Gravitational radiation from realistic relativistic stars: Odd-parity fluid perturbations.
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Biomedical subjects
Publications and source records attributed to T Moore.
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We have examined the feasibility of using reflectance photoplethysmography to assess Gz acceleration tolerance. Reflectance plethysmograms recorded using a sensor placed on the region of the superficial temporal artery were analysed along with the mean value and the pulsatile component of the Doppler velocity recorded from the opposite temporal artery. The photoplethysmogram signal and pulsatile and mean Doppler velocities were examined as predictors of impending peripheral light loss (PLL) during the experiments. Photoplethysmography correctly predicted a large percentage of the PLL runs (80.5%) and non-PLL runs (98.3%). Mean Doppler velocity predicted a higher percentage of PLL runs (88.1%), but with an unacceptably low rate of non-PLL runs (77.2%). The pulsatile Doppler velocity yielded only 50.7% correct prediction of PLL runs. The results of this preliminary study indicate that, with an improved design of the sensor and the electronics, it may be possible to use reflectance photoplethysmography in acceleration tolerance experiments as a reliable predictor of impending peripheral light loss.
To promote early full weight-bearing and rapid rehabilitation, 20 elderly patients (average age, 82.2 years) with unstable intertrochanteric hip fractures were treated with a bipolar head-neck replacement. Seventeen patients had the prosthesis inserted as primary fracture management, and three, for salvage of failed internal fixation. The patients were ambulating with unrestricted weight-bearing at an average of 5.5 days after the operation. The bipolar design may permit conversion to a total hip arthroplasty without removal of the femoral component, and may reduce the risk of acetabular cartilage damage. By using the greater trochanter as a landmark for precise placement of the femoral head, correct limb length was restored.
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This study assessed renal sodium handling in a group of patients with essential hypertension in whom control of the renal blood supply and aldosterone release by angiotensin II is abnormal ("non-modulating") because of recent evidence that these patients have sodium-sensitive hypertension. Sixty-one patients were studied, 25 as balance was achieved with a daily sodium intake of 10 meq and 36 after a shift from a 10 meq to 200 meq sodium intake for five days. Renal and adrenal responsiveness to angiotensin II was assessed by measurement of para-aminohippurate clearance and plasma aldosterone prior to and during the infusion of 3 ng/kg per minute of angiotensin II, to identify the non-modulator group (n = 32). The half-time of the exponential function relating sodium excretion to time during the three to five days when external balance was being achieved with a 10 meq sodium intake was 23.9 +/- 0.3 hours in 60 normal subjects, 24.5 +/- 1.8 hours in the patients with essential hypertension in whom renal responsiveness to angiotensin II was normal, and prolonged (p less than 0.001) to 36.6 +/- 2.1 hours in the non-modulating patients. A prolonged half-time suggests that, with a shift to a high sodium intake, more time will be required to achieve external sodium balance and at the expense of more retained sodium. During the shift from a 10 to 200 meq sodium intake, the non-modulator group showed a delayed rate at which external sodium balance was achieved, greater cumulative positive sodium balance, more weight gain, and a greater frequency of blood pressure rise. The abnormality in the rate at which external sodium balance is achieved in non-modulation results in a difference in total body sodium that varies with sodium intake and that may well contribute to, or cause, sodium-sensitive hypertension.
A prospective comparative analysis of home and hospital comprehensive treatment for advanced non-ambulatory cancer patients was conducted. Patients were assigned to hospital (group A) and home (group B) treatment groups based on geographic location. Home treatment was provided by the Don Monti Home Oncology Medical Extension (HOME) program. A multidisciplinary health team, including an oncologist, oncology nurse, social worker, dietitian, and medical technologist, was transported to the home in a medically equipped van. Services included physical examinations, pain control, psychosocial interventions, chemotherapy and blood transfusions, nutrition consultation, and bereavement counseling. One hundred seventy-four patients were treated at home and 44 in the hospital. Pretreatment characteristics were similar for both groups, with the exception that age under 50 years was more frequent in the hospital group, and home patients were more likely to have gastrointestinal (GI) cancer. Medical benefits for home treatment included decreased narcotic analgesic requirements, decreased hospitalization and length of stay, and improved measurements of fat stores for female patients. Improved survival for home patients was related to Karnofsky performance status, since there was no difference in survival for sicker patients with lower performance status whether they received home or hospital treatment. Patient and family acceptance of home treatment was excellent. Comprehensive home treatment provided by a multispecialty oncology team is an effective alternative to hospitalization for terminal cancer patients.
A comparative study evaluating home and hospital treatment for terminal cancer patients is reported. Home care was provided by a comprehensive home care program, the Don Monti Home Oncology Medical Extension (H.O.M.E.). A multispecialty team including an oncologist, oncology nurse, social worker, dietitian and technologist is transported to the home in a medically-equipped van to render treatment. Services provided include physical assessments, pain control, chemotherapy and transfusion administration, psychosocial support, nutrition education and bereavement counseling. Two-hundred eighteen patients were entered of which 174 were treated at home and 44 in the hospital. Patients were comparable in age, diagnosis, sites of metastases, prior treatment and Karnofsky status. Both groups received similar supportive care either at home or in the hospital. Cost analysis of home and hospital care revealed a per diem cost benefit of $256.00 for home treatment. Comprehensive home treatment provided by a multi-specialty team can deliver effective care with medical and financial benefits to terminal cancer patients.
The electrogastrogram, purportedly a measurement of the stomach's electrical activity, has received increased attention recently. This attention has also created skepticism because measurements are taken from the cutaneous surface. To test the electrogastrogram's ability to measure the stomach's electrical potential, we infused glucagon (0.5 mg), metoclopramide (10 and 20 mg in two sittings), and a placebo into six subjects. The electrogastrogram registered predictable changes in response to these infusions. We conclude that the electrogastrogram measures the stomach's electrical activity. Additionally, the unique data gathered by the electrogastrogram suggest that glucagon and metoclopramide both act directly on the electrical activity of gastric cells.
A liquid chromatographic method using dual-electrode detection has been developed for determination of physostigmine in biological fluids. The limit of detection is in the order of 25-50 pg mol-1 of plasma. A high sample throughput is obtained by a single solvent extraction step and autoinjection into the chromatograph. Data following oral doses of physostigmine are presented.
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We performed a randomized, prospective clinical trial comparing intratracheal administration of human surfactant with conventional treatment with intermittent mandatory mechanical ventilation alone for treatment of severe respiratory distress syndrome in preterm infants of less than 30 weeks gestation. Twenty-two infants (mean gestational age 27.0 weeks, mean birth weight 987 gm) were given surfactant, and 23 infants (mean gestational age 27.2 week, mean birth weight 1055 gm) received intermittent mandatory ventilation. Infants given surfactant required less FiO2 during the first week, had lower mean airway pressure during the first 48 hours, and had improved ventilatory index and a/A PO2 ratio. Death or the occurrence of bronchopulmonary dysplasia was significantly less among infants given surfactant (P = 0.019). Pneumothorax, pulmonary interstitial emphysema, and need for FiO2 greater than or equal to 0.3 for greater than 30 days was significantly less in the surfactant group. This trial confirms the efficacy of treatment with human surfactant in preterm infants with severe respiratory distress syndrome.
The computed tomographic and angiographic features of 15 histologically proven primary extradural juxtasellar tumors were retrospectively reviewed. Five chordomas were characterized by prominent bone erosion and a significant posterior fossa component. Four trigeminal nerve neuromas each demonstrated bone erosion centered about Meckel's cave and moderate to marked contrast enhancement. Two cavernous sinus meningiomas revealed moderate contrast enhancement, expansion of the cavernous sinus, and moderate angiographic stain. Two cavernous hemangiomas of the cavernous sinus were intensely enhancing and demonstrated angiographic stain. Opacification of the sphenoid sinus with prominent bone destruction and lack of contrast enhancement was characteristic of a sphenoid sinus mucocele. The dural reflection could be directly visualized or indirectly inferred in each case.
Lesions of heterotopic ossification were excised from thirty-seven joints in twenty-three adults who had had injuries to the brain. The lesions were excised from twenty-three elbows, twelve hips, and two shoulders. Patients were retrospectively divided into five categories according to the neural residua (cognitive and physical deficits). The patients in Class I (minimum cognitive and physical disability) and patients in Class II (minimum cognitive disability and moderate physical disability) who had fair or good selective control of the affected extremity had the best prognosis for maintaining the range of motion resulting from resecting the lesion and improving function postoperatively. They also had a low incidence of recurrence of the lesion. Seven of the nine elbows and eight of the eight hips in patients in these classes had successful results. All three of the patients in Class V (severe cognitive and physical deficits) who had a lesion of the hip and all eight of the patients in Class V with poor selective control had a poor result. In the twenty-five joints for which adequate follow-up radiographs were available to determine if the lesion recurred, fourteen recurrences were identified (56 per cent). Eleven of these patients were considered to have a poor result. Nine of the fourteen recurrences occurred in patients in Class V. Radiographic evidence of the maturity of the lesion and a normal level of alkaline phosphatase were of limited importance in predicting a low rate of recurrence. The over-all complications included four superficial infections and no instances of osteomyelitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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