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Biomedical subjects

J Miller

Publications and source records attributed to J Miller.

At least 325 records · Page 18Linked to original sources
PubMed1998

Validation of the Madigan ESS simulator.

The Madigan Endoscopic Sinus Surgery (ESS) Simulator, developed by a multi-institution team led by Lockheed Martin, includes force-feedback instrument and virtual endoscope interaction with three-dimensional paranasal anatomy models derived from the Visible Human dataset, supplemented by a variety of graphical and auditory instructional aids embedded in the model. Our formal evaluation of Version 1.2 of the system focused on its validity as an ESS simulator. Run-time and survey data were collected for three groups of subjects on a common protocol progressing through the three basic ESS subtasks: navigation, injection, and dissection. Non-MD subjects performed the tasks on a simplified abstract virtual model with instructional aids (hoops for the navigation path, injection targets, dissection spheres, auditory feedback about task completion, and simulated patient heart rhythm). Non-ENT MDs progressed from this "novice" model to a simulated anterior ethmoidectomy on an "intermediate" model with the aids embedded in the reconstructed and segmented paranasal anatomy. Otolaryngologists ranging from second-year ENT residents through senior staff progressed through both the abstract and intermediate models, and then performed the simulated surgical procedure on an "advanced" model, consisting of the anatomy with no instructional aids. The procedural validity of the simulator is supported by a strong correlation between performance on the simulator and degree of prior ESS experience, by convergent correlation among independent measures of subject task performance, and by subjective evaluations by experienced ESS surgeons.

Algorithms↗
PubMed1998

Jackknife-based method for measuring LRP onset latency differences.

A new method based on jackknifing is presented for measuring the difference between two conditions in the onset latencies of the lateralized readiness potential (LRP). The method can be used with both stimulus- and response-locked LRPs, and simulations indicate that it provides accurate estimates of onset latency differences in many common experimental conditions.

Computer Simulation↗
PubMed1998

Successful management of calyceal fistula following simultaneous pancreas-kidney transplantation.

Calyceal fistula is an unusual complication of renal transplantation. We report a case of calyceal fistula after simultaneous pancreas-kidney transplant that developed after thrombosis of a lower pole artery. Surgical correction was successfully achieved with a lower pole nephrectomy, closure of the involved calyces, and placement of a ureteral stent and a pedicle of greater omentum graft over the affected parenchyma.

Adult↗
PubMed1998

Wall effects observed in tissue-equivalent proportional counters from 1.05 GeV/nucleon iron-56 particles.

Tissue-equivalent proportional counters (TEPCs) have been used to measure energy deposition in simulated volumes of tissue ranging in diameter from 0.1 to 10 microm. There has been some concern that the wall used to define the volume of interest could influence energy deposition within the sensitive volume because it has a density significantly greater than that of the cavity gas. These effects become important for high-velocity heavy ions. Measurements of energy deposition were made for 1 GeV/nucleon iron particles in a TEPC simulating a 1-microm-diameter sphere of tissue. The TEPC was nested within a particle spectrometer that provided identification and flight path of individual particles. Energy deposition was studied as a function of pathlength through the TEPC. Approximately 30% of the energy transfer along trajectories through the center of the detector escapes the sensitive volume. The response of the TEPC, for trajectories through the detector, is always larger than calculations for energy loss in a homogeneous medium. This enhancement is greatest for trajectories near the cavity/wall interface. An integration of the response indicates that charged-particle equilibrium is essentially achieved for a wall thickness of 2.54 mm. However, estimates of the linear energy transfer for the incident particles are influenced by these wall effects.

Gases↗
PubMed1998

Effect of pyrazoloacridine (NSC 366140) on DNA topoisomerases I and II.

Pyrazoloacridine (PA), an acridine congener with an unknown mechanism of action, has shown selective activity against solid tumor cells, cytotoxicity in noncycling and hypoxic cells, and promising antitumor activity in Phase I clinical trials. In the present study, the effect of PA on topoisomerase (topo) activity was evaluated using yeast strains lacking functional topo I or II, mammalian cell nuclear extracts, purified samples of mammalian topo I and topo II, and intact mammalian tissue culture cells. Clonogenic assays revealed that PA cytotoxicity in yeast strains was unaffected by selective loss of topo I or topo II activity. On the other hand, enzyme assays revealed that 2-4 microM PA abolished the catalytic activity of both topo I and topo II in vitro. In contrast to topotecan and etoposide, PA did not stabilize covalent topo-DNA complexes. Instead, PA inhibited topotecan-induced stabilization of covalent topo I-DNA complexes and etoposide-induced stabilization of topo II-DNA complexes in vitro and in intact cells. Consistent with these results, colony-forming assays indicated that short-term PA exposure inhibited the cytotoxicity of topotecan and etoposide, whereas prolonged PA exposure was itself toxic to these cells. Accumulation studies revealed that PA was concentrated as much as 250-fold in drug-treated cells, resulting in intranuclear concentrations that far exceeded those required to inhibit topo I and topo II. Collectively, these results not only suggest that PA can target both topo I and topo II at clinically achievable concentrations but also indicate that its mechanism is distinct from topo I and topo II poisons presently licensed for clinical use.

Acridines↗
PubMed1998

Detailed characterization of the 1087 MeV/nucleon iron-56 beam used for radiobiology at the alternating gradient synchrotron.

We report beam characterization and dosimetric measurements made using a 56Fe beam extracted from the Brookhaven National Laboratory Alternating Gradient Synchrotron (AGS) with a kinetic energy of 1087 MeV/nucleon. The measurements reveal that the depth-dose distribution of this beam differs significantly from that obtained with a 600 MeV/nucleon iron beam used in several earlier radiobiology experiments at the Lawrence Berkeley National Laboratory's BEVALAC. We present detailed measurements of beam parameters relevant for radiobiology, including track- and dose-averaged linear energy transfer (LET), fragment composition and LET spectra measured behind sample holders used in irradiations of biological samples. We also report measurements of fluence behind three depths (1.94, 4.68 and 9.35 g cm(-2)) of polyethylene targets with the 1087 MeV/nucleon beam, and behind 1.94 g cm(-2) of polyethylene with a 610 MeV/nucleon beam delivered by the AGS. These results are compared to earlier measurements with the 600 MeV/nucleon beam at the BEVALAC.

Iron↗
PubMed1998

Acute confusion among hospitalized elders in a rural hospital.

The NEECHAM Confusion Scale was used to study the incidence and severity of acute confusion among elders in a rural community hospital. Thirty-eight patients over the age of 64 were assessed for confusion within 48 hours of admission. The NEECHAM Confusion Scale was readministered to a sub-sample of 17 elders within 24 hours of pending discharge. The incidence of acute confusion was 81.5% at admission with a prevalence of 52.9% at discharge. Staff identified signs of acute confusion in 34.2% of the elders confused upon admission as indicated by the NEECHAM Confusion Scale. These findings have major implications for adult health nursing practice.

Acute Disease↗
PubMed1998

Motivation and continuation of professional development.

Variations in levels of motivation to learn among established general practitioners (GPs) have received scant attention. Building on previous work, we present an analysis of factors contributing to the development of motivation to learn in those who are entering and already established in practice. This approach suggests that individual motivation is both complex and unstable in response to external factors. We draw attention to the possibility of motivational immaturity in recruits to general practice, the contribution of values, and the presence of demotivators. The implications of our analysis are explored in relation to individual professional development and continuing education provision. We suggest that motivational audit will identify individual and contextual factors that are reducing the capacity of GPs to continue learning. A number of approaches addressing these factors are proposed.

Career Mobility↗
PubMed1997

Seasonality of births in schizophrenia and bipolar disorder: a review of the literature.

More than 250 studies, covering 29 Northern and five Southern Hemisphere countries, have been published on the birth seasonality of individuals who develop schizophrenia and/or bipolar disorder. Despite methodological problems, the studies are remarkably consistent in showing a 5-8% winter-spring excess of births for both schizophrenia and mania/bipolar disorder. This seasonal birth excess is also found in schizoaffective disorder (December-March), major depression (March-May), and autism (March) but not in other psychiatric conditions with the possible exceptions of eating disorders and antisocial personality disorder. The seasonal birth pattern also may shift over time. Attempts to correlate the seasonal birth excess with specific features of schizophrenia suggest that winter-spring births are probably related to urban births and to a negative family history. Possible correlations include lesser severity of illness and neurophysiological measures. There appears to be no correlation with gender, social class, race, measurable pregnancy and birth complications, clinical subtypes, or neurological, neuropsychological, or neuroimaging measures. Virtually no correlation studies have been done for bipolar disorder. Regarding the cause of the birth seasonality, statistical artifact and parental procreational habits are unlikely explanations. Seasonal effects of genes, subtle pregnancy and birth complications, light and internal chemistry, toxins, nutrition, temperature/weather, and infectious agents or a combination of these are all viable possibilities.

Bipolar Disorder↗
PubMed1997

FISH probes for mouse chromosome identification.

P1 clones near the telomeres and centromeres of each mouse chromosome except Y have been selected from a mouse genomic library and mapped using fluorescence in situ hybridization (FISH). Each clone was selected to contain a genetically mapped polymorphic DNA sequence as close as possible to the centromere or telomere of a chromosome. The genetic distance from the various P1 clones to the most distal genetically mapped polymorphic sequence ranged from 0 for about half of the clones to 6.7 cM for the probe at the telomere of chromosome 14. The average distance to the most distal or proximal chromosome marker was 1.5 cM. The use of FISH with these probes for mouse chromosome identification during comparative genomic hybridization is illustrated.

Animals↗
PubMed1997

Brief expression of a GFP cre fusion gene in embryonic stem cells allows rapid retrieval of site-specific genomic deletions.

The Cre DNA recombinase of bacteriophage P1 has become a useful tool for precise genomic manipulation in embryonic stem (ES) cells that have been gene modified by homologous recombination. We have re-engineered the cre gene to allow ready identification of living Cre+cells by constructing a functional fusion between Cre and an enhanced green fluorescent protein from Aequorea victoria (GFPS65T). The GFP cre fusion gene product rapidly targeted the nucleus in the absence of any exogenous nuclear localization signal. Moreover, GFPCre catalyzed efficient DNA recombination in both a mouse 3T3 derivative cell line and in murine ES cells. Fluorescence- activated cell sorting (FACS) of transiently GFP cre -transfected ES cells not only allowed rapid and efficient isolation of Cre+cells after DNA transfection but also demonstrated that a burst of Cre expression is sufficient to commit cells to Cre-mediated 'pop-out' of loxP -tagged DNA from the genome. Thus, GFP cre allows rapid identification of living cells in which loxP - flanked DNA sequences are destined to be removed from the genome by Cre-mediated recombination without reliance on recombinational activation or inactivation of a marker gene at the target locus. In addition, the GFP cre fusion gene will prove useful in tracing tissue-specific Cre expression in transgenic animals, thereby facilitating the generation and analysis of conditional gene knockout mice.

Animals↗
PubMed1997

Donor peripheral blood stem cell infusions in recipients of living-related liver allografts.

BACKGROUND: In this pilot study, donor peripheral blood stem cell (DPBSC) infusions were performed in three recipients of living-related liver transplants (LRLT). METHODS: DPBSCs were obtained by leukapheresis after mobilization with granulocyte-colony-stimulating factor (Filgrastim). Donor leukapheresis was performed on the 5th postoperative day, and half of the DPBSCs were infused into the recipient on the day of collection. The second half of the pheresed product was cryopreserved for delayed administration. RESULTS: Results from preliminary studies of chimerism in LRLT recipients, at 20 weeks posttransplant, suggested that the levels of donor cells detected in LRLT recipients treated with DPBSC infusions may be higher than those observed for recipients of cadaver donor liver allografts and vertebral body marrow infusions. CONCLUSIONS: The results of this pilot study indicate that administration of mobilized DPBSC to recipients of LRLT is a feasible procedure for both donor and recipient.

Adult↗
PubMed1997

Toward antibody-directed enzyme prodrug therapy with the T268G mutant of human carboxypeptidase A1 and novel in vivo stable prodrugs of methotrexate.

Antibody-directed enzyme prodrug therapy (ADEPT) has the potential of greatly enhancing antitumor selectivity of cancer therapy by synthesizing chemotherapeutic agents selectively at tumor sites. This therapy is based upon targeting a prodrug-activating enzyme to a tumor by attaching the enzyme to a tumor-selective antibody and dosing the enzyme-antibody conjugate systemically. After the enzyme-antibody conjugate is localized to the tumor, the prodrug is then also dosed systemically, and the previously targeted enzyme converts it to the active drug selectively at the tumor. Unfortunately, most enzymes capable of this specific, tumor site generation of drugs are foreign to the human body and as such are expected to raise an immune response when injected, which will limit their repeated administration. We reasoned that with the power of crystallography, molecular modeling and site-directed mutagenesis, this problem could be addressed through the development of a human enzyme that is capable of catalyzing a reaction that is otherwise not carried out in the human body. This would then allow use of prodrugs that are otherwise stable in vivo but that are substrates for a tumor-targeted mutant human enzyme. We report here the first test of this concept using the human enzyme carboxypeptidase A1 (hCPA1) and prodrugs of methotrexate (MTX). Based upon a computer model of the human enzyme built from the well known crystal structure of bovine carboxypeptidase A, we have designed and synthesized novel bulky phenylalanine- and tyrosine-based prodrugs of MTX that are metabolically stable in vivo and are not substrates for wild type human carboxypeptidases A. Two of these analogs are MTX-alpha-3-cyclobutylphenylalanine and MTX-alpha-3-cyclopentyltyrosine. Also based upon the computer model, we have designed and produced a mutant of human carboxypeptidase A1, changed at position 268 from the wild type threonine to a glycine (hCPA1-T268G). This novel enzyme is capable of using the in vivo stable prodrugs, which are not substrates for the wild type hCPA1, as efficiently as the wild type hCPA1 uses its best substrates (i.e. MTX-alpha-phenylalanine). Thus, the kcat/Km value for the wild type hCPA1 with MTX-alpha-phenylalanine is 0.44 microM-1 s-1, and kcat/Km values for hCPA1-T268G with MTX-alpha-3-cyclobutylphenylalanine and MTX-alpha-3-cyclopentyltyrosine are 1.8 and 0.16 microM-1 s-1, respectively. The cytotoxic efficiency of hCPA1-268G was tested in an in vitro ADEPT model. For this experiment, hCPA1-T268G was chemically conjugated to ING-1, an antibody that binds to the tumor antigen Ep-Cam, or to Campath-1H, an antibody that binds to the T and B cell antigen CDw52. These conjugates were then incubated with HT-29 human colon adenocarcinoma cells (which express Ep-Cam but not the Campath 1H antigen) followed by incubation of the cells with the in vivo stable prodrugs. The results showed that the targeted ING-1:hCPA1-T268G conjugate produced excellent activation of the MTX prodrugs to kill HT-29 cells as efficiently as MTX itself. By contrast, the enzyme-Campath 1H conjugate was without effect. These data strongly support the feasibility of ADEPT using a mutated human enzyme with a single amino acid change.

Animals↗
PubMed1997

Separation of extracts from biological tissues into polycyclic aromatic hydrocarbon, polychlorinated biphenyl and polychlorinated dibenzo-p-dioxin/polychlorinated dibenzofuran fractions prior to analysis.

A low-pressure liquid chromatography method is presented for separating polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins/polychlorinated dibenzofurans (PCDDs/PCDFs) from biological tissue extracts. After removing lipid from extracts, the PAHs are separated from PCBs and PCDDs/PCDFs on a deactivated 13-24 microns silica gel column. The PCBs are subsequently separated from PCDDs/PCDFs by collecting the first fraction from an automated three column cleanup procedure for PCDDs/PCDFs. The complete method has been used to obtain high recoveries of the three compound classes for analysis by GC-electron capture detection (PCBs) or GC-MS (PAHs and PCDDs/PCDFs).

Animals↗
PubMed1997

A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group.

BACKGROUND: Tacrolimus (FK506), a macrolide molecule that potently inhibits the expression of interleukin 2 by T lymphocytes, represents a potential major advance in the management of rejection following solid-organ transplantation. This randomized, open-label study compared the efficacy and safety of tacrolimus-based versus cyclosporine-based immunosuppression in patients receiving cadaveric kidney transplants. METHODS: A total of 412 patients were randomized to tacrolimus (n=205) or cyclosporine (n=207) after cadaveric renal transplantation and were followed for 1 year for patient and graft survival and the incidence of acute rejection. RESULTS: One-year patient survival rates were 95.6% for tacrolimus and 96.6% for cyclosporine (P=0.576). Corresponding 1-year graft survival rates were 91.2% and 87.9% (P=0.289). There was a significant reduction in the incidence of biopsy-confirmed acute rejection in the tacrolimus group (30.7%) compared with the cyclosporine group (46.4%, P=0.001), which was confirmed by blinded review, and in the use of antilymphocyte therapy for rejection (10.7% and 25.1%, respectively; P<0.001). Impaired renal function, gastrointestinal disorders, and neurological complications were commonly reported in both treatment groups, but tremor and paresthesia were more frequent in the tacrolimus group. The incidence of posttransplant diabetes mellitus was 19.9% in the tacrolimus group and 4.0% in the cyclosporine group (P<0.001), and was reversible in some patients. CONCLUSIONS: Tacrolimus is more effective than cyclosporine in preventing acute rejection in cadaveric renal allograft recipients, and significantly reduces the use of antilymphocyte antibody preparations. Tacrolimus was associated with a higher incidence of neurologic events, which were rarely treatment limiting, and with posttransplant diabetes mellitus, which was reversible in some patients.

Acute Disease↗