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Biomedical subjects

M H Kim

Publications and source records attributed to M H Kim.

At least 163 records · Page 9Linked to original sources
PubMed1998

Activin A stimulates meiotic maturation of human oocytes and modulates granulosa cell steroidogenesis in vitro.

OBJECTIVE: To test the hypothesis that activin A promotes in vitro human oocyte meiotic maturation while inhibiting steroid secretion by nonluteinized antral granulosa cells. DESIGN: Prospective randomized controlled study. SETTING: A university medical center. PATIENT(S): Nine women ranging in age from 31-44 years who were undergoing oophorectomy for nonovarian pathology. INTERVENTION(S): Analysis of meiotic maturation of oocytes and steroid secretion by granulosa cells cultured in the presence or absence of activin A. MAIN OUTCOME MEASURE(S): Germinal vesicle breakdown (GVBD) and attainment of metaphase II (MII) in oocytes, and progesterone and E2 secretion by granulosa cells. RESULT(S): Activin A significantly enhanced GVBD (91% vs. 65%) for control and maturation to MII (56% vs. 35% for control) of immature oocytes. Activin A significantly suppressed basal, and inhibin A-and FSH-stimulated progesterone and E2 secretion by nonluteinized granulosa cells. CONCLUSION(S): Activin A is a promoter of oocyte maturation in vitro and a modulator of granulosa cell steroidogenesis in culture.

Activins↗
PubMed1998

Ballooning of the papilla during contrast injection: the semaphore of a choledochocele.

BACKGROUND: Choledochocele is a rare abnormality involving the intramural segment of the common bile duct. ERCP is essential to demonstrate a choledochocele. The aim of this study was to investigate the duodenoscopic and cholangiographic findings during ERCP. METHODS: Over a 4-year period, 17 symptomatic patients (8 men, 9 women; age range 45 to 83 years) were identified as having choledochoceles. The diagnosis of choledochocele was made by both duodenoscopic and cholangiographic findings. RESULTS: As a characteristic duodenoscopic finding, the enlarged bulging papilla was noted in 8 patients (47%), whereas a normal-appearing papilla was noted in 9 patients (53%) before the injection of contrast media. However, in all 17 patients progressive enlargement or ballooning of the papilla was noted during contrast injection. The maximum diameter of the choledochocele, determined by cholangiography, was significantly larger (19 +/-4 mm) in patients with initially bulging papilla than in those with normal-appearing papilla (9+/-3 mm) (p < 0.05). CONCLUSIONS: Ballooning of the papilla during contrast injection may be a specific duodenoscopic finding for choledochocele. To avoid missing the diagnosis of a choledochocele, especially when it is small, it is important to watch the papilla carefully during contrast injection.

Aged↗
PubMed1998

Sequence analysis of the 5'-flanking region of the gene encoding human HOXA-7.

We have isolated and characterized the immediate 5'-flanking region (886 bp) of the gene encoding human HOXA-7. When the total sequence was compared with those of mice, 93% of the 3' 518 bp (nt 370-886) sequences were identical, in which the 245 bases just preceding the AUG initiator codon (nt 614) was as highly conserved as in the coding region (nt 614-886). Sequences further upstream (nt 1-370) by comparison were highly diverged. In the 245 bp region, 8 stop and 3 initiation (including the initiator) codons were located, and a 50-aa long presumptive polypeptide was encoded. Nucleotide sequence analysis revealed three Sp1 and one AP2 binding sites, as well as one CAAT box. However, there was no consensus sequence for a TATA box in the 5' flanking region. One RARE repeat, one krox20 and three Hox-PBC binding sites were detected. Since many of the factor recognition sites were located in the immediate 5' flanking sequences of a highly-conserved region, it might be speculated that a regulatory mechanism for Hox gene expression is conserved throughout the evolution and one possible mechanism could be at the post-translational level.

5' Untranslated Regions↗
PubMed1998

PAC and cosmid contig spanning the HOXA cluster on human chromosome 7p15.

To construct the PAC and cosmid contig map spanning the HOXA cluster on human chromosome 7, we used 9 DNA markers (D7S2243, D7S3010, HOXA1, EVX1, 750, pBH8, p60, p8.0, and HOXA11), among which the final 4 were generated in this study by shotgun cloning strategy. From the libraries, 5 PAC and 35 cosmid clones were screened and as a result, an overlapping continuous array of cosmid and PAC clones covering the genomic region (about 200 kb) spanning the entire cluster were constructed. The isolated cosmids contained several consecutive HOX genes of regional group, probably sharing the regulatory processes such as alternative splicing or polyadenylation, and thus could be used as useful materials for elucidating the molecular mechanism of HOX gene expression in the future.

Bacteriophage P1↗
PubMed1998

Association of periampullary diverticula with primary choledocholithiasis but not with secondary choledocholithiasis.

BACKGROUND AND STUDY AIMS: Several endoscopic studies have reported an association between periampullary diverticula and biliary calculi, but the results are inconsistent when the anatomic site of the stones is considered. The aims of our study are to evaluate the association between periampullary diverticula and gallstones according to their site and to clarify the origin of the common bile duct stones by analyzing their composition. PATIENTS AND METHODS: During a period of 10 months, 611 of 632 consecutive patients having endoscopic retrograde cholangiopancreatography (ERCP) were prospectively enrolled. The data about periampullary diverticula and gallstones were analyzed according to the site of the stones. The stones were initially grouped on the basis of their gross morphology and cross-sectional appearance, and finally analyzed by quantitative infrared spectroscopy. RESULTS: Diverticula were found in 165 of 611 cases (27%) and the incidence increased with age (p<0.01). The incidence of gallbladder or common bile duct stones was higher in patients with periampullary diverticula (73/165,44%) than without (130/446,29%) (p<0.01). Considering the site of the gallstones, this significance was found only in patients with common bile duct stones not associated with gallbladder stones (p<0.001). Of the 40 who had gallstones only in the common bile duct, 32 gave a history of cholecystectomy more than two years previously and had been free of symptoms postoperatively, and on analysis most of the stones (30/36,83%) were brown pigment stones. These therefore were assumed to be primary common bile duct stones. The common bile duct stones with associated gallbladder stones were identical to their paired gallbladder stones in gross and cross-sectional appearance and chemical composition. They were assumed to be secondary common bile duct stones and the difference in the incidence of calculi according to the presence of diverticula was not significant. CONCLUSION: The incidence of gallstones was significantly higher in periampullary diverticula, and when the site and the origin of the gallstones was considered the association between diverticula and gallstones was significant in patients with primary common bile duct stones but not with the secondary ones.

Adult↗
PubMed1998

Routine biliary sphincterotomy may not be indispensable for endoscopic pancreatic sphincterotomy.

BACKGROUND AND STUDY AIMS: It is generally accepted that biliary sphincterotomy is mandatory to avoid possible cholestasis and infection due to edema after pancreatic sphincterotomy. However, biliary sphincterotomy is an invasive procedure and the above claim on dual sphincterotomy has not been proven by a prospective randomized study. The aim of our study was to determine whether cholangitis develops more frequently when the patients have not undergone concomitant biliary sphincterotomy during the endoscopic pancreatic sphincterotomy. PATIENTS AND METHODS: From January 1990 to November 1997, 60 patients (38 men, 22 women, age range 19-45 years) with non-alcoholic chronic calcifying pancreatitis were prospectively enrolled. The patients with jaundice (bilirubin > or = 3 mg/dl), cholangitis, or parenchymal liver disease were excluded. The patients were randomly subjected either to dual sphincterotomy (group I, n = 30) or to pancreatic sphincterotomy alone (group II, n = 30). Groups I and II were further classified as IA (or IIA) and IB (or IIB), according to the level of serum alkaline phosphatase (sALP) and the diameter of the common bile duct (CBD). Group IA (or IIA) was defined when abnormal in both sALP (> or = 2 times the upper limit of normal) and CBD diameter (> or = 12 mm), whereas group IB (or IIB) was defined when normal, or solely abnormal in sALP or CBD diameter. RESULTS: As a complication after sphincterotomy, pancreatitis developed in one of eight patients (12.5%) in group IA, whereas cholangitis occurred in one of 22 (4.5%) and hemorrhage in one of 22 (4.5%) cases in group IB. By contrast, in group IIA, the cholangitis developed in 56% (five of nine patients), which was significantly more frequent than in any other groups (P < 0.05). Hemorrhage (one of 21, 4.8%) and pancreatitis (one of 21, 4.8%) occurred in group IIB. CONCLUSIONS: Our results suggest that dual sphincterotomy may be indicated only in patients who have both dilated choledochus and elevated alkaline phosphatase in chronic pancreatitis. Routine biliary sphincterotomy may not be indispensable for pancreatic sphincterotomy.

Adult↗
PubMed1998

Biliary papillomatosis: clinical, cholangiographic and cholangioscopic findings.

BACKGROUND AND STUDY AIMS: Biliary papillomatosis (BP) is a very rare disease and its clinical features and outcome are not well known. The aims of this study were to describe the characteristic cholangiographic findings and to define the role of cholangioscopic examination in the diagnosis and treatment of this disorder. PATIENTS AND METHODS: Nine patients (six men and three women, mean age 57 years) were diagnosed as BP among 5361 cases of endoscopic retrograde cholangiography (ERC) from 1990 to 1997 in our institution. The cholangiographic and cholangioscopic findings as well as clinical features were retrospectively analyzed. RESULTS: ERC findings showed multiple small, round-to-ovoid filling defects in the bile duct and ductal wall irregularity in all the patients. Seven out of nine patients underwent percutaneous transhepatic cholangioscopic (PTC) examination. Additional small papillary lesions in the intrahepatic bile duct were detected by cholangioscopic examination in four patients whose ERC findings only revealed the extrahepatic lesions. Two of these four patients underwent curative resection. In these two patients, the initial surgical plan was changed from Whipple's operation to hepatico-pancratico-duodenectomy after preoperative cholangioscopic examination due to the detection of new lesions in the intrahepatic bile duct. CONCLUSIONS: ERC findings of BP were highly characteristic. When BP is suspected by conventional imaging including ERC, preoperative percutaneous transhepatic cholangioscopic examination is, however, strongly recommended. This procedure may be beneficial to precisely determine the ductal extension of the disease, hence to decide whether or not hepatic resection is needed as well as to confirm the histology.

Adult↗
PubMed1998

Molecular, serological, and clinical features of 16 consecutive cases of invasive streptococcal disease. Southeastern Minnesota Streptococcal Working Group.

We performed a comprehensive analysis of the molecular, serological, and clinical features of 16 consecutive cases of invasive streptococcal disease (ISD). The majority of cases were linked to two group A streptococcus (GAS) clones closely related by pulsed-field gel electrophoresis (PFGE) and designated as PFGE-1 and PFGE-1.1. These clones, serotyped as M-3, T-3/B3264, carried an allelic variant of the gene that encodes pyrogenic exotoxin A (speA3) and the gene that encodes streptococcal superantigen (SSA) but different emm alleles that encode M-protein. The characteristics and clinical features of patients were similar to those described in previous reports, regardless of the responsible GAS clone. However, worse clinical outcomes (shock and death) were more frequent when patients infected with PFGE1/1.1 clones were considered as a group and compared with all other patients as a group. One striking feature in some patients with deep tissue infection was a lack of inflammatory cells despite the presence of numerous streptococci. An evaluation of PFGE profiles of GAS isolated elsewhere demonstrated that the PFGE-1 clone has caused invasive disease in other locations in the United States and in Japan.

Adult↗
PubMed1998

307-bp fragment in HOXA7 upstream sequence is sufficient for anterior boundary formation.

The HOX genes are expressed in a positionally and temporally restricted manner involving anteroposterior axial pattern formation during early embryogenesis. Previously, we studied the sequence and function of an upstream regulatory region of the human HOXA7 gene. To identify a critical cis-acting element, a deletion analysis was performed along the human control region (HCR) (about 1.1 kb), which was sufficient for setting the anterior boundary of expression in transgenic mice. We demonstrated that a 307-bp control region contains a cis-acting element(s) specifying an anterior boundary as well as a dorsal-ventral restriction in the neural tube at day 12.5 postconception (p.c.). The distinct anterior limit of expression was noted at the level of C7/T1 in the neural tube and spinal ganglia. In addition, our deletion experiments revealed that the HCR consisted of several cis-acting elements which were individually capable of driving regionally restricted expression patterns in the neural tube and limb buds.

Animals↗
PubMed1998

Genomic structure and sequence analysis of human HOXA-9.

In order to understand the regulatory mechanisms establishing and maintaining HOXA-9 gene expression, structural information about the gene is a prerequisite. Therefore, we sequenced the 7.2-kb region of the human HOXA-9 gene and mapped the positions of two partial cDNAs consisting of one of two 5' exons, AB (358 bp) or CD (568 bp), and a common 3' exon (exon II), which are separated by 5.4- and 1.0-kb introns, respectively. When the amino acid sequence homologies were compared with those of other Hox genes belonging to the same paralogous group, exon CD exhibited the strongest homology: 73% of 91 aa residues exactly matched those of chicken Hoxa-9. An intermediate exon (90 bp) was detected within exon CD. It was surrounded by a splice acceptor and a donor at both the 5' and 3' ends, and one branchpoint site was found near the splice-acceptor site. Nucleotide sequence analysis along this region revealed two TATA boxes, one CAAT box, one GC box, and one each of the following binding sites--engrailed, eve-stripe2-hb3, and Krox20--just upstream of exon CD. A CpG island and two RARE repeats were detected within intron I. Northern blot analysis showed that at least four main transcripts were generated along this region: all fetal tissues tested (brain, lung, liver, and kidney) produced a 1.8-kb homeobox-containing transcript (HA-9A); a 2.2- and a 3.3-kb transcript were generated from exon CD and exon II (HA-9B), especially in fetal and adult kidneys as well as in adult skeletal muscle; the 1.0-kb transcript was likely to be generated by the intermediate exon in all adult and fetal tissues. Several weak bands without tissue specificity were likely to be contributed by the hybrid transcripts between HOXA-9 and the other HOXA gene(s). Together, these results may account for the unique degree of conservation of the HOX cluster in general.

Adult↗