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Biomedical subjects

S C Kim

Publications and source records attributed to S C Kim.

At least 19 recordsLinked to original sources

A novel antimicrobial peptide from Bufo bufo gargarizans.

A potent and structurally novel antimicrobial peptide was isolated and characterized from the stomach tissue of Bufo bufo gargarizans, an Asian toad. The 39-amino acid peptide, named buforin I, was purified to homogeneity by heparin-affinity column and reverse-phase HPLC. The amino acid sequence of buforin I was identical in 37 of 39 amino-terminal residues of Xenopus histone H2A. The buforin I showed strong antimicrobial activities in vitro against a broad-spectrum of microorganisms and was found to be more potent than magainin 2. In addition, a 21-amino acid peptide, named buforin II, which was derived from buforin I, showed more potent antimicrobial activities than buforin I.

Amino Acid Sequence

Treatment of posttraumatic chronic high-flow priapisms by superselective embolization of cavernous artery with autologous clot.

Two cases of high-flow priapism that occurred after blunt perineal trauma and lasted for 35 days (case 1) and 40 days (case 2) were successfully treated by embolization of the lacerated cavernous arteries with autologous clots. Cavernous arterial blushes were demonstrated on selective internal pudendal arteriograms in both cases. Case 1 with left cavernous arterial laceration restored 80% of premorbid erectile function with successful intercourse 4 months after superselective embolization. In case 2 with bilateral cavernous arterial lacerations, premorbid erectile function was fully resumed 2 months after bilateral embolization of the cavernous arteries at intervals of 15 days. None developed local or systemic complications.

Adult

Ichthyosis bullosa of Siemens: report of a sporadic case.

We report a sporadic case of ichthyosis bullosa of Siemens occurring in a Korean boy. In this report, the varied findings of the clinical features in one subject over five years are presented along with an investigation of the ultrastructural alteration. The patient had suffered from blistering, superficial peeling, and dark-grey colored lichenified patches on the extremities since infancy. As he grew older, the lesions were more localized to the elbows, knees, buttock and the dorsal aspects of the hands and feet, and were replaced by yellowish, lichenified plaques. Since the original report of Siemens in 1937, nine families including one sporadic case have been reported in the literature. To our knowledge, this is the second report of sporadic case of IBS.

Administration, Topical

Discrepancy of recovery times related to potency between atracurium and mivacurium simultaneously administered in isolated forearms.

Recovery from potent non-depolarising muscle relaxants is slower than from the less potent agents. However, recovery from mivacurium, which is more potent than atracurium, is faster than from atracurium following systemic administration. In an attempt to confirm this discrepancy we compared recovery times following simultaneous administration of equipotent doses of atracurium and mivacurium into the isolated forearms of human volunteers (n = 10). This method enabled us to study the interaction of muscle relaxants with receptors at the neuromuscular junction separated from the effects of plasma drug concentration. In these experiments, the recovery times from maximum block to 50% recovery of control twitch height were significantly longer with mivacurium than with atracurium (mean 25.2(SD 4.7) versus 22.6(3.1) min, p < 0.01). We found that the evidence that mivacurium has a slower recovery than the less potent atracurium may be true using the bilateral, isolated forearm technique and that the discrepancy might be due to a difference in the pharmacokinetic variables of the two drugs.

Adult

Conformation and activity of +H2-Pro-Leu-Gly-NH2 and its analogues modified at the leucyl residue.

In order to investigate the relation between the conformation and the ability to modulate dopamine receptors, conformational free-energy calculations using an empirical potential (ECEPP/3) and hydration shell model were carried out on the tripeptide +H2-Pro-Leu-Gly-NH2 (PLG) and its analogues in which the Leu residue is replaced with Phe, Ahx (L-2-aminohexanoic acid), Ile, Abu and Ala residues in the unhydrated and hydrated states. PLG and two tripeptides possessing Phe and Ahx residues show dopamine receptor modulating activity, while the other tripeptides do not. Irrespective of activities, PLG and its analogues are found to have the high probabilities to form beta-bends of types II and I in the unhydrated state. However, in the hydrated state, the beta-bend probabilities of the PLG analogues decrease significantly compared with those in the unhydrated state. These results indicate that the beta-bend structure is a necessary factor for the PLG analogues to be active, but not a sufficient factor, and that the interactions of water molecules with the backbone may force the tripeptides to be more distorted or extended. The size and the orientation of the hydrophobic moiety of the second residue seem to be of consequence in eliciting the activity of the tripeptides.

Crystallization

Fatal vascular involvement in systemic lupus erythematosus following epidermolysis bullosa acquisita.

Epidermolysis bullosa acquisita may be associated with various systemic diseases, including systemic lupus erythematosus. We describe the clinical and immunological findings in a 38-year-old women with epidermolysis bullosa acquisita and systemic lupus erythematosus. The epidermolysis bullosa acquisita preceded a dramatic flare of systemic lupus erythematosus and fatal cerebral vasculitis. If serologic evidence of lupus erythematosus develops during the course of epidermolysis bullosa acquisita, a thorough investigation is warranted to rule out potentially life-threatening systemic lupus erythematosus.

Adult

A comparison of the relaxation responses of isolated cavernosal smooth muscles by endothelium-independent and endothelium-dependent vasodilators in diabetic men with impotence.

This study was intended to explore the effects of endothelium-independent, direct smooth muscle relaxants(papaverine, verapamil) and endothelium-dependent vasodilators(acetylcholine, bradykinin, adenosine) on the isolated cavernosal smooth muscle strips taken from diabetic men with impotence. When smooth muscle contraction was evoked with norepinephrine for the study of relaxation to these vasodilators, the tension induced was similar in diabetic and non-diabetic men with importance. Papaverine showed the strongest relaxation response followed by verapamil, acetylcholine, bradykinin and adenosine both in non-diabetic and in diabetic men. Relaxation of the cavernosal tissues to endothelium-independent vasodilators was similar in non-diabetic and diabetic men. However, the relaxation response of the tissues to endothelium-dependent vasodilators was significantly reduced in the diabetic group compared with that in the non-diabetic group (p < 0.05). In conclusion, the impairment of endothelium-mediated relaxation of cavernosal smooth muscle seems to play a more important role in the pathogenesis of diabetogenic impotence rather than the problem of smooth muscle itself. This finding forms a rational basis for the use of intracavernosal injections of vasodilators to induce endothelium-independent relaxation of the cavernosal smooth muscle in the patients with diabetogenic impotence.

Adult

A giant ureteral stone.

A 55-year-old woman suffered from right flank pain and had a right giant ureteral stone with hydronephrosis. Ureterolithotomy was performed. The ureteral stone was 11cm long and weighed 45gm.

Female

Phenylketonuria screening: effect of early newborn discharge.

OBJECTIVE: To determine the percentage of term newborns discharged by 24 hours of life and the actions taken by physicians and institutions to avoid false-negative phenylketonuria (PKU) screens in these infants. DESIGN: Descriptive cross-sectional survey. PARTICIPANTS: One hundred forty term nurseries and 157 pediatricians. SELECTION PROCEDURE: Stratified sampling techniques were used to sample nurseries from the 1992 American Hospital Association guide to provide equal representation of each region of the country. Pediatricians were systematically sampled from a national list of practicing pediatricians supplied by Ross Laboratories to provide equal sampling from each state. RESULTS: The response rates were 95% (n = 133) for term nurseries and 83% (n = 131) for pediatricians. Twenty-four percent of healthy newborns are discharged by 24 hours of life. Ninety-three percent of nurseries screen all infants for PKU before discharge. In states without laws mandating rescreening, only 48% of institutions that discharge the majority of their infants (> 50%) by 24 hours of life rescreen. Also, in states without rescreening laws, 64% of pediatricians rescreen. The timing of this repeat screen ranges from less than 72 hours of life to 4 weeks. Determining which infants to rescreen varies by practitioner; some rescreen all infants, whereas others rescreen those discharged early. Just more than half of all pediatricians, whether practicing in a state requiring repeat PKU screening, claim to be familiar with the American Academy of Pediatrics recommendations regarding repeated PKU screening of infants discharged by 24 hours of life. CONCLUSION: Twenty-four percent of term newborns in the United States are discharged by 24 hours of life. Most hospitals screen all infants for PKU before discharge regardless of age. The majority of states do not mandate rescreening; rescreening policies among pediatricians and institutions in those states vary widely. A significant number of infants do not receive repeated screening and are therefore at risk for delayed or missed diagnosis of PKU because of insensitive initial screens. Pediatrician awareness of the need to perform repeated PKU screens on infants discharged by 24 hours is poor.

Age Factors

Universal hepatitis B immunization.

OBJECTIVE: To determine the practices of US nurseries, neonatal intensive care units (NICUs), and pediatricians regarding universal hepatitis B vaccination. DESIGN: Descriptive cross-sectional survey. PARTICIPANTS: One hundred forty term nurseries, 152 NICUs, and 157 pediatricians. Selection procedure. Nurseries and NICUs were systematically sampled from the 1992 American Hospital Association Guide to provide equal sampling from each region of the country. Pediatricians were systematically sampled from a national list of practicing pediatricians supplied by Ross Laboratories to provide equal sampling from each state. RESULTS: The response rates were 95% (n = 133) for term nurseries, 95% (n = 144) for NICUs, and 83% (n = 131) for pediatricians. Sixty-two nurseries (47%) provide routine hepatitis B vaccine (HBV) to their infants. Eighty-five NICUs (59%) routinely vaccinate their preterm infants; 62 (73%) initiate the series just before discharge; and 11 (13%) do so at birth. Principal reasons for not vaccinating include cost and a preference to allow the primary-care physician to initiate the series. One hundred ten (85%) pediatricians provide universal hepatitis B vaccination. Principal reasons for not vaccinating include cost and parents opting against vaccination. CONCLUSIONS: More than half of NICUs provide HBV routinely to their preterm infants, predominantly just before hospital discharge. A minority of NICUs are initiating vaccination at birth, which may provide suboptimal seroconversion. Although less than half of participating term nurseries are routinely vaccinating before discharge, 85% of pediatricians do initiate HBV by two months of age. The principal reasons for not providing vaccine are financial.

Cross-Sectional Studies

Experiences and reflections of former pediatric chief residents.

OBJECTIVE: To compare actual and ideal time commitments of pediatric chief residents between 1972 and 1992 and to determine if actual time commitments have changed. DESIGN: Descriptive, cross-sectional survey. PARTICIPANTS: One thousand two hundred eighty-four former pediatric chief residents. RESULTS: Chief residents between 1972 and 1982 spent a greater percentage of time teaching and providing patient care than chief residents between 1983 and 1992. Chief residents between 1983 and 1992 spent a greater percentage of time scheduling and performing other administrative tasks. In general, chief residents desired more time to teach, to conduct research, and to provide outpatient care and desired less time for scheduling and for performing other administrative duties. CONCLUSIONS: Although chief residents desire to spend more time teaching and less time performing administrative tasks, administrative duties have increased at the expense of teaching and patient care responsibilities over the past 20 years.

Career Choice

Conformation and sweet tastes of L-aspartyl dipeptide methyl esters.

In order to investigate the conformational preferences to elicit tastes, conformational free energy calculations using an empirical potential (ECEPP/2) and the hydration shell model were carried out on the L-aspartyl dipeptide methyl esters, L-(+)HAsp(-)-L-Xaa-OMe, in the hydrated state, where Xaa includes sweet (Phe, Tyr, Met, and Gly), bitter (Ala, Trp, Val, Leu, and Ile), and tasteless (Ser, Thr, and Abu) residues. The refined preferred conformation of the Phe dipeptide (aspartame) with side chain chi 1/2 conformation g- is g-Fg- in the hydrated state, which is consistent with the structure deduced from 1H-nmr experiments. Irrespective of the Xaa and taste, all the dipeptides have the same conformation for the Asp residue, which is attributable to the hydrogen bond between protonated amino hydrogen and carboxylate oxygen and the favored hydration of the carboxylate group. This implies that the L-aspartyl residue is a necessary factor for the dipeptides to be sweet not a sufficient factor. The computed conformational preferences for sweet, bitter, and tasteless dipeptides in the hydrated state indicate to us that the conformation about the N--C alpha bond of the Xaa residue, i.e., the orientation of the hydrophobic moiety with respect to the AH/B functionalities in the aspartyl moiety, seems to be crucial to elicit the tastes. In addition, the hydrophobicity and the size of the Xaa residue are found to play a major role in determining the tastes. These well accord with the related works reported previously.

Aspartic Acid

Prognostic significance of signet ring cell carcinoma of the stomach.

A retrospective analysis of 3,702 gastric cancer patients operated on between 1981 and 1991 was carried out to compare the clinicopathological features of signet ring cell (SRC) gastric cancer with other cell types. Four hundred and fifty patients (12.2%) had signet ring cell gastric carcinoma. There was a tendency for patients with the signet ring cell gastric cancer to be younger and female, and of the middle-third part of stomach to be involved. The proportion of early gastric cancers in signet ring cell gastric cancers was 43%, which was significantly higher than in the other histological types [33% in well differentiated (WD) type, 23% in moderately differentiated (MD) type, and 13% in poorly differentiated (PD) type]. Early stage signet ring cell gastric carcinomas were less invasive in depth and had less lymph node metastasis. However, signet ring cell gastric cancers in advanced stage were more invasive and had more lymph node metastasis than other cell types. There was no significant difference in five year survival rates (5YSR) among patients with different histological cell types in early stage gastric cancers. But, in advanced gastric cancers, the prognosis for patients with the signet ring cell type was significantly worse than for the other types (SRC, 31.9% 5YSR; WD, 45.1% 5YSR; MD, 38.4% 5YSR; PD, 34.5% 5YSR) (P < 0.05), which can be explained by the finding that advanced gastric cancers with signet ring cell type have a larger tumour size, more lymph node metastasis, a deeper invasive depth and more Borrmann type 4 lesions than other histological types. This study suggests that signet ring cell gastric cancer may have a different biological behaviour.

Aged

Non-visualization versus normal appearance of cavernous arteries on selective internal pudendal pharmaco-angiograms: comparison with duplex scanning, cavernosal artery systolic occlusion pressure and penile brachial index.

OBJECTIVE: To determine whether selective internal pudendal pharmaco-angiography (SIPA) is the most reliable diagnostic procedure for evaluating the function of the cavernosal arteries. PATIENTS AND METHODS: Both sides of the selective internal pudendal pharmaco-angiogram taken in 35 patients (70 cases), whose history was suggestive of post-traumatic arteriogenic impotence, were evaluated separately and compared to the corresponding side using the penile brachial index (PBI), duplex scanning and cavernosal artery systolic occlusion pressure (CASOP). RESULTS: There was no significant difference in the peak flow velocity and diameter changes of the cavernosal arteries on duplex scanning, in pressure differences between the brachial artery systolic pressure and the CASOP, and in the PBI between the group with a normal appearance on SIPA and the other where the cavernosal arteries were not visualized. There was no significant difference in the results of these functional evaluations between the normal group and cases where the cavernosal arteries were not visualized accompanied by a completely obstructed internal pudendal artery or common penile artery visible on SIPA. CONCLUSIONS: This study is unable to confirm the value of SIPA in evaluating the function of the cavernosal arteries as it provides only anatomical information.

Adult

Uterine cervical carcinoma: evaluation of pelvic lymph node metastasis with MR imaging.

PURPOSE: To assess accuracy of magnetic resonance (MR) imaging in detection of pelvic node metastasis from uterine cervical carcinoma. MATERIALS AND METHODS: In 136 patients (aged 26-71 years [mean, 49 years]) with uterine cervical carcinoma seen between October 1990 and July 1992, maximum axial diameter (MAAD), minimum axial diameter (MIAD), and signal intensity enhancement ratio of positive nodes were measured. RESULTS: With MAAD of 1.0 cm, MR imaging had an accuracy of 90.4%, sensitivity of 62.2%, and specificity of 94.9% in detection of pelvic node metastasis. Mean MAAD and MIAD were 1.43 and 1.30 cm for true-positive nodes and 1.18 and 0.75 cm for false-positive nodes, respectively. Mean MAAD/MIAD was 1.09 for true-positive and 1.76 for false-positive nodes. With MIAD of 1.0 cm, MR imaging had an accuracy of 93.0% with 62.2% sensitivity and 97.9% specificity. No significant differences were noted in the degree of contrast enhancement between true-positive and false-positive nodes. CONCLUSION: The accuracy of MR imaging was fairly high in detection of pelvic node metastasis from uterine cervical carcinoma, and MIAD was a more accurate size criterion than MAAD.

Carcinoma