponding to the 3' terminus of an mRNA that codes for a protein precursor to SVP-1. The first 40 amino acids of the derived protein sequence are identical to those determined by N-terminal sequencing of SVP-1 isolated from the lumen of the seminal vesicle. This finding confirms that SVP-1 is cleaved from the C terminus of a larger precursor protein. The portion of the nucleotide sequence that codes for SVP-1 contains eight highly homologous but imperfect repeats of a 72-nucleotide domain. This repeated structure is also evident at the amino acid level. The consensus 24-amino acid repeat unit contains two lysine and three glutamine residues. Since the clotting of SVP-1 is known to involve the formation of gamma-glutamyl-epsilon-lysine crosslinks, it is likely that the 24-amino acid repeating unit is the unit of function of SVP-1.

Amino Acid Sequence↗
PubMed1986

Vertical ring gastroplasty for morbid obesity. Five year experience with 1,463 patients.

Vertical gastroplasty is a safer and simpler operation than gastric bypass for morbid obesity, but to produce permanent long-term weight loss, a permanent support is needed for the outlet of the newly created gastric pouch in vertical gastroplasty. The most important finding in this study of 1,463 patients with vertical gastroplasties was the development of a safe and practical use of a Silastic ring to permanently support the outlet. Using an uncovered Silastic ring, erosion of the ring has not been observed and long-term weight loss of 36.7 percent of original weight or 63.4 percent of excess weight has been obtained, which is equivalent to that reported for gastric bypass or other gastric reduction procedures. In addition, lower mortality and lower morbidity rates have been achieved than those reported in studies using other gastric reduction methods. Silastic ring vertical gastroplasty with an uncovered ring is the safest and most effective of the gastric reduction procedures in our experience.

Adolescent↗
PubMed1986

The effects of androgen on the transcription of specific genes in guinea pig seminal vesicle epithelium.

Steroid hormones have been shown to have highly differential effects on the expression of abundant cell-specific protein genes in a multitude of model tissues. In rat seminal vesicle, for example, DNA clones representing two major secretory protein genes have been used to show that both of the genes are differentially regulated by androgen. In this paper, we have examined the effects of androgen on the transcription of two major secretory protein genes in guinea pig seminal vesicle epithelium. Nuclear run-off experiments were used to show that castration of the adult resulted in a 3-fold decrease in total transcription activity. Surprisingly, the decrease in total transcriptional activity was not reflected in a differential decrease in the transcriptional activity of the two major secretory protein genes. When the effects of castration on the transcriptional activity of the major secretory protein genes were compared to the effects on other genes, it was found that the transcriptional activity of each gene examined was decreased by the same magnitude as the major secretory protein genes. Similarly, the transcriptional activity of every gene examined increased by the same magnitude as the major secretory protein genes during hormone repletion of the castrated adult. Thus, in contrast to the differential effects of steroids on the transcription of abundant cell-specific proteins in many other steroid-dependent tissues, the transcription of major secretory proteins in guinea pig seminal vesicle epithelium appears to be regulated in parallel with many other genes. The generalized effects of androgen on transcriptional activity could account for the generalized effects of androgen on seminal vesicle epithelial cell structure and function.

Animals↗
PubMed1985

The cDNA cloning of a 55-kilodalton protein from guinea pig seminal vesicle. Evidence that the protein is the precursor of a 25-kilodalton basic secretory protein.

Guinea pig seminal vesicle epithelium synthesizes and secretes large amounts of four secretory proteins including a basic protein designated SVP-1. The latter migrates as a protein of 25 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. When total cellular RNA from seminal vesicle epithelium was translated in vitro by a rabbit reticulocyte system, SVP-1 was not identifiable as a product. In contrast, a major product of the reticulocyte system was a 55-kDa protein which paradoxically could not be identified as one of the four known secretory proteins or as an abundant tissue protein. We isolated a cDNA clone which corresponded to the mRNA which coded for the 55-kDa protein. The mRNA was 1800 bases and of very high abundance; only the transcripts corresponding to the major secretory proteins SVP-3 and SVP-4 were as conspicuous. From these observations, we decided to test whether the 55-kDa protein was related to SVP-1. The 55-kDa protein was found to share properties of SVP-1, including an alkaline pI and selection by antibody against SVP-1. After proteolytic digestion of the 55-kDa protein, one fragment co-migrated with authentic SVP-1. Furthermore, detectable fragments of the 55-kDa protein smaller than SVP-1 all co-migrated with fragments generated from the proteolytic digestion of SVP-1. Finally, we show that the 55-kDa protein could be processed in vitro by seminal vesicle lumenal extracts to yield a 30-kDa protein and a protein the size of native SVP-1. The best explanation of our results is that the 55-kDa protein represents the primary translation product and precursor of SVP-1. Our proteolytic mapping and in vitro processing studies are consistent with the idea that the 55-kDa protein is a tandem repeat of two SVP-1 molecules. We used the cDNA clone to study the expression of the corresponding gene in different states of androgen depletion and repletion.

Animals↗
PubMed1985

The growth of individual seminal vesicle epithelial cells and their proliferation.

Histologically seminal vesicle epithelium (SVE) of the intact adult guinea pig is a discrete and segregated monolayer of highly specialized tall columnar cells. The epithelial layer is so sharply demarcated from its attached stroma (primarily smooth muscle), that blunt dissection alone is sufficient to separate epithelium from muscle. After castration the epithelial cells decrease in both size and number so that by the fifth day, the surviving cells are greatly involuted structurally and comprise only about 12% of the original numerical population normally present in one seminal vesicle. Injected testosterone leads to restructuring of individual cells followed by cell replenishment. The major goal of this effort was to elaborate upon the processes of individual cell growth and cell replenishment during restoration of the tissue to normal cell size and number. The two separate processes were studied using light and electron microscopy, [3H]thymidine incorporation, and Northern blots with labeled histone gene probes. By approximately 48 hr of hormone repletion, parenchymal cell size had returned to normal as the result of a dramatic anabolic process of individual cell growth while cell number remained unchanged. During the subsequent 48-hr period of hormone repletion, the cell population was restored to normal as cell replenishment became the predominant process. Microscopic analysis at intervals throughout the 96-hr period failed to disclose any mitotic events to account for cell replenishment even when Colcemid had been administered. Nor could the increase in cell numbers be correlated with a great increase in [3H]thymidine incorporation or in histone mRNA synthesis. Thus, we could provide no evidence that mitotic division of the parenchymal cells themselves is responsible for cell replenishment. During the 24- to 48-hr interval of hormone repletion, electron microscopic examination disclosed the presence of small epithelial cells lying in a basal position. Some of these cells were seen to insert themselves between the basal regions of parenchymal cells and to expand from the basement membrane into the parenchyma. Possible origins of the cells which replenish the tissue are discussed.

Animals↗
PubMed1984

Expression of a secretory protein gene during androgen-induced cell growth.

Guinea pig seminal vesicle epithelium is an androgen-dependent tissue composed of tall columnar cells which synthesize four major secretory proteins designated SVP-1-4. Castration promptly causes the seminal vesicle epithelium cells to undergo major morphological changes. By the fifth day after castration, cell number decreases to 12% of normal, and the surviving cells are greatly involuted structurally. An injection of testosterone was sufficient to stimulate individual cell growth to the normal tall columnar configuration by 48 h without increasing cell number. Cell growth following testosterone was preceded by a 4-fold increase between 0-12 h in total cellular RNA signifying a large increase in rRNAs. To aid in the analysis of gene expression during androgen repletion, we identified a cDNA plasmid clone representing the 3'-end of the mRNA of SVP-4. The clone pAT 76 was identified by hybrid-select translation and characterization of the product of in vitro translation. The steady-state levels of SVP-4 mRNA in blots of total cellular RNA increased between 0-24 h; this appeared to be due mainly to a general nonselective increase in all or most of the abundant mRNAs. We demonstrated by in vitro translation studies that the corresponding transcript was still present during the 5th and 36th days of castration without having undergone a selective loss in abundance and during hormone repletion without undergoing a selective increase. Testosterone exerted an early and more conspicuous effect on rRNA synthesis. Whether direct or indirect this may be a key event underlying the ultimate action of testosterone, namely maintenance of cell structure.

Animals↗
PubMed1984

Evolution of a geriatric evaluation clinic.

Multidisciplinary geriatric evaluation units are being established in hospitals and, to a lesser extent, as outpatient clinics. This paper presents results of a chart audit of 332 patients seen from 1978 to 1982 at a university based geriatric outpatient evaluation unit. The relationships of clinic staffing to types of referrals and other aspects of clinic operation are investigated. During the time under study, the proportion of patients whose problems were medical rather than psychiatric or social increased. Presenting problems varied by referral source. Family and self referrals were most likely to identify a medical presenting problem, while physician and community agency referrals were most likely to identify a psychiatric problem. Patients frequently received diagnoses in areas of function other than those identified as the presenting problems. For example, medical clinicians made at least one psychiatric diagnoses for 86 per cent of patients they evaluated. Important questions about the potential contribution of such geriatrics clinics to health care of the elderly remain to be answered.

Aged↗
PubMed1983

Recognition and treatment of depression in a family medicine practice.

To test the hypothesis that depression is significantly underdiagnosed in general medical settings, the Zung Self-Rating Depression Scale was administered to 1,086 family medicine outpatients seen during a 12-month period before their initial medical examination. The effects of such screening on clinical recognition and treatment of depression were examined. Of the 1,086 patients, 143 (13.2%) were symptomatically depressed. These patients were randomized into two groups: 102 were identified as clinically depressed to their physician, and the remaining 41 were not (control group). Physicians diagnosed depression in 15% of the control group and in 68% of the identified group. At 4-week follow-up, 64% of the identified patients who were treated with maprotiline (16 of 25) showed improvement; only 28% of the identified patients who were electively not treated improved. Improvement occurred in only 18% of the control group. It appears that the diagnosis of depression is not ordinarily made in family medicine outpatient settings and that self-rating depression scales are useful diagnostic aids, whose regular use is indicated by the high prevalence of depression in general medical populations.

Adult↗
PubMed1983

A Functional Dementia Scale.

Development of a scale to quantify the severity of functional disabilities associated with dementia is described. The Functional Dementia Scale (FDS) is designed for use by caretakers of disabled elderly. It contains 20 items in three subscales: activities of daily living, orientation, and affect. Cronbach's alpha coefficient of internal consistency for the scale was .90, and test-retest correlation was .88.

Activities of Daily Living↗
PubMed1982

Functional disability in the hospitalized elderly.

Little documentation exists concerning the extent of functional disability in the hospitalized elderly and the impact of this disability on the care of these patients. A physician-led survey was conducted in a 400-bed community hospital of 279 patients aged 70 or more years. Considerable age-correlated disability was documented. Fifty-four percent of the patients aged 85 years or older were moderately or severely disoriented. Thirty-four percent had impaired hearing, 40% had impaired vision, and 25% had speech impairments. More than half of the patients 75 years or older needed assistance with activities of daily living. Modern hospital design and services may interfere with functional recovery. Evaluation of special care units to minimize the hazards of hospitalizing the elderly is recommended.

Activities of Daily Living↗