Biomedical subjects
Publications and source records attributed to M Lee.
The HLA-A, B, C and DR antigen distribution in 128 Korean patients with Graves' disease was compared with that in 220 controls. The frequency of HLA-B13, DR5 and DRw8 (relative risk 3.8, 4.4, and 2.3, respectively) was significantly increased in patients with Graves' disease. There was no significant correlation between the presence of these HLA antigens and the clinical features.
In an open, prospective clinical trial, we evaluated the safety and efficacy of apalcillin in the treatment of complicated urinary tract infection. 21 hospitalized adult patients received apalcillin 2 g IV Q8-12 h for 5-17 days. There were 8 upper tract and 13 lower tract infections. Of 25 functional or anatomic abnormalities of the GU tract among these patients, 9 (36%) were corrected during the study period. Effectiveness of apalcillin was determined by clinical and bacteriologic response. 16 (76.2%) patients had clinical cures, 4 (19.8%) had clinical improvement, and 1 (4.8%) had clinical failure. Based on 26 pretreatment isolates, there were 16 (61.5%) bacteriologic cures and 10 (38.5%) failures. Failures were due to 6 (23.1%) relapses, 2 (7.7%) superinfections, and 2 (7.7%) relapses with superinfection. Adverse reactions were mild, transient, and did not require discontinuation of treatment. Apalcillin appears to be a safe, although marginally effective single agent antibiotic for the treatment of complicated urinary tract infections.
Whereas impaired platelet aggregation is a well-known complication of penicillin usage, thrombocytopenia rarely occurs. We present the first case of apalcillin-induced thrombocytopenia and review the literature about this uncommon adverse effect of penicillins.
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To assess accurately the indication and effects of aorto-coronary bypass graft surgery (ACBG) to the myocardium infarction area, 35 patients with myocardial infarction were analyzed by using exercise thallium-201 myocardial imagings. The patients were classified into group I (18 cases) and group II (17 cases) before ACBG. Group I consisted of patients with regional hypoperfusion in the initial image who showed redistribution in the delayed image to the infarction area of myocardium. Group II consisted of those with regional hypoperfusion in the initial image without redistribution in the delayed image. Group I showed a significant improvement in myocardial perfusion (p less than 0.01), pressure rate product (p less than 0.01), global left ventricular ejection fraction (p less than 0.01), segmental wall motion abnormality (p less than 0.01), and exercise tolerance when compared with those of group II before and after ACBG. The above study showed that the pre- operative redistribution of the infarction area in the delayed image suggests myocardial viability and ACBG will be effective.
The use of mouth intermittent positive pressure ventilation alone or in combination with other noninvasive respiratory techniques as an alternative to tracheostomy in the home management of respirator-dependent postpolio persons was studied in 75 patients. The onset of polio was at an average age of 15 years. At that time, all were dependent on some form of respiratory assistance, most frequently, the iron lung. Fifty-nine percent of them remained respirator-dependent from the onset. Forty-one percent became respirator-dependent at an average of 18 years after onset of polio. Overall, they lost an average of 1.9 percent of vital capacity per year. All used mouth intermittent positive pressure ventilation as their predominant mode of respiratory assistance for an average of 14.5 years. Four of them who had no measurable vital capacity used only mouth intermittent positive pressure ventilation 24 hours per day. Of the 66 who had no significant tolerance off 24 hours per day respiratory assistance, only six had tracheostomies. Despite severe physical disability and dependence on artificial ventilation, the majority of these persons have married, have been gainfully employed, and lead useful lives in society.
Hemorrhagic fever with renal syndrome in Korea (Korean hemorrhagic fever) is an acute viral disease characterized by fever, hemorrhage and renal failure. In Korean patients, the disease manifests more distinctive bleeding tendencies than those of hemorrhagic fever with renal syndrome found in western countries. To investigate the nature and role of the coagulation, fibrinolysis, kinin and immune system in the pathogenesis of such a hemorrhagic manifestation, alterations of these systems were assessed from the early phase of the disease. Decreased platelet count and shortened platelet survival were observed with giant platelets in the peripheral blood. The marked prolongations of bleeding time, prothrombin time and partial thromboplastin time were noticed with the decreased plasma activities of coagulation factors II, V, VIII, IX and X. Shortened half life of fibrinogen, increased fibrinogen-fibrin degradation product, with decreased plasma levels and activities of plasminogen, alpha 2-plasmin inhibitor and antithrombin III were found. On thrombelastogram, the existence of procoagulant activity was confirmed, and prolonged reaction time and clot formation time with decreased maximum amplitude were observed. The appearance of circulating immune complexes was found along with decreased C3 and normal C4 in the serum. Significant decrease of serum C3 was evident in the patients with disseminated intravascular coagulation. These findings of coagulopathy were normalized within ten days of the illness in most cases. Therefore, it can be concluded that disseminated intravascular coagulation and thrombocytopenia in the early phase, and azotemia developing later might play an important role in the pathogenesis of bleeding tendency in Korean hemorrhagic fever.
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Four- to six-week-old hamsters were infected with 1.5 X 10(7) Plasmodium berghei-parasitized hamster red blood cells by intraperitoneal injection. Cheek pouch circulation was observed microscopically in the anesthetized animal; the brain and contralateral pouch were collected for histopathologic examination on days 3-12 post-challenge. Cheek pouch vascular lesions, observed in vivo, appear to involve three phenomena; early (beginning 3-4 days) adhesion of pigment-laden mononuclear cells to endothelium within venous vessels and loss of function of the small capillaries supplying the skeletal muscle fibers and, later (6-9 days), the apparent attraction of erythrocytes to venular and venous endothelium and to adherent monocytes. The aggregation of formed elements on endothelial walls leads to progressive occlusion of venules and small veins and contributes to the observed disruption of flow through capillary networks. Histopathology of the brain and pouch shows vascular changes similar to those seen in vivo; in addition, multifocal hemorrhages are seen commonly in the brain and occasionally in the pouch on postmortem. In severe disease, evidence of cerebral edema is seen in the brain. The data suggest that failure of capillary flow and disruption of venous outflow tracts by cell aggregates are central to vascular failure in both the cheek pouch and brain of the P. berghei infected hamster. This hamster model of human cerebral malaria allows the in vivo observation, still and video photomicrography, and manipulation of the peripheral vascular pathogenesis of a disease process similar to that seen in humans.
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The purpose of this study is to precisely evaluate the indications and the results of direct revascularization surgery in a myocardial area previously infarcted. 35 cases were analyzed using thallium scintigraphy during stress. Before surgery, the patients were divided in two groups. Group I (18 cases) includes patients who presented initially a regional hypoperfusion and a reperfusion at the site of the infarction, on late scintigrams; group II (17 cases) also presented a regional hypoperfusion initially, but showed no reperfusion on late scintigrams. Concerning the results during stress, the thallium 201 scintigrams during exercise show alterations of the myocardial perfusion in the infarcted area, before and after surgery; in group I, a significant improvement (p less than 0.01) is noted in the entire group, i.e. 16 patients (88.9%), except in 2 cases where the graft was occluded, and group II shows an improvement in only 4 cases (NS) after surgery. Concerning the modifications of the product pressure X cardiac rhythm, there is a significant improvement (p less than 0.01) in group I (14 out of 18 patients (77.8%)); 2 out of 4 patients who were aggravated, presented occluded grafts after surgery. Group II shows an improvement in 10 out of 17 patients (58.8%) after surgery (NS). The left ventriculography demonstrates alterations in the global ejection fraction. Group I shows a significant improvement in 15 out of 18 patients (88.3%) (p 0.01); in group II there is improvement in 11 out of 17 patients (64.7%) (NS) after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
Interleukin-1 (IL-1) has been shown to induce stromal cells, including endothelial cells and fibroblasts, to produce multilineage hematopoietic growth factors. Although both of these cell types are well-described elements of the hematopoietic microenvironment, previous studies of IL-1-inducible colony-stimulating factor responses have utilized fibroblasts and endothelial cells from nonhematopoietic sites. Since we hypothesize that this intercellular growth network is active in the hematopoietic microenvironment, we sought to determine the responsiveness of bone marrow fibroblasts to IL-1. We demonstrate here that recombinant human IL-1 alpha and beta stimulate the dose-dependent release of granulocyte-macrophage colony-stimulating activity (GM-CSA) and burst-promoting activity (BPA) by cultured human bone marrow fibroblasts. We conclude that bone marrow fibroblasts produce hematopoietic growth factors in response to interleukin-1, and that this may be a mechanism by which stromal cells regulate cellular growth and differentiation within the hematopoietic microenvironment.
A 74-year old female presented a giant tumor and serosanguineous nipple discharge from the left breast. The tumor was first recognized 26 years ago, and untreated. The resected breast contained several cysts and some small white nodules. Some of the cysts contained intracystic tumors. Histologically, the tumor consisted of a mixture of papillotubular carcinoma and intraductal papilloma. This case seems to represent a malignant change in intraductal papilloma from its long clinical course and by the microscopic findings. Review of this case seems to warrant clinical attention to the possibility that benign intraductal papilloma may transform itself into malignancy after many years.
The effect of maternal alcohol consumption on fetal growth and development during mid-gestation was investigated in Swiss white mice. As early as day 12 of gestation alcohol-exposed fetuses are retarded in both weight and length and remain retarded by about 0.5 to 1 day through day 16, when the experiment was terminated. From day 12 to day 16 alcohol-exposed fetuses were retarded in morphological development by about one half day, compared to controls not exposed to alcohol. Palate development began later in alcohol-exposed fetuses and was not complete in most fetuses until about 15 days 18 hours, whereas fusion was complete in most control fetuses by 15 days 0 hours. No evidence for an effect of uterine position on palate development was observed, either in control or alcohol-exposed fetuses. The manner in which alcohol consumption may affect fetal growth and development is discussed in light of these results.
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