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Biomedical subjects

G E Miller

Publications and source records attributed to G E Miller.

At least 19 recordsLinked to original sources
PubMed1991

RBRVS report: activities of the Ad Hoc Committee for Physicians' Reimbursement.

The Ad Hoc Committee to study the Resource-Based Relative Value Study has been active for more than 2 years. This Committee's membership was initially appointed by The Society for Thoracic Surgeons, but was quickly expanded so as to represent virtually all this nation's surgeons practicing the specialty of cardiothoracic and vascular surgery. This address describes the general activities of the Committee since its organization. It includes: 1. A brief description of the resource-based relative value scale (RBRVS). 2. The Committee's investigation of Harvard RBRVS Phase I as it relates to our specialty. 3. The Committee's findings and resultant testimony to the federal government and the American Medical Association. 4. The genesis and conduct of an independent study of the specialty. 5. A summary of our current position with respect to federal initiatives.

Relative Value Scales↗
PubMed1990

Enhancement of social learning family interventions for childhood conduct disorder.

Social learning family intervention (SLFI) is the treatment of choice for young children exhibiting severe conduct disorder and antisocial behavior. Despite the reported success of this intervention, high levels of resistance, poor engagement, and inadequate maintenance of improvements are observed for a substantial proportion of distressed families. These obstacles have inspired enhancement efforts to improve basic social learning family-intervention models. The present review identifies promising approaches for maximizing treatment gains for the conduct-disordered child. Relevant studies were organized into 3 approaches: enhancements and expansions (a) within a dyadic (parent-child) interaction model, (b) within a broad-based model that acknowledges a wider range of family influences, and (c) through a multisystems model. SLFI enhancements within the dyadic model have centered on either the strengthening of parental skills already included in the SLFI regimen or the adding of new interactional strategies. Some gains, but only partial success, have been achieved with the dyadic model supplements. SLFI expansions from a broad-based model have focused on parental adjustment, parental expectations during treatment, and social-environmental stressors. The multisystems adjuncts to SLFI include cognitive-behavioral interventions to affect peer relations and ecological approaches to sweep across domains. The broad-based and multisystems expansions have produced promising but undertested treatment regimens. Related areas of investigation included therapy process research, medication combined with SLFI, and the involvement of fathers in treatment. Recommendations are offered for improvement of SLFI research. The apparent theoretical crossroads for SLFI treatment of childhood conduct disorder are discussed.

Antisocial Personality Disorder↗
PubMed1990

A multiple disk centrifugal pump as a blood flow device.

A multiple disk, shear force, valveless centrifugal pump was studied to determine its suitability as a blood flow device. A pulsatile version of the Tesla viscous flow turbine was designed by modifying the original steady flow pump concept to produce physiological pressures and flows with the aid of controlling circuitry. Pressures and flows from this pump were compared to a Harvard Apparatus pulsatile piston pump. Both pumps were connected to an artificial circulatory system. Frequency and systolic duration were varied over a range of physiological conditions for both pumps. The results indicated that the Tesla pump, operating in a pulsatile mode, is capable of producing physiologic pressures and flows similar to the Harvard pump and other pulsatile blood pumps.

Assisted Circulation↗
PubMed1989

Picture versus question elaboration on young children's learning of sentences containing high- and low-probability content.

The main purpose of the two experiments reported here was to compare the potency of two types of elaboration on children's learning of sentence content: The effects of partial picture adjuncts were compared to the effects produced by answering "why"-questions about the relationships specified in the sentences. Five- to seven-year-old children heard sentences of the form, subject/verb/direct object/preposition/instrument. Sentences contained either a high-probability or a low-probability instrument given the semantic context. In Experiment 1, sentences either were accompanied by a partial picture depicting the sentence action but omitting the instrument or were presented without a partial picture accompaniment. Recall was improved by provision of partial pictures at study. In Experiment 2, the sentences were accompanied by complete pictures depicting the sentence content. In both experiments, questioning significantly reduced recall of high-probability sentences, with recall of instruments affected especially negatively. Evidence is presented that insufficient attention to instruments may have been one mechanism mediating depressed recall of high- compared to low-probability instruments in the questioned conditions. In summary, partial pictures improved cued recall of sentences in this study; in contrast, all significant effects produced by answering why-questions were negative ones (i.e., later recall was reduced following interrogation at study).

Attention↗
PubMed1988

Role of psychiatrists in the public mental health system.

This paper examines the contributions of the psychiatric profession within the public mental health system. Following a discussion of the current status of psychiatry and the public mental health delivery system, the author outlines a number of key recommendations regarding the appropriate role of psychiatrists in public systems. The author emphasizes the importance of the public mental health system in all areas of psychiatric practice.

Community Mental Health Services↗
PubMed1978

Long-term survival after single aortic or mitral valve replacement with the present model of Smeloff-Cutter valves.

Two hundred fourteen survivors of single aortic (AVR) or mitral valve replacement (MVR) were evaluated. The present model of the Smeloff-Cutter prosthesis was used in these patients, and the series was started in September, 1966, following the last structural change in the valve. Clinical follow-up ended in September, 1976. Bleeding, thromboembolism, and peristent left ventricular dysfunction were the major complications. Thromboembolism occurred at a rate of 0.13 percent per month of patient follow-up. Late deaths occurred in 19.2 percent of patients, half of these within the first year. Acturarial data indicated a 5 year survival rate of approximately 75 percent after both mitral and aortic replacements. Bleeding and thromboembolism were more frequent causes of death after mitral replacement. Myocardial function was of greatest importance in long-term survival after replacement of either valve. Variations in warfarin dosage significantly affected both bleeding and thromboembolic complications.

Anticoagulants↗
PubMed1977

Relationship between dialyzer reuse and the presence of anti-N-like antibodies in chronic hemodialysis patients.

One hundred eleven chronic hemodialysis patients from five dialysis units were tested for the presence of antibodies reactive with red blood cell N substance; 77 patients were available for follow-up study after 18 to 24 months. Initially, 18 patients (16%) had serum anti-N-like antibodies. Thirteen of these patients were in a home dialysis program and were reusing hollow fiber dialyzers. The other five had practiced hollow fiber dialyzer reuse in the past. None of 37 patients using coil dialyzers had anti-N-like antibody. On follow-up testing, anti-N-like antibody persisted in all patients restudied except for one who had a successful renal transplant. Anti-N-like antibodies developed in four additional patients: three were reusing hollow fiber dialyzers at the time, but one had not reused dialyzers for 24 months. Statistical analyses indicated that dialyzer reuse, hollow fiber dialyzers, and home dialysis were significantly related to the presence of anti-N-like antibodies. We interpret the clinical and statistical data to indicate that dialyzer reuse is the major clinical factor in the development of anti-N-like antibody. The likely mechanism involves the prolonged exposure of red cells trapped in the dialyzer to formaldehyde used in preparing dialyzers for reuse. No adverse clinical effects of anti-N-like antibodies were evident in our patients, but hemolysis and acute transplant failure have been reported by others.

Antibodies, Anti-Idiotypic↗
PubMed1977

A study of oxidation of dental amalgams with age.

A quantitative test for corrosion due to oxidation has been accomplished. The oxygen concentration of dental amalgams was measured by fast neutron activation which provides a means of detecting oxygen in as small a quantity as 10 to 20 micrograms. An increase in oxygen content with age of spherical blend amalgam implants was observed, comfirming the importance of oxidation processes in in vivo corrosion.

Adolescent↗
PubMed1976

Attenuation measurements of a fast neutron radiotherapy beam.

Attenuation measurements have been made for pressed wood, steel and lead in the neutron beam generated by 35 MeV deuterons on a thick Be target, using narrow-beam, semibroad-beam and broad-beam geometries. In addition, the measurements were extended to the neutron beams from 25 and 15 MeV D+ on Be, for semibroad-beam geometry only. A tissue-equivalent plastic ionization chamber was used as the detector; hence the measured parameter approximated the total (n + gamma) dose in tissue. After correcting for radiation scattering around the absorbers, the remaining curves were nearly exponential in most cases, and a build-up factor could be employed to describe the varying degree of scattered radiation dose as a function of absorber thickness and geometry. The results given should be applicable in designing primary-beam shields and collimators, as well as providing a useful basis for extending calculations to other geometries through Monte Carlo techniques.

Deuterium↗
PubMed1976

The fate of experimental organ-cultured corneal xenografts.

Human, chicken, and guineapig corneas organ cultured (O.C.) from 1 to 4 weeks were transplanted intralamellarly into rabbits. Chicken and guinea pid corneal xenografts O.C 3 to 4 weeks had statistically significant delayed rejection times reject. Histologically, O.C. xenografts with delayed rejection or nonrejection were hypocellular. Chicken xenografts O.C. 4 weeks in which recipient (autochthonous) rabbit serum replaced the calf serum routinely used in the media also had a significant delay in rejection time when compared to fresh controls or chicken xenografts stored in pooled (allogeneic) rabbit serum. The rejection time of human corneal xenografts O.C. FOR PERIODS UP TO 4 WEEKS WAS NOt delayed. These data suggest that in this model, prolonged survival of xenografts after O.C. is species specific and represents a form of immunological modification, possibly reduced antigenicity sedondary to donor hypocellularity.

Animals↗
PubMed1976

Oxytetracycline in bovine plasma, milk, and urine after intrauterine administration.

Six healthy lactating cows with normal but varying stages of estrous cycles were treated with chelated or nonchelated oxytetracycline by intrauterine infusion, 4 mg/kg body weight. The chelated drug was a mixture of special metal halides and oxytetracycline while the nonchelated form was a commercial oxytetracycline solution suitable for intramuscular or intravenous administration. Oxytetracycline concentrations in plasma, milk, and urine were determined at timed intervals following treatment. Both forms of the drug appeared in the plasma, but the chelated form was a small amount. The nonchelated oxytetracycline also appeared in the milk. However, no oxytetracycline was in milk of cows treated with chelated oxytetracycline. Both forms of the drug were excreted in the urine. Milk should be withheld from market 24 and 0 h after administration of nonchelated and chelated forms.

Animals↗