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Biomedical subjects

S Miller

Publications and source records attributed to S Miller.

At least 379 records · Page 21Linked to original sources

Constancy of central conduction delays during development in man: investigation of motor and somatosensory pathways.

1. A cross-sectional study has been performed on 457 normal subjects to determine changes in conduction delays with age in central and peripheral motor and somatosensory pathways to the upper limb. 2. Electromagnetic stimulation was used to investigate central and peripheral conduction in motor pathways from the cortex to biceps brachii and hypothenar muscles in 308 normal human subjects aged from 32 weeks gestation to 55 years. The responses were recorded in the surface electromyogram. 3. Somatosensory potentials evoked by electrical stimulation of the median nerve have been recorded at Erb's point and over the somatosensory cortex in 149 normal subjects aged from 34 weeks gestation to 52 years to determine central and peripheral somatosensory conduction delays. 4. The conduction delays in the central components of both motor and somatosensory pathways rapidly decrease over the first 2 years after birth and thereafter remain constant at adult values. 5. The conduction delays in the peripheral components of both motor and somatosensory pathways also decrease initially but then from the age of 5 years progressively increase in proportion to arm length. 6. The threshold stimulus intensity for evoking muscle responses following electromagnetic stimulation of the cortex is high initially and falls progressively until the age of 16 years. A linear relationship exists between the threshold intensity and height for the height range 70-180 cm. 7. The threshold stimulus intensities for exciting peripheral motor and somatosensory nerves decrease up to the age of 5 years and then reach a plateau. 8. The results support the conclusion, already reported in the literature that peripheral nerves attain maximum value for fibre diameter and conduction velocity at approximately 5 years of age. 9. In contrast, it is concluded that the maximum fibre diameters in both motor and somatosensory central pathways increase in proportion to height, leading to constant central conduction delays with growth.

Adolescent↗

Radiation of phasic stretch reflex in biceps brachii to muscles of the arm in man and its restriction during development.

1. The phasic stretch reflex in biceps brachii has been recorded in 372 normal subjects aged from 31 weeks gestation to 55 years. The stimulus used was a brief mechanical pulse delivered by a hand-held electromagnetic vibrator and the response was measured in the surface electromyogram. 2. The threshold for eliciting the reflex was low in the newborn and increased over the first 6 years to values corresponding to those of adults. 3. On the basis of timing it is concluded that the phasic stretch reflex has a monosynaptic component at all ages. 4. The surface electromyogram was also recorded in triceps brachii, pectoralis major, deltoid and hypothenar muscles. In some subjects evoking the phasic stretch reflex in biceps brachii resulted in short latency responses in these muscles, a phenomenon termed radiated response. 5. The probability of occurrence of radiated responses and their magnitudes were greatest at birth and decreased over 2-4 years. 6. Experiments were performed to determine how far mechanical transmission of the stimulus to biceps through the tissues of the arm might account for the radiated responses in the other muscles studied. It was concluded that the responses observed in triceps brachii, pectoralis major, deltoid and hypothenar muscles, following vibration of the biceps tendon, are primarily due to the radiation of the activity carried in biceps muscle afferents to the alpha-motoneurones of the respective muscles. 7. On the basis of timing it is concluded that in subjects below 2 years the radiated responses in the muscles studied have a monosynaptic component.

Adolescent↗

mu-receptor mediates elevated glucose and corticosterone after third ventricle injection of opioid peptides.

Four experiments were done to determine which receptor type(s) mediates the effects of third ventricular microinjections of four opioid peptide agonists on blood levels of glucose, free fatty acids, and corticosterone. Tests were performed in unanesthetized adult male albino rats having chronic intraventricular cannulas; blood samples were taken from the tail tip at 0, 15, 30, 60, 90, and 120 min postmicroinjection. In experiment 1, the agonists DAGO (Tyr-D-Ala-Gly-N-methyl-Phe-Gly-ol), beta-endorphin, DSLET (d-Ser2-Leu-enkephalin-Thr), and dynorphin A-(1-17) (0, 0.3, 1, 3, and 10 nmol/rat) produced three distinct patterns of changes in serum glucose, free fatty acid, and corticosterone values. Experiment 2 showed that the effects of DAGO and beta-endorphin were inhibited by prior injection with the opiate-receptor blocker naloxone (1 mg/kg sc) and that the effects of dynorphin were not diminished. Experiment 3 determined that dynorphin effects were also not diminished by naloxone given intraventricularly. Experiment 4 found that blockade of the mu-receptor by intraventricular pretreatment with the specific antagonist beta-funaltrexamine (20 micrograms/rat, 24 h before) completely abolished the effects of DAGO and beta-endorphin on glucose and corticosterone. The mu-receptor is critical to the mediation of the hyperglycemia and hypercorticosteronemia induced by the central administration of opiate agonists. These results imply that mu-opioid binding sites previously identified in central autonomic regions may be involved in the regulation of circulating glucose and corticosterone.

Animals↗

Diet and serum lipids in vegan vegetarians: a model for risk reduction.

The lipid levels and dietary habits of 31 Seventh-Day Adventist vegan vegetarians (aged 5 to 46 years) who consume no animal products were assessed. Mean serum total cholesterol (3.4 mmol/L), low-density-lipoprotein cholesterol (1.8 mmol/L), and triglyceride (0.8 mmol/L) levels were lower than expected values derived from the Lipid Research Clinics Population Studies prevalence data. Mean high-density-lipoprotein cholesterol (1.3 mmol/L) was comparable to expected values. Analysis of quantitative food frequency data showed that vegans had a significantly lower daily intake of total energy, percentage of energy from fat (31% vs 38%), total fat, saturated fat, monounsaturated fatty acids, cholesterol, and protein and a significantly higher intake of fiber than a sample of matched omnivore controls. Vegans' food intake was also compared with expected values, matched for sex and age, derived from the second National Health and Nutrition Examination Survey and Continuing Survey of Food Intakes by Individuals 24-hour recall data. The vegan diet was characterized by increased consumption of almonds, cashews, and their nut butters; dried fruits; citrus fruits; soy milk; and greens. We conclude from the present study that a strict vegan diet, which is typically very low in saturated fat and dietary cholesterol and high in fiber, can help children and adults maintain or achieve desirable blood lipid levels.

Adolescent↗

Cone electroretinographic change during light adaptation in retinitis pigmentosa.

Cone electroretinograms (ERGs) to 30-Hz full-field white light were recorded after dark adaptation from 33 patients with retinitis pigmentosa and 8 normal subjects over a period averaging 8.5 min. Most patients and all normal subjects showed increases in amplitude that approached or reached maximum by the end of the recording. Regression analyses revealed that patients with smaller baseline amplitudes tended to show larger and faster increases in relative amplitude than patients with larger baseline amplitudes, whose amplitude changes over time were comparable to those seen in normal subjects. These findings suggest that both the magnitude and kinetics of cone ERG amplitude change to a light-adapting, flickering stimulus are related directly to the level of cone malfunction in retinitis pigmentosa.

Adaptation, Physiological↗

Accuracy of imaging modalities in staging the local extent of prostate cancer.

In this study, none of the evaluated clinical staging methods was found to predict reliably the presence or absence of extracapsular growth of histologically proved carcinoma of the prostate. In this respect, digital rectal examination, transrectal ultrasound, CT, and MR imaging cannot contribute to treatment decisions in localized prostate cancer. Further studies are under way to determine the value of 7.5-MHz scanners in transrectal ultrasound and high-resolution surface coils in MR imaging.

Biopsy↗

The uncomfortable community meeting and the privacy-urgency coordinate: discussion and case study.

The authors review the literature and describe factors contributing both to the value and to the discomfort of community meetings on an adolescent inpatient unit. The defensive use of an exaggerated estimation of meeting discomfort is discussed, and the concept of a "privacy-urgency coordinate," useful in analyzing group dynamics, is introduced. A case example illustrates the importance of balancing the need of patients for privacy with their need to resolve urgent problems on the unit.

Adolescent↗

Protein-protein recognition and the association of immunoglobulin constant domains.

Four immunoglobulin constant domain interfaces were analysed to determine how the light and heavy chains of the domains recognize each other and secondarily, why the packing of the beta sheets is different from that normally observed in the interior of domains of beta sheet proteins. It was found that two bulky groups in the centre of each of the domain interfaces prevent the alignment of sheet axes by intercalating with residues in the sheet opposite. This intercalation forms the basis of constant domain light chain-heavy chain recognition.

Amino Acid Sequence↗

T lymphocytes can recognize determinants unique to neuropeptides of guinea pig myelin basic protein containing a single D-isomer amino acid substitution.

The present studies were undertaken to examine how the substitution of racemized forms of selected amino acids in synthetic peptides of guinea pig myelin basic protein (GPMBP) would alter the host's immunological ability to recognize such molecules. Using peptides from the 69-84 sequence of GPMBP containing a D-serine at position 70 or 75 (69-84[D-ser70 or D-ser75]) or D-aspartate at position 82 (69-84[D-asp82]), the findings demonstrated that the position of the diastereomer substitution on these neuropeptides was critical with respect to the ability of the immune system to recognize the molecule. Thus substitution of D-asp at position 82 or D-ser at position 75 abrogated the ability of these peptides to induce experimental autoimmune encephalitis and proliferation of host T cells. In contrast, a peptide containing a D-ser70 residue was capable of inducing clinical disease in rats, as well as stimulating T lymphocytes from 69-84-(D-ser70)-injected animals. Moreover, although this D-peptide was shown to share at least some determinant(s) with the 69-84 peptide, the use of 69-84(D-ser70)-stimulated cell lines demonstrated that some epitope(s) unique to this molecule could stimulate CD4+ syngeneic T cells.

Animals↗

First-trimester maternal serum alpha-fetoprotein and human chorionic gonadotropin screening for chromosome defects.

The aim of this study was to determine the efficacy of combined maternal serum alpha-fetoprotein (MSAFP) and maternal serum human chorionic gonadotropin (MShCG) screening in detecting chromosome defects in the first trimester of pregnancy. Sera of 492 women (previously assayed for MSAFP) were analysed for MShCG under code without knowledge of cytogenetic results. Overall, 48 of 492 patients (9.8 per cent) had either an MSAFP multiple of the median less than or equal to 0.5 or an MShCG beta/alpha ratio multiple of the median less than or equal to 0.25, eight of whom had a fetus with a serious chromosome defect. A third of fetuses with Down's syndrome and 83 per cent with trisomy 18 were detected at a potential 'cost' of providing chorionic villus sampling or amniocentesis in 8.6 per cent of women screened.

Adult↗

Grinspan's syndrome: a drug-induced phenomenon?

Three cases of apparently drug-induced Grinspan's syndrome involving the triad of oral lichen planus, diabetes mellitus, and hypertension are reported. Because drug therapy for diabetes mellitus and hypertension is capable of producing lichenoid reactions of the oral mucosa, the question arises as to whether Grinspan's syndrome is an iatrogenically induced syndrome.

Aged↗

Widespread flat warts associated with human papillomavirus type 5: a cutaneous manifestation of human immunodeficiency virus infection.

Numerous flat and tinea versicolor-like warts developed on the face, trunk, and upper extremities of a 10-year-old boy with human immunodeficiency virus infection. Nucleic acid analysis of involved skin revealed human papillomavirus type 5, which has sometimes been associated with epidermodysplasia verruciformis. This human papillomavirus type has also been described in patients with common variable immunodeficiency and dyskeratosis congenita and in renal allograft recipients. Human immunodeficiency virus infection should be added to the list of immune-related disorders that predispose to widespread flat warts.

Acquired Immunodeficiency Syndrome↗

Prospective computer-assisted voice analysis for patients with early stage glottic cancer: a preliminary report of the functional result of laryngeal irradiation.

In January 1987 we began a prospective study aimed at evaluating objective parameters of vocal function for all patients treated with RT for early glottic cancer. All patients underwent vocal analysis using a voice analyzer interfaced with a computer. This allowed for the determination of percent voicing (%V) (normal = presence of phonation = 90-100%V). Other parameters such as breathiness (air turbulence or hoarseness) and strain (vocal cord tension) were also measured. Patients were recorded before RT, weekly during RT, and at set intervals after RT. There have been 25 patients studied. Eighteen (18) are evaluable at 9 months after treatment. All patients were male and ranged from 45-84 years old. Fourteen (14) and T1 lesions and received 66 GY/33 fractions to their larynx and 4 had T2 tumors and received 66-70 Gy/33-35 fractions. To date, all patients are locally controlled. Three distinct patterns of %V changes have been encountered. However, all patients demonstrated normal phonation pattern by 3 months after RT, and this is sustained at 9 months follow-up. In addition, 94% of patients have had significant decrease in breathiness after RT, which objectively documents diminished hoarseness. In 83%, breathiness is normal after RT. Most patients have had increased strain after RT, which documents increased vocal cord tension. However, strain remained within normal limits in 89%. Our preliminary analysis suggests that the majority of patients irradiated for early glottic cancer demonstrate a decrease in breathiness and an increase in strain after RT, and enjoy a resultant voice that has normal phonation maintained at 9 months after RT. Our data also demonstrate three distinct phonation patterns. Further follow-up will allow us to determine the prognostic significance, if any, of these patterns, and to continue to follow objective vocal parameters on larger numbers of patient.

Aged↗