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Biomedical subjects

B Mills

Publications and source records attributed to B Mills.

At least 37 records · Page 2Linked to original sources
PubMed1994

Basilar invagination and mid-line skeletal abnormalities due to in utero exposure to phenytoin.

A case of basilar invagination which is thought to have arisen from the patient's intrauterine exposure to phenytoin is presented. The patient was treated surgically by foramen magnum decompression and occipito-cervical fusion, and by transoral resection of the clivus. His symptoms of brain stem compression were alleviated and the role of phenytoin in the production of his craniocervical abnormality is discussed.

Adult↗
PubMed1993

Psychosexual behavior in hypopituitary men: a controlled comparison of gonadotropin and testosterone replacement.

Nine gonadotropin-deficient hypopituitary men were cycled through periods of treatment with testosterone (T), gonadotropin (Gn), and placebo (Pl) using a blind cross-over design. Self-reports of sexual behavior, recordings of nocturnal penile tumescence (NPT), and sex steroid levels were obtained during each treatment period. Subjects had significantly higher plasma T during the T and Gn treatments than during the control periods. Similarly, self-reported frequency of ejaculation and ratings of libido as well as duration measures of NPT were significantly higher on T and Gn. Two thirds of the sample had no sociosexual experience. Behavioral differences between the T and Gn periods were minimal. These data support the hypothesis that Gn and T are equally effective in stimulating specific aspects of male psychosexual behavior.

Adolescent↗
PubMed1992

Phase I trial of interleukin-2 plus gamma-interferon.

Interleukin-2 (IL-2) and gamma interferon (gamma-IFN) may be synergistic in inducing cell-mediated antitumor cytotoxicity. In order to determine the dose-limiting toxicities and define a maximum tolerated dose of these two agents in combination, we performed a Phase I clinical trial of intravenous IL-2 plus intramuscular gamma-IFN. Patients received both agents on a thrice-weekly schedule consisting of 4 weeks of treatment followed by 2 weeks of rest. Twenty-five patients were treated and received gamma-IFN doses between 0.05-0.25 mg/m2 (1-4 x 10(6) U/m2) with IL-2 doses from 0.33 mg/m2 to 2.33 mg/m2 (6-42 x 10(6) IU/m2). Two patients had partial responses of melanoma and adenocarcinoma of the lung lasting greater than 11 and 8 months, respectively. The toxicities of the combination were those expected from each agent, with no unusual effects, no irreversible organ toxicities, and no patient deaths. The doses recommended for outpatient administration on this schedule are IL-2, 2.0 mg/m2 plus gamma-IFN, 0.25 mg/m2, a dose combination that is unassociated with significant organ toxicity.

Adenocarcinoma↗
PubMed1992

Urinary growth hormone and insulin-like growth factor I. Effects of growth-hormone injection schedule.

Urinary growth hormone (GH) and insulin-like growth factor I (IGF-I) excretion profiles were compared in children receiving biosynthetic GH. Group 1 included 18 healthy controls. Group 2 included nine children given biosynthetic GH three times a week. Group 3 included 14 children given daily GH injections. Overnight urine samples were collected for three consecutive nights in all groups. No significant day-to-day variation in urinary GH output was observed in group 1. In group 2, urinary GH output was significantly higher on day one following injection than on days two and three. Urine GH outputs in group 2 were significantly lower on days two and three than the values observed on all days in group 3. Throughout the three-day study, subjects in group 3 excreted similar amounts of GH significantly higher than those of controls. Urinary IGF-I output (nmol/kg) was similar on all three study days in groups 1 and 3. Group 2 had significantly lower urinary IGF-I output on day three compared with day one. Urinary IGF-I output on day three was also significantly lower in group 2 than in group 3. We conclude that urinary GH and IGF-I outputs are influenced by the frequency of GH administration.

Adolescent↗
PubMed1988

Apheresis techniques in lymphokine-activated killer cell production.

Adoptive transfer of autologous lymphokine-activated killer cells (LAK) in conjunction with recombinant interleukin-2 (rIL-2) has been reported to produce significant regression in metastatic disease in patients with advanced cancer. In an effort to confirm the results reported by the Surgery Branch of the National Cancer Institute, the same IL-2/LAK regimen was used in cancer patients at six extramural cancer centers. In this report we will review our experience with mononuclear cell removal from the blood of cancer patients using apheresis technology and extracorporeal handling of these cells to generate a selective, highly cytotoxic cell population.

Adult↗
PubMed1987

The gut origin septic states in blunt multiple trauma (ISS = 40) in the ICU.

The association between support elements (ventilator days = Vd, enteral protein = EnP, number of antibiotics per day = AB/d) and the magnitude of the septic state (SSS) and its bacteriologic manifestations (bacti. log) in 66 patients with blunt multiple trauma (mean HTI-ISS = 40) over 1649 days have been studied retrospectively. SSS is measured by summing the standard deviation units of change in the septic direction for the 16 measurements taken every day in the intensive care unit. Increasing Vd is tightly associated with an increasing SSS (r = +0.52), after day 10 an increasing bacti. log (r = +0.21 to +0.32), and an increasing AB/d (r = +0.26) (all p less than 0.001, N = 1615 - 1626). The independent variables that best predicted Vd were delayed operations (DORS), day of rising EnP, and total positive blood cultures (TPC) (adj. R sq. = 0.84, F = 104, dF = 3/59). An increasing AB/d was associated with an increasing SSS (r = +0.38), increasing Vd (r = +0.26), and an increased bacti. log (r = +0.14 to +0.18) (all p less than 0.001, N = 1615). Only an increased EnP was consistently associated with a reduced SSS (r = -0.38) and a reduction in bacti. log (r = -0.10 to -0.21) (all p less than 0.001, N = 1626-1636). The independent variables Vd, EnP, AB/d, and TPC best predicted SSS for all surviving patients (adj. R sq. = 0.42, F = 268, dF = 4/1496). The patients who died of sepsis were not different in terms of bacti. log from those with equal Vd but were distinguished by zero EnP, high AB/d, and persistent ventilatory support. In conclusion, DORS is tightly associated with increased Vd, SSS, AB/d, and zero EnP. If Vd exceeds 10, there is an increasing bacti. log and evidence of infection probably from the gut. This responds only to increased EnP and not to AB/d. Death due to sepsis is not associated with increased bacti. log but with zero EnP and high AB/d and their consequences.

Adolescent↗
PubMed1985

Blunt multiple trauma (ISS 36), femur traction, and the pulmonary failure-septic state.

Fifty-six blunt multiple trauma patients (HTI-ISS 22-57) were studied for the effects of immediate versus delayed internal fixation of a femur or acetabular fracture on the pulmonary failure septic state. The pulmonary failure septic state may be defined as an alveolar arterial oxygen tension difference greater than 100, plus fever and leukocytosis. These patients were divided into four groups. Group I (N = 20) had immediate internal fixation, postoperative ventilatory support, and was sitting up at 30 hours. Group II (N = 20) had 10 days of femur traction and postoperative ventilatory support. Group III (N = 9) was immediately extubated after surgery and had 30 days of femur traction. Group IV (N = 7) had special circumstances that should increase the duration of the pulmonary failure septic state. These four groups of patients were statistically identical by 20 different criteria on admission except that Group I had more recognized chest injuries than Group II (12 vs. 9). Group I required 3.4 +/- 2.6 days of ventilator support and 7.5 +/- 3.8 intensive care unit (ICU) days; they had 12 +/- 8.8 elevated white counts, 3.8 +/- 4 febrile days, 0.05 positive blood cultures per patient, four fracture complications out of 93 fractures, 59 injections of narcotics, and 23 +/- 8.6 acute care days. Ten days of femur traction doubled the duration of the pulmonary failure septic state relative to Group I at a statistically significant level for nine out of 10 criteria, while increasing the number of positive blood cultures by a factor of 10, the number of fracture complications by a factor of 3.5, and the use of injectable narcotics by a factor of 2. Thirty days of femur traction increased the duration of the pulmonary failure septic state relative to Group I by a factor of 3 to 5 for all criteria at a statistically significant level, while increasing fracture complications by a factor of 17, positive blood cultures by a factor of 74, and the use of narcotics by a factor of 2. Group IV, which had four out of seven immediate internal fixations, behaved similarly to Group II. Femoral shaft traction should be avoided in the blunt multiple trauma patients because it greatly increases the cost of care and the risk of multiple systems organ failure.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetabulum↗
PubMed1984

Release of insulin-like growth factors and binding protein activity into serum-free medium of cultured human fibroblasts.

We have studied insulin-like growth factors (IGFs) and IGF-binding proteins released by human fibroblasts. Conditioned medium was obtained after incubation of 2 X 10(6) cells in 2 ml serum-free medium for 72 h. IGF binding protein was identified in aliquots of conditioned medium at 4 C for 16 h with [125]IGF II after charcoal separation. After gel filtration in neutral phosphate buffer through Sephadex G-150, the binding activity eluted with an apparent size greater than 100,000 daltons. After gel filtration through Bio-Rad P-100 in 1 M acetic acid, binding activity had a molecular size of about 50,000 daltons. When [125I]IGF-II bound to conditioned medium binding protein was cross-linked with disuccimidyl suberate and subjected to sodium dodecyl sulfate polyacrylamide gel electrophoresis, the complex had an estimated molecular size of 67,000 daltons. Competitive binding studies with labeled and unlabeled IGF-I and IGF-II showed that IGF-II was preferentially bound by fibroblast binding protein. The above findings are characteristic of serum binding protein but not shed IGF surface receptors. To eliminate possible interference from binding proteins in the IGF-I RIA and the IGF-II radioreceptor assay, conditioned medium was subjected to acid gel filtration, and the peptide fractions were pooled. We found that conditioned medium of seven fibroblast lines contained 0.20 +/- 0.06 ng/ml IGF-I. After the addition of 20 ng/ml human GH (hGH), the conditioned medium contained 0.48 +/- 0.09 ng/ml. These results are lower than those previously reported. One of the two lines of fibroblasts from patients apparently resistant to GH had a minimal increase in IGF-I in conditioned medium after hGH addition. We were able to detect IGF-II in fibroblast conditioned medium in concentrations of 4.4 to 21 ng/ml but there was no consistent response to GH either in the normal fibroblast lines or in fibroblasts obtained from children with short stature.

Carrier Proteins↗
PubMed1983

The biochemical characterization of detergent-solubilized insulin-like growth factor II receptors from rat placenta.

A membrane preparation, the R3, obtained by differential centrifugation of rat placental homogenates is enriched in receptors that bind insulin-like growth factor II (IGF-II) preferentially and with avidity (Daughaday, W.H., Mariz, I.K., and Trivedi, B. (1981) J. Clin. Endocrinol. Metab. 53, 282-288). When this preparation was incubated with 2% (w/v) octyl-beta-D-glucopyranoside for 60 min at 0-4 degrees C, 60% of the membrane protein was solubilized without loss of binding activity. The 125I-IGF-II binding properties of the detergent-solubilized receptors were found to be similar to those of the membrane-associated receptor. The rate constants for association, ka, and dissociation, kd, and equilibrium dissociation constant, KD, were 8.5 X 10(8) M-1 min-1, 7.5 X 10(-3) min-1, and 1.3 nM for the detergent-solubilized receptors and 5.3 X 10(8) M-1 min-1, 4.2 X 10(-3) min-1, and 0.6 nM for the membrane receptors. Gel chromatography on Sephacryl S-300 concentrated the solubilized receptors into a major peak of binding activity with a Stokes radius of 7.2 nm; a second peak of less specific binding had a Stokes radius of 4.3 nm. The receptors in the major peak bound 125I-IGF-II with a KD of 0.6 nM; the total binding capacity, Ro, was 21.6 pmol mg of protein-1 compared to 1.6 pmol mg of protein-1 for the membrane-associated receptor. Centrifugation of the receptors on 5-20% (w/v) gradients of sucrose in H2O or D2O disclosed a heterogeneous pattern of receptor distribution. When they were labeled with 125I-IGF-II prior to centrifugation, a major form of the receptor with a sedimentation constant, S20,w, of 9.9 X 10(13) s and other, possibly smaller, forms of the receptor were observed. However, only the 9.9 s20,w form of the receptor was observed if it was labeled with 125I-IGF-II subsequent to centrifugation. Based on these hydrodynamic measurements and a partial specific volume of 0.72 cm3/g, the IGF-II receptor was calculated to have a Mr of 290,000 and frictional ratio, f/fo, of 1.6. This value for the Mr is similar to the mass of 220,000 or 250,000 Dal determined by cross-linking 125I-IGF-II to the membrane- or detergent-solubilized receptors with disuccimidyl suberate and separating the complex by electrophoresis in sodium dodecyl sulfate-containing polyacrylamide gels in the absence or presence of dithiothreitol, respectively.

Animals↗
PubMed1981

Discrete colon ulcers as a cause of lower gastrointestinal bleeding and perforation in end-stage renal disease.

Since 1975 at our institution six cases of discrete colon ulcers have been noted in patients with end-stage renal disease. Five patients were on long-term hemodialysis, and one patient had received a cadaver kidney transplant. Four patients presented with lower gastrointestinal hemorrhage-two acute and two subacute. Two patients presented with diffuse abdominal pain and peritoneal signs. Two colon ulcers were diagnosed by colonoscopy, two were diagnosed in laparotomy, one was diagnosed by arteriography, and one ulcer was diagnosed only on pathologic examination of the resected colon. Pathologic examination disclosed idiopathic ulcers in all six cases. All patients were managed surgically. The mortality rate was 50%. Discrete colon ulcers should be considered in the differential diagnosis when the hemodialysis or kidney transplant patient presents with lower gastrointestinal bleeding or abdominal pain and peritoneal signs.

Acute Kidney Injury↗
PubMed1979

Migrant farm workers: social conditions, adaptive belief systems, and psychiatric care.

Two migrant farm labor camps were observed during two summer harvesting seasons. A part of the observations consisted of interviews with 104 farm laborers, with 16 of them being interviewed intensively. Migrant farm workers were exploited by the crew boss and the farm owner, and they in turn exploited each other. Consequently, many workers left farm work. Those who remained in the camps adapted their attitudes and their views to the conditions. Though they had a begrudging respect for the crew boss, they showed an overriding concern with exploitation. They conveyed a numbness about life, themselves, and their place in society; this numbness was combined with self criticism and an attempt to maintain some self-respect. They expressed distrust for and suspicion of others, and though they could not articulate it very well, they felt great fear and anxiety. In order to diagnose and treat disorder in migrant farm workers, psychiatrists must understand the exploitive social setting of migrant farm work and the adaptations of workers to that setting.

Adaptation, Psychological↗