Biomedical subjects
Publications and source records attributed to S C Kim.
We report bilaterally fractured Hydroflex implants in 2 patients. One fracture was complete and three were incomplete. All the fractures occurred at the junction of the rear reservoir and the inflation chamber.
The effect of ouabain, an inhibitor of the membrane Na+/K+ ATPase, on smooth muscle of the corpus cavernosum was investigated. In an in vivo study using dogs, the intracorporeal pressures (ICPs) were measured before and during electrical stimulation of the cavernous nerve, and during nerve stimulation following intracorporeal injection of ouabain (1 x 10(-7) M). There was a significant drop of ICP following intracorporeal injection of ouabain (P < 0.001). In the in vitro study, ouabain increased the basal tone of the isolated cavernosal strip from the rabbit. When the strip was pretreated with tetrodotoxin (5 x 10(-7) M), phentolamine (1 x 10(-5) M), propranolol (1 x 10(-5) M) and atropine (1 x 10(-5) M), ouabain was still capable of contraction of the strip. The ouabain partly inhibited the relaxation effect of acetylcholine (1 x 10(-6) M), VIP (vasoactive intestinal polypeptide: 1 x 10(-8) M) and 2-chloro-adenosine (1 x 10(-6) M). The ouabain acts directly on the smooth muscle of the corpus cavernosum, increases its basal tone and diminishes the relaxation effect of acetylcholine, VIP and adenosine.
A Health Subcentre-based randomized controlled trial was conducted in order to determine the importance of the motivation of the tuberculosis personnel in improving the results of a treatment programme. A total of 1300 newly detected tuberculosis patients from 7 Health Centres were divided into study and control groups using the Health Subcentre areas as sampling units. In the study group, worker motivation was intensified through special regular sessions and closer supervision, while in the control group the usual procedures were followed. Treatment performance was remarkably improved in the study areas: treatment completion rate was 78.8% in the study group, compared with 65.2% in the control group. Bacteriological conversions among those having completed the treatment were 91.9% and 62.2% respectively, and overall efficacy was 75.2% and 45.8%, respectively. In addition to improved treatment, the follow-up case examinations also showed markedly increased performance. Although this study was done in facilities using conventional regimens which have been replaced with short-course regimens more recently, the study results still clearly indicate the importance of motivating personnel in the field to attain better case management.
The stone-free rate of 248 cases of clinically insignificant residual fragments (CIRF) was 32.7% by 1 month, 73.0% by 3 months, and 92.7% by 6 months of follow-up. The stone-free rate decreased but not remarkably in accordance with the increment of the caliceal dilatation (92.9%, 94.9%, 85.7%, and 83.3% for no, mild, moderate, and severe dilatation, respectively) by 6 months of follow-up. The clearance of the CIRF was not influenced by their location, the pelviocaliceal angle, the infundibular length, or the number of the lower calices. Of 16 patients who had residual stone fragments at 6 months and underwent an additional session of extracorporeal shock wave lithotripsy (SWL), 12 became stone free by another 6 months of follow-up. Therefore, it is desirable to wait for clearance of CIRF for at least 6 months before offering further treatment, regardless of their location and anatomic variation of the calices containing CIRF. Repeated SWL, even for stone fragments of 3 to 4 mm in diameter found initially 1 month after the last session of SWL, might promote clearance of the CIRF, and additional SWL for persistent CIRF could be an appropriate adjunctive measure.
We report a 20-year-old-Korean woman with a congenital giant pigmented nevus and angiolipoma. She was admitted our department with a large, dark, pigmented lesion on the right flank and abdomen and a slowly growing mass on the right flank area since birth. On biopsy, the specimen taken from the giant pigmented patch showed typical findings of compound nevus. The right flank mass was surgically removed. The specimen was composed of mature fat cells with an increased vascular component. These findings are compatible with angiolipoma.
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We report a case of pemphigus foliaceus caused by nifedipine. In this case casual rechallenge with nifedipine confirmed that this drug was the causative agent. The skin lesions cleared quickly after withdrawal of the drug and treatment with a short course of oral steroids. To our knowledge, this is the first reported patient with nifedipine-induced pemphigus.
The corporeal blood gas changes in accordance with the duration of the prolonged erection which developed after intracorporeal pharmacotherapy with papaverine and phentolamine were investigated in 62 impotence patients. The picture of the corporeal blood taken from 15 psychogenic impotence patients (a control group) at 10 minutes after intracavernous injection when they showed full erections was arterial but there was pCO2 rise and pH drop compared to femoral artery blood taken simultaneously. As the erection lasted longer, significant gas changes of the cavernous blood began to appear (p < 0.0001): increase in pCO2 and decrease in pO2 from 4 hours, decrease in pH from 5 hours, decrease in O2 saturation from 6 hours. Erections lasting for more than 16 hours showed significantly worse hypoxia (p < 0.05). Therefore, to prevent hypoxia and metabolic acidosis, drug-induced prolonged erection would be better decompressed before it lasts for more than 4 hours.
The neuromuscular and hem+odynamic effects of mivacurium 0.15 mg/kg and succinylcholine 1 mg/kg were compared in 26 adult patients (ASA I and II) during nitrous oxide-oxygen-propofol-fentanyl anesthesia. Neuromuscular block was monitored by recording the compound electromyogram of the hypothenar muscle resulting from supramaximal train-of-four stimuli applied to the ulnar nerve. Time to onset of over 95% block and duration to 25% recovery of control twitch after injection of mivacurium were significantly longer than for succinylcholine (201 +/- 37.6 vs 54 +/- 5.2 sec and 13.0 +/- 2.2 vs 8.4 +/- 2.1 min; mean +/- SD). Onset of mivacurium with priming technique was shortened (125 +/- 20.7 sec), but was also slower than that of succinylcholine. Although the recovery index during spontaneous recovery was significantly longer for mivacurium than for succinylcholine (6.9 +/- 1.3 vs 5.1 +/- 0.9 min), antagonism with neostigmine at 25% recovery of twitch height sufficiently facilitated the recovery index of mivacurium (4.5 +/- 1.0 min) to a level similar to that of succinylcholine with no statistical difference. The hemodynamic effects of mivacurium were few as compared to those of succinylcholine. In conclusion, mivacurium is considered to have additional advantages for short procedures when succinylcholine is undesirable.
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The levels of catecholamines in penile blood during a papaverine test were measured to investigate whether the secretion of endogenous catecholamines is involved in response to intracorporeal papaverine injection. The level of norepinephrine was higher in patients with psychogenic impotence than in the normal controls and patients with vasculogenic impotence (p less than 0.01), and it was significantly higher in negative responders than in positive responders in the psychogenic impotence group (p less than 0.001). There was no significant difference in the level of epinephrine among the groups. The false negative response to the papaverine test in psychogenically impotent men is believed to be derived from secretion of cavernous norepinephrine, which overwhelms the action of cavernous smooth muscle relaxation by papaverine.
Hypersensitivity to the stings of the Hymenoptera has been described since antiquity. The hypersensitive reactions to insect stings vary from minor skin reactions to severe and sometimes fatal anaphylaxis. Concerns about sting hypersensitivity have been increasing because of many incidents of allergic reactions of patients to the fire ant in the southern area of the United States as well as the harvester ant in some areas. We experienced one unique case with severe allergic reactions by ant of the Ectomomyrmex spp. of the subfamily Ponerinae, which is not a harvester ant. For three years the patient had been suffering from generalized allergic reactions such as anaphylaxis after the ant stings four-five attacks in a year. We determined that her reactions were due to specific IgE mediated type I hypersensitivity by the detection of a high level of specific IgE to the ant venom in her serum. The high level of specific IgG4 to the ant venom was also noted in her serum, however, the role of ant venom IgG4 was not clearly determined.
Individually inactive N- and C-terminal fragments of the m5C-methyltransferase M.BspRI can complement each other resulting in specific, in vivo methylation of the DNA. This was shown by cloning the coding regions for N- and C-terminal parts of the enzyme in compatible plasmids and co-transforming them into E.coli cells. The enzyme could be detached at several different sites, producing either non-overlapping or partially overlapping fragments capable of complementation. Reconstitution of the active methyltransferase from inactive fragments was demonstrated in vitro, as well. Another GGCC-specific methyltransferase, M.BsuRI, showed a similar complementation phenomenon. Moreover, interspecies complementation was observed between appropriate fragments of the two closely related enzymes M.BspRI and M.BsuRI. Fragments of structurally and functionally more different methyltransferases were unable to complement each other.
The mechanism of interaction of quinols and phenols with dopamine beta-monooxygenase (D beta M) has been investigated. The ratio of quinone formation (from catechol) to oxygen consumption rises from a value of 1 in the presence of phenethylamine substrate to 2 in the absence of substrate. These results implicate quinol oxidation at both the reductant- and substrate-binding sites of D beta M. In the presence of saturating ascorbate, catechol and p-hydroquinol behave as mechanism-based inhibitors of D beta M, with partitioning ratios of turnover to inactivation of 21:1 and 41:1, respectively. Phenol is found to inactivate the enzyme in a manner similar to p-cresol, suggesting that the methyl group of p-cresol is not an essential component of enzyme inhibition. Solvent isotope effects on inactivation and turnover have been measured for various inactivators. Although the majority of these inhibitors, including catechol, p-hydroquinol, aniline, phenethylenediamine, and benzylhydrazine, are characterized by relatively small solvent isotope effects (1.5-2.5) on the inactivation rate constant (ki), solvent isotope effects on ki for phenol and p-cresol are 5.7 and 7.4, respectively. By contrast, solvent isotope effects on the turnover of p-cresol are almost unity. Using p-cresol-d7 as substrate, we observe D(kcat) = 5.2 and D(kcat/Km) = 3.1, while isotope effects on inactivation are D(ki) = 0.95 and D(ki/Ki) = 0.59. These results lead us to propose that inhibitors fall into two mechanistic classes, involving either one-electron oxidation to form radical cation intermediates (quinols) or hydrogen atom abstraction (phenols).(ABSTRACT TRUNCATED AT 250 WORDS)
A 20-year-old woman had a pea-sized, tender subcutaneous nodule on the leg. Histopathologically, the panniculus showed multiple microcysts lined by membranes and light brown granules in the histiocytes. Histochemical studies of the membranes of the microcysts and the granules in the histiocytes indicated that they were composed of ceroid. Electron microscopy revealed that the membrane of the microcyst was composed of electron-dense areas of a regular 18.6 nm lamellar array and reticulated vacuolated areas suggestive of degenerating fat cells of unknown origin. Membranous lipodystrophy has been associated with many local and systemic diseases, but it may be idiopathic, as in our patient.
Class-IIS restriction enzymes (ENases-IIS) interact with two discrete sites on double-stranded DNA: the recognition site, which is 4-7 bp long, and the cleavage site, usually 1-20 bp away from the recognition site. The recognition sequences of ENases-IIS are totally (or partially) asymmetric and all of the characterized ENases-IIS are monomeric. A total of 35 ENases-IIS are described (80, if all isoschizomers are taken into consideration) together with ten related ENases (class IIT), and 15 cognate methyltransferases (MTases-IIS). The physical, chemical, and molecular properties of the ENases-IIS and MTases-IIS are reviewed and many unique applications of this class of enzymes are described, including: precise trimming of DNA; retrieval of cloned fragments; gene assembly; use as a universal restriction enzyme; cleavage of single-stranded DNA; detection of point mutations; tandem amplification; printing-amplification reaction; and localization of methylated bases.
A vector was designed to allow predetermined and precise fusion between two cloned genes by constructing a cassette with two unique class-IIS restriction sites, 5'-ACCTGC-3' (BspMI) and 5'-CCGGATG-3' (FokI overlapping with MspI), arranged back-to-back in a divergent manner and inserted at the HincII site of a multiple cloning site (MCS) in plasmid pUC18 or analogous vehicle. Two DNA fragments or genes to be precisely fused are cloned into the MCS parts located on each side of the cassette containing the two unique class-IIS restriction sites. The BspMI and MspI/FokI sites are used to generate unidirectional deletions of the genes as previously described [Hasan et al., Gene 50 (1986) 55-62; Pósfai and Szybalski, Nucleic Acids Res. 16 (1988) 6245]. The precisely trimmed genes are ligated after the cassette containing the unique class-IIS restriction sites are excised with BspMI + FokI and the termini were blunted with mung-bean nuclease. This method was used to construct a hybrid methyltransferase (MTase) from the M.BspRI and M.BsuRI MTases, which share a high degree of overall homology (about 65%) and have the identical sequence specificity (5'-GGmCC-3'). A hybrid MTase composed of the N-terminal part of M.BspRI and the C-terminal part of M.BsuRI was constructed and found to be fully functional.