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Biomedical subjects

L W Martin

Publications and source records attributed to L W Martin.

At least 73 records · Page 4Linked to original sources
PubMed1978

Transplantation of cadaver kidneys from anencephalic donors.

Of 14 potential anencephalic donors, the kidneys of six were transplanted to recipients ranging in age from 4 to 19 years and in weight from 8 to 49 kg. In three recipients, serum creatinine levels are less than 1.0 mg/dl 1.5 to 9.5 years after transplant. The transplants failed in two for technical reasons; in one, the kidneys were lost by rejection. The other anencephalic infants were not suitable as donors because of rapid deterioration of vital signs (4), ABO incompatibility (3), and inability to perfuse the kidney (1). Successfully transplanted kidneys from this source rapidly increase in size and function to accomodate even large recipients.

Adolescent↗
PubMed1977

Malrotation with gastric volvulus, midgut volvulus, and pancreatitis.

A 2-year-old child with intestinal malrotation had simultaneous gastric volvulus, midgut volvulus, acute pancreatitis, and gastric perforation, followed postoperatively by a temporary period of both lactosuria and sucrosuria. The gastric volvulus and midgut volvulus resulted in both proximal and distal obstruction of the duodenum, reproducing clinically a previously reported experimental model designed to produce pancreatitis. Operative reduction of the midgut volvulus and the gastric volvulus and repair of the gastric perforation was accomplished. The child has had normal growth and development during the ensuing nine years.

Child, Preschool↗
PubMed1977

Retinal phlebitis in the Irvine-Gass syndrome.

We reviewed the pathology records from January 1965 through July 1975 for aphakic eyes. After exclusion of unsuitable cases, ten eyes (nine patients) with cystoid macular edema and 142 eyes without cystoid macular edema were studied. Clinical ophthalmic records were available for five of the ten eyes with the Irvine-Gass syndrome. Histologic sections were examined, revealing a significant correlation between the Irvine-Gass syndrome and retinal phlebitis, which has not been reported previously, as well as cyclitis and vitritis. Anterior segment operative complications tended to be more prevalent in eyes with the Irvine-Gass syndrome than in those without the Irvine-Gass syndrome, although the assocation was not statistically significant (P less than .1). Retinal trypsin digestion showed the phlebitis to be distributed posteriorly within primary and secondary retinal veins, frequently occurring near points of bifurcation. The changes in permeability seen in the Irvine-Gass syndrome may be due to this retinal phlebitis and to a generalized inflammation-induced increase in capillary permeability. The case of the phlebitis is not known.

Adult↗
PubMed1977

Intussusception in the 1970s: indications for operation.

Eighty-one patients with proven intussusception were treated at the Cincinnati Children's Hospital from 1970-1974. One died. Seven of these had ileo-ileal intussusception, all treated surgically. Seventy-four had colonic components of their intussusceptions. In 58 of these patients (78%), reduction was attempted at barium enema, successfully in 32. Hydrostatic reduction was abandoned and the patient operated upon when the intussusception was not pushed out of the colon, when barium failed to reflux into several loops of ileum, or when there was a large persistent filling defect in the cecum or terminal ileum. Primary operation without barium enema was done in 16 patients. The appearance of intestinal obstruction by abdominal x-ray seemed to give the best warning about the complicated, incarcerated, or gangrenous intussusception. Primary operation is, therefore, advised for the patient with intussusception if there is x-ray evidence of intestinal obstruction. The age of the patient and the duration of his symptoms do not seem important in this regard, except as they correlate with peritonitis or obstruction. For the patient without peritonitis or intestinal obstruction, attempted reduction of the intussusception at barium enema seems safe and effective, regardless of the patient's age or duration of his symptoms.

Barium Sulfate↗
PubMed1977

Natural history and treatment of renal vein thrombosis in children.

The general features and problems of renal vein thrombosis in children are first discussed. The records of 11 children with this condition, 7 ill neonates and 4 older children with burns, are then reviewed, indicating the clinical course of the disease, how they were treated, the results, and pathological findings. From this study, the natural history is assembled and a protocol for treatment is proposed. Supportive therapy is necessary in all cases to correct dehydration and sepsis. Many children will develop a consumptive coagulopathy. Others will develop pulmonary emboli associated with thrombosis of the inferior vena cava. Anticoagulation should be achieved for these two conditions. Nonvisualization of affected renal units upon initial urographic examination virtually assures an atrophic, functionless kidney later. Nephrectomy will be required because of hypertension, persistent infection, and scarring. Thrombectomy may be attempted when bilateral nonvisualization on urography is associated with a positive venacavogram.

Anticoagulants↗
PubMed1977

Total colectomy and mucosal proctectomy with preservation of continence in ulcerative colitis.

Since ulcerative colitis is a mucosal disease, it would appear possible to remove the diseased rectal mucosa and preserve all anorectal musculature. When performed in conjunction with total colectomy, the terminal ileum could then be placed inside the retained muscular wall of the rectum and anastomosed to the anus. This would remove all of the disease and yet preserve anorectal continence. Seventeen patients with chronic ulcerative colitis have undergone this operation with satisfactory results in 15 and no deaths. Many details of preoperative, operative and postoperative management are presented which are imperative for a successful result. Sufficient experience has been gained that the operation can now be recommended.

Abscess↗
PubMed1976

Jejunoileal atresia: a proposed classification.

An experience with 59 infants with jejunal and ileal atresia is presented along with a proposed classification based on a combination of morphology and clinical characteristics. It would appear that the characteristics of each type are sufficiently distinct as to render this worthwhile classification.

Age Factors↗
PubMed1976

Jejunal atresia with absent mesentery and a helical ileum.

Of 59 infants with jejunoileal atresia, seven presented with absence of mesentery, the main superior mesenteric artery ceasing to exist beyond the origin of the right colic or ileocolic artery, and a helical ileum. This distinctive form of jejunal atresia has been recognized with increasing frequency in recent years. Distal to the atresia, the small bowel receives its blood supply retrograde from an artery derived from the ileocolic or right colic arcades, and the ileum coils around its nutrient artery in an "apple peel" or "Christmas tree" deformity. The first three patients in this report died. The lastion, but they recovered as their malabsorption gradually disappeared. The treatment includes resection of the dilated bowel, as in other atresias. Resection of part of the distal bowel may be required for additional atresias or for poor vascularity with questionable viability. Postoperative malabsorption generally requires intravenous hyperalimentation.

Female↗