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Biomedical subjects

C W Kim

Publications and source records attributed to C W Kim.

At least 145 records · Page 8Linked to original sources

Heat-insoluble cryoglobulin in a patient with essential type I cryoglobulinemia and massive cryoglobulin-occlusive glomerulonephritis.

We report a case of type I essential cryoglobulinemia with massive cryoglobulin-occlusive glomerulonephritis, in which the clinical course and the physical characteristics of the cryoglobulin were unusual. Nine years before appearance of cryoglobulin, this 54-year-old man noted edema and purpura of the lower extremities. Renal biopsy performed 2 years later showed large amounts of amorphous, weakly eosinophilic, weakly periodic acid-Schiff (PAS)-positive materials occluding the glomerular capillaries. Immunostaining showed the material to be weakly immunoglobulin (Ig) G positive, and electron microscopy showed homogeneous, electron-dense deposits. Nephrotic syndrome and azotemia did not respond to steroid treatment, and dialysis was begun 5 years after the biopsy. A small amount of cryoglobulin was first detected 2 years later, 9 years after the onset of disease. The cryoglobulin had a white gelatinous appearance, was resistant to resuspension, and did not redissolve when rewarmed to 37 degrees C. Immunoelectrophoresis of the cryoglobulin, which partially dissolved at 54 degrees C, showed it to be composed of monoclonal IgG-kappa and a small amount of albumin. We consider that the unusual physical characteristics of the cryoglobulin in this case precipitated a massive cryoglobulin-occlusive glomerulonephritis, which progressed to end-stage renal failure in the absence of significant cryoglobulinemia during the initial onset of disease.

Cryoglobulinemia↗

An immunohistochemical analysis of mdr-1 and bcl-2 expressions in neuroblastoma.

Among the differentiation-related changes in neuroblastoma are expressions of mdr-1 and bcl-2, which may be potentially related to the resistance to anticancer chemotherapy. In the present study, the authors performed an immunohistochemical analysis of mdr-1 and bcl-2 expressions in 30 neuroblastomas using monoclonal anti-P-glycoprotein(mdr-1 product) antibody and monoclonal anti-bcl-2 antibody to investigate the significance of their expression. The overall incidence of mdr-1 and bcl-2 expressions were 53.3% (16/30) and 93.3% (28/30), respectively. The expressions of mdr-1 and bcl-2 didn't seem to be related to the status of preoperative chemotherapy or stage of disease. The expression of mdr-1 was closely related to the differentiation of tumor cells (p < 0.01), especially to the neuronal differentiation. The bcl-2 expression was so common that it seemed to be indigenous to this neoplasm. The overall findings suggested that the expression of mdr-1 is one of the differentiation markers, while bcl-2 expression may partly explain the reasons for the relatively poor prognosis of neuroblastoma by the resistance to anticancer chemotherapy, which is a major therapeutic tool for this peculiar neoplasm.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Patterns of bcl-2 expression in placenta.

A total of 39 placentas, whose gestational ages ranged from 8 to 41 weeks, were analyzed for bcl-2 expression using immunohistochemistry and immunoblotting. Immunohistochemically, both intracytoplasmic and nuclear expression of bcl-2 was observed in villous and extravillous trophoblasts, villous mesenchymal cells and capillary endothelial cells, villous macrophages, intermediate trophoblasts, amnionic epithelium, and even in decidua and endometrial glandular epithelium in early gestational periods. The degree of expression significantly decreased in the placentas after the gestational period of 32 weeks which coincides with the declining phase of placental increase. On immunoblotting lysates of 10(4) cells from single cell suspensions of fresh placentas, bcl-2 was detected in the placentas of 22 and 33 gestational weeks, but it was negligible or absent in three term placentas. The results of the present study suggest two possible implications on the role of bcl-2 in placenta: 1) it may be a type of proliferation or maturation-related marker, especially of trophoblasts, which show decreased expression along with terminal differentiation and maturation, and 2) because the primary role of bcl-2 is the inhibition of programmed cell death (PCD), the decrease in placental bcl-2 around term may be a parturition-associated biological change.

Female↗

Peripheral T-cell lymphoma involving subcutaneous tissue.

The peripheral T-cell lymphomas, presumably derived from various immunocompetent peripheral T-cell system components, form a heterogeneous group of non-Hodgkin's lymphomas. We describe two patients with peripheral T-cell lymphoma primarily involving subcutaneous tissue. They presented with multiple subcutaneous nodules. Skin biopsy specimens in both patients demonstrated a lobular subcutaneous infiltrate. The infiltrate consisted of small and medium-sized atypical lymphoid cells. Both patients had a protracted clinical course before they were diagnosed as having malignant lymphoma. We detected latent Epstein-Barr virus infection in the skin lesions of case 2. Latent Epstein-Barr virus infection might be related to the development of this variant of peripheral T-cell lymphoma.

Adult↗

Detection of antiendometrial antibodies in sera of patients with endometriosis by dual-colored, double-labeling immunohistochemical method and western blot.

PROBLEM: This study was undertaken to determine whether specific binding activities against endometrial proteins in sera of patients with endometriosis are detectable and, if so, to identify endometrial antigens involved in autoimmunity in endometriosis. METHOD: Sera from 33 patients with endometriosis and 20 cord sera (controls) were tested against endometria of patients and their protein extracts by dual-colored, double-labeling immunohistochemical method, and Western blotting. RESULTS: Antiendometrial binding activities were detected in sera of 2 (10.0%) control patients and 13 (48.2%) patients with endometriosis by the immunohistochemical method. Endogenous immunoglobulin G (IgG) binding to endometrial proteins had molecular weights (MW) of 26, 28, 54, 85, 107 and 116 kDa. Most sera of both control and patients showed reactivity against endometrial proteins with MW of 34, 36, 56 and 77 kDa. However, there were specific IgG autoantibodies reactive against the endometrial proteins of 71, 92, and 103 kDa in sera of 55.2% (16/29) of patients but not in the control sera. Over 80% (10/12) of patients' sera with binding activities detectable by the immunohistochemical method also tested positive by Western blot analysis. CONCLUSIONS: These data show that specific IgG antibodies reactive against endometrial antigens are detectable in sera from some patients with endometriosis.

Adult↗

Cycloserine-induced lichenoid drug eruption.

A 65-year-old male patient who has taken antituberculous drugs including cycloserine for 8 months showed multiple pruritic, violaceous, flat-topped papules and plaques on his back which had developed 5 months into therapy. Histopathologic findings were consistent with lichenoid drug eruption. Patch test with the drugs revealed a strongly positive reaction to cycloserine only. Four months after discontinuation of oral cycloserine, pruritus resolved and the lesions subsided without any new lesions. Cycloserine is one of the antituberculous drugs. Skin manifestations resulting from its administration are reported to be rare, but to our knowledge, this is the first case report of lichenoid drug eruption from its use.

Aged↗

Detection of 17p loss in gastric carcinoma using polymerase chain reaction.

BACKGROUND: The loss of heterozygosity (LOH) of 17p has been previously studied with conventional Southern blot-restriction fragment length polymorphism analysis, but the relatively low informativity was an obstacle to extensive analysis. To overcome this problem and to investigate the significance of 17p LOH in gastric carcinoma, we employed polymerase chain reaction and subsequent silver staining of DNA. EXPERIMENTAL DESIGN: LOH of p53 gene and D17S5 locus on 17p was analyzed using polymerase reaction; the relationships between 17p LOH and conventional clinicopathologic parameters were evaluated. RESULTS: The LOH of p53 gene and D17S5 was found in 36.5% (23 out of 63) and 63.3% (38 out of 60) informative cases, respectively. There was no significant correlation between LOH of these two loci, whereas the frequency of the D17S5 locus was significantly higher (p < 0.01), which suggested that there may be another putative tumor suppressor gene between the two loci or distal to D17S5. The LOH of p53 gene and D17S5 locus was not significantly associated with abnormal p53 expression, depth of invasion, histologic type of the tumor (Lauren's classification), or the status of lymph node metastasis. CONCLUSIONS: The polymerase chain reaction and silver staining of DNA seemed to be a simple and excellent method for the evaluation of chromosomal allelic loss. The 17p LOH was frequently found in gastric carcinoma, but specific association with conventional clinicopathologic parameters was not found.

Adult↗

Members of the syndecan family of heparan sulfate proteoglycans are expressed in distinct cell-, tissue-, and development-specific patterns.

The syndecans are a gene family of four transmembrane heparan sulfate proteoglycans that bind, via their HS chains, diverse components of the cellular microenvironment. To evaluate the expression of the individual syndecans, we prepared cDNA probes to compare mRNA levels in various adult mouse tissues and cultured mouse cells representing various epithelial, fibroblastic, endothelial, and neural cell types and B cells at various stages of differentiation. We also prepared antibody probes to assess whether the extracellular domains of the individual syndecans are shed into the conditioned media of cultured cells. Our results show that all cells and tissues studied, except B-stem cells, express at least one syndecan family member; most cells and tissues express multiple syndecans. However, each syndecan family member is expressed selectively in cell-, tissue-, and development-specific patterns. The extracellular domain of all syndecan family members is shed as an intact proteoglycan. Thus, most, if not all, cells acquire a distinctive repertoire of the four syndecan family members as they differentiate, resulting in selective patterns of expression that likely reflect distinct functions.

Animals↗

Comparison of bromodeoxyuridine and proliferating cell nuclear antigen labeling in gastric carcinoma.

The proliferative activity of human gastric carcinoma was measured by means of in vitro incorporation of the thymidine analogue, 5-bromo-2'-deoxyuridine (BrdU), into the newly-synthesized DNA of fresh tumors and immunohistochemical staining of proliferating cell nuclear antigen (PCNA) using avidin-biotin peroxidase method. Eighty-two cases of surgically resected human gastric carcinomas consisting of 18 various histologic types were subjected to study. The mean BrdU labelling index (LI) and PCNA LI were 22.9% and 39.1%, respectively. The correlation between BrdU LI and PCNA LI was statistically significant (correlation coefficient mu = 0.61334, p = 0.0001). We concluded that immunohistochemical staining for PCNA may become a practical method instead of in vitro or in vivo BrdU labeling to assess the proliferation fraction of the gastric cancer patient.

Antibodies, Monoclonal↗

Immunoglobulin and T-cell receptor gene rearrangement analysis in malignant lymphoid neoplasms.

Gene rearrangement analysis using Southern-blot hybridization technique is a standard method for evaluating clonal receptor gene rearrangement. Both clonality and lineage can be identified in lymphoid neoplasms by the demonstration of one or more rearranged antigen receptor genes of the immunoglobulin supergene family-immunoglobulin and T-cell receptor genes. To evaluate the diagnostic applicability of antigen receptor gene rearrangements in the diagnosis of malignant lymphomas and leukemias, the authors performed a gene rearrangement analysis of 54 cases by southern blot hybridization technique. One or two clonally rearranged bands were detected in the malignant lymphomas and in the lymphoblastic leukemias with a false-negative rate of 13.8%. No clonal, rearranged band was detected in benign reactive hyperplasias, carcinomas or non-lymphocytic leukemias. Rearrangement analysis could resolve the lineage, clonality and stage of differentiation of malignant lymphoid neoplasms.

Gene Rearrangement↗

Adult T-cell leukemia/lymphoma in a Korean--a case report.

The clinicopathologic features of a Korean patient with adult T-cell leukemia/lymphoma(ATLL) are presented. A 51-year-old man, who has lived in Korea since birth, had multiple cutaneous nodules and multiple lymphadenopathy for the previous two months. A histopathologic study of the lymph node and skin lesion revealed T-cell non-Hodgkin's lymphoma of pleomorphic type, medium and large cell type. Peripheral blood examination showed leukemic features with 30% of abnormal lymphoid cells. HTLV-I proviral DNA pX region was detected in the DNA from peripheral blood mononuclear cells(PBMC) and the specific gag, pol, and env HTLV-I sequences were detected in the lymph node using polymerase chain reaction technique. Human T-cell leukemia/lymphoma type I(HTLV-I) antibodies were present in the serum. An immunophenotypic study of the lymph node revealed CD4 positive and CD8 negative helper/inducer T cell type surface markers. This case is the acute type, i.e. prototypic ATLL. He was treated with an intensive chemotherapy including cyclophosphamide, etoposide, doxorubicin, vincristine, and prednisone. Despite initial transient improvement, the tumor progressed after three cycles of the regimen and became refractory to further chemotherapy. These clinicopathologic findings, including the immunophenotypic analysis, established with certainty the diagnosis of HTLV-I-induced adult T-cell leukemia/lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗

Multiple myeloma presenting as a testicular mass.

Primary testicular plasmacytoma is extremely rare and only a few cases have been reported. Testicular involvement in the course of multiple myeloma is just as rare and it implies a poor prognosis, expressing an acceleration of the malignant process. We present the case of a patient with multiple myeloma presenting as a testicular mass. The literature is reviewed and testicular involvement in plasma cell neoplasms is discussed.

Humans↗

Reproducible elevation of liver transaminases by topical 8-methoxypsoralen.

We present a case of a 17-year-old woman with vitiligo who had no known previous liver diseases nor any exposure to concurrent hepatotoxic drugs and who developed a liver injury while on topical methoxypsoralen photochemotherapy (PUVA). The reaction, manifested by elevated liver enzymes, was provoked on 3 consecutive occasions, and on the last one, with 1% methoxypsoralen lotion only. Although the exact mechanism of liver injury in our patient is unknown, it seems to be an idiosyncratic hypersensitivity reaction to topically applied methoxypsoralen.

Adolescent↗

Studies of the hyperthermophile Thermotoga maritima by random sequencing of cDNA and genomic libraries. Identification and sequencing of the trpEG (D) operon.

Random sequencing of cDNA and genomic libraries has been used to study the genome of the hyperthermophile Thermotoga maritima. To date, 175 unique clones have been analyzed by comparing short sequence tags with known proteins in the PIR and GenBank databases. We find that a significant proportion of sequences can be matched to previously identified protein from non-Thermotoga sources. A high match rate was obtained from an oligo(dT)-primed cDNA library, where one-third of all unique sequences analyzed (21/65) shared high amino acid sequence similarity with proteins in the PIR and GenBank databases. Also, approximately one-third of the unique sequences from a second cDNA library (28/89), constructed with random oligo primers, could be matched to sequences in PIR and GenBank. Identification of genes from the oligo(dT)-primed cDNA library indicates that some Thermotoga mRNAs are polyadenylated. Genes have also been identified from a 1 to 2 kb genomic DNA library. Here, (3/21) of genomic sequences analyzed could be matched to protein in PIR and GenBank. One of the genomic clones had high sequence similarity to the tryptophan synthesis gene anthranilate synthase component I (trpE). Using this sequence tag, the Thermotoga trp operon was isolated and sequenced. The Thermotoga maritima trp operon is arranged with trpE forming an overlapping transcript with a second protein consisting of a fusion of anthranilate synthase component II (trpG) and anthranilate phosphoribosyltransferse (trpD). With regard to the fusion, the operon organization is similar to Escherichia coli and Salmonella typhimurium, but lacks the classic attenuation system of enteric bacteria. Amino acid sequence comparison with 19 trpE, 18 trpG and 14 trpD genes from other organisms suggest that the Thermotoga trp genes resemble corresponding genes from other thermophiles more closely than expected.

Amino Acid Sequence↗

Radiological findings of human fascioliasis.

Fasciola hepatica is a trematode of herbivorous mammals. Humans are accidentally infected by the ingestion of water or raw aquatic vegetables contaminated with the metacercaria. Radiological findings of six patients with fascioliasis (five hepatic fascioliasis, one biliary fascioliasis) were analyzed. The diagnosis was based on serological testing and/or histopathologic findings of eosinophilic abscess in five patients and identification of the adult worm in one patient. The characteristic radiological features of hepatic fascioliasis were (1) cluster of microabscesses arranged in tract-like fashion (burrow tract), (2) subcapsular location of the hepatic lesions, and (3) very slow evolution of the lesion on follow-up examinations. In biliary fascioliasis, there were multiple conglomerated filling defects in the common bile duct. The authors believe that the demonstration of these features, together with peripheral eosinophilia or eosinophilic aspirate from the hepatic lesion, is very helpful in making the correct diagnosis.

Adolescent↗

Pulmonary paragonimiasis: clinical and experimental studies.

Pulmonary paragonimiasis is a disease caused by a lung fluke. It is endemic to East Asia, but there have been several case reports in North America. Human infestation occurs by ingestion of raw or incompletely cooked freshwater crab or crayfish infected with metacercaria. A retrospective study was performed with 78 patients who lived in South Korea and had chest radiographic findings of pleuropulmonary disease; it was subsequently shown that they had paragonimiasis. The diagnosis was based on positive results of serologic tests for Paragonimus-specific antibody or on the detection of eggs in sputum samples. Radiologic findings from these 78 patients were correlated with the pathologic and radiologic findings from a study of experimentally induced pulmonary paragonimiasis in 21 cats. Findings from the correlative study document that the typical radiologic manifestations of pulmonary paragonimiasis vary with the stage of the disease. Early findings include pneumothorax or hydropneumothorax, focal airspace consolidation, and linear opacities and are caused by the migration of juvenile worms. Later findings include thin-walled cysts, dense masslike consolidation, nodules, or bronchiectasis and are due to worm cysts.

Adult↗

[Localization and isozyme patterns of phosphatase in Fibricola seoulensis].

The present study was carried out to investigate the localization and isozyme patterns of acid phosphatase and alkaline phosphatase in metacercariae and in adults of F. seoulensis by enzyme-histochemistry method and electrophoresis. Acid phosphatase showed a strong activity at pH 5 in the intestinal caecum of adults, but showed no reactions in the non-substrate control and in the inhibitor-treated control. Alkaline phosphatase showed a strong activity at pH 8 in the intestinal caecum and the tribocytic organ of adults, and in the intestinal caecum and in the genital anlagen of metacercariae. In non-denature PAGE, ten bands of protein fraction from the extracts of metacercariae and twenty-two bands from adults were detected. In denature PAGE, two protein bands having molecular weights of 192 kDa and 123 kDa were detected in the metacercariae, but absent from adult stage. In adults, protein fractions of 27.5 kDa, 24.5 kDa, 21.4 kDa, 18 kDa, 16 kDa and 15 kDa were detected. In non-denature PAGE, isozymes of acid phosphatase showed the most strong activity at pH 5, whereas no activity was shown at pH 2 and pH 7. One isozyme band (62 kDa) of AcPase was recognized in metacercariae and 4 isozyme bands (95 kDa, 85 kDa, 73 kDa and 62 kDa) in adults.

Acid Phosphatase↗

Piezoelectric lithotripsy of radiopaque gallstones: results and six-month follow-up.

Sixty-eight patients with radiopaque gallbladder stones (38 with a single stone, 30 with multiple stones) were treated with piezoelectric extracorporeal shock wave lithotripsy (ESWL) and results were compared with those of 69 patients with radiolucent stones (28 with a single stone, 41 with multiple stones). Stones were fragmented to 4 mm or less in 76.8% after 41,466 +/- 36,504 shock waves in the radiolucent stone group and 77.9% after 54,686 +/- 51,024 shock waves in the radiopaque stone group (p = 0.876 and 0.130, respectively). In 137 patients, ten patients were lost to follow-up. Average period of follow-up was 220 +/- 198 days. Six-month clearance rate of the radiolucent stone group was 43.5% and that of the radiopaque stone group was 16.4% (p less than 0.05) Figure 1. Six-month clearance rate of patients with single stones smaller than 2 cm was also significantly higher in the radiolucent stone group than in the radiopaque stone group (69.5% vs 18.6%; p less than 0.01). However, in patients with multiple stones, the presence of calcification did not affect rates of successful fragmentation or 6-month clearance. There was no statistically significant difference in incidence of complications between the radiolucent and radiopaque stone groups. Although the number of cases are small and the follow-up period is short, our results of ESWL on radiopaque gallstones are so far not satisfactory in terms of stone clearance. Strict patient selection is needed unless there is an improvement in the lithotripsy procedure or post-lithotripsy management.

Adult↗