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Biomedical subjects

T C Moore

Publications and source records attributed to T C Moore.

At least 37 records · Page 2Linked to original sources
PubMed1990

Advantages of performing the sagittal anoplasty operation for imperforate anus at birth.

The development of the posterior sagittal anorectoplasty approach has been a major recent advance in the repair of imperforate anus. It has been found that sagittal anoplasty can easily and preferably be carried out in the newborn period without the need for colostomy or "tapering." It is suggested that the perineal sagittal approach be attempted first, with the infant positioned so that the abdominal part of the abdominoperineal approach can be used if necessary--this seldom may be required. Neonatal closure of urinary tract fistulas in boys is an added attractive feature of this approach. The importance of optical magnification (microsurgery) and excellent, intense lighting of the perineal area with a headlamp is stressed for this approach in the newborn, particularly for the management of high pouches and high fistulas. This operation at birth relieves alimentary tract obstruction at birth, eliminates urinary tract contamination (when it exists) at birth, establishes anorectal continuity and maximum potential for "normal" defecation reflexes at birth, and achieves all of this in one rather than three operations.

Anal Canal↗
PubMed1990

Appendicitis in children aged 13 years and younger.

During a recent 4 1/2-year period, an increasing number of young children aged 13 years and younger (230 consecutive patients) came to our institution with signs, symptoms, and findings of acute appendicitis, which was perforated in nearly half of the cases (47%). This was accompanied by a marked increase in the number of very young children aged 6 years and younger (32% of our 230 patients). A prompt response to broad preoperative antibiotic coverage and definitive operative intervention (appendectomy in all cases) was found, with no mortality and essentially no major morbidity (less than 1%). The rapid transition from serious illness to near normalcy in the matter of a few hours with a standardized approach to treatment stimulated this review of appendicitis in this pediatric age group in an effort to define factors influencing these findings.

Acute Disease↗
PubMed1990

On ethylene and stem elongation in green pea seedlings.

Maximum elongation of excised internodal stem sections of light-grown pea (Pisum sativum L.) seedlings occurred at 10(-5) molar indoleacetic acid (IAA), with submaximal responses occurring at 10(-4) and 10(-3) molar. Accompanying elongation at concentrations of IAA of 10(-6) to 10(-3) molar was production of ethylene, with the amount increasing up to 10(-4) molar IAA and then becoming nearly constant. Elongation of light-grown sections was not inhibited by exogenous ethylene up to 10,000 ppm in the presence of 10(-5) molar IAA. Marked (up to 50%) inhibition of elongation of internodal segments in situ was observed after treating whole light-grown seedlings with exogenous ethylene for 20 hours. It is concluded that ethylene is not responsible for the submaximal elongation responses of green pea stem sections at high auxin concentrations, but that IAA per se is accountable.

Journal Article↗
PubMed1989

Colectomy for necrotizing amebic pancolitis in early childhood with survival.

A case of necrotizing amebic pancolitis in a 6-year-old boy with asplenia, partial situs inversus, and cyanotic congenital heart disease is reported and the literature is reviewed briefly. Our patient was managed successfully by prompt colectomy, ileostomy, a Stamm gastrostomy, and extensive drainage of the peritoneal cavity with administration of metronidazole postoperatively and prolonged jugular vein Broviac catheter hyperalimentation. This child may be the first survivor of total colonic amebic necrosis in childhood. Necrotizing amebic colitis appears to be more hazardous in infancy and childhood than in adult years. Malnutrition and additional illnesses and malformations may produce greater immunocompromise in the very young, placing them at greater risk for the ultimate of amebic intestinal complications, total colonic necrosis and disintegration.

Age Factors↗
PubMed1989

Malignant hyperthermia: experience in the prospective management of eight children.

Malignant hyperthermia (MH) is a seemingly rare genetic myopathy. Hypermetabolic crisis accompanied by a rise in body temperature to as high as 44 degrees C, is its hallmark. Malignant hyperthermia is usually triggered by potent inhalation anesthetics and/or depolarizing muscle relaxants. Because of the extraordinary incidence of death in patients who are at risk, pediatric surgeons may be reluctant to operate on these patients. Eight such patients were referred to the Pediatric Surgery Service and the UCLA Malignant Hyperthermia Center following pediatric surgical procedures aborted for first episodes of malignant hyperthermia (five) or for a strong family history of malignant hyperthermia (three). They were anesthetized with nitrous oxide, barbiturates, opiates, tranquilizers, and nondepolarizing muscle relaxants. The patients were not treated prophylactically with dantrolene. Cardiac monitoring, end-tidal PCO2, and rectal temperatures were monitored. After completion of their pediatric surgical procedures, all eight patients had a vastus lateralis muscle biopsy performed and subsequent caffeine/halothane contracture studies completed. The contracture study result was positive in all patients studied. No anesthetic or surgical complications were encountered. This study shows that patients at risk for developing MH crisis can have pediatric surgical procedures performed safely with appropriately selected general anesthesia.

Adolescent↗
PubMed1989

Substance P increases lymphocyte traffic and lymph flow through peripheral lymph nodes of sheep.

Substance P, an 11 amino acid residue vasoactive neurotransmitter peptide, has been found on acute infusion (50 micrograms) into cannulated afferent lymphatics of popliteal lymph nodes of sheep to produce marked elevations in both efferent lymph flow and in the outputs of both blast and small recirculating lymphocytes into popliteal node efferent lymph (chronically cannulated). These elevations were characterized by a delay in the onset of major elevations, a marked prolongation of the elevations and a substantially greater stimulative effect on the output of blast lymphocytes. It is suggested that the number and types of substance P receptors on lymphocytes and in sheep peripheral lymph nodes may be responsible for these observations. Infusion of substance P, known for involvement in pain impulse transmission, was able to briefly overcome anaesthesia-induced depression in lymphocyte traffic. The substance P-induced alterations in lymph flow and lymphocyte traffic in vivo were demonstrated to be due to local rather than systemic effects of substance P.

Animals↗
PubMed1988

Massive acquired omental cyst as a complication of ventriculo-peritoneal shunting.

A case of massive acquired omental cyst in a 13-year-old girl as a complication of ventriculo-peritoneal (VP) shunting is reported. This is the first such case to be reported. Most complications of VP shunting involve shunt blockade, infection, or both. The absence of shunt blockade, infection or inflammation, and associated symptoms in this case permitted the acquired omental cyst to reach a massive size before detection; the cyst was managed successfully by simple resection of a large part of its thin wall.

Adolescent↗
PubMed1988

Depression of lymphocyte traffic in sheep by vasoactive intestinal peptide (VIP).

Vasoactive intestinal peptide (VIP) is a 28 amino acid-residue neurovascular and gut peptide with a number of important biological activities. Recent in vitro studies suggest an immunomodulatory (depressant) role for VIP. In the present in vivo studies, employing the Hall and Morris sheep lymphocyte traffic model, acute infusions of VIP into cannulated afferent lymphatics of popliteal lymph nodes produced prompt and marked depressions in the output of both small recirculating and blast lymphocytes into popliteal efferent lymph, with a selective effect on T4 (CD4) lymphocytes. It has been suggested that the HIV (AIDS) virus may employ VIP or VIP-like receptors on brain cells and lymphocytes for intracellular access.

Animals↗
PubMed1988

Depression of lymphocyte traffic in sheep by anaesthesia and associated changes in efferent-lymph PGE2 and antibody levels.

General anaesthesia of sheep with ketamine and xylazine has been found to produce a profound and prolonged depression in lymphocyte traffic through primary peripheral lymph nodes, as mirrored in the output of lymphocytes into efferent lymph. In this study, the depression has been found to be associated with a marked and sustained elevation in prostaglandin E2 (PGE2) levels in efferent lymph. The degree and duration of lymphocyte output depression was found to be modulated (diminished), both in degree and duration, by study-node drainage-area stimulation from prior surgery, inflammation or bacterial immunization. Even when the anaesthesia-associated lymphocyte-output depression was modulated by drainage-area inflammation, the period of lymphocyte-output depression was correlated still with elevated levels of PGE2 in efferent lymph. When drainage-area stimulation was produced by bacterial immunization (killed Salmonella muenchen), the anaesthesia-associated depression in lymphocyte output into efferent lymph (small as well as blast) was accompanied by a depression in antibody output into efferent lymph.

Anesthesia, General↗
PubMed1987

Localized deep hyperthermia increases the traffic of lymphocytes through peripheral lymph nodes of sheep in vivo.

The production of localized deep hyperthermia by the radio frequency wave magnetic-loop induction method has been utilized to study the effects of deep hyperthermia on lymphocyte traffic in sheep in vivo. Deep hyperthermia has been applied both to primary peripheral lymph node drainage areas alone (popliteal and prefemoral) and directly over the study lymph node (popliteal). Deep tissue core temperatures were monitored in all studies and the findings were correlated with alterations in the levels of lymphocyte outputs into study node efferent lymph and the volume of efferent lymph flow. In all of 32 studies, there was a prompt and sharp increase in the output of lymphocytes into efferent lymph at 40-43 degrees C. Efferent lymph flow also was increased promptly but to a lesser degree than the output of lymphocytes. The two were not closely correlated. High deep temperature in the nodal area (45 degrees C) appeared to cause delayed nodal malfunction, which depressed lymphocyte output but did not affect lymph flow. Localized deep hyperthermia is an effective and noninvasive means for the local increase of lymphocyte traffic and lymph flow and may prove to be a useful means for the evaluation of the immunological consequences of altering both deep tissue temperature and lymphocyte traffic.

Animals↗
PubMed1987

Increased outputs of lymphocytes in lymph efferent from the lymph nodes of sheep during systemic arterial hypertension induced by phenylephrine or dopamine.

Induced systemic arterial hypotension by intravenous nitroprusside administration and by acute arterial occlusion in sheep have been found to reduce lymphocyte traffic as mirrored in the output of lymphocytes into the efferent lymph of peripheral lymph nodes. In the present series of experiments in sheep with chronically cannulated efferent lymphatics of peripheral lymph nodes, induced and monitored systemic arterial hypertension with intravenous pump infusions of phenylephrine or dopamine both produced sharp increases in the output of lymphocytes into efferent lymph in all of 27 studies. The increases in lymphocyte output with dopamine were more sustained and less associated with evidence of lymphoid tissue damage than with phenylephrine. Phenylephrine infusions were attended by a high incidence of gross bleeding into the efferent lymph, of increased coagulability of efferent lymph in the absence of gross bleeding and of prolonged depression of lymphocyte outputs after the cessation of intravenous infusion.

Animals↗
PubMed1986

Lymphocyte traffic effects of systemic and local lidocaine in sheep.

The traffic of lymphocytes through lymphoid tissues is of importance in both the initiation and development of the immune response. The effects of lidocaine on lymphocyte traffic through primary peripheral lymph nodes of sheep (popliteal and pre-femoral) was investigated by three routes of lidocaine administration. Infiltration of lidocaine above the study node and as the sole anesthetic agent for study node efferent lymphatic cannulation produced mild depressions in lymphocyte outputs into study node efferent lymph. This depression was comparable to that encountered with regional epidural anesthesia for similar operations, but was significantly less than that associated with general anesthesia (P less than 0.000015). In animals with established chronic cannulation of study node efferent lymphatics, both study node drainage area injection of lidocaine and systemic administration of lidocaine (intravenously by bolus injection at a distant site) produced prompt and sharp depressions in lymphocyte traffic as mirrored in the output of lymphocytes into study node efferent lymph. The output of both small recirculating lymphocytes and of blast lymphocytes was affected.

Anesthesia, General↗