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Biomedical subjects

K J Lee

Publications and source records attributed to K J Lee.

At least 55 records · Page 3Linked to original sources
PubMed2001

An application of artificial neural intelligence for personal dose assessment using a multi-area OSL dosimetry system.

Significant advances have been made in recent years to improve measurement technology and performance of phosphor materials in the fields of optically stimulated luminescence (OSL) dosimetry. Pulsed and continuous wave OSL studies recently carried out on alpha-Al2O3:C have shown that the material seems to be the most promising for routine application of OSL for dosimetric purposes. The main objective of the study is to propose a new personal dosimetry system using alpha-Al2O3:C by taking advantage of its optical properties and energy dependencies. In the process of the study, a new dose assessment algorithm was developed using artificial neural networks in hopes of achieving a higher degree of accuracy and precision in personal OSL dosimetry system. The original hypothesis of this work is that the spectral information of X- and gamma-ray fields may be obtained by the analysis of the response of a multi-element system. In this study, a feedforward neural network using the error back-propagation method with Bayesian optimization was applied for the response unfolding procedure. The validation of the proposed algorithm was investigated by unfolding the 10 measured responses of alpha-Al2O3:C for arbitrarily mixed photon fields which range from 20 to 662 keV.

Algorithms↗
PubMed2001

Crystal structure and kinetic analysis of beta-lactamase inhibitor protein-II in complex with TEM-1 beta-lactamase.

The structure of the 28 kDa beta-lactamase inhibitor protein-II (BLIP-II) in complex with the TEM-1 beta-lactamase has been determined to 2.3 A resolution. BLIP-II is a secreted protein produced by the soil bacterium Streptomyces exfoliatus SMF19 and is able to bind and inhibit TEM-1 with subnanomolar affinity. BLIP-II is a seven-bladed beta-propeller with a unique blade motif consisting of only three antiparallel beta-strands. The overall fold is highly similar to the core structure of the human regulator of chromosome condensation (RCC1). Although BLIP-II does not share the same fold with BLIP, the first beta-lactamase inhibitor protein for which structural data was available, a comparison of the two complexes reveals a number of similarities and provides further insights into key components of the TEM-1-BLIP and TEM-1-BLIP-II interfaces. Our preliminary results from gene knock-out studies and scanning electron microscopy also reveal a critical role of BLIP-II in sporulation.

Amino Acid Sequence↗
PubMed2001

Rac1 regulates heat shock responses by reorganization of vimentin filaments: identification using MALDI-TOF MS.

Rac1 has been implicated in a wide variety of biological processes, including actin remodeling and various signaling cascades. Here we have examined whether Rac1 might be involved in heat shock-induced cell signaling. We found that Rat2 stable cells expressing a dominant negative Rac1 mutant, RacN17 (Rat2-RacN17), were significantly more tolerant to heat shock than control Rat2 cells, and simultaneously inhibited the activation of SAPK/JNK by heat shock compared to control Rat2 cells. However, no discernible effect was observed in typical heat shock responses including total protein synthesis and heat shock protein synthesis. To identify the proteins involved in this difference, we separated the proteins of both Rat2 and Rat2-RacN17 cell lines after heat shock using two-dimensional gel electrophoresis and identified the differentially expressed proteins by matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) after in-gel trypsin digestion. Differentially expressed proteins between two cell lines were identified as vimentin. Rat2-RacN17 cells showed significant changes in vimentin as well as marked changes in vimentin reorganization by heat shock. The vimentin changes were identified as N-terminal head domain cleavage. These results suggest that Rac1 plays a pivotal role in the heat shock-induced signaling cascade by modifying intermediate vimentin filaments.

Animals↗
PubMed2001

Self-expanding coil stent with a long delivery system for palliation of unresectable malignant gastric outlet obstruction: a prospective study.

BACKGROUND AND STUDY AIMS: Peroral intubation of a self-expanding metal stent is usually difficult in patients with unresectable malignant gastric outlet obstruction, because the delivery systems currently available are not long enough and cannot easily pass the angulated gastroduodenal structure. We carried out a prospective study to assess the efficacy of a coil stent with a newly developed long delivery system, for palliation of unresectable malignant gastric outlet obstruction. PATIENTS AND METHODS: In 29 patients with unresectable malignant gastric outlet obstruction, caused by gastric cancer (26 patients), pancreatic head cancer (two patients), or duodenal cancer (one patient), peroral intubation of a self-expanding nickel-titanium coil stent was attempted, using a lengthened delivery system of 150 cm, under endoscopic and fluoroscopic guidance. RESULTS: Management was successful in 26 of 29 patients (89.7 %) without immediate major complications. In one patient in whom peroral intubation failed, percutaneous intubation of the coil stent via percutaneous endoscopic gastrostomy was done. After insertion of the coil stent, food ingestion with symptomatic improvement with regard to vomiting was achieved in 26 of 27 patients (96.3 %), including the patient with percutaneous stent insertion. During the follow-up period, dysphagia and Karnofsky scores improved significantly. Stent migration occurred in two patients, and tumor ingrowth in another two; re-intervention was done successfully performed in two instances. The mean survival time was 124 days (range 34 - 310 days) in the 22 patients who had no need for re-intervention during follow-up; among these was a patient who experienced stent occlusion by food material, which was easily corrected with endoscopic flushing. CONCLUSIONS: Peroral intubation of a self-expanding coil stent using a long delivery system is a safe and effective palliative technique for unresectable malignant gastric outlet obstruction, and significantly improves the quality of life of patients.

Adult↗
PubMed2001

Pediatric heart transplantation: improving results in high-risk patients.

OBJECTIVES: Our institutional experience with 73 pediatric patients undergoing cardiac transplantation between January 1, 1990, and December 31, 1999, was reviewed to determine the impact of unconventional donor and recipient management protocols implemented to extend the availability of this therapy. METHODS AND RESULTS: The introduction of donor blood cardioplegic solution with added insulin was associated with a significant improvement in patient and graft survival (hazard ratio [Cox] = 0.25, P =.08), despite significantly longer ischemic times with this protocol compared with the use of crystalloid-based donor procurement techniques (P <.01). Eleven patients underwent intentional transplantation of ABO-incompatible donor hearts with the aid of a protocol of plasma exchange on bypass. In this subgroup, there were 2 early deaths caused by nonspecific graft failure (n = 1) and respiratory complications with mild vascular rejection (n = 1), and there was 1 late death caused by lymphoma. ABO-incompatible transplantation was not a risk factor for death by multivariate analysis. The postoperative course in these patients suggests minimal reactivity directed against incompatible grafts on the basis of low anti-donor blood group antibody production, in association with a favorable rejection profile. Ten of 13 patients requiring preoperative support with an extracorporeal membrane oxygenator survived transplantation; there were 3 additional late deaths in this subgroup (hazard ratio = 2.88, P =.05). CONCLUSIONS: The results with pediatric cardiac transplantation continue to improve as a result of changes in both surgical and medical protocols permitting successful treatment of patients conventionally considered at high risk or unsuitable for transplantation.

ABO Blood-Group System↗
PubMed2001

Assessment of total body water from anthropometry-based equations using bioelectrical impedance as reference in Korean adult control and haemodialysis subjects.

BACKGROUND: Several indirect prediction equations to estimate total body water (TBW) with simple demographic and anthropometric data are commonly used by researchers and dialysis units. These equations are largely based on observations in subjects of the Western hemisphere. The purpose of this study was to investigate the possible application of anthropometry-based TBW equations to a Korean adult control population and maintenance haemodialysis (HD) patients using multifrequency bioelectrical impedance analysis (BIA) as reference. METHODS: We performed BIA and anthropometric measurements in 67 healthy adults and 101 HD patients. Four anthropometry-based equations were used: 58% of actual body weight (TBW-58), the Watson formula (TBW-W), the Hume formula (TBW-H), and the Chertow formula (TBW-C). Multifrequency BIA was performed at fasting state in controls and after HD. RESULTS: TBW-BIA was 34.6+/-6.9 l in control and 29.9+/-5.1 l in HD patients. TBW-58 and TBW-C gave significantly greater TBWs than TBW-BIA in both control and HD subjects. The correlation coefficients of TBW-BIA with calculated TBWs were lowest in TBW-58 (0.754 in control and 0.856 in HD subjects), and highest in TBW-C (0.944 in control and 0.916 in HD subjects). Mean prediction error was greatest in the Chertow formula for control and HD patients. Mean prediction error, limits of agreement, and root mean square error were lowest between TBW-BIA and TBW-H in control and between TBW-BIA and TBW-W in HD subjects. The correlation coefficient in the Bland-Altman plot was closer to zero and parallel with TBW-W than TBW-H in control and HD subjects. CONCLUSION: Currently available TBW equations overestimate TBW in both Korean normal control subjects and HD patients. Among them, the Watson formula appears to be the closest to TBW and to have the least bias. Based on this analysis, it is reasonable to use the Watson formula for the calculation of TBW in Korean adult control and HD subjects until an Asian-based TBW equation is available.

Adult↗
PubMed2001

Reproductive efficiency and maternal-offspring transfer of gossypol in rainbow trout (Oncorhynchus mykiss) fed diets containing cottonseed meal.

In a preceding study, complete substitution of fish meal protein with cottonseed meal (CM) protein did not affect the survival or growth rate of adult rainbow trout over a 6-mo period. Gossypol, a naturally occurring compound in cottonseeds, has an antifertility effect in terrestrial animals, but information regarding salmonid fish is lacking. Female rainbow trout in this experiment were fed diets with either 0, 25, 50, 75, or 100% (diets 1 to 5) of the fish meal protein replaced with CM protein until first maturation and spawning to study long-term effects on growth and reproduction. Feeding diets containing CM over a total period of 10 mo did not result in differences in growth and mortality compared to the control group (P > 0.05). Increased CM incorporation levels resulted in decreased (P < 0.05) blood hemoglobin (10.6 +/- 1.3, 8.4 +/- 1.8, 7.3 +/- 1.1, 6.9 +/- 0.8, and 5.6 +/- 1.4 g/dL) and hematocrit (49.6 +/- 3.9, 38.5 +/- 9.3, 34.4 +/- 3.7, 34.8 +/- 4.9 and 28.0 +/- 6.8%) levels in diets 1 to 5, respectively. The CM incorporation level had no effect (P > 0.05) on the number of eggs produced per female but led to a reduction (P < 0.05) in egg weight. Eyed stage survival of embryos was low in all dietary groups and did not show differences (P > 0.05). However, an increasing CM incorporation level led to a linear increase (P < 0.05) in the number of females that produced no viable embryos (23.1, 37.5, 42.9, 60.0, and 71.4%). Gossypol in the diet was absorbed by the female trout and transferred to the eggs (0, 2.2 +/- 0.5, 6.7 +/- 1.6, 10.6 +/- 4.2, and 20.0 +/- 2.6 micrograms/g in diets 1 to 5, respectively). A high concentration of gossypol remained in the juveniles at the swim-up stage (endogenous yolk-absorbed) (0.6 +/- 0.3, 2.4 +/- 0.3, 3.4 +/- 0.0, and 4.7 +/- 1.0 micrograms/g, diets 2 to 5, respectively). The findings suggest that replacement of the dietary fish meal protein with CM protein has no effect on fish growth and mortality but may lead to a reduction in reproductive performance in female rainbow trout.

Animals↗
PubMed2001

Emergence of vaccine-induced escape mutant of hepatitis B virus with multiple surface gene mutations in a Korean child.

The S protein of hepatitis B virus is the principal component of virus envelope and the primary target of anti-HBs response. Mutants or variants that escape neutralization by anti-HBs have been selected during immunoprophylaxis of HBV after birth and liver transplantation. We investigated a case of a Korean child who was vaccinated at birth against hepatitis B and also given hepatitis B immunoglobulin, but nevertheless later became infected with the virus. Hepatitis B virus-specific deoxyribonucleic acid covering the region of genome encoding the predominant "a" determinant of hepatitis surface antigen was amplified using polymerase chain reaction, and the nucleotide sequence was determined. We present for the first time in Korea the independent emergence of an escape mutant with substitution of arginine for glycine at amino acid 145 and proline for glutamate at amino acid 120 in "a" determinant after immunization.

Cloning, Molecular↗
PubMed2001

Analysis of vivax malaria cases in Gangwon-do (province), Korea in the year 2000.

A total of 827 malaria cases were reported in the Gangwon-do in the year 2000. There were 18.2 cases per 100,000 inhabitants. There were 283 cases among civilians and 544 cases among the military. 90.6% of cases were reported in Cheorwon--(531), Hwacheon--(152), and Goseong--(66) gun (county), which bordered the demilitarized zone (DMZ). A distinct feature pertaining to the malaria cases in Gangwon-do is that the number of cases has increased about two times over the last year. The mean time from the beginning of symptoms to malaria diagnosis was five days. Control systems for malaria by public health organizations and military organizations are well maintained, but were not able to reduce the malaria prevalence rate. The cause for the increase in pattern of the malaria cases in Gangwon-do may be caused by the spreading of prevalent areas of malaria to the east. Continuous endeavor such as early detection of cases, early treatment, education on clinical symptoms and prevention of mosquito bites with repellent and mosquito nets will help to reduce the infection rate of malaria in Gangwon-do.

Adult↗
PubMed2001

Enterobius vermicularis egg positive rates in primary school children in Gangwon-do (province), Korea.

A survey of the infection rate of Enterobius vermicularis among students in 4 primary schools located in Gangwon-do (Province) was done from May to June 2001. Among the 398 examinees, 39 (9.8%) were infected with E. vermicularis demonstrated by the adhesive cellotape anal swab method. The infection rates ranged from 8.3% to 11.8% among the four schools. The infection rate of males and females was 10.7% and 7.7% respectively. The first grade students showed the highest infection rate, 28.7%. The confirmed cases were treated with albendazole three times at an interval of 15 days. We were able to confirm that E. vermicularis infection is still prevalent among students in Gangwon-do, Korea.

Age Factors↗
PubMed2001

Fatal pulmonary-renal syndrome manifested with immune complex crescentic glomerulonephritis in a patient with MPO-ANCA seropositivity.

Recent reports have indicated that a significant number of immune complex glomerulonephritis (GN) cases are associated with antineutrophilic cytoplasmic antibody (ANCA). However, most of the reported cases were associated with underlying primary glomerular diseases. When primary glomerular diseases were not found, immune deposits tended to be non-specific and the level of ANCA is usually borderline. We report here upon a case of life-threatening pulmonary-renal syndrome manifested simultaneously with immune complex GN and myeloperoxidase (MPO)-ANCA seropositivity. A 29- year-old man was admitted with pulmonary hemorrhage and rapidly progressing renal dysfunction. On admission, ANCA revealed perinuclear staining with a titer of 1:160. The MPO-ANCA level was 59 IU by ELISA. Other serologic markers including ANA, anti-DS-DNA and anti-GBM Ab were negative. Renal biopsy showed cellular crescents in eight of 18 glomeruli. Immunofluorescence staining showed strong granular deposits of C3, C1q, IgG and IgM in the capillary loop and the mesangium. Electron microscopy showed multifocal electron dense deposits scattered in the mesangium, paramesangium, and the subendothelial and subepithelial areas. The patient initially responded to steroid and cyclophosphamide. MPO-ANCA decreased to less than 10 IU. Twenty three days after hospital discharge, the patient was re-admitted urgently with fever, generalized papulonodular skin lesions, and a recurrence of massive pulmonary hemorrhage and renal dysfunction. He died from uncontrolled pulmonary hemorrhage and respiratory insufficiency. P-ANCA titer and MPO-ANCA level at the second admission were 1:320 and 82 U/ml respectively. Interestingly, relapse was shown to be triggered by varicella zoster infection.

Adult↗
PubMed2001

Total occlusion of left main coronary artery by dilated main pulmonary artery in a patient with severe pulmonary hypertension.

A 34-year-old woman was admitted to the hospital because of recently aggravated right heart failure without angina for 5 months. When she was 25 years old, patch repair with Polytetrafluoroethylene (PTFE) was performed for the secondum type of atrial septal defect (ASD) with moderate pulmonary hypertension. The chest PA, echocardiography and cardiac catheterization at current admission revealed Eisenmenger syndrome without intracardiac shunt. Chest CT scan with contrast revealed markedly dilated pulmonary trunk, both pulmonary arteries and concave disfigurement of the left side of the ascending aorta suggesting extrinsic compression, as well as total occlusion of the ostium of the left main coronary artery that was retrogradly filled with collateral circulation from the right coronary artery. The coronary angiography showed normal right coronary artery and the collaterals that come out from the conus branch to the mid-left anterior descending artery (LAD) and that from distal right coronary artery to the left circumflex artery (LCX) and to the distal LAD, respectively. On aortography, the left main coronary artery was not visualized with no stump, suggestive of total occlusion of the ostium of the left main coronary artery. From our experience, it is possible to say that the occlusion of the ostium of the left main coronary can be induced by the dilated pulmonary artery trunk due to ASD with pulmonary hypertension and that, if the ASD closure was too late, the narrowing or obstruction of the left coronary artery could not be resolved even after operation owing to irreversible pulmonary hypertension.

Adult↗
PubMed2001

Incisional hernia after corrective omentectomy for peritoneal dialysis catheter malposition.

Laparotomic correction with or without omentectomy is occasionally required for malposition of a peritoneal dialysis (PD) catheter. We reviewed the incidence of incisional hernia following laparotomic PD catheter correction with or with omentectomy. From January 1996 to December 1998, PD catheters were implanted by non open-dissection technique using a trocar in 148 patients. Laparotomy for PD catheter malposition was required in 20 of the 148 patients. Omentectomy was performed simultaneously in 11 patients. After laparotomy, the wound was closed with interrupted or continuous layered polyglycolidelactide polymer sutures. Dialysis was resumed after the third or fourth day. Incisional hernia developed in 30% (6/20) of all patients undergoing laparotomy, but in none of the patients not undergoing laparotomy. The incidence increased when omentectomy was performed [5/11 (45.5%) vs 1/9 (11.1%)]. Multiparity, female sex, and laparotomy at a later time also predisposed to development of incisional hernia. Among the patients with incisional hernia, 2 patients showed multiple recurrences and 1 patient showed later leakage; PD catheters were lost in these patients. Another 3 patients continued continuous ambulatory peritoneal dialysis (CAPD) without a recurrence. The results suggest that incisional hernia is prevalent following laparotomic PD catheter correction, especially when omentectomy is performed simultaneously. Situations that seem to increase the risk of incisional hernia--inevitably encountered during corrective laparotomic omentectomy--are discussed. An evaluation is necessary concerning whether omentectomy acts as an independent risk factor for incisional hernia, and whether incisional hernia occurs more frequently when omentectomy is performed after a period on CAPD as compared with when it is performed at the time of PD catheter implantation. Laparotomic omentectomy should be performed as a last resort for the correction of PD catheter malposition.

Adolescent↗
PubMed2001

Primary tubercolous osteomyelitis of the sternum.

We present an 82-year-old woman with anterior sternal pain diagnosed as primary mycobacterial osteomyelitis of the sternum. She was treated with simultaneous wide resection and reconstruction of the chest wall. On admission, computed tomographic scan showed a sclerotic sternal mass with soft tissue reaction. Mycobacterium tuberculosis was grown in initial culture. First-line antituberculous medication and local debridement failed. The successful result was achieved by extensive sternal and chondral resection followed by simultaneous bilateral pectoralis major muscle flap positioning.

Aged↗
PubMed2000

DNA ligase IV and XRCC4 form a stable mixed tetramer that functions synergistically with other repair factors in a cell-free end-joining system.

Repair of DNA double-strand breaks in mammalian cells occurs via a direct nonhomologous end-joining pathway. Although this pathway can be studied in vivo and in crude cell-free systems, a deeper understanding of the mechanism requires reconstitution with purified enzymes. We have expressed and purified a complex of two proteins that are critical for double-strand break repair, DNA ligase IV (DNL IV) and XRCC4. The complex is homogeneous, with a molecular mass of about 300,000 Da, suggestive of a mixed tetramer containing two copies of each polypeptide. The presence of multiple copies of DNL IV was confirmed in an experiment where different epitope-tagged forms of DNL IV were recovered simultaneously in the same complex. Cross-linking suggests that an XRCC4.XRCC4 dimer interface forms the core of the tetramer, and that the DNL IV polypeptides are in contact with XRCC4 but not with one another. Purified DNL IV.XRCC4 complex functioned synergistically with Ku protein, the DNA-dependent protein kinase catalytic subunit, and other repair factors in a cell-free end-joining assay. We suggest that a dyad-symmetric DNL IV.XRCC4 tetramer bridges the two ends of the broken DNA and catalyzes the coordinate ligation of the two DNA strands.

Animals↗
PubMed2000

Blastocyst viability and generation of transgenic cattle following freezing of in vitro produced, DNA-injected embryos.

This study examined whether the viability, determined in vitro, of DNA-injected bovine embryos produced in vitro was affected by freezing, and if the frozen embryos developed to term following transfer to recipients. In vitro fertilized zygotes were injected with the pBL1 gene and then co-cultured with mouse embryonic fibroblasts (MEF) in CR1aa medium. Embryos were prepared for cryopreservation by exposure to a 10% (v/v) glycerol solution, loaded into 0.25 ml straws and then frozen by conventional slow freezing. Thawing was by rapid warming in water (37 degrees C) and embryos were rehydrated in PBS diluents of 6%, 3% and 0% (v/v) glycerol supplemented with 0.25 M sucrose and 0.5% (w/v) BSA. In Experiment 1, blastocysts that developed from DNA-injected embryos were individually classified into three morphological groups and three stages of development prior to freezing. DNA-injected blastocysts of excellent quality at freezing showed a higher survival rate (78.8+/-10.6%) after thawing than those of good (60. 9+/-16.4%) or fair (12.5+/-5.9%) quality (P<0.05). Post-thaw survival rate, judged in vitro, increased with more advanced stage of blastocyst development at freezing (early 48.8+/-15.9%, mid 52. 1+/-12.6% and expanded 71.2+/-1.1; P<0.05). In Experiment 2, the frozen/thawed embryos were transferred to recipients to examine in vivo viability. Following transfer of one or two embryos per recipient, pregnancy rates at 60 days of gestation were 13.6% (13/96) for frozen embryos and 26.5% (43/162) for fresh embryos (P<0. 05). Of the 12 live calves born from the frozen/thawed embryos, two males (18.3%) were transgenic. None of the live-born calves derived from fresh embryos exhibited the transgene. One of transgenic bulls did not produce transgenic sperm. Three out of 23 calves (13.0%) produced from cows inseminated with semen of the other bull were transgenic, suggesting that this animal was a germ-line mosaic. These studies indicated that the viability of in vitro produced, DNA-injected bovine blastocysts was affected by freezing and by both the quality and stage of development of the embryo prior to freezing. The generation of transgenic cattle demonstrates that it is feasible to freeze DNA-injected, in vitro produced embryos.

Animals↗