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Biomedical subjects

R E Miller

Publications and source records attributed to R E Miller.

At least 181 records · Page 10Linked to original sources
PubMed1983

The effect of barium enemas and barium sulfate on healing of colorectal biopsy sites.

Twelve mongrel dogs had superficial and deep colon biopsies above and below the peritoneal reflection. Six of the animals were given a barium enema; two had a barium enema immediately, two in three days, and two in six days. The animals were sacrificed 48 hours after the barium enema; the sigmoid was removed and tissue was examined macroscopically and microscopically. When healing rates of the biopsy sites were compared with those of control animals, there was no difference. The results suggest that barium has no deleterious effect on the healing of superficial or deep colorectal biopsies.

Animals↗
PubMed1983

Spontaneous migration of a bullet in the central nervous system.

An example of spontaneous migration of a metallic foreign body within the subarachnoid space is illustrated. An intracranial bullet is shown to move within the cisterns of the posterior fossa and then down the subarachnoid space of the spinal canal. The patient's symptoms correlate well with the movement of the foreign body.

Adolescent↗
PubMed1983

Clonidine in patients with diabetes and mild hypertension.

Clonidine has been reported to adversely affect glucose tolerance in experimental animals and normal man. We assessed its short- and long-term effects in 10 patients with both mild hypertension and diabetes mellitus. Patients were studied before and 10 wk after treatment with 0.1 mg clonidine twice daily, which induced reductions in blood pressure (from 148 +/- 5/93 +/- 2 mm Hg sitting, to 125 +/- 4/80 +/- 2) and control of hypertension in all patients. Clonidine increased the glycemic response to intravenous glucose (incremental glucose AUC from 161 +/- 13 to 184 +/- 14) but did not significantly change long-term diabetic control as assessed by weekly fasting serum glucose, glycosylated hemoglobin, and 24-hr urinary glucose excretions before and after treatment. We conclude that low-dose clonidine controlled blood pressure and impaired the response to an acute glucose challenge in midly hypertensive, type II diabetic patients but did not adversely affect diabetic control over 10 wk.

Adult↗
PubMed1983

Colon and rectal carcinoma: spatial distribution and detection.

Recent studies have challenged the concept that 50% of colon cancers are detectable by digital examination and two-thirds are within reach of the rigid sigmoidoscope. This is an important consideration because of the potential for failure of an otherwise appropriate screening method when evaluating a patient for carcinoma of the colon. An analysis of 2,298 cases of colorectal carcinoma diagnosed over 20 years showed that the most common sites were the rectum (34%) and sigmoid (25%). Over the 20 years, the incidence of cancer in the cecum increased and that in the rectum decreased. Cecal, ascending, and transverse colon cancers accounted for 34% of lesions - all beyond the range of the flexible sigmoidoscope. The changing site distribution emphasizes the need for an accurate and inexpensive technique to evaluate the entire colon. These data suggest that the barium pneumocolon examination should be included in the screening of high-risk patients.

Barium Sulfate↗
PubMed1983

Esophageal food impaction: treatment with glucagon.

Nineteen patients who had foreign bodies in the distal esophagus were examined prospectively to determine the efficacy of intravenous glucagon in relieving the obstruction. The administration of glucagon resulted in clearance of the impacted food in seven patients. Although the success rate is relatively low, the risk is minimal and justifiable. Use of intravenous glucagon is a safe, worthwhile initial step in the treatment of distal esophageal foreign bodies.

Adult↗
PubMed1983

Postendoscopy barium enema examinations.

A study was designed to evaluate whether sigmoidoscopy performed on the same day as barium enema examination interferes with quality or interpretation of the barium study. The study included 295 patients who had either single- or double-contrast barium enema examinations subsequent to sigmoidoscopy performed either on a prior day or the same day. Luminal air, spasm, colonic fluid, and mucosal coating were assessed, as was the resultant diagnostic quality of each barium examination. The results suggest that rigid or fiberoptic sigmoidoscopy can be performed the same day as single- or double-contrast barium enema examinations without adversely affecting the quality or interpretation of the barium study.

Air↗
PubMed1983

Relationships between inmates' past drug practices and current drug knowledge and attitudes.

A questionnaire used in the measurement of past drug practices and current drug knowledge and attitudes was completed by 200 inmates. Data analysis provided an examination of relationships between the variables. Significant positive correlations were recorded between drug knowledge and drug practices, and between drug knowledge and drug attitude scores. However, a significant negative relationship was noted between drug practices and drug attitude scores. Additional findings are presented regarding inmates' demographic characteristics and drug variable measures. Implications are discussed for the development of drug education programs in jails and prisons.

Adult↗
PubMed1983

Metabolism of trichloroethylene in isolated hepatocytes, microsomes, and reconstituted enzyme systems containing cytochrome P-450.

The metabolism of the suspected carcinogen trichloroethylene (TCE) was studied in in vitro systems involving purified rat liver cytochrome P-450; rat, human, and mouse liver microsomes; rat lung microsomes; and isolated rat and mouse hepatocytes. The studies support the view that metabolism of TCE proceeds through formation of a complex with oxygenated cytochrome P-450 which, by rearrangement, can lead to: (a) suicidal heme destruction; (b) formation of chloral, which can be either reduced to trichloroethanol and conjugated to form a glucuronide or oxidized to trichloroacetic acid; (c) formation of TCE oxide, which decomposes to carbon monoxide and glyoxylate; and (d) metabolites which bind irreversibly to protein, DNA, and RNA. Studies with microsomes and reconstituted enzyme systems suggest that the contributions of the four major pathways described above vary depending upon the isozymes of cytochrome P-450 involved and that these pathways cannot be strictly correlated. Conjugation of products with glutathione does not appear to play a major role in TCE metabolism. Treatment of rats and mice with phenobarbital resulted in a number of alterations in metabolism which were more pronounced in the isolated hepatocyte system than in fortified microsomal incubations. In several cases where hepatocytes were used, the bulk of the metabolites which became irreversibly bound to DNA and protein could be trapped outside of the cells by including such macromolecules in the system, implying that metabolites which bind irreversibly must possess a reasonable degree of chemical stability. The results suggest that TCE oxide is not the TCE metabolite responsible for irreversible binding to protein and DNA. The levels of protein adducts and particularly DNA adducts formed were substantially higher in isolated C57BL/6 x C3H F1 mouse hepatocytes than in isolated Osborne-Mendel rat hepatocytes, and these results may help to explain species differences previously reported in carcinogen bioassays.

Animals↗
PubMed1982

Oxidation of trichloroethylene by liver microsomal cytochrome P-450: evidence for chlorine migration in a transition state not involving trichloroethylene oxide.

Trichloroethylene (TCE) was metabolized by cytochrome P-450 containing mixed-function oxidase systems to chloral (2,2,2,-trichloroacetaldehyde), glyoxylic acid, formic acid, CO, and TCE oxide. TCE oxide was synthesized, and its breakdown products were analyzed. Under acidic aqueous conditions the primary products were glyoxylic acid and dichloracetic acid. The primary compounds formed under neutral or basic aqueous conditions were formic acid and CO. TCE oxide did not form chloral in any of these or other aqueous systems, even when iron salts, ferriprotoporphyrin IX, or purified cytochrome P-450 was present. Ferric iron salts catalyzed the rearrangement of TCE oxide to chloral only in CH2Cl2 or CH3CN. A 500-fold excess of iron was required for complete conversion. A kinetic model involving the zero-order oxidation of TCE to TCE oxide by cytochrome P-450 and the first-order degradation of the epoxide was used to test the hypothesis that TCE oxide is an obligate intermediate in the conversion of TCE to other metabolites. Kinetic constants fo the breakdown of TCE oxide and for the oxidative metabolism of TCE to stable metabolites were used to predict epoxide concentrations required to support the obligate intermediacy of TCE oxide. The maximum levels of TCE oxide detected in systems using microsomal fractions and purified cytochrome P-450 were 5-28-fold lower than those predicted from the model. The kinetic data and the discrepancies between the observed metabolites and TCE oxide breakdown products support the view that the epoxide is not an obligate intermediate in the formation of chloral, and an alternative model is presented in which chlorine migration occurs in an oxygenated TCE-cytochrome P-450 transition state.

Animals↗
PubMed1982

The nasal smear for eosinophils. Its value in children with seasonal allergic rhinitis.

Nasal smears for eosinophils obtained by nose blowing and/or posterior nasopharyngeal swabbing were stained with Wright's or Hansel's stains and read in three groups of children aged 4 to 15 years: 65 with seasonal allergic rhinitis, 42 with perennial rhinitis and negative skin tests, and 70 nonallergic controls. Of smears obtained by either or both methods, 69%, 11%, and 7% were positive (greater than or equal to 4%) in the three groups, respectively. Almost identical results were obtained using only the nose-blowing method. In children with seasonal nasal symptoms, the nasal smear for eosinophils appears to be a reliable diagnostic test with moderately high sensitivity and high specificity.

Adolescent↗