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Biomedical subjects

J R Moore

Publications and source records attributed to J R Moore.

At least 19 recordsLinked to original sources
PubMed1992

Neonatal compartment syndrome.

Two cases of forearm compartment syndrome in neonates are presented. The compartment syndrome may be initiated before actual delivery and may appear in an advanced stage. In both children good clinical results were achieved when standard guidelines for managing compartment syndrome and established Volkmann's contracture were applied. Although uncommon, compartment syndrome should be considered in the differential diagnosis of the neonate who is unable to move an extremity.

Compartment Syndromes↗
PubMed1992

Measurement of visceral blood flow with magnetic resonance imaging.

With the increasing application of magnetic resonance imaging (MRI) and MR angiography in parenchymal liver disease, methods are becoming more widely available for noninvasive measurement of visceral blood flow. Amplitude-based (time-of-flight) and phase-based techniques have proved effective for measurement of portal blood flow, and phase-sensitive methods are applicable to arterial flow measurements. Because respiratory motion degrades the quality of examinations in the abdomen, it is desirable to use methods that can generate flow information in a breath-hold period. Although substantial technical difficulties persist for quantitative arterial flow measurements in the abdomen, the technical requirements for venous flow are less stringent, and important clinical information can be derived using straightforward techniques. The authors describe the principles of flow measurement using time-of-flight and phase methods in visceral arteries and veins, and discuss their practical implementation. Clinical applications are discussed, based on the experience of the authors and others working in the field.

Blood Flow Velocity↗
PubMed1992

Real-time NMR beam-directed velocity mapping. V-mode NMR.

BACKGROUND: Currently available noninvasive techniques for measuring blood flow velocities are constrained by limited view orientations (Doppler ultrasound) or limited time resolution (magnetic resonance imaging, MRI). We describe an MRI technique for measuring flow velocities in real time at arbitrary orientations within a cylindrical volume or "beam": V-mode nuclear magnetic resonance (NMR). METHODS AND RESULTS: The technique was implemented on a standard 1.5-T clinical NMR imager with no special hardware and was tested on phantoms and human volunteers. The beam can be fired at rates up to 60 times per second, allowing measurements on a time scale that is appropriate for ungated cardiac studies. In phantoms, steady flow velocities were measured with the beam aligned along the direction of flow, and the measured velocities correlated well with the actual velocities (r > 0.99). The radial distribution of velocities in phantoms under constant flow conditions was also determined. In humans, flow of blood in the descending aortas of normal and aortic insufficiency subjects was measured. Distinctive backflow of blood because of aortic insufficiency was readily apparent. CONCLUSIONS: The V-mode NMR technique is capable of acquiring clinically relevant real-time blood flow information from any desired angle of view with no attenuation at bone or air-tissue interfaces.

Aorta, Thoracic↗
PubMed1992

The transverse carpal ligament. An important component of the digital flexor pulley system.

The effect of release of the transverse carpal ligament on the mechanics of the flexor tendons was investigated with use of a fresh-frozen cadaver model. A 25 per cent increase in the amount of excursion of the tendons that was consumed by motion of the wrist was demonstrated for the digitorum profundus tendons after transection of the transverse carpal ligament, and a 20 per cent increase was noted for the digitorum superficialis tendons (p < 0.001). These values represent 5.4 +/- 1.2 and 5.5 +/- 1.3 millimeters of bow-stringing for each group of tendons.

Humans↗
PubMed1991

Radial shortening for Kienböck disease.

The cases of twenty-nine consecutive patients (thirty wrists) who had radial shortening for the treatment of stages I through IIIB Kienböck disease were reviewed to assess the results of this procedure. Thirteen patients (45 per cent) had a history of trauma, and all thirty wrists had a negative ulnar variance (average, 2.8 millimeters) on radiographs. All wrists were re-examined after an average follow-up of 3.8 years (minimum, two years). At that time, the pain had decreased in 87 per cent of the wrists. Extension of the wrist had improved an average of 32 per cent; flexion, 27 per cent; radial deviation, 30 per cent; ulnar deviation, 41 per cent; and grip strength on the affected side, 49 per cent. Analysis of the radiographs by computer digitization showed no significant changes in the amount of collapse of the lunate at the latest follow-up. In two wrists, there were complications at follow-up (excessive shortening of the radius and non-union of the radial osteotomy). Radial shortening is an effective treatment for Kienböck disease in wrists that do not have degenerative changes in adjacent carpal joints. Pain, range of motion, and strength can be expected to improve, but the radiographic appearance of the lunate changes little, if any.

Adolescent↗
PubMed1990

Glomus tumor originating within a digital nerve.

Glomus tumors are thought to arise from specialized cells normally found within the glomus apparatus of the dermal stratum reticularis. We report the unusual occurrence of a glomus tumor from within a peripheral nerve. Previous investigators have suggested that the rare occurrence of glomus tumors in tissue where the glomus apparatus has not been described arise from ectopic glomus cells or differentiate from nonglomus cell sources. Many of the "ectopic" glomus tumors have been found in regions of extensive arteriovenous shunting such as in the digestive system and lung suggesting the presence of glomera at these locations. The finding of a glomus tumor within a peripheral nerve, a region where extensive arteriovenous shunting and glomus bodies have not been described, supports the occasional origin of a glomus tumor from a nonglomus cell source.

Glomus Tumor↗
PubMed1990

Mohs' technique.

Explore the source record for details and available documents.

Humans↗
PubMed1990

Vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibia.

Free vascularized fibular bone grafts were used in nineteen children, seen consecutively, who had congenital pseudarthrosis of the tibia. The average age was 5.1 years (range, 1.4 to 11.4 years). Sixteen of the patients had been treated with electrical stimulation for at least one year, and the tibia had not united. All but four patients had had at least one previous operative procedure. At an average follow-up of 6.3 years (range, 2.0 to 11.0 years), eighteen (95 per cent) of the nineteen pseudarthroses had healed. The leg-length discrepancy averaged 1.6 centimeters (range, 0 to 4.0 centimeters), but ten tibiae had residual or progressive valgus or anteroposterior malalignment despite bracing. There was minimum morbidity at the donor site.

Bone Transplantation↗
PubMed1990

Unconstrained shoulder arthroplasty. A five-year average follow-up study.

A series of 42 total shoulder arthroplasties and four humeral hemiarthroplasties were performed with either the English-McNab or Neer prosthesis. Retrospective follow-up study averaged five years with a three-year minimum. Preoperative diagnoses included rheumatoid arthritis, osteoarthritis, posttraumatic arthritis, rotator cuff arthropathy, avascular necrosis, failed prosthesis, and congenital dislocation. Postoperatively, pain improved in 94% of shoulders, and active range of motion improved an average of 42 degrees in abduction and 47 degrees in forward flexion. Rotator cuff lesions were correlated with poorer postoperative function. Complications developed in four shoulders (9%) and consisted of humeral component protrusions (two shoulders), loosened prosthesis (one shoulder), and unrecognized, preoperative tuberculous infection (one shoulder). Fifteen glenoid components (36%) and six humeral components (13%) developed lucent lines roentgenographically, but only one glenoid component developed migration.

Adult↗
PubMed1989

Arthritis of the basal joint of the thumb. A critical analysis of treatment options.

The basal joint of the thumb is commonly afflicted with degenerative changes, especially in postmenopausal women. This can be debilitating because of the importance of the thumb to overall hand function. There are a variety of treatment options for the patient with arthritis of the basal joint of the thumb. Most patients can successfully be treated conservatively, which includes splinting, antiinflammatory medications, physical therapy, and activity modification. For those who fail conservative therapy, surgical treatment is based on clinical staging. Patients with early degenerative changes are candidates for ligament reconstructive procedures or arthrodesis. Those with more advanced disease may benefit from excision, tendon interposition arthroplasty, suspensionplasty, silicone implant arthroplasty, or total joint arthroplasty. The advantages and disadvantages of each procedure, as well as the relative indications and contraindications of each, are critically assessed.

Anti-Inflammatory Agents↗
PubMed1989

Oxygen radical scavengers improve vascular patency and bone-muscle cell survival in an ischemic extremity replant model.

We examined the use of oxygen radical scavengers in preventing the no-reflow phenomenon and improving bone-muscle cell survival in an ischemic extremity replant model. A total of 70 Lewis rat modified hindlimb replants were performed after specific periods of cold ischemia and intraarterial perfusion with either superoxide dismutase and catalase, specific oxygen free-radical scavengers, or a control solution. Ischemic hindlimbs treated with superoxide dismutase and catalase showed a statistically significant (p less than 0.05) improvement in vascular patency after prolonged cold ischemia when compared to controls. Histologically, experimental extremities demonstrated greater osteoblast, osteocyte, and muscle cell survival in replanted hindlimbs with patent vascular anastomoses. The perfusion of severed limbs and digits and free vascularized tissue transfers with superoxide dismutase and catalase after a period of ischemia has already occurred may prolong the ischemic "time window" tolerated for successful tissue survival.

Animals↗
PubMed1989

Natural alteration of speaking rate: the effect on passage comprehension by listeners over 75 years of age.

The purpose of the study was to assess the comprehension performance of "old-old" listeners for naturally rate-altered passages. Fourteen men and 14 women between 75 and 84 years of age responded to comprehension questions after hearing matched passages at four different rates. The listeners' performances were significantly worse under 60% time compression than at normal rate and two rates of time expansion. Comprehension differences between the sexes were not significant. The results are compared with prior findings for old-old listeners responding to electronically altered speech stimuli (Schmitt, 1983a) and for "young-old" listeners (65-74 years of age) who also responded to naturally rate-altered passages.

Aged↗
PubMed1989

Capitellocondylar total elbow replacement. A long-term follow-up study.

The results of forty total elbow replacements in which a capitellocondylar prosthesis was implanted in thirty-five patients (five of whom had a bilateral procedure) were reviewed retrospectively. The average length of follow-up was 7.2 years (range, four to twelve years). Pronation, supination, and flexion of the elbow improved considerably, but extension did not change a great deal. The average rating of the elbow, according to the scoring system of Ewald et al., improved from 30 to 88 points, but the functional score, as defined by the American Rheumatism Association, improved in only four patients. Malarticulation or dislocation of the prosthesis occurred in ten patients (29 per cent). In two other patients, a deep infection developed, necessitating removal of the prosthesis. Ten prostheses (ten patients) had radiolucent lines on follow-up radiographs, but these lines were not associated with pain or loosening. Seven patients (seven elbows) had a transient ulnar-nerve palsy. The incidence of this complication was reduced from 30 per cent (five of seventeen patients) to 15 per cent (four of twenty-eight patients) when the lateral Kocher approach to the elbow was adopted.

Adolescent↗
PubMed1988

Congenital pseudarthrosis of the forearm.

Congenital pseudarthrosis of the forearm is a rare condition in which traditional treatment methods have proven unsatisfactory. We report a case of congenital pseudarthrosis of the radius and ulna successfully treated by resection of the distal ulna and excision of the radial pseudarthrosis with replacement by an interpositional free vascularized fibular graft.

Child, Preschool↗
PubMed1988

A behavioral perspective on conduct disorders.

THIS paper provides a selective overview of behavioral approaches for conduct-disordered behavior. Although no definitive statement can be made regarding etiology, some empirical support exists for behavioral strategies. Assessment approaches discussed include the behavioral interview, behavioral observations, and behavioral checklists. Decisions regarding types of behavioral interventions to be employed directly follow from assessment data. Assessment information can be formulated in terms of a behavioral excess/skill deficit model. Hence, conduct-disordered behavior can be a function of excessive disruptive behavior and/or a lack of requisite skills necessary to obtain satisfaction. Parental training strategies in contingency management and contingency contracting are discussed regarding behavioral excesses. Relative to skill deficits, contingency procedures along with skills training in communication, problem-solving and self-control are reviewed, using parental training and cognitive-behavioral frameworks. In general, these interventions have empirically demonstrated efficacy. However, future research is required to identify specific factors that account for successful treatment, and attention should be directed toward preventive issues. Important data could be obtained from the identification of high-risk environmental situations. A predictive understanding of high-risk populations could result in the development of early intervention programs, which might to some extent obviate the occurrence of conduct disorders.

Adolescent↗