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Biomedical subjects

H Y Shin

Publications and source records attributed to H Y Shin.

47 records · Page 3Linked to original sources
PubMed1995

Immunogenicity and safety of a 23-valent pneumococcal polysaccharide vaccine in healthy children and in children at increased risk of pneumococcal infection.

Splenectomized children as well as those suffering from nephrotic syndrome or recurrent asthmatic bronchitis have an increased susceptibility to systemic pneumococcal infections compared to healthy children. To determine the immunogenicity and safety of a 23-valent pneumococcal polysaccharide vaccine (PPV), 119 children (21 healthy, 26 splenectomized children, 48 with nephrotic syndrome and 24 with recurrent asthmatic bronchitis), aged 2-18 years, received one subcutaneous injection of a 23-valent PPV. Anti-capsular antibodies (Ab) to types 6B, 9V, 14, 18C, 19F and 23F were measured by ELISA before and 4 weeks after immunization. In all cases the adverse reactions were mild and transient, consisting of local pain and/or erythema or swelling in 41% and fever above 38.5 degrees C in 2% of the children. The healthy children responded well to vaccination with a mean fold increase (FI) of 2.6 in postvaccination Ab titers compared to prevaccination titers. The combined geometric mean Ab concentrations in the high-risk children were significantly lower than those of healthy children both before and after vaccination. However, the combined geometric mean FI were not significantly different between high-risk and healthy children. These results indicate that PPV is immunogenic and safe in high-risk as well as in healthy Korean children.

Adolescent↗
PubMed1994

A monoclonal antibody to cell surface antigen of human thymic epithelial cell.

The cell surface molecule identified by a monoclonal antibody(TE-1) to human thymic epithelial cell showed the specificity for thymic epithelial cells of both the cortex and medulla. TE-1 reacted with the epithelial cells of normal thymus and thymoma in fresh frozen tissues. The antigen recognized by TE-1 was mostly confined to the cell surface membrane and arranged in reticular network with long processes between thymocytes. On immunohistochemical analysis, TE-1 did not recognize normal epithelial cells of the uterine cervix, skin and stomach, and neoplastic cells of squamous cell carcinoma and gastric adenocarcinoma, all of which were stained with anti-cytokeratin monoclonal antibody. Among the tumor cell lines tested with flow cytometry, most of epithelial and all of hematopoietic cell origin were not labeled with TE-1. In summary, TE-1 appears to be a monoclonal antibody against a surface antigen of human thymic epithelial cell that is immunohistologically different from known epithelial cell surface antigens reported so far.

Animals↗
PubMed1994

Treatment outcome and prognostic factors of medulloblastoma.

Medulloblastoma, once a tumor with a dismal prognosis, is one of the most common primary brain tumors of childhood. As the methods of treatment have been continuously refined, the outcome has improved remarkably during the last few decades. The outcome of 78 medulloblastoma patients, which were managed from 1972 to 1992 at the Department of Neurosurgery of Seoul National University Hospital, were analyzed to calculate the 3-year and 5-year survival rates (3yS and 5yS). Of those, 52 cases which were treated after July 1982 were studied 1) to calculate the 3yS and 5yS, 2) to figure out the prognostic factors of survival, and 3) to investigate the role of adjuvant chemotherapy ('8-drugs-in-a-day' protocol: CCNU, cisplatin, vincristine, hydroxyurea, procarbazine, cytosine arabinoside, methylprednisolone and cyclophosphamide). The 3yS and 5yS of the 78 patients were 57.4% and 47.3%, respectively. Of the 52 patients treated after July 1982, the 3yS and 5yS were 67.8% and 64.1%, respectively. The latest recurrence was at 56 months after surgery. All the recurrences were within the risk period of Collins' rule. Of the prognostic factors studied by univariate analysis (age, sex, Chang's classification T- and M-stages, extent of surgical removal, and chemotherapy), Chang's classification M-stage and sex were the statistically significant factors (p = 0.028 and 0.024 respectively). On multivariate analysis, only the M-stage was statistically significant (p = 0.004). Adjuvant chemotherapy had different influences in different patient groups. Only in the 'poor risk' group, did adjuvant chemotherapy have a strong tendency to better outcome (p = 0.069). Further data collection and analysis will lead to better treatment modalities and better outcome for this most common primary malignant brain tumor in childhood.

Adolescent↗
PubMed1992

Acute leukemias with unusual immunophenotypes.

Over a two-year period, immunophenotypic patterns of 266 acute leukemia cases were analyzed using a panel of tests including TdT, SmIg and 9 surface antigens by the immunofluorescence stains for the assessment of the incidence and grade of phenotypic ambiguity (lineage infidelity) and the possible clinical significance of unusual immunophenotypes. Immunophenotypes were classified into four groups according to the degree of ectopic antigen expression. We classified as Group A (91.7%, 244 of 266 cases) those expressing conventional pattern without ectopic antigen. Group B (3.0%, 8 of 266 cases) was defined to have at least two lineage specific markers and single ectopic antigen. Such a "low grade deviation" did not prevent a definite immunodiagnosis. Group C (4.2%, 11 of 266 cases) revealed a promiscuous coexpression of markers related to different lineages, including two cases (0.8%, 2 cases) of biphenotypic leukemia. Group D (1.1%, 3 cases) included unclassifiable immunophenotypes with no antigen or HLA-DR only expression. Both patients with biphenotypic leukemia and one patient with unclassifiable immunophenotypes failed to respond to induction chemotherapy, suggesting a poor prognosis in these patients. The incidence of acute myelogenous leukemia (AML) cases with one or more ectopic surface antigens was 10 (8.1%) of the 124 AML cases. Ectopic antigen expression was seen in 5 (4%) of the 125 B-lineage acute lymphoblastic leukemia (ALL) cases and 3 (25%) of the 12 T-ALL cases. It is concluded that nearly 95% of cases of acute leukemia cases can be diagnosed accurately with immunophenotyping alone including patients with a mild degree of deviation from expected antigenic patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

Autonomy and decision making between single older women and their caregiving daughters.

We examined perceptions of decisional autonomy and decision-making processes among 64 elderly, single mothers and their caregiving daughters. Mothers were highly involved in decisions affecting their lives, ranging from daily care to major health decisions; daughters were particularly influential over major health, financial and housing decisions. Mothers' level of personal care dependency was negatively associated with both mothers' and daughters' confidence in the mothers' decision-making abilities.

Adult↗
PubMedDate not supplied

Secondary cardiac tumor in children.

We describe our clinical experience of eight cases of secondary cardiac tumor. The pathology of the tumors were lymphoma (three), Wilms' tumor (two), malignant teratoma (one), neuroblastoma (one), and pleuropulmonary blastoma (one). Metastatic sites were the right atrium in Wilms' tumor and neuroblastoma, the left atrium in pleuropulmonary blastoma and malignant teratoma, and multiple sites in lymphoma. Primary masses in the mediastinum extended directly to the heart (three lymphoma, malignant teratoma, pleuropulmonary blastoma). Wilms' tumor and neuroblastoma showed cardiac metastases through the inferior vena cava. Many cases revealed vague abnormal cardiovascular findings (symptoms in six; physical signs in five). In five cases surgery was performed to relieve the possible obstruction to flow and to identify the pathology (lymphoma in three, Wilms' tumor in one, and malignant teratoma in one). Chemotherapy prior to operation resulted in the disappearance of the intracardiac masses in each case of Wilms' tumor and pleuropulmonary blastoma. All three patients with lymphoma died immediately after operation. Four died of multiple metastases or Pneumocystis pneumonia several months after operation. This study indicates that suspicion of a secondary cardiac tumor is crucial to early diagnosis. Because of the poor postoperative outcome, surgery for secondary cardiac tumors should be done cautiously only in cases with definite hemodynamic decompensation.

Antineoplastic Agents↗
PubMedDate not supplied

Teratoid Wilms tumor in childhood: CT and ultrasonographic appearances.

Teratoid Wilms tumor is defined as an unusual variant of nephroblastoma, in which there is a significant diversity of cell types and tissues in a neoplasm, where areas of classic nephroblastoma tissue are also present. We report a case of teratoid Wilms tumor demonstrated as a unilateral cystic and solid renal mass containing fatty tissue on ultrasonography and computed tomography.

Child, Preschool↗
PubMedDate not supplied

Extrapontine myelinolysis caused by electrolyte imbalance during the management of suprasellar germ cell tumors. Report of two cases.

Extrapontine myelinolysis (EPM) is caused by marked fluctuation of the serum electrolyte level. Patients with suprasellar germ cell tumors frequently present with diabetes insipidus, which is often aggravated by administration of steroid hormone. In addition, cisplatin-based chemotherapy is sometimes accompanied by marked serum electrolyte fluctuation because it needs massive hydration to prevent renal damage. Two children with suprasellar germ cell tumors in whom EPM developed secondary to profound hyponatremia and was rapidly corrected are described. The central pons was spared in both cases. Clinically the children showed transient neurological deficits including confusion, pseudobulbar palsy, and deterioration of consciousness. MRI demonstrated bilateral symmetrical, high-signal-intensity (HSI) lesions on T2-weighted images (T2WI) at the basal ganglia and adjacent cerebral cortex. Follow-up T1WI a few months later revealed newly developed HSI lesions in the basal ganglia. The patients gradually improved, but the neurological deficits did not completely disappear. During the perioperative management of suprasellar germ cell tumors, EPM should be considered when a patient has a significant electrolyte imbalance and neurological deficits, especially confusion and pseudobulbar palsy.

Child↗
PubMedDate not supplied

Hepatic choriocarcinoma in a neonate: MR appearance.

We present the MR findings of hepatic choriocarcinoma in a 2-week-old infant. Two masses of heterogeneous signal intensity were evident; one was an extensive mass on the left side of the liver and the other was a "daughter" nodule in the right lobe. Peripheral portions of the masses were hyperintense on T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) suggesting subacute hemorrhage. Central portions of the masses were hypointense on T1WI and bright on T2WI. T1-weighted postgadolinium imaging showed peripheral enhancement of both tumor nodules. The infant's mother had normal serum beta-human chorionic gonadotropin levels and pelvic CT.

Biomarkers, Tumor↗
PubMedDate not supplied

Neonatal choriocarcinoma of liver.

Neonatal choriocarcinoma associated with a seemingly normal gestation is rare. A total of 20 cases of either primary or metastatic choriocarcinoma in infancy have been reported until 1992. We report an additional case of a huge choriocarcinoma of the liver in a 2-month-old boy, who died of tumor hemorrhage. This baby was born to a 19-year-old unmarried mother. The placenta was thought to be normal and was not examined histologically. The liver mass was first noted 2 weeks after birth, and he was admitted because of poor feeding and pallor. Before any therapy was instituted, he died of massive tumor bleeding. Autopsy revealed a huge hemorrhagic tumor mass with massive necrosis in the left lobe of the liver. Several nodular metastases were found only in the lung. The remainder was unremarkable except for bilateral cleft lip and palate. It is presumed that the choriocarcinoma in the liver could be either a primary tumor in the absence of any primary focus in the mother or the infant or a metastatic lesion from an occult choriocarcinoma of the placenta.

Adult↗