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Biomedical subjects

J D Miller

Publications and source records attributed to J D Miller.

At least 55 records · Page 3Linked to original sources
PubMed2000

Changes in rainfall chemistry and airborne particulates during a period of major local industrial change.

Data from a site in central Scotland were used to quantify the changes in rainfall quality from 1989 to 1998. During this period there have been major changes in industrial activities in the area, particularly the decline in local steel-making and steel-processing activities. Many element concentrations in rainfall decreased over time in parallel with the phased reduction in the activity of local pollutant sources. Trend analyses of the rainfall data identified that the most significant responses have been the lower concentrations of Ca, SO4-S and Mn. There was also a dramatic decline in the capture of airborne particulates by the interception rainfall gauges. Particulates were found to contain mainly hematite, magnetite and quartz, that is similar to what would be expected to be derived from the neighbouring steel industries. The eventual disappearance of these particulates and the responses in rainfall quality match the timescale for the decline and closure of some of the potential sources of pollutants.

Air Pollutants↗
PubMed2000

A randomized, controlled trial comparing thoracoscopy and limited thoracotomy for lung biopsy in interstitial lung disease.

BACKGROUND: Lung biopsies are frequently needed to diagnose diffuse interstitial lung diseases. A prospective randomized, controlled trial comparing limited thoracotomy (open lung biopsy) and thoracoscopy for lung biopsy was done. METHODS: Ambulatory patients with a clinical diagnosis of diffuse interstitial lung disease were randomized to thoracoscopy or limited thoracotomy. Data on postoperative pain, narcotic requirements, operating room time, adequacy of biopsy, duration of chest tube drainage, length of hospital stay, spirometry, and complications were collected. RESULTS: A total of 42 randomized patients underwent lung biopsy (thoracoscopy 20, thoracotomy 22). The two study groups were comparable with respect to age, gender, corticosteroid use, and preoperative spirometry. Visual analog scale pain scores were nearly identical in the two groups (p = 0.397). Total morphine dose was 50.8 +/- 27.3 mg in the thoracoscopy group and 52.5 +/- 25.6 mg in the thoracotomy group (p = 0.86). Spirometry (FEV1) values in the two groups were not significantly different on postoperative days 1, 2, 14, and 28 (p = 0.665). Duration of operation was similar in both groups (thoracoscopy 40 +/- 30 minutes, thoracotomy 37 +/- 15 minutes; p = 0.67). The thoracoscopy and thoracotomy groups had equivalent duration of chest tube drainage (thoracoscopy 38 +/- 28 hours, thoracotomy 31 +/- 26 hours; p = 0.47) and length of hospital stay (thoracoscopy 77 +/- 82 hours, thoracotomy 69 +/- 55 hours; p = 0.72). Definitive pathologic diagnoses were made in all patients. CONCLUSIONS: There is no clinical or statistical difference in outcomes for thoracoscopic and thoracotomy approaches. Both thoracoscopy and thoracotomy are acceptable procedures for diagnostic lung biopsy in diffuse interstitial lung disease.

Biopsy↗
PubMed2000

Air sampling results in relation to extent of fungal colonization of building materials in some water-damaged buildings.

We studied the extent and nature of fungal colonization of building materials in 58 naturally ventilated apartments that had suffered various kinds of water damage in relation to air sampling done before the physical inspections. The results of air samples from each apartment were compared by rank order of species with pooled data from outdoor air. Approximately 90% of the apartments that had significant amounts of fungi in wall cavities were identified by air sampling. There was no difference in the average fungal colony forming unit values per m3 between the 15 apartments with the most fungal contamination and the 15 with the least. In contrast, the prevalence of samples with fungal species significantly different than the pooled outdoor air between the more contaminated versus the less contaminated apartments was approximately 10-fold. We provide information on methods to document fungal contamination in buildings.

Air Pollution, Indoor↗
PubMed2000

Quantification of endometriosis-associated pain and quality of life during the stimulatory phase of gonadotropin-releasing hormone agonist therapy: a double-blind, randomized, placebo-controlled trial.

OBJECTIVE: The purpose of this study was a quantification of changes in endometriosis-associated pain and quality of life during the stimulatory phase of gonadotropin-releasing hormone agonist therapy. STUDY DESIGN: One hundred twenty women with significant endometriosis-associated pain participated in a 1-month double-blind, randomized, placebo-controlled trial. Pain was measured at baseline and at 2 and 4 weeks with visual analog scales and the Endometriosis Symptom Severity score. Quality of life was measured with the SF-36 instrument. Group means and SEMs were calculated. Paired t tests were used after determination of data normality. RESULTS: Compared with placebo-treated control subjects women treated with gonadotropin-releasing hormone agonist had a statistically (P <. 0001) and clinically significant temporary increase in pain and a concomitant decrease in quality of life. CONCLUSION: The stimulatory phase of gonadotropin-releasing hormone agonist therapy is associated with an increase in endometriosis-associated pain and a decrease in quality of life.

Adolescent↗
PubMed2000

Personality and sexual risk taking: a quantitative review.

Findings from a quantitative review of the empirical research literature on normal personality and sexual risk taking are reported. The review focuses on domains identified in major models of normal personality representing the psychobiological and taxonomic perspectives. Focal sexual risk-taking behaviors were number of partners, unprotected sex, and high-risk sexual encounters (e.g., sex with a stranger). A comprehensive search produced 53 studies relevant to the review. A striking feature of the results is the paucity of research on domains of normal personality and sexual risk taking for all domains other than sensation seeking, which accounted for 64% of the effect sizes. The preponderance of studies (81%) took the psychobiological perspective and were published since 1990 (75%). Among the substantive findings were effects for sensation seeking, impulsivity, and agreeableness on all sexual risk-taking behaviors considered. Additionally, there were effects on specific behaviors for neuroticism and conscientiousness. The implications of these findings for future research on normal personality and sexual risk taking are discussed.

Adult↗
PubMed2000

Laser resection of a pedunculated tracheal adenoma.

We report a case of tracheal adenoma presenting as hemoptysis and reversible airflow obstruction in an ex-smoker. A questionable defect in the tracheal air shadow on a posteroanterior chest radiograph was shown on CT to be a pedunculated, mid-tracheal tumor. Two-stage bronchoscopic laser resection resulted in an apparently normal tracheal mucosa. Results of postresection spirometry were normal.

Adenoma↗
PubMed2000

Lung volume reduction surgery: results of a Canadian pilot study. Canadian Lung Volume Reduction Surgery Study Group.

OBJECTIVE: To present preliminary experience with lung volume reduction surgery (LVRS) before the institution of the Canadian LVRS trial. DESIGN: A prospective case series between December 1995 and January 1997. SETTING: University hospitals in London and Hamilton, Ont. PATIENTS: Forty-nine patients who had disabling dyspnea or emphysema with hyperinflation, able to participate in respiratory rehabilitation. Twenty-three patients were excluded because of comorbid conditions precluding surgery, pulmonary hypertension, excessive steroid dependence, malnutrition, obesity, previous thoracotomy, large solitary bullae, concurrent malignant disease, chronic bronchitis, hypercapnia or psychiatric illness. INTERVENTIONS: Preoperative respiratory rehabilitation followed by LVRS via median sternotomy. MAIN OUTCOME MEASURES: Impairment, disability and handicap were assessed before and 12 months after LVRS. Impairment was assessed by changes in pulmonary function test results and blood gas measurements, disability by the 6-minute walk test and cardiopulmonary exercise test, and handicap by the disease-specific chronic respiratory disease questionnaire (CRQ), the generic medical outcomes survey short form 36 (SF-36) and the generic health utilities index mark III (HUI-III). RESULTS: Two patients died of respiratory failure while in rehabilitation. Twenty-four patients (17 men, 7 women) successfully completed rehabilitation and underwent LVRS. The mean age was 63 years (range from 49 to 78 years) and the median length of hospital stay was 12.5 days (range from 7 to 90 days). Two patients (8%) died in the early postoperative period (within 30 days) of pneumonia. One patient died of respiratory failure 8 months after LVRS after a difficult 90-day postoperative hospital stay. There were 27 major complications. There was a 36% relative increase in the mean forced expiratory volume in the first second (p = 0.01) and a 10% relative increase in the 6-minute walk test (p = 0.06). The mean CRQ dyspnea score increased 2.3 points (p = 0.01), and the SF-36 general health domain increased 20 points (p = 0.01). There was no significant change in the HUI-III (p = 0.73). CONCLUSION: LVRS appears to lessen the respiratory impairment and handicap for at least 1 year in selected patients with advanced emphysema.

Aged↗
PubMed2000

Comparison of videothoracoscopy and axillary thoracotomy for the treatment of spontaneous pneumothorax.

Surgical treatment of spontaneous pneumothorax can be done through a thoracotomy or a video-thoracoscopic approach. Although the videothoracoscopic technique is currently popular it is not obviously superior to a more traditional axillary thoracotomy approach. We compared our recent experience with both techniques to determine the optimal surgical treatment for spontaneous pneumothoraces. A retrospective review of 79 patients treated surgically (34 thoracotomy and 45 thoracoscopy) for spontaneous pneumothoraces was done. Patients were treated between 1991 and 1997. Patients older than 60 years of age and those with spontaneous pneumothoraces secondary to generalized pulmonary emphysema were excluded. There were no operative deaths. Recurrence rate [thoracotomy, two of 34; thoracoscopy, three of 45 (P < 0.89)], air leak exceeding 7 days [thoracotomy, three of 34; thoracoscopy, three of 45 (P < 0.73)], operating room times [thoracotomy, 54 +/- 26 minutes; thoracoscopy, 53 +/- 16 minutes (P < 0.59)], and postoperative length of stay [thoracotomy, 5.7 +/- 4.3 days; thoracoscopy, 4.7 +/- 4.4 days (P < 0.26)] were not significantly different for the two techniques. We conclude that axillary thoracotomy and videothoracoscopy are equally effective surgical treatments for spontaneous pneumothoraces. A large randomized trial would be needed to determine whether one approach is truly superior to the other.

Adult↗
PubMed1999

Brain TXA(2) and PGI(2) levels in impact acceleration diffuse brain injury coupled with secondary insults.

OBJECTIVE: To study the changes of brain TXA(2) and PGI(2) levels in a new rodent model of impact acceleration diffuse brain injury with hypotention and hypoxia and the effect of diaspirin cross linked hemoglobin solution (DCLHb) on brain TXA(2) and PGI(2) levels. METHODS: Thirty-two male SD rats were randomized into sham, head injury alone, head injury with secondary insults and injury with insults followed by DCLHb administration groups. Animals were physiologically monitored throughout the experiment and the prostanoids were measured via radioimmunoassay (RIA). RESULTS: There were no changes in TXB(2) and 6-keto-PGF1alpha (stable metabolites of TXA(2) and PGI(2)) levels in injury alone group while TXB(2) level in secondary insults group elevated significantly and both TXB(2) and 6-keto-PGF1alpha levels in injury with insults followed by DCLHb administration augmented significantly in comparison with the corresponding value of sham at 4 h postimpact. CONCLUSIONS: The only increase in TXA(2) level in secondary insults rats suggests that there may be both thrombotic episodes and vasoconstriction leading to focal increase in micro-circulatory resistance which contributes to a decreased focal cerebral blood flow (CBF). And it is hypothesed that DCLHb may exert its protective properties through increasing PGI(2) production in injured brain by affecting CBF and cerebral perfusion pressure (CPP).

Journal Article↗
PubMed1999

Developmental changes in nicotinic receptor mRNAs and responses to nicotine in the suprachiasmatic nucleus and other brain regions.

Our previous studies demonstrated that nicotine induces c-fos expression in the suprachiasmatic nucleus (SCN) of the rat during a narrow developmental window occurring in the perinatal period. We have extended these observations by showing that c-fos cannot be induced in the adult SCN by nicotine even during the subjective night, when phase shifts do occur. In contrast to the SCN, significant induction of c-fos and NGFI-A was observed in the medial habenula and paraventricular nucleus at all circadian times. In the fetal rat SCN we show that NGFI-A and junB are also induced by nicotine, but not c-jun. To investigate whether changes in nicotinic acetylcholine receptor (nAChR) expression in the SCN may underlie this change in sensitivity during the perinatal period, we examined nAChR mRNAs across this developmental period. By Northern analyses, alpha2, alpha3 and alpha4 subunit mRNAs are relatively abundant in the fetal SCN but decline substantially in the adult. alpha7 mRNA increases substantially while beta2 mRNA is relatively abundant throughout development. We also examine expression in the whole mouse brain beginning at embryonic day 11. Many mRNA sizes for nAChR subunits in both the rat and mouse are characterized here for the first time by Northern analyses and some show very large changes in expression across development. In particular, a small 1.4 kb alpha2-related mRNA is highly expressed during early development, perhaps indicating an important novel function for this subunit.

Acetylcholine↗
PubMed1999

The glutamate induced phase shift in the SCN slice: a two pulse study.

The short-term dynamics of resetting the circadian 'clock' was assessed by a double-pulse paradigm in vitro. On day 1, single and double 1 h 'pulses' of 1 mM l-glutamate were applied to the rat suprachiamastic nuclei (SCN). On days 2 and 3, single unit activity (SUA) was recorded and time-of-peak SUA was used as a phase marker of the circadian rhythm. The time-of-peak in untreated slices at 'Zeitgeber' time (ZT; hours after lights-on) 6, was used to evaluate effects of glutamate on phase. In accordance with published data, a single glutamate pulse at ZT 14 resulted in a 3 h delay of peak SUA on days 2 and 3. A 2nd pulse, given 3 h after a 1st pulse, resulted in two distinct peaks on day 2: a 1st at ZT 7 and a 2nd at ZT 12, i. e., a 6 h phase delay and hence twice the delay obtained after a single pulse. On day 3, no peak in SUA was observed which indicates that a new steady state was not reached on day 2. The bimodal distribution of SUA on day 2 corroborates other findings which suggest that the SCN comprises two distinct neuronal populations with circadian firing patterns that are normally coupled but, possibly due to different sensitivities to glutamate, can desynchronize. The additive phase-shifting effect of two consecutive glutamate pulses suggests that, at least for one sub-population of SCN neurons, the phase shift is completed within 3 h.

Animals↗
PubMed1999

The fungal metabolite culmorin and related compounds.

This paper reviews the toxicology of culmorins, a family of compounds found in grains contaminated by Fusarium graminearum and related fungi. We include the results of an Ames test and studies based on Quantitative Structure-Activity Relationships. Culmorin has low toxicity in several in vitro assays and in one study in swine and is Ames test negative. Culmorin is moderately antifungal. QSAR analysis suggested that the plant compound longifolene was similar. Longifolene is a GRAS compound used in cosmetics and is also moderately antifungal.

Antifungal Agents↗
PubMed1999

A comparison of thoracic and lumbar epidural techniques for post-thoracoabdominal esophagectomy analgesia.

PURPOSE: To compare thoracic epidural analgesia (TEA) using a bupivacaine/fentanyl mixture and lumbar epidural analgesia (LEA) with morphine, in respect to the time to extubation and the quality of post-operative analgesia, in patients having thoracoabdominal esophagectomy. METHODS: Twenty two patients scheduled for elective thoracoabdominal esophagectomy were randomized to TEA or LEA. Postoperatively, the TEA group received Patient Controlled Epidural Analgesia (PCEA) with bupivacaine 0.125% and 5 microg x ml(BI) fentanyl, and the LEA group received PCEA with 0.2 microg x ml(BI) morphine. A blinded observer assessed criteria for tracheal extubation and the time of tracheal extubation was recorded. Early extubation was defined as tracheal extubation within four hours postoperatively. Visual analogue pain scores at rest (Static Visual Analogue Pain Scores, SVAPS) and with movement (Dynamic Visual Analogue Pain Scores, DVAPS) were recorded at 1, 6, 12, 18 and 24 hr post-extubation. Failure of the epidural protocol (FEP) was defined as a request for additional analgesia. RESULTS: Tracheal extubation was achieved in 70% of the LEA and 100% of the TEA at four hours postoperatively (P=NS). However, the TEA group achieved earlier extubation times when assessed with log rank testing (P = 0.01). By six hours post-extubation FEP had occurred in 50% of the LEA group but in none of the TEA group (P = 0.01). Mean SVAPS and DVAPS were lower in the TEA than in the LEA group at all measured times (P < 0.01). CONCLUSION: This study has demonstrated superior pain control in patients undergoing thoraco-abdominal esophagectomy treated with TEA than with LEA, particularly for pain with movement. Tracheal extubation occurred earlier in the TEA group, but this difference was not significant at four hours postoperatively.

Adult↗
PubMed1999

Surgeons' assessment of symptoms suggesting extrathoracic metastases in patients with lung cancer. Canadian Lung Oncology Group.

BACKGROUND: In patients with apparently operable non-small cell lung cancer (NSCLC), clinicians often omit investigation for M disease in asymptomatic patients. Previous investigations have not specified in detail what is meant by "symptomatic," and this could differ between surgeons. We have investigated the extent to which surgeons' criteria differ for presence of symptoms. METHODS: Participating surgeons from seven centers, enrolled patients they judged "asymptomatic" in a randomized trial of investigational strategies for NSCLC. Patients completed a structured questionnaire describing symptoms of the central nervous system (CNS). In 685 patients, we documented CNS symptom recurrence after resectional surgery over 1 year of follow-up. RESULTS: Two centers enrolled only patients without even the mildest symptoms. Three centers took an intermediate approach, occasionally classifying patients with mild symptoms as "asymptomatic" and thus enrolling them in the trial. Two centers classified an appreciable number of patients with minimal symptoms, and occasionally with more than minimal symptoms, as "asymptomatic." Patients with even mild CNS symptoms were more likely to subsequently present with CNS metastases. CONCLUSIONS: Thoracic surgeons differ in their ideas of what may constitute the symptoms of M disease. Patients with structured questionnaire results that suggest symptoms of CNS disease are more likely to have CNS symptom recurrence after resectional surgery.

Bone Neoplasms↗
PubMed1999

Voicing judgements by chinchillas trained with a reward paradigm.

Experiments were performed to replicate and extend previous findings of similar categorization of voiced/voiceless consonant-vowel (CV) syllables by humans and chinchillas. A reward paradigm was applied to the question of how stimulus range affects the voice-onset-time (VOT) corresponding to the voiced/voiceless category boundary. Each of four adult chinchillas and four human subjects identified synthetic CV syllables as voiced (/ba/, /da/, /ga/) or voiceless (/pa/, /ta/, /ka/) using voiceless standards of either 80 or 120 ms. In both humans and animals, extending the VOT range from 80 to 120 ms shifted category boundaries to longer VOTs, but to a different extent across listeners. Control experiments suggested that listeners were attending to different phonetic cues in a manner that depended on the listener, rather than on species. The results are interpreted in terms of similar contextual effects and use of multiple phonetic cues to voicing in humans and animals.

Adult↗
PubMed1999

Direct assessment of MHC class I binding by seven Ly49 inhibitory NK cell receptors.

Mouse NK cells express at least seven inhibitory Ly49 receptors. Here we employ a semiquantitative cell-cell adhesion assay as well as class I/peptide tetramers to provide a comprehensive analysis of specificities of Ly49 receptors for class I MHC molecules in eight MHC haplotypes. Different Ly49 receptors exhibited diverse binding properties. The degree of class I binding was related to the extent of functional inhibition. The tetramer studies demonstrated that neither glycosylation nor coreceptors were necessary for class I binding to Ly49 receptors and uncovered peptide-specific recognition by a Ly49 receptor. The results provide a foundation for interpreting and integrating many existing functional studies as well as for designing tests of NK cell development and self-tolerance.

Alleles↗
PubMed1999

Delayed intracranial hypertension: relationship to leukocyte count.

OBJECTIVE: Secondary intracranial hypertension has been linked to leukocytosis. We examined our data bank containing physiologic recordings and outcome data of severely head injured patients to investigate the relationship between delayed increases in intracranial pressure (ICP), defined as occurring after a 12-hr period of normal ICP values, and leukocytosis. DESIGN: A retrospective study of observational data. SETTING: Regional neurosurgical unit and intensive care unit. PATIENTS: Sixty-four patients suffered increased ICP >20 mm Hg. Thirty-five patients fulfilled selection criteria for delayed increases in ICP (group 1). Twenty-nine patients with increased ICP with no preceding or intervening periods of normal ICP were selected as a comparison group (group 2). MEASUREMENTS AND MAIN RESULTS: Comparison of 12-month outcome revealed that 11% of group 1 patients died, with 49% remaining severely disabled, in contrast to group 2, where 35% of patients died and 14% were left severely disabled (p = .021). The pattern of outcome was independent of monitoring time, or injury severity. Regression modeling was performed for prediction of delayed increase in ICP. Of 46 patients with an initial increase then decrease in leukocyte count in the first 48 hrs, 65% experienced delayed increases in ICP, as compared with 18% of the 11 patients without this pattern p = .01 1). CONCLUSIONS: Patients with delayed increases have a significantly different pattern of outcome. Change in leukocyte count from admission to day 2 is a significant predictor of such a delayed increase.

Adult↗