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Biomedical subjects

Dong Kee Kim

Publications and source records attributed to Dong Kee Kim.

10 recordsLinked to original sources

Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea.

The number of North Korean defectors entering South Korea has been increasing rapidly since 1994. Two hundred North Korean defectors in South Korea were studied to identify their experiences of traumatic events in North Korea and during defection, and the correlation with Posttraumatic Stress Disorder (PTSD). Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, and the PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: Physical Trauma, Political-Ideological Trauma, and Family-Related Trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: Physical Trauma, Detection and Capture-Related Trauma, Family-Related Trauma, and Betrayal-Related Trauma. In multifactorial logistic regression analysis, Family-Related Trauma in North Korea had a significant odds ratio.

Adolescent↗

Chronologically different impacts of immunologic and non-immunologic risk factors on renal allograft function.

INTRODUCTION: Upon analysis of the risk factors affecting renal graft survival and function, the time-dependent effects of each risk factor should be differentiated from their net effects. To evaluate the chronologically different impacts of risk factors on graft renal function, we reviewed 390 recipients who received a kidney from 1-haplotype-matched living-related donors. MATERIALS AND METHODS: Until 5-yr post-transplantation (TX), yearly serum creatinine (Scr), 24-h urinary excretion of protein, and their yearly changes were compared by the episodes of acute rejection within 1 yr, the kidney weight to recipient body weight (KW/BW) ratio, the donor/recipient (D/R) age ratio, and the D/R gender pairing. The Kaplan-Meier method, Cox proportional hazard model, ANOVA, and repeated measures ANOVA were each applied for different purposes. RESULTS: Only the episodes of acute rejection were a significant risk factor affecting graft survival. The episodes of acute rejection, KW/BW ratio, D/R age ratio, and D/R gender pairing consistently and independently had significant influences on Scr. Recipients having the lowest KW/BW ratio (first quartile) or the highest D/R age ratio (fourth quartile) had rapid increments of Scr after 4-yr post-TX. After 3-yr post-TX, there were significant correlations between the number of non-immunologic risk factors present and the yearly changes in Scr. CONCLUSIONS: Non-immunologic factors had a detrimental effect on renal graft function, especially after 3-yr post-TX. If immunologic risks seem to be similar, size matching, age, and gender pairing should be considered for better long-term graft function in renal TX recipients.

Age Factors↗

The relation between anger expression, depression, and somatic symptoms in depressive disorders and somatoform disorders.

BACKGROUND: In previous studies, the relationship between either anger suppression and depression or anger suppression and somatic symptoms was examined. However, the relationship between anger expression, depression, and somatic symptoms was not examined in depressive disorders and somatoform disorders. METHOD: The DSM-IV-diagnosed subjects included 73 patients with depressive disorders and 47 patients with somatoform disorders. The Anger Expression Scale was used to assess the level of anger expression or suppression. The severity of depression was assessed using the Symptom Checklist-90-Revised (SCL-90-R). The Somatization Rating Scale and the SCL-90-R somatization subscale were used to assess the severity of somatic symptoms. Data were collected from March 2000 to March 2001. RESULTS: The results of the path analyses showed that in depressive disorder patients, anger expression had a stronger effect on somatic symptoms through depression than did anger suppression, although both anger expression and anger suppression had a significant indirect effect on somatic symptoms. The depressive disorder group also showed a significant but negative direct effect of anger suppression on anger expression in the path from anger suppression to anger expression to depression to somatic symptoms. However, only anger suppression had an indirect effect on somatic symptoms through depression in somatoform disorder patients. CONCLUSIONS: The results suggest that anger expression might play a more predominant role in depression and somatic symptoms of depressive disorder patients than anger suppression, but only anger suppression might be associated with depression and somatic symptoms of somatoform disorder patients. In addition, incomplete anger suppression followed by anger expression is likely to be associated with depression and somatic symptoms in depressive disorders.

Adult↗

Onset of analgesia and analgesic efficacy of tramadol/acetaminophen and codeine/acetaminophen/ibuprofen in acute postoperative pain: a single-center, single-dose, randomized, active-controlled, parallel-group study in a dental surgery pain model.

BACKGROUND: The combination of tramadol and acetaminophen has demonstrated good efficacy in various clinical pain models. However, there is a need for comparisons of the onset of analgesia and other measures of analgesic efficacy with this combination and other strong combination analgesics for the management of acute pain. OBJECTIVE: The goal of this study was to compare the time to onset of analgesia and other measures of analgesic efficacy with tramadol/acetaminophen 75/650 mg (Tr/Ac) and codeine/acetaminophen/ibuprofen 20/500/400 mg (Co/Ac/Ib) in the management of acute pain after oral surgery. METHODS: This was a single-center, single-dose, randomized, active-controlled, parallel-group study in healthy subjects who had undergone surgical extraction of > or =1 impacted third molar requiring bone removal. When patients reported at least moderate pain after dental surgery (score > or =5 on a 10-point scale), they were randomized to 1 of 2 treatment groups. The time to onset of analgesia was measured using a 2-stopwatch technique. The time to the onset of perceptible and meaningful pain relief, pain intensity, pain relief, patient's overall assessment, and adverse events were recorded for 6 hours after dosing. RESULTS: One hundred twenty-eight subjects participated in the study, 64 in each treatment group. The 2 groups were similar in terms of baseline pain severity and demographic characteristics (mean age, 23.7 and 23.4 years in the Tr/Ac and Co/Ac/Ib groups, respectively; mean body weight, 58.5 and 60.3 kg). The median times to the onset of perceptible pain relief were a respective 21.0 and 24.4 minutes, and the median times to the onset of meaningful pain relief were 56.4 and 57.3 minutes. Mean total pain relief and the sum of pain intensity difference were also similar in the early period after dosing (0-4 hours). However, between 4 and 6 hours, Co/Ac/Ib was associated with significant differences in both variables compared with Tr/Ac (P < 0.05). Although similar through the 4-hour assessment, mean pain intensity difference was significantly greater with Co/Ac/Ib at 5 to 6 hours. The proportion of patients assessing their assigned treatment as good or better was significantly greater with Co/Ac/Ib compared with Tr/Ac (P < 0.05). The safety profile of Tr/Ac was comparable to that of Co/Ac/Ib. CONCLUSIONS: In this small and selected group of subjects, the onset of analgesia and analgesic efficacy of Tr/Ac was comparable to that of Co/Ac/Ib. Tr/Ac provided rapid and effective analgesia for acute postoperative dental pain in this population.

Acetaminophen↗

Increased nephron volume is not a cause of supranormal renographic differential renal function in patients with ureteropelvic junction obstruction.

PURPOSE: Increasing clinical importance is being placed on the role of differential renal function (DRF) in the management of congenital ureteropelvic junction obstruction. Supranormal DRF of the hydronephrotic kidney on renal scan is a puzzling phenomenon and is hypothesized to be due to an increase in single nephron filtration or nephron volume without sound evidence. We studied the histopathological changes of hydronephrotic kidneys to determine whether glomerular hypertrophy underlies supranormal DRF. MATERIALS AND METHODS: We retrospectively evaluated the records of 3 females and 32 males with unilateral congenital hydronephrosis who underwent pyeloplasty. Mean patient age at operation was 12.6 months (range 0.1 to 144). Needle biopsies from 3 different sites at the lower pole of the kidney were performed during surgery. To evaluate the presence of glomerular hypertrophy, the maximal planar area of glomeruli was measured under light microscopy using an image analyzer. Tissue samples obtained from kidneys without a history of urinary tract disease at autopsy were used as controls. The mean glomerular areas of the patient and control groups were evaluated according to DRF and age. RESULTS: The mean glomerular area values of the patient group were smaller than those of the control group, except for 4 patients. The glomerular areas of the hydronephrotic kidneys with supranormal DRF were not significantly different from those of the control group. Instead, the probability of larger renal glomeruli increased with decreasing DRF (p = 0.1155). CONCLUSIONS: Increased nephron volume can be discounted as a cause of supranormal DRF.

Biopsy↗

Screening test data analysis for liver disease prediction model using growth curve.

This study was done based on screening test data accumulated from 1994 to 2001 for studying of risk factor related with liver disease and prediction model of liver disease. In the existing study related with liver, the main current is studying on liver cancer, not on liver disease, previous step into liver cancer. As a result of estimating prediction model through the risk factors of liver disease and the growth curve on the basis of data, it is shown that most of the risk factors about liver disease are also those about known well as liver cancer. In addition, to investigate liver disease prevalence from the viewpoint of the future, this study presumed risk factor through the various growth curve analysis and examined logistic regression, decision tree and neural network from those estimators. In the case of neural network using growth curve estimator of Xi(5)=alphai+betaiT+epsiloniT, accuracy of liver disease was 72.55% and sensitivity was 78.62%. On the other hand, in the case of liver disease prediction model using recent screening test data estimator, accuracy was 72.09% and sensitivity was 71.72%. Those are lower than liver disease prediction model of growth curve analysis. In the various liver disease prediction models assumed by growth curve and many distinction models, when growth curve estimator was used, sensitivity value was improved.

Humans↗

Evidence that the ratio of donor kidney weight to recipient body weight, donor age, and episodes of acute rejection correlate independently with live-donor graft function.

BACKGROUND: We demonstrated that higher donor kidney weight-to-recipient body weight (KW/BW) ratio showed better graft function in acute rejection-free renal recipients. METHODS: We investigated the impacts of KW/BW ratios on the graft function including acute rejection and donor's age in 259 live-donor renal recipients. Renal parameters were measured yearly. Correlations between the variables and each parameter were assessed by mixed regression and analysis of variance. RESULTS: Renal function showed a positive correlation with the KW/BW ratio, but an inverse correlation with the rejection episodes and donor's age. The regression slope for serum creatinine or creatinine clearance by these covariants was consistent each year. On comparing the lower KW/BW ratios (<3.0) with higher ratios (> or =4.5), the higher was associated with better graft function. Increased donor's age was associated with worse graft function. CONCLUSIONS: KW/BW ratio, donor's age, and the number of acute rejections are independent covariants for graft function.

Adult↗

Syndromic diagnosis at the epilepsy clinic: role of MRI in lobar epilepsies.

PURPOSE: Magnetic resonance imaging (MRI) is an essential diagnostic tool for the management of epilepsy at modern epilepsy clinics. This study was conducted to incorporate MRI features into the international classification of epilepsies and epilepsy syndromes (ICEES) proposed by the International League Against Epilepsy (ILAE). METHODS: Three hundred consecutive patients newly registered in the Yonsei Epilepsy Clinic underwent stepwise classifications based on clinical features, clinical EEG, and clinical EEG-MRI correlations. The patients were required to have epilepsy and have undergone both EEG and MRI for inclusion in the study. Interictal epileptiform discharges (IEDs) in the EEG were divided into lobar, multilobar, and generalized. MRI lesions were divided into lobar and multilobar lesions. Lobar epilepsies (LEs) were divided into temporal, frontal, parietal, occipital, rolandic, temporoparietooccipital junctional, multilobar, and nonlocalized LEs. RESULTS: Two hundred forty-nine patients satisfied the inclusion criteria. In the first-step diagnosis, 190 patients were classified as having localization-related epilepsy; 24 patients, generalized epilepsy; 34 patients, undetermined epilepsy; and one patient, a special syndrome. EEG revealed IEDs in 124 (50%) patients, and the second-step diagnosis changed the diagnostic categories of 79 (32%) patients. MRI detected lesions in 106 (43%) patients, and the third-step diagnosis changed the diagnostic categories of 30 (12%) patients. The nonspecific diagnostic categories of ICEES decreased from 49% to 37% and then to 29%, as diagnosis progressed from steps one to three. In cases of LE, MRI was superior to EEG in its clinical correlation. Additionally, the diagnostic precision in temporal lobe epilepsy was far better than that for other LEs. CONCLUSIONS: The impact of MRI on ICEES was only modest in terms of changing diagnostic categories, although MRI provided a structural substrate for epilepsy in 38% of patients with negative EEGs. In LE, MRI was as sensitive as EEG, and its clinical correlation was superior to that of EEG, which strongly supports the rationale of incorporating MRI into ICEES.

Adult↗

Regression models for overdispersed jejunal surviving crypts data.

The dose-response model concerns to establish a relationship between a dose and the magnitude of the response produced by the dose. A common complication in the dose-response model for jejunal crypts cell surviving data is overdispersion, where the observed variation exceeds that predicted from the binomial distribution. In this study, two different methods for analyzing jejunal crypts cell survival after regimens of several fractions are contrasted and compared. One method is the logistic regression approach, where the numbers of surviving crypts are predicted by the logistic function of a single dose of radiation. The other one is the transform-both-sides approach, where the arcsine transformation family is applied based on the first-order variance-stabilizing transformation. This family includes the square root, arcsine, and hyperbolic arcsine transformations, which have been used for Poisson, binomial, and negative binomial count data, as special cases. These approaches are applied to a data set from radiobiology. Simulation study indicates that the arcsine transformation family is more efficient than the logistic regression when there exists moderate overdispersion.

Cell Survival↗

SS-penogram: a new diagnostic test for erectile dysfunction.

The clinical reports on Sildenafil sulfate (Viagra) are mainly based on individual observations. However, there is a paucity of objective studies in the literature. In order to objectively examine the effect of Sildenafil, a SS (Sexual Stimulation)-Penogram that is a non-invasive, simple and physiologic method was developed using a radioisotope (RI). One hundred and four SS-penograms were performed on patients who had a documented erectile dysfunction (ED) lasting for more than 6 months. After an intravenous injection of 99mTc-RBC (15 mCi), the first penogram was taken immediately after sexual stimulation, which was done by 30 minutes of erotic videotape viewing. Forty minutes after administering 25 to 100 mg of Sildenafil, a second penogram was taken. The characteristics of each penogram were analyzed according to a previously reported method. The results were graded as follows; Type I(normal function; 5 min or more of peak erectile response with an induction period of 1 to 6 min), Type II-A (impossible function type; i.e., showing less than 2 times the basal radioactivity level), Type II-B (the unstable type; showing less than 5 min of peak erectile response), and Type II-C (the delayed type; which showed a delay of more than 15 min after the start of sexual stimulation). The patients were grouped according to their response after Sildenafil administration, and the effect of Sildenafil was assessed by comparing the radioactivity from between 7 to 22 minutes and the changes in the characteristics of the penogram. The mean age of the patients was 44.9 +/- 10.2 (23 - 68) years. In the first penogram, Type I was found in 12 patients, and Type II-A in 14, Type II-B in 73, Type II-C in 1 and a mixed (II-B + C) type was found in 4 patients. A second penogram after Sildenafil administration, showed Type I in 46 patients, and Type II-A in 10, Type II-B in 46 and a mixed type was found in 2 patients. The responses after Sildenafil were categorized as follows: 1) An excellent response group (consisting of 56 patients-53.9%); Those who showed greater than 50% increase in the RI area after Sildenafil treatment. 2) A good response group consisting of (23 patients-22.1%); i.e., those who showed a less than 50% but greater than a 20% increase in the RI area after Sildenafil administration. 3) A borderline group (consisting of 15 patients-14.4%); showing less than a 20% change in the RI area after Sildenafil treatment. 4) non-response group (consisting of 10 patients-9.6%). The therapeutic efficacy of Sildenafil, as determined by the SS-penograms, revealed that there was an augmentation in the erectile capabilities in 76% of men (79/104) but a non-response was observed in 9.6% (10/104). The efficacy of Sildenafil on the SS-penogram did not correlate with the patient's age (p=0.198). It is believed that the SS-penogram can be used to accurately evaluate the natural erectile status in sexual and pharmacological stimulation, and provides the most objective erectile response in any therapeutic trial. Consequently, the primary challenge for any erectile dysfunction remedy is to be able to demonstrate its efficacy. A further evaluation is warranted in the non-response group, which was not based on any severe organic dysfunction.

Adult↗