Biomedical subjects
Publications and source records attributed to J Martin.
Herein we review 2 cases of posterior urethral valves in adults. Significant secondary bladder neck obstruction occurred in both cases and required transurethral incision before the bladder outlet obstruction was relieved. The management is described of the secondary upper tract changes that occurred.
A simple and inexpensive uroflowmeter has been designed that uses a common carbon dioxide cystometer. The patient voids urine in a specially designed container connected at the bottom of the carbon dioxide source in the cystometer. After proper calibration (500 cc fluid for a 20 mm. deflection in the paper) the patient is asked to void while carbon dioxide flows through the container and the paper recording commences. Any change of volume in the container produces a change in the pressure recorded by the cystometer, which will allow us to know, following calibration, the 2 factors involved in flow: 1) volume voided and 2) time. A table of average flow is available for a quick reading of the findings only by superimposing the table on the uroflow study. The only attachment needed for the cystometer is the special container. Our results support the use of this economical new way to determine urinary flow.
1. In a previous study in rats, an increased PAH clearance was found following chronic phenobarbitone administration. These results formed the basis for the present study in which fifteen healthy male volunteers were investigated and the parameters of liver microsomal enzyme activity and renal function were measured. 2. As parameters of liver microsomal enzyme activity, the antipyrine elimination in the plasma, the gamma-glutamyl-transpeptidase and the D-glucaric excretion in the urine were measured. Endogenous creatinine clearance, 51Cr-EDTA and 125I-Hippuran clearance were determined as measurements of renal function. 3. No correlation was found between any of the parameters of microsomal enzyme activity and renal function. 4. Of the fifteen volunteers, seven having a mean antipyrine half-life of 13.3 h were given antipyrine (500 mg) daily for 3 weeks. Afterwards all measurements of liver microsomal enzyme activity and renal function were repeated. The antipyrine half-life decreased to 8.5 h, while the antipyrine clearance was increased by about 56%. gamma-glutamyl-transpeptidase and D-glucaric acid were also significantly increased, while renal function remained unchanged. 5. Therefore, an increased PAH-clearance, as found in the rat, is not obtained in man following induction of liver microsomal enzyme activity.
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The pathologico-anatomic and even more the histological pattern of experimental Haemophilus parahaemolyticus pleuropneumonia in specific-pathogen-free piglets was found to be characteristic in the peracute, acute, and subacute-chronic stages of the disease. It is an infection which can be morphologically differentiated from other forms of pneumonia in swine primarily by three factors, localisation of the changes, inflammation, and a typical cell response. Changes following experimental Haemophilus parasuis infection were found to occur irregularly on serous skins and, in continuation, in the lung and joints. These were not characteristic and failed to exhibit morphological peculiarities.
Pasteurella can be isolated from about 50 per cent of pneumonically changed pig lungs. Isolation, however, is possible also from intact lungs of conventional or secondary SPF animals. The authors of this paper used the positive hyaluronidase test and identified exclusively Pasteurella multocida, with predominance of capsular type A. Most of the Pasteurella strains tested in this context caused pneumonia in SPF animals, particularly, following intratracheal application. No correlations were found to exist with murine virulence, the serological type or the origin of the strains from affected or intact lungs. Apart from virulence differences between the strains, host reactivity was found to depend primarily on high germ counts and, under natural conditions, on environmental stresses. Pasteurella multocida, hence, can be considered as one of the potential pathogens of porcine pneumonia. Pneumonia foci with transduced localised fibrinous pleuritis are characteristic and constitute a process of purulent inflammation with early involvement of fibrin.
Experimental infections were applied to specific pathogen free (SPF) piglets and store pigs, using five haemophilus (H.) parahaemolyticus and two H.-parasuis strains. Different germs counts and modes of application were chosen for each of the animals involved (intratracheal, intranasal, and subcutaneous routes). Clinical and pathologico-anatomic changes typical of haemorrhagic-necrotising pleuropneumonia were obtained from all germ counts and methods of application. Only one of the test animals could be successfully infected to exhibit manifestations of pneumonia or serositis when H. parasuis was used. The high pathogenicity of H. parahaemolyticus, as recorded from the above experiments, was in agreement with the growing incidence of that haemophilosis recordable for some time from pig stock.
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Hemangiopericytoma is a potentially malignant tumor of vascular origin. It usually is a solitary lesion and may arise in the chest or in extrathoracic areas. It is usually encapsulated. Microscopic features vary with the degree of differentiation of the individual tumor. The more differentiated variety exhibits abundant capillaries with open lumina surrounded by ovoid tumor cells; in the less differentiated tumors, the capillaries lack lumina and the tumor cells are spindle shaped. The prognostic significance of the microscopic pattern is controversial. However, prominent mitotic activity, necrosis, hemorrhage, and increased cellularity are ominous signs and are usually noticed in tumors that later exhibit malignant behavior. The larger the lesion, the more likely that it will be symptomatic. Treatment of choice is ample surgical resection.
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Bordetella have been frequently detectable from lesioned lung material of swine as well as from the upper respiratory tracts of clinically intact animals. Pneumonia, different in extent, was produced in primarily specific pathogen free pigs by intratracheal and intranasal application of eight Bordetella isolates. Moderate to medium manifestations of focal pneumonia with scattered speckles developed, with severity depending on dosage and mode of infection. Histologically, they were characterised by vascular lesions and fibroblastic proliferation. This type of pneumonia thus was differentiated by the above characteristics from pneumonia caused by heamophils and Pasteurellae. Under conditions of natural exposure, Bordetella pneumonia can be expected to develop primarily due to defective host-patasite relationship. Bordetellae, in this context, are considered only conditionally pathogenic. Bordetellal infection will have to be taken into consideration in differential diagnosis whenever checks are made on pigs in industrialised units.
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Cardiovascular and behavioural responses elicited by novel, noxious or aversive stimuli have been studied in dogs and cats. Hindlimb blood flow, heart rate and arterial blood pressure increased in dogs when an orienting response was elicited by a novel stimulus (a sound). Similar cardiovascular responses occurred in dogs to mild noxious stimulus and in cats displaying a threatening posture when confronted by a dog. The cardiovascular components of the orienting response to a sound habituated with repetition of the sound. In two dogs however sensitization (increase) of the response occurred with reped by repetition of the confrontations: the vasodilation in the muscles waned and eventually was replaced by vasoconstriction while the cardiac acceleration and pressor response persisted. The threatening response was the most persistent. The modification of the behavioural and cardiovascular aspect of the response was not developing in parallel. The cardiovascular pattern was altered before any apparent changes of the behavioural pattern occurred. The cardiovascular responses of the noxious stimulus in dogs and cardiovascular components of the defence reaction in cats were readily conditioned to a sound. The possible role of the modification of the cardiovascular pattern in defence reactions in pathogenesis of hypertension is discussed.
Although the vascular manifestations of the thoracic outlet syndrome are infrequent, their presence is an ominous portent for the affected limb. The cases of two recent patients indicate the importance of prompt recognition, urgent angiography, and definitive surgery. Regarding the surgical procedure, we used a two-incision approach-supraclavicular and intraclavicular-combining scalenotomy, resections of the cervical rib if present, the first thoracic rib, and the subclavian artery with retroclavicular interposition woven Dacron graft reconstruction. Preceding graft replacement, a Fogarty catheter thrombectomy of the distal brachial artery tree is done with completion arteriography to ensure freedom from retained distal thrombus. First rib resection is easily performed; subsequent vascular repair is also carried out, using this approach. We did not add sympathectomy to these cases, believing that early recognition and treatment will obviate its necessity. Follow-up has supported the efficacy of the treatment plan as presented.