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Biomedical subjects

F Miller

Publications and source records attributed to F Miller.

At least 127 records · Page 7Linked to original sources
PubMed1989

Malakoplakia in renal transplantation: an expression of altered tissue reactivity under immunosuppression.

This report describes the successful treatment in a transplant recipient of a case of MK originating from the native urinary tract. As demonstrated, MK may pursue unexpected patterns to which conventional therapeutic guidelines may not be applicable. The type of surgical intervention used must be dictated by the extent and location of the disease and its complications. Withdrawal of immunosuppressive medication was useful in improving the patient's prognosis.

Adult↗
PubMed1988

Correlation of presence of granulomas with clinical and immunologic variables in Crohn's disease.

Approximately 50% of patients with Crohn's disease have epithelioid granulomas present in the diseased intestine. Some studies have associated the presence of granulomas with a good prognosis. In this prospective study, 44 patients with Crohn's disease requiring surgery were followed up for five years. Twenty-two patients (50%) had granulomas. Patients with granulomas were younger and had a shorter duration of disease. They also had more extensive disease and a greater degree of peripheral lymphopenia. Follow-up showed a trend toward greater recurrence rate in the patients with granulomas. It seems that patients with aggressive and extensive Crohn's disease are not protected from the development of symptomatic early recurrence by the presence of epithelioid granulomas.

Adult↗
PubMed1988

Effects of relaxin on the fertilization capacity of human spermatozoa.

Relaxin, a polypeptide hormone found in human seminal plasma, exerted favorable effects on the function of spermatozoa. This study was designed to investigate the effect of this hormone on the fertilization capacity of human spermatozoa from 10 oligospermic men (group A), 11 asthenospermic men (group B), 10 normospermic infertile men (group C), and 10 men with verified fertility (group D). We compared the effects of purified porcine relaxin at different concentrations (0, 50, and 150 ng/ml). Parameters include motility, hypoosmolar swelling test, and zona-free hamster egg penetration test. In group A and group B, relaxin increased the results of the hamster egg penetration test and motility. In group C, results of the hamster egg penetration test and motility improved only at the concentration of 50 ng/ml. In group D, relaxin increased the results of the hamster egg penetration test only at a concentration of 150 ng/ml. Results of the hypoosmolar swelling test were not consistently altered in any study group. Relaxin appears to enhance the fertilization capacity and motility of human spermatozoa in oligospermic and asthenospermic subjects.

Animals↗
PubMed1987

In vitro fertilization and embryo transfer in patients with one ovary.

The purpose of this investigation was to compare follicular response and pregnancy rates in patients with one and two ovaries who have undergone in vitro fertilization (IVF). No statistically significant difference was found in serum estradiol levels on the day of human chorionic gonadotropin administration, mean number of follicles (greater than 15 mm), mean total number of oocytes recovered, mean number of mature oocytes recovered, or number of pregnancies per transfer. The total number of oocytes recovered in the one- and two-ovary groups was 47 and 123, respectively. There was a significantly greater mean number of immature oocytes recovered (1.5 +/- .03 versus 0.5 +/- 0.2, P less than 0.01) and embryos transferred (2.7 +/- 0.3 versus 1.7 +/- 0.3, P less than .04) in patients with two ovaries. Though not statistically significant, a trend was noted in the two-ovary group for a greater number of pregnancies per transfer (9:25 versus 2:14). The authors conclude that single-ovary patients may have a reduced outcome with IVF compared with patients with two ovaries.

Adult↗
PubMed1987

Value of percutaneous core needle biopsy in the differential diagnosis of renal transplant dysfunction.

The value of percutaneous core needle biopsy in the differentiation of rejection from other causes of renal allograft dysfunction, and its subsequent effect on patient management were assessed in 64 consecutive biopsies performed on 34 patients in whom the clinical diagnosis was was uncertain. A complete clinical, biochemical and radiographic assessment was made in each patient before biopsy. Only 1 biopsy (1.6 per cent) yielded tissue inadequate for evaluation, while another biopsy caused a renal artery pseudoaneurysm that ruptured and resulted in graft loss. In 27 of these 64 biopsies (42 per cent) the results differed from the pre-biopsy diagnosis and directly affected patient management, particularly the use of steroids. The remaining biopsy specimens were helpful to confirm uncertain clinical impressions, and allowed accurate counseling for patients and family. Biopsies were of special usefulness in separating acute rejection from complications, such as acute tubular necrosis, cytomegalovirus infections, recurrence of original disease, cyclosporin toxicity and acute superimposed-upon chronic rejection. Of 64 biopsies 22 (34.3 per cent) demonstrated the absence of rejection and 8 demonstrated chronic rejection (12.5 per cent), thereby averting the use of steroids in 46.8 per cent of the patients. All patients with evidence of severe small vessel disease and/or antibody-mediated rejection eventually lost the grafts, including 2 with cytomegalovirus glomerulopathy who also suffered such vascular changes. These data highlight the extreme usefulness of needle biopsy in the evaluation and management of renal allograft dysfunction.

Biopsy, Needle↗
PubMed1987

Effect of hemorrhagic reduction in blood pressure on recovery from acute renal failure.

The effect of hemorrhagic reduction in systemic blood pressure (SBP) to 90 mm Hg for four hours on autoregulation of renal blood flow (RBF), renal function, and renal histology was examined in control rats, one week norepinephrine-induced acute renal failure (NE-ARF) rats with intact renal nerves, and one week NE-ARF rats with prior renal denervation. The results showed that in control rats, hemorrhagic SBP reduction to 90 mm Hg had no effect on autoregulation of RBF (autoregulatory index = 0.09 +/- 0.02), creatinine clearance, or renal histology. However, in one week NE-ARF rats with intact renal nerves, hemorrhagic reduction in SBP to 90 mm Hg was associated with marked impairment of autoregulation of RBF (autoregulatory index = 3.49 +/- 0.25), further reduction in creatinine clearance from 0.59 +/- 0.08 ml/min to 0.36 +/- 0.14 ml/min, and histologic evidence of recurrent ischemic injury. Renal denervation prior to SBP reduction improved autoregulation of RBF (autoregulatory index = 0.30 +/- 0.09), prevented the further reduction in creatinine clearance, and significantly ameliorated the deleterious effect on renal histology seen in innervated NE-ARF rats. These results suggest the potential importance of the loss of autoregulation of RBF on the course of NE-ARF, and further support the pathogenetic role of renal nerves in the loss of autoregulation.

Acute Kidney Injury↗
PubMed1987

Immunohistologic analysis of human renal allograft dysfunction.

The value of percutaneous core needle biopsy in the immunohistological evaluation of renal allograft dysfunction was studied in 72 consecutive biopsies performed in 42 patients. The phenotypes of infiltrating cells mediating graft destruction were identified with monoclonal antibodies and immunoperoxidase staining techniques. Light microscopy, electron microscopy, and immunofluorescence staining were performed in all biopsies. Biopsies were divided into groups depending on their classification on the basis of standard histologic criteria, i.e., acute tubular necrosis (ATN), acute interstitial rejection, acute vascular rejection, chronic rejection and renal disease in native kidneys (RDNK) of nontransplant patients. Immunohistologic analysis of graft biopsies showed a significant increase in Leu 1 (pan-T cells), (P less than 0.001), Leu 2 (cytotoxic/suppressor cells) (P less than 0.001), and Leu 3 cells (P less than .05) in acute interstitial rejection. The expression of DR antigen was significantly increased in both acute (P less than .025) and chronic (P less than .05) rejection, when compared with the findings in ATN biopsies. Leu M1 (monocytes/activated T cells) and Leu 10 (B cells/macrophages) were significantly increased (P less than 0.05 and P less than .005, respectively) in acute interstitial rejection only. The helper/suppressor ratio of infiltrating cells showed no significant change in any clinopathologic category. There was no correlation between the cell populations infiltrating the graft and those monitored in the peripheral blood. Allograft mononuclear cell infiltrates in cyclosporine (CsA) vs. azathioprine-treated patients revealed significantly fewer Leu 2 (P less than .05) and Leu M1 (P less than .05) cell populations in CsA patients during acute rejection. In 32 of these 72 biopsies (44.4%), the biopsy results provided a direct contraindication to the use of steroids, by allowing differentiation between allograft rejection and other causes of graft dysfunction. A total of 38% of the biopsies yielded a histological diagnosis that contradicted the clinical pre-biopsy diagnosis. All allografts showing evidence of severe small vessel disease and/or antibody-mediated rejection eventually were lost. These data highlight the usefulness of needle biopsy material as a guide to the study of intragraft immune events and to clinical management of recipients.

Acute Kidney Injury↗
PubMed1987

Unrecognized drug dependence in psychiatrically hospitalized elderly patients.

The psychiatric in-patient records of 90 patients greater than or equal to 65 years of age were reviewed retrospectively to determine the prevalence of chemical dependence and if lack of recognition and treatment of chemical dependence resulted in serious complications. Nineteen of the 90 patients were characterized as drug dependent and ten of these patients were neither recognized nor detoxified. Seven of the ten nondetoxified patients, but only one of the nine detoxified patients, experienced serious medical complications typically requiring transfer to a medical floor or medical intensive care unit. Unrecognized chemically-dependent patients were significantly more likely to be female benzodiazepine abusers, while recognized chemically dependent patients were significantly more likely to be male alcohol abusers.

Aged↗
PubMed1987

The relation of delusional content in psychotic depression to life-threatening behavior.

A retrospective analysis of all medically serious suicide attempts made by 45 patients hospitalized consecutively at the Payne Whitney Clinic with the DSM-III discharge diagnosis of Unipolar Major Depression, Recurrent, With Psychotic Features was undertaken. Patients with delusions of bodily disease, damage, and malfunction were significantly less likely to make medically serious suicide attempts than patients with delusions of sinfulness, guilt, deserved punishment, or persecution.

Adult↗
PubMed1987

Reactivity of monoclonal anti-human pancreatic carcinoma antibodies AR2-20 and AR1-28 with tumors of nonpancreatic origin.

The reactivity of two IgG1 murine monoclonal antibodies, AR2-20 and AR1-28 directed against the RWP-1 and RWP-2 human pancreatic cell lines was evaluated with paraffin sections of nonpancreatic human carcinomas. These monoclonal antibodies, which are directed against a 200-kd glycoprotein, and which did not stain normal tissues, were both reactive with 6 of 116 neoplasms (6 of 103 carcinomas) by indirect immunofluorescent histochemistry. This contrasts with the positive incidence of staining obtained with 29 of 34 human pancreatic adenocarcinomas. The two antibodies have specificities different from those previously described that reacted with pancreatic neoplasms. The significance of these findings is discussed with respect to the use of these antibodies in a diagnostic panel.

Antibodies, Monoclonal↗
PubMed1987

Lithium-neuroleptic neurotoxicity is dose dependent.

Lithium-neuroleptic combination treatment was studied retrospectively. Six of 22 manic patients who were administered the combination developed neurotoxicity. The dosage of neuroleptic administered, and not the serum lithium level or lithium dose, predicted which patients became neurotoxic.

Adult↗