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Biomedical subjects

H Y Choi

Publications and source records attributed to H Y Choi.

At least 55 records · Page 3Linked to original sources

Ciprofloxacin-induced renal dysfunction in patients with mycobacterial lung infections.

3 patients with mycobacterial lung infections, one due to Mycobacterium avium-intracellulare and 2 due to M. tuberculosis, developed ciprofloxacin-induced acute renal dysfunction while receiving the drug together with other antimycobacterial agents. These episodes took place 8-10 days after commencement of therapy and recovered spontaneously after cessation of all antimycobacterial drugs for 2-8 weeks. No recurrence was noted when patients were restarted on regimens that did not contain ciprofloxacin.

Acute Kidney Injury↗

A case of rectal cancer with sternal metastasis as initial presentation.

Colorectal cancer with bone metastasis as initial manifestation is a very rare event. We have reported a case of rectal cancer presenting with sternal metastasis. A 30 year-old man was evaluated due to pain in the sternal area with a bulging mass. History and physical examination did not suggest any specific disease. A radionuclide bone scan revealed increased uptake in the sternal area, right 6th rib, and sacrum. Microscopic examination of a biopsy specimen from the sternum showed metastatic adenocarcinoma. A barium enema and CT scan of the pelvis suggested carcinoma of the upper rectum. Adenocarcinoma of the rectosigmoid junction area was demonstrated by colonoscopic examination with biopsy. He received palliative transverse colostomy for obstruction without further treatment.

Adult↗

Ethambutol-induced pulmonary infiltrates with eosinophilia and skin involvement.

A 67 year old woman presented with miliary tuberculosis. She was treated with streptomycin, isoniazid, rifampicin, ethambutol and pyrazinamide. However, she developed rifampicin-induced thrombocytopenia after 6 weeks of treatment, and skin rash, blood eosinophilia and pulmonary infiltrates after 8 weeks of therapy. The latter was found to be ethambutol related. Additional evidence, including blood and sputum eosinophilia and the rapidity of its response to corticosteroid, suggested that the pulmonary infiltrates might also be eosinophilic in nature. To the best of our knowledge, this constitutes the first report of such adverse drug reaction, induced by ethambutol.

Aged↗

Congenital bilateral perisylvian syndrome: analysis of the first four reported Korean patients.

The advent of MRI technique has enabled the diagnosis of neuronal migration disorders(NMD) and made it possible to make "in vivo" diagnosis. Congenital bilateral perisylvian syndrome(CBPS) is a recently described disease identify characterized by pseudobulbar palsy, epilepsy, mental retardation, and migration disorders in the bilateral perisylvian area. We have identified four CBPS patients based on neuroimaging and dysarthria patterns among the candidates for epilepsy surgery. All the patients had orofacial diplegia and variable degrees of mental retardation. In the spectrographic analysis of dysarthria, the loss of specific characteristics of formants of vowels and increment of noise in the high frequency formants were observed. Epilepsy was present in all, but only one patient showed intractable seizure requiring surgical intervention. MRI was most helpful in identifying NMD and polymicrogyria in both centroparietal areas in this context. Great alertness is needed to identify this disorder to determine the etiology of epilepsy and dysarthria of uncertain origin.

Adolescent↗

Work-load and outcomes of diabetes care in general practice.

The effect of starting a general practice diabetes clinic on practice work-load and intermediate outcome measures was studied retrospectively using patient records. The 35 diabetic patients included had been diagnosed greater than 4 years before the diabetes clinic started and were followed for 6 years in the clinic, together with a group of age- and sex-matched controls. There was a significant rise in the consultation rates of the diabetic patients, due to an increase in diabetes-related consultations, from 3.9 consultations yr-1 to 6.7 consultations yr-1 (p less than 0.001). There was a fall in HbA1c level of 0.22 (99% CI 0.13, 0.32) %Hb yr-1 over the 6 years and in body mass index of 0.37 (99% CI 0.22, 0.52) kg m-2 yr-1, suggesting an improvement in diabetes management.

Aged↗

Can general practitioners assess diabetic control? Can anybody do any better?

A prospective study assessing the ability of various health professionals to estimate the control of diabetic patients from the accepted measures made for diabetes care was carried out. Patients were stratified into four categories according to the estimated HbA1c, and 45-60% were accurately assigned by the professionals. Patients were also divided into two broader groups according to their need to have changes in treatment made. None of the professionals could assign patients with Type 1 diabetes into these two groups with an accuracy of greater than 71%. With Type 2 diabetic patients accuracy improved up to 98% and there was little difference between the professionals. The current HbA1c was accurately predicted into two broad groups by the previous HbA1c alone in 89% of cases of Type 2 diabetes. These findings have implications for the routine care of diabetic patients and the education of health care professionals.

Adolescent↗

Detection of retained products of conception following spontaneous abortion in the first trimester.

A retrospective analysis was performed to determine whether ultrasound could reliably rule in or out retained products of conception (POC) in women after first-trimester spontaneous abortions (miscarriages). Ninety-seven first-trimester pregnancies with pathologically proven results from dilatation and curettage (D&C) were studied within 7 days of ultrasound examination (60% within 2 days), either by the abdominal or a combination of abdominal and vaginal approaches. Cases were eliminated if there was clinical evidence of a spontaneous evacuation of POC during the interval between the ultrasound and the D&C. POC were diagnosed only if chorionic villi were evident pathologically. The pertinent ultrasound findings were related to the endometrium (thickness, echogenicity, a gestational saclike structure or a space-occupying collection). The results indicated that ultrasound could correctly diagnose POC in all of the cases by detecting a gestational sac or collection (77 cases), or a thickened endometrium of greater than 5 mm (6 cases). Ultrasound was less reliable in ruling out retained POC. When only a thin endometrial stripe of less than 2 mm was present, there was little likelihood of having POC (1 of 7 cases) with a moderately thick endometrium of 2 to 5 mm not diagnostic. Vaginal ultrasound added little new information and failed to change the ultrasound interpretation.

Abortion, Incomplete↗

Compatibility of autologous fibrin adhesive with implant materials.

A safe, effective method for securing autologous and alloplastic implants would benefit modern surgery substantially. We studied the effects of a new autologous fibrin tissue adhesive with various alloplastic implants and ear cartilage. Twelve rabbits had Proplast (a woven combination of Teflon and organic fibers), Silastic, Supramid polyfilament surgical sheeting, and ear cartilage implanted. One side of each animal had implants secured with tissue adhesive. The other, control side had identical implants placed in "subcutaneous tunnels." The tissue adhesive was biodegradable and produced no apparent toxic reaction, infection, or foreign-body reaction. It did not adhere to Silastic, but bound to the other implants. Glued implants had no more clinical or histologic evidence of inflammation than controls. Autologous fibrin tissue adhesive seems to be promising as a safe, biologic bonding material for securing certain alloplastic and autologous implants.

Animals↗

Giant cholesterol cysts of the petrous apex.

The giant cholesterol cyst is a clinical entity distinct from cholesterol granulomas and other destructive lesions of the petrous bone. Preoperative assessment by computed tomographic scan and magnetic resonance imaging is extremely helpful. Attempts at total resection of the lesion are not necessary. Adequate surgical drainage may be established through the mastoid or middle fossa.

Adolescent↗

Lymphadenopathy and entero-vesical fistula in Fabry's disease.

A case of a 55-year-old man with known Fabry's disease, complicated by entero-vesical fistula and associated with enlarged mesenteric lymph nodes, is reported. Histopathologic and ultrastructural findings of the involved lymph nodes are described, and pathogenesis of the entero-vesical fistula is briefly discussed. This is the first case, to the authors' knowledge, of urologic complication in Fabry's disease.

Fabry Disease↗

Eccrine porocarcinoma.

Eccrine porocarcinoma is a rare malignancy of the eccrine sweat duct unit. This article brings to 79 the number of cases reported. Our report and a review of the literature illustrate the natural history and pathological findings of this disease. Patients' ages at the time of appearance for treatment range from 19 to 90 years. The lesions show no predilection for site; their location follows the distribution of sweat glands in the body. Thirty-nine percent of all patients had cutaneous, regional lymph node, or visceral metastases. Primary treatment is wide surgical excision. The value of adjunctive therapy has not been proved.

Adenocarcinoma↗

Multicenter validation study of real-time ultrasonography, arteriography, and pathology: pathologic evaluation of carotid endarterectomy specimens.

The morphologic description and measurements of endarterectomy specimens are usually believed to be accurate and are used as the gold standard against which the findings of diagnostic procedures are judged. Pathology data on 289 endarterectomy specimens from five participating centers and the corresponding angiography and B-mode ultrasonography data provided a basis for scrutinizing the validity of using the morphologic measurements as a standard. Discrepancies of greater than 1 mm between pathology and angiography measurements of minimum residual lumen occurred in 35% of the cases and between pathology and B-mode ultrasonography measurements in 64% of the cases. Discrepancies of greater than 1 mm between pathology- and angiography-measured lesion width occurred in 81% of the cases and between pathology and B-mode ultrasonography measurements in 64% of the cases. The cases representing mismatches of greater than 1 mm at one participating center were subjected to a rigorous review, with remeasurement of all morphologic features, in an attempt to explain the discrepancies. Various types of artifactual distortion of the specimens, the presence of slit-like and occluded lumens that were likely related to loss of perfusion pressure, and an inability to match planes of interrogation used in angiography and B-mode ultrasonography with pathology planes contributed significantly to the existence of mismatches. On the other hand, fixation and decalcification produced minimal and insignificant distortional changes. We conclude that the acquisition of quantitative data from endarterectomy specimens and the acceptance of morphologic data as a standard are limited by a number of problems that can be defined but have been difficult to resolve.

Carotid Arteries↗

Estrone sulfate sulfohydrolase in the developing brain and pituitary of rat, mouse and guinea pig.

The pattern of estrone sulfate sulfohydrolase (estrogen sulfatase) development in the brain of rat, mouse and guinea pig has been established by assaying whole homogenates. Activity was measurable in each species from the fetal state to adulthood. Maximum brain content was reached at about 20 days of age in rat, 14 days in mouse and 15 days in guinea pig. A considerable decrease occurred between 14 days and adulthood in mouse and lesser decreases were seen in rat and guinea pig. The subcellular distribution of enzyme in rat and mouse brain appeared to change from the immature to the adult state. No major differences in enzyme activity occurred between the sexes at any age. Tissue concentration of enzyme in the hypothalamic-preoptic area of rat and mouse was similar to that in the remainder of the brain. In guinea pig the brain concentration was slightly lower than that of the hypothalamic-preoptic region. Sulfatase content of the pituitary was low in all 3 species but the tissue concentration was considerably higher than that of brain, particularly in rat and mouse. Apparent Km values for brain sulfatase were in the range 6-17 microM, with no striking sex difference. Apparent Km's for pituitary sulfatase of immature rat and guinea pig were similar to those for brain in the same animals but that for mouse pituitary (0.9 microM) was much lower. It is unlikely that brain or pituitary sulfatase is by itself, a major factor in making available potentially active estrogen for use during differential sex development in these species.

Aging↗

Significance of membrane thickness in the sonographic evaluation of twin gestations.

A retrospective study of 55 twin pregnancies was performed to determine the role of sonography in distinguishing between dichorionic and monochorionic diamniotic gestations solely by evaluating the thickness of the membrane between the fetuses. The presence of a thick dividing membrane indicated a dichorionic diamniotic gestation in 38 (90%) of 42 cases in which it was identified. Inability to identify a membrane between dichorionic diamniotic twins occurred most commonly during the third trimester. A thin membrane indicated monochorionic diamniotic twinning and was seen in three (25%) of 12 cases. Membrane thickness was indeterminate in one case. Therefore, on the basis of the thickness of the dividing membrane imaged by sonography, dichorionic diamniotic gestations can be distinguished from monochorionic diamniotic gestations. Inability to show a separating membrane by sonography, however, can occur with any form of twin gestation, particularly in the third trimester. Membrane thickness should be used in conjunction with other sonographic criteria to predict the amnionicity and chorionicity of twin gestations.

Extraembryonic Membranes↗