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Biomedical subjects

S D Miller

Publications and source records attributed to S D Miller.

269 records · Page 15Linked to original sources
PubMedDate not supplied

Schneiderian symptoms in multiple personality disorder and schizophrenia.

We report structured interview data from a series of 102 cases of multiple personality disorder (MPD) diagnosed in four centers. Schneiderian first-rank symptoms of schizophrenia were equally common in all four centers. The average MPD patient had experienced 6.4 Schneiderian symptoms. When these 102 cases are combined with two previously reported series of MPD cases, an average of 4.9 Schneiderian symptoms in 368 cases of MPD is noted. This compares with an average of 1.3 symptoms acknowledged by 1,739 schizophrenics in 10 published series. Schneiderian symptoms are more characteristic of MPD than of schizophrenia.

Adult↗
PubMedDate not supplied

Differential recognition of sequences within the encephalitogenic region of myelin basic protein capable of eliciting cell-mediated immune responses in experimental autoimmune encephalomyelitis.

The fine specificity of myelin basic protein (MBP) epitopes capable of eliciting in vivo delayed-type hypersensitivity responses in Lewis rats with experimental autoimmune encephalomyelitis (EAE) was compared to those eliciting in vitro antigen-specific T cell proliferation and augmentation of disease transfer. Utilizing a panel of synthetic peptides with sequences representing the 68-86 region of guinea pig (GP-) or bovine myelin basic protein (B-MBP), animals were primed with one species of peptide and subsequently challenged with either the same peptide or peptides with truncations or substitutions representative of the other species of MBP. In regard to minimal length sequences capable of eliciting delayed-type hypersensitivity (DTH), rats primed with GP-MBP and complete Freund's adjuvant (CFA) exhibited a hierarchical pattern of responsiveness to challenge with a series of truncated peptides, ranking as follows: GP-68-86 > GP-72-86 > GP-68-84 > > GP-75-86 = no activity. This response pattern corresponds to that previously reported for T cell proliferation and activation for disease transfer. Furthermore, a comparison of these T cell-mediated immune parameters, as elicited by the substituted peptides, revealed the response patterns of DTH reactivity to be similar to that previously described for in vitro T cell proliferation with significant DTH responses generated only by the peptide species for which the animal was primed. In contrast, a cross-reactive pattern of recognition was observed in cells mediating disease transfer, with all four 68-86 sequences capable of augmenting activation for adoptive transfer of disease, regardless of the peptide species for which the animal was primed.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗
PubMedDate not supplied

Accuracy of clinical diagnosis of genital ulcer disease.

In Africa, establishment of an accurate clinical diagnosis in cases of genital ulcer disease is difficult owing to atypical presentation of ulcerations and mixed infections. This is compounded by the frequent lack of suitable laboratory facilities. In 240 cases of genital ulcer disease among mineworkers in Carletonville, South Africa, this study endeavored to correlate the clinical diagnosis with laboratory findings. Clinical accuracy and positive and negative predictive values were determined for each type of genital ulcer disease encountered. Overall, the accuracy of clinical diagnosis was 68% for single infections, 80% for chancroid, 55% for primary syphilis, 27% for lymphogranuloma venereum (LGV), and 22% for genital herpes. Adequate laboratory facilities are indispensible for the establishment of an accurate etiologic diagnosis of genital ulcer disease and thus the institution of appropriate antimicrobial therapy.

Chancroid↗
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Ultrasound catheter placement for deep posterior compartment pressure measurements in chronic compartment syndrome.

Medial shin pain, often referred to as shin splints, is a common but difficult to diagnose entity in many athletes. Chronic deep posterior compartment syndrome as a cause of medial leg pain is still controversial. The problems of deep posterior compartment pressure measurement contribute to this controversy. These problems include safety of catheter insertion and the possibility that the patient has more than one deep posterior compartment. In this paper, we present a new technique for catheter placement in which continuous ultrasound guidance is used. This technique allows for the safe placement of the catheter into the deep posterior compartment and for documentation of catheter tip location.

Catheterization↗
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Delayed nasal mucociliary clearance in patients with nonallergic rhinitis and nasal eosinophilia.

This study investigated nasal mucociliary clearance as related to nasal eosinophilia in nonallergic rhinitis patients using the technique of nasal saccharin challenge. Fifty-six consecutive patients with nonallergic rhinitis were evaluated with nasal cytology and saccharin challenge. A saccharin challenge time of greater than 25 minutes was considered abnormal. Twelve of 56 patients (21.4%) had nasal eosinophilia. Fifteen of 56 patients (26.8%) had prolonged nasal circulation times greater than 25 minutes, indicating delayed mucociliary clearance. Although 7 of 12 patients (58.3%) with nasal eosinophilia had delayed mucociliary clearance, only 8 of 44 patients (18.2%) without eosinophilia had circulation times longer than 25 minutes. The correlation of nasal eosinophilia with prolongation of the nasal circulation time is statistically significant (chi square 5.84, P = .0156). We postulate that damage to the nasal mucociliary system may be an etiologic factor for a subset of patients with nonallergic rhinitis and that this damage may be mediated by eosinophils.

Adult↗
PubMedDate not supplied

Follow-up of hymenoptera-sensitive patients without active immunotherapy.

Presently there is no definitive guideline for the treatment of adult patients suffering from generalized insect sting reactions limited to skin manifestations or purely respiratory compromise who have not been treated with immunotherapy. Previous studies in adults demonstrate that the majority of patients with insect sting anaphylaxis have a decreased reactivity to re-sting with time, suggesting the insect allergy itself may be self-limiting. In this study, we evaluated 63 patients with initial insect sting manifestations limited to the skin and the respiratory system and noted the incidence and degree of natural re-sting reactions to these patients who had not undergone venom immunotherapy. In those patients with mild systemic reactions limited to the skin, none experienced an increase in severity. A local reaction was found on repeat sting in three of five patients in this group, and two of five had an equivalent cutaneous response (i.e., urticaria/angioedema). In five patients who had an initial respiratory reaction, four of the patients had a local reaction while one patient repeated the same respiratory manifestations. None of the patients with cutaneous or respiratory symptoms demonstrated a more severe reaction upon re-sting. This demonstrates that there is a natural progression of tolerance to insect stings in the adult population.

Adolescent↗
PubMedDate not supplied

Urticaria and angioedema.

Urticaria and angioedema are commonly seen in the outpatient setting. Their pathogenesis involves complex cellular and humoral factors. Diagnosis depends on historical information such as duration of symptoms, exacerbating factors, and atopy. While many etiologic factors have been implicated, in most chronic cases no specific etiology is found. This article reviews physical and hereditary syndromes and discusses therapeutic regimens based on the duration and severity of symptoms.

Acute Disease↗
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Developmental outcomes in very low birth weight infants: a six-year study.

Advances in neonatal care have led to survival of more Very Low Birth Weight (VLBW) infants weighing < 1,500 grams with growing concerns about neuro-developmental outcomes. To identify relationships between outcomes and birth weight, we evaluated 213 VLBW infants over a six-year period using a standardized test to identify relationships between outcomes and birth weight, and participation in early intervention programs at a one-year follow-up. Average Mental Development Indices were obtained for the majority of infants across all birth weight categories with the smallest group (500-750 grams) scoring significantly lower than infants in all other categories. Infants who did not participate in early intervention scored better which suggests this group was healthier and less likely to need intervention services. Further clarification of the salient components of early intervention is recommended in future studies.

Analysis of Variance↗
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Prevalence of back pain among radiation therapists.

Low back pain among radiation therapists appears to be positively associated with age, time working as a radiation therapist and a number of other factors including level of fitness and perceived stress levels. These are the authors' findings from a pilot survey they conducted of radiation therapists employed in eight radiation oncology departments.

Adult↗
PubMedDate not supplied

Inhibition of orally-induced immune tolerance in mice by prefeeding an endopeptidase inhibitor.

Intragastric feeding of T-dependent protein antigens to mice induces substantial systemic tolerance in specific antibody and cell-mediated immune responses. To evaluate the role of gastrointestinal digestion in this phenomenon, the trypsin inhibitor aprotinin was fed to adult BDF1 mice prior to tolerogenic feedings of ovalbumin or human gamma globulin. As assessed by measurement of protein-specific antibody responses, aprotinin significantly reduced tolerance induced by feeding carrier protein, but not tolerance induced by parenteral antigen injection. Aprotinin also reduced oral tolerance to ovalbumin as measured by delayed-type hypersensitivity and T cell proliferative responses. However, aprotinin did not alter antibody tolerance to a carrier-associated hapten in the same animals. Feeding of human gamma globulin concomitantly with aprotinin induced specific antibody responses without further immunization, and reduced subsequent tolerance. Aprotinin also increased the level of immunologically detectable ovalbumin found in the serum following antigen feeding. The data support the hypothesis that aprotinin indirectly mediated changes in specific stimuli available to the lymphoid system as a result of alterations in gastrointestinal processing of fed antigens rather than to direct effects of aprotinin upon systemic immune responses.

Administration, Oral↗
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Endopeptidase inhibition and intestinal antigen processing in mice.

The role of gastrointestinal digestive processes in the systemic availability of ingested protein antigens was examined by feeding the trypsin inhibitor aprotinin intragastrically to mice and measuring uptake of ovalbumin and 14C-polyethylene glycol (MW 4000) from the gastrointestinal tract. Trypsin and chymotrypsin activities in the intestinal lumen were significantly reduced by aprotinin feeding. Aprotinin slowed stomach emptying, but radioimmunoassays for immunoreactive ovalbumin in the serum of mice prefed aprotinin showed 12-fold elevations within 1 hr after ovalbumin feeding. Uptake of a nonmetabolized macromolecular probe, 14C-polyethylene glycol-4000, increased less than two-fold when fed with aprotinin under the same conditions, indicating that the increased uptake of immunoreactive ovalbumin was not due to changes in intestinal permeability. The results show that inhibition of luminal proteolysis caused significant increases in the serum concentration of immunoreactive ovalbumin, indicating that acute inhibition of luminal proteases permits larger quantities of relatively intact protein to interact with mucosal absorptive surfaces. These results support the hypothesis that pancreatic proteases modulate antigen absorption from the lumen in adult animals.

Animals↗