Miller Technique Research Articles

OBTAINING LACTIC ACID FROM THE FERMENTATION OF RESIDUAL SUGAR CANE, CORN, AND CASSAVA

In this research, lactic acid (LA) was obtained by fermentation from three agricultural residues: cassava husk(CH), corn forage (CF), and sugarcane bagasse (SB). The content of moisture, ash, protein, fat, hemicellulose, cellulose, and lignin for each residue were determined. Then, two chemical pretreatments were applied to CH, CF, and SB: alkaline with 3 % (v.v-1) NaOH, and acid with 8 % (v.v-1) H2SO4. Total reducing sugars (TRS) were determined through the Miller technique (DNS) to select the pretreatment conditions that offered a higher yield in terms of sugar production. Lactic acid fermentation was carried out for 72 hours at 37°C and the amount of lactic acid obtained was determined through HPLC. The highest concentration of ART in acid (8611.90 mg/L) and alkaline hydrolysis was for BC (5526.87 mg/L), respectively. Agricultural residues are a potential resource for the production of biobased products, which currently use raw materials of fossil origin.

Salvage of Mega-fistula with Nezakatgoo Technique

Introduction: Mega-fistula is understood as an arteriovenous fistula that is very dilated throughout its course, tortuous, sometimes aneurysmal, and that presents flows above 2L/min; this carries the risk of generating multiple complications (from aneurysmal rupture, recirculation, and heart failure due to overload, among others). Its usual treatment is ligation or prosthetic replacement. Material and methods: The technique described by Nezakatgoo et al. was performed on three patients with mega fistulas (operated between 2020 and 2023) in whom salvage surgery and recovery of the entire fistula was performed. Complete dissection of the fistula from its anastomosis to the arch of the cephalic vein is performed, the vein is calibrated with a 24-34 Fr chest tube, and the excess of the mega-fistula and aneurysms are resected. In the case of stenotic areas, these are enlarged, or new anastomoses are made, and in the case of stenosis of the arch, a new anastomosis is made in the axillary vein. Results: The first case describes a left humerocephalic fistula made in 2011, which, after the plastic surgery, required two angioplasties due to stenosis in the middle third (at 125 and 236 days after the plastic surgery). It remains patent, with a total patency of 156 months since its initial confection and 36 months since the plastic. The second patient presents a mega-fistula performed in April 2019, which, after plastic surgery, required angioplasty for stenosis at one time at 509 days and continues to be permeable to date, with a total patency of 56 months and 30 months since plastic. The third fistula was operated in the context of total fistula thrombosis and required, in the first instance, a thrombectomy prior to reconstruction. It evolved in two episodes (at months 2 and 5), with stage IIb steal treated by banding (Miller technique) on both occasions. It presents a total patency of 57 m and 18 m from the plastic. All patients remain on dialysis to date due to the reconstructed fistula. Conclusions: Salvage of mega-fistula is a valid procedure to continue the useful life of native fistulas in the short and medium term; if necessary, complementary procedures are required to solve problems similar to those of other fistulas.

Modified Miller banding technique for ischemia in native fistulae

Treating upper limb ischemia or dialysis access-associated steal syndrome (DASS) is controversial. Many treatments have been described for this pathology; one of the techniques of preference in our institution is banding with the technique described by Miller et al. of minimally invasive endoluminal-assisted limited ligation revision (MILLER), in which we have modified to avoid the intercurrences it causes. Four cases of stage II steal are presented in which the Miller technique is performed in which, instead of banding with a 2-0 Prolene suture, it is surrounded with a 1 cm wide PTFE segment. An angioplasty balloon is used to calibrate the desired diameter of the banding, and a Doppler ultrasound is performed to evaluate the flow before and after the procedure, as in the Miller technique. The procedure allowed ischemia to be resolved, and the fistulas were found to be permeable without evidence of the complications usually described.

Interventional Management of High Flow Hemodialysis Access (MILLER Technique): What Size of Balloon is Appropriate for the Procedure?

Interventional Management of High Flow Hemodialysis Access (MILLER Technique): What Size of Balloon is Appropriate for the Procedure?

Prosthetic Rehabilitation in Older Adult with Free Gingival Graft: Case Report

Aim: The aim of the present study was to perform the clinical evaluation of the thickness of the soft tissue around dental implants using a free gingival graft obtained from the palate.
 Background: Rehabilitation in elderly patients improves physiological functions and quality of life, and when this rehabilitation involves a surgical stage, it becomes a challenge, even for more experienced surgeons.
 Methods: a 64-year-old, white, female patient with a complaint of difficulty chewing and discomfort stemming from her dental status. Rehabilitation was proposed involving a multidisciplinary approach to reestablish esthetics, function and wellbeing. For such, 4.1 Bone Level Tapered® implants were installed. During the presurgical preparation, a free gingival graft was planned to increase the gingival area using the Miller technique. After establishing the suitability of the oral environment, impressions were made in alginate for the fabrication of an acrylic surgical stent to protect the donor site on the hard palate and minimize the morbidity of the surgical intervention.
 Conclusion: In the case reported, the increase in the gingival tissue using a free gingival graft provided satisfactory peri-implant health in an older patient throughout annual follow-up for 15 years.

Lifetime prediction of high-modulus polyethylene yarns subjected to creep using the Larson–Miller methodology

The aim of the present work is to apply the Larson–Miller technique for the study of the mechanical behavior under creep of high-modulus polyethylene (HMPE) fibers focused on use as in offshore mooring ropes. Creep is known to be a long-term phenomenon, so in most cases, reproducing such experiments in real time is not feasible, and as the life span of anchoring systems must be in the order of decades, accelerated tests are required to verify the long-term mechanical behavior of the material. The methodology using the Larson–Miller parameter is a well-documented and powerful technique for materials’ lifetime prediction, although seldom applied to polymeric materials. It involves in performing accelerated (high temperature and/or loads) creep tests to determine the parameters that are later used to estimate the rupture time of the material under constant load. It is concluded that the Larson–Miller technique is efficient for calculating the lifetime of HMPE subjected to creep.

PC100. First Experience of Creating a Secondary Hemodialysis Access Using a Modified MILLER Technique

Although autogenous arteriovenous fistulas provide the best source of prolonged hemodialysis access, up to 30% are fail and require creation of a new access. In some cases, the fistula requires banding to treat symptoms of high flow or steal syndrome. This study describes our first experience with a modification of the MILLER banding technique that allows us to control flow through the fistula and preserve a secondary access, which can be opened endovascularly and used immediately if the primary access fails. From 2008 to 2017, in 52 patients a secondary vein was preserved by banding in addition to the creation of a fistula. A coronary artery dilator is placed outside a nonprimary access vein and a Prolene stitch is used to band the vein to the desired size (modified MILLER technique). This banding can be broken in case of primary access failure, and the secondary access can be used immediately without creation of a new AV fistula. Patients were followed for up to 4 years to calculate patency rates. Patients with standard MILLER banding were used as a comparison group. Primary patency rates at 6 months, and 1, 2, 3, and 4 years were 88%, 72%, 50%, 50%, and 37%, respectively. Primary assisted patency rates at 6 months, a d 1, 2, 3, and 4 years were 96%, 80%, 52%, 52%, and 41%, respectively. These rates were not different than in the comparison group. Stenosis developed in 32 fistulas and thrombosis developed in three fistulas. In one case, after stenosis caused failure of the primary access, the banding was opened and the secondary fistula was used without additional time for maturation. In four patients, a banded basilic vein was used as a secondary construct without breaking the banding after failure of the primary access vein to mature. In three of these patients, brachial artery to translocated basilic vein fistulas were created. In one patient, the primary access vein was ligated and the secondary fistula was functional. Bandings were unintentionally opened four times during angiography. Modified MILLER banding offers an alternative access for hemodialysis without additional maturation time upon fistula failure. The primary patency and primary assisted patency rates of modified MILLER banding do not differ from patients with MILLER banding.

IP129. Modified MILLER Technique for Preferentially Directing Blood Flow in Dialysis Patients

IP129. Modified MILLER Technique for Preferentially Directing Blood Flow in Dialysis Patients

Free Gingival Autograft and Subepithelial Connective Tissue Graft for the Treatment of Gingival Recession: A Brief Review and Report of Three Cases

ABSTRACTGingival recession is the migration of the free gingival margin apical to the cementoenamel junction. There are various factors contributing toward gingival recession apart from periodontal disease that include faulty tooth brushing, tooth position or malaligned teeth, high muscle or frenal attachment, alveolar bone dehiscence, orthodontic forces, and iatrogenic factors leading to problems of esthetics, hypersensitivity, and root caries.Several periodontal plastic surgical techniques have been introduced in the previous literature aiming to correct marginal tissue recessions, the predictability of which depends upon careful evaluation of the defect type, presence of attached gingiva, keratinized tissue width, and presence of single or multiple gingival recessions. The use of free gingival graft (FGG) and subepithelial connective tissue graft (SCTG) in root coverage is indicated for the treatment of single or multiple gingival recessions. Although both FGGs and SCTGs provide significant reduction in recession depth and clinical attachment gain for Miller's Class I and II gingival recession defects, SCTG seems to offer root coverage with a better color match between donor and recipient site tissue rendering better esthetics. Considering the advantages and disadvantages of FGG and SCTG in root coverage procedures, the following case reports describe the clinical results using FGG by Miller's technique, and using SCTGs by technique of Langer and Langer, and Zabalegui tunnel technique for the treatment of gingival recession.How to cite this articleRijhwani JA, Kini VV, Pereira R, Yadav S. Free Gingival Autograft and Subepithelial Connective Tissue Graft for the Treatment of Gingival Recession: A Brief Review and Report of Three Cases. J Contemp Dent 2016;6(3):225-232.

High performance reversed nested Miller frequency compensation

This paper presents an enhanced technique to improve frequency compensation in three stages operational transconductance amplifiers (OTA). Based on the reversed nested Miller technique, it uses a current subtractor in the common node of the Miller capacitors, thus significantly improving the gain-band width product (GBW) while ensuring unconditional stability and removing the feed forward path. Also, compared to other existing frequency compensation techniques such as AC boosting compensation or active feedback frequency compensation, the proposed approach exhibits better figure of merits with less power consumption. The simulations of a three-stage OTA with 100 pF capacitive load exhibited 5 pF of total compensation capacitors, 63° phase margin and 4.75 MHz as GBW.

A Review of Manchester, Miller, and FM0 Encoding Techniques

Encoding techniques are becoming more important in communication. Techniques such as Miller, Manchester, and FM0 encoding can be used in various applications. Each technique has different operations based on their needs. Each encoding scheme should be used without losing any of its parameters. The finite state machine can be used for all encodings, because at a time the input has given the corresponding output can be occurred due to this. So speed can be increased. The fully-reused VLSI architecture of FM0, Manchester, and Miller encoders has reduced the number of transistors and maintains the DC balance. The simulation results of Xilinx indicate successful functions.

Potential of the Miller cycle on a HSDI diesel automotive engine

The paper explores, by means of CFD simulations, the potential of the Miller cycle, applied to High Speed Direct Injection (HSDI) Diesel engines, facing the challenge of emissions reduction enforced by the near-term regulations, with particular reference to Euro VI. In fact, a valuable benefit of the Miller technique is the strong reduction of combustion temperature, thus the abating of NOx emissions, compared to a traditional cycle with the same values of AFR and EGR rate.The practical application of the Miller cycle yields a number of critical issues, which are generally addressed in the paper. However, the goal of the study is to assess the potential and the limits of this technique, more than develop a specific engine configuration.For the analysis, a 2.8L 4-cylinder turbocharged engine produced by VM Motori was selected, carrying out a comprehensive experimental campaign, at both full and partial load. The experimental data allowed the authors to calibrate two types of numerical models, one for the whole engine analyses (0/1D), the other for the combustion process simulation (CFD-3D). The integrated use of these computational tools provides a reliable comparison between the base engine and the one modified according to the Miller cycle, in terms of both emissions and fuel consumption in the European Driving Cycle. It was found a reduction of NOx and Soot of 25% and 60%, respectively, and a worsening of fuel efficiency of 2%. The abating of NOx can be further enhanced, since it is demonstrated that the engine operated according to the Miller cycle can tolerate higher rates of EGR.

Comparative Results Of Frenectomy By Three Surgical Techniques- Conventional, Unilateral Displaced Pedicle Flap And Bilateral Displaced Pedicle Flap

Maxillary labial frenum is capable of creating a diastema and recession, affecting aesthetics. Archer's classical frenectomy technique is an extensive procedure which causes scarring and loss of interdental papilla. This leads towards the conservative approaches like Edward's frenectomy, frenum relocation by Z-plasty and free gingival graft. Since the procedure of frenectomy was first proposed, a number of modifications have been developed to solve the problem caused by an abnormal labial frenum. But in most of the techniques the zone of attached gingiva and aesthetics are not considered. Thus, the aim of this case report is to present case series of various frenectomy techniques for management of aberrant frenum. A series of cases of an aberrant frenum were approached by various surgical frenectomy techniques like conventional (classical) technique, Miller's technique using unilateral pedicle flap and frenectomy technique using bilateral pedicle flap and results are reported. The frenectomy technique using pedicle flap gives good aesthetic results, colour match, gain in attached gingiva and no anaesthetic scar formation as healing takes place by primary intention.

Challenges in quantifying the Ki67 proliferation index in well-differentiated gastroenteropancreatic neuroendocrine tumours: assessment of a standardised manual technique

<h3>Aims</h3> Treatment decisions for gastroenteropancreatic neuroendo-crine tumours (GEP-NETs) are currently based on grading systems that incorporate the Ki67 proliferation index (PI). The reported Ki67 PI is often an ‘eyeball' estimation that is prone to inter-observer variability. We trialled the use of a standardised method of manual Ki67 quantification. <h3>Methods</h3> The Miller Square is an ocular graticule that is typically used in haematology to facilitate the rapid, accurate and reproducible counting of reticulocytes. We used this method to calculate the Ki67 PI in a retrospective review of thirty consecutive GEP-NETs. <h3>Results</h3> The Miller Square method produced high inter-observer agreement, with an intra-class correlation coefficient (ICC) of 0.99 (95%CI 0.98–0.99). When restricted to grade 1 and 2 tumours, there was only moderate inter-observer agreement, ICC 0.49 (95%CI 0.14–0.73). Using this method, five (18%) of 27 grade 1 and 2 tumours were classified differently by the two observers. Three (11%) of the tumours classified as grade 1 by eyeball estimation were upgraded by the Miller technique. <h3>Discussion</h3> Precise quantification of the Ki67 PI at low values to distinguish grade 1 and grade 2 tumours is challenging, both by eyeball estimation and when using a standardised counting technique. These results highlight the practical difficulties of current grading systems.

Frenectomy: A Review with the Reports of Surgical Techniques

The frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, the gingiva, and the underlying periosteum. The frena may jeopardize the gingival health when they are attached too closely to the gingival margin, either due to an interference in the plaque control or due to a muscle pull. In addition to this, the maxillary frenum may present aesthetic problems or compromise the orthodontic result in the midline diastema cases, thus causing a recurrence after the treatment. The management of such an aberrant frenum is accomplished by performing a frenectomy.The present article is a compilation of a brief overview about the frenum, with a focus on the indications, contraindications, advantages and the disadvantages of various frenectomy techniques, like Miller's technique, V-Y plasty, Z-plasty and frenectomy by using electrocautery. A series of clinical cases of frenectomy which were approached by various techniques have also been reported.

4505 ORAL A population pharmacokinetic/pharmacodynamic (PK/PD) analysis of exposure–response for sunitinib in metastatic renal cell carcinoma (mRCC)

To ascertain the pharmacological activity of erythropoietin (EPO) administered by self-dissolving micropiles (SDMP), four kinds of EPO SDMPs were prepared and were administered to rats in 4 consecutive days at 200, 500, 1000 and 2300 IU/kg. After the start of the experiment, blood samples were obtained once a day for 10 days and percent circulating reticulocytes were counted using Miller technique. At the lower doses, 200 and 500 IU/kg, pharmacological activity of EPO was not obtained. By increasing EPO dose to 1000 IU/kg, circulating reticulocytes significantly increased at days 4, 5, 6 and 7 after the start of the experiment and the average value for the change in reticulocyte levels during day 1 and day 5 was 170.9%. With the highest dose, 2300 IU/kg, higher circulating reticulocytes levels started to increase at the 4th day after the start of the experiment and maintained from day 5 to day 10. The average of the changes in reticulocyte from day 5 to day 10 was 251%. Dose-dependent circulating reticulocytes increase was observed at the higher dose range, 1000 and 2300 IU/kg. To study the linearity on the serum EPO level vs. time curves, pharmacokinetic experiment was performed with rats. After the administration of EPO SDMPs to rats, 200, 500, 1000 and 2300 IU/kg, serum EPO levels gradually increased and reached to the maximum level, Cmax, at 18 h after administration. The Cmaxs were 100.4 ± 11.7 mIU/ml (200 IU/kg), 346.6 ± 11.8 mIU/ml (500 IU/kg), 391.6 ± 17.6 mIU/ml (1000 IU/kg), and 1094.9 ± 114.8 mIU/ml (2300 IU/kg), respectively. AUCs were 1407 ± 231, 3843 ± 402, 5363 ± 482 and 15,566 ± 1894 mIU h/ml. Linear relation was obtained between serum EPO level and EPO dose administered as SDMP. With histological study, any adverse effect was not found out on the skin where SDMPs were administered for consecutive 4 days. These results suggest the usefulness of SDMP as a new percutaneous delivery system of EPO.

Pharmacokinetic and pharmacodynamic studies following percutaneous absorption of erythropoietin micropiles to rats

To ascertain the pharmacological activity of erythropoietin (EPO) administered by self-dissolving micropiles (SDMP), four kinds of EPO SDMPs were prepared and were administered to rats in 4 consecutive days at 200, 500, 1000 and 2300 IU/kg. After the start of the experiment, blood samples were obtained once a day for 10 days and percent circulating reticulocytes were counted using Miller technique. At the lower doses, 200 and 500 IU/kg, pharmacological activity of EPO was not obtained. By increasing EPO dose to 1000 IU/kg, circulating reticulocytes significantly increased at days 4, 5, 6 and 7 after the start of the experiment and the average value for the change in reticulocyte levels during day 1 and day 5 was 170.9%. With the highest dose, 2300 IU/kg, higher circulating reticulocytes levels started to increase at the 4th day after the start of the experiment and maintained from day 5 to day 10. The average of the changes in reticulocyte from day 5 to day 10 was 251%. Dose-dependent circulating reticulocytes increase was observed at the higher dose range, 1000 and 2300 IU/kg. To study the linearity on the serum EPO level vs. time curves, pharmacokinetic experiment was performed with rats. After the administration of EPO SDMPs to rats, 200, 500, 1000 and 2300 IU/kg, serum EPO levels gradually increased and reached to the maximum level, C max, at 18 h after administration. The C maxs were 100.4 ± 11.7 mIU/ml (200 IU/kg), 346.6 ± 11.8 mIU/ml (500 IU/kg), 391.6 ± 17.6 mIU/ml (1000 IU/kg), and 1094.9 ± 114.8 mIU/ml (2300 IU/kg), respectively. AUCs were 1407 ± 231, 3843 ± 402, 5363 ± 482 and 15,566 ± 1894 mIU h/ml. Linear relation was obtained between serum EPO level and EPO dose administered as SDMP. With histological study, any adverse effect was not found out on the skin where SDMPs were administered for consecutive 4 days. These results suggest the usefulness of SDMP as a new percutaneous delivery system of EPO.

A Comparison of Three Bioassay Techniques to Determine Amitraz Susceptibility in &lt;I&gt;Boophilus microplus&lt;/I&gt; (Acari: Ixodidae)

The ability of the Miller, Soberanes, and White bioassay techniques to describe amitraz susceptibility in three different strains of Boophilus microplus (Canestrini) (Acari: Ixodidae) was compared. For a susceptible strain, all techniques adequately described amitraz susceptibility by producing a full range of mortality that corresponded with increasing concentration of amitraz. However, when resistant strains were evaluated, only the Miller and the Soberanes techniques adequately estimated the dose-response relationship. Lethal concentrations were not precisely estimated when all the data were included in the analyses for every strain and technique tested. Better estimates were obtained when subsets of data around the range of interest were subjected to probit analysis. For the Soberanes technique, the slope of the probit regression was steeper for the Brazilian resistant and Texan susceptible strains compared with the heterozygous Mexican strain. The pattern was different when the same strains were tested with the Miller technique. The slopes of the regressions for the Mexican and the Texan strains did not differ significantly, but the Brazilian strain had a steeper slope than the other strains. Resistance ratios were much greater when the Soberanes technique was used than when the Miller technique was used on the same strains. However, neither technique produced enough separation between susceptible and resistant strains to develop a traditional discriminating dose (DD) test that required a concentration of 2x LC99.9 estimate. A DD test at the LC99 would be possible for both techniques. We discuss the strengths and weaknesses of the three techniques, including potential improvements to the White technique. The White technique has the greatest potential to determine the mechanisms of amitraz resistance in detailed synergist studies. Currently, only the Miller method can fulfill this task. The Miller and Soberanes techniques are well suited for the study of the epidemiology of resistance worldwide, because they use commercially available, formulated amitraz that is easy and inexpensive to obtain.

Pharmacokinetic and pharmacodynamic studies following oral administration of erythropoietin mucoadhesive tablets to beagle dogs

Oral administration of mucoadhesive tablets containing erythropoietin (EPO) and an absorption enhancer Labrasol was studied in rats and dogs. Mucoadhesive tablets were prepared using Sylysia 550 holding the absorption enhancer and Carbopol 974P as a mucoadhesive agent. Mucoadhesive tablets were covered with a water-insoluble backing layer made of cellulose acetate and a pH-sensitive covering layer made of Eudragit L/Eudragit S. Tablet was administered into the rat jejunum at EPO dose of 100 IU/kg and serum samples were collected for 6 h. Serum EPO level was analysed with a standard ELISA procedure. After administration, rats showed a maximum serum EPO level of C max 70.6 ± 8.9 mIU/ml. Oral administration of a single tablet containing 100 IU/kg EPO to beagle dogs showed a C max of 24.6 ± 4.1. When EPO dose was increased to 500 IU/kg and the number of tablets was also increased to 5, the C max was 54.8 ± 9.0 mIU/ml. However, when EPO, 100 IU/kg dose was divided into five tablets, the C max was 15.5 ± 1.8 mIU/ml. In the absence of absorption enhancer, the C max was 35.8 ± 3.8 with 500 IU/kg dose distributed among five tablets. Pharmacodynamic studies were carried out following oral administration of mucoadhesive tablets for 6 consecutive days at an EPO dose of 500 IU/kg. Whole blood samples were collected and percent circulating reticulocytes were counted using Miller technique. The increase in percent circulating reticulocytes was found to be 1.7% on day 8 following oral administration. As a control study, EPO was administered by i.v. route at a dose of 300 IU/kg for 3 consecutive days and the percent circulating reticulocytes were counted. Mucoadhesive tablets showed promising results as an oral drug delivery system for protein therapeutics.

High-frequency harmonic distortion in feedback amplifiers: analysis and applications

An approach for the evaluation of high-frequency harmonic-distortion factors in feedback systems is proposed and the results obtained are applied to feedback amplifiers. Under the assumption that transistors are not driven out of their linear operating regions, small-signal analysis and conventional algebra are exploited to derive understandable and compact expressions highly improving the comprehension of harmonic-distortion generation. The impact of the frequency compensation utilized (namely, dominant-pole or Miller technique) on linearity performance is evaluated and the high-frequency distortion properties of closed-loop single-stage and two-stage amplifiers are analyzed and compared. The accuracy of the analysis, also in view of the given applications, is confirmed through extensive simulations with Spectre on idealized models as well as on CMOS transistor-level circuits. Despite the approximated nature of the analytical models, predicted data are found in very close agreement with simulations in nearly all the frequency range of interest.