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Biomedical subjects

T R Miller

Publications and source records attributed to T R Miller.

At least 217 records · Page 12Linked to original sources
PubMed1981

Fine-needle aspiration biopsy in the management of thyroid nodules.

A prospective study was carried out of 136 patients with thyroid nodules. In all of the cases, fine-needle aspiration (FNA) cytology was used in the clinical management. Of the specimens taken, 129 were satisfactory for cytology; 5 were clearly malignant and the diagnosis was confirmed during surgical operation. The diagnosis of follicular neoplasm or "suspicious for malignancy" was made in 29 patients. Operations were done in 21; adenoma was found in 15, cancer in 2 and multinodular goiter in 4. The cases in which a benign diagnosis was made are being followed clinically. From these data and a review of the literature, a plan for the management of patients with thyroid nodules can be outlined. FNA biopsy of the thyroid is an excellent method for eliminating unnecessary operations in patients with thyroid nodules.

Biopsy, Needle↗
PubMed1980

Ocular metastases from systemic melanoma.

We studied two patients, a 72-year-old man and a 27-year-old woman, with metastatic melanoma documented by cytologic examination of the ocular fluids. Neither patient had a clinically detectable ocular mass. Fine-needle aspiration with cytologic examination may be useful in the diagnosis of metastatic ocular melanoma.

Adult↗
PubMed1979

The value of liver scintigraphy in choroidal melanoma.

Radionuclide liver scintigraphy was performed as part of the initial diagnostic evaluation in 35 patients with choroidal melanoma and no overt evidence of extraocular metastic diseases. The scans were normal in all but one patient in whom a solitary hepatic defect (due to an hemangioma) was found. The results of this study suggest that routine liver scans are not indicated in the initial staging evaluation of patients with choroidal melanoma, normal liver enzyme levels, and no other evidence of metastasis because of the low yield of scintigraphically detectable disease under these circumstances.

Aspartate Aminotransferases↗
PubMed1979

Effect of central catecholamine depletion on the osmotic and nonosmotic stimulation of vasopressin (antidiuretic hormone) in the rat.

The central nervous system (CNS) mechanism(s) for the release of antidiuretic hormone (ADH) by various stimuli is unknown. In this study, the role of CNS catecholamines in effecting ADH release was examined in conscious rats 10-14 d after the cerebroventricular injection of 6-hydroxydopamine (6-OHDA). This dose of 6-OHDA caused a 67% depletion of brain tissue norepinephrine and only 3% depletion of heart norepinephrine, as compared with controls, which were injected with the vehicle buffer alone. Either intravenous 3% saline (osmotic stimulus) or intraperitoneal hyperoncotic dextran (nonosmotic stimulus) was administered to water-diuresing rats through indwelling catheters. Neither of these maneuvers changed arterial pressure, pulse, or inulin clearance in control or 6-OHDA rats. The 3% saline caused similar increases in plasma osmolality (15 mosmol/kg H(2)O) in control and 6-OHDA rats. The control rats, however, increased urinary osmolality (Uosm) to 586 mosmol/kg H(2)O, whereas 6-OHDA rats increased Uosm only to 335 mosmol/kg H(2)O (P < 0.005). These changes in Uosm were accompanied by an increase in plasma ADH to 7.6 muIU/ml in control animals vs. 2.9 muIU/ml in 6-OHDA rats (P < 0.005). All waterdiuresing animals had undetectable plasma ADH levels. Dextran-induced hypovolemia caused similar decrements (- 10%) in blood volume in both control and 6-OHDA animals, neither of which had significant changes in plasma osmolality. This nonosmotic hypovolemic stimulus caused an increase in Uosm to 753 mosmol/kg H(2)O in control rats, whereas Uosm in 6-OHDA rats increased to only 358 mosmol/kg H(2)O (P < 0.001). At the same time, ADH levels also were significantly greater in Cont rats (2.4 muIU/ml) than in the 6-OHDA animals (0.69 muIU/ml; P < 0.05). These results therefore suggest that CNS catecholamines may play an important role in mediating ADH release in response to both osmotic and nonosmotic (hypovolemic) stimuli.

Animals↗
PubMed1978

Imaging of canine tumors with 11C-methylputrescine.

The polyamines--putrescine, spermidine and spermine--are present in elevated concentrations in rapidly growing cell lines and in several neoplasms. Five dogs with benign or malignant tumors and one normal dog were imaged with a rectilinear scanner following I.V. administration of 2--8 mCi 11C-methylputrescine. High concentrations of 11C-methylputrescine were found in the liver, and in the kidneys and urine in the dogs with good renal function. Concentrations were higher in tumors than in skeletal muscle, blood or lung. The tumor/blood ratio varied from 2--21; tumors were demonstrated by imaging in four dogs in which the ratio exceeded 4.0. 11C-methylputrescine is a possible tumor imaging agent.

Animals↗
PubMed1978

Urinary diagnostic indices in acute renal failure: a prospective study.

A prospective analysis of the value of urinary diagnostic indices in ascertaining the cause of acute renal failure was undertaken. Our results show that in the setting of acute oliguria a diagnosis of potentially reversible prerenal azotemia is likely with urine osmolality greater than 500 mosm/kg H2O, urine sodium concentration less than 20 meq/litre, urine/plasma urea nitrogen ratio greater than 8, and urine/plasma creatinine ratio greater than 40. Conversely, a urine osmolality less than 350 mosm/kg, urine sodium concentration greater than 40 meq/liter, urine/plasma urea nitrogen ratio less than 3, and urine/plasma creatinine ratio less than 20 suggest acute tubular necrosis. A significant number of oliguric patients will not have urinary indices that fall within these guidelines. In this setting, urine sodium concentration divided by the urine-to-plasma creatinine ratio (the renal failure index) and the fractional excretion of filtered sodium provide a reliable means of differentiating reversible prerenal azotemia from acute tubular necrosis.

Acute Kidney Injury↗
PubMed1977

Nonoliguric acute renal failure.

To delineate the clinical spectrum of nonliguric renal failure, we studied prospectively 90 patients with acute renal failure 54 of whom were nonoliguric throughout their periods of azotemia. Although the causes of nonoliguric renal failure varied, nephrotoxic failure occurred more frequently in nonoliguric than in oliguric subjects (P is less than 0.01). As com pared to oliguric patients, those without oliguria had significantly lower urinary sodium concentrations (P is less than 0.05) and fractional excretions of sodium (P is less than 0.02), had shorter hospital stay (P is less than 0.01), had fewer septic episodes, neurologic abnormalities, gastrointestinal bleeding and acidemia, required dialysis less frequently (P is less than 0.001) and had lower mortality rate (26 per cent in nonoliguric vs. 50 per cent in oliguric patients -- P is less than 0.05). Nonoliguric renal failure occurs more often than is generally recognized and causes less morbidity and mortality than oliguric acute renal failure.

Acute Kidney Injury↗
PubMed1977

Psychophysiologic aspects of cancer: the James Ewing lecture.

Clinicians have long been aware of the influence of the neuro-endocrine axis and the action of the hypothalmus on the humoral immune response in the origin and course of cancer. Little attention has been paid, however, to the psychophysiologic aspects of cancer. These psycho-social effects may be related to hypothalamic activity, the autonomic nervous system, and neuro-endocrine activity. More attention should be paid to the manipulation of the psyche in the prevention and management of cancer.

Behavior↗
PubMed1977

Surgical management of malignant bone tumours.

The evolution of treatment for osteogenic sarcoma at the Memorial Sloan-Kettering Cancer Center is reviewed. The possible control of micrometastases by chemotherapy and the excision of macrometastases at single or multiple thoracotomies by the thoracic surgeon have added greatly to the salvage rate of this tumour. Intensive chemotherapy has made possible en bloc resection of bones involved by tumour, with preservation of the limb. Despite advances, however, amputation or en bloc resection is still necessary to control the primary tumour.

Adult↗