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Biomedical subjects

W C Miller

Publications and source records attributed to W C Miller.

At least 145 records · Page 8Linked to original sources
PubMed1978

Decreased angiotensin-converting enzyme in the adult respiratory distress syndrome.

Using hippuryl-L-histidyl-L-leucine as substrate, serum angiotensin-converting enzyme was measured in 13 patients who had adult respiratory distress syndrome, eight patients with respiratory failure without adult respiratory distress syndrome, and two groups of controls: 24 healthy blood donors and 24 hospitalized patients with a variety of conditions but without respiratory failure or adult respiratory distress syndrome. Serum angiotensin-converting enzyme expressed in units/ml was 14.60 +/- 5.60 for adult respiratory distress syndrome compared with 28.92 +/- 6.60 for the blood donors, 20.76 +/- 5.87 for the patients with respiratory failure without adult respiratory distress syndrome and 20.20 +/- 5.94 in the hospitalized patients without respiratory failure or adult respiratory distress syndrome. These differences were significant, P less than .001 when adult respiratory distress syndrome was tested against the blood donors and P less than .01 against the other two groups. The significance of these findings is not clear, but the possibility is raised that the decrease of angiotensin-converting enzyme in adult respiratory distress syndrome results from a loss of pulmonary endothelial cells, which are known both to produce angiotensin-converting enzyme and to be damaged in adult respiratory distress syndrome.

Adolescent↗
PubMed1978

Monocrotaline model of noncardiogenic pulmonary edema in dogs.

Monocrotaline, a plant alkaloid shown histologically to produce pulmonary endothelial damage and edema, was used in dogs to produce an acute model of noncardiogenic pulmonary edema. Following intravenous injection there was no change in pulmonary vascular pressures or heart rate; cardiac output fell and pulmonary vascular resistance increased. After 2 h measurement of lung water demonstrated modest pulmonary edema in all animals. The degree of edema produced was more consistent and reproducible than that following alloxan or alpha-naphthylthiourea.

Alkaloids↗
PubMed1978

Contribution of systemic venous hypertension to the development of pulmonary edema in dogs.

Systemic venous hypertension (SVH) is a frequent finding in pulmonary edema. To study the possible contributory or even causal role of SVH in pulmonary edema, a dog model was developed in which balloon catheters were placed in the left and right atria. Inflation of the left atrial balloon produced a tendency to pulmonary edema by causing pulmonary venous hypertension (PVH) (pulmonary artery wedge pressure of 20 mmHg). Inflation of the right atrial balloon produced SVH (central venous pressure of 15 mm Hg). After 2 hours, dogs with SVH with or without PVH demonstrated a greater amount of lung fluid accumulation (P less than 0.01) compared to controls or PVH alone. There was no significant difference in lung water in SVH dogs with or without PVH. Pulmonary blood flow was not significantly different between the experimental groups, each of which was less than control. Impairment of pulmonary lymphatic flow is one possible mechanism producing the worsening edema; however, bronchial venous hypertension or neurogenic reflexes cannot be excluded. We conclude that the contribution of systemic venous hypertension to the development of pulmonary edema may have therapeutic implications.

Animals↗
PubMed1978

Polyamine synthesis in bone marrow granulocytes: effect of cell maturity and early changes following an inflammatory stimulus.

Enriched fractions of mature and immature neutrophil granulocytes, isolated from guinea pig bone marrow, were assayed for ornithine decarboxylase activity and polyamine content. The results show that immature granulocytes contain at least ten times more ornithine decarboxylase activity and two times more spermidine than mature granulocytes. The incorporation of 14C-ornithine into putrescine and spermidine of intact immature granulocytes was three to four times and ten times, respectively, that of mature granulocyte preparations. Six hours after an inflammatory stimulus, transient increases of 14-fold and 3-fold in the activities of ornithine decarboxylase and S-adenosyl-L-methionine decarboxylase, respectively, were observed in immature bone marrow granulocytes. At this time the incorporation of 14C-ornithine into putrescine and spermidine in bone marrow granulocytes from stimulated animals was 14 times that of cells from controls. A maximum increase in DNA synthesis in these cells during the inflammatory response occurred 6 hr after the maximum increase in the polyamine synthetic activity. Together these data suggest that polyamine synthesis in the granulocyte compartment of the bone marrow is associated chiefly with immature proliferating cells and that increased polyamine synthesis precedes increased granulocyte proliferation in the bone marrow following an inflammatory stimulus.

Adenosylmethionine Decarboxylase↗
PubMed1977

The effect of stored blood on mesenteric oxygen extraction during exdotoxin shock.

Storage of blood in acid-citrate-dextrose (ACD) solution gradually depletes red cell 2,3-diphosphoglycerate (DPG) and increases the affinity of hemoglobin for oxygen. We examined the effect of exchange transfusion of DPG-depleted blood on mesenteric blood flow and oxygen consumption in dogs subjected to endotoxin shock. Two groups of 6 dogs each were anesthetized and subjected to exchange transfusion with either fresh ACD blood or 21-day-old ACD blood prior to administration of Escherichia coli endotoxin (2 mg/kg). Mesenteric blood flow, arteriovenous oxygen content difference and systemic arterial blood pressure were monitored continuously before and for 60 min after endotoxin. Mesenteric blood flow was reduced from 250 +/- 21 ml/min before endotoxin to 114 +/- 15 ml/min at 5 min, 157 +/- 29 ml/min at 30 min, and 112 +/- 17 ml/min at 60 min after endotoxin in the dogs exchanged with fresh blood. Corresponding values for intestinal oxygen consumption were 10.4 +/- 1.0, 7.5 +/- 0.8, 8.4 +/- 1.0, and 6.8 +/- 0.7 ml/min. In dogs transfused with 21-day-old blood, pre-endotoxin blood flow was 208 +/- 2ml/min and declined to 115 +/- 12, 93 +/- 5, and 80 +/- 8 ml/min at 5, 30, and 60 min post-endotoxin. Corresponding values for intestinal oxygen consumption were 8.1 +/- 0.9, 6.6 +/- 0.7, 6.2 +/-0.5, and 5.5 +/- 0.7 ml/min. There was no significant difference (p greater than 0.1) in responses of blood flow or oxygen consumption to endotoxin shock between the two groups of dogs. These findings indicate that exchange transfusion with DPG-depleted blood does not impair oxygen extraction by the ischemic intestine.

Acids↗
PubMed1977

Clinical investigation of fenoterol, a new bronchodilator, in asthma.

In a randomized, double-blind, noncrossover, study, 28 asthmatic patients received either ephedrine or fenoterol (Th1165a) a new beta 2-sympathomimetic bronchodilator, for 90 days. Forced expiratory flows and volumes and plethysmography were performed after a single test dose on days 1, 45, and 90. The subjects' clinical course was followed for patient acceptance and side effects. Compared to ephedrine, Th1165a was demonstrated to be a potent bronchodilator with a prolonged duration of action. Adrenergic side effects were minimal, and no tolerance or toxicity was demonstrated.

Asthma↗
PubMed1977

Selection among benzodiazepines for alcohol withdrawal.

Four pharmacologic differences among the benzodiazepines, which are the drugs of choice to conduct alcohol withdrawal, guide selection of the appropriate one: chlordiazepoxide, diazepam, oxazepam, or chlorazepate. Bases for selection include: (1) availability of other than oral dosage forms; (2) differences in additive effect with alcohol in producing central nervous system depression; (3) differences in anticonvulsant effect; and (4) differences in duration of effect in the body (ie, half-life). Decreasing dosage schedules are preferred to a steady dosage. Illustrative dosage schedules for using chlordiazepoxide and diazepam to conduct alcohol withdrawal are given.

Administration, Oral↗
PubMed1977

Postoperative lobar torsion and gangrene.

Following left upper lobectomy for a pulmonary nodule, complete 180-degree torsion of the left lower lobe with haemorrhagic infarction occurred. Despite re-exploration within 24 hours of the initial procedure the patient died. Postoperative torsion requires early diagnosis and resection of the gangrenous tissue.

Aged↗
PubMed1977

Mycoplasma pneumonia: a study on hospitalized American patients with pneumonia in Vietnam.

A prospective study on consecutively hospitalized pneumonia patients showed that 41.5% of 58 patients had a fourfold rise in the complement-fixation titer for Mycoplasma pneumoniae. Viral isolation techniques and serologic tests for influenza A1, A2 and B, parainfluenza 1 and 3, respiratory syncytial virus and the adeno virus group yielded only a single positive isolate for influenza A2. Serologic tests for melioidosis, leptospirosis, scrub, murine and epidemic typhus and psittacosis were all negative. The clinical manifestations were not distinctive for the positive M. pneumoniae patients when compared with the patients having a negative M. pneumoniae complement-fixation test. The symptoms and signs and laboratory and radiologic findings were similar to those described in other reports on primary atypical pneumonia.

Adult↗
PubMed1977

A computerized approach to closing volume determination.

A computer program was designed to analyze the single-breath nitrogen curve and calculate closing volume. The program solved simultaneously the two regression equations of phases III and IV with the intersection representing the point of closing volume. Thirty volunteers were asked to perform three consecutive single-breath nitrogen tests, all administered by an experienced laboratory technician. The tracings were also analyzed independently by two experienced observers. Correlation between visual and computer determination was excellent (r = 0.84), indicating that the computer method is as accurate in its closing volume analysis as is the present day method of visual determination. The results of this study suggest that widespread use of such a program could prove timesaving and eliminate the problems of interobserver and intraobserver variation, which presently impair the reliability of the SB N2 test.

Computers↗
PubMed1977

Lymphocytotoxic antibodies in patients with inflammatory bowel disease and their spouses--evidence for a transmissible agent.

Serum lymphocytotoxic antibodies (LCA) were detected in twenty-seven out of fifty-three (51%) patients with inflammatory bowel disease (IBD) and in twenty-three out of their fifty-three (43%) unaffected spouses. The prevalence of LCA in both groups was significantly increased (P less than 0.001) compared to that in age- and sex-matched controls (11%) or in control spouses (6%). Concordant expression of LCA occurred in sixteen out of the fifty-three (30%) patient-spouse pairs compared to only one out of the fifty-three (2%) control-spouse pairs (P less than 0.001). In contrast to the LCA results, heterophile antibody titres were similarly distributed in all four study groups. It is suggested that LCA may represent markers of infectious agents in IBD and that their occurrence in unaffected close contacts of patients may indicate transmission of such agents to these subjects.

Antibodies↗
PubMed1977

Psychological assessment of the burn patient.

Emotional and intellectual responses of 25 burn patients, 16 males and 9 females, were assessed with the MMPI and the six verbal subtests of the WAIS. These measures were administered upon hospital admission and 11 to 12 months after discharge. Data analysis entailed Hotelling's T2 tests for paired observations, paired t-tests and product-moment correlations. Results did not reveal the emotional and intellectual deterioration commonly reported in the literature. The composite group MMPI profiles were essentially normal at both administrations with significant pre-post increments on the L Scale, Scale 9 and Scale 0, p less than .05. Male patients did not show significant pre-post changes, while females showed a significant pre-post increment on Scale 0, p less than .05, which indicates increased social orientation and gregariousness. Patients as a group showed significant pre-post increments on the Information (p less than .05) and Digit Span (p less than .01) subtests of the WAIS. Males demonstrated more dramatic increases than did females. Discrepancies between these findings and those reported by other investigators are attributed to the use of young children as participants in other studies, the absence of discernible premorbid factors that have been associated with post-trauma adjustment difficulties in other investigations and possible differential effectiveness of psychological intervention during hospitalization. The WAIS and MMPI were found to be sensitive to the emotional and intellectual changes experienced by participants, which suggests their application to assess the psychological aspects of the burn patient's recovery.

Adult↗
PubMed1976

Psychosocial support in the treatment of severely burned patients.

A psychosocial team took part in the total patient care program of a burn unit. Psychometric data were gathered during the treatment phase and at one-year followup. The treatment plan included adequate analgesics, major tranquilizers when indicated, attention to sleep requirements for patients, and active participation of family members in the treatment program, with supportive psychotherapy. Standardized psychological and intelligence tests were administered to adult patients during treatment and one year after discharge, and scores compared.

Adaptation, Psychological↗