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Biomedical subjects

D C Martin

Publications and source records attributed to D C Martin.

At least 181 records · Page 10Linked to original sources
PubMed1985

Composite tissue (limb) allografts in rats. II. Indefinite survival using low-dose cyclosporine.

Cyclosporine has reawakened interest in transplantation of peripheral composite tissue allografts (CTA) of skin, muscle, bone, vessel, and nerves. The purpose of this study was to examine whether cyclosporine could produce indefinite survival of CTA. Two groups of LEW recipients of LBN limb transplants were given different long-term treatments of cyclosporine. Tolerance was achieved in many of the animals. Several possibilities for the mechanism of this tolerance are discussed.

Animals↗
PubMed1985

Community-based geriatric assessment.

A comprehensive review of the multidisciplinary functional assessment and treatment of 800 patients seen at a community-based geriatric assessment center was performed to profile clinical characteristics of patients attending such a program and to evaluate possible predictors of institutionalization. The most common problems addressed were senile dementia (46%), hypertension (31%), clinically significant depression (30%), and burdened caregiver (24%). More than 90% of patients were able to remain in the community after multidisciplinary treatment of their problems and marshalling of support services. The most potent predictors of institutionalization in rank order of predictive value were: falls or unstable gait, senile dementia, caregiver strain, lack of support services, and moderate to severe impairment of ability to perform activities of daily living (multiple R = 0.45; P = .001). Advantages and impediments to community-based assessment are discussed.

Activities of Daily Living↗
PubMed1985

Association of ureteropelvic pseudo-obstruction with cryptorchidism.

A variety of upper urinary tract anomalies have been described in cryptorchidism. This report is of an asymptomatic patient with cryptorchidism, who appeared to have bilateral ureteropelvic-junction obstruction on excretory urography. Further investigations, including urodynamic studies and glomerular- and tubular-function tests, revealed no abnormalities. Ureteropelvic pseudo-obstruction can, therefore, be added to the list of numerous renal and urinary tract anomalies known to be associated with cryptorchidism.

Adolescent↗
PubMed1985

CO2 laser laparoscopy for the treatment of endometriosis associated with infertility.

Both medical and surgical therapy have been used in the treatment of infertility associated with endometriosis. Danazol has been used following screening laparoscopy to avoid the discomfort, expense and risk of laparotomy. The CO2 laser offers the advantage of precise excisional surgery at the initial laparoscopy and thus potentially avoids further surgery and the use of danazol. In 50 infertile women in whom initial or second-look laparoscopy revealed the presence of endometriosis, CO2 laser laparoscopy was used to excise (vaporize) the endometriotic lesions. At 7-19 months of follow-up, 11 patients had become pregnant. One pregnancy was ectopic, and one aborted. The estimated long-term pregnancy rate was 60% or greater. Of those who were not yet pregnant at this writing, 59% had either a cervical factor, male factor or both. There was a 70% decrease in the use of danazol for stage I endometriosis and a 78% decrease for stage II endometriosis without a decrease in the overall pregnancy rates when compared to those for previous therapy with laparoscopic coagulation. However, the highest pregnancy rates resulted from a combination of laparoscopic laser excision and danazol.

Adult↗
PubMed1984

Alcohol exposure in utero and functional deficits in children during the first four years of life.

The behavioural effects of varying amounts of alcohol exposure in utero were studied using a longitudinal prospective design. An unselected sample of 1529 pregnant women was interviewed in the fifth month of pregnancy regarding beverage consumption, diet, drug use, and socioeconomic background; a cohort of approximately 500 infants was selected at delivery for follow-up. Lengthy individual behavioural and anthropometric examinations were made of the children between birth and four years of age. Alcohol-related behavioural effects are still statistically significant at four years, as they were at birth and eight months, even after adjustment for variables such as maternal smoking, drug use and diet, education, birth order and family stress. Habituation, sucking pressure and latency to suck are some of the behaviours most affected on days 1 and 2, while reaction time, attention and response latency are most affected at four years. Thus alcohol exposure in utero appears to affect the speed and accuracy of information-processing in the offspring. The findings support a dose-response rather than a threshold effect on most of these behavioural outcomes. However, increased risk of a clinically suspect or abnormal child occurs only at the heavier drinking levels. Examination of the cohort of 500 children at seven years of age is under way.

Child Behavior Disorders↗
PubMed1984

Tubal patency and pelvic adhesions at early second-look laparoscopy following intraabdominal use of the carbon dioxide laser: initial report of the intraabdominal laser study group.

It has been suggested that the carbon dioxide (CO2) laser, by virtue of its hypothetical capabilities for precise incisions, minimization of tissue handling and bleeding, and shortened operating time, may improve the success rate of gynecologic infertility surgery. To assess this hypothesis, a multicenter prospective study was performed to assess tubal patency and adhesion formation at early second-look laparoscopy after intraabdominal laser surgery. Procedures performed included salpingoneostomy, fimbrioplasty, lysis of adhesions, vaporization of endometriosis, and ovarian wedge resection. The results were compared with those of another multicenter prospective study that utilized nonlaser reconstructive pelvic surgery. Use of the CO2 laser was found to result in a greater tubal patency rate at the time of the second-look procedure. Adhesions present at the time of the second-look procedure were reduced from initial presentation at most sites; however, nonlaser infertility surgery appeared to have equal or greater efficacy in the prevention of adhesion formation at most sites. Thus, the CO2 laser does not appear to be a panacea for the treatment of tuboperitoneal causes of infertility. Pregnancy rates following intraabdominal use of the CO2 laser remain to be established.

Adolescent↗
PubMed1984

Acquired renal cystic disease in renal transplant recipients.

End-stage kidneys are known to undergo cystic transformation in patients treated with long-term hemodialysis. Little has been published, however, on the occurrence of acquired renal cystic disease (ACD) in renal transplant recipients. The available clinical and histopathological data were gathered on 22 renal transplant recipients who had undergone either necropsy or nephrectomy. None of our patients exhibited cystic changes in their donor kidneys. However, 11 patients (50%) had ACD of the native kidneys while the remaining patients lacked ACD. The duration of dialysis prior to transplantation was significantly longer and the life of the functional transplant kidney was significantly shorter in the ACD group as compared to the noncystic group. The combined duration of ESRD (dialysis + transplantation), however, was comparable in the two groups. It thus appears that the presence of a functioning renal allograft somehow retards the evolution of cystic changes in the diseased native kidneys. 1 of the patients in the ACD group exhibited superimposed multifocal clear cell carcinoma of the affected kidney, while none of the patients in the noncystic group exhibited renal neoplasm.

Adenocarcinoma↗
PubMed1984

Cytomegalovirus viremia detected by molecular hybridization and electron microscopy.

Fatal cytomegalovirus interstitial pneumonitis developed in a patient with chronic leukemia. The diagnosis was suspected on the basis of cytologic examination of bronchial washings. The virus was subsequently recovered from saliva, urine, and blood leukocytes after 8, 9, and 18 days in culture respectively. Premortem cytomegalovirus DNA was found by molecular hybridization methods using a complete viral genome probe in blood leukocytes after 4 hours' reaction time. Electron microscopic examination showed herpes-like virions consistent with cytomegalovirus in 3% of the patient's granulocytes. Thus, DNA:DNA hybridization and ultrastructural methods can be used for rapid diagnosis of disseminated cytomegalovirus infection.

Aged↗
PubMed1984

Infant size at 8 months of age: relationship to maternal use of alcohol, nicotine, and caffeine during pregnancy.

To examine the relationship of maternal alcohol consumption, caffeine use, and smoking to infant size at 8 months of age, a follow-up cohort of 453 infants was examined at birth and again at their 8-month birthday. Even after adjustment for other relevant variables, maternal alcohol use during early pregnancy (average ounces of absolute alcohol by self-report) was significantly related to infant weight and length at 8 months of age but not as strongly related to head circumference. Maternal smoking and caffeine use during pregnancy were not significantly related to infant size at 8 months, although nicotine use had been highly related to the birth size in this sample. Maternal use of marijuana was significantly and negatively related to infant length at 8 months of age, but not to weight or head circumference. The magnitude of the growth retardation is smaller at 8 months than at birth in this sample of infants whose mothers are primarily white, married, and well-educated, and who report a variety of alcohol use patterns. Significance was tested using multiple regression analyses that adjusted for the effects of nicotine use, caffeine use, birth order, maternal height, and gestational age as well as sex and age of infant at examination.

Alcohol Drinking↗
PubMed1984

Pathology of endocrine organs in chronic renal failure--an autopsy analysis of 66 patients.

Gross and microscopic findings at autopsy are reported in 66 patients with end-stage renal disease (ESRD). Nineteen patients received renal transplant, and 47 were maintained on chronic dialysis. Thyromegaly was seen in over half of the dialysis patients and in a third of the transplant recipients. The mean weight of the thyroid gland in the two groups was similar (26.2 +/- 4.5 g in the transplant group and 27.2 +/- 6 g in the group on dialysis). The parathyroid glands were hyperplastic in 10/11 dialysis patients (91%), but of normal size in 78% of the transplant recipients. Adrenal gland atrophy was common in the transplant group, probably reflecting adrenal suppression by glucocorticoids. Seminiferous tubular atrophy was observed in 12/16 dialysis patients and small testes were noted on gross examination in 50% of the transplant recipients. Prominent autopsy findings were goiter, parathyroid gland hyperplasia, and testicular atrophy. Following transplantation parathyroid gland hyperplasia declined, whereas goiter and testicular atrophy appeared to persist.

Adolescent↗
PubMed1983

Comparison of drinking and smoking patterns during pregnancy over a six-year interval.

Changes in the drinking and smoking habits of pregnant women in Seattle, Washington, were examined in the 6-year period that followed the first American announcement of the fetal alcohol syndrome. Between 1974/1975 and 1980/1981, the number of women who reported any alcohol use around the time of the first prenatal visit dropped from 81% to 42%, whereas the number of smokers dropped from 25% to 22%; binge and heavier drinking also declined. However, among drinkers, there was no decrease in the proportion of women who reported heavier drinking. Although the proportion of women who drink during pregnancy has decreased in the past 6 years, the relative constancy in the proportion of "heavier" drinkers and binge drinkers, particularly around the time of conception, suggests the need for more attention to this important period of gestation in advice to women who are planning a pregnancy. Possible reasons for such changes in this particular community are discussed.

Adolescent↗