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Biomedical subjects

R B Miller

Publications and source records attributed to R B Miller.

At least 127 records · Page 7Linked to original sources
PubMed1977

Plasma pregnenolone and 17-OH-pregnenolone in patients with adrenal tumors, ACTH excess, or idiopathic hirsutism.

Plasma levels of the delta5-pregnenes, pregenolone and 17-OH-pregnenolone, were measured in patients with disordered steroidogenesis. While 17-OH-pregnenolone was within the normal range in patients with hypercortisolemia due to Cushing's disease, ectopic ACTH or adrenal adenrenal adenoma, 4 of 6 patients with an adrenal carcinoma had elevated levels of this precursor. Thus, elevated plasma 17-OH-pregnenolone levels in patients with Cushing's syndrome indicate adrenal carcinoma, although a normal value does not exclude this diagnosis. Abnormal resistance of delta5-pregnenes to suppression with dexamethasone proved useful in detecting the presence of residual tumor in the post-operative evaluation of adrenal carcinoma. Basal plasma pregnenolone was within the normal range in 19 of 20 patients with Cushing's disease and was invariably normal in patients with other varieties of hypercortisolism. Since acute administration of ACTH causes marked elevation of delta5-pregnene levels while patients with chronic ACTH excess (Cushing's disease and ectopic ACTH production) have normal levels, it is suggested that ACTH has a chronic influence on the intraadrenal utilization of delta5-pregnenes in addition to stimulating their formation. In pre-menopausal women with idiopathic hirsutism, basal levels of both delta5-pregnenes were elevated (P less than 0.001). Following dexamethasone administration the absolute decrease in delta5-pregnenes levels was greater than that seen in normal subjects. This observation indicates that the metabolism of delta5-pregnenes is abnormal in patients with idiopathic hirsutism.

17-alpha-Hydroxypregnenolone↗
PubMed1977

Cystic fibrosis diagnosed after age 13. Twenty-five teenage and adult patients including three asymptomatic men.

Cystic fibrosis was diagnosed after age 13 in 25 patients. All had an elevated sweat chloride and either a sibling with cystic fibrosis or typical pulmonary infection or digestive symptoms caused by exocrine pancreatic deficiency. Fourteen had long-standing pulmonary or digestive symptoms. In contrast, four of eight patients whose symptoms began after age 13 presented with biliary cirrhosis. Three male patients were asymptomatic at diagnosis. Opacification of all paranasal sinuses was found in all patients examined radiologically. At diagnosis, pulmonary-function testing showed obstructive changes in 19 patients and sputum cultures showed Pseudomonas aeruginosa in 15 patients. Delayed menarche in five of seven female patients and infertility in the asymptomatic male patient (two of whom were found to have aspermia) could have led to earlier diagnosis. Teenagers and young adults with long-standing pulmonary or digestive symptoms, unexplained cirrhosis, aspermia, or a sibling with cystic fibrosis should be sweat-tested by pilocarpine iontophoresis.

Adolescent↗
PubMed1975

Observations on abortions in cattle: a comparison of pathological, microbiological and immunological findings in aborted foetuses and foetuses collected at abattoirs.

Fifty nonaborted and 50 aborted bovine foetuses were examined utilizing histology, immunoelectrophoresis, bacteriology and the fluorescent antibody technique. Lesions were observed in 12 of the nonaborted foesuses and in four of these immunoglobulins were demonstrated. In addition, two of the nonaborted foetuses had immunoglobulins in the absence of observed lesions. Lesions were observed in 48 of the aborted foetuses and immunoglobulins were detected in 22 of these. An etiological diagnosis was arrived at in 24 of the 50 aborted foetuses. The tissues most frequently observed to have lesions of diagnostic significance were eyelid, intestine, liver, lung and placenta. Intestinal lesions were observed in several foetuses in association with a variety of agents including infectious bovine rhinotracheitis. Foetuses diagnosed as aborting because of mycotic infection consistently displayed lesions in their eyelids. The value of taking eyelid sections in cases of suspected mycotic abortions, the significance of foetal intestinal lesions, the evaluation of abomasal aspirates and the diagnostic importance of immunoglobulin determinations in aborted foetuses are discussed.

Abortion, Veterinary↗