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Biomedical subjects

W H Moore

Publications and source records attributed to W H Moore.

At least 19 recordsLinked to original sources
PubMed1995

Myocardial revascularization with laser. Preliminary findings.

BACKGROUND: We assessed the transmyocardial laser revascularization (TMLR) as sole therapy in patients with symptomatic coronary artery disease refractory to interventional or medical treatment. METHODS AND RESULTS: Thirty-one patients were evaluated with positron emission tomography (PET), dobutamine echocardiography, 201Tl single-photon emission computed tomography (201Tl-SPECT), and multigated acquisition radionuclide ventriculography (MUGA). TMLR was performed in 21 patients who had demonstrable ischemia in viable myocardium. The mean Canadian Cardiovascular Society (CCS) angina class was 3.70 +/- 0.7 (4 patients with unstable angina). Untreated septal segments were used as controls. At 3 months, (n = 15 patients), the mean CCS angina class was to 2.43 +/- 0.9 (P < .05). On dobutamine echocardiography, the mean resting wall motion score index was improved by 16% in lased segments (P < .03 vs control), and mean LVEF at peak stress increased by 19% (P = NS vs baseline). On 201Tl-SPECT, perfusion of lased and nonlased segments did not change. On PET, the mean ratio of subendocardial to subepicardial perfusion (SEn/SEp) increased 14% over baseline (P < .001 vs control). At 6 months (n = 15 patients), the mean CCS angina class was 1.7 +/- 0.8 (P < .05). The mean resting wall motion score index was up by 13% in lased segments (P < .05 vs control). Resting LVEF was unchanged. Stress LVEF increased 21% (P = NS vs baseline). Myocardial perfusion remained unchanged by 201Tl-SPECT. On PET, 36% of the lased segments were better, and 25% were worse compared with baseline. The resting SEn/SEp by PET was up 21% (P < .001 vs control). All deaths (two perioperative and three late) occurred in patients with preoperative congestive heart failure. Two patients required repeat revascularization of new coronary lesions. CONCLUSIONS: These results suggest that TMLR improves anginal status, relative endocardial perfusion, and cardiac function in patients who do not have preoperative congestive heart failure.

Aged↗
PubMed1994

Clinical applications of nuclear medicine in gastroenterology.

Nuclear medicine (NM) has traditionally been a non-nursing field. This specialty has grown rapidly and continues to expand. Most nurses have had very limited exposure to nuclear medicine, except in the area of patient preparation for the nuclear medicine department. Because this specialty has had significant advances that require patient monitoring in many diagnostic and therapeutic procedures, nurses will benefit by learning more about this field and by equipping themselves to care for pre- and postprocedural patients. This article is an overview of the nuclear medicine process and its most common clinical applications in the GI field as they relate to nursing practice.

Adult↗
PubMed1991

Evaluation of soft tissue injury by Tc-99m bone agent scintigraphy.

Six patients with soft tissue injury secondary to different etiologic factors are presented. The degree and extent of tissue necrosis was precisely identified by scintigraphy. In two of these, radionuclide imaging helped to establish accurately the level of amputation that resulted in appropriate wound healing.

Adult↗
PubMed1991

Inaccuracies in quantitative radionuclide renal imaging due to patient position or diverging collimation.

Radionuclide renal studies with quantitative measurements in patients confined to intensive care units usually require the use of a 10-inch field-of-view mobile gamma camera and a diverging collimator to image both kidneys simultaneously. The patient must frequently be in the lateral decubitus position so imaging can be performed in the posterior projection. Due to spatial distortion caused by the diverging collimator, variations in detector angulation and kidney depth produce different detection efficiencies for each kidney. Counts in regions of interest over the kidneys were compared as a function of detector angulation and patient position (prone and lateral decubitus). Substantial variations were observed comparing the diverging collimator data to 15-inch field-of view parallel hole acquisitions. Significant variation can also be obtained with parallel hole collimators when the patient's position is changed.

Gamma Cameras↗
PubMed1991

Prenatal glucose screening.

Of 3,563 consecutive obstetric patients undergoing glucose screening, 517 (14.5%) were found to have plasma values of greater than or equal to 140 mg%, and 74 (14.3%) of 517 were found to be diabetic on standard oral glucose tolerance testing, for an overall incidence of 2.1%. There was no absolute value on the glucose screen that predicted an abnormal oral glucose tolerance test. Twenty-eight of the 74 diabetics demonstrated none of the classic risk factors for glucose intolerance during pregnancy. Only when combining those patients over 30 years of age and with a mean body weight greater than 120% of the ideal body weight was statistical significance reached when that group was compared to the overall group. Thus, our data support the recommendation for universal prenatal glucose screening.

Adult↗
PubMed1990

EEG alpha asymmetries in stutterers and non-stutterers: effects of linguistic variables on hemispheric processing and fluency.

The EEG hemispheric alpha asymmetry technique was used to gather data from anterior and posterior language areas during a resting condition and in a sentence repetition task. Subjects were nine adult stuttering males and nine adult fluent male controls. Sentences were controlled for imagery, syntactic complexity, and rate. Significant within- and between-groups differences were found for both resting and testing conditions. Posteriorly, stutterers showed no differences between resting and testing conditions, while controls showed increased left hemisphere activation. Of the linguistic variables investigated, only imagery was involved in a significant interaction. Fluent males showed greater posterior left hemispheric activation for high and low visual imagery sentences, compared to greater posterior right hemispheric activation in stuttering males. Significantly greater alpha power was found for low vs high imagery sentences in the anterior and posterior left hemisphere sites for both subject groups, and in the right hemisphere sites for the stuttering group only. Fluency data is presented. Differences between groups in alpha power changes from resting to testing conditions are discussed.

Adolescent↗
PubMed1990

Metastatic calcification in a patient with malignant parathyroid carcinoma. Correlation of clinical, surgical, radiographic, and scintigraphic findings.

A patient whose bone scan showed features typical of a "superscan," having extensive pulmonary, cardiac, and renal calcifications is described. Metastatic parathyroid carcinoma with renal insufficiency and phosphate retention are cited as the cause. Early diagnosis and surgical extirpation offer the best chance for cure or palliation. Pitfalls of plain film radiography in identifying metastases and pathologic soft tissue calcifications in the setting of severe hyperparathyroidism are discussed, and the advantages of functional radionuclide imaging assessments are emphasized.

Bone Neoplasms↗
PubMed1990

Quantification of the reversibility of stress-induced thallium-201 myocardial perfusion defects: a multicenter trial using bull's-eye polar maps and standard normal limits.

A multicenter trial was performed on 140 patients from four centers to determine the accuracy of quantitative analysis of stress/delayed thallium-201 myocardial tomograms using normal limits to assess the relative amount of reversibility of stress-induced defects. The patients were found to have 85 fixed and 124 reversible defects, as determined by visual interpretation. Reversibility bull's-eye polar maps were compared to gender-matched normal limits from 36 normals. Regions were identified as reversible if their normalized difference between stress and 4 hr greater than 1.5 s.d.s. from the mean normal limits. Overall agreement between experts at multicenter sites and reversibility maps was 73% for reversible defects and 80% of fixed defects. Sensitivity in detecting reversibility was highest for the left circumflex (88%) and lowest for the right coronary (60%). These results indicate that reversibility polar maps and normal limits offer an objective, accurate technique for determining the reversibility of stress-induced perfusion defects.

Adult↗
PubMed1989

Indium-111 WBC scan in acute toxic centrilobular hepatic necrosis.

In this case of prolonged fever and abnormal liver functions, dual tracer scintigraphy with In-111 WBCs and Tc-99m SC led to a biopsy-proven diagnosis of severe acute toxic hepatitis (hepatocellular necrosis). Correlation of the Tc-99m SC scan findings with those previously reported for "pseudotumors" of the liver is discussed. A "pseudonormal" scan pattern is described for the In-111 WBC scintigraphy. Discordance between In-111 WBC and Tc-99m SC scintigraphy in this clinical setting should raise the possibility of hepatic necrosis as a diagnostic alternative to hepatic abscess.

Adult↗
PubMed1988

Radionuclide bone/joint imaging in children with rheumatic complaints.

We reviewed the medical records and technetium bone/joint scans of 160 children presenting to the inpatient Pediatric Rheumatology service over a 3-year period. When the scan result (normal versus abnormal) was considered for each patient as a whole, scan sensitivity and specificity were both approximately 75%. However, when each joint was considered individually, sensitivity decreased to 37%, while specificity rose to more than 95% when compared to clinical examination. Reasons for these variations and their clinical correlation are discussed. Overall, radionuclide bone/joint scanning was found to be very useful in the evaluation of monoarticular and nonrheumatic disorders, but it did not alter therapy in children with known connective tissue disorders or other polyarticular diseases.

Adolescent↗
PubMed1988

Thoracic gallium uptake in patients with lymphomatoid granulomatosis.

Lymphomatoid granulomatosis (LG) is a rare condition with histological similarities to Wegener's granulomatosis and malignant lymphoma. Characteristically there is an angiocentric, angiodestructive lymphoreticular cell infiltrate. The lungs are usually affected, and, less frequently, the skin, nervous system, kidney, and bowel are involved. The prognosis is poor and frank lymphoma develops, in some cases terminally. The usual radiological appearance of the lungs consists of bilateral nodular lower zone opacities. The authors report two patients (siblings) with LG, and their gallium scans are presented. In each case there was a significant accumulation of gallium in the lungs at times of clinically active disease. The limited role of gallium imaging in this disease is discussed.

Child↗
PubMed1988

Upper extremity radionuclide venography in the diagnosis and management of venous disease associated with intravenous catheters.

The utility of upper extremity radionuclide venography (RNV) in the assessment of suspected catheter-related central venous thrombosis (CRVT) was evaluated in 40 patients with subclavian venous catheters. Twenty normal patients (Group A) served as controls and their venographic patterns were analyzed by using four criteria: (1) delayed tracer transit time, (2) nonuniformity of flow and venous pooling, (3) jugular venous reflux, and (4) collateral venous filling. Control studies displayed no collaterals as a distinguishing characteristic but demonstrated the other three features to a variable degree. Of 106 extremities suspected of CRVT, 67 (Group B) were initially considered to have normal RNV findings (no collaterals). Contrast venography confirmed a normal pattern in 3 but identified CRVT with collaterals in 3 others. Retrospective review of the RNV studies confirmed faint collaterals in these latter 3. The 39 remaining extremities (Group C) showed abnormal RNV findings; contrast venography and postmortem studies confirmed the presence of venous disease in 5 patients. The authors believe that RNV is a reliable, noninvasive procedure for early diagnosis of venous occlusion associated with subclavian venous catheters.

Blood Flow Velocity↗
PubMed1987

Hemispheric alpha asymmetries in fluent and dysfluent aphasics during linguistic and resting conditions.

The hemispheric alpha asymmetries of a group of normal males, normal females, fluent aphasic males and dysfluent aphasic males were investigated during the auditory presentation of sentences, a short story and a resting condition in the absence of linguistic stimuli. No differences were found for the groups' mean alpha ratio scores during the resting condition. Fluent aphasics were found to demonstrate greater right hemispheric alpha suppression than the other groups for the sentence and story conditions. The dysfluent aphasics showed greater right hemispheric alpha suppression for the sentence condition than either of the normal groups. Results are discussed in terms of the right hemisphere's contribution to language recovery following unilateral left hemispheric damage resulting in aphasia.

Adult↗