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Biomedical subjects

M L Lee

Publications and source records attributed to M L Lee.

At least 109 records · Page 6Linked to original sources
PubMed1995

Effect of Candida albicans infection and clotrimazole treatment on vaginal microflora in vitro.

OBJECTIVE: To determine the effect of Candida albicans infection and clotrimazole treatment on vaginal microflora. METHODS: Studies were conducted using a model simulating the healthy vaginal ecosystem. The model consisted of a mixed culture of Lactobacillus acidophilus, Staphylococcus epidermidis, Prevotella bivia, and group D Streptococcus sp grown in continuous culture in a chemically defined medium. The status of the model was assessed using a mathematical equation that determines the probability a microflora is normal or abnormal. RESULTS: Challenge of the model with C albicans was followed within 24 hours by the development of microbial populations representing an abnormal microflora. Treatment of the system with clotrimazole (100 micrograms/mL) resulted in a decrease in C albicans counts to 0 within 48 hours. However, treatment also altered other components of the vaginal microflora, which did not return to normal. Addition of clotrimazole (100 micrograms/mL) to the system in the absence of C albicans also resulted in an abnormal model by 24 hours. CONCLUSIONS: Candida albicans infection of the vaginal ecosystem, as represented by this in vitro model, has a deleterious effect on members of the normal microflora. Clotrimazole, although effective against C albicans infection, also has a deleterious effect on components of the normal vaginal microflora. One of the implications for women using clotrimazole for microbiologically undocumented vaginal yeast infections is an increased risk of infection or disease through the disruption of the protective microflora barrier.

Antifungal Agents↗
PubMed1995

Visualization of pulmonary vein obstruction by pulmonary artery wedge injection and documentation by pressure tracings: report of one case with persistent wheezing following correction of total anomalous pulmonary venous connection.

A 21-month-old boy presented with persistent wheezing 16.5 months after cardiac surgery for supracardiac total anomalous pulmonary venous connection. He had presented at birth with cyanosis and at the age of 25 days, underwent initial cardiac surgery in the form of anastomosis of the pulmonary venous confluence to the left atrium. Non-invasive investigations including transthoracic and transesophageal echocardiograms revealed stenosis of the right pulmonary veins. Visualization and documentation of right pulmonary vein obstruction by pulmonary arterial wedge angiography and pressure tracings are presented.

Anastomosis, Surgical↗
PubMed1995

Neonatal enterovirus infection: virology, serology, and effects of intravenous immune globulin.

A prospective study of the virology of and serological responses to enterovirus infection in 16 neonates (< or = 2 weeks of life) and their mothers was performed. At study entry, 11 neonates did not have detectable serum neutralizing antibody to their own viral isolates, despite the presence of neutralizing antibody in 9 of 11 mothers of these infants. Viremia and viruria were demonstrated in 8 and 7 neonates, respectively, with maximal detected titers of 6.3 x 10(3) 50% tissue culture infective dose per mL (TCID50) and 6.8 x 10(1) TCID50/mL, respectively. Viremia was associated with onset of illness in the first 5 days of life, low initial serum neutralization titer, and the presence of echovirus serotypes. Randomized administration of intravenous immune globulin (IVIG; 750 mg/kg) to nine neonates overall modestly increased serum neutralization titers but did not reduce the daily incidence of viremia and viruria compared with that of controls. However, receipt of IVIG containing a neutralization titer of > or = 1:800 to the patients' own viral isolates was associated with significantly higher serum neutralization titers and more rapid cessation of viremia and viruria. Future trials of IVIG for neonatal enterovirus disease should assess the efficacy and safety of higher or repeated doses of this agent and/or of IVIG selected for their high titers to frequently circulating and/or particularly virulent enterovirus serotypes.

Antibodies, Viral↗
PubMed1995

Bacteremia with nontyphi Salmonella and therapeutic implication.

OBJECTIVES: The recent decades witnessed the increased incidence of bacteremia with nontyphi Salmonella, especially in patients with underlying diseases. To evaluate clinically the patients with bacteremia by nontyphi Salmonella, we investigated the clinical records of the patients. METHODS: Retrospective study was performed on 30 cases of bacteremia with nontyphi Salmonella admitted to Soon Chun Hyang University Hospital from 1987 to 1993, and we analyzed with regard to age distribution, underlying diseases, clinical presentation and fatality. RESULTS: Children below 2 years of age were seven patients and patients over 55 years of age were 8 patients. The male to female ratio was 3:2. Only five cases were nosocomially acquired. More than two-thirds (21 patients) had no discernible other illness at the time of their bacteremia. A quarter of the patients presented without gastrointestinal manifestation. There were four deaths in the 30 patients with nontyphi Salmonella septicemia (13.3%). CONCLUSIONS: We investigated the clinical characteristics of 30 cases of non-typhi Salmonella bacteremia, which has a relatively high incidence nowadays while, to the contrary, Salmonella typhi trends toward being on the decrease in Korea.

Adolescent↗
PubMed1995

Expression of atrial natriuretic peptide in cultured adult cardiac ventricular muscle cells as studied by immunofluorescence microscopy.

Atrial natriuretic peptide (ANP) is known to be present predominantly in the granules of adult cardiac atrial muscle cells. The functional role of this peptide is known to be involved in diuresis, natriuresis and control of blood pressure. The present study using antibody to ANP, revealed that the cultured adult cardiac ventricular muscle cells, unlike their counterparts in vivo, expressed ANP to be as abundant as in adult atrial cells. Cultured atrial cells did not express ANP any more than their counterparts in vivo. Both cells, specifically ventricular cells, contained various forms of ANP such as granular, aggregate, ring-shape, fibrous and amorphous in different parts of the cell body. Vesicular or granular ANP was also observed beneath the cell membrane, above the cell membrane or outside the cell body, which were possibly suggestive of exocytosis of ANP by cells. The current studies were extended to the cultured embryonic ventricular and atrial cardiac myocytes, and revealed that these cells expressed considerable ANP, which were comparable to those in in vivo cells, reported by others. The high expression of ANP in cultured adult ventricular cardiac muscle cells indicates that these adult cells are capable of producing high content of ANP as observed in embryonic ventricular cells.

Animals↗
PubMed1995

Gonadoblastoma and chroiocarcinoma in dysgenic gonads: report of a case.

Dysgenetic gonads are well known to be associated with gonadoblastoma and various germ cell tumors, but very rarely with choriocarcinoma. We describe a 16-year-old, phenotypic female patient with a 46XY karyotype who developed gonadoblastoma on the right gonad and choriocarcinoma on the left. There was no co-existence of the two tumor cell types in the same gonad. This case emphasizes the importance of bilateral gonadectomy for "46XY female" patients, as soon as the cytogenetic evidence is known.

Adolescent↗
PubMed1994

Passive hyperimmune plasma therapy in the treatment of acquired immunodeficiency syndrome: results of a 12-month multicenter double-blind controlled trial. The Passive Hyperimmune Therapy Study Group.

High-titer anti-human immunodeficiency virus (HIV) antibodies reduced circulating HIV viral burden and has shown promise in previous small uncontrolled studies, warranting a larger controlled study of passive hyperimmune therapy (PHT) in persons with acquired immunodeficiency syndrome (AIDS). The objective of this study was to determine the efficacy and safety of PHT in 220 AIDS subjects in a 12-month double-blind placebo-controlled dosing study. Subjects were randomized to receive monthly infusions of 500 mL of plasma (full dose), 250 mL of plasma diluted in 250 mL of 5% human serum albumin (half dose), or 500 mL of 5% human serum albumin (placebo). Positive treatment effects occurred only in full-dose-treated subjects with baseline CD4 cell counts between 50 and 200 cells/mm3. Reduced mortality was observed, 1 death in 21 (full dose) versus 3 deaths in 21 (half dose) and 6 deaths in 30 (placebo) (P = .065). CD4 cells improved an average of 32.7 cells/mm3 over baseline (full dose) versus 0.9 cells/mm3 (half dose) and a loss of 3.5 cells/mm3 (placebo) (P = .043). No adverse effects or toxicity was noted in donors or recipients. Based on these findings, PHT appears to be a safe, promising therapy warranting further study.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Molecular entrapment of small molecules within the interior of horse spleen ferritin.

A procedure for trapping small molecules inside the interior of horse spleen ferritin (HoSF) and methods for characterizing HoSF and its small entrapped molecules are described. HoSF is first dissociated into subunits by adjustment to pH 2 in the presence of the small molecules to be trapped. The pH of the dissociated HoSF is then increased to 7 at which time the dissociated subunits reassemble reforming the 24-mer HoSF, thereby trapping solvent within its interior. HoSF is then separated from unbound molecules by dialysis, ultrafiltration, and/or ammonium sulfate precipitation. Sephadex G-25 and DEAE chromatographic methods were also used to separate HoSF from unbound small molecules. Capillary electrophoresis (CE) was used to demonstrate the association of small molecules with HoSF after the pH-induced unfolding-refolding process. The pH indicator neutral red was clearly associated with HoSF and presumed trapped within the ferritin interior. Acid/base titrations suggested that the trapped indicator had a different pKa than the free indicator, a result which indicates that the ferritin interior is different than the external solution. The utility of using trapped molecules for gaining information on ferritin function is proposed and discussed.

Ammonium Sulfate↗
PubMed1994

Intrauterine intervention in a case of recurrent meconium peritonitis.

We present a case of recurrent meconium peritonitis detected in the second trimester and treated by intrauterine intervention. Antenatal ultrasound findings included fetal ascites and intra-abdominal calcification. Aspiration of fetal ascites under ultrasound guidance and determination of the bilirubin concentration established the diagnosis of meconium peritonitis. Paracentesis was repeated to remove irritating intestinal contents and to decrease pressure on the fetal thorax. Although the exact cause of the meconium peritonitis remains unknown, the recurrence of the condition suggests a genetic basis. A possibility of cystic fibrosis was not considered because the clinical picture did not suggest it. Intrauterine intervention helped to establish the diagnosis of meconium peritonitis and may have contributed to the good outcome.

Adult↗
PubMed1994

A capillary electrophoresis method for studying apo, holo, recombinant, and subunit dissociated ferritins.

A capillary electrophoresis (CE) method is described for detecting and quantitating apo and holo ferritins from horse spleen (HoSF), rat liver (RLF), recombinant human light chain (rLF), recombinant human heavy chain (rHF), site-directed variants of human light chain, and Azotobacter vinelandii bacterial ferritin (AVBF). This procedure is carried out at pH 8.2, where the ferritin molecules are associated into their 24-mers. Protein mobilities as expressed as elution times were clearly resolved and could be used to distinguish one ferritin type from another, providing a means for detecting and quantitating various ferritin species in purified or partially purified states. Measurements of these and other ferritins were also conducted at pH 2.0, where dissociation into their respective subunits occurs. For HoSF and RLF, the individual L and H subunits were resolved and their relative concentrations were determined by integrating the areas of the elution peaks. HoSF gave 89.8% L and 10.2% H and RLF gave 70.7% L and 29.3% H, while rLF, rHF, and AVBF gave only a single subunit, all in agreement with reported values obtained by polyacrylamide gel electrophoresis. CE of HoSF, containing increasing amounts of iron in the interior, in general, showed that protein mobilities increased, reached a plateau, and then slowly decreased with increasing core size, although buffer effects altered this CE behavior to some extent. Such results indicate that species formed early during core formation have individual iron atoms present and differ from those formed later in which the oligomeric iron core has formed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Capillary electrophoresis of nucleotides on ucon-coated fused silica columns.

Ucon-coated columns have been used to isolate nucleotides, such as ribonucleotides, deoxyribonucleotides, and pyridine nucleotides, by capillary zone electrophoresis. This neutral, hydrophilic column coating (Ucon) significantly reduced macromolecule adsorption and electroosmotic flow, which provides the maximum resolution of the nucleotides separated under moderate buffer conditions (pH about 5-6). The relative standard deviations of the nucleotides were less than 1%. Low minimum detectable concentrations (about 2-8 microM) and quantities (about 70-360 fmol) of the ribonucleotides were obtained. A qualitative and quantitative analysis of the ribonucleotides in hybridoma cell extracts shows the applicability of the developed methodology for the determination of intracellular nucleotide pools under the desirable buffer conditions.

Cells, Cultured↗
PubMed1994

Levoatriocardinal vein in mitral atresia mimicking obstructive total anomalous pulmonary venous connection.

This report briefly describes two cases of levoatriocardinal vein, in the setting of mitral atresia and a restrictive interatrial shunt, with clinical as well as echocardiographic features mimicking obstructive total anomalous pulmonary venous connection. One patient died of pulmonary hypertensive crisis, and the other survived the palliative procedures including the atrioseptectomy and pulmonary artery banding. The echocardiography, cine-angiocardiography, and magnetic resonance image for such an anomalous channel are presented. It is tempting to speculate that the thrombocytopenia and indirect hyperbilirubinemia be associated with the destructive consumption of thrombocytes and red blood cells in the serpentine levoatriocardinal vein.

Cineangiography↗
PubMed1994

Infracardiac total anomalous pulmonary venous connection in tetralogy of Fallot with decreased pulmonary flow and masked pulmonary venous obstruction: report of one case.

We describe an 8-month-old male infant, who received a rerouting procedure for infracardiac total anomalous pulmonary venous connection and a 4-mm Gore-Tex central shunt for tetralogy of Fallot with pulmonary atresia. The masking effect of the pulmonary outflow in tetralogy of Fallot on the pulmonary venous obstruction in infracardiac total anomalous pulmonary venous connection is discussed. Preoperative recognition of this rare association is warranted, as palliative surgery alone may be disastrous. In addition, juxtaductal pulmonary artery coarctation in tetralogy of Fallot with pulmonary atresia may play a role in camouflaging the pulmonary venous obstruction in this case. Unmasking pulmonary venous obstruction by oral prostaglandin and augmenting pulmonary blood flow by a Gore-Tex shunt, pari passu, did harm this patient.

Arteriovenous Shunt, Surgical↗
PubMed1994

Oral bioavailability of the antiretroviral agent 9-(2-phosphonylmethoxyethyl)adenine (PMEA) from three formulations of the prodrug bis(pivaloyloxymethyl)-PMEA in fasted male cynomolgus monkeys.

The bioavailability of PMEA from three oral formulations of the prodrug bis(POM)-PMEA has been evaluated in fasted male cynomolgus monkeys. The formulations examined included a hydroxypropyl-beta-cyclodextrin (HPBCD) complex, a PEG based cosolvent solution, and an aqeous suspension. Oral formulations containing 3H-bis(POM)-PMEA were compared to intravenous 3H-PMEA at 10.9 mg-eq/kg in a crossover study in four monkeys, with a 7 day washout period. No intact bis(POM)-PMEA or monoester were detected in plasma. Bioavailabilities of PMEA from the prodrug were 24.7 +/- 6.5%, 27.3 +/- 12.3% and 22.2 +/- 15.6% for the HPBCD complex, PEG solution and aqueous suspension, respectively. The oral bioavailability of PMEA from bis(POM)-PMEA was not limited by dissolution rate of the prodrug. Data for the PEG cosolvent solution and suspension indicate that the prodrug could potentially be formulated as a soft gelatin capsule or a tablet.

2-Hydroxypropyl-beta-cyclodextrin↗
PubMed1994

Epidemiology of community-acquired Clostridium difficile-associated diarrhea.

The epidemiology of clinically recognized community-acquired Clostridium difficile-associated diarrhea was assessed in a retrospective cohort study of members of a health maintenance organization (HMO). Potential cases were identified through positive toxin assay results and confirmed by review of automated full-text medical records. Of 51 cases identified (7.7 per 100,000 person-years), 42 (82%) were diagnosed and treated exclusively in the ambulatory care setting; 33 cases occurred within 42 days after 494,491 exposures to antibiotics dispensed by an HMO pharmacy. Antibiotic-specific attack rates varied from 0 to 2040 cases per 100,000 exposures. Increased age was associated with C. difficile-associated diarrhea (P < .001). Age-adjusted antibiotic-specific attack rates were at least 10-fold higher (P < .05) for nitrofurantoin, cefuroxime, cephalexin plus dicloxacillin, ampicillin/clavulanate plus cefaclor, and ampicillin/clavulanate plus cefuroxime than for ampicillin or amoxicillin; several other antibiotics were associated with similar but not significantly increased risks.

Adolescent↗
PubMed1994

A cross-over pharmacokinetic and thrombogenicity study of a prothrombin complex concentrate and a purified factor IX concentrate.

A prospective cross-over study was carried out on 19 patients with haemophilia B. comparing the pharmacokinetics of a purified factor IX concentrate prepared by metal chelate affinity chromatography (9MC) with a conventional three-factor prothrombin complex concentrate (9A). The highly purified factor IX concentrate was shown to have a half-life comparable to the PCC; the in vivo recovery of the purified concentrate was significantly greater than that of the complex (P < 0.01). The 20% change in the value of the International Standard for Factor IX Concentrate, introduced in 1988, might have been expected to lower the recovery values. However, the in vivo recovery for both concentrates was somewhat higher than reported previously, particularly in the older literature. In nine patients, serial assays for fibrinopeptide A, prothrombin fragment F1+2 and thrombin-antithrombin complexes (TAT) were performed to assess the potential thrombogenicity of the two concentrates. Evidence was obtained that there was significantly less activation of coagulation following administration of purified factor IX (9MC), as compared to the activation that occurred after the PCC.

Blood Coagulation↗
PubMed1994

Cyclosporin treatment of atopic dermatitis: five case studies and literature review.

This study reports on five adult patients with severe atopic dermatitis who were treated in our department with a three month course of cyclosporin. All patients demonstrated significant clinical improvement with minimal side effects. We conclude that provided safety guidelines are observed, cyclosporin can be used with good effect in those patients where conventional treatment is unsatisfactory. This paper also reviews the use of cyclosporin in atopic dermatitis and includes a brief discussion of how it may alter pathophysiologic mechanisms.

Adolescent↗