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Biomedical subjects

N H Kim

Publications and source records attributed to N H Kim.

At least 37 records · Page 2Linked to original sources
PubMed2003

Relation between insulin resistance and hematological parameters in elderly Koreans-Southwest Seoul (SWS) Study.

In this study, we investigated the relation between insulin resistance and hematological parameters in elderly Koreans. This study included 1314 non-diabetic subjects over the age of 60, selected from a cross-sectional study, which was conducted in 1999 in Seoul, Korea. We measured fasting and post-load 2 h plasma glucose, insulin levels, lipid profiles, anthropometric measures, and hematological parameters. The degree of insulin resistance was assessed using the homeostasis model assessment (HOMA). We found a correlation between insulin resistance and hemoglobin concentrations in non-smoking men (r=0.20, P=0.0186). In non-smoking women, insulin resistance correlated with hemoglobin (r=0.10, P=0.0017) and with white blood cell (WBC) count (r=0.15, P=0.001). Hemoglobin concentrations and WBC counts were also associated with other components of the insulin resistance syndrome such as body mass index, blood pressure, lipid profiles and fasting plasma insulin levels (surrogate for insulin resistance). Furthermore, the group in the upper quartile for insulin resistance showed higher hemoglobin concentrations and WBC counts than the lower quartile, independent of smoking status and serum iron concentrations. Using HOMA-IR as a dependent variable in a multiple regression analysis, age, body mass index (BMI), waist-to-hip ratio (WHR), systolic blood pressure, HDL cholesterol, triglyceride, WBC count, hemoglobin, hematocrit and serum TIBC were significant. Our results provide support for a relation between insulin resistance/hyperinsulinemia and hematological parameters such as hemoglobin concentrations and WBC counts in elderly Koreans. This suggests that increased erythropoiesis and subclinical inflammation could be part of the metabolic syndrome in elderly Koreans.

Aged↗
PubMed2003

Factor analysis of the metabolic syndrome among elderly Koreans--the South-west Seoul Study.

AIMS: To examine the relationship between the components of the metabolic syndrome and to explore whether insulin resistance unifies the clustering of components of the metabolic syndrome among urban elderly Koreans using exploratory factor analysis. METHODS: We included 1314 non-diabetic subjects over the age of 60 years, selected from a cross-sectional study, which was conducted in 1999 in Seoul, Korea. Factor analysis was carried out using the principle components analysis with Varimax orthogonal rotation of the components of the metabolic syndrome. RESULTS: We found four major factors of cardiovascular disease risk variables in our study subjects. Impaired glucose tolerance, dyslipidaemia, hypertension and obesity aggregated as the major domain. Obesity and dyslipidaemia variables were closely related and loaded on the same factor. However, hypertension was not linked closely with other factors of the metabolic syndrome. CONCLUSIONS: Insulin resistance is not the only contributor to the metabolic syndrome among urban elderly Koreans. Although the components of the metabolic syndrome were closely related, the finding of more than one factor suggests that more than one pathophysiological mechanism underlies full expression of the metabolic syndrome among elderly Koreans.

Aged↗
PubMed2002

Comparison of ADA and WHO criteria for the diagnosis of diabetes in elderly Koreans.

AIMS: This study was conducted to compare the prevalence and cardiovascular risk factors of different categories of glucose tolerance in the elderly Korean population using World Health Organization (WHO) and American Diabetes Association (ADA) criteria. METHODS: This study included 1456 non-diabetic subjects over the age of 60 years, selected from a cross-sectional study, which was conducted in 1999 in Seoul, Korea. Fasting and post-challenge 2-h plasma glucose, insulin levels, body mass index (BMI), waist-hip ratio (WHR), blood pressure, and lipid profiles were examined. Prevalence of glucose tolerance categories and the level of agreement (kappa statistics) were obtained using WHO 2-h criteria and ADA fasting criteria. Comparison of cardiovascular risk factors among several concordant and discordant glucose intolerance groups was done. RESULTS: The prevalence rates of newly diagnosed diabetes of elderly men defined by WHO 2-h criteria and ADA fasting criteria were 11.8% and 4.8%, respectively. That of elderly women was 8.1% by WHO 2-h criteria and 3.1% by ADA fasting criteria. The prevalence of impaired glucose tolerance (IGT) by WHO criteria was also higher than that of impaired fasting glucose (IFG) by ADA criteria (23.5% vs. 10.0% men, 23.7% vs. 7.5% women). The level of agreement between ADA fasting criteria and WHO 2-h criteria was low (weighted kappa = 0.228 men, weighted kappa = 0.301 women). The concordant diabetic women by both ADA fasting criteria and WHO 2-h criteria showed higher BMI, WHR, diastolic blood pressure, total cholesterol and triglyceride levels than concordant normal subjects. However, the isolated post-challenge hyperglycaemia (IPH) women group was not different significantly from the concordant normal women group except in BMI. CONCLUSIONS: Our results clearly show that the 1997 ADA fasting criteria are less sensitive for diagnosing diabetes than oral glucose tolerance test (OGTT)-based WHO criteria in elderly Koreans. Also, there is a poor agreement of different categories of glucose tolerance between ADA and WHO criteria; therefore, the OGTT remains a valuable test in diagnosing diabetes and classifying various categories of glucose intolerance, especially in elderly Koreans.

Aged↗
PubMed2002

[The Transverse Coloplasty Pouch (TCP)--function and subjective judgement in comparison with the surgically more complicated J-Pouch].

The present study shows the comparison of function and subjective judgement between two pouch-constructions after TME as treatment for rectal cancer. In 61 cases we constructed a J-Pouch, in 25 cases a transverse coloplasty pouch (TCP). The sex distribution was nearly the same. The influence of additional treatment like neoadjuvant radiotherapy or adjuvant chemo-radiatio was considered. Patients were asked about stool frequency, -consistency, continence, quality of life etc. 9 patients were not alive at follow up. 54 patients (70 %) could be interviewed and examined. 6 months after operation patients with a J-Pouch had a daily stool frequency of 4 times versus 6 times with a TCP. 19 % of patients with a J-Pouch suffered from incontinence problems compared to 33 % with a TCP. Obstipation was only a problem after J-Pouch-construction (12 %). The question on a "good" quality of life was positively answered by 56 % of patients in the J-pouch-group versus 39 % in the TCP-group. 17 % after J-pouch-construction versus 6 % after TCP-construction judged the quality of life as "bad". The results of this study show the TCP being a good alternative pouch-construction instead of the surgically more complicated J-pouch after TME.

Aged↗
PubMed2002

Typing of clinical isolates of Mycobacterium leprae and their distribution in Korea.

Although there is no genetic diversity in isolates of Mycobacterium leprae, the variance of tandem repeats in the rpoT gene was recently demonstrated. We have typed clinical isolates of M. leprae in Korea using difference of the tandem repeats in the rpoT gene. Among 69 patients, 65 Korean isolates (94.2%) demonstrated four copies of the 6 bp tandem repeat (GACATC) in the rpoT gene, and incidences of three copies were found in only two Koreans and two foreigners (2.9%, respectively).

Base Sequence↗
PubMed2001

Lumbosacral scoliotic list by lumbar disc herniation.

STUDY DESIGN: A prospective study of 45 patients with lumbar disc herniation and scoliotic list who had undergone conventional open discectomy. OBJECTIVES: To determine the association between the location of the disc herniation and the direction of sciatic scoliotic list and to clarify the mechanism of sciatic scoliosis. SUMMARY OF BACKGROUND DATA: The association between the scoliotic list and lumbar disc herniation is well known. However, there have been few studies regarding the direction of scoliotic list and the location of the disc herniation observed during surgery. METHODS: The direction of scoliotic list, the preoperative and postoperative Cobb's angle, and the displacement of the first lumbar vertebra from the center sacral line were measured. The location, side, and degree of disc herniation were observed during surgery. RESULTS: There was no statistically significant association observed between the location or degree of nerve root compression and the direction or degree of sciatic scoliosis. Moreover, there was no statistically significant association observed between the location or degree of nerve root compression and the displacement of the first lumbar spine from the center sacral line. However, there was a significant association between the side of the disc herniation and the direction of sciatic scoliosis. Most of the sciatic scoliotic list disappeared after surgical decompression. CONCLUSION: The direction of sciatic scoliosis was not observed to be associated with the location of nerve root compression, although it was related to the side of disc herniation.

Adolescent↗
PubMed2001

Recurrent lumbar disc herniation: results of operative management.

STUDY DESIGN: A retrospective evaluation of 28 patients with recurrent lumbar disc herniation. OBJECTIVES: To analyze the outcome of the revisions (repeat discectomy), the risk factors of recurrent disc herniation, and the factors that influenced the outcomes of repeat discectomy. SUMMARY OF BACKGROUND DATA: Recurrent herniation following disc excision has been reported in 5-11% of patients. There have been many studies on recurrent disc herniation, but these studies have analyzed mixed patient populations. METHODS: Recurrent lumbar disc herniation was defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. Eight women and 20 men were studied. The levels of disc herniation were L4-L5 (19 cases) and L5-S1 (9 cases). Gadolinium-enhanced magnetic resonance imaging was performed in all patients. Revision surgery was performed in all patients by using conventional open discectomy. The pain-free interval, side and degree of herniation, operation time, duration of hospital stay, and clinical improvement rate were recorded. RESULTS: The mean pain-free interval was 60.8 months. There were 21 cases of ipsilateral herniation and 7 cases of contralateral herniation. The degrees of herniation in revision were protrusion (14 cases), subligamentous extrusion (3 cases), transligamentous extrusion (8 cases), and sequestration (3 cases). The degrees of herniation in the previous discectomy were protrusion (17 cases), subligamentous extrusion (10 cases), and transligamentous extrusion (1 case). The length of surgery was significantly different (P = 0.003) between the revision surgery and the previous discectomy. There were no significant differences between revision and previous surgery in terms of hospital stay or clinical improvement rates. Age, gender, smoking, professions, traumatic events, level and degree of herniation, and pain-free interval did not affect the clinical outcomes. CONCLUSION: Conventional open discectomy as a revision surgery for recurrent lumbar disc herniation showed satisfactory results that were comparable with those of primary discectomy. Based on the results of this study, repeat discectomy can be recommended for the management of recurrent lumbar disc herniation.

Adolescent↗
PubMed2001

Synthesis and phosphodiesterase 5 inhibitory activity of novel phenyl ring modified sildenafil analogues.

New sildenafil analogues containing an ether ring fused into the phenyl moiety, 6a--d and 7a--d, were efficiently synthesized from the readily available starting materials, 1a--d and 2, in five steps. Ab initio calculations indicated that introduction of a cyclic ether to the phenyl group might enhance the co-planarity of the molecule. The torsional angles were calculated to be 2--3 degrees for the 5-membered cyclic ether derivatives, 6a, 6c, 7a, and 7c, and 12--16 degrees for the 6-membered ones, 6b, 6d, 7b, and 7d. On the other hand, sildenafil showed the least co-planarity with the torsional angle of 23 degrees compared with the target compounds, 6a--d and 7a--d. In the enzyme assay, however, the in vitro PDE 5 inhibitory activity was found out to be inversely related to the degree of co-planarity. In other words, the least planar sildenafil showed the highest activity, and the most planar 5-membered cyclic ether derivatives were least active by 100--200-fold compared with sildenafil. Our study clearly demonstrated that the open chain 2'-alkoxy group of the phenyl ring, although less effective for inducing the co-planarity, seemed to act as a much better lipophilic requirement than the cyclic alkoxy moiety.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2001

Synthesis and phosphodiesterase 5 inhibitory activity of new 5-phenyl-1,6-dihydro-7H-pyrazolo[4,3-d]pyrimidin-7-one derivatives containing an N-acylamido group phenyl ring.

New sildenafil analogues with an N-acylamido group at the 5'-position of the phenyl ring, 6a--e, were prepared from the readily available starting compound 2 in four straightforward steps. Enzyme assays demonstrated that all the target compounds 6a-e showed higher PDE5 inhibitory activities than sildenafil. It was observed that the PDE5 inhibitory activity was enhanced as the chain length of R group increased, but introduction of the branched alkyl groups such as isopropyl (6d) and cyclohexyl (6e) resulted in the drop of potency compared with 6c. In particular the N-butyrylamido derivative 6c exhibited the highest PDE5 inhibitory activity, and was about 6-fold more potent than sildenafil. However, all the compounds exhibited somewhat weak selectivity (1--3-fold) over PDE6, indicating that the compounds 6a--e have intrinsically lower selectivity than sildenafil.

Phosphodiesterase Inhibitors↗
PubMed2001

Synthesis and phosphodiesterase inhibitory activity of new sildenafil analogues containing a carboxylic acid group in the 5'-sulfonamide moiety of a phenyl ring.

New sildenafil analogues possessing a carboxylic acid group in the 5'-sulfonamide of the phenyl ring, 9a-l, were prepared from the readily available starting compounds 6a-b and cyclic amines 3-5 in a three-step sequence. In the enzyme assays, it has been shown that all the target compounds 9a-l proved to be more potent in inhibiting phosphodiesterase type 5 (PDE5) than sildenafil by 4-38-fold. The effects on the IC(50) values were investigated by varying the alkoxy group (R) of the phenyl ring, the sulfonamide type (X), and the length of the methylene chain linking the carboxylic acid, and the results were discussed in detail. From this study, we have clearly demonstrated that introduction of a carboxylic acid group to the 5'-sulfonamide moiety of the phenyl ring greatly enhanced PDE5 inhibitory activity, probably by mimicking the phosphate group of cGMP. The piperidinyl propionic acid derivative 9i, which showed the highest PDE5 inhibitory activity and comparable to better selectivity over PDE isozymes in comparison with sildenafil, has been selected for more detailed biological investigations.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2001

Design of a PC-based multimedia telemedicine system for brain function teleconsultation.

During time-critical brain surgery, the detection of developing cerebral ischemia is particularly important because early therapeutic intervention may reduce the mortality of the patient. The purpose of this system is to provide an efficient means of remote teleconsultation for the early detection of ischemia, particularly when subspecialists are unavailable. The hardware and software design architecture for the multimedia brain function teleconsultation system including the dedicated brain function monitoring system is described. In order to comprehensively support remote teleconsultation, multi-media resources needed for ischemia interpretation were included: EEG signals, CSA, CD-CSA, radiological images, surgical microscope video images and video conferencing. PC-based system integration with standard interfaces and the operability over the Ethernet meet the cost-effectiveness while the modular software was customized with a diverse range of data manipulations and control functions necessary for shared workspace and standard interfaces.

Brain Ischemia↗
PubMed2001

In vitro development of reconstructed bovine embryos and fate of donor mitochondria following nuclear injection of cumulus cells.

In this study we examined the developmental potential of reconstructed embryos and the fate of donor mitochondria during preimplantation development after nuclear transfer in cattle. Isolated cumulus cells were used as donor cells in nuclear transfer. Cumulus cells labelled with MitoTracker Green FM fluorochrome were injected into enucleated bovine MII oocytes and cultured in vitro. MitoTracker labelling on donor cells did not have a detrimental effect on blastocyst formation following nuclear transfer. Cleavage rate was about 69% (56/81) and blastocyst formation rate was 6.2% (5/81) at 7 days after nuclear transfer. The labelled mitochondria dispersed to the cytoplasm and became distributed between blastomeres and could be identified up to the 8- to 15-cell stage. Small patches of mitochondria were detected in some 8- to 15-cell stage embryos (5/20). However, donor mitochondria were not detected in embryos at the 16-cell stage and subsequent developmental stages. In the control group, mitochondria could be identified in arrested 1-cell embryos up to 7 days after nuclear transfer. These results suggest that disappearance of the labelled donor mitochondria in nuclear transfer bovine embryos is not due to fading of the fluorochrome marker, but is rather an as yet undefined cytoplasmic event.

Animals↗
PubMed2001

In vitro and in vivo evaluation of albumin synthesis rate of porcine hepatocytes in a flat-plate bioreactor.

Several configurations of extracorporeal bioartificial liver devices have been developed for the potential treatment of fulminant hepatic failure or as a bridge to liver transplantation. Recently, we developed a microchannel flat-plate bioreactor with an internal membrane oxygenator in which porcine hepatocytes are cultured as a monolayer on the bottom glass surface. In the present study, we investigated synthetic function of porcine hepatocytes in the bioreactor in both in vitro and in vivo flow circuit models. In vitro, albumin synthesis was stable in the bioreactor for up to 4 days of perfusion. In vivo, with the extracorporeal connection of the bioreactor to rat vasculature, porcine albumin was detectable for 24 h in the rat plasma. We also developed a simple mathematical model to predict the in vivo porcine albumin concentration in rat plasma. These results indicate that this configuration of a microchannel flat-plate bioreactor has potential as a liver support device and warrants further investigation.

Albumins↗
PubMed2001

Pelvic aspergillosis with tubo-ovarian abscess in a renal transplant recipient.

Common clinical manifestations of aspergillosis in renal transplant recipients are fever and pulmonary infiltrates, but involvement of the reproductive system is rare. We report a case of pelvic aspergillosis with tubo-ovarian abscess in a renal transplant patient. The patient received a cadaveric renal transplantation, and two episodes of acute rejection were treated with methylprednisolone pulse therapy. Surgical biopsy specimens of pelvic abscess detected by ultrasonogram and CT revealed Aspergillus. With amphotericin B treatment, the patient is well with normalization of erythrocyte sedimentation rate and C-reactive protein.

Abdominal Abscess↗
PubMed2001

Angiotensin II activates Akt/protein kinase B by an arachidonic acid/redox-dependent pathway and independent of phosphoinositide 3-kinase.

Angiotensin II (Ang II) exerts contractile and trophic effects in glomerular mesangial cells (MCs). One potential downstream target of Ang II is the protein kinase Akt/protein kinase B (PKB). We investigated the effect of Ang II on Akt/PKB activity in MCs. Ang II causes rapid activation of Akt/PKB (5-10 min) but delayed activation of phosphoinositide 3-kinase (PI3-K) (30 min). Activation of Akt/PKB by Ang II was not abrogated by the PI3-K inhibitors or by the introduction of a dominant negative PI3-K, indicating that in MCs, PI3-K is not an upstream mediator of Akt/PKB activation by Ang II. Incubation of MCs with phospholipase A2 inhibitors also blocked Akt/PKB activation by Ang II. AA mimicked the effect of Ang II. Inhibitors of cyclooxygenase-, lipoxyogenase-, and cytochrome P450-dependent metabolism did not influence AA-induced Akt/PKB activation. However, the antioxidants N-acetylcysteine and diphenylene iodonium inhibited both AA- and Ang II-induced Akt/PKB activation. Dominant negative mutant of Akt/PKB or antioxidants, but not the dominant negative form of PI3-K, inhibited Ang II-induced protein synthesis and cell hypertrophy. These data provide the first evidence that Ang II induces protein synthesis and hypertrophy in MCs through AA/redox-dependent pathway and Akt/PKB activation independent of PI3-K.

Angiotensin II↗
PubMed2001

Oxidative stress and neurodegeneration in prion diseases.

Transmissible spongiform encephalopathies (TSEs), also termed prion diseases, are a group of fatal neurodegenerative diseases that affect humans and a number of other animal species. The etiology of these diseases is thought to be associated with the conversion of a normal protein, PrPC, into an infectious, pathogenic form, PrPSc. The PrPSc form shows greater protease resistance than PrPC and accumulates in affected individuals, often in the form of extracellular plaques. The pathogenesis and the molecular basis of neuronal cell death in these diseases are not well understood. Oxidative stress has been proposed to play an important role in the pathogenesis of several neurodegenerative disorders. In the present study, evidence of oxidative stress in scrapie, the archetype disease of the TSEs, is discussed. In addition, the mechanisms whereby oxidative stress could lead to neuronal degeneration are described.

Animals↗