A case of primary antiphospholipid syndrome and Type 2 diabetes mellitus with large artery thromboses successfully treated by abdominal stent implantation.
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Adult↗
Biomedical subjects
C S Kim
Publications and source records attributed to C S Kim.
Early and late reversal of rocuronium with pyridostigmine during sevoflurane anaesthesia in children.
This study investigated the effect of pyridostigmine administered at different levels of recovery of neuromuscular function after rocuronium during sevoflurane anaesthesia in children. Fifty-one patients aged 3 to 10 years, ASA physical status 1 or 2 were randomized to 4 groups: a spontaneous recovery group; or, reversal with pyridostigmine 0.25 mg/kg with glycopyrrolate 0.01 mg/kg at one of three times: 5 minutes after rocuronium administration; at 1% twitch height (T1) recovery; or at a 25% twitch height (T25) recovery. Anaesthesia was induced with thiopentone (5-7 mg/kg) and maintained with 2-3% sevoflurane and 50% nitrous oxide. Atropine (0.015 mg/kg) and, after calibrating the TOF-Watch, rocuronium (0.6 mg/kg) were then administered. Maximal block occurred 1.1+/-0.5 min (mean, SD) after rocuronium administration. In the spontaneous recovery group, the clinical duration (recovery to T25) was 40.1+/-8.8 min and the recovery index (time between T25 and T75) 19.9+/-9.8 min. Recovery to TOF >0.9 from the time of rocuronium administration was reduced by approximately 30% in the pyridostigmine groups compared to the spontaneous recovery group. There was no significant difference among the three pyridostigmine groups. When pyridostigmine was given at T1 or T25, the time from pyridostigmine administration to TOF >0.9 was shorter than for the group receiving pyridostigmine 5 minutes after rocuronium.
Analysis of Variance↗
Distribution of bisphenol A in the neuroendocrine organs of female rats.
The distribution of 14C-bisphenol A (BPA) in plasma and neuroendocrine organs was determined in Fischer 344 female rats following three oral doses (0.1, 10 or 100mg/kg). Plasma and tissue maximum concentrations (Cmax) were reached within 15-30 min of dosing. Plasma areas-under-the-curve (AUC) ranged from 0.06 to 53.9 microg-h/mL. The AUCs of the pituitary gland and uterus/gonads were 16-21% higher than that of plasma. The AUCs of hypothalamus and the rest of the brain were 43.7% and 77% of the plasma AUCs, respectively. In the brain tissue, the exposure increased linearly with the oral dose, as the dose was increased from 0.1 to 10 and 100 mg/kg; the exposure in the brain relative to the plasma increased by factors of 1, 1.19 and 1.24. This indicates that the brain barrier systems do not limit the access of the lipophilic BPA to the brain. The increases of the uterus/gonads relative to the plasma were 1, 1.07 and 1.04. Tissue partitioning was also examined in vitro by the uptake of 14C-BPA. The BPA tissue/blood partition coefficients were as follows: heart, 7.5; liver, 6.1; kidney, 6.4; fat, 3.6; muscle, 2.6; breast, 3.6; ovaries, 9.1; uterus, 5.9; stomach, 5.1; and small intestine, 6.7. The tissue/cerebrospinal fluid partition coefficients were as follows: pituitary gland, 12.8; brain stem, 6.1; cerebellum, 6.4; hippocampus, 7.1; hypothalamus, 6.1; frontal cortex, 4.9; and caudate nucleus, 6.8.
Administration, Oral↗
Lactulose production by beta-galactosidase in permeabilized cells of Kluyveromyces lactis.
Lactulose production from lactose and fructose was investigated with several commercial beta-galactosidases. The enzyme from Kluyveromyces lactis exhibited the highest lactulose productivity among the beta-galactosidases tested. The reaction conditions for lactulose production were optimized using cells that had been permeabilized by treatment with 50% (v/v) ethanol: cell concentration, 10.4 g l(-1); concentration of substrates, 40% (w/v) lactose and 20% (w/v) fructose; temperature, 60( degrees )C; pH 7.0. Under these conditions, the permeabilized cells produced approximately 20 g l(-1) lactulose in 3 h with a lactulose productivity of 6.8 g l(-1) h(-1). These results represent 1.3- and 2.1-fold increases in lactulose concentration and productivity compared with untreated washed cells. This is the first reported trial of enzymatic synthesis of lactulose using permeabilized yeast cells.
Cell Membrane Permeability↗
Consistent resolution of possible anomalies in B0-->phi K(S) and B+ --> eta'K+ Decays.
In the framework of R-parity violating (R(p)) supersymmetry, we try to find a consistent explanation for both recently measured CP asymmetry in B0 --> phi K(S) decay and the large branching ratio of B+/- --> eta'K+/- decay, which are inconsistent with the standard model (SM) prediction. We also investigate other charmless hadronic B -- >PP and B --> VP decay modes whose experimental data favor the SM: for instance, recently measured CP asymmetries in B0 --> eta(')K(S) and B0 -- >J/Psi K(S). We find that all the observed data can be accommodated for certain values of R(p) couplings.
Journal Article↗
Human exposure assessment to mancozeb during treatment of mandarin fields.
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Adult↗
Developmental hemispheric asymmetry of interregional metabolic correlation of the auditory cortex in deaf subjects.
The functional connectivity of the auditory cortex might be altered in deaf subjects due to the loss of auditory input. We studied the developmental changes of functional connectivity of the primary auditory cortex (A1) in deaf children, deaf adults, and normal hearing adults by examining interregional metabolic correlation with (18)F-FDG PET. The mean activity of FDG uptake in the cytoarchitectonically defined A1 region served as a covariate in the interregional and interhemispheric correlation analysis. A1 metabolic rate was correlated with that of the ipsilateral superior temporal lobe in both normal and deaf subjects. This correlated area was larger in deaf children than in deaf or normal hearing adults. Concerning the functional connectivity of A1, a hemispheric asymmetry was found in that the extent of interregional correlation was clearly larger in the right than in the left hemisphere. This asymmetry was particularly pronounced in the younger deaf children. Both extent and asymmetry of the functional connectivity of A1 subsided with age. Contrary to this, a correlation between the left and the right primary auditory cortices was absent in younger deaf children but became apparent as they grew older.
Adolescent↗
Association of HLA-DR and type II collagen autoimmunity with Meniere's disease.
To investigate HLA-associated genetic susceptibility to Meniere's disease in relation to type II collagen (CII) autoimmunity status, HLA-DRB1 genotyping and ELISA measurement of anti-CII antibody were performed in 41 Korean patients with Meniere's disease. In the anti-CII positive subgroup (20%) of patients, the frequency of HLA-DRB1*0405 was significantly increased (uncorrected) compared with both controls (63% vs 16%) and anti-CII negative patients (63% vs 12%). In the anti-CII negative subgroup, HLA-DRB1*1201 was significantly increased (uncorrected) (27% vs 10%) and DRB1*13 was decreased (6% vs 24%) compared with controls; these alleles appeared to confer susceptibility and resistance to the development of the disease. Association of HLA-DRB1*0405 with anti-CII positive Meniere's disease in this study suggests that it shares a specific HLA-DR sequence, QRRAA, as a genetic susceptibility factor with the anti-CII positive rheumatoid arthritis. In conclusion, whilst type II collagen autoimmunity may have a partial role in Meniere's disease, different HLA-DR alleles may also be associated with either susceptibility or resistance to the development of the disease in relation to anti-CII antibody status.
Adult↗
Clinical trial of esmolol-induced controlled hypotension with or without acute normovolemic hemodilution in spinal surgery.
BACKGROUND: Drug-induced controlled hypotension (CH) combined with acute normovolemic hemodilution (ANH) is being widely used for blood conservation in surgical patients. The purpose of this study was to investigate the efficacy and safety of esmolol-induced CH combined with ANH (hematocrit down to 28%). METHODS: Thirty patients who were scheduled to receive spinal surgery were randomly divided into two groups: an esmolol-induced CH alone group (esmolol group, n=15) and a CH-ANH combined group (E-ANH group, n=15). Controlled hypotension was induced with esmolol 500 micro g/kg, followed by a continuous infusion of 0-300 micro g/kg/min to maintain mean arterial pressure at 55-65 mmHg. RESULTS: The mean infusion rate of esmolol in the esmolol-ANH group was 46+/-6 micro g/kg/min (mean+/-SD), which was significantly lower than the 77+/-9 micro g/kg/min used in the esmolol group (P<0.05). The number of units of homologous blood (packed RBC) transfused perioperatively was 2.2+/-0.6 units in the esmolol-ANH group, which was significantly less than 4.3+/-0.4 units used in the esmolol group (P<0.01). While O2 delivery decreased significantly during CH, O2 consumption remained unchanged in both groups. No complications resulted from CH or ANH in any of the groups. CONCLUSION: Our data suggest that ANH of moderate degree can be combined with esmolol-induced CH to improve blood conservation in surgical patients.
Adrenergic beta-Antagonists↗
Recent trends of plutonium fallout observed in Japan: plutonium as a proxy for desertification.
Plutonium in monthly deposition samples collected in Tsukuba (the Meteorological Research Institute), Japan from 1990 to end of 2001 is reported, together with monthly plutonium deposition in Nagasaki and Yonaguni in 2000. The annual deposition of (239,240)Pu during the period from 1990 to 2001 shows no systematic interannual variation. However, monthly (239,240)Pu depositions show a typical seasonal variation with a maximum in spring season (March to April), which corresponds to seasonal cycle of soil dusts originating from the East Asian arid area. Plutonium isotopic ratios in the deposition samples suggest that significant amounts of the recent (239,240)Pu deposition observed in Japan are attributed to the resuspension of plutonium-bearing surface soil particles; resuspended plutonium originates from the East Asian arid areas. The recent increased tendency of (239,240)Pu content in residues in deposition samples may reflect desertification in the East Asian continent.
Asia↗
Positioning internal jugular venous catheters using the right third intercostal space in children.
BACKGROUND: Central venous catheters are used for pressure measurement, and drug and fluid therapy in children. Several reports have described serious complications related to catheter positioning. We evaluated the possibility of using the right third intercostal space as an anatomic landmark for determining the optimal insertion depth of a central venous catheter from the right internal jugular vein. METHODS: The distance between the skin puncture site and the right third intercostal space (SK-ICS) was measured in 83 children. The catheter was inserted to a depth equal to the measured distance. Postoperatively, the distance between the catheter tip and the radiographic junction of the superior vena cava and the right atrium was measured. This was defined as the optimal catheter length, which placed the catheter tip at the SVC/RA junction (SK-SVC/RA). RESULTS: A significant correlation was found between the SK-ICS and SK-SVC/RA (regression equation: SK-SVC/RA = 0.35 + 0.98 x SK-ICS, r2 = 0.8554). Based on the data obtained, a simple formula, SK-ICS-1 (cm), predicted that a CVC would be positioned above the RA in 98.8% of patients. CONCLUSIONS: Using the right third intercostal space as an anatomic landmark allows positioning of the catheter tip in the SVC near to but not in the RA in children.
Catheterization, Central Venous↗
Computer simulations of particle deposition in the lungs of chronic obstructive pulmonary disease patients.
Epidemiology data show that mortality rates for chronic obstructive pulmonary disease (COPD) patients increase with an increase in concentration of ambient particulate matter (PM). This is not seen for normal subjects. Therefore, the U.S. Environmental Protection Agency (EPA) has identified COPD patients as a susceptible subpopulation to be considered in regulatory standards. In the present study, a computer model was used to calculate deposition fractions of PM within the lungs of COPD patients. The morphology of COPD lungs was characterized by two distinct components: obstruction of airways (chronic bronchitis component), and degeneration of alveolar structure (emphysema component). The chronic bronchitis component was modeled by reducing airway diameters using airway resistance measurements in vivo, and the emphysema component was modeled by increasing alveolar volumes. Calculated results were compared with experimental data obtained from COPD patients for controlled breathing trials (tidal volume of 500 ml, respiratory time of 1 s) with a particle size of 1 microm. The model successfully depicts PM deposition patterns and their dependence on the severity of disease. The findings indicate that airway obstructions are the main cause for increased deposition in the COPD lung.
Aerosols↗
Aerosol transport and deposition in a triple bifurcation bronchial airway model with local tumors.
Airflow characteristics and particle deposition have been numerically simulated in a triple bifurcation lung airway model (from generation 3-6 airways) with local tumors protruded from the sidewalls of generation 5 airways. The effects of tumors in terms of size and location on airflow, particle transport, and deposition patterns were analyzed for constant inspiratory flow rates with inlet Reynolds (Re(match) = 463 and 1882) and Stokes number (St(match) = 0.02-0.12) combinations that match different cyclic inhalation waveforms. The size of tumors was varied to induce an obstruction of airway lumen by 16-74%. Extreme conditions, 2 and 100% obstruction, were also examined. The results show that enhanced deposition occurs in the carina region at each bifurcation, and deposition increases with increasing Stokes and Reynolds number as expected from earlier studies. In addition, deposition increases at the tumor site until the tumor blocks about half of the airway lumen and then decreases with a further obstruction. In other words, there exists a maximum particle deposition fraction (DF) for a protruding tumor that occludes the lumen. The maximum DF at the tumor was 10.2% within the test conditions used. Deposition occurs mainly on the frontal surface of the tumors, but spreads out to the opposite wall, or upstream sections, or sister branches of the tumor at high flow rates and Stokes number. The present results (1) help in the understanding of the complex toxic or therapeutic aerosol dynamics in the lung with local airways obstruction, and (2) provide quantitative information on critical tumor size and particle deposition to health care specialists.
Administration, Inhalation↗
Computational analysis of micron-particle deposition in a human triple bifurcation airway model.
Steady laminar axisymmetric inhalation flow and wall deposition of micron-size particles in representative triple bifurcation airways have been simulated using a commercial finite-volume code with user-enhanced programs. Assuming spherical non-interacting particles (3 microm</=d(p)</=7 microm), various inlet Reynolds numbers (Re=500-2000) and Stokes numbers (St=0.02-0.23) were considered. The resulting particle deposition patterns were analyzed and then summarized in terms of deposition efficiencies, i.e. DE=DE(Re,St) Surprisingly high DE-values occur at relatively low Reynolds numbers (e.g., Re=500) in the third bifurcation. The quantitative results are of interest to researchers either conducting health risk assessment studies for inhaled particulate pollutants or analyzing drug aerosol inhalation and deposition at desired lung target sites.
Administration, Inhalation↗
Induced thermolysis of tert-butyl phenylperacetates by thiophenol: simultaneous occurrence of homolysis and single electron transfer.
Thermolysis of tert-butyl phenylperacetates in the presence of thiophenol takes place via dual mechanism. The two-bond homolysis indicates rho(+)(4)= -1.16, testifying to polar transition states. The single electron transfer yields a radical anion intermediate which undergoes fragmentation with rho(ET) = 1.01.
Journal Article↗
Epinephrine, vasodilation and hemoconcentration in syncopal, healthy men and women.
Healthy young people may become syncopal during standing, head up tilt (HUT) or lower body negative pressure (LBNP). To evaluate why this happens we measured hormonal indices of autonomic activity along with arterial pressure (AP), heart rate (HR), stroke volume (SV), cardiac output (CO), total peripheral resistance (TPR) and measures of plasma volume. Three groups of normal volunteers (n = 56) were studied supine, before and during increasing levels of orthostatic stress: slow onset, low level, lower body negative pressure (LBNP) (Group 1), 70 degrees head up tilt (HUT) (Group 2) or rapid onset, high level, LBNP (Group 3). In all groups, syncopal subjects demonstrated a decline in TPR that paralleled the decline in AP over the last 40 s of orthostatic stress. Ten to twenty seconds after the decline in TPR. HR also started to decline but SV increased, resulting in a net increase of CO during the same period. Plasma volume (PV, calculated from change in hematocrit) declined in both syncopal and nonsyncopal subjects to a level commensurate with the stress, i.e. Group 3 > Group 2 > Group 1. The rate of decline of PV, calculated from the change in PV divided by the time of stress, was greater (p < 0.01) in syncopal than in nonsyncopal subjects. When changes in vasoactive hormones were normalized by time of stress, increases in norepinephrine (p < 0.012, Groups 2 and 3) and epinephrine (p < 0.025, Group 2) were greater and increases in plasma renin activity were smaller (p < 0.05, Group 2) in syncopal than in nonsyncopal subjects. We conclude that the presyncopal decline in blood pressure in otherwise healthy young people resulted from declining peripheral resistance associated with plateauing norepinephrine and plasma renin activity, rising epinephrine and rising blood viscosity. The increased hemoconcentration probably reflects increased rate of venous pooling rather than rate of plasma filtration and, together with cardiovascular effects of imbalances in norepinephrine, epinephrine and plasma renin activity may provide afferent information leading to syncope.
Adult↗
Depletion of praziquantel in plasma and muscle tissue of cultured rockfish Sebastes schlegeli after oral and bath treatment.
Depletion of praziquantel in plasma and muscle tissue after oral and bath treatments was studied in cultured rockfish Sebastes schlegeli. In the oral treatment, a single dose of 400 mg praziquantel kg(-1) body weight was administered by intubation of the stomach. A bath treatment at 100 ppm of praziquantel for 4 min was also carried out. Plasma and muscle tissue samples were collected at 3, 6, 12, 24, 48, 72, 96, 120, 144 and 168 h post-treatment, and analyzed for praziquantel by reversed-phase HPLC using diazepam as the internal standard. Following oral treatment, praziquantel was detected in plasma and muscle tissue until 96 h after treatment. In plasma the praziquantel concentration was highest at the 9 h sampling time and declined sharply at the 48 h sampling point. The concentrations of praziquantel in the muscle tissue were lower than those in the plasma, and the highest value was found at the 9 h sampling time. Following bath treatment, praziquantel was found in plasma and muscle tissue until 72 and 24 h after treatment, respectively. In plasma the praziquantel concentration was highest at the 12 h sampling time and declined sharply thereafter. The concentrations of praziquantel in the muscle tissue were significantly lower than those in the plasma, and the concentrations declined consistently with time.
Administration, Oral↗
Phase II trial of epirubicin, cisplatin, oral uracil and tegafur, and leucovorin in patients with advanced gastric carcinoma.
BACKGROUND: The results of chemotherapy for patients with gastric carcinoma generally have been modest, although regimens developed more recently have produced higher response rates. One such regimen is epirubicin, cisplatin, and protracted infusion of 5-fluorouracil (ECF). The advantage of a long-term oral administration of uracil and tegafur (UFT) is that this treatment may be used to mimic the protracted infusion of 5-fluorouracil (5-FU). In addition, UFT treatment combined with leucovorin had a favorable activity and tolerable toxicity in patients with advanced gastric carcinoma. Instead of the inconvenience of an infusion pump and intravenous catheter for the protracted infusion of 5-FU, the authors administered UFT plus leucovorin in an ECF regimen for the treatment of patients with advanced gastric carcinoma. METHODS: Fifty-two patients with advanced gastric carcinoma received epirubicin, cisplatin, and oral UFT plus leucovorin. Epirubicin 50 mg/m(2) and cisplatin 60 mg/m(2) were administered on Day 1 by intravenous injection. Tegafur and uracil 360 mg/m(2)/day orally was administered in conjunction with leucovorin administered at a fixed dose of 45 mg/day orally in divided daily doses for 21 days followed by a 7-day rest period. These courses were repeated every 4 weeks. The median age of the patients was 59 years with a median World Health Organization performance status of 1. Patients received a median of five courses of treatment (range, 1-10). RESULTS: Among the 47 patients evaluated, three patients achieved complete response, and 24 patients had partial responses, for an overall response rate of 57.5% (95% confidence interval, 71.5-43.3%). Stable disease was reported in 11 patients (23.4%), and another 9 patients (19.1%) showed disease progression. The median duration of survival was 15 months (range, 2-33+). The main toxicity was nausea/vomiting and neutropenia. Significant toxicity (modified National Cancer Institute common toxicity Grade 3 or 4) included neutropenia in 22 patients (42%), nausea in 14(27%), vomiting in 9 (18%), oral mucositis in 3 (6%), and diarrhea in 3 (6%) patients. CONCLUSIONS: The authors conclude that epirubicin, cisplatin, and oral UFT plus leucovorin, a convenient regimen, has a significant activity and tolerable toxicities in patients with gastric carcinoma.
Administration, Oral↗