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Biomedical subjects

D Miller

Publications and source records attributed to D Miller.

At least 919 records · Page 51Linked to original sources
PubMedDate not supplied

The role of brushing cytology in the diagnosis of gastric malignancy.

The results of endoscopic biopsy and brushing cytology in 234 consecutive patients with established histologic diagnoses of discrete gastric lesions were analyzed. A histopathologic diagnosis of malignancy, established by independent means, was made in 74 patients. Brushing cytology was positive for malignancy in 63, a diagnostic sensitivity of 85%. Endoscopic biopsy was positive in 64, a diagnostic sensitivity of 86%. The sensitivity for combined cytology and biopsy was 91%, which was not significantly greater than for biopsy alone (P = .6). Cytology yielded false-positive results in 5 of 160 patients (3.1%) with confirmed benign disease. There were no false-positive biopsy reports. Although both brushing cytology and biopsy have high diagnostic sensitivities, based on the findings of this study, the routine addition of cytology to biopsy in the endoscopic evaluation of gastric lesions is not recommended. Cytology could be reserved for situations in which difficulty is encountered in obtaining adequate tissue for histologic examination and for cases with a high suspicion of malignancy that have yielded negative biopsies.

Adenocarcinoma↗
PubMedDate not supplied

The effect of cyclosporine, total lymphoid irradiation, and cobra venom factor on hyperacute rejection.

Transplantation into sensitized recipients is contraindicated due to the potential for hyperacute rejection. In order to study the mechanism of hyperacute rejection and the role of immunosuppression in the face of presensitization, we evaluated the effect of total lymphoid irradiation, cyclosporine, and cobra venom factor, alone and in combination, on hyperacute rejection of heterotopic rat heart allografts. Lewis rats were sensitized to strongly RT-1-incompatible ACI rats by three successive skin grafts. Heart allografts were then performed, and survived for a mean period of 15.7 +/- 7.4 hours. Neither preoperative treatment of hypersensitized rats with total lymphoid irradiation alone nor with cyclosporine (5 mg/kg/day) resulted in a prolongation of survival (20.4 +/- 16.6 hours and 35.6 +/- 6.2 hours, respectively). However, complement depletion using cobra venom factor significantly prolonged mean graft survival time to 114.4 +/- 31.0 hours (p less than 0.05). Cyclosporine (10 mg/kg/day) also significantly prolonged survival to 149 +/- 29 hours (p less than 0.01), but did not lower the antibody or complement levels. The addition of total lymphoid irradiation or cyclosporine to treatment with cobra venom factor did not result in longer survival than cobra venom factor alone. In conclusion, cobra venom factor and cyclosporine delay but do not prevent hyperacute rejection, while total lymphoid irradiation has no observable effect on hyperacute rejection.

Animals↗
PubMedDate not supplied

Speech discrimination in children: auditory and auditory/visual processing with binaural and monaural presentation.

The Word Intelligibility by Picture Identification test was recorded with electret microphones inserted at the ear canals of a child listener. This recording paradigm has been shown to preserve binaural cues. Thirty normal-hearing children (ages 6 to 14) responded to binaural and monaural stimulation under auditory and auditory/visual presentation at six signal-to-noise (S/N) ratios (varying from +3 to -12 dB). At the higher and lower S/N ratios, the binaural advantage was minimized. For the auditory alone mode, the largest mean difference of 21% intelligibility improvement from monaural to binaural presentations occurred at -6 dB S/N, whereas in the auditory/visual mode, an intelligibility improvement of 20.8% occurred at -9 dB S/N. Implications for binaural amplification for the hearing impaired who operate on minimal residual hearing follow from the results of this study.

Acoustic Stimulation↗
PubMedDate not supplied

Intensive chemotherapy with daunorubicin, 5-azacytidine, 6-thioguanine, and cytarabine (DATA) for the blastic transformation of chronic granulocytic leukemia.

Thirty patients with blastic transformation of chronic granulocytic leukemia were treated with a combination of daunorubicin, 5-azacytidine, 6-thioguanine, and cytarabine. Hematopoietic toxic effects were substantial and eight of 23 patients developed hepatic dysfunction (bilirubin greater than 5.5 mg/dl). Although the regimen resulted in marked decrease in peripheral blood blast cells and produced marrow hypoplasia in most of the patients (20 of 23), there was little therapeutic benefit. Seven patients died while aplastic, nine had recurrence of blastic leukemia, and only four had partial improvement in marrow function.

Adolescent↗
PubMedDate not supplied

Treatment of advanced squamous cell carcinoma of the head and neck with cisplatin, bleomycin, and methotrexate (PBM).

Twenty-nine of 32 patients with advanced squamous cell carcinoma of the head and neck were treated with two courses of an intensive chemotherapy regimen consisting of cisplatin, bleomycin, and methotrexate (PBM). The frequency of toxic effects (in 29 evaluable patients) associated with this regimen was low. Serious neutropenia occurred in 17% and thrombocytopenia in 10% of the courses. Nausea (50%) and severe vomiting (6%) were easily managed. All 26 (100%) evaluable patients with squamous cell carcinoma had significant reduction (less than 50%) of measurable tumor. Complete regression was noted in seven patients (27%). Fifteen patients were treated with PBM prior to receiving radiation therapy or surgery as definitive treatment for their disease. Antitumor response in these patients was rapid, occurring within 3 weeks from the initiation of chemotherapy. Maximal antitumor effect was achieved by Week 6 of induction chemotherapy. No patient showed tumor regrowth prior to the institution of radiation therapy or surgery. Twelve patients with recurrent disease following previous radiotherapy and/or surgery also received PBM chemotherapy. In our study, previous radiotherapy or surgery did not diminish the antitumor effect of PBM, but toxicity was more severe.

Adolescent↗
PubMedDate not supplied

Reaction of the human tibia to bone wax.

In 12 patients treated by elevation of the tibial tubercle, bone wax was used to prevent bleeding from the cut surface. Biopsy specimens of the tissues obtained at the time of removal of the screws, five to 13 months after the operation, showed a definite foreign body giant cell reaction. Giant cells endocytosed bone wax from the site. The giant cell response culminated in a marked fibrous reaction.

Adult↗