751
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Al-Tabbaa A, Gonzalez RM, Lee D. The role of state-of-the-art echocardiography in the assessment of myocardial injury during and following cardiac surgery. Ann Thorac Surg 2001; 72:S2214-8; discussion S2218-9, S2267-70. [PMID: 11789844 DOI: 10.1016/s0003-4975(01)03300-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Use of intraoperative echocardiography during open heart surgery, transesophageal probes, high-frequency transducers, and color Doppler imaging provide important diagnostic information to surgeons and anesthesiologists. Early detection of myocardial ischemia, assessment of valvular disorders, and the ability to monitor for intracardiac air are among the most important roles of intraoperative transesophageal echocardiography. Large prospective studies are necessary to evaluate whether these changes affect the outcome of patients undergoing coronary artery bypass grafting in terms of morbidity, mortality, hospital length of stay, and functional recovery. The application of new techniques such as contrast-enhanced transesophageal echocardiography helps to assess the adequacy of cardioplegia distribution and, thus, myocardial protection during cardiopulmonary bypass, which has a significant influence on outcomes as well.
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752
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Neese RA, Siler SQ, Cesar D, Antelo F, Lee D, Misell L, Patel K, Tehrani S, Shah P, Hellerstein MK. Advances in the stable isotope-mass spectrometric measurement of DNA synthesis and cell proliferation. Anal Biochem 2001; 298:189-95. [PMID: 11700973 DOI: 10.1006/abio.2001.5375] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Methods for measuring rates of DNA synthesis, and thus cell proliferation, in humans had not been available until recently. We (D. C. Macallan, C. A. Fullerton, R. A. Neese, K. Haddock, S. S. Park, and M. K. Hellerstein, 1998, Proc. Natl. Acad. Sci. USA 95, 708-713) recently developed a stable isotope-mass spectrometric technique for measuring DNA synthesis by labeling the deoxyribose (dR) moiety of purine deoxyribonucleotides through the de novo nucleotide synthesis pathway. The original analytic approach had limitations, however. Here, we describe technical improvements that increase yield, stability, sensitivity, and reproducibility of the method. The purine deoxyribonucleoside, deoxyadenosine (dA), is directly isolated from hydrolysates of DNA by using an LC18 SPE column. Two derivatives were developed for analyzing the dR moiety of dA alone (without the base), an aldonitrile-triacetate derivative, and a reduced pentose-tetraacetate (PTA) derivative. The PTA derivative in particular exhibited greater stability (no degradation after several weeks), greater GC/MS signal, and much less abundance sensitivity of isotope ratios (i.e., less dependence of mass isotopomer abundances on the amount of material injected into the mass spectrometer source), compared to previous derivatives of dA. The need for complex, multidimensional abundance corrected standard curves was thereby avoided. Using the PTA derivative, dR enrichments from DNA of fully turned over cells of rodents with 2H2O enrichments in body water of 2.2-2.8% were 9.0-9.5%, and less than 1.0 microg DNA (ca. 2 x 10(5) cells) was required for reproducible analyses. In summary, these methodologic advances allow measurement of stable isotope incorporation into DNA and calculation of cell proliferation and death rates in vivo in humans and experimental animals, with fewer cells, greater reproducibility, and less labor. Many applications of this approach can be envisioned.
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753
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Altman IS, Lee D, Song J, Choi M. Experimental estimate of energy accommodation coefficient at high temperatures. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2001; 64:052202. [PMID: 11735987 DOI: 10.1103/physreve.64.052202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2001] [Indexed: 05/23/2023]
Abstract
The energy accommodation coefficient (EAC), which is used to characterize gas-surface interactions, was experimentally estimated at high temperatures. A method utilizing laser irradiation to heat up nanoparticles that are generated in a flame was proposed. From the obtained dependence of particle temperature upon laser power, the EAC was derived to be approximately equal to 0.005, which agrees nicely with our recent rigorous theoretical result. It indicates that the efficiency of heat transfer between gas and particles is sufficiently small in high temperature system at large Knudsen numbers.
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754
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Abstract
Steady flow in a complete by-pass tube was simulated numerically. The study was to consider a complete flow field, which included both the by-pass and the host tubes. The changes of the hemodynamics were investigated with three parameters: the inlet flow Reynolds number (Re), anastomotic angle (alpha) and the position of the occlusion in the host tube. The baseline flow field was set up with Re=200, alpha=45 degrees and the centered position of occlusion. The parametric study was then conducted on combination of Re=100, 200, 400, alpha=35 degrees, 45 degrees, 60 degrees, 75 degrees, 90 degrees and three occlusion positions: left, center and right. It was found that in the baseline case, large slow/recirculation flows could be seen in the host tube both upstream and downstream of the occlusion. The separation points were on the opposite walls to the junctions. Recirculation zones were also found near the toe and in the proximal outer wall of the by-pass tube. Their sizes were about one diameter of the tube or smaller. In some cases, pairing vortices could be seen in the host tube upstream of the occlusion. The shear rate distribution associated with the flow fields was presented. The flow pattern obtained was agreeable to those observed experimentally by other investigators. The difference of the flow fields between a complete bypass and simple anastomosis was discussed. The present numerical code provides a preliminary simulation/design tool for bypass graft flows.
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755
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Kao WJ, Lee D. In vivo modulation of host response and macrophage behavior by polymer networks grafted with fibronectin-derived biomimetic oligopeptides: the role of RGD and PHSRN domains. Biomaterials 2001; 22:2901-9. [PMID: 11561896 DOI: 10.1016/s0142-9612(01)00037-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Polymorphonuclear leukocytes, monocytes/macrophages, foreign body giant cells (FBGC), and lymphocytes are central in directing the host foreign body and inflammatory/immune reactions that impact material biostability, biocompatibility, and device efficacy. We employed the functional architecture of fibronectin to probe the mechanisms of protein-cell interaction in modulating leukocyte behavior. We demonstrated previously that the RGD and PHSRN domain of fibronectin and the spatial orientation between the motifs were crucial in regulating macrophage function in vitro. The current study delineates the role of RGD and PHSRN in modulating the host inflammatory response and macrophage behavior in vivo. Oligopeptides containing RGD and/or PHSRN domains were grafted onto a polyethyleneglycol-based substrate and subcutaneously cage implanted into rats. Peptide identity played a minimal role in modulating the host inflammatory response and adherent macrophage density. The RGD motif, either alone or at the terminal position with the PHSRN-containing flanking sequence, elicited a rapid macrophage fusion to form FBGCs at the early stage of implantation. Both the RGD motif and the PHSRN motif were important in mediating FBGC formation at the later implantation time. However, the PHSRN motif, specifically in the configuration of G3 RGDG6 PHSRNG, evoked a larger extent of FBGC coverage. Our results indicate the importance of RGD and PHSRN in modulating macrophage function in a time and orientation dependent fashion in vivo.
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756
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Lee D. Electronic health records. BRITISH JOURNAL OF PERIOPERATIVE NURSING : THE JOURNAL OF THE NATIONAL ASSOCIATION OF THEATRE NURSES 2001; 11:483. [PMID: 11892557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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757
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Lee S, Yoo CH, Hong IC, Bai S, Nam S, Lee D, Sileshi B, Nozawa M, Niewiadomski S, Fazi M, Wolf P, Tatum T, Gittes RF. Syngeneic consecutive rat spleen transplantation bearing infantile testis. Microsurgery 2001; 21:166-9. [PMID: 11494386 DOI: 10.1002/micr.1032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Seventy-seven Lewis adult rats received autologous testicular implants in the spleen. These spleens were retransplanted in a consecutive transplant fashion as we described earlier. Some were observed as long as 26 to 27 months. Although earlier splenic-testicular transplants showed benign granulosa cell tumors, some of the long-term follow-ups showed a seminoma-like transformation.
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758
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Nguyen TM, Lee D. A novel reactivity of SeO(2) with 1,3-dienes: formation of syn 1,2- and 1,4-diols via a facile C-Se bond oxidation. Org Lett 2001; 3:3161-3. [PMID: 11574020 DOI: 10.1021/ol016462e] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
[reaction: see text] A novel reaction between 1,3-dienes and selenium dioxide to give syn 1,2- and 1,4-diol cyclic selenites was studied in detail. This study indicates that an initial concerted [4 + 2] cycloaddition followed by a stereospecific carbon-selenium bond oxidation is involved in this unprecedented syn dihydroxy addition reaction mediated by selenium dioxide.
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759
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Lee D, Ouhibi N, Battaglia D. Cryopreservation of ovarian tissue: banking reproductive potential for the future. CURRENT WOMEN'S HEALTH REPORTS 2001; 1:152-6. [PMID: 12112962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Cryopreservation of ovarian tissue is a technology that holds promise for banking reproductive potential for the future. It may be apropos for cancer survivors who have undergone treatment with sterility-inducing chemotherapy. Although there is some evidence suggesting cellular and molecular injury with the freezing and thawing process, there are examples in both animals and humans that transplantation of cryopreserved ovarian tissue can effectively bank reproductive potential for the future. This technology may ultimately have applications for in vitro fertilization, and preventing natural or iatrogenic menopause.
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760
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Lee D, Bhat KP, Fong HH, Farnsworth NR, Pezzuto JM, Kinghorn AD. Aromatase inhibitors from Broussonetia papyrifera. JOURNAL OF NATURAL PRODUCTS 2001; 64:1286-1293. [PMID: 11678652 DOI: 10.1021/np010288l] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Bioassay-guided fractionation of an ethyl acetate-soluble extract from the whole plants of Broussonetia papyrifera, using an in vitro aromatase inhibition assay, led to the isolation of five new active compounds, 5,7,2',4'-tetrahydroxy-3-geranylflavone (1), isogemichalcone C (8), 3'-[gamma-hydroxymethyl-(E)-gamma-methylallyl]-2,4,2',4'-tetrahydroxychalcone 11'-O-coumarate (9), demethylmoracin I (10), and (2S)-2',4'-dihydroxy-2' '-(1-hydroxy-1-methylethyl)dihydrofuro[2,3-h]flavanone (11), and 10 known (12-21) compounds which were also found to be active. Of these compounds, the most potent were 9 (IC(50) 0.5 microM), 11 (IC(50) 0.1 microM), isolicoflavonol (12, IC(50) 0.1 microM), and (2S)-abyssinone II (13, IC(50) 0.4 microM). Additionally, six new compounds, 5,7,3',4'-tetrahydroxy-6-geranylflavonol (2), 5,7,3',4'-tetrahydroxy-3-methoxy-6-geranylflavone (3), (2S)-7,4'-dihydroxy-3'-prenylflavan (4), 1-(2,4-dihydroxyphenyl)-3-(4-hydroxyphenyl)propane (5), 1-(2,4-dihydroxy-3-prenylphenyl)-3-(4-hydroxyphenyl)propane (6), and 1-(4-hydroxy-2-methoxyphenyl)-3-(4-hydroxy-3-prenylphenyl)propane (7), were isolated and characterized, but proved to be inactive as aromatase inhibitors, as were an additional 21 known compounds. The structures of the new compounds (1-11) were elucidated by spectroscopic methods. Structure-activity relationships in the aromatase assay were determined for the benzofurans, biphenylpropanoids, coumarins, and various types of flavonoids (chalcones, flavans, flavanones, and flavones) obtained among a total of 42 constituents of B. papyrifera.
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761
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Bradley JP, Lee D. Anaesthesia in the United Nations Military Hospital, Dili, East Timor. Anaesth Intensive Care 2001; 29:527-9. [PMID: 11669436 DOI: 10.1177/0310057x0102900514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An analysis of the anaesthesia caseload of the United Nations Military Hospital and its predecessors over the first 12 months of operation from September 1999 has been performed. Most patients were East Timorese civilians or Australian Military personnel. General anaesthesia using the ULCO Portable Field Anaesthesia Machine was most commonly administered.
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762
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Lee D, Bouffard JA. Ultrasound of the knee. EUROPEAN JOURNAL OF ULTRASOUND : OFFICIAL JOURNAL OF THE EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY 2001; 14:57-71. [PMID: 11567855 DOI: 10.1016/s0929-8266(01)00146-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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763
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Lee D, Fuisz AR, Fan PH, Hsu TL, Liu CP, Chiang HT. Real-time 3-dimensional echocardiographic evaluation of left ventricular volume: correlation with magnetic resonance imaging--a validation study. J Am Soc Echocardiogr 2001; 14:1001-9. [PMID: 11593205 DOI: 10.1067/mje.2001.113647] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The purpose of our study was to validate the ability of real-time 3-dimensional echocardiography (RT3D) to measure cardiac volume. METHODS We studied 25 patients with various cardiac disorders who had a regular heart rhythm and a good precordial echocardiographic window. Each patient underwent complete transthoracic echocardiography (TTE), RT3D, and magnetic resonance imaging (MRI) studies. Left ventricular dimension was calculated from slices of the whole left ventricle obtained by 7 different equidistant azimuth tilts. Planimetry of the endocardial (for volume data) and epicardium (for mass data) surface was performed for each azimuth tilt. The left ventricular end-diastolic volume (LVEDV) and the left ventricular end-systolic volume (LVESV) were calculated. The cardiac mass data were derived with the formula (Epicardial volume - LVEDV) x 1.055. The parameters of LVEDV, LVESV, stroke volume, ejection fraction, and cardiac mass were compared with those derived from MRI. RESULTS No statistically significant differences were found between the data from RT3D and MRI (P > or =.05). Good correlations were found between these two methods for left ventricle volume and mass measurements (r from 0.92 to 0.99). However, a weaker correlation was found with larger chamber sizes because extrapolation was necessary for the volume of myocardial segments that were not covered by the small sector angle. CONCLUSIONS For data acquisition, RT3D is faster than either TTE or MRI. It is also better than MRI for measuring cardiac volume and mass. To improve results with larger cardiac chamber sizes, enlargement of the sector angle will be necessary.
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764
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Xu E, Lee D, Turek P, Reijo Pera R. Detection of mutations and polymorphisms in a candidate male fertility gene by screening infertile patients. Fertil Steril 2001. [DOI: 10.1016/s0015-0282(01)02292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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765
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Cole BJ, Rodeo SA, O'Brien SJ, Altchek D, Lee D, DiCarlo EF, Potter H. The anatomy and histology of the rotator interval capsule of the shoulder. Clin Orthop Relat Res 2001:129-37. [PMID: 11550858 DOI: 10.1097/00003086-200109000-00015] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Forty-seven rotator interval regions from fetuses and 10 fresh-frozen rotator interval regions from adult cadavers were evaluated by gross dissection and light microscopy. Specimens from adults also were evaluated with ultrasound and magnetic resonance imaging. An analysis of 37 fetal specimens (> 14 weeks gestation) revealed two rotator interval types: Type I (9 of 37) was defined by a contiguous bridge of capsule consisting of poorly organized collagen fibers. A Type II rotator interval (28 of 37) had a complete defect covered by only a thin layer of synovium. Similar to the Type II rotator interval in the fetus, a rotator interval defect was present in six of eight specimens from adults. Histologically, the capsular tissue within the rotator interval consisted of poorly organized collagen fibers in specimens from the fetus and adult. Maximal opening of the rotator interval was seen by ultrasound with internal rotation and downward traction of the hyperextended arm in the coronal, oblique, and sagittal planes. Magnetic resonance imaging of the rotator interval region permitted anatomic evaluation. The complete absence of tissue in 28 of 37 fetuses suggests that the rotator interval defect is congenital. The authors recommend that surgeons carefully evaluate the integrity of the tissue within the rotator interval. When rotator interval closure is desired such as in patients with a persistent sulcus sign after arthroscopic stabilization, suturing the edges of more substantial tissue immediately adjacent to the boundaries of the rotator interval region would seem prudent.
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766
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Goff BA, Lentz GM, Lee D, Fenner D, Morris J, Mandel LS. Development of a bench station objective structured assessment of technical skills. Obstet Gynecol 2001; 98:412-6. [PMID: 11530121 DOI: 10.1016/s0029-7844(01)01473-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We have previously shown that objective structured assessment of technical skills performed in an animal model was an innovative, reliable, and valid method of assessing surgical skills. Our goal was to develop a less costly bench station objective structured assessment of technical skills and to evaluate the feasibility, reliability, and validity of this exam. METHODS A seven-station examination was administered to 24 residents. The tests included laparoscopic procedures (salpingostomy, intracorporeal knot tying, closure of port sites) and open abdominal procedures (subcuticular closure, bladder neck suspension, repair of enterotomy, abdominal wall closure). All tasks were performed using life-like surgical models. Residents were timed and assessed at each station using three methods of scoring: a task-specific checklist, a global rating scale, and a pass/fail grade. RESULTS Assessment of construct validity, the ability of the test to discriminate among residency levels, found significant differences on the checklist, global rating scale, time for procedures, and pass/fail grade by level of training. Reliability indices calculated with Cronbach's alpha were 0.77 for the checklists and 0.94 for the global rating scale. Overall interrater reliability indices were 0.91 for the global rating scale and 0.92 for the checklists. Total cost for replaceable parts and facilities was $1900. CONCLUSION The less costly and more portable bench station objective structured assessment of technical skills can reliably and validly assess the surgical skills of gynecology residents. This type of examination can be a useful tool to identify residents who need additional surgical instruction, provide remediation, and may become a mechanism to certify surgical skill competence.
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767
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Lee D, Hutchison JC, DeSimone JM, Murray RW. Diffusive transport of micelles and monomeric solutes in supercritical CO(2). J Am Chem Soc 2001; 123:8406-7. [PMID: 11516294 DOI: 10.1021/ja0162818] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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768
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Lee D. Hospital legacies. Tale of the unexpected. THE HEALTH SERVICE JOURNAL 2001; 111:24-7. [PMID: 11534252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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769
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Lee D. Interactive digital television. BRITISH JOURNAL OF PERIOPERATIVE NURSING : THE JOURNAL OF THE NATIONAL ASSOCIATION OF THEATRE NURSES 2001; 11:341. [PMID: 11892572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
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770
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Abstract
OBJECTIVE/HYPOTHESIS To reconcile conflicting reports and opinions of the value of preoperative coagulation studies for patients undergoing tonsillectomy. STUDY DESIGN Meta-analysis: Articles were identified by MEDLINE search, references from review articles, textbook chapter, and retrieved reports. Independent observers selected prospective trials of patients undergoing tonsillectomy or adenoidectomy and tonsillectomy. Retrospective studies meeting other inclusion and exclusion criteria were included for sensitivity analyses of results. METHODS Data were abstracted from studies for an end point of bleeding with normal and abnormal coagulation tests. Four prospective studies met all inclusion and exclusion criteria. These four studies were used in the data synthesis. An additional eight retrospective studies met all other criteria and were used in the sensitivity analysis. RESULTS Pooled analysis of 3384 patients revealed a rate of 3.3% (95% confidence interval [CI], 2.5%-4.1%) for post-tonsillectomy bleeding in patients with normal coagulation studies. A rate of 8.7% (95% CI, 1.5%-15.9%) was obtained for bleeding in patients with abnormal coagulation studies. No significant rate difference in post-tonsillectomy bleeding was demonstrated. CONCLUSION There is no difference in the rate of post-tonsillectomy bleeding in patients with abnormal coagulation studies as compared with patients with normal coagulation studies obtained preoperatively.
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771
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Lee D, Hsu TL, Chiou CW, Mar GY, Tseng CJ, Chiao CD, Chiang T, Lee CY, Wang WC, Jin PL, Liu CP, Chiang HT. Transthoracic and transesophageal echocardiographic diagnosis of aneurysm of the sinus of Valsalva: a review of five year experience. ZHONGHUA YI XUE ZA ZHI = CHINESE MEDICAL JOURNAL; FREE CHINA ED 2001; 64:469-73. [PMID: 11720146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Aneurysms of the sinus of Valsalva (SVA) are uncommon congenital lesions. The clinical presentations vary from asymptomatic to progressive heart failure following rupture of the aneurysm into an adjacent cardiac chamber. Retrograde aortogram is the diagnostic tool of choice preoperatively. Recent studies have demonstrated that the SVA can be accurately diagnosed using transthoracic two-dimensional, and color Doppler flow mapping, even for surgical preparation without cardiac catheterization. We report our 5-year experience of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in the evaluation of SVA. METHODS Eleven adult patients with SVA with or without rupture were studied using both TTE and TEE. All of the diagnoses were subsequently comfirmed by either cardiac catheterization or surgical findings. RESULTS Aneurysms originated in the right coronary sinus (n = 9) and noncoronary sinus (n = 2); they ruptured into the right ventricle in 5 patients and the right atrium in 5 patients. An unruptured right SVA was noted in 1 patient. Both TTE and TEE could identify the site of the aneurysm, rupture sites, and the receiving chamber equally well. Co-existent cardiac lesions included 11 cases of valvular aortic regurgitation (mild in 7, moderate in 2 and severe in 2). Two cases of perimembranous type ventricular septal defect (VSD) and 6 cases of supracristal type VSD (including 1 case of tetraology of Fallot, 3 supracristal, 1 muscular and 1 subaortic) were noted. Three cases were complicated with valvular vegetations (1 aortic valve, 1 aortic and tricuspid valve and 1 aortic and pulmonic valve). One patient had patent ductus arteriosus and 2 patients had pulmonic valvular stenosis. CONCLUSIONS TEE provides clearer definition for the detailed anatomy of the ruptured sac and co-existent cardiac lesions than TTE through high resolution and closer approach. We conclude that TEE is a powerful complementary diagnostic tool in the evaluation of patients with SVA. TEE also provides additionally useful information for guiding the surgical approach and for assessing the operative results even without cardiac catheterization.
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772
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Harjunpää A, Wiklund T, Collan J, Janes R, Rosenberg J, Lee D, Grillo-López A, Meri S. Complement activation in circulation and central nervous system after rituximab (anti-CD20) treatment of B-cell lymphoma. Leuk Lymphoma 2001; 42:731-8. [PMID: 11697503 DOI: 10.3109/10428190109099335] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Rituximab (IDEC-C2B8, Mabthera, Rituxan), a chimeric monoclonal antibody against the B-cell specific CD20-antigen, has been demonstrated to be effective in the treatment of non-Hodgkin's B-cell lymphoma (B-NHL). Previous in vitro studies have shown that direct complement-dependent cytotoxicity (CDC), ADCC and apoptosis are important in the rituximab-induced killing of lymphoma cells. It is, however, unknown whether rituximab penetrates the blood-brain barrier. Therefore, we studied rituximab levels and complement (C) activation in blood and cerebrospinal fluid (CSF) following intravenous rituximab therapy in a patient with relapsing non-Hodgkin's lymphoma with central nervous system (CNS) involvement. Longitudinal samples from blood and CSF were taken at 13 time-points during the treatment period. The results show that the C cascade becomes activated in blood during the first mAb infusion (C3a-desArg concentration rose from 55 to 138 microg/ml during the first 2 hours). After the first infusion the proportions of lymphocytes positive for the CD19- and CD20-antigens in the peripheral blood were reduced from 41% and 35%, respectively, to a level of 2% (for both). In CSF the rituximab concentration increased after successive infusions, but remained below 0.55 microg/ml (compared to a Cmax of 400 microg/ml in peripheral blood). Although a minor and delayed C activation response was seen in the CSF the treatment did not clear CD20-positive cells away from the CNS. Thus, it appears that an intact blood-brain barrier restricts the entry of rituximab into the CNS. Possible options to circumvent this would be dose escalation or intrathecal rituximab treatment.
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773
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Warner MD, Walker AM, D'Souza DC, Lee D, Nasseri D, Peabody CA. Lower prolactin bioactivity in unmedicated schizophrenic patients. Psychiatry Res 2001; 102:249-54. [PMID: 11440775 DOI: 10.1016/s0165-1781(01)00256-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In previous work, prolactin (PRL) abnormalities of a lower bioassay (BA) to radioimmunoassay (RIA) ratio were found in schizophrenic patients. This line of research was extended in seven male patients with schizophrenia who were neuroleptic-free; seven male control subjects were also studied. PRL values were assessed by RIA and Nb(2) BA techniques. The schizophrenic group had a significantly lower PRL BA as compared to normal controls and a lower PRL ratio of BA/RIA. The lower ratio is consistent with an earlier finding and suggests that schizophrenic patients have different molecular forms of PRL than control subjects. This difference could be due to a disordered tuberoinfundibular dopamine system or the long-term effects of neuroleptic medications.
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774
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Jenkins M, Hussain N, Lee D, Jog MS. Reversible parkinsonism and MRI diffusion abnormalities in cortical venous thrombosis. Neurology 2001; 57:364-6. [PMID: 11468335 DOI: 10.1212/wnl.57.2.364-a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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775
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Shin J, Lee W, Lee D, Koo BK, Han I, Lim Y, Woods A, Couchman JR, Oh ES. Solution structure of the dimeric cytoplasmic domain of syndecan-4. Biochemistry 2001; 40:8471-8. [PMID: 11456484 DOI: 10.1021/bi002750r] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The syndecans, transmembrane proteoglycans which are involved in the organization of cytoskeleton and/or actin microfilaments, have important roles as cell surface receptors during cell-cell and/or cell-matrix interactions. Since previous studies indicate that the function of the syndecan-4 cytoplasmic domain is dependent on its oligomeric status, the conformation of the syndecan-4 cytoplasmic domain itself is important in the understanding of its biological roles. Gel filtration results show that the syndecan-4 cytoplasmic domain (4L) itself forms a dimer stabilized by ionic interactions between peptides at physiological pH. Commensurately, the NMR structures demonstrate that syndecan-4L is a compact intertwined dimer with a symmetric clamp shape in the central variable V region with a root-mean-square deviation between backbone atom coordinates of 0.95 A for residues Leu(186)-Ala(195). The molecular surface of the 4L dimer is highly positively charged. In addition, no intersubunit NOEs in membrane proximal amino acid resides (C1 region) have been observed, demonstrating that the C1 region is mostly unstructured in the syndecan-4L dimer. Interestingly, two parallel strands of 4L form a cavity in the center of the dimeric twist similar to our previously reported 4V structure. The overall topology of the central variable region within the 4L structure is very similar to that of 4V complexed with the phosphatidylinositol 4,5-bisphosphate; however, the intersubunit interaction mode is affected by the presence of C1 and C2 regions. Therefore, we propose that although the 4V region in the full cytoplasmic domain has a tendency for strong peptide--peptide interaction, it may not be enough to overcome the repulsion of the C1 regions of syndecan-4L.
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