Biomedical subjects

B C Lee

Publications and source records attributed to B C Lee.

At least 127 records · Page 7Linked to original sources

PubMed1995

Preliminary study of magnetic resonance imaging characteristics in 8- to 16-year-olds with mania.

OBJECTIVE: To examine magnetic resonance imaging (MRI) characteristics in children and adolescents with mania according to DSM-III-R criteria. METHOD: A convenience sample of consecutively referred 8- to 16-year-old manic (n = 10) and normal (n = 5) subjects were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode Version, the Children's Global Assessment Scale, and the Family History-Research Diagnostic Criteria. MRI scans were obtained from unsedated subjects using a 1.5 T MR scanner to acquire T1-weighted coronal and sagittal images and T2-weighted axial images. Images were assessed by blind clinical interpretation, ratings of T2-weighted deep white matter hyperintensities and petalia, and computer-assisted volumetric analysis of ventricular and cerebral volumes. RESULTS: Eight of 10 manic subjects and all 5 controls completed the scans. Scans of 4 manic subjects and 1 control subject showed ventricular or white matter abnormalities by clinical interpretation. Significant findings were positive correlations between increasing age and both right and left ventricular volumes. Two of the 8 manic subjects and no controls had confluent subcortical hyperintensities. CONCLUSIONS: MRI brain scanning was feasible in 8- to 16-year-olds. Preliminary findings from clinical interpretations and structured ratings suggest structural differences between young manic and normal subjects. Investigations of larger samples are needed to better characterize the differences.

Adolescent↗

PubMed1995

Quelling the red menace: haem capture by bacteria.

Haem is an important bacterial nutrient. As a prosthetic group of several proteins, haem functions as a cofactor mediating oxygen transport, energy generation, and mixed-function oxidation. In addition, the iron chelated in the porphyrin ring may serve as an iron substrate for growth. However, because of its propensity for oxidizing cellular constituents, haem is always associated with proteins. Therefore, the uptake and transit of haem across bacterial membranes requires the participation of protein escorts. Bacteria have evolved a diverse array of surface-exposed receptors dedicated to binding haem and haem-proteins. Following this selective recognition at the bacterial cell surface, haem is transported across the outer membrane via a TonB-dependent process. The control of receptor expression appears to be multifactorial, probably involving a number of global regulators. A model integrating this information is presented.

Bacterial Proteins↗

PubMed1995

Accuracy of neurologic examination and history in detecting evidence of MRI-diagnosed cerebral infarctions in children with sickle cell hemoglobinopathy.

We determined the accuracy of neurologic examination and the history of a previous neurologic event in detecting clinical evidence of a magnetic resonance imaging (MRI)-diagnosed cerebral infarction in 30 children with sickle cell hemoglobinopathy. Each patient had an MRI of the brain, neurologic examination, chart review, and psychometric evaluation. Seventeen children (57%) had MRI evidence of cerebral infarction based on demonstration of parenchymal abnormalities in a vascular distribution. Among the 17 children with MRI evidence of cerebral infarction, only 12 (71%) had an abnormal neurologic examination, and 11 (65%) had a history of a prior neurologic event. In contrast, among the 13 children with normal MRIs, 12 (92%) had normal neurologic examinations, and no child had a previous history of a neurologic event. Multiple, bilateral, heterogeneous cerebral infarctions frequently occur without overt neurologic signs or symptoms in children with sickle cell hemoglobinopathy. Previous studies that relied on a focal neurologic examination or a history of a neurologic event to identify cerebral infarctions in patients with sickle cell hemoglobinopathy most likely underrepresented the true frequency of cerebral infarctions in this population. Future prospective studies of cerebral infarctions in children with sickle cell hemoglobinopathy should include MRIs for identification and classification, rather than neurologic examination or clinical history alone.

Adolescent↗

PubMed1995

Palliative treatment for tetralogy of Fallot with percutaneous balloon dilatation of right ventricular outflow tract.

Percutaneous balloon pulmonary dilatation of the right ventricular tract was performed on 16 children with tetralogy of Fallot for palliative purposes after routine cardiac catheterization. Immediate improvement in aortic saturation from 73.4 +/- 6.8 to 84.0 +/- 4.8% (mean +/- SD = 10.6 +/- 2.7%, p < 0.001) and clinical symptoms were achieved in all 16 cases. The pressures in the right ventricle, pulmonary artery, left ventricle and aorta showed no remarkable changes after percutaneous balloon dilatation. The diameters of the proximal end and at the first branching of the right and left pulmonary arteries, pulmonary arterial index and the diameter of the descending aorta at the diaphragm increased significantly after balloon dilatation (p value 0.0004-0.006). One child suffered from repeated cyanotic spells in spite of the immediate improvement of aortic saturation. She received a left side Blalock-Taussig shunt 2 months after the balloon dilatation. None of the children had a significant complication. Eight had follow-up cardiac catheterization one year later and demonstrated much improvement in the diameters of the proximal end and at the first branching of the right and left pulmonary arteries, pulmonary arterial index and the diameter of the descending aorta at the diaphragm (p value 0.005-0.04). All 8 patients had their cardiac lesions successfully corrected. Percutaneous balloon dilatation is an alternative palliative therapy for children with tetralogy of Fallot.

Cardiac Catheterization↗

PubMed1995

Triopia: craniofacial malformation with prosencephalic duplication.

A case of ocular duplication with complex craniofacial and central nervous system anomalies is described. The anomaly is termed triopia because the child's most overt and distinguishing feature was three eyes: the left orbit contained two globes with independent ocular adnexa; the right orbit contained one normal appearing and functioning globe. Computer assisted medical imaging was used to define, in vivo, the intra- and extracranial soft and hard tissue anomalies: the cerebral hemisphere ipsilateral to the ocular duplication was also duplicated. Possible bases for this anomaly include duplication of primordia for the eye and secondary prosencephalon.

Abnormalities, Multiple↗

PubMed1995

Fast spin-echo magnetic resonance imaging for radiological assessment of neonatal brachial plexus injury.

Neurosurgical management of birth-related brachial plexus palsy involves observing the patient for a period of several months. Operative intervention is usually undertaken at 3 to 6 months of age or more in infants who have shown little or no improvement in affected muscle groups. Ancillary tests such as electromyography and nerve conduction studies are occasionally useful. No radiological study has been consistently helpful in operative planning, except for contrast computerized tomography (CT) myelography, which requires general anesthesia in infants. This is because the infant's small size exceeds the functional resolution of the imaging modalities. This report describes the use of a special sequence of magnetic resonance (MR) imaging entitled "fast spin echo" (FSE-MR). Unlike CT myelography, this technique provides high-speed noninvasive imaging that allows clinicians to evaluate preganglionic nerve root injuries without the use of general anesthesia and lumbar puncture. The utility of this technique is illustrated in three cases, two involving either infraclavicular exploration or a combination of infraclavicular and supraclavicular exposure based on FSE-MR findings. The FSE-MR imaging offers an excellent alternative to contrast CT myelography in evaluation of infants with birth-related brachial plexus injuries.

Birth Injuries↗

PubMed1994

Glycolipid composition of human cataractous lenses. Characterization of Lewisx glycolipids.

We have studied the glycolipid composition of human cataractous lenses. Neutral and acidic lipid fractions were isolated by column chromatographies on DEAE-Sephadex and Iatrobeads. The neutral glycolipid fraction and acidic glycolipid fraction contained 0.6-0.9 micrograms of lipid-bound glucose (Glc) per mg of protein and 0.8-1.3 micrograms of lipid-bound sialic acid (NeuAc) per mg of protein, respectively. The neutral glycolipid fraction was found to contain LacCer (39.0% of total neutral glycolipids), Gb3 (16.2%), Gb4 (1.1%), nLc4 (5.0%), X (29.0%), and Y (9.2%). The acidic lipid fraction was found to contain mainly GM3 (33.1% of the total ganglioside fraction), GM1 (8.3%), LM1 (7.3%), GD1a (16.0%), and G (30.1%). The structures of neutral glycolipids X and Y and ganglioside G were elucidated by high performance thin-layer chromatography overlay method of glycolipids, gas-liquid chromatography, proton NMR spectrometry, and liquid secondary ion mass spectrometry as follows: 1) X, Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1'Cer, III3FucnLc4 (Lex); 2) Y, Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-3Gal beta 1-4(Fuc alpha 1- 3)GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1'Cer, V3FucIII3FucnLc6; and 3) G, NeuAc alpha 2-3Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-3 Gal-beta 1-4Glc beta 1-1'Cer, IV3NeuAcIII3FucnLc4 (sialosyl-Le(x)). A minor neutral glycolipid Z was isolated and tentatively characterized as GlcNAc beta 1-3?Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1'Cer (GlcNAc-Le(x)), suggesting that it may be the precursor of glycolipid Y. The major long-chain base of these human cataract glycolipids was C18:0 sphingosine (sphinganine). The major fatty acids were C16:0, C24:1 and C24:0, and monounsaturated fatty acids accounted for 40-55% of the total fatty acids.

Aged↗

PubMed1994

Low ignition propensity cigarettes: smoke analysis for carcinogens and testing for mutagenic activity of the smoke particulate matter.

In 1990, more than 20% of the almost 5200 deaths from fires in the United States occurred in fires from cigarettes. This fact led to the investigation of cigarettes with low ignition propensity. 32 experimental cigarettes differing in tobacco, cigarette circumference and in cigarette paper were tested for ignition propensity. This communication reports the results of comparative analyses of smoke from two low-propensity experimental cigarettes, A and B, which differed only in the porosity and treatment of the paper, and of the smoke from a reference cigarette C and from two leading US commercial cigarettes D and E. Model cigarette A delivered higher smoke yields of total particulate matter (TPM), nicotine, CO and benzo[a]pyrene than the other four cigarettes, but had lower smoke yields of the carcinogenic, volatile, and tobacco-specific N-nitrosamines than cigarettes C, D and E. The TPM of cigarette A was less active as a frameshift mutagen in tests with Salmonella strain TA98 than was the TPM of cigarettes C, D and E. TPM of cigarette A was also less active as a frameshift mutagen in tester strain TA1538 than was the TPM of reference cigarette C. However, when the mutagenic potencies of the particulate matters were compared on a cigarette-to-cigarette basis, there were no significant differences between the TPM of the individual cigarettes. Replacing the conventional cigarette filter with a perforated filter may significantly reduce the smoke yield of cigarette A. If this can be achieved without changing the ignition propensity, detailed chemical-analytical analyses and in vitro and in vivo assays for toxicity, ciliatoxicity, mutagenic activity and carcinogenicity need to be obtained for the smoke of such a prototype cigarette.

Carcinogens↗

PubMed1994

The significance of calf muscle pump function in venous ulceration.

PURPOSE: Patients with clinically evident chronic venous insufficiency were evaluated to relate the degree of insufficiency and calf muscle pump dysfunction to venous ulceration. METHODS: Sixty-nine limbs in 55 patients with chronic venous insufficiency by Society for Vascular Surgery/International Society for Cardiovascular Surgery Classification were compared in three groups: classes 1 and 2 with no history of ulceration (19 limbs); class 3 with healed ulceration (20 limbs); and class 3 with active ulcers (30 limbs). Air plethysmography measurements of outflow fraction, venous volume, venous filling time, venous filling index, ejection fraction, ejection volume, residual volume fraction, and residual volume were made. In 62 of the 69 limbs, color-flow duplex ultrasonography was used to determine the pattern of reflux. RESULTS: The outflow fraction was normal in 84%, 75%, and 77% of nonulcerated, healed, and ulcerated limbs. The venous filling index was abnormal in most limbs (nonulcerated 95%, healed 90%, ulcerated 98%) but not significantly different among groups. Differences in calf muscle pump function were significant. Ulcerated limbs had significantly poorer ejection fractions (p = 0.0002) and greater residual volume fractions (p = 0.0006) than nonulcerated or healed limbs. By ultrasonography, deep and superficial vein incompetence was present in most limbs and was not statistically different among groups. Although venous insufficiency was not measurably different among groups, limbs with active venous ulcers had significantly poorer calf muscle pump function than those with healed ulcers or with no history of ulceration. CONCLUSION: Venous insufficiency is necessary but not sufficient to cause ulceration, and a deficiency of the calf muscle pump is significant to the severity of venous ulceration.

Adult↗

PubMed1994

Isolation and characterization of the haemin-binding proteins from Neisseria meningitidis.

The mechanism of haem-iron acquisition in Neisseria meningitidis is poorly understood. Using haemin-agarose in a batch affinity chromatography method, two haemin-binding proteins of 97 and 50 kDa were isolated from total membranes derived from Neisseria meningitidis B16B6 grown under iron-deficient but not under iron-replete conditions. No binding proteins were affinity-purified when total membranes underwent limited proteolysis with trypsin, suggesting a haem-protein interaction. When biotinylated human haemoglobin was used as the affinity ligand, proteins of identical molecular mass were isolated. Detection of haemin-binding proteins in a whole cell binding assay demonstrated a surface-exposed location. Competitive binding studies indicated that this haem-protein interaction was specific, because only haemin or human haemoglobin, but not cytochrome c111, protoporphyrin IX, iron-loaded human lactoferrin, iron-loaded human transferrin or Fe(NO3)3, could abrogate binding. The presence of similar haemin-binding proteins in a limited survey of clinical meningococcal strains indicated that the expression of the haemin-binding proteins is not serogroup-specific.

Bacterial Outer Membrane Proteins↗

PubMed1994

Acquisition of heme iron by Neisseria meningitidis does not involve meningococcal transferrin-binding proteins.

Similarities in size between hemin-binding protein 1 (HmBP1) and transferrin-binding protein 1 (TBP1) of Neisseria meningitidis suggest that these proteins are functionally homologous. However, a meningococcal mutant lacking the transferrin-binding proteins retained the capacity to acquire iron from heme and hemoglobin. In immunoblots, hyperimmune polyclonal antiserum against TBP1 did not react with HmBP1.

Animals↗

PubMed1994

A comparison of cylindrical and Inoue balloon techniques for mitral valvotomy in patients in the United Kingdom.

OBJECTIVES: To compare the use of cylindrical balloons and the Inoue balloon for percutaneous mitral valvotomy in patients in the United Kingdom. DESIGN: Comparison of the haemodynamic results, complications, and symptomatic outcome of balloon dilatation for mitral stenosis in consecutive patients treated by cylindrical balloons and a second consecutive series of patients treated by the Inoue balloon. SETTING: A tertiary cardiac referral centre in Scotland. PATIENTS: 70 patients (mean age 60.6 years) treated by the single or double cylindrical balloon technique and 70 patients (mean age 58.9 years) treated with the Inoue balloon method. MAIN OUTCOME MEASURES: Success in obtaining dilatation at the mitral orifice, procedure and screening times, increase in valve area, complications, and early symptomatic outcome. RESULTS: Dilatation of the mitral valve was obtained in 91% of patients when cylindrical balloons were used and in 99% of patients treated with the Inoue balloon. Use of the Inoue balloon gave significantly shorter procedure and screening times. Technical problems in obtaining and maintaining the position at the mitral orifice were more common with cylindrical balloons. Improvements in valve area and symptoms were not significantly different with use of the two types of balloon. The Inoue balloon avoided cardiac tamponade and the creation of larger atrial septal defects, but had a higher incidence of increase in mitral reflux. CONCLUSIONS: In these elderly patients, the Inoue balloon method was safer and faster for percutaneous mitral valvotomy, with a higher success rate for dilatation within the valve orifice. Haemodynamic and symptomatic improvement was similar with the two techniques.

Adolescent↗

PubMed1994

Binding kinetics of ATP gamma S35 on cultured primary tracheal surface epithelial cells.

Extracellular ATP can stimulate mucin release from primary hamster tracheal surface epithelial (HTSE) cells via a P2 purinoceptor-mediated mechanism, based on agonist potency studies of mucin release (Br. J. Pharmacol. 1991; 103:1053-1056). In the present study, we examined the kinetics of ATP binding to the surface of intact HTSE cells at 4 degrees C using ATP gamma S35 as a radioligand. We found that ATP gamma S35 bound to HTSE cells in a saturable, reversible manner, reaching an equilibrium at about 30 min. Scatchard analysis of equilibrium binding suggested the presence of two binding sites with Kd values of 0.47 and 9.4 microM. Competitive binding experiments, based on the ability of nucleotides and ATP analogs to block ATP gamma S35 revealed a rank order of ATP > ADP > alpha,beta-methylene ATP > 2-methylthio ATP > or = beta, gamma-methylene ATP. Neither AMP nor adenosine could inhibit the ATP gamma S35 binding. A comparison between the ability of nucleotides to compete with ATP gamma S35 binding and their ability to induce mucin release revealed a rather poor correlation (r2 = 0.67) with all of the above nucleotides but a good correlation (r2 = 0.96) without 2-methylthio ATP, indicating the presence of heterogenous ATP binding sites on the HTSE cell surface. UTP, a pyrimidine nucleotide, which is almost equipotent with ATP in its ability to stimulate mucin release, was much less potent than ATP in its ability to displace the ATP gamma S35 binding in these HTSE cells.

Adenine Nucleotides↗

PubMed1994

Intra-carotid thrombolytic therapy in acute ischemic stroke of carotid arterial territory.

Intra-carotid urokinase (UK) infusion in 20 patients with acute internal carotid artery (ICA) territorial ischemic stroke achieved immediate recanalization in 45% and the clinical outcome in patients with recanalization was superior to that of patients without recanalization. The procedure was most effective in patients with smaller arterial occlusions: 7 of 10 patients with MCA branch occlusions (M2 to M4) achieved recanalization compared to only 2 of 10 with distal ICA or M1 occlusions, which should be an important issue for the critical evaluation of the efficacy of thrombolytic therapy (TT). Hemorrhagic transformation was observed in 9 patients on CT scan; petechial hemorrhage in 5 and intraparenchymal hematoma formation in 4. Among 4 patients with hematoma formation, clinical deterioration was seen in 3 cases and the angiography at the immediate end of the UK infusion showed recanalization in only one patient. The average dose of UK in patients with parenchymal hematoma formation was higher than that of patients without hemorrhagic transformation (123.3 x 10(4) units vs 101 x 10(4) units). The administration of a large dose of UK, probably more than 100 x 10(4) units, and the absence of immediate recanalization seemed to increase the risk of parenchymal hematoma formation. Despite the effort of investigators, the in-hospital time delay for the TT was significant which was mainly related to the time consuming preparation for angiography especially during night. A more effective system for the earlier intervention of acute ischemic stroke needs to be developed.

Adult↗

PubMed1993

Smith-Lemli-Opitz syndrome type II: report of a case with additional radiographic findings.

A phenotypically female infant with 46-XY chromosomes was found to have Smith-Lemli-Opitz syndrome, type II a rare congenital malformation syndrome with many features of the more common classic Smith-Lemli-Opitz syndrome. The patient's skeletal survey revealed characteristic and previously undescribed skeletal anomalies which are reported. In addition a lipoma of the pituitary gland was found on magnetic resonance imaging. This lesion is particularly interesting given the hypothesized steroid abnormality in Smith-Lemli-Opitz, type II syndrome, the sexual ambiguity of males with this syndrome and the similarity of this syndrome to the Pallister-Hall syndrome which characteristically has a hamartoblastoma of the hypothalamus.

Abnormalities, Multiple↗

PubMed1993

Tuberculous fasciitis and tenosynovitis. An unusual presentation of miliary tuberculosis.

A case of miliary tuberculosis presenting initially as pyogenic fasciitis and tenosynovitis is described. The unusual presenting clinical features suggestive of a noninfectious inflammatory condition resulted in delayed diagnosis. Tuberculous fasciitis and tenosynovitis were diagnosed by the presence of acid-fast bacilli in histopathologic sections and confirmed by the growth of Mycobacterium tuberculosis from cultures of tissue specimens.

Fasciitis↗

PubMed1993

Diagnosis of tuberculous meningitis by detection of immunoglobulin G antibodies to purified protein derivative and lipoarabinomannan antigen in cerebrospinal fluid.

Enzyme-linked immunosorbent assay of immunoglobulin G (IgG) activity in cerebrospinal fluid (CSF) and sera was conducted prospectively in 27 patients with tuberculous meningitis (TBM) by using purified protein derivative (PPD) and lipoarabinomannan (LAM) antigens, from January 1989 to August 1990. 29 patients with aseptic meningitis and 49 patients with non-inflammatory neurological illnesses served as controls. All patients had a computed tomography (CT) scan of the head before a lumbar puncture. The IgG antibodies to the antigens were significantly elevated in TBM, and the reactivity was more frequently positive in the CSF than in the sera, suggesting a local synthesis of IgG in the central nervous system (CNS). The sensitivity and the specificity for the diagnosis of TBM were 59.2% and 93.9% for PPD antigen, and 85.2% and 95.9% for LAM antigen, respectively. Assay of IgG reactivity to LAM antigen was clinically very useful for the early diagnosis of TBM and was superior to PPD for detecting the serological evidence of TBM.

Adolescent↗

PubMed1993

Low incidence of hypercalcaemia in tuberculosis in Malaysia.

In this study we examined the incidence of hypercalcaemia among patients with tuberculosis in Malaysia. Serum calcium concentration and other calcium metabolism parameters were studied in 43 newly diagnosed tuberculous patients from the Kuala Lumpur General Hospital and the National Tuberculosis Centre. Forty-four patients admitted to the medical wards of the General Hospital, Kuala Lumpur were recruited as controls. The incidence of hypercalcaemia was found to be only 1/43 (2.3%). There was no significant difference between the mean serum calcium and other calcium metabolism parameters between the patients and the controls. Despite earlier reported incidences of 30-50%, this study showed that hypercalcaemia in tuberculosis is uncommon in Malaysia.

Adult↗