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Biomedical subjects

M E Moran

Publications and source records attributed to M E Moran.

44 records · Page 3Linked to original sources
PubMed1979

Comfort, care for families who must wait.

Volunteers staff a special waiting room that extends humanistic care to meet the needs of families as they wait to learn the outcomes of their relatives' surgery or tests.

Family↗
PubMedDate not supplied

Training for minimally invasive surgery. Need for surgical skills.

Controversy exists regarding the training of surgeons for the performance of minimally invasive surgical procedures. The use of live animals is essential, especially in teaching dissection techniques. Seventeen percent of animals experienced excessive operative hemorrhage, which contributed to premature mortality during training exercises, demonstrating the need for live animals in this component of the training. A number of abdominal procedures can be performed with minimally invasive techniques without suturing by utilizing a rapidly expanding array of devices. However, other procedures cannot be successfully accomplished without suturing skills. Laparoscopic suturing skills are particularly demanding; thus specific training and practice prior to hands-on exercises in animal models is recommended. Emphasis on acquisition of advanced laparoscopic surgical skills is a necessity.

Animals↗
PubMedDate not supplied

Resolution of a left ureteral stone using electrohydraulic lithotripsy in a thoroughbred colt.

A 3-year-old Thoroughbred colt was presented for evaluation of azotemia and anorexia. Physical examination revealed a ureterolith in the left ureter, approximately 10 cm from the bladder, which was thought to obstruct urine flow by approximately 90% when viewed cystoscopically. Ultrasonographic examination of both kidneys revealed indistinct corticomedullary junctions, and the right kidney was more hyperechoic. A percutaneous biopsy of the right kidney revealed chronic interstitial nephritis with marked interstitial medullary fibrosis. Medical therapy consisting of IV fluids, sodium chloride PO, and ammonium chloride PO was initiated. Ureteroscopic electrohydraulic lithotripsy via a perineal urethrostomy was used to successfully remove the stone. Klebsiella oxytoca, which responded to oral enrofloxacin therapy, was cultured from the urine after surgery. Azotemia resolved and the horse resumed training.

Animals↗
PubMedDate not supplied

Intramalleolar triplane fractures of the distal tibial epiphysis.

The intramalleolar triplane fracture of the distal tibial epiphysis is a relatively rare injury in children. We studied five children with intramalleolar triplane fractures. Four of the five children were competitive athletes. Each child underwent computerized tomography with three-dimensional reconstruction. Delineation of the intramalleolar fracture pattern with computerized tomography with three-dimensional reconstruction demonstrated three distinct types of intramalleolar triplane fractures: I. intraarticular and within the weight-bearing zone, II. intraarticular and outside the weight-bearing zone, and III. extraarticular. Computerized tomography with three-dimensional reconstruction delineated the fracture pattern and allowed selection of the optimal treatment method. A classification scheme of the three types of intramalleolar triplane fracture is proposed.

Adolescent↗
PubMedDate not supplied

Minimally traumatic techniques for in utero access and fetal surgery.

BACKGROUND AND OBJECTIVES: Prenatal interventions may prevent some sequelae of congenital anomalies, yet open fetal surgery is limited by pre-term labor. We are developing amnioscopic strategies to reduce risks for in utero surgery. METHODS: Seven fetal sheep were accessed percutaneously under ultrasound guidance, via maternal laparoscopy/transuterine trocars, or via laparoscopically assisted partial uterine exteriorization (mini-hysterotomy). Three fetal immobilization methods were investigated: 2 mm grasping forceps, 2-0 absorbable Roeder loop lasso, and detachable metal T-fasteners. RESULTS: Percutaneous access with 2 mm trocars required accessible amniotic fluid pockets. The laparoscopically assisted method enabled 5 mm trocar placement under direct fetal visualization. Mini-hysterotomy avoided trocars and was leak-proof. 2 mm graspers enabled fetal manipulation with repeatable applications. Roeder loop sutures were not readily repositioned, and required two 3 mm or larger trocars. T-fasteners were easily deployed into fetal skin via the self-contained needle applicator with minimal hemorrhage. Cutaneous marks were present immediately from the grasper and T-fastener, but not at postoperative day 10. The Roeder loop produced no observable effects. All devices demonstrated adequate intrauterine performance. CONCLUSIONS: Minimally invasive fetal surgery promises to lower maternal-fetal risks. All strategies permitted prolonged amnioscopy and fetal manipulation. The 2 mm grasper was easiest to use, producing no observable lasting trauma.

Animals↗