Search PubMed⌕ Search

Biomedical subjects

L C Miller

Publications and source records attributed to L C Miller.

107 records · Page 6Linked to original sources
PubMedDate not supplied

Wegener's granulomatosis: case report and literature review.

Wegener's granulomatosis (WG) is a necrotizing granulomatous vasculitis usually affecting the upper and lower respiratory tracts and kidneys. Any organ system can be affected by the pathologic process, which remains an etiologic enigma. Limited forms of the disease are recognized in which few extrapulmonary and no renal lesions occur. Cutaneous manifestations occur in 40% to 50% of patients with WG (1). Early diagnosis is imperative because treatment regimens reduce morbidity and mortality in this potentially fatal disease. We report WG in a 10-year-old boy whose upper respiratory tract symptoms began at age 8 years. The case is illustrative of the difficulties that can be encountered in attempting to make this diagnosis. Skin is an easily accessible organ for biopsy, thus an increasing familiarity with the typical biopsy specimen findings within a consistent clinical setting may aid in earlier diagnosis of WG.

Child↗
PubMedDate not supplied

Body fat distribution as a risk factor for coronary artery atherosclerosis in female cynomolgus monkeys.

Central fat deposition is associated with increased risk of coronary heart disease morbidity and mortality in women. Subcutaneous fat distribution was investigated as a potential factor that might exacerbate diet-induced coronary artery atherosclerosis (CAA) in female cynomolgus monkeys (Macaca fascicularis) which share with North American Caucasian women a gender-related protection against CAA. In a retrospective necropsy study (n = 36), the distribution of the antemortem ratio of subscapular/triceps skinfold thickness was divided at the mean and the two resulting groups were designated high and low for this variable. CAA was quantified as the mean cross-sectional intimal area based on nine coronary artery sections. The extent of CAA was significantly greater in the high skinfold ratio group as compared to the low skinfold ratio group. Ponderosity was closely associated with the skinfold ratio but was not a useful predictor of CAA. These findings suggest that female cynomolgus macaques may provide a primate model of the health consequences of regional fat distribution in women.

Adipose Tissue↗
PubMedDate not supplied

The health of children adopted from Romania.

OBJECTIVE: To determine the medical condition of Romanian adoptees and the effects of the Romanian orphanage system on their health. DESIGN: Case series. SETTING: The international adoption clinics at the University of Minnesota, Minneapolis, and the New England Medical Center, Tufts University, Boston, Mass. PARTICIPANTS: Sixty-five Romanian adoptees who were brought to the United States during a 12-month period beginning in October 1990. MAIN OUTCOME MEASURES: Incidence of hepatitis B, intestinal parasites, tuberculosis, syphilis, human immunodeficiency virus type 1, growth failure, and developmental delay. RESULTS: Although the adopted children were presumably chosen from the most vital and attractive adoptees, only 15% were judged to be physically healthy and developmentally normal. Fifty-three percent had serological evidence of past or present hepatitis B infection, and 20% of screened children tested positive for hepatitis B surface antigen. In children aged 7 months or older, the overall prevalence of chronic hepatitis B was 23%. Intestinal parasites were found in 33% of subjects, and 45% of infected children had two or more pathogens identified. All the children tested for human immunodeficiency virus type 1 were negative. Two patterns of growth failure were observed that resembled the two subtypes of psychosocial short stature that occur in association with prolonged psychological harassment or emotional deprivation. Infants' length, weight, head circumference, and weight-for-height were adversely affected by institutionalization. Older children's height was reduced. Only 10% of children older than 12 months were developmentally normal. CONCLUSION: Romanian adoptees are an extraordinarily high-risk pediatric group as a consequences of decades of government-sanctioned child neglect and abuse.

Adoption↗
PubMedDate not supplied

Evaluation of a media-based mammography program.

Reports indicate that only 15%-20% of women 50 years of age and older have had a mammogram. To promote screening mammography, the San Diego County Unit of the American Cancer Society sponsored a community-wide program that featured (1) discounted mammograms through participating clinics, (2) program promotion through television news, and (3) availability of a phone bank for obtaining referrals for mammography. Pre- and postintervention random sample phone surveys indicated that women's intentions to obtain a mammogram increased significantly after the media campaign, particularly in those aware of the program. Women's intentions after the media campaign predicted mammography compliance in the following year. A total of 3,102 women received mammograms directly through the program, with a "suspicious finding" rate of 4%. Participant satisfaction with the program was high.

Adult↗
PubMedDate not supplied

Synthesis of tumor necrosis factor alpha and interleukin-1 receptor antagonist, but not interleukin-1, by human mononuclear cells is enhanced by exposure of whole blood to shear stress.

Extracorporeal circulation exposes blood to shear stress. In many studies, researchers reported effects of shear stress on morphology and function of various blood cells, but effects on cytokine synthesis have not been studied. The authors investigated the effect of shear stress on the synthesis of interleukin-1 beta, interleukin-1 alpha, tumor necrosis factor alpha, and interleukin-1 receptor antagonist by human peripheral blood mononuclear cells. Whole heparinized blood at room temperature was exposed to shear stresses of 50, 200, or 500 dyne/cm2 for 5 min or 30 sec, and to 980 dyne/cm2 for 5 sec. Peripheral blood mononuclear cells were then separated from sheared blood and cultured for 24 hrs with or without lipopolysaccharide or Staphylococcus epidermidis. Total (intra + extracellular) cytokine synthesis was measured by specific radioimmunoassay. Viability of cultured peripheral blood mononuclear cells, determined by trypan blue exclusion and lactate dehydrogenase release, was not significantly affected by shear stress. Shear stress without lipopolysaccharide or S. epidermidis stimulation did not affect synthesis of interleukin-1 or tumor necrosis factor alpha but did enhance synthesis of interleukin-1 receptor antagonist. Lipopolysaccharide- or S. epidermidis- induced synthesis of interleukin-1 was not significantly altered by shear stress. In contrast, lipopolysaccharide-induced tumor necrosis factor alpha synthesis increased with increasing shear stress and was significantly elevated over unsheared controls, whereas S. epidermidis-induced tumor necrosis factor alpha and lipopolysaccharide- or S. epidermidis-induced interleukin-1 receptor antagonist synthesis were not significantly enhanced by shear. Therefore, sublytic trauma, such as exposure to shear stress, affects in vitro responses of peripheral blood mononuclear cells to secondary stimuli.

Cell Survival↗