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Biomedical subjects

H S Wu

Publications and source records attributed to H S Wu.

At least 19 recordsLinked to original sources

Projection patterns of single mossy fibers originating from the lateral reticular nucleus in the rat cerebellar cortex and nuclei.

Projection of neurons in the lateral reticular nucleus (LRN) to the cerebellar cortex (Cx) and the deep cerebellar nuclei (DCN) was studied in the rat by using the anterograde tracer biotinylated dextran amine (BDA). After injection of BDA into the LRN, labeled terminals were seen bilaterally in most cases in the vermis, intermediate zone, and hemisphere of the anterior lobe, and in various areas in the posterior lobe, except the flocculus, paraflocculus, and nodulus. Areas of dense terminal projection were often organized in multiple longitudinal zones. The entire axonal trajectory of single axons of labeled LRN neurons was reconstructed from serial sections. Stem axons entered the cerebellum through the inferior cerebellar peduncle (mostly ipsilateral), and ran transversely in the deep cerebellar white matter. They often entered the contralateral side across the midline. Along the way, primary collaterals were successively given off from the transversely running stem axons at almost right angles to the Cx and DCN, and individual primary collaterals had longitudinal arborizations that terminated as mossy fibers in multiple lobules of the Cx. These collaterals arising from single LRN axons terminated bilaterally or unilaterally in the vermis, intermediate area, and sometimes hemisphere, and in different cerebellar and vestibular nuclei simultaneously. The cortical terminals of single axons appeared to be distributed in multiple longitudinal zones that were arranged in a mediolateral direction. All of the LRN axons examined (n = 29) had axon collaterals to the DCN. All of the terminals observed in the DCN and vestibular nuclei belonged to axon collaterals of mossy fibers terminating in the Cx.

Animals

Pseudomonas aeruginosa central nervous system infections: analysis of clinical features of 16 adult patients.

BACKGROUND: The purpose of this study was to analyze the clinical features and therapeutic outcome of 16 adult patients with Pseudomonas aeruginosa central nervous system (CNS) infection. We also attempted to identify the factors that significantly influence the prognosis of this potentially fatal CNS infection. METHODS: Sixteen adult patients with P aeruginosa CNS infection, nine men and seven women, aged from 18 to 86 years, were included in this retrospective study. The clinical features and the laboratory data of these patients were analyzed. Potential prognostic factors were compared by means of Fisher's exact test and the relative risks were estimated by odds ratio. RESULTS: Of the 16 patients, 13 had meningitis and three had focal suppuration (two with brain abscess and one with spinal epidural abscess). The 13 meningitis patients with nosocomial or community-acquired infections were classified into two forms: the spontaneous form and the neurosurgical form. The overall mortality rate was 37.5% (6/16). In the meningitis group, the patients with the neurosurgical form had a lower mortality rate (11.1%; 1/9) than the patients with the spontaneous form (100%; 4/4), and those with community-acquired meningitis had a higher mortality rate (80%; 4/5) than those with nosocomial infections (12.5%; 1/8). All the meningitis patients who did not receive appropriate antibiotic treatment expired. The statistically significant prognostic factors included the acquisition of infection, form of infection, bacteremia, initial level of consciousness and the use of appropriate antibiotics. CONCLUSIONS: Vigilance for P aeruginosa is particularly important in patients with predisposing factors such as head injury, neurosurgical procedures and long-term debilitating diseases. Early appropriate antibiotic therapy and neurosurgical intervention for patients with suppurative infections can bring about improved therapeutic results.

Adolescent

Fractal characterization of chromatin appearance for diagnosis in breast cytology.

This study explores the use of fractal analysis in the numerical description of chromatin appearance in breast cytology. Images of nuclei from fine-needle aspiration biopsies of the breast are characterized in terms of their Minkowski and spectral fractal dimensions, for 19 patients with benign epithelial cell lesions and 22 with invasive ductal carcinomas. Chromatin appearance in breast epithelial cell nuclear images is demonstrated to be fractal, suggesting that the three-dimensional chromatin structure in these cells also has fractal properties. A statistically significant difference between the mean spectral dimensions of the benign and malignant cases is demonstrated. The two fractal dimensions are very weakly correlated. A statistically significant difference between the benign and malignant cases in lacunarity, a fractal property characterizing the size of holes or gaps in a texture, is found over a wide range of scales. These differences are particularly pronounced at the smallest and largest scales, corresponding respectively to fine-scale texture, indicating whether chromatin is clumped or fine, and to large-scale structures like nucleoli. Logistic regression and artificial neural network classification models are developed to classify unknown cases on the basis of fractal measures of chromatin texture. Using leave-one-out cross-validation, the best logistic regression classifier correctly diagnoses 95.1 per cent of the cases. The best neural network model can correctly classify all of the cases, but it is unclear whether this is due to overtraining. Fractal dimensions and lacunarity are useful tools for the quantitative characterization of chromatin appearance, and can potentially be incorporated into image analysis devices to assure the quality and reproducibility of diagnosis by breast fine-needle aspiration biopsy.

Biopsy, Needle

A parametric fitting algorithm for segmentation of cell images.

This paper presents a parametric fitting algorithm for segmentation of cervical and breast cell images from cytology smears. A parametric elliptical model for cells is introduced and the parameters adjusted to fit the cell shapes while minimizing a cost function. Segmentation results of noisy human cervical cell and textured breast cell images demonstrate that the proposed parametric fitting algorithm is very successful in segmentation of images of both nonoverlapped and overlapped elliptically shaped cells.

Algorithms

Campylobacter jejuni lipopolysaccharides in Guillain-Barré syndrome: molecular mimicry and host susceptibility.

OBJECTIVE: This study was designed to determine if the presence of specific ganglioside-like moieties in Campylobacter lipopolysaccharides (LPSs) is related to the development of Guillain-Barré syndrome (GBS), and to discover how frequently such moieties, including GM1, are present in these LPSs. METHODS: We studied Campylobacter isolates and sera from seven patients with GBS (five acute motor axonal neuropathy, one acute inflammatory demyelinating polyneuropathy, and one Fisher's syndrome), and compared them with similar specimens from patients with Campylobacter enteritis alone. RESULTS: All GBS patients had antiganglioside antibodies. Anti-GM1 and anti-GD1a titers were significantly elevated in post-Campylobacter GBS, both axonal and demyelinating, compared with normal control subjects or those with uncomplicated Campylobacter diarrhea. Campylobacter isolated from patients with GBS and with enteritis alone had similar ganglioside-like moieties. CONCLUSIONS: These results indicate that patients who develop GBS respond differently to the ganglioside-like epitopes on Campylobacter than do non-GBS diarrhea patients. Our findings support a role for host susceptibility as a determinant for the outcome following Campylobacter infection. These findings have important implications for the development of vaccines against Campylobacter jejuni.

Adult

Hepatic resection for bilobar multicentric hepatocellular carcinoma: is it justified?

BACKGROUND: Hepatic resection for multiple hepatocellular carcinomas (HCCs) involving both lobes of the liver is rarely recommended because of high operative risks and low radicality. Thus the justification of hepatic resection for bilobar multicentric HCC remains undefined. METHODS: Two hundred eleven patients with HCC, who underwent curative hepatic resection, were studied retrospectively. The patients were divided into two groups. Group A consisted of 39 patients with bilobar (both sides of Cantlie's line) multicentric HCCs. Group B consisted of 172 patients with HCC with solitary or unilobar lesions. The backgrounds and resectional results of patients in groups A and B were compared. RESULTS: Patients in group A usually required multiple separate liver resections and a longer operative time. However, the operative blood loss, amount of blood transfused, and operative morbidity and mortality rates were not significantly different. Patients in group A showed higher incidences of associated satellite nodules, microscopic vascular invasion, and a lack of capsules. The 6-year disease-free and actuarial survival rates of patients in groups A and B were 30.5% and 41.8% (p = 0.17) and 42.9% and 51.4% (p = 0.12), respectively. For patients in group A the presence of satellite nodules in any resected tumor was the only independent unfavorable feature that influenced the actuarial survival rate after multivariate analysis. CONCLUSIONS: Liver resection is justified for bilobar multicentric HCCs in selected patients, if the tumors can be totally resected. Postoperative adjuvant therapies should be considered when satellite nodules are present in any resected tumor.

Adult

Ovarian metastasis from cervical carcinoma.

OBJECTIVE: To study the prognosis and metastatic route of cervical carcinoma with ovarian metastasis. METHOD: From 1980 to 1993, 10 of the 1507 patients with cervical carcinoma operated and who had ovarian metastasis were analyzed. RESULTS: Six patients had squamous cell carcinomas and 4 patients had adenocarcinomas. Their mean age was 45 years. Six of 9 patients undergoing pelvic lymphadenectomy had nodal metastasis. One patient did not have nodal dissection in the treatment course. Five of 10 patients had involvement of corpus: 3 were accompanied with nodal metastasis, 1 was not and 1 other was unknown. None of our cases survived more than 5 years. Their mean survival time was 20.8 months for squamous cell carcinomas and 29 months for adenocarcinomas. CONCLUSIONS: (1) Ovarian metastasis is histologically one of the ominous signs of cervical carcinomas regardless of stage. The prognosis of patients with ovarian metastasis from cervical squamous cell carcinoma from our data is not different from those from cervical adenocarcinoma. (2) Lymphatic spread and transtubal implantation are possible pathways of cervical cancer metastasizing to ovary, and involvement of the corpus may potentiate this mechanism.

Adenocarcinoma

Reproducibility and accuracy of interactive segmentation procedures for image analysis in cytology.

The segmentation of nuclear images is a crucial step in the development of procedures using image analysis for the cytological diagnosis of cancer. The purpose of this study is to evaluate the reproducibility and accuracy of several interactive segmentation methods which can be used in this context. Four methods were studied: a thresholding-based method enabling selection of intensity histogram contrast and brightness, manual tracing with a stylus, and arc- and ellipse-fitting routines. Features of nuclear size and shape were derived from nuclei segmented on repeated occasions by several individuals. Variance component models provided a statistical framework for evaluating the intraobserver and interobserver variability of these measurements in terms of their intraclass correlation coefficients. Of the methods tested, the arc-fitting segmentation method gave the most reproducible results, and thresholding the least. Reproducibility was generally very high both between individuals and for repeated segmentations by a single individual. Accuracies of area measurements for the various methods, as determined with respect to point counting, paralleled the reproducibilities of the methods. Sample size requirements were observed to be more dependent on the biological variability of the tissue sampled than on the particular segmentation method or on the number of individuals performing segmentation.

Cell Biology

A prospective clinical and electrophysiologic survey of acute flaccid paralysis in Chinese children.

We studied 29 children admitted to Beijing Children's Hospital (BCH) with acute flaccid paralysis between June 1991 and June 1993. Twenty-seven patients had Guillain-Barré syndrome--7 with acute inflammatory demyelinating polyneuropathy and 20 with acute motor axonal neuropathy (AMAN). Two had poliomyelitis. The most common cause of acute flaccid paralysis at BCH is the AMAN pattern of GBS.

Acute Disease

Pneumocephalus and respiratory depression after accidental dural puncture during epidural analgesia--a case report.

A case of pneumocephalus and respiratory depression after dural puncture during lumbar epidural analgesia is reported. The loss of resistance to air technique was employed to identify the epidural space. Severe respiratory depression and stuporous consciousness developed one hour after a bolus of 2 mg morphine was given epidurally at the end of operation. With computerized tomographic brain scanning and continuous observation of clinical course, the neurologic symptoms were thought to be a mixed complication of pneumocephalus and possible intrathecal morphine overdose. We suggest that in order to avoid iatrogenic pneumocephalus by inadvertent dural puncture in the attempt to identify the epidural space the use of the loss of resistance to normal saline technique or the hanging-drop technique is more reliable than the loss of resistance to air technique. A small test dose prior to a full dose is given and should not be omitted to further confirm the proper placement of the epidural catheter during epidural analgesia.

Aged

Neuroimages of Japanese encephalitis: report of three patients.

The cranial computed tomography (CT) and magnetic resonance image (MRI) studies of three Japanese encephalitis (JE) patients, 24 to 37 years of age, are reported. The initial findings of CT study were limited but initial MRI studies revealed multiple lesions involving the brainstem, basal ganglia and bilateral thalami. Follow-up MRI studies showed small residual lesions only. The result shows that MRI can delineate and detect brain lesions better than CT in patients in the acute stage of JE. The locations of lesions in MRI study are noteworthy and have a good correlation with pathologic anatomic distribution. Therefore, MRI study is helpful in early diagnosis of JE.

Adult

Klebsiella pneumoniae meningitis: analysis on clinical features of thirty-two adult patients.

BACKGROUND: To assess the clinical features and therapeutic outcomes of adult Klebsiella pneumoniae (KP) meningitis. METHODS: Thirty-two adult patients with KP meningitis were included in this study. Their clinical features, the outcomes with the third generation cephalosporin (moxalactam, cefotaxime, ceftazidime) treatment and prognostic factors were analyzed. RESULTS: These patients' diseases were predominantly community-acquired. Males outnumbered females (3:1). Diabetes mellitus (DM) was the most common underlying disease, followed by other debilitating diseases such as liver cirrhosis, neoplasm and end-stage renal disease (ESRD). Patients with spontaneous meningitis had a more fulminant course with a higher prevalence of bacteremia, shock and death (66%). Metastatic septic abscess was frequent (19%). Among the 21 patients who received initial appropriate antimicrobial therapy (IAAT), 2 took cefotaxime and 1 died; 13 took moxalactam of whom 5 died; and 6 took ceftazidime of whom 3 died. All of the other 11 patients who did not receive IAAT died. CONCLUSIONS: The clinical features of KP meningitis are various and indistinguishable from other form of bacteria meningitis. Most of the patients with KP meningitis are associated with underlying medical problems, such as diabetes mellitus and liver cirrhosis. Many factors, including septic shock, bacteremia, high cerebrospinal fluid lactate concentration, and IAAT, might influence the prognosis. In spite of a high mortality rate, however, IAAT is mandatory to improve the overall survival rate.

Adult

An iterative algorithm for cell segmentation using short-time Fourier transform.

In this paper, an iterative cell image segmentation algorithm using short-time Fourier transform magnitude vectors as class features is presented. The cluster centroids of the magnitude vectors are obtained by the K-means clustering method and used as representative class features. The initial image segmentation classifies only those image pixels whose surrounding closely matches a class centroid. The subsequent procedure iteratively classifies the remaining image pixels by combining their spatial distance from the regions already segmented and the similarities between their corresponding magnitude vectors and the cluster centroids. Experimental results of the proposed algorithm for segmenting real cell images are provided.

Algorithms

[The thermoregulatory threshold during surgery with propofol-nitrous oxide anaesthesia].

BACKGROUND: Thermoregulatory responses are thought to be drastically suppressed by general anesthesia. In previous studies, it was shown that halothane, isoflurane and fentanyl-N2O combination decrease the threshold of vasoconstriction in general anesthesia. Propofol is a recently introduced intravenous anesthetic. The thermoregulatory threshold of its administration during surgery has not been quantified. MATERIALS: Fourteen unpremedicated ASA class I patients were anesthetized with N2O (67%) and propofol (2 mg/kg in bolus followed by 6 mg/kg/h infusion) during elective surgery of free flap. Patients were randomly assigned either to receive additional warming (n = 5) or standard (n = 9) management. Significant vasoconstriction was prospectively defined as the temperature gradient between forearm surface and finger-tip surface is > or = 4 degrees C, and the thermoregulatory threshold was defined as the esophageal temperature (core temperature) at a point where the skin temperature gradient between two tested zones exceeds 4 degrees C. RESULTS: Vasoconstriction did not occur in patients who received additional warming and they remained in nearly normothermia. The average minimum core temperature was 36.3 +/- 0.4 degrees C. In patients who underwent standard management the core temperature ranged from 32.8 to 34.6 degrees C (33.6 +/- 0.7 degrees C), signifying significant vasoconstriction. CONCLUSIONS: General anesthesia with propofol/N2O during surgery drastically inhibits thermoregulatory vasoconstriction. This effect should also be noted during long-term use of propofol (e.g. ICU-sedation).

Adult

The clinical correlates of high-titer IgG anti-GM1 antibodies.

Serum IgG anti-GM1 antibodies have been reported to occur in a variety of disorders, including Guillain-Barré syndrome and chronic polyneuropathies. Of over 5,000 serums tested in our laboratory, high titers of selective IgG anti-GM1 antibodies (> 1:1,000) and without binding to sulfatide were found in 35 patients. Clinical correlation revealed that almost all patients had axonal, motor neuropathies. One subgroup was comprised of individuals with an acute motor neuropathy, described either as an acute axonal Guillain-Barré-like syndrome that was occasionally associated with a prodrome of Campylobacter jejuni enteritis or as Chinese paralysis syndrome. A second group of patients had chronic asymmetric lower motor neuron (LMN) syndromes with no conduction block or other evidence of demyelination. The presence of selective high-titer IgG anti-GM1 antibody reactivity in serum is uncommon but when present is strongly associated with acute axonal motor neuropathies or chronic asymmetric LMN syndromes.

Antibodies

[4-Aminopyridine induced histamine release and its antagonism by certain drugs].

4-Aminopyridine (4-AP), a known potassium channel blocker, was shown to induce histamine release from mast cells in mice. After ip 4-AP 5 mg.kg-1 the histamine content increased in blood, but decreased in the lung tissue. Calcium antagonists nifedipine (NIF) 500 mg.kg-1 ig, TMB-8 300 mumol.L-1 in vitro and potassium channel opener minoxidil (MIN) 100 mg.kg-1 inhibited the histamine release induced by 4-AP from mouse peritoneal mast cells (PMC). These results provide evidence that potassium channels are present in mouse mast cell membranes and indicate that the mechanism of histamine release by 4-AP may be related to the potassium channel blocking effect. As the result of this effect, the calcium channels open and the Ca2+ influx to the mast cells increases, thus eliciting histamine release.

4-Aminopyridine

[Cardiac arrhythmia after lung cancer surgery--an analysis of 140 pneumonectomy cases].

Among 808 surgically resected lung cancer cases at Shanghai Chest Hospital during the period of January 1991 to December 1992, 140 of them (17.3%) underwent pneumonectomy (47 right, 93 left). In the 140 cases: 124 male, 16 female; aged 27-74 yrs, pre-operative abnormal EKG was found in 38 cases. Postoperatively, arrhythmia occurred in 76 cases, with an incidence of 54.3%. Of the 76 arrhythmias, atrial fibrillation was seen in 7 patients, atrial premature beats in 2, supraventricular tachycardia in 1 and sinus tachycardia in 66. The results indicate that cardiac arrhythmia is a common complication after pneumonectomy for lung cancer surgery. The major causes of arrhythmia were incisional pain, hypovolemia due to blood loss and respiratory insufficiency due to anoxia. The perioperative measures to prevent arrhythmia were discussed.

Adenocarcinoma