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Biomedical subjects

M R Mueller

Publications and source records attributed to M R Mueller.

29 records · Page 2Linked to original sources
PubMed1985

Assessing physician/patient perceptions in rheumatoid arthritis. A vital component in patient education.

Patient education surveys were completed by 101 patients with rheumatoid arthritis and by 28 rheumatologists to assess and compare patients' reports with physicians' perceptions of patients' needs regarding content, provider, and education program delivery methods. Both groups agreed on the importance of patients' education about arthritis, especially on the topics of medication, physician/patient communication, quackery, and maintaining ambulation. A higher proportion of physicians reported that patient education was needed in psychosocial areas, activities of daily living, sexual concerns, and community resources. Patients sought more education in disease process, diagnostic procedures, and nutrition. Patients rated pharmacists and nutritionists significantly more important as educational sources than did physicians. Both groups reported individual patient/practitioner meetings as the preferred delivery method. Physicians reported group education to be valuable for some psychosocial topics; patients disagreed significantly. Despite considerable consensus, disagreements were evident in the psychosocial area and in the role of allied health professionals. Clarification, understanding, and resolution of these differences should be sought before implementing patient education programs.

Adult↗
PubMed1983

Gold therapy in patients with systemic lupus erythematosus.

Despite a progressively more favorable prognosis in systemic lupus erythematosus (SLE) a need remains for therapeutic agents with greater benefit and less toxicity than corticosteroids and immunosuppressive drugs. Therefore, we treated 16 patients with SLE but without renal diseases with auranofin, a drug with proved efficacy and safety in rheumatoid arthritis. A modest diminution in overall disease activity, as judged by the investigators, and a reduction in maintenance corticosteroid dosage was achieved. However, neither laboratory assessments nor more objective clinical measurements of SLE disease activity disclosed any improvement over baseline. One case each of proteinuria and thrombocytopenia was observed, most likely related to underlying disease and not the drug, suggesting that auranofin may be safe in patients with SLE. A controlled trial, utilizing a broader spectrum of patients with SLE, may be warranted.

Adrenal Cortex Hormones↗
PubMed1983

NaHCO3 therapy corrects the increased urinary Na, K, Cl and H2O excretion induced by NH4Cl.

Micropuncture studies conflict as to whether the proximal volume reabsorptive defect of acute hyperchloremic metabolic acidosis corrects when the acidosis is repaired with NaHCO3. Whether NaHCO3 improves the elevation in urinary solute and water excretion rates induced by acidosis in euvolemic animals, reflecting normalization of proximal reabsorption, has not been previously examined. In these studies in awake rats, NH4Cl caused the plasma bicarbonate concentration to fall from 22 to 11 mEq/l concomitantly with a 1 1/2- to 3-fold increase in sodium, potassium, chloride and volume urinary excretion rates. Isotonic NaHCO3 (5% body weight) infusion restored the plasma bicarbonate concentration to 21 mEq/l and urinary electrolyte and volume excretion rates returned to control values. Comparable volume expansion with NaCl did not correct the acidosis or improve urinary excretion rates. We conclude that correction of acute metabolic acidosis by NaHCO3 therapy repairs the natriuresis, kaluresis, chloruresis and diuresis, presumably by improving proximal reabsorption.

Acidosis↗
PubMed1975

The effect of a copper intrauterine device during the early stages of pregnancy in the rabbit.

Copper wire intrauterine devices (CuIUD) were surgically inserted into mature female rabbits 15 days prior to artificial insemination. Gold wire intrauterine devices and sham surgery served as controls. Animals were autopsied 48, 72, 96, 120, 144, and 192 hours after artificial insemination. At autopsies performed 48 to 144 hours after insemination, the reproductive tract was flushed and the embryos were examined. At 192 hours, implantation sites were counted and measured. A significant (P less than 0.05) loss of copper from the devices was observed when the devices were weighed after autopsy. The CuIUD had no effect on ovulation, fertilization, or embryo transport up to 120 hours after artificial insemination. The presence of a CuIUD resulted in a slight, but not statistically significant, increase in embryonic degeneration by 120 hours, almost total absence of blastocysts from the uterus by 144 hours, and complete absence of implantation sites 192 hours after insemination. The antifertility effect of a copper intrauterine device appears to occur in the late preimplantation stage of pregnancy in the rabbit.

Animals↗
PubMed1975

The effect of a copper intrauterine device on the uterine histology and progestational response in pregnant and immature rabbits.

A copper wire intrauterine device (GuIUD) was inserted into mature female rabbits 14 days prior to artificial insemination (AI), and its effect on the histology of the pregnant uterus was studied 48 to 192 hours after AI. In a related study, estrogen-primed immature femal rabbits were fitted with a device consisting of 321 mm of copper wire wound around a 17-mm plastic carrier and treated subcutaneously for 5 days with 0.1 mg of progesterone daily. Uterine tissue samples were obtained on the following day, examined histologically, and tested for carbonic anhydrase activity. In both studies, gold wire devices, similar to the respective copper devices, and sham surgery served as controls. In the pregnant rabbit, the McPhail score (McPhail MK: J Physiol (Lond) 83:145, 1934) measuring arborization of the luminal epithelium was significantly lower in tissue surrounding the CuIUD than in tissue anterior to the CuIUD or in tissue from the contralateral control horn bearing an AuIUD or subjected to sham surgery, 96 to 192 hours after AI. The morphologic development of the epithelial cell structure was retarded only in areas surrounding the CuIUD 96 to 192 hours after AI. There were no observable differences in the stroma or in the leukocytic infiltration of the tissue. In the estrogen-primed immature rabbits, the ability of the tissue to react to exogenous progesterone was depressed in tissue surrounding the copper device, as determined by the lower McPhail score, compared with tissue anterior to the copper device or from contralateral controls. Similary, progestational stimulation of carbonic anhydrase was blocked significantly in tissue surrounding the CuIUD and, to a lesser extent, in tissue anterior to the CuIUD. The data suggest that copper ions eluted from the CuIUD produce a contraceptive effect by locally blocking the action of progesterone on the epithelial tissue.

Animals↗
PubMedDate not supplied

Pleural and bone marrow metastasis from supratentorial oligoastrocytoma grade III.

We report a 62-year-old man with symptomatic metastasis to the pleural cavity and the bone marrow from a supratentorial oligoastrocytoma grade III, 24 years after the initial symptoms. Before tumor dissemination, the patient underwent brain surgery four times in 5 years. Six months after the last treatment, extraneural dissemination to the right pleural cavity was discovered. Despite resection of the pleural metastasis, local and distant spread to the bone marrow developed. The patient died 5 months after the occurrence of extraneural tumor metastasis. It is speculated that repeated brain surgery and extended survival may promote extraneural dissemination of supratentorial oligoastrocytoma grade III.

Astrocytoma↗
PubMedDate not supplied

Platelet function after total artificial heart replacement: clinical application and experiment.

Clinical application of artificial blood pumps for mechanical circulatory support has been hampered by thromboembolic events. The underlying mechanisms are complicated and may differ from patient to patient. Because the calf is commonly used for artificial heart studies, the object was to determine the value of data gained in an animal model. To this end, the average of 10 calf experiments was compared with three clinical applications of an orthotopically implanted total artificial heart in patients with terminal heart failure. Platelet reactivity was investigated in vitro by collagen-induced whole blood aggregometry, radioimmunoassay methods, and scanning electron microscopy over a 10-day period. An analogous periodicity of platelet function was found in human and animal recipients. Improvement of platelet function preceded that of platelet counts in the early postoperative phase. Exaggerated responses to aggregative agents were observed at days 3 and 7. On the basis of our data, we believe that we can comment about the prospective course of the function and number of human platelets, which may contribute to the identification of critical phases of such treatment, during total artificial heart replacement.

Adult↗
PubMedDate not supplied

Advances in the understanding of lung cancer.

Lung cancers still represent an incurable group of malignancies, where we have to admit that therapy, be it surgery, chemotherapy or radiation, still fails. The emphasis in research has centered on exogenous factors causing the initiation and progression of the different types of lung cancer, especially exposure to tobacco smoke. But so far we have learned that endogenous factors play an equal, if not a more important role, in the onset of this group of diseases. Cancer arising spontaneously never appears to be due to one specific factor, but experimental cancers have been shown to do so. In this light, recent advances in molecular biology have pointed out the relevance of the role of oncogenes and tumor suppressor genes in the pathogenesis of lung cancers. It is the purpose of this paper to review these latest findings, especially from a genetic point of view.

Chromosome Mapping↗
PubMedDate not supplied

Racial variation in lung cancer.

Lung cancer claimed about 153,000 lives in 1994 in the United States. Despite research overall lung cancer survival has still not improved during the last 20 years, with 5-year relative survival remaining about 13%. In addition several epidemiologic and molecular studies showed a difference in the incidence of lung cancer in the three major races. The aim of our study was to investigate the variations of race in lung cancer patients, in order to identify potential risk factors linked to the different racial status. In this light we compared a 10 years lung cancer data of black population from Howard University Hospital, Washington D.C., U.S.A. and a 20 years data of white population from the Vienna University Hospital, Austria. Our results did not show any significant difference in mean age or tumor localization in both groups, but highlighted a remarkable difference in the incidence of the lung cancer histological types also according to the sex. In this respect it could be more successful to consider carcinogenesis like a protracted process of gene function deregulation in response to cell injury from exposure to genotoxic substances with individual specificity.

Adult↗
PubMedDate not supplied

Ethnic variations in lung cancer.

Cancer of the lung is the most frequent cancer in the world, but with wide geographical variation in risk. It is most spread among males of all races worldwide, the only exception being its incidence among Chinese women aged 70 years and older. When comparing the different ethnic groups we have to consider that besides inhaling cigarette smoke actively or as a passive smoker the exposure to occupational carcinogens varies considerably according to different work places. In our study we compared 10 years of data from African-Americans in Howard University Hospital, Washington D.C. with 20 years of data from the white population in the University Hospital of Vienna, Austria. Ethnic patterns are generally consistent within each group in terms of both incidence and mortality. The difference in susceptibility between the sexes, the three major racial groups and already proven differences in genetic variations indicate the difference between individuals concerning the initiation and progression of lung cancer.

Adenocarcinoma↗