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Biomedical subjects

D G Miller

Publications and source records attributed to D G Miller.

At least 109 records · Page 6Linked to original sources
PubMed1979

Home parenteral nutrition in treatment of severe radiation enteritis.

Ten patients with radiation enteritis unresponsive to conventional medical and surgical therapy were put on long-term parenteral nutrition at home. Six of the patients are alive at home; four patients died, two from recurrent cancer. Some of the patients have been able to resume oral intake, but none have been able to discontinue parenteral nutrition. Fistulas healed or had a marked decrease in output. Two patients in our series were given prednisone and slinical improvement of radiation enteritis with this therapy.

Abdominal Neoplasms↗
PubMed1979

Emergency.

Explore the source record for details and available documents.

Coal Mining↗
PubMed1978

Effect of signaled versus unsignaled stress of rat myocardium.

Foot-shock stress resulted in a threefold increase in myocardial uptake of technetium-99m-methylene diphosphonate (Tc-99m-MDP) in rats compared to unstressed controls. The introduction of a 4-sec signal prior to each shock resulted in a two-thirds reduction in this stress-induced Tc-99m-MDP myocardial uptake, suggesting that most of the stress-induced myocardial damage was psychologically mediated.

Animals↗
PubMed1978

Semantic integration of verbal information into a visual memory.

A total of 1,242 subjects, in five experiments plus a pilot study, saw a series of slides depicting a single auto-pedestrian accident. The purpose of these experiments was to investigate how information supplied after an event influences a witness's memory for that event. Subjects were exposed to either consistent, misleading, or irrelevant information after the accident event. Misleading information produced less accurate responding on both a yes-no and a two-alternative forced-choice recognition test. Further, misleading information had a larger impact if introduced just prior to a final test rather than immediately after the initial event. The effects of misleading information cannot be accounted for by a simple demand-characteristics explanation. Overall, the results suggest that information to which a witness is exposed after an event, whether that information is consistent or misleading, is integrated into the witness's memory of the event.

Auditory Perception↗
PubMed1977

Feasibility of fecal occult-blood testing for detection of colorectal neoplasia: debits and credits.

A screening program for colorectal cancer and adenomas has been applied to 6,579 mostly asymptomatic men and women age 40 years and older utilizing fecal occult-blood testing followed by investigation of patients with positive slides by air-contrast barium enema and colonoscopy. A control population of 7,325 patients had sigmoidoscopy only and no occult-blood testing. Approximately 1% of the patients had positive slides; most patients had only one or two slides positive. Approximately 50% of patients with positive slides had significant neoplastic lesions, including 23 patients with large adenomas and 7 patients with cancers. Pathological staging of cancers was more favorable in the screened asymptomatic group as compared with the control group. Neoplastic lesions seen on sigmoidoscopy in screened patients who had negative fecal occult-blood tests included 2 cancers and 15 large adenomas. Reasons for false negativity include possible conversion of initially positive slides to negative. Screening for colorectal cancer and adenomas with fecal occult-blood testing appears to be feasible approach with good patient compliance, and manageable rate of positive slides productive of a high percentage of neoplastic lesions. The number of false-positives seems to be low. False negativity has been observed and will require further study.

Adenoma↗
PubMed1977

Ethical issues in investigation of screening strategies.

Screening programs can be designed to be useful for data collection to study effectiveness of screening. High-risk populations may be identified, and screening techniques applied to a randomly selected subgroup with another subgroup serving as controls. This raises the ethical question of not applying helpful surveillance to individuals known to be at high-risk. Attention should be paid to management of controls, for example, to screen them less frequently, or at least to inform them of their increased risk and advise periodic exams. Against such recommendations is that differences between test and control groups would be minimized and the study less conclusive. Another approach is to use adaptive design, selecting the study group for a large population which is being subject to medical surveillance for some other reason. As in other clinical trails, studies of screening programs must include appropriate surveillance for controls to properly safeguard their rights and medical needs.

Control Groups↗
PubMed1977

Quantitative determination of stress-induced myocardial damage in rats.

The degree of myocardial damage produced in rats by exposing them to unsignalled, irregular foot-shock stress was determined in three ways: by measuring (1) enzymes (LDH, GOT and GPT) released into the circulation, (2) the rate of release of one of these enzymes (LDH) from isolated perfused hearts into the perfusate, and (3) the cardiac uptake, in vivo, of the radioactively labeled bone-seeking agents, technetium-99m-stannous pyrophosphate or technetium-99m-methylene diphosphonate. The latter two methods permitted quantitative determination of the degree of myocardial damage produced. Determination of cardiac technetium-99m uptake was found to be simple, quantitative, highly sensitive and truly indicative of cardiac damage, and therefore most suitable for studies of the effects of stress on cardiac injury.

Animals↗
PubMed1977

Myocardial uptake of Tc-99m skeletal agents in the rat after experimental induction of microscopic foci of injury.

The cardiac uptake of Tc-99m tagged skeletal agents was studied after myocardial injury produced by subcutaneous catecholamine injection and random foot-shock stress. Rats stressed for 2 hr developed microfocal myocardial injury, without gross change, whereas those stressed for 12 hr sustained more confluent and sometimes grossly visible damage. Tc-99m MDP and Tc-99m PPi concentrations in these hearts were significantly above control (undamaged) heart levels, producing positive gamma-camera images. Subcutaneous epinephrine injections resulted in grossly visible lesions, with tracer concentrations higher than those previously reported in vasoocclusive infarcts. We postulate that the stress-induced scattered microfocal lesions may accumulate radiopharmaceutical on a per-gram basis in the same way as the larger catecholamine-induced lesions, since tracer delivery to the injured areas in each case is probably less impeded than in frankly vasoocclusive models. Such microfoci, then, could provide an explanation for some of the "false positive" myocardial scans observed clinically.

Animals↗
PubMed1976

What is early diagnosis doing?

Programs for the early detection of cancer in the past have been beset with problems of low yield, inability to recruit high risk populations, poor utilization of physicians, and inadequate end results evaluation. Nevertheless, for twelve forms of cancer representing 80% of all cancers and 70% of all cancer mortality there is a useful form of early detection or prevention. Furthermore, the ultimate benefit of early diagnosis to patients is supported by long-term relative survival rate studies, and for certain forms of cancer by reduction in mortality rates as well. Efforts are now underway to develop risk factor detection programs which will overcome some of the aforementioned problems. One such program is the risk factor analysis project, operating in the CANSCREEN clinics, which was designed to detect high risk indicators for cancer which are amenable to intervention by primary prevention or diagnosis and treatment. A triage system with linkages to comprehensive cancer centers has been established and a medical information system prepared for centralized statistical and epidemiological studies. The clinics are operated entirely by nurse examiners and health educators. Results of pilot studies are encouraging with regard to the feasibility of implementing such programs.

Age Factors↗
PubMed1976

Population cancer screening.

Controlled trials to evaluate mass screening programs for cancer detection have been singularly lacking. High cost, lack of medical manpower, and low yield have contributed to this problem. A new program in cancer detection (CANSCREEN) has been developed jointly by The Fox Chase Cancer Center in Philadelphia and the Preventive Medicine Institute in New York City. This program attempts to provide a quality cancer-detection examination with increased cost effectiveness. Features include: 1) a self-administered questionnaire on medical history, symptoms, and risk factors; 2) nonphysican examiners; 3) risk-facotr analysis with a predetermined decision logic to determine type and periodicity of examination; and 4) primary intervention (health education). This collaborative program between two institutions in two cities demonstrates the feasibility of introducing similar programs elsewhere. A data base shared by cooperating centers permits information on all patients to be used for evaluation of new techniques, end results, etc. A randomized controlled trial has been designed to evaluate the effectiveness and efficiency of the questionnaire alone and of the questionnaire and examination.

Breast Neoplasms↗
PubMed1975

Effect of nutritive and bulk intake on the suppression of food-deprivation polydipsia in the gerbil.

Gerbils which become polydipsic when food-deprived, were refed with mixtures of Laboratory Chow and a non-nutritive material (Sterolit) after 2 days of food deprivation. Suppression of polydipsia was not related to bulk of material ingested. Instead, when the intake of Chow in the mixture reached 6 g, suppression appeared precipitously suggesting the existence of a threshold for suppression. It was concluded that nutritional, rather than stomach fill, factors were primary in suppressing polydipsia on the refeeding day.

Animals↗