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Biomedical subjects

S B Moore

Publications and source records attributed to S B Moore.

At least 19 recordsLinked to original sources
PubMed1992

Ischemic-type biliary complications after orthotopic liver transplantation.

Nonanastomotic biliary strictures that involve only the biliary tree of the graft occur after orthotopic liver transplantation in patients with hepatic artery thrombosis, chronic ductopenic rejection and ABO blood group incompatibility. This complication may also occur in the absence of these known risk factors. The major focus of our study was to evaluate the risk factors for nonanastomotic biliary stricturing of unknown cause after orthotopic liver transplantation. Results demonstrate that the development of biliary strictures is strongly associated with the duration of cold ischemic storage of allografts in both Euro-Collins solution and University of Wisconsin solution. Results also demonstrate that strictures are not associated with the type of biliary reconstruction, the primary liver disease, cytomegalovirus infection, allograft rejection or the presence of a positive lymphocytotoxic crossmatch. More recently, we have markedly reduced the occurrence of nonanastomotic biliary stricturing by decreasing the ischemia time of our allografts. Thus nonanastomotic biliary strictures appear to be the result of the ischemia/reperfusion-induced tissue injury associated with the harvest and implantation of allografts.

Adenosine↗
PubMed1992

Lack of association between cytomegalovirus infection, HLA matching and the vanishing bile duct syndrome after liver transplantation.

In this study we evaluated the association between cytomegalovirus infection alone or in relation to human leukocyte antigen matching and the development of vanishing bile duct syndrome, a form of chronic hepatic allograft rejection. A total of 81 consecutive liver transplant recipients were studied. Cytomegalovirus infection developed in 46 recipients (57%), and vanishing bile duct syndrome occurred in 9 recipients (11%). Cytomegalovirus infection developed in only five of the nine patients with vanishing bile duct syndrome. Univariate analysis of pretransplant recipient/donor cytomegalovirus serological tests and human leukocyte antigen typing showed they were not significant risk factors for the development of vanishing bile duct syndrome. Time-dependent analysis of cytomegalovirus infection after transplantation as a risk factor for vanishing bile duct syndrome, in a multivariate analysis with human leukocyte antigen match, showed no statistical significance. In our study, no association was found between cytomegalovirus infection alone or in relation to class I or II human leukocyte antigen match and the subsequent development of vanishing bile duct syndrome.

Acyclovir↗
PubMed1992

Mayo Clinic experience with allogeneic and syngeneic bone marrow transplantation, 1982 through 1990.

Between April 1982 and July 1990, 101 patients underwent allogeneic or syngeneic bone marrow transplantation at the Mayo Clinic. This patient population consisted of 30 with acute nonlymphocytic leukemia, 25 with acute lymphoblastic leukemia, 29 with chronic granulocytic leukemia, and 17 with other diseases (aplastic anemia in 7, myelodysplastic syndrome in 5, and lymphoma in 5). The results achieved in our patients who underwent transplantation in first complete remission of both acute nonlymphocytic leukemia and acute lymphoblastic leukemia compare favorably with previously reported results. Only 1 of 15 patients (7%) with acute nonlymphocytic leukemia and 2 of 8 patients (25%) with acute lymphoblastic leukemia who underwent transplantation in first complete remission had a relapse. Thus, we recommend early bone marrow transplantation during initial complete remission for patients with either of these disorders who have adverse prognostic factors. In contrast, of 12 patients with either acute nonlymphocytic leukemia or acute lymphoblastic leukemia who underwent transplantation during relapse, 11 died within 6 months. Therefore, such patients should be offered new experimental treatments. Our patients with chronic granulocytic leukemia fared better when they underwent transplantation early during the course of their disease rather than during the accelerated or blast phase. Prospective studies are needed to determine the best approach in these patients.

Academic Medical Centers↗
PubMed1992

Simplified enrollment for autologous transfusion: automatic referral of presurgical patients for assessment for autologous blood collections.

We implemented a pilot program at our institution for automatic referral of patients for presurgical assessment for preoperative and intraoperative collection of autologous blood. Although patients and clinicians support the use of autologous transfusion, often a request for collection of autologous blood is not initiated. During 11 months, 269 patients (82%) of three orthopedic surgeons entered the program, and 218 underwent operation and were dismissed from the hospital. A total of 940 units of autologous blood (675 preoperatively and 265 intraoperatively) was collected from these 218 patients, and 84% of the units were transfused. Throughout hospitalization, 86% of the patients received only autologous blood, whereas 14% received various proportions of homologous and autologous blood. In contrast, only 26% of a concomitant control group of 220 consecutive orthopedic surgical patients not participating in the automatic-referral program received only autologous blood. Thus, the automatic-referral program increased the percentage of elective orthopedic surgical patients who received only autologous blood from 26% to 86% (P less than 0.001). This study also showed that the same amount of blood was used for autologous transfusions as was routinely used for homologous transfusions in similar cases. The automatic-referral system was convenient for physicians and patients and offered the benefits of reduction of transfusion-associated risks and amelioration of patient anxieties.

Blood Transfusion, Autologous↗
PubMed1979

HLA.

HLA typing in 1979 is more complex and more complete than in former years. The distribution of antigens in the HLA system and various methods of identifying them and of determining their structure and function are described. The usefulness of HLA typing in organ transplantation and paternity testing has been well established, and its place in blood component therapy is to some degree still conjectural. Detection of HLA antigens associated either positively or negatively with specific disease states has great importance for several reasons. From an academic point of view, these association may help to define pathogenetic mechanisms, and from a practical viewpoint, there is now good reason to believe that HLA typing may shortly be useful as a diagnostic and predictive tool. Further elucidation of the role of the HLA molecules in the immune response gives hope for better understanding of the immune and autoimmune disorders, which is surely the first step in defining rationally based therapeutic regimens.

Blood Donors↗
PubMed1979

Heterogeneity of HLA-BW35 based on the diallelic BW4-BW6 system.

Utilizing the diallelic BW4-BW6 system of antigens and antibodies, we divided subjects possessing HLA-BW35 into two groups, depending on the association of their BW35 antigens with BW4 or BW6, and demonstrated in family studies that the associated antigens appeared to be inherited together. Absorption experiments were performed to establish the validity of the typings. Anti-human beta2-microglobulin was used in an effort to "map" the location of the BW4 and BW6 antigenic determinants on the HLA molecule.

Alleles↗
PubMed1978

Tuberculous prostatitis.

A study of 5 patients with tuberculosis prostatitis revealed that (1) there is a greater chance of striking a noncaseating granuloma than a caseating lesion by needle biospy when both are present; (2) the absence of caseation on biopsy does not necessarily rule out tuberculosis; and (3) special stains may be negative for tuberculosis because of the small size of the tissue sample. Thus, if the clinical suspicion of tuberculous prostatitis is high and if noncaseating lesions are found, a second biopsy specimen should be taken for culture only.

Adult↗
PubMed1976

Effect of beta-adrenergic blockade on plasma-renin activity and intractable hypertension in patients receiving regular dialysis treatment.

The effect of propranolol has been studied in two patients with chronic renal failure and hypertension which remained refractory despite the removal of excess sodium and water by dialysis. Measurements of plasma-renin, exchangeable sodium, and blood-volume demonstrated that in both patients hypertension was due to excess renin. The administration of propranolol was followed by a rapid fall in blood-pressure to normal, thereby obviating the need for bilateral nephrectomy. In both patients the fall in blood-pressure was accompanied by a striking fall in plasma-renin, and in one there was a highly significant association between plasma-renin activity and mean arterial pressure.

Adult↗
PubMed1975

Palpation thyroiditis (multifocal granulomatour folliculitis).

Disseminated inflammatory lesions constituting a multifocal granulomatous folliculitis in the thyroid are described. These lesions were present in the majority (greater than 83%) of thyroids removed surgically because of thyroid or nonthyroid (carcinoma of the larynx) disease. They also were found at autopsy in patients who died while hospitalized but not in those who died at home. An identical lesion was produced experimentally in dogs by vigorously squeezing their thyroids. The human folliculitis is believed to result from traumatic injury or rupture of isolated thyroid follicles caused by palpation of the gland (palpation thyroiditis). Palpation thyroiditis may have little, if any, clinical importance. The remote possibility that it might be associated with iatrogenically produced metastasis of thyroid carcinoma is being investigated.

Adenoma↗