Biomedical subjects

E K Wong

Publications and source records attributed to E K Wong.

At least 19 recordsLinked to original sources

PubMed2006

Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms.

OBJECTIVES: Although acupuncture therapy has demonstrated itself to be effective in several clinical areas, the underlying mechanisms of acupuncture in general and the analgesic effect in particular are, however, still not clearly delineated. We, therefore, have studied acupuncture analgesic effect through fMRI and proposed a hypothesis, based on the obtained result, which will enlighten the central role of the brain in acupuncture therapy. METHODS: The proposed model, termed as a broad sense hypothalamus-pituitary-adrenal (BS-HPA) axis, was based on our observed neuroimaging results. The model incorporates the stress-induced HPA axis model together with neuro-immune interaction including the cholinergic anti-inflammatory model. RESULTS: The obtained results coupled with accumulating evidence suggest that the central nervous system is essential for the processing of these effects via its modulation of the autonomic nervous system, neuroimmune system and hormonal regulation. CONCLUSIONS: Based on our fMRI study, it appears that understanding the effects of acupuncture within a neuroscience-based framework is vital. Further, we have proposed the broad sense-HPA axis hypothesis which incorporates the experimental results.

Acupuncture Therapy↗

PubMed2000

Importance of the medial meniscus in the anterior cruciate ligament-deficient knee.

The incidence of meniscal tears in the chronically anterior cruciate ligament-deficient knee is increased, particularly in the medial meniscus because it performs an important function in limiting knee motion. We evaluated the role of the medial meniscus in stabilizing the anterior cruciate ligament-deficient knee and hypothesized that the resultant force in the meniscus is significantly elevated in the anterior cruciate ligament-deficient knee. To test this hypothesis, we employed a robotic/universal force-moment sensor testing system to determine the increase in the resultant force in the human medial meniscus in response to an anterior tibial load following transection of the anterior cruciate ligament. We also measured changes in the kinematics of the knee in multiple degrees of freedom following medial meniscectomy in the anterior cruciate ligament-deficient knee. In response to a 134-N anterior tibial load, the resultant force in the medial meniscus of the anterior cruciate ligament-deficient knee increased significantly compared with that in the meniscus of the intact knee; it increased by a minimum of 10.1 N (52%) at full knee extension to a maximum of 50.2 N (197%) at 60 degrees of flexion. Medial meniscectomy in the anterior cruciate ligament-deficient knee also caused a significant increase in anterior tibial translation in response to the anterior tibial load, ranging from an increase of 2.2 mm at full knee extension to 5.8 mm at 60 degrees of flexion. Conversely, coupled internal tibial rotation in response to the load decreased significantly, ranging from a decrease of 2.5 degrees at 15 degrees of knee flexion to 4.7 degrees at 60 degrees of flexion. Our data confirm the hypothesis that the resultant force in the medial meniscus is significantly greater in the anterior cruciate ligament-deficient knee than in the intact knee when the knee is subjected to anterior tibial loads. This indicates that the demand on the medial meniscus in resisting anterior tibial loads is increased in the anterior cruciate ligament-deficient knee compared with in the intact knee, suggesting a mechanism for the increased incidence of medial meniscal tears observed in chronically anterior cruciate ligament-deficient patients. The large changes in kinematics due to medial meniscectomy in the anterior cruciate ligament-deficient knee confirm the important role of the medial meniscus in controlling knee stability. These findings suggest that the reduction of resultant force in the meniscus may be a further motive for reconstructing the anterior cruciate ligament, with the goal of preserving meniscal integrity.

Aged↗

PubMed1999

In situ force distribution in the glenohumeral joint capsule during anterior-posterior loading.

Our objective was to examine the function of the glenohumeral capsule and ligaments during application of an anterior-posterior load by directly measuring the in situ force distribution in these structures as well as the compliance of the joint. We hypothesized that interaction between different regions of the capsule due to its continuous nature results in a complex force distribution throughout the glenohumeral joint capsule. A robotic/universal force-moment sensor testing system was utilized to determine the force distribution in the glenohumeral capsule and ligaments of intact shoulder specimens and the joint kinematics resulting from the application of external loads at four abduction angles. Our results suggest that the glenohumeral capsule carries no force when the humeral head is centered in the glenoid with the humerus in anatomic rotation. However, once an anterior-posterior load is applied to the joint, the glenohumeral ligaments carry force (during anterior loading, the superior glenohumeral-coracohumeral ligaments carried 26+/-16 N at 0 degrees and the anterior band of the inferior glenohumeral ligament carried 30+/-21 N at 90 degrees). Therefore, the patient's ability to use the arm with the humerus in anatomic rotation should not be limited following repair procedures for shoulder instability because the repaired capsuloligamentous structures should not carry force during this motion. Separation of the capsule into its components revealed that forces are being transmitted between each region and that the glenohumeral ligaments do not act as traditional ligaments that carry a pure tensile force along their length. The interrelationship of the glenohumeral ligaments forms the biomechanical basis for the capsular shift procedure. The compliance of the joint under our loading conditions indicates that the passive properties of the capsule provide little resistance to motion of the humerus during 10 mm of anterior or posterior translation with anatomic humeral rotation. Finally, this knowledge also enhances the understanding of arm positioning relative to the portion of the glenohumeral capsule that limits translation during examination under anesthesia.

Aged↗

PubMed1999

Use of robotic technology for diathrodial joint research.

Knowledge of diarthrodial joint mechanics and specific function of the ligaments are needed in order to understand injury mechanisms, improve surgical procedures and design better post-surgical rehabilitation protocols. To facilitate these needs, a robotic/universal force-moment sensor (UFS) testing system was developed to measure joint kinematics in multiple degree-of-freedom and the in situ forces in the ligaments. When operated in the position control mode, the testing system applies a known load to the intact joint while the motion and force data are recorded. After transection of a ligament, the recorded motion for the intact joint is repeated and new force and moment data is recorded by the UFS. Since the robot reproduces the identical initial position as well as path of joint motion before and after a ligament is transected, the in situ force in the ligament is the difference between the two sets of force and moment data. In force control mode, a known force is applied to the intact knee while the kinematics are recorded. After ligament transection, the same force is applied while the changes in kinematics are again recorded. Testing in this mode is similar to a clinical examination that diagnoses ligament injury. To date, this testing system has been used for experimental studies that examine the anterior cruciate ligament & posterior cruciate ligament of the knee and ligaments of the shoulder. A three-dimensional finite element model has also been constructed based on CT/MRI scans of a knee specimen and validated using data obtained with the testing system. Once in vivo kinematics (such as during gait analysis or throwing activities) are available, the robotic/UFS testing system can be programmed to reproduce these joint kinematics on young human cadaveric specimens in order to generate a database for in situ forces in the ligaments, or Ligament replacement grafts. With appropriate computational models, the stresses and strains in these tissues in vivo can also be determined. Potential applications of this combined approach include pre-operative surgical planning, improvement of surgical procedures as well as development of appropriate post-operative rehabilitation protocols.

Biomechanical Phenomena↗

PubMed1999

Injury and reconstruction of the anterior cruciate ligament and knee osteoarthritis.

OBJECTIVE: The objective of this study was to study injury and reconstruction of the anterior cruciate ligament (ACL) and their effects on knee osteoarthritis. DESIGN: This manuscript discusses the function of knee ligaments, including the basic mechanical properties, the structural properties of their respective bone-ligament-bone complexes, as well as their time- and history-dependent viscoelastic characteristics. The in-situ forces in the ACL and its replacement grafts and knee kinematics before and after ACL reconstruction are also examined. RESULTS: A robotic/universal force-moment sensor (UFS) testing system has been developed which offers a unique method in determining the multiple-degree of freedom knee kinematics and in-situ forces in human cadaveric knees. Under a 110 N anterior tibial load we found at flexion angles of 15 degrees or lower, there was a significantly larger in-situ force in the PL bundle (approximately 75 N) of the ACL as compared to the AM bundle (approximately 35 N)(P < 0.05). We also found that a quadruple semitendinosus and gracilis tendon ACL graft may be better at fully restoring in-situ forces for the whole range of knee flexion when compared to a bone-patellar tendon-bone ACL graft. CONCLUSIONS: The robotic/UFS testing system allows us to determine knee kinematics and the in-situ forces in cadaveric knees in a non-invasive, non-contact manner. Additionally, the ability to reproduce kinematics during testing allows us to evaluate ACL and ACL graft function under external and simulated muscle loading conditions. Finally, we can also examine many of the variables of ACL reconstructions that affect knee kinematics and graft forces including graft tensioning, graft type, graft placement and tibial positioning during graft fixation.

Anterior Cruciate Ligament↗

PubMed1999

An analytical approach to determine the in situ forces in the glenohumeral ligaments.

The purpose of this study was to use an analytical approach to determine the forces in the glenohumeral ligaments during joint motion. Predictions from the analytical approach were validated by comparing them to experimental data. Using a geometric model, the lengths of the four glenohumeral ligaments were determined during anterior-posterior loading simulations and forward flexion-extension. The corresponding force in each structure was subsequently calculated based on length data via load-elongation curves obtained experimentally. During the anterior loading simulation at 0 deg of abduction, the superior glenohumeral ligament carried up to 71 N at the maximally translated position. At 90 deg of abduction, the anterior band of the inferior glenohumeral ligament had the highest force of 45 N during anterior loading. These results correlated well with those found in previous experimental studies. We believe that this validated analytical approach can be used to predict the forces in the glenohumeral ligaments during more complex joint motion as well as assist surgeons during shoulder repair procedures.

Aged↗

PubMed1998

New findings of the correlation between acupoints and corresponding brain cortices using functional MRI.

A preliminary study of the correlation between acupuncture points (acupoints) for the treatment of eye disorders suggested by ancient Oriental literature and the corresponding brain localization for vision described by Western medicine was performed by using functional MRI (fMRI). The vision-related acupoint (VA1) is located in the lateral aspect of the foot, and when acupuncture stimulation is performed there, activation of occipital lobes is seen by fMRI. Stimulation of the eye by directly using light results in similar activation in the occipital lobes by fMRI. The experiment was conducted by using conventional checkerboard 8-Hz light-flash stimulation of the eye and observation of the time-course data. This was followed by stimulation of the VA1 by using the same time-course paradigm as visual light stimulation. Results obtained with 12 volunteers yielded very clean data and very close correlations between visual and acupuncture stimulation. We have also stimulated nonacupoints 2 to 5 cm away from the vision-related acupoints on the foot as a control, and activation in the occipital lobes was not observed. The results obtained demonstrate the correlation between activation of specific areas of brain cortices and corresponding acupoint stimulation predicted by ancient acupuncture literature.

Acupuncture Points↗

PubMed1998

Effects of the acoustic noise of the gradient systems on fMRI: a study on auditory, motor, and visual cortices.

MR acoustic, or sound, noise due to gradient pulsing has been one of the problems in MRI, both in patient scanning as well as in many areas of psychiatric and neuroscience research, such as brain fMRI. Especially in brain fMRI, sound noise is one of the serious noise sources that obscures the small signals obtainable from the subtle changes occurring in oxygenation status in the cortex and blood capillaries. Therefore, we have studied the effects of acoustic, or sound, noise arising in fMR imaging of the auditory, motor, and visual cortices. The results show that the effects of acoustic noise on motor and visual responses are opposite. That is, for motor activity, there is an increased total motor activation, whereas for visual stimulation, the corresponding (visual) cortical activity is diminished substantially when the subject is exposed to a loud acoustic sound. Although the current observations are preliminary and require more experimental confirmation, it seems that the observed acoustic-noise effects on brain functions, such as in the motor and visual cortices, are new observations and could have significant consequences in data observation and interpretation in future fMRI studies.

Adult↗

PubMed1997

Analysis of acoustic noise in MRI.

Acoustic or sound noise due to gradient pulsing has been one of the problems in magnetic resonance imaging (MRI), both in patient scanning as well as in many areas of psychiatric and neuroscience research such as functional MRI. Our recent observations in functional MRI for the visual and motor cortex show very different results with sound noise in comparison with the results obtained without sound noise. Although a number of ideas have been suggested in the literature about the possible elimination or reduction of sound noise, progress has been slow due to the basic role of gradient pulsing in MR imaging. Before we tackle the sound-noise-reduction problem, we believe that a systematic study of sound or acoustic noise behavior will provide important information for future endeavors in this area of research in MRI systems, in both commercial and research systems. Therefore, we report on some typical behavior of sound noise observed from MRI scanners and the analyses of their characteristics. Data are obtained both from a commercial MRI scanner (GE Signa 1.5-T EPI system) as well as a research-type MRI scanner (KAIS 2.0-T) developed at a university laboratory setting.

Magnetic Resonance Imaging↗

PubMed1996

Comparison of natural killer activity of human bone marrow and blood cells in cultures containing IL-2, IL-7 and IL-12.

Previous studies have suggested that autologous bone marrow or mobilized peripheral blood progenitor cell transplants activated by prior culture of the cells in IL-2 may capture some of the beneficial graft-versus-leukemia effects obtained with unmanipulated allogeneic, but not autologous, transplants. To investigate ways of improving this approach,we have compared the ability of two other immunomodulating cytokines, IL-7 and IL-12, either alone or in combination with IL-2, to stimulate human bone marrow cells (BMC) or peripheral blood cells (PBC) to acquire the potential to lyse K562 or Daudi cells. For these studies, we measured the cytotoxic activity of BMC or PBC both before and at the end of their incubation with various cytokine(s) using a standard 51-chromium release assay. Results suggest that IL-2 at optimal concentration induces cytotoxicity significantly higher than IL-7 or IL-12 when tested alone. At optimal concentration, the combination of IL-2 and IL-12 showed a synergistic effect for BMC. Such a synergistic effect could be observed for PBC only when suboptimal concentrations of IL-2 were used. In addition, the ability of the hematopoietic cells to reduce the number of K562 cells remaining at the end of various culture periods in the presence of the cytokines was measured. This was made possible by the use of a G418-resistant K562 cell line which could, in contrast to normal human BMC or PBC, form colonies that wer detectable after 1 week in methylcellulose cultures containing the neomycin analog G418. Normal human PBC, stimulated by either IL-7 or IL-12 alone effectively suppressed K562 proliferation in both of these assays, whereas no activity could be detected when BMC were incubated under the same conditions. On the other hand, cells from both sources displayed anti-leukemic activity when incubated with IL-2 and IL-12 together, although IL-2/IL-12-activated PBC suppressed the growth of co-cultivated K562-neor cells about eight-fold more efficiently than IL-2/IL-12-activated BMC. Cryopreservation and subsequent stimulation of BMC and PBC with cytokines did not cause a significant decrease in cytotoxicity or their ability to inhibit the growth of co-cultivated K562 cells compared to fresh cells. However, the synergistic effect observed with the combination of IL-2/IL-12 was no longer detectable for BMC. These results suggest that (1) PBC are superior to BMC with respect to developing effective natural killer (NK) activity after culture in cytokines and that, (2) the combination of IL-2 and IL-12 may be more effective than IL-2 alone to inhibit proliferation/growth of K562 cells.

Blood Cells↗

PubMed1994

Absorption of fluorescein given under the upper lid.

BACKGROUND: The need for a more efficacious approach to administer topical ocular medications prompted the authors to consider applying conventional eye drops under the upper lid rather than beneath the lower lid. Preliminary observations on patients with glaucoma using a beta-blocker beneath the upper lid suggested a drop in intraocular pressure into the normal range in some previously refractory patients being treated with the same medications. To test this clinical observation, the authors observed if there were any physiologic differences in topical fluorescein absorption into the anterior chamber when given beneath the upper lid versus the lower lid. METHODS: A 5-microliters drop of fluorescein solution was placed under the upper-lid fornix of one eye and under the lower-lid fornix of the other eye in human volunteers, and absorption into the anterior chamber was measured at hourly intervals, for a total of 3 hours. RESULTS: Hotelling T2 multivariate analysis for all 3 hours demonstrates that upper-lid administration of fluorescein results in significantly higher absorption of fluorescein into the anterior chamber than does lower-lid administration (P = 0.0088; for hours 2 and 3, the statistical differences is even more dramatic: P < 0.0044). CONCLUSION: Using conventional eye drops beneath the upper lid, the authors observed increased absorption of fluorescein into the anterior chamber when compared with lower-lid administration. Profuse tearing, especially by younger subjects, significantly and rapidly diminished anterior chamber absorption of fluorescein. It is reasonable to consider further clinical studies to test this new approach to drug delivery.

Absorption↗

PubMed1994

Deformation of orthodontic archwires over time.

Most previous studies of archwire deformation over time (hereafter referred to as "time-dependent deformation of orthodontic wires") have been conducted at a constant room temperature. In the clinical situation however, arch wires are exposed to 37 degrees C as well as to periods of temperature increase when hot foods or fluids are ingested. The effects of the latter on time-dependent behaviour are largely unknown. Since the introduction of direct electric resistance heat treatment to superelastic nickel titanium wires, there have been no reports on its effect on time-dependent deformation. This study investigated the effects of repeated temperature increases (70 degrees C) on stainless steel, nickel titanium and beta titanium wires. The wires were deflected by approximately 3 and 5 mm on two jigs for periods of 1 minute, 1, 7, 14 and 28 days. Permanent deformation was measured optically with a measuring microscope and the amount of time-dependent deformation was calculated. Beta titanium wires demonstrated the greatest amount of time-dependent deformation; followed by non-superelastic nickel titanium, stainless steel, and superelastic nickel titanium. Exposure to repeated temperature (70 degrees C) increases and direct electric resistance heat treatment of superelastic nickel titanium did not affect time-dependent behaviour.

Dental Stress Analysis↗

PubMed1993

Intestinal absorption of dietary fat in patients with multiple sclerosis.

Fat absorption was studied in 24 patients with clinically definite multiple sclerosis and in 36 healthy control subjects. Beta-carotene and vitamin A in their plasma were also measured. This double-blind and randomized study showed no differences between these two populations with regard to the three parameters. We did not find evidence for fat malabsorption in multiple sclerosis.

Adult↗

PubMed1989

A selective mapping algorithm for computer analysis of voided urine cell images.

One of the fundamental targets of the automated image analysis of cytologic preparations is the reduction of computer classification errors due to cells or other objects that do not lend themselves to image segmentation or that have morphologic features that may mislead the cell classification schemes. In prior work from this laboratory, the achievement of this goal was attempted by hierarchical analysis of sequential microscopic objects at high resolution. This paper reports on the successful development and implementation of an automated "selective mapping algorithm" that selects cells at low power for further analysis and eliminates a large proportion of unwanted "objects." The algorithm classifies the objects and extracts appropriate features from a 256 X 240 digital image obtained via a 10 X planachromatic objective. The five-node binary tree classifier used in this triage is described. The algorithm was trained and tested initially on 501 visually classified microscopic "objects," resulting in a correct acceptance rate of 61.3% and correct rejection rate of 81.3%. The selective mapping algorithm was subsequently integrated into the video-based image analysis system constructed at the Montefiore Medical Center for the diagnostic evaluation of sediments of voided urine. The algorithm was then tested on ten cytocentrifuge preparations for a preliminary evaluation of its performance. Up to 100 "objects" per case were selected by the algorithm for further classification by the computer at high power. Of the 810 "objects" selected by the selective mapping algorithm, 344 (42.5%) were classified by the computer at high resolution as cells of diagnostic value ("WELL" cells) and 466 were rejected.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗

PubMed1988

An expert system designed as a tutoring tool in cervical cytology: TTCC-1 system.

A knowledge-based intelligent system being developed as a computer-assisted tutoring tool that can be used by teachers and students of cervical cytology is described. This system uses a combination of frames and rules as knowledge representation. Combination data structures called "prototypes" characterize the typical cytoplasmic and nuclear features of classes of cervical cells by using a specific prototype for each hypothesized cell type. A hypothesis-directed approach is used for problem solving. Rules are associated with each prototype or hypothesis. There are two major kinds of rules: deducing rules, used for deducing certainty factors (expressed as degrees of certainty of the hypotheses), and strategy rules, used for guiding the user in reaching a conclusion about the test cell. With an easy-to-use interactive menu, the user inputs a series of sets of qualitative cell features, which the system utilizes at various inference stages and finally arrives at a decision about the cell type.

Cell Biology↗

PubMed1987

First-order Wiener kernel visually evoked potentials obtained from multiple sclerosis patients.

Visually evoked potentials (VEP) were measured in multiple sclerosis patients with five sizes of reversing check stimuli. The VEPs were obtained using random binary sequence triggered check reversals. The random binary sequence was cross-correlated with scalp potential responses to obtain the estimates of the linear response of the system. For each evaluation a series of five VEPs, one for each of five check sizes, was done. A correlation coefficient was calculated to evaluate check size versus amplitude of the major negative wave. A tabulation was made to compare Snellen chart visual acuity with these correlation coefficients. For the eyes with a Snellen acuity of 20/20, 63% of the VEP amplitudes increased as the check size was decreased with correlation coefficients of -0.6 to -1. For the eyes with a Snellen acuity of 20/70 or less the amplitude decreased with the check size decrease, showing a correlation coefficient of +0.6 to +1 in 45% of the evaluations. The check size giving the largest amplitude was also tabulated with respect to the visual acuity, but did not appear to have as strong a relationship to visual acuity.

Evoked Potentials, Visual↗

PubMed1984

Clinical evaluation of the Humphrey automatic refractor.

A new automatic objective refractor was used on healthy adults. In the absence of cycloplegic drugs, spherocylindrical objective refractions performed with the instrument provided 20/20 acuity 96% as often as with standard subjective techniques. No instrument-induced accommodations effects were seen. One hundred percent of instrument spherical findings were repeatable within 0.50 diopters; all cylindrical findings were repeatable within 0.37 D. This result represents a higher level of repeatability than that reported for standard subjective refraction under clinical conditions. In the absence of cycloplegic drugs, the correlation coefficient between the instrument's findings and standard subjective spherical findings was .97 v .98 between two practitioners' subjective refractions. The average difference between cylindrical findings of the instrument and those of an experienced practitioner was 0.04 D larger than the average difference seen between two practitioners using subjective techniques.

Accommodation, Ocular↗

PubMed1983

Erythrocyte membrane 2', 3'-cyclic nucleotide 3'-phosphodiesterase activity in multiple sclerosis.

The specific activities of 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase, EC3.1.4.37) in erythrocyte membranes from five patients with active multiple sclerosis (MS) and five normals were compared. The CNPase assay used 2',3'-cyclic NADP as the substrate in an enzyme coupled reaction to produce fluorometrically detectable NADPH. The specific activity of CNPase in the MS and normal groups were 19.2 +/- 2.3 and 28.7 +/- 1.8 mumol/h/mg protein, respectively. The difference was significant with p less than 0.006, based on a one-tailed t-test.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗