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Biomedical subjects

H I Miller

Publications and source records attributed to H I Miller.

At least 109 records · Page 6Linked to original sources

Chronic caffeine intake alters the composition of various parts of the brain in young growing rats.

Time-pregnant rats were fed a regular laboratory diet until delivery. Litters delivered within an 8-hour period were combined and 8 randomly selected pups were assigned to each dam. Dams were then divided into two groups. Group I received a 20% protein diet. Group II was pair-fed to group I with a 20% protein diet containing caffeine (1 mg/100 g body weight) until day 22 postpartum. On weaning (day 22), only male pups were selected and fed the 20% protein or 20% protein + caffeine diet according to which diet their respective dams had been fed. On day 43, rats were killed and the brains were divided into 6 different areas. DNA, RNA, protein and cholesterol contents were measured. Caffeine supplementation resulted in a decrease in the total brain weight, and DNA and RNA content. DNA value of cortex-midbrain was smaller in the caffeine group whereas the values of medulla oblongata and striatum were greater in comparison with the controls. Caffeine's effects on RNA included an increase in the cerebellum, cortex-midbrain and hippocampus and a decrease in the medulla oblongata. Protein content of cerebellum was increased and of hippocampus decreased due to caffeine supplementation. Cholesterol content of the medulla oblongata and hippocampus was less in the caffeine group than in the control group. The present study shows that chronic caffeine intake during rapid periods of growth influences various parts of the brain in entirely different biochemical manners.

Animals↗

Atrial fibrillation and atrial enlargement in patients with mitral stenosis.

The present study was designed to assess the relative contribution of atrial fibrillation and left atrial pressure to changes in the size of the left and right atria in patients with mitral stenosis. The study included 155 subjects, 102 of whom underwent prospective echocardiography and Doppler cardiography, and 69 of whom underwent cardiac catheterization. The size of the atria was determined by two-dimensional echocardiography. There were no significant hemodynamic differences between patients with mitral stenosis who were in either sinus rhythm or atrial fibrillation. The left atrium was larger (p less than 0.001) in patients with mitral stenosis and atrial fibrillation (37.6 +/- 10.8 cm2) than in patients in sinus rhythm (27.8 +/- 7.7 cm2) or normal subjects (15 +/- 3.3 cm2). The size of the right atrium was larger (p less than 0.001) in patients with mitral stenosis and atrial fibrillation (21.7 +/- 5.2 cm2) than in patients in sinus rhythm (13.4 +/- 3.9 cm2) or normal subjects (13.8 +/- 3.7 cm2). Multiple regression analysis showed that the severity of mitral stenosis accounted for 38%, age for 7%, and atrial fibrillation for 11% of the change in the size of the left atrium. Atrial fibrillation accounted for 24%, age for 11, and mitral valve area for 3% of the change in the size of the right atrium. The analysis suggests that the onset of left atrial dilatation in mitral stenosis is the result of an early increase in left atrial pressure. Atrial fibrillation, which develops irrespective of the severity of the mitral stenosis, contributes to a further enlargement of the left and right atria.

Adult↗

Early intervention in acute myocardial infarction: significance for myocardial salvage of immediate intravenous streptokinase therapy followed by coronary angioplasty.

Sixteen patients with acute myocardial infarction underwent treatment with streptokinase up to 3 hours after the onset of chest pain. Nine patients (group I) received streptokinase within 1 hour of the onset of pain, and seven patients (group II) received it within 2 to 3 hours. All underwent multigated radionuclide ventriculography after streptokinase therapy and 1 week later. Percutaneous transluminal coronary angioplasty of the infarct artery was performed within 24 hours in all patients. An effort-limited treadmill stress test was performed before discharge. There was no mortality or serious complication. Mean peak total creatine kinase was 521 +/- 289 mU/ml in group I, and 1,614 +/- 709 mU/ml in group II (p less than 0.05). The mean initial left ventricular ejection fraction was 47 +/- 11% in group I and 37 +/- 10% in group II. After early angioplasty (within 24 hours) and at 1 week recovery, left ventricular ejection fraction increased to 53 +/- 9% in group I (p less than 0.05) and to 40 +/- 7% in group II (p = NS). Seven of the nine patients in group I had normal radionuclide ventriculograms at discharge compared with none of the seven patients in group II. Thrombolytic therapy administered less than 1 hour after the onset of symptoms of acute myocardial infarction followed by angioplasty of the infarct artery results in preservation of left ventricular function, whereas therapy given after 2 hours has only a limited effect.

Adult↗

Overproduction of Escherichia coli integration host factor, a protein with nonidentical subunits.

Integration host factor (IHF) is a small, basic protein that is needed for efficient recombination of bacteriophage lambda, as well as for other host and viral functions. We have constructed strains in which the two subunits of IHF, encoded by the himA and hip genes of Escherichia coli, are expressed under the control of the lambda rho L promoter. Separate overexpression of himA and hip led to the production of unstable and insoluble peptides, respectively. In contrast, the overexpression of both genes conjointly led to the accumulation of large amounts of active IHF. Extracts of such cells provided the starting material for a rapid purification procedure that results in milligram quantities of apparently homogeneous IHF.

Bacterial Proteins↗

Anomalous origin of the right coronary artery from the ascending aorta. Diagnosis by digital subtraction angiography.

The anomalous origin of a coronary artery often poses diagnostic difficulties at angiography. The right coronary artery is more rarely affected than the left. A patient is presented in whom the right coronary artery arose from the ascending aorta. The diagnosis of this rare anomaly was facilitated by the use of digital subtraction aortography and allowed selective angiography of the artery with an appropriately shaped catheter.

Angiography↗

Percutaneous transluminal coronary angioplasty as a cause of isolated right ventricular infarction.

Acute myocardial infarction is a recognized major complication of percutaneous transluminal coronary angioplasty (PTCA). Isolated right ventricular infarction is rare. A 60-year-old patient underwent PTCA 24 h following clinically successful thrombolytic therapy for an acute occlusion of a dominant right coronary artery. Following successful PTCA of this artery, a right ventricular branch was noted to be occluded. This was associated with chest pain, elevated venous pressure, S-T segment elevation in ECG leads V1-3, and a transient rise in serum creatine kinase. The clinical course was uneventful and a week later the right ventricular ejection fraction had increased from 18 to 36%. The long-term effects of right ventricular infarction are benign and occlusion of a right ventricular branch during PTCA is rarely of clinical significance.

Angioplasty, Balloon↗

Effect of chronic caffeine intake on myocardial function during early growth.

The purpose of these studies was to evaluate the effects of chronic caffeine ingestion on the myocardium during fetal and neonatal growth and development. The isolated perfused working heart preparation was used to evaluate cardiac function. During gestation and lactation, one group of dams consumed a caffeine supplemented diet (10 mg/kg/day). Their offspring were sacrificed and the hearts analyzed 50 days after birth. We found that the intake of caffeine by the dams resulted in significant increases in the offspring's coronary flow, peak systolic pressure, and myocardial work. A second group of dams ingested a diet containing caffeine (10 mg/kg/day) during lactation only. Their pups continued to consume the caffeine diet until 50 days. Pup hearts exhibited significant reductions in cardiac output, stroke volume, pressure development, myocardial work, and external efficiency when compared to controls. Caffeine did not affect body or heart weight or adipose size or number in these experiments. Thus, continued caffeine consumption following birth may alter cardiac performance of the offspring.

Adipose Tissue↗

Resuscitation fluid composition and myocardial performance during burn shock.

The present study examines the effects of resuscitation fluid composition on myocardial function, myocardial high-energy phosphate content, and survival following third-degree anesthetic burn to 35-40% body surface area in the guinea pig. Treatment regimens used were 1) no resuscitation, 2) isotonic saline, 3) Ringer's lactate and 4) Ringer's acetate. Fluids were administered at the rate of 0.334 ml/kg/hr/% burn for 4 hr following injury, at which time myocardial function was assessed. Nonburned animals served as controls. In isolated working hearts, significant depression of myocardial function was observed in nonresuscitated and saline-resuscitated animals as evidenced by decreased cardiac output, dP/dt, -dP/dt, and stroke work. Lactate resuscitation produced some improvement in these parameters but did not restore them to those of nonburned control animals. In contrast, Ringer's acetate resuscitation resulted in normal cardiac output and contractility. Myocardial ATP content of hearts obtained from the various resuscitation groups did not differ from that of nonburned control hearts, except for hearts from Ringer's lactate group, which were significantly lower in myocardial ATP than those of the other groups. No differences were found in creatine phosphate content. Resuscitation with the different fluid regimens for 48 hr produced significant differences in survival. Fluids were given at the rate of 4 ml/kg/% burn for 24 hr. Half of the fluid was given in the first 8 hr and the rest during the remaining 16 hr. Nonresuscitated and saline-resuscitated animals showed significant mortality by 24 hr, whereas lactate- and acetate-treated animals had survival rates of 100% and 87.5%, respectively. However, by 48 hr, only acetate-treated animals survived. These data indicate that important differences exist in the effectiveness of different resuscitation fluids and that Ringer's lactate, the fluid most often utilized clinically, may not provide optimum benefit. In light of these results, serious consideration should be given to the substitution of acetate for lactate during the resuscitation of burn shock patients.

Animals↗

High frequency electrocardiography using an advanced method of signal averaging for non-invasive detection of coronary artery disease in patients with normal conventional electrocardiogram.

The ability to detect coronary artery disease (CAD) in patients with normal, conventional electrocardiograms (ECG) was studied using high frequency electrocardiography and an advanced method of signal averaging in three groups of subjects. Group A consisted of ten healthy subjects under the age of 30; Group B of 15 patients with chest pains and normal coronary arteries; and Group C of 20 patients with chest pains and CAD. Four hundred ECG waveforms from leads V3, V4 and V5 were recorded, and the recorded analog data were digitized. The digitized waveforms were averaged using a cross-correlation function which operates in the frequency domain (fast-Fourier transform algorithm). The signals were filtered with a digital band pass filter with 150 and 250 Hz low and high cut-off frequencies, respectively. Zones of reduced amplitude in the envelope of the filtered QRS complex of at least two precordial leads were found more significantly in patients with CAD (75%) than in patients without CAD (12% for Groups A and B, p less than 0.00003). However, no significant difference was found between the voltage over the high frequency QRS complex and that of its envelope between the three groups. It is concluded that the morphology of the high frequency QRS complex as determined by this advanced method of analysis of the signal averaged ECG may be a useful indicator for the presence of CAD in patients with normal conventional ECG's.

Adult↗

Transcatheter electrical shock ablation of ventricular tachycardia.

Transcatheter shock ablation of ventricular tachycardia was attempted in seven patients who had drug-resistant ventricular tachycardia and in one patient in whom ventricular tachycardia was electrophysiologically induced during therapy with multiple antiarrhythmic drugs. Seven patients had previous myocardial infarction and five of them were high risk candidates for surgical therapy. One patient without organic heart disease had repetitive ventricular tachycardia manifesting two different patterns of left bundle branch block. After endocardial mapping, synchronized unipolar 250 to 300 J shocks (one to six) were delivered between the pole recording the earliest endocardial activity during ventricular tachycardia (40 to 200 ms before the onset of the QRS complex) and a body surface electrode. Immediate complications included severe but reversible cardiogenic shock (one patient), nonclinical ventricular tachycardia (two patients, requiring cardioversion in one), transient atrioventricular and intraventricular conduction disturbances (three patients) and permanent left bundle branch block (one patient). A late complication in one patient, left heart failure, occurred 3 days after delivery of five intracardiac shocks. In two patients, left ventricular ejection fraction markedly decreased and in one of them new ventricular contraction abnormalities appeared. Clinical ventricular tachycardia did not recur in five of the seven post-myocardial infarction patients after 7 to 17 months, and it was not inducible in the four patients undergoing late electrophysiologic study. In the patient with idiopathic ventricular tachycardia, one of the configurational types of ventricular tachycardia recurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗