Biomedical subjects

S J Shin

Publications and source records attributed to S J Shin.

At least 55 records · Page 3Linked to original sources

PubMed2000

Pregnancy-like (pseudolactational) hyperplasia: a primary diagnosis in mammographically detected lesions of the breast and its relationship to cystic hypersecretory hyperplasia.

Pregnancy-like (pseudolactational) hyperplasia (PLH) has long been recognized as an incidental finding in breast biopsies performed for various clinically detected benign and malignant conditions. The histologic features of PLH have been well described, including some instances exhibiting cytologic and structural atypia. The presence of calcifications in these lesions was rarely mentioned and was considered to be of little consequence. More recently, however, calcifications in PLH have become the target of needle localization and needle core biopsies. The authors report 12 instances in which PLH was the primary diagnosis in biopsy specimens obtained for radiographic abnormalities, usually calcifications. Six of 12 procedures (50.0%) were performed for mammographically detected calcifications, four cases for a mass, one for an "abnormal mammogram," and one for galactorrhea. Calcifications were present in PLH in 10 biopsies, in benign terminal ducts in one specimen, and were not identified histologically in the remaining specimen. In most instances, calcifications associated with PLH had smooth round or lobulated contours and distinctive, internal, unevenly spaced laminations. Cystic hypersecretory hyperplasia (CHH) was present in five specimens. In four of the five specimens, CHH merged with PLH (PLH/CHH). Four of 12 specimens (33.3%) showed atypia within foci of PLH/CHH. PLH should be recognized as a primary diagnosis in breast biopsies for mammographically detected abnormalities such as calcifications. Some calcifications associated with PLH have a distinctive histologic appearance, and their recognition can aid in the diagnosis of PLH. Additional cases of PLH/CHH must be studied to ascertain the clinical significance, if any, of this previously undescribed entity. The precancerous significance of PLH/CHH and of PLH with atypia has not been determined. In most instances, surgical excision would be prudent if PLH/ CHH or PLH with atypia is present in a needle core biopsy specimen.

Adult↗

PubMed2000

Arthroscopic treatment for limitation of motion of the elbow.

This study describes the long-term clinical results and serial changes of postoperative range of motion after arthroscopic treatment for limitation of motion of the elbow. Sixty-three patients with limitation of motion of the elbow were treated with arthroscopic procedures. The total range of motion was 79 degrees before surgery. The range of motion showed a progressive increase until 1 year after surgery (mean, 121 degrees). However, after 1 year, the range of motion showed little additional increase. The range of motion acquired during surgery (mean, 122 degrees) usually was the same range that patients achieved during the rehabilitation period (mean, 122 degrees at an average 42.5 months of followup). Extension improved an average of 21 degrees, and flexion increased an average of 23 degrees. The range of motion showed more improvement in patients whose duration of symptoms was less than 1 year (49 degrees) than in those whose duration of symptoms was longer than 1 year (30 degrees). Patients with posttraumatic stiffness had more marked limitation of extension and decreased total range of motion (73 degrees) than did those with degenerative stiffness (86 degrees) before surgery. However, no significant difference existed in the postoperative total range of motion (posttraumatic stiffness, 123 degrees; and degenerative stiffness, 121 degrees). Based on the authors' experience, 92% of patients obtained significant improvement in range of motion after arthroscopic procedures. The minimally invasive nature of elbow arthroscopy is a reproducible and effective procedure for limitation of motion of the elbow with minimal morbidity.

Adolescent↗

PubMed2000

Endoscopic carpal tunnel release in patients receiving long-term hemodialysis.

This study evaluated the clinical results of endoscopic carpal tunnel release in carpal tunnel syndrome caused by long-term hemodialysis and compared the results with that of idiopathic carpal tunnel syndrome. Operations were done in 32 patients (60 hands) with idiopathic carpal tunnel syndrome and in eight patients (15 hands) with carpal tunnel syndrome resulting from long-term hemodialysis. There was no significant difference in findings of preoperative evaluations and postoperative clinical results between the two groups, except for a difference with the patient satisfaction score with surgery on a visual analogue scale. The mean satisfaction score was 9.0 at 6 months, 9.3 at 1 year, and 9.5 at the 2-year followup in the group of patients with idiopathic carpal tunnel syndrome. However, in the group of patients with carpal tunnel syndrome resulting from long-term hemodialysis, the mean satisfaction score was 8.5 at 6 months, 8.2 at 1 year, and 6.5 at the 2-year followup. The score began to decrease at an average of 17.2 months after surgery. Long-term hemodialysis related carpal tunnel syndrome showed satisfactory short-term clinical results until approximately 1.5 years after the operation. After that time, the symptoms tended to deteriorate in 50% of the patients who received hemodialysis continuously.

Carpal Tunnel Syndrome↗

PubMed2000

Arthroscopic treatment for localized pigmented villonodular synovitis of the knee.

This study investigated 11 patients with localized pigmented villonodular synovitis of the knee that was diagnosed and treated by arthroscopic technique. There were six male and five female patients between the ages of 15 and 59 years (mean, 34.6 years). Seven patients reported extension limitation without joint line tenderness. Four of the 11 patients had a history of trauma before the onset of knee symptoms. All patients were treated by arthroscopic resection with partial synovectomy. The most common involved site was the anteromedial synovium near the anterior horn of the medial meniscus (five patients). The remaining cases were located in the anterior fat pad (two patients), suprapatellar pouch, posteromedial compartment, medial gutter, and the anterior horn of the lateral meniscus. Nine patients had one mass, and the remaining patients each had two or three masses. There was no evidence of recurrence at followup for an average of 29.9 months (range, 24-48 months). Arthroscopy is effective in the diagnosis of localized pigmented villonodular synovitis with minimal morbidity, and complete arthroscopic excision can be considered the definitive treatment for localized pigmented villonodular synovitis.

Adolescent↗

PubMed2000

Prevalence of Escherichia coli O157:H7 from cull dairy cows in New York state and comparison of culture methods used during preharvest food safety investigations.

A number of protocols for the cultural detection of Escherichia coli O157:H7 in clinical fecal specimens have been proposed. In the present study direct plating of cattle feces was compared to three different broth enrichment protocols, i.e., a protocol with modified E. coli broth with novobiocin, a protocol with Trypticase soy broth with cefixime and vancomycin, and a protocol with Gram-Negative Broth with novobiocin, for their relative abilities to detect E. coli O157:H7 in feces. In all enrichment protocols, dilutions of the enrichment broths onto 150-mm sorbitol-MacConkey agar plates to which cefixime and tellurite were added were used along with reading of agar plates at both 24 and 48 h. Fecal samples came from a preharvest food safety project in which feces from New York cull dairy cattle from a northeastern packing plant along with experimentally inoculated adult dairy cow feces were tested. The performances of the broth enrichments were comparable to each other, but the broth enrichments were superior to direct plating in their ability to detect E. coli O157:H7. Regardless of the culture protocol used, recovery of E. coli O157:H7 is more likely from fresh fecal specimens than from frozen samples. An overall prevalence of E. coli O157:H7 fecal shedding by New York cull dairy cattle of 1.3% was found in specimens just before processing at the packing plant.

Animals↗

PubMed2000

Diagnostic and public health dilemma of lactose-fermenting Salmonella enterica serotype Typhimurium in cattle in the Northeastern United States.

The presence of lactose-fermenting Salmonella strains in clinical case materials presented to microbiology laboratories presents problems in detection and identification. Failure to detect these strains also presents a public health problem. The laboratory methods used in detecting lactose-fermenting Salmonella enterica serotype Typhimurium from six outbreaks of salmonellosis in veal calves are described. Each outbreak was caused by a multiply-resistant and lactose-fermenting strain of S. enterica serotype Typhimurium. The use of Levine eosin-methylene blue agar in combination with screening of suspect colonies for C8 esterase enzyme and inoculation of colonies into sulfide-indole-motility medium for hydrogen sulfide production was particularly effective for their detection. A hypothesis for the creation of lactose-fermenting salmonellae in the environment is presented. It is proposed that the environment and husbandry practices of veal-raising barns provide a unique niche in which lactose-fermenting salmonellae may arise.

Animal Feed↗

PubMed2000

Increased renal medullary endothelin-1 synthesis in prehypertensive DOCA- and salt-treated rats.

To investigate the role of renal endothelin-1 (ET-1) synthesis in water-sodium homeostasis, we measured mRNA expressions, protein levels, enzyme activity, and receptor binding of the renal ET-1 system in a DOCA- and salt-treated rat model. Male Wistar rats were divided into control and DOCA- and salt-treated (DOCA-Salt) groups. The DOCA-Salt group received 25 mg/kg body wt DOCA and was maintained on 1% NaCl drinking water. Rats were killed on days 1, 2, 4, and 10 of the experiment. Urinary ET-1-like immunoreactivity significantly increased from the second day in the DOCA-Salt group and correlated well with the urinary sodium excretion rate (r = 0.81, P < 0.001). Renal endothelin-converting enzyme (ECE) activity, ET-1, and ECE-1 mRNA expressions were significantly increased in the renal medullary area of DOCA-Salt rats. In situ hybridization and immunohistochemical studies showed that the increase in ET-1 synthesis was mainly localized in the inner medullary collecting ducts. The maximum binding of endothelin B receptor also increased from the second day in the renal medulla of the DOCA-Salt group. Our results suggest that renal medullary synthesized ET-1 may be a natriuretic factor and may participate in the intrarenal regulation of water and salt homeostasis in prehypertensive DOCA-and salt-treated rats.

Animals↗

PubMed2000

Up-regulation of adrenal cortical and medullary atrial natriuretic peptide and gene expression in rats with deoxycorticosterone acetate-salt treatment.

Our previous study demonstrated that human adrenal medulla is a site of atrial natriuretic peptide (ANP) synthesis. To further evaluate the role of adrenal ANP in body fluid homeostasis, we investigated the changes in adrenal ANP in rats receiving deoxycorticosterone acetate (DOCA)-salt treatment. In situ hybridization and immunohistochemical study showed that adrenal ANP messenger RNA (mRNA) and ANP-like immunoreactivities (ANP-LI) were mainly localized in the zona glomerulosa and medulla of vehicle-treated rats. DOCA-salt treatment activated ANP mRNA and peptide expression in all adrenal zones, especially in the zona fasciculata/reticularis from 12 h to the entire 8-day study period. Using a semiquantitative RT-PCR technique, the relative quantities of ANP mRNA in the adrenals of the DOCA-salt-treated group were significantly increased from 1 to 8 days, whereas the adrenal weights of DOCA-salt-treated rats were significantly decreased from day 2 to day 8. Our results are the first to indicate that ANP is synthesized not only in the adrenal medulla but also in the adrenal cortex and their syntheses are markedly increased in DOCA-salt-treated rats. These results imply that adrenal ANP may participate in the intraadrenal regulation of adrenal function on water-electrolyte homeostasis in an autocrine or paracrine manner.

Adrenal Cortex↗

PubMed2000

Diagnostic utility of the monoclonal antibody A103 in fine-needle aspiration biopsies of the adrenal.

Fine-needle aspiration (FNA) of the adrenal is a useful modality for the evaluation of primary and metastatic neoplasms. Until now, however, few reliable markers existed for the positive identification of adrenal cortical cells. Originally studied as a melanoma marker, Melan-A, as detected by the murine monoclonal antibody, A103, has gained recent attention as a marker for steroid-producing cells. Formalin-fixed, paraffin-embedded cell blocks from 24 adrenal FNA specimens were stained for cytokeratins (AE1/AE3) and Melan-A (A103). Seven of 8 cases containing normal, hyperplastic, and neoplastic adrenal cortical cells were positive for A103. Among 16 cases of metastatic carcinoma, tumor cells in 14 samples were positive for cytokeratins but negative for A103. The A103 monoclonal antibody is a sensitive marker for the identification of normal, hyperplastic, and neoplastic adrenal cortical cells in cell blocks of adrenal FNA specimens. With the exception of melanoma, A103 reactivity is restricted to adrenal cortical and other steroid-producing cells. A103 should be used routinely for the evaluation of FNA specimens of adrenal mass lesions.

Adrenal Cortex↗

PubMed2000

Determination of size in invasive breast carcinoma: pathologic considerations and clinical implications.

The widespread use of mammography has made the detection of increasingly small, often impalpable, invasive breast carcinomas possible. An enhanced understanding of morphological factors, among the foremost of which is size of invasive component of carcinoma, is changing the management of breast cancer To the uninitiated, the determination of size of invasive component is seemingly simple but in practical terms is complicated by a number of ambiguous issues. Practical guidelines for the assessment of size of invasive carcinoma are proposed.

Adult↗

PubMed2000

Quantifying mammary duct carcinoma in situ: a wild-goose chase?

Duct carcinoma in situ (DCIS) is a malignant neoplasm of the breast that is limited to the glandular component. The introduction of mammographic screening allows for earlier detection of carcinoma, at the stage of DCIS, before it invades the surrounding stroma. Although DCIS has been studied extensively, its quantification remains a dilemma. Several methods for measuring DCIS exist, including clinical measurement, radiographic assessment, and gross pathologic assessment. Other methods have been employedfor this purpose, such as counting the number of tissue sections involved, direct measuring of DCIS from glass slides, and even counting the number of ducts involved. Furthermore, there is no consensus for assessing adequacy of margins. The myriad of techniques for quantifying DCIS has profound implications for treatment and for prognostic evaluation. The inherent difficulties in quantifying DCIS are multifactorial, and the need to establish a standardized approach for reporting the extent of DCIS by correlating radiographic, clinical, gross, and histologic findings is imperative.

Breast Neoplasms↗

PubMed2000

Virologic factors related to interferon-alpha-induced thyroid dysfunction in patients with chronic hepatitis C.

OBJECTIVE: Hepatitis C virus (HCV), being reported to be associated with a high prevalence of serological markers of autoimmunity in HCV-infected patients, and possibly sharing partial sequences in amino acid segments with thyroid tissue antigens, may be associated with interferon-alpha (IFN-alpha)-induced thyroid dysfunction in chronic hepatitis C patients. We conducted this study to clarify the issue. DESIGN AND METHODS: One hundred and fifty chronic hepatitis C patients with normal baseline thyroid function were treated with IFN-alpha 2a, 2b and n1 (3-6 million Units three times weekly for 24 weeks). Pretreatment sera were tested for HCV genotype and HCV RNA levels. Serum thyrotropin, total thyroxine and free thyroxine index were performed every 4 weeks for 24 weeks followed by every 8 weeks for another 24 weeks. RESULTS: Twenty-one (14.0%) patients developed early thyroid dysfunction (abnormal thyroid function during the first 3 months of therapy). Female gender, lower HCV RNA levels, IFN-alpha n1 and a lower IFN-alpha dose were significantly associated with early thyroid dysfunction. On multivariate analysis, gender, IFN-alpha preparation and HCV RNA levels were the significant factors associated with early thyroid dysfunction. Seven (4.7%) patients developed thyroid dysfunction during the second 3 months of IFN-alpha therapy. Taken together, 18.7% patients developed thyroid dysfunction. Female, mixed HCV genotype infection and lower HCV RNA levels were significantly associated with thyroid dysfunction. However, only gender remained significantly associated with IFN-alpha-induced thyroid dysfunction in multivariate analysis. CONCLUSIONS: The virologic features of HCV may be associated with thyroid dysfunction in chronic hepatitis C patients treated with IFN-alpha. Nevertheless, gender still plays the most important role in IFN-alpha-induced thyroid dysfunction.

Adolescent↗

PubMed2000

Endoscopic bone graft for delayed union and nonunion.

We performed endoscopic bone grafting for eight patients of delayed union and nonunion which developed after femoral and humeral shaft fractures. The mean interval from initial intervention to endoscopic bone grafting was 7.3 months. Six patients of delayed union and nonunion healed at 4.1 months on average. Two patients had unsatisfactory healing and eventually underwent non-endoscopic revisional surgery. There was no intraoperative on postoperative complication. Endoscopic bone grafting can be a less invasive alternative, obtaining rapid bone union in cases of compromised healing of the diaphyseal fracture.

Adult↗

PubMed2000

A case of primary intestinal T-cell lymphoma involving entire gastrointestinal tract: esophagus to rectum.

Primary intestinal T-cell lymphoma is a rare disease entity, which is approximately 10% to 25% of intestinal lymphomas, and most of the lymphomas occur in the small intestine. We report here a case of a 56-year-old woman who has been suffering from chronic diarrhea and weight loss for 6 months. Abdominal CT scan and small bowel series showed diffuse wall thickening of the small bowel. Gastroscopic examination showed diffuse erythematous lesions on the esophagus and small gastric ulcerations on the antrum of the stomach, and colonoscopic examination also showed multiple punched-out ulcerations and erosions on the entire colon, including the sigmoid colon to the terminal ileum. Diffuse infiltration of CD 3 positive lymphoma cells was found on biopsy. The patient was diagnosed as primary intestinal T-cell lymphoma with diffuse involvement of the entire gastrointestinal tracts from the esophagus to the rectum. Although the patient received systemic combination chemotherapy and achieved partial response initially, the lymphoma relapsed repeatedly.

Esophageal Neoplasms↗

PubMed2000

MR imaging features of clear-cell meningioma with diffuse leptomeningeal seeding.

Clear-cell meningioma is a rare disease entity showing a more aggressive nature, clinically, than those of other subtypes of meningioma. It occurs in younger persons and commonly in the spinal canal. The recurrence rate has been reported to be as high as 60%. We present a case of clear-cell meningioma in a 17-year-old man in whom initial MR imaging showed localized leptomeningeal enhancement that had progressed into the entire subarachnoid space after surgical resection of the primary tumor.

Adolescent↗

PubMed2000

Mutation analysis of PTEN/MMAC 1 in sporadic thyroid tumors.

Recently, a putative tumor suppressor gene, PTEN/MMAC1, has been identified at chromosome 10q23.3. This gene encodes a 403 amino acid dual specificity phosphatase containing a region of homology to tensin and auxillin. Somatic mutations of the PTEN/MMAC1 gene have been found in a number of cancer cell lines and primary cancers. Cowden disease, an autosomal dominant harmartoma syndrome associated with thyroid and breast tumors, has been found to be associated with mutations of PTEN/MMAC1 gene. To evaluate the role of the PTEN/MMAC1 gene in sporadic thyroid tumors, we studied 17 sporadic thyroid tumors, of which 12 were papillary thyroid carcinomas, 1 was follicular thyroid carcinoma, 1 was medullary thyroid carcinoma and 3 were thyroid adenomas. Direct sequencing of PCR-amplified products was performed for all nine exons of PTEN/MMAC1. No mutations of PTEN/MMAC1 gene were observed in any of the sporadic thyroid tumors. Our results indicate that the PTEN/MMAC1 gene may not play a major role in sporadic thyroid tumors.

Genes, Tumor Suppressor↗

PubMed1999

Laser welding for vascular anastomosis using albumin solder: an approach for MID-CAB.

BACKGROUND AND OBJECTIVES: To improve minimally invasive direct coronary artery bypass surgery (MID-CAB), new techniques of vascular anastomosis that are faster and more reliable need to be developed. STUDY DESIGN/MATERIALS AND METHODS: Common carotids in a canine model were transected and an end-to-end anastomosis was performed by using one of four techniques (1) continuous 6-0 polypropylene closure (suture; n=6), (2) vascular clip (VCS; n=6), laser welding using 50% albumin solder with (3) a 1.32-micro laser (1.32las; n=6), and (4) a 1.9-micro diode laser (1.9las; n=4). Times for anastomosis (TA) were compared between groups by t-test. Pressures at which anastomosis failed (leak point pressure, LPP) were determined and compared by analysis of variance. RESULTS: TA was faster for 1.32las and 1.9las at 8.4+/-0.7 and 7.8+/-0.3 min, respectively, when compared with suture at 13.8+/-1.0 min (P=0.001, confidence interval [CI]-8.1, -2.6 for 1.32las and CI -8.9, -3.1 for 1.9las). There was no statistical difference between VCS (8.3+/-3.3 min) and any other group (P > 0.17). LPPs (mm Hg) were similar for all groups: 350+/-37 for 1.32las, 280+/-31 for 1.9las, 347+/-46 for suture, and 358+/-53 for VCS, P=0.68. CONCLUSIONS: In this study, laser welding using 50% human albumin solder resulted in faster anastomotic times. Anastomoses were equivalent to conventional sutured anastomoses in failing at similar pressures. Laser welding using human albumin solder may be advantageous in improving coronary anastomoses during MID-CAB, but long-term anastomotic strength and histologic evaluation need to be investigated.

Adhesives↗

PubMed1999

Effect of laser welding with human serum albumin on the expression of P-selectin on platelets.

BACKGROUND AND OBJECTIVE: Artery repair by means of laser energy induces activation of platelets with a risk of thrombosis and local inflammatory reactions. The aim of this study was to investigate the effect of human serum albumin, the most common solder in laser surgery, on platelet activation. STUDY DESIGN/MATERIALS AND METHODS: Platelet activation was evaluated in canine blood by using two-color flow cytometry with a phycoerythrin-labeled antibody to a common platelet marker, glycoprotein IIb/IIIa and fluorescein isothiocyanate-labeled antibody to a platelet activation molecule, P-selectin. Human serum albumin was applied in vitro and in vivo, as a solder during laser reconstruction of canine arteries. RESULTS: In vitro, albumin significantly (P < 0.01) reduces the expression of P-selectin on platelets. This is most likely related to the blockage of P-selectin by albumin, which binds to the platelet surface, as confirmed by flow cytometry with fluorescein isothiocyanate-labeled albumin. In vivo, application of albumin solder tended to result in a lower percentage of P-selectin-expressing platelets in laser-repaired arteries compared to suture-repaired arteries. CONCLUSION: Albumin decreases the percentage of P-selectin-expressing platelets in vitro. Further research may allow the platelet activation inhibiting properties of albumin to be further optimized in vivo.

Animals↗