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Biomedical subjects

H C Martin

Publications and source records attributed to H C Martin.

25 records · Page 2Linked to original sources

Liver disease and common-bile-duct stenosis in cystic fibrosis.

To determine the incidence of common-bile-duct lesions and their relation to liver disease in cystic fibrosis, we performed hepatobiliary scanning in 50 of 61 patients with cystic fibrosis who had hepatomegaly, abnormal liver function, or both and in 31 of 92 patients with cystic fibrosis who did not have hepatomegaly or abnormal liver function. Ninety-six percent of the patients with liver disease had evidence of biliary tract obstruction, which was defined cholangiographically as a stricture of the distal common bile duct in the majority of cases. All the patients without liver disease had normal intrahepatic and common-duct excretion of tracer. Abdominal pain was significantly more common in patients with common-duct obstruction (P less than 0.001), and enlarged gallbladders occurred only in such patients. Since fasting levels of serum bile acids were elevated in nearly half these patients, irrespective of the severity of their liver disease, serum bile acids may be markers of the severity of the common-duct lesion. We conclude that strictures of the distal common bile duct are common in patients with cystic fibrosis and liver disease. This association requires further study, since surgical relief of common-duct obstruction may prevent or ameliorate the hepatic complications of cystic fibrosis.

Adolescent↗

Balanitis xerotica obliterans in children.

Balanitis xerotica obliterans was studied in 48 fully developed and 6 early cases in children aged 2-15 years. It occurred in 9% of 100 consecutive circumcisions for all, including religious, reasons and in 19% of 232 other circumcisions for disease of the prepuce and penis. Seven cases developed after surgery for hypospadias. The boys nearly always presented with inability to retract the prepuce; half also had discomfort after micturition, and a quarter had obstructive signs, usually minor. At surgery, half had involvement of glans or meatus, previously considered rare in childhood, 3 requiring meatotomy. The condition, once seen, was easily recognized clinically as well as microscopically. The early cases, characterized by focal narrow hyaline edematous zones in severe diffuse chronic balanitis, suggest that the condition may be an inflammation in which the usual increased permeability of small vessels in inflammatory reaction is accentuated in a loose vascular region.

Adolescent↗

Salmonella ileocecal lymphadenitis masquerading as appendicitis.

Salmonella infection requiring surgical intervention is rare. A case of localized ileocecal lymphadenitis due to Salmonella newport is reported. A review of the literature demonstrates that this is one of a spectrum of conditions of tissue infection by Salmonella in the ileocecal region. The outlook is good, and no untoward effects have arisen from surgery so that awareness of this condition should not alter the operative approach to a patient with a clinical diagnosis of acute appendicitis.

Acute Disease↗

Primary bone tumours in infants. Short literature review and report of 10 cases.

Ten cases of primary bone tumours in infants (1 osteosarcoma, 3 Ewing's sarcoma, 1 chondroblastoma and 5 angiomatosis) are reported. All cases of angiomatosis showed characteristic radiographic findings. In all the other tumours the X-ray appearances were different from those usually seen in older children and adolescents. In the authors' opinion the precise diagnosis of malignant bone tumours in infancy is very difficult as no characteristic X-ray features are present in this age period.

Angiomatosis↗

Pyomyositis tropicans: a diagnostic dilemma.

Pyomyositis tropicans is a rare disease in non-tropical climates and thus presents diagnostic difficulties. Two children with single staphylococcal psoas muscle abscesses were recently successfully treated. Computerized axial tomography was found to be a useful diagnostic aid, allowing exact localization of the lesion. The diagnosis and therapy of these abscesses are discussed.

Abscess↗

Type I hyperlipoproteinaemia and recurrent scrotal pain.

A three-year-old boy is described with type I hyperlipoproteinaemia in association with recurrent scrotal pain and hepatosplenomegaly. His parents are consanguinous and it is likely that he is homozygous for an autosomal recessive trait, characterized by the absence of plasma lipoprotein lipase following intravenous injection of heparin. Studies have been performed in a number of first degree relatives, but the findings are inconclusive. He has responded well to a low fat diet with dramatic reductions in elevated plasma triglyceride concentrations.

Adult↗