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Biomedical subjects

B H Miller

Publications and source records attributed to B H Miller.

At least 55 records · Page 3Linked to original sources
PubMed1988

Clinical features and history of the destructive lung disease associated with alpha-1-antitrypsin deficiency of adults with pulmonary symptoms.

Alpha-1-antitrypsin (alpha 1AT) deficiency is a hereditary disorder characterized in adults by a high risk for the development of severe destructive lung disease at an early age. The present study was designed to draw conclusions concerning the characteristics of a referral population of 124 patients with alpha 1AT deficiency and symptomatic emphysema. Typically, the alpha 1AT level was 30 mg/dl, and the alpha 1AT phenotype was almost always PiZZ. The individuals in this population were most often male, caucasian, and ex-smokers, and they had become dyspneic between 25 and 40 yr of age. Most routine blood tests were normal. The chest radiographs and ventilation-perfusion studies typically showed abnormalities with a lower zone distribution, and about one third of the study population had evidence suggestive of pulmonary hypertension. Lung function tests were typical for emphysema; the FEV1 and DLCO were the parameters most dramatically reduced, and the annual rate of decline of those parameters was greater than that of the general population. The cumulative probability of survival of this population indicated a significantly shortened lifespan with a mean survival of 16% at 60 yr of age compared with 85% for normal persons.

Adolescent↗
PubMed1987

Factors affecting the retention and fit of gold castings.

A study was designed to simulate clinical conditions. Several factors were evaluated for effect on retention and fit (margin adaptation) of gold castings. Twenty-six castings (13 pairs) were made by different investigators using a standard preparation but with varying fabrication techniques. One of each pair of castings was made on a spaced die and one on an unspaced die. A significant difference in the postcementation retention was observed in the varying techniques of each investigator. Retentive values varied from 29 to 129 lbs. Complete seating of the castings during cementation was improved by the use of die spacer. Castings made on the spaced dies had more retention than corresponding unspaced castings. Die spacing has positive benefit when properly used. Moderate roughness of axial surfaces improves retention when zinc phosphate cement is used. Physical properties of restorative materials are important, but the individual technique and care of each investigator has a major effect on the ultimate fit and retention of the cast restoration.

Cementation↗
PubMed1985

The chest radiograph and sarcoidosis. Reevaluation of the chest radiograph in assessing activity of sarcoidosis: a preliminary communication.

Classic radiographic staging of sarcoidosis, utilizing stages 0 through III, is a purely descriptive classification and bears no relation to the clinical activity of the disease. We propose a new method of determining sarcoidosis activity based solely on the chest radiograph. This "staging" is based on the presence or absence of air bronchograms, peribronchial cuffing, and subpleural thickening. Adenopathy, reticular, reticulonodular, and nodular opacities are not included in our methodology. Other diagnostic methods currently utilized for staging activity include Gallium scanning, bronchoalveolar lavage, and physiologic studies. In 85 studies performed in 51 patients with biopsy-proven sarcoidosis, this staging method agreed with Gallium scintigraphy results in 68.2%. The system failed in specific and identifiable subgroups of patients. We feel that the chest radiograph compares favorably with other staging methods in detecting the alveolitis phase of sarcoidosis, and is reproducible, noninvasive, and cost efficient.

Adult↗
PubMed1985

The use of pressimmune in renal transplantation: a four-year study.

Over a three year period, 22 diabetic and 87 non-diabetic patients received 120 cadaver kidney transplants at Dulwich Hospital. Horse antilymphocyte globulin (ALG), azathioprine and low-dose intra-muscular methyl prednisolone were used as immunosuppressive agents. A control group of 98 non-diabetic patients (113 transplants) at Guy's Hospital during the same period were treated with a standard azathioprine and oral steroid regime. Four main findings emerged: Firstly, survival rates for first grafts in the non-diabetic patients were similar in both centers. This suggests that neither the ALG or more conventional immunosuppressive regime holds any advantage in this patient group. Secondly, the first grafts in diabetic patients did significantly worse than similar grafts in the non-diabetics. Thirdly, in patients receiving the more conventional regime, second grafts did significantly worse than first grafts. Fourthly, and in contrast, the ALG regime gave similar survival figures for both first and second grafts. Thus, ALG had no apparent advantage over conventional steroid regimes on the survival of first grafts but it did produce a marked improvement in the outcome of subsequent grafts.

Adult↗
PubMed1984

Pleural effusion as a sequela to aelurostrongylosis in a cat.

A two-year-old domestic cat was admitted with dyspnea and coughing. Unilateral pleural effusion with characteristics of an eosinophilic exudate was demonstrated. A direct fecal smear was positive for Aelurostrongylus abstrussus larvae. Treatment with levamisole and fenbendazole was curative. Aelurostrongylosis should be suspected in any cat with dyspnea, coughing, or pleural effusion.

Animals↗
PubMed1983

Canine pancreatic endocrine function after interruption of pancreatic exocrine drainage.

Pancreatic endocrine function was studied in forty dogs after ligation or free i.p. drainage of the pancreatic duct, with or without simultaneous partial pancreatectomy. Shrinkage and fibrosis of the pancreas occurred in all dogs, with equal severity in the open duct and duct-tied groups. Fasting blood sugars remained within the normal range but fasting levels of plasma insulin and glucagon were reduced. Dynamic tests of endocrine function indicated that partial pancreatectomy reduced the insulin response to i.v. injection of dextrose or glucagon and delayed the reestablishment of glucose homeostasis. Glucose tolerance was normal in dogs with intact pancreases, but duct ligation was associated with deteriorating recovery after glucagon injection. The precise coordination of circulating glucose, insulin, and glucagon levels seen in normal dogs was lost in both partial and intact pancreas groups and these disturbances were attributed to the fibrotic changes arising from interference with the ductal drainage. Both ligation and free i.p. drainage of the pancreatic duct therefore resulted in abnormalities of islet function. When combined with partial pancreatectomy, both techniques were associated with significant pancreatic endocrine insufficiency.

Animals↗
PubMed1975

Immunization of children with attenuated measles-rubella bivalent vaccine.

The effects of simultaneous administration of Schwarz-strain measles virus vaccine and Cendehill-strain rubella virus vaccine as a single bivalent injection was evaluated in 346 children susceptible to both diseases. With placebo and monovalent controls, four bivalent preparations were used in a double-blind protocol to determine the effects of variations in the concentration of one or both components. No unusual reactions occurred and simultaneous administration did not enhance clinical reactivity. For measles, the seroconversion rate was 97% for monovalent vaccine and 97% to 100% (average 98%) for bivalent vaccines. For rubella, the rate was 100% for monovalent vaccine and 94% to 100% (average 99%) for bivalent vaccines. Thus, the vaccines were as safe and effective when given together as when given separately.

Bronchitis↗