Biomedical subjects

C W Lee

Publications and source records attributed to C W Lee.

At least 91 records · Page 5Linked to original sources

PubMed2000

Monitoring of extracellular pyruvate, lactate, and ascorbic acid during cerebral ischemia: a microdialysis study in awake gerbils.

In vivo microdialysis coupled with liquid chromatography was developed for the continuous monitoring of brain neurochemicals during cerebral ischemia in awake, free moving gerbils. The dead volume of the microdialysis system was estimated to be less than 30 microl. The detection limits of the present assay were 0.2 to 2.0 microM for analytes at a signal to noise ratio of five. To validate this assay, a focal cerebral ischemia was produced by occlusion of one common carotid artery for 60 min and then reperfusion for additional 3 h in awake gerbils. A microdialysis probe was inserted into the striatum of the gerbil. Dialysates were autoinjected and analyzed extracellular pyruvate, lactate, and ascorbic acid by liquid chromatography with a UV detector during cerebral ischemia. Significant changes of pyruvate and the lactate/pyruvate ratio were observed. Biphasic and dynamic changes in ascorbic acid and lactate were proposed to correlate a secondary damage. This assay can be used as a tool to study dynamic changes of brain neurochemicals in awake animals.

Animals↗

PubMed2000

Intravascular ultrasonic predictors of angiographic restenosis after long coronary stenting.

The intravascular ultrasound (IVUS) criteria for stent optimization have not been determined in stenting long lesions. We evaluated the predictors of angiographic restenosis and compared it with stent lumen cross-sectional area (CSA) and stent length between short (stent length <20 mm) and long (> or =20 mm) coronary stenting. IVUS-guided coronary stenting was successfully performed in 285 consecutive patients with 304 native coronary lesions. Six-month follow-up angiogram was performed in 236 patients (82.8%) with 246 lesions (80.9%). Results were evaluated using conventional (clinical, angiographic, and IVUS) methods. The overall angiographic restenosis rate was 22.8% (56 of 246 lesions) (short stent 17.6% vs. long stent 32.2%, p = 0.009). Using multivariate logistic regression analysis, the independent predictors of angiographic restenosis were the IVUS stent lumen CSA (odds ratio 1.51, 95% confidence intervals 1.18 to 1.92, p = 0.001) and stent length (odds ratio 0.95, 95% confidence intervals 0.91 to 1.00, p = 0.039). The angiographic restenosis rate was 54.8% for stent lumen CSA of <5.0 mm2 (short stent 37.5% vs. long stent 73.3%, p = 0.049), 27.4% for CSA between 5.0 and 7.0 mm2 (short stent 24.1% vs. long stent 31.7%, p = 0.409), 10.5% for CSA between 7.0 and 9.0 mm2 (short stent 10.0% vs. long stent 12.5%, p = 0.772), and 11.4% for stent lumen CSA of > or =9.0 mm2 (short stent 10.4% vs. long stent 13.3%, p = 0.767) (p = 0.001). Compared with short coronary stenting, long coronary stenting is effective treatment modality to cover long lesions with comparable long-term clinical outcomes in cases of stent lumen CSA of > or =7.0 mm2. Regardless of the stent length, the most important factor determining angiographic restenosis was the IVUS stent lumen CSA in relatively large coronary artery lesions.

Blood Vessel Prosthesis Implantation↗

PubMed2000

The effect of inoculum density and conditioned medium on the production of ajmalicine and catharanthine from immobilized Catharanthus roseus cells.

The effect of the cell-inoculum size and the addition of conditioned medium on ajmalicine and catharanthine production were studied using immobilized Catharanthus roseus cells. Higher specific-uptake rates of ammonium, nitrate, and sugars were observed in the low-inoculum-density cultures (50 g FW/L) compared to the high-inoculum-density cultures (100 g FW/L). Alkaloid production was not correlated with the exhaustion of a particular nutrient from the medium. The high-inoculum-density cultures produced higher ajmalicine concentrations throughout the experiment. Catharanthine production was similar between the two inoculum-density cultures. The addition of conditioned medium to MS-production medium dramatically improved the production of ajmalicine and catharanthine. The addition of conditioned medium enhanced ajmalicine production from immobilized Catharanthus roseus cultures on day 15 by at least two- to fourfold compared to media without the conditioning factors. Catharanthine production was increased by nearly fivefold in cultures with conditioned medium compared to those without conditioned medium. The enhancing effects of conditioned medium on alkaloid production were attributed to an unidentified factor produced and secreted by suspension cultures of C. roseus. The presence of conditioned medium also decreased the sucrose hydrolysis rate. The ajmalicine concentration in these immobilized cell cultures was found to be a function of the fresh-weight concentration, irrespective of the inoculum density or the culture medium. The medium choice and the inoculum density determined how rapidly fresh weight was accumulated and thus, how quickly ajmalicine was produced. Ajmalicine production correlated positively with fresh-weight concentration, but catharanthine production was not correlated with fresh-weight concentration.

Biotechnology↗

PubMed2000

Stent placement for ostial left anterior descending coronary artery stenosis: acute and long-term (2-year) results.

This study was performed to assess the acute and long-term results of elective stenting for the treatment of ostial left anterior descending coronary artery (LAD) stenosis. One hundred and eleven consecutive patients with ostial LAD stenting were included for this study. Follow-up angiography was performed at 6 months and clinical evaluation at regular intervals after stenting. Procedural success rate was 97.3%. Four patients developed non-Q myocardial infarction and one patient underwent emergency bypass surgery due to a large dissection after stenting. Angiographic restenosis rate was 26.1% (18/69), and target lesion revascularization rate 11.7%. The final luminal diameter after stenting was the only predictor of angiographic restenosis. Clinical follow-up was obtained in all patients at 21.5 +/- 16.0 months. Two patients died during the follow-up. Event-free survival rate was 84.6 +/- 3.8%. In conclusions, stenting with or without debulking atherectomy may be considered as an acceptable therapeutic option for the treatment of ostial LAD stenosis.

Aged↗

PubMed2000

Side-branch occlusion after rotational atherectomy of in-stent restenosis: incidence, predictors, and clinical significance.

We evaluated the incidence, predictors, and clinical significance of side-branch occlusion (SBO) after rotational atherectomy (RA) for treatment of in-stent restenosis (ISR) and compared it with those of native coronary artery (NC). RA was performed in 64 patients with 34 ISR (42 side branches) and 30 NC (40 side branches). SBO occurred 14% after RA in ISR group compared with 0% in NC group (P < 0.05), and 33% after adjunctive balloon inflation in ISR group compared with 2.5% in NC group (P < 0.01). Non-Q myocardial infarction developed in seven patients in ISR group and four patients in NC group (P = NS). The presence of significant side-branch (SB) ostial disease (OR = 4.7, P < 0.05) and ISR lesions (OR = 15.5, P < 0.05) were the only independent predictors of SBO by multivariate analysis. The incidence of SBO is higher after RA of ISR than RA of NC and may be associated with an increased risk of non-Q myocardial infarction.

Angioplasty, Balloon, Coronary↗

PubMed2000

Long-term outcomes of minor plaque prolapsed within stents documented with intravascular ultrasound.

The direct relationship between minor plaque prolapsed within stents and late in-stent restenosis is unknown. Therefore, we evaluated the impact of minor plaque prolapse on late angiographic in-stent restenosis. Intravascular ultrasonography (IVUS)-guided single-coronary stenting was successfully performed on 384 consecutive patients with 407 native coronary lesions. Six-month follow-up angiographic evaluation was performed on 315 patients (82. 0%) with 334 lesions (82.1%). Minor plaque prolapsed within the stent was found in 75 of 334 lesions (22.5%). Results were evaluated using angiographic and IVUS methods. The development of minor plaque prolapse was significantly associated with infarct-related artery (P = 0.000) and small pre-intervention minimal lumen diameter (P = 0. 001). The overall angiographic restenosis rate was 23.1% (77/334)-21.3% (16/75) in the lesions with plaque prolapse vs. 23.6% (61/259) in the lesions without plaque prolapse (P = 0.806). In conclusion, minor plaque prolapsed within stents might not be associated with late angiographic in-stent restenosis.

Aged↗

PubMed2000

Determinants of coronary blood flow following primary angioplasty for acute myocardial infarction.

The aim of this study was to evaluate determinants of coronary blood flow following primary angioplasty (PA) in acute myocardial infarction (AMI). The corrected TIMI (thrombolysis in myocardial infarction) frame count and the TIMI flow grade were used as indexes of coronary blood flow, and its determinants were examined in 115 consecutive AMI patients who underwent PA (pain onset </= 12 hr). The following were validated as univariate predictors of slower corrected TIMI frame count: a lower pressure-derived farctional collateral flow (PDCF) index (P < 0.01), poor angiographic collaterals (P < 0.01), TIMI flow 0, 1 before PA (P < 0.05), and the presence of heavy thrombi (P < 0.01). The PDCF index and the presence of heavy thrombi were independent predictors of the corrected TIMI frame count. Likewise, the PDCF index (chi(2) = 12.9; P < 0.01) and the presence of heavy thombi (chi(2) = 11.4; P < 0.01) were independent predictors of TIMI 3 flow. In conclusion, collateral flow and the presence of thrombi are major determinants of coronary blood flow after PA in AMI.

Aged↗

PubMed2000

Immediate and late clinical and angiographic outcomes after GFX coronary stenting: is high-pressure balloon dilatation necessary?

BACKGROUND: The GFX stent is a balloon-expandable stent made of sinusoidal element of stainless steel. The adjunct high-pressure balloon dilatations were usually recommended in routine stenting procedure. HYPOTHESIS: The aim of this study was to evaluate the immediate and long-term clinical and angiographic outcomes and to investigate the necessity of high-pressure balloon dilatation during GFX stenting. METHODS: In all, 172 consecutive patients underwent single 12 or 18 mm GFX stent implantation in 188 native coronary lesions. Two types of stenting technique were used: (1) stent size of a final stent-to-artery ratio of 1:1 (inflation pressure > 10 atm, high-pressure group), and (2) stent size of 0.5 mm bigger than reference vessel (inflation pressure < or = 10 atm, low-pressure group). The adjunct high-pressure balloon dilatations were performed only in cases of suboptimal results. RESULTS: The adjunct high-pressure balloon dilatation was required in 11 of 83 lesions (13%) in the high-pressure group and in 7 of 105 lesions (7%) in the low-pressure group (p = 0.203). Procedural success rate was 100%. There were no significant differences of in-hospital and long-term clinical events between the two groups. The overall angiographic restenosis rate was 17.7%; 18.4% in the high-pressure group and 17.1% in the low-pressure group (p = 0.991). CONCLUSIONS: The GFX stent is a safe and effective device with a high procedural success rate and favorable late clinical outcome for treatment of native coronary artery disease. Further randomized trials may be needed to compare stenting techniques in GFX stent implantation.

Catheterization↗

PubMed2000

Immunomodulating activity of a polysaccharide isolated from Mori Cortex Radicis.

The immunomodulating activity of a polysaccharide isolated from Morus alba (PMA) root bark was examined in murine splenic lymphocytes. PMA enhanced proliferation of splenic lymphocytes in a synergistic manner in the presence of mitogens. However, PMA suppressed primary IgM antibody production from B cells, which was activated with lipopolysaccharide, a polyclonal activator, or immunized with a T-cell dependent antigen sheep red blood cells. Our observations showed that the immunomodulating activity of PMA increased lymphocyte proliferation and that PMA decreased antibody production from B cells, which was distinct from those of other plant-originated polysaccharides.

Adjuvants, Immunologic↗

PubMed2000

Effect of extracellular cations on the chemotherapeutic efficacy of anticancer drugs.

Cancer development and the efficiency of chemotherapy relies on the patients calcium-related pathological status such as hyper- or hypocalcemia. In the present study, we investigated the effect of extracellular cations such as calcium and magnesium on the therapeutic efficacy of antitumor drugs. The analytic parameters used were cellular drug uptake/excretion and the chemosensitivity of the human breast cancer cell lines, MCF7 and MCF7/ADR. Both calcium and magnesium ions decreased the membrane permeability of cancer cells, which was determined by cell size analysis. These divalent ions also lowered the drug uptake and the cytoplasmic levels of rhodamine 123 and adriamycin, suggesting that they might interfere with the diffusion of these drugs by modifying the physical properties of the cytoplasmic membrane. The acute cytotoxicity of adriamycin after a short period of incubation correlated with changes in its cytoplasmic level. Our results indicate that these extracellular cations might play an important role in the therapeutic activities of anticancer drugs in cancer patients. These results also provide insight a new aspect of chemotherapy, because they suggest that the therapeutic doses of anti-cancer drugs should be modified in cancer-bearing patients presenting with abnormal blood calcium levels.

Antineoplastic Agents↗

PubMed2000

Detection of radiation effects using recombinant bioluminescent Escherichia coli strains.

Effects of ionizing radiation (0.1-500 Gy) on recombinant Escherichia coli cells containing the stress promoters recA, grpE, or katG, fused to luxCDABE, were characterized by monitoring transcriptional responses reflected by the bioluminescent output. The minimum dose of gamma-irradiation detected by E. coli DPD2794 (recA::luxCDABE) was about 1.5 Gy, while the maximum response was obtained at 200 Gy. The amount of emitted bioluminescence increased proportionally with the gamma-ray doses which were found to elicit a DNA damage response in a range of 1-50 Gy. In addition, the cell growth rate was severely, but transiently, retarded by about 50 Gy. Quantification of the gamma-ray dose may be possible using the recA promoter fusion, since linear enhancement of the bioluminescence emission with increasing gamma-ray dose was observed. Other irradiated strains (50 Gy) responsive to either oxidative stress (DPD2511, katG::luxCDABE) or protein-damaging stress (TV1061, grpE::luxCDABE) did not display an increased bioluminescent output, while DPD2794 irradiated by the same dose of gamma-rays gave a significant bioluminescent output. This indicates that the recA promoter is the one most suitable for developing a biosensor for ionizing radiation.

Bacterial Proteins↗

PubMed2000

Evidence of genetic diversity generated by recombination among avian coronavirus IBV.

Previously, we demonstrated that the DE072 strain of IBV is a recombinant which has an IBV strain D1466-like sequence in the S gene. Herein, we analyzed the remaining 3.8 kb 3' end of the genome, which includes Gene 3, Gene 4, Gene 5, Gene 6, and the 3' non-coding region of the DE072 and D1466 strains. Those two viruses had high nucleotide similarity in Gene 4. However, the other individual genes had a much different level of sequence similarity with the same gene of the other IBV strains. The genome of five IBV strains, of which the complete sequence of the 3' end of the genome has been determined, were divided at an intergenic (IG) consensus sequence (CTGAACAA or CTTAACAA) and compared phylogenetically. Phylogenetic trees of different topology indicated that the consensus IG sequences and the highly conserved sequence around this regions may serve as recombination 'hot spots'. Phylogenetic analysis of selected regions of the genome of the DE072 serotype field isolates further support those results and indicate that isolates within the same serotype may have different amounts of nucleotide sequence similarity with each other in individual genes other than the S gene. Presumably this occurs because the consensus IG sequence serves as the template switching site for the viral encoded polymerase.

Animals↗

PubMed2000

Mixed connective tissue disease associated with skin defects of livedoid vasculitis.

A 21-year-old woman who had a 2-year history of mixed connective tissue disease (MCTD) developed rapidly evolving ulcers consistent with livedoid vasculitis (LV) in all distal extremities. She presented clinically with Raynaud's phenomenon, polyarthritis and swollen hands; serologically with high titres of ANA and anti-nRNP; and immunogenetically with HLA-DR4 and HLA-DR53. Although there was initial success in treatment except for the skin defects over the ankles, the patient died from disseminated intravascular coagulation. We suggest that LV may be a poor prognostic manifestation in MCTD.

Adult↗

PubMed2000

Multivessel coronary stenting versus bypass surgery in patients with multivessel coronary artery disease and normal left ventricular function: immediate and 2-year long-term follow-up.

BACKGROUND: Compared with coronary artery bypass surgery (CABG), the clinical benefits of intracoronary stenting have not been established in patients with multivessel coronary lesions. METHODS AND RESULTS: To compare the clinical outcomes of intracoronary stenting with that of CABG, we reviewed the outcomes of patients with multivessel coronary artery disease from an observational database. Two hundred consecutive patients with multivessel coronary artery disease and normal left ventricular function were evaluated. In 200 patients, multivessel stenting was performed in 100 and CABG was performed in 100. Complete revascularization was achieved in 95% in the CABG group and in 69% in the stent group (P <.05). The duration of total hospital stay and coronary care unit admission was significantly shorter in the stent group (P <.05). The long-term survival was similar between the 2 groups. There were no significant differences of cardiac events between the 2 groups except for the recurrence of angina (19% in stenting vs 8% in CABG, P =.03) and target lesion revascularization (19% vs 2%, P <.01) in the patients with stents. CONCLUSIONS: In selected patients with multivessel coronary artery disease and normal left ventricular function, intracoronary stenting may offer an effective alternative to coronary bypass surgery.

Aged↗

PubMed2000

Safety and clinical impact of ergonovine stress echocardiography for diagnosis of coronary vasospasm.

OBJECTIVES: We sought to address the issues of safety, feasibility and clinical impact of noninvasive diagnosis of coronary vasospasm (CVS). BACKGROUND: The safety of ergonovine provocation for CVS performed outside the catheterization laboratory has been questioned. METHODS: We performed a retrospective analysis of the results of bedside ergonovine provocation testing by monitoring left ventricular regional wall motion abnormalities (RWMAs) using two-dimensional echocardiography (Erg Echo). RESULTS: After confirming that there was no significant epicardial coronary stenosis, Erg Echo was performed on 1,372 patients from July 1991 to December 1997. Ergonovine echocardiography was terminated prematurely in 13 patients (0.9%) because of limitations caused by side effects unrelated to myocardial ischemia. Among 1,359 completed tests, 31% (n = 421) showed positive results, with development of RWMAs in 412 tests (98%) or ST displacement in electrocardiograms of nine tests (2%). Arrhythmias developed in 1.9% (26/1,372), including transient ventricular tachycardia (n = 2) and atrioventricular block (n = 4), which were promptly reversed with nitroglycerin. There was no mortality or development of myocardial infarction. Based on the angiographic criteria of 218 patients, the sensitivity and specificity of Erg Echo for the diagnosis of CVS were 93% and 91%, respectively. Since 1994, Erg Echo has become a more popular diagnostic method than invasive spasm provocation testing in the catheterization laboratory and has comprised more than 95% of all spasm provocation tests during the last three years. In the outpatient clinic, 453 patients underwent Erg Echo safely. CONCLUSIONS: Although this is a retrospective study in a single center, we believe that Erg Echo is highly feasible, accurate and safe for the diagnosis of CVS and can replace invasive angiographic spasm provocation testing in the catheterization laboratory.

Adult↗

PubMed2000

The standard of reporting of health-related quality of life in clinical cancer trials.

UNLABELLED: The standard of reporting of randomized controlled trials (RCTs) is important to the interpretation of outcomes such as health-related quality of life (HRQL). HRQL is used increasingly as an outcome in clinical cancer trials. DESIGN: All 1997 issues of 36 selected journals were hand searched to identify original articles that included the term "quality of life" in the title, abstract, keywords or methods. Studies were included if they were RCTs and addressed cancer-related topics. A checklist to assess the adequacy of reporting of HRQL was developed based on a guideline previously published by an expert panel. Two unblinded reviewers applied the quality of life reporting (QLR) and CONSORT checklists, along with an instrument to assess the likelihood of bias to each selected RCT. RESULTS: 72 articles were identified of which 20 were RCTs and cancer-related. For these 20 reports the median number of items in the QLR checklist that were adequately reported is 42% (range 15% to 85%). The median number of items in the CONSORT checklist that were adequately reported is 70% (range 47% to 95%). The mean score for the instrument to assess the likelihood for bias is 2.6 (95% CI 2. 08-3.12). CONCLUSIONS: The current standard of reporting of HRQL needs to be improved. Major deficiencies that should be addressed are failure to provide a rationale for HRQL assessment and inadequate description of methodology. Development and application of structured formats for presentation of HRQL may help to improve the standard of reporting of HRQL in the literature.

Guidelines as Topic↗

PubMed2000

Conductimetric membrane strip immunosensor with polyaniline-bound gold colloids as signal generator.

For point-of-care examination, an immuno-chromatographic assay system based on conductimetric detection was investigated by utilizing, as signal generator, colloidal gold with polyaniline bound on the metal surface. Although the gold is a widely used label for antibodies to produce colorimetric signals, the tracer does not lend itself for a suitable electric conduction along the gold particles due to the presence of protein barriers (e.g. immunoglobulin and blocking agent) against electron transfer. To overcome this problem, we introduced a conducting polymer, for instance, polyaniline, as a conductivity-modulating agent on the gold surface after immobilizing an antibody specific to human albumin used as model analyte. This novel signal generator amplified the conductimetric signal 4.7 times compared with the plain gold, and the signal was also maximum 2.3-fold higher than that from the photometric system under the same analytical conditions. The latter effect resulted from an exponential pattern in the dose-response curve of the electric signal that was different from the conventional sigmoidal shape.

Aniline Compounds↗

PubMed2000

Clinical outcome of internal iliac artery occlusions during endovascular treatment of aortoiliac aneurysmal diseases.

PURPOSE: To determine the clinical outcome of hypogastric artery occlusion in patients who underwent endovascular treatment of aortoiliac aneurysmal disease. MATERIAL AND METHODS: From January 1994 to March 1998, 94 patients underwent endovascular treatment of aneurysmal diseases involving the infra-abdominal aorta or iliac arteries. Preoperative and intraoperative radiologic data were reviewed. Discharge summaries, clinic visits, and phone calls formed the basis for clinical follow-up, with a mean follow-up period of 7.3 months (range, 1-24 months). RESULTS: Because of the anatomy of the aneurysms, 28 patients required occlusion of one or more hypogastric arteries. One of the 28 patients died of unrelated causes before follow-up. Seven (26%) of the remaining 27 patients developed symptoms attributable to the hypogastric artery occlusions. Five patients developed new buttock or thigh claudication; of these five patients, three with initially mild symptoms noted complete or near complete resolution of symptoms upon follow-up. One patient with originally significant claudication at 2-year follow-up noted near resolution of symptoms. The other patient with severe pain did not improve significantly on final 1-year follow-up before his death (of unrelated causes). Other clinical complications were worsening sexual function in one patient and a nonhealing sacral decubitus ulcer that developed in a debilitated patient in the postoperative setting, which required surgery. No bowel ischemia was observed. CONCLUSION: When treating aortoiliac aneurysmal disease through an endovascular approach, the occlusion of internal iliac artery is often necessary but carries with it a small but finite chance of morbidity.

Adult↗