Biomedical subjects
Publications and source records attributed to M H Postma.
We describe seven children with subcutaneous rheumatoid nodules who had no clinical evidence of rheumatoid arthritis. Only one girl was seropositive for antinuclear factors and had a slightly raised erythrocyte sedimentation rate. Clinical aspects, risks for developing rheumatoid arthritis, and treatment of this entity are discussed.
Thirty-four cases of cerebellar abscess, diagnosed by computed tomographic (CT) scanning, were managed according to a standard protocol during a 4-year period. Triple high dosage intravenous antibiotics were used, open catheter drainage of the abscess was instituted, and external ventricular drainage was added if obvious hydrocephalus was present. Seventeen patients made a good recovery, and five remained minimally disabled. Ten patients died, and two were left severely disabled. A relationship between the level of consciousness on admission and final outcome was established. In addition, two particular CT scan features (viz. the presence of hydrocephalus and the stage of the abscess) were significant adverse prognostic factors.
From 1956 to 1985, 38 patients with a carcinoid of the intestine were treated. Tumours originating from the duodenum, ileum and colon had the worst prognosis. Fourteen out of 15 patients showed lymph-node metastases, and eight liver secondaries. Metastatic spread was rare (9%) if the primary tumour was small or an incidental finding (appendix). Even with metastatic spread there may be a longer survival due to the slow growth pattern of carcinoid metastases, which often become manifest several years after resection of the primary tumour. Metachronous liver metastases should be considered for surgical resection. Three of the 38 patients suffered from a carcinoid syndrome.
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Seventy-six black patients with intussusception are reviewed. Infants (59%) presented with features similar to classic intussusception; ileocolic lesions were most common (80%) and a high resection rate (36%) was the sequel to delay in presentation. Children over 2 years of age (41%) presented with a pattern of 'tropical' intussusception in which primary colocolic lesions predominated (55%) and leading points were rare (3,5%). A high percentage of older children appears to characterize series from tropical areas. The relative proportions of these groups may vary between, and within, geographical regions and differing causes are likely. However, the management of both groups is similar. Hydrostatic reduction was not effective in those patients in whom it was attempted.