Biomedical subjects
Publications and source records attributed to D C Wong.
An incidental finding of an intracranial posterior fossa meningioma detected by bone scintigraphy is presented. Most of the published literature on the diagnosis of meningioma is on the use of CT and MRI. There is limited published literature on the detection of meningioma with bone scintigraphy.
The detection of methyl tertiary-butyl ether (MTBE) in groundwater and surface water in recent years has drawn attention to its potential effects in aquatic ecosystems. To address concerns regarding MTBE environmental effects and to establish safe concentrations in surface waters, a collaborative effort was initiated in 1997 to develop aquatic toxicity databases sufficient to derive ambient water quality criteria for MTBE consistent with United States Environmental Protection Agency (U.S. EPA) requirements. Acute toxicity data for six species, chronic toxicity data for a fish and an invertebrate, and plant toxicity data were developed in order to complete the freshwater database. The toxicity tests followed U.S. EPA and American Society for Testing and Materials (ASTM, Philadelphia, PA, USA) procedures and were conducted in accordance with U.S. EPA Good Laboratory Practice guidelines. Based on measured exposure concentrations, acute toxicity endpoints ranged from 472 to 1742 mg MTBE/L, while chronic endpoints (IC25) were 57 to 308 mg MTBE/L. Aquatic invertebrates were generally more sensitive than fish to MTBE in both acute and chronic exposures. Acute-to-chronic ratios for fathead minnows and Daphnia magna were 3.4 and 11.3, respectively. The measured acute and chronic toxicity were within a 10-fold factor of toxicity predicted from quantitative structure-activity relationships for baseline toxicity or nonpolar narcosis typical of ether compounds. The data developed in this study were consistent with existing data and showed that MTBE has low acute and chronic toxicity to freshwater organisms. Reported environmental concentrations of MTBE are several orders of magnitude lower than concentrations observed to cause effects in freshwater organisms.
Development of straightwire appliances and improvement in archwire technology have simplified fixed appliance therapy in orthodontics. Although straightwire appliances are routinely used to treat most malocclusions, there are inherent limitations and it is necessary to look at the needs of each individual case rather than to simply proceed through a "cookbook" series of archwires to achieve a desired result. The Bioprogressive Therapy, although biomechanically complex, offers several advantages that can be integrated with the straightwire appliances to overcome the latter's shortcomings. This article illustrates the use of simplified Bioprogressive mechanics by means of utility arch in the treatment of a Class II deep bite malocclusion with high anchorage requirement.
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UNLABELLED: The aim of this study was to evaluate the use of quantitative gravity-assisted drainage (GAD) using >50% residual activity as an indicator to confirm obstruction in diuretic renography in the investigation of hydronephrosis and hydroureteronephrosis in infants and children. This was evaluated in 2 groups: furosemide clearance half-time (t 1/2) > 20 min (obstructed range) and t 1/2 = 10-20 min (indeterminate range). METHODS: Two hundred children (155 boys, 45 girls; age range, 2 d to 16 y; median age, 26 wk) were studied over a 2-y period. One hundred thirty-five F+20 (diuretic given 20 min after radiopharmaceutical) and 65 F+0 (simultaneous administration of diuretic and radiopharmaceutical) studies were performed with intravenous administration of 99mTc-mercaptoacetyltriglycine (MAG3) and furosemide. At the end of the 20-min diuretic phase, a 5-min post-GAD image was obtained, and the percentage of residual activity was calculated by comparison with the last 5 min of the diuretic phase. All patients were monitored for 6-12 mo, and the final diagnoses were based on either surgical findings or conservative management with follow-up sonography or 99mTc-MAG3 studies. Results of the diuretic renography using quantitative GAD were then compared with the final diagnoses. RESULTS: A renal unit was defined as a kidney and its ureter. In the 200 patients studied, 256 hydronephrotic renal units were analyzed: 10 units showed no function, 1 unit showed poor function, 131 units had t 1/2 < 10 min, 62 units had t 1/2 > 20 min, and 52 units had t 1/2 = 10-20 min. Of the 131 renal units with t 1/2 < 10 min, there was only 1 case of obstruction. Using GAD > 50% residual activity for the diagnosis of obstruction in 62 renal units with t 1/2 > 20 min, the sensitivity was 88.4%, the specificity was 73.7%, and the accuracy was 83.9%. Similarly, using GAD > 50% residual activity for the diagnosis of obstruction in 52 units with t 1/2 = 10-20 min, the sensitivity was 100%, the specificity was 79.5%, and the accuracy was 82.7%. CONCLUSION: The quantitation of GAD > 50% residual activity in diuretic renography can help to differentiate between obstruction and nonobstruction in renal units with t 1/2 > 20 min and t 1/2 = 10-20 min. The quantitation of GAD when t 1/2 < 10 min is not useful because obstruction has already been excluded.
Effects of a homologous series of three primarily linear alcohol ethoxylate surfactants were studied in laboratory flow-through 28-day early-life-stage tests with fathead minnow (Pimephales promelas Rafinesque). Surfactants were a C(9-11), C(12-13), and C(14-15) with an average of 6, 6.5, and 7 ethylene oxide units per mole of alcohol, respectively. Average measured surfactant recoveries were 103%, 81%, and 79% of nominal concentrations for the C(9-11) EO 6, C(12-13) EO 6.5, and C(14-15) EO 7 studies, respectively. Embryo survival at 48 h was not adversely affected at any of the concentrations tested. Impaired hatching and deformed fry were observed only in the C(12-13) EO 6.5 study. The 28-day LC50 values were 4.87, 2.39, and 1.02 mg/L for the C(9-11) EO 6, C(12-13) EO 6.5, and C(14-15) EO 7 surfactants, respectively. The corresponding NOECs for survival were 1.01, 1.76, and 0.74 mg/L. Posthatch fry growth was more sensitive than survival for the C(12-13) EO 6.5 and C(14-15) EO 7 surfactants. Survival of posthatch fry decreased with increasing surfactant alkyl chain length. Twenty-eight-day laboratory data were compared to 96-h laboratory, 10-day laboratory and 30-day stream mesocosm data for fathead minnow previously determined for these surfactants. Survival endpoints from the different exposures were comparable and only varied within a factor of two. Similarity of results suggests that it is possible to effectively use 96-h, 10-day, or 28-day laboratory data to predict environmental effects concentrations of these surfactants for fish. http://link.springer-ny. com/link/service/journals/00244/bibs/37n4p536.html</++ +HEA
A case report of a large inguino-scrotal hernia detected in the early phase of a radionuclide bone scan is presented.
Hepatitis C virus (HCV) was transmitted from a patient with fulminant hepatitis C to a chimpanzee. The patient had developed two episodes of fulminant hepatitis C, each occurring after a separate liver transplantation. Serial serum and liver samples from the patient and the chimpanzee were analyzed for HCV replication, genotype, quasispecies heterogeneity, and antibodies. In the patient, the levels of HCV replication in serum and liver correlated with the degree of hepatocellular necrosis and the clinical expression of fulminant hepatitis. The same HCV strain, genotype 1a, was recovered from both episodes of fulminant hepatitis. An unusually severe acute hepatitis was also observed in the chimpanzee. The viruses recovered from the patient and the chimpanzee were almost identical and displayed relatively little quasispecies heterogeneity. Thus, the same HCV strain induced two episodes of fulminant hepatitis in a single patient and severe hepatitis in a chimpanzee, suggesting that the pathogenicity or virulence of a specific HCV strain may be important in the pathogenesis of fulminant hepatitis C.
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UNLABELLED: The purpose of this study was to evaluate the feasibility of modifying diuresis renography by the simultaneous administration of 99mTc-mercaptoacetyltriglycine (MAG3) and furosemide in the investigation of hydronephrosis and hydroureteronephrosis in infants and children. Two parameters were assessed: the diuretic response in normal kidneys and the ability of the F+0 study to differentiate between renal obstruction and nonobstruction and to identify the level of obstruction in cases of renal obstruction. METHODS: Seventy-two patients (48 males, 24 females; age 2 d to 7 y; median age 6 wk) with sonographic diagnoses of hydronephrosis or hydroureteronephrosis were reviewed prospectively over a 3-y period. All patients had prior sonographic studies and micturating cystourethrography. Bladder catheterization was not routinely performed and was undertaken only if the child had suspected vesicoureteric junction (VUJ) obstruction or grade II or more vesicoureteric reflux. A weight-adjusted dose of 99mTc-MAG3 (maximum 200 MBq, minimum 20 MBq) and 1 mg/kg of furosemide (maximum 40 mg) were administered intravenously at the same time. Posterior imaging of the kidneys and bladder was performed for 20 min and followed by gravity-assisted drainage or imaging after voiding. All patients were followed-up for 6-12 mo, and the final diagnoses were based on either surgery or conservative management with repeated sonography or follow-up 99mTc-MAG3 studies (or both). The results of the F+0 diuresis renography were then compared with the final diagnoses. RESULTS: A renal unit was defined as a kidney and its ureter. There were 151 renal units with 1 patient having bilateral duplex kidneys, 6 patients having unilateral duplex kidneys and 1 patient having a solitary kidney. Fifty-five normal renal units and 96 abnormal renal units on the basis of sonographic findings were assessed. The furosemide clearance half-time for the 55 normal renal units was 1.3-6.3 min (mean 3.8 min). Of the 96 abnormal renal units, 53 were classified as nonobstructed and 43 were classified as obstructed. Of the 53 renal units classified as nonobstructed, there were 48 true-negative studies and 5 false-negative studies; of the 43 renal units classified as obstructed, there were 40 true-positive studies and 3 false-positive studies. The sensitivity was 88.9%, specificity was 94.1% and accuracy was 91.7%. The level of obstruction, either pelviureteric junction or VUJ, was also correctly identified. CONCLUSION: F+0 diuresis renography shows excellent diuretic responses in normal kidneys and is a valid method for the investigation of hydronephrosis and hydroureteronephrosis in infants and children.
Estrogen can be hydroxylated at both 2- and 16alpha-positions. These two reactions are mutually exclusive. The 2-hydroxylated estrogen is relatively inactive compared with the 16alpha-derivative; hence, one approach in anti-estrogenic therapy is to look for drugs that can induce the 2-hydroxylation pathway. In the present study, using Balb/c and C57B/6 mice as the animal models, the induction effect of several isoprenyl compounds on estradiol-2-hydroxylase and ethoxyresorufin-O-deethylase activities was studied. The compounds examined included 2'- and 3'-methylbutadienyl-indoles and their respective acid condensation products, isopropyl indolocarbazole and yuehchukene; positional isomers of indole carbinols and carboxyaldehydes, as well as 3-methylcholanthrene, the prototype inducer of cytochrome P450 1A1. Our results demonstrated that while all of them were capable of inducing cytochrome P450 1A1-mediated ethoxyresorufin-O-deethylase activity, only the 3' isomers could induce estradiol-2-hydroxylase activity. The induction of these two activities did not show any direct correlation, suggesting that cytochrome P450 1A1 was not the same enzyme catalyzing both ethoxyresorufin-O-deethylation and estradiol-2-hydroxylation. Nevertheless, both inductions were mediated by the aryl hydrocarbon receptor. Among the compounds tested, yuehchukene showed competitive binding to estrogen receptor. This, together with the induction of estradiol-2-hydroxylase activity, may account for the anti-estrogenic effect of yuehchukene.
Six major genotypes (genotypes 1-6) of hepatitis C virus (HCV) have been identified. These genetic variants are being transmitted to chimpanzees, the only recognized animal model for the study of HCV. Genotype 5a (strain SA13), a variant found primarily in South Africa, has been transmitted to chimpanzees for the first time. Experimental infection of 2 chimpanzees was characterized by early appearance of viremia and peak virus titers of 10(5)-10(6) genome equivalents/mL. The HCV infection was resolved by week 15 after inoculation in 1 chimpanzee and persisted in the other. Both chimpanzees became anti-HCV-positive by week 14 after inoculation. Both chimpanzees developed viral hepatitis. The infectivity titer of a genotype 5a challenge pool prepared from the first passage of HCV in a chimpanzee was approximately 10(4) infectious doses/mL. Finally, sequence analysis of strain SA13 confirmed that genotype 5a is genetically distinct from other genotypes of HCV.
A 68-year-old woman reported acute severe pain in both lower limbs during a dipyridamole sestamibi myocardial perfusion scan. The pain was rapidly relieved by the administration of intravenous aminophylline. A review of the literature on the adverse effects of dipyridamole did not include this symptom.
Culture supernatant harvested from Daudi cells, a lymphoplastoid cell line, after 58 days of infection with the H77 strain of hepatitis C virus (HCV), was inoculated into a chimpanzee. HCV RNA, as detected by RT-PCR, first appeared in the serum and liver 5 and 6 weeks, respectively, after inoculation. Peripheral blood mononuclear cells (PBMC) collected on week 7 were also positive for HCV RNA. The major sequences of hypervariable region 1 (HVR1) of the viral genome recovered from the inoculated chimpanzee were the ones which were the majority in the original H77 inoculum and not those which were in the majority in the culture supernatant. Only the sequence recovered from PBMC was the same as the major one found in the cell culture.
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Two case reports of intra-axial posterior fossa cryptococcosis in immunocompetent patients are presented. Magnetic resonance findings of solitary abscesses with mildly irregular peripheral enhancement within the medulla, and irregular peripheral enhancement with a nodular component within the right cerebellum are described.
Of 13 different strains of hepatitis C virus (HCV) in the inoculum used, only 1 persisted in human lymphocyte cell lines infected in vitro (N. Nakajima, M. Hijikata, H. Yoshikura, and Y. K. Shimizu, J. Virol. 70:3325-3329, 1996). To determine whether that particular strain (designated H1-2) has a tropism for lymphocytes in vivo, we sequenced hypervariable region 1 (HVR1) of the genome of HCV recovered from the sera, livers, and peripheral blood mononuclear cells (PBMC) of chimpanzees infected with plasma H77, the same inoculum used for the in vitro studies. In the PBMC collected from two chimpanzees during the early phase of infection, H1-2 was detected as the only or predominant HVR1 sequence. H1-2 was also detected in PBMC obtained during persistent infection from a chimpanzee that had been treated with immunosuppressants. From the livers of these chimpanzees, two to six different strains were recovered but H1-2 was not detected. Thus, H1-2 appeared to have an affinity for lymphocytes not only in vitro but also in vivo. In samples collected from a chimpanzee after 6 years of infection, however, such tissue compartmentalization of the HCV genome was not observed; a single strain became predominant in the serum, liver, and PBMC. An HCV strain capable of replicating in both the liver and PBMC probably emerged during in vivo replication and persisted.
We describe a patient with acquired immunodeficiency syndrome (AIDS) and an unusual rheumatoid factor-positive symmetric inflammatory polyarthritis who met all 7 American College of Rheumatology criteria for RA, but who also had many features suggestive of seronegative inflammatory arthritis. Although cutaneous vasculitis has also been described in human immunodeficiency virus infection, this is the first report of cutaneous extravascular necrobiotic granuloma (rheumatoid papule) in AIDS. This case highlights the immunopathogenesis of inflammatory arthritis in AIDS and illustrates the difficulties in making a classic rheumatic diagnosis in the setting of the immune dysregulation caused by AIDS.