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Biomedical subjects

K Kim

Publications and source records attributed to K Kim.

At least 19 recordsLinked to original sources
PubMed1992

Percutaneous fenestration of dissecting intima with a transseptal needle. A new therapeutic technique for visceral ischemia complicating acute aortic dissection.

Noncardiac visceral ischemia is a major complication with acute aortic dissection and is caused by obstruction of the major visceral arteries by dissecting intima. Two patients with this condition underwent emergency percutaneous fenestration of dissecting intima, and the blood flow to the lower extremity and kidney was restored. A transseptal needle and peripheral angioplasty balloon catheter were used for fenestration. There were no associated complications in either patient. One patient was treated medically and another had ascending aortic replacement surgery the day after percutaneous fenestration. Clinical follow-up of 10 and 5 months, respectively, revealed good clinical outcomes. Percutaneous fenestration should be considered the treatment of choice for visceral ischemia due to acute aortic dissection.

Aortic Dissection↗
PubMed1992

Inhibitory effect of purines in meiotic maturation of denuded mouse oocytes.

The potential action of purines, such as hypoxanthine and adenosine, in meiotic arrest was examined using denuded mouse oocytes. The spontaneous meiotic maturation of denuded oocytes was significantly inhibited by hypoxanthine and/or adenosine in a dose-dependent manner. Germinal vesicle breakdown (GVBD) was inhibited even at a low concentration (1 nM) of hypoxanthine, when hypoxanthine was microinjected into the cytoplasm of denuded oocytes. This inhibitory action was potentiated by co-injection with allopurinol, a metabolic blocker of hypoxanthine that can block a metabolic pathway to uric acid. By contrast, a microinjection of adenosine was no longer effective in inhibiting GVBD. Inhibitory action of purines in meiotic maturation was correlated with sustaining intracellular cAMP levels. GVBD was resumed by econazole, one of the nitroimidazole derivatives which act as inhibitors of catalytic subunit of adenylate cyclase. This compound was effective in counteracting the effect of adenosine, but not the action of 3-isobutyl-1-methylxanthine (IBMX) on GVBD, indicating that adenosine is probably exerted at the level of oocyte plasmalemma. These data suggest that the inhibitory action of hypoxanthine and adenosine in oocyte meiotic maturation may be involved in the regulation of cAMP metabolism in a differential manner.

1-Methyl-3-isobutylxanthine↗
PubMed1992

Sample size determination for group sequential clinical trials with immediate response.

The use function approach to group sequential methods has been explored previously. Any group sequential design requires specifying the frequency and times of repeated analyses, but only the use function approach allows deviations from those specified in the design, without affecting the type I error in the analysis. This paper illustrates how the use function provides a simple and flexible design procedure and how the initially projected maximum sample size can be calculated for randomized clinical trials in which responses are known relatively soon after patient entry and for which there is an early stopping rule built into the study protocol. Also the consequence of using the proposed design procedure is investigated in terms of the operating characteristics of the subsequent group sequential analyses.

Breast Neoplasms↗
PubMed1992

Study duration for group sequential clinical trials with censored survival data adjusting for stratification.

The study duration in a clinical trial with censored survival data is the sum of the accrual duration, which determines the sample size in a traditional sense, and the follow-up duration, which more or less controls the number of events to be observed. We propose a design procedure for determining the study duration or for calculating the power in a group sequential clinical trial with censored survival data and possibly unequal patient allocation between treatments, adjusting for stratified randomization. The group sequential method is based on the use function approach. We describe a clinical trial recently activated by the Eastern Cooperative Oncology Group for an illustration of the proposed procedure.

Carcinoma, Non-Small-Cell Lung↗
PubMed1992

Intracranial astrocytoma in elderly patients.

Because little is known about intracranial astrocytomas occurring in those in the increasing geriatric population, twenty-three persons evaluated at the university affiliated hospitals over a 26-year period are reported. Progressive mental dysfunctions and motor deficits were the most common manifestations of disease. Glioblastoma multiforme was the predominant (87%) histopathologic diagnosis. The overall median period of survival in 21 evaluable individuals was four (range 0 to 15) months. Median survival was longer in patients who were more functional, who had tumors located in the temporal lobes of the brain, and who received more than one treatment modality. The absence of intercurrent disease or being in a younger 'elderly' age group was not associated with an improvement in prognosis. The poor survival of this group as well as the survivals quoted in the literature for those with glioblastoma multiforme demands a new therapeutic approach.

Aged↗
PubMed1992

The evaluation of low-dose cytarabine in the treatment of myelodysplastic syndromes: a phase-III intergroup study.

One hundred and forty one patients were treated in a combined Eastern Cooperative Oncology Group and Southwest Oncology Group phase-III study evaluating low-dose cytarabine (LDAC) versus supportive therapy for the treatment of myelodysplastic syndrome (MDS). Patients were randomized to either cytarabine 10 mg/m2 subcutaneously BID or supportive therapy. Central pathology review was required. All patients were classified according to the FAB criteria for MDS. The overall concordance rate for the MDS subtype was 52%, and 25 patients were pathology exclusions, including 20 with AML. The overall response rate to a single cycle of LDAC was 32%, with 11% complete and 21% partial responses. The median duration of response was 5.9 months, with a range of 1.4-33.5 months. Responses were seen in all subtypes. Infections were more common in the LDAC arm. There was no difference in the time to progression or the overall survival for patients treated with LDAC or supportive therapy. The incidence of leukemic transformation was similar in both arms at 15%, but it differed according to the MDS subtype. Patients receiving LDAC had a decreased transfusion requirement after 3 months. There was a significant correlation between the degree of cytoreduction after receiving a single cycle of LDAC and survival. This survival difference was most marked in patients with the RAEB and RAEB-T subtypes. Although LDAC produced responses in all subtypes of the MDS, there was no effect on overall survival or transformation to AML. However, selected patients benefited from a single cycle of LDAC with durable responses. A cytoreductive effect appears to be required for a durable response. Future studies should include pathology review and must address the clinical and biological heterogeneity of MDS.

Adult↗
PubMed1992

Isolation, sequence and molecular karyotype analysis of the actin gene of Cryptosporidium parvum.

Actin is an ubiquitous and highly conserved microfilament protein which is hypothesized to play a mechanical, force-generating role in the unusual gliding motility of sporozoan zoites and in their active penetration of host cells. We have identified and isolated an actin gene from a Cryptosporidium parvum genomic DNA library using a chicken beta-actin cDNA as an hybridization probe. The nucleotide sequences of two overlapping recombinant clones were identical and the amino acid sequence deduced from the single open reading frame was 85 % identical to the P. falciparum actin I and human gamma-actin proteins. The predicted 42 106-Da Cryptosporidium actin contains 376 amino acids and is encoded by a single-copy gene which contains no introns. The nucleic acid coding sequence is 72% biased to the use of A or T in the third position of codons. Chromosome-sized DNA released from intact C. parvum oocysts was resolved by OFAGE into 5 discrete ethidium bromide-staining DNAs ranging in size from 900 to 1400 kb; the cloned C. parvum actin gene hybridized to a single chromosomal DNA of approximately 1200 kb.

Actins↗
PubMed1992

More resources better health? A cross-national perspective.

This study is an attempt to examine the relative importance of health care resources in predicting infant mortality within industrialized, developing, and underdeveloped countries. The analyses were based on the data of 117 countries. Findings from this study suggest that health resources as a whole do not make a significant contribution to accounting for the variance of infant mortality rates over and above the variance accounted for by socioeconomic resources only. The contribution of health resources to the health of the population as a whole is really rather small in comparison to the role of socioeconomic resources.

Developing Countries↗
PubMed1992

Phase II trials of interferons-alpha and -beta in advanced sarcomas.

Interferons (IFNs)-alpha and -beta were administered to patients with metastatic sarcomas in two different Eastern Cooperative Oncology Group studies. In one study, patients received IFN-alpha 2b, 20 million units/m2 i.v. 5 days/week x 4, then 10 million units s.c.t.i.w. In the second study, patients received IFN-beta ser 180 million units t.i.w. Of 87 patients evaluable for response, there were three responses in 64 patients (5%) treated with IFN-alpha-2b and no responses in 23 patients treated with IFN-beta ser. Severe or life-threatening fatigue with decline in performance status complicated treatment of 37% of patients receiving IFN-alpha 2b and 17% of patients receiving IFN-beta ser. Further investigation of IFNs in sarcomas should depend on evidence from preclinical studies demonstrating synergistic effects of IFNs combined with a cytoreductive modality which has proven activity in these malignancies.

Adult↗
PubMed1992

Detection of occult metastases in pancreatic adenocarcinoma with anticytokeratin antibody.

Fifty-six lymph nodes excised from 11 patients with pancreatic adenocarcinoma were studied for evidence of metastasis by standard light microscopy and immunohistochemistry using an anticytokeratin monoclonal antibody. Eight of 56 nodes contained metastatic carcinoma as demonstrated by conventional techniques. By immunohistochemistry, positive-staining cells were easily identified. In 10 of 56 nodes, the positive staining was accompanied by cytologic atypia, changes consistent with malignancy. In seven additional nodes, positive-staining cells were present, but cytologic atypia was lacking. The use of immunohistochemistry facilitated recognition of malignant cells and raised questions that single-cell metastasis may be present. Positive staining for cytokeratin should prompt a close examination of cells to determine if morphologic features of malignancy are present.

Adenocarcinoma↗
PubMed1992

Immunoglobulin G subclasses in human colostrum, milk and saliva.

Previous studies have suggested local production of IgG4 in human colostrum and mature milk. We extended these observations to examine all IgG subclasses in mammary secretions and in saliva, a mucosal secretion. In human colostrum and milk, the geometric mean percentages of IgG contributed by IgG2 were 44% and 43%, respectively, and by IgG4, 6% in both. These percentages are significantly increased compared to the contributions in matched plasma, 29% for IgG2 and 2% for IgG4. The contribution of IgG1 (47%) and IgG3 (less than 4%) were decreased compared to plasma which contained 64% IgG1 and 6% IgG3. Similarly, in salivary secretions the percentages of IgG contributed by IgG2 and IgG4 were increased compared to serum while the percentage of IgG1 was decreased. IgG3 was not measurable in any saliva specimen by the technique used. These data demonstrate that IgG subclass distribution in two separate mucosal secretions is uniquely different from that in matching plasma or serum.

Antibody Specificity↗
PubMed1992

[Prognostic significance of echogenic lesion within small hepatocellular carcinoma].

To evaluate prognostic significance of echogenic lesion within small hepatocellular carcinoma (SHCC, less than or equal to 2 cm in diameter), clinical and pathological findings of 32 cases with SHCC containing echogenic lesion (echogenic SHCC) were compared with those of 55 cases with non-echogenic SHCC. Compared with the non-echogenic SHCC group, the frequency of clinical stage I was significantly higher, and there were significantly more cases with solitary tumor relative to cases with multiple tumors in the echogenic SHCC group. Histologically, the incidence of the HCC composed of well-differentiated tumor cells corresponding to Edmondson's grade I was significantly higher in the echogenic SHCC group than in the non-echogenic SHCC group. Although HCCs tended to become progressively less differentiated with increasing tumor sizes in the both groups, the process of cellular change appeared to proceed more slowly in the echogenic SHCC group. Survival rate after tumor detection was 73% at three years, 56% at five years and 48% at seven years and nine years in the echogenic SHCC group, while it was 46% at three years, 42% at five years and 0% at seven years in the non-echogenic SHCC group. The present results showed that the presence of echogenic lesion within SHCC could be useful prognostic indicator.

Aged↗
PubMed1992

[Molecular size heterogeneity of SPan-1 antigen and co-expression with Lewis phenotype determinants in sera from gastrointestinal malignant diseases].

Molecular size of SPan-1 antigen and co-expression between SPan-1 epitope and Lewis phenotype determinants (LPD) on the same molecule in sera from patients with pancreatic, gastric and colon cancer and in culture medium from cancer cell line were studied. Column chromatography study on culture medium and sera showed that SPan-1 immunoreactivity was found in the void volume region as single major peak, or followed by one or two minor peak in the included volume. All of 4 pancreatic cancer cell lines showed molecular size heterogeneity. Co-expression between SPan-1 epitope and LPD on the same molecule was recognized in sera from cancer patients with Lewis a or Lewis b positive, but not in patients with Lewis a-, b-. Molecular carrying SPan-1 epitope had more frequently SPan-1 epitope than LPD in sera from cancer patients. These findings suggest that molecular size heterogeneity of SPan-1 antigen was more often in pancreatic cancer cells and overexpression of SPan-1 epitope on the same molecule seems to be specific for cancer.

Antigens, Neoplasm↗
PubMed1992

[Assessment of myocardial viability with 201Tl myocardial SPECT 24 hours after injection].

Recently many investigators reported that conventional stress-redistribution myocardial scintigraphy with 201Tl underestimated the presence of ischemic but viable myocardium. We studied the usefulness of 24 hour 201Tl myocardial single photon emission computed tomography (SPECT) to assess myocardial viability and investigated the factors affect to the quality of 24 hour SPECT images. Study patients were consisted with 70 patients with old myocardial infarction (OMI), 72 patients with angina pectoris without OMI (AP) and 43 patients with angiographically proven normal coronary arteries. To obtain SPECT images, 10 minute and 4 hour imagings were sampled 30 seconds per projection. Twenty-four hour imaging was sampled 60 seconds per projection. Twenty-four hour images were visually interpreted as good, moderate and poor quality. Then study patients were divided into 2 groups, group A with good 24 hour images and group B with moderate or poor 24 hour images. One hundred and fifty-eight patients (85.4%) of study patients had 24 hour SPECT images on a good quality. Only 4 patients (2.2%) had poor quality SPECT. All of these 4 patients had broad myocardial infarction. In patients with OMI 61 patients (87.1%), in AP 63 patients (87.5%) and in normal 35 patients (81.4%) had a good 24 hour SPECT. Total sampling counts and myocardial ROI counts were significantly higher in group A than in group B. Body weight was significantly higher and there were more male patients in group B than in group A. Late redistribution was seen in 20 patients (28.5%) with OMI and in 11 patients (15.3%) with AP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Surgical curability and prognosis for standard versus extended resection for T1 carcinoma of the pancreas.

The prognosis of 185 patients who underwent surgical resection of small carcinomas of less than 2.0 centimeters (T1) of the pancreas in whom either standard or extended resection was used was analyzed. Pancreatic resection was performed upon 98.3 percent of the patients who were more than 49 years old. The location of the tumor was the head of the pancreas in 83.4 percent of the patients, the body of the pancreas in 13.2 percent and the tail of the pancreas in 3.3 percent. Tumor staging revealed 42.9 percent in stage I and the remainder in advanced stage, that is 33.1 percent stage II, 18.8 percent stage III and 5.1 percent stage IV. When standard resection was performed, surgical cure rates were more than 80 percent in stage I, II and III, but in stage IV, it was only 16.6 percent. After extended resection, the surgical cure rates increased even in stage IV (100 percent). There were no significant differences in the overall postoperative cumulative survival rates between standard and extended operation. In stage II, however, a significant better survival rate was observed after extended resection than after standard resection.

Adult↗
PubMed1992

[A case report of primary cardiac lymphoma presented with marked cardiac accumulation of 67Ga-citrate].

A case of primary malignant lymphoma of the heart is reported. The patient who was a 67-year old male presented with dyspnea on exertion. The chest X-ray film showed an enlarged cardiac silhouette. UCG showed massive pericardial effusion and a mass in the right atrium. Although pathological confirmation was failed in the cardiac biopsy, malignant cardiac tumor was strongly suspected by a gallium scintigraphy, which showed marked accumulation in the heart. After irradiation therapy the cardiac tumor diminished in size and the cardiac 67Ga-citrate accumulation also disappeared. Multiple skin metastases, however, were soon noted, and a subsequent skin biopsy confirmed the diagnosis of malignant lymphoma. He died within 11 months in spite of systemic chemotherapy. Primary cardiac lymphoma is extremely rare, but this case suggested the cardiac mass with positive gallium scintigraphy have a possibility of cardiac lymphoma.

Aged↗