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Biomedical subjects

H H Miller

Publications and source records attributed to H H Miller.

At least 37 records · Page 2Linked to original sources
PubMed1976

Fate of the retained rectum after subtotal colectomy for inflammatory disease of the colon.

Of forty-nine consecutive patients who underwent subtotal colectomy for inflammatory disease of the colon, 73.5 per cent required subsequent combined abdominoperineal resection of the retained rectum and only two patients had successful ileoproctostomy. For the patient whose rectum is substantially diseased along with the rest of the colon, one-stage total proctocolectomy is the preferred operation.

Adolescent↗
PubMed1976

Total thyroidectomy for occult familial medullary carcinoma of the thyroid in children.

Experience with 17 children in one kindred with familial medullary carcinoma of the thyroid and pheochromocytoma has demonstrated the utility and validity of periodic provocative testing by calcium infusion or pentagastrin injection in the identification of children with early medullary carcinoma of the thyroid or its premalignant precursor, C-cell hyperplasia. In these 17 patients with two consecutive elevations of calcitonin levels greater than 0.55 ng/ml after stimulation all but one have had MTC or CCH at operation. Total thyroidectomy has been well tolerated and can be performed with an acceptably low incidence of complications in this group of patients.

Adolescent↗
PubMed1976

Adrenal medullary hyperplasia. A morphometric analysis in patients with familial medullary thyroid carcinoma.

The syndrome of familial medullary thyroid carcinoma (MTC), pheochromocytoma, and parathyroid hyperplasia is inherited as an autosomal dominant trait, and is characterized by development of bilateral and multicentric thyroidal and adrenal medullary tumors. One of the earliest manifestations of adrenal medullary hyperfunction in patients with this syndrome is an increased ratio of epinephrine to norepinephrine in urine. In order to define the morphologic correlates of these early catecholamine abnormalities in a large kindred with familial MTC, a morphometric analysis based on a point-counting system to asses adrenal medullary volume was undertaken. These studies clearly revealed adrenal medullary hyperplasia as reflected by a two- to three-fold increase in medullary volume and weight as compared to age- and sex-matched controls. The increase in total medullary mass resulted from diffuse and multifocal modular proliferations of adrenal medullary cells primarily within the head and body regions of the glands. These results support the hypothesis that the pheochromocytomas in patients with familial MTC may, in fact, represent extreme degrees of nodular hyperplasia of the medulla.

Adrenal Medulla↗
PubMed1976

Streptozocin-treated Verner-Morrison Syndrome: plasma vasoactive intestinal peptide and tumor responses.

A patient with watery diarrhea, hypokalemia, hypochlorhydria, and a non-beta islet cell carcinoma of the pancreas (Verner-Morrison syndrome) was found to have an elevated vasoactive intestinal peptide (VIP) concentration in the plasma as well as in the tumor. Treatment with streptozocin resulted in a dramatic subjective and objective tumor response in this patient. Plasma VIP concentration fell into the normal range after four courses of treatment, diarrhea ceased after the third course of therapy, and measurable tumor mass markedly decreased during that same period of time. The patient remains in clinical remission with no evidence of tumor regrowth 18 months after the beginning of treatment. In this patient, plasma VIP measurements were an excellent marker of tumor activity and correlated well with objective disease measurements and clinical response.

Adenoma, Islet Cell↗
PubMed1975

Emergency and urgent operations for ulcerative colitis. The procedure of choice.

Eighty consecutive emergency and urgent colectomies for ulcerative colitis were performed. One-stage total proctocolectomy was performed in 37 patients, with a 9.1% mortality; ileostomy with subtotal colectomy was performed in 43, with a 7.0% mortality. The overall mortality was 7.5%. Postoperative morbidity after total proctocolectomy (mean postoperative hospitalization, 27.6 days; nonseptic complication rate, 29.4%; septic complication rate, 29.4%) was not substantially different from that after subtotal colectomy (postoperative hospitalization, 33.3 days; nonseptic complications, 45.0%; septic complications, 35.0%). Survivors of subtotal colectomy required abdominal-perineal resection of the colorectal remnant in 75.7% of patients, and no patient had successful subsequent ileorectal anastomosis. It is suggested that one-stage total proctocolectomy be adopted as the surgical procedure of choice in emergency or urgent operations for ulcerative colitis.

Abdomen↗
PubMed1975

Natural history of the familial medullary thyroid carcinoma-pheochromocytoma syndrome and the identification of preneoplastic stages by screening studies: a five-year report.

1. In the fifth year of followup, 8 of 12 original patients thyroidectomized for MTC, diagnosed solely by abnormal calcitonin values, are disease free by all criteria. Elevated calcitonin levels are the only manifestation of active disease in three patients with presumed metastases. 2. Routine annual screening of susceptible individuals is a practical measure and has in 6 cases detected the premalignant condition of G-cell hyperplasia and in 1 patient a premetastatic state of MTC. It is premature to conclude that yearly screening is sufficient to detect all cases of premetastatic disease and for this reason we are recommending a yearly screen with pentagastrin and calcium tests and the more convenient pentagastrin test at 6 month intervals for those in the high-risk age group between 8 and 18. If screening at such intervals proves to be ineffective in preventing the disease in every case, consideration must be given to prophylactic thyroidectomy although we are not currently recommending this precedure. 3. Pentagastrin injection is often a more effective secretagogue for calcitonin than is calcium infusion, but this is not uniformly true. We therefore recommend use of both tests as the most appropriate screening procedure. 4. Epinephrine is a major secretory product of pheochromocytomas in the J-kindred and sequential E/N ratios may be of use in the early detection of pheochromocytoma in other kindreds. 5. Adrenal medullary hyperplasia has been found in 3 adrenal glands and is probably a preneoplastic condition analogous to C-cell hyperplasia.

Adolescent↗
PubMed1973

Degradation of methylmercury by bacteria isolated from environmental samples.

A total of 207 bacterial cultures, isolated from environmental samples, was screened for ability to degrade methylmercury. Of these, 30 were found positive for aerobic demethylation. Twenty-two of these were shown to be facultative anaerobes and 21 of these degraded methylmercury anaerobically. All positive species volatilized methylmercury aerobically, and methane was produced as a degradation product. Although methylmercury degradation was complete in most cases, material balances indicated some of the inorganic mercury formed was not volatilized and is presumed bound to the cells. All positive isolates were tolerant to at least 0.5 mug of methylmercury per ml, and the extent of volatilization of mercury increased with concentration to the threshold value. The results indicate that demethylating species are prevalent in the environment and may be important in suppressing the methylmercury content of sediments.

Aerobiosis↗
PubMed1971

Chromosomal aberrations and mortality of x-irradiated mammalian cells: emphasis on repair.

Chromosomal aberrations induced by x-rays in synchronized Chinese hamster cells correlated well with mortality as the radiosensitivity was made to vary by a factor of 4 by treating the cells with colcemid or 5-bromodeoxyuridine and by irradiating the cells in different parts of the cell cycle. 37% survival was observed when the cells sustained about one aberration per cell. Furthermore, the positive correlation was observed during repair of damage. Repair was measured by the reduction in damage observed either as the incubation period between two doses was increased (repair of sublethal lesions), or as the cells were held at 20 degrees C after a single dose of radiation (repair of potentially lethal lesions). Repair of both sublethal and potentially lethal lesions occurred with a half-time of about 12 min and was inhibited at 0 degrees C. These correlations strongly support the hypothesis that x-ray-induced cell death results from damage in chromatin structures.

Animals↗