Search PubMed⌕ Search

Biomedical subjects

R E Miller

Publications and source records attributed to R E Miller.

At least 127 records · Page 7Linked to original sources
PubMed1987

Multiple endocrine neoplasia type IIb: a description of several patients and review of the literature.

Our experience exemplifies the varied clinical presentations of patients with MEN IIb. This syndrome may be familial or sporadic, and clinical stigmata may be identifiable in infancy, particularly the characteristic facies and the appearance of ganglioneuromas. First-degree relatives of affected propositi and individuals with other stigmata of the syndrome should be screened carefully and repeatedly for both medullary thyroid carcinoma and pheochromocytoma. The availability of sensitive screening tests may permit detection of C-cell hyperplasia of the thyroid and adrenal medullary hyperplasia before the development of malignancy or hemodynamic consequences of pheochromocytoma. Early detection of these thyroid and adrenal disorders will permit early surgical intervention.

Adolescent↗
PubMed1987

Surgical management of complications of upper gastrointestinal endoscopy and esophageal dilation including laser therapy.

There are a variety of complications associated with upper gastrointestinal endoscopy (EGD) and esophageal dilation including laser therapy. Life-threatening complications, such as perforation and hemorrhage, may require surgical intervention. The records of all patients undergoing EGD and dilation of benign and malignant esophageal strictures including laser therapy at St. Luke's-Roosevelt Hospital Center were reviewed. Complications potentially correctable by operation were found in 18 patients. There were three (16%) deaths, and each was attributed to a delay in diagnosis of perforation and operative correction. The key to successful outcome is a high index of suspicion, radiographic confirmation, and prompt treatment.

Adult↗
PubMed1987

Contact lens wear at altitude: subcontact lens bubble formation.

A concern in the past regarding contact lens wear in aviation has been the fear of subcontact lens bubble formation. Previous reports have documented the occurrence of bubbles with hard (PMMA) lenses. Reported here are the results of contact lens bubble studies with soft hydrophilic and rigid gas-permeable lenses. Testing was accomplished in hypobaric chambers and onboard USAF transport aircraft. Hypobaric chamber flights were of three types: high-altitude flights up to 7,620 m (25,000 ft); explosive rapid decompressions from 2,438.4 m (8,000 ft) to 7,620 m (25,000 ft); and 4-h flights at 3,048 m (10,000 ft). Flights aboard transport aircraft typically had cabin pressures equivalent to 1,524-2,438.4 m (5,000-8,000 ft), and ranged in duration from 3 to 10 h. For subjects wearing rigid gas-permeable lenses, central bubbles were detected in 2 of 10 eyes and occurred at altitudes greater than 6,096 m (20,000 ft). With soft contact lenses, bubble formation was detected in approximately 24% (22 of 92 eyes) of the eyes tested, sometimes occurring at altitudes as low as 1,828.8 m (6,000 ft). Soft lens bubbles were always located at the limbus and were without sequela to vision or corneal epithelial integrity. Bubbles under the rigid lenses were primarily central, with potential adverse effects on vision and the corneal epithelium.

Altitude↗
PubMed1986

Selection of a rat glutamine synthetase cDNA clone.

We have selected a glutamine synthetase clone (pGSRK-1) from a rat kidney cDNA library. A partial restriction map has been constructed for the 1.65 kilobase pair (kbp) glutamine synthetase cDNA. Northern hybridization analysis indicates that 1) GS-specific RNA increases many-fold during adipocyte differentiation and 2) dexamethasone increases and insulin decreases GS-specific RNA in 3T3-L1 adipocytes.

Adipose Tissue↗
PubMed1986

Breast cancer and meningioma.

A unique association between meningioma and breast cancer has recently been observed. A review of the literature reveals 33 such cases. Certain similarities exist between these two tumors. They each occur more frequently in women in the fifth and sixth decade, and pregnancy accelerates the symptoms of both entities. Furthermore, an increase in estrogen and progesterone receptor protein has been noted in each. A patient with established breast cancer who presents with central nervous system symptoms cannot be assumed to have cerebral metastases. A thorough workup to rule out meningioma is necessary. Furthermore, patients with proven meningioma must be observed closely for the subsequent development of breast cancer.

Aged↗
PubMed1986

Token swap test of significance for serial medical data bases.

Established tests of statistical significance are based upon the concept that observed data are drawn randomly from a larger, perhaps infinite source population. The significance value, p, is the probability that the observations are drawn from a source population satisfying the null hypothesis; if p is small enough (less than 5 percent, 1 percent, etc.), then the null hypothesis is rejected. Serial medical data bases, such as a hospital clinic intake or autopsy case accessions, often do not have an identifiable source population from which they are randomly drawn. In an effort to make a reasonable interpretation of these less-than-ideal data, this report introduces a "token swap" test of significance, in which the usual paradigm of repeated drawing from a source population is replaced by a paradigm or misclassification within the observed data themselves. The token swap test consists of rearranging the data into a balanced distribution, and determining the disparity between the observed and the balanced distribution of data. In a two-by-two contingency table, patients are represented as "tokens" distributed into four "cells." Significance is determined by the proportion of "token swaps" that are able to transform the balanced table into the observed table. The token swap test was applied to three series of autopsy observations, and gave results roughly comparable to the corresponding (two-tail) chi-square and one-tail Fisher exact tests. The token swap test of significance may be a useful alternative to classic statistical tests when the limiting assumptions of a retrospective, serial medical data base are present.

Computer-Assisted Instruction↗
PubMed1986

Automated translation of German to English medical text.

The feasibility of automated translation of scientific and medical documents remains controversial. This report describes a minicomputer-based German-to-English translation system (TRANSOFT) that employs word order rearrangement followed by word-for-word translation and disambiguation based on context. This translation system was applied to a computer-readable version of Adler's Knochenkrankheiten (Bone Diseases), which contains 118,604 words, with 10,216 distinct words in 7,211 sentences averaging 16.4 words each. The translation required 2,791 word rearrangement formulas, 78 percent of which were first used in the first half of the document. There were 2,392 occurrences of 12 potentially ambiguous terms, of which only 18 (0.8 percent) were not resolvable from the immediate context. As foreign language medical documents become increasingly available in computer-readable form through computerized typesetting, electronic publishing, and improved optical character recognition equipment, automated translation systems may provide a rapid and inexpensive means of obtaining draft translations.

Computers↗
PubMed1986

Schistosoma mansoni: salicylanilides as topical prophylactic against cercarial penetration of mice.

Salicylanilide and 37 of its analogs were applied topically to mice as candidate chemoprophylactic agents against Schistosoma mansoni cercarial penetration. The compounds were solubilized in absolute methanol, dimethyl sulfoxide, or isopropanol at concentrations not exceeding 1.25% W/V. The tails of the mice of each experimental group were treated by immersion for 5 min in the test compound solution or in the vehicle. The treated tails of 5 mice from each group were washed for 30 min in flowing tap water 3-4 hr after compound application. Tails of all mice were then exposed to approximately 100 cercariae by tail immersion for 1 hr, 24 hr after treatment. The portal veins were perfused 49 days after exposure and worm burdens were determined. The protective capacity of each compound was calculated by comparing the reduction of the mean worm burdens of the compound treated mice to the worm burdens of those treated with only the vehicle and expressing the resulting value as percentage protection. Of the 38 compounds tested, 20 provided 98% or better protection if the treated tails were not washed before exposure to cercariae. Of these 20 active compounds, 16 provided 98% or better protection from infection by S. mansoni cercariae even after the mouse tails were subjected to the 30 min wash.

Administration, Topical↗
PubMed1986

Multilingual translation techniques in the analysis of narrative medical text.

The feasibility of computer translation of scientific and medical documents is controversial. This report describes a minicomputer-based translation system (TRANSOFT) that employs word order rearrangement followed by word-for-word translation and resolution of ambiguities based on context. This translation system was applied to an entire medical textbook written in German and to short medical texts written in French, Italian, Spanish and Turkish. Results suggest the versatility of TRANSOFT for narrowly defined translation problems. As foreign language medical documents and medical records become increasingly available in computer readable form through word processing, computerized typesetting and hospital information systems, computer translation methods may provide a rapid and inexpensive means of obtaining draft translations.

Computers↗
PubMed1986

Glutamine synthetase mRNA in cultured 3T3-L1 adipocytes. Complexity, content and hormonal regulation.

Glutamine synthetase (GS) activity increases more than 100-fold during adipocyte differentiation of cultured 3T3-L1 cells. We now find that Northern hybridization analysis of RNA from 3T3-L1 adipocytes with a rat GS cDNA clone (pGSRK-1) yields two hybridizable GS RNAs of length 3.2 and 1.6 kilobases (kb). Densitometric analyses of autoradiographs of the Northern blots probed with pGSRK-1 indicate that the 3.2 kb GS-specific RNA is at least 4- to 5-fold more abundant than the 1.6 kb GS RNA. Analyses of both total and poly(A+)RNA from 3T3-L1 adipocytes yielded similar results. (It is noteworthy that an mRNA of 1.2 kb would be sufficient to encode the 42 500 Da GS subunit.) Quantitative dot-blot hybridization analysis indicates that dexamethasone increases GS mRNA while both insulin and dibutyryl cAMP decrease GS mRNA and/or prevent the dexamethasone-mediated increase. Our data suggest that there are at least two GS mRNAs in 3T3-L1 adipocytes and that they are regulated in parallel by dexamethasone, insulin and dibutyryl cAMP.

Adipose Tissue↗
PubMed1986

Test-taking behaviors by hypertensive and normotensive individuals.

Systematic ratings were made on the Tulane Test-Behavior Scale of the global and integrated behaviors observable for hypertensive and normotensive subjects as they worked to complete a battery of neuropsychological tests--the degree of attention and effort displayed, for example, self-confidence and self-criticism. The results for 82 subjects (41 subject pairs matched for age, race, and education) revealed substantial and consistent differences between groups. Early, mild hypertensive subjects (unmedicated) displayed significantly less optimal behaviors than did normotensive controls. These may be best understood as subtle functional consequences of the abnormal physiological state imposed on the brain by a chronically elevated blood pressure, just as the functional disruptions of reduced kidney filtration fraction or minor abnormalities of the electrocardiogram appear early in the course of the disorder for other target organs. Certain testable implications of this hypothesis are discussed.

Arousal↗
PubMed1986

Percutaneous endoscopic gastrostomy. Procedure of choice.

Operative gastrostomy (OG) for gastrointestinal decompression or feeding has stood the test of time. Nevertheless, this procedure is often associated with significant morbidity and occasional mortality. Furthermore, although it is often performed under local anesthesia, general anesthesia is frequently necessary. A recent alternative to OG is percutaneous endoscopic gastrostomy (PEG). The purpose of this study is to describe our experience with 100 consecutive PEGs in 98 patients. There were no complications, and no patient died as a result of PEG. Furthermore, PEG never required general anesthesia and was rapid and less costly than OG. Since PEG is so simple to perform, it may be employed earlier in the patient's course, thus avoiding nasogastric feedings or parenteral alimentation. PEG is the procedure of choice should gastrostomy be needed.

Adolescent↗
PubMed1986

Sensitivity of double-contrast barium study for left-colon polyps.

A blinded, prospective study was conducted to determine the sensitivity of double-contrast barium enema examination (DCBE) in detecting left-colon polyps. Metal clips were endoscopically placed on normal mucosa either adjacent to polyps (in 65 study subjects with 92 polyps) or not adjacent to polyps (in 50 control subjects). DCBE had a high sensitivity for detection of polyps greater than or equal to 1 cm and 6-9 mm in size (100% and 83% detection, respectively) but was insensitive in detecting polyps in the 4 to 5-mm and 2 to 3-mm size ranges (56% and 22% detection, respectively). The factors contributing most commonly to false-negative interpretations were the presence of air bubbles, overlap of bowel loops, and luminal fecal debris. No error in radiographic technique was evident to account for false-negative interpretations in 14 (41%) of 34 polyps that were not detected by DCBE.

Barium Sulfate↗