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Biomedical subjects

W Lee

Publications and source records attributed to W Lee.

At least 217 records · Page 12Linked to original sources
PubMed1996

The significance of ultrasonographically diagnosed fetal wrist position anomalies.

OBJECTIVE: Our purpose was to determine the clinical significance of ultrasonographically diagnosed fetal wrist position anomalies. STUDY DESIGN: The relationship of the fetal hand to the forearm was prospectively evaluated in all second- and third-trimester scans over a 5-year period. If an abnormal wrist position was detected, a targeted scan, including echocardiography, was performed. The outcomes of abnormal pregnancies were obtained. RESULTS: An abnormal relationship of the hand to the forearm was found in 22 fetuses in 27,467 scans. Nine had a normal karyotype, and 13 had an abnormal karyotype. Among the nine with normal chromosomes, three had evidence of a movement disorder. Three with normal karyotypes are alive; two of these are the only normally functioning survivors. They had no other major anomalies and were shown prenatally to have normal movement of the limbs. CONCLUSIONS: An abnormal fetal wrist position is associated with a high incidence of karyotype and movement abnormalities.

Chromosome Aberrations↗
PubMed1996

The use of second-trimester transvaginal sonography to predict placenta previa.

Our objective was to determine the incidence and rate of persistence of placenta previa diagnosed at 15-20 weeks' gestation by using transvaginal sonography (TVS), and to describe the characteristics of TVS that predict placenta previa at delivery. Patients having placental tissue within 20 mm of the cervical os were prospectively identified by transabdominal ultrasound and underwent TVS. The distance of the placental edge from the cervical os was measured in millimeters. Characteristics of TVS predicting placenta previa at delivery were analyzed by logistic regression. The incidence of placenta previa diagnosed by TVS at 15-20 weeks was 1.1%; 14% persisted until delivery. Gestational age at the time of TVS and the distance of the placental edge to the cervical os helped predict placenta previa at delivery. Between 15 and 24 weeks' gestation, placenta overlapping the internal os by > or = 10 mm identified patients at risk of placenta previa at delivery with 100% sensitivity and 85% specificity. The use of TVS in the second trimester to diagnose placenta previa resulted in a lower incidence than was historically reported with the use of transabdominal ultrasound. The distance of the placental edge from the cervical os helps identify patients at risk of previa at delivery.

Female↗
PubMed1996

Interphase cytogenetics of non-Hodgkin's lymphoma using non-fluorescent in situ hybridization in paraffin embedded tissue.

Paraffin-embedded tissue samples from 30 cases of non-Hodgkin's lymphoma(NHL) and 10 of reactive hyperplasia, were processed for interphase cytogenetic chromosomal study. We performed non-fluorescent in situ hybridization(NFISH) using the enzymatic method with digoxigenin-labeled DNA centromeric probes for chromosome 7,12,18 and X, and a painting probe for chromosome 18. Chromosomal aberrations were observed in 27(90%) out of 30 cases of NHL. The most commonly observed numerical aberration was extracopy of X chromosome. There were some characteristic aberrations corresponding to each grade and group of NHL by International Working Formulation: In low grade NHL(9 cases), a third were associated with extracopy of chromosome 12, and disomy X was frequently found in small lymphocytic lymphoma(75%). With intermediate grade(16 cases), tetraploidy(25%), translocation of chromosome 18(25%), and extracopy of chromosome 18(19%) were characteristically associated. These results suggest that interphase NFISH is an easily performable method in retrograde cytogenetic study of archival materials. Some specifically correlated chromosomal aberrations corresponding to the histopathologic grades and groups could provide us more valuable information for determining pathologic diagnosis and assessing the clinical outcome of NHL.

Chromosome Aberrations↗
PubMed1996

OzCare: a workflow automation system for care plans.

An automated environment for implementing and monitoring care plans and practice guidelines is very important to the reduction of hospital costs and optimization of medical care. The goal of our research effort is to design a general system architecture that facilitates the implementation of (potentially) numerous care plans. Our approach is unique in that we apply the principles and technologies of Oz a multi-user collaborative workflow system that has been used as a software engineering environment framework, to hospital care planning. We utilize not only the workflow modeling and execution facilities of Oz, but also its open-system architecture to interface it with the World Wide Web, the Medical Logic Module server, and other components of the clinical information system. Our initial proof-of-concept system, OzCare, is constructed on top of the existing Oz system. Through several experiments in which we used this system to implement some Columbia-Presbyterian Medical Center care plans, we demonstrated that our system is capable and flexible for care plan automation.

Computer Simulation↗
PubMed1995

Photoperiod affects the expression of neural cell adhesion molecule and polysialic acid in the hypothalamus of the Siberian hamster.

Immunohistochemical and immunoblot procedures were used to examine the effects of inhibitory short day (SD) photoperiod on the expression of neural cell adhesion molecule (NCAM) and its polysialylated form (PSA-NCAM) in the hypothalamus and preoptic area (POA) of the adult male Siberian hamster. In animals that had undergone SD-induced gonadal regression, immunoblot analyses revealed significant reductions in the content of immunoreactive PSA in anterior hypothalamic (AH) and mediobasal hypothalamic (MBH) regions. These changes were accompanied by increased contents of the 180 kDa NCAM isoform in the POA and AH, and decreased content in the MBH. The 140 kDa NCAM isoform also was elevated in the AH. Light microscopic analysis revealed a marked reduction in the density of NCAM-immunoreactive tanycyte-like processes in the MBH of animals exposed to SD. This effect was not blocked by castration, indicating that this may be a primay (sex steroid-independent) effect of altered photoperiod in the hypothalamus. Also, photoperiod-induced alterations in NCAM expression were not evident in non-responsive hamsters that maintained active testes under SD exposure. Collectively, these results are evidence that seasonal changes in photoperiod affect the expression of NCAM and PSA in the hypothalamus. Such changes could help promote plastic morphological rearrangements related to the regulation of seasonal reproductive and/or metabolic cycles.

Analysis of Variance↗
PubMed1995

Determination of a novel cognitive enhancer, X9121, and its mono N-oxide metabolite, XG696, in dog plasma by reversed-phase high-performance liquid chromatography with ultraviolet detection.

A selective and sensitive high-performance liquid chromatographic assay for a novel cognitive enhancer, X9121 (I), and its mono N-oxide metabolite, XG696 (II), in dog plasma has been developed. Compounds I, II and internal standard (I.S.) were first extracted from dog plasma using a solid-phase Bond Elut Certify I 10-ml LRC reservoir extraction cartridge. Chromatographic separation of I, II and I.S. was conducted on a reversed-phase Zorbax Stable Bond cyano column. Ammonium acetate buffer (0.05 M, pH 6)-acetonitrile-triethylamine (75:25:0.1, v/v) was used as the mobile phase. Detection of all three compounds was by UV light absorbance at 313 nm. Using 0.5 ml of dog plasma for extraction, the minimum quantifiable limit was 10 ng/ml and the assay was linear from 10 to 5400 ng/ml. The coefficients of variation for intra-day precision ranged from 2.2 to 8.5% for I and from 2.5 to 9.8% for II. The coefficients of variation for the inter-day precision for these two compounds ranged from 2.6 to 9.0% and from 3.6 to 16.2%, respectively. The absolute percent differences for the accuracy results were within 11.0% of the spiked concentrations. Compounds I and II were stable in frozen plasma at -20 degrees C for at least 67 days.

Animals↗
PubMed1995

Hepatitis C--associated glomerular disease in liver transplant recipients.

Hepatitis C virus (HCV) infection may be associated with extrahepatic illness including renal disease. We investigated the clinical and virological characteristics of three patients who developed a mesangial proliferative and sclerosing glomerulopathy alone or in association with membranoproliferative glomerulonephritis after liver transplantation for end-stage liver disease secondary to HCV infection. Using polymerase chain reaction technology and the IgM RIBA assay, viral load, genotype and IgM antibody response to HCV in the setting of glomerulonephritis was evaluated. Within 1 year of transplantation, the patients showed decreased renal function, proteinuria and recurrent hepatitis C liver disease. Likewise, HCV viral load increased following transplantation, whereas the viral genotypes remained unchanged. Although the first patient presented with classic type II cryoglobulinemia in association with glomerulonephritis, the second patient developed an IgM directed specifically against the hepatitis C core antigen. The third patient developed a low-titered IgM directed against the hepatitis C core antigen with rheumatoid factor activity but without cryoglobulinemia. All of the patients show IgM in glomerular capillary walls by biopsy. One patient has shown a clinical response to interferon (IFN) alfa-2b therapy without evidence of hepatic allograft rejection. The second and third patients have not responded to IFN or developed hepatic rejection. This study suggests that HCV-associated glomerulonephritis may complicate liver transplantation in conjunction with the production of increased amounts of IgM of variable specificity. The posttransplant setting may provide a unique situation in which to investigate the specific requirements for the onset of renal disease.

Adult↗
PubMed1995

Rapid corepressor exchange from the trp-repressor/operator complex: an NMR study of [ul-13C/15N]-L-tryptophan.

[ul-13C/15N]-L-tryptophan was prepared biosynthetically and its dynamic properties and intermolecular interaction with a complex of Escherichia coli trp-repressor and a 20 base-pair operator DNA were studied by heteronuclear isotope-edited NMR experiments. The resonances of the free and bound corepressor (L-Trp) were unambiguously identified from gradient-enhanced 15N-1H HSQC, 13C-1H HSQC, 13C- and 15N-edited 2D NOESY spectra. The exchange off-rate of the corepressor between the bound and free states was determined to be 3.4 +/- 0.52 s-1 at 45 degrees C, almost three orders of magnitude faster than the dissociation of the protein-DNA complex. Examination of the experimental NOE buildup curves indicates that it may be desirable to use longer mixing times than would normally be used for a large molecule, in order to detect weak intermolecular NOEs in the presence of exchange. Intermolecular NOEs from bound corepressor to trp-repressor and DNA were analyzed with respect to the mechanism of ligand exchange. This analysis suggests that, in order for the ligand to diffuse out of the complex, there must be significant movement or 'breathing' of the protein and/or DNA.

Bacterial Proteins↗
PubMed1995

Interactive multimedia for prenatal ultrasound training.

This demonstration project examines the utility of interactive multimedia for prenatal ultrasound training. A laser-disc library was linked to a three-dimensional (3-D) heart model and other computer-based training materials through interactive multimedia. A testing module presented ultrasound anomalies and related questions to house-staff physicians through the image library. Users were asked to evaluate these training materials on the basis of perceived instructional value, question content, subjects covered, graphics interface, and ease of use; users were also asked for their comments. House-staff physicians indicated that they consider interactive multimedia to be a helpful adjunct to their core fetal imaging rotation. During a 9-month period, 16 house-staff physicians correctly diagnosed 78 +/- 4% of unknown cases presented through the testing module. The 3-D heart model was also perceived to be a useful teaching aid for spatial orientation skills. Our findings suggest that interactive multimedia and volume visualization models can be used to supplement traditional prenatal ultrasound training. The system provides a broad exposure to ultrasound anomalies, increases opportunities for postnatal correlation, emphasizes motion video for ultrasound training, encourages development of independent diagnostic ability, and helps physicians understand anatomic orientation. We hypothesize that interactive multimedia-based tutorials provide a better overall training experience for house-staff physicians. However, these supplementary methods will require formal evaluation of effectiveness to better understand their potential educational impact.

Computer Simulation↗
PubMed1995

Ultrasonographic left cardiac axis deviation: a marker for fetal anomalies.

OBJECTIVE: To determine if a relation exists between left cardiac axis deviation and fetal anomalies. METHODS: Estimation of cardiac axis was attempted prospectively as part of the cardiac examination in approximately 41,500 second- and third-trimester fetuses scanned between 1987-1993. Those with heart axes greater than 75 degrees to the left were considered to have left axis deviation. Only cases with postnatal follow-up were included. RESULTS: Thirty-four fetuses with left cardiac axis deviation had postnatal follow-up; eight were normal and 26 abnormal (positive predictive value 76%). Twenty-one fetuses had cardiac abnormalities (ten of these had additional extracardiac findings), and five had extracardiac findings only. CONCLUSION: Although left cardiac axis deviation can occur as an isolated sonographic finding in an otherwise normal fetus, most cases will demonstrate abnormalities of cardiac and/or extracardiac anatomy. Left cardiac axis deviation is largely associated with cardiac abnormalities, especially conotruncal anomalies, which may not be detectable by a four-chamber view alone. Therefore, the cardiac axis should be examined routinely as part of the four-chamber view of the fetal heart.

Congenital Abnormalities↗
PubMed1995

Tetralogy of Fallot: prenatal diagnosis and postnatal survival.

OBJECTIVES: To correlate prenatal echocardiographic findings with infant outcome in a large screening population affected by tetralogy of Fallot. METHODS: Inclusion criteria required confirmed postnatal cardiac diagnosis, at least one fetal ultrasound examination with satisfactory heart visualization, and infant delivery at our institution. Aortic and pulmonary artery diameters were measured from real-time ultrasound or videotaped scans and compared against published nomograms. The pulmonary artery to aorta ratio was also evaluated in a similar manner. Infant survival was assessed 1 year after delivery. RESULTS: Seventeen fetuses were confirmed to have a ventricular septal defect and an overriding aorta with varying degrees of right ventricular outflow obstruction after delivery. All karyotypes were normal. Ultrasound screening identified 12 of 17 abnormal hearts at a mean gestational age of 22.9 +/- 5.1 weeks; two of these fetuses were thought to have only ventricular septal defect before delivery. Five fetuses had enlarged aortic roots during the initial scan. Only two of the ten fetuses with a measurable pulmonary artery had initial sonographic evidence for valve stenosis. Six other pulmonary arteries became abnormally small with advancing pregnancy. The pulmonary artery to aorta ratio was decreased in six of the ten fetuses with a measurable pulmonary artery. Sixteen infants survived at least 1 year after birth and successfully completed either corrective or palliative cardiac surgery. CONCLUSION: Fetuses with tetralogy of Fallot may present with only a ventricular septal defect and aortic septal override by prenatal ultrasound examination. Pulmonary artery stenosis is not always present at initial ultrasound examination, but this finding can develop or worsen during pregnancy. Furthermore, a normal aortic diameter does not exclude tetralogy of Fallot. Infant survival appears to be favorable in the absence of other major structural or chromosomal anomalies.

Female↗
PubMed1995

Plasma processing of interstellar PAHs into solar system kerogen.

Processes resulting in the formation of hydrocarbons of carbonaceous chondrites and the identity of the interstellar molecular precursors involved are an objective of investigations into the origin of the solar system and perhaps even life on earth. We have combined the resources and experience of an astronomer and physicists doing laboratory simulations with those of a chemical expert in the analysis of meteoritic hydrocarbons, in a project that investigated the conversion of polycyclic aromatic hydrocarbons (PAHs) formed in stellar atmospheres into alkanes found in meteorites. Plasma hydrogenation has been found in the University of Alabama at Birmingham Astrophysics Laboratory to produce from the precursor PAH naphthalene, a new material having an IR absorption spectrum (Lee, W. and Wdowiak, T.J., Astrophys. J. 417, L49-L51, 1993) remarkably similar to that obtained at Arizona State University of the benzene-methanol extract of the Murchison meteorite (Cronin, J.R. and Pizzarello, S., Geochim. Cosmochim. Acta 54, 2859-2868, 1990). There are astrophysical and meteoritic arguments for PAH species from extra-solar sources being incorporated into the solar nebula, where plasma hydrogenation is highly plausible. Conversion of PAHs into alkanes could also have occurred in the interstellar medium. The synthesis of laboratory analogs of meteoritic hydrocarbons through plasma hydrogenation of PAH species is underway, as is chemical analysis of those analogs. The objective is to clarify this heretofore uninvestigated process and to understand its role during the origin of the solar system as a mechanism of production of hydrocarbon species now found in meteorites. Results have been obtained in the form of time-of-flight spectroscopy and chemical analysis of the lab analog prepared from naphthalene.

Alkanes↗
PubMed1995

Evidence of a direct relationship between neutrophil collagenase activity and periodontal tissue destruction in vivo: role of active enzyme in human periodontitis.

To assess the temporal relationship between periodontal tissue destruction and the activity of collagenase, exudate from inflamed periodontal tissues was collected and latent and active collagenase activities were measured by a functional assay in a longitudinal cohort study. Comparisons were made between human subjects with either: 1) inflammation with a previous history of progressive loss of connective tissue and bone support (n = 14); 2) inflammation and previous history of bone loss but now clinically stable (n = 27); or 3) inflammation and no loss of bone support (n = 17). Experiments using specific enzyme inhibitors, blocking antibodies and SDS-PAGE fluorograph to identify the pattern of collagen substrate degradation demonstrated that the collagenase activity was derived from neutrophils and not from bacteria or other host cells. Active collagenase activity pooled from 6 sites per subject was respectively 5 and 6-fold higher in the group with progressive loss of connective tissue compared to the groups with either inflamed tissues alone or with inflammation and previous bone loss. In contrast, latent collagenase was increased up to 2 fold higher in the group with inflammation but no bone loss compared to the group with progressive lesions. Moreover, the ratio of active to total collagenase activity was 50% higher in the group with progressive lesions. Although in all subjects successive measurements of site-specific active collagenase 1 month apart demonstrated wide variation (r < 0.50), only in sites with progressive periodontal destruction was there significant increase of active collagenase with time (1.28 x 10(-4) collagenase units per day). There were also sharp elevations in active enzyme level at the time of detection of loss of connective tissue attachment in specific sites of 8 subjects. At the time of detection of connective tissue attachment loss, there was an overall 40% increase of pooled active collagenase activity in all subjects with progressive loss of connective tissue compared to pre-breakdown sampling times. These data provide strong in vivo evidence for a direct role of active neutrophil collagenase in the pathological destruction of periodontal connective tissue.

Adult↗