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Biomedical subjects

C Lee

Publications and source records attributed to C Lee.

At least 721 records · Page 40Linked to original sources
PubMed1992

Septic shock: does adrenaline have a role as a first-line inotropic agent?

Fifteen adult patients, admitted to Baragwanath Hospital ICU with septic shock after adequate fluid loading and on no other inotropic agents, were given adrenaline in incremental doses. Oxygen transport and haemodynamic variables were monitored with each dose increment until a systolic blood pressure of 120 mmHg was obtained. This was reached on an average dose of adrenaline of 0.16 +/- 0.02 micrograms/kg/min. Mean arterial blood pressure increased by 22 +/- 2 mmHg mainly due to an increase in cardiac index (1 +/- 0.2 l/min/m2) and systemic vascular resistance index (130 +/- 41 dyn.s.cm.-5m-2) with a small increase in heart rate of 8 +/- 3 beats per minute. Oxygen delivery was increased with no significant increase in oxygen consumption and lactate levels increased. Adrenaline is therefore an effective initial inotropic agent. Patients may respond to lower doses than when used concurrently with other inotropic agents but there was still a significant dose variation in response. We cannot, however, exclude a deleterious effect on oxygen utilization.

Adult↗
PubMed1992

Basic fibroblast growth factor: a potential mediator of stromal growth in the human prostate.

Studies were undertaken, using isolated prostatic epithelial and stromal cells, to evaluate the role of basic fibroblast growth factor (bFGF) in the regulation of benign prostatic growth. bFGF was detected in lysates, but not the conditioned media, of cultured prostatic epithelial and stromal cells by Western immunoblotting and immunoprecipitation of metabolically labeled proteins. Immunofluorescence analysis of benign human prostate localized the majority of bFGF to the prostatic stroma. In addition, bFGF was a potent stimulator of stromal cell proliferation in vitro, but was not mitogenic to cultured epithelial cells. Further studies demonstrated bFGF receptors (Kd = 258 pM; 61,400 receptors/cell) on stromal cells, but not epithelial cells. Epithelial cell-conditioned medium was mitogenic for stromal cells, suggesting the presence of paracrine interactions. However, bFGF does not appear to be the mediator of this interaction, since the mitogenic effect of epithelial cell-conditioned medium on stromal cells was not significantly reduced by the addition of anti-bFGF. Additional studies showed that concentrated stromal cell-conditioned medium was not mitogenic to cultured stromal cells under serum-free defined conditions, indicating the lack of an external autocine mechanism. These studies demonstrate that bFGF is actively synthesized by isolated prostatic epithelial and stromal cells, but is largely not secreted. Prostatic stroma, but not epithelia, are responsive to the mitogenic effect of bFGF in vitro. However, because of the limited secretion of bFGF by prostatic cells, the mechanism(s) of bFGF-mediated regulation of stromal growth remains unclear.

Cell Division↗
PubMed1992

The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part III. Reliability of a standardized MRI evaluation of Alzheimer's disease.

The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) has developed procedures for standardized imaging and reporting of magnetic resonance (MR) findings in Alzheimer's disease (AD) for use by neuroradiologists in multiple medical centers using a variety of MR equipment and field strengths. After initial pretesting, we revised the protocol, expanded the summary rating scale to seven points, and added more illustrations. Fourteen participating neuroradiologists evaluated 28 MR scans of elderly patients, giving us the basis for judging interrater agreement. We obtained acceptable intraclass correlations (greater than 0.79) for rating the size of the lateral and third ventricles and the temporal horn. Less satisfactory intraclass correlations occurred when rating other areas, including (1) global atrophy of the brain (0.70); (2) dilatation of the sulci of the temporal lobe (0.66); (3) frequency, location, and severity of white matter lesions (0.77); (4) sylvian fissure enlargement (0.70); and (5) cerebral sulcal dilatation (0.64). We also saw considerable variation in the reporting of cortical and lacunar infarcts. Despite careful design of the rating methodology and readings by experienced neuroradiologists, we did not find satisfactory interrater agreement for interpreting MR findings in elderly subjects. These findings may explain the difficulties encountered in applying similar subjective rating techniques that meet with success at one institution to multicenter studies. More objective and reproducible procedures are needed for interpretation of neuroimaging findings of AD in multicenter studies.

Alzheimer Disease↗
PubMed1992

Congenital cytomegalovirus infection in Korean population with very high prevalence of maternal immunity.

In order to asses congenital cytomegalovirus (CMV) infection in Korea, five hundred and seventy five pregnant women (mean age 29.5 +/- 3.8 yrs., mean gestational age at test 37.5 +/- 6.7 weeks) visiting the prenatal clinic at Severance Hospital, Seoul, Korea were studied. CMV IgG antibody was present in 96% (552/575) and IgM antibody was present in 0.7% (4/575) of the pregnant women by the third trimester. Four of 445 cord sera were positive for CMV IgM antibody (0.9%). Urine samples from 514 newborns were tested for the evaluation of congenital CMV infection. Six (1.2%) of 514 newborns excreted CMV in their urine. All the congenitally infected infants had subclinical involvement at birth and during the 12 months of the follow-up period. These results indicate that Korean pregnant women were highly immunized against CMV by the third trimester. Furthermore this study suggests that the rate of congenital CMV infection is relatively as high as rates previously reported from other countries, although there is a very high prevalence of maternal immunity. The incidence of maternal primary infection during pregnancy seems to be rare and therefore most congenital infections in Korea might be following by maternal reactivation or reinfection.

Adult↗
PubMed1992

Incidence estimation of genitourinary cancer in Korea.

A nation-wide study was performed to estimate the incidence of bladder, kidney, renal pelvis and ureter, prostate, testicular and other genitourinary cancer among Koreans in Korea using medical records of the inpatients of the beneficiaries of the Korea Medical Insurance Corporation (KMIC) from Jan. 1, 1989 to Dec. 31, 1989. The crude incidence rate of bladder cancer (ICD-9 188) is estimated to be 4.43 and 0.98 per 100,000 in males and females, respectively. Around 1,093 new cases of bladder cancer (895 male and 198 female) are estimated to occur in a year. The adjusted rate for the world population is 7.76 in males and 1.19 in females which is similar to that of Japanese in Osaka and Chinese in Shanghai, but lower than in American whites and blacks. The crude incidence of kidney, renal pelvis and ureteral cancer (ICD-9 189) is estimated to be 1.61 and 0.87 in males and females, respectively. Around 507 new cases of kidney, renal pelvis and ureteral cancer (332 male and 175 female) are estimated to occur in a year. The adjusted rate for the world population is 2.69 in males and 1.04 in females. In the prostate (ICD-9 185), the crude incidence rate of cancer is estimated to be 1.36. Around 274 new cases of prostate cancer are occurring in a year. The adjusted rate for the world population is 2.98 which is similar to the Chinese rate. The incidence of genitourinary cancer continuously increases with age.

Adult↗
PubMed1992

A seventeen kilodaltons peptidyl-prolyl cis-trans isomerase of the cyclosporin-producer Tolypocladium inflatum is sensitive to cyclosporin A.

A peptidyl-prolyl cis-trans isomerase (PPIase) was purified to homogeneity about 24-fold from the cyclosporin-producing fungus Tolypocladium inflatum. The molecular mass of the enzyme was in the range of 17 kdaltons. Remarkably, the enzyme could be inhibited by cyclosporin A in the nanomolar range as has been shown for numerous other cyclophilins from eukaryotic organisms. This indicates, that Tolypocladium inflatum must possess a self protection system in order to survive in the presence of cyclosporin.

Amino Acid Isomerases↗
PubMed1992

Utilization of the Boyden chamber to further characterize in vitro migration and invasion of benign and malignant human prostatic epithelial cells.

In the present study, we assessed various tissue culture conditions on the motility and invasiveness of benign and malignant prostatic epithelial cells using the Boyden chamber system. In DME and RPMI-1640 media, benign human prostatic epithelial cells were unable to penetrate through a basement-membrane-coated filter. However, the prostatic carcinoma cell lines, PC3 and DU145, showed a significant frequency of invasion under those conditions. When cultured in the low-calcium WAJC 404 medium, benign prostatic epithelial cells efficiently penetrated through the basement-membrane-coated filter. PC3 and DU145 cells showed an attenuated capability to invade when cultured in WAJC 404 medium. The effect of extracellular calcium on the behavior of these cells in the Boyden chamber was further evaluated by gradual addition of calcium chloride in WAJC 404 medium. These studies showed that the number of benign prostatic epithelial cells penetrating through the filter decreased as the calcium ion concentration increased. Conversely, the number of PC3 cells invading through the filter increased as calcium ion concentration was increased to 0.4 mM and decreased at higher calcium ion concentrations. These results suggest that the extracellular calcium concentration is one of the factors which may affect cell behavior in the Boyden chamber system.

Basement Membrane↗
PubMed1992

[The role of total gastrectomy in the management of gastrinoma syndrome].

Total gastrectomy used to be considered as a standard operation in the surgical treatment for gastrinoma syndrome. Although this end organ resection is a good palliation, to cure this ulcerogenic disease, gastrinoma resection is preferred. It remains a question if a total gastrectomy is necessary when a gastrinoma is found and resected. In a period of 12 years, nine out of 17 patients with gastrinoma syndrome were surgically treated. Fifteen gastrinomas were removed without histologic evidence of malignancy. Total gastrectomy was added in three, Whipple's operation was done in one and tumor resection alone in five. Serial examination of the resected stomach didn't find any gastrinoma. Eight gastrinomas of seven patients were found located in the pancreas, duodenum and lymph nodes within the gastrinoma triangle. These patients except one were followed up for six months to five years (mean 32 months). One died of post-operative hepatic failure, and one died of hypophysectomy for a co-existent huge prolactinoma (MEN I) four years later. Cure of the disease in terms of normal fasting serum gastrin levels, symptom free without medication, endoscopic evidence of healed ulcer, and a negative conversion of secretin provocative test was found in 2/3 of the patients with additional total gastrectomy, and 4/6 of the others. All cured patients had their gastrinomas located in the gastrinoma triangle, and six of the seven (85.7%) patients with gastrinomas in the triangle were cured. It is our conclusion that total gastrectomy was retrospectively unnecessary in most of the patients with gastrinomas in the gastrinoma triangle. Staged operations should be planned.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Neuromuscular blocking effect and placental gradient of pipecuronium bromide in elective caesarean section.

We studied the suitability of pipecuronium for maintenance of neuromuscular block during 20 elective Caesarean sections under light general anaesthesia with a rapid-sequence technique facilitated by i.v. suxamethonium 0.6-0.8 mg kg-1. An initial dose of 0.035 mg kg-1 or 0.05 mg kg-1 of pipecuronium provided satisfactory relaxation of similar speed of onset (3.1 +/- 0.3 vs 3.8 +/- 0.6 min, p = 0.25); however the higher dose had a significantly longer duration of action than the lower dose (from injection to recovery to 20% of baseline 13.1 +/- 1.8 vs 39.3 +/- 6.9 min, p < 0.05). A spontaneous recovery of the T1 twitch of the train-of-four to 25% of baseline (residual block 75%) assured rapid antagonism of the residual block with either edrophonium 0.5 mg kg-1 or neostigmine 0.04 mg kg-1. A residual block greater than 80% depression of T1 markedly prolonged the time taken to achieve a satisfactory reversal. Pipecuronium had negligible cardiovascular effects and placental transfer. It had no observable effect on the newborn. In spite of some advantages, we conclude that pipecuronium is a suitable alternative during Caesarean section only when used judiciously in small doses for maintenance of neuromuscular block and recommend that the initial dose be no greater than 0.035 mg kg-1.

Adolescent↗
PubMed1992

Symptomatic predictors of ECT response in medication-nonresponsive manic patients.

BACKGROUND: Relations between pretreatment symptom ratings and ECT outcome were examined in acute manic patients admitted at a state psychiatric center who were nonresponsive to medication. METHOD: One or 2 days after undergoing pretreatment clinical ratings, patients were randomly assigned to intensive pharmacotherapy, right unilateral ECT, left unilateral ECT, or bilateral ECT. Patients who failed to respond to any of the first three treatment conditions were assigned to crossover bilateral ECT. Patients who failed to respond to a primary treatment condition other than bilateral ECT but refused crossover bilateral ECT and those in whom ECT was terminated due to an organic brain syndrome were not considered for this study. No psychotropic drugs were prescribed for 4-7 days before, or during, the course of ECT. Of the 24 patients who entered the study, 18 patients completed the protocol. Based on independent clinical assessments by two research psychiatrists, a favorable treatment response was defined as a complete recovery from manic episode that was sustained for 1 week during which no psychotropic medications were prescribed. RESULTS: ECT nonresponders were significantly more angry, irritable, and suspicious than ECT responders. Severity of mania and depression ratings at baseline were not related to ECT response. CONCLUSION: Symptoms associated with poor response to ECT may overlap with those that have been reported to predict nonresponse to treatment with lithium. Our evidence also may support the view that differential symptom patterns may predict treatment outcomes to ECT and carbamazepine, respectively, in manic patients who do not respond to treatment with lithium or neuroleptics.

Adult↗
PubMed1992

The CD34+ cell fraction in bone marrow and blood is not universally predictive of CFU-GM.

We have measured the presence of granulocyte-macrophage colony forming cells (CFU-GM) and CD34+ cells in blood and bone marrow. We have compared these hematopoietic cell assays using regression analysis. We have found that under the limited and specific case of blood cells from an individual recovering from myelo-suppressive chemotherapy, the fraction of cells that is CD34 positive is predictive of the number of granulocyte-macrophage colonies (CFU-GM) which will grow. This result is in agreement with published data. We have found, however, that in bone marrow aspirates, or in the blood of individuals recovering from cyclophosphamide chemotherapy and receiving either granulocyte-macrophage colony stimulating factor (G-CSF) or folinic acid (FA) therapy, there is poor correlation between CD34+ cell fraction and CFU-GM. Accordingly, the use of CD34+ fraction cannot be relied upon to substitute for the CFU-GM assay in assessing the hematopoietic cell content of blood or bone marrow samples.

Antigens, CD↗
PubMed1992

Interaction of nutrition and infection: effect of copper deficiency on resistance to Trypanosoma lewisi.

The copper-deficient rat-trypanosome system was used to study copper deficiency in Sprague Dawley rats infected with Trypanosoma lewisi. Throughout the observational period, animals on the deficient diet had lower plasma and liver copper concentrations compared with complete and pair-fed animals. In all dietary groups, the food intake and body weight changes of rats inoculated with T lewisi showed significant increases over the noninoculated controls. The rate of these indices were significantly less in the copper-deficient animals compared with the animals fed complete diets. Copper-deficient and pair-fed control rats showed greater numbers of parasites than controls throughout the infection. The duration of the trypanosomal infection was longer in copper-deficient rats compared with other groups. In all of the dietary groups, severe depression in the primary and secondary antibody responses (IgM and IgG) to in vivo immunization with sheep erythrocytes was observed in infected animals over noninfected controls. The results of the present study indicate that during copper deficiency, there are significant changes in food consumption and body weight and enhanced susceptibility to infection as measured by an increased parasitemia and depression in the antibody responses.

Animals↗