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Biomedical subjects

R A Miller

Publications and source records attributed to R A Miller.

At least 127 records · Page 7Linked to original sources

CD4 memory T cell levels predict life span in genetically heterogeneous mice.

Aging leads to changes in the relative proportions of several functionally distinct T cell subsets, including increases in the proportions of memory cells in the CD4 and CD8 subsets and in the proportion of T cells expressing the multiple-drug resistance pump P-glycoprotein. To see whether individual differences in T cell subset levels predict life span, we measured the levels of five age-sensitive T cell subsets, at 8 and again at 18 months of age, in the peripheral blood of genetically heterogeneous mice bred as the progeny of CB6F1 females and C3D2F1 males. The strongest immunological predictor of life span in univariate regression analyses was the proportion of CD4 memory cells measured at 18 months of age (P=0.003). CD4 memory cell levels remained strongly correlated with life span (P<0.0003) in a multiple regression analysis after adjustment for sex. The proportion of CD4 cells expressing P-glycoprotein was also correlated with life span (P<0.01), but only in male mice. Weaker relationships were observed between life span and 8-month tests of CD8 memory and CD8 P-glycoprotein levels, for CD4 naive cells at 18 months, and for the change in CD4 naive cells between 8 and 18 months of age; these were, however, near the margin of statistical significance and could reflect chance relationships. The relationship between CD4 memory cell levels and life span was similarly strong regardless of the cause of death in mice whose death was attributable to lymphoma, fibrosarcoma, mammary carcinoma, and other forms of terminal pathology. Additional work is needed to discriminate between two hypotheses: 1) that high levels of CD4 memory cell themselves predispose to disease and early death, particularly from neoplasia; or 2) that accumulation of CD4 memory cells is a biomarker of some underlying process-perhaps accelerated aging-that itself leads to early mortality.

Animals↗

When will the biology of aging become useful? Future landmarks in biomedical gerontology.

Where should we look to find the causes of and cure for aging? This essay considers a number of scientific discoveries, not yet made, that might dramatically increase the proportion of biogerontologists doing useful work. I will consider, in turn, problems and prospects in the areas of comparative biology, mammalian and invertebrate genetics, biomarker research, caloric restriction, and clonal senescence and then conclude with a discussion of potential links between aging and late life disease.

Aged↗

Early activation defects in T lymphocytes from aged mice.

Aging affects both calcium signals and protein kinase cascades in mouse T lymphocytes. The decline in calcium signal development largely represents differences between naive and memory T cells; the latter are resistant to increases in calcium concentration, and are more common in aged mice. Aging leads to declines in phosphorylation of a wide range of substrates in T cells stimulated by either anti-CD3 antibodies or by substances, such as phorbol myristate acetate (PMA) or ionomycin, that act at intracellular sites, but some phosphoproteins respond only in old T cells, and others respond regardless of age. Tyrosine phosphorylation of the CD3 zeta chain declines with age, both in resting T cells and after activation, but the proportion of Zap-70 that is bound to CD3 zeta increases in T cells from old mice. Zap-70 function and phosphorylation of CD3 zeta-associated Zap-70 change only slightly after stimulation of T cells by anti-CD3 and anti-CD4, and are at similar levels in activated old and young T cells. Nonetheless, induction of Raf-1, MEK, and ERK kinase activity declines with age in CD4 T cells. The effect of aging on T-cell activation is not simply an overall decline in signal intensity, but a set of qualitative changes that differ among subsets and depend at least partly on the nature of the stimulus.

Adaptor Proteins, Signal Transducing↗

Role of oxidants in microbial pathophysiology.

Reactive oxidant species (superoxide, hydrogen peroxide, hydroxyl radical, hypohalous acid, and nitric oxide) are involved in many of the complex interactions between the invading microorganism and its host. Regardless of the source of these compounds or whether they are produced under normal conditions or those of oxidative stress, these oxidants exhibit a broad range of toxic effects to biomolecules that are essential for cell survival. Production of these oxidants by microorganisms enables them to have a survival advantage in their environment. Host oxidant production, especially by phagocytes, is a counteractive mechanism aimed at microbial killing. However, this mechanism may be contribute to a deleterious consequence of oxidant exposure, i.e., inflammatory tissue injury. Both the host and the microorganism have evolved complex adaptive mechanisms to deflect oxidant-mediated damage, including enzymatic and nonenzymatic oxidant-scavenging systems. This review discusses the formation of reactive oxidant species in vivo and how they mediate many of the processes involved in the complex interplay between microbial invasion and host defense.

Animals↗

Nitric oxide and renal effects of volume expansion in conscious monkeys.

Experiments were performed to determine the effects of nitric oxide (NO) synthase inhibition on the renal responses to volume expansion in conscious cynomolgus monkeys. All animals were volume expanded with 3% dextran in normal saline under three conditions: 1) during a control state, 2) during constant infusion of the NO synthase inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME, 30 microg x kg(-1) x min(-1)), and 3) during simultaneous infusion of L-NAME and excess NO substrate L-arginine (0.6 mg x kg(-1) x min(-1)). The control volume expansion increased urine flow from 0.27 +/- 0.05 to 0.94 +/- 0.28 ml/min and sodium excretion from 21 +/- 9 to 95 +/- 26 microeq/min. During L-NAME infusion, these responses were attenuated in that urine flow only increased from 0.13 +/- 0.03 to 0.28 +/- 0.09 ml/min and sodium excretion from 13 +/- 8 to 35 +/- 23 microeq/min. Addition of L-arginine to the L-NAME infusion abolished these renal excretory effects of L-NAME alone. With combined L-NAME/L-arginine, volume expansion increased urine flow from 0.37 +/- 0.23 to 1.09 +/- 0.23 ml/min and sodium excretion from 38 +/- 27 to 150 +/- 24 microeq/min, responses similar to control. L-Arginine also markedly attenuated the effect of L-NAME to increase mean arterial pressure and abolished the L-NAME decreases in creatinine and p-aminohippurate clearances. However, an L-NAME-induced bradycardia could only be partially reversed. These results demonstrate that a functioning NO system may be important in mediating normal renal responses to volume expansion in this primate species.

Animals↗

Treating halitosis.

Explore the source record for details and available documents.

Dental Prophylaxis↗

Ten years of sedoanalgesia and how it has affected urological practice.

This article describes the use of midazolam in combination with local anaesthesia for the performance of endoscopic and open operations in urological practice. The technique is called sedoanalgesia. The sedation greatly facilitates the possibilities of local anaesthetic surgery and has transformed urological practice. Eighty percent of urological cases in our unit can be performed as a day case using this method. The procedure is not only safe but highly cost-effective.

Analgesia↗

A modular six-directional force sensor for prosthetic assessment: a technical note.

A device designed to measure the forces and moments transmitted through prostheses of persons with lower limb amputation is presented. The sensing unit design is an advancement over previous prosthesis force measurement devices in that it is very thin (19 mm) and lightweight (527.5 g, including signal-conditioning instrumentation). The disk-shaped transducer fits between the socket and socket adapter of a standard modular prosthesis, measuring all six force and moment components at this location. Twelve strain gages were used, configured into six two-arm active Wheatstone bridge circuits. A 6X6 matrix was constructed from calibration data to relate the 6-component bridge-output vector to a 6-component force and moment vector. In a bench-test setting, the sensor was evaluated under typical load combinations encountered during the walking of a person with transtibial amputation (TTA) and shown to have errors less than 7.2% of the full-scale output for each direction. Data collected on a subject with TTA walking at different speeds are presented.

Amputation, Surgical↗

Design of a general clinical notification system based on the publish-subscribe paradigm.

We describe the design and initial implementation of a notification sub-system, as a component of a modern information management architecture. The system, based on the publish-subscribe paradigm, provides a framework of event-based communications for the implementation of various important clinical applications including the notification of alerts and reminders with escalation algorithms, the reliable distribution of documents, and the implementation of intelligent patient-specific monitoring processes. The initial implementation of the system, providing the notification of the unit staff about new orders, indicates that the model is viable both in terms of functionality and ability to scale up.

Algorithms↗

Compositional and enumerative designs for medical language representation.

Medical language is in essence highly compositional, allowing complex information to be expressed from more elementary pieces. Embedding the expressive power of medical language into formal systems of representation is recognized in the medical informatics community as a key step towards sharing such information among medical record, decision support, and information retrieval systems. Accordingly, such representation requires managing both the expressiveness of the formalism and its computational tractability, while coping with the level of detail expected by clinical applications. These desiderata can be supported by enumerative as well as compositional approaches, as argued in this paper. These principles have been applied in recasting a frame-based system for general medical findings developed during the 1980s. The new system captures the precise meaning of a subset of over 1500 medical terms for general internal medicine identified from the Quick Medical Reference (QMR) lexicon. In order to evaluate the adequacy of this formal structure in reflecting the deep meaning of the QMR findings, a validation process was implemented. It consists of automatically rebuilding the semantic representation of the QMR findings by analyzing them through the RECIT natural language analyzer, whose semantic components have been adjusted to this frame-based model for the understanding task.

Internal Medicine↗

Inhalation toxicity and carcinogenicity of isoprene in rats and mice: comparisons with 1,3-butadiene.

As with 1,3-butadiene (BD), inhalation exposure of B6C3F1 mice to isoprene (2-methyl-1,3-butadiene) caused a macrocytic anemia; induced increases in sister chromatid exchanges in bone marrow cells and in levels of micronucleated erythrocytes in peripheral blood; and produced degeneration of the olfactory epithelium, forestomach epithelial hyperplasia, and testicular atrophy. Most notable was the finding that like BD, isoprene induced neoplasms in the liver, lung, Harderian gland, and forestomach of mice. The carcinogenic effects of isoprene were observed after a 26-week exposure (6 h/day, 5 days/week) of male mice to 700 ppm or higher concentrations of isoprene followed by a 26-week recovery period. Unlike BD, isoprene did not induce lymphomas or hemangiosarcomas of the heart in mice under these conditions nor did it induce chromosomal aberrations in mouse bone marrow cells. No toxicological effects were evident in rats exposed for 13 weeks to either isoprene or BD at concentrations up to 7000 ppm or 8000 ppm, respectively. Interstitial cell hyperplasia of the testis was observed in male F344 rats exposed to 7000 ppm isoprene for 26 weeks, and following a 26-week recovery period, there was a marginal increase in benign testicular interstitial cell tumors.

Administration, Inhalation↗

Regulatory interactions between virgin and memory CD4 T lymphocytes.

Naive and memory CD4 T cells from mouse spleen, alone or in a 1:1 mixture, were tested for Con A-induced proliferation in limiting dilution cultures. Dose-response curves for naive cells were linear, but curves for memory cells were hyperbolic, suggesting that positive responses required the activation of several cells of the memory type. Mixtures (1:1) gave zig-zag curves, consistent with a previously described quantitative model in which memory cells block naive cell proliferation at low multiplicities and generate their own positive responses at higher multiplicities. Inhibition of naive cell proliferation by memory cells could be mimicked by IL-10 and blocked by anti-IL-10 antibody. IL-2 addition converted the multihit dose curves of memory T cells to single-hit curves, suggesting that poor IL-2 production limits growth in memory cell cultures. Surprisingly, IL-2 addition to cultures of naive cells led to a decrease in proliferation at high cell input doses. This inhibitory effect of IL-2 could be blocked by antibody to IL-10, and may reflect the presence of contaminating memory cells in the naive cell preparations. These models for analysis of interaction between naive and memory T cells in limiting dilution conditions point to a series of reciprocal interactions between IL-10 and IL-2 producing cells.

Animals↗

The aging immune system: primer and prospectus.

Changes in T lymphocyte populations underlie much of the age-related decline in the protective immune response. Aging leads to the replacement of virgin T cells by memory T cells and to the accumulation of cells with signal transduction defects. Studies of antibody gene assembly, accessory cell function, post-thymic T cell development, skewed selection of T cell receptor repertoire, and the clinical concomitants of immune senescence will shed new light on the causes and consequences of age-dependent immune failure.

Aged↗

Detection of plasma membrane Ca(2+)-ATPase activity in mouse T lymphocytes by flow cytometry using fluo-3-loaded vesicles.

The plasma membrane Ca(2+)-ATPase (PMCA) is the primary means by which many cell types pump calcium out of the cytosol following release of calcium from internal stores, returning intracellular calcium concentrations to normal levels. Traditional methods for measuring PMCA activity utilizing isotopic calcium uptake into inside-out (IO) membrane vesicles have poor specificity for PMCA activity and require large numbers of cells. A flow cytometric method has been devised that allows the measurement of calcium uptake in IO vesicles using the fluorescent calcium chelator fluo-3. IO vesicles from mouse lymphocytes were loaded with fluo-3 pentapotassium salt and analyzed by flow cytometry following treatment with buffered calcium and/or ATP. IO vesicles appeared as a subpopulation of low forward-scatter/low side-scatter events, which were distinguishable from higher side-scatter debris. Treatment of vesicles with calcium and ATP resulted in a 5-fold to 30-fold increase in IO vesicle fluo-3 fluorescence. Measurement of uptake kinetics gave K0.5 values of approximately 0.2-0.8 microM and 2 mM for calcium- and ATP-stimulated PMCA activity, respectively, which were consistent with published values obtained by other methods. Broad specificity P-type ATPase inhibitors and more narrowly specific PMCA and calmodulin inhibitors all blocked calcium uptake, whereas thapsigargin (an endoplasmic/sarcoplasmic reticulum (ER/SR-AT-Pase) inhibitor) had no effect, indicating that the assay provides a specific measure of vesicular PMCA activity. Flow cytometric analysis, therefore, may represent a useful approach for quantifying PMCA activity in mammalian cells.

Adenosine Triphosphate↗

Gadolinium(III) texaphyrin: a tumor selective radiation sensitizer that is detectable by MRI.

Gadolinium(III) texaphyrin (Gd-tex2+) is representative of a new class of radiation sensitizers detectable by magnetic resonance imaging (MRI). This porphyrin-like complex has a high electron affinity [E1/2 (red.) approximately = -0.08 V versus normal hydrogen electrode] and forms a long-lived pi-radical cation upon exposure to hydrated electrons, reducing ketyl radicals, or superoxide ions. Consistent with these chemical findings, Gd-tex2+ was found to be an efficient radiation sensitizer in studies carried out with HT29 cells in in vitro as well as in in vivo single and multifraction irradiation studies with a murine mammary carcinoma model. Selective localization of Gd-tex2+ in tumors was confirmed by MRI scanning.

Animals↗

Radioimmunotherapy of relapsed B-cell lymphoma with yttrium 90 anti-idiotype monoclonal antibodies.

Tumor-specific anti-idiotype (anti-Id) monoclonal antibodies (MoAbs) to B-cell lymphomas have been administered to patients, resulting in significant clinical responses. However, clinical responses have been limited by the emergence of Id-negative lymphoma. To overcome the problem of tumor heterogeneity, we conducted a pilot evaluation of the safety and effectiveness of yttrium 90 (90Y)-labeled anti-Id and shared Id (sId) MoAbs in non-Hodgkin's B-cell lymphoma. Nine patients with relapsed B-cell lymphoma in whom tumor was successfully targeted with 111In-labeled anti-Id MoAb were treated with 90Y-labeled anti-Id MoAb. A total of 19 courses (one to four per patient) were administered using 1,000 to 2,320 mg unlabeled clearing MoAb and 10 to 54 mCi 90Y MoAb per patient. Two of nine patients had a complete response, one a partial response, three stable disease, and three disease progression. Time to progression varied from 1 to 12 months. Toxicities were predominately hematologic, and only one patient developed infection and required transfusion. At progression, three of five assessable patients had Id-positive lymphoma and two had Id-negative lymphoma. Human antimouse antibodies (HAMA) did not develop in the patients after treatment. 90Y anti-Id MoAbs demonstrated excellent in vivo stability, produced significantly tumor regression in three of nine patients, exhibited acceptable toxicities, and elicited no HAMA formation. Further investigation of repetitive, low-dose 90Y anti-Id and MoAb therapy is warranted; however, the advantages of a pan B MoAb may prove the latter to be the agent of choice for the radio immunotherapy of B-cell lymphoma.

Adult↗