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D Martin

Publications and source records attributed to D Martin.

At least 433 records · Page 24Linked to original sources
PubMed1995

Combined endoscopic ultrasound and stimulated biliary drainage in cholecystitis and microlithiasis--diagnoses and outcomes.

BACKGROUND AND STUDY AIMS: It is becoming increasingly evident from a number of studies that endoscopic ultrasound (EUS) is much more sensitive in the diagnosis of cholecystitis than transabdominal ultrasound (TUS). The present study was undertaken to further evaluate this relative sensitivity. PATIENTS AND METHODS: Sixty-six patients with biliary-type pain and a negative transabdominal ultrasound examination underwent combined endoscopic ultrasound and stimulated biliary drainage (EUS/SBD). Stimulated biliary drainage was obtained following intraduodenal infusion of magnesium sulfate or intravenous sincalide, a CCK analogue. EUS was considered positive if sludge or small stones were seen in the gallbladder. Stimulated biliary drainage was considered positive if calcium bilirubinate granules or cholesterol crystals were seen on microscopic examination of aspirated bile. RESULTS: At operation, 61 of the patients had cholecystitis documented histologically. Fifty-eight of the patients had gallbladder sludge or small stones on EUS. One patient had a negative EUS, but had calcium bilirubinate granules in the bile. Twenty-one patients were followed post-operatively for a period of seven to 17 months, with an average of 10.5 months. Nineteen patients (90.5%) remain free of biliary pain. CONCLUSIONS: Combined endoscopic ultrasound and stimulated biliary drainage (EUS/SBD) had a high sensitivity of 92.4% and a positive predictive value of 100% in the diagnosis of cholecystitis when transabdominal ultrasound was negative. A significant majority (90.5%) of patients with positive EUS/SBD who underwent cholecystectomy had resolution of their biliary pain.

Cathartics↗
PubMed1995

Bone growth after replantation in children.

Bone growth and the development of epiphyseal plates are disturbed after the replantation of amputated extremities in children, but the potential for continued skeletal growth is almost always maintained in the replanted part. In this reported series of 12 children, all younger than 15 years old, 13 amputated parts of the upper limb have been successfully replanted. After long-term follow-up (from 21 to 216 months), bone growth of the replanted parts was clinically and radiologically evaluated. Two different growing segments were distinguished: the proximal bone segment, directly injured from the initial trauma, and the distal replanted part. Average longitudinal growth recorded was 94.5 percent and 92.7 percent, respectively. Two young patients demonstrated overgrowth of the proximal bone segment, which attained 110 percent and 118 percent of expected growth. Although it is difficult to determine all the parameters affecting the prognosis of post-traumatic reactions in growing cartilaginous plates, the level of amputation is considered to be a significant prognostic factor for the epiphyseal growth of the replanted part.

Adolescent↗
PubMed1995

Role of beta-adrenergic mechanisms in exercise training-induced metabolic changes in respiratory and locomotor muscle.

To test the hypothesis that beta-adrenergic stimulation is required for the normal increase in oxidative capacity of respiratory and locomotor skeletal muscle in response to exercise training, we examined the effects of beta-blockade on muscle oxidative capacity in trained and sedentary rats. Thirty-four female adult Sprague-Dawley rats were randomly divided into four experimental groups: 1) trained+propranolol (TP); 2) trained + sham injection (TS); 3) sedentary + propranolol (SP); and 4) sedentary + sham injection (SS). Training increased (p < 0.05) citrate synthase (CS) activity in the plantaris (+29%) and costal diaphragm (+12%) of TS animals compared to SS animals. In contrast, training did not (p > 0.05) increase costal diaphragm CS activity in TP animals compared to the SS group. Further, although training increased (p < 0.05) plantaris CS activity in the TP group (+18%) compared to the SP group, the training-induced increase in muscle CS activity was 11% lower (p < 0.05) than observed in TS animals. Collectively, these results suggest that beta-adrenergic mechanisms may play a role in the normal training-induced increase in oxidative capacity in both respiratory and locomotor skeletal muscles.

Adaptation, Physiological↗
PubMed1995

Linkage of the 1981 and 1991 U.K. censuses using surface modelling concepts.

Problems involving the comparative analysis of data for the 1981 and 1991 U.K. censuses are explored. The authors note that "the integration of 1981 and 1991 data is far from straightforward because of changes in census geography and definitions, in the administration of the census, and in the format and nature of the data. It is explained how, by a further refinement of population surface modelling concepts, these two data sets can be transformed into a single, consistent geographical database independent of the two original and inconsistent zonal structures....The resulting models permit intercensal analysis with considerable spatial flexibility and a number of computational advantages. Illustration is made of the types of analysis that can be supported, and attention is drawn to the availability of the remodelled data to the academic community."

Censuses↗
PubMed1995

Increasing severity of invasive group A streptococcal disease in Australia: clinical and molecular epidemiological features and identification of a new virulent M-nontypeable clone.

We conducted a 12-year review of all cases of group A streptococcal (GAS) bacteremia that were seen at Royal Children's Hospital in Melbourne, Australia, from 1982 through 1993. Forty-two cases were identified. There was a trend towards increased incidence of infections, as well as a clear increase in their severity, during the study period; more previously healthy children were affected during the last 6 years of the study (80% of cases) than during the first 6 years (47% of cases), and more complications occurred during the latter period than during the former (40% vs. 20%, respectively, with an 88% complication rate over the last 12 months). Seventy-four GAS isolates (41 invasive, 23 noninvasive, and 10 indeterminate) were analyzed. An M type 1 clone that was positive for the pyrogenic exotoxin A gene (speA) and that has been found to cause invasive disease in the Northern Hemisphere was most frequent among invasive isolates. Molecular typing also identified a genetically distinct strain that was virulent, mucoid, and M nontypable. Invasive GAS disease in Melbourne has become increasingly aggressive. Newer typing methods should be used in conjunction with traditional serotyping in order to maintain epidemiological surveillance of virulent strains.

Adolescent↗
PubMed1995

Training room evaluation of chest pain in the adolescent athlete.

A physician or athletic trainer will often be faced with an athlete complaining of chest pain during or after an event. Chest pain in children and adolescents is usually of a noncardiac origin; only 5% of cases are due to cardiac problems. With a properly documented history and physical evaluation, one can usually identify the etiology of the chest discomfort or at least rule out any serious difficulties. The various diagnostic possibilities include cardiac, musculoskeletal, pulmonary, gastrointestinal, and psychiatric causes of pain. We discuss several specific conditions, as well as the signs, symptoms, and basic management.

Adolescent↗
PubMed1995

Ethanol inhibition of AMPA and kainate receptor-mediated depolarizations of hippocampal area CA1.

Longitudinal hippocampal slices were prepared from adult female rats. The excitatory amino acids, alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AMPA) and kainic acid, were applied to area CA1, and the resulting depolarizations were measured using the grease-gap electrophysiological technique. Agonist dose-response curves were generated in the presence and absence of various concentrations of ethanol. Ethanol (25-200 mM) significantly attenuated the depolarizations that were produced by each agonist. In addition, we found that ethanol potently antagonized kainate-induced depolarizations across the agonist concentration-response curve, whereas it significantly suppressed only AMPA responses that were induced with moderate-to-high agonist concentrations. These results indicate that ethanol has potent antagonist actions against non-N-methyl-D-aspartate (NMDA) excitatory amino acid-induced neuronal depolarizations in hippocampal area CA1. Moreover, the relative potency of ethanol depends on the specific excitatory agonist tested and the concentration of that agonist. This suggests that, in addition to the known effects of ethanol on NMDA receptor-mediated activity, it may also potently attenuate ongoing "fast" glutamatergic synaptic activity in the hippocampus.

Animals↗
PubMed1995

Registration error quantification of a surface-based multimodality image fusion system.

This paper presents a new reference data set and associated quantification methodology to assess the accuracy of registration of computerized tomography (CT) and magnetic-resonance (MR) images. Also described is a new semiautomatic surface-based system for registering and visualizing CT and MR images. The registration error of the system was determined using a reference data set that was obtained from a cadaver in which rigid fiducial tubes were inserted prior to imaging. Registration error was measured as the distance between an analytic expression for each fiducial tube in one image set and transformed samples of the corresponding tube obtained from the other. Registration was accomplished by first identifying surfaces of similar anatomic structures in each image set. A transformation that best registered these structures was determined using a nonlinear optimization procedure. Even though the root-mean-square (rms) distance at the registered surfaces was similar to that reported by other groups, it was found that rms distances for the tubes were significantly larger than the final rms distances between the registered surfaces. It was also found that minimizing rms distance at the surface did not minimize rms distance for the tubes.

Biophysical Phenomena↗
PubMed1995

Evaluation and validation of a monoclonal immunofluorescent reagent for direct detection of Bordetella pertussis.

An outbreak of pertussis in Manitoba, Canada, provided an opportunity to evaluate the recently developed monoclonal antibody (MAb) BL-5 for the direct detection of Bordetella pertussis. The MAb recognizes a lipooligosaccharide epitope. A total of 1,507 consecutive nasopharyngeal swabs for culture and companion smears for direct fluorescent-antibody (DFA) detection were evaluated at Cadham Provincial Laboratory between September and November 1994. The cutoff for DFA positivity was four fluorescing organisms with morphology characteristic of B. pertussis. PCR analysis for B. pertussis DNA was performed on a subset of 100 smears by eluting material from the slides after DFA examination. In comparison with culture, the sensitivity, specificity, and positive and negative predictive values of BL-5 were 65.1% (41 of 63 samples), 99.6% (1,438 of 1,444 samples), 87.2% (41 of 47 samples), and 98.5% (1,438 of 1,460 samples), respectively. The sensitivity of culture compared with PCR was 45.5% (10 of 22 samples) for the subset of 100 specimens tested by both procedures. An expanded "gold standard" of positivity by culture or PCR for these 100 specimens resulted in DFA sensitivity, specificity, and positive and negative predictive values of 32.3, 97.1, 83.3, and 76.1%, respectively. The utility of MAb BL-5 for direct detection of B. pertussis in a clinical laboratory setting has been demonstrated by this investigation.

Adult↗
PubMed1995

Risk factors for primary cerebral hemorrhage: a population-based study--the Stroke Registry of Dijon.

Risk factors for primary cerebral hemorrhage remain uncertain. The population-based Stroke Registry of Dijon provides data on the risk factors. Among residents of Dijon (France), 130 cases of primary cerebral hemorrhage hospitalized from 1985 to 1992 were matched with 130 controls by age and sex. The following data were collected: history of hypertension, alcohol consumption, tobacco consumption, history of coagulation disorder, diabetes mellitus, dyslipidemia, and infectious disease in the 7 days before admission. The following parameters were measured on admission: blood pressure, blood glucose, cholesterol, triglycerides, hematocrit, fibrinogen, prothrombin levels, platelet counts, prothrombin time, bilirubin, transaminases, gamma-glutamyltransferase, and alkaline phosphatase. Electrocardiogram and Doppler ultrasound examination of cervical arteries were performed. Statistical analysis was performed by means of relative risk ratio for paired samples when dealing with proportions, and Student's t test for quantitative variables. A stepwise discriminant analysis was carried out to establish the relative weight of the different risk factors and their discriminant values. Among the qualitative data, the significant factors were history of hypertension, alcohol consumption, cardiac arrhythmia, atherosclerosis of carotid arteries and a previous infectious disease in the 7 days before admission. Among the quantitative data, the significant factors were early hypertension, high blood glucose levels, high hematocrit, and low cholesterol levels, in the acute stage of the stroke. After multifactorial analysis, only two factors were significant: hypertension and low cholesterol levels. Our population-based case-control study showed that hypertension and low cholesterol levels are the two discriminant risk factors for both lobar and basal ganglia primary cerebral hemorrhage. Therefore, treatment of hypercholesterolemia may increase risk of cerebral hemorrhage.

Adult↗
PubMed1995

[Ulnar parametacarpal flap. Anatomical study and clinical application].

The ulnar border of the hand provides a new skin flap which is very useful in the reconstruction of defects of the palm of the hand and ulnar fingers. An anatomical study of the dorsal carpal branch of the ulnar artery and its various branches has led us to propose the ulnar parametacarpal flap either as a pedicle or free microsurgical transfer. The territory of the dorsal carpal branch of the ulnar artery allows harvesting of a simple sensitive skin flap or a composite flap comprising a bone or tendon island flap. Description of the distal communicating vessels with the ulnar collateral artery of the little finger extends the territory of the ulnar parametacarpal flap; based on a retrograde blood supply, it can reach the dorsal and palmar surfaces of the ulnar fingers. The authors present several clinical applications and define the place of this new flap among the various treatment options for the hand.

Hand↗
PubMed1995

Laparoscopic hysterectomy.

Laparoscopic hysterectomy was first performed in 1989 by Dr. H. Reich in the USA. Laparoscopic hysterectomy is a procedure which should be considered as an alternative to abdominal hysterectomy, not a substitute for vaginal hysterectomy. Traditionally, vaginal hysterectomy has been offered to women who have a small uterus with a degree of uterine descent, with no apparent adnexal pathology, pelvic adhesions, or large fibroids.

Female↗
PubMed1995

An update on AIDS.

Explore the source record for details and available documents.

AIDS Vaccines↗
PubMed1995

[1984-1994: Ten years of skin flaps. Development of transfer techniques. New methods of autoplasty described during this period].

Ten years of flaps represent a little and a lot. It is little compared to the 2600 years since the first flap in plastic surgery: the Susruta Indian flap, but it is a lot in view of the phenomenal acceleration of this speciality since the Second World War. In 1994 alone, more than two hundred references are listed under the heading "new flaps". As it is impossible to be exhaustive, the author has chosen to focus on two main aspects: a theoretical review of new transfer techniques, dealing successively with: the principles of reverse flow flaps, venous flaps, neurocutaneous flaps, so-called "extracorporeal" transfers, reverse flow YV technique; and practical aspects based on a review of eighteen autoplasties or donor sites selected for their surgical value, their reproductibility and their innovative nature. The author's objective is not to present a technical treatise, but rather to make the reader aware of several key points or even, in some cases, the very existence of these autoplasties. This paper is designed to be didactic, with extensive references, in order to act as a practical guide. It also demonstrates, as if there were any need, to what extent plastic surgery is able to create new solutions and the essential value of continuing research.

Arm↗
PubMed1995

Comparison of the endocervical brush and the endocervical curettage for the evaluation of the endocervical canal.

OBJECTIVE: To evaluate and compare the efficacy in obtaining an adequate endocervical sampling using the endocervical brush and the endocervical curettage. METHODS: Analysis of the cytology and histology of samples obtained from patients referred to the University of Puerto Rico School of Medicine Tertiary Care Center Anaplasia Clinics for colposcopy due to an abnormal Pap smear having atypical cells or higher as classified according to the Bethesda System. All patients underwent evaluation of the endocervical canal with an endocervical brush and an endocervical curettage. RESULTS: Fifty three of fifty-eight patients had correlating endocervical brush Papanicolaou smear and endocervical curettage. Only five patients presented discrepancies. All endocervical brush samples had sufficient tissue for diagnosis. CONCLUSION: The endocervical curettage is operator dependent, is difficult to perform in patients with a stenotic cervical os or in menopausal patients. The endocervical brush is easier to use, malleable and has a lower processing cost. In view of these findings evaluation of the endocervix can be safely performed with the use of an endocervical brush. When used properly, the endocervical brush has a sensitivity of 90%, a specificity of 92.1% and a positive predictive value of 87.5%.

Adolescent↗
PubMed1994

Molecular analysis of 53 fragile X families with the probe StB12.3.

Fifty-three pedigrees with the fragile X syndrome have been studied for amplification of the CGG repeat sequence adjacent to the CpG island in the FMR1 gene. Probe StB12.3 allowed direct detection of affected males, carrier females, normal transmitting males, as well as prenatal diagnosis. Comparison of our molecular data with our previous linkage data from 38 families indicates the effectiveness of direct DNA analysis. A total of 325 individuals were studied and no new mutation was found. All daughters of males with a premutation had a premutation. When the mother had a full mutation no children had a premutation. In premutated mothers, the size of the premutation seems to be a determining factor for the transition to the full mutation. All affected males had a full mutation or mosaicism and only 42% of the females with a full mutation were mentally impaired. Analysis of large families over 3 generations illustrated clearly the Sherman paradox. Furthermore, the analysis of these families is in reasonable agreement with the multiallelic model of Morton and Macpherson [Proc Natl Acad Sci USA 89:4215-4217, 1992]. Mosaic cases in the offspring of the mothers with a full mutation suggest a maternal germinal mosaicism. Then an abnormal methylation and a somatic heterogeneity established in very early steps of embryogenesis could explain these cases.

Alleles↗