Biomedical subjects

C Lee

Publications and source records attributed to C Lee.

At least 433 records · Page 24Linked to original sources

PubMed1997

A linear goal programming model for human resource allocation in a health-care organization.

This paper presents the development of a goal programming (GP) model as an aid to strategic planning and allocation for limited human resources in a health-care organization. The purpose of this study is to assign the personnel to the proper shift hours that enable management to meet the objective of minimizing the total payroll costs while patients are satisfied. A GP model is illustrated using the data provided by a health-care organization in the midwest area. The goals are identified and prioritized. The model result is examined and a sensitivity analysis is performed to improve the model applicability. The GP model application adds insight to the planning functions of resource allocation in the health-care organizations. The proposed model is easily applicable to other human resource planning process.

Algorithms↗

PubMed1997

A neural network application to classification of health status of HIV/AIDS patients.

This paper presents an application of neural networks to classify and to predict the health status of HIV/AIDS patients. A neural network model in classifying both the well and not-well health status of HIV/AIDS patients is developed and evaluated in terms of validity and reliability of the test. Several different neural network topologies are applied to AIDS Cost and Utilization Survey (ACSUS) datasets in order to demonstrate the neural network's capability.

Activities of Daily Living↗

PubMed1997

Mood and symptom reporting among middle-aged women: the relationship between menopausal status, hormone replacement therapy, and exercise participation.

Vasomotor, somatic, and psychological symptoms associated with menopause are often treated with hormone replacement therapy (HRT), but the role of nonpharmacological interventions has received little attention. Two studies used the Profile of Mood States (POMS) and Women's Health Questionnaire (WHQ) to examine the effects of exercise among 4 groups of Australian women: premenopausal, perimenopausal, postmenopausal without HRT, and postmenopausal with HRT. Study 1, a comparison of exercisers and nonexercisers, showed that exercisers' moods were significantly more positive than sedentary women's moods, regardless of menopausal state. Exercising women also scored lower on somatic symptoms and memory-concentration difficulties. Study 2 examined the acute effects of aerobic exercise (premenopausal, postmenopausal without HRT, and postmenopausal with HRT) and found significant enhancements in mood and reductions in reported somatic and vasomotor symptoms immediately following an aerobic class. Exercise may assist in the alleviation of some menopausal symptoms.

Adult↗

PubMed1997

Process optimization for large-scale production of TGF-alpha-PE40 in recombinant Escherichia coli: effect of medium composition and induction timing on protein expression.

The effects of medium composition and induction timing on expression of a chimeric fusion protein TGF-alpha-PE40 (TP-40) in Escherichia coli strain RR1 were examined using a complex medium at several fermentor scales. Two distinctive phases in E. coli catabolism were identified during fermentation based on preferential utilization between protein hydrolysate and glycerol. Maximum specific and volumetric productivities were achieved by inducing the culture when the cells were switching substrate utilization from protein hydrolysate to glycerol. By increasing the yeast extract concentration in the production medium, initiation of the catabolic switch was delayed until high cell mass was achieved. The final titer of TP-40 at the 15-L fermentation scale was doubled from 400 mg L-1 to 850 mg L-1 by increasing the yeast extract concentration from 1% to 4% (w/v) and delaying the time of induction. This fermentation process was rapidly scaled up in 180-L and 800-L fermentors, achieving TP-40 titers of 740 and 950 mg L-1, respectively.

Antineoplastic Agents↗

PubMed1997

Central regulation of gastric emptying of solid nutrient meals by corticotropin releasing factor.

Central regulation of gastric emptying of a solid nutrient meal and spatial and temporal parameters of gastro-pyloro-duodenal contractions by corticotropin-releasing factor (CRF) were investigated in conscious dogs. Intracerebroventricular (i.c.v.) infusion of CRF at 0.033 nmol kg-1 min-1 for 15 min in a volume of 0.2 mL significantly delayed the total gastric emptying time of the meal. I.c.v infusion of CRF also increased the mean frequency of proximal duodenal contractions and decreased the percentage of distally propagating contractions in the whole duodenum. The remaining parameters of pyloric and duodenal contractions were not affected. A prior i.c.v. infusion of I-helical CRF9-41 (0.166 nmol kg-1 min-1 for 15 min in a volume of 0.2 mL) blocked the central effects of CRF on gastric emptying time and the duodenal contractions. Central infusion of CRF had no significant effect on the lag phase of gastric emptying. Bilateral truncal vagotomy significantly delayed the gastric emptying time of the solid nutrient meal. However, after vagotomy, i.c.v. infusion of CRF had no effect on gastric emptying time or the spatial and temporal parameters of gastro-pyloro-duodenal contractions. In conclusion, CRF, the mediator of stress response, delays the total gastric emptying time of solid nutrient meals. The delay in gastric emptying may not be due to a change in the spatial and temporal parameters of gastric or pyloric contractions, but mainly due to changes in the parameters of duodenal contractions. The central effects of CRF on gastric emptying and duodenal contractions may be mediated by the vagus nerves.

Animals↗

PubMed1997

A high-risk group for prostatism: a population-based epidemiological study in Korea.

OBJECTIVE: To evaluate the effect of sociodemographic, dietary and physical factors on prostatism in Korean men aged 50 and over. SUBJECTS AND METHODS: A community-based cross-sectional epidemiological study was performed in Yonchon County, Korea. The Korean version of the International Prostate Symptom Score (IPSS) was used to assess the severity of prostatism. Data on occupation, marital status, education, smoking habits, alcohol intake, daily consumption of nutrients, body mass index, abdominal circumference, waist-to-hip ratio, blood pressure, serum glucose, cholesterol, triglyceride and high-density lipoprotein (HDL) levels were analysed. The age-adjusted relative risk of these factors was calculated for moderate to severe prostatism (IPSS > or = 8). A multivariate analysis of all significant factors was performed to examine the joint effect of risk factors. RESULTS: Of 514 subjects, 119 (23.2%) had moderate to severe prostatism, the risk for which was related to age and alcohol consumption; waist-to-hip ratio (which represents the degree of abdominal obesity) and the serum level of HDL showed a biphasic association with prostatism in the multivariate analysis. CONCLUSION: In addition to previously reported risk factors, these data suggest that there might be an association between the development of prostatism and abnormal lipid metabolism.

Age Factors↗

PubMed1997

Clinical comparison of selective and non-selective alpha 1A-adrenoreceptor antagonists in benign prostatic hyperplasia: studies on tamsulosin in a fixed dose and terazosin in increasing doses.

OBJECTIVE: To compare the efficacy and safety of a fixed dose (0.2 mg) of tamsulosin, a selective alpha 1A-adrenoreceptor antagonist, with an increasing dose (1-5 mg) of terazosin, a non-selective antagonist, in the treatment of urinary outflow obstruction associated with benign prostatic hyperplasia (BPH) in Korean patients. PATIENTS AND METHODS: The study comprised a single-blind and randomized design with tamsulosin or terazosin taken once daily for 8 weeks. A total of 98 patients was enrolled, with 72 patients included in the analyses after 4 and 8 weeks. The primary variables assessed were changes in the maximum urinary flow rate Qmax and the total International Prostate Symptom Score (IPSS), with the post-void residual urine volume, 'obstructive' and 'irritative' questions in the IPSS, and the investigators' global assessment of efficacy also determined. The number of patients with a clinically significant response to treatment with tamsulosin or terazosin was determined and defined as those with > 20% improvement from the baseline Qmax or > 20% decrease in total IPSS. Adverse reactions possibly or probably related to study medication were recorded throughout the treatment period. RESULTS: Both tamsulosin and terazosin produced similar significant improvements in subjective and objective symptoms of urinary outflow obstruction (P > 0.05). Systolic and diastolic (standing) blood pressures decreased significantly in patients treated with terazosin (P < 0.05). The adverse reactions, most frequently dry mouth and dizziness which were usually mild and transient, were significantly higher in patients on terazosin (18 patients, versus one on tamsulosin, P < 0.001). The changes led to discontinuation of therapy in two patients on terazosin. CONCLUSION: Tamsulosin was as effective as terazosin in treating urinary outflow obstruction associated with BPH, but had a markedly better safety profile.

Adrenergic alpha-Antagonists↗

PubMed1997

Differential expression of ferritin heavy chain in THP-1 cells infected with Mycobacterium bovis BCG.

To identify the host genes induced or suppressed by infection of mycobacteria, the reverse transcriptase polymerase chain reaction (RT-PCR) and the differential display reverse transcriptase polymerase chain reaction (DD RT-PCR) methods were used. In this study, cDNAs complement to mRNA extracted from human peripheral monocyte derived naive THP-1 cells, THP-1 cells infected with live Mycobacterium bovis BCG, THP-1 cells treated with heat-killed BCG, and THP-1 cells incubated with IgG-coated glass-beads were compared on the sequencing gel. One (TG2-1) of the clones selected by DD RT-PCR is 446 bp long and is identical to human ferritin heavy (H) chain gene. Northern blot analysis confirmed that ferritin H chain gene has been markedly over-expressed in monocytic THP-1 cells incubated with live and dead M. bovis BCG. Differential display techniques of host genes whose expression levels were varied by infection of mycobacteria could provide information about the response of macrophages to mycobacterial infection.

Amino Acid Sequence↗

PubMed1997

Endoscopic repair of a complex midfacial fracture.

Inadequate treatment of complex midfacial fractures involving the orbit and zygomatic arch can result in important functional and aesthetic deformity. Accurate repair of fractures at the zygomatic arch and orbital floor has traditionally necessitated coronal scalp and lower eyelid incisions respectively. Complications such as facial nerve injury, alopecia, external scarring, ectropion, and eyelid edema have been associated with these traditionally open surgical techniques. We report an endoscopic-assisted technique of open reduction and rigid fixation of a complex midfacial fracture. The endoscopic-assisted technique facilitated the anatomic repair of associated zygomatic arch and orbital floor fractures. The technique minimized ocular globe manipulation and eliminated the need for coronal scalp and lower eyelid incisions.

Adult↗

PubMed1997

Detectability of small liver metastases with gadolinium BOPTA.

RATIONALE AND OBJECTIVES: The ability to detect small liver metastases was evaluated with both gadolinium Gd BOPTA and Gd HP-DO3A on high-field (1.5 tesla [T]) magnetic resonance (MR) imaging using a rabbit tumor model. METHODS: Five New Zealand White rabbits with metastatic liver disease (VX-2 adenocarcinoma) were imaged on a 1.5 T Siemens Vision MR system. Magnetic resonance studies were obtained in each animal on days 8 and 9 after tumor implantation. Each animal was studied twice, once after injection of 0.3 mmol/kg Gd HP-DO3A (gadoteridol or ProHance) and once after injection of 0.1 mmol/kg Gd BOPTA (gadobenate dimeglumine or MultiHance). The order of injection for the two agents was randomized with the two studies in any one animal separated by 24 hours to allow for clearance. Magnetic resonance image acquisition was performed in all cases with suspended respiration. Baseline two-dimensional FLASH T1-weighted and turbo-spin echo T2-weighted scans were acquired first. The contrast was then administered as an intravenous bolus. T1-weighted scans were acquired at 1, 5, 15, 30, 45, and 60 minutes after administration of Gd BOPTA and 1, 5, and 15 minutes after administration of Gd HP-DO3A. Each rabbit was killed after completion of imaging, their liver removed and taken to the veterinarian at the University's animal disease diagnostic laboratory for lesion confirmation. RESULTS: Despite acquisition of precontrast T2-weighted scans, lesions could not be identified with certainty in four of five animals in the Gd HP-DO3A study. Normal liver signal intensity increased from 895 +/- 17 to a peak of 1384 +/- 50 at 1 minute after Gd HP-DO3A administration. After Gd BOPTA administration, normal liver signal intensity increased from 899 +/- 105 to a peak of 1433 +/- 76 at 15 minutes. Liver enhancement thereafter decreased gradually to 1297 +/- 84 at 60 minutes. The injection of 0.3 mmol/kg Gd HP-DO3A resulted in parenchymal enhancement, which was statistically superior (P < 0.01) to an injection of 0.1 mmol/kg Gd BOPTA at 1 minute, not statistically different at 5 minutes, and inferior (P < 0.02) at 15 minutes. From region of interest measurements, lesion detectability was statistically superior on scans at 15 to 60 minutes after Gd BOPTA administration compared with precontrast T1- and T2-weighted scans (P values: < 0.03- < 0.005). Lesion detectability was maximum at 30 minutes postcontrast (15.2 +/- 4.5), markedly superior to that precontrast on both T1- (5.7 +/- 5.0) and T2-weighted scans (7.2 +/- 1.5). On masked film review of the Gd BOPTA case set, no lesions were noted prospectively on T2-weighted scans. Lesions in all five animals were well visualized on scans 45 to 60 minutes after Gd BOPTA administration. The Gd HP-DO3A case set was not read masked, as lesions could be identified only in one of the five animals with all films available for inspection. An additional feature of scans with Gd BOPTA (used at a dose of 0.1 mmol/kg), in distinction to those with Gd HP-DO3A (used at a dose of 0.3 mmol/kg), was the diminished enhancement of hepatic vessels. CONCLUSIONS: Using a rabbit model, small metastatic lesions (diameter, 2-4 mm) were well visualized on delayed postcontrast Gd BOPTA scans. These lesions could not be diagnosed prospectively on T2-weighted images. In only one of five animals were lesions detected on early dynamic post-contrast high-dose Gd HP-DO3A scans.

Adenocarcinoma↗

PubMed1997

Contrast-enhanced magnetic resonance imaging in a spinal epidural tumor model.

RATIONALE AND OBJECTIVES: A spinal epidural tumor model was developed, using the VX-2 adenocarcinoma in rabbits, to assess the strengths and weaknesses of magnetic resonance (MR) as a cross-sectional imaging modality for the evaluation of epidural neoplastic disease. High-resolution MR images were acquired both before and after intravenous gadolinium chelate injection, assessing lesion detectability and efficacy of imaging technique. METHODS: An adenocarcinoma tumor (VX-2) was produced in the epidural space of six New Zealand White rabbits and subsequently studied on a 1.5 tesla whole body MR scanner. VX-2 tumor tissue was removed from the thigh of a carrier rabbit, minced, and screened. Under fluoroscopic guidance, 0.2 mL of the tumor preparation was then injected into the epidural space of the experimental rabbits. The injection was performed at the L5-6 level using an epidural needle and polyethylene tubing sleeved within the needle. The rabbits were imaged using a circular small parts surface coil 5 to 15 days after the epidural injection. In all six animals, one complete MR exam was obtained within the time frame of days 9 to 11. T1- and T2-weighted axial scans were obtained before contrast injection, with the T1 scans acquired both with and without fat saturation. Postcontrast T1 scans also were obtained, using fat saturation, after the injection of 0.1 and 0.3 (cumulative dose) mmol/kg gadoteridol (Gd HP-DO3A; ProHance) in all animals. The film images were interpreted in a prospective fashion by a single neuroradiologist who was masked to imaging technique and contrast dosing. The digital data was analyzed by region of interest measurement. At the end of the imaging studies, the animals were sacrificed and the epidural lesion confirmed by gross and microscopic exam. RESULTS: On a prospective masked read of the MR films, epidural tumor was depicted best on postcontrast fat saturation T1-weighted scans using a cumulative contrast dose of 0.3 mmol/kg. Substantial contrast enhancement of the tumor was observed in all instances on postcontrast scans. The precontrast T1-weighted scan was least efficacious for lesion identification and differentiation from the compressed spinal cord. Depending on the pulse sequence used, one (T2-weighted) to three (T1-weighted without fat saturation) of the lesions could not be identified prospectively on precontrast scans. Lesion growth with time after implantation was chronicled by MR imaging, accompanied by progression of symptoms. On region of interest analysis, differentiation of epidural tumor from normal cord was greatest (11.6 +/- 6.1) on postcontrast scans using a cumulative contrast dose of 0.3 mmol/kg. The level of differentiation achieved was twice that of postcontrast scans using a contrast dose of 0.1 mmol/kg (5.9 +/- 3.6). These results were superior on statistical analysis to that with all other scan techniques (P = 0.002-0.0005). Cord and tumor could not be differentiated on the basis of signal intensity, with any statistical significance, using precontrast T1 and T2 scans. The lesions were confirmed in each animal by gross and microscopic exam. On inspection of the gross specimen, the tumors were noted to be located in the epidural space and to cause cord compression. On microscopic exam, the tumor was composed of epithelial cells that were moderately pleomorphic. CONCLUSIONS: In the New Zealand White rabbit, an epidural tumor could be created consistently using the described percutaneous approach. These lesions are suitable for MR imaging studies, examining lesion detectability and efficacy of imaging technique. The lesions created in the current study could not be diagnosed prospectively in all cases on precontrast T1 and T2 scans images. Postcontrast scans were most efficacious for diagnosis and lesion delineation, with high-dose (0.3 mmol/kg) scans superior to standard dose (0.1 mmol/kg).

Adenocarcinoma↗

PubMed1997

The effect of angiotensin converting enzyme inhibition and angiotensin II receptor antagonism on obstructed rat bladder.

PURPOSE: Others have demonstrated that inhibition of angiotensin II production partially ameliorates obstructive changes in the neonatal rabbit bladder. We examined the effect of angiotensin II converting enzyme inhibition and receptor antagonism on the obstructed rat bladder. MATERIALS AND METHODS: Three groups of animals were investigated. Partial bladder neck obstruction was created in 23 rats by placing a 2-zero silk ligature around the vesicourethral junction. Eight rats were given untreated tap water, 9 were given water supplemented with 50 mg./kg. of the angiotensin-converting enzyme inhibitor captopril and 6 were given water with 30 mg./kg. of the angiotensin II subtype AT1 receptor antagonist losartan potassium. Eight unobstructed rats served as controls. After 2 weeks of partial outlet obstruction the animals were sacrificed and bladders were harvested. Routine histological evaluation and assays for total protein, deoxyribonucleic acid and collagen content were performed. RESULTS: Histological evaluation revealed that administration of captopril or losartan potassium resulted in a mild decrease in the degree of obstructive bladder changes. Biochemically neither captopril nor losartan potassium caused a significant decrease in the amount of total deoxyribonucleic acid, protein or collagen content per bladder compared to untreated obstructed bladders. CONCLUSIONS: In contrast to previous studies in neonatal rabbits, neither captopril nor losartan potassium significantly ameliorated the histological or biochemical features of partial bladder outlet obstruction in the rat. Further investigation is necessary into species specific differences to understand better the role that angiotensin II may have in mediating the bladder changes of experimentally induced obstruction.

Angiotensin Receptor Antagonists↗

PubMed1997

Epidemiologic survey of lower urinary tract symptoms in Asia and Australia using the international prostate symptom score.

BACKGROUND: The prevalence of lower urinary tract symptoms was determined by survey as an initial step in estimating the significance of benign prostatic hyperplasia (BPH) in Asia and Australia. METHODS: The symptom index (0 to 35) and quality-of-life (QOL) index (0 to 6) of the international prostate symptom score were measured in 7588 men in 9 Asian countries and 146 men in Australia. RESULTS: The percentages of Asian men considered to be symptomatic (symptom index > or = 8) were 18%, 29%, 40%, and 56% in the age groups of 40 to 49, 50 to 59, 60 to 69, and 70 to 79 years, respectively. For Australian men, these figures were 36%, 33%, and 37% in the 50 to 59, 60 to 69, and 70 to 79 year age groups, respectively. CONCLUSIONS: Our estimates indicate that the prevalences of symptomatic men in Asia and Australia are similar to or greater than those in Europe and America, and suggest BPH is similarly common in these areas.

Adult↗

PubMed1997

Prognostic markers of intravesical bacillus Calmette-Guérin therapy for multiple, high-grade, stage T1 bladder cancers.

BACKGROUND: Prediction of a response to intravesical bacillus Calmette-Guérin (BCG) therapy for bladder cancer is clinically important. We determined whether several molecular markers have prognostic value in intravesical BCG therapy for multiple, high-grade, stage T1 bladder cancers. METHODS: The expressions of p53 (clone D07), bcl-2 (100-D5), cathepsin-D (C5), c-myc(9E11), c-erbB-2 (CB11) and Ki-67 (MM1) were determined by immunohistochemistry in paraffin-embedded tissues from 32 multiple, T1, grade II-III bladder cancer patients (15 BCG responders, 17 nonresponders) who had undergone a single course of BCG therapy (Pasteur strain, 5 x 10(8) CFU weekly for 6 weeks) after complete removal of the tumors. The association between the expression of these markers and the response to BCG was assessed by univariate and multivariate analyses. RESULTS: There was no difference in patient and tumor characteristics between the 2 groups. Using multivariate analysis, the only useful marker was p53, with the overexpression of the p53 protein inversely related to the response to BCG therapy (P = 0.0182). CONCLUSION: Our results suggest that the status of p53 expression offers significant clinical information and may be a useful tool in the selection of suitable candidates for BCG therapy in multiple, high-grade stage T1 bladder cancer patients.

Adjuvants, Immunologic↗

PubMed1997

Cellular interactions in prostate cancer.

This article will review the different modes of action of soluble growth factors in the growth of benign and malignant prostatic cells. Cellular proliferation, growth arrest or even apoptosis requires the participation of appropriate growth factors [1]. Proliferative activities of prostatic epithelial cells, like other cells, are governed by the action of a variety of growth factors. Prostatic growth is traditionally considered to be regulated by androgen, as the prostate is an androgen-sensitive organ, in that the growth and maintenance of the structure and functional integrity are dependent upon the presence of circulating androgen [2,3]. A depletion of this androgenic support, e.g. by bilateral orchidectomy in the host, results in massive apoptosis in prostatic epithelial cells, leading to a rapid rate of tissue involution [4]. Subsequent androgen replacement therapy reactivates prostatic growth. Therefore, androgen is the most potent mitogen to the prostate. It is now apparent that this mitogenic effect of androgen on the prostate is mediated through the action of various growth factors as a consequence of an intricate cell-to-cell interaction, a characteristic feature of benign prostatic growth [5,6]. On the other hand, malignant prostatic growth is characterized by additional mechanisms of cellular proliferation that provide a distinct growth advantage over that of their benign counterparts. Cancer develops as a result of a series of genetic mutations [7]. Prostatic cancer is no exception; however, its progression seems to follow a relatively predictable course, from an androgen-sensitive state to an autonomous state [8]. Sensitivity to androgen in prostatic cancer is mainly due to the presence of androgen receptors in malignant cells, which retain some properties of the benign prostatic cells. However, the manner in which androgen interacts with prostatic cancer cells can be drastically different from that in which it reacts with benign cells. Despite androgen playing an important role in the progression of prostatic cancer, eventually these cancer cells are able to convert from an androgen-responsive growth mode to an androgen-independent mode. Often, a conversion from one state to another is associated with a poorer prognosis and is preceded by the acquisition of new growth advantages within the cancer cells. Again, soluble growth factors are the underlying mechanisms of androgen-sensitive and androgen-insensitive malignant growth. The abnormal growth behaviour in prostatic cancer cells can be manifested by an over-expression of growth-stimulating factor(s) and/or a loss of expression (or function) of growth-suppressive factor(s). The production and action of growth factors in the context of benign and malignant growth of prostatic cells will be the focus of the present discussion.

Androgens↗

PubMed1997

Amniotic fluid granulocyte colony stimulating factor levels: a rapid marker for diagnosing chorioamnionitis.

PROBLEM: To assess the usefulness of amniotic fluid (AF) granulocyte colony stimulating factor (G-CSF) levels as a rapid marker for diagnosing chorioamnionitis. METHOD OF STUDY: AF levels were obtained from term and preterm patients with and without chorioamnionitis (CAM). Patients with urinary tract, respiratory tract, and other infections were excluded. Results obtained from the AF G-CSF assays were compared with those from other parameters used for diagnosing CAM: maternal fever, leukocytosis, tachycardia, fetal tachycardia, AF glucose levels, white blood cell count, Gram stain, and aerobic and anaerobic cultures. The sensitivity, specificity, and predictive values were calculated. RESULTS: In the uninfected AF samples, G-CSF levels were present but low, ranging from 400 to 1600 pg/ml. Levels in the infected samples, however, were markedly increased, ranging from 1600 to 14,000 pg/ml; P < 0.05. When a cutoff of 2000 pg/ml was used as a clear marker for CAM, the sensitivity was 67%, the specificity was 100%, and the positive and negative predictive values were 100% and 86%, respectively. The comparison of the other AF G-CSF laboratory parameters also revealed high sensitivity, specificity, and predictive values for detecting CAM. CONCLUSION: (i) AF G-CSF levels are elevated in CAM. (ii) An AF G-CSF level > 2000 pg/ ml is a strong positive predictor of CAM. (iii) Elevated AF G-CSF levels appear to be more reliable in predicting CAM than any other single test currently used in clinical practice.

Amniotic Fluid↗

PubMed1997

Amniotic fluid granulocyte colony stimulating factor levels in chorioamnionitis do not predict neonatal sepsis.

PROBLEM: To assess the usefulness of amniotic fluid (AF) granulocyte colony-stimulating factor levels (G-CSF) in chorioamnionitis (CAM) to predict neonatal sepsis. METHOD OF STUDY: AF samples were obtained from term and preterm patients with (Group I) and without (Group II) CAM and were assayed for G-CSF levels. Patients with other infections were excluded. All AF samples were also tested for gram stain and cultures. The sensitivity, specificity, and predictive values of these parameters for diagnosing neonatal sepsis were assessed. RESULTS: Positive AF cultures were the best predictors of neonatal sepsis in CAM, with a sensitivity of 67% and a positive predictive value (PPV) of 80%. Elevated AF G-CSF levels (> 1,000 pg/ml) were poor predictors of neonatal sepsis with a sensitivity of 29% and PPV of 39%. CONCLUSION: Even though AF G-CSF levels were markedly elevated in patients with CAM, they were poor predictors of subsequent neonatal sepsis.

Amniotic Fluid↗

PubMed1997

Morphometry and strain distribution in guinea pig duodenum with reference to the zero-stress state.

The aim of the present study is to determine the distribution of residual circumferential strains along the duodenum in anesthetized guinea pigs. A silicone elastomer was allowed to harden in the duodenal lumen under a pressure of 0.7 kPa. The duodenum was excised with the cast and photographed. The zero-stress state was obtained by cutting rings of duodenum radially. The geometric configuration at the zero-stress state is of fundamental importance, because it is the basic state with respect to which the physical stresses and strains are defined. A basic piece of information is the way the tangent vector rotates from one end of the circumference to the other. In the duodenum at zero-stress state, the total rotation of the tangent from one tip to the other is -500 to -850 , with the lowest absolute value in the proximal duodenum. In other words, the duodenum usually turns itself inside out on changing from a loaded state to the zero-stress state. The serosal circumference, the duodenal wall thickness, and the ratio of wall thickness to mucosal circumference decreased in the distal direction. In the pressurized state, the serosal Cauchy strain was tensile and increased in the distal direction; the mucosal Cauchy strain was compressive in the proximal half of the duodenum and tensile in the distal half. The large circumferential residual strains must be taken into account in a study of physiological problems in which the stresses and strains are important, e.g., the bolus transport function.

Animals↗