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Biomedical subjects

M L Miller

Publications and source records attributed to M L Miller.

At least 199 records · Page 11Linked to original sources
PubMed1979

The post-aspirin bleeding time: a screening test for evaluating haemostatic disorders.

To evaluate the usefulness of the template bleeding time post-aspiring ingestion, this test was performed with other tests of haemostasis in 28 controls and 71 patients. The mean bleeding time (B.T.) in 24/28 true controls was 3.5 +/- 1 min (1 SD). Following the ingestion of 600 mg aspirin the B.T. was 6.3 +/- 1.4 min. Four out of 28 false 'controls' with negative bleeding histories were documented to have asymptomatic von Willebrand's disease and abnormal post-aspirin B.T. Of the 71 patients studied, 22 had initial B.T. that were abnormal (16 with classical von Willebrand's disease and six with platelet dysfunction). Of the remaining 49 patients with initially normal B.T., 30 had abnormal post-aspirin B.T. Of these 30 patients 13 had von Willebrand's disease. In eight, initially the abnormal B.T. post-aspirin was the only abnormality demonstrable but later they were shown to have von Willebrand's disease. In four the abnormal post-aspirin B.T. was combined with abnormal Ristocetin aggregations and a positive family history. These patients were presumed to have a variant of von Willebrand's disease. The remaining five had platelet dysfunctional states. Of the 19 patients with normal initial post-aspirin B.T., 16 demonstrated no haemostatic abnormality, and three were proven to have von Willebrand's disease. The aspirin tolerance test raised the sensitivity of the B.T. as a screening test for haemostasis from 40% to 94% in the abnormal patient population.

Adolescent↗
PubMed1979

Endotoxin toxicity in rats with 6-sulfanilamidoindazole arthritis.

Seven oral administrations of 6-sulfanilamidoindazole (6-SAI) to 10- to 12-month-old rats sensitized the animals to endotoxin, with dosages as small as 2.5 microgram causing death in 80% of animals. Endotoxin in a dosage of 3,000 microgram was not lethal for nonmedicated control animals. 6-SAI-treated 1-month-old rats were not as sensitive to endotoxin as aged animals. The sulfonamide-induced sensitivity to endotoxin could not be passively transferred and could not be explained by blockade of the reticuloendothelial system or impairment of endotoxin detoxification. 6-SAI administration was associated with both depletion of liver glycogen and lowering of blood glucose concentration without changes in blood lactic acid concentration. Disseminated intravascular coagulation is believed to be involved in the pathogenesis of shock and death as evidenced by: (i) concomitant decreases in plasma fibrinogen concentration and elevations in fibrin degradation products after endotoxin challenge; (ii) protection against lethal actions of endotoxin by pretreatment with heparin. Treatment of 6-SAI-medicated rats with glucocorticoids before endotoxin challenge protected the animals against lethal doses of endotoxin and prevented deposition of fibrin thrombi in the glomerular capillaries.

Aging↗
PubMed1978

Chronic idiopathic thrombocytopenic purpura. A familial immunodeficiency syndrome?

We studied three children with chronic idiopathic thrombocytopenic purpura (ITP) and their immediate families. All three patients and 10/13 family members manifested at least one immunologic defect, eg, decreased numbers of T lymphocytes (1/3, 5/13), diminished in vitro response to phytohemagglutinin (2/3, 6/13), dysgammaglobulinemia (2/3, 4/13), altered autoantibodies (1/3, 5/13), and decreased serum properdin levels (3/3, 2/13). In addition, one parent and two asymptomatic siblings of two of the propositi had shortened platelet life spans with normal platelet counts. The HLA antigens A3 and B7 were identified in all three families. There also appeared to be an association between a familial haplotype and the immunologic defects. Chronic ITP appears to occur in families with underlying immunologic defects, which are genetically related.

Adolescent↗
PubMed1978

Erythroid hypoplasia. An unusual presentation of childhood acute lymphocytic leukemia.

A 3-year-old girl had pancytopenia and bone marrow erythroid hypoplasia. The pancytopenia resolved without therapy, but the erythroid hypoplasia persisted for four months in spite of a five-week course of corticosteroid therapy. She responded briefly when androgens were added to the corticosteroid regimen, but within three weeks of stopping therapy she developed acute lymphocytic leukemia. The differential diagnosis of RBC aplasia in childhood is discussed. To our knowledge, this is the first case reported with erythroid hypoplasia as a prodrome of acute lymphocytic leukemia of childhood.

Anemia, Aplastic↗
PubMed1978

Consumptive coagulopathy. A complication of therapy of solid tumors in childhood.

The association of consumptive coagulopathy and malignancy is thought to be rare in pediatrics. In one patient with Ewing's sarcoma and in two with rhabdomyosarcoma consumptive coagulopathy developed in the presence of either diffuse metastatic disease or an extensive primary tumor. The coagulopathy was a major clinical problem, developing within five days of the onset of chemotherapy. Resolution coincided with the clinical response of the tumor.

Adolescent↗
PubMed1975

Emulsions of perfluorinated solvents for intravascular gas transport.

During the past several years we have progressed from the use of perfluorinated substances, which were good gas solvents but often produced unexpected physiological reactions, to a point where emulsions of pure perfluorinated substances can be made in a reproducible way. A standardized method of making emulsions has now been developed. The physical properties of the perfluorinated substances needed to make useful emulsions have been defined. Specifically, perfluorinated substances having vapor pressures above about 40 torr must be avoided as they produce pulmonary gas embolism; also lower boiling components having vapor pressures above about 40 torr must be excluded. The relationship between chemical structure and several physiological and pharmacological effects has been delineated. Perfluorinated substances containing only carbon and fluorine, or those containing carbon, fluorine, and either bromine or iodine have reasonably short dwell times in the liver. Perfluorinated iodo- and bromo-compounds dissolve oxygen and are radiopaque. Present iodo-perfluorinates are unstable in the presence of light. Perfluorodecalin can enter and leave the liver without changing the liver's ultrastructure. Both egg phospholipid and Pluronic F68 are useful in making perfluorodecalin emulsions. Perfluorodimethyladamantane makes a fine-particle stable emulsion. There is a bright future for perfluorinated substances in a number of areas of research in biology and medicine.

Animals↗