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Biomedical subjects

J G Miller

Publications and source records attributed to J G Miller.

At least 73 records · Page 4Linked to original sources
PubMed1995

A proposed microscopic elastic wave theory for ultrasonic backscatter from myocardial tissue.

The physical structures responsible for ultrasonic scattering from myocardial tissue have not yet been conclusively defined. It is hypothesized in this paper that the backscatter from myocardium is primarily due to inhomogeneities approximately the size of the myocytes. In particular, it is proposed that the acoustic contrast responsible for the scattering is that between the extracellular collagen network that surrounds each myocyte (or myocyte bundle) and the rest of the tissue (the myocytes' intracellular contents). To test this hypothesis, a simple elastic wave scattering model for myocardium was developed. An elementary scatterer is modeled as an ellipsoidal shell, having the material properties of wet collagen, imbedded in a host medium having the average properties of myocardium. The first Born approximation to elastic scattering is used to calculate the frequency-dependent scattering from a single scatterer. To scale up from a single scatterer to a distribution of scatterers, it is assumed that the power received at the transducer is simply the sum of the power scattered in the direction of the transducer by each individual scatterer located in the active volume of the beam (an independent-scatterer approximation). Calculations are restricted to the backscattering direction (pulse-echo), although the theory can accommodate pitch-catch scattering at all angles. With the aid of a computer program, the acoustic backscatter coefficient is calculated using the Born formalism and then measurement effects (frequency-dependent beam width and attenuation correction factors) are incorporated to arrive at calculated integrated (frequency-averaged) backscatter. Both the backscatter coefficient and integrated backscatter are calculated for angles of incidence that range from parallel to the long axis of the scatterer to perpendicular to this fiber direction. For the low MHz frequencies typically used in clinical echocardiography, the calculated absolute magnitude of the acoustic backscatter coefficient lies within a range from 0.0001 to 0.001 cm-1 sr-1. For selected fiber geometries, the anisotropy in integrated backscatter as the angle of incidence is varied with respect to the fiber orientation is about 10 dB. The predicted frequency dependence of the acoustic backscatter coefficient is calculated to be about f3.9 in the low MHz frequency range. These calculated results are reasonably consistent with published experimental measurements and provide a successful preliminary test of the hypothesis.

Acoustics↗
PubMed1995

Estimation of the elastic stiffness coefficient c13 of fixed tendon and fixed myocardium.

Recent studies from our laboratory have detailed the anisotropy of velocity of quasilongitudinal-mode ultrasonic waves through formalin fixed samples of normal human myocardium and bovine Achilles tendon. Results of these studies were used to determine the elastic stiffness coefficients c33, corresponding to the propagation of longitudinal-mode waves parallel to the fiber axis of the tissue, and c11, corresponding to the propagation of longitudinal-mode waves perpendicular to the fiber axis. For a tissue possessing a unidirectional arrangement of fibers with a random transverse distribution, three additional coefficients, c13, c44, and c12, are needed to describe its linear mechanical properties completely. Direct ultrasonic measurements of these coefficients in solids typically require the propagation of transverse-mode waves through the sample. Such measurements are difficult to perform in soft tissues because transverse-mode ultrasonic waves are very highly attenuated by the tissue. This study therefore employs a technique to estimate c13 based on measurements of the velocity of quasilongitudinal-mode ultrasonic waves for numerous angles of propagation relative to the fiber axis of the tissue. Analysis of data obtained from formalin fixed bovine Achilles tendon and human myocardium yield estimated values for c13 of 3.17 and 2.46 GPa, respectively.

Achilles Tendon↗
PubMed1995

Comparison of the anisotropy of apparent integrated ultrasonic backscatter from fixed human tendon and fixed human myocardium.

The content and organization of collagen in the cardiac interstitium may represent significant determinants of the ultrasonic scattering properties of myocardium. This study was designed to investigate the anisotropic backscattering properties of a fibrous soft tissue exhibiting an ordered arrangement of fibers similar to myocardium, but possessing a substantially greater content of collagen. Human Achilles tendon was chosen for this study because it possesses a simple unidirectional arrangement of fibers and a high content of collagen compared to normal myocardium. Integrated (frequency-averaged) backscatter was measured from ten formalin fixed samples of tendon as a function of insonifying angle relative to the fiber axis of the tissue. The samples were insonified in a water bath using a 5-MHz center frequency piezoelectric transducer. Maximum backscatter occurred for insonification perpendicular to the fibers, and minimum backscatter occurred for insonification parallel to the fibers. The mean peak to nadir variation, or magnitude of anisotropy, of integrated backscatter for the ten formalin fixed samples of tendon was 36.3 dB. This compares to 14.5 dB for formalin fixed human myocardium measured in an earlier study by our laboratory.

Achilles Tendon↗
PubMed1995

Predictors of high and low levels of HIV risk behavior among adults with chronic mental illness.

OBJECTIVE: Several recent studies confirm elevated rates of human immunodeficiency virus infection among acute and chronic mentally ill adults in large urban areas. This research sought to characterize risk for HIV infection among adults with chronic mental illness and to examine psychosocial factors predictive of risk. METHODS: Two hundred and twenty-five adults with chronic mental illness who were sexually active in the past year outside of exclusive relationships were individually interviewed in community mental health clinics using a structured HIV risk assessment protocol. RESULTS: More than 50 percent of the study participants were sexually active in the past month, and 25 percent had multiple sexual partners during that period. Fifteen percent of the men had male sexual partners. In more than 75 percent of occasions of sexual intercourse, condoms were not used. When participants were categorized as at either high or lower risk for HIV infection based on their pattern of condom use, psychosocial factors that predicted risk level included measures of participants' self-reported efficacy in using condoms, perceptions of social norms related to safer sex among peers and sexual partners, and expectations about outcomes associated with condom use, as well as participants' level of objectively assessed behavioral skills in negotiation and assertiveness in sexual situations. CONCLUSIONS: Interventions aimed at prevention of HIV and AIDS are urgently needed in settings that provide services to persons with chronic mental illness.

Adolescent↗
PubMed1994

Early cardiorespiratory patterns in patients with major burns and pulmonary insufficiency.

We examined the case records of 50 consecutive patients with major cutaneous burns who required early mechanical ventilation. In 22 patients full haemodynamic and respiratory data were available within 24 h of their injury. Unexpectedly the haemodynamic and oxygen transport patterns of survivors and non-survivors were essentially similar although pulmonary artery occlusion pressure measurements and estimations of net fluid input suggest that non-survivors were relatively underresuscitated compared with survivors. Both groups showed inadequate oxygen utilization in the early stages of their injury despite normal (or above normal) levels of oxygen delivery. Invasive monitoring could possibly help this subgroup of burns patients.

Adult↗
PubMed1994

Effect of collagen on the anisotropy of quasi-longitudinal mode ultrasonic velocity in fibrous soft tissues: a comparison of fixed tendon and fixed myocardium.

The widespread use of echocardiography has generated considerable interest in the ultrasonic properties of myocardial collagen. This study was designed to investigate the effect of collagen on the propagation of ultrasound by measuring the anisotropy of ultrasonic velocity through formalin fixed specimens of bovine Achilles tendon. Tendon was chosen for this study because it possesses a high content of collagen and a well-defined unidirectional arrangement of fibers. Ultrasonic velocity data were acquired from nine samples of fixed tendon that were each insonified at multiple angles relative to the fibers in 2 degrees increments for a full 360 degrees. Analysis of the data revealed a substantial angular dependence of velocity qualitatively similar to that reported for formalin fixed specimens of normal human myocardium, but approximately 17 times larger in magnitude. Together with measured values of density, these results were used to compute the elastic stiffness coefficients C11 (corresponding to propagation perpendicular to the fibers) and C33 (corresponding to propagation parallel to the fibers) of fixed tendon, yielding 3.08 and 4.51 GPa, respectively.

Achilles Tendon↗
PubMed1994

New composite biocarriers engineered to contain adsorptive and ion-exchange properties improve immobilized-cell bioreactor process dependability.

Novel biocarriers that combine the adsorptive properties of activated carbon with the ion-exchange properties of zeolite-based type Z inorganic oxide biocarriers (D. R. Durham, L. C. Marshall, J. G. Miller, and A. B. Chmurny, Appl. Environ, Microbiol. 60:3329-3335, 1994.) were developed. These biocarriers, designated Type CZ, possess fundamental properties that heretofore have not been described for available microbial immobilization matrices. Type CZ biocarriers provide an environment that promotes dense microbial colonization and maintains bioreactor productivity by buffering immobilized microorganisms from unfavorable operating conditions. Data demonstrating protection of immobilized bacteria from organic shock loads and extended pH shocks are presented. In addition, bioreactors containing the composite Type CZ biocarriers continue to remove waste stream contaminants during periods of oxygen deprivation and nutrient limitation.

Journal Article↗
PubMed1994

Characterization of Inorganic Biocarriers That Moderate System Upsets during Fixed-Film Biotreatment Processes.

Inorganic matrices were developed for fixed-film bioreactors affording protection to microorganisms and preventing loss of bioreactor productivity during system upsets. These biocarriers, designated Type-Z, contain ion-exchange properties and possess high porosity and a high level of surface area, which provide a suitable medium for microbial colonization. Viable cell populations of 10/g were attainable, and scanning electron micrographs revealed extensive external colonization and moderate internal colonization with aerobic microorganisms. Laboratory-scale bioreactors were established with various biocarriers and colonized with Pseudomonas aeruginosa, and comparative studies were performed. The data indicated that bioreactors containing the Type-Z biocarriers were more proficient at removing phenol (1,000 ppm) than bioreactors established with Flexirings (plastic) and Celite R635 (diatomaceous earth) biocarriers. More significantly, these biocarriers were shown to moderate system upsets that affect operation of full-scale biotreatment processes. For example, subjecting the Type-Z bioreactor to an influent phenol feed at pH 2 for periods of 24 h did not decrease the effluent pH or reactor performance. In contrast, bioreactors containing either Celite or Flexirings demonstrated an effluent pH drop to approximately 2.5 and a reduction in reactor performance by 75 to 82%. The Celite reactor recovered after 5 days, whereas the bioreactors containing Flexirings did not recover. Similar advantages were noted during either nutrient or oxygen deprivation experiments as well as alkali and organic system shocks. The available data suggest that Type-Z biocarriers represent an immobilization medium that provides an amenable environment for microbial growth and has the potential for improving the reliability of fixed-film biotreatment processes.

Journal Article↗
PubMed1994

Cellular mechanisms of captopril-induced matrix remodeling in Syrian hamster cardiomyopathy.

BACKGROUND: Although angiotensin-converting enzyme (ACE) inhibitors have become a mainstay of treatment for chronic congestive heart failure (CHF), it is not known whether the cardiac remodeling effects are a secondary phenomenon, resulting from ACE inhibitors' hemodynamic actions of afterload reduction, or occur through an independent mechanism. METHODS AND RESULTS: We used ultrasonic tissue characterization to define potentially salutary effects of treatment with ACE inhibitors on the material properties of the heart and its potential influence on cardiac remodeling at the cellular level. Ten 1-month-old, cardiomyopathic (CM) Syrian hamsters and 6 normal (NL) hamsters were treated with captopril (2 g/L water ad libitum), and 10 CM hamsters and 10 NL hamsters were maintained untreated for 3 months. Hearts were excised, and backscattered radiofrequency data were acquired from 1200 independent sites from each specimen with a high-resolution 50-MHz acoustic microscope for calculation of integrated backscatter (IB). Treatment with captopril reduced left ventricular mass, calcium concentration, and IB in CM hearts without affecting myofiber size or collagen concentration. The IB from grossly normal regions of myocardium in NL hamsters, treated CM hamsters, and untreated CM hamsters was not significantly different. The IB from the microscopic regions of scar tissue in treated CM hamsters was significantly less (P = .0004) than that from scar tissue in untreated CM hamsters. CONCLUSIONS: The reduced IB from treated scar tissue components reflects specific alterations in the material properties (elastic stiffness, density) of fibrous regions in CM hearts induced by captopril. This is the first report that defines specific cellular effects of ACE inhibitors on the material properties of isolated components of cardiac tissue in experimental cardiomyopathy. These alterations in material properties of scar tissue components represent a potential mechanism for the salutary actions of ACE inhibitors in heart failure.

Animals↗
PubMed1994

Ultrasonic tissue characterization: integrated backscatter imaging for detecting myocardial structural properties and on-line quantitation of cardiac function.

Quantitative myocardial tissue characterization is being developed as an adjunct to conventional echocardiography to delineate the physical state of myocardium under diverse pathophysiological states. Real-time quantitative integrated backscatter imaging has made possible clinical investigations carried out in the United States, Europe, and Japan in patients with ischemic heart disease, hypertrophic cardiomyopathy, and cardiac allograft rejection, among others. A modification of the imaging processing used for characterization of tissue facilitates automatic detection of endocardial blood interfaces and on-line quantification of ventricular size and function, which has been recently introduced in clinical practice. Further progress and developments in quantitative ultrasonic imaging will place in perspective the clinical use of tissue characterization based on myocardial backscatter.

Animals↗
PubMed1993

Greater than the sum of its parts. II. Matter-energy processing subsystems.

Behavioral science theory has changed greatly since 1978, when Miller's Living Systems was published. Much of the change represents progress, particularly in the biological fields. During that time, living systems theory (LST) developed in many ways. Among the most significant developments have been the addition of another level, the community, to the seven levels previously included in LST and the addition of another subsystem, the timer, to become the 20th subsystem. The present article is the second to be published in this journal which describe relatively briefly and simply the current state of scientific knowledge about the subsystems of living systems. It deals with the first six matter-energy processing subsystems, the ingestor, distributor, convertor, producer, matter-energy storage, and extruder.

Adaptation, Physiological↗
PubMed1993

Quantification of ventricular remodeling in the tight-skin mouse cardiomyopathy with acoustic microscopy.

To determine the role of ultrasonic tissue characterization for the detection of changes in myocardial architecture associated with cardiomyopathy, acoustic microscopy was performed on the hearts of 4- to 6-month-old tight-skin mice [TSK/+, C57-B10.D2 (58B)/SN strain], a model of cardiomyopathy characterized by diffuse interstitial fibrosis. Ultrasonic backscatter was measured from excised segments of left ventricular free walls of five TSK mice and five sex- and age-matched normal controls with a 50 MHz broad band focused piezoelectric transducer operated in a saline-filled water tank at room temperature. Forty-nine radio frequency (RF) lines were digitized from each specimen at 2 ns/sample. Power spectral analysis of RF data was performed and mean integrated backscatter (IB) computed. The TSK group demonstrated greater IB (-53.6 +/- 0.6 dB, n = 5) than did the control group (-56.6 +/- 0.7 dB, n = 5; p < 0.02). Myocardial collagen content determined by hydroxyproline assay increased by 11% in the TSK group (2.54 +/- 0.08 microgram/mg dry wt, n = 5) over that in controls (2.28 +/- 0.07 microgram/mg dry wt, n = 5; p < 0.05). A significant linear relationship was observed between myocardial hydroxyproline concentration and IB (r = 0.74; p < 0.02). Thus, ultrasonic tissue characterization permits sensitive detection of modest changes in the extent of interstitial fibrosis that accompany tissue remodeling in the early stages of cardiomyopathy.

Acoustics↗
PubMed1993

Quantification of ultrasonic anisotropy in normal myocardium with lateral gain compensation of two-dimensional integrated backscatter images.

Anisotropy of ultrasonic scattering and attenuation in heart tissue depends on the specific orientation of myofibers with respect to angle of insonification. We used lateral gain compensation (LGC) to correct two-dimensional cardiac images for physiologic anisotropy. Normal hearts excised from three dogs and five pigs were insonified in a water tank with both 2.5 and 5.0 MHz phased-array transducers. Integrated backscatter was measured from a short-axis approach in the anterior wall perpendicular to the principal fiber axis, and in the septum parallel to the fiber axis. The gain in a vertical sector encompassing the septum was adjusted to compensate the image for anisotropy by matching the intensity of scattering from septal and anterior regions. The average gain required to compensate the septum for anisotropy was 16 dB at 2.5 MHz, and 20 dB at 5.0 MHz. Five healthy volunteers underwent imaging with a 2.5 MHz transducer from a parasternal short-axis view. The LGC required in vivo was approximately 16 dB at 2.5 MHz and was equivalent to that required for correction of septal anisotropy in excised hearts. Thus, normal myocardium exhibits substantial ultrasonic anisotropy that can be quantified and compensated for with clinically applicable tissue characterization techniques.

Animals↗
PubMed1993

On-line assessment of left atrial area and function by echocardiographic automatic boundary detection.

BACKGROUND: Direct assessment of left atrial (LA) function has not been previously performed by noninvasive techniques; rather, LA function has been evaluated only indirectly via the analysis of transmitral flow velocity by Doppler. The recent development of real-time two-dimensional echocardiographic automatic boundary detection suggests that LA dimensions can be measured instantaneously to provide on-line assessment of its systolic and diastolic functions. METHODS AND RESULTS: We performed echocardiographic assessment of LA dimensions and function with automatic boundary detection in 45 patients by using the apical four-chamber view. Thirty-seven patients had structural or functional cardiac abnormalities, 35 patients were in sinus rhythm, and 10 patients had atrial fibrillation. Moderate to severe mitral regurgitation (MR) was noted in 16 patients. We also studied 10 control subjects to assess normal values of LA cavity area and indexes of function. From the instantaneously derived LA area, we derived indexes of systolic atrial expansion and diastolic atrial emptying. There were excellent correlations between the on-line-derived LA areas and those measured off line from videotaped images of conventional echocardiography (r = .91 for end-diastolic and .93 for end-systolic areas; SEE, 4.0 and 3.8 cm2, respectively). Patients in atrial fibrillation had depressed diastolic emptying index (0.17 +/- 0.05) compared with those in sinus rhythm (0.28 +/- 0.12; P < .02). Furthermore, patients with chronic MR exhibited larger LA cavity areas and depressed systolic and diastolic LA function as compared with those without MR. In addition, the Doppler-determined mitral E/A ratio was related to the ratio of early diastolic-to-late diastolic change in LA cavity area (r = .79; SEE 0.6; n = 35). CONCLUSIONS: Instantaneous LA cavity area measurement by echocardiographic automatic boundary detection is accurate and feasible in patients with diverse cardiac disorders. Patients with atrial fibrillation had a depressed diastolic emptying index and those with significant mitral regurgitation had depressed systolic expansion index as well. LA functional indexes in both systole and diastole can be derived providing an approach for quantitative evaluations of left atrial-left ventricular interactions based on geometric assessment noninvasively.

Atrial Fibrillation↗