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Biomedical subjects

J M Miller

Publications and source records attributed to J M Miller.

At least 253 records · Page 14Linked to original sources
PubMed1995

A reversible ischemia model in gerbil cochlea.

A completely reversible cochlear-ischemia animal model was developed, and an initial study of ischemia/reperfusion-induced cochlear function change is presented. The bulla of the anesthetized gerbil was opened through a ventral approach and the anterior inferior cerebellar artery and its branches were exposed. Cochlear blood flow (CBF) from the basal turn of the cochlea was monitored with a laser Doppler flowmeter. An electrically isolated microclamp was used to occlude the labyrinthine artery (LA). During LA clamping, the cubic distortion product (DP) was continuously recorded. The LA was repeatedly clamped for different durations in all animals, and CBF consistently showed full recovery after clamp release. No obvious change in vessel diameter or flow pattern was observed under a stereomicroscope. Mean blood pressure did not show significant change during clamping. Immediately upon LA clamping, CBF decreased rapidly nearly to zero. After clamp release, CBF demonstrated an immediate rapid increase, followed by a secondary gradual recovery to baseline. CBF recovery patterns were clamp duration-related. Within a few seconds of occlusion, DP decreased and reached a minimum of approximately 24% of the initial level in less that 30 s. Following reperfusion of the cochlea, DP gradually increased, decreased again, then slowly recovered. Time delay between CBF reperfusion and the first increase of DP was proportional to clamping duration, and the increased amplitudes demonstrated a negative relationship to clamp duration. We assume that the first decrease in DP during clamping was caused by ischemia in the cochlea; the second decrease, during the cochlear reperfusion, could be a form of reperfusion-induced change in cochlear function. This ischemia/reperfusion model in gerbil cochlea demonstrates excellent repeatability and reversibility. Since DP and other measurements can be used to dynamically monitor cochlear or hair cell functions, this model is useful in studies of auditory physiology and pathophysiology.

Animals↗
PubMed1995

Visual acuity modeling using optical raytracing of schematic eyes.

PURPOSE: We developed a methodology to predict changes in visual performance that result from changes in the optical properties of the eye. METHODS: Exact raytracing of schematic eyes was used to calculate the point spread function and the modulation transfer function of the visual system. The Stiles-Crawford effect, photopic response, diffraction, and the retinal contrast sensitivity are included in the model. Visual acuity was predicted by examining the modulation of the resultant retinal image of a bar target and by determining when the modulation falls below a threshold value. Visual acuity was predicted for refractive errors ranging from 0 to 5 diopters and for pupil diameters ranging from 0.5 to 8 mm. RESULTS: Visual acuity predictions were compared to clinically found Snellen visual acuities and were found to be highly correlated (r2 = .909). CONCLUSIONS: This modeling technique shows promise as a means of evaluating clinical and surgical procedures before undertaking clinical trails.

Contrast Sensitivity↗
PubMed1995

Studies of inner ear blood flow in animals and human beings.

This article reviews current studies on inner ear blood flow, discusses their relevance to the maintenance of normal homeostasis of the inner ear, reports for the first time clear changes in fundamental properties of cochlear blood flow in the chronic hydropic ear, and describes the potential of applying laser Doppler flowmetry technology to the measurement of inner ear blood flow in human beings. Studies of the guinea pig in which perfusion pressure is varied demonstrate a broad range of autoregulatory capabilities of the inner ear vasculature. Gain factors range from 0.76 and higher for recovery for less than 1 minute of modified perfusion pressure. This is significantly greater than reports obtained for brain autoregulation. In a series of four investigations of cochlear blood flow in the hydropic ear in guinea pigs, a decreased responsiveness to electrical stimulation and direct stimulation of the superior cervical ganglia was found, indicating a change in sympathetic control of cochlear tone. Reduced vasomotion was observed, and autoregulatory capabilities were reduced. In human investigations, changes in cochlear blood flow were demonstrated with direct electrical stimulation of the round window and warm water irrigation of the ear canal, but not with carbogen breathing. Increased cochlear blood flow was observed with increased systemic blood pressure, and a remarkable decrease in cochlear blood flow was observed with the application of 1:10,000 epinephrine to the round window. These observations indicate the potential for development of laser Doppler flowmetry technology in the diagnosis and treatment of inner ear vascular disorders, and the animal investigations suggest that changes may occur in the chronic hydropic ear that compromise autoregulation and thus increase the sensitivity of the hydropic ear to other stress factors. Treatments can be found to modify such changes in vascular tone.

Animals↗
PubMed1995

Efficacy of antitachycardia pacing in patients presenting with cardiac arrest.

The efficacy of antitachycardia pacing (ATP) incorporated into implantable cardioverter defibrillators (ICDs) was assessed in 29 consecutive survivors of cardiac arrest, not attributable to acute myocardial infarction, ischemia, or drug and electrolyte effects. The cohort included 25 men and 4 women with a mean age of 65 years and a mean left ventricular ejection fraction of 29%. Seventeen patients had coronary artery disease, 11 had nonischemic dilated cardiomyopathy, and 1 had long QT syndrome. Programmed stimulation yielded monomorphic ventricular tachycardia (VT) in 17 patients, polymorphic VT in 6, and no inducible VT in 6. During a mean follow-up of 22 months, a total of 91 episodes of monomorphic VT occurred, 73 of which were successfully pace terminated (83%). Monomorphic VT amenable to pace termination recurred only in the group that had this arrhythmia inducible. The recurrent arrhythmias in the 12 patients having either no inducible VT or polymorphic VT were all rapid VTs, having a cycle length < 220 ms; and therefore, not amenable to pace termination. These results suggest that ATP incorporated into ICDs is useful in survivors of cardiac arrest and may significantly reduce the number of shocks that these patients would otherwise receive. Programmed stimulation may also help to define those patients who would receive the maximum benefit from ATP.

Adult↗
PubMed1995

Radiofrequency ablation of a supraventricular tachycardia due to interatrial conduction from the recipient to donor atria in an orthotopic heart transplant recipient.

Interatrial conduction of recipient atrial tachycardia to the donor atria of an orthotopic heart transplant recipient resulted in a unique cause of supraventricular tachycardia. An electrophysiologic study was performed, and the recipient atria was found to be in an atrial tachycardia, cycle length of 210 msec, with periods of both 2:1 and 1:1 conduction to the donor atria resulting in a donor atrial cycle length of 420 msec and 210 msec, respectively. The site of interatrial conduction was mapped to the right atrial suture line, along the atrial free wall, and was successfully disrupted with radiofrequency energy. Arrhythmias of a similar mechanism may also be observed in other postsurgical patients.

Aged↗
PubMed1995

Ability of commercial identification systems to identify newly recognized species of Citrobacter.

The genus Citrobacter was recently determined to contain 11 genetically distinct species. In addition, the International Committee on Systematic Bacteriology no longer recognizes C. diversus and has, instead, validated the name C. koseri in its place. The 11 species are C. freundii, C. koseri, C. amalonaticus, C. farmeri, C. youngae, C. braakii, C. werkmanii, C. sedlakii, and three unnamed groups, genomospecies 9, 10, and 11. To determine the ease with which some identification systems could respond to these changes, we evaluated five systems for their potential ability to recognize current species in the genus Citrobacter. A simple dichotomous key using conventional biochemicals is presented that may be helpful to presumptively identify Citrobacter strains.

Citrobacter↗
PubMed1995

Four-year prospective study of STAPH-IDENT system and conventional method for reference identification of Staphylococcus, Stomatococcus, and Micrococcus spp..

A 4-year prospective study compared the accuracy of the STAPH-IDENT system (bioMérieux Vitek, Inc., Hazelwood, Mo.) with that of the reference procedure of the Centers for Disease Control and Prevention for the identification of Staphylococcus species, Stomatococcus mucilaginosus, and Micrococcus species. The study compared the results from 1,106 cultures (500 eye cultures, 217 strains submitted for reference identification, and 389 known stock strains) representing 21 species of the family Micrococcaceae. The overall agreement of genus and species identifications was 81.1%. The percent agreement for the five most common clinical isolates was as follows: Staphylococcus epidermidis, 97.1% (517 isolates); Staphylococcus hominis, 82.5% (57 isolates); Staphylococcus aureus, 77.2% (162 isolates); Staphylococcus haemolyticus, 75.8% (61 isolates); and Staphylococcus warneri, 64.1% (39 isolates). The lowest percent agreement was with Staphylococcus cohnii (11.1%; (9 isolates). Of the 217 isolates sent to the Centers for Disease Control and Prevention for identification, 60.4% (131) were correctly identified by the STAPH-IDENT system. Of these, S. epidermidis accounted for 23.9%, S. aureus accounted for 15.6%, S. warneri accounted for 6.9%, Staphylococcus lugdunensis accounted for 6.5%, S. haemolyticus accounted for 5.5%, and S. hominis accounted for 4.1%. The STAPH-IDENT system did not perform adequately when dealing with commonly encountered organisms and is unsuitable for identifying uncommon isolates.

Bacterial Typing Techniques↗
PubMed1995

Evaluation of API An-IDENT and RapID ANA II systems for identification of Actinomyces species from clinical specimens.

We compared the accuracy of the An-IDENT system (bioMerieux Vitek, Inc., Hazelwood, Mo.) and the RapID ANA II system (Innovative Diagnostic Systems, Norcross, Ga.) with that of conventional biochemical tests for the identification of 85 strains of Actinomyces species. In our hands, the overall accuracy of the An-IDENT was 59% and that of the RapID ANA II was 24%. The error rate for the An-IDENT was 18% and that for the RapID ANA II was 38%. The results of this study suggest that although the An-IDENT was more accurate than the RapID ANA II (P < 0.005), neither system, in our hands, was able to identify Actinomyces species with an acceptable degree of accuracy. It is recommended that suspected Actinomyces isolates be identified by conventional testing.

Actinomyces↗
PubMed1995

Pulsed-field gel electrophoresis as a replacement for bacteriophage typing of Staphylococcus aureus.

Bacteriophage typing (BT) (World Health Organization method) has been used at the Centers for Disease Control and Prevention for over 30 years to type isolates of Staphylococcus aureus. Since studies have shown that BT patterns have poor reproducibility and because BT fails to type a high percentage (15 to 20%) of isolates, the Centers for Disease Control and Prevention has converted from using BT to using pulsed-field gel electrophoresis (PFGE) for strain typing S. aureus. We compared the results of BT with results of PFGE for typing 300 isolates of S. aureus, including strains from several well-characterized outbreaks. Ninety-six isolates were BT group I, 19 were group II, 82 were group III, 7 were group V, and 96 were nontypeable. PFGE identified subgroups within each phage group and thus was more discriminating than BT, which identified no subgroups. PFGE was able to type all isolates and distinguish related from unrelated strains of S. aureus. Our modified, standardized PFGE methodology should enable typing laboratories to obtain rapid, reliable results in 3 to 4 days when starting with an isolated colony on agar media.

Bacteriophage Typing↗
PubMed1995

Use of Presumpto Plates to identify anaerobic bacteria.

Identification of anaerobic bacteria requires special media and growth conditions that contribute to a higher cost per identification than that for aerobic isolates. Newer rapid methods streamline the identification process, but confirmation to the species level is often difficult. The Presumpto Plate method for the identification of commonly encountered anaerobes consists of three quadrant plates, each containing four conventional media, that result in the generation of 21 test parameters: growth on Lombard-Dowell medium; production of indole, indole derivative, catalase, lecithinase, and lipase; proteolysis of milk, H2S, and esculin; growth on 20% bile; precipitate on bile; DNase, glucose, casein, starch, and gelatin hydrolysis; and fermentation of lactose, mannitol, and rhamnose. Identification charts were developed by using the results from 2,300 anaerobic isolates. Because conventional media were used, there was a high degree of agreement between the Presumpto Plate method and the reference method when testing commonly encountered anaerobes. The Presumpto Plate method is as accurate as commercially available enzyme systems for the identification of many anaerobic species but is less expensive to perform.

Bacteria, Anaerobic↗
PubMed1995

Evaluation of a new, semiquantitative screening culture device for urine specimens.

The EZ Streak urine culture device (Difco Laboratories, Detroit, Mich.) combines the advantages of both the dip-slide and the classic urine culture technique, enabling bacterial enumeration and isolation following a simple inoculation step. Five hundred clean-catch urine specimens submitted by outpatients attending a health maintenance organization were used to compare the EZ Streak with culture using a 0.001-ml loop. Complete agreement of colony counts determined by the two methods was obtained for 114 (91.2%) of 125 positive specimens, but 99.2% of the results agreed in clinical interpretation, indicating the presence or absence of bacteriuria. Overall agreement between the EZ Streak and culture was 95.7%. The sensitivity and specificity of the EZ Streak were determined to be 98.4 and 99.4%, respectively. For this patient population, the EZ Streak was determined to be a reliable replacement for routine urine culture.

Bacteriological Techniques↗
PubMed1995

Evaluation of AnaeroGen system for growth of anaerobic bacteria.

The Oxoid AnaeroGen system was compared with the BBL GasPak for the production of an anaerobic atmosphere and was evaluated for its ability to support the growth of 135 clinically significant anaerobic bacteria. An anaerobe chamber was used as the "gold standard" for supporting the growth of anaerobes. The AnaeroGen requires no catalyst, produces no hydrogen, requires no water, and reduces preparation time to a minimum. The water-activated BBL GasPak generates hydrogen. For 132 of the 135 strains tested, better initial growth at 48 h was noted for the jar methods than for the anaerobe chamber. At 72 h, 113 of the 135 strains showed equal growth, and at 7 days, only marginal differences in growth patterns were noted. The AnaeroGen never failed to reduce the anaerobic indicator, while the BBL GasPak occasionally failed to do so. The AnaeroGen performed at least as well as, and sometimes better than, the established methods. The AnaeroGen is a good alternative for use in anaerobic jars.

Atmosphere Exposure Chambers↗
PubMed1995

Expression of the rotavirus SA11 protein VP7 in the simple eukaryote Dictyostelium discoideum.

The outer capsid protein of rotavirus, VP7, is a major neutralization antigen and is considered a necessary component of any subunit vaccine developed against rotavirus infection. For this reason, significant effort has been directed towards producing recombinant VP7 that maintains the antigenic characteristics of the native molecule. Using a relatively new expression system, the simple eukaryote Dictyostelium discoideum, we have cloned the portion of simian rotavirus SA11 genome segment 9, encoding the mature VP7 protein, downstream of a native D. discoideum secretion signal sequence in a high-copy-number extrachromosomal vector. The majority of the recombinant VP7 expressed by transformants was intracellular and was detected by Western immunoblot following gel electrophoresis as two or three bands with an apparent molecular mass of 35.5 to 37.5 kDa. A small amount of VP7 having an apparent molecular mass of 37.5 kDa was secreted. Both the intracellular VP7 and the secreted VP7 were N glycosylated and sensitive to endoglycosidase H digestion. Under nonreducing electrophoresis conditions, over half the intracellular VP7 migrated as a monomer while the remainder migrated with an apparent molecular mass approximately twice that of the monomeric form. In an enzyme-linked immunosorbent assay, intracellular VP7 reacted with both nonneutralizing and neutralizing antibodies. The monoclonal antibody recognition pattern paralleled that found with VP7 expressed in either vaccinia virus or herpes simplex virus type 1 and confirms that D. discoideum-expressed VP7 is able to form the major neutralization domains present on viral VP7. Because D. discoideum cells are easy and cheap to grow, this expression system provides a valuable alternative for the large-scale production of recombinant VP7 protein.

Animals↗
PubMed1995

Reproducibility of corneal astigmatism measurements with a hand held keratometer in preschool children.

AIMS: To evaluate the overall accuracy and reproducibility of the Alcon portable autokeratometer (PAK) measurements in infants and young children. METHODS: The accuracy of the Alcon PAK in measuring toric reference surfaces (1, 3, 5, and 7 D) under various suboptimal measurement conditions was assessed, and the reproducibility of PAK measurements of corneal astigmatism in newborn infants (n = 5), children (n = 19, age 3-5 years), and adults (n = 14) was evaluated. RESULTS: Measurements of toric reference surfaces indicated (a) no significant effect of distance (17-30 mm) on accuracy of measurements, (b) no systematic relation between amount of toricity and accuracy of measurements, (c) no systematic relation between angle of measurement and accuracy, (d) no difference in accuracy of measurements when the PAK is hand held in comparison with when it is mounted, (e) no difference in accuracy of measurements when axis of toricity is oriented obliquely than when it is oriented horizontally, with respect to the PAK, and (f) a small positive bias (+0.16 D) in measurement of spherical equivalent. The PAK did not prove useful for screening newborns. However, measurements were successfully obtained from 18/19 children and 14/14 adults. There was no significant difference in median measurement deviation (deviation of a subject's five measurements from his/her mean) between children (0.21 D) and adults (0.13 D). CONCLUSIONS: The PAK produces accurate measurements of surface curvature under a variety of suboptimal conditions. Variability of PAK measurements in preschool children is small enough to suggest that it would be useful for screening for corneal astigmatism in young children.

Astigmatism↗
PubMed1995

Hydrops-induced changes in cochlear blood flow.

Laser Doppler flowmetry was used to assess cochlear blood flow (CBF) in the hydropic ear in four experiments. 1) The increase in CBF elicited by local electrical stimulation of the cochlea in the hydropic ear was compared to that observed in normal controls. The magnitude of the evoked CBF change was reduced by approximately 30% in the hydropic ear compared to the normal ear. 2) The reduction in CBF evoked by direct electrical stimulation of the superior cervical ganglion was reduced by approximately one third in the hydropic ear compared to a normal ear. 3) Rhythmic (flux motion or vasomotion) variations in CBF, observed in association with lower blood pressure and thought to extend the autoregulatory range in an organ system, were reduced or eliminated in the hydropic ear. 4) The autoregulatory response to a decreased perfusion pressure, produced by decreased cardiac output, was clearly reduced relative to control in the hydropic ear. These findings represent the first report of significant CBF changes with hydrops. They are consistent with reports of increased sensitivity of the hydropic ear to trauma and stress and may be relevant considerations in the treatment of hydrops in humans.

Animals↗
PubMed1995

Representation of videokeratoscopic height data with Zernike polynomials.

Videokeratoscopic data are generally displayed as a color-coded map of corneal refractive power, corneal curvature, or surface height. Although the merits of the refractive power and curvature methods have been extensively debated, the display of corneal surface height demands further investigation. A significant drawback to viewing corneal surface height is that the spherical and cylindrical components of the cornea obscure small variations in the surface. To overcome this drawback, a methodology for decomposing corneal height data into a unique set of Zernike polynomials is presented. Repeatedly removing the low-order Zernike terms reveals the hidden height variations. Examples of the decomposition-and-display technique are shown for cases of astigmatism, keratoconus, and radial keratotomy.

Cornea↗
PubMed1995

Heart beat modulation of spontaneous otoacoustic emissions in guinea pig.

It has been reported that background variation in the frequency of spontaneous otoacoustic emission (SOAEs) may arise from the cardiovascular system and that the side-bands in the spectra of SOAEs may be modulated by heartbeat. For better understanding of the mechanical influence of the cardiac cycle on cochlear functions under physiological and pathophysiological conditions, this study investigated heartbeat-induced modulation of SOAEs in guinea pig. Possible mechanisms of these phenomena are also discussed. The external ear canal acoustic signal, round window electric signal, and the ECG were recorded for off-line analysis from five pigmented guinea pigs with SOAEs. Time and frequency domain averages with synchronization of the heartbeat indicate that both the external ear canal acoustic and round window electric signal contain some component contributed by ECG and phonocardiography. High resolution FFT spectra suggest that SOAEs were modulated by heartbeat and respiration. Theoretically the change in the SOAEs could be from frequency modulation or a combination of frequency and amplitude modulations. Results of a heartbeat-synchronized average of a wave analyzer output at SOAE frequency indicates that amplitude modulation of SOAE does occur. Data obtained in the current experiment support the hypothesis that the heartbeat-related modulation of SOAE in guinea pig is a combination of frequency and amplitude modulation. The proposed mechanism is that pulsatile cochlear blood flow may cause oscillations in cochlear pressure and affect cochlear performance, resulting in heartbeat modulation of SOAEs.

Animals↗