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Biomedical subjects

D S Han

Publications and source records attributed to D S Han.

At least 91 records · Page 5Linked to original sources
PubMed1992

Effect of captopril on heavy proteinuria in patients with various glomerular diseases.

The effect of captopril on proteinuria was evaluated in twenty patients with various glomerular diseases excreting heavy proteinuria (> 3.0 g/day). Captopril in a daily dose of 37.5 mg was administered orally three times a day to all patients and they were followed for eight weeks. Twenty-four hour urinary excretion of protein, creatinine, sodium, selective protein index (SPI), and blood chemistry including serum electrolytes were measured every two weeks. Twenty-four hour urinary protein excretion per gram creatinine started to fall within two weeks of captopril administration and became nearly stable after four weeks of therapy (p < 0.05). Mean 24-hour urinary protein excretion decreased significantly from a pretreatment value of 9.0 +/- 6.0 gm/gm of cr. to 4.4 +/- 3.5 gm/gm of cr. after eight weeks of captopril treatment. The serum albumin level increased progressively at six and eight weeks after the captopril treatment period and was significantly higher than the pretreatment value (p < 0.05). The decrease in proteinuria did not coincide with a fall in blood pressure or any changes in creatinine clearance. We conclude that captopril does have a significant antiproteinuric effect in patients excreting heavy proteinuria with various glomerular diseases. However, the long term therapeutic efficacy and any renal protective effect of this drug remain to be proven.

Adult↗
PubMed1992

Single-center experience of unrelated living-donor renal transplantation in the cyclosporine era.

Renal transplantation from the unrelated living-donor might be an alternative when the cadaveric or related donor is not available, because graft and patient survival rates are superior to those of kidneys from cadaveric donors and even comparable to those from related donors. Among the many factors that might contribute to these excellent results, we believe that the good quality of kidneys (lacking preservation or ischemic injury) is the most important one. In addition, our criteria for patient selection requiring well-matched HLA typing might partially contribute to our success. For the successful renal transplantation program using unrelated-living donors, high ethical standards, accumulated experience from living-related donor transplantation, and dedicated professionalism are strongly recommended.

ABO Blood-Group System↗
PubMed1991

An analysis of 2361 cases of renal biopsy in Korea.

To evaluate the distribution pattern of renal diseases based on needle biopsy, we analyzed 2361 cases of renal biopsy and necropsy material examined at the Department of Pathology from 1973 to 1988. The average age was 21.1 years for males and 23.7 years for females. The adult cases comprised 60.2% and the child cases 39.8%. The male to female ratio was 1.6: 1 in adults and 2.3:1 in children. Glomerular diseases were 97.8% of the total; primary glomerulonephritis (GN) 59.8% and secondary GN 27.6% The major glomerular diseases, in descending order of frequency, were; minimal change nephrotic syndrome (MCNS; 24.2%), IgA nephropathy (IgAN; 17.8%), benign recurrent hematuria (BRH; 8.8%), membranous GN (MGN; 7.9%), acute poststreptococcal GN (APSGN; 7.3%), mesangioproliferative GN (MspGN; 5.5%), minimal mesangiopathy (5.5%), membranoproliferative GN(4.1%), and focal segmental glomerulosclerosis (FSGS; 2.7%). GN of systemic disease included 77 cases of lupus nephritis, 157 cases of Henoch-Schönlein purpura nephritis (HSPN) and 7 cases of systemic infection excluding Hepatitis B viral hepatitis. The most common glomerular diseases were MCNS, IgAN, MGN and MspGN in adults, and MCNS, BRH, HSP-N and APSGN in children. HBs antigenemia was found in 71 cases, of which MGN and IgAN were the most frequent. HBs antigenemia-associated MGN was prevalent in male children, whereas IgAN was prevalent in adults.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Cellular mechanism of stimulation of renin secretion by the mercurial diuretic mersalyl.

The aim of the present study was to elucidate the cellular mechanism by which the mercurial diuretic mersalyl stimulates renin secretion in rabbit renal cortical slices in vitro. The stimulatory effect of mersalyl on renin secretion was rapid, reversible and concentration dependent. The stimulation was not dependent on the presence of ions such as Na+, Cl- and Ca++, and it was unaffected by inhibitors of Na+/K+/2Cl- cotransport, such as bumetanide and furosemide. However, the stimulation was blocked and reversed by thiols, such as L-cysteine and dithiothreitol. Furthermore, the maximal stimulatory effect of mersalyl on renin secretion was not additive to that produced by the non-diuretic mercurial sulfhydryl reagent P-chloromercuriphenylsulfonate nor to that produced by the non-mercurial diuretic sulfhydryl reagent, ethacrynic acid. These results support the hypothesis that mersalyl stimulates renin secretion by forming a reversible mercaptide bond with sulfhydryl groups, located perhaps on the plasma membrane of juxtaglomerular cells. These particular sulfhydryl groups appear to have no functional role in the diuretic action of mersalyl.

4-Chloromercuribenzenesulfonate↗
PubMed1990

Does reperfusion extend necrosis? A study in a single territory of myocardial ischemia--half reperfused and half not reperfused.

The purpose of this study was to confirm or disprove the existence of reperfusion-induced extension of necrosis. To avoid the effect of the variability of collateral circulation when groups of dogs are compared, we compared the effect of reperfusion and nonreperfusion on myocardial necrosis in a single ischemic territory, half of which was reperfused and half of which was not. The left anterior descending coronary artery (LAD) territory between its last diagonal branch and the apex was studied because it was found to have uniform collateral blood flow. In 20 dogs, the LAD was occluded for 90-240 minutes to produce necrosis of different degrees of transmurality. Before release of this occlusion, the LAD was occluded distally halfway to the apex to keep the distal half nonreperfused. After 5 minutes of proximal reperfusion. Monastral blue dye was injected into the left atrium for demarcation of the reperfused region, and the heart was arrested, excised, cut parallel to the LAD, and placed into triphenyl tetrazolium chloride (TTC) solution for delineation of the region of necrosis. The validity of TTC staining under the conditions of this study was confirmed by light and electron microscopy. The transmurality of necrosis, measured within 1 or 0.5 cm on either side of the boundary, ranged from 30% to 88% of wall thickness and was not different in the reperfused compared with the nonreperfused region (paired t test). Reperfusion did not advance the epicardial edge of necrosis compared with the nonreperfused region. In conclusion, at 5 minutes after reperfusion, comparison of necrosis in the reperfused and nonreperfused halves of a single ischemic territory could not demonstrate an extension of necrosis by reperfusion.

Animals↗
PubMed1990

Influence of nutritional status on CAPD peritonitis.

To investigate the effect of nutritional status of continuous ambulatory peritoneal dialysis (CAPD) patients on the development of peritonitis, a cross-sectional study of the nutritional status of 79 CAPD patients and a retrospective study on the incidence of peritonitis in these patients were done. The incidences of peritonitis were compared according to the nutritional status of these patients on CAPD. Protein-caloric malnutrition assessed by a score system based on triceps skinfold thickness, mid-arm circumference, serum albumin level and relative body weight was demonstrated in 27 patients (34%) among 79 total CAPD patients. The incidence of peritonitis was significantly higher in poor nutritional status patients, with 1.09 +/- 0.86/patient-year, than that in normal nutritional status patients with 0.64 +/- 0.72/patient-year (p less than 0.05). In patients with the same nutritional status, patients using Dianeal solution had a trend of a lower incidence of peritonitis than those using Peritosol solution. In conclusion, the nutritional status and possibly the type of CAPD solution may influence CAPD peritonitis as risk factors.

Dialysis Solutions↗
PubMed1990

Significance of mesangial IgA deposition in minimal change nephrotic syndrome: a study of 60 cases.

We studied 60 cases of minimal change nephrotic syndrome (MCNS) with mesangial IgA deposits occurring over a 6 year period. There were 43 adults and 17 children. Hematuria occurred in 69.0% of the adults and 88.2% of the children. Two adults and six children had gross hematuria during the course of the disease. Mesangial IgA deposits were noted in 100% of the cases, and concomitant IgG or IgM deposits were found in 78.6% of adults and 73.7% of children. The fluorescent intensity of mesangial IgA deposits was trace (+/-) to 1+ in 86.1% and 70.6% of the adults and children respectively. Most of the patients showed electron microscopic findings consistent with minimal change nephrotic syndrome. We speculate that most of our cases are variants of minimal change nephrotic syndrome but are neither IgA nephropathy nor an overlapping syndrome, and that environmental or genetic factors may be related to the deposition of IgA in these MCNS patients.

Adult↗
PubMed1990

Hepatitis C infection in hemodialysis units.

We performed an epidemiological study of the hepatitis C infection on 112 patients of 3 urban hemodialysis units using a recently developed anti-HCV recombinant based assay. Eleven patients (9.8%) were positive for anti-HCV. Among them, 8 (72.7%) were positive for anti-HBc, one of whom was HBsAg positive and 6 of whom were also anti-HBs positive. Surprisingly, all of the anti-HCV (+) patients were normal alanine aminotransferase. The mean age of the anti-HCV (+) patients was 50.7 +/- 3.3 (mean +/- SE) and that of the anti-HCV (-) was 47.6 +/- 1.3. The mean duration (month) of hemodialysis of the anti-HCV (+) and anti-HCV (-)groups were 52.7 +/- 7.2 (mean +/- SE) and 60.9 +/- 9.7, respectively. The prevalence of anti-HCV among anti-HBc positive subjects was 9.5% and that among anti-HBc negative subjects was 17.6%. This didn't have any statistical significance according to the criteria of the study (p = 0.308). The prevalence of anti-HCV among the transfusion positive group was 11.0% and that of the transfusion negative group was 7.7%. This data showed the tendency for a higher prevalence of anti-HCV among the transfusion positive group, but this also didn't reach statistical significance (p = 0.424). Of the 40 normal controls, none were anti-HCV positive. The prevalence of HBsAg in our hemodialysis units was 12.5%. This rate was not so much higher than the average population in Korea. The prevalence of anti-HCV and previous hepatitis B virus infection also had no significant relationship.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

High-performance liquid chromatographic assay for mitoxantrone in plasma using electrochemical detection.

A sensitive and specific high-performance liquid chromatographic (HPLC) assay was developed for the quantitation of mitoxantrone in plasma using electrochemical detection. Bisantrene was chosen as the internal standard. A reversed-phase, 10-microns muBondapak C18 analytical column (30 cm X 3.9 mm) with an isocratic mobile phase of 28% acetonitrile in 80 mM sodium formate buffer (pH 3.0) was used. The eluent was monitored by both electrochemical detection at an applied potential of +0.75 V vs. Ag/AgCl and visible absorbance at 660 nm. Only electrochemical detection was able to quantitate the internal standard and provided ten times higher sensitivity than visible absorbance for mitoxantrone with a detection limit as low as 0.1 ng/ml. Calibration curves in the range 0.1-1000 ng/ml showed good linearity (r = 0.998) and precision (coefficient of variation less than 10%). This HPLC method utilized a reproducible and inexpensive liquid-liquid extraction procedure. Using methylene chloride, the extraction efficacy of mitoxantrone from plasma was 85.3% with a coefficient of variation less than 2.1%. This new assay was then applied to measure mitoxantrone concentrations in plasma obtained from two leukemic patients receiving 12 mg/m2 mitoxantrone as a 1-h infusion.

Chromatography, High Pressure Liquid↗
PubMed1987

A clinical and pharmacokinetic study of mitoxantrone in acute nonlymphocytic leukemia.

Twenty-two patients with relapsed or refractory acute leukemia received 31 treatment courses of mitoxantrone (10 to 12 mg/m2/d) as a one-hour infusion for five days. Seven of the 13 patients who had greater than or equal to 95% reduction in the leukemia cell mass, calculated using the bone marrow examination on day 6, achieved a complete remission (CR). These remissions lasted up to 14 months without additional therapy. There were no CRs among the 18 patients who had less than 95% cytoreduction by day 6. The sequential addition of 5-azacytidine (200 mg/m2/d) for three days in those patients with residual disease on day 6 provided little additional benefit. Nonhematological toxicity from mitoxantrone was mild, although fever and infection were common. A new high-performance liquid chromatography (HPLC) assay was used to describe the clinical pharmacokinetics of mitoxantrone. Neither clinical response nor toxicity was strongly correlated with the peak plasma mitoxantrone concentration on the first day (mean +/- SD, 510 +/- 206 ng/mL), nor the area under the concentration-time curve (484 +/- 229 ng X h/mL), nor the systemic clearance (405 +/- 124 mL/min/m2). Mitoxantrone causes rapid cytoreduction in acute nonlymphocytic leukemia (ANLL), but the optimal dose and schedule remain to be determined.

Acute Disease↗
PubMed1986

Control of renin secretion by Ca2+ and cyclic AMP through two parallel mechanisms.

The cellular mechanism of action of cyclic AMP (cAMP) mediating the beta-adrenergic stimulation of renin secretion was studied, with special reference to its interactions with the inhibitory pathway of renin secretion by Ca2+ calmodulin. Forskolin, a potent stimulator of adenyl cyclase that bypasses the hormone-receptor interactions, stimulated renin secretion in vitro from rabbit renal cortical slices in a concentration-dependent manner. Renin secretion stimulated by submaximal concentration of forskolin was partly or completely antagonized or blocked by raising intracellular Ca2+ concentration by incubating slices in a high-K+ depolarizing medium, but renin secretion stimulated by the maximal effective concentration of forskolin was not inhibited by Ca2+. In addition, the maximal effective concentration of forskolin (10(-5) M) increased renin secretion by a fixed amount independent of medium (by inference, intracellular) Ca2+ concentration in the range of 10(-8) to 10(-6) M in a high-K+ medium. Furthermore, the degree of stimulation of renin secretion by forskolin was greater with greater removal of the inhibitory effect of Ca2+ calmodulin pathway on renin secretion with use of potent calmodulin antagonists, suggesting that the stimulatory effect of cAMP on renin secretion may be maximal in the absence of the inhibitory influence of Ca2+. These results are consistent with the hypothesis that cAMP (by inference, the beta-adrenergic stimulus) stimulates renin secretion through a cellular mechanism independent of that through the Ca2+ -calmodulin pathway.

Animals↗
PubMed1981

Calcium in the control of renin secretion: Ca2+ influx as an inhibitory signal.

The mechanism for the inhibition of renin secretion in vitro from renal cortical slices by angiotensin II, antidiuretic hormone, ouabain, and high K+ concentration was studied. The inhibitory effect of these agents was blocked by a Ca antagonist, verapamil. In addition, epinephrine stimulated renin secretion and its stimulatory action was blocked by ouabain. These results support the hypothesis that Ca2+ influx into juxtaglomerular cells plays a role as an inhibitory signal whereas Ca2+ efflux is a stimulatory signal for renin secretion. Renin secretion was greatly stimulated by lowering incubation temperature, indicating that renin secretion is not energy dependent. The possibility is discussed that Ca2+ of juxtaglomerular cells might activate an enzyme(s) that then modulates some sequential steps of renin secretory processes, thereby controlling the rate of renin secretion.

Animals↗