Biomedical subjects

J Kim

Publications and source records attributed to J Kim.

At least 1,243 records · Page 69Linked to original sources

PubMedDate not supplied

Colorectal cancer screening. Knowledge and practices among Korean Americans.

PURPOSE: The purpose of this study was to examine knowledge and practices of colorectal cancer screening among Korean Americans. DESCRIPTION OF STUDY: The sample consisted of 104 Korean American men and 159 women, 40 to 69 years of age, living in the Chicago area. The National Health Interview Survey (NHIS) Cancer Control Supplement Questionnaire, prepared by the National Center for Health Statistics, was used to collect data regarding colorectal cancer screening knowledge and practices. The NHIS questionnaire was translated into Korean with minor modification. RESULTS: The percentage of male respondents ever having had a digital rectal exam (DRE) and fecal occult blood test (FOBT) were 13.5% and 10.6%, respectively. Only 11.3% of women reported DRE and 8.8% FOBT. Multiple logistic regression analysis results indicate that gender, education, knowledge of the seven cancer warning signals, and length of residence in the United States were significantly related to having heard of DRE. For those having had DRE, knowledge of the seven cancer warning signals, and length of residence in the United States were the only significant variables. Gender and education were significantly related to having heard of FOBT. None of the variables were found to be significantly related to having had FOBT. The findings indicate that a majority of respondents were unaware of these cancer screening examinations and forego these tests due to an underestimation of their importance. CLINICAL IMPLICATIONS: The findings of this study underscore the importance of cancer education and further research addressing the cancer screening needs of Korean Americans. Currently, Korean Americans do not see healthcare providers or health brochures as valuable sources of health information. Therefore, healthcare professionals need to target this population by 1) coordinating their efforts with church and other community leaders and 2) developing health brochures that are in the Korean language and sensitive to the Korean culture.

Adult↗

PubMedDate not supplied

Smoking behavior, knowledge, and beliefs among Korean Americans.

PURPOSE: The purpose of the study was to examine smoking behavior, knowledge, and beliefs among Korean Americans. DESCRIPTION OF STUDY: One hundred four Korean American men and 159 women, 40 to 69 years old, living in Chicago, Illinois, served as study respondents. The National Health Interview Survey (NHIS) Cancer Control Supplement Questionnaire was used to collect data. The NHIS was translated into Korean with minor modifications to develop a culturally appropriate instrument. RESULTS: This study suggests that smoking is almost exclusively a male behavior (38.5%) and that Korean American men smoke mostly cigarettes. Almost 90% of women have never smoked, whereas 23% of men reported never smoking. Respondents with a non-Christian background or no religious affiliation were 16.5 times more likely to be current smokers. Respondents who had lived in the United States less than 10 years were 12.5 times more likely to be current smokers. More than 90% of men, regardless of smoking status, were able to identify an association between smoking and major chronic diseases. CLINICAL IMPLICATIONS: The prevalence of smoking among these Korean American men places them at considerable risk for smoking-related disease. Healthcare providers must be better informed about smoking behavior in this group, and specific attention to recently migrated men and those reporting religions other than Christianity is recommended. Health-protecting strategies for women and children who fall victim to secondhand smoke, or who may be targeted by tobacco advertising, are also an important step in disease prevention for this population.

Adult↗

PubMedDate not supplied

Study on in vitro release patterns of fentanyl-loaded PLGA microspheres.

In order to study the development of the delivery device of long-acting local anaesthetics for post-operative analgesia and control of chronic pain of cancer patient, fentanyl loaded poly(l-lactide-co-glycolide) (PLGA, molecular weight; 5000, 8000, 20,000, and 33,000 g/mole) microspheres (FMS) were studied. FMS were prepared by an emulsion solvent-evaporation method. The influence of several preparation parameters such as initial drug loading, PLGA concentrations, emulsifier concentrations, oil phase volume and mole ratio and molecular weight has been investigated on the fentanyl release patterns. Generally, the drug showed the biphasic release patterns, with an initial diffusion followed by a lag period before the onset of the degradation phase, but there were no lag times in the device. Fentanyl was slowly released from FMS over 10 days in vitro, with a quasi-zero order property. The release rate increased with increasing drug loading as well as increasing polymer concentration with a relatively small initial burst effect. From the results, FMS may be a good formulation to deliver the anaesthesia for the treatment of chronic pain.

Analgesics↗

PubMedDate not supplied

Current distribution under electrodes in relation to stimulation current and skin blood flow: are modern electrodes really providing the current distribution during stimulation we believe they are?

Carbonized rubber electrodes were tested extensively when they were first developed 30 years ago, but modern carbonized rubber electrodes have not received the type of scrutiny that the first electrodes received. Modern electrodes differ from the original electrodes in that they come with a self-adhesive electrode gel called hydrogel as part of their composition. The present study was undertaken to examine the current distribution and impedance characteristics of five brands of carbonized rubber electrodes and to examine the current distribution between electrodes during electrical stimulation in six subjects. Several different electrode sizes were tested between 3 and 10 cm. The current flow between the electrodes was determined by measuring the voltage across the skin on human subjects in 15 discrete locations between the electrodes. Blood flow was also measured between the electrodes with a laser Doppler flow meter to assess the physiological effect of current distribution on the skin at several skin temperatures. The results of these studies showed that at low currents, such as is used in TENS, very little current is actually applied through the skin due to the high impedance of the electrodes. At current levels normally used for electrical stimulation for functional movement, while current flow is better in most electrodes, it is very uneven, resulting in high current density in the centre of the electrodes and a fall off of at least 50% in current intensity at the edges of the electrode. There was very little difference in current density between small and large electrodes due to the high current density in the centre. Skin blood flow altered the movement of current between the electrodes and also may contribute to electrode performance. The implication of these studies is that electrode design needs to be altered for better current distribution, especially at low stimulation currents.

Adult↗

PubMedDate not supplied

The shaping of individual meanings assigned to assistive technology: a review of personal factors.

PURPOSE: This review article examines the development of individualized meanings assigned to assistive technology and how these personal meanings influence the integration of assistive technology into daily activities. METHODS: A review of the published literature regarding assistive technology use and abandonment was conducted by performing two independent searches using 26 search terms and three databases. Publications were reviewed for whether they addressed device use, device abandonment, coping, adjustment, adaptation, values, outcomes and/or cultural issues; 81 publications met these criteria. RESULTS: The evidence suggests that psychosocial and cultural issues influence the shaping of individualized meanings assigned to assistive technology. Theoretical arguments suggest that the process of adapting to disability is another influential factor. CONCLUSIONS: The synthesis of evidence and theories suggests that successful integration of assistive technology into daily lives requires potential device users to explore: (1) the meanings they assign to devices; (2) their expectations of assistive technology; (3) the anticipated social costs; and (4) ways to understand that disability is one, but not the defining, feature of one's identity.

Adaptation, Psychological↗

PubMedDate not supplied

Structure-activity relationships of apio nucleosides as potential antiviral agents.

Several types of novel apio nucleosides were synthesized starting from 1,3-dihydroxyacetone and evaluated for antiviral activity. Among compounds tested, amino substituted apio dideoxynucleosides exhibited anti-HBV activity, while thioapio dideoxynucleosides were found to be active against HIV-1. Apio dideoxydidehydro nucleosides showed moderate to potent anti-HCMV activity, but their bioisosteric thioapio dideoxydidehydro nucleosides did not exhibit any significant antiviral activity.

Antiviral Agents↗

PubMedDate not supplied

Nocardial infection as a complication of AIDS: report of six cases and review.

Nocardiosis has been increasingly recognized as a serious infection among persons who otherwise appear healthy and among those with underlying chronic disease, neoplasms, and immunosuppression. Nocardial infection as a complication of AIDS has been reported infrequently. Six patients with AIDS and nocardiosis were identified at one New York City hospital from January 1980 through March 1989. Sites of nocardial infection in these patients included the lungs, brain, esophagus, and suprarenal and paraspinal masses. Mycobacteria, fungi, viruses, and bacteria other than Nocardia species caused concomitant infections in three patients. Three patients died of nocardiosis. Because of such factors as the growth properties of Nocardia species, the presence of other organisms, the common use of sulfonamides for treatment of patients with AIDS, and a low index of suspicion among physicians, the incidence of nocardiosis as a complication of AIDS may possibly be underreported. Early recognition of nocardial infection may lead to an improved prognosis.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Effect of shear rates on protein adsorption in the total artificial heart.

Plasma protein adsorption is the first event in blood-material interaction and influences subsequent platelet adhesion and thrombus formation. Thromboembolic events are strongly influenced by surface characteristics of materials and fluid dynamics inside the blood pump. In vitro flow visualization, and an animal experiment with a moving actuator total artificial heart (TAH), were performed to investigate fluid dynamic effects on protein adsorption. The different levels of shear rate inside the ventricle were determined by considering the direction of opening of the four heart valves in the implanted TAH, and the visualized flow patterns as well. Each ventricle of the explanted TAH was cut into 12 segments according to the shear rate level. The adsorbed protein on each segment was quantified using an ELISA method after soaking in 2% (w/v) SDS/PBS for 2 days. Adsorbed protein layer thicknesses were measured by the immunogold method under transmission electron microscopy. Scanning electron microscopic observation showed that the right ventricle, immobilized with albumin, displayed different degrees of platelet adhesion on each segment, whereas the left ventricle, coated with polythyleneoxide-sulfonate, indicated nearly the same platelet adhesion behavior, regardless of shear rates. The surface concentrations of adsorbed proteins in the low shear rate region are higher than those in the high shear region, which was confirmed statistically.

Adsorption↗

PubMedDate not supplied

Markers of thromboembolization in a bovine ex vivo left ventricular assist device model.

The production of blood microemboli (BME) was studied using an ex vivo exteriorized left ventricular assist device (LVAD) model in calves. Each of eight calves received a series of three LVADs, each operating for 24 hr. Blood microemboli were measured directly by a laser (624 nm and 828 nm) light scattering microemboli detection (LSMD) system through the LVAD outflow cannula and by constant pressure filtration (CPF) of blood samples from the LVAD outflow cannula. Hematologic parameters were also measured. After LVAD removal, perivalvular thrombi were evaluated using polar coordinate mapping. The average LSMD and CPF results correlated. For example, in one series of three calves, one ventricle exhibited significantly greater thrombogenesis than did the other ventricles, as indicated by both the LSMD and CPF results. In a series of five calves, one calf developed an abnormally high activated thromboplastin time (APTT), even in the absence of heparin. For two of the three ventricles tested in that calf, microemboli concentration (CPF), Factor XII activity, level of fibrin degradation products (FDP), and accumulated thrombus were significantly lower than for the other calves. The whole blood viscosity (WBV, at 230 s-1) in this calf also decreased to lower values than were seen with the other calves.

Animals↗

PubMedDate not supplied

Effect of shear stress on fibrinogen adsorption and its conformational change.

The composition and molecular organization of adsorbed protein films are strongly correlated with thrombogenesis on artificial surfaces. In particular, the antibody-detectable (that is, conformationally intact) bound fibrinogen, but not that the total amount of adsorbed fibrinogen, is correlated with platelet reactivity. In this work, the authors quantified the adsorbed plasma protein distribution inside the left ventricular assist device. They also evaluated the effect of wall shear stress on protein adsorption and conformational change of adsorbed fibrinogen. Conformational change of adsorbed fibrinogen was measured by exposing the fibrinogen preadsorbed polyurethane to three anti-fibrinogen monoclonal antibodies; the 134B-29 detectable alpha 566-580 domain of fibrinogen was increased with increasing concentration of adsorbed fibrinogen, whereas the other two fibrinogen domains were almost saturated when increasing the concentration of adsorbed fibrinogen. The adsorbed amounts of total fibrinogen and monoclonal antibody detectable fibrinogen was decreased with increasing shear rate. Results of in vivo plasma protein adsorption on polyurethane surfaces disclosed that the adsorbed amount of fibrinogen, as well as albumin and globulin, was also decreased with increasing shear rate. In conclusion, less protein was adsorbed in the higher shear region and the effect of shear level on fibrinogen adsorption and its conformational change was strongly dependent upon the surface characteristics of the biomaterials. The monoclonal antibody 134B-29 against the 566-580 domain of fibrinogen was the most reactive with the fibrinogen adsorbed on polyurethane surfaces in this experiment.

Adsorption↗

PubMedDate not supplied

In vivo experiment leading to clinical application of an electrohydraulic ventricular assist device with magnetic coupling.

We developed an electrohydraulic ventricular assist device with magnetic coupling. The integrated system consists of a blood pump, a water conduit for pressure transmission, a bellows type pumping sac, an actuator for transforming the circular motion of a motor to the linear motion of a pusher plate attached to the pumping sac with magnetic coupling, and a controller. The purpose of the coupling was to prevent excessive sucking against the atrial wall. Number 21 Medtronic Hall (Irvine, CA) mechanical valves were used in the inflow and outflow ports of the blood pump. Maximum dynamic stroke volume was 48 ml, and against a mean afterload of 100 mm Hg, maximum pump output was 7 L/min. Chronic in vivo experiments were performed in three sheep, and during these evaluations the system showed no noticeable problems related to mechanical or electronic devices. When left atrial pressure decreased below 0 mm Hg, the magnetic coupling system decoupled the pumping sac and pusher plate with satisfactory reliability. The device was clinically applied in a postoperative patient with chronic dilating cardiomyopathy, and no significant device related problems ensued. These results prove that the electrohydraulic ventricular assist system with magnetic coupling is a suitable ventricular assist device.

Animals↗

PubMedDate not supplied

Replacement of a tracheal defect with autogenous mucosa lined tracheal prosthesis made from polypropylene mesh.

Reliable prosthetic or tissue grafts for the trachea have not, as yet, been developed for reconstruction of large, circumferential tracheal defects. Major limitations are anastomotic dehiscence and stenosis, attributed to the poor epithelialization and vascularization of the prosthetic graft. We have developed a new tracheal prosthesis that has a well vascularized and viable mucosa. The prosthesis consists of a Prolene mesh reinforced with polypropylene rings, and coated with gelatin. We lined the luminal surface of the prosthesis with transplanted autogenous oral mucosa, wrapped the prosthesis with greater omentum, and placed it in the peritoneal cavity for 2 weeks. Complete surgical resection and replacement of a segment (5 cm in length, 8 to 10 tracheal rings) of the thoracic trachea was then performed in nine adult mongrel dogs. The transplanted mucosa was well vascularized and maintained its normal histology in prereplacement analysis. Dogs with tracheal replacement regained their full activity and did not show any respiratory problems until sacrifice at 1, 2, and 6 months. After 6 months, the prostheses were completely incorporated by the host trachea in all dogs and confluent epithelialization was confirmed histologically from the upper to the lower anastomotic site of the prosthesis; furthermore, the transplanted mucosal cells had changed to ciliated columnar epithelium.

Animals↗

PubMedDate not supplied

Experimental cerebral vasospasm and cyclic adenosine monophosphate (c-AMP).

Blood induced acute and chronic cerebral vasospasm were studied in Rhesus monkeys by serial angiography. Two vasoactive agents were evaluated. In acute spasm, phosphodiesterase inhibition by Aminophylline consistently reversed the vasospasm. This agent alone was ineffective in chronic spasm and required the addition of Isoproterenol to produce reversal of vasospasm. It is proposed that cerebral vasospasm may be associated with a decrease of intracellular c-AMP in vascular smooth muscle which can be reversed by manipulation of the enzyme pathway involved. It is further proposed that c-AMP is a basic common pathway through which adrenergic vascular reactivities are mediated.

Aminophylline↗

PubMedDate not supplied

Papillary adenocarcinoma of the lung: radiologic and pathologic findings.

We describe the radiologic and pathologic findings of papillary adenocarcinoma of the lung in three patients. The tumor appeared as a peripheral lung nodule (n = 1) or a mass (n = 2) on chest radiographs. On CT, the tumor appeared as a solitary pulmonary nodule, as a mass containing internal bubble lucencies with surrounding ground-glass opacity and satellite micronodules, and as a triangular mass with satellite micronodules. On pathology, all tumors showed distinct histologic features with papillary architecture, distortion and/or destruction of normal pulmonary architecture, and nuclear atypism.

Adenocarcinoma, Papillary↗

PubMedDate not supplied

Spectrum of neurogenic tumors in the thorax: CT and pathologic findings.

Neurilemomas and neurofibromas appear as round soft tissue masses at CT. Variable enhancement with either homogeneity or heterogeneity is seen in neurilemomas. Attenuation of the tumors on enhanced CT depends on histology: the extent of Antoni A or B tissue and the amount of myxoid or cystic degeneration or hemorrhage. Neurofibromas are usually homogeneous low attenuation lesions on unenhanced CT. They show homogeneous enhancement or early central blush on enhanced scan. The extent of enhancement depends on the proportions of tumor components: nerve sheath cells, collagen bundles, and areas of myxoid degeneration. Malignant nerve sheath tumors show variable attenuation. Bony destruction, pleural effusion, and metastatic pulmonary nodules may also occur. Ganglioneuromas appear as oblong homogeneous low attenuation lesions on both enhanced and unenhanced CT. This low attenuation is due to their pathologic components, with an abundant amount of myxoid matrices and a relatively small amount of ganglion cells. Neuroblastomas appear as aggressive soft tissue lesions with calcification. Ganglioneuroblastomas may appear with features in between those of ganglioneuromas and neuroblastomas. The typical location of the posterior mediastinum or the aortopulmonary window and high enhancement with administration of contrast medium at CT suggest the diagnosis of paragangliomas.

Adult↗

PubMedDate not supplied

Primary tumors and mediastinal lymph nodes after neoadjuvant concurrent chemoradiotherapy of lung cancer: serial CT findings with pathologic correlation.

PURPOSE: The purpose of this work was to describe the changes of primary tumor and mediastinal lymph nodes on CT after neoadjuvant concurrent chemoradiotherapy and to correlate the CT findings with pathology. METHOD: Twenty-one consecutive patients [N2 disease (n = 19) or resectable T4 and N2 disease (n = 2)] with non-small cell lung cancer underwent neoadjuvant concurrent chemoradiotherapy. Changes of primary tumor and mediastinal nodes before and after the therapy were assessed using CT. The CT findings were correlated with pathologic findings. RESULTS: With neoadjuvant therapy, decrease in T stage was achieved in 9 of 21 (43%) patients on CT. On pathology, the remaining tumor consisted mostly of fibrosis and necrosis with little proportion of viable tumor cells (mean volume 17%, range 0-55%). Decrease in nodal stage was achieved in 14 of 21 (67%) patients on pathologic examination. Seven patients had cancer cells in mediastinal lymph nodes: in 6 of 9 (67%) patients with adenocarcinoma and 1 of 12 (8%) patients with squamous cell carcinoma (p = 0.016). CONCLUSION: With neoadjuvant concurrent chemoradiotherapy, the remaining tumor consists mostly of fibrosis or necrosis. Decreased nodal stage on pathology is achieved especially in patients with N2 disease of squamous cell carcinoma. The CT findings of the tumor and mediastinal nodes are not helpful in predicting the pathology after the therapy.

Adenocarcinoma↗

PubMedDate not supplied

Pulmonary tuberculosis: CT and pathologic correlation.

Typical CT findings of active postprimary pulmonary tuberculosis include centrilobular nodules and branching linear structures (tree-in-bud appearance), lobular consolidation, cavitation, and bronchial wall thickening. The CT findings of inactive pulmonary tuberculosis include calcified nodules or consolidation, irregular linear opacity, parenchymal bands, and pericicatricial emphysema. The typical appearance of primary tuberculosis on CT scans is homogeneous, dense, well-defined segmental or lobar consolidation with enlargement of lymph nodes in the hilum or the mediastinum. Miliary nodules may be seen in primary and postprimary tuberculosis. On CT, tuberculomas appear as a nodule with surrounding satellite nodules and internal cavitation on CT. Atypical radiologic manifestations of tuberculosis, encountered in as many as one third of the cases of adult-onset tuberculosis, are single or multiple nodules or masses, basilar infiltrates, miliary tuberculosis with diffuse bilateral areas of ground-glass opacity, and reversible multiple cysts. Underlying histopathologic findings of typical and atypical CT findings of tuberculosis are caseating granulomas or pneumonia in the active phase and fibrosis and dystrophic calcification in the inactive phase.

Adult↗

PubMedDate not supplied

T1 lung cancer on CT: frequency of extrathoracic metastases.

PURPOSE: To determine the frequency of extrathoracic metastases in T1 non-small-cell lung cancer. METHOD: Ninety patients with T1 lung cancer identified on CT were included. Extrathoracic metastases were evaluated at the time of initial diagnosis and during a 1-year follow-up study. The frequency of metastases was compared in terms of cell type (squamous or nonsquamous), size (<2 cm or >2 cm), and the initial CT findings of the tumor. RESULTS: Extrathoracic metastases were identified in 12 (13%) of 90 patients at the time of diagnosis and in 10 patients at the 1-year follow-up study (total, 22 of 90 [24%] patients). Tumors with ground-glass opacity on CT were associated with a significantly lower prevalence of metastases (p = 0.042). The area of ground-glass opacity was seen in 1 of 13 (85%) patients with bronchioloalveolar carcinoma and in 12 of 53 (23%) patients with adenocarcinoma other than bronchioloalveolar carcinoma (p < 0.001). There was no significant difference in the prevalence of metastases between squamous and nonsquamous cell carcinoma, between tumors smaller than 2 cm (n = 17) and larger than 2 cm in diameter (n = 73) and between tumors with or without mediastinal nodal metastases (p>0.05). CONCLUSION: Extrathoracic metastases were apparent at the initial examination in 13% of patients and at the 1-year follow-up examination in 11% of patients. The prevalence is significantly lower in tumors with ground-glass opacity.

Carcinoma, Non-Small-Cell Lung↗