Biomedical subjects
E Martin
Publications and source records attributed to E Martin.
Once-daily administration of ceftriaxone in the treatment of meningitis and other serious infections in children.
Forty-three children (ten neonates, 15 infants and 18 older children) were treated with single daily doses of ceftriaxone (50 to 100 mg/kg) intravenously or intramuscularly for serious bacterial infections. The infections included meningitis (31 patients), brain abscesses (four patients), septicaemia (three patients), pleuro-pneumonia (two patients), septic arthritis and soft tissue phlegmona (three patients). No other antibacterial agents were used except in four patients with brain abscesses, in whom ceftriaxone was combined with ornidazole. The overall bacteriological cure rate was 98%, and sterilisation of the cerebrospinal fluid occurred in 27 of 28 patients (96%) with proven bacterial meningitis. Two patients died, three survived with severe neurological sequelae; one neonate required partial gut resection. A complete clinical cure was achieved in the remaining 37 patients. Only one treatment failure was directly related to the drug therapy. The only side effect noted were sterilisation of the gut with overgrowth of Candida albicans in 35% of neonates and infants, an prolonged fever in 13% of all patients. Ceftriaxone given in a 24-hourly regimen is convenient and highly effective in serious bacterial infections in children and is without significant toxicity.
Spontaneous complete closure of a congenital coronary artery fistula.
The first documentation is reported of spontaneous closure of a coronary artery to right ventricle fistula that was demonstrated initially in a 14 month old boy. Over a 4 year period after diagnosis, the characteristic continuous murmur gradually disappeared. When the patient was 5 1/2 years of age, selective coronary arteriography showed normal coronary vessels and circulation. Six other cases of coronary fistula observed during the past 10 years are also reviewed. This study supports the rationale for clinical follow-up rather than obligatory surgical intervention in asymptomatic patients with a small shunt who have no evidence of myocardial dysfunction.
Spontaneous long-term survival of liver allografts in inbred rats: comparison between semi-allogenic and fully allogeneic strain combinations.
Spontaneous tolerance of liver allografts can be observed in inbred rats. In order to study the influence of the density of major histocompatibility complex alloantigens on the fate of liver allografts in the rat, liver allografts were performed in a semi-allogeneic and a fully allogeneic combination. Comparisons of the fate of heart and kidney allografts were made in the same combinations. A similar proportion of spontaneously tolerated liver allografts was observed in the two combinations; after a few months these animals were in a state of donor-specific unresponsiveness. A spontaneous prolongation of kidney allografts was observed only in the semi-allogeneic combination. These animals were not in a state of donor-specific unresponsiveness. These results suggest that induction of liver allograft tolerance in the rat is not decisively influenced by the importance of the density of major histocompatibility complex antigens present on the graft and that its mechanism may be different from that which causes spontaneous prolongation of semi-allogeneic kidney allografts.
Graft-versus-host reaction induced by spleen grafting in inbred strains of rats. Influence of portal venous drainage.
Acute graft-versus-host (GvH) reaction was induced by spleen grafting in inbred rats. A comparison of the influence of portal or caval drainage of the spleen graft on the survival time was made. This comparison revealed a prolongation of survival time in case of a portal drainage when the graft was an auxiliary half-spleen graft. This result suggests that the liver may have, in some conditions, protective capacities against an acute GvH reaction.
Leiomyomatous lung lesions: a proposed classification.
A case of multiple pulmonary leiomyomas is presented. In a review of the literature, a confusing array of rare diseases all pertaining to multiple leiomyomas was found. These were reduced to three entities: leiomyomatosis in women, metastatic leiomyoma in men and children, and multiple pulmonary fibroleiomyomatous hamartoma occurring in anyone. The leiomyomatous diseases in women are related to uterine leiomyomas and they are hormone-sensitive. This is of great prognostic importance. The classification, definitions, and discussion should prove helpful in understanding these rare multiple diseases.
Absence of transplantation tolerance and strong sensitization in the host after transplantation of spleen allografts in the (LEW X BN)F1 leads to lew strain combination.
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[Adiastole caused by a secondary cardiac hemochromatosis. Successful treatment with an iron chelating agent].
Severe congestive cardiac failure developed in a few weeks in a 44 year old man who had undergone porto-caval anastamosis for post-hepatitis cirrhosis one year previously and then treated for anaemia by repeated blood transfusion and chronic daily oral iron therapy. Infiltrative, congestive and restrictive cardiomyopathy was diagnosed in the presence of global cardiomegaly, electrocardiographic changes (microvoltage, diffuse ST-T wave changes), echocardiographic appearances (dilatation of the left ventricle, with hypertrophic and hypokinetic walls), and hemodynamic signs of adiastole with equalisation of filling pressures at 15 mmHg and a cardiac index of 1,88 l/min/m2. Cardiac haemochromatosis was confirmed by the laboratory (serum iron: 35 mumol/l; siderophilin saturation: 100 p. 100; serum ferritin: 1854 ng/ml; induced siderouria: 51 mg/24 hours) and histological findings (endomyocardial biopsy showing pigment overload). The absence of a family history, of homozygote A3 antigen, of diabetes, of iron overload on hepatic biopsy one year previously, excluded the diagnosis of familial idiopathic haemochromatosis. A secondary form of the disease was diagnosed on a possible genetic predisposition (heterozygote A3 antigen) and on environmental factors (blood transfusions, iron therapy, cirrhosis, alcoholism and perhaps the porto-caval anastamosis. Cardiac haemochromatosis was cured in this case by iron chelating therapy comprising daily subcutaneous infusions of 2 g of desferrioxamine for 2 months. The cure was confirmed by regression of the signs of clinical cardiac failure and of cardiomegaly, the increase in QRS voltages and the near normalisation of the hemodynamic and laboratory findings.
[Pseudotumors and benign tumors of the liver in adults and children. Inaccuracies of semantics and histogenesis].
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[Circulating immune complexes and alcoholic liver disease: relation between the presence of circulating immune complexes and the degree of histologic involvement of the liver].
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Immunohistological study of precancerous mucus modification in human distal colonic polyps.
The M1 antigens associated with gastric fucomucins, oncofetal markers of the distal colonic mucosa, were demonstrated to be more closely associated with adenomas [92 of 139 (66%)] than with invasive adenocarcinomas [27 of 218 (12%)]. They were always expressed in tumors containing the M3 antigen normally associated with the intestinal mucus. The M1 antigens, present in 100% of hyperplastic polyps (30 of 30), were not specific for a particular histological type of adenoma but were found to be more closely associated with those showing a villous differentiation [41 of 47 (87%)] than with those having a tubular pattern [51 of 92 (55%)]. The presence of these M1 antigens depended neither on the size nor on the degree of cytological atypia of the nodular adenomas. However, M1 antigens were found in 94% of the adenomas (35 of 37) concomitant with adenocarcinomas; in contrast, only 56% of adenomas (55 of 102) observed on noncancerous mucosa contained these M1 antigens. As already demonstrated during rat colonic carcinogenesis, mucus modification characterized by the presence of M1 antigens could represent early molecular changes occurring before malignant transformation related to a chemical carcinogen. These M1 antigens might be regarded as early precancerous markers of an oncofetal type, associated with human distal colonic mucosa.
A counsellor in general practice: a one-year survey.
A counsellor was included within the professional staff of a practice of 11,000 patients cared for by five partners. A review of her work over a 12-month period is described. Eighty-seven patients were counselled in 197 sessions. Thirty-five per cent of first appointments and 22 per cent of subsequent appointments were not kept. The problems dealt with most frequently were anxiety and stress, marital troubles and abortion. Patients perceived the service as giving relief by allowing them to talk and helping them to work out their problems.
Giant pancreatic stones in teetotal women due to absence of the "stone protein"?
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Antigens of the basement membrane and the peritumoral stroma in human colonic adenocarcinomas: an immunofluorescence study.
Twenty colonic adenocarcinomas were studied by immunofluorescence with antisera against components of the basement membrane: type IV collagen, laminin and heparan sulfate-rich proteoglycan, as well as antisera against antigens of the connective tissue: type-III collagen, fibronectin and hyaluronectin. Marked alterations of the basement membranes were consistently observed on staining with each one of the first three antisera. In contrast, staining of the normal components of connective tissue was in most cases as intense as in normal colonic mucosa. Hyaluronectin, a marker of peritumoral stroma, was found to be present in 12 out 15 tumors studied.
Hormonal and histological study of the luteal phase in women following aspiration of the preovulatory follicle.
A hormonal and histologic study of 60 luteal phases was carried out in 40 patients during spontaneous and stimulated cycles before and after follicle puncture for oocyte recovery. The duration of the luteal phase was modified neither by follicle rupture nor by hormonal stimulation. The aspiration of a spontaneous preovulatory follicle caused a temporary deficiency in plasma progesterone (P) (P less than 0.01) on the third day following aspiration, and a higher prolactin (PRL) level (P less than 0.02) on the ninth day. Dystrophia of the endometrium was observed in one-third of the cases, whereas the P level was normal. In cycles stimulated by clomiphene citrate, no P deficiency was observed. When luteinizing hormone (LH) discharge occurred spontaneously, biopsies carried out 3 days following follicle aspiration indicated a normal secretory state of the endometrium, and the P level was higher from, the sixth day following aspiration (P less than 0.05), as compared with the control cycles. This phenomenon was not observed when human chorionic gonadotropin (hCG) was administered.
Nonoperative management of a traumatic peroneal artery false aneurysm.
The standard approach to management of traumatic false aneurysms is operative. This report describes successful treatment of a traumatic peroneal artery aneurysm following a gunshot wound in a 29-year-old man by an intraluminal steel coil occlusion technique. The coil was guided through the popliteal artery and aneurysm into the distal peroneal artery via a percutaneously placed catheter: following disengagement of the coil the outflow tract of the aneurysm was occluded, and another passed and released into the proximal peroneal artery occluded the inflow tract.
Management of the patient in a Halo brace.
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[Haemodynamic changes in infrarenal aortic aneurysm operations (author's transl)].
UNLABELLED: Haemodynamic changes after aortic cross-clamping were measured during operation of 11 patients suffering from infrarenal aortic aneurysm. Systemic vascular resistance, mean arterial pressure and pulmonary capillary wedge pressure are increased, while cardiac index is significantly decreased. Heart rate and right atrial pressure remain nearly unchanged. The elevations in systemic vascular resistance, mean arterial pressure and pulmonary capillary wedge pressure are reversed by continuous nitroglycerin infusion, cardiac index is increased. CONCLUSIONS: 1. meticulous haemodynamic monitoring is very important in operations including abdominal aortic cross-clamping in order to prevent imminent cardiac complications. 2. the haemodynamic changes induced by aortic cross-clamping can be reversed by infusion of nitroglycerin.