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Biomedical subjects

R Miller

Publications and source records attributed to R Miller.

At least 559 records · Page 31Linked to original sources
PubMed1990

Improvement of anal sensation with preservation of the anal transition zone after ileoanal anastomosis for ulcerative colitis.

One of the most important considerations in restorative proctocolectomy for ulcerative colitis is postoperative continence. Preservation of the anal transition zone has been associated with improved results after this procedure in the pediatric age group. This study was carried out to determine the effect of preservation of the amal transition zone in adult patients undergoing restorative proctocolectomy, comparing a group of patients with the anal transition zone preserved with a group of patients with the anal transition zone removed. Physiologic testing demonstrated improved sensation in those patients with a preserved anal transition zone. Functional results were not significantly improved, although there was a trend toward improved continence and discrimination in those with the anal transition zone preserved. Although the results are early and are not conclusive from the clinical standpoint, they are certainly encouraging and may justify continued use of this technique.

Adult↗
PubMed1990

Isolation of Protomonas extorquens (the 'red phantom') from a patient with AIDS.

We report the isolation of a pigmented, slowly growing, environmental organism with pink colonies from the blood of a patient with AIDS. The organism was characterised biochemically and by protein 'fingerprinting' as Protomonas extorquens biovar 3. This is the first report of isolation of this organism from a patient with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Multiplex PCR amplification and immobilized capture probes for detection of bacterial pathogens and indicators in water.

Detection of pathogens (Legionella species) and indicator bacteria (coliform bacteria) was achieved by multiplex (simultaneous) PCR amplification of diagnostic gene sequences and by hybridization to immobilized poly-dT-tailed capture probes using a dot- or slot-blot approach. Complex manipulations of primer concentrations and staggered additions of primers were required in order to achieve equal amplification of multiple genes. Multiplex PCR amplification of two different Legionella genes, one specific for L. pneumophila (mip) and the other for the genus Legionella (5S rRNA), was achieved by staggered amplification. Multiplex PCR amplification using differing amounts of primers specific for lacZ and lamB genes permitted the detection of coliform bacteria and those associated with human faecal contamination, including the indicator bacterial species E. coli and enteric pathogens Salmonella and Shigella. Hybridization of biotin-labelled amplified DNA, in which the biotin was incorporated during PCR amplification from biotinylated-dUTP, to immobilized 400-dT-tailed capture probes permitted specific and sensitive detection of target gene sequences. The sensitivity of colorimetric detection achieved by PCR amplification of target DNA was at a level equivalent to 1-2 bacterial cells, which is the same level of sensitivity obtained with radioactive detection. The simultaneous amplification of several genes and hybridization to immobilized capture probes with colorimetric detection is an effective, efficient and rapid detection method for various human bacterial pathogens.

Bacteriological Techniques↗
PubMed1990

Detection of Legionella with polymerase chain reaction and gene probe methods.

Methods were developed for the detection of Legionella in environmental water sources, based upon the polymerase chain reaction (PCR) and gene probes. All species of Legionella, including all 15 serogroups of L. pneumophila tested, were detected by PCR amplification of a 104 bp DNA sequence that codes for a region of 5S rRNA followed by radiolabelled oligoprobe hybridization to an internal region of the amplified DNA. Strains of L. pneumophila (all serogroups) were specifically detected based upon amplification of a portion of the coding region of the macrophage infectivity potentiator (mip) gene. Pseudomonas spp. that exhibit antigenic cross-reactivity in serological detection methods did not produce positive signals in the PCR-gene probe method using Southern blot analyses. Single cell, single gene Legionella detection was achieved with the PCR-gene probe methods.

Base Sequence↗
PubMed1990

High resolution computed tomography of Pneumocystis carinii pneumonia in AIDS.

High resolution computed tomography (CT) was performed on 11 homosexual men with the Acquired Immune Deficiency Syndrome (AIDS). All had bronchoscopically proven Pneumocystis carinii pneumonia (PCP). Six patients were re-scanned following treatment and symptomatic recovery. All the scans were abnormal, most showing fine diffuse bilateral alveolar consolidation with bronchial wall thickening, despite having a normal or near-normal chest radiograph in three cases. A variety of unexpected changes such as peripheral consolidation only, upper or lower zone predominance, unilaterality, bronchial dilatation, cystic air spaces and sub-pleural sparing were also seen. Following therapy, resolution of CT changes was shown to be incomplete despite clinical recovery, and whilst all the cases showed a reduction in alveolar consolidation, other findings such as new interstitial shadowing, peripheral predominance, and persistent cystic changes were observed, suggesting the healing process to be complex. Whilst the changes of PCP and its progression following treatment are well described on the plain chest radiograph, this is the first specific documentation of its appearances on narrow section CT, and its response to therapy. The usefulness of high resolution CT scanning to show early infection with PCP in the face of a normal chest radiograph is discussed, and the wide variety of CT changes occurring once the disease is established is emphasized.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Additional evidence that "plasmacytoid T-cell lymphoma" associated with chronic myeloproliferative disorders is of macrophage/monocyte origin.

Plasmacytoid T-cell lymphoma (PTL) is a rare lymphoma with unique morphologic, immunologic, and clinical features. Thus far, only three cases have been reported, each terminating in myeloid leukemia. The macrophage/monocyte rather than T-cell origin of "plasmacytoid T-cells" in reactive lymph nodes has been suggested in the past, but there has been no extensive investigation to demonstrate whether the PTLs are also of this lineage. The authors now report on a patient with PTL who had a long history of clinically stable idiopathic myelofibrosis. Immunocytochemical staining of the neoplastic plasmacytoid cells, with a large panel of monoclonal antibodies used on fresh-frozen and paraffin-embedded tissue sections, showed that the neoplastic cells expressed several macrophage/monocyte-associated markers, i.e., CD31, CD36 (thrombospondin receptor), and CD68 (KP1). Other markers of the macrophage/monocyte lineage (e.g., CD11b, CD11c, CD16) were absent. The neoplastic cells lacked B-cell-associated antigens and lacked most T-cell-associated markers, with the exception of CD2 and CD4. These findings are in close agreement with those of previous studies on normal plasmacytoid T-cells and support the macrophage/monocytic origin of PTL. Molecular hybridization studies provided additional support for the nonlymphoid origin of the plasmacytoid cells by demonstrating the absence of T-cell-receptor beta-chain and immunoglobulin heavy-chain gene rearrangements in the neoplastic cells. The results of the authors' studies indicate that "plasmacytoid T-cell lymphoma" associated with a chronic myeloproliferative disorder is of macrophage/monocyte lineage.

Gene Rearrangement, beta-Chain T-Cell Antigen Rece↗
PubMed1990

Women's anticipation and experience of childbirth: the independence of fulfillment, unpleasantness and pain.

Adjectives or phrases used by women in their description of childbirth were identified by interviewing two groups of 10 women, one drawn from an antenatal clinic, the other following delivery of a healthy child. The terms obtained were formed into a questionnaire on which 106 antenatal women described their expectations of childbirth and 82 postnatal women described their experience. Principal components analysis revealed two important findings. First, the ratings were multidimensional; that is, a dimension of fulfillment and achievement was independent of one of emotional feeling. Second, painfulness was not associated with either dimension.

Adaptation, Psychological↗
PubMed1990

Polyclonal anti-idiotypic antibodies exhibit antigenic mimicry of limited type 1 fimbrial proteins of Escherichia coli.

Polyclonal anti-idiotypic antibodies (anti-Ids)(fim) developed against idiotypes on antibodies (Ab-1s) that specifically bind structural, organelle fimbrial proteins of Escherichia coli were able to modulate immune function in anti-Id(fim)-immunized mice. Proliferation or suppression of splenic lymphoid cell responses by polyclonal anti-Ids in tissue culture appeared to be dose dependent. Anti-Ids were able to induce a dose-dependent T-cell-mediated immunity specific for type 1 fimbrial antigen(s) in immunized animals when assessed in vitro, but they failed to elicit in vivo positive ear-swelling skin reactions. Anti-Ids were unable to induce protective immunity against an in vivo infectious challenge with E. coli in anti-Id-immunized adult animals, but they stimulated a specific, secondary antibody response in anti-Id-challenged mice. Anti-Ids stimulated the development of anti-anti-Ids (Ab-3s) specifically binding a fimbrial antigen(s) and revealed the presence of antibody idiotypes binding E. coli adhesin proteins in the 27- to 29-kilodalton range. Results suggest discrete, but subtle, immunomodulatory effects of the anti-Ids and potential vaccinoid properties capable of stimulating a specific humoral and cellular response in vivo.

Adhesins, Escherichia coli↗
PubMed1990

Evaluation of amino-oxyacetic acid as a palliative in tinnitus.

Amino-oxyacetic acid (AOAA) was evaluated as a palliative in tinnitus. Sixty-six patients with tinnitus presumed to be of cochlear origin were given either a placebo or 75 mg of AOAA four times a day for 1 week. Response was evaluated by both audiometric measurement of tinnitus loudness and subjective rating by patients of change or no change in tinnitus severity. Because loudness measurements and self-rating have not been shown to be independent, and since the aim of clinical treatment of tinnitus is the alleviation of subjective distress, greater weight was given to the patient's self-rating. A total of 21% of all patients reported a subjective decrease in tinnitus severity, usually within 3 to 4 days after the start of AOAA use. Patients with tinnitus caused by presbycusis or Meniere's disease were the most likely to respond to AOAA treatment with a reduction in tinnitus severity, whereas those with drug-induced tinnitus were the least likely to respond. Nausea and dysequilibrium were the most common side effects of AOAA use. Of the 21% of patients who responded to AOAA, 71% developed some type of side effect. Amino-oxyacetic acid produces a reduction in the severity of tinnitus in about 20% of patients; however, the incidence of side effects makes the drug unacceptable for clinical use.

Acetates↗
PubMed1990

New initiatives in a district AIDS counselling unit, 1988-89.

This paper describes the workload of the AIDS Counselling Unit in Hampstead District Health Authority during its second year of service. Between April 1988 and March 1989, the average number of patients seen each month by the Unit doubled. It is anticipated that the caseload in the district will continue to increase, both among those with human immunodeficiency virus (HIV) infection and those without. New initiatives were developed within the district during the year. These included a new inpatient facility for patients with the acquired immunodeficiency syndrome (AIDS), the appointment of a designated HIV/AIDS consultant, and counselling services for people attending the antenatal clinic as well as those entering drug trials. Appropriate counselling services will need to be established in other health districts to meet local demand.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Developing AIDS counselling services: problems and problem-solving.

AIDS counselling is vitally important in the prevention of HIV transmission. It is also widely used in the context of patient management. Culturally sensitive counselling approaches need to be developed for the African setting. Establishing counselling services requires problem-solving, managerial interventions and interpersonal skills, much the same as an AIDS counselling interview. A framework for problem-solving is described in this paper.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Effects of benzoyltropine and tropacocaine on several cholinergic processes in the rat brain.

Benzoyltropine and tropacocaine are two contaminants of street-cocaine reported to have parasympatholytic activity. Because the mechanism underlying this activity is obscure, we investigated the effects of these compounds on several cholinergic processes: sodium-dependent choline uptake, sodium-independent choline uptake, acetylcholine synthesis, acetylcholine release (spontaneous and veratridine-induced) and binding of [3H]quinuclidinyl benzylate to muscarinic receptors. These studies used rat cerebral cortical synaptosomes, except for the receptor-binding studies, which used whole brain plasma membranes. Benzoyltropine and tropacocaine each inhibited sodium-dependent choline uptake and acetylcholine synthesis in a dose-related manner that was competitive with extracellular choline. Benzoyltropine was 4 to 5 times more potent in both actions than tropacocaine. Sodium-independent choline uptake was not affected by either compound. Benzoyltropine (30 microM) had no effect on the sodium-dependent uptake of norepinephrine, gamma-amino-butyric acid, glutamate or serotonin; tropacocaine (30 microM) inhibited only norepinephrine uptake at this concentration. Benzoyltropine and tropacocaine each inhibited the spontaneous and veratridine-induced release of newly synthesized acetylcholine, but not via activation of presynaptic muscarinic receptors. Instead, each compound was able to attenuate the oxotremorine-induced inhibition of the release of acetylcholine, suggesting antimuscarinic activity. Binding experiments showed that benzoyltropine and tropacocaine were, respectively, about 1,000- and 10,000-fold less potent than scopolamine as receptor antagonists. Finally, we demonstrated that benzoyltropine accumulates in the rat brain after its peripheral injection (10 mg/kg i.p.) and remains there with a half-life similar to that of cocaine.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗
PubMed1990

Renal replacement therapy in the ICU: the role of continuous arteriovenous haemodialysis.

Conventional haemodialysis is not available on all intensive care units (ICUs) and there are relatively few renally trained nurses able to run haemodialysis machines. Continuous arteriovenous haemodialysis provides effective renal replacement therapy for critically ill patients in the ICU. Unlike continuous arteriovenous haemofiltration it provides sufficient control over electrolyte, solute and water balance to obviate the need for additional treatment with intermittent conventional haemodialysis.

Acute Kidney Injury↗