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Biomedical subjects

S Y Cho

Publications and source records attributed to S Y Cho.

At least 91 records · Page 5Linked to original sources

The prevalence and associated risk factors of renal artery stenosis in patients undergoing cardiac catheterization.

Renal artery stenosis may be a cause of hypertension and a potential contributor to progressive renal insufficiency. However, the prevalence of renal artery disease in a general population is poorly defined. The purposes of this study were to evaluate the prevalence of angiographically-determined renal artery narrowing in a patient population undergoing routine cardiac catheterization, and to identify the risk factors for renal artery stenosis. After left ventriculography, abdominal aortography was performed to screen for the presence of renal artery stenosis. A total of 427 patients (274 males, 153 females) were studied and the mean age was 59 years. Renal artery narrowing was identified in 10.5% of patients. Significant (> or = 50% diameter narrowing) renal artery stenosis was found in 24 patients (5.6%) and insignificant stenosis was found in 21 patients (4.9%). Significant unilateral stenosis was present in 4.2% of patients and bilateral stenosis was present in 1.4%. The stem of the renal artery was a more common site of stenosis in 62.2% of patients than in the ostium (37.8%), but the severity of stenosis was not significantly different according to the site of stenosis. By univariate and multivariate logistic regression analysis, the association of clinical variables with renal artery stenosis was assessed. Multivariable predictors included age, hypertension and peripheral vascular disease (p < 0.05). The variables such as sex, smoking history, hyperlipidemia, renal insufficiency, as well as the presence of obesity, severity of coronary heart disease and D.M., were not associated. In conclusion, the prevalence of angiographically-determined renal artery narrowing in a patient population undergoing cardiac catheterization is 10.5%. Old age, hypertension and evidence of peripheral vascular disease represent the predictors of renal artery stenosis.

Adult↗

Identification of H-2K(b)-restricted T-cell epitopes within the nucleocapsid protein of Hantaan virus and establishment of cytotoxic T-cell clones.

Although neutralizing antibodies against Hantaan virus (HTV) can protect hosts from viral infection, T-cell responses to HTV are also important in host defense against HTV. However, much less is known about cytotoxic T lymphocyte (CTL) responses to HTV. To identify CTL epitopes in the HTV nucleocapsid protein (NP), we selected 7 H-2K(b)-motif-fitting peptides. Of these peptides, 3 peptides (NP3, NP4, and NP7) were recognized by CTL responses derived from HTV-immunized mouse splenocytes. NP3 and NP4 peptides were also recognized by HTV-immunized splenocytes after secondary in vitro stimulation with the relevant peptide, but NP7 could not be recognized after in vitro stimulation. These results agree well with peptide immunization studies showing that peptide-specific CTL responses could be induced with NP3 and NP4 but not with NP7 peptide. Furthermore, CTL activity assay using targets, prepared to express the antigen (NP) endogenously, demonstrated that NP3 and NP4 peptides could be presented endogenously. CTL elicited with NP4 peptide retained some cross-reactivity and was difficult to long-term culture. However, NP3-elicited CTL was very specific for NP3 peptide and was stable enough to be cloned. Among many CTL lines elicited with HTV or HTV NP peptides, 6 NP3-specific CTL clones were established and have been maintained more than 2 years. All 6 CTL clones were characterized to be CD3+, CD4-, CD8+, CD25+, CD62L-, and NK1.1-, and to use TCR Vbeta6. This preferential usage of TCR Vbeta6 indicates that TCR Vbeta6 regions are important for recognition of the HTV NP3 epitope (NP221-228, SVIGFLAL) on H-2K(b) molecule. Our data demonstrate the definition of mouse CTL epitopes in HTV and the generation of HTV-specific mouse CTL clones.

Animals↗

Oral care for children with leukaemia.

OBJECTIVES: To review the oral care regimens for children with acute leukaemia, and to present an easy-to-follow oral care protocol for those affected children. DATA SOURCES: Medline and non-Medline search of the literature; local data; and personal experience. STUDY SELECTION: Articles containing supportive scientific evidence were selected. DATA EXTRACTION: Data were extracted and reviewed independently by the authors. DATA SYNTHESIS: Cancer is an uncommon disease in children, yet it is second only to accidents as a cause of death for children in many countries. Acute leukaemia is the most common type of malignancy encountered in children. The disease and its treatment can directly or indirectly affect the child's oral health and dental development. Any existing lesions that might have normally been dormant can also flare up and become life-threatening once the child is immunosuppressed. Proper oral care before, during, and after cancer therapy has been found to be effective in preventing and controlling such oral complications. CONCLUSION: Proper oral care for children with leukaemia is critical. Long-term follow-up of these children is also necessary to monitor their dental and orofacial growth.

Child↗

Usefulness of cilostazol versus ticlopidine in coronary artery stenting.

A combination of ticlopidine and aspirin has been accepted as the standard antithrombotic regimen after coronary stenting. However, ticlopidine poses serious side effects such as neutropenia or thrombocytopenia. Cilostazol, a cyclic adenosine monophosphate phosphodiesterase inhibitor, is a novel antiplatelet agent with vasodilatory properties. We compared the efficacy and safety of cilostazol plus aspirin (C+A) with ticlopidine plus aspirin (T+A) in elective coronary stenting. Three hundred patients were randomly assigned to receive C+A or T+A 2 days before stenting. The primary end point was a composite of angiographic stent thrombosis, or major cardiac events (death, myocardial infarction, bypass surgery, repeat intervention) at 30 days. The secondary end points were bleeding vascular complications, neutropenia, thrombocytopenia, or side effects requiring discontinuation of the drugs at 30 days. The primary end point was reached in 1.4% in the C+A group and 2.0% in the T+A group (p = 1.0). The rate of bleeding vascular complications was 1.4% in the C+A group and 2.0% in the T+A group (p = 1.0). The rate of drug-related side effects was not statistically different between the 2 groups but slightly higher in the T+A group than in the C+A group (2.7% vs 0.7%, p = 0.37). However, neutropenia was seen in 2 patients only in the T+A group. As a poststenting antithrombotic, C+A is as effective as T+A in preventing major cardiac events including stent thrombosis, and safer in that it does not cause neutropenia despite the fact that there is no statistical difference in the incidence of adverse effects and complications.

Adult↗

Echocardiographic and morphologic characteristics of left atrial myxoma and their relation to systemic embolism.

We examined the relation between the echocardiographic morphology of cardiac myxoma and systemic embolism in 25 patients. Two distinct types of myxoma could be identified by echocardiography: round type characterized by solid and round shape with nonmobile surface (n = 13, 52%), and polypoid type characterized by soft and irregular shape with mobile surface (n = 12, 48%); multiple regression analysis revealed the polypoid type of tumor was the only independent predictor of systemic embolism (p = 0.0029).

Adolescent↗

Differential expression of mouse Disabled 2 gene in retinoic acid-treated F9 embryonal carcinoma cells and early mouse embryos.

Using a differential display PCR, we identified a differentially expressed cDNA fragment which was detectable in retinoic acid (RA) treated F9 embryonal carcinoma (EC) cells but not in untreated F9 cells. A homology search of the Gene Bank indicated that the cDNA fragment is part of the mouse homolog of the Drosophila Disabled (mDab2) gene. Aggregate cultures of F9 EC cells grown in the presence of the RA differentiated into nonmalignant cells resembling the visceral endoderm of the mouse embryo. Upon induction of endodermal differentiation with 10(-7) M RA, the gene expression of mDab2 was increased gradually during the first 96 h. Neither undifferentiated F9 cells, nor the undifferentiated aggregate cells without RA expressed mDab2. Whole-mount in situ hybridization and quantitative RT-PCR also showed that the temporal expression pattern of the mDab2 gene coincides with the initiation pattern of RA synthesis that occurs during mouse embryogenesis. Also, two alternative splicing messages of mDab2 were detected in a tissue specific manner. All the data indicate that mDab2 may play an important role in RA-induced signal transduction during mouse development.

Adaptor Proteins, Signal Transducing↗

Purification and characterization of a serine protease with fibrinolytic activity from Tenodera sinensis (praying mantis).

Mantis egg fibrolase (MEF) was purified from the egg cases of Tenodera sinensis using ammonium sulfate fractionation, gel filtration on Bio-Gel P-60 and affinity chromatography on DEAE Affi-Gel blue gel. The protease was assessed homogeneous by SDS-polyacrylamide gel electrophoresis and has a molecular mass of 31500 Da. An isoelectric point of 6.1 was determined by isoelectric focusing. Amino acid sequencing of the N-terminal region established a primary structure composed of Ala-Asp-Val-Val-Gln-Gly-Asp-Ala-Pro-Ser. MEF readily digested the Aalpha- and Bbeta-chains of fibrinogen and more slowly the gamma-chain. The nonspecific action of the enzyme results in extensive hydrolysis of fibrinogen and fibrin releasing a variety of fibrinopeptide. The enzyme is inactivated by Cu2+ and Zn2+ and inhibited by PMSF and chymostatin, yet elastinal, aprotinin, TLCK, TPCK, EDTA, EGTA, cysteine, beta-mercaptoethanol, iodoacetate, E64, benzamidine and soybean trypsin inhibitor do not affect activity. Antiplasmin was not sensitive to MEF but antithrombin III inhibited the enzymatic activity of MEF. Among chromogenic protease substrates, the most sensitive to MEF hydrolysis was benzoyl-Phe-Val-Arg-p-nitroanilide with maximal activity at pH 7.0 and 30 degrees C. MEF preferentially cleaved the oxidized B-chain of insulin between Leu15 and Tyr16. D-Dimer concentrations increased on incubation of cross-linked fibrin with MEF, indicating the enzyme has a strong fibrinolytic activity.

Amino Acid Sequence↗

Immunogenicity of synthetic HIV-1 V3 loop peptides by MPL adjuvanted pH-sensitive liposomes.

A successful HIV-1 vaccine should be capable of generating humoral and cellular immune responses at the same time. The only response shown to be effective in this regard is virus-neutralization antibodies and virus-specific cytotoxic T-lymphocytes (CTL) directed against the viral antigens. In the present study, it is shown that V3 peptides encapsulated pH-sensitive liposomes elicit the virus neutralization antibodies and virus specific CTL response at the same time in Balb/c mice. None of the immunization protocols elicited an antibody response and CTL response when R15K and T26K was used as immunogen without liposomes. In contrast, antibodies and CTL response were detectable in the mice which were immunized with peptide encapsulated pH-sensitive liposomes. Antibody production was confirmed by virus neutralizing assay. CD4+ T-cells are involved in target cell lysis to some degree but CTL activity is mainly due to the CD8 + T-cells. The consistency of the antibody and CTL response was related to the V3 loop peptides size. The T26K (26mer) peptide induced a stronger antibody and CTL response than R15K (15mer) in vivo. Based on the results of this study, T26K was used as a potentially effective HIV-1 vaccine component and T26K encapsulated pH-sensitive liposomes composed of phosphatidylethanolamine-beta-oleoyl-gamma-palmitoyl (POPE)/cholesterol hemisuccinate (CHOH)/monophosphoryl lipid A (MPL) (7:3:0.1, mole ratio) may be used as a potentially immunomodulating adjuvant system for the development of HIV and other viral vaccines.

AIDS Vaccines↗

Definitive diagnosis of intestinal volvulus in utero.

Midgut volvulus with or without intestinal malrotation can occur in fetal life. Several reports have described congenital midgut volvulus showing non-specific sonographic findings of intestinal obstruction and perforation in utero. None of the previously reported cases, however, were definitively diagnosed as midgut volvulus by fetal sonography. We report two cases both exhibiting the sonographic 'whirlpool' sign, in utero. Color Doppler interrogation provided a clue to the viability of the involved intestinal segment.

Adult↗

A recombinant 10-kDa protein of Taenia solium metacestodes specific to active neurocysticercosis.

Neurocysticercosis (NCC) is an important cause of neurological disease worldwide. A 10-kDa antigen of Taenia solium metacestodes (TsMs) has been shown to be specific for immunodiagnosis of NCC. Screening of a TsM complementary DNA (cDNA) library isolated a cDNA encoding this protein. The cloned cDNA contained a 258-bp complete open-reading frame that encodes an 86-amino acid polypeptide with a calculated molecular weight of 9582 Da. It showed 73% homology with a 10-kDa antigen of T. crassiceps. The recombinant protein was expressed bacterially as a fusion protein at a high level. In immunoblot with recombinant protein, 97% (184/190) of sera from patients with active NCC showed strong reactivity, whereas 14% (4/29) of those from patients with chronic calcified NCC reacted weakly. In 180 sera from other patients with parasitic infections and from normal controls, it showed 98% specificity. A single recombinant TsM antigen has a high potential for serological differentiation of active NCC.

Amino Acid Sequence↗

Paroxysmal tachycardia and hypertension with or without ventricular fibrillation during laparoscopic adrenalectomy: two case reports in patients with noncatecholamine-secreting adrenocortical adenomas.

We present two cases of sudden unanticipated cardiovascular complications in patients with noncatecholamine-secreting adrenocortical adenomas during laparoscopic adrenalectomy. In the first case, the patient developed paroxysmal tachycardia and hypertension followed by ventricular fibrillation shortly after clipping of the adrenal vein. In the second case, the patient suffered hypertension and bigeminy during manipulation of the adrenal gland just around the adrenal vein. Awareness of such complications during either conventional or laparoscopic adrenalectomy is important even if the operation is performed in a patient with an apparently noncatecholamine-secreting adrenocortical adenoma.

Adenoma↗

Experimental hepatobiliary fascioliasis in rabbits: a radiology-pathology correlation.

RATIONALE AND OBJECTIVES: The authors sought to correlate the radiologic findings of hepatobiliary fascioliasis with pathologic features. METHODS: Serial ultrasound, computed tomography (CT), and magnetic resonance findings in seven rabbits with experimentally induced fascioliasis were obtained every other week. Direct cholangiogram was also obtained after the rabbits were killed. Radiology-pathology correlation was done in specimens. RESULTS: In the parenchymal phase (an acute phase of parenchymal invasion of a larva), CT showed subcapsular clustered areas of low attenuation. Magnetic resonance appearance was similar in shape but better than CT in characterizing the hemorrhagic nature of the lesion. Ultrasound findings were nonspecific in this phase. In the ductal phase (a stationary phase after residing in the bile duct), CT showed dilatation of central ducts with symmetric periportal hypoattenuation (periportal tracking). Magnetic resonance could not depict mild ductal dilatation. Ultrasound was most valuable in demonstrating the moving worm within the dilated duct. Pathologically, the hepatic parenchymal lesions consisted of a cluster of eosinophilic granulomas with hemorrhagic change (migratory tract of the flukes). Ductal changes were observed predominantly in the central bile ducts. Periportal lymphangiectasia was also noted. CONCLUSIONS: Computed tomography or magnetic resonance can demonstrate the characteristic evolutionary pattern of fascioliasis that reflects the unique life cycle of Fasciola hepatica. The role of ultrasound, although limited in the parenchymal phase, was most useful in the ductal phase in that it demonstrated the moving worms themselves.

Animals↗

Noninvasive evaluation of coronary artery bypass graft patency using three-dimensional angiography obtained with contrast-enhanced electron beam CT.

OBJECTIVE: The purpose of this study was to determine the accuracy of three-dimensional coronary angiography obtained with electron beam CT in the assessment of the patency of coronary artery bypass grafts. SUBJECTS AND METHODS: Twenty-five patients who had undergone coronary artery bypass graft surgery were included. All patients underwent electron beam CT and conventional coronary angiography for the evaluation of the status of their bypass grafts. Three-dimensional reconstructions of the heart and bypass grafts were compared with selective angiographic images of the bypass grafts. RESULTS: Fifty-seven saphenous vein grafts and 22 left internal mammary artery grafts were evaluated for occlusion or patency. Sensitivity and specificity of electron beam CT in revealing left internal mammary artery patency were 80% and 82.4%, respectively. Sensitivity and specificity of electron beam CT in revealing saphenous vein graft patency were 91.7% and 91.1%, respectively. Sensitivity and specificity of electron beam CT for evaluating saphenous vein grafts according to coronary area were as follows: saphenous vein grafts to left anterior descending artery, 100% and 100%, respectively; to diagonal branch, 100% and 100%; to left circumflex artery, 100% and 88.9%; and to right coronary artery, 75% and 85.7%. CONCLUSION: Three-dimensional coronary angiography obtained with electron beam CT is a promising, useful, and relatively accurate diagnostic imaging technique for the evaluation of graft patency in patients who have undergone coronary artery bypass graft surgery.

Coronary Angiography↗

Assessment of myocardial metaiodobenzylguanidine uptake and its relation to left ventricular systolic and diastolic functional parameters in dilated cardiomyopathy.

The purpose of this study was to assess the relation between myocardial metaiodobenzylguanidine (MIBG) uptake and left ventricular systolic and diastolic functional parameters, both of which are known as predictors of prognosis in patients with dilated cardiomyopathy. Echocardiography and iodine-123-MIBG myocardial scintigraphy were performed in 35 patients of dilated cardiomyopathy with normal sinus rhythm. Mean myocardial MIBG uptake in the patient group at early and delayed images were significantly lower than those in normal control subjects (10.6 +/- 1.1, 9.8 +/- 1.2 vs 12.4 +/- 1.0, 12.1 +/- 1.0, p < 0.01). There were, however, no significant differences of mean MIBG uptake in the lung and mediastinum between the two groups (p > 0.05). There were no significant correlations between myocardial MIBG uptake, expressed as the ratio of heart/mediastinum MIBG activity at delayed image, and left ventricular systolic and diastolic functional parameters [left ventricular ejection fraction, left ventricular end-diastolic dimension, peak velocity of early diastolic filling (E velocity), deceleration time of E wave, cardiac output, left ventricular end-diastolic pressure]. In conclusion, the myocardial uptake of MIBG is decreased in patients with dilated cardiomyopathy assessed by iodine-123-MIBG myocardial scintigraphy. There were, however, no significant correlations between myocardial MIBG uptake and left ventricular systolic and diastolic functional parameters derived from echocardiography.

3-Iodobenzylguanidine↗

Age-dependent infectivity of orally transferred juvenile Fasciola hepatica.

Juvenile Fasciola hepatica is infective when administered orally. To determine whether the age of juveniles is a factor in infectivity by oral transfer, experimental mice were challenged orally with immature F. hepatica that had been grown in donor mice for 12, 14, 16, and 18 days. Experimental mice were examined for infections 12 16 days after the oral transfers. The infection success in experimental mice decreased with the age of juveniles. The worm recovery also decreased according to the age of juveniles. None of the juveniles was infective when grown for longer than 11 days. Once infected, orally transferred worms continued to grow. Juvenile age was a significant factor in determining the infectivity of orally transferred juvenile F. hepatica.

Age Factors↗

A review of glass ionomer restorations in the primary dentition.

Glass ionomer cements are tooth-coloured materials that bond chemically to dental hard tissues and release fluoride for a relatively long period. They have therefore been suggested as the materials of choice for the restoration of carious primary teeth. However, the clinical performance of conventional and metal-reinforced glass ionomer restorations in primary molars is disappointing. And although the handling and physical properties of the resin-modified materials are better than their predecessors, more clinical studies are required to confirm their efficacy in the restoration of primary molars.

Child↗