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Biomedical subjects

H Kim

Publications and source records attributed to H Kim.

At least 235 records · Page 13Linked to original sources
PubMed2001

Urinary stones following renal transplantation.

BACKGROUND: The formation of urinary tract stones following renal transplantation is a rare complication. The clinical features of stones after transplantation differ from those of non-transplant patients. Renal colic or pain is usually absent and rarely resembles acute rejection. METHODS: We retrospectively studied 849 consecutive kidney transplant patients in The Rogosin Institute/The Weill-Cornell Medical Center, New York who were transplanted between 1980 and 1997 and had functioning grafts for more than 3 months, to determine the incidence of stone formation, composition, risk factors and patient outcome. RESULTS: At our center, urinary stones were diagnosed in 15 patients (1.8%) of 849 functioning renal grafts for 3 or more months. Of the 15 patients, 10 were males and 5 were females in their third and fourth decade. Eight patients received their transplant from living donors and 7 from cadaveric donors. The stones were first diagnosed between 3 and 109 months after transplantation (mean 17.8 months) and 5 patients had recurrent episodes. The stones were located in the bladder in 11 cases (73.3%), transplanted kidney in 3 cases and in multiple sites in one case. The size of stones varied from 3.4 mm to 40 mm (mean 12 mm). The composition of stones was a mixed form of calcium oxalate and calcium phosphate in 5 cases and 4 patients had infected stones consisting of struvite or mixed form of struvite and calcium phosphate. Factors predisposing to stone formation included tertiary hyperparathyroidism (n = 8), hypercalciuria (n = 5), recurrent urinary tract infection (n = 5), hypocitraturia (n = 4), and obstructive uropathy (n = 2). Many cases had more than one risk factor. Clinically, painless hematuria was observed in 6 patients and dysuria without bacteriuria in 5 patients. None had renal colic or severe pain at any time. There were no changes in graft function at diagnosis and after removal of stones. Five patients passed stones spontaneously and 8 patients underwent cystoscopy for stone removal. CONCLUSION: Urinary stone formation following kidney transplantation is a rare complication (1.8%). Hyperparathyroidism, hypercalciuria, recurrent urinary tract infection and hypocitraturia are the most common risk factors, but often there are multiple factors which predispose to stone formation. To detect stones and determine their location and size, ultrasonography appears to be the most useful diagnostic tool. Prompt diagnosis, the removal of stones and stone-preventive measures can prevent adverse effects on renal graft outcome.

Adult↗
PubMed2001

Kidney transplantation in patients with type 1 diabetes mellitus: long-term prognosis for patients and grafts.

Kidney transplantation is the best therapeutic choice to improve survival and quality of life in patients with end-stage diabetic nephropathy. Long-term prognosis in diabetic patients who received kidney transplants, however, has not been delineated. We, therefore, studied patient and graft survival, graft function and cause of graft failure in 78 Type I diabetic kidney transplant recipients in The Rogosin Institute/The Weill-Cornell Medical Center, New York who had functioning grafts for more than one year. The results were compared with 78 non-diabetic patients who had functioning grafts for more than one year and were matched for age, gender, donor source, time of transplantation and immunosuppressive therapy protocol. Cumulative patient survival rates for diabetic patients were significantly lower than those of non-diabetic patients (86% vs. 97% at 5 years and 74% vs. 95% at 10 years, respectively; p < 0.05). The most common cause of death was cardiovascular disease. Graft survival rates for diabetic patients were also lower than that of non-diabetic patients (71% vs. 80% at 5 years and 58% vs. 72% at 10 years, respectively), but the differences did not reach statistical significance. Among the 22 failed grafts in diabetic patients, 7 (32%) were due to patient death rather than primary graft failure. If the patients who died with a functioning graft were censored, graft survival rates of diabetic patients approached those of non-diabetic patients (80% vs. 81% at 5 years and 65% vs. 73% at 10 years, respectively). Creatinine clearances in diabetic patients were lower than that in non-diabetic patients through the follow-up period, but the differences were significant only for the first few years. At no time was there a higher creatinine clearance for diabetic patients. Among the 16 patients who had transplant kidney biopsies two to seven years post-transplant, 6 showed morphological changes consistent with diabetic nephropathy. One patient lost graft function solely by recurrent diabetic nephropathy. We conclude that long-term patient survival for diabetic patients is significantly lower than that of non-diabetic patients, due primarily to cardiovascular disease. Graft survival is comparable between the two groups. Creatinine clearances of diabetic patients are lower than those of non-diabetic patients. There is no apparent glomerular hyperfiltration at any time in diabetic patients. Recurrence of diabetic nephropathy is a rare cause of graft failure in the first 10 year post-transplant period. Aggressive intervention to modify cardiovascular risk factors should improve patient and graft survival in diabetic kidney transplant recipients.

Adult↗
PubMed2001

Predictors for benign solitary pulmonary nodule in tuberculosis-endemic area.

BACKGROUND: Solitary pulmonary nodule (SPN) may show different presentation in tuberculosis (TB)-endemic countries. The aim of this study was to identify clinical and radiological predictors favoring benign or malignant SPN in TB-endemic region. METHODS: Two hundred one SPNs in 201 consecutive Korean patients were included (< 3 cm in diameter, all confirmed by pathology or bacteriology, 93 benign and 108 malignant diseases). For clinical parameters, age, sex, smoking status and amount, and past history of pulmonary tuberculosis and diabetes mellitus were investigated retrospectively. For radiological parameters, size, location, margin characteristics, presence of calcification, pleural tag, surrounding satellite nodule, cavitation, internal low attenuation, open bronchus sign, surrounding ground-glass opacity, enhancement pattern of the SPNs and mediastinal lymph node (LN) enlargement were analyzed on chest CT scans. RESULTS: Patients with a older age (60.7 +/- 9.6 vs 56.2 +/- 13.1, p = 0.008) and more than 40-pack years smoking (27.8% vs 14.0%, p = 0.017) were more frequently related with malignant than benign SPN. On chest CT scans, spiculated margin, contrast enhancement more than 20 Hounsfield unit and presence of pleural tag and mediastinal LN enlargement were more frequently observed in malignant than benign SPNs. In contrast to previous studies, satellite lesions (21.5% vs 1.9%, p < 0.001) and cavitation (20.4% vs 5.6%, p = 0.001) were more frequently seen in benign than malignant SPN. Positive predictive values of benignity were 90.9% and 76.0%, respectively, when satellite lesions and cavitation were found in cases of SPN. CONCLUSION: Satellite lesions and cavitation on chest CT scan could be useful predictors for benign SPN in TB-endemic areas.

Adult↗
PubMed2001

Identification of novel deletion regions on chromosome arms 2q and 6p in breast carcinomas by amplotype analysis.

DNA fingerprinting by arbitrarily primed PCR (AP-PCR) was employed to identify molecular genetic alterations in 37 primary breast carcinomas. AP-PCR is a PCR-based technique that uses only one primer of arbitrary sequence that generates a molecular karyotype (amplotype) of tumors. The breast cancer amplotype generated with two arbitrary primers (MCG1 and Blue) showed a relatively high frequency (more than 20% of the tumors) of gains at chromosomes 1, 4, and 8, and of losses at chromosomes 2, 4, 6, 9, 10, 11, 13, and the X chromosome. We further analyzed the regions most commonly gained at chromosome 8 (47%) and lost at chromosomes 2 (38%) and 6 (49%) by determining the subchromosomal localization of the fingerprint bands from these chromosomes. The region of gain at chromosome 8 was mapped at 8q24.1, close to MYC. Band MCG1-A1 was assigned to chromosome band 2q22, and band Blue-J was assigned to 6p21. Common losses of these chromosomal regions have not been described for breast cancer. To map these deletion regions more precisely, we performed loss of heterozygosity (LOH) analysis by microallelotyping on 20 of the 37 cancers previously analyzed by AP-PCR and another additional 52 breast carcinomas. The results suggest that the regions at 2q21-24 and 6p21-23 may harbor novel tumor suppressor genes for breast cancer. LOH at 2q21-24 (D2S2304) was more frequent in high-grade tumors (59%) than in low-grade tumors (29%) (P = 0.03). This suggests that this genetic alteration may be associated with tumor progression and shows the power of the amplotype approach in detecting novel genetic alterations that are useful as clinical parameters of breast cancer.

Breast Neoplasms↗
PubMed2001

Differential induction of rat hepatic cytochromes P450 3A1, 3A2, 2B1, 2B2, and 2E1 in response to pyridine treatment.

Pyridine (PY) effects on rat hepatic cytochromes P450 (CYP) 3A1 and 3A2 expression were examined at the levels of metabolic activity, protein, and mRNA and were compared with those of CYP2B1/2 and CYP2E1. CYP3A metabolic activity as well as CYP3A protein and mRNA levels increased following treatment of rats with PY. CYP3A1 and CYP3A2 were differentially affected by PY treatment in terms of induction levels, dose dependence, and stability of mRNA. CYP3A1 mRNA levels maximally increased ~42-fold after PY treatment, whereas CYP3A2 mRNA level increased ~4-fold. Moreover, CYP3A1 mRNA levels decreased more rapidly than those of CYP3A2 as determined following inhibition of transcription with actinomycin D or cordycepin. Treatment of rats with PY resulted in a dose-dependent increase in CYP3A1, CYP3A2, and CYP2B1/2B2 protein levels. In contrast to the effects of PY treatment on CYP3A1 and 2B, CYP2E1 protein levels increased in the absence of a concomitant increase in CYP2E1 mRNA levels. Treatment of rats with PY at 200 mg/kg/day for 3 days increased both protein and mRNA levels of CYP3A2, whereas treatment with higher than 200 mg/kg/day for 3 days increased CYP3A2 protein levels without an increase in CYP3A2 mRNA levels. These data demonstrated that PY regulates the various CYPs examined in this study at different levels of expression and that PY regulates CYP3A1 expression through transcriptional activation and CYP3A2 expression through transcriptional and post-transcriptional activation at a low- and high-dose PY treatment, respectively.

Animals↗
PubMed2001

Independent association of angiogenesis index with outcome in prostate cancer.

New molecular factors have been characterized that are associated with the prognosis of prostate carcinoma patients, including p53 status and angiogenesis. We reported recently that mutant p53 (mp53) was associated with decreased expression of an endogenous inhibitor of angiogenesis, thrombospondin-1 (TSP-1), and increased microvessel density in melanoma and breast cancer. In this study, we performed a similar analysis on primary prostate carcinoma to determine whether these factors were associated with each other or patient outcomes. Paraffin-embedded specimens of 98 cases of primary prostate carcinoma were obtained and examined to confirm tissue diagnosis and Gleason scores. Carcinoma-specific levels of p53, TSP-1, and tumor angiogenesis were determined using semiquantitative immunohistochemistry (IHC) methods. Acquisition of mp53 was significantly associated with decreased TSP-1 (P = 0.002) and increased angiogenesis (P < 0.0001). An angiogenesis index integrating mp53, TSP-1, and angiogenesis (CD31) scores was found to be an independent predictor of survival in univariate and multivariate analyses that included Gleason score, clinical stage, and patient age. Further validation of the angiogenesis index in prostate carcinoma may provide a new tool to stratify patient risk.

Adenocarcinoma↗
PubMed2001

Experimental use of an illuminated and magnetic tip, flow-directed pulmonary artery catheter for lung resection.

The authors performed a study to design and evaluate a device giving the surgeon added protection against pulmonary artery injury in a closed thoracic compartment. Eleven swine were used for a total of 12 lobectomies. A light-bearing, magnetic-tipped, modified Swan-Ganz catheter was passed through the jugular vein into the left pulmonary artery. By using magnetic guidance through a port site and balloon inflation, cessation of flow in the pulmonary artery was documented by Doppler. Twelve video-assisted lobectomies were performed. Nine of 12 (75%) lobectomies were completed successfully by using the magnetic-tipped, illuminated balloon catheter. In 4 cases, the catheter displaced because of the short left main pulmonary artery in swine. In one case, the balloon was recovered, and successful lobectomy was performed. The use of a magnetic-tipped, flow-directed device may provide an effective means of endovascular control during thoracoscopic pulmonary arterial dissection.

Animals↗
PubMed2001

Health related quality of life differences between black and white men with prostate cancer: data from the cancer of the prostate strategic urologic research endeavor.

PURPOSE: Understanding the potential consequences of racial differences in prostate cancer outcomes, from survival rates to quality of life considerations, is important for the clinician and patient. We examined demographic, clinical and health related quality of life data comparing black with white patients just after treatment of prostate cancer and 1 year later. MATERIALS AND METHODS: We analyzed data on 1,178 patients who were newly diagnosed with prostate cancer in the Cancer of the Prostate Strategic Urologic Research Endeavor, a national observational database of men recruited from 35 community and academic urology practices throughout the United States. Patient demographics, clinical characteristics and validated health related quality of life questionnaires were reviewed. A total of 958 white and 161 black patients with prostate cancer who completed at least 2 surveys were compared. RESULTS: The black patients were younger, and had lower income and education levels than white patients. Controlling for age, education and income differences, black patients generally had worse clinical characteristics at presentation and lower baseline health related quality of life data scores in most generic and disease specific categories at treatment. The most notable exception was sexual function, which was the only score that was higher in black patients at treatment. With time, health related quality of life improved in both groups but black patients had slower rates of improvement for general health, bodily pain, physical function, role function, disease worry and bowel function. They continued to have higher sexual function. CONCLUSIONS: Significant differences exist in clinical presentation, sociodemographic characteristics, and health related quality of life between black and white men with prostate cancer. These health related quality of life differences remain after treatment. Physicians should not assume that outcomes in black men would be similar to other patients.

Black or African American↗
PubMed2001

Clinical studies on the visualization of gastric lesions using virtual CT endoscopy.

OBJECTIVE: We evaluated the clinical usefulness of virtual CT gastroendoscopy (VCTGE). METHODS: The subjects were 124 patients with endoscopically identified gastric lesions. VCTGE images were obtained using a GE-Navigator. We evaluated VCTGE in the visualization of gastric lesions for their presence and morphology. RESULTS: The detection rate of all gastric lesions by VCTGE was 76% (94 of 124 patients). The smallest detectable early gastric cancer was II c measuring 10 x 8 mm. The detection rates of each gastric lesion by VCTGE were 73% in early gastric cancer, and 90% in advanced gastric cancer. VCTGE imaging in the advanced gastric cancer was good in 12 (30%), fair in 25 (60%) and poor in 4 (10%). VCTGE imaging in early gastric cancer was good in 20 (46%), fair in 12 (27%) and poor in 12 (27%). The significance P level was 0.005 between the evaluation of the imaging of advanced and early gastric cancer. CONCLUSIONS: VCTGE visualized the characteristics of diverse gastric lesions and was considered useful for the detection and the diagnosis of these lesions.

Adult↗
PubMed2001

Blockade of p38 mitogen-activated protein kinase pathway inhibits interleukin-6 release and expression in primary neonatal cardiomyocytes.

The induction of interleukin-6 (IL-6) using combined proinflammatory agents (LPS/IFN-gamma or TNF-alpha/IFN-gamma) was studied in relation to p38 mitogen-activated protein kinase (MAPK) and NF-kappaB transcriptional factor in primary neonatal cardiomyocytes. When added to cultures of cardiomyocytes, the combined agents (LPS/IFN-gamma or TNF-alpha/IFN-gamma) had stimulatory effect on the production of IL-6 and the elevation was significantly reduced by SB203580, a specific p38 MAPK inhibitor. SB203580 inhibited protein production and gene expression of IL-6 in a concentration-dependent manner. In this study, IFN-gamma enhancement of TNF-alpha-induced NF-kappaB binding affinity as well as p38 MAP kinase activation was observed. However, a specific inhibitor of p38 MAPK, SB203580, had no effect on TNF-alpha/IFN-gamma or LPS/IFN-gamma-induced NF-kappaB activation. This study strongly suggests that these pathways about TNF-alpha/IFN-gamma or LPS/IFN-gamma-activated IL-6 release can be primarily dissociated in primary neonatal cardiomyocytes.

Animals↗
PubMed2000

Atomic force microscopy of the three-dimensional crystal of membrane protein, OmpC porin.

Three-dimensional microcrystals of OmpC osmoporin were air-dried slowly and imaged in air with an atomic force microscope (AFM). The overall structural features in AFM images are in good agreement with the X-ray diffraction data of these OmpC osmoporin crystals: monoclinic P2(1) with the unit cell constants a=117.6 Å, b=110 Å, c=298.4 Å, beta=97 degrees. Such a good correspondence between X-ray diffraction and AFM data suggests that the slow and mild air-drying of these crystals did not induce any significant alterations in the crystal lattices as expected upon crystal dehydration. At the (100) crystal face, individual trimeric protein-detergent complexes were resolved. These results show the potential for studying the molecular structure of microcrystals of integral membrane proteins. This study also suggests that the crystal grew in a fashion of rapid two-dimensional expansion along the bc plane followed by a slow deposition along the a axis, perhaps as a rate-limiting nucleation process. Thus, AFM imaging of air-dried crystals would also be of considerable use in the early stages of a project to grow large three-dimensional crystals of membrane proteins suitable for high-resolution X-ray diffraction studies.

Journal Article↗
PubMed2000

Tissue-specific expression of rat IL-18 gene and response to adrenocorticotropic hormone treatment.

IL-18 is a pleiotropic cytokine also proposed to have a role in modulating immune function during stress. Initially found in immune cells, IL-18 mRNA is detectable in several tissues including the cells of the zona reticularis and the zona fasciculata of the adrenal cortex, where its levels are elevated by acute stress or adrenocorticotropic hormone treatment. In the present study, we compared the expression of IL-18 in the adrenal cortex with that of spleen and duodenum, two other IL-18-positive tissues. In situ hybridization showed that, in contrast to the adrenal cortex, in spleen and duodenum IL-18 is primarily localized to immune cells. In duodenum, IL-18 mRNA was also detectable in epithelial cells. Northern blot demonstrated that while the adrenal gland synthesized IL-18 mRNA of 1.1 kb, spleen and duodenum produced a 0.9-kb transcript. RT-PCR, sequencing, Western blot, primer extension, and rapid amplification of cDNA end analysis demonstrated that the three tissues synthesize IL-18 mRNAs containing the same coding region and produce the same IL-18 peptide, but differ in the length of their 5'-untranslated region, indicating tissue-specific usage of the promoter region. Finally, in contrast to the adrenal gland, adrenocorticotropic hormone treatment did not increase the levels of IL-18 mRNA in spleen and duodenum. These results demonstrate tissue-specific expression and promoter usage of IL-18 gene and suggest that the adrenal cortex and not immune cells may be the source of IL-18 during stress.

Adrenal Glands↗
PubMed2000

Genomic analysis and functional expression of canine dopamine D2 receptor.

Dopamine D2 receptor (DRD2) is one of the five dopamine receptors with seven transmembrane domains that are coupled to the G protein. We have cloned and characterized the genomic and cDNA sequences of the canine DRD2 gene, which are 12.7 and 2.7 kb in size, respectively. The genomic DNA is composed of seven exons and six introns, encoding a 443 amino acid protein with 95% amino acid identity to other mammalian D2 receptors. A length polymorphism was detected in intron 3 of the receptor gene. We also characterized alternatively spliced forms of DRD2 cDNAs, DRD2L and DRD2S. They showed a higher level of expression in midbrain and thalamus. The ratio between the long and short form is similar in RT-PCR reaction. In human and rodent, the same two spliced forms are known to be coupled to G(i)-type heterotrimeric GTP binding protein, thereby opening an inwardly rectifying potassium channel, GIRK1. When the canine DRD2L and DRD2S were heterologously expressed in Xenopus oocytes, both forms activated GIRK1 potassium channels through coupling with G(i) protein. This activation was dose-dependent, demonstrating its ligand specificity.

Amino Acid Sequence↗
PubMed2000

In vitro and in vivo studies of AT-1362, a newly synthesized and orally active inhibitor of thrombin.

AT-1362 was found to be a potent, selective, and competitive inhibitor of thrombin, with a Ki value of 6.7 nM. In a rat model of venous thrombosis induced by partial stasis and endothelial disruption, the ID(50) values (a dose required to obtain 50% inhibition of thrombus formation over each vehicle group) of AT-1362 and argatroban were 0.03 mg/kg i.v. plus 0.5 microg/kg/minute and 0. 13 mg/kg i.v. plus 8.7 microg/kg/minute, respectively, and the antithrombotic effect of AT-1362 without prolongation of bleeding time lasted for 2 hours and disappeared 4 hours after oral administration of 30 mg/kg. In the rat tail transection model, the BT(2) values (a dose causing two-fold prolongation of the bleeding time over each vehicle group) of AT-1362 and argatroban were 0.56 mg/kg i.v. plus 9.3 microg/kg/minute and 1.1 mg/kg i.v. plus 73.3 microg/kg/minute, respectively. The reduction of thrombus formation and the prolongation of bleeding time were correlated with an ex vivo activated partial thromboplastin time (APTT) for both drugs. AT-1362 at 0.3 mg/kg i.v. plus 5 microg/kg/minute and argatroban at 0.6 mg/kg i.v. plus 40 microg/kg/minute significantly (p<0.05 and p<0.01, respectively) improved the vessel patency in a FeCl(2)-induced carotid artery thrombosis model in rats. These results suggest that AT-1362 may be a potent antithrombotic agent for the treatment of thrombotic diseases.

Administration, Oral↗
PubMed2000

Suppression of NF-kappaB activation and cytokine production by N-acetylcysteine in pancreatic acinar cells.

Reactive oxygen species (ROS), generated by infiltrating neutrophils, are considered as an important regulator in the pathogenesis and development of pancreatitis. A hallmark of the inflammatory response is the induction of cytokine gene expression, which may be regulated by oxidant-sensitive transcription factor, nuclear factor-kappaB (NF-kappaB). Present study aims to investigate whether neutrophils primed by 4beta-phorbol 12beta-myristate 13alpha-acetate (PMA) affect the productions of H(2)O(2) and lipid peroxide (LPO), NF-kappaB activation and cytokine production in pancreatic acinar cells, and whether these alterations were inhibited by N-acetylcysteine (NAC) and superoxide dismutase (SOD). Neutrophils generated ROS by stimulation with PMA, which was inhibited by NAC and SOD. In acinar cells, PMA-primed neutrophils increased the productions of H(2)O(2), LPO, and cytokines both time and dose dependently. PMA-primed neutrophils resulted in the activation of two species of NF-kappaB dimers (a p50/p65 heterodimer and a p50 homodimer) in acinar cells. Both NAC and SOD inhibited neutrophil-induced, oxidant-mediated alterations in acinar cells. In conclusion, ROS, generated by neutrophils, activates NF-kappaB, resulting in upregulation of inflammatory cytokines in acinar cells. Antioxidants such as NAC might be useful antiinflammatory agents by inhibiting oxidant-mediated activation of NF-kappaB and decreasing cytokine production.

Acetylcysteine↗
PubMed2000

Immunological characterization of 130 kDa phospholipase C-beta 4 isozyme in rat cerebellar Purkinje cells.

We have developed a monoclonal antibody, beta4-22-9 that recognizes an epitope on pleckstrin homology (PH) domain (1-136 amino acids) located at the amino terminus of rat 130 kDa phospholipase C-beta4 (PLC-beta4). Tissue distribution of 130 kDa PLC-beta4 was determined with this monoclonal antibody. One hundred and thirty kiloDalton PLC-beta4 was exclusively expressed in the nervous tissues including cerebellum and cerebrum, especially at very high levels in cerebellum. The expression of 130 kDa PLC-beta4 in cerebellum was gradually increased from 5 days after birth to adulthood. In the adult cerebellum, especially high level of 130 kDa PLC-beta4 was localized on the periphery of Purkinje cells in the patch-like pattern. These data implies that 130 kDa PLC-beta4 may a role in cerebellar Purkinje cells.

Animals↗