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Biomedical subjects

M Moss

Publications and source records attributed to M Moss.

At least 19 recordsLinked to original sources
PubMed1992

Extracorporeal membrane oxygenation for cardiac failure after congenital heart operation.

Despite continuing improvement in myocardial protection and surgical technique, the repair of complex congenital heart lesions can result in cardiopulmonary compromise refractory to conventional therapy. In a 29-month period, 24 patients (aged 14 hours to 6 years) were treated with extracorporeal membrane oxygenation (ECMO) 28 times for profound cardiopulmonary failure. Four patients required ECMO after each of two cardiopulmonary bypass procedures. Seventeen patients required ECMO to be initiated in the operating room: 12 (71%) were weaned successfully from ECMO, and 8 (47%) survived. Seven patients had ECMO initiated in the intensive care unit: 6 (86%) were weaned, and 5 (71%) survived. Serial echocardiograms demonstrated substantial recovery of cardiac function in 18 of 21 instances (86%) of ventricular failure from myocardial dysfunction. Overall, 18 of 24 patients (75%) were successfully weaned from ECMO including all 4 who underwent 2 ECMO treatments. We conclude that ECMO can successfully salvage children who have serious cardiopulmonary failure immediately after a congenital heart operation and that long-term survival is possible after two ECMO treatments.

Cardiac Output, Low↗
PubMed1991

A two-factor model of caregiving appraisal and psychological well-being.

Groups of spouse (N = 285) and adult child (N = 244) caregivers of elderly parents suffering from Alzheimer's disease were interviewed regarding their caregiving behaviors, evaluations of caregiving, and general psychological well-being. A model of caregiving dynamics where the objective stressor, caregiver resources, and subjective appraisal of caregiving (operationalized as caregiving satisfaction and burden) were studied as they affected both positive affect and depression was tested. For spouses, caregiving satisfaction was not related to aspects of the stressor, but was a significant determinant of positive affect. Among adult children, high levels of caregiving behavior resulted in both greater caregiving satisfaction and burden. Burden, in turn, was related to depression in both groups but, among adult child caregivers, positive affect was not affected by caregiving satisfaction. Limited support was found for the hypothesis that the positive and negative aspects of caregiving contributed to analogous aspects of generalized psychological well-being but not to the opposite-valence outcomes.

Aged↗
PubMed1990

Molecular biology of Crohn's disease mycobacteria.

A Glasgow surgeon, T.K. Dalziel, published a detailed description of chronic enteritis in humans in 1913. He proposed that the disease was caused by the same organisms as those responsible for chronic enteritis, Johne's disease, in animals described a few years earlier (1895). Dalziel's dilemma was that he could see acid-fast bacilli in the diseased animal tissues but not in the diseased human tissues. Little real progress in the medical understanding of the causes of chronic enteritis in humans occurred over the next half a century or more. From 1978, a decade of research in many laboratories using improved methods for the culture of environmental mycobacteria showed that these could be grown in bacillary form from about one in five cases of Crohn's disease, from the same proportion of cases of ulcerative colitis, and from about one in ten control tissues. Spheroplasts were grown from two in five cases of Crohn's disease, one in five cases of ulcerative colitis, and rarely from control tissues. The nature of these agents was often uncertain. We describe work which began in 1985 and led rapidly to the identification of IS900, a DNA repetitive element in an uncharacterized Crohn's disease mycobacterial isolate. With other isolates, these were then shown by DNA fingerprinting to be indistinguishable from Mycobacterium paratuberculosis, Johne's bacillus. Similar techniques also demonstrated the wood-pigeon strain of M. avium in some Crohn's disease cultures. This bacillus can also cause chronic enteritis in calves. IS900 is the first of a family of unusual DNA insertion sequences which extend widely throughout environmental mycobacteria. Use of assays based on PCR amplification of highly specific DNA sequences from these insertional elements, and recombinant and synthetic peptides from their predicted proteins, will revolutionize the detection and characterization of these agents. These methods, applied to animal, human and environmental samples, will indicate new ways for the prevention and treatment of chronic enteritis, as well as other disorders associated with infections by environmental mycobacteria.

Actinomycetales↗
PubMed1990

The effects of marital status and partner support on rape trauma.

Psychological functioning within the first four weeks after rape was compared for married and single victims. Marital status did not significantly affect psychological symptoms following the assault. For married women, lack of support by the partner--particularly when it was unexpected--was significantly related to poor psychological functioning after the rape.

Adaptation, Psychological↗
PubMed1990

The quality of the last year of life of older persons.

Researchers have begun devising measures of the quality of the entire last year of life of older community residents. Investigators in Philadelphia surveyed 150 living elderly on features of their quality of life, and matched the responses with 200 retrospective estimates obtained from relatives of decedents who had resided in the community much of the year. Most indicators showed declines for the decreased over their final year when compared with persons still alive; 82 percent of the decedents, however, experienced a majority of "positive-quality" months in their last year. Debates on the costs and ethical aspects of treatment and care need to take account of "positive" and "negative" aspects of quality of life reflecting individuals' multifaceted existence.

Activities of Daily Living↗
PubMed1990

Liver cancer in Wisconsin: the potential for prevention.

In this study liver cancer deaths that could be attributed to certain risk factors were calculated. Applying population attributable risk methodology, the attributable risk of liver cancer was estimated for alcohol use, hepatitis B viral exposure, and occupational and industrial exposures. We found that these three risk factors accounted for 38% of liver cancer mortality in Wisconsin; 29% was attributable to alcohol consumption, 7% to occupational exposures, and 2% to hepatitis B viral infection. More than half of liver cancer mortality, however, was not accounted for by the three risk factors studied.

Alcohol Drinking↗
PubMed1989

Measuring caregiving appraisal.

Caregivers of disabled older people were studied in terms of their appraisal of the caregiving process. A conceptual approach based on stress theory suggested that such appraisal was broader than the traditional term, "caregiving burden." An item pool was constructed using traditional and new items to represent dimensions of subjective caregiving burden, caregiving satisfaction, caregiving impact, caregiving mastery, and traditional caregiving ideology. Component analysis of responses of 632 caregivers in a respite research project yielded factors that corresponded with those hypothesized; the content of similar factored responses from 239 caregivers in another study was quite similar. A series of exploratory and confirmatory factor analyses resulted in acceptance of the subjective burden, caregiving satisfaction, and caregiving impact factors. Used as composite item scores, evidence of their psychometric quality is presented.

Adaptation, Psychological↗
PubMed1989

Mucinous carcinoma of the breast: further characterization of its three subtypes.

Nineteen cases of mucinous carcinoma of the breast were studied. Twelve tumours were of the pure type, and seven were mixed. All had abundant neutral and acidic mucin, and stained strongly with CAM 5.2. Of the 12 pure mucinous tumours, six were devoid of argyrophilic granules and were S-100 negative, and only one was CEA positive. All six patients are alive with no evidence of recurrence (mean follow-up 42 months). The other six pure mucinous tumours were rich in argyrophilic granules. Five of these showed S-100 positivity and all were CEA positive. One patient developed local recurrence and one died of myocardial infarction with no evidence of tumour recurrence (mean follow-up 80 months). Of the seven mixed tumours, only one contained an occasional cell with argyrophilic granules and four had variable degrees of CEA positivity. Two patients died and one developed bony metastasis (mean follow-up 40 months). Our findings emphasise the microscopic and prognostic differences between the three subtypes of mucinous carcinoma of the breast, and support the concept of dividing pure mucinous tumours into two distinct subtypes. We suggest that the latter subtyping can be qualitatively made on the basis of the presence or absence of argyrophilic granules in the tumour cells.

Adenocarcinoma, Mucinous↗
PubMed1989

Neonatal state profiles: reliability and short-term prediction of neurobehavioral status.

Observations were made on 40 newborns prior to hospital discharge in which states were scored every 10 sec in two 35-70-min periods separated by 6-48 hours. Newborns' states, particularly sleep states and crying, were fairly reliable across observation sessions. Cluster analyses identified 3 separable state profiles that subsequently differentiated infants on the Neonatal Behavioral Assessment Scale with Kansas Supplements (NBAS-K) at 2 weeks of age. Additionally, state observations and NBAS-K exams showed significant agreement on individual differences in neurologically based measures, such as startles, tremulousness, and lability of state.

Arousal↗
PubMed1988

Neonatal behavioral organization and visual processing at three months.

In 2 studies, the Range of State cluster derived from infants' scores on the Neonatal Behavioral Assessment Scale with Kansas Supplements (NBAS-K) was found to correlate significantly with visual discrimination performance at 3 months of age. Contrary to the expectation that NBAS-K orientation scores would predict visual discrimination at 3 months, it was neonatal behavioral state organization that related to later cognitive functioning in infancy.

Child Behavior↗
PubMed1988

Hypoxanthine and lactate concentrations in lambs during hypoxic and stagnant hypoxia.

To determine the suitability of plasma hypoxanthine as a marker of tissue hypoxia, we studied the relationship of arterial plasma hypoxanthine and blood lactate concentrations to the cumulative O2 deficit during hypoxemia and low cardiac output (hypoxic and stagnant hypoxia, respectively). Eight intact, chronically catheterized lambs were studied using ketamine sedation. Comparable reductions in O2 transport and consumption were produced with each form of hypoxia. Lactate was linearly related to O2 deficit during both forms of hypoxia, although the slope of the regression was greater for low cardiac output (0.049) than hypoxemia (0.032). Hypoxanthine was linearly related to cumulative O2 deficit only during low cardiac output. During hypoxemia, hypoxanthine concentration initially increased but plateaued with further increases in O2 deficit. The discrepancy in response of hypoxanthine was most likely caused by differences in the rate of elimination between stagnant and hypoxic hypoxia. We concluded that plasma hypoxanthine concentration was not a reliable marker for tissue hypoxia because it differed with the cause of O2 deprivation and did not necessarily reflect the severity of O2 deprivation.

Algorithms↗
PubMed1987

The role of S-adenosylmethionine in the lysine 2,3-aminomutase reaction.

The interconversion of L-lysine and L-3,6-diamino-hexanoate (L-beta-lysine) catalyzed by lysine 2,3-aminomutase is known to be stimulated by added S-adenosylmethionine (Chirpich, T. P., Zappia, V., Costilow, R. N., and Barker, H. A. (1970) J. Biol. Chem. 245, 1778-1789). In this paper we show that enzyme activated by S-[2,8,5'-3H]adenosylmethionine catalyzes the conversion of L-lysine to the equilibrium mixture of L-lysine and L-beta-lysine with incorporation of high levels of tritium into both isomers. The tritium levels in the isomers reflect the equilibrium constant for their interconversion, 84% in the L-beta-lysine and 16% in L-lysine compared with Keq = 5.3 +/- 0.3 in the direction of the formation of L-beta-lysine at pH 7.7 and 30 degrees C. No significant tritium is incorporated into lysine from S-[2,8-3H]adenosylmethionine or S-adenosyl[methyl-3H] methionine under comparable conditions. Therefore, the tritium incorporated into lysine in the former reaction arises from the 5'-position of the 5'-deoxyadenosyl group in S-adenosylmethionine. These experiments implicate the 5'-deoxyadenosyl portion of S-adenosylmethionine in the hydrogen transfer mechanism of this reaction, perhaps in a role analogous to that played by the 5'-deoxyadenosyl moiety of deoxyadenosyl cobalamin in coenzyme B12-dependent rearrangements.

Amino Acid Isomerases↗
PubMed1987

Use of computer analysis in flap research.

A computer based analysis of survival of experimental rat skin flaps is presented. The two commonly used experimental flaps, the modified McFarlane dorsal skin flap and the ventral skin flap, are compared. The analysis of the data showed that although the McFarlane flap is random, and the ventral flap based on one epigastric vascular bundle is both axial and random, there was no statistically significant difference in the percent of survival of these flaps. The advantages of the computer based method are discussed.

Animals↗
PubMed1987

Oxygen transport and metabolism in the conscious lamb: the effects of hypoxemia.

We studied the response of O2 consumption, systemic O2 transport, arterial blood lactate concentration, base deficit, and respiratory exchange ratio (CO2 production/O2 consumption) to graded alveolar hypoxia (fractional concentration of inspired oxygen 0.21, 0.16, 0.12, and 0.08) in seven intact, conscious chronically catheterized lambs at less than 1 wk after birth, at 25-40 days and at greater than 40 days. To test whether there was an age related difference in the metabolic response to a decline in O2 transport due to hypoxemia, we related the changes in blood lactate and base deficit to the systemic O2 transport and to the fractional change in O2 consumption. Systemic O2 transport and O2 consumption decreased with severe hypoxemia, while lactate concentration and respiratory exchange ratio increased in all age groups. The changes in base deficit were not significant. When the hypoxemia-induced reduction in O2 consumption was less than 15% of the baseline value (at fractional concentration of inspired oxygen 0.21) there was no elevation in lactate concentration; however, when O2 consumption was reduced by more than 15%, lactate concentration consistently increased by more than 1 mmol/liter. There were no apparent differences amongst the age groups in this response. Therefore, the newborn lamb does show metabolic consequences of a fall in O2 consumption with hypoxemia which is similar to the older sheep, however, there is a "buffer zone" in which O2 consumption may decrease before evidence of tissue hypoxia can be found. The mechanism by which O2 consumption can decrease without accumulation of lactate remains speculative.

Age Factors↗
PubMed1986

The Shaw Scalpel: thermal control of surgical bleeding.

Hemostasis during surgical procedures has always been a primary concern in patient treatment. The Shaw Scalpel represents a significant development in the surgeon's armementarium to control hemorrhage in soft tissue surgery. It offers immediate hemostasis, improved visibility, and reduced blood loss. Surgery can be performed using a single instrument for simultaneous cutting and sealing of vessels without passing any electrical current through the patient's body. Tissue healing rates are similar to cold steel and significantly better than with electrosurgical techniques.

Electrosurgery↗