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Biomedical subjects

A S Miller

Publications and source records attributed to A S Miller.

At least 37 records · Page 2Linked to original sources
PubMed1997

Association between attitudes toward health promotion and opinions regarding organ transplants in Japan.

Health promotion activities to educate the public about health lifestyles have been performed widely in industrialized countries where chronic adult diseases have become prevalent. According to a basic principle of health promotion activities, the symptoms of many diseases are regarded as the result of inadequate health behavior, curable by modifying health behavior. It is thus possible that an exposure to health promotion activities might instill negative attitudes towards organ transplants, because program participants may conclude that persons who need an organ transplant have become unhealthy as the result of their own poor health habits. In this study, two types of surveys were undertaken to test this hypothesis. The subjects of the first cross-sectional study were 712 male and female Japanese citizens, and those of the second case-control study were 240 female company employees in Japan. In the first study, a logistic regression analysis was used and the following findings were obtained. (1) Compared with the persons who felt that they did not have enough practical knowledge about individual health practices, those who felt that they had adequate knowledge were 0.66 times less likely to support organ transplants. (2) Compared with those who were not willing to spend money on healthful things, the persons who were willing to do so were 0.51 times less likely to support organ transplants. In the second case-control study, it was revealed that the subjects who had negative attitudes towards organ transplants had consistently healthier lifestyles than did those who had positive attitudes towards organ transplants. Based upon the present findings and the nature of the basic principles of health promotion activities, we infer that community health promotion activities have a negative influence upon citizens' opinions of organ transplants. Since these findings have health policy implications, more studies are necessary to conclusively evaluate the effects of health promotion activities upon attitudes toward organ transplants.

Attitude to Health↗
PubMed1997

Lymphangiomas of the oral cavity: a clinicopathologic, immunohistochemical, and electron-microscopic study.

PURPOSE: This study evaluated the demographics, treatment outcomes, histology, and basement lamina characteristics of a large series of lymphangiomas. MATERIAL AND METHODS: Forty-seven lymphangiomas of the oral cavity were evaluated microscopically and representative specimens were also evaluated immunohistochemically (IMH) and by electron microscopy (EM). RESULTS: Patient's ages ranged from 2 to 84 years. The dorsal surface of the tongue was the most common site. Discontinuities in the basement membrane were detected with IMH and EM. CONCLUSION: The discontinuous basement membrane may explain why sclerosing agents have not been effective as a form of treatment for lymphangioma.

Adolescent↗
PubMed1997

Plasmacytoma of the oral cavity and jaws: a clinicopathologic study of 13 cases.

Plasmacytoma of the jaw bones and oral cavity, as in other anatomic sites, comprises three distinct entities: multiple myeloma, solitary plasmacytoma of bone, and extramedullary plasmacytoma. This article is a retrospective study of 13 cases; 9 occurred in the mandible and 4 in the maxilla. The most common radiographic finding was a radiolucency that many times was superimposed on the roots or apices of nearby teeth. The most common symptom was localized pain, and the most frequent clinical sign was a raised red lesion on the alveolar ridge. The disease affects older persons, and the posterior mandible is the most frequently reported location. The degree of dysplasia of tumor cells was evaluated as there is a reported correlation with survival rates.

Adult↗
PubMed1997

Organ transplanting in Japan: the debate begins.

OBJECTIVES: Japan is currently considering changing its long-standing policy of banning most organ transplants. This paper reviews the current state of organ transplantation in Japan and presents results from a recently conducted survey regarding attitudes toward the removal of organs from brain-dead donors, and potential methods of allocating those organs in a fair manner. METHODS: Survey data were collected by the Research Project Team on Network Systems for Organ Transplants funded by the Japanese Ministry of Health and Welfare. The sample consisted of 1093 randomly selected citizens. Predictors of attitudes supporting organ transplantation were analyzed using logistic regression. RESULTS: Although many Japanese people support organ transplantation, few are willing to donate their organs. General knowledge of transplantation was the best predictor of support for such a program and willingness to donate organs. In addition, younger respondents and male respondents were more likely to support programs and donate organs. Implications of these results are discussed.

Adult↗
PubMed1996

Electrophysiological effects of a cannabinoid on neural activity in the globus pallidus.

The globus pallidus contains a dense distribution of cannabinoid receptors and appears to be a site of action of cannabinoids in the production of catalepsy. Single unit electrophysiology was used to explore the role of cannabinoid receptors in the globus pallidus of the rat. Intravenous injections of the potent and selective synthetic cannabinoid (R)-(+)-[2,3-dihydro-5-methyl-3-[(4-morpholinyl)methyl]-pyrrolo [1,2,3-de]-1,4-benzoxazin-6-yl](1-napthalenyl) methanone (WIN 55,212-2; up to 0.5 mg/kg, i.v.) inhibited the spontaneous firing of neurons in the globus pallidus. In a second set of experiments, WIN 55,212-2 antagonized the inhibition of pallidal firing produced by electrical stimulation of the striatum. The pharmacological specificity of the effects of WIN 55,212-2 on basal and evoked activity in the globus pallidus was demonstrated by the lack of effect of the inactive enantiomer WIN 55,212-3. These results indicate that cannabinoids may produce functionally opposite effects on spontaneous and evoked activity in the globus pallidus: a decrease in spontaneous firing and a decrease in the inhibition of firing produced by the striatopallidal projection.

Action Potentials↗
PubMed1996

Does eversion of the anorectum during restorative proctocolectomy influence functional outcome?

PURPOSE: The aim of this study was to determine the effect of eversion of the anorectum during restorative proctocolectomy (RP) for ulcerative colitis on functional outcome. METHODS: One hundred seventeen patients underwent RP with stapled end-to-end ileal pouch-anal anastomosis (EEA), without resection of the anal mucosa. Sixty-four underwent EEA with eversion of the anorectum, and 53 underwent EEA without eversion. Each patient underwent paired studies of anorectal function before and a median of 12 months after RP. RESULTS: One year after RP, median (interquartile range) maximum resting pressure was 69 (range, 51-88) cmH2O in those patients who underwent eversion vs. 80 (range, 64-90) cmH2O in patients without eversion (P < 0.04). Threshold sensation in the upper, middle, and lower thirds of the anal canal were 9.1, 7.4, and 6.8 mA after eversion vs. 6.9, 4.9, and 3.8 mA without eversion (P = 0.003, P < 0.001, P < 0.001, respectively). Before operation, all patients had a rectoanal inhibitory reflex; however, after RP, 54 of 64 patients in the eversion group and 50 of 53 patients with a stapled EEA without eversion had an inhibitory reflex (P = not significant). Leakage of mucus was experienced by 11 patients who underwent eversion, compared with 9 patients without eversion. Fifty-six of 64 patients with eversion could defer defecation for more than 30 min compared with 43 of 53 patients without eversion. Twenty-two of 64 patients in the eversion group retained perfect discrimination between flatus and feces compared with 38 of 54 without eversion (P < 0.001). Level of the anastomosis was 1 (range, 0.5-3) cm above dentate line after eversion compared with 1.5 (range, 0-6) cm without eversion. CONCLUSION: Clinical outcome after RP with eversion was not as good as outcome after stapled EEA without eversion. Such a conclusion requires confirmation in a prospective control trial.

Adult↗
PubMed1996

CD22 is both a positive and negative regulator of B lymphocyte antigen receptor signal transduction: altered signaling in CD22-deficient mice.

B cell activation following antigen receptor cross-linking can be augmented in vitro by ligation of cell surface CD22, which associates with the SHP1 protein tyrosine phosphatase. The targeted deletion of CD22 in mice demonstrated that CD22 differentially regulates antigen receptor signaling in resting and antigen-stimulated B lymphocytes. B cells from CD22-deficient mice exhibited the cell surface phenotype and augmented intracellular calcium responses characteristic of chronically stimulated B cells, as occurs in SHP1-defective mice. Thus, CD22 negatively regulates antigen receptor signaling in the absence of antigen. However, activation of CD22-deficient B lymphocytes by prolonged IgM cross-linking resulted in modest B cell proliferation, demonstrating that CD22 positively regulates antigen receptor signaling in the presence of antigen.

Animals↗
PubMed1996

Prospective controlled trial of duplicated (J) versus quadruplicated (W) pelvic ileal reservoirs in restorative proctocolectomy for ulcerative colitis.

AIMS: A prospective randomised controlled trial was conducted to find out what influence the design of the pelvic reservoir had on the functional outcome. PATIENTS AND METHODS: Sixty patients received either a duplicated (J) or a quadruplicated (W) reservoir, constructed with either 30 or 40 cm of ileum. Each patient underwent laboratory tests of anorectal function before and one year after operation. RESULTS: One year after operation, 57 patients were available for assessment: each had good anal continence, though eight experienced minor leakage of mucus, and all were able to defer defecation for more than 15 minutes. Median bowel frequency in 24 hours (IQR) in patients with J reservoirs (5 (4-7)) did not differ significantly from that of patients with W reservoirs (5 (4-6)). Likewise, bowel frequency in patients with the smaller (30 cm) reservoirs did not differ significantly from bowel frequency in patients with the larger (40 cm) reservoirs. However, patients with large W40 reservoirs had the lowest bowel frequency of the four groups (median 4 per 24 hours, p = NS). The capacity and compliance of the W40 reservoirs were greater than those of the other types of reservoir, but the differences were not statistically significant. CONCLUSIONS: These findings provide support for the use of a relatively small (30 cm), duplicated (J) ileal reservoir, which is simple to construct with linear stapling instruments.

Adolescent↗
PubMed1996

[Problems related to organ transplantation as an allocation of scarce medical resources: a review].

The criteria for allocation of medical resources at three different stages which lead to organ transplantation are discussed, along with advantages and disadvantages. When each criterion was examined individually, it was difficult to determine the best criterion for selection of recipients of donated organs in the most ethically desirable fashion. However, when we examined the suggested criteria on the basis of an actual case, the efficacy of transplantation or expected length of the survival years was most often used as a criterion to select the recipients of donated organs. To increase more support for organ transplantation in our society, it is necessary to more fully discuss how scarce donated organs should be allocated to recipients in a fair and equitable manner.

Decision Making↗
PubMed1995

Effects of a cannabinoid on spontaneous and evoked neuronal activity in the substantia nigra pars reticulata.

Single unit electrophysiology was used to explore the role of cannabinoid receptors in the substantia nigra pars reticulata. Intravenous and intraperitoneal injections of the potent and selective synthetic cannabinoid (R)-(+)-[2,3-dihydro-5-methyl-3-[(4-morpholinyl)methyl]pyrrolo[1,2,3- de]-1,4-benzoxazin-6-yl](1-naphthalenyl) methanone (WIN 55,212-2) produced modest but significant increases in the spontaneous firing rate of neurons in the substantia nigra pars reticulata. In a second set of experiments, WIN 55,212-2 (up to 1.0 mg/kg i.v.) antagonized the inhibition of firing produced in the substantia nigra pars reticulata by electrical stimulation of the striatum. The pharmacological specificity of this effect was demonstrated using the inactive enantiomer WIN 55,212-3. The possibility that WIN 55,212-2 exerts its effects by regulating gamma-aminobutyric acid (GABA) release from striatonigral fibers was suggested by the observation that bicuculline (up to 0.5 mg/kg i.v.) reversed the effect of striatal stimulation. It thus appears that cannabinoid receptors on striatonigral neuron terminals may regulate movement by disinhibiting the activity of substantia nigra pars reticulata neurons, perhaps by inhibiting the release of GABA into the substantia nigra pars reticulata.

Analgesics↗
PubMed1995

Identification of the ligand-binding domains of CD22, a member of the immunoglobulin superfamily that uniquely binds a sialic acid-dependent ligand.

CD22 is a B cell-restricted member of the immunoglobulin (Ig) superfamily that functions as an adhesion receptor for leukocytes and erythrocytes. CD22 is unique among members of the Ig superfamily in that it has been suggested to bind a series of sialic acid-dependent ligands, potentially through different functional domains expressed by different splice variants of CD22. In this study, the epitopes identified by a large panel of function-blocking and non-function-blocking CD22 monoclonal antibodies were localized to specific Ig-like domains, revealing that all function-blocking monoclonal antibodies bound to the first and/or second Ig-like domains. Consistent with a single ligand-binding region, the two amino-terminal domains were the functional unit that mediated CD22 adhesion with lymphocytes, neutrophils, monocytes, and erythrocytes. The predominant cell surface species of CD22 was a full length 140,000 relative molecular mass seven Ig-like domain glycoprotein and a minor 130,000 relative molecular mass form lacking the fourth domain. While the two amino-terminal Ig-like domains of CD22 are structurally similar to those found in other members of the Ig superfamily involved in cell adhesion and containing an amino acid sequence motif associated with integrin recognition, site-directed mutagenesis of critical residues surrounding this motif did not disrupt CD22-mediated adhesion. These results demonstrate that the unique ligand-binding properties of CD22 are distinct from those of other members of the Ig superfamily involved in integrin-mediated cell adhesion.

Amino Acid Sequence↗
PubMed1995

Factors that influence functional outcome after coloanal anastomosis for carcinoma of the rectum.

Thirty consecutive patients had laboratory assessment of anorectal function after rectal excision and stapled coloanal anastomosis for rectal carcinoma. Eleven patients experienced perfect continence but 19 had faecal leakage with or without urgency of defaecation. Median (interquartile range) function was related to the pressures generated in the anal sphincter at rest (good versus poor function: 80 (63-91) versus 51 (23-60) cmH2O, P < 0.01), during maximum squeeze (160 (126-203) versus 102 (58-112) cmH2O, P < 0.01) and during reflex inhibition (58 (23-63) versus 36 (18-54) cmH2O, P < 0.05). Poor function was significantly commoner in women than in men (P < 0.01). These findings suggest that occult damage may have occurred to the anal sphincter before low anterior resection. Careful preoperative evaluation with manometry and endoanal ultrasonography may detect such damage and allow selection of patients for colopouch reconstruction.

Adult↗
PubMed1995

Clinical and physiological evaluation of anorectal eversion during restorative proctocolectomy.

Fifty patients had a restorative proctocolectomy with stapled end-to-end ileoanal anastomosis by the eversion technique. Median (interquartile range) maximum resting anal pressure was 90 (73-116) cmH2O before restorative proctocolectomy and 71 (51-88) cmH2O 1 year after surgery (P < 0.001). Median maximum squeeze pressure was 141 (110-185) cmH2O before surgery and 146 (118-186) cmH2O 1 year after surgery (P not significant). Median thresholds for sensation in the lower third of the anal canal before and 1 year after surgery were 5.3 and 7.1 mA, respectively (P = 0.006). One year after restorative proctocolectomy, all patients were continent, although two experienced leakage of mucus requiring a pad. Forty-two patients (84 per cent) could discriminate between faeces and flatus. Eversion of the anorectum during restorative proctocolectomy impairs the motor and sensory functions of the anal sphincter. Most patients achieved satisfactory anal continence, however, despite these physiological changes.

Adolescent↗
PubMed1995

Recovery of physiologic and clinical function after low anterior resection of the rectum for carcinoma: myth or reality?

PURPOSE: The aim of this study was to examine the serial changes that take place in the first year after low anterior resection for rectal carcinoma, in terms both of anorectal physiology and clinical bowel function. Our hypothesis was that some patients never regain satisfactory anorectal function, because the operative procedure leads to permanent impairment of anorectal reflex and motor function. METHOD: Nineteen patients underwent serial tests of anorectal function, before and for one year after low anterior resection. The median level of the anastomosis above the anal high-pressure zone was 3 (range, 1-6) cm. RESULTS: Anal resting pressure (median (interquartile range)) was significantly decreased three months after operation (62 (46-72) cm H2O) and one year after operation was still significantly less (58 (48-73) cm H2O) than before operation (77 (58-93) cm H2O) (P < 0.01). Maximum tolerated volume in the neorectum decreased from 130 (88-193) ml before operation to 80 (51-89) ml three months after operation (P < 0.005) but returned to preoperative values by six months (125 (60-140) ml) (P = not significant) and remained at these values one year after operation. The volume in the "neorectal" balloon required to elicit a maximum rectoanal inhibitory reflex was significantly less three months after operation than before operation (50 (43-60) ml compared with 100 (73-100) ml; P < 0.005); one year after operation, the volume required was still significantly less than before operation (50 ml vs. 100 ml) (P < 0.015). Bowel frequency increased from 1 (1-2) in 24 hours before operation to 4 (2-5) times in 24 hours after operation and remained at 4 times in 24 hours throughout the first year after operation. Three months after operation, 53 percent of patients experienced some degree of fecal leakage and 24 percent experienced urgency of defecation. These aspects of bowel function improved with time, but even one year after operation, 29 percent of patients continued to experience fecal leakage and 18 percent wore a protective pad. CONCLUSIONS: Anal resting pressure decreased significantly after low anterior resection and did not recover in the course of the first year after operation. Moreover, the volume of an air-filled balloon in the neorectum that was required to elicit maximum inhibition of the anal sphincter was significantly less after anterior resection that before operation. These long-term and presumably permanent changes in physiologic behavior of the anoneorectum after low anterior resection provide an explanation for the failure of some patients to regain satisfactory bowel function following that procedure.

Aged↗
PubMed1995

Rhabdomyosarcoma of the oral cavity. Report of four cases.

Clinical and pathologic findings of four cases of rhabdomyosarcoma of the oral soft tissues are described that include findings from immunohistochemistry and electron microscopy. Three cases occurred in children under 16 years of age and one in a 22-year-old. Included is a brief discussion on reported gene abnormalities that may contribute to neoplastic development.

Adolescent↗
PubMed1995

Search for evidence of three viral agents in radicular (periapical) cysts with immunohistochemistry.

Sections from 20 paraffin-embedded radicular cysts and positive-control subjects were subjected to immunostaining procedures after treatment of the sections with polyclonal antibodies was performed to search for evidence of human papilloma virus and herpes viruses 1 and 2 in the lining epithelium. All 20 specimens examined were negative for the presence of all three viruses.

Herpesvirus 1, Human↗
PubMed1995

Preservation of complete anal sphincteric proprioception in restorative proctocolectomy: the inhibitory reflex and fine control of continence need not be impaired.

This study evaluates whether reflux function of the anal sphincter remains unchanged after restorative proctocolectomy, provided that the sphincter remaining is kept intact, without mucosal stripping or endo-anal anastomosis. Paired tests of anorectal function were performed before, and a median of 6 (range 2-12) months after restorative proctocolectomy with stapled, end to end pouch-anal anastomosis. Beforehand, distension of the rectum with 50 ml of air produced a median (interquartile range) increase in pressure within the rectum of 22 (15-29) cm H2O and reflex inhibition of the anal sphincter from a pressure of 76 (62-106) cm H2O to a pressure of 34 (15-52) cm H2O. After the procedure, distension of the ileal pouch with 50 ml of air produced an increase in pressure within the pouch of only 5 (4-8) cm H2O (p < 0.001 compared with beforehand) and reflex inhibition of the anal sphincter from a pressure of 62 (25-79) cm H2O to 37 (17-68) cm H2O. Maximal reflex inhibition of the upper third if the anal sphincter to a pressure of 26 (15-48) cm H2O was observed when pressure within the pouch increased by 16 (11-22) cm H2O. After restorative proctocolectomy, all patients were continent (two experienced minor nocturnal leakage of mucus) and 25 could discriminate between flatus and faeces. Thus, reflux function was preserved in response to changes in pressure, ensuring that the subtler aspects of anal continence were preserved.

Adolescent↗