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Biomedical subjects

C R Martinez

Publications and source records attributed to C R Martinez.

At least 19 recordsLinked to original sources
PubMed2001

Preventing problems with boys' noncompliance: effects of a parent training intervention for divorcing mothers.

This study provided a randomized, experimental test of the efficacy of a parent training intervention on coercive discipline, positive parenting practices, and child noncompliance in a sample of 238 divorcing mothers and their sons in Grades 1-3. Intervention effects were evaluated 5 times from baseline to 30 months. The intervention produced enduring benefits to coercive discipline, positive parenting, and boys' noncompliance. These benefits followed a classic prevention effect: Mothers and sons in the experimental group maintained stable outcome trajectories, whereas those in the control group deteriorated. The intervention's impact on boys' noncompliance was mediated independently by its impact on coercive discipline and positive parenting. Change in positive parenting was more strongly associated with change in noncompliance than was change in coercive discipline, although each explained unique variance in change in noncompliance.

Adult↗
PubMed1995

Computerized axial tomography to define the distribution of solution after stellate ganglion nerve block.

STUDY OBJECTIVE: To define the spread of local anesthetic after C6 stellate ganglion nerve block using computerized axial tomography (CAT). DESIGN: Prospective, open descriptive study. SETTING: Outpatient pain consult center. PATIENTS: 10 ASA status I patients undergoing stellate ganglion nerve blocks for sympathetically maintained pain. INTERVENTIONS: Radiocontrast and local anesthetic was given in 5 ml increments to 20 ml total volume for C6 stellate ganglion nerve blocks in eight patients and C7 in two patients. MEASUREMENTS AND MAIN RESULTS: CAT scanning was performed at baseline and after 5, 10, 15, and 20 ml of injectate was administered. Cervical level and pattern of injectate spread was recorded after each increment. Neck pressure above C6 did not promote caudal spread. One half of the injections were beneath prevertebral fascia. Injections on top of the fascia spread more diffusely around C6. All injections in high volume reached the medial aspect of T1 around the head, not neck, of the first rib. CONCLUSIONS: Solutions injected for C6 stellate ganglion nerve block concentrate medial to the stellate ganglion at T1. Thus, they must produce upper extremity sympathectomy by a mechanism other than contact with the ganglion.

Adult↗
PubMed1995

CT-guided renal biopsy using a coaxial technique and an automated biopsy gun.

In this series, 35 patients with medical renal disease had renal biopsy guided by computed tomography (CT). Biopsies were done by a coaxial technique in which a thin-walled 16 guage guide needle is placed adjacent to the renal capsule of the lower pole. An 18 gauge cutting needle is then placed through the guide needle, and multiple samples (2 to 4) are obtained with an automated biopsy gun. Adequacy of specimens is immediately checked in the CT suite using low-power microscopy. Specimens are submitted for light, electron, and immunofluorescence microscopy. Adequate tissue for definite diagnosis was obtained in 33 of the 35 patients (94%). One patient had moderate postbiopsy bleeding and was hospitalized. There were no major complications. CT-guided renal biopsy using a coaxial technique and automated biopsy gun is an effective means of obtaining tissue for the evaluation of medical renal disease.

Adult↗
PubMed1994

Gorham disease of the spine.

STUDY DESIGN: This is a case report of Gorham disease of the spine with review of the literature. OBJECTIVE: To review the diagnosis, therapy, clinical course, and prognosis of Gorham disease of the spine. SUMMARY OF BACKGROUND DATA: This is the 17th reported case of spinal involvement by this rare type of idiopathic osteolysis. METHODS: The patient was studied with radiographs, nuclear bone scans, computed tomography scans, magnetic resonance scans, and biopsies. His spine was stabilized by posterior and anterior rods, corpectomies, and bone grafts. RESULTS: The patient's spine had remained stable for 22 months after surgery, but intractable chylothoraces and spreading bone destruction were present. CONCLUSIONS: Spinal Gorham disease has high morbidity and mortality, but the course in an individual patient is difficult to predict. Early spinal stabilization should be considered before irreversible neurologic complications occur.

Adolescent↗
PubMed1992

Evaluation of acetabular fractures with two- and three-dimensional CT.

The authors applied a widely used radiographic system of classifying acetabular fractures to axial computed tomographic (CT) scans and three-dimensional reconstructions in over 100 cases. In the classification system, fractures are analyzed according to the extent of involvement of two acetabular columns--the posterior and the anterior. To provide a better understanding of the CT anatomy of the acetabulum, the authors defined the boundaries of the columns on axial CT scans. They illustrated the most common fractures (posterior wall, transverse, transverse with posterior wall, and both columns) with radiographs, axial CT scans, and three-dimensional reconstructions. Axial CT scans readily demonstrated the fractures and presence of intraarticular fragments. Three-dimensional images helped in understanding the precise plane of the fracture, the degree of disruption of the articular surface, and spatial relationships of fragments. Although present three-dimensional CT is not without limitations, the authors believe that the technique is valuable and that, in their experience, it has facilitated preoperative planning.

Acetabulum↗
PubMed1991

Unique brain anomalies in an infant of a diabetic mother.

An offspring of a class F diabetic primigravida with marginal control during the first 8 weeks of the gestation had a level II sonogram at 23 weeks. It showed polyhydramnios and "hydrocephaly." Macrosomia, right hydroureter, megacystis and premature birth corroborated the diagnostic impression of diabetic embryopathy. At age 3 years, the child functions within the moderate range of mental retardation. Angiography, choanogram, CT and MRI scans showed unique CNS abnormalities that appeared secondary to a hamartomatous growth within the left cerebral hemisphere. Such anomaly, most likely a part of the phenotype of the diabetic embryopathy, implies a growth disturbance secondary to dysregulated paracrine growth factors (somatomedins, nerve growth factor, panregulin and/or their receptors in this case). It also indicates a possibility of interaction between two dysregulated major growth mechanisms; the endocrine in the mother considered responsible for the overall phenotype of the diabetic embryopathy/fetopathy and the paracrine fine tuning mechanism in the embryo incriminated by the hamartomatous over/undergrowth.

Adult↗
PubMed1990

Inadvertent cervical cord puncture during myelography via C1-C2 approach.

C1-C2 puncture is a procedure commonly performed to assure satisfactory cervical myelography. Cord injury with neurological deficit has been reported following intramedullary injection of myelographic contrast material. We report a case of inadvertent intramedullary injection of metrizamide which was initially discovered during postmyelographic CT scanning. The patient had very minimal symptoms during the procedure and had no immediate or long-term complications.

Adult↗
PubMed1989

Subhypothalamic high-intensity signals identified by magnetic resonance imaging in children with idiopathic anterior hypopituitarism. Evidence suggestive of an 'ectopic' posterior pituitary gland.

Magnetic resonance imaging in two children with idiopathic hypopituitarism demonstrated a signal of high intensity near the optic tract that was consistent with the signal produced by posterior pituitary tissue. Patient 1 was a 15-year-old girl with panhypopituitarism but intact posterior pituitary function. Computed tomography disclosed widening of the superior aspect of the pituitary stalk and a partially empty sella. Magnetic resonance imaging disclosed a 3-mm high-intensity signal abutting the optic tract in the midline just above the sella. The pituitary stalk was not clearly defined, the pituitary gland was small, and the sella was filled with cerebrospinal fluid. Patient 2 was a 12-year-old boy with isolated deficiency of growth hormone secretion. Findings from magnetic resonance imaging and computed tomography were similar to those in patient 1. These data suggest that the high-intensity magnetic resonance imaging findings represent a displaced or "ectopic" posterior pituitary gland, and that the hypopituitary state is due to an insult to the pituitary stalk.

Adolescent↗
PubMed1989

Magnetic resonance imaging of intracranial epidermoid tumours.

Epidermoid tumours are rare lesions within the skull which are usually found in a cerebellopontine angle. In the computed tomography (CT) literature, they have been described as well-defined lesions of low density which seldom show calcification or tissue enhancement. We have recently encountered three intracranial epidermoids, which appeared to exhibit uniform findings on low field strength magnetic resonance (MR) of moderate signal intensity in the T1-weighted images and a bright signal (increased T2) in the T2-weighted sequences. It may be possible to predict accurately the presence of an epidermoid tumour when this particular configuration of findings is present.

Adult↗
PubMed1989

False-positive diagnosis of an odontoid fracture by CT scan.

Although computed tomography (CT) is a valuable tool for evaluating spine trauma, it's usefulness is limited. Horizontally oriented fractures of the cervical spine, particularly type 2 fractures at the base of the odontoid process, may be difficult to detect with CT. Our case report illustrates a false-positive diagnosis of this fracture and suggests that conventional polytomography is superior to CT for demonstrating this particular lesion when minimal displacement is present.

Adolescent↗
PubMed1986

Hypothalamic-pituitary dysfunction in primary empty sella syndrome in childhood.

In a series of 37 consecutive CT scans performed in children referred to our pediatric endocrine unit, an empty (eight) or partially empty (one) sella turcica was found in nine (24%) patients with short stature or delay in sexual maturation, precocious puberty, or hypoparathyroidism. The size and contour of the sella were abnormal in only three patients. Five of the nine children had evidence of decreased growth hormone secretion as determined by subnormal GH secretory responses to provocative tests (peak GH concentration less than 7 ng/ml) or assessment of endogenous 24-hour GH secretion (mean 24-hour GH concentration less than 3 ng/ml). Two children had multiple pituitary hormone deficiencies. Although primary empty sella syndrome was often associated with hypothalamic-pituitary dysfunction in this series, the prevalence of an empty sella in normal children is unknown. Further identification and evaluation of children with empty sella may provide new information regarding the cause of pituitary dysfunction in childhood.

Adolescent↗
PubMed1986

CT of the pulmonary nodule: a cooperative study.

To evaluate the role of computed tomography (CT) in the investigation of pulmonary nodules, a special reference phantom that enabled CT densitometric measurements independent of variations between scanners and patients was used in ten institutions. A total of 384 nodules not considered calcified by conventional methods were examined; 118 (31%) proved to be benign, and in 65 of these (55%), unsuspected calcification was demonstrated. In 28 of the 65, definite calcification could be identified on thin-section CT scans by simple inspection of the scans at narrow windows. In the remaining 37, presence of calcification could not be clearly established without comparison with the reference CT number from the calibration phantom. CT was most effective in establishing the benignancy of nodules 3 cm or less in diameter and those with discrete or smooth margins. CT rarely yields a confident diagnosis of benign disease in larger nodules and in those with irregular or spiculated borders. After review of prior spot radiographs, low kilovolt peak spot radiographs, and conventional tomograms, the authors conclude that thin-section CT aided by a reference phantom in equivocal cases should be an integral part of the diagnostic approach to the pulmonary nodule.

Adult↗
PubMed1985

Computed tomography of the neck.

The capabilities of CT to distinguish between soft tissue structures of varying densities, bone and air, coupled with the added advantage of utilizing intravascular contrast, particularly suits this method of examination to the study of head and neck disorders. With improved equipment permitting thinner sections and shorter exposure times, applications in head and neck diagnosis are increased. CT is used in the evaluation of salivary gland enlargements, staging of known tumors, the evaluation of a variety of neck swellings and in the assessment of laryngeal and facial trauma. In some cases, CT alone may be the only imaging procedure necessary, while in other situations, CT may comprise an important portion of comprehensive imaging evaluation.

Head and Neck Neoplasms↗
PubMed1983

Computed tomography of extracranial nerve sheath tumors with pathological correlation.

Computed tomography was obtained in 15 patients with extracranial nerve sheath tumors, including eight with neurofibromatosis. The studies included two schwannomas, six neurofibromas, four plexiform neurofibromas, and three neurofibrosarcomas. Lesions with attenuation values exceeding 30 Hounsfield units had dense bands of collagen in resected specimens. Eleven of the lesions had attenuation values which were significantly lower than muscle. Histological examination of hypodense lesions revealed five factors contributing to reduced attenuation values: (a) a population of lipid-rich Schwann cells; (b) the presence of adipocytes (transformed fibroblasts) in neurofibromas; (c) entrapment of perineural adipose tissue by plexiform neurofibromas; (d) a coalescence of interstitial fluid to form cystic spaces in schwannoma with Antoni B tissue; and (e) cystic degeneration secondary to infarction or necrosis within neurofibromas and neurofibrosarcomas.

Adolescent↗