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Biomedical subjects

H M Kim

Publications and source records attributed to H M Kim.

296 records · Page 17Linked to original sources

Long-term follow-up after TIPS: use of Doppler velocity criteria for detecting elevation of the portosystemic gradient.

PURPOSE: To evaluate the performance of Doppler ultrasound as a screening test for detecting elevated portosystemic gradients in failing transjugular intrahepatic portosystemic shunts (TIPS). MATERIALS AND METHODS: Twenty-seven of 61 patients who underwent TIPS creation between November 1991 and March 1996 were studied. At routine intervals, angle-corrected velocity measurements of portal venous and intrashunt blood flow (at the portal venous, middle, and hepatic venous levels of the shunt) were obtained. These were compared with portal hemodynamics for diagnostic accuracy in predicting clinically significant elevation of the portosystemic gradient. Venographic and manometric correlations were obtained on all patients available for follow-up and were not limited to those with symptoms or "abnormal" Doppler studies. Receiver-operating characteristic (ROC) curves were done. Linear regression was done to study correlation of shunt velocities with portal pressure, and logistic regression was done to predict shunt stenosis with use of shunt velocities. RESULTS: The most accurate location for shunt velocity measurement was the main portal vein, but this had an area under the ROC curve of only 0.70. Accuracy of any velocity threshold (including maximum shunt velocity) was no greater than 70%. Maximum shunt velocity of less than 60 cm/sec was 93% specific for detecting shunt restenosis, but only 25% sensitive, for an overall accuracy of 64%. High sensitivity (90%) could only be achieved with poor specificity (< 33%). Linear regression revealed poor correlation between shunt or portal vein velocity measurements and portal pressure (/r/ < 0.23 for all). CONCLUSIONS: Intrashunt and portal venous Doppler velocities alone do not accurately predict elevation of the portosystemic gradient on long-term follow-up after TIPS.

Adult↗

Chemical modification of implantable biologic tissue for anti-calcification.

Biologic porcine tissue was modified by coupling sulfonated polyethyl-eneoxide (PEO-SO3) and the effect of modification on calcification was evaluated in vitro and in vivo. The modification process involves grafting PEO-SO3 to porcine valve leaflet either by carbodiimide (EDC) activation or by direct coupling using glutaraldehyde. Thermal property, measured by differential scanning calorimetry, showed that the shrinkage temperature of modified tissue increased compared with control tissue and fresh tissue, suggesting increased thermal stability. Resistance to collagenase digestion revealed that modified tissues have greater resistance to enzyme digestion than do control tissues. In vitro calcification showed that modified tissues have less calcium deposition than do control tissues. In vivo calcification, using a rat subcutaneous implantation model, also showed less calcification of modified tissue than that of control. The resistance of modified tissue to collagenase, higher shrinkage temperature, and reduced calcification, when compared with control tissue, attest to the usefulness of this chemical modification for implantable biologic tissue.

Animals↗

Phorbol ester synergistically increases interferon-gamma-induced nitric oxide synthesis in murine microglial cells.

The effect of phorbol ester on the synthesis of nitric oxide (NO) in murine microglial cells was examined. Phorbol 12-myristate 13-acetate (PMA), a protein kinase C (PKC) activator, alone had no effect, whereas PMA with recombinant interferon (rIFN)-gamma synergistically increased NO synthesis in murine microglial cells. The maximal effect of PMA on NO synthesis increase always fitted with the range for full activation of PKC in these cells. The increase of NO synthesis was reflected as increased amount of immunologic NO synthase (iNOS) mRNA detected by Northern blotting. Treatment with PKC inhibitors such as staurosporine or polymyxin B decreased rIFN-gamma-plus-PMA-stimulated NO synthesis. Further, prolonged incubation of the cells with PMA, which down-regulates PKC activity, abolished the synergistic cooperative effect with IFN-gamma. NG-monomethyl-L-arginine monohydrate, an analogue of L-arginine, and arginase inhibited rIFN-gamma-plus-PMA-induced NO production in murine microglial cells. On the basis of these observations, we conclude that PKC might not be involved in the expression of iNOS, but instead, might be involved in the posttranscriptional modification of iNOS mRNA.

Alkaloids↗

Heterozygous ras mutations are preserved in serially passaged human tumor xenografts and established cell lines.

We examined c-K-ras gene point mutations in human tumor xenografts and established cell lines as markers of genetic stability. Our previous study demonstrated the stability of c-K-ras gene mutations in human primary neoplasms and their tumor xenografts through serial passages in mice. In this study, we established 27 human cell lines derived from various human tumor xenografts in nude mice. Point mutation of the c-K-ras gene at codon 12 was found in 29.6% (8/27) of the cell lines, as well as in 29.6% (8/27) of the xenografts. The eight ras-mutated cell lines were derived from corresponding tumor xenografts carrying the ras mutation. Heterozygous ras gene mutation was confirmed in seven of the eight ras-mutated cell lines, as well as their corresponding xenografts. The incidence, type and heterozygosity of the c-K-ras gene mutation showed no discrepancies between the original xenografts and the established cell lines. From these findings, we concluded that point mutation of the c-K-ras gene was very stable in human tumor xenografts and established cell lines derived from the xenografts.

Animals↗

Multizone photorefractive keratectomy for myopia of 9 to 14 diopters.

We performed photorefractive keratectomy (PRK) using new multizone software of the Summit Omnimed excimer laser (Summit Technology, Inc., Waltham, Mass.) on thirteen highly myopic eyes. Average preoperative myopia was -10.94 diopters (D) (range -8.60 D to -13.50 D). Mean postoperative spherical equivalent refraction was -0.15 D (range +1.50 D to -4.00 D), at 3 months postoperatively. Uncorrected visual acuity of all the eyes improved markedly. There was no serious complication except one eye that lost two lines of spectacle corrected visual acuity possibly due to decentration. Though we need longer follow-up data and a larger sample size, the new multizone software seems to be effective for correcting high myopia.

Adult↗

In vivo canine studies of a Sinkhole valve and vascular graft coated with biocompatible PU-PEO-SO3.

PU-PEO-SO3 was applied as a coating material over a newly designed Sinkhole bileaflet PU heart valve and a porous PU vascular graft. Performance and biocompatibility were evaluated using an in vivo canine shunt system between the right ventricle and pulmonary artery. The survival periods in three implantations were 14, 24, and 39 days, during which no mechanical failure occurred in any Sinkhole valve or vascular graft. Scanning electron microscopy (SEM) studies demonstrated much less platelet adhesion and thrombus formation on PU-PEO-SO3 grafts than on PU vascular grafts. Cracks in the valve leaflet were occasionally observed on PU surfaces, but not on PU-PEO-SO3. After a 39 day implantation, calcium deposition on vascular grafts was decreased as compared with valve leaflets, and calcification on PU-PEO-SO3 was much lower than on PU. These results suggest that Sinkhole valves and vascular grafts are promising, and PU-PEO-SO3 as a coating material is more blood compatible, biostable, and calcification resistant in vivo than in untreated PU.

Animals↗

Effects of extracellular matrix constituents on the attachment of human oral epithelial cells at the titanium surface.

This in vitro study attempts to delineate the role of extracellular matrix (ECM) constituents at the epithelial tissue-implant interface. To know which ECM constituents have a beneficial influence on the behavior of epithelial cells, the attachment, proliferation, morphologic pattern, and differentiation or cytoskeletal organization of human oral epithelial cells on ECM-coated (type IV collagen, fibronectin, type I collagen, laminin, and vitronectin) and noncoated titanium surface have been evaluated and compared. In each experiment comparing commercially pure titanium and oxygen plasma-cleaned titanium, the same ECM constituents were used. In this study, type IV collagen could provide an excellent substratum for epithelial cell attachment on titanium surface, but vitronectin-coated titanium revealed lower effectiveness for attachment of epithelial cells than noncoated titanium. These results suggested that type IV collagen could be used as a means for obtaining good epithelial seal, whereas vitronectin could be used to restrain the attachment of epithelium to dental implants.

Adult↗