Biomedical subjects
M C Miller
Publications and source records attributed to M C Miller.
Choosing practice management software. How sophisticated should you get?
In order to make informed purchasing decisions about practice management software, dental professionals must first assess their needs by determining the types of tasks they expect from a system and then compare that list against the features offered by each system. Because technology is changing rapidly, much of what was advanced a few years ago is now considered basic. Three general levels of sophistication are discussed, with attention to the complexity of features that can be expected to be found at each level.
Preventive dentistry for pediatric patients.
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Deoxyribonucleic acid ploidy analysis as a predictor of recurrence following radical prostatectomy for stage T2 disease.
Deoxyribonucleic acid (DNA) ploidy image analysis was used postoperatively to predict recurrence of 112 clinically localized adenocarcinomas of the prostate. All men underwent radical retropubic prostatectomy between 1978 and 1991. Patients with positive lymph nodes or positive seminal vesicles were excluded because progression is nearly inevitable in these men. The minimum followup for men without progression was 5 years (range 5 to 15). Patients were considered to have clinically evident disease progression based on local recurrence (8%), distant metastases (4%) and/or an isolated elevation of serum prostate specific antigen (87%). Of the tumors 43% were diploid and 57% were nondiploid. In a multivariate analysis comparing grade, ploidy, capsular penetration and surgical margins, Gleason sum was the best predictor of progression (p < 0.0001). Nevertheless, a subset of patients remained with well to moderately differentiated Gleason grade tumors (Gleason sum 6 or less) who failed. DNA ploidy was able to predict recurrence in this particular group (p = 0.034). In addition, we compared different methods of tissue preparation to determine which best predicted progression. We found that ploidy analysis on tissue sections was more predictive than ploidy performed on disaggregated tissue. In summary, our study revealed that DNA ploidy analysis can offer additional prognostic information following radical prostatectomy for men with low grade prostatic adenocarcinoma.
Double-blind comparison of paroxetine and nortriptyline on the postural stability of late-life depressed patients.
This article describes a 6-week study evaluating body sway during double-blind therapy with nortriptyline versus paroxetine in geriatric patients. Body sway was measured with patients' eyes open, then closed, using a stable force platform at 4 timepoints: before starting antidepressant medication, and after 1, 2, and 6 weeks of treatment. Measures such as the length (L) of path of the center of pressure (COP) and the area included within the COP path were selected for quantitative assessment of stability. A repeated measures analysis of variance (ANOVA) model with planned comparisons was used to examine the pair-wise difference at baseline and Weeks 1, 2, and 6 of treatment. No significant difference was found in body sway parameters over the 6 weeks of study for patients treated with either nortriptyline or paroxetine.
The pregnant dental patient.
This article summarizes current literature, interviews with experts and universally accepted methods of handling the dental needs of the pregnant patient. General guidelines are offered to help understand the medical constraints of the pregnant patient and provide for her care.
Expanding dental practices with computer technology.
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Guided tissue regeneration using a biodegradable barrier membrane for new attachment: a clinical, histologic, and histometric study in dogs.
Although nonbiodegradable barrier membranes have proven partially successful in achieving regeneration of lost periodontium through the principles of guided tissue regeneration, their use requires a second surgical procedure for their removal. The results of a study, in which a biodegradable collagen membrane was used to treat dehiscence defects in dogs, are presented. The membrane was an effective barrier to the downgrowth of gingival epithelium during the early stages of healing and tended to increase the regeneration of new cementum and connective tissue attachment. It was also biocompatible and biodegradable.
Computing for synchrotron radiation experiments.
Computing provision is of major concern to synchrotron radiation researchers. An overview is presented of the computing facilities for synchrotron radiation work at the Synchrotron Radiation Source, Daresbury Laboratory. Data acquisition, reduction and analysis are seen as an integrated activity essential for full utilization of beam time. We discuss the evolution of data-acquisition systems from stand-alone systems of limited computing power, to a unified project computing village using state-of-the-art equipment for combined-technique, high-data-rate experiments. A brief account of software packages for data reduction and analysis is also given.
Guided tissue regeneration with and without decalcified freeze-dried bone in mandibular Class II furcation invasions.
The purpose of this study was to compare periodontal soft and hard tissue repair using expanded polytetrafluoroethylene (ePTFE) membranes with and without decalcified freeze-dried cortical bone allografts (DFDBA). Six patients with 17 mandibular Class II buccal molar furcal invasions received oral hygiene instructions followed by scaling and root planing. Baseline soft tissue measurements with periodontal probes were made to assess probing depths (PD), recession (REC), and probing attachment levels (PAL). After non-surgical therapy, 10 teeth were randomly selected as test sites (ePTFE + DFDBA) and 7 as controls (ePTFE alone). Full-thickness flaps were elevated, and open surgical measurements were made to determine alveolar crestal height (CEJ-AC) and vertical (CEJ-BDF) and horizontal (HPDF) defect depth. The ePTFE membranes were removed at 6 weeks. After 6 months, all sites were reentered and both soft tissue and open surgical measurements recorded. The following mean changes (mm) were found for ePTFE and ePTFE + DFDBA treated sites respectively: decreased PD = 1.5, 2.2; increased REC = 1.3, 1.3; loss(-)/gain PAL = -0.2, 0.8; decreased CEJ-BDF = 3.8, 5.0; increased CEJ-AC = 0.5, 0.4; and decreased HPDF = 2.3, 2.4. None of the changes were statistically significant. The addition of DFDBA to the GTR procedure did not significantly improve any of the mean soft tissue and open surgical measurements between control (ePTFE alone) and test (ePTFE+DFDBA) groups in mandibular Class II buccal furcations. Both treatment procedures resulted in significant decreases in PD, CEJ-BDF, and HPDF and a significant increase in REC. There were no differences for PAL and CEJ-AC within control and test groups seen with this sample. Larger randomized clinical trials are needed to more fully evaluate whether combined graft and GTR procedures offer an advantage over GTR alone.
Infection control in a new office.
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Infection control considerations when designing and equipping a dental office.
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Characteristics and job satisfaction of nonphysician full-time family medicine faculty members.
BACKGROUND: Nonphysician educators comprise a significant portion of the faculty in family medicine, yet little is actually known about this cohort of educators. This survey identifies and examines the population of nonphysician faculty. METHODS: a questionnaire was sent to 859 nonphysician faculty teaching full time in 113 family medicine departments and 377 family medicine residency programs. The questionnaire was used to determine the composition, characteristics, and levels of job satisfaction of respondents. The responses of this nonphysician cohort were compared to responses of physician faculty who participated in a previous study. RESULTS: Nonphysician faculty were more satisfied with the jobs they performed than they were with the recognition and rewards they received. Satisfaction levels of nonphysicians were significantly greater than their physician colleagues in the areas of research, clinical work, and administration. Physicians were significantly more satisfied than nonphysicians only in response to questions relating to teaching. CONCLUSIONS: Further research is needed to determine how to optimally integrate nonphysicians into family medicine education and fully utilize their expertise.
High technology in esthetic dentistry.
Unimagined only a few years ago, high-technology tools for the dental practice are now widely available. Ranging from video cameras to computer-enhanced diagnostics that fabricate porcelain restorations on site, these new technologies have many applications in esthetic dentistry. Because they make it easier to communicate to patients what can realistically be achieved, high-technology tools tend to involve the patient more in treatment planning and thus may help prevent disappointing outcomes.
Computer applications in the diagnosis and monitoring of periodontal disease.
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Rats are not aversive when exposed to 60-Hz magnetic fields at 3.03 mT.
Thirty-two male rats were tested in two replicates of an experiment to determine whether body currents induced by 60-Hz magnetic fields might lead to avoidance behavior comparable to that which results from exposure to strong 60-Hz electric fields. The test apparatus was a two-compartment Plexiglas shuttlebox enclosed in a sound-attenuating plywood chamber, which in turn was encompassed by two copper bus bars that, when energized, served as a source of 60-Hz magnetic fields. Location of the rat, and traverse activity in the shuttlebox were monitored by nine infra-red photo detectors equally spaced along the length of the apparatus. Rats were divided into 2 groups: 1 group of rats (n = 8 per group per replicate) was sham exposed while rats in the other group (n = 8 per group per replicate) were exposed to a 3.03 mT (30.3 G), 60-Hz magnetic field whenever they traversed to or were located on the side (L or R) predetermined as the exposed side. To control artifact incident to side preference, the side exposed (L or R) was alternated over the exposed rats. Each rat was tested individually in a 1-h session. A 2-factor ANOVA (exposed vs. control, replicate 1 vs. replicate 2) failed to reveal any significant effects due to either factor or to an interaction between factors. These data demonstrate that rats do not avoid exposure to 60-Hz magnetic fields at a flux density of 3.03 mT and further imply that the avoidance by rats of high level 60-Hz electric fields is mediated by something other than the internal body currents induced by the exposure.
The antineoplastic and cytotoxicity of benzohydroxamic acids and related derivatives in murine and human tumor cells.
Benzohydroxamic acids proved to be potent cytotoxic agents suppressing the growth of a number of murine and human cell lines grown in tissue culture, e.g. leukemia, colon, uterine and glioma. Selected compounds demonstrated activity against the growth KB nasopharynx, bronchogenic lung, osteosarcoma and skin cancer. In vivo activity against Ehrlich ascites carcinoma growth was shown with certain compounds. In L1210 cells compound 2 inhibited DNA synthesis significantly within 60 min. the site of action of the agent appears to involve the purine de novo synthesis pathway at PRPP amido transferase and IMP dehydrogenase. Dihydrofolate reductase and nucleoside kinase activities were inhibited by the agent. The levels of d(NTP)s in L1210 cells were reduced after drug treatment. The drug did not appear to affect the DNA template directly causing any damage which might alter transcription and replication nor was there any inhibition of HeLa topoisomerase activity by the drug. Thus the drug appears to be a metabolic inhibitor of nucleoside metabolism.
Chronic-pain medications: equivalence levels and method of quantifying usage.
Medication use is an important consideration in chronic-pain rehabilitation programs (CPRPs). However, it is difficult to quantify this aspect of chronic-pain treatment, because patients often take multiple medications that can differ by pharmacological class as well as dosage level. The Medication Quantification Scale (MQS) provides a method for quantifying medication use in patients with chronic, nonmalignant pain. Scores are calculated for each medication based on weights assigned by medication class and dosage level, and these scores are summed to provide a quantitative index of total medication usage suitable for statistical analysis. The method for calculating MQS scores is illustrated, and research data on MQS reliability and validity are presented. Interrater reliability was rho = 0.985 (p less than 0.0001) for 30 MQS scores calculated by two clinicians. MQS scores for 88 patients correlated well with the clinical judgment of 12 health care professionals (mean rho = 0.755, p less than 0.0001). The MQS scores for 60 chronic-pain patients (30 treated in a CPRP and 30 untreated) were obtained at two time points: evaluation and 1-year follow-up. A two (groups) by two (time points) analysis of variance yielded a significant group-by-time interaction (F = 8.82, p less than 0.0043). Treated patients decreased their medication intake significantly (p less than 0.0001), whereas untreated patients did not (p greater than 0.57). The MQS offers a reliable and valid method for quantifying medication usage in chronic-pain patients.