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Biomedical subjects

D F Martin

Publications and source records attributed to D F Martin.

At least 127 records · Page 7Linked to original sources
PubMed1991

Abdominal distension in female patients with irritable bowel syndrome: exploration of possible mechanisms.

Abdominal distension is a common but little understood symptom of the irritable bowel syndrome. The authenticity of the symptom was confirmed by appreciable increases in girth measurement during the day in 20 patients with the irritable bowel syndrome compared with 20 control subjects. Objective corroboration of this finding was shown in the group with the irritable bowel syndrome by a highly significant increase in lateral abdominal 'profile' on computed tomography. Previously postulated mechanisms for distension--namely, retention of gas, depression of the diaphragm, and excess lumbar lordosis--were excluded by the radiological findings. Voluntary protrusion of the abdomen produced a completely different pattern on computed tomography to that observed in the irritable bowel syndrome. These observations suggest that abdominal distension may be related to changes in motility or tone of gastrointestinal smooth muscle.

Abdomen↗
PubMed1991

Ultrasonic evaluation of gallbladder function prior to non-surgical treatment of gallstones.

A comparative analysis of ultrasonic and oral cholecystographic assessment of gallbladder function in symptomatic patients with cholelithiasis is presented. Ultrasonic evaluation demonstrated non-contractile gallbladders in all but one patient with non-opacification during oral cholecystography, whereas all those opacifying on oral cholecystography contracted on ultrasonography. Both techniques showed similar abilities to quantify the size and number of biliary calculi within the limits necessary to determine suitability for treatment. Although computed tomography remains necessary to quantify gallstone density prior to non-surgical treatment, ultrasonography is a safe, acceptable, cheap and preferable alternative to oral cholecystography in assessing gallbladder function.

Adult↗
PubMed1991

Chronic compartment syndrome caused by aberrant fascia in an aerobic walker.

The following is a case presentation of a 36-yr-old female athlete who presented with the symptoms and signs of chronic anterior compartment syndrome. Pre-exercise and post-exercise tissue pressure measurements revealed increased compartment pressures in both of her anterior leg compartments. Aberrant fascial bands overlying and compressing the anterior compartments were discovered at the time of surgery. Fasciotomies led to complete recovery and return to previous levels of athletic activity. This is the first report of aberrant fascia as a cause of chronic anterior compartment syndrome.

Adult↗
PubMed1990

Vitreous cefazolin levels after intravenous injection. Effects of inflammation, repeated antibiotic doses, and surgery.

We devised a standardized rabbit model of intraocular inflammation using heat-killed Staphylococcus epidermidis as the inducing organism. We applied this model to study the effects of (1) inflammation, (2) repeated antibiotic doses, and (3) surgical status of the eye on cefazolin levels in the vitreous cavity after intravenous administration. Intravenous cefazolin sodium, 50 mg/kg, was administered every 8 hours for 48 hours. Eyes were harvested for assay of vitreous cavity antibiotic levels at various intervals from 1 to 49 hours. Drug levels were compared in inflamed and noninflamed eyes under both phakic and aphakic/vitrectomized conditions. At 1 hour, levels in phakic specimens were 3.0 mg/L in inflamed eyes vs undetectable in noninflamed eyes (P less than .01), but progressively increased to 10.6 mg/L at 49 hours (P less than .02) in inflamed eyes only. Levels in aphakic/vitrectomized eyes at 1 hour were 6.7 mg/L in inflamed eyes vs 4.2 mg/L in noninflamed eyes (P less than .1), but progressively increased to 24.9 mg/L at 49 hours (P less than .001) in inflamed eyes only. Levels at 49 hours in inflamed phakic and inflamed aphakic/vitrectomized eyes were well above the minimum inhibitory concentrations for organisms termed sensitive to cefazolin. We would conclude, therefore, that repeated doses of intravenous cefazolin may play an important adjunctive role in the treatment of endophthalmitis.

Analysis of Variance↗
PubMed1990

Small bowel phytobezoar mimicking presentation of Crohn's disease.

A case of small bowel phytobezoar formed from unusual ingested vegetation is described. The patient presented with recurrent subacute obstruction and a right iliac fossa mass mimicking the presentation of Crohn's disease. None of the usual gastrointestinal disorders that predispose to bezoar formation were present. The phytobezoar passed spontaneously following small bowel enema and colonoscopy. It is possible that relaxation of the gut secondary to the antispasmodics administered at investigation or the physical disturbance during these procedures enabled migration through the ileocecal valve. Antispasmodics may be of use in the conservative management of bezoars obstructing otherwise normal bowel.

Adult↗
PubMed1990

Combination of radiation therapy and intracranial bleomycin in the 9L rat brain tumor model.

The rat 9L brain tumor model was used to investigate the therapeutic potential of a combined modality approach using intracranial Bleomycin and radiation therapy. Bolus Bleomycin was delivered intracranially into the tumor volume via cannula guides; for continuous infusions, osmotic mini-pumps were implanted subcutaneously between the scapulae with flexible tubing to deliver the drug directly into the tumor and brain. Two to six bolus injections of Bleomycin (1 unit/kg each) over 5-11 days produced modest (usually statistically significant, p less than 0.05) increases in the median survival time compared to controls. Continuous infusion of Bleomycin by osmotic pump (10 units/kg over 7 days or 15 units/kg over 14 days) was also effective at significantly increasing median survival times compared to that of controls. Radiation therapy schedules of 10 daily fractions in 12 days (2 weeks) or 10 twice-daily fractions in 5 days produced dose-dependent increases in median survival time. Multiple bolus injections of Bleomycin when combined with fractionated radiation therapy significantly increased the median survival time due to fractionated radiation therapy alone for low doses (40 or 50 Gy). However, at higher radiation doses, the addition of Bleomycin either had no effect on median survival time or actually shortened it. Continuous infusion of Bleomycin by osmotic pump was effective when added to low dose radiation therapy in several experiments, twice for a total radiation dose of 50 Gy and once for radiation therapy of 60 Gy. However, it was also observed (once for 60 Gy and twice for 70 Gy) that the addition of continuous infusion Bleomycin either had no effect or served to decrease the improvement of median survival time obtained by radiation therapy alone. Thus, we conclude that increases in normal tissue toxicity can prevent full attainment of improved therapeutic advantage from the addition of Bleomycin to fractionated radiation therapy in the rat 9L model. These results should be considered when attempts are made to combine radiation therapy and intracranial Bleomycin for the treatment of patients with primary malignant brain tumors.

Animals↗
PubMed1990

Retroperitoneal perforation during ERCP and endoscopic sphincterotomy: causes, clinical features and management.

Eleven patients with retroperitoneal perforation complicating endoscopic management of bile duct obstruction were seen over a seven-year period. In nine patients endoscopic sphincterotomy or pre-cut papillotomy had been performed, but in two who had not undergone sphincterotomy perforation occurred because of the penetration of a guidewire during attempts to negotiate a malignant bile duct stricture. Eight out of eleven patients remained asymptomatic, and all recovered with conservative management. Asymptomatic retroperitoneal perforation can complicate therapeutic ERCP even when sphincterotomy is not performed, but conservative management is usually effective if the complications is recognized immediately.

Bile Ducts↗
PubMed1990

Tips of the trade #28. Accurate tunnel placement using drill guides in knee ligament reconstruction.

Knee ligament reconstruction is optimized when intra-articular grafts are placed isometrically. Several drill guides have been designed to facilitate accurate tunnel placement. The use of an intra-articular keying hole, made with a burr, enhances proper and secure drill guide placement. Sterile mineral oil lubrication of the drill guide components will help prevent their distortion and will eliminate improper tunnel placement.

Anterior Cruciate Ligament↗
PubMed1989

Arthroscopic treatment of chronic synovitis of the ankle.

Arthroscopic synovectomy is a valuable tool in treating synovitis of the knee joint. We have identified a group of patients who benefit from ankle synovectomy. To determine the indications and long-term results of arthroscopic synovectomy of the ankle, we evaluated the history, preoperative examination, roentgenograms, and operative data of patients who underwent this procedure and had a minimum of 2 years of follow-up. Sixteen patients who underwent arthroscopic ankle synovectomy were identified. Sprains and inversion-type injuries were common in this young patient group. All had failed conservative therapy. Operative findings revealed hypertrophic synovium in all cases. Good or excellent results were obtained in 75% of patients, using a subjective and functional evaluation scale. Complications were one deep infection, one superficial infection, and one temporary sensory paresthesia. Chronic synovitis, or anterior soft-tissue impingement, was responsive to arthroscopic treatment and results did not deteriorate over time.

Adult↗
PubMed1989

The influence of type of tube and experience of the operator on performance of small bowel enema.

Seventy patients underwent small bowel enema (SBE) to assess the influence of experience of the radiologist on the ease of jejunal intubation and the adequacy of SBE using two types of tubes. Comparing intubation time, intubation screening time, total screening time and total room time, we conclude that jejunal intubation is achieved easily, in a reasonable time with both types of tube, by all grades of radiologist, although the experienced operator using the Silk tube achieved intubation in a significantly shorter time. Overall patient acceptability was satisfactory (75%) but was better using the Silk tube, with which entero-gastric reflux and vomiting were less.

Adolescent↗
PubMed1989

Campylobacter pylori, NSAIDS, and smoking: risk factors for peptic ulcer disease.

Campylobacter pylori, nonsteroidal anti-inflammatory drugs, and smoking are associated with ulcer disease. To define further the role of these factors in ulcer disease, one hundred seven subjects presenting for endoscopy were tested for specific IgG and IgA antibodies to C. pylori, and questioned about nonsteroidal use and smoking. Sixty were dyspeptic patients, 28 were disease controls, and 19 were healthy asymptomatic volunteers. Considering all subjects, 81% (87/107) were either taking nonsteroidals or had antibody to C. pylori, and 32% of these (28/87) had an ulcer. Nineteen percent (20/107) were neither taking nonsteroidals nor had antibody to C. pylori, and none of these had an ulcer, p less than 0.01. Smokers, 41% (11/27), were more likely to have an ulcer than nonsmokers, 20% (16/80), p less than 0.05, but only because of the increased prevalence of ulcers in smokers who also had C. pylori, 73% (11/15) versus 27% (12/45) of nonsmokers with C. pylori, p less than 0.01. The use of nonsteroidals and antibody to C. pylori identify people at risk for ulcers. Smoking increases this risk in subjects with C. pylori. Absence of a history of nonsteroidal use and antibody to C. pylori identify individuals with a low probability of ulcer disease.

Adult↗