Search PubMed⌕ Search

Biomedical subjects

J M Miller

Publications and source records attributed to J M Miller.

At least 217 records · Page 12Linked to original sources
PubMed1996

Primary ablation of atrial flutter and atrial fibrillation.

Direct treatment of atrial flutter and atrial fibrillation--that is, attempting to prevent arrhythmia recurrences by ablating atrial tissue--has been a challenge because of uncertainty about the location of optimal target tissues as well as the amount of atrial tissue requiring destruction to effect cure. Advances have yielded success rates for ablation of the common form of atrial flutter comparable to those for other types of supraventricular tachycardia and provide reason for optimism about the use of catheter techniques, to treat atrial fibrillation definitively. This article discusses some of these advances as well as the current status of catheter ablation for atrial flutter and atrial fibrillation and, finally, what the future may bring.

Animals↗
PubMed1996

Anna Freud. A historical look at her theory and technique of child psychoanalysis.

This paper traces historically the development of Anna Freud's thinking about the theory and technique of child psychoanalysis. Representing more than fifty years of work, her ideas were refined and many were altered, influenced by naturalistic and clinical observations and her developmental viewpoint. The paper begins with her 1926 Introductory Lectures, which contain both her early views about the technique used with children as compared to adults and the origins of many of her later ideas. It follows her theories up through her final papers, published in the late 1970s.

Adolescent↗
PubMed1996

Gram-negative bacteremia in open-heart-surgery patients traced to probable tap-water contamination of pressure-monitoring equipment.

OBJECTIVE: To determine the cause(s) of an outbreak of gram-negative bacteremia (GNB) in open-heart-surgery (OHS) patients at hospital A. DESIGN: Case-control and cohort studies and an environmental survey. RESULTS: Nine patients developed GNB with Enterobacter cloacae (6), Pseudomonas aeruginosa (5), Klebsiella pneumoniae (3), Serratia marcescens (2), or Klebsiella oxytoca (1) following OHS; five of nine patients had polymicrobial bacteremia. When the GNB patients were compared with randomly selected OHS patients, having had the first procedure of the day (8 of 9 versus 12 of 27, P = .02), longer cardiopulmonary bypass (median, 122 versus 83 minutes, P = .01) or cross-clamp times (median, 75 versus 42 minutes, P = .008), intraoperative dopamine infusion (9 of 9 versus 15 of 27, P = .01), or exposure to scrub nurse 6 (6 of 9 versus 4 of 27, P = .001) were identified as risk factors. When stratified by length of the procedure, only being the first procedure of the day and exposure to scrub nurse 6 remained significant. First procedures used pressure-monitoring equipment that was assembled before surgery and left open and uncovered overnight in the operating room, whereas other procedures used pressure-monitoring equipment assembled immediately before the procedure. At night, operating rooms were cleaned by maintenance personnel who used a disinfectant-water solution sprayed through a hose connected to an automatic diluting system. Observation of the use of this hose documented that this solution could have contacted and entered uncovered pressure-monitoring equipment left in the operating room. Water samples from the hose revealed no disinfectant, but grew P aeruginosa. The outbreak was terminated by setting up pressure-monitoring equipment immediately before the procedure and discontinuing use of the hose-disinfectant system. CONCLUSIONS: This outbreak most likely resulted from contamination of uncovered preassembled pressure-monitoring equipment by water from a malfunctioning spray disinfectant device. Pressure-monitoring equipment should be assembled immediately before use and protected from possible environmental contamination.

Adult↗
PubMed1996

Evaluation of new computer-enhanced identification program for microorganisms: adaptation of BioBASE for identification of members of the family Enterobacteriaceae.

We report the use of BioBASE, a computer-enhanced numerical identification software package, as a valuable aid for the rapid identification of unknown enteric bacilli when using conventional biochemicals. We compared BioBASE identification results with those of the Centers for Disease Control and Prevention's mainframe computer to determine the former's accuracy in identifying both common and rare unknown isolates of the family Enterobacteriaceae by using the same compiled data matrix. Of 293 enteric strains tested by BioBASE, 278 (94.9%) were correctly identified to the species level; 13 (4.4%) were assigned unacceptable or low discrimination profiles, but 8 of these (2.7%) were listed as the first choice; and 2 (0.7%) were not identified correctly because of their highly unusual biochemical profiles. The software is user friendly, rapid, and accurate and would be of value to any laboratory that uses conventional biochemicals.

Bacteriological Techniques↗
PubMed1996

Case of bacterial endophthalmitis caused by an Agrobacterium radiobacter-like organism.

A case of postsurgical endophthalmitis caused by Agrobacterium radiobacter in a 70-year-old male is reported. A. radiobacter organisms are normally environmental bacteria but may occasionally be opportunistic pathogens. Infection in this case occurred after the patient was discharged following routine cataract surgery. The infection cleared after empiric therapy intraocular administration of vancomycin and gentamicin.

Aged↗
PubMed1996

Atmospheric growth requirements for Alloiococcus species and related gram-positive cocci.

The growth of Alloiococcus otitis under different atmospheres and nutritional conditions was studied. The growth rates of 25 strains of gram-positive cocci representing five genera on heart infusion agar plates containing 5% rabbit blood and on brucella agar plates with and without sheep blood under aerobic, increased CO2, and anaerobic atmospheres were compared. Eight strains of alloiococci plated on heart infusion agar with rabbit blood and on brucella sheep blood agar grew under aerobic and candle jar atmospheres. Two of these strains showed poor anaerobic growth after 7 days. Strains of Aerococcus viridans, Aerococcus urinae, Helcococci kunzi, Dolosigranulum pigrum, Gemella haemolysans, and Gemella morbillorum grew well under all three atmospheres and on the three types of media and in thioglycolate broth. These results confirm all the aerobic atmospheric requirements for Alloiococcus strains and show that aerobic growth characteristics help distinguish the alloiococci from the other gram-positive cocci that are facultatively anaerobic.

Aerobiosis↗
PubMed1996

Do histopathology reports of primary cutaneous melanoma contain enough essential information?

AIMS: To audit the content of primary cutaneous malignant melanoma histopathology reports with special reference to Breslow thickness and lateral excision margins. METHODS: The Trent Regional Cancer Registry was asked to provide details of primary cutaneous malignant melanomas for the most recent year available (1990). Histopathology departments were then requested to provide copies of the relevant reports, which were then analysed. RESULTS: In total, 178 reports were obtained from 16 departments. Breslow thickness was present in 87.1% (155/178) and a comment had been made on lateral excision in 85.4% (152/178). A specific clearance measurement was recorded in 5.6% (10/178), and in 9.6% (17/178) tumour was stated to extend to the margin. In 4.5% (8/178) neither thickness nor a comment on excision was recorded. Clinical advice on excision was offered in 12.4% (22/178). A macroscopic description was absent in 6.7% (12/178). CONCLUSIONS: Deficiencies were identified in the quality of malignant melanoma histopathology reports in Trent Region. There is no reason to believe that significant improvements have occurred since 1990 or that other regions are performing differently. A national standard for reporting primary cutaneous malignant melanoma is recommended. As a minimum, all reports should include Breslow thickness and a specific measurement of lateral clearance. This will facilitate prognostic evaluation, clinical management and audit. This standard would not exclude the reporting of other information, depending on local policy. As with all standards, continual review must be undertaken and consideration given as to whether other more recent parameters, such as growth phase, also warrant future inclusion.

Humans↗
PubMed1996

Distribution of lesions in cattle infected with Mycobacterium bovis.

Detailed postmortem examinations were conducted on 30 cattle from a dairy herd with bovine tuberculosis to determine the distribution of lesions in Mycobacterium bovis-infected cattle. Twenty-four different tissue specimens from each animal were examined for gross lesions and collected for bacteriologic culturing and histologic examination. Tuberculosis was confirmed in 15 cattle with evidence of infection in 1 or more of the following tissues: medial retropharyngeal, parotid, tracheobronchial, mediastinal, caudal deep cervical, and subiliac lymph nodes; palatine tonsil; and lung. Gross and histologic lesions were present most frequently in lymph nodes of the thoracic region. Mycobacterium bovis was isolated from 3 cattle that had no gross lesions of tuberculosis. One animal had lesions only in the subiliac lymph node, which is not routinely examined during slaughter surveillance. Results of this study indicate that not all cattle infected with M. bovis have visible lesions of tuberculosis in sites that are routinely inspected. These findings are important because detection of gross lesions of tuberculosis during inspection of carcasses at slaughter is the primary method for detection of tuberculous cattle and herds in the United States.

Animals↗
PubMed1996

Comparison of three videokeratoscopes in measurement of toric test surfaces.

PURPOSE: We compared the accuracy of the Computed Anatomy TMS-1 (1.41), the EyeSys Laboratories Corneal Analysis System (2.1), and the Visioptic EH-270 (3.0) videokeratoscopes in measuring toric surfaces. These non-rotationally symmetric aspheric surfaces served as models of corneal astigmatism. METHODS: Precision diamond-turned toric surfaces modeling 0.00 diopter (D) to 7.00 D of astigmatism were fabricated. A three-dimensional contact profiler was developed to calibrate the aspheric surfaces. Videokeratoscopic data taken at "best focus" were compared to the theoretical shape to quantify device measurement errors. RESULTS: The Computed Anatomy system measurement accuracy shows no statistically significant correlation between measurement error and surface toricity (r2 < 0.13). Measurement error increased linearly with surface astigmatism for the EyeSys Laboratories system (0.12 D rms error per D of astigmatism, r2 > 0.96, p < 0.001 and the Visioptic system (0.03 D error per D of astigmatism, r2 = 0.88, p < 0.001). CONCLUSIONS: This study found systematic performance differences among the three machines. Under ideal alignment conditions, the Computed Anatomy TMS-1 is more accurate at detecting astigmatism. The EyeSys Laboratories Corneal Analysis System apparently underestimates the amount of surface astigmatism because of excessive data smoothing. The Visioptic EH-270 errors are primarily in the central zones and may be due to ring localization errors.

Algorithms↗