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Biomedical subjects

H S Kim

Publications and source records attributed to H S Kim.

At least 55 records · Page 3Linked to original sources
PubMed2004

A prospective, randomized trial of endoscopic band ligation versus endoscopic hemoclip placement for bleeding gastric Dieulafoy's lesions.

BACKGROUND AND STUDY AIMS: Dieulafoy's lesion is a rare cause of massive gastrointestinal hemorrhage, most commonly in the proximal stomach. Mechanical endoscopic methods have recently become the standard therapeutic approach. However, there have been few studies comparing the efficacy of different mechanical endoscopic methods in treating gastric Dieulafoy's lesions. This study was therefore carried out to compare the hemostatic efficacy and safety of endoscopic band ligation (EBL) and endoscopic hemoclip placement (EHP) in the treatment of bleeding gastric Dieulafoy's lesions. PATIENTS AND METHODS: Between January 2002 and October 2003, 26 consecutive patients with bleeding gastric Dieulafoy's lesions were prospectively enrolled and were randomly assigned to undergo EBL (13 patients) or EHP (13 patients). Demographic characteristics, endoscopic variables, and outcome parameters, including rates of hemostasis and recurrent bleeding, were analyzed. RESULTS: One O-ring was applied in each case in the EBL group, and the median number of hemoclips applied was one (range one to four) in the EHP group. There were no significant differences between the groups with regard to age, sex, presence of shock, initial hemoglobin level, coagulopathy, concurrent diseases, location of the lesion, type of bleeding stigmata, blood transfusion requirements, or hospitalization periods. Primary hemostasis was achieved in all 26 patients. There was one case of recurrent bleeding in each group; secondary hemostasis was achieved with EBL in one of these patients and by endoscopic epinephrine injection in the other. There were no second episodes of recurrent bleeding, no procedure-related complications, no cases in which surgery was needed, and no bleeding-related deaths in either group. CONCLUSIONS: In this small study, no differences were detected in the efficacy or the safety of EBL vs. EHP in the management of bleeding gastric Dieulafoy's lesions.

Adult↗
PubMed2004

Cartilage oligomeric matrix protein increases in serum after the start of growth hormone treatment in prepubertal children.

Both GH and IGF-I stimulate bone growth, but the molecular mechanisms mediating their effects on the growth plate are not fully understood. We measured gene expression by microarray analysis in primary cultured human chondrocytes treated with either GH or IGF-I. One of the genes found to be up-regulated by both GH and IGF-I was that encoding cartilage oligomeric matrix protein (COMP). This protein is predominantly found in the extracellular matrix of cartilage. Mutations in the COMP gene have been associated with syndromes of short stature. To verify that COMP is regulated by GH in vivo, we measured COMP levels in serum in short children treated with GH. The study included 113 short prepubertal children (14 girls and 99 boys) with a mean (+/- sd) age of 8.84 +/- 2.76 yr, height sd score of -2.74 +/- 0.67, and IGF-I sd score of -1.21 +/- 1.07 at the start of GH administration. Serum levels of COMP were 1.58 +/- 0.28, 1.83 +/- 0.28 (P < 0.0001), 1.91 +/- 0.28 (P < 0.0001), 1.78 +/- 0.28 (P < 0.001), and 1.70 +/- 0.24 (P < 0.05) microg/ml at baseline and after 1 wk and 1, 3, and 12 months, respectively. In conclusion, we have demonstrated that COMP expression is up-regulated by both GH and IGF-I in primary cultured human chondrocytes. Furthermore, serum levels of COMP increase after the start of GH treatment in short children.

Body Height↗
PubMed2003

BRAF mutations in non-Hodgkin's lymphoma.

Ras proteins control signalling pathways that are key regulators of several aspects of normal cell growth and malignant transformation. BRAF, which encodes an RAF family member in the downstream pathway of RAS, is somatically mutated in a number of human cancers. The activating mutation of BRAF is known to play a role in tumour development. As there have been no data on the BRAF mutation in non-Hodgkin's lymphoma (NHL), we analysed the genomic DNAs from 164 NHLs by polymerase chain reaction (PCR)-based single-strand conformation polymorphism (SSCP) for the detection of somatic mutations of BRAF (exons 11 and 15). Overall, we detected BRAF mutations in four NHLs (2.4%). Whereas most BRAF mutations in human cancers involved V599 of BRAF, all of the four BRAF mutations in the NHLs involved other amino acids (one G468A, two G468R and one D593G). To our knowledge, this is the first report on BRAF mutation in NHL, and the data indicate that BRAF is occasionally mutated in NHL, and suggest that BRAF mutation may contribute to the tumour development in some NHLs.

Cell Transformation, Neoplastic↗
PubMed2003

Multidetector row computed tomography for follow-up of patients with coronary artery aneurysms due to Kawasaki disease.

Multidetector row computed tomography (MDCT) coronary angiography was performed using a 16-slice MDCT scanner in three children with coronary aneurysms due to Kawasaki disease. Patients were given a beta-blocker. Following contrast injection, all data were acquired during a 20-second breathhold. Results were compared with those of conventional coronary angiography performed previously. MDCT provided clear visualization of coronary artery aneurysms, with coronary calcifications but which had not yet progressed to stenotic lesions. Because MDCT allows noninvasive detection and exclusion of coronary obstructions, it may be able to replace repeat conventional angiography as a follow-up study for children with coronary artery disease.

Child↗
PubMed2003

Coexistence of ductal constriction and closure of the foramen ovale in utero.

We report a fetus with an unusual combination of a narrow ductus arteriosus (DA) and foramen ovale. A pregnant mother was referred at 26 weeks of gestation for fetal pericardial effusion. Fetal echocardiography showed pericardial effusion, right atrial enlargement, right ventricular hypertrophy, and tricuspid regurgitation. The DA looked tortuous with S-shaped kinking. The atrial septum primum bulged into the left atrium. Color Doppler did not show any flow across the atrial septum. Cesarean section was performed at 31 weeks of gestation. Admission to intensive care was required after delivery, but the infant gradually improved and was discharged home without any sequela.

Adult↗
PubMed2003

Effect of maturation media and oocytes derived from sows or gilts on the development of cloned pig embryos.

In order to develop a culture system and recipient cytoplasm that could improve the developmental competence of somatic cell nuclear transfer (SCNT) embryos for successful cloning of pigs, we evaluated the effect of donor oocytes and in vitro maturation (IVM) media on maturation of oocytes and developmental competence of SCNT embryos. In Experiment 1, oocytes derived from sows or gilts were matured in two IVM media (TCM-199 versus NCSU-23) and maturation of oocytes was evaluated by the status of chromatin configuration, the diameter of matured oocytes, the thickness of the zona pellucida, and the size of the perivitelline space (PVS). Sow oocytes matured in TCM-199 (S-TCM group) and NCSU-23 (S-NCSU group) showed significantly higher (P<0.05) maturation rates (S-TCM and S-NSCU, 86+/-4 and 82+/-4%, respectively) when evaluated by metaphase-II status than the gilt oocytes matured in TCM-199 (G-TCM group, 71+/-3%) and in NCSU-23 (G-NCSU-23 group, 71+/-3%). Oocyte diameter, the thickness of the zona pellucida, and the perivitelline space of sow oocytes (S-TCM and S-NCSU) were larger than those of gilt oocytes (G-TCM and G-NCSU) after IVM (P<0.05). In Experiment 2, SCNT was performed, using in vitro-matured oocytes from each group as recipient cytoplasm and porcine fetal fibroblasts as karyoplasts. The reconstructed embryos were electrically fused and activated, and cleavage and blastocyst formation were monitored under a stereomicroscope. The total cell number of flattened blastocysts stained with 5 microM bisbenzimide on day 7 were counted. In addition, in vitro matured non-enucleated oocytes were also electrically activated (parthenogenetic activation) and pronuclear formation was monitored. No difference in pronuclear formation rate after parthenogenetic activation and fusion rate after SCNT was observed among experimental groups. A significantly higher cleavage rate (P<0.05) was observed in S-TCM (69+/-4%) when compared with only G-NCSU (58+/-4%), but not with G-TCM (60+/-4%) or S-NCSU (68+/-4%). The rate of blastocyst formation was significantly higher (P<0.05) in sow oocytes (24% in S-TCM and S-NCSU), when compared to that observed in G-TCM (15%), and G-NCSU (14%). When the same source of oocytes was used, there was no significant difference in rate of blastocyst formation in the two culture media. Total cell number of blastocysts were not significantly different among experimental groups. In conclusion, the present study clearly demonstrated that sow oocytes have a greater developmental competence than gilt oocytes, regardless of the maturation medium examined.

Animals↗
PubMed2003

Prediction of lymph nodes metastasis by sentinel node biopsy in gastric cancer.

AIM: The application of sentinel node (SN) biopsy in gastric cancer remains controversial. In this study, detection rate and predictive values of SN biopsy were determined to evaluate its feasibility in gastric cancer. Various clinicopathologic features were also analysed to determine the factors affecting the detection rate and predictive values. METHODS: Seventy-one gastric adenocarcinoma patients without serosal invasion and distant metastasis, were studied. One percent isosulfan blue stained nodes were defined as SNs, and standard gastrectomy with D2 lymphadenectomy was performed. All lymph nodes were studied by hematoxylin and eosin staining. RESULTS: SNs were identified in 65 of 71 patients and average number of SNs per patient was 2.5 (range 1-8). Among the 65 patients with SNs, metastatic SNs were found in 11 and the remaining 54 were free of metastasis. In eight of the 11 patients with metastasis of the SNs, metastases were also identified in non-SNs. CONCLUSIONS: SN biopsy is feasible in early stage gastric cancer. However, complementary procedures may be needed to improve the detection rate and predictive values. SNs biopsy results should be treated with caution in male patients and for tumours at the upper part of stomach due to the low detection rate.

Adenocarcinoma↗
PubMed2003

Prediction of severity of mean arterial pressure elevation after tracheal intubation in hypertensive patients by preanesthetic recurrence quantification analysis of heart rates.

BACKGROUND: We tried to determine whether the severity of additional mean arterial pressure (MAP) elevation after endotracheal intubation during general anesthesia could be predicted with preanesthetic recurrence quantification analysis of heart rates in hypertensive and normotensive patients. METHODS: Twenty-four newly diagnosed hypertensive patients and 34 normotensive patients were included. We defined DeltaMAP = maximal mean MAP after endotracheal intubation - average MAP before general anesthesia. We classified each of the hypertensive and normotensive patients into mild (DeltaMAP </= 35 mmHg [median value of DeltaMAP in the hypertensive patients]) and severe group (DeltaMAP > 35 mmHg). Using preanesthetic RR interval data, we calculated classical linear and non-linear indices of RR interval dynamics, and performed recurrence quantification analysis to calculate three preanesthetic recurrence indices, percentage of recurrence (%REC), percentage of determinism (%DET), and maximal length of recurrence (Lmax). RESULTS: In the hypertensive patients, all preanesthetic classical indices showed no significant difference between the mild and severe group and showed no significant linear correlation with the DeltaMAP. However, the Lmax was significantly higher in the severe than in the mild group (16.10 +/- 3.79 vs. 7.90 +/- 0.73, P < 0.005) and, moreover, linearly correlated with the DeltaMAP (r = 0.671, P = 0.001). In the normotensive patients, all preanesthetic classical and recurrence indices showed no significant difference between the two groups. CONCLUSION: In hypertensive patients, the severity of additional MAP elevation after tracheal intubation during general anesthesia can be predicted by the preanesthetic recurrence quantification analysis of heart rates.

Adult↗
PubMed2003

A double-blind, randomised- placebo, controlled, parallel group, multicentre, flexible-dose escalation study to assess the efficacy and safety of sildenafil administered as required to male outpatients with erectile dysfunction in Korea.

The efficacy and safety of sildenafil was evaluated in a randomiSed, double-blind, placebo-controlled, flexible-dose study in Korean men aged 28-78 y with erectile dysfunction (ED) of broad-spectrum aetiology and more than 6 months duration. A total of 133 patients were randomised at six centres in Korea to receive either sildenafil (50 mg initially, increased if necessary to l00 mg or decreased to 25 mg depending on efficacy and tolerance) (n=66) or matching placebo (n=67) taken on an 'as needed' basis l h prior to anticipated sexual activity for a period of 8 weeks. At the end of this time, the primary efficacy variables relating to the achievement and maintenance of erections sufficient for sexual intercourse, and the secondary efficacy variables, which included: (1) the five separate domains of sexual functioning of the International Index of Erectile Function (IIEF) scale, (2) the percentage of successful intercourse attempts, and (3) a global assessment of erections, were all statistically significantly improved by sildenafil in comparison with placebo (P&<0.0001). Treatment-related adverse events occurred in 56.1% of patients receiving sildenafil and 20.9% receiving placebo. The most common adverse events with sildenafil were vasodilatation (flushing), headache and abnormalities in colour vision (31.8, 22.7 and 6.1% of patients, respectively), and most were mild in nature. The efficacy and safety of sildenafil in this population of Korean men appears similar to that reported in other studies in western populations.

Adult↗
PubMed2003

Alteration of E-cadherin-mediated adhesion protein is common, but microsatellite instability is uncommon in young age gastric cancers.

AIMS: Gastric adenocarcinoma in young patients has been considered to differ in many ways from gastric carcinoma in older patients. This study was designed to determine the clinicopathological features and molecular mechanisms. METHODS AND RESULTS: Based on 4123 patients of gastric cancer in Seoul National University Hospital, 135 patients (3.3%) were chosen by the age of 30 years or younger. Expression of E-cadherin, beta-catenin, p53 and Epstein-Barr virus (EBV) was analysed using the tissue array method in formalin-fixed paraffin-embedded specimens and microsatellite instability (MSI) was determined. As a control, 320 cases of older patients were compared. Gastric adenocarcinoma of young patients revealed significant female predominance, type IV gross type, proximal location, diffuse type and frequent lymph node metastasis. In-situ hybridization for EBV showed higher positivity in young patients (9/78, 11.5%) than in older ones, but not statistically significant. In EBV+ cases, p53 over-expression was significantly higher in young patients than older patients (P < 0.05). Alteration of E-cadherin or beta-catenin was significantly higher in younger patients than in older patients (P < 0.05). Overall survival was significantly poorer in younger patients than older ones. The frequency of MSI was rare (1.3%, P < 0.05) in young patients compared with older patients (9.3%). CONCLUSIONS: These data indicate that gastric adenocarcinoma of young patients has a poor prognosis, possesses aggressive histopathological features, exhibits reduced expression of E-cadherin and beta-catenin, and demonstrates lower MSI than tumours in older patients.

Adenocarcinoma↗
PubMed2003

Positioning internal jugular venous catheters using the right third intercostal space in children.

BACKGROUND: Central venous catheters are used for pressure measurement, and drug and fluid therapy in children. Several reports have described serious complications related to catheter positioning. We evaluated the possibility of using the right third intercostal space as an anatomic landmark for determining the optimal insertion depth of a central venous catheter from the right internal jugular vein. METHODS: The distance between the skin puncture site and the right third intercostal space (SK-ICS) was measured in 83 children. The catheter was inserted to a depth equal to the measured distance. Postoperatively, the distance between the catheter tip and the radiographic junction of the superior vena cava and the right atrium was measured. This was defined as the optimal catheter length, which placed the catheter tip at the SVC/RA junction (SK-SVC/RA). RESULTS: A significant correlation was found between the SK-ICS and SK-SVC/RA (regression equation: SK-SVC/RA = 0.35 + 0.98 x SK-ICS, r2 = 0.8554). Based on the data obtained, a simple formula, SK-ICS-1 (cm), predicted that a CVC would be positioned above the RA in 98.8% of patients. CONCLUSIONS: Using the right third intercostal space as an anatomic landmark allows positioning of the catheter tip in the SVC near to but not in the RA in children.

Catheterization, Central Venous↗
PubMed2003

Biokinetics of radiotellurium in rats.

Radiotellurium is present in the environment primarily due to its release during nuclear reactor accidents. Little is known of tellurium metabolism in juveniles, although the element is relatively abundant and has a number of industrial uses. A biokinetic study of radiotellurium in rats was performed using gamma-ray counting. Wistar strain rats were used to determine the uptake of H2(123m)TeO3 by the whole-body retention of juvenile rats and the conceptus in relation to its gestational stages, by measurements in the placenta, fetal membranes, fetal fluid and fetus. The whole-body retention of 123mTe in juvenile rats was higher than that of adult rats. The relative concentration in the placenta and fetal membranes was higher than in the fetus. No activity was observed in the fetal fluid. These results indicate that the placenta and fetal membranes play significant roles as barriers to the transfer of 123mTe into the fetus. The ratio, relative concentration in fetus/relative concentration in mother (C(F)/C(M)), was calculated. The C(F)/C(M) ratio was dependent on the stage of gestation and ranged from 0.2 to 0.5. A little 123mTe was transferred to the suckling rats through the mother's milk when the isotope was administered intravenously to the mother.

Administration, Oral↗
PubMed2003

Advantages of the circular dumbbell decoy in gene therapy and studies of gene regulation.

Decoy oligodeoxynucleotides (ODN) that can reduce the trans-activity of transcription factors may be highly useful in gene therapy and the study of transcriptional regulation. Several different types of these double-stranded DNA decoys have been developed, including unmodified oligonucleotide duplexes, alphabeta-anomeric oligonucleotides, and oligonucleotide duplexes with methylphosphonate- and phosphorothioate-modified linkages. The latter ODNs have been particularly extensively studied but suffer from a number of limitations, including their insensitivity to polymerases, their lack of sequence specificity, and their tendency to activate immune responses. To resolve these problems, circular dumbbell (CD) double-stranded ODNs were developed. These CD ODNs are constructed by the circularization of the 3' and 5' ends of the oligonucleotides and enzymatic ligation. They exhibit high resistance to nucleases, are easily taken up by cells, and have a nontoxic unmodified backbone that resembles natural DNA. In this article, we review the method of constructing CD ODNs and their advantages compared to other modified ODNs for use as transcription decoys.

Animals↗
PubMed2003

Intramuscular neurilemoma.

In this retrospective study, we analysed the clinical features of neurilemoma when it is located in muscle. Twelve patients had an intramuscular neurilemoma as shown on magnetic resonance (MR) scans and confirmed at operation. In six it was located in the upper limb, in five in the lower limb, and in one in the back. The mean age of the patients was 41 years (12 to 58). Nine complained only of a palpable mass and the other three of a mass with slight tenderness. None had neurological symptoms or signs, such as radicular pain, a positive Tinel sign, or motor weakness. There were no postoperative complications or recurrence of the tumour after a mean follow-up of two years (1 to 10).

Adult↗
PubMed2002

Expression of multidrug resistance-associated protein1,P-glycoprotein, and thymidylate synthase in gastric cancer patients treated with 5-fluorouracil and doxorubicin-based adjuvant chemotherapy after curative resection.

Both 5-fluorouracil and doxorubicin are commonly used agents in chemotherapy of gastric cancer in adjuvant setting as well as metastatic disease. In a variety of malignancies, high expression of multidrug resistance-associated protein1 and P-glycoprotein has been associated with resistance to doxorubicin, whereas 5-fluorouracil resistance has correlated with the level of thymidylate synthase expression. We evaluated the expression of multidrug resistance-associated protein1, P-glycoprotein, and thymidylate synthase using immunohistochemistry in 103 locally advanced gastric cancer patients (stage IB-IV) who underwent 5-fluorouracil and doxorubicin-based adjuvant chemotherapy after curative resection and investigated the association between their expression and clinicopathologic characteristics including prognosis of the patients. While high expression (> or =5% of tumour cells positive) of multidrug resistance-associated protein1 and P-glycoprotein was observed in 70 patients (68%) and 42 patients (41%), respectively, 65 patients (63%) had primary tumours with high expression (> or =25% of tumour cells positive) of thymidylate synthase. There was a significant association between multidrug resistance-associated protein1 and P-glycoprotein expression (P<0.0001) as well as P-glycoprotein and thymidylate synthase expression (P<0.0001). High multidrug resistance-associated protein1 and P-glycoprotein expressions were associated with well and moderately differentiated histology (P<0.0001 and P=0.03, respectively) and intestinal type (P<0.0001 and P=0.009, respectively). High multidrug resistance-associated protein1 expression correlated with lymph node metastasis (P=0.037), advanced stage (P=0.015), and older age (P=0.021). Five-year disease-free survival and overall survival of total patients were 55.2% and 56.2%, respectively, with a median follow-up of 68 months. There were no significant differences in disease-free survival and overall survival according to the expression of multidrug resistance-associated protein1 (P=0.902 and P=0.975, respectively), P-glycoprotein (P=0.987 and P=0.955, respectively), and thymidylate synthase (P=0.604 and P=0.802, respectively). Concurrent high expression of these proteins (high multidrug resistance-associated protein1/P-glycoprotein, high multidrug resistance-associated protein1/thymidylate synthase, high P-glycoprotein/thymidylate synthase) did not correlate with disease-free survival or overall survival. Even high expression of all three proteins was not associated with poor disease-free survival (P=0.919) and overall survival (P=0.852). In conclusion, high expression of multidrug resistance-associated protein1, P-glycoprotein, and thymidylate synthase did not predict poor prognosis of gastric cancer patients treated with 5-fluorouracil and doxorubicin-based adjuvant chemotherapy. A larger study including patients treated with surgical resection alone would be necessary.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2002

Infection after prosthetic reconstruction in limb salvage surgery.

Among 145 patients that underwent prosthetic reconstruction between 1985 and 1998, infection developed in 18. Osteosarcoma was the most common primary tumour, and staphylococci were the major pathogenic organisms. Infections were controlled in five patients with débridement only and in two patients with a two-stage revision. Arthrodeses were performed in three and amputations in two. In six patients, infection was suppressed with antibiotics but not cured. Pulmonary metastasis developed in four of ten patients in whom chemotherapy was delayed or interrupted. Infection controls were poor in cases of delayed débridement over 2 weeks, in cementless fixation of implant, and soft tissue defects ( P<0.01). Infection after prosthetic reconstruction is not only difficult to treat but also influences the prognosis reverse.

Adolescent↗