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Biomedical subjects

D W Kim

Publications and source records attributed to D W Kim.

At least 127 records · Page 7Linked to original sources

Topotecan-based combination chemotherapy in patients with transformed chronic myelogenous leukemia and advanced myelodysplastic syndrome.

BACKGROUND: Patients with transformed chronic myelogenous leukemia(CML) and advanced myelodysplastic syndrome(MDS) have poor prognosis. The aim of this study is to evaluate the feasibility of second chronic phase induction in accelerated phase(CML-AP) or blastic crisis of CML(CML-BC) and remission induction in advanced MDS by combining topoisomerase I inhibitor (topotecan) with topoisomerase II inhibitor(mitoxantrone). METHODS: Twenty-four evaluable patients were entered on this study with a median age of 34 years. Eighteen patients with transformed CML(7 CML-AP, 11 CML-BC) and 6 patients with advanced MDS were treated. Topotecan was administered as 1.5 mg/m2/day by continuous infusion over 24 hours daily for 5 days every 4 to 8 weeks until remission. To enhance the tumoricidal effects, mitoxantrone(12 mg/m2/day, Days 1-3) was added. RESULTS: Eight patients(33%) achieved a complete remission(CR). Four of 7 patients with CML-AP(57%), 2 of 4 patients with CML-lymphoid blastic crisis (-LBC)(50%) and 2 of 6 patients with advanced MDS(33%) had CR lasting more than 45 days(45 to 400 days). There was no CR in the patients with CML-myeloid blastic crisis(-MBC). The dose level of 1.5 mg/m2/day(7.5 mg/m2/course) of topotecan was well tolerated in all patients. Mucositis occurred in 69% of patients (severe in 5%) and diarrhea in 67%(severe in 8%). In addition, there were no new or unexpected toxicities in the patients who were treated at this dose(7.5 mg/m2/course). In patients who recovered their neutrophil count, the absolute neutrophil count(ANC) remained below 500/microL for a period of 13 to 58 days(median 21 days) and the time to ANC recovery was associated with pretreatment severity of bone marrow fibrosis(mainly CML patients). Likewise, in the patients who recovered unsupported platelets, the platelets remained below 20,000/microL for a period of 0 to 37 days (median 19 days). CONCLUSION: The combination of topotecan-mitoxantrone has shown modest activity in CML-AP, CML-LBC and advanced MDS with acceptable toxicities.

Adult↗

Effects of mixed chimerism and immune modulation on GVHD, disease recurrence and survival after HLA-identical marrow transplantation for hematologic malignancies.

BACKGROUND: The success of allogeneic bone marrow transplantation(allo-BMT) is affected by underlying disease relapse. Although mixed chimerism(MC) is not necessarily a poor prognostic factor, several groups have suggested that MC is associated with an increased risk of disease relapse. There is evidence that patients with MC benefit from additional immunotherapy if the treatment is started in minimal residual disease status(mixed chimerism status), not in frank hematological relapse. The purposes of this study are to evaluate 1) the risk for relapse or graft rejection in correlation to persistent MC status after allo-BMT, and 2) the possibility of preventing relapse by immune modulation treatments (withdrawal or rapid taper-off of post-transplant immuno-suppression, additional interferon treatment, or the administration of donor lymphocytes) in hematologic malignancies. PATIENTS AND METHODS: Of 337 allogeneic donor-recipient pairs between March 1996 and August 1998, 12 patients who showed persistent or progressive MC and who received immune modulation treatments were evaluated. Twelve patients, median age 31 years(range 9 to 39 years), received an allo-BMT for: acute myelogenous leukemia(AML, n = 5), chronic myelogenous leukemia(CML, n = 4), acute lymphocytic leukemia(ALL, n = 3). Serial polymerase chain reaction(PCR) analysis of YNZ 22-, 33.6-minisatellites or Y chromosome-specific PCR analysis at short term intervals(pre- and post-transplant 1, 3, 6, 9, ... months) was performed. Once MC was detected, immune modulation treatments on the basis of increasing MC in an early phase of recurrence of underlying disease were started. RESULTS: Nine of 12 patients converted to complete chimerism(CC) (AML 5/5, CML 3/4, ALL 1/3). Four of 9 CC patients developed graft-versus-host disease(GVHD) grade < or = 2 during immune modulation. All were treated successfully with steroids. Three patients who were not converted to CC showed relapse of underlying diseases or graft failure. CONCLUSION: The results demonstrate that, in patients with hematologic malignancies after allo-BMT, persistent MC is associated with relapse of underlying diseases or graft failure. Furthermore, when patients receive early immune modulation treatment, MC can be changed to complete donor pattern chimerism and ultimately prevent relapse.

Adolescent↗

Short-term vestibular responses to repeated rotations.

To investigate the short-term vestibular habituation, we performed the 4 successive velocity step tests on 28 volunteers, the peak velocity of which was 100 deg/sec with acceleration and deceleration of 100 deg/sec2. As the repeated rotations might alter the vestibulo-ocular reflex (VOR), sinusoidal rotations at a frequency of 0.16 Hz were also given before and after the 4 successive velocity step tests to investigate the changes of gain and phase of VOR. The 28 volunteers were divided into two groups, group I and II, according to their responses to repeated rotations. In group I (25 subjects, mean age 23.7 year), the mean values of the slow cumulative eye position (SCEP), the time integral of eye velocity during nystagmus, was reduced after each trial of the 4-successive velocity step tests as follows; 403.4 +/- 29 degree (1st trial), 346.2 +/- 37 degree (2nd trial), 278.3 +/- 33 degree (3rd trial) and 256.6 +/- 36 degree (4th trial). The time constant of the nystagmus was also reduced as follows; 12.9 +/- 0.78 second (1st trial), 12 +/- 0.63 second (2nd trial), 9.7 +/- 0.78 second (3rd trial) and 9.9 +/- 0.54 second (4th trial). In group II (3 subjects, mean age 28.3 year), the mean values of SCEP gradually increased; 774.3 +/- 135 degree (1st trial), 1127 +/- 178 degree (2nd trial), 1096.3 +/- 123.4 degree (3rd trial) and 1225.7 +/- 199.7 degree (4th trial). The time constant of the nystagmus increased; 15.7 +/- 2.7 second (1st trial), 22 +/- 4.5 second (2nd trial), 22.3 +/- 3.3 second (3rd trial) and 23.3 +/- 5.7 second (4th trial). The gain of vestibulo-ocular reflex (VOR) induced by sinusoidal rotations at a frequency 0.16 Hz increased in both groups: 0.59 +/- 0.03 to 0.78 +/- 0.06 (group I) and 0.65 +/- 0.07 to 1.15 +/- 0.06 (group II). Phase changes were also observed. In group I, the phase was shifted from 0.6 +/- 0.6 degree to -0.40 +/- 0.6 degree. In group II, the phase was shifted from 3.67 +/- 1.86 degree to -0.33 +/- 0.33 degree. The repeated rotation did not induce a common nystagmic response in all subjects. Thus, person to person variations should be considered in short term vestibular habituation.

Adult↗

Effects of age and dietary restriction on animal model SAMP8 mice with learning and memory impairments.

This study was to investigate a hypothesis that dietary restriction (DR) suppresses learning and memory impairments in dementia animal model SAMP8 mice. Four-week-old female SAMP8 mice were fed either ad libitum (AL) or fed restricted (40% of the food consumed by AL). Results showed that acetylcholine (ACh) levels in hippocampus at aged 12 months of age were 12% higher in DR than that of AL group. Dopamine (DA) and norepinephrine (NE) levels in cerebellum at 8 and 12 months of age were significantly higher (26~94% and 34~43%, respectively) in DR group than those in AL group. Serotonin (5-HT) levels in cerebellum at aged 12 months of age were markedly increased (~53%) in DR group. Homovanillic acid (HVA) and 5-hydroxyindole acetic acid (5-HIAA) levels in cerebellum at 8 and 12 months of age were significantly increased (28~41% and 24~64%, respectively) in DR group compared with AL group. In addition, neurotransmitter-related enzymes, choline acetyltransferase (ChAT) and acetylchoinesterase (AChE) activities at 8 and 12 months of age were elevated (6~8% and 5~7%, respectively) in DR group. Monoamine oxidase-B (MAO-B) that catalyzes oxidative deamination in brain were suppressed by 7~10% in DR group. At aged 12 months of age, the generation of basal and induced reactive oxygen species (ROS) in brain significantly decreased by 20% in DR group compared with AL group. These results suggest that inhibitory effect of oxidative stress by DR may play a pivotal role in attenuating the age-related changes observed in dementia animal model SAMP8.

Age Factors↗

Necrotizing enterocolitis: experience of 27 cases from a single Korean institution.

Necrotizing enterocolitis (NEC) can involve any site in the gastrointestinal tract and is a fatal complication of immunosuppression. To characterize NEC, clinical and radiological characteristics were analyzed. A total of 27 cases of NEC were identified from January 1993 to August 1998, and medical records were reviewed. NEC was diagnosed by clinical and radiological criteria, and other mimicking conditions were excluded. Of the NEC cases, 22 (81.5%) occurred in patients with underlying hematologic malignancy. All patients complained of abdominal pain and fever at the time of inclusion. Escherichia coli was the most common pathogen identified. The most common finding by computed tomography was single-layered diffuse bowel wall thickening with variable density. Other findings were ascites, fascial thickening, pneumatosis, and mesenteric lymphadenopathy. Of the patients, 25 were treated with antimicrobials with or without recombinant hematopoietic growth factors, and 2 were treated with surgery because of perforation and profound bleeding. Among the 12 patients who died, NEC was the direct cause of death in 7 patients. In conclusion, computed tomography is an effective tool for early diagnosis of NEC. Bowel rest, broad-spectrum antimicrobials, and recombinant hematopoietic growth factors are important aspects of treatment. Surgery should be reserved for complicated cases.

Adolescent↗

Phase II clinical trial of SKI-2053R, a new platinum analog, in the treatment of patients with advanced gastric adenocarcinoma.

BACKGROUND: SKI-2053R (SK Chemicals, Kyungki-Do, South Korea) is a new platinum derivative with antitumor activity against various cell lines, including cisplatin-resistant tumor cell lines. Preclinical studies have suggested that it is less nephrotoxic than cisplatin. This study evaluated the efficacy and toxicity of SKI-2053R in the treatment of patients with advanced gastric adenocarcinoma. METHODS: Thirty-seven patients with advanced gastric adenocarcinoma that was unresectable or metastatic were treated. No prior chemotherapy or radiotherapy was allowed. Patients received SKI-2053R 360 mg/m(2) by 1-hour infusion on Day 1. After the first cycle, subsequent doses were adjusted according to the toxicity. Courses were repeated every 28 days. RESULTS: Thirty-five patients were evaluable for response and toxicity. Six patients achieved a major response (17%; 95% confidence interval, 8-33%); 2 were complete and 4 were partial responses. The median duration of response was 7.2 months, with a range of 1-20 months. Patients could tolerate the treatment without significant toxicity. No patients had Grade 3 or 4 toxicity. The most frequent toxicity was Grade 1 or 2 proteinuria (26% of cycles), but it was mild and transient. Leukopenia, thrombocytopenia, azotemia, nausea and vomiting, and neurotoxicity were not frequent. These low toxicity profiles indicated that the dose of SKI-2053R could be increased in future studies. CONCLUSIONS: SKI-2053R was active in the treatment of patients with gastric adenocarcinoma and had favorable toxicity profiles.

Adenocarcinoma↗

Measurement of leg arterial compliance of normal subjects and diabetics using impedance plethysmography.

In this study, compliance, a mechanical characteristic of the lower leg arteries, was measured noninvasively. Changes in blood volume and pressure were measured using impedance plethysmography and a mercury sphygmomanometer, respectively. Compliance was calculated by dividing the change in blood volume by the change in pulse pressure (systolic-diastolic pressure). Subjects were 24 asymptomatic persons ranging from 30 to 58 years and 14 diabetics ranging from 41 to 59 years. Peak compliance, mean pressure, and systolic pressure were statistically analyzed using a t test between the asymptomatic and diabetic groups. The average peak compliance of the asymptomatic and diabetic groups was measured as 2.79 and 1.82 microL/mmHg/cm, respectively, and these were significantly different (p < 0.01). It was also found that compliance is a better parameter in differentiating vascular disease than the mean or systolic blood pressure.

Adult↗

Chondroid hamartoma presenting as a neonatal nasal mass.

We present a case of a 3-month-old female with a right nasal mass. Upon evaluation with computed tomography, magnetic resonance imaging and angiography, a large right intranasal mass extending through the cribiform plate, displacing the dura, was noted. The patient underwent a combined midfacial degloving and bifrontal craniotomy for complete resection of the tumor mass. Pathologic evaluation demonstrated a mesenchymal tumor with spindle and stellate cells from which islands of immature cartilage emerged. The spectrum of histologic features closely resembled a mesenchymal chondroid hamartoma typically located in the chest wall. It is the first reported case of a chondroid hamartoma of the head and neck in the literature to date. We examine the characteristics and treatment of this unusual tumor.

Diagnostic Imaging↗

Intra-articular ganglion cysts of the knee.

A ganglion is a cystic mass with myxoid matrix that occasionally occurs within muscles, tendons, and menisci. A ganglion cyst within the knee is very rare, with few reports to be found. We are reporting eight cases of a ganglion within the knee joint. Our cases include two ganglia in the infrapatellar fat pad which have not been previously reported. Ganglion cysts do not have specific symptoms. We hypothesize that symptoms of a ganglion cyst may correlate with the size and the location within the knee joint. The diagnosis of ganglia within the knee was established by magnetic resonance imaging study and confirmed by pathological testing. All the patients were treated successfully using the arthroscopic technique.

Adolescent↗

Age-dependent differences in flurothyl seizure sensitivity in mice treated with a ketogenic diet.

Despite strong clinical data confirming the anticonvulsant efficacy of a ketogenic diet (KGD) in pediatric patients, corroborative experimental data in young animals are limited. In the present study, the effects of a KGD on flurothyl seizure susceptibility were examined in normal juvenile mice after a dietary duration of 3, 7, or 12 days, and in adult mice for 15 days. In all groups of KGD-treated mice, blood beta-hydroxybutyrate levels were significantly elevated over those measured in controls. The present KGD was anticonvulsant (i.e. delayed onset) against the first (clonic) flurothyl-induced seizure for juvenile mice treated for either 7 or 12 days, but not for juvenile mice and adult mice fed the diet for 3 and 15 days, respectively. While this KGD was not anticonvulsant against the second (tonic extension) seizure induced by flurothyl in any of the juvenile groups, it significantly delayed tonic extension in the adult group. In addition, juvenile mice fed a KGD exhibited a lower mortality rate following flurothyl-induced seizures compared to mice fed a standard diet. In our discussion of animal models of the KGD, we highlight the need to understand better the impact of important variables such as dietary composition, genetic background, and mode of seizure induction in the study of the KGD.

3-Hydroxybutyric Acid↗

Involvement of superoxide and/or nitric oxide in renal tissue injury.

We examined the influence of superoxide (O2-) and/or nitric oxide (NO) on renal tissue injury estimated from the levels of lipid peroxidation and sulfhydryl (SH) oxidation. Pyrogallol, an O2- generator and precursor of hydrogen peroxide, produced marked tissue injury, but this was prevented by superoxide dismutase (SOD)/catalase (CAT). Hemoglobin (Hb), a NO scavenger, provided protection from tissue injury caused by sodium nitroprusside (SNP). The tissue injury produced by 3-morpholinosydnonimine (SIN-1), which is thought to form peroxynitrite (ONOO-) as a simultaneous O2- and NO generator, was blocked by SOD/CAT or Hb. On the other hand, protein-SH and nonprotein-SH were significantly increased by addition of SOD/CAT or Hb. These data suggest that the renal tissue injury induced by O2-, NO and ONOO- can be blocked by SH, suggesting an important protective role against these reactive oxygen species in the mechanism of tissue defense.

Animals↗

The effect of syringe size on the performance of an infusion pump.

This study investigated the effect of using three different sized syringes on the accuracy of fluid delivery when using an infusion pump at low infusion rates (1 ml.h-1). The study also measured the influence of the syringe size on the time to occlusion alarm, and on the size of the subsequent bolus dose that might be infused after relief of the occlusion which triggered the alarm. The use of a larger size syringe was found not to affect the accuracy of infusate delivery, but delayed the time to occlusion alarm and increased the size of the postocclusion bolus dose.

Equipment Design↗

The changes in hair growth pattern after autologous hair transplantation.

BACKGROUND: Recently donor dominance has been emphasized in autologous hair transplantation while the influence of the recipient site has been considered negligible. In fact, there have been few studies that show this. OBJECTIVE: This study was performed to examine the influence of the recipient site on transplanted hairs. A clinical study of 19 leprosy patients was performed. These patients had received single hair transplantation due to madarosis and were admitted to The Leprosy Mission, Jesus Hospital, Taegu, Korea, or had visited its outpatient clinic. METHODS: In this study, the rate of growth, thickness of shaft, and graying rate between the transplanted eyebrow hair in the recipient site and scalp hair near the donor site were compared to observe the changes in the growth pattern of the hairs after transplantation. RESULTS: For most of the patients, the growth rate and graying rate of transplanted hairs were lower than those of hairs in the donor site. CONCLUSION: It seems that the recipient site may have an influence on the transplanted hairs. Further studies are needed, including clinical, histopathologic, and molecular biological methods.

Aged↗

Development of the Valvo pump: an axial flow pump implanted at the heart valve position.

Pulsatile artificial hearts having a relatively large volume are difficult to implant in a small patient, but rotary blood pumps can be easily implanted. The objective of this study was to show the feasibility of using the Valvo pump, an axial flow pump implanted at the heart valve position, in such cases. The Valvo pump consists of an impeller and a motor. The motor is waterproofed with a ferrofluidic seal. A blood flow of 5 L/min was obtained at a pressure difference of 13.3 kPa (100 mm Hg) at 7,000 rpm. The normalized index of hemolysis (NIH) was 0.030 +/- 0.003 (n = 3) for a blood flow of 5 L/min at a pressure difference of 13.3 kPa. The pressure resistance of the ferrofluidic seal was 37.5 kPa in a static condition and 26.3 kPa at 10,000 rpm. The seal exhibited no leaks for 41+ days against 20.0 kPa. The results showed that the Valvo pump can maintain systemic circulation with an acceptable level of hemolysis.

Animals↗

High-copy suppressor analysis reveals a physical interaction between Sec34p and Sec35p, a protein implicated in vesicle docking.

A temperature-sensitive mutant, sec34-2, is defective in the late stages of endoplasmic reticulum (ER)-to-Golgi transport. A high-copy suppressor screen that uses the sec34-2 mutant has resulted in the identification of the SEC34 structural gene and a novel gene called GRP1. GRP1 encodes a previously unidentified hydrophilic yeast protein related to the mammalian Golgi protein golgin-160. Although GRP1 is not essential for growth, the grp1Delta mutation displays synthetic lethal interactions with several mutations that result in ER accumulation and a block in the late stages of ER-to-Golgi transport, but not with those that block the budding of vesicles from the ER. Our findings suggest that Grp1p may facilitate membrane traffic indirectly, possibly by maintaining Golgi function. In an effort to identify genes whose products physically interact with Sec34p, we also tested the ability of overexpressed SEC34 to suppress known secretory mutations that block vesicular traffic between the ER and the Golgi. This screen revealed that SEC34 specifically suppresses sec35-1. SEC34 encodes a hydrophilic protein of approximately 100 kDa. Like Sec35p, which has been implicated in the tethering of ER-derived vesicles to the Golgi, Sec34p is predominantly soluble. Sec34p and Sec35p stably associate with each other to form a multiprotein complex of approximately 480 kDa. These data indicate that Sec34p acts in conjunction with Sec35p to mediate a common step in vesicular traffic.

Amino Acid Sequence↗

Electric and laser energy for endoscopic surgery.

Improvements in surgery have focused on refinements in the ability to dissect and limit blood loss. The electrosurgery unit (ESU) and laser (light amplification by stimulated emission of radiation) have been widely used in recent endoscopic surgery. ESU is a form of surgery in which high-frequency (100 kHz-5 MHz) electric currents are used to incise, destroy, and remove tissue and to seal blood vessels in order to maintain hemostasis. The use of lasers in surgery has added a new dimension to operative technique through increased precision, improved hemostasis, and less tissue manipulation. This paper aims to explain the basic principles and applications of electrosurgery and lasers.

Electrosurgery↗

Clonazepam release from poly(DL-lactide-co-glycolide) nanoparticles prepared by dialysis method.

Aim of this work is to prepare poly(DL-lactide-co-glycolide) (PLGA) nanoparticles by dialysis method without surfactant and to investigate drug loading capacity and drug release. The size of PLGA nanoparticles was 269.9 +/- 118.7 nm in intensity average and the morphology of PLGA nanoparticles was spherical shape from the observation of SEM and TEM. In the effect of drug loading contents on the particle size distribution, PLGA nanoparticles were monomodal pattern with narrow size distribution in the empty and lower drug loading nanoparticles whereas bi- or trimodal pattern was showed in the higher drug loading ones. Release of clonazepam from PLGA nanoparticles with higher drug loading contents was slower than that with lower loading contents.

Clonazepam↗

Growth inhibitory activities of kalopanaxsaponins A and I against human pathogenic fungi.

Antifungal activities of the compounds isolated from Kalopanax pictus against representative fungi of dermatomycosis were investigated using paper disc diffusion method. It was found that kalopanaxsaponins A and I were effective in inhibiting the growth of Candida albicans KCTC 1940 and Cryptococcus neoformans KCTC 7224 with minimum inhibitory concentration (MIC) of 25 micrograms/ml. It showed that antifungal activity of both compounds have strong selectivity against the fungi of dermatomycosis.

Antifungal Agents↗