Biomedical subjects
Publications and source records attributed to L Lee.
Septic thrombophlebitis of a mesenteric vein can occur as a rare complication of diverticulitis. We report a case of septic thrombophlebitis of the inferior mesenteric vein diagnosed with computed tomography, in a patient with sigmoid diverticulitis.
Herbal therapy is one of several holistic therapies gaining recognition within the health care community in the United States. As a discipline, herbal medicine is in its infancy regarding educational standards for credentialling, standardization, and regulation of products and clinical applications within this health care system. This article discusses professional considerations for midwives who are interested in integrating herbal healing into their clinical practices, and offers examples of how to incorporate herbal medicine into midwifery care. Resources for practitioners including books, newsletters, journals, courses, computer sites, and databases are presented. The author offers guidance for creating an herbal practice manual for the midwifery office as well as the hospital setting and for documenting herbal healing in the medical record. Collegial support, barriers to practice, liability, and insurance issues are discussed. A clinical applications section includes specific herbal formulas for preconception health, pregnancy-induced hypertension, gestational diabetes, and postdates pregnancy.
BACKGROUND: Enterococcus spp. is an important nosocomial and community-acquired pathogen. Recent studies have documented the increasing importance of this pathogen in children, particularly in the hospital setting. Our objective in this study was to report the frequency of antimicrobial resistance in enterococci and to determine the characteristics of high-level gentamicin resistance (HLGR) plasmids in Enterococcus faecalis clinical isolates. METHODS: Two hundred eighty-nine enterococcal isolates were collected during an 18-month period from a tertiary-care pediatric hospital in Mexico City. Isolates were screened for antibiotic resistance, including HLGR. High-level, gentamicin-resistant E. faecalis strains were selected for pulsed-field electrophoresis (PFGE) typing and plasmid analysis. Transferability of resistance markers was carried out using filter matings. RESULTS: Seventy-six percent of isolates were E. faecalis, 10% were E. avium, 5.2% E. faecium, 5.2% E. raffinossus, 1.38% E. malodoratus, 0.6% E. hirae, and 0.6% E. casseliflavus. Antimicrobial resistance was ampicillin and penicillin 29%, imipenem 17%, and vancomycin 3%, HLGR 5%. The following 15 high-level, gentamicin-resistant isolates were identified: six E. faecalis; four E. avium; three E. faecium, and two E. casseliflavus. Five of the six E. faecalis isolates were different by PFGE and transferred gentamicin and streptomycin resistance on filter membranes. Transfer frequencies ranged from 8.2 x 10(-4) to 6.92 x 10(-5) transconjugants/recipient cell. The plasmid content of donors and transconjugants were homogeneous (one plasmid of 47 kb). CONCLUSIONS: In this pediatric hospital, antimicrobial resistance in Enterococcus spp. is common. Frequency of high-level, gentamicin-resistant strains is low. Mechanism of HLGR appears to be due to a single plasmid dissemination.
A scanning endoscope has been designed with the ability to both project three-dimensional images and provide precise measurements of internal structures. This is beneficial for minimally invasive surgery, where surgeons suffer from a lack of depth perception, limited field of view, and the absence of a reference frame for dimensional measurements. Borrowing from the insect compound eye, the design uses an array of prisms, each facing a different direction but with overlapping fields of view. The prisms redirect their respective images normal to a fibre optic imaging plane and are individually controlled by electro-chromic shutters. The device thereby retains the ability to scan in multiple directions without mechanical parts and uses only a single camera. Comparison of the overlapping images with known prism positions allows for the calculation of absolute coordinates. Results from large-scale models show that the technology is plausible, and fabrication methods for a smaller device are discussed.
Batch and chemostat culture of Staphylococcus aureus strain S411 was conducted in an investigation of the role of Mg++ in the control of production of toxic shock syndrome toxin 1 (TSST-1). Under both growth conditions, Mg++ influenced bacterial growth, and TSST-1 production was correlated with bacterial growth. The specific activity of TSST-1 (ng/mg yield, ng/mg total protein) increased with increasing concentrations of Mg++ and was maximal at physiologic levels of Mg++. No production of TSST-1 was observed under anaerobic conditions. In chemostat cultures in which valine nutrient limitation was used with various levels of tryptophan in the chemically defined medium, tryptophan concentration controlled the production of TSST-1 by strain S411, regardless of the concentration of Mg++.
The acid and enzymatic hydrolysis rates for two morphine metabolites, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G), were compared. Urine fortified with M3G or M6G was hydrolyzed in a boiling water bath or with beta-glucuronidases. Optimal temperatures for beta-glucuronidases were 60 degrees C for Helix pomatia and abalone and 50 degrees C for Escherichia coli. A 3-h incubation with 1,000-1,500 Fishman units of enzyme gave complete hydrolysis of M3G. The enzymatic hydrolysis rate of M6G was approximately 25% of the hydrolysis rate of M3G and required 24 h for completion. The acid hydrolysis rate of M6G was slower than M3G and required a 0.5-h incubation with a 1:1 mixture of concentrated HCl in a boiling water bath for completion. For comparison, the acid hydrolysis rate of codeine conjugates was found to be similar to the rate of M6G, but the enzymatic rate of codeine conjugates appeared slower than the rate of M6G.
PURPOSE: The development of structural probabilistic brain atlases provides the framework for new analytic methods capable of combining anatomic information with the statistical mapping of functional brain data. Approaches for statistical mapping that utilize information about the anatomic variability and registration errors of a population within the Talairach atlas space will enhance our understanding of the interplay between human brain structure and function. METHOD: We present a subvolume thresholding (SVT) method for analyzing positron emission tomography (PET) and single photon emission CT data and determining separately the statistical significance of the effects of motor stimulation on brain perfusion. Incorporation of a priori anatomical information into the functional SVT model is achieved by selecting a proper anatomically partitioned probabilistic atlas for the data. We use a general Gaussian random field model to account for the intrinsic differences in intensity distribution across brain regions related to the physiology of brain activation, attenuation effects, dead time, and other corrections in PET imaging and data reconstruction. RESULTS: H2(15)O PET scans were acquired from six normal subjects under two different activation paradigms: left-hand and right-hand finger-tracking task with visual stimulus. Regional region-of-interest and local (voxel) group differences between the left and right motor tasks were obtained using nonparametric stochastic variance estimates. As expected from our simple finger movement paradigm, significant activation (z = 6.7) was identified in the left motor cortex for the right movement task and significant activation (z = 6.3) for the left movement task in the right motor cortex. CONCLUSION: We propose, test, and validate a probabilistic SVT method for mapping statistical variability between groups in subtraction paradigm studies of functional brain data. This method incorporates knowledge of, and controls for, anatomic variability contained in modern human brain probabilistic atlases in functional statistical mapping of the brain.
In 1992, a large outbreak of bloody diarrhea caused by Escherichia coli O157 infections occurred in southern Africa. In Swaziland, 40,912 physician visits for diarrhea in persons ages >5 years were reported during October through November 1992. This was a sevenfold increase over the same period during 1990-91. The attack rate was 42% among 778 residents we surveyed. Female gender and consuming beef and untreated water were significant risks for illness. E. coli O157:NM was recovered from seven affected foci in Swaziland and South Africa; 27 of 31 patient and environmental isolates had indistinguishable pulsed-field gel electrophoresis patterns. Compared with previous years, a fivefold increase in cattle deaths occurred in October 1992. The first heavy rains fell that same month (36 mm), following 3 months of drought. Drought, carriage of E. coli O157 by cattle, and heavy rains with contamination of surface water appear to be important factors contributing to this outbreak.
PURPOSE: To evaluate the frequency of NY-ESO-1 expression in cultured lung cancer cells and to determine if this cancer-testis antigen can be presented for recognition by an HLA-restricted cytolytic T-cell clone specific for NY-ESO-1. METHODS AND RESULTS: Reverse transcriptase and polymerase chain reaction amplification techniques were utilized to screen a panel of lung and esophageal cancer cell lines for expression of NY-ESO-1 encoding a recently identified cancer-testis antigen. NY-ESO-1 expression was detected in 11 of 16 small cell lung cancer lines, three of seven non-small cell lung cancer lines, and zero of 12 esophageal cancer lines. 5-Aza-2' -deoxycytidine induced expression of NY-ESO-1 in lung cancer cells. Expression of HLA-A31 by plasmid transfection or retroviral transduction enabled recognition of lung cancer cells by an HLA-A31-restricted cytotoxic T lymphocyte clone specific for NY-ESO-1. CONCLUSIONS: NY-ESO-1 expression may be analogous to MAGE gene expression in lung cancer lines in terms of frequency and mechanism of transcriptional regulation. Furthermore, NY-ESO-1 can be presented on lung cancer cells for recognition by HLA-restricted cytotoxic T lymphocytes. Further investigation is warranted to determine if NY-ESO-1 can be exploited for the immunotherapy for lung cancer.
DNA sequence analysis of the BamHI-C fragment of Marek's Disease Virus (MDV) reveals the presence of a 513 amino acid open reading frame (ORF). This ORF codes for a protein with an estimated M(r) of 58,901. Comparison of the amino acid sequence with those available in the Swiss-Prot database indicates extensive homology with a protein kinase (PK) of herpes simplex virus (HSV) and varicella-zoster virus (VZV). In Northern blot hybridization, a transcript of 2.0 kb was detected in MDV (GA strain) infected duck embryo fibroblasts (DEFs). A portion of the ORF was expressed in Escherichia coli as a trpE-fusion protein and used to generate antiserum in New Zealand rabbits. This antiserum specifically detected a protein of 60 kDa in MDV serotype 1, 2 and 3 infected DEFs or chicken embryo fibroblasts (CEFs) by Western blot analysis. This ORF codes for a functional PK.
This study investigated the effects of heparin in patients with peripheral arterial disease, before and during operation. The relation between heparin dosage and heparin response and consumption were calculated from changes in the activated clotting time (ACT). Before operation, 38 patients were each given 10,000 units of heparin by intravenous injection and ACT was measured after 5, 10, 20, 30 and 60 minutes. Assuming a linear relation between heparin dosage and ACT, a dose of heparin was calculated which should double the normal ACT. This was given during operation in 21 patients while a standard dose of 7,500 units of heparin was given to another 10 patients. ACT was measured during operation at the same time intervals as before operation. ACT was always at its highest level at the 5 minute test and was always still raised at 60 minutes, both before and during operation. No significant correlation was found between ACT, heparin response or heparin consumption, and the patients' ages, sex, body weights and creatinine levels, either before or during operation. It was not possible to predict the intraoperative response from the preoperative test. It is concluded that the heparin effect should be monitored during operation in each patient if the best dose response is to be obtained.
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The residual effect of premature loss due to extraction of the four maxillary primary incisors on speech production was studied. The articulation of twenty-six subjects who had their teeth extracted before the age of five years was evaluated at eight, nine, or ten years old and compared with the articulation of an age-matched comparison group with normal exfoliation of their incisors. T-tests for related measures revealed no statistically significant differences between the group with premature loss and the comparison group. These results suggest that loss of maxillary incisors in children younger than five years is not likely to result in defective articulation while the teeth are missing or when the permanent dentition is acquired.
BACKGROUND: Little is known regarding the prevalence rate of hypertension among recent Southeast Asian refugees to the United States. METHODS: In this randomized, prospective study, four northern California counties with large Southeast Asian refugee populations were screened for the prevalence rates of hypertension and borderline hypertension. A population density method based upon 1988 census data was used to screen a representative sample of subjects from each county. Criteria for hypertension came from the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. RESULTS: In all, 964 subjects were screened. We found a prevalence rate of 4.8 percent for hypertension and 10.9 percent for borderline hypertension. CONCLUSIONS: The relatively low prevalence rates of this disease can be explained by the youth of this refugee population, mean age 37.6 +/- 0.36 years, as the presence of hypertension increases with chronological age.