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Biomedical subjects

J C Shin

Publications and source records attributed to J C Shin.

At least 19 recordsLinked to original sources
PubMed2006

Supportive management of pregnancy-associated aplastic anemia.

OBJECTIVE: To examine maternal and fetal outcomes of pregnancy-associated aplastic anemia treated with supportive care. METHODS: From January 1995 to December 2004, 14 women newly diagnosed as having pregnancy-associated aplastic anemia were recruited for the study. RESULTS: Diagnosis was made during the second or third trimester for 11 (78%) of the 14 patients, and 3 of the 8 severe cases of aplastic anemia were diagnosed at initial presentation. All patients had conservative management with transfusions but no specific immunologic or hormonal therapy during pregnancy. Of the 12 women eligible for follow-up, 1 achieved complete remission and 8 achieved partial remission after delivery. The pregnancies progressed uneventfully in most cases. CONCLUSIONS: This study demonstrated favorable maternal and neonatal outcomes with transfusion support alone for pregnancy-associated aplastic anemia.

Adult↗
PubMed2006

Relationship between inspiratory muscle strength and cough capacity in cervical spinal cord injured patients.

STUDY DESIGN: Prospective single centre study. OBJECTIVES: Pulmonary rehabilitation focuses on improving the expiratory muscle function in order to increase the reduced cough capacity in patients with cervical spinal cord injuries (SCI). However, an improvement in the inspiratory function is also important for coughing effectively. Therefore, this study was to examine the significance of the inspiratory muscle strength on the cough capacity in the patients with a cervical SCI. SETTING: SCI unit, Yonsei Rehabilitation Hospital, Seoul, Korea. METHODS: The vital capacity (VC), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) were measured. Moreover, the unassisted peak cough flow (PCF) and assisted PCF under three conditions were evaluated. RESULTS: All three assisted cough methods showed a significantly higher value than the unassisted method (P < 0.001). The VC correlated with the voluntary cough capacity and the MIP (R = 0.749) correlated more significantly with the VC than the MEP (R = 0.438) (P < 0.01). The MIP showed a higher correlation with both the unassisted PCF and all three assisted PCFs than the MEP (P < 0.001). CONCLUSIONS: The management of the inspiratory muscle strength should be considered in the pulmonary rehabilitation at cervical SCI patients.

Adult↗
PubMed2006

Effect of the intravesical resiniferatoxin instillation evaluated by the ice provocative urodynamic study.

STUDY DESIGN: Prospective urodynamic investigation before and after intravesical resiniferatoxin instillation treatment. OBJECTIVE: To evaluate the effectiveness of intravesical resiniferatoxin instillation for the treatment of neurogenic detrusor overactivity (NDO), using conventional and ice provocative urodynamic studies to monitor the activity of the unmyelinated C-fiber. SETTING: Spinal Cord Injury Unit, Yonsei Rehabilitation Hospital, Seoul, Korea. METHODS: A measure of 100 ml of resiniferatoxin solution, at a concentration of 100 nM diluted in 10% ethanol, was intravesically instilled into the bladder of 15 spinal cord injury patients with NDO. Conventional and ice provocative urodynamic studies were performed to evaluate the change in the involuntary detrusor activity, reflex volume, maximal bladder capacity, compliance, maximal detrusor pressure and reflex volume ratio 7 days before and 30 days after the instillation. RESULTS: Before the intravesical resiniferatoxin instillation, all patients exhibited NDO in both the conventional and ice provocative urodynamic studies, with a mean reflex volume ratio of 0.45+/-0.22. There was no significant change in the maximal bladder capacity, compliance and maximal detrusor pressure at the follow-up urodynamic study, but the reflex volume ratio was significantly increased (P<0.05) after the intravesical resiniferatoxin instillation. Among the 15 patients, three (20%) showed complete and nine (60%) partial suppression of the unmyelinated C-fiber activities. CONCLUSION: Intravesical resiniferatoxin instillation was partially controlled by the unmyelinated C-fiber activities, which were estimated by an ice provocative urodynamic study. Therefore, further studies on the optimal dosage and accurate indications for resiniferatoxin instillation are required.

Administration, Intravesical↗
PubMed2004

Elective vs. conservative management of ovarian tumors in pregnancy.

OBJECTIVES: To determine optimal management of the ovarian tumors in pregnancy. METHODS: This study included 89 cases of the ovarian tumor in pregnancy that required surgery at Holy Family hospital of the Catholic University from January, 1990 to December, 2001. Among 89 cases, 36 and 53 were emergency and elective surgery, respectively. Student's t-test and the chi(2)-test were used for statistical analysis and a P-value of <0.05 was considered statistically significant. RESULTS: The most common size of torsion of ovarian tumors during pregnancy was 6-10 cm and the incidence was the most frequent during the first trimester of pregnancy. The incidence of preterm delivery (<37 weeks) was higher in emergency surgery, but there was no difference in the gestational age at delivery, also no difference in the birth weight or the method of delivery. CONCLUSIONS: Although surgery for ovarian tumors in pregnancy is delayed until the onset of symptoms, adverse pregnancy outcome is not worsened when compared with that after elective surgery. We propose that conservative management would be used in optimal management of pregnant women with ovarian tumors.

Adult↗
PubMed2004

Verrucous carcinoma of the foot from chronic pressure ulcer.

STUDY DESIGN: This is a case report with literature review. OBJECTIVE: To describe a case of verrucous carcinoma, a rare histopathologic type, complicating a chronic pressure ulcer of duration less than 3 years. SETTING: The department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, USA. METHOD: A 24-year-old African-American male with long-standing incomplete paraplegia visited the wound clinic due to a pressure ulcer that had lasted for more than 1 year on the medial side of the right foot. Despite conservative management for almost 2 years after the initial visit, the ulcer is suspected to have undergone malignant transformation. Histological study led to the diagnosis of verrucous carcinoma that necessitated transtibial amputation on the right foot. RESULT: The carcinoma developed within 3 years, which was a relatively short time period for a pressure ulcer to have undergone malignant transformation. The diagnosis of verrucous carcinoma has never been reported as carcinoma complicating a pressure ulcer. No evidence of local recurrence or distant metastasis was seen in postoperative 10 months. CONCLUSION: The possibility of malignant transformation should be kept in mind in cases of pressure ulcers that are unresponsive to treatment or that show morphological changes suspected to be cancerous. Furthermore, early detection and intervention increases the probability for successful outcome.

Adult↗
PubMed2003

Expression of insulin-like growth factor-II and insulin-like growth factor binding protein-1 in the placental basal plate from pre-eclamptic pregnancies.

OBJECTIVES: To determine whether expressions of insulin-like growth factor-II (IGF-II) and insulin-like growth factor binding protein-1 (IGFBP-1) are altered in pre-eclamptic placenta and to elucidate the possible relationship between their expressions and a mechanism for inadequate trophoblast invasion in pre-eclampsia. METHODS: Placental tissues were obtained at cesarean delivery from five normotensive, nine mild pre-eclamptic and five severe pre-eclamptic women at 33-39 completed weeks of gestation. After total ribonucleic acid was extracted, reverse transcriptase-polymerase chain reaction was performed to determine IGF-II and IGFBP-1 mRNA expression. Product bands were quantitated by scanning densitometry and results were expressed as ratio of cytokines/beta-actin. Western blot analysis was also done to determine IGF-II and IGFBP-1 protein expression. Statistical analysis was determined by Kruskal-Wallis analysis of variance with the Scheffe multiple post-hoc test. RESULTS: The IGF-II mRNA levels of mild and severe pre-eclamptic placenta were significantly lower than that of uncomplicated placenta (P<0.005, P<0.001, respectively), with the level of severe pre-eclamptic placenta being significantly lower than that of mild pre-eclamptic placenta (P<0.05). As for the IGF-II protein expression, a significant decrease was found among the three groups (P<0.001), correlating with the IGF-II mRNA results. However, the mean IGFBP-1 mRNA levels of mild and severe pre-eclamptic placenta were significantly higher than that of uncomplicated placenta (P<0.05, P<0.005, respectively), with the level of severe pre-eclamptic placenta being significantly raised compared with that of mild pre-eclamptic placenta (P<0.05). Finally, a significant increase of IGFBP-1 protein expression was noted among the three groups (P<0.001), correlating with the IGFBP-1 mRNA results. CONCLUSIONS: This study suggests that IGF-II and IGFBP-1 might be associated with the impaired trophoblastic invasion that may lead to pathogenesis of pre-eclampsia.

Actins↗
PubMed2002

Significance of low compliance bladder in cauda equina injury.

STUDY DESIGN: Prospective investigation using serial urodynamic studies. OBJECTIVE: To evaluate type of neurogenic bladder and to observe changes of autonomous detrusor contraction (ADC) after the normalization of the compliance and capacity of the bladder in cauda equina injury. SETTING: Spinal Cord Injury Unit, Yonsei Rehabilitation Hospital, Seoul, Korea. METHODS: Urodynamic studies were performed in 50 patients with complete cauda equina injury from trauma with an infusion ratio of 30 ml/min. Findings of urodynamic studies and clinical features of patients with low compliance were compared with those of the normal compliant patients. Fourteen patients with low compliance received oral administration of oxybutynin and propiverine and intravesical instillation of oxybutynin to increase the compliance and capacity of the bladder, and follow-up urodynamic studies to monitor the change were undertaken. RESULTS: Bladder compliance was decreased in 14 (28%) patients and normal in 36 (72%) patients. There was a significantly long time interval between the onset of injury and the initiation of rehabilitative treatment in the neurogenic bladder group with low compliance when compared to those of the normal compliance group (P < 0.05). Clean intermittent catheterization was used as the voiding method, significantly less than the normal compliance group (P < 0.05). ADC was observed in six out of fourteen patients with low compliance neurogenic bladder, but none in the normal compliance group. Upon the completion of conservative treatment, ADC disappeared in four patients whose compliance and capacity of the bladder were normalized on follow-up urodynamic studies. CONCLUSION: ADC was only observed in the low compliant bladder and as ADC disappeared when compliance and capacity of the bladder was normalized; low compliance appeared to be the main cause of ADC. In addition, this study supports that the maintenance of compliance of the bladder may be the most important factor in the management of neurogenic bladder.

Administration, Intravesical↗
PubMed2001

Involvement of phospholipase D in oxidative stress-induced necrosis of vascular smooth muscle cells.

Phospholipase D (PLD) has been associated with necrosis. However, it is not clear whether PLD plays a causative role in this cellular process. We investigated the role of PLD in oxidative stress-induced necrosis of vascular smooth muscle cells (VSMCs). Pervanadate (hydrogen peroxide plus orthovanadate) but not hydrogen peroxide alone activated PLD in a dose- and time-dependent manner. Exposure of VSMCs to pervanadate resulted in necrosis. Pretreatment with butan-1-ol, a PLD inhibitor, attenuated both pervanadate-induced necrosis and increase of intracellular Ca(2+). Removal of extracellular Ca(2+) inhibited pervanadate-induced necrosis by 50%. These results suggest that PLD activation mediates pervanadate-induced necrosis of VSMCs, which is at least partly due to Ca(2+) toxicity.

Animals↗
PubMed2001

Protease activity and host cell binding of the 42-kDa rhoptry protein from Toxoplasma gondii after secretion.

Three proteases were identified in the excretory/secretory proteins (ESP) from Toxoplasma gondii by the gelatin acrylamide gel electrophoresis (GAGE), of which the molecular masses were 80, 70, and 42 kDa. One of the proteases with 42 kDa was reactive to a monoclonal antibody (mAb), Tg786 clone, which was localized in the rhoptry of T. gondii by immunohistochemistry. The protease was maximally active at the pH range between 7.5 and 8.5, and was sensitive to inhibition by TPCK and EGTA. The gelatinolytic activity of the protease was dependent on the concentration of calcium ion. The protease was active only in the millimolar ranges of calcium but not in micromolar ranges, implicating that the secretion is critical event for the activation of the protease. The secreted protease was shown to bind to the host cells upon Western blot and immunofluorescence analysis. It is suggested that the protease may target to the plasma membrane of the host cells, which provides appropriate environment for the entry of the parasite into host cells. The mAb (Tg786) of T. gondii also reacted with a protein of the same size and equivalent locality of rhoptry in Neospora caninum, a similar Apicomplexan protozoa, suggesting that secreted protease mediates a common function in the mechanism of entry into host cells.

Animals↗
PubMed2001

Spectral analysis of fetal heart rate variability as a predictor of intrapartum fetal distress.

OBJECTIVE: To evaluate the usefulness of power spectral analysis on fetal heart rate variability as a new diagnostic method of fetal distress. STUDY DESIGN: Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into three groups: normal fetus group (36); presumed distress group (26); and acidemic distress group (14). In order to perform linear analysis on the raw data of the fetal heart rate, after resampling, we performed Fourier transformation and investigated power distributions among very low frequency (VLF), low frequency (LF), high frequency (HF) bands, and autonomic balance (LF/HF). RESULTS: The results of the spectral analysis showed that in normal fetus group, the difference in the distribution of power spectrums of VLF, LF and HF was significantly higher than in presumed distress group and acidemic distress group. In fetal distress, the LF and VLF value (< or = 0.0023, > or = 0.0437) were good predictors (sensitivity 97.5%, 75.0% and specificity 86.1%, 94.4%). The LF value (< or = 0.0013) was a good predictor in fetal acidemia (sensitivity 97.5% and specificity 86.1%). CONCLUSIONS: A computerized spectral analysis of fetal heart rate variation is a good predictor of fetal distress, which is made automatically and objectively.

Adult↗
PubMed2001

Molecular cloning and characterization of peroxiredoxin from Toxoplasma gondii.

A cDNA of 1.1 kb comprising the gene encoding the peroxiredoxin of Toxoplasma gondii (TgPrx) has been cloned. The open reading frame of 591 bp was translated into a protein of 196 amino acids with a molecular mass of 25 kDa. Conserved 2 cysteine domains of Phe-Val-Cys-Pro and Glu-Val-Cys-Pro indicated TgPrx belonged to 2-Cys Prx families. TgPrx showed the highest homology with that of Arabidopsis thaliana by 53.9% followed by Entamoeba histolytica with 39.5% by the amino acid sequence alignment. Polyclonal antibody against recombinant TgPrx detected 25 kDa band in T. gondii without binding to host cell proteins. TgPrx was located in the cytoplasm of T. gondii extracellularly or intracellularly by immunofluorescence assay. The expression of TgPrx was increased as early as 30 min after the treatment with artemisinin in the intracellular stage, while no changes in those of host Prx I and TgSOD. This result implies that TgPrx may function as an antioxidant protecting the cell from the attack of reactive oxygen intermediates. It is also suggested that TgPrx is a possible target of chemotherapy.

Amino Acid Sequence↗
PubMed2000

Prosthetic ambulation in a paraplegic patient with a transfemoral amputation and radial nerve palsy.

Great importance and caution should be placed on prosthetic fitting for a paraplegic patient with an anesthetic residual limb if functional ambulation is to be achieved. The combination of paraplegia with a transfemoral amputation and radial nerve palsy is a complex injury that makes the rehabilitation process difficult. This article describes a case of L2 paraplegia with a transfemoral amputation and radial nerve palsy on the right side. Following the rehabilitation course, the patient independently walked using a walker at indoor level with a transfemoral prosthesis with ischial containment socket, polycentric knee assembly, endoskeletal shank and multiaxis foot assembly and a knee ankle foot orthosis on the sound side. The difficulties of fitting a functional prosthesis to an insensate limb and the rehabilitation stages leading to functional ambulation are reviewed.

Adult↗
PubMed1999

Expression of ICAM-1 on conjunctival epithelium and ECP in tears and serum from children with allergic conjunctivitis.

BACKGROUND: Conjunctival eosinophilia may be considered to be an indicator of conjunctival allergic disease. The absence of eosinophils on conjunctival scraping, however, cannot rule out the diagnosis of allergic conjunctivitis because eosinophil infiltration may be deeper in conjunctival tissue. Eosinophil cationic protein (ECP) is a toxic product secreted by activated eosinophil as a marker of eosinophil activation. Eosinophil cationic protein concentrations in body fluids correlate with the severity of some allergic diseases. ICAM-1 promotes adhesion of leukocytes to epithelium, endothelium, and upregulates inflammation. Expression of adhesion can be modified by many extracellular and intracellular variables such as proinflammatory cytokines, extracellular matrix proteins, and viral infection. OBJECTIVE: We investigated whether local eosinophils are only activated in conjunctival epithelium or circulating activated eosinophils are involved in peripheral blood during allergic reaction of the eye. We also demonstrated the possible expression of ICAM-1 on epithelial cells from conjunctival scraping and compared them with soluble ICAM-1 values of serum and tears in children with allergic conjunctivitis and healthy children. METHODS: Seventeen subjects were selected on the basis of clinical manifestations, history, skin prick test, and total serum IgE. A microcapillary tube was used to collect the tears from the inner canthus. Conjunctival epithelia were obtained by scraping the upper tarsal conjunctiva. The level of ECP was measured by the CAP system, soluble ICAM-1 was measured by ELISA, and ICAM-1 on conjunctival epithelial cells were expressed by the avidine-biotin peroxide complex procedure. RESULTS: Serum IgE and the eosinophil count were increased in 10 out of 17 patients, positive skin prick tests were positive in 11 patients (Dermatophagoides pternyssinus; 9, Dermatophagoides farinae: 8), and eosinophilia in conjunctival epithelium was in 11 patients (4 patients: >3/HPF, 7 patients: 1-3/HPF). The ECP levels in tears were significantly increased in the patient group (12.0+/-8.0 versus 3.9+/-3.8 microg/mL, P = .01), but not in serum (52.5+/-43.1 versus 28.3+/-25.9 microg/mL). There is significant correlation between the eosinophil count in peripheral blood and on conjunctival epithelium (P = .007, r = .62; n = 25). The ICAM-1 expression score on conjunctival epithelial cells was significantly different between the patient group and controls (patient group: 1.77+/-1.25 versus control: 0.13+/-0.35 ng/mL, P = .002). There was a significant correlation between ICAM-1 expression on conjunctival epithelial cells and the ECP levels of tears (P = .01, r = .58; n = 25). Soluble ICAM-1 levels in serum and tears showed no significant difference between the patient group and controls, and also, there was no correlation between sICAM-1 levels in the serum and tears. CONCLUSION: Eosinophil cationic protein in tears and ICAM-1 expression scores on conjunctival epithelium showed a significant difference between children with allergic conjunctivitis and the healthy controls, but circulating ECP and sICAM-1 in serum were not significantly different between the two groups. These results may suggest that ICAM-1 is locally upregulated in inflammation, mediating eosinophil activation and migration to conjunctival epithelium, but is not involved as inflammatory mediators in peripheral blood during allergic response in children with allergic conjunctivitis.

Adolescent↗
PubMed1999

Experimental observation of a torus-doubling transition to chaos near the ferroelectric phase transition of a KH2PO4 crystal.

A ferroelectric KH2PO4 crystal is implemented in a simple series connection of an RLC circuit and the transition to chaos near the phase-transition temperature is investigated. The torus-doubling scenario to chaos, the theory of which was expounded by Kaneko for high-dimensional dynamical systems, has been found in the crystal. These experimental results suggest that observation of the nonlinear dynamical behavior in condensed matter can give much information about the correlation between the generation of nonlinearity and the order-parameter dynamics of the crystal near the phase-transition temperature.

Journal Article↗
PubMed1999

Distribution of proteoglycans in the human trabecular meshwork: histochemical electron microscopic findings with cuprolinic blue.

The distribution of sulfated proteoglycans (PGs) in the normal human trabecular meshwork was studied by histochemical electron microscopy using the cationic dye, cuprolinic blue (CB).. The trabecular meshwork was obtained from human enucleated eyes and incubated for three days. After incubation, they were stained with 0.2% CB at a critical electrolyte concentration and prepared for histochemical electron microscopy. Ultrastructurally, PG-CB complexes were found as small punctate or filamentous structures, and were associated with collagen fibrils in the cores of the trabecular beams and the basal laminae of trabecular endothelial cells. In addition, large filamentous PG-CB complexes were mainly associated with areas of amorphous extracellular matrix between the collagen fiber bundles and in the fine fibrillar material near the basal laminae of endothelial cells of Schlemm's canal. This investigation resulted in an illustration of the ultrastructural distribution of PGs in the human trabecular meshwork. Further studies will be needed to specify the nature of PGs and their role in the aqueous outflow system.

Cells, Cultured↗
PubMed1999

Palpebral myiasis.

Myiasis is most prevalent in Mexico, central and south America, tropical Africa, and the southwestern United States. Although dermal myiasis is rare in most of the United States, it is a disorder that may be seen in international travelers. In the United States, external myiasis is usually caused by the cattle botfly. We report here a case of ophthalmomyiasis involving the left upper eyelid of a child. We examined a six-year-old boy who presented to the Massachusetts Eye and Ear Infirmary (MEEI) in September 1998. He complained of persistent swelling of his left upper eyelid for the previous ten days. The edema and erythema were unresponsive to warm compresses and oral antibiotics. Ocular examination revealed a mild preseptal cellulitis of the left upper eyelid with a small draining fistula. On slit-lamp examination, we found one larva protruding intermittently from the fistula site. The larva was extracted with forceps, wrapped in a moist towel and sent in a jar to the parasitology laboratory. The specimen was identified as a Cuterebra larva by a parasitologist at the Harvard School of Public Health. One week later, the patient's eyelid edema and erythema had completely resolved.

Animals↗
PubMed1999

Prospective evaluation of perinatal risk factors for cerebral palsy and delayed development in high risk infants.

Prematurity, intrauterine infection and perinatal brain injury have been reported to be significant risk factors of cerebral palsy (CP). We examined the perinatal predictors of cerebral palsy and delayed development (DD) in 184 high risk infants. Thirty-five infants were diagnosed as cerebral palsy and delayed development at 12 months corrected age. Antenatal, intrapartum, and neonatal factors were prospectively evaluated in 2 groups of high risk infants compared with controls; Group A (n = 79), infants weighing less than 2,000 g; Group B (n = 43), infants weighing 2,000 g or more. In univariate analysis, there were no significant antenatal and intrapartum factors associated with cerebral palsy and delayed development in either group. We found that significant postnatal risk factors of CP in group A included sepsis (p = 0.008), BPD (bronchopulmonary dysplasia) (p = 0.028), IVH (intraventricular hemorrhage) (p = 0.042), ventriculomegaly (VM) (p = 0.001) and a longer duration of mechanical ventilation (p = 0.001); while in group B, sepsis (p = 0.047) and neonatal seizure (p = 0.027) were significant risk factors. In multivariate analysis, sepsis in group B was a moderate risk factor of CP (OR (odds ratio) 1.47; 95% CI (confidence interval) 1.02-2.13). In conclusion, neonatal sepsis may contribute to the development of cerebral palsy and delayed development. We suggest that high risk infants who have sepsis should be carefully followed for cerebral palsy and delayed development. The prevention of cerebral palsy may be feasible by decreasing neonatal risk factors such as sepsis during the neonatal period.

Cerebral Palsy↗