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Biomedical subjects

W Chew

Publications and source records attributed to W Chew.

At least 19 recordsLinked to original sources
PubMed2006

Downloadable computer models for renal replacement therapy.

Mathematical models can predict solute clearances and solute concentrations during renal replacement therapy. At present, however, most nephrologists cannot use these models because they require mathematical software. In this report, we describe models of solute transport by convection and diffusion adapted to run on the commonly available software program Excel for Macintosh computers and PCs running Windows. Two programs have been created that can be downloaded from http://www.stanford.edu/~twmeyer/ or http://dev.satellitehealth.com/research/journal.asp. The first, called 'Dr Addis Clearance Calculator', calculates clearance values from inputs including the blood flow Q(b), the hematocrit, the ultrafiltration rate Q(f), the dialysate flow rate Q(d), the reflection coefficient sigma and the mass transfer area coefficient K(o)A for the solute of interest, and the free fraction f if the solute is protein bound. Solute concentration profiles along the length of the artificial kidney are displayed graphically. The second program, called 'Dr Coplon Dialysis Simulator', calculates plasma solute concentrations from the clearance values obtained by the first program and from additional input values including the number of treatments per week, the duration of the treatments, and the solute's production rate and volumes of distribution. The program calculates the time-averaged solute concentration and provides a graphic display of the solute concentration profile through a week-long interval.

Animals↗
PubMed1996

Genetic characterization of Mycobacterium avium isolates recovered from humans and animals in Australia.

Genetic relationships amongst 115 mainly Australian isolates of Mycobacterium avium were assessed using multilocus enzyme electrophoresis (MEE). The isolates were divided into 58 electrophoretic types (ETs), with a mean genetic diversity of 0.29. Isolates from humans were closely related to but distinct from those cultured from birds, whilst some porcine isolates belonged to the same ETs as certain human isolates. Pulsed field gel electrophoresis (PFGE) was used to differentiate related isolates, and those from birds and some from other animals, including pigs, were distinguished from the human isolates. The results of MEE and PFGE suggested that certain strains of M. avium may be transmitted between birds and pigs, but there was no clear evidence of transmission to humans. The serovar of the M. avium isolates was not obviously related to their ET assignment or their PFGE type.

Animals↗
PubMed1996

Image reconstruction with acoustic measurement using distorted Born iteration method.

The distorted Born iterative method (DBIM) is applied to solve electromagnetics and ultrasonics inverse scattering problems. First, we use the DBIM to process the data, which are the scattered fields from two-dimensional cylinders with arbitrary cross section. From this simulation, we confirmed that the first-order Born approximation can be applied to larger objects as long as the phase change of a wave passing through the object due to its presence is smaller than a limit. Then we applied DBIM to process the ultrasonic measurement data. Images for a balloon and an egg that are immersed in water have been reconstructed and compared with those from the first-order diffraction tomography (DT).

Humans↗
PubMed1995

Plasticity of craniomandibular muscle function: 31P magnetic resonance spectroscopy of the rabbit masseter muscle.

The masseter muscle was studied during postnatal development of the rabbit from the juvenile to adult stage in which the oral function was altered during maturation by modifying the diet to soft food. The muscle was assessed using phosphate magnetic resonance (31P NMR) spectroscopy with a single-turn copper surface coil to study potential changes in phosphate metabolism. The 31P NMR spectra consisted of five peaks related to unbound forms of inorganic phosphate (Pi), creatine phosphate (PCr), and three peaks related to the adenosine triphosphate (ATP). The masseter was assessed in one group of five rabbits at 8 weeks postnatally (juvenile) and after 4 months of this experimental group masticating on soft food. They were compared with a control group of five rabbits raised on a normal hard diet. The Pi/PCr ratio increased in the adult masseter much higher during twitching, tetany, and periodic contraction than in the juvenile regardless as to whether the adult animal had been raised from the juvenile period on soft or hard diet. There were relatively few differences between the experimental adult animals raised on a soft diet and the normal adult animals despite the soft diet animals demonstrating a significantly lower weight and smaller muscle mass. These findings suggest that chronic underuse of the masseter muscle by decreasing the masticatory loads has a minimal effect on the phosphate metabolism of the maturing masseter.

Adaptation, Physiological↗
PubMed1995

Effect of maturation on 31P magnetic resonance spectroscopy of the rabbit masseter muscle.

This work studies the dynamic metabolic changes of the rabbit masseter muscle during post-natal development. The composition and proportion of oxidative and glycolytic muscle fibers alter during maturation. The masseter muscle, as most muscles of the craniofacial region, exhibits unusual development in composition of isoforms of myosin. The effect of this unusual composition on the dynamic metabolic properties of the masseter muscle have not been assessed. The metabolism of the rabbit masseter muscle was studied by means of 31P-nuclear magnetic resonance (NMR) spectroscopy. Contraction was elicited by electrical stimulation of the muscle in the anesthetized animal. Five animals were studied at 8 weeks and 24 weeks so that both the juvenile and adult stages could be evaluated. The dynamic biochemical changes in the masseter muscle were studied by the analysis of NMR spectra. A single-turn surface coil (copper) was used, and the original signal was treated with Fourier transforms to obtain 31P spectra. The low signal-to-noise ratio required averaging 16 acquisitions (acquisition time = 400 msec, repetition rate = 1.8 sec) in 30 sec and then obtaining continuous spectra for 27 min. Each averaged spectrum demonstrated five peaks: inorganic phosphate (Pi), creatine phosphate (PCr), and three peaks related to adenosine triphosphate (ATP). The protocol involved recording an initial three-minute rest period, stimulating the muscle at 5 Hz for 3 min twice, separated by three-minute rest periods, and stimulating the muscle at 50 Hz twice for 3 min separated by rest periods. The Pi/PCr ratio increased significantly in the adult masseter during both 5-Hz stimulations, evoking twitching, and the first 50-Hz stimulation, evoking tetany (repeated ANOVA, P < 0.05). The resting pH (6.96 +/- 0.13) was significantly lowered during both twitching (6.85 +/- 0.10; P < 0.0038) and tetany (6.55 +/- 0.13; P < 0.0001), but only in the adult masseter muscle. These finding suggest that the adult masseter muscle possesses more glycolytic fibers as it modifies its metabolism during postnatal development.

Adenosine Triphosphate↗
PubMed1995

Magnetic resonance spectroscopy of the human masseter muscle in nonbruxing and bruxing subjects.

The masseter muscles of six nonbruxing subjects (five men, one woman) and six bruxing subjects (four men, two women) were assessed during chewing by nuclear magnetic resonance spectroscopy (31P-NMR). The NMR spectra were collected on a GE Sigma 1.5T whole body magnet with a double-tuned 31P/1H surface coil. Two-minute trials of rest/chewing/rest were completed three times. Averaged spectra of inorganic phosphate, phosphocreatine, and three adenosine 5' triphosphate peaks were collected in each trial. Bruxing subjects had a lower concentration of total phosphate and phosphocreatine than nonbruxing (control) subjects at rest. Bruxing subjects increased their inorganic phosphate during chewing significantly less than control subjects. The pH levels during rest and during chewing were similar in both controls and bruxers. These preliminary results suggest that bruxing subjects exhibit an altered phosphate metabolism during rest and exhibit a different phosphate metabolism pattern during chewing as compared to nonbruxing subjects.

Adenosine Triphosphate↗
PubMed1994

Parceling of mesial frontal motor areas during ideation and movement using functional magnetic resonance imaging at 1.5 tesla.

Finger movement-related responses were identified in three discrete sites of mesial frontal cortex in 7 normal subjects using high resolution functional magnetic resonance imaging. During imagination of the same movements there was a differential response with rostral areas more active than caudal areas. Humans have multiple motor areas in mesial frontal cortex that subserve different functions in motor planning and execution.

Adult↗
PubMed1994

31P-magnetic resonance spectroscopy of the rabbit masseter muscle.

Dynamic biochemical changes in the masseter muscle were studied in 14 New Zealand adult male rabbits by 31P-nuclear magnetic resonance (NMR) spectroscopy. NMR spectra were obtained during rest and electrical stimulation of the muscle in the anaesthetized animal at 33 recording sessions. Electrical stimulation was applied by a pair of copper wires placed separately with hypodermic needles into the muscle. NMR spectra were acquired with a 2 x 3 cm, double-turn, copper transmit/receive coil. Sixteen spectra were averaged over 30 s to obtain averaged spectra continuously during a 30-min recording. The spectra were processed automatically using a non-linear 'least-squares' fitting program on the spectrometer. A Lorentzian line shape was assumed for the peaks, and values of peak height, area and chemical shifts were generated. Each averaged spectrum consisted of five peaks: inorganic phosphate (Pi), creatine phosphate (PCr), and three peaks related to ATP. Data were analysed as to absolute changes in Pi and PCr, in the ratio of Pi/PCr, and the shift of Pi to PCr to estimate pH. Several protocols were used in which ranges of frequency, intensity and duration of electrical stimulation were tested. The protocol for detailed studies involved stimulating the muscle twice at 5 Hz for 3 min separated by a 3-min rest period, then stimulating twice at 50 Hz for 3 min separated by a rest period. During contraction of the muscle, there was a significant increase in the Pi/PCr ratio (p < 0.05) as compared to the resting level. The ratio reached a plateau over a 3-min contraction using 5-Hz stimulation, then increased significantly more with the 50-Hz stimulation but decayed during the 3 min. Sustained stimulation with 50 Hz for 15-45 min evoked an initial sharp change in Pi/PCr, which then reached a steady plateau that remained over the entire stimulation. These findings indicate that the rabbit masseter muscle is relatively fatigue resistant in maintaining a steady-state equilibrium in the relation of Pi to PCr.

Adenosine Triphosphate↗
PubMed1994

Subtyping of Mycobacterium avium complex (MAC) isolates by thin-layer chromatography--distribution of subtypes from patients with AIDS compared with clinically non-significant isolates.

Thin-layer chromatography (TLC) was compared with seroagglutination for subtyping of Mycobacterium avium complex (MAC) bacteria. Seventy-five significant MAC isolates from patients with AIDS were typed by both methods and 36 isolates, judged to be clinically non-significant, were examined by TLC only. Overall, 75% of isolates tested were typable by seroagglutination and 91% by TLC; the results correlated between the two except for minor discrepancies. Serovars 1, 8 and 21 and mixed serovars 1-21 and 1-8-21 were common among isolates from AIDS patients and together represented 83% of isolates compared with only 36% in the non-significant group (odds ratio 8.4; 95% confidence interval 3.4-23.3). This difference remained significant after exclusion of serovar 41 (M. scrofulaceum), which was the commonest isolate (28%) in the non-significant group but was not isolated from patients with AIDS. TLC is useful to supplement seroagglutination for subtyping of MAC. Further study is required to determine whether apparent differences between isolates from patients with AIDS and from other sources reflect differences in virulence or in environmental prevalence of MAC subtypes.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Epidemiology of diabetes mellitus in a regional hospital medical unit.

Diabetics form a significant proportion of patients requiring admission to medical units in Singapore. We conducted a cross-sectional study of all diabetic patients admitted to Alexandra Hospital over a two-month period (1 September 1990 to 31 October 1990). One hundred and thirty-five patients (57 males, 78 females) were entered into the study. The population characteristics, admitting medical diagnoses, complications, treatment modalities and follow-up of these patients were studied. The study group accounted for 13.1% of all hospital admissions over the study period (total admissions 1033). Eighty-seven (64.4%) were Chinese, 25 (18.5%) Indians and 23 (17.1%) Malays. Of the microvascular complications, the most common was diabetic nephropathy. Eighty-two (60.7%) patients had albuminuria and 35 (25.9%) were azotemic. Dermopathy was present in 15.5% (21) and 32.6% (44) had peripheral neuropathy. Cataracts were present in 32.6% (44) of the study population and retinopathy in 18.5% (25). Associated diseases like hypertension were detected in 51.9% (70), hyperlipidemia in 41.5% (56) and coronary heart disease in 28.1% (38) of the group. Eighty-four patients (62.2%) were treated with oral hypoglycaemic tablets, 27 (20.0%) with insulin and 24 (17.7%) were managed with diet alone. Thirty-four patients (25.2%) were admitted with acute infections, most of which were respiratory infections. The mean glycosylated haemoglobin value was 11.7%. The mean duration of hospitalisation was 6.48 days. No significant correlation was found between the glycosylated haemoglobin value and the duration of hospitalisation.

Adolescent↗
PubMed1991

Tuberculosis in Australia: an analysis of cases identified in reference laboratories in 1986-88.

The Special Interest Group in Mycobacteria within the Australian Society for Microbiology has carried out a collaborative study of cases of tuberculosis diagnosed in Australian reference laboratories in the years 1986, 1987 and 1988. Annual totals of 574, 584 and 613 respectively, suggest that the incidence of bacteriologically-positive tuberculosis is continuing at 3-4 cases per 100,000 population. The highest rates were detected in males over 50 and females over 65 years of age. Three-quarters of the total cases relate to pulmonary disease. Resistance to at least 1 anti-tuberculosis drug was detected in 78 (12.7%) of isolates tested in 1988. The negligible decline in incidence of tuberculosis in Australia, the high prevalence in S.E. Asian countries, and the fact that HIV-infection is an important risk factor, make it imperative that Australia's diagnostic and management programmes be maintained.

Adolescent↗
PubMed1990

Fat-saturation MR imaging of the upper abdomen.

The fat-saturation (fatsat) MR technique decreases the signal intensity of fat, thereby enhancing the definition of upper abdominal organs and reducing artifacts while maintaining the T1 and T2 information available on spin-echo sequences. To evaluate the potential of fatsat in examining the abdomen, we conducted a prospective study involving 30 subjects, including four normal volunteers, 18 patients investigated for liver disease, and eight patients studied for miscellaneous abdominal disease. Short TR, 300-600/15-20 (TR/TE), and long TR, 2000-2500/20-30, 70-80, spin-echo images with and without fatsat were compared. The images were evaluated both qualitatively and quantitatively. Qualitative assessment was made with receiver-operating-characteristic (ROC) curve analysis of the confidence level of observers to detect the presence of disease, comparing fatsat with standard spin-echo sequences. ROC analysis showed greater interpreter confidence and accuracy for fatsat sequences than for standard spin-echo sequences. The measured signal-difference-to-noise (SD/N) ratio comparing upper abdominal organs with surrounding tissue revealed the highest values for short TR/TE regular spin echo, followed by short TR/TE fatsat. The highest SD/N ratio for hepatic masses was with long TR/TE fatsat followed by short TR/TE fatsat. The results of this study suggest that the fatsat technique may improve abdominal MR imaging.

Abdomen↗
PubMed1990

Diabetic retinopathy--results of a two year screening programme in two medical units in Singapore.

Three hundred patients with Diabetes Mellitus from 2 medical units in Singapore were screened for retinopathy over a 24 month period. Prevalence of retinopathy in this population was 38% with sight-threatening retinopathy in 17%. Risk factors associated with retinopathy included a longer duration of disease, the presence of hypertension, nephropathy and poor glycaemic control. Prevalence of retinopathy was higher in females. Malays and Indians had higher prevalence of retinopathy than Chinese.

Diabetic Nephropathies↗
PubMed1989

Nicardipine reduces ischemic brain injury. Magnetic resonance imaging/spectroscopy study in cats.

We investigated whether the calcium channel entry blocker nicardipine would reduce ischemic brain damage in barbiturate-anesthetized cats subjected to permanent unilateral occlusion of the middle cerebral artery. The evolution of cerebral injury was assessed in vivo in 24 cats by a combination of proton magnetic resonance imaging and phosphorus-31 magnetic resonance spectroscopy for 5 hours following occlusion. Immediately thereafter, the volume of histochemically ischemic brain tissue was determined planimetrically in triphenyl tetrazolium chloride-stained serial coronal sections. Nicardipine was initially administered as an intravenous bolus injection of 10 mg/kg/hr 15 minutes before or 15 minutes after occlusion, followed by continuous infusion at 8 mg/kg/hr for the 5 hours of the experiment. Compared with untreated controls, cats that received nicardipine before or after occlusion showed a significant reduction in the extent of edema in the ipsilateral cerebral cortex, internal capsule, and basal ganglia. The results of phosphorus-31 magnetic resonance spectroscopy studies suggest that nicardipine may protect against cerebral ischemic damage by an action on cellular metabolic processes that preserve high-energy phosphates during the ischemic period.

Animals↗
PubMed1987

Localized imaging using stimulated echoes.

Stimulated-echo localized spectroscopy was combined with phase- and frequency-encoding gradients to obtain "zoom" or magnified images of specific organs in situ. The technique requires neither surface coils nor an imaging coil arrangement that exclusively isolates the target organ. This technique can be readily applied to conventional spectrometer imagers that have limited computational capabilities.

Animals↗
PubMed1987

An in vivo study of halothane uptake and elimination in the rat brain with fluorine nuclear magnetic resonance spectroscopy.

A recent NMR study reported the elimination of halothane from the brain of rabbits to be ten times slower than expected, based on known anesthetic solubility and cerebral blood flow. The authors conducted a study in five rats using fluorine nuclear magnetic resonance (NMR) spectroscopy to see if major pharmacokinetic discrepancies are associated with the uptake, maintenance, and elimination of halothane from the brain. The rats underwent a 60-min period of halothane anesthesia. They employed a spatially selective NMR spectroscopy technique known as surface coil "depth-pulsing" to assure that the fluorine NMR signals originated in brain tissue, and not in the scalp, muscle, adipose tissue, and bone marrow that surround the brain. After the inspired anesthetic concentration was decreased to zero, the amplitude of the fluorine NMR signal decreased to 40% of its maximum value within 34 +/- 8.0 minutes (n = 5), rather than after 7 h as in the recent study, where the fluorine signal may have contained substantial contributions from metabolites or tissues outside the brain. Fluorine was barely detectable in all of the animals 90 min after stopping the administration of halothane. The authors' results are in agreement with model calculations and several other investigations.

Anesthesia↗
PubMed1987

An in vivo 19F nuclear magnetic resonance study of isoflurane elimination from the rabbit brain.

19F nuclear magnetic resonance spectroscopy was performed at 2.0 Tesla to evaluate the washout of isoflurane from the adult rabbit brain after 90 min of anesthesia. This investigation reconciles previous in vivo NMR studies of others, which observed a slow anesthetic washout, with invasive non-NMR studies that found a rapid washout, as predicted by perfusion-limited models of anesthetic uptake and elimination. Two NMR surface coil experiments were performed: in the first, a 1-cm surface coil was placed directly over the exposed dura to be certain that the washout was observed only from the brain; in the second, a 3-cm coil was placed noninvasively over the intact scalp to emulate previous NMR experiments. As in previous NMR experiments, a slow washout of isoflurane was observed with the large coil. The NMR signal that is observed with the large coil cannot be attributed solely to brain tissue. Fat surrounding the brain contributes significantly to the fluorine NMR spectra that are observed with the 3-cm coil, and its contributions lengthen the apparent washout time. A rapid washout of isoflurane from the rabbit brain was observed with the small coil, whose signal unambiguously arises only from brain tissue. The observed rapid washout is consistent with previous invasive biochemical measurements of anesthetic washout from the brain.

Anesthesia↗