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Biomedical subjects

V Mooney

Publications and source records attributed to V Mooney.

At least 91 records · Page 5Linked to original sources
PubMed1986

Coralline hydroxyapatite bone-graft substitutes in a canine metaphyseal defect model. Radiographic-histometric correlation.

Radiographic and histometric evaluation of a new form of bone-graft substitute derived from reef-building sea coral was performed in a canine metaphyseal defect model. Blocks of this material were implanted into the proximal tibial metaphyses of eight dogs, with radiographic densitometry and harvesting performed at two, four, six, and 12 months. Histometric analysis demonstrated progressive apposition of host compact bone at the margins and trabecular bone at the interior of the implants with time following surgery. Corrected transmission density determinations correlated significantly with degree of osseous ingrowth (R = -0.78), void volume fraction (R = 0.88), and postoperative interval (R = 0.88). These results support the successful early application of coralline hydroxyapatite bone-graft substitutes as an alternative to autogenous grafting in the clinical setting, and indicate that the course of incorporation into host bone can be noninvasively monitored using densitometric techniques.

Absorptiometry, Photon↗
PubMed1986

Surgical experience following intervertebral discolysis with collagenase.

Of 410 patients with refractory herniated lumbar disc disease treated with intradiscal collagenase, 82 (20%) did not respond to enzyme treatment and subsequently underwent surgery. Failure to improve in 6 to 8 weeks was the predominant cause for surgical intervention (53 patients). Increased pain (18 patients), progressing neurological deficit (10 patients), and disc-space infection (one patient) were the other indications for surgery. At surgery, extrusions and/or sequestrations were found in 46 patients, undigested protrusions in 16 patients, and other causes of treatment failure in 14 patients. Six patients had normal findings. There was no evidence of adverse enzyme activity on the surrounding structures. Surgical results showed an overall success rate of 87%, and did not appear to be compromised by the previous enzyme therapy.

Adult↗
PubMed1986

Porous hydroxyapatite as a bone-graft substitute in metaphyseal defects. A histometric study.

Porous hydroxyapatite (Interpore 500) formed by conversion of the Porites goniopora coral exoskeleton has pores averaging 600 micrometers and pore interconnections averaging 260 micrometers in diameter. In the proximal tibial metaphysis of eight dogs, a defect one cubic centimeter in size was created unilaterally and was fitted with a block of Interpore 500. Both proximal tibial metaphyses were retrieved at two, four, six, and twelve months. Stained undecalcified sections were examined by light microscopy and quantitated by histometric methods. The implant-side specimens contained compact bone along the external surface and trabecular bone interiorly. The interior of these specimens was composed of 51.9 +/- 1.3 per cent soft tissue, 13.0 +/- 1.2 per cent bone, and 35.1 +/- 1.2 per cent Interpore 500 (mean and standard error). The interior of the normal specimens was composed of 79.7 +/- 1.4 per cent soft tissue and 20.2 +/- 1.4 per cent bone. The allocation of implant pore space between bone and soft tissue was proportional to that of bone and soft tissue in the normal tibiae. The stereological distribution of regenerated bone in the porous hydroxyapatite was also the same as in the normal tibiae. The appositional process of incorporation of the implant was confirmed by the finding that 66.5 per cent of the surface of the Interpore 500 was covered with bone ingrowth at twelve months.

Animals↗
PubMed1985

Compressive properties of polymer coated synthetic hydroxyapatite for bone grafting.

A porous hydroxyapatite material hydrothermally converted from the calcium carbonate exoskeleton of the coral, genus Goniopora (CHAG) was either microcoated using polymethylmethacrylate (PMMA) or polylactic acid (PLA) to cover all internal surfaces, or externally coated to produce a shell, with the objective of reducing the brittleness of the material. Compressive testing showed that while CHAG, externally coated with PMMA, showed the largest increases in strength, stiffness, and energy absorption, the uncoated hydroxyapatite core cracked at low loads although the shell remained intact. CHAG internally microcoated with PMMA showed a 3.84 increase in compressive strength while specimens with internal PLA coatings had 1.81 times the compressive strength of uncoated CHAG specimens. Compared to the mechanical properties of cancellous graft material, specimens internally microcoated with either polymer could be produced having properties equivalent to or greater than those of cancellous graft.

Animals↗
PubMed1985

Comparative study of porous hydroxyapatite and tricalcium phosphate as bone substitute.

This study was performed to quantitate the bone ingrowth and biodegradability of porous calcium phosphate. Two kinds of coralline hydroxyapatite (CHA), along with sintered tricalcium phosphate (TCP), were evaluated. All implants had totally interconnecting pores. These pores measured 260-600 mu for CHA-Goniopora (CHAG), 190-230 microns for CHA-Porites (CHAP), and 100-300 microns for TCP. Cylindrical implants (3 mm in diameter by 8 mm in length) were implanted into the diaphyses of rabbit tibias for 3 to 24 weeks. The quantity of regenerated bone, remaining implant, nonmineralized space, and the middle two quarters of the cortical area were measured by a computerized operator-assisted analysis for bone histomorphometry. At 3 weeks after implantation, 17.3% of CHAG, 11.3% of CHAP, and 7.0% of TCP were infiltrated by regenerated bone. At 24 weeks, 56.1% of CHAG, 52.7% of CHAP, and 44.7% of TCP were occupied by lamellar-type bone. Implant degradation was noted to be 46.4% for TCP and 27.5% for CHAP. In contrast, CHAG did not show appreciable degradation until 24 weeks.

Animals↗
PubMed1985

Early fitting of the below knee amputee.

A comparison was made of the rehabilitation of patients undergoing below knee amputation during the calendar year 1982 on the orthopedic, general, and vascular surgical services at Parkland Hospital. Eight of nine trauma patients on the orthopedic service were fit with a temporary prosthesis and subsequently were fitted with a definitive prosthesis. Of the remaining 53 patients, only three were fitted with a temporary prosthesis and eventually 13 were fit with a definitive prosthesis. This experience identified a need for an alternative fitting method, which resulted in the design of a temporary, adjustable below knee prosthesis intended to be useful for a significant portion of the below knee population. Thus early ambulation is encouraged, possibly resulting in a higher percentage of successful ambulators. Gratifying early results with eight patients are described.

Amputation, Surgical↗
PubMed1985

Quantification of lumbar function. Part 2: Sagittal plane trunk strength in chronic low-back pain patients.

A prototype sagittal plane trunk strength tester was used to measure trunk strength in 286 chronic low-back pain patients. Initial data for this patient group are compared with data acquired previously from a group of controls, adjusted for age, sex, and body weight. Distinct patterns characterize the patient sample as opposed to the controls: Patient values for both flexors and extensors were markedly decreased, with greater variability; Extensor strength was affected more significantly than flexor strength; Discrepancies between patients and controls were greater for females than for males; High-speed dropoff ratios were much lower for patients, both in flexion and extension. These results demonstrate that strength deficits are a major factor in the deconditioning syndrome associated with chronic low-back pain.

Adult↗
PubMed1985

Quantification of lumbar function. Part 3: Preliminary data on isokinetic torso rotation testing with myoelectric spectral analysis in normal and low-back pain subjects.

A prototype isokinetic torso rotation unit and an EMG signal processing system were utilized to obtain preliminary information on torso rotation. In Study 1, range-of-motion was found to be surprisingly uniform between low-back pain patients and normal subjects, although there was a significant strength variation between them at all isokinetic speeds tested. Both female patients and normal females showed approximately 70%-75% of the strength (torque/body weight) levels relative to their male counterparts. The decrement in trunk strength at high speeds was proportional for both patients and controls and was not nearly as dramatic as the decrement seen in the sagittal plane. In Studies 2 and 3, anatomic relationships evaluated by EMG testing of obliques and erector spinae showed that the contralateral abdominal obliques were the most consistent muscles providing a significant torsional moment to the spine.

Adult↗
PubMed1985

Quantification of lumbar function. Part 4: Isometric and isokinetic lifting simulation in normal subjects and low-back dysfunction patients.

The present study collected the first normative data on a new dynamic isokinetic lifting device and compared a normal subject sample (n = 65) with a chronic low-back pain patient sample (n = 68) on this device. In addition, a comparison was made between isometric lifting measures collected for these controls and patients, and a normative industrial sample used in an earlier isometric testing protocol. Results demonstrated significant differences between controls and patients on all measures. An unanticipated finding was the greater lifting capacity levels of the present normal sample relative to those reported in the earlier isometric testing. These findings demonstrate that dynamic lifting simulation offers an important new tool for medical and industrial assessment, and conservative medical management.

Adult↗
PubMed1984

Use of noninvasive techniques for quantification of spinal range-of-motion in normal subjects and chronic low-back dysfunction patients.

Quantitative measures of physical function (range of motion, strength, stability) are critical to musculoskeletal care of the extremities, yet such objective measures in the spine are currently unavailable. In this paper, the authors present a simple, single inclinometer modification of the method of Loebl, which offers the opportunity to separate the components of the compound motion of hip and spine. Analysis of the motion in normal and chronic low-back pain patients allows differentiation of the groups, demonstration of progress in rehabilitation programs, determination of impairment, and provides tests of patient compliance and level of motivation.

Adult↗
PubMed1984

A coralline hydroxyapatite bone graft substitute. Preliminary report.

Experimental histologic and biomechanical studies were performed in 52 dogs by use of a bone substitute composed of hydroxyapatite converted from sea coral calcite. The results demonstrate some potentially useful practical applications. The material was totally incorporated in bone. Although initially too weak to tolerate physiologic stresses, once incorporated it becomes almost as strong as the native bone. Clinical experience with internal fixation of fractures with hydroxyapatite in 18 patients is encouraging.

Adult↗
PubMed1983

The relationship of Minnesota Multiphasic Personality Inventory (MMPI) profile clusters to pain behaviors.

Previous research involving cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI) profiles among persons with chronic low back pain has suggested the existence of four distinct profile clusters. The present study had two goals: (1) to replicate the previous finding independently and (2) to investigate the relationship of the profiles to the subjects' self-reported pain history and response to treatment. Subjects were 92 patients in a multimodal inpatient low back-pain treatment program. A cluster analysis of the MMPI profiles was performed and the resultant clusters were compared in terms of histories and treatment outcome. The four clusters were successfully replicated for the total sample and for males and females separately. The profiles were significantly related to subjects' pain histories, but only one outcome difference was found. It was inferred that the MMPI is of value in understanding patients' pain coping behaviors but that further research is needed to explore the utility of the MMPI in understanding their response to treatment.

Back Pain↗
PubMed1983

The syndromes of low back disease.

The details of the various clinical syndromes are presented in the text, with further expansion by the various references. I attempted to summarize these in Tables 1 and 2. As in all aspects of medicine, the ultimate disease problem is a blend of various factors. Probably no single syndrome can stand alone without aspects of the others, but if a rational treatment plan is to be undertaken, some framework for action must be involved.

Adolescent↗
PubMed1981

An occupational therapy program for chronic back pain.

This paper describes a multidisciplinary approach to the evaluation and treatment of the patient with chronic spinal pain with particular emphasis on the cooperative roles of the physical disabilities occupational therapist and the psychosocial occupational therapist. The goal of the total program is to help patients progress from a sick role of dependent, painful behavior to a less pain-centered, more productive role--one in which they have begun to assume control over the way they feel and function. The success of the program is measured by the patient's increased activity level and improved ability to cope with the demands of home and job. A review of patient records after one year of operation showed that only 4 of 54 patients who completed both phases of the program were returning to the orthopedic back clinic as outpatients.

Back Pain↗