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Biomedical subjects

Jason Miller

Publications and source records attributed to Jason Miller.

7 recordsLinked to original sources

Effect of hemostasis and electrosurgery on the development and evolution of brain tumor surgery in the late 19th and early 20th centuries.

Hemostatic options available to the surgeon in the late 19th and early 20th centuries were limited. The surgical ligature was limited in value to the neurological surgeon because of the unique structural composition of brain tissue as well as the approaches and operating angles used in this type of surgery. In this manuscript the authors review the options available and the evolution of surgical hemostatic techniques and electrosurgery in the late 19th and early 20th centuries and the impact of these methods on the surgical management of tumors of the brain and its coverings.

Brain↗

General anesthesia and the neural correlates of consciousness.

The neural correlates of consciousness must be identified, but how? Anesthetics can be used as tools to dissect the nervous system. Anesthetics not only allow for the experimental investigation into the conscious-unconscious state transition, but they can also be titrated to subanesthetic doses in order to affect selected components of consciousness such as memory, attention, pain processing, or emotion. A number of basic neuroimaging examinations of various anesthetic agents have now been completed. A common pattern of regional activity suppression is emerging for which the thalamus is identified as a key target of anesthetic effects on consciousness. It has been proposed that a neuronal hyperpolarization block at the level of the thalamus, or thalamocortical and corticocortical reverberant loops, could contribute to anesthetic-induced unconsciousness. However, all anesthetics do not suppress global cerebral metabolism and cause a regionally specific effect on thalamic activity. Ketamine, a so-called dissociative anesthetic agent, increases global cerebral metabolism in humans at doses associated with a loss of consciousness. Nevertheless, it is proposed that those few anesthetics not associated with a global metabolic suppression effect might still have their effects on consciousness mediated at the level of thalamocortical interactions, if such agents scramble the signals associated with normal neuronal network reverberant activity. Functional and effective connectivity are analysis techniques that can be used with neuroimaging to investigate the signal scrambling effects of various anesthetics on network interactions. Whereas network interactions have yet to be investigated with ketamine, a thalamocortical and corticocortical disconnection effect during unconsciousness has been found for both suppressive anesthetic agents and for patients who are in the persistent vegetative state. Furthermore, recovery from a vegetative state is associated with a reconnection of functional connectivity. Taken together these intriguing observations offer strong empirical support that the thalamus and thalamocortical reverberant network loop interactions are at the heart of the neurobiology of consciousness.

Anesthesia, General↗

Gene and alternative splicing annotation with AIR.

Designing effective and accurate tools for identifying the functional and structural elements in a genome remains at the frontier of genome annotation owing to incompleteness and inaccuracy of the data, limitations in the computational models, and shifting paradigms in genomics, such as alternative splicing. We present a methodology for the automated annotation of genes and their alternatively spliced mRNA transcripts based on existing cDNA and protein sequence evidence from the same species or projected from a related species using syntenic mapping information. At the core of the method is the splice graph, a compact representation of a gene, its exons, introns, and alternatively spliced isoforms. The putative transcripts are enumerated from the graph and assigned confidence scores based on the strength of sequence evidence, and a subset of the high-scoring candidates are selected and promoted into the annotation. The method is highly selective, eliminating the unlikely candidates while retaining 98% of the high-quality mRNA evidence in well-formed transcripts, and produces annotation that is measurably more accurate than some evidence-based gene sets. The process is fast, accurate, and fully automated, and combines the traditionally distinct gene annotation and alternative splicing detection processes in a comprehensive and systematic way, thus considerably aiding in the ensuing manual curation efforts.

Alternative Splicing↗

ThurGood: evaluating assembly-to-assembly mapping.

The alignment and mapping of large genomic sequences is the focus of much recent research. However, relatively little has been done so far about testing and validating alignment methods. We introduce criteria and new tools we have developed for alignment evaluation. These tools have already proved useful in the evaluation and ranking of several methods for assembly-to-assembly mapping, which were recently used to map multiple versions of the human genome to each other (Istrail et aL, 2004).

Algorithms↗

The genome sequence of the malaria mosquito Anopheles gambiae.

Anopheles gambiae is the principal vector of malaria, a disease that afflicts more than 500 million people and causes more than 1 million deaths each year. Tenfold shotgun sequence coverage was obtained from the PEST strain of A. gambiae and assembled into scaffolds that span 278 million base pairs. A total of 91% of the genome was organized in 303 scaffolds; the largest scaffold was 23.1 million base pairs. There was substantial genetic variation within this strain, and the apparent existence of two haplotypes of approximately equal frequency ("dual haplotypes") in a substantial fraction of the genome likely reflects the outbred nature of the PEST strain. The sequence produced a conservative inference of more than 400,000 single-nucleotide polymorphisms that showed a markedly bimodal density distribution. Analysis of the genome sequence revealed strong evidence for about 14,000 protein-encoding transcripts. Prominent expansions in specific families of proteins likely involved in cell adhesion and immunity were noted. An expressed sequence tag analysis of genes regulated by blood feeding provided insights into the physiological adaptations of a hematophagous insect.

Animals↗

Intravascular drug delivery with a pulsed liquid microjet.

Occlusions of the retinal veins and arteries, associated with diseases such as hypertension and arteriosclerosis, are a major cause of severe and irreversible loss of vision. Treatments for retinal vascular diseases have been unsatisfactory owing in part to the difficulty of delivering drugs to the site of disease within the eye. In this article, we demonstrate that a new device, the vapor bubble-driven pulsed liquid microjet, can deliver drugs into the lumen of small vessels such as those found in the retina. A 15- micro m-diameter liquid jet traveling at more than 60 m/s was shown to penetrate and deliver fluid through the wall of a blood vessel that was 60 micro m in diameter. Perforation of the wall of the blood vessel did not extend beyond the jet diameter.

Allantois↗

Complications of transrectal versus transperineal prostate biopsy.

BACKGROUND: There are two established techniques of prostate biopsy: the more widely used transrectal technique, and the transperineal technique. Although the transrectal technique is faster, it is reported to have an increased risk of septic complications, which may be life threatening. The present study compares complication rates of both techniques at Nambour General Hospital. METHODS: The present retrospective study was performed by reviewing all available medical charts of men who underwent prostate biopsy during the years 1996-2001. The following data were recorded in a database: date of birth; digital rectal examination findings; serum prostate specific antigen (PSA); biopsy technique; number of cores taken; number of positive cores; Gleason grade and score; complications. Results were tabulated and simple statistical analysis performed to compare both groups. RESULTS: A total of 197 biopsies was included in the study, with 81 transperineal biopsies in 75 men, and 116 transrectal biopsies in 103 men. There was no statistically significant difference in complication rates, including sepsis, between transrectal biopsy and transperineal biopsy. The rate of sepsis was 1.2% for the transperineal technique, and 0% for the transrectal technique (P = 0.411, Fisher exact test). Overall complication rates were 22.2% for transperineal technique and 19.8% for transrectal technique (P = 0.773, Fisher exact test). CONCLUSION: Although the present study was limited by retrospective design and size it suggests that both techniques are equally safe. A review of medical literature supports a tranperineal approach to patients who will tolerate sepsis poorly, or who have a suspected inflammatory cause of their raised PSA.

Aged↗