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Biomedical subjects

S A Miller

Publications and source records attributed to S A Miller.

At least 73 records · Page 4Linked to original sources
PubMed1996

Increasing staff knowledge of and improving attitudes toward patients with borderline personality disorder.

This study examined the effect of a self-instructional program on nurses' knowledge of and attitudes and behavioral intentions toward patients with borderline personality disorder. The sample consisted of registered nurses working on inpatient psychiatric units of general hospitals: 19 in the experimental group and 13 in the control group. The Questionnaire on Borderline Personality Disorder was administered before and after nurses completed the program. Significant postintervention differences in knowledge of and attitudes toward patients with the disorder were found between the experimental group and the control group. Self-instruction may improve nurses' care of patients with borderline personality disorder.

Adult↗
PubMed1996

Diet after pancreas transplantation.

OBJECTIVE: To determine whether discontinuation of insulin therapy and glucose monitoring and instructions to increase dietary salt and water intake after pancreas transplantation (PTX) resulted in changes in food choices. RESEARCH DESIGN AND METHODS: All PTX recipients who had completed a preoperative diet record, had received their PTX > 6 months before, had stable pancreas and kidney function, and were on a stable diet were invited to submit a 3-day post-PTX diet record. Of the 14 eligible, 11 agreed to participate and completed the study (2 women and 9 men). Their pre- and post-PTX diet records were analyzed by computer program. Weight, glycohemoglobin, blood pressure, medications, and fasting lipids both before and after PTX were also analyzed. RESULTS: The recipients were studied 576 +/- 60 days post-PTX, on average. Total calories and BMI were unchanged after PTX. Before PTX, 34% of calories were in fats, 49% in carbohydrate, and 17% in protein with no change in distribution of calories after PTX, although there was a trend toward greater saturated fat intake. Total salt intake was increased after PTX (P < 0.01) because of sodium bicarbonate administration, although dietary salt intake did not change. The HDL cholesterol concentration increased and cholesterol-to-HDL ratio decreased after PTX (P < 0.05), while the remaining lipids were unchanged. CONCLUSION: Weight, total calories and distribution of calories, and dietary salt were unchanged after PTX, and diet did not explain the changes in HDL cholesterol or cholesterol-to-HDL ratio. These preliminary diet results suggest that greater emphasis on dietary instruction may be needed after PTX.

Body Weight↗
PubMed1996

The relationship of vibrissal motor cortex unit activity to whisking in the awake rat.

Rats actively sweep their whiskers back and forth to locate and palpate objects within their immediate environment. Microstimulation studies in anesthetized rats have demonstrated the presence of a large vibrissal motor representation in agranular cortex. However, the manner in which motor cortex neurons contribute to whisking behavior in the awake animal is unknown. This study represents an initial investigation of the relationship between the activity of task-related neurons in vibrissal motor cortex and the electromyographic (EMG) activity of the deep vibrissal pad muscles in the awake, freely whisking rat. Each animal was gently held in an experimenter's hands while the animal whisked the air. A spring-loaded, metal microelectrode mounted in a removable, miniature microdrive provided stabile recordings of motor cortex unit activity. Fine-wire electrodes implanted in the mystacial pad simultaneously recorded facial muscle activity. Results showed that the discharge of task-related neurons was correlated with changing levels of muscle output. Unit discharge was related in a tonic or phasic-tonic fashion to EMG activity. No units were found to discharge rhythmically in a 1:1 fashion with the periodicity of the whisking pattern. These findings support a role for vibrissal motor cortex in the initiation and modulation of the overall level of mystacial pad muscular output, but not in the generation of bursts of EMG activity responsible for individual whisking sweeps.

Animals↗
PubMed1996

Experience of FK506 immune suppression in pediatric heart transplantation: a study of long-term adverse effects.

BACKGROUND: Immunosuppression with FK506 for pediatric heart transplantation has been used in this institution since 1989. This study reports the unique toxicity of this macrolide agent in these heart transplant recipients. METHODS: Between October 1989 and August 1994, 49 patients were managed with FK506, which was the initial primary agent in 38 patients. The remaining 11 were switched from cyclosporine A because of persistent rejection or side effects from the cyclosporine A or prednisone. Data were obtained retrospectively from medical records. RESULTS: Mean duration of follow-up was 29 months (median 37 months, range 3 to 96 months). Twenty-nine patients (59%) were receiving FK506 alone; 20 patients (41%) were receiving additional treatment with azathioprine, prednisone, or methotrexate. There were seven deaths. Twenty patients (41%) had elevated creatinine levels between 1 to 2 mg/dl. Five patients (11%) had levels greater than 2 mg/dl. Two patients with preexisting renal dysfunction while receiving cyclosporine A had chronic renal failure 32 and 36 months after switching to FK506 and required kidney transplantation. Hyperkalemia was a persistent finding in 26 patients. Of eight patients with hypertension, four had preexisting disease while receiving cyclosporine A; two had impaired renal function, and two were receiving prednisone. Severe anemia developed in eight patients (16%), two of whom had parvovirus. Moderate anemia developed in 21 patients (43%). Eosinophilia occurred in 19 patients; 11 of 19 patients (58%) had allergic symptoms. There was one case of diabetes mellitus. There were 12 significant infections with four infection-related deaths. Lymphoproliferative disease was noted in three patients, two of whom survived. Gastrointestinal symptoms, including chronic diarrhea, recurrent abdominal pain, and reflux esophagitis were present in 10 patients. CONCLUSIONS: In our experience, anemia, renal toxicity, hyperkalemia, chronic diarrhea, and allergies were the most common adverse effects of FK506. Unlike cyclosporine A, hypertension, gingival hyperplasia, coarsening of facial features, and hirsutism were not seen.

Anemia↗
PubMed1996

The distribution of F13A subtypes in four populations using agarose isoelectric focusing and Western Blot detection.

Using an isoelectric focusing gel containing agarose, urea, a separator and a narrow range ampholyte of pH 5-6, a system was designed to split the F13A*1 and F13A*2 alleles into the subtypes 1A, 1B, 2A and 2B. Four population groups (European-Americans, African-Americans, Mexican-Americans and Native-Americans) were data based. Subtyping F13A increased the information content significantly over the previous F13A typing system by doubling the number of alleles and increasing the number of phenotypes from three to ten. The new system has proved to be of value in parentage testing by increasing exclusionary power in cases of non-paternity and increasing the paternity index in non-exclusionary cases. Though there does not appear to be any significant variation among U.S. populations, published data on Japanese populations suggests that significant differences among populations may exist, leading to an anthropological usefulness as well.

Black or African American↗
PubMed1995

Prospective incidence of photic maculopathy after cataract surgery.

PURPOSE/METHODS: To determine the incidence of photic retinal injury during cataract surgery, we studied 37 consecutive patients with intravenous fluorescein angiography within ten days after cataract surgery. The microscope irradiance was standardized for all cases. RESULTS/CONCLUSIONS: Fluorescein evidence of photic retinal injury did not develop in any of the 37 cataract patients. Incidence rates for photic retinal injury induced by the surgical microscope vary considerably among ophthalmologists and most likely reflect differences in microscope brightness, surgical duration, and surgical technique.

Cataract Extraction↗
PubMed1995

Effect of pedal cadence on parameters of the hyperbolic power-time relationship.

The purpose of this study was to evaluate the effect of pedal cadence methodology on the relationship between power output and time to exhaustion. Twenty-four subjects each performed 12 all-out cycle ergometer tests (four at a constant 60 rpm, four at a constant 100 rpm, and four where they were allowed to select and, within each test, vary their cadence). The parameters of the hyperbolic power-time relationship, AWC (anaerobic work capacity) and CP (critical power), were estimated for each pedal cadence methodology using three regression models: nonlinear power-time, linear work-time, and linear power-time-1. In all cases, R2 was high and standard errors of the estimate of AWC and CP were low. With the two constant rpm methodologies, the estimates of AWC and CP were influenced by the choice of regression model. The estimates of AWC and CP were also influenced by the pedal cadence in the all-out tests. For example, the CP derived from the 100 rpm tests (mean +/- SD: 195 +/- 50 W) was lower (p < 0.05) than the CP from the other methodologies (207 +/- 50 W and 204 +/- 48 W), and the AWC from the variable cadence methodology (16.1 +/- 6.2 kJ) was greater than the AWC from constant rpm trials (14.5 +/- 5.9 kJ and 14.6 +/- 5.7 kJ). It is concluded that pedal cadence methodology influences the parameters of the power-time relationship.

Acceleration↗
PubMed1995

Neoplastic transformation of neonatal human fibroblasts exposed in vitro to radiation from a quartz-halogen lamp.

The use of unfiltered quartz-halogen lamps exposes human skin to radiation that spans much of the ultraviolet (UV) spectrum. Reports indicate that exposure to quartz-halogen lamps is erythemogenic, mutagenic, and carcinogenic. To compare the carcinogenic potential of quartz-halogen lamps with that of other UV sources, we determined the dose dependence for cytotoxicity and neoplastic transformation in neonatal human fibroblasts exposed in vitro to: a 15 W germicidal lamp (primarily 254 nm radiation), a 15 W Cool White fluorescent lamp, and an unfiltered 20 W quartz-halogen lamp. Fluence-survival relationships were multiphasic with linear dose response below about 40% survival, and all three sources produced fluence-dependent transformation as indicated by induction of anchorage-independent growth. Maximum transformation frequencies were observed at fluences of 5-8 J/m2 for the germicidal lamp, 6.3 kJ/m2 for the fluorescent lamp, and 300 J/m2 for the quartz-halogen lamp. These data confirm the carcinogenic potential of the quartz-halogen lamp.

Cell Death↗
PubMed1995

Furocoumarin-photosensitized hydroxylation of guanosine in RNA and DNA.

Guanosine hydroxylation was used as a marker for assessing photooxidation of DNA and RNA sensitized by monofunctional and bifunctional furocoumarins. DNA or RNA, treated with sensitizer and UVA light, was enzymatically hydrolyzed, dephosphorylated and then analyzed by reversed-phase HPLC with electrochemical detection. Hydroxylated guanosine, i.e. 8-hydroxy-2'-deoxyguanosine (8-OHdG) or 8-hydroxyguanosine (8-OHG), was quantitated. 3-Carbethoxypsoralen (3-CP) was found to be an efficient photosensitizer for oxidation of guanosine in DNA, resulting in conversion of up to 0.4% of guanosine residues to 8-OHdG. In contrast, dramatically lower levels of guanosine hydroxylation were observed in 3-CP-photosensitized RNA. Psoralen was found to be a more efficient photosensitizer than angelicin in both DNA and RNA. Additional studies of oxidation of 3-CP-photosensitized DNA indicated that double-stranded DNA is 10 times more susceptible to photooxidation than single-stranded DNA, implicating 3-CP binding to DNA as an important mechanistic step in photooxidation of guanosine. The effects of D2O and degassing with argon on photooxidation of guanosine in DNA sensitized by 3-CP were inconsistent with a mechanism involving 1O2. In addition, chelation of adventitious metal ions present in preparations of DNA photosensitized by 3-CP had no effect on hydroxylation of guanosine.

Animals↗
PubMed1995

Confidential inquiries into cot deaths in British Forces Germany.

Confidential inquiries into cases of cot death in British Forces Germany were introduced in 1990. The information which has been collected so far suggests that the current attention to the position in which a baby is placed in a cot, the prevention of overheating and the avoidance of cigarette smoke, is not misplaced. Despite the considerable reduction in the cot death rate which has occurred in British Forces Germany since 1990 it is recommended that confidential inquiries should be continued so that possible opportunities to further reduce the risks are not missed.

Confidentiality↗
PubMed1995

Parents' attributions for their children's behavior.

Parents' attributions for children's behavior are of interest both as a form of adult social cognition and as possible contributors to children's development. This article reviews work on the determinants and the effects of parents' attributions. Included in the discussion of possible determinants are characteristics of the target (e.g., age and sex), characteristics of the judge (e.g., mothers vs. fathers), and characteristics of the behavior to be explained (e.g., positive or negative). Included in the discussion of possible effects are effects on parents' affect and behavior and on children's development. The evidence suggests that parents do form attributions for their children's behavior and that these attributions vary in predictable (although not perfectly consistent) ways across judges, targets, and outcomes. The evidence also suggests, although less certainly, that attributions affect both parents' behavior and children's development. The review concludes with suggestions for future research.

Adult↗
PubMed1994

Cyclosporine challenge in the decision of combined kidney-pancreas versus solitary pancreas transplantation.

Combined kidney-pancreas transplantation has become the treatment of choice for many patients with end-stage diabetic nephropathy. Pancreas transplantation (PTx) alone is an option for type I diabetic patients without end-stage diabetic nephropathy. Knowledge of factors contributing to or predicting the rate of renal deterioration (including the effect of CsA on the patient's renal function before transplantation) is necessary to determine candidacy for either kidney-pancreas transplantation or PTx alone. To address this issue, we selected 12 pre-uremic patients with creatinine clearances (CrCl) above 40 ml/min and less than 100 ml/min to participate in a 6-week oral CsA challenge test. Serum chemistries, including serum creatinine (SCr) and CsA level, were measured weekly. Urinary protein and CrCl were measured at 0, 2, 4, and 6 weeks. Glomerular filtration rate (GFR) (by 125I-sodium iothalamate clearance) was measured at 0, 3, and 6 weeks. All patients initially received oral CsA at 10 mg/kg/day in 2 divided doses. Doses were adjusted to maintain a 12-hr trough level of 500-1000 ng/ml using a whole blood polyclonal TDX assay. Data are presented as mean +/- SEM and as box-plot graphs. One patient was a CsA challenge test failure because SCr exceeded 3.0 mg/dl despite a reduction in CsA dose and level. Therefore, this patient was not a candidate for PTx alone and was excluded from further analysis. Among the 11 nonfailures, the mean CsA level at 6 weeks was 640 +/- 76 ng/ml. SCr increased from 1.2 +/- 0.1 mg/dl to 1.6 +/- 0.1 mg/dl (33% increase) (P = 0.0001). CrCl decreased from 82 +/- 9 ml/min to 63 +/- 8 ml/min (24% decrease) (P = 0.03). GFR decreased from 95 +/- 15 ml/min to 70 +/- 10 ml/min (26% decrease) (P = 0.009). CrCl and GFR did not differ from one another at 0 and 6 weeks (r = 0.77 and 0.98; P = 0.3 and 0.7, respectively). Urinary protein decreased from 1.0 +/- 0.3 g/day to 0.7 +/- 0.3 g/day at both 4 and 6 weeks (P = 0.03 and 0.06, respectively). Three of the 11 patients have not yet received transplants. Eight patients subsequently received PTx alone and were followed prospectively. Two allografts were lost early to rejection. Six were followed from 5 to 19 months after PTx alone. Serum creatinine and CrCL measurements during the CsA challenge test predicted post-PTx levels: SCr 1.6 +/- 0.1 vs. 1.7 +/- 0.3 mg/dl, P = 0.48, and CrCl 68 +/- 10 vs. 53 +/- 3 ml/min, P = 0.17, respectively.

Adult↗
PubMed1994

Domains of differential cell proliferation and formation of amnion folds in chick embryo ectoderm.

Patterns of cell proliferation in ectoderm epithelium that will form avian amnion correlate with morphogenesis, but not in an obvious pattern with respect to large-scale folding. At sites where the pre-axial amnion folds will first appear in 4- to 8-somite embryos, patterns of proliferation do not separate into domains that presage location of the single pre-axial fold that is commonly described in embryology texts. Instead, increased cell proliferation occurs in a significant, bilateral pattern. In stages with 13 to 27 somites, when lateral amnionic folds are prominent, five paraxial domains of cell proliferation correlate with morphology and show decreasing levels of cell proliferation with distance from the neural axis. Slowly growing areas surround rapidly growing areas and could assist buckling of epithelium by providing constraints on expansion of faster growing areas. Proliferation domains in ectoderm correlate with morphology and morphological events when localized changes in cell shape are lacking and suggest a role for differential cell proliferation in formation of large-scale epithelial folds in early chick embryos.

Amnion↗
PubMed1994

Paclitaxel (Taxol) treatment for refractory ovarian cancer: phase II clinical trial.

OBJECTIVE: Our aim was to determine the efficacy and toxicity of paclitaxel in the treatment of refractory and platinum-resistant epithelial ovarian cancer. STUDY DESIGN: Eligibility required three prior failed chemotherapy regimens and documented platinum resistance. One hundred patients with advanced ovarian cancer received paclitaxel 135 mg/m2 over 24 hours every 21 days with optional granulocyte colony-stimulating factor support. RESULTS: Paclitaxel was generally well tolerated. In four patients bowel perforation or fistula developed. After three cycles 34% of patients had stable disease and 25% of patients demonstrated a response, either partial or complete. After six cycles 24% of patients continued to respond. To date, six patients have achieved a complete response. CONCLUSION: A 25% response rate in patients with refractory ovarian cancer was observed, which was durable to six cycles.

Aged↗