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Biomedical subjects

J Y Shim

Publications and source records attributed to J Y Shim.

24 records · Page 2Linked to original sources
PubMed1996

The physicians' recognition and attitude about patient education in practice.

The purpose of this study was to investigate the current status of physicians' recognition and their attitude towards patient education in actual clinical practice. We sent surveys containing self-questionnaires to one-hundred and fifty physicians in five university hospitals and one general hospital from the period of April to July 1995. The self-questionnaire was designed to evaluate the physicians' recognition and attitude towards patient education at his or her clinical practice. A total of 137 answered-sheets were returned and they were subsequently analyzed. 1) The frequency of physicians' recognition of patient education as an essential component in practice was 76.6%. There was a significant difference between family physicians and other physicians, 97.1% 69.6%, respectively (p = 0.03). 2) The frequency of physicians' accomplishment of a satisfactory doctor-patient relationship was 51.1%; board certified physicians and residents, 79.4%, 43.3%, respectively (p = 0.001). 3) The percentage of physicians who explained details about examinations and procedures was 73.0%, who interpreted the findings of exams, tests and x-rays 72.3%, but who assessed patient readiness to modify behavior was only 29.9%. The frequency of physicians' education to patient about the biomedical diagnosis and treatment was high, but that of physicians' approach towards patient as a biopsychosocial model was relatively low. Therefore, it is concluded that much more time and emphasis should be placed on patient education in the undergraduate and postgraduate medical education curricula.

Adult↗
PubMed1995

Computational modeling of a putative fetal alcohol syndrome mechanism.

Fetal alcohol syndrome (FAS) refers to a pattern of birth defects occurring in a subpopulation of children born to women who consume alcohol during pregnancy. The significant medical, social, and economic impact of FAS is increasing. Particularly hard-hit are African-American and native-American women and children. Over the past two decades, basic and clinical research produced voluminous data on ethanol effects on developing organisms. In 1991, Duester and Pullarkat proposed that competition of ethanol with retinol at the alcohol dehydrogenase (ADH) binding site formed the basis of the FAS mechanism. This competition adversely affects the developing fetus caused by deregulation of retinoic acid (RA) homeostasis essential for proper fetal tissue development. Stated concisely, the FAS hypothesis is: 1. Class I ADH catalyzes the rate-limiting step in oxidation of retinol (ROH) to RA, and ethanol (ETOH) to acetic acid, thus establishing competition for ADH between ROH and ETOH. 2. RA is required as a signal molecule for cell differentiation critical for normal fetal morphogenesis. 3. ADH binds ingested ETOH, thus deregulating RA homeostasis leading to improper RA signal transduction. Preliminary results from molecular modeling studies of ROH-ADH and ETOH-ADH structures, and physiologic pharmacokinetic modeling confirm the hypothesis with remarkable fidelity.

Alcohol Dehydrogenase↗
PubMedDate not supplied

Serous retinal detachment in a patient with rhino-orbital mucormycosis.

BACKGROUND: Rhino-orbital mucormycosis is a difficult disease to treat. We report one case of rhino-orbital mucormycosis, complicated by serous retinal detachment, that responded to aggressive treatment. CASE: A 38-year-old man with diabetic ketoacidosis was referred to the emergency department of our hospital with fever, proptotic right eye, and complaint of lethargy. OBSERVATIONS: Fundus examination showed serous retinal detachment and focal lesions of retinitis with exudate at the inferior portion coincident with the position of opacification in the orbit on MRI. Fluorescein angiography showed pooling of dye in the detached retina and leakage from focal lesions of retinitis. We thoroughly removed the large necrotic materials in the orbit and sinus through the lower conjunctiva without enucleation or exenteration. Microscopic examination and culture of the necrotic materials that were removed from the orbit proved that the patient had mucormycosis. The serous retinal detachment improved 10 days after orbital debridement combined with intravenous and local (intraorbital) amphotericin B treatment. Visual acuity recovered to 20/50. CONCLUSION: We propose that inflammation of the sclera in close contact with necrotic fungi materials may cause serous retinal detachment.

Adult↗
PubMedDate not supplied

Conformational aspects of glutathione conjugates of chlorinated alkenes: a computational study.

The nephrotoxicity of halogenated alkenes is due to the beta-lyase mediated bioactivation of the hepatic glutathione (GS) conjugate to mutagenic or cytotoxic reactive species in kidney. Experimental evidence obtained for regioisomers and geometric isomers of haloalkene GS conjugates indicates that different isomers may be metabolized and excreted at different rates, follow different metabolic pathways, and exhibit different toxicities. Computational methods were applied in the present work to a conformational study of GS-haloalkene conjugates to determine the relative stabilities of possible regioisomers and geometric isomers of the conjugates. The halogenated alkenes studied were 1,1,2-trichloroethylene (TCE), hexachloro-1,3-butadiene (HCBD), and 1,1,2-trichloro-3,3,3-trifluoro-1-propene (TCTFP). Calculated energies of GS conjugate products were used to approximately infer relative product abundance under synthetic and in vivo conditions. This approach neglects differential solvent effects and enzyme selectivity and assumes a late transition state for GS conjugation and/or some thermodynamic control of the conjugation process. Relative population predictions of GS conjugate isomers, based on computed energies, were in agreement with experimental synthetic and in vivo isomer determinations in the case of TCE, where careful analytical characterization of the isomers was definitive. In the case of HCBD, where analytical determinations were not performed and isomer assignments were based on general reactivity concepts, calculations from the present study supported one GS conjugate isomer assignment and disagreed with the other. Finally, in the case of TCTFP, the calculations predicted that three isomers would have similar populations, whereas only two were detected in the experimental study.

Alkenes↗
PubMedDate not supplied

Lipoblastoma of the parietal pleura in a 7-month-old infant.

A 7-month-old infant boy with pleural lipoblastoma is presented. The diagnosis was confirmed by operation. Radiologic findings consisted of a pleura-based mass with well-defined margin. The main differentiation is from liposarcoma, which is extremely rare in children under 3 years of age.

Adipocytes↗