Polymerase chain reaction-triggered preemptive or deferred therapy to control cytomegalovirus-associated morbidity and costs in renal transplant patients.
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Antilymphocyte Serum↗
Biomedical subjects
S B Miller
Publications and source records attributed to S B Miller.
Verrucous carcinoma of the foot: a review and report of two cases.
Verrucous carcinoma is an uncommon form of squamous cell carcinoma. Clinical and histological features of this condition are reviewed. Excision is the treatment of choice due to local aggressiveness and infrequent metastasis. Two cases involving the foot are presented as well as a survey of previously documented cases of this condition.
Carcinoma, Verrucous↗
Cardiovascular reactivity in anger-defensive individuals: the influence of task demands.
This study examined whether the elevated cardiovascular response to stressful stimuli previously suggested for individuals who are defensive in their reporting of anger might be moderated by the demands of the stressor task. Forty male undergraduates were exposed to four tasks: shock avoidance video game, handgrip, film, and cold pressor. Employing cluster analysis, defensive/low anger subjects were identified by high scores on the Marlowe-Crowne Social Desirability scale and low scores on the Spielberger Anger Expression and Trait Anger questionnaires. These individuals exhibited elevated heart rate and systolic blood pressure responses as compared with other subjects, but only to the shock avoidance task. Defensive/low anger subjects also reported less state anger to all tasks. It is proposed that an anger defensive style results in elevated cardiovascular activity only in interaction with stressors that elicit a sympathetic nervous system response and/or involve evaluation threat.
Adult↗
Parental history of hypertension, menstrual cycle phase, and cardiovascular response to stress.
The present study examined whether inconsistent findings for elevated cardiovascular response to stress in female offspring of hypertensives might be a function of 1) lack of control for menstrual cycle phase, and 2) stressor type employed. Thirty healthy women (18-35 years), half of whom were offspring of hypertensives, were tested in both the luteal and follicular phases of the menstrual cycle. Order of testing was counterbalanced between subjects and cycle phase was confirmed by measurement of serum sex hormone levels. In each session, subjects were exposed to four tasks: the cold pressor test, interpersonal speech, shock-avoidance video-game, and reading. The most consistent menstrual cycle effect was for offspring of normotensives who exhibited higher diastolic blood pressure and state-anger responses to the speech task in the follicular compared with the luteal phase. Though menstrual cycle had no consistent effect on offspring of hypertensives, their luteal phase diastolic blood pressure and state-anger responses to the speech task were elevated compared with controls. Potential limitations of the observed familial differences in luteal phase response are discussed.
Adolescent↗
Parental history of hypertension, sodium loading, and cardiovascular response to stress.
Parental history of hypertension, dietary sodium, and psychological stress have all been implicated in the development of essential hypertension and may interact in elevating disease risk. The mechanism by which this might occur is unclear, but it may be related to changes in the peripheral vasculature. The present study examined the effects of parental history and sodium on cardiovascular responses to an extended stressor. Eighteen normotensive offspring of hypertensives and 18 offspring of normotensives were exposed to a 1-hour shock-avoidance video-game procedure after 14 days of sodium loading (10 1-g tablets/day) and again after 14 days of placebo tablets. Order of sessions was counterbalanced between subjects in a double-blind design. In offspring of hypertensives, sodium loading elevated total peripheral resistance and norepinephrine responses to stress relative to placebo conditions and compared with offspring of normotensives. These increases were accompanied by decreases in stroke volume and cardiac output, which may explain the absence of familial differences in blood pressure responses to stress and sodium. Sodium loading had no effect on offspring of normotensives. The elevated resistance in offspring of hypertensives may suggest the initiation of pathological processes. The absence of sodium effects on resting values indicates the importance of research under conditions of stress.
Adult↗
A one-hour active coping stressor reduces small bowel transit time in healthy young adults.
OBJECTIVE: To examine the effect of a prolonged active coping stressor on the transit of a substance from the mouth through small intestine in normal human volunteers. METHOD: Twelve healthy undergraduate males were administered 10 g of the nonabsorbable carbohydrate lactulose in two experimental sessions. In normal individuals, lactulose produces hydrogen gas upon exposure to bacteria residing in the colon. Repeated measurements of breath hydrogen were obtained for 2 hours. In one session, subjects rested quietly for the 2-hour period. In the other counterbalanced session, subjects avoided mild electric shocks by playing videogames for the first hour. RESULTS: Stress produced a statistically and clinically significant reduction in mean transit time, from 79 to 55 minutes. The magnitude of stress-induced reduction in small bowel transit time was significantly correlated with change in an index of cardiac sympathetic activity, pulse transit time. CONCLUSIONS: A prolonged active coping stressor with minimal motor requirements produced a decrease in small bowel transit time comparable with that observed in several studies of the effects of physical exercise and in comparisons between normal controls and patients with diarrhea-predominant irritable bowel syndrome.
Adaptation, Psychological↗
Hostility, sodium consumption, and cardiovascular response to interpersonal stress.
OBJECTIVE: Previous studies have reported poorer health behaviors in high vs. low hostile subjects. The role of stress in these observed differences has not been explored although interpersonal stress does increase cardiovascular response in high hostiles. Given evidence that stress may induce increased salt-intake, this study examined the role of hostility and interpersonal stress in increasing sodium consumption in addition to cardiovascular reactivity. METHOD: Sixty-nine male undergraduates were categorized into high (HiHo) and low hostile (LoHo) groups based on Buss-Durkee Hostility Inventory scores. Subjects engaged in either a math task with harassment, math task without harassment, or a control/rest condition. Sodium intake was assessed posttask by having subjects ingest a sodium-free soup that was presented with a saltshaker without any comments. Cardiovascular measures were also recorded. RESULTS: HiHo subjects consumed more salt than LoHo subjects irrespective of experimental condition. HiHo subjects who were harassed also exhibited greater cardiac output, systolic blood pressure, and forearm blood flow than did HiHo nonharassed, HiHo control, or LoHo subjects. CONCLUSION: HiHo subjects exhibited increased salt-intake, although evidence for stress-induced salt-intake was not obtained. Nonetheless, the combination of salt and stress may contribute to the cardiovascular hyperreactivity and risk for cardiovascular disease in hostile individuals.
Adult↗
Functional MR imaging of the porcine kidney: physiologic changes of prolonged pneumoperitoneum.
BACKGROUND: Increased intraabdominal pressure (IPA) during laparoscopy has been associated with decreased urine output. The purpose of this study was to use a noninvasive MRI technique to measure renal vessel flow velocity and change in differential renal medulla and cortex perfusion during pneumoperitoneum. STUDY DESIGN: Six female farm pigs underwent general endotracheal anesthesia and dynamic imaging following left ventricular (LV) injection of Gd-DTPA, utilizing a dual echo gradient echo sequence. MRI was repeated after three hours of continuous 15 mm Hg pneumoperitoneum in three study pigs and after three hours of monitored general anesthesia without pneumoperitoneum in three control pigs. Renal artery and renal vein flow velocities were calculated using cine phase-contrast technique. Renal perfusion was independently measured by LV injection of radiolabelled microspheres. RESULTS: There was a decrease in mean renal vein flow velocity in the pneumoperitoneum group as compared to the control group. During pneumoperitoneum there was a similar percentage reduction in the perfusion of the cortex (-28%) and medulla (-31%); this corresponded with a decreased urine output. In addition, radiolabelled microspheres corroborated the similar decrease in both cortical and medullary perfusion rates during pneumoperitoneum. CONCLUSIONS: Prolonged IAP is associated with a decrease in renal vein flow velocity and urine output. There is a similar decrease in the renal medulla and cortex perfusion rates during pneumoperitoneum of 15 mm Hg.
Animals↗