"David C. Miller"

The KPS Rinspirator (Kerberos Proximal Solutions, Cupertino, Calif.) is a new thrombectomy device that operates by manually controlled, simultaneous, intravessel infusion and aspiration of fluid to cause localized clot dissolution. We evaluate the ability of the KPS Rinspirator to treat acute (<3 days) and subacute (3-7 days) deep venous and arteriovenous graft thrombosis in 4 patients and 13 vessels (2 arteriovenous grafts and 11 deep veins). Technical and clinical success was achieved in the two patients with acute arteriovenous graft thromboses...

A measure of the functional importance of G protein-coupled receptors (GPCRs) as signalling molecules is that over seven hundred have been cloned and identified in the human genome alone. Yet few have been characterized in the lower metazoan phyla, especially in the phylum Cnidaria which is well positioned phylogenetically for tracing the early evolution of GPCRs owing to their possession of the first-evolved nervous systems. We report here the cloning and characterization of four novel rhodopsin-like GPCR cDNAs from the staghorn coral Acropora millepora that share significant similarity with each other but not with the majority of other members of the rhodopsin alpha subfamily...

CONTEXT: The cytologic features of hepatocellular carcinoma in fine-needle aspirates are well described. While some cases are easily distinguished from adenocarcinoma, poorly differentiated tumors can be difficult to differentiate. We reviewed the cytologic findings for 9 aspirates from cases of hepatocellular carcinoma that were frequently misclassified as adenocarcinoma and compared them with another 10 cases of hepatocellular carcinoma that were rarely misclassified. OBJECTIVE: To compare the cytologic features of cases of hepatocellular carcinoma in fine-needle aspirates that were both rarely and frequently misclassified as adenocarcinoma...

CONTEXT: The cytologic features of adenocarcinoma/ metastatic carcinoma in liver fine-needle aspirates are well described. We review the cytologic findings from 16 aspirates of adenocarcinoma/metastatic carcinoma that were frequently misclassified as hepatocellular carcinomas and compare them with 17 cases that were rarely misclassified. OBJECTIVE: To compare the cytologic features of adenocarcinoma/metastatic carcinoma in fine-needle aspiration specimens of the liver that were frequently misclassified as hepatocellular carcinoma with those of aspirates that were rarely misclassified...

PURPOSE: The purpose of this study was to determine whether "clinical inertia"-inadequate intensification of therapy by the provider-could contribute to high A1C levels in patients with type 2 diabetes managed in a primary care site. METHODS: In a prospective observational study, management was compared in the Medical Clinic, a primary care site supervised by general internal medicine faculty, and the Diabetes Clinic, a specialty site supervised by endocrinologists...

Fumonisins are common contaminants of maize (Zea mays L.) grain products, especially in countries where maize is a major constituent of the diet and are harmful to human and animal health. There is a need to better define environmental conditions that favor fumonisin accumulation in the grain of maize. The impacts of biotic and abiotic factors, and hybrids containing the Cry1Ab protein from Bacillus thuringiensis (Bt), were associated with fumonisin accumulation in the grain of maize across contrasting environments in Argentina and the Philippines between 2000 and 2002...

Inhibition of acetylcholinesterase (AChE) by the organophosphorous compound sarin (GB) results in the accumulation of acetylcholine and excessive cholinergic stimulation. There are few data in the literature regarding the effects of multiple low-level exposures to GB and other organophosphorous compounds via relevant routes of exposure. Therefore, the present study was undertaken, and is the first, to investigate the effect of low-level repeated whole-body inhalation exposures to GB vapor on pupil size and cholinesterase activity in the eyes and blood...

Anthropogenic input of mercury (Hg) into the environment has elevated risk to fish and wildlife, particularly in northeastern North America. Investigations into the transfer and fate of Hg have focused on inhabitants of freshwater aquatic ecosystems, as these are the habitats at greatest risk for methylmercury (MeHg) biomagnification. Deviating from such an approach, we documented MeHg availability in a terrestrial montane ecosystem using a suite of insectivorous passerines. Intensive and extensive sampling of Bicknell's thrush (Catharus bicknelli) indicated significant heterogeneity in MeHg availability across 21 mountaintops in northeastern North America...

OBJECTIVE: The purpose of this study was to examine Central Collegiate Hockey Association ice hockey players' attitudes regarding the use of athletic mouthguards and to determine the effects of mouthguard type, player position, education, and usage time with respect to attitudes. METHODS: A questionnaire measuring players' attitudes toward mouthguards was sent to certified athletic trainers (ATC) responsible for providing healthcare coverage at 10 institutions of the Central Collegiate Hockey Association (CCHA)...

Cognitive impairment is a prominent feature of schizophrenia. The availability of very brief measures may increase the use of cognitive assessment in routine care settings. We examined the reliability and validity of the brief cognitive assessment (BCA), a battery that takes approximately 15 min to administer and score, and that was designed to be sensitive to changes in cognition with novel antipsychotics. The BCA was administered to 340 outpatients on two occasions, 3 months apart. A sub-sample of subjects received a full battery of cognitive tests (n=97) and additional measures of functional outcome...

OBJECTIVE: Our purpose was to examine undergraduate athletic training students' perceptions of how time is utilized during clinical field experiences while enrolled in Commission on Accreditation of Allied Health Education Program (CAAHEP)-accredited athletic training programs and to determine the effects of clinical field-experience length and setting, academic standing, sex, clinical assignment, and National Collegiate Athletic Association level on active learning. DESIGN AND SETTING: Using the Athletic Training-Clinical Education Time Framework (AT-CETF) and Utilizing Time and Active Learning Survey, subjects completed a 1-day, self-reported observation of how their clinical field-experience time was utilized...

Although corals are nominally diploblastic, the early development of Acropora millepora involves a process that clearly resembles gastrulation in higher metazoans. This similarity at the morphological level led us to search for the Acropora equivalents of genes whose key roles in gastrulation are conserved across the higher Metazoa. We here report the characterisation of one such gene, snail, which in both Drosophila and the mouse is expressed in cells undergoing an epithelial-mesenchyme transition and/or morphogenetic movements...

PURPOSE: This study was conducted to determine how time is allocated to diabetes care. METHODS: Patients with type 2 diabetes who were receiving care from the internal medicine residents were shadowed by research nurses to observe the process of management. The amount of time spent with patients and the care provided were observed and documented. RESULTS: The total time patients spent in the clinic averaged 2 hours and 26 minutes: 1 to 9 minutes waiting, 25 minutes with the resident, and 12 minutes with medical assistants and nurses...

BACKGROUND: Type 2 diabetes mellitus is highly prevalent in minority populations in the United States. We studied the relationship of age to glycemic control in a predominantly urban African American population with type 2 diabetes. METHODS: We selected all patients with type 2 diabetes who were enrolled in the Grady Diabetes Clinic, Atlanta, Ga, between April 1, 1991, and December 31, 1998, and had a hemoglobin A(1c) (HbA(1c)) level measured at their initial visit and at follow-up 5 to 12 months later (n = 2539)...

African Americans have an increased burden of both diabetes and diabetes complications. Since many patients have high glucose levels novel interventions are needed, especially for urban patients with limited resources. In the Grady Diabetes Clinic in Atlanta, a stepped care strategy improves metabolic control. However, most diabetes patients do not receive specialized care. We will attempt to translate diabetes clinic approaches to the primary care setting by implementing a novel partnership between specialists and generalists...

Falciparum malaria is a major cause of disease and death in African children and pregnant women, primarily due to severe anemia. We studied anemia in vaccinated Aotus monkeys during a second infection where the animals were considered to be semi-immune. Most animals had extremely low or undetectable levels of parasitemia; in some, anemia did not develop and reticulocytemia remained unchanged; in others, moderate to severe anemia developed with inappropriately low reticulocytemia indicating bone marrow dysfunction...