Biomedical subjects

T Kim

Publications and source records attributed to T Kim.

At least 145 records · Page 8Linked to original sources

PubMed1997

Risk factors for hemorrhage from gastric fundal varices.

The incidence and the risk factors of hemorrhage from gastric fundal varices (FV) have not been fully evaluated. We therefore conducted a retrospective and prospective study to define the incidence and risk factors for such episodes. We investigated 132 patients with cirrhosis and gastric FV. Of these 132 patients, 15 patients had hemorrhagic FV at the time of enrollment. The clinical characteristics were compared between these patients and those without a first hemorrhage from FV. In the patients who had never previously bled, the incidence and risk factors were prospectively investigated. The size of FV was greater and red-spot on the FV were more prevalent in patients with hemorrhagic FV. Child's status was also more severe in these patients. In the 117 patients who had never bled, 34 hemorrhages from FV occurred during the follow-up period. The cumulative risk for such hemorrhage at 1, 3, and 5 years was 16%, 36%, and 44%, respectively. A multiple regression analysis (Cox's model) revealed the size of varices, red-spot on the FV, and Child's status to be statistically significant, as well as independent predictors for hemorrhage from FV. The endoscopic criteria (size of the largest varix and presence of red-spot), as well as the hepatic functional reserve, provide the most essential information for predicting a hemorrhage from FV. An estimation of the probability for hemorrhage from FV based on Cox's model may therefore be beneficial in the clinical management of patients with high-risk FV.

Adult↗

PubMed1997

CT arterial portography and CT arteriography with a triple-lumen balloon catheter.

PURPOSE: To evaluate the usefulness of the triple-lumen balloon catheter in the serial performance of CT arterial portography (CT-AP) and CT arteriography (CT-A). MATERIAL AND METHODS: A combined CT-AP and CT-A examination of 58 patients was carried out in which a cobra-type triple-lumen balloon catheter was used. CT-AP was performed by injecting contrast medium either into the splenic artery through a side-hole in the catheter proximal to the balloon inflated in the common hepatic artery, or into the superior mesenteric artery through an end-hole in the catheter. Then CT-A was serially performed by delivering contrast medium either to the common hepatic artery or the proper hepatic artery from the end-hole, or to the accessory right hepatic artery through a side-hole proximal to the inflated balloon. RESULTS: Sufficient CT-APs were obtained in 53 of the 58 patients (91%), CT-A in 42 (72%), and both in 42 (72%). Incomplete CT-AP was due to technical failure or anatomical anomaly, as was incomplete CT-A. No complications were seen. CONCLUSION: The triple-lumen balloon catheter technique is useful and convenient in the serial performance of CT-AP and CT-A.

Carcinoma, Hepatocellular↗

PubMed1997

Evaluation of the AMPLICOR CMV test for direct detection of cytomegalovirus in plasma specimens.

We evaluated the AMPLICOR CMV test (PCR) for the direct detection of cytomegalovirus in plasma. Sixty-eight specimens were involved for the comparison between the AMPLICOR test and the antigenemia assay. The sensitivities, specificities, and positive and negative predictive values were 97.1, 100, 100, and 97.1%, respectively, for the AMPLICOR test and 79.4, 100, 100, and 82.9%, respectively, for the antigenemia assay.

Antigens, Viral↗

PubMed1997

The antiretrovirus drug 3'-azido-3'-deoxythymidine increases the retrovirus mutation rate.

It was previously observed that the nucleoside analog 5-azacytidine increased the spleen necrosis virus (SNV) mutation rate 13-fold in one cycle of retrovirus replication (V. K. Pathak and H. M. Temin, J. Virol. 66:3093-3100, 1992). Based on this observation, we hypothesized that nucleoside analogs used as antiviral drugs may also increase retrovirus mutation rates. We sought to determine if 3'-azido-3'-deoxythymidine (AZT), the primary treatment for human immunodeficiency virus type 1 (HIV-1) infection, increases the retrovirus mutation rate. Two assays were used to determine the effects of AZT on retrovirus mutation rates. The strategy of the first assay involved measuring the in vivo rate of inactivation of the lacZ gene in one replication cycle of SNV- and murine leukemia virus-based retroviral vectors. We observed 7- and 10-fold increases in the SNV mutant frequency following treatment of target cells with 0.1 and 0.5 microM AZT, respectively. The murine leukemia virus mutant frequency increased two- and threefold following treatment of target cells with 0.5 and 1.0 microM AZT, respectively. The second assay used an SNV-based shuttle vector containing the lacZ alpha gene. Proviruses were recovered as plasmids in Escherichia coli, and the rate of inactivation of lacZ alpha was measured. The results indicated that treatment of target cells increased the overall mutation rate two- to threefold. DNA sequence analysis of mutant proviruses indicated that AZT increased both the deletion and substitution rates. These results suggest that AZT treatment of HIV-1 infection may increase the degree of viral variation and alter virus evolution or pathogenesis.

Antiviral Agents↗

PubMed1997

F-actin disruption attenuates agonist-induced [Ca2+], myosin phosphorylation, and force in smooth muscle.

Cytochalasins B and D (at 10 microM) inhibited stress development induced by 1 microM carbachol in bovine tracheal smooth muscle by 55% and 90%, respectively. Glucose depletion was ineffective in inhibiting carbachol-induced contraction, indicating that inhibition of glucose transport was not the cause. Cytochalasin D-treated smooth muscle cells appeared collapsed, with spiky protrusions from the cell membrane. Deconvolution of fluorescent images of fluorescein isothiocyanate-phalloidin-labeled smooth muscle cells revealed concentrations of actin filaments near the cell periphery, including near the spiky protrusions. Cytochalasin B attenuated carbachol-induced intracellular Ca2+ concentration ([Ca2+]), especially the initial peak intracellular [Ca2+]. Cytochalasin B also attenuated carbachol-induced myosin light chain phosphorylation. However, when the myosin phosphorylation data were plotted against time-matched intracellular [Ca2+] data, the two relationships in control and cytochalasin B-treated smooth muscle were similar, suggesting that the changes in myosin phosphorylation could be explained by the changes in intracellular [Ca2+]. These results suggest that actin filaments in smooth muscle cells are dynamic and may be an integral component of Ca2+ regulation and/or signal transduction in receptor-coupled mechanisms.

Actins↗

PubMed1997

Production of hepatocyte growth factor is increased in chronic renal failure.

Hepatocyte growth factor (HGF) facilitates recovery from tissue injuries. We previously reported that serum HGF levels were elevated in chronic renal failure (CRF) patients. In the present study Western blot analysis of CRF patients' sera showed the majority of their serum HGF was a single-chain precursor molecule. In CRF rats developed by 5/6 nephrectomy or high adenine diet, both HGF mRNA expression levels and tissue HGF concentrations were increased in liver and spleen. The results suggest that HGF production increases in CRF, which may be a response to chronic progressive renal injuries in an endocrine manner.

Adult↗

PubMed1997

Hepatocyte growth factor in glycerol-induced acute renal failure.

Hepatocyte growth factor (HGF) facilitates the regeneration of injured kidney in acute renal failure (ARF). Here we investigated the HGF production in glycerol-induced ARF rats. HGF mRNA expression levels were elevated in liver, spleen, and lung 6-24 h after glycerol injection. Tissue HGF protein levels determined by an enzyme-linked immunosorbent assay also increased in liver and spleen, whereas they decreased in the injured kidney 24 h after injection. Immunohistochemical studies showed that the number of HGF-producing cells did not increase in the liver. HGF receptor/c-Met mRNA levels were elevated only in the kidney. These results indicate that HGF supplied in an endocrine manner may play an important role in the regenerating process following ARF.

Acute Kidney Injury↗

PubMed1997

Renal cortical retention on delayed CT after angiography and contrast associated nephropathy.

The aim of this study was to examine the relationship between renal cortical retention (RCR) of contrast media observed on delayed CT (median delay: 20 h) and contrast associated nephropathy (CAN). We investigated the incidence of both phenomena in 270 patients. CAN was defined as an increase in the creatinine level > 0.5 mg dl-1 (44 mumol l-1) and > 25% on day 1, 3 or 7, while RCR was recognized when CT values for the renal cortex showed either mild RCR (CT value > 50) or severe RCR (CT value > 100). RCR was demonstrated in 127 patients (47%), mild in 78 (29%) and severe in 49 (18%), on delayed CT after angiography. CAN was found in eight patients (3%). Patients with severe RCR showed a higher CAN rate (8%) than other patients (mild RCR: 4%, RCR (-): 1%) (p = 0.02). The type of contrast medium was independently associated with the incidence of RCR (p = 0.0001). Although severe RCR was associated with a higher frequency of CAN than the milder forms of RCR, RCR as such was not always associated with CAN.

Adolescent↗

PubMed1997

Helical CT during arterial portography and hepatic arteriography for detecting hypervascular hepatocellular carcinoma.

OBJECTIVE: We assessed whether helical CT hepatic arteriography (CTHA) improves detection of hypervascular hepatocellular carcinoma (HCC) when used in conjunction with helical CT obtained during arterial portography (CTAP). SUBJECTS AND METHODS: One hundred two patients with 254 hypervascular HCC nodules underwent both CTHA and CTAP. CTHA and CTAP were separately interpreted for detection of hypervascular HCC nodules by three observers who were unaware of tumor burden in the liver, lodized oil CT performed 1 week and 1 month after transcatheter arterial chemoembolization with iodized oil was the gold standard. Sensitivity and positive predictive value for CTHA alone, CTAP alone, and CTAP and CTHA combined were calculated and compared using the McNemar test. RESULTS: We found no significant difference between the sensitivity of CTAP (85%) and CTHA (87%) for revealing hypervascular HCC nodules. The combination of CTAP and CTHA showed significantly higher sensitivity than either CTAP or CTHA alone for revealing HCC nodules smaller than 20 mm in diameter (p < .01). CONCLUSION: The combination of CTHA and CTAP is recommended to improve the detection sensitivity of small hypervascular HCC nodules.

Adult↗

PubMed1997

Detection of hepatocellular carcinoma in patients with cirrhosis: MR imaging versus angiographically assisted helical CT.

OBJECTIVE: The purpose of our study was to compare the combination of conventional spin-echo, phase-shift gradient-recalled echo (GRE), and triple-phasic dynamic GRE MR imaging with the combination of helical CT hepatic arteriography (CTA) and CT performed during arterial portography (CTAP) in the preoperative detection of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Thirty-seven patients with cirrhosis underwent MR imaging and angiographically assisted CT imaging. Paired T1- and T2-weighted spin-echo images, paired in-phase and out-of-phase GRE images, triple-phasic dynamic GRE images, the combined MR images, and the paired CTA and CTAP images were retrospectively and independently reviewed by three radiologists. Image review was done on a segment-by-segment basis. Of the 280 liver segments, 58 segments contained 79 HCCs that were 0.5-8.0 cm (mean, 2.0 cm) in diameter. The diagnostic value of each pair of images was rated by means of receiver operating characteristic curve analysis. RESULTS: The diagnostic accuracy of combined CTA and CTAP (mean area under the receiver operating characteristic curve [Az] = 0.94) was significantly better than that of spin-echo (Az = 0.86, p < .0001), phase-shift GRE (Az = 0.83, p < .0001), dynamic GRE (Az = 0.85, p < .0001), and all combined (Az = 0.91, p < .001) MR imaging. The relative sensitivity of combined CTA and CTAP (89%) was also significantly (p < .0005) better than that of the combined MR imaging (75%). CONCLUSION: Angiographically assisted helical CT imaging was superior to MR imaging combined with conventional spin-echo, phase-shift GRE, and triple-phasic dynamic GRE techniques in the detection of HCC in patients with cirrhosis. The noninvasive dedicated combined MR imaging could not obviate invasive angiographically assisted CT imaging. Combined CTA and CTAP is recommended, especially in the preoperative examination of patients with HCC.

Aged↗

PubMed1997

[Preliminary evaluation of the apparent diffusion coefficient of the kidney with a spiral IVIM sequence].

We examined the usefulness of the spiral intravoxel incoherent motion (IVIM) sequence in measuring the apparent diffusion coefficient (ADC) of the kidneys. Five volunteers and five patients with chronic renal failure underwent diffusion-sensitive magnetic resonance imaging of the kidneys with the spiral IVIM sequence. The ADC values in patients with chronic renal failure were significantly lower than those in the renal cortex of volunteers. The mean value of ADC in patients with chronic renal failure was lower than that in volunteers, although there was no statistically significant difference. In volunteers, the ADC of the renal cortex was significantly higher than that of the renal medulla. The phantom study indicated that the accuracy of ADC depended on the signal to noise ratio. A spiral IVIM sequence with a high enough signal to noise ratio may be useful in evaluating renal function especially that of the cortex.

Adult↗

PubMed1997

Hepatocellular carcinoma patients showing long-term complete responses to chemoembolization.

The objective was to evaluate hepatocellular carcinoma (HCC) patients showing a long-term complete response (CR) to chemoembolization. We defined the criteria of CR as normalized tumor marker, no enhanced tumor in diagnostic images, and no tumor cells found at autopsy. Five HCC patients showing long-term CR to chemoembolization were evaluated. The CR period ranged from 3.5 to 7 years (mean, 5.7 years). The survival period ranged from 3.5 to 9 years (mean, 6.7 years). Four cases (80%) were stage IV according to the TNM classification due to a portal tumor thrombus. The liver function was rated as Child's A in four cases (80%). Long-term CR to chemoembolization can be achieved even in some advanced HCC cases with a tumor thrombus. We speculate that the good antitumor effect is brought about by the stagnation of both the arterial and portal blood flows to the HCC. Good liver function is also considered to be an important factor for long-term CR and a long survival period. If the liver function is good, advanced HCC with a portal tumor thrombus should be treated aggressively with chemoembolization.

Aged↗

PubMed1997

[A case of vesical endometriosis associated with Wunderlich syndrome].

A case of vesical endometriosis associated with unilateral renal agenesis and uterus didelphys (Wunderlich syndrome) is reported. A 20-year-old unmarried woman visited the gynecologic department with dysmenorrhea. She was referred to us because a bladder mass was detected on abdominal ultrasonography. She had no episode of gross hematuria. Cystoscopy revealed a finger tip-sized cystic mass dark red to dark blue in color. Computerized tomography and magnetic resonance imaging demonstrated right renal agenesis and uterus didelphys. The mass was located at the ureterovesical pouch and protruded into the bladder. Partial cystectomy, right hysterectomy and right salpingo-oophorectomy were performed. Histopathological diagnosis was endometriosis. The patient was treated with 400 mg danazol for 6 months has had no recurrence and regular menstruation.

Adult↗

PubMed1997

[Trial of a detachable Y-shaped tube with two valves for serial examinations of CT arterial portography and CT hepatic arteriography].

In five patients with hepatocellular carcinoma, CT arterial portography (CTAP) and CT hepatic arteriography (CTHA) were performed serially by using a newly developed detachable Y-shaped tube with two valves that could be attached to a conventional angiographic sheath. Two catheters could be inserted into the conventional angiographic sheath without blood backflow by using the Y-shaped tube. One catheter could be easily and safety placed on the common or proper hepatic artery, and the other on the superior mesenteric artery. This detachable Y-shaped tube with two valves could make it easy to perform serial CTAP and CTHA examinations.

Angiography↗

PubMed1996

Excretion study of furazabol, an anabolic steroid, in human urine.

Furazabol and 16-hydroxyfurazabol represented the most abundant peaks in urinary metabolic profiles for two men obtained by gas chromatography-mass spectrometry (GC-MS) after oral administration of 5 mg furazabol. The excreted amounts of unchanged furazabol were determined and its response in GC-MS was compared with that of the 16-hydroxy metabolite. The maximum excretion rates of these compounds were reached 2-3 h after oral administration. The half-lives of unchanged furazabol for two human subjects, were 1.87 and 1.29 h respectively and the recovered amount in 48 h was 24% (33% for one, 15% for the other). Also the spectrum of an unidentified metabolite is reported.

Administration, Oral↗

PubMed1996

Differential expression of rab3 isoforms in oligodendrocytes and astrocytes.

The small GTP-binding protein Rab3a is involved in regulated secretory pathways and is enriched in synaptic and neuroendocrine secretory vesicles. We have reported previously the developmental regulation of Rab3a in oligodendrocytes in culture and purified central nervous system myelin (Huber et al.: FEBS Lett 347: 273-278, 1994). Since multiple rab3 isoforms exist in the brain and may be associated with different secretory pathways, we have investigated the differential expression of the rab3 isoforms in oligodendrocytes, astrocytes, and Schwann cell line RT4-D6P2T. The expression of specific rab3 isoforms (rab3a-c) was detected by polymerase chain reaction (PCR) amplification and confirmed by sequence analyses. These data show that in addition to the previously reported expression in neurons, the two macroglial populations, astrocytes and oligodendrocytes, also express rab3 isoforms. Rab3b was preferentially amplified from purified, cultured astrocytes, while rab3a and rab3c were preferentially amplified from highly enriched populations of both cultured oligodendrocytes and those isolated directly from the brain by immunopanning. No novel rab3 isoform was detected in glia. These results indicate that glial cells in the brain express specific isoforms of the vesicular trafficking Rab3 protein family.

Amino Acid Sequence↗

PubMed1996

Systemic hemodynamics and serum nitrate levels in patients undergoing endoscopic variceal ligation.

The effects of endoscopic variceal ligation (EVL) on systemic hemodynamics are unknown. This study was conducted to determine whether the obliteration of portal-systemic collaterals by EVL affects systemic hemodynamics and serum nitrate concentrations in patients with compensated cirrhosis. We measured systemic and hepatic hemodynamics, azygos vein blood flow (AzBF), and serum nitrate concentrations before and immediately following EVL. A prompt decrease in left ventricular end-diastolic volume (LVEDV), stroke volume, cardiac index (CI), and an increase in systemic vascular resistance index (SVRI) were observed following variceal ligation. The reduction in LVEDV was associated with a decline in CI with a rise in SVRI. There was also a prompt reduction in serum nitrate concentration following variceal ligation. AzBF also significantly decreased following variceal ligation. These findings indicate that EVL decreased cardiac output via a reduction in cardiac preload (central venous return). Blood flow through portal-systemic collaterals has an important role in the enhanced cardiac preload of cirrhotic patients. The sudden decrease in serum nitrate concentrations suggests that endogenous nitric oxide may be involved in the regulation of systemic hemodynamics in patients with compensated cirrhosis.

Aldosterone↗

PubMed1996

Sustained-release morphine for epidural analgesia in rats.

BACKGROUND: Epidural opioid analgesia often requires either continuous infusion or repeated injections, which are inconvenient for patients, increase risk of infection, and consume expensive physician and nursing time. In addition, potential respiratory depression is a major safety concern. The authors studied whether a single dose of epidurally administered, sustained-release morphine could prolong analgesia and reduce toxic effects in rats. METHODS: Sustained-release morphine (DTC401) was prepared by encapsulating morphine sulfate in DepoFoam (Dep. Tech, San Diego, CA), a lipid-based, sustained-release drug delivery system. A standard hot-plate test for analgesia, pulse oximetry for hemoglobin oxygen saturation, corneal-reflex loss, and incidence of catalepsy were used to assess efficacy and toxicities. Cerebrospinal fluid and serum pharmacokinetic studies were performed after a single epidural dose, using a commercially available radioimmunoassay kit. RESULTS: Single epidural doses of DTC401 resulted in equivalent onset time to peak analgesia but significantly prolonged analgesia compared with morphine sulfate. Hemoglobin oxygen saturation was decreased minimally, and the incidences of catalepsy and corneal-reflex loss were minimal, even at large doses of DTC401. In contrast, the larger doses of morphine sulfate significantly decreased hemoglobin oxygen saturation, and caused catalepsy and loss of the corneal-reflex. The Cmax for DTC401 was 32% in cerebrospinal fluid and 6% in serum, relative to morphine sulfate. The terminal half-life for DTC401 was increased 32 fold in the cerebrospinal fluid compared with morphine sulfate. CONCLUSIONS: A single epidural dose of DTC401, compared with morphine sulfate, prolonged duration of analgesia, with minimal supraspinal toxic effects, in rats.

Analgesia, Epidural↗