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Biomedical subjects

C M Miller

Publications and source records attributed to C M Miller.

At least 199 records · Page 11Linked to original sources
PubMed1986

A simple rapid technique for vena cava clip replacement.

A method to facilitate clipping of the inferior vena cava is presented. The inferior surface of the clip is protected by a red rubber catheter while being passed behind the vena cava. This avoids any trauma to the posterior wall that may be caused by the serrations or sharp edges of the clip and facilitates passage. Once in place, this catheter is then advanced off the clip and a previously placed silk tie is secured. The operation is then finished expeditiously. Although inferior vena caval clipping has become a less frequently used method of vena cava interruption, definite indications remain for its use and it must be kept in the armanentarium of the surgeon. This method should facilitate the execution of this procedure.

Catheterization↗
PubMed1985

Femoral pseudoaneurysm following nonpenetrating trauma in a patient with aortic insufficiency.

Although not uncommon after penetrating vascular trauma, arterial pseudoaneurysms rarely develop following blunt trauma. A patient is described in whom indirect trauma led to pseudoaneurysm of the profunda femoris artery, and persistent bleeding required surgical intervention. In this case, the coexistence of significant aortic valvular regurgitation suggests that wide pulse pressure may predispose to this arterial complication.

Aged↗
PubMed1985

Rupture of surgically thrombosed abdominal aortic aneurysm.

A case of late rupture of an abdominal aortic aneurysm that had been successfully treated by surgically induced thrombosis is presented. After emergency surgery consisting of ligation of the neck of the aneurysm, the patient survived and is doing well. The literature on surgically induced thrombosis of abdominal aortic aneurysm is reviewed. It is stressed that complete thrombosis of aortic aneurysm induced by distal ligation does not preclude rupture, and if patients present with symptoms of expansion or rupture, they should undergo emergency surgery.

Aged↗
PubMed1985

Long-term prolongation of cardiac allografts by subtherapeutic levels of cyclosporine in rats conditioned with pretransplant blood transfusions and cyclosporine.

This study was aimed at ascertaining whether long-term graft survival was achievable with short term cyclosporine (CsA) therapy or with subtherapeutic doses of CsA in rats conditioned with blood transfusions (BT) combined with CsA. Previous studies had shown that donor-specific transfusions combined with a short course of CsA interacted synergistically, resulting in considerable prolongations of ACI and BUF grafts in LEW hosts receiving no postoperative treatment. The donor-specific depression of alloreactivity was confirmed in the present study by showing a depression of mixed-lymphocyte reaction (MLR) reactivity as well as of humoral antidonor responses in BT-CsA conditioned rats. The effects of postoperative CsA were then studied in recipients conditioned with BT-CsA or BT alone. ACI and BUF cardiac graft survival in LEW hosts conditioned with BT and treated with a five-day postoperative course of CsA (20 mg/kg/day) were indistinguishable from graft survival in untransfused hosts (ACI: 35.6 +/- 15.5 vs. 38.8 +/- 7.4; BUF: 58.4 +/- 39.8 vs. 48.0 +/- 21.7) indicating no interaction between BT and CsA under these conditions. In contrast, the effect of a post-operative five-day course of CsA (10 mg/kg/day) was extended by conditioning the recipients with donor-specific BT and CsA (ACI:41.7 +/- 7.0 vs. 27.4 +/- 11.6; P less than 0.05). More remarkably, a thirty-day course of subtherapeutic doses of CsA (2.5 mg/kg/day) resulted in long-term prolongation (greater than 100 days) of ACI grafts in a large proportion of hosts conditioned with donor-specific BT and CsA, while the majority of controls conditioned with nonspecific BT and CsA or CsA alone rejected their grafts within three weeks (P less than 0.01). The possible mechanisms of this phenomenon are discussed.

Animals↗
PubMed1984

Comparison of the sensitivity of commercial APTT reagents in the detection of mild coagulopathies.

This study was undertaken to evaluate the precision and sensitivity of three different commercial APTT reagents containing the activators kaolin, micronized silica, or ellagic acid. These reagents varied greatly in their ability to detect mild coagulopathies. The ellagic acid reagent was able to detect the mildest deficiencies for the most common coagulopathies. This reagent was sensitive to 50% levels of Factor VIIIC, whereas the APTT with the kaolin reagent was not prolonged until levels of 35% or less were attained. The micronized silica reagent was the least sensitive to Factor IX deficiency, detecting levels of 12% or less. Precision was similar for all reagents when tested with normal and slightly abnormal plasmas. Since methods and instrumentation vary, each laboratory should evaluate their APTT reagent to determine its precision and sensitivity.

Blood Coagulation Disorders↗
PubMed1984

Infected false aneurysms of the subclavian artery: a complication in drug addicts.

Two cases of infected false aneurysms of the subclavian artery in drug addicts are described. The clinical findings related to the location of these rare lesions are presented, together with an attempt to explain their pathophysiology. The signs and symptoms include a tender supraclavicular mass in an obviously septic patient associated with brachial plexus palsy, a swollen edematous arm, Horner's syndrome, and hemoptysis. Because of the complexity of symptoms, delay in diagnosis is common. It is emphasized that the recognition of this constellation of symptoms should prompt the physician to perform emergency angiography followed by immediate surgery.

Aneurysm, Infected↗
PubMed1983

Male sexual dysfunction as related to alcohol consumption: a pilot study.

Personal interviews were conducted with 44 male volunteers consecutively admitted to outpatient treatment in a county alcoholism program. Fifty-three per cent of the subjects were still drinking minimally or in moderation at the time of the interview. Quantity, frequency, and duration of drinking, from onset of regular drinking to present, were related to sexual dysfunctions. During heavy drinking. 59% of patients experienced erection dysfunction, 48% reported ejaculation incompetence, and 84.4% had experienced at least one kind of sexual dysfunction.

Alcohol Drinking↗
PubMed1983

Effect of technetium Tc 99m pertechnetate on bacterial survival in solution.

Survival of Staphylococcus epidermidis (10(2) organisms/ml) in solutions containing various levels of radioactivity was assessed. Six test preparations contained nonbacteriostatic 0.9% sodium chloride solution; four of these contained technetium Tc 99m pertechnetate (99mTcO-4) in various quantities (80, 250, 500, and 750 mCi). A fifth contained technetium that had decayed to an essentially nonradioactive form, and a sixth contained 0.9% sodium chloride solution only. Each of the six 20-ml solutions was inoculated with 2 ml of single-strength trypticase soy broth (TSB) containing 10(3) organisms/ml. At various times up to 12 hours after inoculation, 1-ml aliquots of each test solution were withdrawn and passed through 0.22-micron filters, thereby preventing further irradiation of the filtered organisms. The filters were incubated in single-strength TSB at 37 degrees C, and samples were examined for turbidity at 24, 48, and 72 hours. After 24 hours, 25 of the 36 sample tubes showed turbidity; after 48 hours, the turbid samples totaled 28. Bacteria in the two nonradioactive solutions remained viable throughout the 12-hour sampling period. Accumulated doses of radiation obtained in the 250-, 500-, and 750-mCi samples inhibited bacterial growth. To be a valid quality-control measure, sterility monitoring of prepared radiopharmaceutical dosage forms may need to be performed concurrently with their preparation.

Bacteria↗
PubMed1982

Evaluation of three methods for detecting low-level bacterial contamination in intravenous solutions.

The accuracy of three sterility-testing methods in detecting low-level contamination in deliberately contaminated intravenous solutions was studied. One-liter bags of 5% dextrose (D5W) and 0.9% sodium chloride (saline injections were contaminated with Staphylococcus epidermidis and Pseudomonas aeruginosa; approximately 10(1) viable bacteria were injected into each bag. Two membrane-filtration methods (Ivex-2 and Addi-Chek) and one aliquot method [twice concentrated trypic soy broth (2X-TSB)] were used to test each of 10 diliberately contaminated solutions for both D5W and saline; 500 ml of each liter bag was filtered or added to 2X-TSB. Incubation containers were stored at 37 degrees C and inspected at 24, 48, and 72 hours for turbidity. There was no significant difference among the three methods in the detection of contaminated saline solutions. The Addi-Chek system was significantly less effective in detecting contamination in D5W than either of the other methods. It is concluded that the Ivex-2 system is accurate and the easiest-to-use system of the three tested.

Bacteriological Techniques↗
PubMed1975

An in vivo assay for anti-LH-RH and anti-FSH-RH activity of inhibitory analogues of LH-RH.

A convenient and sensitive method for testing anti-LH- and FSH-releasing activities of antagonists of LH-RH was devised. The peptides to be tested were injected subcutaneously together with synthetic LH-releasing hormone (LH-RH) in immature male rats. Serum LH and FSH concentrations were measured 30 min later by radioimmunoassay. In this system, [DesHis2]-LH-RH failed to block the pituitary response to LH-RH in agreement with previous data. The administration of [DesHis2, desGly10]-LH-RH ethylamide, [Des-His2, Leu3, des Gly10]-LH-RH ethylamide, [Des-His2, D-Ala6, des-Gly10]-LH-RH ethylamide, and [DESHis2, D-Ala6]-LH-RH in doses of 200 mug/rat, and [DesHis2, Leu3, D-Ala, desGly10]-LH-RH ethylamide in doses ranging from 100-400 mug/rat caused a significant inhibition of LH-RH-induced release of LH and FSH. On the other hand, [DesHis2, desGly10]-LH-RH propylamide, and [Leu2, Leu3, D-Ala6, desGly10]-LH-RH ethylamide failed to block the response to LH-RH. Among the peptides tested, [DesHis2, d-ala6, desGly10]-LH-RH etylamide, [Leu2, Leu3, D-Ala, desGly10]-LH-RH ethylamide in doses of 200 mug and [DesHis2, Leu3, D-Ala6, desGly10]-LH-RH ethylamide in a dose of 400 mug/rat showed some intrinsic LH and FSH-releasing activities. The method described here is simple and convenient for studying the anti-LH-RH release activity of inhibitory analogues of LH-RH, and also enabled us to demonstrate for the first time an in vivo inhibition of FSH release by these analogues.

Animals↗
PubMedDate not supplied

Living donor liver transplantation in adult patients: our experience.

INTRODUCTION: Living donation in adult liver transplantation (LDLTx) is an important resource because of the waiting list growth. We started a living donor program to overcome the shortage of cadaveric sources. PATIENTS: From May 2001 to May 2003, 36 patients underwent LDLTx: 27 received a right lobe, 8 received a left lobe, and 1 received segments II and III. RESULTS: The 1-year actuarial survival rate was 77.7%, with a mean follow-up, in survivors, of 754 +/- 248 days. Eleven of 27 (40.7%) right lobe recipients died. Among left graft recipients, 3 patients died (33%). We undertook retransplantation in 4 cases, because of 2 "small for size" syndrome, 1 late hepatic artery thrombosis, and 1 early portal vein thrombosis. After a period of 797 days, all 36 donors returned to a normal social and working life. Two donors, who underwent right lobe donation, experienced major complications: 1 case of biliary stenosis, treated by stenting, and 1 case of biliary leak from the cut surface of the liver, requiring laparotomy and abscess drainage. Left lobe donors developed no complications. CONCLUSIONS: LDLTx has a learning curve for experienced liver transplantation surgeons. Our last 18 cases showed better survivals than the first 18 (9 deaths vs 5), even if, in the latter group, we transplanted 8 left livers. In our experience, LDLTx of a left liver graft has an increased risk of "small for size syndrome," but patients, both donors and recipients, report improved outcomes.

Actuarial Analysis↗