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Biomedical subjects

K D Miller

Publications and source records attributed to K D Miller.

At least 127 records · Page 7Linked to original sources
PubMed1986

The early kinetics of the neutralizing antibody response after booster immunizations with human diploid cell rabies vaccine.

Persons immunized in developing countries were recently shown to have low titers after pre-exposure immunization with human diploid cell rabies vaccine (HDCV). An investigation into the response to HDCV boosters was conducted to determine if immunologic sensitization had occurred and if there was a response difference in persons immunized in and outside of the United States. Intramuscular (im) booster doses of vaccine were administered to 113 persons previously immunized outside the United States and 47 persons immunized in the United States. The post-exposure booster regimen of a single 1.0-ml im booster, as recommended by the World Health Organization for all but the most severe bites, produced a one-dilution (5-fold) rise in antibody titer in 14 (11%) of 123 persons tested 5 days after booster and in 56 (89%) of 63 persons studied 7 days after booster. Persons immunized in the United States and those immunized outside the United States had similar responses. Persons with low pre-booster titers were more likely to exhibit a 5-fold rise in antibody titer 5 days after booster (P = 0.03) than persons with higher pre-booster titers. The post-exposure booster regimen of 2 1.0-ml im doses (one each on days 0 and 3), recommended in the United States, produced a more rapid response than the single booster regimen in only some persons; a 5-fold response occurred in 6 (50%) of 12 persons 5 days after booster.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Viral↗
PubMed1985

Pre-exposure rabies immunization with human diploid cell vaccine: decreased antibody responses in persons immunized in developing countries.

In November 1982, a U.S. Peace Corps volunteer in Kenya completed pre-exposure rabies prophylaxis with a standard 3 dose intradermal (ID) series of human diploid cell rabies vaccine (HDCV). In May 1983, she was bitten by a dog and died of rabies 3 months later. An initial investigation revealed that the patient, as well as 9 of 11 others immunized at the same time, had no rabies antibody titers (less than 1:5). We therefore instituted investigations into the immunogenicity of pre-exposure HDCV both in the United States and in developing countries. A serosurvey revealed unexpectedly low rabies titers in both Peace Corps volunteers and others immunized in developing countries. Antibody titers measured 2-3 weeks after ID immunization were compared in 9 groups totaling 271 persons in the United States and Kenya. There was no statistically significant difference in antibody titers in the 6 U.S. groups immunized from 1980-1984 (P greater than 0.15); however, groups immunized in the United States had significantly higher titers than a group of Kenyan nationals (P less than or equal to 0.0001), and the Kenyans had significantly higher titers than 2 Peace Corps groups immunized in Kenya (P less than or equal to 0.0001). No single hypothesis proposed (laboratory error, vaccine potency, vaccination technique, or specific immune suppression) accounted for the observed differences. Although we cannot fully explain the poor response to HDCV, it is probably due to multiple factors. We conclude that persons immunized with ID pre-exposure HDCV in developing countries should have rabies antibody titers determined to ensure their seroconversion; for persons immunized in the United States, such titers need not be routinely determined.

Adult↗
PubMed1983

Tuberculous arthritis of the shoulder: delayed diagnosis aided by arthrography.

Tuberculous arthritis of the shoulder was not diagnosed in an 80-year-old man with Addison's disease until the appearance of a draining abscess in his arm. Initially signs, symptoms, x-rays and laboratory studies were consistent with calcific tendonitis and degenerative arthritis. Then an arthrogram demonstrated a connection between the shoulder joint and the abscess. A high level of suspicion for tuberculous arthritis should be maintained in an elderly patient whose past medical history is suspicious for tuberculosis and whose articular complaints are chronic.

Abscess↗
PubMed1983

Inhibition of herpes simplex virus replication by cobra alpha-neurotoxoid.

A peptide, prepared by gentle oxidative detoxification of a methionine-free cobra alpha-neurotoxin, was evaluated for antiviral activities in vivo and in vitro. When added to BHK cells before infection the peptide reduced herpes simplex virus type 1 (HSV-1)-induced TCD50 in a dose- and time-dependent manner. The antiviral effect was also expressed on initiation of cell treatment 1 h after infection if the peptide was left in contact with cells. Single, intracerebral doses of the toxoid in suckling mice significantly increased 50% survival times, and reduced virus replication in the infected brain tissues. Cutaneous lesions and resultant scar formation induced by HSV-1 in hairless mice were also significantly reduced by subcutaneous peptide injections.

Animals↗
PubMed1982

Hospital treatment of alcoholism: a profile of middle income Americans.

3,411 first admissions for alcoholism treatment to nine proprietary hospitals were studied with standardized questionnaire and diagnostic instruments. Despite the patients' relative economic and social stability, severe patterns of addictive alcohol use had developed and persisted for many years with a high incidence of alcohol-related and intercurrent medical disorders which required prompt medical intervention. Although most patients had a personal physician, less than 9% of referrals for hospital treatment for alcoholism were made by physicians; most patients responded to television outreach programs, recommendations by former patients or were self or family referred. This survey shows that persons who are neither socially disadvantaged nor economically deprived may have severe alcohol-related problems. Such patients constitute a significant challenge to the medical profession to develop strategies for early intervention and more efficacious treatment.

Adolescent↗
PubMed1982

Respiratory center output and ventilatory timing in patients with acute airway (asthma) and alveolar (pneumonia) disease.

To investigate the mechanism for hyperventilation in two common but dissimilar conditions, asthma (A) and lobar pneumonia (P), we examined the ventilatory pattern in 17 A and six P subjects. When acutely ill, hyperventilation (PaCO2) was similar in the two groups. Minute ventilation (VE) however, was slightly greater in group A than in P. In A patients, measurements of occlusion pressure (dP/dT) and inspiratory flow rate (VT/ti) during quiet breathing showed enhancement of respiratory center output. By contrast, in P patients, dP/dT and VT/ti were not elevated. Tidal volume (VT) was 0.59 +/- 0.19 L in A; 0.45 +/- 0.09 in P. Respiratory rate was increased in both groups. With supplementary oxygen therapy, neither VE nor PaCO2 changed in either group. The mechanism for the increased ventilatory drive in group A is unclear. Most likely, reflexes initiated by either bronchospasm or by the sudden increase of end-expiratory lung volume (EELV), not operative in P, account for the increased respiratory center output seen in A. To examine the latter possibility, we studied the ventilatory pattern at both normal and increased EELV in six nonasthmatic subjects. Both dP/dT and VT/ti were increased in all subjects after elevation of EELV. Thus, changes in EELV may be important for the regulation of ventilation during bronchospasm.

Airway Resistance↗
PubMed1981

"Data still pending".

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Clinical Laboratory Techniques↗
PubMed1981

Computed tomography of deep cerebral venous thrombosis in children.

Three cases of deep cerebral venous thrombosis in children are presented, and the cranial computed tomographic (CT) findings and angiographic findings reviewed. Two patients had findings indicative of brain death at the time of initial CT examination. The third patient recovered without neurological sequelae. Noncontrast-enhanced CT examinations showed abnormally dense-appearing deep venous structures, mimicking a contrast-enhanced study. On the arteriogram the deep venous system failed to opacify, and multiple collaterals to the superficial venous system were formed.

Angiography↗
PubMed1980

Effect of acute ethanol ingestion on integrated plasma prolactin levels in normal men.

Healthy male subjects ingested 1.0 g ethanol/kg (Alcohol Day) and caloric equivalents of sucrose (Control Day). Plasma prolactin was determined on samples collected at 20-min intervals by serial constant blood exfusion, from 2 hr before to 4 hr after the drink. In 14 of the 15 men studied, plasma prolactin levels during the 2-hr period after alcohol administration were elevated an average of 31% above values for the preceding 2-hr period. Data pooled for all subjects revealed a small but statistically significant increase in prolactin coinciding with ascending and peak concentrations of blood alcohol. A significant increment in prolactin was associated with peak blood alcohol levels when values were compared between control and alcohol treatment days. Although of statistical significance, these transient and variable increases were within the normal range of basal prolactin levels for most subjects and are unlikely to be physiologically meaningful.

Adult↗
PubMed1979

Angiodysplasia of the colon.

Angiodysplasia of the colon was diagnosed by arteriography in 33 patients. Approximately one fourth of the lesions were located in the left side of the colon. Three patients with sigmoid lesions had a second lesion elsewhere in the gastrointestinal tract. The lesions on the left involved a more extensive segment of bowel than those on the right. Almost one third of the patients were younger than 60, and 2 were in their thirties. The angiodysplasia is the source of the bleeding in most patients, and its resection results in cure.

Adult↗