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Biomedical subjects

T M Moore

Publications and source records attributed to T M Moore.

At least 55 records · Page 3Linked to original sources

Susceptibility to AIDS: what college students do and don't believe.

In-depth, qualitative discussion using the nominal group technique examined freshmen's perceived susceptibility to AIDS and barriers to prevention. Groups were led by dormitory resident advisors as a follow-up to a survey questionnaire of college students' knowledge and beliefs about AIDS. Students' comments showed that many misunderstandings lay behind an apparent understanding of the facts about AIDS. These findings underscore how imperative it is that college health education programs be attuned to the needs and address the deficiencies of the particular student body. In-depth, qualitative research techniques such as the nominal group are described as useful in tailoring AIDS prevention to the specific campus audience and are an appropriate introduction to an AIDS-education session. Suggestions, based on students' comments, are made for improving AIDS-prevention programs on campus.

Acquired Immunodeficiency Syndrome↗

Morphometric analysis of epithelial cells of frog urinary bladder, II. Effect of ADH, calcium ionophore (A23187) and verapamil on isolated dissociated cells.

Isolated frog urinary bladder epithelial cells, upon dissociation lose their polarity and develop microridges and occasional microvilli in a global fashion. These cells, when exposed only to isotonic Ringer's solution manifest a membrane conformation with smooth discontinuous microridges, a cytoplasm with numerous free ribosomes, rough ER, thin Golgi cisternae, mitochondria, small vacuoles, electron-dense granules, few microtubules, and numerous microfilaments and intermediate filaments with an apparent random distribution, the dissociated cells, when treated with ADH or calcium ionophore (A23187), have the appearance of numerous elongated microvilli over the entire cell surface. The cytoplasm, under these conditions, is occupied by large vacuoles with a distribution of long profiles of aggrephores and associated vesicles. The peripheral cytoplasm as well as the cavities of the elongated microvilli of these cells contain large concentrations of microfilaments often showing a strong axial orientation to the long axis of the microvilli. Many of these filamentous elements appear in contact with the apical membrane of these microvilli with an alignment with the external glycocalyx. There is an indication that these morphocytological changes as revealed by SEM and TEM studies, correlated with a redistribution and realignment of microfilaments and possibly microtubules as detected by fluorescent microscopy using immunofluorescent antibody labeling for actin and tubulin. Cells treated with verapamil, a calcium antagonist, presented dwarf and stout microvilli with little detectable alterations in the cytoplasmic compositions from that of non-hormonal treated cells. Verapamil prevented ADH induction of microvilli, with the membrane, under these conditions, appearing as compact microridges. The results indicate that calcium ionophore, like ADH, produces intense formation of microvilli in dissociated cells, mobilization and realignment of microfilaments, microtubules, increase in the density of vesicles, aggrephores and possibly secretory granules, whereas the calcium antagonist, verapamil, opposes these actions. The results suggests a prominent role of calcium in the morphological changes induced by ADH.

Animals↗

Diaphyseal intraosseous ganglion.

Ganglion cysts of bone are noted to occur most often in the metaphysis of epiphysis of a long bone. A unique ganglion cyst, developing in a diaphyseal location, was excised from the leg of a 14-year-old boy. The follow-up examination showed no recurrence one year following surgery.

Adolescent↗

Ipsilateral diaphyseal femur fractures and knee ligament injuries.

Three hundred and nine consecutive patients with 320 diaphyseal femur fractures were retrospectively reviewed to determine the incidence of ligament injury in the ipsilateral knee. Ligamentous injuries were diagnosed if serious (Grades II and III) instability was apparent on admission, found at surgery for femoral stabilization, or disclosed on roentgenograms during closed management. Seventeen patients with unilateral shaft fractures of the femur had ipsilateral knee ligament injuries, or 5.3%. There was no relationship between specific ligament damage and the cause of the injury or level of fracture. Twelve patients were followed for an average of 34 months. Five patients lacked full extension and ten lacked full flexion. Two of seven patients with ligament repair and three of five patients without ligament repair had at least one unstable ligament. Better range of knee motion was obtained when both the femur and ligament injuries were surgically managed, but most (seven of 12) patients were disabled.

Adult↗

Alteration in osteoblast cell number and cell activity in the presence of invading malignant fibrous histiocytoma.

Correct prediction of tumor behavior and interpretation of local factors in the tumor microenvironment rely in part upon accurate determination of tissue changes after tumor invasion. The authors examined local bone changes in primary malignant fibrous histiocytoma (MFH) of bone in a 59-year-old woman. Three noninvolved and three tumor-involved sites were evaluated by quantitative determinations of bone structural and dynamic features. Compared to noninvolved sites, tumor-involved bone was characterized by significantly increased osteoblast index (89.4 +/- 15.6 [mean +/- SEM] versus 7.3 +/- 6.0, P = 0.008), percent osteoid area (12.1 +/- 2.7 versus 1.2 +/- 0.5, P = 0.02), percent of trabecular surface covered by osteoid (70.0 +/- 6.0 versus 14.5 +/- 4.8, P = 0.002), and percent osteoid lined by osteoblasts (36.4 +/- 3.6 versus 3.7 +/- 3.0, P = 0.002). Bone 7.8 mm distant from invading tumor cells showed features characteristic of noninvolved sites, whereas bone completely surrounded by tumor showed markedly decreased osteoblast features. Osteoblast function also was affected by tumor; the amount of matrix laid down per day bore a significant positive correlation with the osteoblast index. These data indicate the following: distinctive bone morphologic changes occur in situ during invasion by MFH; changes affect aspects of bone formation but not resorption during invasion; both osteoblast number and osteoblast activity are significantly altered; and changes are local in nature and probably reflect the osteoblast response to local tumor factor(s) and are dependent upon the extent of tumor invasion.

Bone Neoplasms↗

Tibial plateau fractures: definition, demographics, treatment rationale, and long-term results of closed traction management or operative reduction.

Results of a decade of experience with 988 tibial plateau fractures are presented. Maximum plateau depression was measured on initial and follow-up x-ray studies, and knee instability was clinically evaluated to identify minor and major fractures as a guide to management. Demographic, treatment, and complication data were gathered prospectively in 753 fractures. Four hundred thirty-seven "major" tibial plateau fractures (44% of cases) were treated operatively; the remainder were treated by traction. Three hundred twenty patients who sustained only a plateau fracture were followed from 1 to 10 years, with an average of 3.7 years. Nonsurgical treatment included Buck's traction (89% of closed treatment cases) or a "knee exerciser" device utilizing skeletal traction in a Hodgson-Pearson apparatus. Early intermittent passive and active knee motion was encouraged. The complication rate of traction was 8%. The complication rate in operated patients was 19%, much of which was due to infection. Methods for objective and subjective scoring of both traction and operative results were developed and utilized. Results show that anatomic reduction of plateau fractures, in addition to early motion, is a major factor contributing to successful management of this potentially disabling injury.

Adolescent↗

Limb salvage and prosthetic joint reconstruction for low-grade and selected high-grade sarcomas of bone after wide resection and replacement by autoclaved [corrected] autogeneic grafts.

Wide resection is an acceptable alternative to amputation for the management of primary sarcomas of the long bones or pelvis. The resected bone can be debrided of gross tumor tissue, autoclaved, and then replaced over intramedullary fixation to reconstruct the limb anatomically. The procedure can be combined with prosthetic reconstruction of adjacent joints with sufficient strength to allow early unprotected weight-bearing. Resection and replacement for 28 low-grade (G1) and 14 selected high-grade (G2) sarcomas were performed in 42 patients. The hemipelvis was resected and replaced four times, the proximal or distal femur 28 times, the proximal or distal tibia eight times, and the proximal humerus two times. Replacement of an adjacent joint, most commonly using a long-stemmed hip or knee prosthesis, was accomplished in 33 patients. All patients had been followed for a minimum of two years, nine months after treatment. The mean follow-up period is four years, ten months. Six individuals, all with high-grade sarcomas, developed tumor-related complications. Two evidenced a local recurrence of tumor, and four developed distant metastases. None of the patients with low-grade sarcomas developed a recurrence or metastases. Fifteen patients suffered complications unrelated to tumor control; 13 required reoperation, including two who required amputations for persistent pseudoarthrosis and graft infection, respectively. There was one other infection, successfully eradicated by drainage followed by local and systemic antibiotics. Due to mechanical failure or loosening, six patients were treated by successful revision of their joint arthroplasties. Two years after initial surgery, five patients had failures of union at the graft-host junction. Four healed after cancellous grafting and one was revised to a custom prosthesis. There were no late fatigue fractures of the grafts. The technique does not compromise the margins for adequate tumor resection. It preserves a graft strong enough to support a joint arthroplasty and to allow early weight-bearing with a low risk of pseudarthrosis or late fatigue fracture.

Adolescent↗

The stabilizing effect of soft-tissue constraints in artificial Galeazzi fractures.

Shortening of the radius is observed in Galeazzi (Piedmont) fractures and results from muscle pull after distal radioulnar joint disruption. A cadaver study was designed to examine the normal laxity at the distal radioulnar joint and contributions of the fibrocartilaginous complex (triangular ligament) and the interosseous membrane in prevention of proximal displacement of the distal radius fragment. It was found that up to 5 mm of radial shortening occurred after osteotomy alone. Shortening of over 10 mm did not occur unless both the interosseous ligament and the triangular ligament were sectioned. Some Galeazzi-type fractures may occur in the absence of distal radioulnar joint disruption, and others may result in disruption of the interosseous membrane of the forearm in addition to disruption of the triangular ligament at the wrist. Diaphyseal fractures of the distal radius may occur in several stages of severity. Attempts to produce a Galeazzi lesion by axial loading and pronation of the forearm above the dorsiflexed wrist caused a variety of injuries but did not result in an isolated fracture of the distal radius or disruption of the distal radioulnar joint.

Cadaver↗

Results of compression-plating of closed Galeazzi fractures.

Diaphyseal fractures of the distal third of the radius that are associated with disruption of the distal radio-ulnar joint accounted for eighty-four (6.8 per cent) of 1236 fractures in the forearm that were treated during a five-year period at the Los Angeles County-University of Southern California Medical Center. Thirty-six closed Galeazzi fractures, twenty-eight in male and eight in female patients, were followed for 1.5 to seven years after treatment using standard AO-compression plates with four to seven holes. Complications included seven injuries to the sensory or dorsal interosseous branch of the radial nerve, two infections, two non-unions, two re-fractures after plate removal, and shortening of the radius of five millimeters in one patient. The complication rate was 39 per cent. The average grip strength at follow-up was 71 per cent of the calculated normal value. The loss of strength was not related to use of a volar or dorsal surgical approach, the patient's age, or a delay of surgery for more than ten days after injury. The average loss of grip strength in the seven upper extremities with restricted motion of the wrist and forearm was 48 per cent, compared with an average loss of 29 per cent in the whole group. Of the twelve patients who were operated on more than ten days after injury, six had loss of motion at follow-up, compared with three who had such a loss among the twenty-four patients who were operated on within ten days after injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Use of antibiotics in open tibial fractures.

Data concerning 1102 open fractures are presented with bacteriologic and antibiotic considerations analyzed in 363 open tibiae fractures treated in three prospective one-year studies during the period from 1970 to 1980. The highest infection rate was in open tibiae receiving no antibiotics (24%, 6 infections in 25 open tibial fracture wounds), and the lowest was in the group receiving a cephalosporin and an aminoglycoside (4.5%, 5 infections in 109 open tibial fracture wounds).

Anti-Bacterial Agents↗

Considerations in reducing the infection rate in open tibial fractures.

During the period from 1979 to 1980, 109 patients with open tibial fractures were treated by a cephalosporin and an aminoglycoside, and by saline and topical antibiotic wound irrigation; partial closure was used for Types I and II open tibial wounds, and all Type III wounds were left open. Stabilization was accomplished by plaster alone, external pins in plaster, or an external fixator with full transfixion pins. The overall infection rate was 4.5% (5 of 109 wounds) in this study. This represents a significant reduction from the previous infection rate of 14% in 254 open tibial fractures treated by the authors in previous years by all methods.

Adolescent↗

Fracture--dislocation of the knee.

Fractures of the proximal tibia involving the articular surfaces vary greatly in type, severity, and prognosis, and a considerable percentage have significant associated ligamentous injuries. This report classifies and analyzes 132 particular fractures separated from over 1,000 patients with fractures of the proximal tibia. The remaining cases were considered to have tibial plateau fractures. Eighty-six fractures required operative treatment, and it was possible to divide them into five distinct types. The characteristic of these five types is marked joint instability with a high incidence of serious soft-tissue and/or neurovascular injury. Knee dislocation is a discrete entity. Plateau fracture is a discrete entity that requires definition (and which in large measure has little or no implication of significant soft-tissue injury). Fracture--dislocation of the knee is a much more serious injury than plateau fracture. For successful treatment of this injury, a radically different understanding of fractures of the proximal tibial condyles is needed.

Adult↗

Effect of moderately elevated temperatures on dermatophyte survival in clinical and laboratory-infected specimens.

The effect of increased temperature during transportation of clinical dermatophyte specimens was investigated. Recovery rates from untransported specimens cultured at dermatologists' offices and from duplicate transported specimens were compared. During the months of hot weather specimens could be exposed intermittently to temperatures as high as 60 degrees C during transportation from Tucson area clinics to the University laboratory. The rates of recovery from known positive specimens were found not to be significantly different at these places regardless whether specimens were transported during the hot months or cooler months of the year. In a controlled experimental approach to the effect of this elevated temperature on clinical specimens weighed amounts of skin scales collected from guinea pigs artificially infected with Trichophyton mentagrophytes were exposed to 60 degrees C for up to four hours and then digested with 0.5% (:300) trypsin for one hour. Analysis of plate counts done from the digestion mixture showed no significant difference between counts obtained from specimens exposed to elevated temperature and unexposed controls.

Animals↗

Closed biopsy of musculoskeletal lesions.

Five hundred and thirty-one closed biopsies have been done in our general hospital since 1967. Four hundred and eighty-four were for lesions of bone and forty-seven were for soft-tissue lesions. More than half of the lesions were infections or nonspecifically reactive. The procedure was done under local anesthesia in 73 per cent and roentgenographic or image-intensifier control was generally required. The Craig needle was used for cancellous bone near vital structures; the Michele trephine, for cortical or sclerotic bone at a distance from vital structures; and a special needle was used for soft tissue. Closed biopsy provided an adequate specimen that was accurately diagnosed in 66 per cent of bone lesions and in 76 per cent of soft-tissue lesions. This compared favorably with both aspiration and open-biopsy success rates reported by others, and was accompanied by a 1 per cent complication rate, mostly neural and mostly in association with vertebral lesions.

Biopsy↗

Determination of the vascularity of the femoral head with technetium 99m-sulphur-colloid.

The results of technetium 99m-sulphur-colloid scans performed at the Los Angeles County-University of Southern California Medical Center and Rancho Los Amigos Hospital to assess the vascular status of the femoral head after sixty-five displaced and thirty undisplaced fractures of the neck of the femur and forty-four traumatic hip dislocations as well as in fifty patients with idiopathic ischemic necrosis of seventy femoral heads were evaluated by histological and clinical examination after follow-up of two years or more. The accuracy of the scan as corroborated by the histological findings and clinical results was 95 per cent. The method is safe, reliable, accurate, and simple in contrast to other methods which have disadvantages related primarily to technical complexities, difficulty in interpretation, and expense.

Biopsy↗