Search PubMed⌕ Search

Biomedical subjects

F Miller

Publications and source records attributed to F Miller.

At least 109 records · Page 6Linked to original sources

The neuromuscular pathology of the Eosinophilia-Myalgia syndrome.

The Eosinophilia-Myalgia Syndrome (EMS) is a recently reorganized disorder in patients ingesting pharmacologic doses of L-tryptophan. We studied the lesions of skeletal muscle, peripheral nerve and skin in 12 cases of EMS. Perimyositis was severe in four, moderate in two, mild in three and absent in three cases. The lesions contained many eosinophils, T-helper cells, mast cells and activated macrophages. Type 2 myofiber atrophy was present in five cases and in one, this was the only pathologic finding. Severe epineurial inflammation was seen in the three sural nerve biopsies. Indirect evidence for peripheral neurologic involvement in three other cases consisted of inflammation surrounding intramuscular nerve twigs (two cases) and neurogenic atrophy (one case). Phlebitis accompanied the connective tissue inflammation in five cases and endarteritis in one. Fasciitis was present in three of four skin biopsies and dermal fibrosis in one.

Adult↗

Evidence for keratin proteins in normal and abnormal human meibomian fluids.

Hyperkeratinization of meibomian glands has been postulated to cause gland dysfunction. Recent investigations on rabbits show that keratin proteins are indeed present in the meibomian fluids of these animals. In this report we present our findings on the presence of these water-insoluble proteins in human meibomian secretions. 6 anti-cytokeratin antibodies, CK8, 18, 19, CK7, CK8, CK14, CK19 and AE1/AE3 were used against the keratin proteins expressed from the human meibomian fluids. Using the immunoblotting (dot blot) technique, abnormal waxy meibomian fluids obtained from subjects diagnosed to have meibomian gland dysfunction (MGD) were compared to normal clear meibomian fluids. The results show that keratins are present in a higher concentration (10%) in the abnormal human meibomian excreta as compared to the normals. Even though the presence of protein markers for keratinization in the abnormal meibomian excreta were not shown, the increased presence of keratin proteins in the abnormal meibomian fluids suggests that, in MGD patients, hyperkeratinization of ductal epithelium may have taken place. More keratin proteins (possibly those of higher molecular weights) were produced in addition to the keratin proteins normally produced by the duct epithelium. The increased amount of keratin proteins in the abnormal meibomian fluids may be explained by the susceptibility of duct epithelium to undergo the process of hyperkeratinization as postulated by other researchers.

Antibodies, Monoclonal↗

Significance of DNA content abnormalities in small rectal cancers.

Several studies have shown that the presence of DNA content abnormalities, measured by flow cytometry, may correlate with a poor prognosis in a variety of cancers. The predictive value of DNA content in patients with small rectal cancers has not been well determined. Thirty-nine patients with primary rectal adenocarcinoma smaller than 3 cm were studied in a comparison of DNA content with established prognostic variables. The following covariates were evaluated for their prognostic value: sex, age, tumor size, location, distal margin, Dukes' classification, tumor differentiation, and DNA content. DNA content was assessed by flow cytometric analysis, and each tumor was categorized as diploid or nondiploid. Of the parameters studied, Dukes' classification and tumor DNA content were found to be independent prognostic indicators. Determination of DNA content seems to provide additional useful prognostic information in patients with small rectal tumors.

Adenocarcinoma↗

Multivariate and Boolean factor analysis of immune complex/complement deposits and their effects on renal blood flow during allograft rejection.

The role of humoral immune factors in graft destruction is not fully understood. With immunofluorescence techniques the possibility of a specific pattern and/or clustering of immune complex or complement deposits was analyzed in 140 percutaneous kidney needle biopsies performed in 73 patients with renal allograft dysfunction. The results were correlated with concomitant alterations in renal blood flow as measured by cortical and global perfusion indexes and graft survival. The deposition of IgG, IgM, C3 and C4 correlated significantly with acute rejection confirmed by biopsy (p less than 0.05, less than 0.001, less than 0.02 and less than 0.001, respectively). Subsequent graft survival was compromised when IgA, IgG, IgM, C3, C4 and properdin were present together in biopsy specimens (p less than 0.05). There was a significant clustering of IgA with C3, of IgG with C3 and C4, and of IgM with C1, C3 and C4 (p less than 0.001). There also was a significant association among alterations in renal blood flow, deposition of IgA (p less than 0.05) and C4 (p less than 0.02), and graft outcome. Higher perfusion indexes, indicative of decreased blood flow, showed significant associations (p less than 0.007 and less than 0.04 for the cortical and global perfusion indexes, respectively) with a greater risk of graft loss. Although it primarily is a cellular event, the data suggest that acute rejection is associated with a deposition of various humoral factors that may mediate alterations in renal blood flow. The latter may affect graft function and structural integrity, and, thus, may show a direct correlation with the outcome of a graft.

Antigen-Antibody Complex↗

A preliminary study of unresolved grief in families of seriously mentally ill patients.

Investigations of the grief reactions experienced by families when a relative develops a serious mental illness have been hampered by the lack of an appropriate instrument to measure such reactions. The authors devised the Mental Illness Version of the Texas Inventory of Grief, adapted from the Texas Revised Inventory of Grief, to assess family members' initial and present feelings about their relative's loss of mental health. A test of the instrument with 58 family members of patients with schizophrenia or bipolar disorder revealed a surprisingly low level of initial grief but higher levels of present grief.

Adaptation, Psychological↗

Pelvic anatomy relative to lumbosacral instrumentation.

Anatomical study of 72 pelves revealed that the most substantial area of bone that could best support a rod for surgical fixation is the body of the ilium, with the best part of the bone being the area above the sciatic notch. Placement of the rods into the body of the ilium provides good fixation but requires complex bending of the rods and a good three-dimensional perception of the osseous anatomy of the pelvis. This study was undertaken to define the intraosseous anatomy and the range of anatomical variation of the ilium. The results of this study are useful in developing a prebent spinal fixation rod, providing a better understanding of this anatomical area from a three-dimensional perspective and providing better lumbosacral spinal instrumentation.

Anthropometry↗

Economic impact of motor vehicle restraints in Kentucky: a trauma center's experience.

Motor vehicle seat belts save lives and decrease the cost of care. Victims involved in motor vehicular accidents requiring ED evaluation and in-patient care were evaluated for seat belt usage. In addition to outcome parameters, the economic impact was assessed. During the five month study period, 38 (14%) restrained drivers and 238 (86%) unrestrained drivers were entered. Unrestrained drivers were more likely to be killed or disabled. The average cost of medical care for unrestrained drivers ($18,165) was significantly higher than that for restrained drivers ($7,634) (p less than .02). Twenty-eight percent of the unrestrained drivers' bills were paid with public funds. Assuming mandatory seat belt legislation would alter usage patterns as demonstrated in other states, the Commonwealth of Kentucky could save not only lives but millions of tax dollars.

Accidents, Traffic↗

Influence of parental age on degree of curvature in idiopathic scoliosis.

One hundred and seventy-seven patients who had adolescent idiopathic scoliosis were followed from the time of the initial evaluation to skeletal maturity or arthrodesis. At that time, we analyzed the degree of curvature to determine if it was related to parental age at the time of the patient's birth. Patients who were born to mothers who were twenty-seven years old or more had a mean curve of 35.2 degrees, which was significantly greater (p = 0.02) than that of patients whose mothers were younger than twenty-seven years, who had a mean curve of 30.4 degrees. More patients whose mothers were twenty-seven years old or older ultimately needed arthrodesis than did those whose mothers were younger than twenty-seven years (26 compared with 12 per cent). Therefore, a maternal age of twenty-seven years old or more is a risk factor for greater progression of the curve and indicates a potential need for arthrodesis. No difference in the degree of curvature was seen when the patients were grouped according to paternal age.

Adolescent↗

Eosinophilic neuritis, perimyositis, and vasculitis associated with ingestion of L-tryptophan.

Four cases are described of a clinical syndrome which developed in the setting of L-tryptophan ingestion. The major manifestations consisted of myalgias, neuropathy, weakness, and profound eosinophilia. Pathologically a vasculitis involving predominantly small veins was observed along with a mixed cellular infiltrate in the perimysium and epineurium. Clusters of eosinophils were characteristically noted in the tissue specimens. The clinical course appears to be chronic although further longterm followup will be required. One patient pursued a relentless downhill course with progressive neurologic impairment and death. Although the mechanism of tissue injury in these individuals is speculative, the possible association of this widely used nonprescription medication with this syndrome should be recognized.

Administration, Oral↗

Prognostic significance of DNA content abnormalities in young patients with colorectal cancer.

Several studies have shown that the presence of DNA ploidy abnormalities, measured by flow cytometry, may correlate with a poor prognosis in a variety of cancers. The predictive value of these DNA abnormalities in young patients with colorectal cancer has not been well studied. Fifty patients aged 40 years and younger with colorectal adenocarcinoma were studied to determine the correlation of tumor DNA abnormalities with survival. DNA content was determined by flow cytometric analysis and each tumor was categorized as diploid or nondiploid. Of the parameters studied, Dukes' classification and tumor DNA ploidy were found to be significant prognostic indicators. Determination of DNA content seems to provide additional useful prognostic information in young patients with colorectal cancer.

Adenocarcinoma↗