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Biomedical subjects

Sung-Woo Lee

Publications and source records attributed to Sung-Woo Lee.

13 recordsLinked to original sources

Arterial minus end-tidal CO2 as a prognostic factor of hospital survival in patients resuscitated from cardiac arrest.

AIMS: The purpose of this study was to determine the clinical value of arterial minus end-tidal CO(2) [P(a-et)CO(2)] and alveolar dead space ventilation ratio (V(dA)/V(t)) as indicators of hospital mortality in patients that have been resuscitated from cardiac arrest at emergency department. MATERIALS AND METHODS: Forty-four patients with a return of spontaneous circulation (ROSC) after cardiac arrest were studied in the emergency department of a university teaching hospital from March 2004 to February 2006. Mean arterial pressure (MAP), serum lactate, arterial blood gas studies, end-tidal CO(2) (EtCO(2)), P(a-et)CO(2), and V(dA)/V(t) were evaluated at 1 h after ROSC. We compared these variables between hospital survivors and non-survivors. RESULTS: The rates of ventricular fibrillation and pulseless ventricular tachycardia in hospital survivors were higher than those of non-survivors (53.0 and 9.7%, respectively, p=0.002). Hospital survivors had significantly higher MAP, lower serum lactate, lower P(a-et)CO(2), and lower V(dA)/V(t) value than non-survivors. Receiver operator characteristic (ROC) curves of serum lactate, P(a-et)CO(2), and V(dA)/V(t) showed significant sensitivity and specificity for hospital mortality. Specifically, lactate > or = 10.0 mmol/L, P(a-et)CO(2) > or = 12.5 mmHg, and V(dA)/V(t) > or = 0.348 were all associated with high hospital mortality (p=0.000, 0.001 and 0.000, respectively). CONCLUSIONS: This study showed that high serum lactate, high P(a-et)CO(2) and high V(dA)/V(t) during early ROSC in cardiac arrest patients suggest high hospital mortality. If future studies validate this model, the P(a-et)CO(2) and V(dA)/V(t) may provide useful guidelines for the early post-resuscitation care of cardiac arrest patients in emergency departments.

Algorithms↗

Mixed pollutant degradation by Methylosinus trichosporium OB3b expressing either soluble or particulate methane monooxygenase: can the tortoise beat the hare?

Methanotrophs have been widely investigated for in situ bioremediation due to their ubiquity and their ability to degrade halogenated hydrocarbons through the activity of methane monooxygenase (MMO). It has been speculated that cells expressing the soluble form of MMO (sMMO) are more efficient in cleaning up sites polluted with halogenated hydrocarbons due to its broader substrate range and relatively fast degradation rates compared cells expressing the other form of MMO, the particulate MMO (pMMO). To examine this issue, the biodegradation of mixtures of chlorinated solvents, i.e., trichloroethylene (TCE), trans-dichloroethylene (t-DCE), and vinyl chloride (VC), by Methylosinus trichosporium OB3b in the presence of methane using either form of MMO was investigated over longer time frames than those commonly used, i.e., days instead of hours. Growth of M. trichosporium OB3b along with pollutant degradation were monitored and analyzed using a simple comparative model developed from the Omega model created for analysis of the competitive binding of oxygen and carbon dioxide by ribulose bisphosphate carboxylase. From these findings, it appears that at concentrations of VC, t-DCE, and TCE greater than 10 microM each, methanotrophs expressing pMMO have a competitive advantage over cells expressing sMMO due to higher growth rates. Despite such an apparent growth advantage, pMMO-expressing cells degraded less of these substrates at these concentrations than sMMO-expressing cells during active growth. If the concentrations were increased to 100 muM, however, not only did pMMO-expressing cells grow faster, they degraded more of these pollutants and did so in a shorter amount of time. These findings suggest that the relative rates of growth substrate and pollutant degradation are important factors in determining which form of MMO should be considered for pollutant degradation.

Biodegradation, Environmental↗

Low plasma BDNF is associated with suicidal behavior in major depression.

Brain-derived neurotrophic factor (BDNF), the most abundant neurotrophin in the brain, has a known association with the pathophysiology of anxiety and depression. However, the role of BDNF in suicide has not been well investigated to date. This study examined plasma BDNF levels in 32 major depressive disorder (MDD) patients who had recently attempted suicide, 32 non-suicidal MDD patients, and 30 normal controls. The lethality of the suicide attempt was measured using the Risk-Rescue Rating (RRR) and Lethality Suicide Attempt Rating Scale (LSARS). The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS). Plasma BDNF levels were measured by enzyme linked immunosorbent assay. BDNF levels were significantly lower in suicidal MDD patients (430.5+/-397.0 pg/ml) than non-suicidal MDD patients (875.80+/-663.02 pg/ml) or normal controls (889.4+/-611.3 pg/ml) (F=6.682, p=0.002). The most suitable cut-off point of BDNF level between suicidal depression and non-suicidal depression groups was 444.58 pg/ml. At this cut-off point, the sensitivity=68.7%, specificity=78.1%, positive predictive value=75.9%, and negative predictive value=71.4%. However, there was no significant difference in BDNF levels between the depressive control and normal control groups (p=0.996). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal patients. In addition, BDNF levels were not different between fatal and non-fatal suicide attempts. These results suggest that reduction of plasma BDNF level is related to suicidal behavior in major depression and that BDNF level may be a biological marker of suicidal depression.

Adult↗

Increased plasma nitric oxide level associated with suicide attempt in depressive patients.

BACKGROUND: Nitric oxide (NO) is known to influence cerebral monoaminergic activity, including the activity of serotonin. We evaluated plasma NO metabolite (NO(x)) levels in depressive patients with and without a recent history of suicide attempt. METHOD: Plasma NO(x) levels were measured in 39 depressive patients who had recently attempted suicide, 44 non-suicidal depressed patients, and 70 normal controls. The severity of depression was measured with the Hamilton's Depression Rating Scale. The lethality of the suicide attempt was scored using Weisman and Worden's risk-rescue rating scale and Lethality Suicide Attempt Rating Scale. RESULTS: Plasma NO(x) levels were significantly higher in suicidal depressive patients than non-suicidal depressive patients or normal control subjects (Z=-2.472, p=0.013). However, higher plasma NO(x) levels in suicidal depressive patients were significantly related to a lower lethality of suicide attempts and lower severity of depression. CONCLUSIONS: Our study suggests that increased plasma NO(x) level is associated with suicide attempts in depressive patients. Moreover, higher plasma NO(x) level is related with suicide attempts in mild depressed patients. However, further studies are required to understand the role of NO system in depression and suicidal behavior.

Adult↗

Increased plasma nitric oxide metabolites in suicide attempters.

OBJECTIVE: To evaluate any correlation between plasma levels of nitric oxide metabolites (NO(x)) and suicide attempt. METHOD: Plasma NO(x) levels were measured in 53 patients who had recently attempted suicide, 58 non-suicidal psychiatric patients, and 75 normal controls. The severity of suicidal behaviors was evaluated using Weisman and Worden's Risk-Rescue Rating Scale. RESULTS: Plasma NO(x) levels were significantly higher in suicidal patients than non-suicidal psychiatric patients or normal control subjects (F=11.029, d.f.=2, 183, p<0.001). Among the patients with a diagnosis of major depression, suicidal depressive patients had significantly higher plasma NO(x) levels than non-suicidal depressive patients (t=-3.090, d.f.=84, p=0.003). CONCLUSION: Our study suggests that increased NO production in plasma is associated with suicide attempt, especially in depressive patients.

Adult↗

Dose calculation of 142Pr microspheres as a potential treatment for arteriovenous malformations.

Arteriovenous malformation (AVM), especially cryptic AVM, can cause highly variable cerebral neurological defects. Injection of 142Pr microspheres into arteries feeding an AVM in order to simulate radio-embolism has been proposed as a novel treatment method. To investigate optimization of radiation dose to the clinically important arterial wall area, preliminary dosimetric studies have been performed. Monte Carlo calculations were performed for simulated arteries filled with microspheres packed by random packing. Arterial radii from 0.05 mm to 3 mm and microsphere radii from 0.01 mm to 0.7 mm were used in the simulation. For constant arterial size, dose varied significantly with microspheres radius. Inter-arterial effect was also simulated using simplified geometry. For the inter-arterial sites, the dose rate was calculated between two arteries of the same size parallel to each other. The dose increased significantly for large arteries (>1 mm radius) filled with large microspheres (>0.3 mm radius). The dose increase between small arteries (<0.3 mm radius) was not as significant as that between large arteries. Overall results indicate that arterial size and microsphere size significantly affect the dose profile. This factor should be taken into account in future clinical applications.

Animals↗

The relationship between PTC taster status and taste thresholds in young adults.

OBJECTIVE: The aim of this study was to compare taste detection and recognition thresholds of young males and females, and young phenylthiocarbamide (PTC) "tasters" and "nontasters" for stimuli representing sweet, sour, bitter, salty, and umami classes of taste sensations. STUDY DESIGN: Thirty-eight men and 37 women (mean [SD] age = 24.5 [2.5] years) were classified as PTC tasters and nontasters according to their PTC recognition thresholds. Detection and recognition thresholds for the non-PTC stimuli were determined using a 2-alternative, forced choice procedure. RESULTS: The detection thresholds for quinine-HCl and sucrose and the recognition threshold for quinine-HCl were significantly higher in the PTC nontasters than in the tasters. The PTC threshold showed significant correlations with detection or recognition thresholds for sucrose, sodium chloride, quinine-HCl, and monosodium glutamate. The sucrose recognition threshold was lower in women than in men. CONCLUSION: In this study, gender and PTC taster status were found to be associated with thresholds for sucrose and quinine-HCl.

Adult↗

A novel needle-based miniature x-ray generating system.

The basic concept, design and performance of a novel needle-based x-ray system for medical applications are reported. The main principle of the system is based on a two-stage production of x-rays. The system comprises a conventional x-ray tube with an Ag anode, any known type of conditioning optics and a 2.2 mm diameter hollow needle with an interchangeable Mo target. The target can be moved along the needle axis and rotated around the needle axis. The needle x-ray device allows for adjustment in energy and flux intensity of the x-rays emitted by the target. The depth dependence of the intensity, dose rate as well as spatial and energy distribution of the radiation emitted by the target have been experimentally measured. The depth dose rate results have been compared with theoretical calculations using a Monte Carlo simulation of the x-ray production process. These studies have experimentally confirmed that the concept of this x-ray system is correct. Further improvement of the device can increase the dose rate up to the levels required for clinical applications.

Brachytherapy↗

Dose backscatter factors for selected beta sources as a function of source, calcified plaque and contrast agent using Monte Carlo calculations.

Electron backscattering is a prominent secondary effect in beta dosimetry, and is closely correlated with factors such as the geometries of the source and the scattering material, as well as the composition of the scattering material. Previous results were varied depending on the experimental setup and detector resolution, and were generally performed for monoenergetic electron beams, which makes direct application of these factors to beta sources difficult. In this work, backscattering factors were calculated with MCNP 4C for selected beta sources currently in use (32P and 90Sr/90Y) as well as for sources of potential therapeutic use (45Ca, 142Pr and 185W). Specifically, the calculations used beta spectra generated by the SADDE MOD2 code. The factors were calculated as a function of the distance from the interface between water and scatterers. The scatterers include source surroundings, source supporting materials and contrast agents commonly used for imaging purposes in brachytherapy. The results were fit by a simple function for future incorporation into a dose point kernel code. Due to the high-Z material content (iodine, Z = 53) in the contrast agent, a significant dose backscatter was observed near the water interface. Different cross-section algorithms in the MCNP code (inherent and ITS 3.0) affect the factor calculations. The results generated by the ITS 3.0 algorithm closely matched the EGS4 calculations for 32P. The dependence of backscatter factors on log(Z + 1) (Baily 1980 Med. Phys. 7514-9) was observed for all the beta sources with a high correlation coefficient, R (> 0.95). The overall results indicate that the backscattering effect is significant at short distances from the surface of the interface between water and the scattering material. This model can also aid in choosing a source support or mixing materials for beta brachytherapy sources.

Beta Particles↗

Image-guided procedures for intensity-modulated spinal radiosurgery. Technical note.

Radiosurgery for brain tumors has been well established in the radiation oncology and neurosurgery fields. Radiosurgery of extracranial tumors such as those involving the spine is, however, still in the early stage because of difficulties in patient immobilization and organ motion. The authors describe an image-guided procedure for intensity-modulated spinal radiosurgery that was developed at Henry Ford Hospital.

Algorithms↗

The relationship between oral Candida carriage and the secretor status of blood group antigens in saliva.

OBJECTIVE: The aim of the study was to investigate the relationship between oral Candida carriage and the secretor status of blood group antigens. STUDY DESIGN: Unstimulated whole saliva and oral rinse samples were obtained from 180 healthy subjects. These samples were plated on Sabouraud's dextrose agar media to determine oral Candida carriage. Sodium dodecylsulfate polyacrylamide gel electrophoresis and immunoblotting were performed on whole saliva samples to determine the secretor status of blood group antigens. RESULTS: The oral Candida carriage rate was found to be 45.0%. The sensitivity of the concentrated rinse culture proved to be superior. Oral Candida carriage was not significantly related to the blood group or secretor status of ABH or Lewis antigens. No significant relationship was found between oral Candida carriage and salivary flow rate. However, smoking affected oral Candida carriage. CONCLUSION: Oral Candida carriage in healthy individuals is not significantly related to blood group or secretor status.

ABO Blood-Group System↗

The relationship between volatile sulfur compounds and major halitosis-inducing factors.

BACKGROUND: Although tongue coating and periodontal conditions have been reported to be major halitosis-inducing factors, the relationship between volatile sulfur compounds (VSC) and these 2 major factors is not yet fully understood. The aim of this study was to investigate the relationship of VSC concentrations to tongue coating and periodontal health. METHODS: Forty subjects (mean age 33.3 years, range 14 to 64 years) were enrolled in this study. Gas chromatography was performed to analyze each VSC component from the mouth air sampled prior to tongue scraping, after tongue scraping, and after a subsequent prophylaxis on the interdental spaces. RESULTS: CH3SH was the most malodorous component among the 3 major VSC from the mouth air. The high CH3SH group showed a significantly higher organoleptic rating (P < 0.01), gingival index (P < 0.01), bleeding index (P < 0.01), probing depth (P < 0.05), and VSC concentrations prior to tongue scraping (P < 0.01), except for the amount of tongue coating, compared to the low CH3SH group. All VSC concentrations were vastly reduced by tongue scraping in both groups, and the remaining contents were nearly all removed by the subsequent prophylaxis. The VSC contents produced by the tongue coating played a major role [H2S: 76%; CH3SH: 52%; (CH3)2S: 55%] in the low CH3SH group. In the high CH3SH group which had poor periodontal health, the tongue coating still played a major role [H2S: 67%; CH3SH: 59%; (CH3)2S: 48%], but the interdental spaces also contributed to VSC production [H2S: 26%; CH3SH: 32%; (CH3)2S; 36%]. CONCLUSIONS: The tongue coating was demonstrated to be a primary halitosis-inducing factor. Periodontal health was also shown to contribute to VSC production.

Adolescent↗

Analysis of residual saliva and minor salivary gland secretions in patients with dry mouth.

The importance of oral mucosal wetness in the condition of dry mouth and the role of salivary proteins in proper oral function are acknowledged. A negative correlation between mucosal wetness and the protein concentration of residual saliva has been reported in normosalivators. Here, to examine the suggestion that a reduction in residual salivary volume leads to a concomitant elevation of its protein concentration, the amount of residual saliva and minor salivary gland secretions, and their protein concentrations, were measured in hyposalivators and normosalivator controls. A Periotron 8000 micro-moisture meter was used to measure the thickness of the mucosal film at six selected mucosal surfaces and the minor salivary gland secretion rate at two mucosal surfaces. The unstimulated whole salivary flow rate was measured by the spitting method. The total protein concentration of all salivary samples was measured by bicinchoninic acid assay. The hyposalivators had significantly lower amounts of residual saliva and minor salivary gland secretions than the normosalivators at all selected mucosal sites except the soft palate. In both groups, the site with the thinnest coat of residual saliva was the anterior hard palate and the wettest site was the anterior dorsal mucosa of the tongue. The protein concentration of residual saliva was significantly higher in hyposalivators than normosalivators. In the minor salivary gland secretions there was no significant difference in protein concentration between the normo- and hyposalivators. When the hyposalivators were divided into two subgroups according to their severity of dryness, the reduction of residual salivary volume and the elevation of protein concentration were more apparent in the group with the more severe dry mouth. Collectively, these results indicate that oral mucosal wetness is associated with the flow rate of unstimulated whole saliva. The function of the minor salivary glands was less affected and relatively well preserved in patients with dry mouth. The increased protein concentration of residual saliva in the hyposalivators appeared to be the result of decreased salivary volume.

Adolescent↗