The axillopectoral muscle seen on mammography.
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Biomedical subjects
Publications and source records attributed to H W Chung.
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To evaluate the effects of genetic polymorphisms of OPG, RANK, and ESR1, which regulate osteoclastogenesis, on bone mineral density (BMD), a cross-sectional study was conducted in 650 Korean postmenopausal women. BMDs of the distal radius and the calcaneus were measured by dual energy X-ray absorptiometry (DXA). Genetic polymorphisms of OPG 163 A > G, 1181 G > C; RANK 421 C > T, 575 T > C; and ESR1 1335 C > T, 2142 G > A were determined by matrix-assisted laser desorption/ionization-time of flight (MALDI-ToF) mass spectrometry. The differences between the BMDs of the genotypes of OPG, RANK, and ESR1 were analyzed by multiple linear regression model adjusted for age and body mass index. Women with the OPG 1181 CC genotype had higher BMDs at the distal radius (7%) and calcaneus (10%) than those with the GG genotype; and these differences were statistically significant (P = 0.001 and P = 0.007, respectively). A significant association was also observed between RANK 575 T > C and calcaneus BMD (P for trend = 0.017). No significant association was observed between BMDs and the polymorphisms of ESR1. The association between OPG 1181 G > C and BMD was profound in subjects with the RANK 575 TT or ESR1 2142 GG genotypes; women with OPG 1181 CC had higher BMDs at the distal radius (11%) and calcaneus (11%) than those with OPG 1181 GG only in women with RANK 575 TT genotype (P = 0.002 and P = 0.021, respectively). These results suggest that OPG genetic polymorphisms, especially with the RANK 575 TT or ESR1 2142 GG genotypes, are related to low BMD in postmenopausal Korean women.
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Due to its extraordinarily high sensitivity, polymerase chain reaction (PCR) is widely used for amplifying cDNA copies of low abundance mRNA. However, quantitation is unreliable because the amount of PCR product increases exponentially with each cycle of amplification; therefore, minute differences in any of the variables that affect the efficiency of amplification can dramatically alter product yield. Coamplification with a different reporter gene product is a semiquantitative mRNA quantitation method. Thus, we constructed an internal standard with a defined deletion fragment from the target cDNA, and used the same primers to coamplify the unknown and the competitor, allowing us to quantify the amount of specific target cDNA available. In addition, because the efficiency of amplification of the internal control molecules is identical to that of the target template, quantitative PCR can avoid the discrepancies associated with tube-to-tube or sample-to-sample variations in the kinetics of the RT reaction. For RNA quantitation, Northern blots are widely used. However, the Northern blot technique requires at least 10mg of total RNA for semiquantitation while QC-PCR requires only 1mg of total RNA and is useful when only small amounts of tissue are available. QC-PCR is a simple, and inexpensive method in which competitive PCR is used for highly accurate quantitation of mRNA and DNA from a small number of cells.
OBJECTIVES: The cadherin/catenin adhesion complex is fundamentally involved in epithelial cancer invasion and metastasis. Much evidence suggesting that epidermal growth factor (EGF) induced the scattering and invasion of cancer cells, probably by affecting E-cadherin function, has been reported. The present study aimed to confirm the hypothesis that EGF/epidermal growth factor receptor (EGFR) was related with the E-cadherin adhesion system in cervical cancer cells and that EGF might induce tyrosine phosphorylation of beta- and gamma-catenin. METHODS: Cervical cancer cells were treated for different time durations with 30 ng/ml of EGF. Alteration of the cell morphology was examined by light microscopy and the expression of E-cadherin, beta-catenin, gamma-catenin, EGFR, and activated EGFR was assayed using Western blotting. Tyrosine phosphorylation of beta- and gamma-catenin was also examined using immunoprecipitation. RESULTS: E-cadherin and EGFR were expressed in CaSki, HT-3, and ME-180 cell lines, which showed epithelial contact growth. The expression of E-cadherin and beta- and gamma-catenin did not change after treatment with EGF. The expression of EGFR decreased and activated EGFR expression increased in 30 min and then decreased subsequently. The simultaneous expression of activated EGFR and tyrosine phosphorylation of beta- and gamma-catenin was found. CONCLUSIONS: EGF-induced scattering of the E-cadherin-positive cervical cancer cells might be the result of tyrosine phosphorylation of the beta- and gamma-catenin. Phosphorylation of the beta- and gamma-catenin may hamper the adhesive function of the E-cadherin-catenin complex.
OBJECTIVE: To investigate mRNA expression of metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-3 (TIMP-3) in ectopic endometriosis tissue and uterine endometrium from women with and without endometriosis throughout the menstrual cycle. DESIGN: Molecular studies in human tissue. SETTING: Department of Gynecology and Obstetrics, Reproductive Immunology Laboratory, Stanford University Medical Center. PATIENT(S): Fifty-three premenopausal woman (23 women with endometriosis and 30 women without endometriosis undergoing laparoscopic surgery). Endometrium and ectopic endometriosis tissue were obtained at the time of surgery. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): mRNA expression from eutopic and ectopic endometrium was analyzed by quantitative, competitive PCR. RESULT(S): Both uterine endometrium and ectopic endometriotic tissue from women with endometriosis expressed significantly (P<.05) lower levels of TIMP-3 than endometrium from normal women. Also, ectopic endometrium expressed higher levels of MMP-9 and a higher ratio of MMP-9/TIMP-3 than eutopic endometrium from normal and endometriosis patients. CONCLUSION(S): These results suggest that ectopic and eutopic endometrium from endometriosis patients may be more invasive and prone to peritoneal implantation because of greater MMP and less TIMP-3 mRNA expression than endometrium from women without endometriosis. Thus, increased proteolytic activity may be one of the reasons for the invasive properties of the endometrium, resulting in the development of endometriosis.
A case of tuberculous dactylitis in an immunocompetent patient is presented and the radiographic findings and differential diagnosis discussed. MR image, although nonspecific, was helpful for differential diagnosis and evaluating the extent of the lesion. Although this is a rare condition, the diagnosis should be considered when dealing with an unusual destructive bony lesion.
RATIONALE AND OBJECTIVES: Ultrasonography (US) has a potential role in the diagnosis of osteomyelitis. The purpose of this study was to determine the characteristic sonographic features of acute osteomyelitis and correlate them with pathologic findings. MATERIALS AND METHODS: An experimental model of acute osteomyelitis was produced in the tibiae of 20 rabbits. Daily US and plain radiography were performed for 2 weeks. The authors evaluated periosteal reaction, subperiosteal fluid collection, and soft-tissue changes seen with US. A hypoechoic band and a hyperechoic line lying along the cortex were considered positive signs of subperiosteal fluid collection and periosteal reaction, respectively. The findings of periosteal reaction were compared for US and radiography, and pathologic findings were also correlated. RESULTS: The most common sonographic finding was a hypoechoic band along the cortex (21 [75%] of 28 tibiae), usually associated with a linear periosteal reaction (20 [71%] of 28). This juxtacortical abnormal echogenicity corresponded to periosteal elevation with loose fibrovascular connective tissue and granulation, associated with subperiosteal abscess formation. The periosteal reactions were detected with US before they were seen on radiographs. The periosteum showed gradual thickening during the disease process. In 50% of infected tibiae, inflammation or abscess formation was observed in the surrounding soft tissue. CONCLUSION: US readily demonstrates juxtacortical abnormal echogenicity and soft-tissue infection related to acute osteomyelitis. The abnormal echogenicity correlated well with the pathologic findings of periosteal reaction and subperiosteal abscess.
PURPOSE: To examine possible differences between the evolution of cerebral watershed infarction (WI) and that of territorial thromboembolic infarction (TI) by using diffusion-weighted (DW) and T2-weighted magnetic resonance (MR) images and apparent diffusion coefficient (ADC) maps. MATERIALS AND METHODS: Fourteen patients with TI and nine with WI underwent MR imaging from the acute to chronic infarction stages. ADC maps were derived from DW images. Lesion-to-normal tissue signal intensity ratios on ADC maps (rADC), echo-planar T2-weighted images, and DW images were calculated. Lesion volumes at acute or early subacute infarction stages were measured on DW images, and final lesion volumes were estimated on fluid-attenuated inversion-recovery images. RESULTS: Analysis of variance revealed a significant difference in temporal evolution patterns of rADC between WI and TI (P <.001). rADC pseudonormalization following TI began about 10 days after symptom onset, but that following WI did not occur until about 1 month after symptom onset. The Pearson correlation coefficient between final and initial infarct volumes was 0.9899 for both infarction subtypes, indicating that the initial ischemic injury volume measured at the acute or early subacute stage predicted the final lesion volume fairly well. CONCLUSION: The evolution time of ADC is faster for TI than for WI. This difference, which likely originates from the different pathophysiologic and hemodynamic features of the two infarction types, might account for the relatively large range of ADC values reported for the time course of ischemic strokes.
PURPOSE: To assess magnetic resonance (MR) imaging features in differentiating tuberculous arthritis from pyogenic arthritis. MATERIALS AND METHODS: Findings in 29 patients with tuberculous arthritis were compared with those of 13 patients with pyogenic arthritis. Bone erosion, marrow signal intensity, synovial lesion signal intensity, boundaries (smooth or irregular) for extraarticular extension of infection, and abscess rim enhancement (thin and smooth or thick and irregular) were analyzed. RESULTS: Bone erosion was more common in patients with tuberculous arthritis (24 [83%] of 29) than in those with pyogenic arthritis (six [46%] of 13) (P =.026), while subchondral marrow signal intensity abnormality was seen more frequently in patients with pyogenic arthritis (12 [92%] of 13) than in those with tuberculous arthritis (17 [59%] of 29) (P =.036). On T2-weighted images, there was no significant difference between the synovial lesion signal intensities of tuberculous arthritis and pyogenic arthritis. Lesions in 16 (70%) of 23 patients with tuberculous arthritis and two (17%) of 12 patients with pyogenic arthritis had smooth extraarticular boundaries, while those in seven (30%) of 23 patients with tuberculous arthritis and 10 (83%) of 12 patients with pyogenic arthritis had irregular boundaries (P =.005). Tuberculous abscesses (16 [100%] of 16) had thin and smooth rim enhancement, while most pyogenic abscesses (five [71%] of seven) had thick and irregular rims (P =.001). CONCLUSION: MR imaging of bone abnormalities, extraarticular lesions, and associated abscesses provides useful information in the differentiation of tuberculous arthritis and pyogenic arthritis.
The interleukin-1 (IL-1) system plays an integral role in local intercellular interactions during implantation. In addition, the plasminogen activator system, especially urokinase plasminogen activator (u-PA), plasminogen activator inhibitor (PAI-1), and u-PA receptor (u-PAR), are crucial during embryo implantation. Decidualization and implantation are complex processes dependent upon several proteases, including u-PA, and IL-1 is known to affect PA activity in several cell types. We investigated the role of IL-1beta in regulating u-PA, PAI-1, u-PAR, and soluble u-PAR messenger ribonucleic acid (mRNA) expression in cultured human endometrial stromal cells using quantitative competitive PCR. For confirmation of the mRNA data, we measured PAI-1 and u-PAR protein by enzyme-linked immunosorbent assay. Confluent stromal cell cultures treated with progesterone and estradiol for 9 days were stimulated with IL-1beta, and IL-1beta plus IL-1beta antibody for an additional 24 h. Total RNA was extracted, reverse transcribed, and coamplified using quantitative and competitive PCR with internal standards. IL-1beta increased PAI-1, u-PAR, and soluble u-PAR expression in a dose-dependent manner, and this result was reversed by anti-IL-1beta antibody treatment. u-PA mRNA expression was not dependent on IL-1beta. These results suggest that IL-1 may be important in regulating PAI-1 and u-PAR during stromal cell decidualization before implantation.
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We present a rare case of juxtacortical chondromyxoid fibroma arising in the lesser trochanter of the right femur which corresponds to an apophysis. Radiography showed a well-defined expansive lesion with a sclerotic margin measuring 5x3.5 cm in diameter in the lesser trochanter. On spin echo T1-weighted images, the lesion revealed low signal intensity similar to muscle. On spin echo T2-weighted images, the lesion revealed high heterogeneous signal intensity, which after gadolinium injection showed heterogeneous enhancement. The inner margin of the cortex was intact and adjacent bone marrow was of normal signal intensity. The outer margin of the lesion was also clearly defined and extension into adjacent soft tissue beyond the exophytic cortical outgrowth was not evident.
OBJECTIVE: Automatic detection of epileptic EEG spikes via an artificial neural network has been reported to be feasible using raw EEG data as input. This study re-investigated its suitability by further exploring the effects of data preparation on classification performance testing. METHODS: Six hundred EEG files (300 spikes and 300 non-spikes) taken from 20 patients were included in this study. Raw EEG data were sent to the neural network using the architecture reported to give best performance (30 input-layer and 6 hidden-layer neurons). RESULTS: Significantly larger weighting of the 10th input-layer neuron was found after training with prepared raw EEG data. The classification process was thus dominated by the peak location. Subsequent analysis showed that online spike detection with an erroneously trained network yielded an area less than 0.5 under the receiver-operating-characteristic curve, and hence performed inferiorly to random assignments. Networks trained and tested using the same unprepared EEG data achieved no better than about 87% true classification rate at equal sensitivity and specificity. CONCLUSIONS: The high true classification rate reported previously is believed to be an artifact arising from erroneous data preparation and off-line validation. Spike detection using raw EEG data as input is unlikely to be feasible under current computer technology.
PURPOSE: To analyse chromosome aberrations in nuclear-power-plant workers taking account of the mean lifetime of lymphocytes (MLTL). MATERIALS AND METHODS: Analysis of chromosome aberrations was performed on peripheral lymphocytes from 395 nuclear-power-plant workers and 135 controls. An equivalent acute dose (EAD) was calculated utilizing MLTL values of either 4.3 or 10 years. RESULTS: Using an MLTL value of 10 years produced an EAD range of 0.O1 mSv -182mSv(mean 46.6mSv), while using an MLTL, of 4.3 years produced results ranging from 0.01 mSv to 86.2 mSv (mean 23.4 mSv). A significant increase of chromosome-type exchange by the equivalent acute dose was observed using an MLTL of either 10 or 4.3 years when including the control in the analysis, but a significant increase was not seen when only the exposed was considered. A significant increase of chromosome-type deletion by EAD was seen even when only the exposed group was considered. CONCLUSIONS: EAD values based on an MLTL of either 4.3 or 10 years, as well as cumulative dose, showed no significant association with chromosome aberrations, when radiation workers only were analysed. The narrow dose range examined in this study might have contributed to this finding.
Indirect signs of anterior cruciate ligament (ACL) injury on magnetic resonance imaging (MRI) include bony contusions in the lateral femoral condyle and the posterior portion of the lateral tibial plateau. This study was undertaken to assess the value of single photon emission tomography (SPET) in the diagnosis of ACL injury by examining the uptake pattern in the distal femur and the proximal tibia. Thirty-five patients were examined using SPET, MRI and arthroscopy. Seventeen patients were found to have ACL tears on arthroscopy. The duration of symptoms was 4 days to 10 years (mean 26.4 months). MRI and SPET images were analysed retrospectively without information from arthroscopic examination. Radionuclide uptake in the lateral femoral condyle and the posterior lateral tibial plateau was considered an indirect sign of ACL injury on SPET. We evaluated the diagnostic value of indirect signs of ACL injury obtained on SPET by comparing these findings with arthroscopic and MRI results. Fifteen of 17 patients with ACL injury showed indirect signs on SPET. The sensitivity, specificity, positive predictive value and negative predictive value for indirect signs of ACL injury were 88%, 56%, 65% and 83% on SPET and 59%, 94%, 91% and 71% on MRI, respectively. However, despite the higher sensitivity of indirect signs on SPET than on MRI, the overall diagnostic value of MRI is better than that of SPET. In the clinical setting, indirect signs of ACL injury may be of value in interpreting incidental findings on SPET.
OBJECTIVE: The purpose of this study was to investigate, on images obtained in nuclear medicine examinations, the physical meanings and consequent implications of fractal analysis developed in a recent study that was reported to be effective in quantifying the heterogeneous distribution of carbon particle radioaerosol in the lungs. MATERIALS AND METHODS: Fractal dimensions were computed for 108 sets of radionuclide imaging data from 28 patients according to the methods in a previous report, and were then correlated with the ratio of tissue areas segmented at two thresholds (15% and 35% of maximal radioactivity). RESULTS: Fractal dimension was found to linearly correlate with the ratio natural logarithm of tissue areas segmented at two different threshold levels (n = 108, r = 0.999), with regression slope accurately predicted (error = 0.06%). Bland-Altman analysis showed that fractal dimensions ranging from 0.2 to 1.9 can be explained by this area ratio with disagreement of only 5.13% at two standard deviations; thus, fractal dimension seems to be an over-simplified parameter unrelated to spatial heterogeneity of radioaerosol distribution. CONCLUSION: The analysis of this study suggested that the fractal dimension defined in a previous report was limited to the indication of the percentage area of low-radioactivity regions with respect to total tissue area in the image. Because the fractal dimension partially reflects, but is not specific to, a certain degree of focal spots of low radioactivity, we suggest using fractal analysis in clinical practice only with careful control and thorough understanding of the physical meanings.