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Biomedical subjects

A Wu

Publications and source records attributed to A Wu.

At least 109 records · Page 6Linked to original sources
PubMed1995

Reliability of post-mortem chart diagnoses of schizophrenia and dementia.

The reliability of psychiatric diagnosis has a direct effect on the validity of post-mortem analyses of neuropathological data, yet little is known about the reliability of retrospective diagnostic procedures which rely on review of medical records. In this paper, we report on the reliability of DSM-III-R psychiatric diagnoses assigned by a pool of 8 raters to a set of 106 state hospital charts of elderly, chronic patients who had died while institutionalized and were autopsied. Diagnoses were grouped by general diagnostic class, and Kappa coefficients computed for agreement among raters, as well as for agreement between ultimate consensus diagnoses and those made while subjects were living. Interrater agreement for those diagnoses that occurred most frequently in this sample (e.g. Schizophrenia and Dementia) was excellent, and comparable to the the agreement observed for ratings of live patients. Interrater agreement for less frequently occurring diagnoses (e.g. Mental Retardation, Mood Disorders, other non-Schizophrenic Psychoses) ranged from excellent to poor. We found high agreement between our rates diagnoses and those assigned by state hospital personnel while patients were living, although post-mortem review produced lower rates of diagnosis of both schizophrenia and Alzheimer-type dementias. Overall, results suggest that the reliability of chart review diagnosis is comparable to that obtained from interviews of live patients when experienced raters are used and diagnostic base rates are high enough to produce stable estimates of reliability.

Aged↗
PubMed1995

A simple technique for fabrication of transmission block for concomitant treatment of bilateral anterior inguinal lymphatics and pelvic/perineal structures.

The efficacy of transmission block technique with contiguous photon irradiation of inguinal as well as pelvic and perineal structures has been reported in literature. In this paper, a simple and accurate method for the proper fabrication of transmission block has been described and also demonstrated to be effective and useful. The procedures for a precise geometrical alignment and dose verification are also detailed.

Anus Neoplasms↗
PubMed1995

[Magnetic resonance imaging in the diagnosis and staging of endometrial carcinoma].

The value of magnetic resonance imaging (MRI) in the diagnosis and staging of endometrial carcinoma was studied in 43 cases of clinically suspected endometrial carcinoma and 7 normal women. All of the 43 cases showed abnormal endometria measured by MRI, among which were pathologically proven 40 cases of endometrial carcinoma, 2 cases of endometrial polyps and 1 case of adenomyosis. This suggested that MRI showed a high susceptibility in the diagnosis of endometrial carcinoma, and a lack of specificity. MRI could predict myometrial invasion, its accuracy being verified by surgico-pathological findings in 11 of 13 cases. MRI staging was correct in 10 of the 13 primarily operated cases, and only half of the clinical staging was in conformity with surgical staging. The results suggest that MRI is useful in the staging of endometrial carcinoma and therefore is of value in the choice of treatment planning, although it is not yet an ideal diagnostic aid to detect small metastatic pelvic lesions.

Adult↗
PubMed1995

[Serum hepatitis B antigen-antibody system in patients with hepatocellular carcinoma].

Serum hepatitis B antigen-antibody system was detected by ELISA method in 150 patients suffering from hepatocellular carcinoma (HCC) with positive AFP. The overall infection rate of hepatitis B virus (HBV) was 86.0% (129/150). According to the antigens and antibodies to HBV, two major types of seven models could be demonstrated. In type I (including models 1 to 4) HBV infection was present in 81.9%, 74.6% among whom were considered to be of weak infectivity and 7.3% of strong one. In type II (including models 5 to 7) 18.0% (27/150) had no antigen and antibody to HBV was detected, indicating the absence of HBV infection. This study suggests that chronic infection with HBV is the major etiologic agent for human HCC and the patients with HCC often accompanied by active HBV replication.

Adult↗
PubMed1995

[Effect of ovarian cancer produced-transforming growth factor-beta on phytohemagglutinin and interleukin-2-inducing proliferation of peripheral blood mononuclear cells].

OBJECTIVES: Our previous observation has demonstrated that human ovarian cell lines COC1 and COC2 are able to secrete transforming growth factor-beta (TGF-beta) in serum-free culture. The effect of ovarian cancer produced-TGF-beta was observed on phytohemagglutinin and interleukin-2-inducing proliferation of peripheral blood mononuclear cells. METHODS: The effects of COC1 and COC2 from patients' ascitic fluid (AS1, AS2), the serum-free conditioned medium (SFCM1, SFCM2), and COC1- and COC2- bearing nude mice sera (NS1, NS2) on phytohemagglutinin (PHA) and interleukin-2 (IL-2)-inducing peripheral blood mononuclear cell (PBMC) proliferation and their correlation with TGF-beta were observed and compared. RESULTS: It was shown that AS, SFCM and NS possessed inhibitory effects on PBMC proliferation. But in very low concentrations, PHA-induced by SFCM2 and IL-2-induced by SFCM1 as well as by NS1 and NS2 exerted promotive effects on PBMC proliferation. The above-mentioned SFCM effects similar to that of TGF-beta, might be partially blocked by anti-TGF-beta antibody. CONCLUSIONS: The present results suggest that ovarian cancer cells may inhibit the host anti-tumor immunity through secreting TGF-beta, which may be associated with the highly malignant biological behavior of ovarian cancer and the threatening progressiveness of its clinical course.

Animals↗
PubMed1994

Studies of the mechanism underlying increased Na+/Ca2+ exchange activity in Alzheimer's disease brain.

The Na+/Ca2+ exchanger was characterized in plasma membrane vesicles derived from frozen human postmortem tissues. The frontal cortex, temporal cortex and cerebellum of control and Alzheimer's disease (AD) tissues were compared. Na+/Ca2+ exchange activity was defined as the change in vesicular Ca2+ content seen after Na+ loaded vesicles were diluted into choline buffer. The time course of changes in Ca2+ content after dilution was similar in all three regions of control brain. In AD brain, both frontal and temporal cortex vesicles showed elevated Ca2+ content, most evident as an increased peak Ca2+ content at 2 min. The AD cerebellar cortex time course was similar to control and did not show an elevated peak at 2 min. No differences were seen in the passive permeability to Ca2+ when comparing plasma membrane vesicles prepared from control and AD brain. Vesicles from the frontal and temporal cortex of AD brain showed increases in the Vmax of the initial velocity of Ca2+ uptake when compared to control brain, whereas, the cerebellum did not. There were no significant effects of AD on the Km for Ca2+ activation of the initial velocity. Ca2+ influx measured during the rise in vesicular Ca2+ content was elevated in vesicles from AD temporal cortex when compared to control. Two known inhibitors (exchange inhibitory peptide and dichlorobenzamil) of the cardiac Na+/Ca2+ exchanger inhibited the human brain exchanger equally well in control and AD vesicles. Increased Na+/Ca2+ exchange activity was not due to astrocytic gliosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Alzheimer Disease↗
PubMed1994

Validity of universal wedge equation over the range of 60Cobalt to 25 MV photon beam energies.

PURPOSE: Evaluating the validity of the universal wedge equation over the range of 60Cobalt (60CO) to 25 MV photon beam energies. METHODS AND MATERIALS: The universal wedge equation relates the beam weight of the wedged field to the effective wedge angle produced by combining the wedged field to the nonwedged field and is expressed as tan (theta) = B tan (theta w), where B is the normalized weight imposed on the wedged field, theta w is the maximum wedge angle of the wedge filter, and theta is the effective wedge angle. The isodose distributions from 60Co to 25 MV photon beam energies were used. For each photon energy, the isodose distributions of wedged and nonwedged fields were combined in different proportions. The effective wedge angle was determined from each resultant isodose distribution. RESULTS: The relationship between the weight of wedged field and the effective wedge angle was found to be nonlinear for wedge filters with maximum wedge angle greater than 30 degrees. The universal wedge equation predicts the effective wedge angle to within 2 degrees compared to the measured value.

Cobalt Radioisotopes↗
PubMed1994

Dosimetric considerations of commercially fabricated esophageal applicators.

Two commercially fabricated esophageal applicators for low dose rate intraluminal brachytherapy were compared using the dose non-uniformity ratio (DNR). One of the applicators has a single afterloading catheter while the other applicator has six afterloading catheters to accommodate low dose rate 192Ir ribbon or wire sources. Five sets of source configurations, each with a different ribbon length in the range of 5-17 cm were analysed using the DNR. The DNR shows the delivery of relatively higher total doses at higher dose rates to tissues closer to the applicators. The difference in the inhomogeneity of dose rates and the treatment volume exposed to higher dose rates than the prescribed dose rate between the two applicators are minimal. The dose homogeneity is better for the single-source applicator while the worst dose homogeneity for the six-source applicator is caused by the placement of each source closer to the surface of the applicator. The implications of higher dose rates were discussed using the alpha/beta model.

Brachytherapy↗
PubMed1994

Effects of extended SSD on electron-beam depth-dose curves.

The effects of extended source-to-surface distance (SSD) on the electron-beam depth dose curves were examined for five electron beam energies ranging from 6 MeV to 20 MeV. The depth dose curves were measured with the water phantom surface set at 100 cm, 110 cm, and 120 cm from the source. Except for the dose in the build-up region, negligible depth dose curve changes due to extended SSD were observed for electron energies less than or equal to 12 MeV. For electron beams greater than 12 MeV, the percent surface dose decreases and, additionally, the depth of maximum dose shifts deeper into the phantom as the SSD increases. Changes in the rapid falloff region of the depth dose curves were apparent only for the higher energy electron beams, in particular 20 MeV. Extended SSD has no observable effect on the tail portion of the depth dose curves. As such, the energies of the electron beams are not changed significantly by increasing the SSD.

Electrons↗
PubMed1994

Characterization of exchange inhibitory peptide effects on Na+/Ca2+ exchange in rat and human brain plasma membrane vesicles.

The inhibitory effects of Na+/Ca2+ exchange inhibitory peptide (XIP), which corresponds to residues 219-238 of the Na+/Ca2+ exchange protein from canine heart, were studied in both rat and human brain plasma membrane vesicles. XIP had very high potency with respect to the inhibition of the initial velocity of intravesicular Na(+)-dependent Ca2+ uptake in both rat brain [IC50 = 3.05 +/- 0.69 microM (mean +/- SE)] and human brain (IC50 = 3.58 +/- 0.58 microM). The maximal inhibition seen in rat brain vesicles was approximately 80%, whereas human brain vesicles were inhibited 100%. XIP also inhibited extravesicular Na(+)-dependent Ca2+ release, and the inhibitory effect was enhanced by increasing the extravesicular Na+ concentration. In contrast, the inhibitory effect of bepridil was competitive with respect to extravesicular Na+. When XIP was added at steady state (5 min after the initiation of intravesicular Na(+)-dependent Ca2+ uptake), it was found that the intravesicular Ca2+ content declined with time. Analysis of unidirectional fluxes for Ca2+ at steady state showed that 50 microM XIP inhibited Ca2+ influx and efflux approximately 85 and 70%, respectively. This result suggested that XIP inhibited both Na+/Ca2+ exchange and Ca2+/Ca2+ exchange but had no effect on the passive release pathway for Ca2+. The results suggest structural homology among cardiac, rat, and human brain exchangers in the XIP binding domain and that the binding of Na+ or other monovalent cations, e.g., K+, is required for XIP to have its inhibitory effect on Ca2+ transport.

Amino Acid Sequence↗
PubMed1994

Nonvalvular atrial fibrillation and primary stroke prevention from a geriatric point of view.

Cerebrovascular disease constitutes one of the major causes of death. Patients with atrial fibrillation are known to be at high risk for stroke. The efficacy of oral anticoagulant therapy in the primary prevention of stroke in individuals with nonvalvular atrial fibrillation has been demonstrated in several large randomized trials. However, many geriatricians remain reluctant to prescribe anticoagulants. This article focuses on the risks and benefits of stroke prophylaxis with anticoagulant therapy in elderly patients with nonvalvular atrial fibrillation.

Aged↗
PubMed1994

Prognosis-based futility guidelines: does anyone win? SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.

OBJECTIVE: Advocates for health care reform and others claim that significant savings could be achieved if "futile" care were eliminated. Our objective was to provide an initial estimate of the effects of a public policy that would preclude futile life-sustaining treatments, defined as those employed despite < or = 1% chance of surviving for 2 months. DESIGN: Simulation using data from an observational cohort study. SETTING: Five academic medical centers. PATIENTS: Seriously ill hospitalized adults enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT). METHODS: We examined the impact of prognosis-based futility guidelines on survival and hospital length of stay on a cohort of seriously ill adults. We calculated the number of days of hospitalization that would not be used if, on the third study day, life-sustaining treatment had been stopped or not initiated for subjects with estimated 2-month survival probability of < or = 1%. RESULTS: Of the 4301 patients, 115 (2.7%) had an estimated chance of 2-month survival of < or = 1%. All but one of these 115 subjects died within 6 months. Almost 86% died within 5 days of prognosis. At the time of death, 92 subjects (80.0%) had had no attempt at resuscitation; 35 (30.4%) had had a life-sustaining mechanical ventilator withdrawn. A Do-Not-Resuscitate order was written either before (n = 61) or within 5 days (n = 18) of reaching this prognosis for 68.6% of the patients. These 115 subjects had total hospital charges of $8.8 million. By forgoing or withdrawing life-sustaining treatment in accord with a strict 1% futility guideline, 199 of 1,688 hospital days (10.8%) would be forgone, with estimated savings of $1.2 million in hospital charges. Nearly 75% of the savings in hospital days would have resulted from stopping treatment for 12 patients, six of whom were under 51 years old, and one of whom lived 10 months. CONCLUSIONS: Patients at a high risk of dying can be identified prospectively. Implementation of a strict, prognosis-based futility guideline on the third day of a serious illness would result in modest savings.

Adolescent↗
PubMed1994

The use of a radiochromic detector for the determination of stereotactic radiosurgery dose characteristics.

The measurement of absorbed dose as well as dose distributions (profiles and isodose curves) for small radiation fields (as encountered in stereotactic surgery) has been difficult due to the usual large detector size or densitometer aperture (> 1 mm) relative to the radiation field (as small as 4 mm). The radiochromic direct-imaging film, when read with a scanning laser microdensitometer (laser beam diameter 0.1 mm), overcomes this difficulty and has advantages over conventional film in providing improved precision, better tissue equivalence, greater dynamic range, higher spatial resolution, and room light handling. As a demonstration of suitability, the calibrated radiochromic film has been used to measure the dose characteristics for the 18-, 14-, 8-, and 4-mm fields from the gamma-ray stereotactic surgery units at Mayo Clinic and the University of Pittsburgh. Intercomparisons of radiochromic film with conventional methods of dosimetry and vendor-supplied computational dose planning system values indicate agreement to within +/- 2%. The dose, dose profiles, and isodose curves obtained with radiochromic film can provide high-spatial-resolution information of value for acceptance testing and quality control of dose measurement and/or calculation.

Film Dosimetry↗
PubMed1993

Yeast bZip proteins mediate pleiotropic drug and metal resistance.

Saccharomyces cerevisiae contains a group of transcription factors related to mammalian c-Jun. This yeast Jun-family of proteins consists of GCN4, a regulator of genes involved in amino acid biosynthesis, and yAP-1, a factor conferring pleiotropic drug resistance when overexpressed. In the work described here, we show that a third member of the yeast Jun-family exists. This protein has been designated CAD1 and provides resistance to cadmium when present on a high-copy plasmid. CAD1 and yAP-1 are related in their amino-terminal DNA binding domains and can recognize the same DNA target site in vitro. Overproduction of CAD1 leads to transcriptional activation of an artificial reporter gene in delta yap1 cells. High level production of either CAD1 or yAP-1 causes cells to acquire a pleiotropic drug-resistant phenotype and to be able to tolerate normally toxic levels of iron chelators and zinc. Surprisingly, disruption of the CAD1 gene has no effect on the normal cellular resistance to cadmium but delta yap1 mutants are hypersensitive to this cytotoxic metal. The cadmium hypersensitivity of the delta yap1 mutant described here indicates that one major role of YAP1 in the yeast cell is to mediate resistance to this metal.

Amino Acid Sequence↗
PubMed1993

Concept of dose nonuniformity in interstitial brachytherapy.

PURPOSE: Evaluation of the 3-dimensional dose distributions of interstitial implants using the dose uniformity ratio. METHODS AND MATERIALS: Single source, two sources, three and four sources arranged both linearly and in the form of a triangle or a square, ribbons with different seed spacings, a single-plane and double-plane implants were evaluated. The evaluations involved the use of differential dose volume histograms and the dose nonuniformity ratio defined as the ratio of the high dose volume to the reference volume. RESULTS: For a single source, the dose nonuniformity is the same regardless which dose rate is selected as the treatment dose rate. For any multi-source implant, the dose nonuniformity is altered depending on the selection of the reference dose rate. In addition, the dose nonuniformity curve exhibited three characteristics zones. CONCLUSION: The dose nonuniformity ratio can be a useful tool in assessing and optimizing interstitial implants.

Brachytherapy↗
PubMed1993

Evaluation of the substitution of Ir-192 seed ribbons for wires in Paris system using dose nonuniformity ratio.

The substitution of Ir-192 seed ribbons for wires in the Paris system of interstitial implants was re-evaluated using the dose nonuniformity ratio. The dose nonuniformity ratio, which is based on volumetric data, measures the dose nonuniformity of the implant quantitatively. The lower the dose nonuniformity ratio value, the smaller the dose nonuniformity, and the better is the dose homogeneity for the implant. Implants configured in a single-plane and double-planes in the form of squares or triangles using Ir-192 wires or seed ribbons were considered. The difference between the particular reference dose rate that yielded a minimum in the dose nonuniformity ratio curve for wire implants and seed implants is about 4 cGy/hr. The difference between the minimum dose nonuniformity ratio value representing the optimal dose homogeneity of the implants is about 5%. The dose homogeneity may be considered better for implants configured using seed ribbons.

Brachytherapy↗
PubMed1993

Transmission block technique for the treatment of the pelvis and perineum including the inguinal lymph nodes: dosimetric considerations.

Radical radiotherapy of pelvic malignancies (e.g., vulva, anus) includes therapeutic dosage to the inguinal nodes. To minimize the dosage to the femoral head, the transmission block technique has been developed to fully irradiate the central pelvis midplane and inguinal nodes. Originally, this technique compensated for dose inhomogeneity in the transverse plane only. In some patients, however, we have observed a significant dose variation along the sagittal plane. The authors have developed a lead compensation technique to homogenize the sagittal dose variations due to the longitudinal sloping in the patient, along with further refinements in this technique. Dosimetric and technical details are also discussed.

Anus Neoplasms↗