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Biomedical subjects

M H Kim

Publications and source records attributed to M H Kim.

At least 343 records · Page 19Linked to original sources
PubMed1981

Hirsutism: implications, etiology, and management.

Hirsutism usually results from a subtle excess of androgens. As such, it is a clue to possible endocrine disturbance in addition to presenting cosmetic problems. We use the term hirsutism to mean male-pattern hirsutism--excessive growth of hair in areas where female subjects normally have considerably less than male subjects. An elevation of the plasma free (unbound) testosterone level is the single most consistent endocrinologic finding in hirsutism. The plasma free testosterone level is sometimes elevated when the total level of plasma testosterone is normal because testosterone-estradiol--binding globulin (TEBG) levels are often depressed in hirsute women. Frequent blood sampling is sometimes necessary to demonstrate subtle hyperandrogenic states since androgen levels in the blood are pulsatile and seemingly reflect episodic ovarian and adrenal secretion. The source of hyperandrogenemia can usually be determined from dexamethasone suppression testing. Those patients whose plasma free androgen levels do not suppress normally usually have functional ovarian hyperandrogenism (polycystic ovary syndrome variants). Very high plasma androgen levels or evidence of hypercortisolism, which is not normally suppressible by dexamethasone, should lead to the search for a tumor or Cushing's syndrome. Those patients in whom hyperandrogenemia is suppressed normally by dexamethasone have a form of the adrenogenital syndrome, a prolactinoma, obesity, or idiopathic hyperandrogenemia. In such patients, glucocorticoid therapy may reduce hirsutism and acne and normalize menses. The treatment of hirsutism resulting from functional ovarian hyperandrogenism is not as satisfactory; estrogen-progestin treatment is the most useful adjunct to cosmetic approaches to hirsutism in this country. However, other manifestations of polycystic ovary syndrome, such as infertility, may take precedence over hirsutism when an optimal therapeutic program is designed for many patients.

Adrenal Glands↗
PubMed1981

Viable deletions of the M13 complementary strand origin.

The single-stranded DNA of bacteriophage M13 is converted to a duplex replicative form by a mechanism involving RNA-primed initiation at a single unique site on the viral DNA. The DNA sequence that specifies the RNA primer is contained largely within one of two adjacent hairpin structures protected from DNase degradation by RNA polymerase. We have used in vitro techniques to construct a series of M13 mutants having deletions in the region of the complementary strand origin. Deletions of the duplex replicative form DNA range in size from 54 to 201 base pairs. The largest deletions remove both of the RNA polymerase-protected hairpins and the entire sequence specifying the primer RNA. Mutants lacking one or both hairpins form faint plaques, give reduced phage yields, and show a lag in phage production of >30 min. The rate of conversion of the single-stranded viral DNA to the parental replicative form is reduced both in vivo and in vitro. These results indicate that both the RNA polymerase-protected hairpins and the RNA primer-coding sequence are important, but not essential, for replication. Other sequences within the origin region, or possibly elsewhere in the genome, may play a role in complementary strand initiation in these mutant phages. The M13 viral strand is initiated by extension of the 3' terminus generated by site-specific nicking of the viral strand of the replicative form DNA by the M13 gene II protein. This specific nicking site is retained in all of the M13 deletion mutants. Deletion end points do not extend into a 13-nucleotide sequence preceding the viral strand nicking site. We propose that a sequence including these 13 nucleotides is required for gene II protein action at this site.

Base Sequence↗
PubMed1981

Hormonal screening of hyperestrogenic, elderly, obese females for a granulosa cell tumor.

Two elderly, obese, postmenopausal patients demonstrated, for their age, inappropriate estrogen stimulation, elevated serum concentrations of estrone (E1) and estradiol (E2) and low serum concentrations of gonadotrophins. Hormonal evaluations before and after hysterectomy and bilateral salpingo-oophorectomy are reported. The first patient represents the eighth reported case of a granulosa cell tumor with documented preoperative and postoperative estrogen serum concentrations. Though the second patient had no evidence of an ovarian neoplasm, she demonstrates the complexity of attempting to preoperatively diagnose an early granulosa cell tumor in the elderly, obese female by hormonal profiles. The contribution of gonadotrophins and estrogens in making this diagnosis is discussed.

Aged↗
PubMed1980

High frequency mechanical ventilation in severe hyaline membrane disease an alternative treatment?

Twenty-four preterm infants with respiratory failure from severe hyaline membrane disease (HMD) received mechanical ventilation at high respiratory frequencies. The average birthweight of the infants was 1244 +/- 301 g, and 7 babies weighed less than 1000 g. The average gestational age was 30 +/- 2 weeks, and 6 infants were born at 28 weeks or less. The method of ventilation included (1) respiratory frequencies of 60--110/min, sometimes with brief manual ventilation at more rapid rates, (2) peak inflation pressures (PIP) of less than 35 cm H2O, (3) inspiratory durations of 0.15--0.25 sec, (4) positive end-expiratory pressure (PEEP) of 4--9 cm H2O, and (5) weaning from mechanical ventilation by reducing tidal volume until peak inflation pressure (PIP) reached 20--25 cm H2O, whereupon respiratory frequency was decreased. PaCO2 was kept at 30--40 torr and PaO2 at 60--80 torr. Of the infants, 22 survived (92%) with few major complications.

Evaluation Studies as Topic↗
PubMed1980

The effect of ampicillin on oral contraceptive effectiveness.

The effectiveness of oral contraceptives with concomitant use of ampicillin has been questioned. Eleven volunteer subjects were studied during 2 consecutive menstrual cycles; they were given Demulen with placebo or ampicillin during each of the cycles. Serum estradiol (E2), progesterone (P4), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were evaluated on days 13 and 19 of each cycle. Testosterone-binding globulin (TeBG) capacity and ferning of cervical mucus were evaluated on day 13 of each cycle. Subjective symptoms were recorded. All cycles appeared to be anovulatory. Steroid suppression was present in 10 of 11 patients during both cycles. Estrogen-dependent TeBG was not affected by ampicillin. It is possible that cervical mucus ferning was improved by concurrent ampicillin administration. Ampicillin appears unlikely to diminish the effectiveness of the oral contraceptive studied.

Adult↗
PubMed1980

Lack of predictive indices in kernicterus: a comparison of clinical and pathologic factors in infants with or without kernicterus.

A review of 398 neonatal autopsies at Downstate Medical Center revealed 27 cases of kernicterus during the seven-year period from 1971 through 1977. With the current intensive care of the sick newborn, kernicterus continues to occur, mainly in premature infants with relatively low levels of serum bilirubin (mean of 11.5 mg/100 ml). To understand the factors contributing to the development of kernicterus, clinical and pathologic findings in 27 infants with kernicterus were compared to 103 "control" infants with retrospectively. Birth weight, gestational age, sex, and Apgar scores were comparable in both groups. The duration of survival was significantly shorter in infants with kernicterus than in the control infants. The clinical signs and symptoms of kernicterus were nonspecific and the premortem diagnosis of kernicterus was not suspected in most of the cases. There were no significant differences in the peak serum bilirubin values, incidence of hypothermia, hypoglycemia, convulsions, anemia, infection, use of phototherapy, transfusion and exchange transfusion in the two groups. Serum albumin values and bilirubin binding capacity measured by 2-(4-hydroxybenzeneazo)benzoic acid were significantly lower in the kernicteric group although the bilirubin-albumin molar ratio was equal in both groups. The incidences of severe acidosis and hypoxic encephalopathy were significantly higher in the kernicteric infants. In this study, acidosis, hypoxia, hypoalbuminemia, and low bilirubin binding capacity were seen more often in kernicteric infants than in control infants. However, analysis of previously suggested risk factors failed to identify any single factor or combination of factors which could be predictive to the development of kernicterus.

Bilirubin↗
PubMed1979

Vasoactive intestinal polypeptide in tissues of the human female reproductive tract.

Vasoactive intestinal peptide (VIP) is a known potent hypotensive and vasodilatory agent. Studies were performed to determine the possible role of VIP in the human menstrual cycle in 44 patients in the reproductive age group, some of whom were using oral contraceptives, three pregnant patients, and four postmenopausal patients. No significant relationship between VIP and menstrual cycle phase was found.

Cervix Uteri↗
PubMed1979

Ovarian hyperandrogenism with normal and abnormal histologic findings of the ovaries.

Thirty-one patients with clinical features of polycystic ovary syndrome (PCO) were studied to determine the correlation between biochemical and histologic findings. The biochemical features investigated were the effects of adrenocortical and ovarian suppression by dexamethasone and oral contraceptives (Ovulen) on plasma free androgens. Four patients showed a histologic picture consistent with PCO (Group A), and five had histologically normal ovaries (Group B). The remaining 22 patients had no tissue available for histologic examination (Group C). The baseline values of plasma free testosterone (FTel) were higher and those of testosterone-binding globulin (TeBG) were lower (p less than 0.05) in Group A than in Group B, although plasma total testosterone (T) and the free 17beta-hydroxysteroid androgen index (FHSl) were similar in the two groups. During dexamethasone administration in all study groups, T and FTel fell slightly (17.7% to 33.8%), and FHSl levels decreased moderately (36% to 46.6%); in no case did both indices of free androgen levels fall to the normal range for dexamethasone-suppressed women. However, no change was noted in TeBG in all three groups. On the other hand, Ovulen treatment suppressed T and free androgens to normal in all groups, and raised TeBG more than 350% from the baseline. These data suggest a decrease in androgen production. The effects of dexamethasone and Ovulen on all three groups were similar in percent changes. As Group B patients resemble those of Group A biochemically and clinically, except for possibly being less hyperandrogenic, the concept of ovarian hyperandrogenism should be expanded to include patients with no anatomic ovarian abnormality, particularly in milder cases.

Adult↗
PubMed1979

Pregnancy in a true hermaphrodite.

True hermaphroditism is a rare form of intersexuality, and fertility in such an anomaly has been reported only once before in literature. A 19-year-old true hermaphrodite reared as a female with normal secondary sex characteristics and a karyotype of 46,XX was treated by removal of the left ovotestis. The right ovary and other pelvic organs were of a normal female. Ten months after the treatment she became pregnant. The pregnancy was complicated by a premature delivery of a 1500-g male infant that showed no congenital anomalies. Histologic findings of the ovotestis and clinical findings of a true hermaphrodite with pregnancy are presented.

Adult↗
PubMed1979

Dysmenorrhea in unicornis with rudimentary uterine cavity.

Two adolescents with a rare müllerian anomaly, uterus unicornis with a noncommunicating rudimentary uterine cavity, are presented because of clinical manifestations characterized by dysmenorrhea and pelvic pain requiring multiple hospitalizations and surgical procedures prior to the correct diagnosis. A high index of suspicion and proper diagnostic evaluation are essential for all adolescent patients presenting with dysmenorrhea associated with menarche and subsequent menstruation. The details of 2 cases and their diagnostic and therapeutic emphasis are presented.

Adolescent↗
PubMed1978

Partial gonadotrophin-resistance in pseudohypoparathyroidism.

A patient with classical Albright's pseudohypoparathyroidism was investigated because of oligomenorrhoea. Hypo-oestrogenism was associated with elevated basal gonadotrophin values [mean basal serum LH and FSH were 272 +/- 84 (SD) ng/ml and 593 +/- 83 ng/ml, resplectively (normal less than or equal to 220 and less than or equal to 400, respectively)]. The response to gonadotrophin releasing hormone (Gn-RH) was exaggerated, with maximal LH and FSH increments of 1688 and 458 ng/ml, respectively. These results and the findings on ovarian biopsy were compatible with partial ovarian resistance to gonadotrophins. This resistance could be overcome by administration of human menopausal gonadotrophins. This is the first evidence for gonadotrophin resistance in pseudohypoparathyroidism. The plasma cyclic adenosine-3',5'-monophosphate response to glucagon administration by two different protocols was about 70% that of normal control subjects. Other endocrine glands whose responses to hormones are mediated via the adenylate cyclase system evidenced minor abnormalities of questionable significance. This indirect evidence is compatible with a more extensive defect in the adenylate cyclase system in pseudohypoparathyroidism than has hitherto been suspected.

Adenylyl Cyclases↗
PubMed1978

Estrogen therapy.

Explore the source record for details and available documents.

Adolescent↗
PubMed1977

Immunoglobulins, proteinase inhibitors, albumin, and lysozyme in human cervical mucus. I. Communication: hormonal profiles and cervical mucus changes--methods and results.

The serum levels of luteinizing hormone (LH), estradiol-17beta, and progesterone were determined simultaneously with the concentrations of immunoglobulin (Ig) G, IgA, C'3, alpha1-antitrypsin, inter-alpha-trypsin inhibitor, alpha1x-antichymotrypsin, albumin, and lysozyme in cervical mucus during nine ovulatory cycles. Spinnbarkeit and ferning were also assessed, and the basal body temperature was measured and recorded during these cycles. The profiles were synchronized according to the LH peak. The midcycle period, characterized by the rapid increase and decline of estrogen and the beginning rise of progesterone, shows a prounced minimum of immunoglobulins, C'3, proteinase inhibitors, albumin, and lysozyme in cervical mucus, which is known to be most receptive to sperm penetration at this time. Although the variation of cervical mucus values is considerable during the early proliferative and the luteal phases, the midcycle values appear to be constantly low, showing slight differences among the profiles of the different parameters. The statistical evaluation and the assessment of the significance of parameters for ovulation detection and the assessment of the fertile period as well as the correlation of these parameters with basal body temperature will be the subject of the second communication of this series.

Adult↗
PubMed1976

The effects of dexamethasone on plasma free androgens during the normal menstrual cycle.

In order to evaluate the ovarian and adrenal contribution to peripheral plasma concentrations of total testosterone (TTe), indixes of the plasma concentrations of free testosterone (FTeI), free 17 beta-hydroxysteroid androgens (FHSI), and testosterone-binding globulin (TeBG) during the menstrual cycle, women were examined during three normal cycles and three other cycles under dexamethasone (0.5 mg., four times a day) suppression. All study cycles were apparently ovulatory. The mean TTe and FTeI during the midcycle period were significantly higher than during the early follicular (P less than 0.005) and the midluteal periods (P less than 0.01 and P less than 0.001, respectively). During the menstrual cycles under dexamethasone suppression only the difference in TTe and FTeI between the midcycle (37 +/- 12.4 (S.D.) ng. per 100 ml. and 10.5 +/- 4.0 (S.D.), respectively) and the midluteal (26.0 +/- 10.1 (S.D.) ng. per 100 ml and 7.2 +/- 3.2 (S.D.), respectively) periods was significant statistically (P less than 0.05). No significant differences in the mean levels of FHSI and TeBG between three periods within the cycle were noted in either the control or the dexamethasone-treated cycle. When each phase was compared, the mean levels of TTe, FTel, and FSHI were significantly lower in the dexamethasone-treated cycles than in the normal cycles. The data suggest that the level of TeBG is not perceptibly affected by physiologic fluctuation of estrogen levels during the menstrual cycle, and the FHSI levels are stable throughout the ovulatory cycle. Decrease in levels of TTe, FTeI, and FHSI during dexamethasone suppression seems to be due to reduction of androgen production as TeBG, a major determinant of the metabolic clearance rate of androgens, was not affected by dexamethasone.

Adult↗
PubMed1976

Pituitary responses to LRH in the postpartum periods.

Pituitary responses to luteinizing-hormone-releasing-hormone (LRH) in the postpartum periods were studied. Following a subcutaneous injection of 100 mug of synthetic LRH to postpartum subjects, no statistically significant changes in the levels of LH and FSH could be demonstrated in five subjects on postpartum day 1 or 3 and the three subjects on postpartum day 8. A normal elevation of LH and FSH following LRH was demonstrated in one subject 36 days post partum. The findings are in agreement with previous studies demonstrating a persistence of pituitary suppression during the early postpartum period. No correlation could be drawn between the pituitary responses to LRH and the plasma levels of estradiol-17 beta and progesterone.

Estradiol↗