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Biomedical subjects

K Miller

Publications and source records attributed to K Miller.

At least 559 records · Page 31Linked to original sources
PubMed1986

Multimodal treatment (extracorporeal shock wave lithotripsy and endourology) of complicated renal stone disease.

From October 1983, (installation of the extracorporeal shock wave lithotripsy unit) to August 1985, 207 patients presented at the Katharinenhospital Stuttgart with complicated renal stone disease (70 borderline stones, 77 partial and 60 complete staghorn calculi). 197 patients were treated with the new technology for urinary stone therapy, i.e. extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCN), and ureterorenoscopy. The combination of PCN and ESWL proved to be the optimal therapeutic approach in the majority of cases (44%), particularly for partial and complete staghorns, whereas PCN or ESWL monotherapy are indicated for borderline stones (51% ESWL, 26% PCN, 20% combination, 3% surgery) and selected cases of staghorn calculi only. Based on this treatment policy (minimal invasiveness and morbidity), 75 patients with partial staghorn (21% ESWL, 28 PCN, 44% combination, 7% surgery) and 52 cases of complete staghorn stone (2% ESWL, 13% PCN, 74% combination, 11% surgery) have been treated successfully. The rate of major complications was low (2.5% septicemia, 2% major renal hemorrhage, 0.5% mortality). With this new concept of multimodal therapy (ESWL and endourology), even cases of malignant stone formation ('stone cancer') may be treatable, since these methods can be applied repeatedly without damaging the renal parenchyma.

Adolescent↗
PubMed1986

Extracorporeal shockwave lithotripsy of distal ureteral calculi.

To date, the use of extracorporeal shockwave lithotripsy (ESWL) has been limited to renal calculi and ureteral calculi above the pelvic brim. Modifying the position of the patient on the support of the Dornier lithotripter HM3, we were able to localize and treat distal ureteral calculi. Until April 1986, 43 patients with stones in the lower ureter underwent contact-free lithotripsy. Treatment was successful in 39 patients (90%), 2 of these requiring 2 sessions. In 4 patients treatment failed and stone removal was accomplished using ureteroscopy or open surgery. No complications or adverse side effects were encountered in the whole series. ESWL is now the method of choice for the treatment of distal ureteral calculi in our department.

Adult↗
PubMed1986

Cutaneous cholesterol emboli with infarction clinically mimicking heparin necrosis--a case report.

Cutaneous necrosis secondary to anticoagulation (heparin and warfarin) and cholesterol (atheromatous) emboli can be similar clinically and histologically. A unique case is reported of cholesterol emboli clinically mimicking heparin necrosis. The patient was a 57 year old white male who underwent coronary angioplasty and was treated with intravenous heparin. Shortly after he developed large ecchymotic areas at the level of the umbilicus and distally which progressed to eschar. Renal failure ensued and he died secondary to stress ulcers. Cholesterol emboli were demonstrated in small muscular arteries of the dermis and panniculus along with a full thickness infarct. Because of the increasing popularity of angioplasty utilizing a retrograde femoral approach plus heparin anticoagulation, it is important to recognize the difficulty in making a clinical diagnosis when cutaneous necrosis supervenes. An incisional biopsy of the skin is recommended.

Angioplasty, Balloon↗
PubMed1986

Frequency and efficacy of pelvimetry: Saskatoon experience.

The pelvimetry rate in Saskatoon for the period 1979-1981 was low in comparison with published rates. Pelvic measurements alone are poor predictors of the outcome of labor. Management usually proceeded independently of these measurements. There was substantial variability among ten different observers in measuring the same set of pelvimetry films.

Canada↗
PubMed1986

Enalapril: a well-tolerated and efficacious agent for the paediatric hypertensive patient.

Enalapril, either alone or with a diuretic, was administered to 14 children with various renal diseases and hypertension. Five were transplant recipients on immunosuppressive agents. No adverse clinical or laboratory experiences were encountered. Renal function improved in seven children. Normal blood pressure for age was achieved in all 14 children. However, eight children required the addition of a diuretic. In four children blood pressure remained normal despite a reduction in the dose of enalapril. Enalapril was efficacious as a once per day agent. Concomitant ingestion of food did not attenuate the blood pressure-lowering effect of enalapril.

Adolescent↗
PubMed1985

Incidence of strabismus in neonates.

In an attempt to learn whether esotropia is present at birth or develops later in infancy, we observed 1,219 alert infants in a normal newborn nursery at a city hospital. Of these, 593 (48.6%) had orthotropic findings; 398 (32.7%) had exotropia, 40 (3.2%) had esotropia (intermittent in 17 with 14 varying between esotropia and exotropia and nine with a variable esotropia), and 188 (15.4%) were not sufficiently alert to permit classification. No infant displayed typical signs of congenital esotropia. We concluded that congenital-infantile esotropia is not connatal but rather develops in the first few weeks or months after birth.

Eye Diseases↗
PubMed1985

Unilateral esotropia after enucleation in infancy.

Five patients developed esotropia in the remaining eye after unilateral enucleation in the first few weeks to months of life. Esotropia was associated with a face turn toward the opposite side and abduction nystagmus with a null point in extreme adduction. Our experience with these patients supports the reflexogenic theory for the development of a type of congenital-infantile esotropia. An intact globe-ocular muscle relationship, even in a blind eye, may have a stabilizing effect on the fellow eye in the first few weeks to months of life, and this should be considered before enucleation is done.

Cataract Extraction↗
PubMed1985

Visual function and academic performance.

Evaluation of 1,910 first-, second-, and third-grade students indicated that visual function and academic performance as measured by reading were not positively related. Visual function tests included visual acuity, muscle balance, preferred eye and hand, color vision, refraction, sensory and motor function, and a writing and drawing task. Academic tests included the Metropolitan Readiness Test, the Cognitive Abilities Test, the Iowa Test of Basic Skills, and the teacher's assessment of reading level. A simple test which can be completed during the office visit and interpreted by the ophthalmologist in the office included drawing, copying, and writing. A segment of this test, the "draw a bicycle test," can be used by an ophthalmologist to demonstrate the difference between vision and performance when examining a child up to third-grade level who is referred because of school failure.

Accommodation, Ocular↗
PubMed1985

Purification and characterization of cultures of oligodendroglia from rat brain.

It is possible to purify small dark cells from rat brain which by ultrastructural criteria are oligodendroglia. The modified technique involves the use of an isolation medium less damaging to the initial cell suspension and then differential plating of a stratified primary cell culture obtained from 1-3-day-old rat brain which has been described. Five percent serum encourages the growth of oligodendroglia. In this system, the oligodendroglia can be harvested several times from the primary cultures. To retain the homogeneous populations of oligodendroglia, it is necessary to constantly manipulate the cultures by hitting the flasks and replating the suspended cells. Electron microscopy reveals that the small dark cells are differentiated oligodendroglia with prominent microtubules. Immunofluorescence staining of the cells shows that the majority of the cells are negative for known surface markers which include cerebrosides and 04 antigen (markers for oligodendroglia), glial fibrillary acidic protein, and fibronectin. Interestingly, it is possible to increase the number of 04-positive cells by the addition of dibutyryl cyclic AMP to the medium. Rat oligodendroglia are able to incorporate about 20% of the radioactivity into cerebrosides, using the substrate, [3H]galactose; this is a biochemical feature unique to oligodendroglia. The expression of all the oligodendroglial antigens should be remarkably enhanced when the cells are induced to produce myelin.

Animals↗
PubMed1985

Levels of sulfatide synthesis distinguish oligodendroglia in different stages of maturation.

In the central nervous system, oligodendroglia elaborate extensive quantities of membranes to form the multilamellar myelin sheath. Whether the production of extensive networks of processes by oligodendroglia in culture is a similar type of phenomenon as the formation of myelin is an unanswered question. Rat oligodendroglia, prepared by a modification of a differential shaking and plating method, elaborate extensive processes in culture. In contrast, bovine oligodendroglia, obtained by a bulk-isolation method, produce whorls of membrane lamellae, adjacent to the cell soma. The incorporation of various radiolabeled substrates into specific lipids was compared with the two cell types. It was found that rat oligodendroglia do produce myelin specific lipids, but at a lower level than bovine oligodendroglia which are actively synthesizing myelin lipids, especially cerebrosides, from a variety of substrates. Interestingly sulfatides are produced at a higher level in the cells not producing myelin, rat oligodendroglia. Other lipids that are associated with myelination (cerebrosides with alpha-hydroxy fatty acids and phosphatidylinositides) are produced at higher levels in bovine oligodendroglia. Thus it appears that the extension of processes by oligodendroglia in culture is a different phenomenon than the production of myelin membranes and requires lower levels of myelin lipids.

Animals↗
PubMed1985

Immunological consequences of dioctyltin dichloride (DOTC)-induced thymic injury.

Inbred rats fed diets containing 75 ppm dioctyltin dichloride (DOTC) for 8 or 12 weeks demonstrated marked reduction in thymic weight. This reduction was accompanied by a decrease in the number of W3/25 positive phenotypic circulating lymphocytes and an impaired ability to respond to suboptimal mitogenic stimulation. Responsiveness to alloantigenic stimulation, as measured by mixed leucocyte reactions, was depressed in DOTC-fed animals whereas no effect on natural cytotoxicity in nonimmunized treated or control rats was evident. No difference was found in the ability of treated compared to untreated animals to mount specific antibody responses against sheep red blood cells, and no evidence was found to indicate toxicity to lymphocytes in vivo. The investigation showed that DOTC administration resulted in a selective immunodeficiency.

Administration, Oral↗
PubMed1985

Iota-carrageenan induced reaginic antibody production in the rat--I. Characterisation and kinetics of the response.

The intraperitoneal injection of graded amounts of ovalbumin into inbred PVG strain rats was found to produce a dose dependent anti-ovalbumin antibody response without eliciting the production of ovalbumin-specific reaginic antibodies. The injection of ovalbumin admixed with iota-carrageenan enhanced the anti-ovalbumin response and simultaneously elicited the de novo production of reaginic anti-ovalbumin antibodies. Isotype analysis of the anti-sera revealed the presence of both IgG and IgE class anti-ovalbumin antibodies and demonstrated that non-reaginic IgE anti-ovalbumin antibodies were also a feature of this reaction. The reaginic antibody phase of the response, although transient in nature, was re-elicited by secondary antigen challenge. The administration of ovalbumin prior to the ovalbumin-carrageenan preparation was shown to abrogate the reaginic antibody response without significantly influencing the non-reaginic component of the response. Conversely the injection of iota-carrageenan prior to antigen, significantly suppressed the normal agglutinating anti-ovalbumin response but did not prevent the induction of reaginic antibodies. These observations demonstrate that iota-carrageenan can, under specific conditions, function as an efficient adjuvant, and is capable of by-passing the normal mechanisms responsible for controlling antigen specific reaginic antibody production.

Animals↗