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Biomedical subjects

K M Miller

Publications and source records attributed to K M Miller.

At least 73 records · Page 4Linked to original sources
PubMed1994

Phacoemulsification in the standing position with loupe magnification and headlamp illumination.

A patient who could not recline from the seated position because of myotonic dystrophy and advanced interstitial lung disease presented to the UCLA Department of Ophthalmology Inpatient Consultation Service complaining of poor vision in both eyes as a result of corticosteroid-induced cataracts. We performed phacoemulsification and posterior chamber intraocular lens implantation in the standing position using magnifying loupes and fiber optic headlamp illumination. The excellent red reflex provided by the coaxial headlamp and the surgical control provided by bracing the operating hand against the cheek made this approach a viable option for this severely compromised patient. We discuss the surgical technique and its limitations.

Adult↗
PubMed1994

In situ gamma-ray spectrometry for the measurement of uranium in surface soils.

The application of the technique of in situ gamma-ray spectrometry to the measurement of uranium isotopes in surface soils is described. A basic review of the in situ methodology using high resolution germanium gamma-ray spectrometers is given and specifics on calculated fluences, dose rates in air, and calibration factors are provided for relevant uranium isotopes and their progeny. The influence of the uranium depth distribution on measured concentrations is examined as it pertains to the comparison of in situ results with those obtained with soil sampling. Results from the analysis of spectra collected in the vicinity of the Fernald Environmental Management Project are presented as an example of the application of the technique.

Gamma Rays↗
PubMed1994

Research priorities for all phases of postanesthesia nursing: a survey by ASPAN.

This ASPAN survey was conducted by Research Committee members regarding the future of research for postanesthesia nursing and asked this question: What do postanesthesia nurses view as priorities for postanesthesia nursing research in various phases of practice? The design for the study was the Delphi technique, which uses a multiple, sequential survey to reach consensus among a group of experts. Four rounds of questionnaires were used to survey volunteer participants (N = 54). The group of experts remained stable (N = 41) for rounds 2 through 4. Findings from the survey indicated several areas of priorities for postanesthesia nursing. Of the top 10 ranked statements, 4 related to discharge criteria. Another high-priority area identified was pain management, with 5 statements pertaining to this subject being ranked in the top 10. Based on this small sample of postanesthesia nurses, this study provides a beginning step for prioritizing areas of research necessary to expand the body of knowledge for postanesthesia nursing.

Adult↗
PubMed1993

Unsuspected glove perforation during ophthalmic surgery.

OBJECTIVES: To determine the rate of perforation of surgical gloves after ophthalmic surgery and to identify factors that contribute to the development of perforations. DESIGN: Case-control study of used and unused surgical gloves collected during a 7-month period. SETTING: The ophthalmology surgical suites of a major teaching hospital. MAIN OUTCOME MEASURES: Development of glove perforations as measured by five different techniques. RESULTS: We tested 103 pairs of latex surgical gloves before use and 454 pairs of gloves after use. Of five techniques used to test for pinholes, air inflation with water submersion and compression was found to be the most sensitive, yielding a 6.80% prevalence in control glove pairs and a 21.81% prevalence in study glove pairs (P = .0005). When examined by subspecialty area, the lowest perforation rate (11.39%; P = .00009) occurred in cataract and intraocular lens surgery and the highest rate (41.67%; P = .003) occurred in oculoplastic surgery. Factors that correlated significantly with the development of perforations as determined by multiple logistic regression analysis included pediatric ophthalmology and strabismus surgeries, oculoplastic surgeries, level of training of the surgeon, duration of operation, and larger glove size. The thumb and index fingers of the nondominant hand contained the largest numbers of pinholes. CONCLUSIONS: The rate of surgical glove perforation after ophthalmic surgery is relatively high. Recommendations for reducing the rate of glove perforation are discussed.

Case-Control Studies↗
PubMed1993

Bacterial endophthalmitis following sutureless cataract surgery.

We examined a patient who developed group G streptococcal endophthalmitis following phacoemulsification with intraocular lens implantation and sutureless wound closure. Pathologic examination of the enucleated globe 1 month after surgery revealed an intense suppurative reaction centered in the anterior chamber and an open surgical wound filled with fibrinopurulent granulation tissue. Inadequate draping, a high number of instruments passing into and out of the eye during surgery, and wound testing for water tightness with viscoelastic substance in the eye were observed on a videotape of the surgery.

Aged↗
PubMed1993

Changing protective and risky behaviors to prevent child-to-parent transmission of cytomegalovirus.

Child-to-parent transmission of cytomegalovirus may be reduced by increasing protective behaviors (handwashing and glove use) and decreasing risky behaviors (intimate contact between child and parent). This study showed that an educational intervention resulted in increases in reported and objective measures of protective behaviors and decreases in reported risky behaviors. Further study must determine if changes in protective and risky behavior are maintained and prevent cytomegalovirus transmission.

Behavior Therapy↗
PubMed1992

Occult glove perforation during ophthalmic surgery.

We examined the latex surgical gloves used by 56 primary surgeons in 454 ophthalmic surgical procedures performed over a 7-month period. Of five techniques used to detect pinholes, air inflation with water submersion and compression was found to be the most sensitive, yielding a 6.80% prevalence in control glove pairs and a 21.8% prevalence in postoperative study glove pairs, for a 15.0% incidence of surgically induced perforations (P = 0.000459). The lowest postoperative perforation rate was 11.4% for cataract and intraocular lens surgery, and the highest was 41.7% for oculoplastic procedures. Factors that correlated significantly with the presence of glove perforations as determined by multiple logistic regression analysis were oculoplastic and pediatric ophthalmology and strabismus surgical procedures, surgeon's status as a fellow in training, operating time, and glove size. The thumb and index finger of the nondominant hand contained the largest numbers of pinholes. These data suggest strategies for reducing the risk of cross-infection during ophthalmic surgery.

Chi-Square Distribution↗
PubMed1991

Onchocerca volvulus: characterization of monoclonal antibodies reactive with surface components of third-stage larvae.

Five murine monoclonal antibodies (Mab's) have been produced which are reactive with the surface of the third-stage larvae (L3) of Onchocerca volvulus. These were produced from a fusion performed after intrasplenic injection of 10 live O. volvulus L3. Hybridomas were first screened by Elisa using a PBS extract of O. volvulus female adult worms. Elisa negative wells were screened by IFA on whole formalin-fixed L3. Five Mab's were isolated which were reactive with the surface of L3, all were found to be of the IgM isotype. All five Mab's were cross-reactive with the surface of O. lienalis L3, but not with the L3 of Brugia malayi, B. pahangi, Dirofilaria immitis, or Acanthocheilonema viteae. One of the Mab's, OV3-9, reacted with an antigen common to many species of helminths. The other four were genus specific reacting only with O. volvulus and O. lienalis. All 5 Mab's reacted with L2 of O. volvulus, but not with the L4 by IFA on whole fixed larvae. Only Mab's OV3-8 and OV3-9 reacted with cryosections of adult O. volvulus by IFA indicating that the other 3 Mab's are specific for the surface of L2/L3 of the genus Onchocerca. None of the Mab's reacted with detergent dissociated L3 proteins in Western Blot analysis. The ability of L3 to bind the Mab's was abolished by incubating larvae in either proteinase K or trypsin but was unaffected by incubation of larvae in detergents, or by treatment with periodate, indicating the proteinaceous nature of the Mab specific epitopes. Anti-phosphorylcholine Mab (Gib-13) did not react with the surface of L3.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Radioactive fallout reconstruction from contemporary measurements of reservoir sediments.

The temporal history of atmospheric deposition to a watershed area can be preserved in the sediment of a lake or reservoir that is supplied by the watershed. The 137Cs and isotopic Pu concentrations with depth were determined in the sediments of two reservoirs, Enterprise and Deer Creek, which are located in widely separated regions of the state of Utah. Our data not only reconstruct the history of the total radioactive fallout in the area, but also permit estimating the contributions from global sources and from the Nevada Test Site detonations in the 1950s.

Cesium Radioisotopes↗
PubMed1990

Relaxation technique and postoperative pain in patients undergoing cardiac surgery.

A two-group pretest and posttest quasi-experimental design was used to determine the effectiveness of a slow, deep-breathing relaxation technique in relieving postoperative pain after coronary artery bypass graft surgery. A convenience sample of 29 subjects was divided into an experimental group (n = 15), who received relaxation training on the evening before surgery and performed the technique after surgery, and a control group (n = 14), who did not receive relaxation training. Analysis of variance was used to analyze the data. Significant decreases were demonstrated as a result of relaxation, in blood pressure, heart rate, respiratory rate, and report of pain on the visual descriptor scale. No significant differences were seen in analgesic use or visual analogue scale scores. Eleven subjects (73.3%) said the technique was helpful in their pain management. All experimental subjects stated that the relaxation technique was simple to perform, and they would recommend it to others who have postoperative pain.

Adult↗
PubMed1990

An economical procedure for screening of hybridoma supernatants for surface reactive antibodies to filarial larvae.

Third- and fourth-stage larvae of Onchocerca volvulus can be attached to the lids of 96-well microtiter plates to facilitate the screening of hybridoma supernatants reactive with filarial larvae. Plates are coated with a solution consisting of 0.1% gelatin, and 0.01% chrome alum. Following coating of plate lids one larva per depression is placed on the lid. An immunofluorescence assay (IFA) was conducted in which there were two 45 minute incubations and eight separate washes by immersion in PBS. At the completion of the assay over 90% of the larvae remain attached. The background in IFA is minimal and the results are consistent with those obtained using a suspension IFA. This technique permits rapid identification of antibody producing hybridomas with small numbers of larvae.

Animals↗
PubMed1989

In vitro stimulation of fibroblast activity by factors generated from human monocytes activated by biomedical polymers.

Biomedical polymers used in constructing implantable artificial devices may affect host responses to the material and ultimately contribute to the success or failure of a device via mechanisms of cell-polymer interactions. Human peripheral blood monocytes (MO) cultured in the presence of several such biomedical polymers released factors that stimulated fibroblast proliferation and/or collagen synthesis. The factors that stimulated fibroblast proliferation were differentially released from monocytes cultured in the presence of Dacron, polyethylene, expanded polytetrafluoroethylene (ePTFE), polydimethylsiloxane, and polystyrene (control). Supernatants obtained from monocytes cultured in the presence of Biomer, a segmented polyetherurethane, were unable to stimulate fibroblast proliferation. However, supernatants from all cultures, including MO-Biomer cultures, were able to induce collagen production from the same target fibroblasts. These same supernatants also were shown to contain interleukin 1 (IL1) activity. Neutralization of the fibroblast stimulatory potential (FSP) activity with antibodies directed against human IL1 and human PDGF demonstrated that IL1 and not PDGF was responsible for the FSP activity. Results of this study show that by affecting macrophage activation, different biomedical polymers can affect host biocompatibility responses by altering fibroblast proliferation and function.

Adult↗
PubMed1989

Generation of IL-1-like activity in response to biomedical polymer implants: a comparison of in vitro and in vivo models.

Of the many factors determining host biocompatibility responses to implanted biomedical polymers, the cellular interactions at the tissue/material interface have been recognized to be some of the most important. The present study has combined results both from an in vitro cell culture system and from an in vivo animal model to examine this host response. In vitro results suggest that a variety of polymer materials can differentially activate human monocytes to produce a protein(s) having different biological activities. The polymers tested induce the production of the regulatory inflammatory protein interleukin 1 as well as a factor that enhances fibroblast proliferation and collagen synthesis. The observed activities of these factors appear to be related but not identical, and are dependent upon the specific polymer. Evaluation of exudate and tissue responses to these same polymer materials in an in vivo model are also presented. Both in vitro and in vivo results support the hypothesis that monocyte/macrophage activation with subsequent synthesis of regulatory factors such as interleukin 1 plays a significant role in determining the host response to biomedical polymer implants.

Adult↗