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Biomedical subjects

S C Kim

Publications and source records attributed to S C Kim.

At least 199 records · Page 11Linked to original sources
PubMed1997

A dose-response study of alprostadil sterile powder (S.Po.) (Caverject) for the treatment of erectile dysfunction in Korean and Indonesian men.

This open-label, dose-escalation study investigated the efficacy and safety of alprostadil (PGE1, prostaglandin E1) Sterile Powder (S.Po.) (Caverject) for treatment of erectile dysfunction (ED) in 84 men with ED of various etiologies lasting > or = 4 months. Doses started with 2.5 micrograms, then 5 micrograms, 10, 15, 20, 30, up to a 40 micrograms maximum. Eligible patients received single alprostadil injections in the physician's office until an erection occurred. Ten minutes after injection, the patient's erection was clinically evaluated. Optimal response was defined as erection sufficient to permit vaginal penetration and lasting 30-60 min. The patient also reported his own evaluation of response and any side effects. Patients were 24-65 y old (mean: 43.7 y), had ED of psychogenic, vascular, or neurogenic origin lasting 4 months-30 y (mean: 3.75 y). Of 84 patients enrolled, 82 completed the study. In the 82 patients who completed the study 78 (92.9%) achieved an optimal response; 18/78 patients (23.1%) had an optimal response at 2.5 micrograms, 9/78 (11.5%) at 5 micrograms, 21/78 (26.9%) at 10 micrograms, 12/ 78 (15.4%) at 15 micrograms, and 11/78 (14.1%) at 20 micrograms. Only 5/78 (6.4%) at 30 micrograms and 2/78 (2.6%) at 40 micrograms achieved an optimal response. Mean optimal alprostadil dose was 11.9 micrograms, and the mean minimal effective dose was 9.9 micrograms. Mean onset of erection was 11.2 min; mean duration of erection was 50.5 min. Penile pain in five patients (6%) was the only reported side effect.

Adult↗
PubMed1997

Epidermolysis bullosa acquisita in childhood--a case mimicking chronic bullous dermatosis of childhood.

Epidermolysis bullosa acquisita (EBA) is rarely reported in childhood, but we now describe a 6-year-old Korean girl with the condition. She presented with multiple tense bullae annularly distributed on the perioral, periorbital and genital areas, and was successfully treated with dapsone. The clinical and histological features were similar to those of chronic bullous dermatosis of childhood. We review seven previously reported childhood EBA cases and contrast their features with those of adult EBA. We suggest that some childhood EBA is different from the adult form and shares features with chronic bullous dermatosis of childhood.

Adult↗
PubMed1997

Experience with EDAP LT02 extracorporeal shockwave lithotripsy in 1363 patients: comparison with results of LT01 SWL in 1586 patients.

A new piezoelectric lithotripter, the EDAP LT02, differs from the earlier LT01 in two important respects: a stone-localization system consisting of ultrasound and fluoroscopy and more energy per shockwave. The results of SWL monotherapy with the LT02 in 1363 patients and with the LT01 in 1586 patients who completed SWL treatment were compared. All of the stones could be localized by ultrasound (62.7%), fluoroscopy (0.3%), or both (37%) on the LT02, but the renal stones of three patients who had a history of open renal surgery and 29 upper ureteral stones could not be localized by real-time ultrasound on the LT01. The success rate (stone free or residual fragments < 4 mm in diameter) with the LT02 and LT01 according to stone location was not significantly different: 86.4% and 88.5%, respectively, for renal stones, 89.1% and 88.9% for ureteral stones, and 87.0% and 89.0% overall. The overall stone-free rate of LT02 and LT01 SWL was 78.8% and 87.9%, respectively. For mid-ureteral stones, the success rate with LT02 SWL was 76.8%. (Such stones were not an indication for LT01 SWL.) The mean number of treatment sessions with the LT02 (1.9) was much less (P < 0.001) than with the LT01 (3.3). The retreatment rates of LT02 and LT01 SWL were 68.2% and 198.2%, and the auxiliary treatment rates were 3.4% and 6.3%, respectively. Thus, the efficiency quotient was 45.9% in LT02 SWL, which was much higher than the 28.9% of the LT01. There was no significant difference in the occurrence of complications between LT02 and LT01 SWL. Therefore, LT02 piezoelectric lithotripsy is more efficient than the LT01 in localizing stones and can lessen the number of treatment sessions.

Adolescent↗
PubMed1997

Twitch augmentation and train-of-four fade during onset of neuromuscular block after subclinical doses of suxamethonium.

We have studied the train-of-four (TOF) response mechanomyographically during onset of neuromuscular block produced by subclinical doses of suxamethonium in order to follow the augmentation of the first twitch of the TOF (T1) and TOF fade compared with control TOF responses before the drug was given. In the groups given suxamethonium 0.05, 0.1, 0.2 and 0.3 mg kg-1, the increments in T1 after administration of the drug were observed before twitch depression occurred; these were mean 22.3 (SEM 8.1)%, 19.2 (3.3)%, 10.8 (2.0)% and 4.2 (2.2)%, respectively. This effect was more marked with the lower doses (P < 0.05). The degree of TOF fade was moderate during onset of neuromuscular block and depended on the dose of drug. The results of this study suggest that low doses of suxamethonium produced transient increase in muscle tension and twitch depression with significant TOF fade. We conclude that suxamethonium was associated with presynaptic effects as a consequence of brief stimulation of acetylcholine release followed by progressive diminution at the neuromuscular junction.

Adult↗
PubMed1997

Matrix metalloproteinase-9 in cerebral aneurysms.

OBJECTIVE: Generalized disruption of arterial wall morphological changes in patients harboring cerebral aneurysms has been documented; however, little is known regarding the pathogenesis of these changes. To explore the role of the elastolytic gelatinase, matrix metalloproteinase-9 (MMP-9), levels of this enzyme in the wall of intracranial aneurysms were compared with those in both intracranial and extracranial arteries. The tissue levels of its major inhibitor, tissue inhibitor of metalloproteinase (TIMP), were measured in these tissues as well. The activity of MMP-9 in plasma was also evaluated. METHODS: The aneurysm wall was excised from three of six patients undergoing craniotomies for aneurysm clipping. A 1-cm segment of superficial temporal artery (STA) was obtained from each of six patients. Additional STAs were obtained from six patients in the control group who were undergoing craniotomies for nonvascular disease. An intracranial artery was also obtained from the anterior temporal neocortical resection of a patient undergoing a craniotomy for mesial temporal sclerosis. MMP-9 and TIMP levels were determined via Western blot analysis. Using substrate gel Zymography, MMP-9 plasma activity was determined for a separate cohort of patients with aneurysms (n = 6) and patients in the control group (n = 6). RESULTS: MMP-9 and TIMP levels in the aneurysm wall were markedly increased beyond levels in both extracranial arteries (STAs from patients with aneurysms and patients in the control group) and the intracranial artery. There were no differences in the levels of MMP-9 in the STAs of patients harboring aneurysms when compared with patients in the control group. Also, no differences were noted in plasma MMP-9 activity. CONCLUSION: Local rather than systemic perturbations in MMP-9 levels may contribute to the matrix disruption associated with cerebral aneurysms. This local up-regulation is not the result of TIMP down-regulation. The lack of increased systemic metalloproteinase activity precludes the use of plasma MMP-9 activity as a screening tool for presymptomatic aneurysms. However, local therapeutic modulation of MMP-9 activity may help arrest aneurysm progression.

Aneurysm, Ruptured↗
PubMed1997

cDNA cloning of the 210-kDa paraneoplastic pemphigus antigen reveals that envoplakin is a component of the antigen complex.

Although the 210 and 190-kDa proteins are the most frequently detected antigens reacting with sera of patients with paraneoplastic pemphigus (PNP) in immunoblot analysis, there is still uncertainty as to the nature of these PNP antigens. To isolate and characterize a cDNA clone encoding the 210-kDa PNP antigen, we screened a human keratinocyte lambda gt 11 cDNA expression library by the immunoperoxidase method with serum IgG from a PNP patient. The IgG used for the immunoscreening of a keratinocyte cDNA expression library recognized 210- and 190-kDa antigens by immunoblotting. A single clone, called here the PNP clone, producing a fusion protein that reacted strongly with the patient's IgG, was further characterized. Only the PNP patient's IgG, but not IgG from a normal control, pemphigus foliaceus, or pemphigus vulgaris patients, bound the plaques of this positive clone. Furthermore, PNP IgG affinity purified on plaques of this clone, but not unrelated clones, bound to keratinocyte cell surfaces by immunofluorescence and reacted with the 210-kDa PNP antigen by immunoblotting. EcoRI digestion of the clone's cDNA insert demonstrated a 1.4-kbp fragment. This cDNA insert was placed into a M13 mp 18 vector and sequenced. Sequence analysis revealed that the cDNA insert of the PNP clone encodes a part of the central rod domain and the COOH-terminal C domain of envoplakin, a newly defined precursor of the cornified envelope that is homologous to desmoplakin. This result demonstrates that the 210-kDa PNP antigen is envoplakin and PNP is an autoimmune disease that produces autoantibodies against intermediate filament-associated proteins in desmosomes and hemidesmosomes, desmoplakin, bullous pemphigoid antigen 1 (BPAG 1), and envoplakin.

Autoantibodies↗
PubMed1997

Dyschromatosis universalis hereditaria: an electron microscopic examination.

We report electron microscopic findings from both hyperchromic and achromic macules of dyschromatosis universalis hereditaria (DUH). The keratinocytes of the hyperchromic macules contained numerous, fully melanized melanosomes; almost all of them were aggregated to form the melanosome complex. In contrast, the melanosomes were absent from both keratinocytes and melanocytes of achromic macules, even though intact melanocytes were found. Our results suggest that DUH may be a disorder of melanosome production and distribution in epidermal melanin units rather than a a disorder of melanocyte number.

Aged↗
PubMed1997

Efficacies of ofloxacin, rifampin, and clindamycin in treatment of Staphylococcus aureus abscesses and correlation with results of an in vitro assay of intracellular bacterial killing.

We studied the efficacies of ofloxacin, rifampin, and clindamycin in a Staphylococcus aureus abscess model and seven antimicrobial regimens in an intracellular killing assay. Ofloxacin plus rifampin was the most effective regimen in the abscess model, and rifampin and ofloxacin were the most active regimens in the intracellular killing assay.

Abscess↗
PubMed1997

Exacerbation of cerebral injury in mice that express the P-selectin gene: identification of P-selectin blockade as a new target for the treatment of stroke.

There is currently a stark therapeutic void in the treatment of evolving stroke. Although P-selectin is rapidly expressed by hypoxic endothelial cells in vitro, the functional significance of P-selectin expression in stroke remains unexplored. In order to identify the pathophysiological consequences of P-selectin expression and to identify P-selectin blockade as a potential new approach for the treatment of stroke, experiments were performed using a murine model of focal cerebral ischemia and reperfusion. Early P-selectin expression in the postischemic cerebral cortex was demonstrated by the specific accumulation of radiolabeled anti-murine P-selectin IgG, with the increased P-selectin expression localized to the ipsilateral cerebral microvascular endothelial cells by immunohistochemistry. In experiments designed to test the functional significance of increased P-selectin expression in stroke, neutrophil accumulation in the ischemic cortex of mice expressing the P-selectin gene (PS +/+) was demonstrated to be significantly greater than that in homozygous P-selectin-null mice (PS -/-). Reduced neutrophil influx was accompanied by greater postischemic cerebral reflow (measured by laser Doppler) in the PS -/- mice. In addition, PS -/- mice demonstrated smaller infarct volumes (5-fold reduction, P<.05) and improved survival compared with PS +/+ mice (88% versus 44%, P<.05). Functional blockade of P-selectin in PS +/+ mice using a monoclonal antibody directed against murine P-selectin also improved early reflow and stroke outcome compared with control mice, with reduced cerebral infarction volumes noted even when the blocking antibody was administered after occlusion of the middle cerebral artery. These data are the first to demonstrate a pathophysiological role for P-selectin in stroke and suggest that P-selectin blockade may represent a new therapeutic target in the treatment of stroke.

Animals↗
PubMed1997

Immunogenicity of hepatitis B vaccine in preterm infants.

OBJECTIVE: To determine the immunogenicity of hepatitis B vaccine in preterm infants when the first dose of vaccine is delayed until hospital discharge. METHODS: One hundred two preterm infants (23 to 36 weeks gestational age) born to hepatitis B surface antigen-negative mothers were enrolled. Immunization was initiated just before hospital discharge with subsequent doses 1 and 6 months later. Serum specimens were obtained before the administration of each vaccine dose and 3 months after the last dose and were tested for antibody to hepatitis B surface antigen (antiHBs). RESULTS: Eighty-seven infants (85%) completed the study. Ninety percent (n = 78) of infants who completed the study seroconverted (antiHBs > or = 10 mIU/mL); 10% (n = 9) remained seronegative at study completion. The geometric mean antibody titer to hepatitis B surface antigen for infants who seroconverted was 200 mIU/mL. Nonresponders (NR) differed from responders (R) in birth weight (NR = 2090 g, R = 1560 g) gestational age (NR = 33 weeks, R = 31 weeks), and weight gain before vaccine initiation (NR = 244 g, R = 633 g). There were no differences in weight or age at vaccine initiation, Apgar scores, interval between vaccine doses, or bacterial infections, steroid use, or transfusions before vaccine initiation. CONCLUSIONS: Ninety percent of preterm infants responded to hepatitis B vaccine when the first dose of vaccine was delayed until hospital discharge. Nonresponders were more likely to be preterm infants of higher birth weight and higher gestational age, and to have gained less weight before vaccine initiation.

Gestational Age↗
PubMed1997

Laparoscopic mobilization of the inferior epigastric artery for penile revascularization in vasculogenic impotence.

A laparoscopic approach was used for penile revascularization in a patient with vasculogenic impotence to avoid the long abdominal incision which was traditionally required to harvest the inferior epigastric artery as a neoarterial source. Despite the time-consuming nature of laparoscopy, this procedure was as efficacious but less morbid and required less convalescence than open revascularization. Whether more patients may benefit from this procedure must be evaluated in further studies.

Epigastric Arteries↗
PubMed1997

Characteristics of pain following intracavernous injection of prostaglandin E1.

The aim of this study was to determine the incidence and characteristics of pain following intracavernous injection of prostaglandin E1 (PGE). We injected PGE into the cavernous tissues of 156 patients with erectile dysfunction who had never previously been injected with PGE. The incidence and characteristics of pain after injection were evaluated by the patients' response to a questionnaire. The intensity of pain was determined by the degree of impediment to intercourse, verbal rating scale (VRS), numerical rating scale (NRS), and visual analogue scale (VAS). Patients scoring 'no pain' on the VRS, NRS, and VAS were 11.5%, 7.7%, and 7.7%, respectively. Overall incidence of pain was 91%. There was 'much' or 'very much' impediment to intercourse because of pain in 14 (9.1%) patients. The most common kind of pain was 'heavy pain' in 90% of the patients followed by 'throbbing' in 38%, 'aching' in 21%, 'tightening' in 18%, and 'shooting' in 13%. The mean duration of pain was 101.2 +/- 63.7 minutes and it lasted during the entire erection period in 71(50.4%) patients. There were significant correlations among the degree of impediment to intercourse, VRS, NRS, and VAS scores (all p < 0.01). However, no association was noted between pain intensity and both erectile response to PGE and injected dose. The higher incidence of intracavernous PGE-induced pain reported here compared to other studies might be related to difference in pain thresholds among races. The high incidence of pain but low frequency of much impediment to intercourse would be related to the pain characteristics as well as the intensity of pain.

Adult↗
PubMed1997

Myxoma: life-threatening benign nonepithelial tumor of the larynx.

Myxoma is a rare nonepithelial neoplasm of the larynx frequently misdiagnosed as a large vocal polyp due to its slow-growing nature. Myxoma is a benign but often infiltrating neoplasm of uncertain mesenchymal cell origin, characterized by irregular round, spindle or stellate cells within a matrix containing abundant mucoid material, scant vascularity and a variable meshwork of reticulum and collagen. We report one case of myxoma with life-threatening dyspnea requiring tracheotomy.

Critical Illness↗
PubMed1997

Monitoring of WT-1 gene expression in peripheral blood of patients with acute leukemia by semiquantitative RT-PCR; possible marker for detection of minimal residual leukemia.

The expression of the WT-1 gene which is found exclusively in human leukemic blasts frequently disappears from bone marrow of leukemia patients in complete remission (CR). Using semiquantitative RT-PCR, we investigated the expression of the WT-1 gene in peripheral bloods (PBs) of 33 patients with acute leukemia (AML 26; ALL 7) and monitored its expression after achievement of CR. None of the 6 normal controls expressed detectable levels of WT-1 transcripts (< 10(-4), background level), whereas 31 (93.9%) of 33 patients expressed variable levels of WT-1 transcripts (range, 10(-4) to 10(1)) at diagnosis. The level of WT-1 expression was not different between AML and ALL. By monitoring WT-1 gene expression in PB of 31 patients during CR, 5 patients relapsed (two from the 18 patients with undetectable levels of WT-1 gene expression and three from the 13 with WT-1 gene expression in low levels). Three of the 5 relapsed patients showed preceding reappearance or rise of WT-1 gene expression. From these results, we reconfirmed that the WT-1 gene is a pan-acute leukemic marker, which can be used to monitor minimal residual leukemia (MRL) after chemotherapy or in patients with CR.

Biomarkers, Tumor↗
PubMed1996

cDNA cloning and characterization of buforin I, an antimicrobial peptide: a cleavage product of histone H2A.

A cDNA containing coding information for buforin I, the toad stomach antimicrobial peptide, was identified by PCR. The cloned cDNA encoded a protein of 129 amino acids whose 39-amino-acid N-terminus was identical to buforin I. Nucleotide sequence analysis of the cloned cDNA revealed that it had over 90% amino acid homology with histone H2A, the replication-dependent protein. Both Northern and Southern blot analysis of the toad genome suggested that histone H2A and buforin I were encoded by the same gene. A specific protease responsible for the generation of buforin I from histone H2A was found to be present in the crude extracts of the toad stomach. These results suggest that there exists a specific regulation mechanism which converts the toad histone H2A to the antimicrobial peptide buforin I.

Amino Acid Sequence↗
PubMed1996

Solution structure of an antimicrobial peptide buforin II.

The structure of 21-residue antimicrobial peptide buforin II has been determined by using NMR spectroscopy and restrained molecular dynamics. Buforin II adopts a flexible random structure in H2O. In trifluoroethanol (TFE)/H2O (1:1, v/v) mixture, however, buforin II assumes a regular alpha-helix between residues Val12 and Arg20 and a distorted helical structure between residues Gly7 and Pro11. The model structure obtained shows an amphipathic character in the region from Arg5 to the C-terminus, Lys21. Like other known cationic antimicrobial peptides, the amphipathic structure might be the key factor for antimicrobial activity of buforin II.

Amino Acid Sequence↗
PubMed1996

A common origin for woody Sonchus and five related genera in the Macaronesian islands: molecular evidence for extensive radiation.

Woody Sonchus and five related genera (Babcockia, Taeckholmia, Sventenia, Lactucosonchus, and Prenanthes) of the Macaronesian islands have been regarded as an outstanding example of adaptive radiation in angiosperms. Internal transcribed spacer region of the nuclear rDNA (ITS) sequences were used to demonstrate that, despite the extensive morphological and ecological diversity of the plants, the entire alliance in insular Macaronesia has a common origin. The sequence data place Lactucosonchus as sister group to the remainder of the alliance and also indicate that four related genera are in turn sister groups to subg. Dendrosonchus and Taeckholmia. This implies that the woody members of Sonchus were derived from an ancestor similar to allied genera now present on the Canary Islands. It is also evident that the alliance probably occurred in the Canary Islands during the late Miocene or early Pliocene. A rapid radiation of major lineages in the alliance is consistent with an unresolved polytomy near the base and low ITS sequence divergence. Increase of woodiness is concordant with other insular endemics and refutes the relictural nature of woody Sonchus in the Macaronesian islands.

Atlantic Islands↗