Search PubMed⌕ Search

Biomedical subjects

L Yao

Publications and source records attributed to L Yao.

At least 163 records · Page 9Linked to original sources

Evaluation of an enhanced digital film-duplication system by receiver operating characteristic analysis.

RATIONALE AND OBJECTIVES: Over- or underexposure often results in poor quality radiographs. Using receiver operating characteristic analysis, the authors investigated the potential utility of a system that corrects densities in such images to improve the accuracy of lung nodule detection. METHODS: Chest radiographs were digitized by a laser film digitizer. Simulated nodules were superimposed on 36 improperly exposed chest radiographs. All images, with and without nodules, were then processed by a nonlinear density-correction technique. Hard-copy images were produced by a laser film printer. Eight radiologists evaluated the corrected and uncorrected images for the presence or absence of lung nodules using a continuous (0-100) confidence-rating scale. RESULT: The detectability of lung nodules improved significantly in the retrocardiac/retrodiaphragmatic regions of underexposed images and in the peripheral lung region of overexposed images. CONCLUSIONS: This system may increase diagnostic accuracy in detection of lung nodules in improperly exposed images.

Confidence Intervals↗

Clinical experience with an advanced laser digitizer for cost-effective digital radiography.

Film digitization has not been widely pursued in clinical settings mainly because of perceived limitations involving film latitude and image quality. However, a high-quality laser digitizer can be combined with wide-latitude film and specially developed digital processing techniques to achieve image quality comparable or superior to that of storage phosphor computed radiography (SPR) over a wide range of exposure. This film digitization system provides the operational advantages of digital radiography, such as consistent image density, high-quality inexpensive duplicates, and digital storage and retrieval capability. The reliability and monetary costs of the system also compare favorably with those of SPR. In the long term, technologies that employ reusable plates and do not require chemical processing to produce diagnostic images may well replace screen-film systems. Presently, however, film digitization remains a practical and cost-effective approach to digital radiography.

Cost-Benefit Analysis↗

Spring ligament of the ankle: normal MR anatomy.

The plantar calcaneonavicular or spring ligament is visualized inconsistently and incompletely on routine MR images of the foot. This ligament is a vital stabilizer of the longitudinal arch of the foot, providing support for the head of the talus, which rests on the ligament's central portion. Laxity or rupture of the spring ligament permits plantar flexion of the talus. This motion results in valgus alignment of the calcaneus and a flatfoot deformity (pes planovalgus). Laxity or rupture of the spring ligament can develop in cases of chronic dysfunction of the posterior tibial tendon. In rupture of the posterior tibial tendon, surgical management may include plication of the spring ligament in addition to repair or reconstruction of the tendon to stabilize the medial column of the foot. Thus, the status of the spring ligament can be a significant consideration in preoperative planning. This pictorial essay illustrates the normal MR anatomy of the spring ligament, the planes of imaging required for optimal depiction of the ligament, and the neighboring structures with which the ligament can be confused.

Ankle↗

Magnetic resonance imaging of a symptomatic meniscal ossicle.

Meniscal ossicles are uncommon in humans. They are usually located in the posterior horn of the medial meniscus and are generally first observed on roentgenograms as intraarticular corticated bone densities. Many different entities appear similar to meniscal ossicles on roentgenography. Magnetic resonance imaging (MRI) can help to distinguish between these different entities and thereby assist in guiding treatment. Magnetic resonance imaging also can identify concurrent intraarticular pathology (e.g., meniscal tears), which may influence the choice of treatment. In a 29-year-old man, MRI confirmed the intrameniscal location of a corticated bone density seen in the posteromedial knee on roentgenograms. An associated medial meniscus tear was found at arthroscopy. The patient's symptoms were relieved after resection of the meniscal ossicle and the associated meniscal tear.

Adult↗

Experimental and clinical investigations of human insoluble bone matrix gelatin. A report of 24 cases.

Human bone matrix gelatin (hBMG) was implanted into the quadriceps muscles of mice to determine its osteoinductive activity and immune responses. The host mouse muscle assay reacted positively to the hBMG, providing an experimental basis for clinical application. At two weeks after implantation, cartilage was produced in the mouse muscle, and new bone and bone marrow were formed at three to four weeks after implantation. Human bone matrix gelatin, which was thus shown to have osteoinductive activity, was subsequently implanted in 24 patients. Generally, the bone defects were filled with new bone tissue with increased density within two to four months after operation. Nonunion and delayed unions were healed at two to six months after surgery.

Adult↗

Case report 715. Necrotic giant cell tumor of the femur.

We present a giant cell tumor of the distal end of the femur that exhibited unusual diaphyseal extension and atypical MRI features. MRI demonstrated differing zonal signal characteristics in the distal metaphyseal/epiphyseal versus the diaphyseal components of the tumor. It also depicted an irregular, proximal tumor margin with an unusual, enhancing, peripheral zone. The atypical MRI features may be related to the unusual finding at pathological examination of an almost entirely necrotic giant cell tumor. This massive necrosis may illustrate a stage in the evolution of some giant cell tumors to fibrous histiocytoma-like variants of giant cell tumor or to conventional, benign fibrous histiocytoma of bone.

Adult↗

Rapid disruption of cochlear function and structure by trimethyltin in the guinea pig.

Trimethyltin (TMT) is a potent ototoxicant which acutely disrupts generation of the action potential evoked by a broad range of tone frequencies and subsequently produces selective high frequency impairment and outer hair cell (OHC) damage in the extreme basal turn of the cochlea. We investigated the development of TMT ototoxicity in the guinea pig 6-48 h following treatment using the compound action potential (CAP), cochlear microphonic (CM), endocochlear potential (EP) and light and electron microscopic examinations. At all time intervals studied, TMT reduced CAP sensitivity and CM amplitude. The effect was relatively broad across test frequencies at 6 h and subsequently became restricted to higher frequencies. No disruption of the EP was observed between 6 and 24 h following TMT. OHC pathology in the basal turn of the cochlea 12 h following TMT consisted of vacuolization in the supranuclear region and disruption of the cuticular plate; some mitochondria exhibited dark inclusions. Type 1 spiral ganglion cells appeared swollen at 24 h with separation of myelin from the cell bodies. No pathological changes were observed in the inner hair cells (IHC). The present data identify the OHC as targets responsible for the loss of CM sensitivity after TMT as the EP was unaffected. These data suggest that CAP and CM recovery at low and middle frequencies following acute TMT administration is accompanied by recovery of neurotransmission at the IHC or Type 1 SGC level and OHC recovery at apical regions of the cochlea.

Action Potentials↗

Effects of dobutamine and dopamine on whole brain blood flow and metabolism in unanesthetized monkeys.

Dobutamine (DO) and dopamine (DA) are positive inotropic agents used clinically to improve cardiac output in patients in acute or chronic heart failure or to counteract intracranial vasospasm. These patients are also at risk for cerebrovascular disease, but studies on the effects of DA on cerebral blood flow (CBF) and metabolism are few and for DO nonexistent. We evaluated the effects on DO and DA on whole brain CBF and cerebral metabolic rates of oxygen (CMRO2) and glucose (CMRglc) in unanesthetized rhesus monkeys. Microelectrodes and catheters inserted in the superior sagittal sinus monitored H2 clearance and sampled cerebral venous blood. Studies were done at low and high doses with control measurements between doses. At 5.10, and 15 microg/kg/min (n = 6), neither systemic nor cerebral variables were affected by either drug. At doses of 50 and 100 microg/kg/min (n = 4), DO and DA increased arterial blood pressure and heart rate by 15 to 30%. Whereas CBF, CMRO2, and CMRglc were clearly unaffected by DO at high doses, they increased by 20-30% with DA, 100 microg/kg/min and although not significant (p >0.05), the consistency and magnitude of the increase along with the likelihood of a type II error led us to conclude that (a) both DO and DA are less effective in monkeys than in humans and (b) whereas DO at all doses tested showed no indication of affecting CBF and CMR, DA increased CBF and CMR by 20 to 30% at a dose of 100 microg/kg/min.

Journal Article↗

Effect of 80% Xe on whole brain blood flow and metabolism in awake monkeys.

We previously reported that 33% xenon (Xe) did not activate cerebral blood flow (CBF) and metabolism in monkeys as it appears to do in humans. However, monkeys may be less sensitive to Xe than humans are, which would explain the discrepancy in the results, but no one has studied the effects of higher concentrations of Xe on CBF and metabolism in monkeys. Therefore, we studied the effect of 80% Xe on whole-brain CBF, cerebral metabolic rate for oxygen (CMRO2) and glucose (CMRG) in five awake rhesus monkeys. Platinum microelectrodes and catheters inserted into the torcular Herophili were used to measure H2 clearance CBF, and to withdraw cerebral venous blood for O2 and glucose analysis. Cerebral variables were measured after 15 min exposure to 80% N2/20% O2 followed by 80% Xe/20% O2. Eighty percent Xe compared with 80% N2 increased (p <0.01) CBF by 52.7% from 74 +/- 16 to 113 +/- 25 (mean +/- SD) ml 100 g(-1)/min(-1), CBF/CMRO by 154% from 13 to 33, and decreased (p <0.05) CMRO2 by 39.3% from 6.1 +/- 0.9 to 3.7 +/- 0.8 ml 100 g(-1)/min(-1) and CMRG by 52.4% from 8.4 +/- 2.6 to 4.0 +/- 2.0 mg 100 g(-1)/min(-1). Electroencephalogram frequency decreased from a predominantly alpha to dagger rhythm in three of five monkeys. The 40 and 50% reduction in CMRO2 and CMRG, respectively, by 80% Xe suggests an anesthetic effect at this dose in the rhesus monkey but also activates CBF by 50%.

Journal Article↗

Diagnosis of soft-tissue masses with MR imaging: can benign masses be differentiated from malignant ones?

A blinded, retrospective review of 83 soft-tissue masses (49 benign and 34 malignant) was performed to evaluate the ability to distinguish benign from malignant soft-tissue masses with magnetic resonance (MR) imaging. The correct histologic diagnosis was reached in 31% of cases by one reader and in 16% of cases by the second reader. Mean sensitivity was 50% for benign masses and 80% for malignant masses. The majority of both benign and malignant masses had inhomogeneous signal intensity and at least partially irregular borders. Malignant masses uncommonly had smooth borders and homogeneous signal intensity. MR imaging can be used to evaluate the extent of soft-tissue masses, but most masses will require biopsy to determine if they are benign or malignant.

Adult↗

MR imaging of joints: analytic optimization of GRE techniques at 1.5 T.

To clarify the choice of imaging parameters for optimal gradient-recalled echo MR scanning of joints, we analyzed the behavior of contrast-to-noise and signal-to-noise ratios for spoiled (i.e., fast low-angle shot [FLASH] or spoiled GRASS) and steady-state (i.e., gradient-recalled acquisition in the steady state [GRASS] or fast imaging with steady precession) techniques at 1.5 T. The analysis is based on tissue characteristics derived from spin-echo measurements of hyaline cartilage and synovial fluid signal in the patellofemoral joints of 11 volunteers. Separate analysis of contrast-to-noise and signal-to-noise ratios for multiplanar (long TR) acquisitions shows that these parameters are each improved compared with single-slice methods. At TRs greater than 250 msec, there is no significant difference in the contrast behavior of FLASH and GRASS. For optimal contrast-to-noise ratio (synovial fluid-cartilage), the best multiplanar sequence (for TE less than 23 msec) is with a short TE and a large flip angle (e.g., 400/9/73 degrees [TR/TE/flip angle]). If a single-scan or three-dimensional technique is desired, than a GRASS sequence at minimal TR and TE and intermediate flip angle (18/9/32 degrees) is best. For optimal signal-to-noise ratio (for both synovial fluid and hyaline cartilage), the best multiplanar sequence uses a short TE and an intermediate flip angle (e.g., 400/9/30 degrees). If a short TR, high signal-to-noise technique is desired, then GRASS (18/9/13 degrees) is superior to FLASH.

Cartilage, Articular↗

Effects of posture, Valsalva maneuver and respiration on atrial flutter rate: an effect mediated through cardiac volume.

The effects of passive upright tilting from 0 degrees to +60 degrees (n = 27), Valsalva maneuver (n = 16) and respiration (n = 10) on the rate of atrial flutter were studied in 27 patients. After tilting to +60 degrees, the atrial flutter cycle length shortened in all patients from 247.5 +/- 7 to 236.7 +/- 6.9 ms (range of shortening 1 to 21 ms, p less than 0.001). The Valsalva maneuver (strain of 40 mm Hg) shortened the flutter cycle length during the strain (phase 2) from 242.2 +/- 4.6 to 230.5 +/- 5 ms (range of shortening 2 to 19 ms, p less than 0.001). In 10 patients whose respiration was monitored, the flutter cycle length consistently prolonged during inspiration and shortened during expiration. Combined beta-adrenergic and muscarinic receptor blockade in six patients did not significantly alter the flutter cycle length at rest or the effects of the various maneuvers on the changes in flutter cycle length. This study revealed that the atrial flutter cycle length can be shortened by passive upright tilting, the strain phase of the Valsalva maneuver and expiration. Changes in flutter cycle length were independent of autonomic tone, implying that by decreasing cardiac volume, these maneuvers affect characteristics of the atrial flutter circuit, thereby producing dynamic changes in the rate of atrial flutter.

Atrial Flutter↗

Tibial collateral ligament bursa: MR imaging.

The bursa of the tibial collateral ligament (TCL) may be visualized at magnetic resonance (MR) imaging when it becomes distended with fluid. In the authors' experience, this finding signifies a pathologic condition either in the medial capsuloligamentous complex or in the bursa itself. Such a finding may indicate TCL bursitis. TCL bursitis can be suspected in the setting of isolated pain in the medial joint line in the absence of mechanical symptoms. Prolonged relief of symptoms after injection of steroid into the bursa is supportive of the diagnosis. Seven cases are presented in which a fluid-filled TCL bursa was identified at MR imaging. In five cases, TCL bursitis was suspected. The differential diagnosis for the MR findings is discussed.

Adult↗

The cytoplasmic domain of the CD8 alpha-chain is required for its interaction with p56lck.

The CD8 glycoprotein expressed on the surface of CTLs is a heterodimer composed of alpha (Lyt-2) and beta (Lyt-3) chains. Recent studies have shown that CD4 and CD8 are physically associated with a T cell-specific protein-tyrosine kinase p56lck. Our previous experiments have suggested strongly that p56lck interacts directly with CD4 and CD8 molecules. The present report using cytoplasmic deletion mutants of the CD8 alpha-chain gene has extended our observations to demonstrate unequivocally that the cytoplasmic domain of the CD8 alpha chain is responsible for interaction with p56lck. The data has also confirmed the importance of the conserved twelve amino acid sequence motif of the CD8 alpha cytoplasmic domain in complex formation with p56lck.

Amino Acid Sequence↗

Empyema of the gallbladder in a patient with AIDS-related complex.

A case of staphylococcus aureus empyema of the gallbladder in a patient with AIDS-related complex is presented. The case is remarkable for the indolence of the clinical presentation and the magnitude of gallbladder dilatation noted at computed tomographic (CT) examination. Empyema of the gallbladder may constitute an unusual manifestation of bacterial disease in patients with AIDS or AIDS-related complex and cholelithiasis.

AIDS-Related Complex↗