Documenting enhanced quality outcomes in a managed care world.
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Documentation↗
Biomedical subjects
S E Miller
Publications and source records attributed to S E Miller.
Nursing management of patients receiving brachytherapy for early stage prostate cancer.
New technologies used in the area of prostate brachytherapy have resulted in a resurgence of interest in this modality of therapy for early stage prostate cancer. Results of prostate brachytherapy have been reported to be as favorable as radical prostatectomy. Nursing care is multifaceted and necessitates a thorough understanding of brachytherapy techniques, sequelae, and radiation safety.
Brachytherapy↗
Needles, syringes, injection drug users, and the Oklahoma State Medical Association.
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Acquired Immunodeficiency Syndrome↗
Expression of a copper-containing amine oxidase by human ciliary body.
PURPOSE: To examine the molecular structure and ultrastructural distribution of a novel amine oxidase in human ciliary body. METHODS: Human ciliary bodies were solubilized with a nonionic detergent. The solubilized material was subjected to affinity chromatography with 2B4.14.1, a monoclonal antibody which recognizes a family of ciliary body glycoproteins. Proteins eluted from the affinity column were further separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Peptides produced from a 2B4.14. 1-reactive protein with an approximate molecular weight of 100 kDa were analyzed by Edman degradation. The protein thus identified was further examined by Western blotting and immunoelectron microscopy with anti-peptide antisera. RESULTS: Peptide sequences from the 100 kDa ciliary body protein were identical to the predicted protein sequence of an amine oxidase identified recently in a human placental cDNA library. The identity of the ciliary body protein was confirmed by Western blotting with rabbit antiserum generated against the predicted carboxy-terminal peptide of human placenta amine oxidase. Western blotting under nonreducing conditions and following glycosidase digestion indicated that the native enzyme is a disulfide-linked homodimer with multiple N-linked oligosaccharide side chains. By immunoelectron microscopy, the ciliary body amine oxidase was localized to the plasma membranes of inner epithelial cells. CONCLUSIONS: Human placenta amine oxidase is present on the plasma membranes of ciliary body inner epithelial cells. This finding provides a potential explanation for amine oxidase enzyme activity detected in previous studies of anterior segment tissues. Though the functional role of human placenta amine oxidase in the eye is unclear, it may contribute to the production of H2O2 in aqueous humor.
Aged↗
Special techniques in diagnostic electron microscopy.
The power of electron microscopy as a diagnostic tool can be amplified considerably by the application of ancillary preparative and analytic methods. Subcellular chemistry and structure can be examined by various forms of microprobe analysis and by special staining methods, including cytochemical, immunocytochemical, and negative staining. Qualitative ultrastructural examination can be augmented by morphometric analysis. Correlative microscopic survey methods can be used as a means of targeting ultrastructural investigations. This article provides an overview of the use of these special techniques in the diagnosis and classification of tumors and other selected pathologic processes.
Diagnosis, Differential↗
Novel large apolipoprotein E-containing lipoproteins of density 1.006-1.060 g/ml in human cerebrospinal fluid.
Although the critical role of apolipoprotein E (apoE) allelic variation in Alzheimer's disease and in the outcome of CNS injury is now recognized, the functions of apoE in the CNS remain obscure, particularly with regard to lipid metabolism. We used density gradient ultracentrifugation to identify apoE-containing lipoproteins in human CSF. CSF apoE lipoproteins, previously identified only in the 1.063-1.21 g/ml density range, were also demonstrated in the 1.006-1.060 g/ml density range. Plasma lipoproteins in this density range include low-density lipoprotein and high-density lipoprotein (HDL) subfraction 1 (HDL1). The novel CSF apoE lipoproteins are designated HDL1. No immunoreactive apolipoprotein A-I (apo A-I) or B could be identified in the CSF HDL1 fractions. Large lipoproteins 18.3 +/- 6.6 nm in diameter (mean +/- SD) in the HDL1 density range were demonstrated by electron microscopy. Following fast protein liquid chromatography of CSF at physiologic ionic strength, apoE was demonstrated in particles of average size greater than particles containing apoA-I. The largest lipoproteins separated by this technique contained apoE without apoA-I. Thus, the presence of large apoE-containing lipoproteins was confirmed without ultracentrifugation. Interconversion between the more abundant smaller apoE-HDL subfractions 2 and 3 and the novel larger apoE-HDL1 is postulated to mediate a role in cholesterol redistribution in brain.
Apolipoprotein A-I↗
Community respiratory viral infection in adult lung transplant recipients.
STUDY OBJECTIVE: To define the epidemiology, clinical manifestations, and long-term complications of respiratory viral infections in adult lung transplant recipients. DESIGN: Retrospective review of the records of 122 adult lung transplant recipients over a 5-year period at one institution. RESULTS: Ten episodes of infection with respiratory syncytial virus, parainfluenza, influenza, or adenovirus were identified. All patients presented with symptoms of respiratory tract infection. Two patients died acutely and four patients subsequently had development of obliterative bronchiolitis (OB). CONCLUSIONS: These data suggest community respiratory viral infections cause significant morbidity and mortality in lung transplant recipients. Further prospective studies are warranted to clarify the relationship between respiratory viral infection and OB and to define the optimal therapy for these viral infections.
Adult↗
Oligomerization of expanded-polyglutamine domain fluorescent fusion proteins in cultured mammalian cells.
Six inherited neurologic diseases, including Huntington's disease, result from the expansion of a CAG domain of the disease genes to produce a domain of more than 40 glutamines in the expressed protein. The mechanism by which expansion of this polyglutamine domain causes disease is unknown. Recent studies demonstrated oligomerization of polyglutamine-domain proteins in mammalian neurons. To study oligomerization of polyglutamine proteins and to identify heterologous protein interactions, varying length polyglutamine-green fluorescent protein fusion proteins were expressed in cultured COS-7 cells. The 19- and 35-glutamine fusion proteins (non-pathologic length) distributed diffusely throughout the cytoplasm. In contrast, 56- and 80-glutamine fusion proteins (pathologic length) formed fibrillar arrays resembling those previously observed in neurons in Huntington's disease and in a transgenic mouse model. These aggregates were intranuclear and intracytoplasmic. Intracytoplasmic aggregates were surrounded by collapsed intermediate filaments. The intermediate filament protein vimentin co-immunoisolated with expanded polyglutamine fusion proteins. This cellular model will expedite investigations into oligomerization of polyglutamine proteins and their interactions with other proteins.
Animals↗
Caffeine enhances initial but not extended learning of a proprioceptive-based discrimination task in nonsmoking moderate users.
We examined the effects of caffeine on fine motor performance and learning using a multiple-force discrimination task. 93 college-aged subjects performed this task on which multiple measurements were made in an operant response paradigm. Quantitative measures of accuracy of response, duration of response, latency of response, force, and variability of force were examined. Significant interactions for caffeine dose by session on accuracy of response and latency of response indicated that caffeine enhanced the initial learning of a proprioceptive motor task but did not improve performance beyond that of normal practice.
Adolescent↗
Identification of two subpopulations of rat monocytes expressing disparate molecular forms and quantities of CD43.
Expression of CD43 (leukosialin, sialophorin) by rat blood monocytes was analyzed by flow cytometric, microscopic, and biochemical techniques. Monocytes were identified cytometrically using a combination of light-scatter parameters and binding of the anti-monocyte/macrophage monoclonal antibody (mAb) OX-41. Two-color flow cytometry studies with W3/13 and HIS 17, two anti-CD43 mAb that react with different antigenic epitopes, revealed two subpopulations of monocytes expressing disparate levels of CD43 (referred to hereafter as hi-CD43 MO and lo-CD43 MO). In three-color flow cytometry studies, hi-CD43 MO were found to express higher levels of CD4 than lo-CD43 MO; in contrast, lo-CD43 MO bound higher levels of RP-3, a mAb raised against rat neutrophils. Hi- and lo-CD43 MO expressed comparable amounts of CD14, CD45, and intercellular adhesion molecule-1 (CD54); hi-CD43 MO expressed somewhat more lymphocyte function-associated antigen-1 alpha chain (CD11a) and CD18 than their lo-CD43 MO counterparts. A minority of cells in both subpopulations expressed class II histocompatibility antigens. Hi- and lo-CD43 MO isolated by fluorescence-activated cell sorting had features typical of monocytes as assessed by light and electron microscopy. In Western blotting experiments, lo-CD43 MO and elicited peritoneal macrophages were found to express a less heavily sialylated form of CD43 than hi-CD43 MO.
Animals↗
Spontaneous rupture of the oesophagus: case report of a delayed diagnosis and subsequent management.
Spontaneous rupture of the oesophagus is a rare but potentially fatal condition. Initially described by Boerhaave in 1724, this condition remained a pathological curiosity until a subsequent case was reported by Barrett in 1946. The diagnosis is often difficult and, thus, the appropriate management is delayed. An oesophageal disruption may occur within the mediastinum or between the mediastinum and the visceral lung pleura, resulting in an oesophago-pleural fistula. We report a case of a spontaneously occurring oesophageal disruption which was successfully managed with minimum surgical intervention.
Aged↗
Enteric viruses associated with HIV infection in Tanzanian children with chronic diarrhea.
OBJECTIVE: To determine whether specific viruses are associated with HIV infection in Tanzanian children with chronic diarrhea. DESIGN: Cross-sectional survey. SETTING: Major national teaching hospital in Dar es Salaam, Tanzania. PATIENTS: Consecutively admitted, human immunodeficiency virus (HIV)-infected and HIV-uninfected children with chronic diarrhea, and controls without diarrhea, aged 15 months to 5 years. MAIN OUTCOME MEASURE: Enteric viruses identified by electron microscopy (EM) of fecal specimens. RESULTS: Small round structured viruses (SRSV) were more frequent in HIV-infected than HIV-uninfected children with chronic diarrhea (4 of 21 vs 1 of 32, prevalence ratio = 6.09, 90% confidence limits 1.03, 36.14). Rotavirus and coronavirus-like particles (CVLP) were not associated with HIV infection. CONCLUSION: SRSV may be associated with HIV infection in Tanzanian children with chronic diarrhea. Larger, confirmatory studies are needed.
AIDS-Related Opportunistic Infections↗
Characterization of a novel family of ciliary body glycoproteins.
PURPOSE: To isolate and characterize ciliary body epithelial antigens reactive with a monoclonal antibody, 2B4.14.1. METHODS: A mouse monoclonal antibody generated against human corneal endothelium, 2B4.14.1 reacts with nonpigmented epithelium of human and guinea pig ciliary bodies. The ciliary body proteins reactive with 2B4.14.1 were identified by Western blotting and were partially purified by affinity chromatography with 2B4.14.1 coupled to a solid support matrix. Carbohydrate components of the antigenic molecules were analyzed by lectin chromatography and by digestion with the enzymes N-glycosidase F and endoglycosidase F. The cellular and subcellular distribution of the antigens was examined by immunoperoxidase staining and by immunoelectron microscopy of ultracryotome sections of ciliary body. RESULTS: 2B4.14.1 reacted with families of guinea pig and human ciliary body glycoproteins with estimated molecular weights ranging from 250 to 325 kD. In Western blots of samples reduced before electrophoresis, the high molecular weight bands were replaced by weakly reactive bands at 115 to 130 and 210 kD, indicating that the 2B4.14.1 ligands have disulfide bonds. 2B4.14.1 ligands from both guinea pig and human ciliary body were bound by immobilized lectins, including concanavalin A, Datura stramonium lectin, and Lens culinaris hemagglutinin, which recognize components of N-linked oligosaccharides. Guinea pig ciliary body antigens digested with N-glycosidase F and endoglycosidase F failed to react with 2B4.14.1 in Western blots, confirming the presence of N-linked oligosaccharide chains and indicating that they form an integral part of the 2B4.14.1-reactive antigenic site. Molecular weight shifts of glycosidase-digested antigens were consistent with the presence of two to four N-linked oligosaccharide units. In immunoperoxidase-stained sections of guinea pig and human ciliary body, 2B4.14.1 reacted primarily with nonpigmented epithelial cells. Staining of guinea pig epithelial cells was fairly uniform; staining of human epithelial cells was concentrated on the basal surface. By immunoelectron microscopy, a majority of the 2B4.14.1 antigenic reactivity was localized immediately external to the nonpigmented epithelial cell plasma membrane. CONCLUSIONS: 2B4.14.1 reacts with a novel family of high molecular weight glycoproteins associated with the nonpigmented epithelial cell surface in guinea pig and human ciliary body.
Aged↗
Generation of reovirus core-like particles in cells infected with hybrid vaccinia viruses that express genome segments L1, L2, L3, and S2.
When mouse L fibroblasts are infected with various combinations of recombinant vaccinia viruses possessing thymidine kinase (TK) genes with inserted reovirus genes that encode core components, particles are formed that closely resemble reovirus cores. In cells infected with vaccinia viruses that express reovirus proteins lambda 1 and sigma 2, particles are formed that are very similar to reovirus core shells; if, in addition, the cells are also infected with vaccinia virus that expresses protein lambda 2, particles are formed that also possess the characteristic icosahedrally located projections/spikes that are present on reovirus cores. If, in either case, the cells are also infected with vaccinia virus that expresses the reovirus RNA polymerase, protein lambda 3, the resultant particles are morphologically identical with those formed in its absence, but also contain protein lambda 3.
Animals↗
Eruptive pseudoangiomatosis: a unique childhood exanthem?
We describe three children with an acute onset and spontaneous resolution of angioma-like papules during an apparent viral illness. A biopsy specimen from one patient revealed a unique histologic appearance that consisted of dilated dermal blood vessels with plump hobnail-shaped endothelial cells. On the basis of the natural history and histopathologic features of this exanthem, we suggest the name eruptive pseudoangiomatosis.
Angiomatosis↗
Children's perceptions of responsibility: attitudes while working with peers with disabilities.
The purpose of this study was to examine whether participation in a community-based cooperative learning program affected attitudes toward responsibility of 13 talented and gifted students toward 49 peers with disabilities. A survey was administered to measure role perception of these students as they interacted in gross motor recreational activities with students with disabilities. There was a significant difference between pre- and posttest scores on three of six attitude items. Ordinal data suggested the gifted subjects showed an increase in their felt responsibility in this cooperative learning.
Child↗
Six-year retrospective surveillance of gastroenteritis viruses identified at ten electron microscopy centers in the United States and Canada.
To identify the prevalence, seasonality and demographic characteristics of patients with viral gastroenteritis, we reviewed 6 years of retrospective data on viral agents of gastroenteritis screened by electron microscopy at 10 centers in the United States and Canada. From 52,691 individual electron microscopic observations, a virus was detected in 16% of specimens, and the yearly positive detection rate among centers ranged from 8 to 34%. Rotavirus was the agent most commonly observed (26 to 83%), followed by adenoviruses (8 to 27%, respiratory and enteric combined), and small round viruses (SRVs) (0 to 40%) which were second most common at two of the centers. Rotavirus and astrovirus detections occurred more often in the winter but seasonal trends in detection were not apparent for the other viruses. Of all astroviruses detected 64% were found in infants (less than 1 year); unlike the other agents studied SRVs were detected in a large percentage of infants (48%) and older children and adults (20%). Among hospitalized patients a majority of all astroviruses, caliciviruses and SRVs were detected 7 days or more after admission in contrast to both rotaviruses and adenoviruses which were more likely to be detected earlier. The data suggest that SRVs are common agents of gastroenteritis and may be important causes of nosocomial infections. Because of the relative insensitivity of direct electron microscopy as a screening method for SRVs, astroviruses and caliciviruses, these data probably underestimate the true prevalence of disease caused by these agents.
Adenoviruses, Human↗
A phase I study of hepatic arterial infusion using difluoromethylornithine.
Ten patients with metastatic disease to the liver were treated with difluoromethylornithine (DFMO) administered by continuous hepatic arterial infusion. Two of nine evaluable patients had an objective partial response. Stable disease was recorded in three patients. Ototoxicity was encountered in all patients who received a daily dose of DFMO equal to or greater than 1.0 g/m2.
Adult↗