PubMed HealthSearch

Biomedical subjects

E B Miller

Publications and source records attributed to E B Miller.

At least 19 recordsLinked to original sources

Association of serum beta-hCG levels with myosalpingeal invasion and viable trophoblast mass in tubal pregnancy.

OBJECTIVE: To test the hypothesis that myosalpingeal invasion and viable trophoblast mass are associated with serum beta-hCG levels in tubal-ampullary pregnancy. METHODS: Twenty-seven salpingectomy specimens of tubal-ampullary pregnancies were assessed for the presence or absence of myosalpingeal invasion. The mass of viable trophoblast was quantified in terms of the number of high-power fields (x400) occupied. The cases were stratified into three groups: small, less than one field; medium, one or two fields; and large, more than two fields and/or embryo present. Beta-hCG was measured before the procedure (mIU/mL, Third International Standard). RESULTS: The mean (+/- standard error of the mean) beta-hCG level for the nine cases exhibiting myosalpingeal invasion was significantly higher than for the 18 cases without invasion (13,665 +/- 2986 versus 2169 +/- 870 mIU/mL; P = .0001). Beta-hCG levels greater than or equal to 5400 mIU/mL predicted myosalpingeal invasion in eight of nine cases (positive predictive value 89%). In contrast, levels less than 5400 mIU/mL were associated with lack of myosalpingeal invasion in 17 of 18 cases (negative predictive value 94%). The volume of trophoblast mass correlated with both beta-hCG levels (r = 0.647, P = .0003) and myosalpingeal invasion (r = 0.735, P = .0001). There was no invasion in the 13 cases in the group with small trophoblast mass, whereas two of five cases in the medium-mass group displayed myosalpingeal invasion. In this group, the mean beta-hCG for cases with myosalpingeal invasion was higher than in the cases without invasion (16,917 +/- 117 versus 3799 +/- 1094 mIU/mL; P = .003). In the group with large trophoblast mass, seven of nine specimens showed myosalpingeal invasion. CONCLUSION: Both myosalpingeal invasion and viable trophoblast mass correlate positively with serum levels of beta-hCG. Myosalpingeal invasion is highly likely when beta-hCG levels reach 5400 mIU/mL.

Chorionic Gonadotropin

Reduced natural killer cell activity in patients with systemic sclerosis. Correlation with clinical disease type.

Natural killer (NK) cell number and function were determined in 69 systemic sclerosis (SSc) patients (41 with diffuse cutaneous SSc, 24 with limited cutaneous SSc, and 4 with scleroderma in an overlap syndrome). The results were compared with those obtained from 5 patients with Raynaud's disease and from 27 normal controls. Natural and antibody-dependent killing was reduced in the total group of SSc patients compared with controls, but these differences were primarily attributable to patients with the diffuse form of the disease who were seen early in their illness (less than 5 years after onset). NK cell numbers were not significantly reduced in patients compared with controls, although lower numbers were observed in individuals with early diffuse disease. Other clinical parameters, such as treatment with D-penicillamine or the presence of scleroderma-specific autoantibodies, did not exert an independent effect on NK cell function. These findings suggest a possible central role for NK cells in the pathogenesis of SSc.

Adult

The psycho-flexed hand.

Five mentally disturbed patients had flexion contractures of the middle, ring, and little fingers of one or both hands. All gave a history of psychiatric illness manifested by depression. Since no organic etiology for the contractures was found, the authors name this condition the "psycho-flexed hand." Four of the five patients were middle-aged women who suffered long-term depression, hypochondriasis, and/or schizophrenia. The patients' severely contracted fingers often macerated the palm. Manipulation under anesthesia and splinting only temporarily relieved the contractures. Multiple complications occurred following splinting and hand therapy, as well as surgery. Therefore, caution is urged when attempting surgical correction before resolving the mental illness.

Aged

Chronic posttraumatic radial instability of the thumb metacarpophalangeal joint.

Radial collateral ligament injuries accounted for 35% of 26 patients undergoing surgery for lateral instability of the thumb metacarpophalangeal joint in a 3-year period. Nine patients with chronic radial instability presented with significant disability but with a symptom complex distinct from the weak pinch and grasp of chronic ulnar instability. Functional and clinical stability was obtained in these patients with a surgical procedure that consisted of repair of the callateral ligament at the site of injury, distal advancement of the abductor pollicis brevis tendon, and repair of the abductor aponeurosis.

Adolescent