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Biomedical subjects

W S Moore

Publications and source records attributed to W S Moore.

At least 217 records · Page 12Linked to original sources
PubMed1979

The fibrinolytic system. A key to tumor metastasis?

Neither histologic nor clinical staging reliably correlates with patient survival or the time course of tumor metastatic spread. There is no general biologic tumor marker which is able to distinguish those patients with microscopic residual cancer who may benefit from adjuvant anticancer treatment from those patients cured by their primary treatment who do not require additional anticancer therapy. Our data suggest that tumor activation and inhibition of fibrinolysis are related to the likelihood of tumor spread. Calculation of mean activation/inhibition ratios (A/I ratios) in groups of tumors with and without metastatic spread demonstrated a statistically significant difference between their respective A/I ratios (p less than 0.001). In addition, the mean activation/inhibition ratios for secondary or "metastatic" lesions were significantly different from the mean activation/inhibition ratios of the original tumors from which they metastasized (p less than 0.001). Therefore, tumor activation/inhibition ratios would appear to have clinical reliability as biologic markers for the presence or absence of tumor metastases. These data may have important therapeutic implications that would permit the use of activation/inhibition ratios as a biologic marker for the presence or absence of tumor spread at the time of primary surgical excision of the tumor. These observations warrant further investigation into the mechanisms of tumor interaction with the fibrinolytic system.

Fibrinolysis↗
PubMed1979

An in vivo study of the fore-arm and hand by thin section NMR imaging.

A series of transverse thin section NMR images of the living fore-arm and hand is compared with the morphology of corresponding cadaver sections. Each image is derived from the distribution of the density of mobile protons within the section. The contrast and spatial resolution achieved indicate the potential information that future whole-body systems could provide.

Forearm↗
PubMed1978

Natural history of nonstenotic, asymptomatic ulcerative lesions of the carotid artery.

To define the natural history of the asymptomatic, nonstenotic, ulcerative lesion involving the carotid artery bifurcation, the arteriograms and clinical course of 67 patients with 72 asymptomatic ulcerative lesions of the carotid artery were reviewed. The angiographic appearance of ulceration was classified into three groups: minimal (group A), large (group B), and compound (group C). Using life-table methods, the clinical course of these patients was compared between groups and was also compared to a nonrandomized surgically treated group of patients with nonstenotic ulcerative lesions in whom operation was performed for hemispheric or monocular symptoms. There were no significant (P greater than .1) differences in mortality, but the differences in stroke incidence was highly significant (P less than .001). The annual stroke rate, averaged over seven years, was 0.4% per year for group A, 1.47% per year for the surgically treated group, and 12.5% per year for groups B and C. The data indicate that group A ulcers have a benign prognosis, in noticeable contrast to group B and C ulcers which incur a high risk for subsequent stroke.

Adult↗
PubMed1978

Internal structural mapping by nuclear magnetic resonance.

Nuclear magnetic resonance (NMR) is a well-established tool for studying the properties of materials at the molecular level. The technique has recently been applied to the internal morphological analysis of biological material by producing a series of thin cross-sectional images derived from the distribution of mobile protons. There are grounds for believing that NMR will be more than a mere alternative to computer tomography, for it may prove possible to achieve both a useful degree of tissue characterization through analysing components of the complex NMR signal and also an approach to the measurement of blood flow in vivo.

Humans↗
PubMed1978

Autogenous profundaplasty: The key to long-term patency in secondary repair of aortofemoral graft occlusion.

The records of 281 patients undergoing aortic grafting to 522 femoral arteries over a period of 18 years were reviewed. Fifty-four patients suffering graft limb occlusion to 71 femoral arteries requiring subsequent secondary repair were identified for detailed analysis. Occlusive disease of the profunda femoris artery was identified as the primary cause of thrombosis. Repair consisted of profunda femoris angioplasty, and transfemoral retrograde graft thrombectomy was possible in all but three instances which were managed by cross-over femoral-femoral bypass. In no instance was laparotomy and abdominal graft replacement necessary. The 30 day operative survival and graft patency were 100%. Analysis of factors that have influenced late graft patency demonstrated that the key factors were the method of profundaplasty and the association of diabetes mellitus. When autogenous profundaplasty (on-lay arterial patches, saphenous vein, or limited endarterectomy) was employed, the overall patency combining diabetics and non-diabetics was two and one-half times greater than when profundaplasty was performed with an on-lay Dacron((R)) patch. If diabetics were separated from nondiabetics in the autogenous angioplasty group, the 36 month patency for non-diabetics was 85%, and 0% for diabetics. We conclude that autogenous profundaplasty provides considerable advantage from the standpoint of long-term patency and that the diabetic patients are relatively poor candidates for secondary arterial repair of an occluded aortofemoral bypass graft.

Adult↗
PubMed1978

Display of cross sectional anatomy by nuclear magnetic resonance imaging.

High definition cross-sectional images produced by a new nuclear magnetic resonance (NMR) technique are shown. The images are a series of thin section scans in the coronal plane of the head of a rabbit. The NMR images are derived from the distribution of the density of mobile hydrogen atoms. Various tissue types can be distinguished and a clear registration of gross anatomy is demonstrated. No known hazards are associated with the technique.

Animals↗
PubMed1978

Maintenance of viable arterial allografts by cryopreservation.

An experimental study, designed to investigate the feasibility of maintaining fresh, viable arterial allografts by cryopreservation, is presented. Cryopreserved femoral arterial allografts were shown to be equal in patency rate when compared with fresh controls. The cryopreserved allografts were shown to be superior to fresh allografts in the parameters of intimal integrity, absence of host rejection, and reduced surface thrombogenicity. This experimental study supports the thesis that cryopreservation in liquid nitrogen, utilizing 15% dimethyl sulfoxide (DMSO) and methylprednisolone as a cryoprotectant solution, is an excellent method of preserving and storing fresh allograft arteries for use as a small vessel replacement.

Animals↗
PubMed1977

Tuberculous infection in a vascular prosthesis: a case of aortic graft infection resulting from disseminated tuberculosis.

Insertion of an aortic prosthetic bypass graft in a patient with untreated disseminated tuberculosis resulted in graft infection with formation of a pseudoaneurysm. Microbiologic cultures implicated Mycobacterium tuberculosis as the causative agent, and a subsequent review of the literature indicated this report to be the first clinical demonstration of the susceptibility of vascular prosthesis to M tuberculosis infection to our knowledge.

Aorta↗
PubMed1977

Below-knee amputation: a modern approach.

Immediate and long-term results of 113 below-knee amputations in 103 patients are presented to justify a comprehensive program of management that includes an objective method for determining amputation level with xenon 133 clearance, precise surgical technic, immediate postoperative prosthesis, and an aggressive program of rehabilitaion. Prediction of healing of the last 30 below-knee amputations was 100% successful, showing the value of 133Xe clearance for determination of amputation level. Zero per cent thirty-day mortality and 100% prosthetic rehabilitation of patients on below-knee prostheses justifies the use of immediate postoperative prosthesis. Long-term follow-up of our patients demonstrates that the five year survival rate of diabetic patients is poor (39%) compared with the nondiabetic amputee (75%) who approached the survival of the normal, age-adjusted male population (85%). The fact that 75% of patients were alive after five years and were still independently ambulatory on their prostheses is final testimony to the value of the program.

Adult↗
PubMed1977

Fifteen year experience with subcutaneous bypass grafts for lower extremity ischemia.

A 15-year experience with 92 subcutaneous arterial bypass grafts for lower extremity revascularization has been reviewed. Fifty-nine AF and 33 FF bypass operations were performed on 89 patients whose average age was 66 years. The overall five-year survival was 33% compared to an expected survival of 80%. 88% of the AF, and 76% of the FF operations were performed for limb salvage, bypass of an aortic aneurysm, or replacement of an infected aortic graft. The remainder were performed for intermittent claudication on patients who were too ill to withstand an intra-abdominal operation. 75% of the patients with AF grafts and 64% of those with FF grafts experienced complete relief of lower extremity ischemia, including all of the patients with claudication. Graft patency was analyzed by the life table method. In the FF series, 74% of the grafts remained patent for one year; 73% for two years; 66% for three years; and 53% for four years. A 50% incidence of thrombosis occurred at the end of two years in the AF group. The patency rate of the AF grafts was also studied with regard to the type of graft material employed: a 50% incidence of thrombosis was reached at 36 months with knitted Dacron; at 18 months with weave-knit Dacron; and at 9 months with woven Dacron. THESE DATA INDICATE THAT: (1) contrary to our previous report, weave-grafts provide adequate blood flow to the lower extremities but do not remain patent as long as more conventional types of reconstruction; (2) subcutaneous grafts should be performed only when an intra-abdominal procedure is contraindicated or life expectancy is limited.

Aged↗