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Biomedical subjects

G R Kim

Publications and source records attributed to G R Kim.

At least 19 recordsLinked to original sources

Reducing the paper load: computer-based patient records.

Physicians burdened with increasing paper work may find relief in computer-based patient records (CPR). CPRs may aid clinicians in the areas of billing, documentation, reporting, and data retrieval. Value-added features like decision support and event monitoring facilitate patient outcome, decrease health care costs and allow improved administration. The authors discuss obstacles in the use of computers in patient care with a focus on security, confidentiality, and Y2K.

Computer Security↗

Restricted natural language processing for case simulation tools.

For Interactive Patient II, a multimedia case simulation designed to improve history-taking skills, we created a new natural language interface called GRASP (General Recognition and Analysis of Sentences and Phrases) that allows students to interact with the program at a higher level of realism. Requirements included the ability to handle ambiguous word senses and to match user questions/queries to unique Canonical Phrases, which are used to identify case findings in our knowledge database. In a simulation of fifty user queries, some of which contained ambiguous words, this tool was 96% accurate in identifying concepts.

Computer Simulation↗

Molecular biological characterization of enterovirus variant isolated from patients with aseptic meningitis.

In Korea, there was a big outbreak of aseptic meningitis in 1993. Six clinical isolates of enterovirus were obtained from patients with aseptic meningitis and were identified as echovirus type 9 by serotyping with a pool of neutralizing antisera. For molecular characterization of the isolates, the nucleotide sequences of 5'-noncoding region (NCR), VP4, VP2, VP1, 2A and 2C regions of the isolates were compared with the corresponding regions of echovirus type 9 Hill and Barty strains. Unlike Hill strain, Barty strain contained a C-terminal extension to the capsid protein VP1 with an RGD (argnine-glycine-aspartic acid) motif. To determine whether similar structural features were present in our isolates, their nucleotide sequences including the VP1 region were analyzed. All isolates exhibited the VP1 extension with the RGD motif. We concluded the Korean isolates in the year of 1993 as the echovirus type 9 Barty strain although the isolates showed 15-20% nucleotide sequence differences in the several genomic regions.

5' Untranslated Regions↗

Rapid subgrouping of nonpolio enterovirus associated with Aseptic Meningitis by RFLP (Restriction Fragment Length Polymorphism) assay.

In Korea, there was a big outbreak of Aseptic Meningitis due to enterovirus infection in 1993. Since virus isolation and neutralizing tests are too laborious and time-consuming for the detection of enterovirus from clinical specimen, we have developed a new molecular identification method for rapid subgrouping of isolates from patients with aseptic meningitis. For the rapid subgrouping of isolates, RT-PCR (Reverse Transcription-Polymerase Chain Reaction) and RFLP (Restriction Fragment Length Polymorphism) assays were used. We have selected two oligonucleotide primers from the conserved 5'-UTR/VP2 and VP1 regions. A 652 bp (base pair) product was amplified from the 5'-UTR/VP2 region of reference viruses and the isolates. For the subgrouping of the isolates by RFLP assay, we have used 12 reference viruses (Echovirus, E6, E9, E11, E12, Coxsackievirus, CB1, CB3, CB4, CB5, Coxsackievirus, CA9, CA16, CA21, CA24), which are the common viral agents associated with aseptic meningitis. By using subgroup-specific restriction enzymes BsmAI, , HinP1I, and PleI, the isolates were classified into Echovirus subgroups. We have also shown that subgrouping of the isolates by RFLP assay based on the VP1 region is possible.

Capsid↗

Nucleotide sequencing of a part of the 5'-noncoding region of echovirus type 9 and rapid virus detection during the acute phase of aseptic meningitis.

A part of the 5'-noncoding region of echovirus type 9 isolates was sequenced, and an attempt was made for rapid virus detection in clinical samples obtained from 22 subjects hospitalized with aseptic meningitis. The sequence identity of 440-bp products amplified from the region by RT-PCR was 87.7% between the standard echovirus type 9(Hill strain) and the isolates. Specific IgM antibodies to Hill strain were positive in 45.5% by immunofluorescent antibody staining of virus-infected cells. A high detection rate of PCR products was observed in cerebrospinal fluids (CSFs; 54.5%) at admission, and in peripheral mononuclear cells (PMCs; 72.7%) at the end of hospitalization. Viral genomes were detectable for 2 days in serum samples, and for 6 days in PMC samples after onset of disease. When specific IgM antibody titers were less than 1:40, the amplification rate of viral genome from serum samples was 50.0%. These results indicate that the combination of specific IgM determination and viral genome amplification from CSFs will be a rapid and reliable method for early diagnosis.

Acute Disease↗

Genomic characterization of M and S RNA segments of hantaviruses isolated from bats.

Genomic analysis of three Hantaan-like virus isolates from bats was performed. Cleavage patterns of reverse transcription (RT)-polymerase chain reaction (PCR) products and nucleotide sequences of G2 region of M RNA segment and N protein region of S RNA segment of the isolates were compared to that of Hantaan 76-118 strain. Genomic characteristics of the bat isolates were identical to that of Hantaan virus.

Animals↗

A new natural reservoir of hantavirus: isolation of hantaviruses from lung tissues of bats.

Two species of bats were confirmed as new natural reservoirs of hantavirus. Antibodies to Hantaan virus were detected in 3.40% (23 of 677) of bats captured from 1989 to 1992 in Korea by the IFA technique. Areal distribution of immunofluorescent antibody were different, and seropositive rates were much high in sera of bats captured in summer (3.82%) and winter (5.82%). Viral antigens were observed in the lungs (3 of 16) and kidney (1 of 7). Two hantaviruses were isolated from lung tissues of E. serotinus and R. ferrum-equinum through a cell culture system, designated CUMC-92B8 and -92B48, respectively. Using Rous associated virus-2 reverse transcriptase-directed PCR and 2 oligonucleotide primer pairs, genomic sequences of the isolates were amplified. Amplified products of the isolates and reactivities to monoclonal antibodies very closely resembled those of Hantaan virus. These data suggest that the serotype of the isolates is closely related to Hantaan virus, and bats serve as reservoirs of hantavirus.

Animals↗

Variability of the surgical anatomy of the neurovascular complex of the cerebellopontine angle.

The variability of the anatomic relationship of the anterior inferior cerebellar artery (AICA) to the facial (seventh) and vestibulocochlear (eighth) nerves was studied in 52 cerebellopontine angles (CPAs) from 26 adult cadavers. The AICA originated from the basilar artery (98.1%) or from the vertebral artery (1.9%) as a single (92.3% of CPAs) or duplicate (7.7%) artery. Each of the 52 CPAs had one or more arterial trunks that coursed in close proximity to the seventh and eighth cranial nerves and thus were said to be nerve-related. The nerve-related arterial trunks were divided into three segments based on their relationship to the nerves and meatus: the premeatal, meatal, and postmeatal segments. The nerve-related branches of the AICA gave rise to the internal auditory artery in 92.3% of the CPAs, the recurrent perforating artery in 78.8%, and the subarcuate artery in 30.8%. The importance of understanding the surgical anatomy of the neurovascular complex of the CPA when performing a vestibular neurectomy is reviewed.

Adult↗

Magnetic control for the vocal cord adduction in the canine.

An entirely satisfactory and physiologic solution to adduct paralyzed vocal cord during phonation, coughing, and swallowing has not yet been achieved. The authors noticed that velopharyngeal closure takes place simultaneously with adduction of vocal cords in order to perform phonation, coughing, and swallowing. We devised a new laryngeal pacing system to adduct the paralyzed vocal cord, utilizing velopharyngeal closure under magnetic control. Two mongrel dogs were anesthetized and the interior of the larynx was exposed using a Lynch suspension laryngoscope. A small magnet wrapped by thin Silastic was inserted into the nasal side of the soft palate via a small incision. After making a vertical midline neck incision, the pharynx was dissected and the Gaussmeter probe was inserted into the retropharyngeal space. The Gaussmeter probe was connected to the Gaussmeter and finally to the pacemaker. Electrodes were inserted into the paralyzed adductor laryngeal intrinsic muscles via punctures of the cricothyroid membrane. When the pacing system operated, arbitrarily elevated soft palate to the posterior pharyngeal wall brought about an abrupt increase in magnetic force and thus obvious adduction of the paralyzed vocal cords could be seen.

Animals↗

RFLP analysis of HLA-DR beta and -DQ beta genes in the Korean patients with insulin-dependent diabetes mellitus.

Human genomic DNA samples from 19 Korean patients and 31 controls of known serological DR antigen specificity were studied for insulin-dependent diabetes mellitus (IDDM)-associated variation in HLA-DR beta and -DQ beta restriction fragment length polymorphisms (RFLPs). Genotyping allowed for accurate assignment of HLA-DR types. For HLA-DRw6, a 12kb/DR beta/Taq I fragment was decreased in Korean IDDM (p less than 0.05). However, we could not find an increased frequency of a 12kb/DQ beta/Bam HI fragment or decreased frequency of a 3.7kb/DQ beta/Bam HI fragment in Korean IDDM. These results suggest a possible protective role of the HLA-DRw6 specificity in IDDM, irrespective of ethnic background, the absence of a specific DQ beta RFLP pattern associated with IDDM in Koreans, and the difference of the Korean population in the genetic of IDDM, compared to the Caucasoid population.

Asian People↗

Laryngeal pacemaker using a temperature sensor in the canine.

With the use of a temperature sensor that would detect temperature changes during the respiratory cycle in the pharynx, electrical stimulation of the posterior cricoarytenoid muscle was achieved in dogs whose recurrent laryngeal nerves were artificially paralyzed. Due to the temperature difference between inspiratory and expiratory air flow, a trigger pulse was generated at the beginning of inspiration. The stimulation pulse following the trigger pulse stimulated the electrodes inserted into the posterior cricoarytenoid muscles. In all five canines, obvious abduction of the vocal folds synchronized with inspiration was observed during electrical pacing.

Animals↗

Ribavirin therapy for Hantaan virus infection in suckling mice.

We recently reported that ribavirin inhibited Hantaan virus (HV) replication in vitro. In the present study, we used the HV suckling mouse model to evaluate the efficacy of treatment with various doses of ribavirin. Beginning on day 10, untreated animals, infected with ten times the amount of HV (strain 76/118) required to kill 50% of the animals, lost weight; by days 15 to 18, they developed paralysis of both hind limbs, and they died between days 20 and 21. Treatment with 50 mg of ribavirin/kg per day begun on day 10-following onset of early clinical signs and demonstrable virus in serum and organs--saved 11 of 20 animals compared with 0 of 70 controls. Treated animals did not develop further signs of infection, and by day 22, survivors resumed normal weight gain. After ribavirin treatment, titers of virus decreased in serum, liver, and spleen by two days; in lung within six days; and in the kidney by eight days. By day 18, titers in organs of treated animals were 100-fold lower than in sham-treated animals, with the exception of the brain. Titers of virus in brain fell by day 20, when virus in untreated animals reached greater than 10(7) pfu/g. Treated survivors continued to have decreasing titers of virus in organs and were followed for 75 days with no sign of disease recurrence.

Animal Population Groups↗

Hantaan virus infection in suckling mice: virologic and pathologic correlates.

The Hantaan virus suckling mouse model was examined to delineate virologic and histopathologic characteristics of infection at the organ level. Viral antigen and infectious virus were detected in all organs examined, with highest titers achieved in brain, lung, and kidney. A constellation of histologic lesions was identified in brain (diffuse meningoencephalitis with bilaterally symmetrical thalamic necrosis), liver (pericholangiohepatitis), lung (pneumonitis), and spleen (lymphoid hyperplasia); this tetrad is apparently unique to this model system. The chronology of clinical, virologic, serologic, and pathologic findings in Hantaan-infected newborn mice suggests an immune-mediated mechanism in disease pathogenesis.

Animals↗

Pathogenesis of Hantaan virus infection in suckling mice: clinical, virologic, and serologic observations.

Hemorrhagic fever with renal syndrome (HFRS) is a debilitating disease of humans caused by Hantaan virus (HV), the prototype member of a newly proposed genus of Bunyaviridae. Studies of HV pathogenesis have been limited by the absence of a well defined model for a virus-induced disease state. In an attempt to devise a model for HV pathogenesis in laboratory rodents, newborn outbred suckling ICR mice were shown to be uniformly susceptible to lethal infection with non-mouse adapted HV by intracerebral (IC), intraperitoneal (IP), intramuscular (IM), and subcutaneous (SC) inoculation routes. Clinical course, mean time to death, and fatal outcome were age-dependent. With an inoculum of 10 LD50, mortality was 100% in mice infected within 72 hr of birth, but declined to 50% by 7 days. By 2-2.5 weeks, animals developed complete resistance to clinical disease. Virus was consistently detected in serum by day 6 post-infection in IC- and IP-inoculated animals, and reached peak levels of congruent to 10(5) PFU/ml by day 8. Mice infected IM and SC showed delays in onset of viremia, but achieved similar titers. Immunofluorescent antibody appeared by 17-18 days, and neutralizing antibody by 15 days, in all experimental groups. Two of 8 inbred mouse strains were identified as resistant to clinical disease: SJL/J and A/J.

Age Factors↗