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Biomedical subjects

J M Miller

Publications and source records attributed to J M Miller.

At least 55 records · Page 3Linked to original sources
PubMed2001

Case-control study of antenatal cocaine use and platelet levels.

OBJECTIVE: Our aim was to determine the prevalence of thrombocytopenia in pregnant patients who did and did not use cocaine. STUDY DESIGN: A 1:1 case-control study of 326 patients attending an inner-city, neighborhood-based antenatal program between January 1992 and December 1998 is presented. Data concerning cocaine use (history and urine toxicology study) and platelet count, along with gestational age, were compared by nonparametric techniques (chi2 test, Fisher exact test, Wilcoxon rank sums, and receiver operating characteristic curve). RESULTS: The prevalence of thrombocytopenia during pregnancy was not different between cocaine-using patients (13/160; 8.1%) and nonusing patients (11/160; 6.9%; difference not significant). In patients who abused cocaine and for whom both positive and negative urine screening results were obtained concomitantly with platelet levels, no difference in platelet counts was evident. Overall, thrombocytopenia occurred more often in the third trimester than earlier in pregnancy for both control and cocaine-using pregnant women. CONCLUSION: Cocaine use among pregnant women was not associated with thrombocytopenia. A low platelet count was found more often later in pregnancy.

Adolescent↗
PubMed2001

Detection of improper fixation in MTI photoscreening images.

PURPOSE: To determine the effect of fixation shift on photoscreening crescents, the ability of human interpreters to detect fixation shift, and the potential improvement by image processing. METHODS: MTI photoscreening (Medical Technologies & Innovations, Inc, Lancaster, PA) images, measured at 11 positions of gaze, were obtained from 10 subjects (9 with refractive error warranting spectacle correction). Photographs were taken with subjects fixating at 20, 15, 10, and 5 cm to the left and the right of the camera fixation target (1 m distant); 5 cm above and below the camera fixation target; and on-axis. Photographs were inspected by 11 experienced raters, who indicated if the subject appeared to be looking directly at the camera. The photographs were digitized, enlarged, contrast enhanced, and measured by 3 raters. For each photograph, distance from the corneal light reflex to the nasal limbus was measured and a measure of asymmetry computed. RESULTS: Raters could reliably detect off-axis fixation greater than 10 cm away from the intended fixation target. Raters correctly identified on-axis subject viewing 73% of the time. Crescents became larger when the fixation shifted off-axis for both the myopic and hyperopic subjects. Image analysis correctly classified 10 of 10 on-axis measurements and 34 of 39 off-axis measurements. CONCLUSION: Direct inspection of photoscreening images by trained raters can result in the failure to detect small but relevant errors of fixation. These fixation shifts can cause crescents to become larger than expected, resulting in false-positive classification. Image analysis offers a potential improvement in the detection of off-axis fixation in MTI photoscreening images.

Adult↗
PubMed2001

Conservation of recognition of antibody and T-cell-defined alloantigens between species of equids.

Serological and cellular assays and molecular techniques were used to define features of the major histocompatibility complex (MHC) of the donkey With this information in hand, immune recognition of MHC determinants within and between donkeys and horses was compared. An antibody-mediated, complement-dependent, microcytotoxicity assay using a variety of antisera to donkey histocompatibility antigens, including those induced as a result of intraspecies or interspecies pregnancy in horse mares and jenny donkeys, delineated five donkey leukocyte antigen (DoLA) specificities. Antisera raised across species barriers (horse anti-donkey and donkey anti-horse) recognized polymorphic antigenic determinants in the target species. These determinants were often indistinguishable from polymorphic antigens recognized by alloantisera raised within horses or donkeys. The data indicate that a strong correlation exists between the serological antigenic types identified and the specificity of cytotoxic T lymphocytes raised by lymphocyte co-cultures, either within or between species. Moreover, in an analysis of a small number of donkey MHC class I cDNA gene sequences, no features distinguishing horse or donkey MHC class I molecules were identified. These molecular findings explain in large measure why antibody- and T-cell-defined alloantigen recognition is conserved among these closely related equids.

Amino Acid Sequence↗
PubMed2001

Prospective comparison of the startle test (recoil) and non-stress test.

OBJECTIVE: Our purpose was to compare fetal heart rate reaction to external physical stimulation with the non-stress test (NST). METHODS: This was a prospective study evaluating documentation of fetal heart accelerations by two methods. The standard NST was performed prior to the ultrasound evaluation. The NST results were not available to the ultrasonographer. M-mode ultrasound was used to establish a stable fetal heart rate. The ultrasound transducer was used to stimulate fetal movement by indentations of the uterus over the fetal small parts. A second fetal heart rate was determined within 15 s after stimulation. RESULTS: A total of 122 patients had 159 studies performed. The fetal heart rate range due to fetal startle (recoil) was -22 to 14 (median of 3) in the 45 fetuses with non-reactive NSTs and 1 to 38 (median of 15) in the 114 fetuses with a reactive NST (p <0.001). A receiver operating curve comparing the fetal response to the startle and the NST revealed an area under the curve of 0.972, consistent with high specificity and sensitivity. CONCLUSION: The fetal heart rate response to external stimulation correlates with the formal NST.

Female↗
PubMed2001

Effects of an external nasal dilator on the work of breathing during exercise.

PURPOSE: The effect of an external nasal dilator on the work of breathing (WOB) was measured during exercise in 14 untrained college students (age, 23 +/- 2.7 yr). METHODS: Two maximal, incremental ergometer tests were performed to exhaustion. Subjects wore a placebo or an active nasal dilator strip, in random order, during each test. An esophageal balloon was placed through each of the subject's mouth into the esophagus for measurement of inspiratory elastic work (INEW), inspiratory resistive work (INRW), and expiratory resistive work (EXRW). Subjects breathed through a Hans Rudolph(R) face mask that covered both the mouth and nose during both tests. Measured variables included oxygen uptake (VO2), ventilation (VE), tidal volume (VT), frequency of breathing (f), INEW, INRW, and EXRW (work expressed in joules). An alpha level was set at P < 0.05. RESULTS: No significant differences were found in INEW, INRW, and EXRW between conditions at 70% of VO2max (mean +/- SD; Placebo: INEW, 25.6 +/- 17.8 J.min-1; INRW, 22.4 +/- 15.8 J.min-1; EXRW, 16.7 +/- 12.3 J.min-1; Active: INEW, 24.7 +/- 12.9 J.min-1; INRW, 19.7 +/- 11.9 J.min-1; EXRW, 15.2 +/- 8.6 J.min-1; P > 0.05). No difference was found in INEW, INRW, and EXRW at maximal exercise between conditions (mean +/- SD; Placebo: INEW, 50.2 +/- 29.9 J.min-1; INRW, 67.3 +/- 42.3 J.min-1; EXRW, 102.3 +/- 78.4 J.min-1; Active: INEW, 45.7 +/- 19.6 J.min-1; INRW, 62.6 +/- 36.7 J.min-1; EXRW, 86.3 +/- 50.9 J.min-1; P > 0.05). There were no differences in VO2, VE, VT, or f between conditions. CONCLUSION: Wearing an external nasal dilator does not significantly reduce the work of breathing during exercise.

Adult↗
PubMed2001

Protocol for detection of biofilms on needleless connectors attached to central venous catheters.

Central venous catheter needleless connectors (NCs) have been shown to develop microbial contamination. A protocol was developed for the collection, processing, and examination of NCs to detect and measure biofilms on these devices. Sixty-three percent of 24 NCs collected from a bone marrow transplant center contained biofilms comprised primarily of coagulase-negative staphylococci.

Biofilms↗
PubMed2001

Biofilm formation by gram-negative bacteria on central venous catheter connectors: effect of conditioning films in a laboratory model.

Human blood components have been shown to enhance biofilm formation by gram-positive bacteria. We investigated the effect of human blood on biofilm formation on the inner lumen of needleless central venous catheter connectors by several gram-negative bacteria, specifically Enterobacter cloacae, Pseudomonas aeruginosa, and Pantoea agglomerans. Results suggest that a conditioning film of blood components promotes biofilm formation by these organisms in an in vitro system.

Bacterial Adhesion↗
PubMed2001

Therapist reporting of suspected child abuse and maltreatment: factors associated with outcome.

Several studies have found that making a report of suspected child abuse or maltreatment concerning a client in psychotherapy is more likely to have a positive outcome for the relationship or to effect no change, than to be damaging. The current study examined factors that were associated with outcome. Three variables, all of which concerned the client-therapist relationship, were found to be important for outcome. The quality of the relationship before the report made the greatest contribution to predicting outcome, with stronger alliances associated with positive outcome. Also important is the length of time in treatment, with longer periods of time related to positive outcome. In addition, more effective handling of making the report is related to positive outcome in that it differentiated improved from no-change groups. Lastly, statistical trends were found both for a relationship between therapist comfort in reporting and positive outcome, and for families tending to have more negative outcomes than adults in individual treatment or children. This is the first time that the examination of factors related to outcome was based upon information received from mental health professionals who were confirmed by CPS as reporters of suspected child abuse and maltreatment. Findings from this and related studies should be incorporated into training programs to ease concerns about the effects of reporting on the psychotherapy relationship and to offer guidance about factors that could increase positive outcomes. Such training could provide needed information to practitioners in reporting situations and enable more complete reporting.

Adult↗
PubMed2001

Preliminary findings on the experimental transmission of chronic wasting disease agent of mule deer to cattle.

To determine the transmissibility of chronic wasting disease (CWD) to cattle and to provide information about clinical course, lesions, and suitability of currently used diagnostic procedures for detection of CWD in cattle, 13 calves were inoculated intracerebrally with brain suspension from mule deer naturally affected with CWD. Between 24 and 27 months postinoculation, 3 animals became recumbent and were euthanized. Gross necropsies revealed emaciation in 2 animals and a large pulmonary abscess in the third. Brains were examined for protease-resistant prion protein (PrP(res)) by immunohistochemistry and Western blotting and for scrapie-associated fibrils (SAFs) by negative-stain electron microscopy. Microscopic lesions in the brain were subtle in 2 animals and absent in the third case. However, all 3 animals were positive for PrP(res) by immunohistochemistry and Western blot, and SAFs were detected in 2 of the animals. An uninoculated control animal euthanized during the same period did not have PrP(res) in its brain. These are preliminary observations from a currently in-progress experiment. Three years after the CWD challenge, the 10 remaining inoculated cattle are alive and apparently healthy. These preliminary findings demonstrate that diagnostic techniques currently used for bovine spongiform encephalopathy (BSE) surveillance would also detect CWD in cattle should it occur naturally.

Animals↗
PubMed2001

Diagnosis of preclinical and subclinical scrapie in a naturally infected sheep flock utilizing currently available postmortem diagnostic techniques.

Scrapie is a naturally occurring transmissible encephalopathy of sheep and goats. Currently available methods for diagnosis are the presence of characteristic histopathologic changes and detection of an abnormal form of prion protein (PrPres) in the brains of affected animals. This study documents preclinical and subclinical scrapie in a flock of 16 sheep utilizing histopathology, immunohistochemistry (IHC), western blot, and electron microscopy (for scrapie-associated fibrils) for confirmation of the disease. Prior to necropsy, none of the sheep showed signs of clinical scrapie. Based on the results of histopathology and positive PrPres tests, 3 ewes were found to have subclinical scrapie. An additional ewe, which did not have histopathologic changes in the brain but was positive by IHC and western blot,was considered a preclinical case of scrapie. None of the sheep had amyloid in the brain stem.

Animals↗
PubMed2001

serpent, a GATA-like transcription factor gene, induces fat-cell development in Drosophila melanogaster.

The GATA-like transcription factor gene serpent is necessary for embryonic fat-cell differentiation in Drosophila (Sam, S., Leise, W. and Hoshizaki, D. K. (1996) Mech. Dev. 60, 197-205) and has been proposed to function in a cell-fate choice between fat cell and somatic gonadal precursors (Moore, L. A., Broihier, H. T., Van Doren, M. and Lehmann, R. (1998) Development 125, 837-44; Riechmann, V., Irion, U., Wilson, R., Grosskortenhaus, R. and Leptin, M. (1997) Development 124, 2915-22). Here, we report that deregulated expression of serpent in the mesoderm induces the formation of ectopic fat cells and prevents the migration and coalescence of the somatic gonadal precursors. The ectopic fat cells do not arise from hyperproliferation of the primary fat-cell clusters but they do associate with the endogenous fat cells to form a fat body that is expanded in both the dorsal/ventral and anterior/posterior axes. Misexpression of serpent also affects the differentiation of muscle cells. Few body-wall muscle precursors are specified and there is a loss of most body-wall muscle fibers. The precursors of the visceral mesoderm are also absent and concomitantly the visceral muscle is absent. We suggest that the ectopic fat cells might originate from cells that have the potential, but do not normally, differentiate into fat cells or from cells that have acquired a fat-cell fate. In light of our results, we discuss the role of serpent in fat-cell specification and in cell fate choices.

Adipocytes↗
PubMed2001

A framework for the multiple roles of librarians in problem-based learning.

Librarians are playing numerous roles within problem-based learning curricula. While many of these roles are described in the literature, there is no framework to describe and organize these roles. This paper proposes such a framework. It arranges librarian roles according to level of curricular involvement and includes the following levels: assistance at the reference desk, instruction at the reference desk, course-related instruction, resource management and utilization, consultation with faculty and students, and group facilitation.

Curriculum↗
PubMed2001

Gambling as an addictive disorder among athletes: clinical issues in sports medicine.

This article examines the role of gambling as an addictive disorder experienced by athletes, both college and professional. Gambling may often be seen as a comorbid factor with other addictions and with depression among athletes. The focus on addictions among athletes has gained considerable attention among sports medicine clinicians. Diagnostic indicators, risk and protective factors, and a stage model of addiction among athletes are addressed. An algorithm and pathway of care for athletes with an addictive disorder is offered as are recommendations that sports physicians, sports medicine specialists, coaches and counsellors need to address athletes who have an addictive disorder.

Behavior, Addictive↗
PubMed2001

Bovine tuberculosis in free-ranging carnivores from Michigan.

During a survey of carnivores and omnivores for bovine tuberculosis conducted in Michigan (USA) since 1996, Mycobacterium bovis was cultured from lymph nodes pooled from six coyotes (Canis latrans) (four adult female, two adult male), two adult male raccoons (Procyon lotor), one adult male red fox (Vulpes vulpes), and one 1.5-yr-old male black bear (Ursus americanus). One adult, male bobcat (Felis rufus) with histologic lesions suggestive of tuberculosis was negative on culture but positive for organisms belonging to the Mycobacterium tuberculosis complex when tested by polymerase chain reaction. All the tuberculous animals were taken from three adjoining counties where M. bovis is known to be endemic in the free-ranging white-tailed deer (Odocoileus virginianus) population. There were two coyotes, one raccoon, one red fox, and one bobcat infected in Alpena county. Montmorency County had two coyotes and one raccoon with M. bovis. Two coyotes and a bear were infected from Alcona County. These free-ranging carnivores/omnivores probably became infected with M. bovis through consumption of tuberculous deer. Other species included in the survey were opossum (Didelphis virginiana), gray fox (Urocyon cinereoargenteus), and badger (Taxidea taxus); these were negative for M. bovis.

Animals↗
PubMed2001

Comparison of preschool vision screening methods in a population with a high prevalence of astigmatism.

PURPOSE: To compare the effectiveness of four methods of screening 3- to 5-year-old children for astigmatism high enough to require spectacle correction. METHODS: Lea Symbols Visual Acuity Screening (LSVAS), MTI Photoscreening (MTIPS), Nidek KM-500 Keratometry Screening (KERS), and Retinomax K-Plus Noncycloplegic Autorefraction Screening (NCARS) were attempted on 379 preschool children who are members of a Native American tribe having a high prevalence of astigmatism that is primarily corneal in origin. The need for spectacle correction was determined by cycloplegic refraction. Receiver Operating Characteristic (ROC) curves were fit, confidence intervals were determined, and area under the curves was compared. RESULTS: Astigmatism > or = 1.00 D was present in the right eye of 47.5% and in the left eye of 48.0% of children. Spectacles were prescribed for children < 48 months of age who had cylinder > or = 2.00 D and children > or = 48 months who had cylinder > or = 1.50 D, with the result that 33% of subjects required spectacles. Area under the ROC curve was 0.98 for NCARS, 0.92 for KERS, 0.78 for MTIPS, and 0.70 for LSVAS, and each of these values differed significantly from the other three (all P < 0.007). Testability was significantly higher for NCARS (99.5%) and KERS (99.7%) than for MTIPS (93.5%) and LSVAS (92.0%). CONCLUSIONS: In a population that included many children with astigmatism, objective, fully automated screening methods (NCARS and KERS) were superior to both visual acuity screening and photoscreening with subjective interpretation in identifying children who had astigmatism requiring spectacle correction.

Amblyopia↗
PubMed2001

Resistance of cattle to scrapie by the oral route.

Early epidemiological information indicated that bovine spongiform encephalopathy (BSE) originated from scrapie in sheep. The question arose if scrapie in North America would induce a BSE-like disease in cattle. Six years ago, we reported that brain tissue from sheep with scrapie caused a neurologic disease when injected directly into the brains of cattle, but the disease induced was different from BSE as it occurs in the United Kingdom and Europe. Here, we report that cattle fed raw brain or meat and bone meal and tallow prepared from sheep with scrapie remained normal for 8 years after exposure. This work indicates that cattle are highly resistant to North American scrapie by the oral route.

Animals↗
PubMed2001

Pulsed electron avalanche knife (PEAK) for intraocular surgery.

PURPOSE: To develop a better and more economical instrument for precise, tractionless, "cold" cutting during intraocular surgery. The use of highly localized electric fields rather than laser light as the means of tissue dissection was investigated. METHODS: A high electric field at the tip of a fine wire can, like lasers, initiate plasma formation. Micrometer-length plasma streamers are generated when an insulated 25 micron (microm) wire, exposed to physiological medium at one end, is subjected to nanosecond electrical pulses between 1 and 8 kV in magnitude. The explosive evaporation of water in the vicinity of these streamers cuts soft tissue without heat deposition into surrounding material (cold cutting). Streamers of plasma and the dynamics of water evaporation were imaged using an inverted microscope and fast flash photography. Cutting effectiveness was evaluated on both polyacrylamide gels, on different tissues from excised bovine eyes, and in vivo on rabbit retina. Standard histology techniques were used to examine the tissue. RESULTS: Electric pulses with energies between 150 and 670 microJ produced plasma streamers in saline between 10 and 200 microm in length. Application of electric discharges to dense (10%) polyacrylamide gels resulted in fracturing of the gel without ejection of bulk material. In both dense and softer (6%) gels, layer by layer shaving was possible with pulse energy rather than number of pulses as the determinant of ultimate cutting depth. The instrument made precise partial or full-thickness cuts of retina, iris, lens, and lens capsule without any evidence of thermal damage. Because different tissues require distinct energies for dissection, tissue-selective cutting on complex structures can be performed if the appropriate pulse energies are used; for example, retina can be dissected without damage to the major retinal vessels. CONCLUSIONS: This instrument, called the Pulsed Electron Avalanche Knife (PEAK), can quickly and precisely cut intraocular tissues without traction. The small delivery probe and modest cost make it promising for many ophthalmic applications, including retinal, cataract, and glaucoma surgery. In addition, the instrument may be useful in nonophthalmic procedures such as intravascular surgery and neurosurgery.

Animals↗