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Biomedical subjects

H C Miller

Publications and source records attributed to H C Miller.

At least 109 records · Page 6Linked to original sources
PubMed1977

The assessment of left ventricular ejection fraction in patients with ischaemic heart disease by contrast ventriculography and nuclear angiography.

1. In 18 patients with ischaemic heart disease left ventricular ejection fraction, measured by two different nuclear angiographic methods, has been compared with ejection fraction measured by single-plane contrast angiography. 2. The first nuclear angiographic technique involves detection of variation in the radio-activity from the left ventricle during the initial passage of a bolus of 99Tcm-labelled human serum albumin injected intravenously; the second is our own modification of a "gated" method, which accumulates the radioactivity detected during the continuing recirculation of the plasma bound radioisotope, so presenting an "averaged" ventricular volume curve. 3. Ejection fraction, measured by the "bolus" method, is lower than that measured either by contrast ventriculography or by the "gated" method. This may be due to a damping effect. 4. Ejection fraction measured by the "gated" method is well correlated with that measured by contrast ventriculography (r = 0-89). 5. Our modification of the "gated" method, which presents the changes in ventricular volume throughout the cardiac cycle, without needing computer facilities, is a useful non-invasive means for assessment of left ventricular function.

Angiography↗
PubMed1977

Closure of a postexstrophy prostatic fistula.

A technique for closure of difficult prostatic fistulas has been used in two patients with exstrophy and epispadias. In this technique, a rotated, twisted full thickness skin flap is used. The tip of the flap forms the roof of the closed fistula and is made out of the epidermis. The pedical of the flap is buried, and therefore, the epidermis is removed, leaving only the dermal layer to be buried. Consequently, there is no tension on the fistula closure, and the chance of breakdown is vastly reduced. The long term results is these two patients has been excellent. In the older child or adult, this technique may provide the only consistent means for achieving such a closure. The technique is obviously adaptable to other situations in which a simple closure is plagued with secondary breakdown.

Adolescent↗
PubMed1976

Fetal growth retardation in relation to maternal smoking and weight gain in pregnancy.

Two types of fetal growth retardation were recognized in term infants. One type was characterized by an abnormally low ponderal index (defined as birth weight in grams X 100 divided by crown-heel length in cubic centimeters.) The other type of growth-retarded infants had abnormally short crown-heel lengths for fetal age. Both types were observed under all conditions studied. However, mothers who smoked cigarettes during pregnancy were more likely to have infants with short body lengths for dates, whereas mothers who had low weight gain in pregnancy were more likely to have infants with low ponderal indices. Social group, prepregnancy weight, parity, marital status, and fetal sex were found to be less determinant of fetal growth than were maternal weight gain and smoking habits.

Birth Weight↗
PubMed1976

Postprostatectomy incontinence: George Washington University technique.

The original concept of external compression on the urethra to provide urinary continence in the male has undergone significant modifications since the original work of Berry fifteen years ago. The technique used at George Washington University is a successful extension of Berry's concept. This article presents a very precise description of the operation. There has been only one failure in 13 patients referred to us, therefore the technique is recommended as an excellent means of correcting postprostatectomy incontinence.

Humans↗
PubMed1976

Socioeconomic factors in relation to fetal growth in white infants.

Over 1,200 white mothers who were delivered consecutively at this medical center were classified in four different socioeconomic classes according to family affluence and occupations of the heat of the household. The frequency of low-birth-weight infants was highest in the lowest socioeconomic class. The high incidence of LBW infants in the lowest socioeconiomic group was not affected by any significant increase in number of mothers with medical problems or medical complications of pregnancy; it was dependent on the large number of mothers who were involved in four specific practices, largely of their own choosing, including low-weight gains, cigarette smoking, use of certain drugs during pregnancy, and refraining from all prenatal care. Mothers in the four socioeconomic classes who were not involved with these four specific practices (smoking, etc.) and whose pregnancies were free of medical problems and complications had uniformly low incidences of LBW infants and the mean birth weights of their infants were uniformly high and not significantly different. Unfavorable outcome of pregnancy with respect to fetal growth in this study appeared to depend less directly on socioeconomic circumstances than on the four specific maternal practices listed above.

Body Weight↗
PubMed1976

Urologic abdominal masses in infants and children.

A series of 167 infants and children presenting with palpable urologic abdominal masses from 1960 to 1973 has been reviewed. The groupings by age at presentation and type of urologic lesion enable us to make certain general statements. Emphasis is placed upon adequate preoperative evaluation in any child with an abdominal mass to avoid unnecessary laparotomy and morbidity.

Adolescent↗
PubMed1976

Genitourinary complications of abdominoperineal resection.

The genitourinary complications of 86 consecutive cases of abdominoperineal resection at the University of Oklahoma Health Sciences Center are described. Vesical dysfunction was the most common problem, occurring in 11 patients in our series. Eight required prostatectomy for urinary retention. The significance and treatment of vesical dysfunction is somewhat controversial, but an attempt to document the cause should be made in every case. Voiding symptoms and results of intravenous urogram with postvoiding films, cystogram, cystometrogram, and cystoscopy are diagnostically pertinent. Accordingly, preoperative urologic evaluation is indispensable to proper treatment of rectosigmoid carcinoma.

Abdomen↗
PubMed1976

Electrophysiologic effects of propranolol on sinus node function in patients with sinus node dysfunction.

The electrophysiologic effects of intravenously administered propranolol (0.1 mg/kg) on three parameters of sinus node function were examined in ten symptomatic patients with sinus node dysfunction. The patients ranged in age from 26 to 79 years. Symptoms ranged from fatigue to frank syncope. Sinoatrial (SA) block and sinus pauses were observed in one patient; sinus pauses alone were observed in three patients. Five (5/10) patients had intraatrial block; three (3/10) patients had atrioventricular block; four (4/10) patients had an intraventricular conduction disturbance. At the time of electrophysiologic study, two patients had a control spontaneous sinus cycle length that exceeded 1000 msec. Following propranolol, the mean spontaneous cycle length increased by 17.4% (924 to 1085 msec, P less than 0.005) and spontaneous second degree SA block reappeared in the one patient. The maximum escape cycle ranged from 116% to 229% of the prepacing spontaneous cycle length and was considered to be prolonged in two of ten patients. Propranolol had no significant effect on the maximum escape cycle/prepacing cycle length X 100 (%). The estimated sinoatrial conduction time (SACT) was determined in seven patients and ranged in value from 120 to 238 mes. Propranolol increased the mean value of the estimated SACT from 179 to 213 msec, P less than 0.025. Propranolol may cause marked bradyarrhythmias in some patients with sinus node dysfunction, and should be used with caution in these patients.

Adult↗
PubMed1976

Membrane expression of Thy-1,2 and GM1 ganglioside on differentiating T lymphocytes.

C3H mouse bone marrow cells were separated by discontinuous BSA gradient centrifugation. Marrow cells from the 17 to 19%, 19 to 21% to 23%, 23 to 25%, 25 to 27% interfaces and the cell pellet were treated with thymic factor (TF) or with Vibrio cholerae neuraminidase (VCN), followed by anti-Thy-1,2 and anti-GM1 ganglioside antisera. Antigens determined by anti-Thy-1.2 or anti-GM1 were expressed either with TF or VCN within a 30-min incubation. Cells expressing these antigens after VCN or TF treatment were concentrated in the 19 to 21% layer and the 21 to 23% layer whereas there was little or no antiserum cytotoxicity in the other layers. A small amount of Thy-1.2 of GM1 could be detected by cytotoxicity on 19 to 21% layer marrow cells within 15 min of either TF or VCN treatment. Treatment of 19 to 21% layer cells with TF or VCN had no effect on anti-H-2 cytotoxicity. Pretreatment of TF-treated marrow cells with cholera toxin or choleragenoid (which bind cell surface GM1) abrogated the cytotoxicity of anti-Thy-1.2 or anti-GM1 without affecting anti-H-2 cytotoxicity. Pretreatment of Thy-1.2 positive C3H thymocytes with cholera toxin or choleragenoid greatly reduced the cytotoxicity of anti-Thy-1.2 antisera without affecting the cytotoxicity of anti-H-2 antisera. Nude mouse splenocytes, after treatment with VCN or TF, were susceptible to the lytic action of anti-Thy-1.2 and anti-GM1. The possibility that nonspecific autologous antibodies were responsible for anti-Thy-1.2 cytotoxicity toward VCN-treated marrow cells was eliminated because anti-Thy-1.2 was not cytotoxic for VCN treated AKR (Thy-1.1) marrow cells.

Animals↗
PubMed1975

George Washington University technique for surgical correction of post-prostatectomy incontinence.

We have described a procedure with long-term followup and modification for the correction of post-prostatectomy incontinence. The procedure involves the combined principle of rigidly placed support under the urethra to which is attached an inflatable, adjustable pillow, allowing for fine control of the urethral resistance. Of the 22 patients treated 16 are completely dry, 4 have occasional dampness and 2 are failures. More significant is the fact that since the silicone gel pillow has been enclosed in the marlex strap we have had 6 successes., 1 partial successs and no failures. The complication rate is almost non-existent. No infections were encountered and no prostheses were removed for other than reoperation. We believe that the combination of bony fixation plus the adjustable pillow gives the best control of the troublsome problem of post-prostatectomy incontinence.

Aged↗
PubMed1975

Digitalis and the sick sinus syndrome. Clinical and electrophysiologic documentation of severe toxic effect on sinus node function.

Digoxin, in a common clinical dose and at a low serum level, brought out severe manifestations of sinus node dysfunction in a patient who had previously undergone successful mitral valve replacement. This report presents the results of extensive clinical and electrophysiologic studies of this patient before and after a digoxin challenge. In the absence of cardiac glycoside, the only demonstrable abnormalities of sinus node function were mild resting sinus bradycardia and failure to respond to atropine administration. Responses to isoproterenol administration, programmed premature atrial stimulation, and overdrive pacing at several cycle lengths were normal. Following the administration of intravenous digoxin, 1.025 mg/24 hrs, the resting sinus cycle length increased and the response to overdrive pacing became markedly abnormal. The latter was followed by sinus pauses in excess of six seconds, even at relatively slow overdrive pacing rates. The electrophysiologic and clinical implications of these data are discussed. It is suggested that despite previous reports that digitalis preparations are relatively well tolerated by patients with sick sinus syndrome, caution should be used when administering these drugs to this group of patients.

Arrhythmia, Sinus↗