Biomedical subjects

John J Kim

Publications and source records attributed to John J Kim.

7 recordsLinked to original sources

PubMed2005

Repopulation of cancer cells during therapy: an important cause of treatment failure.

Radiotherapy and chemotherapy are given in multiple doses, which are spaced out to allow the recovery of normal tissues between treatments. However, surviving cancer cells also proliferate during the intervals between treatments and this process of repopulation is an important cause of treatment failure. Strategies developed to overcome repopulation have improved clinical outcomes, and now new strategies to inhibit repopulation are emerging in parallel with advances in the understanding of underlying biological mechanisms.

Antineoplastic Agents↗

PubMed2005

Mouse embryonic stem cells for quality control testing in assisted reproductive technology programs.

OBJECTIVE: To compare the mouse embryonic stem (ES) cell assay with the sperm motility test or 1-cell mouse embryo bioassay for embryotoxic materials. STUDY DESIGN: Cryo-preserved-thawed mouse ES-D3 cells, 1-cell mouse embryos and donor sperm were incubated for 1-4 days in culture medium exposed to a control and 4 different test materials. ES cell viability (eosin method), apoptosis (Sybr-Gold fluorescence), development of blastocysts and sperm motility parameters were measured. RESULTS: The initial viabilities of ES cell were determined to be 37.0 +/- 4.2% (n = 225) and 54.8 +/- 7.4% (n = 218) by the eosin and Sybr Gold methods, respectively. Reduced viability of ES cells in latex glove-treated medium (25.6 +/- 0.3% and 25.7 +/- 0.3% versus control, 32.8 +/- 0.2% and 33.5 +/- 1.0% by eosin or Sybr Gold, respectively, p < 0.05) was consistent with standard bioassays. However, toxicity in the syringe was detected only by the ES cell assay. The ES cell assay sensitivities were 33% and 67% (eosin and Sybr Gold methods, respectively), and specificities were 100% for both methods. CONCLUSION: Mouse ES cell assay based on Sybr-Gold asssessment was as effective as standard bioassays for detecting embryotoxicity. The results suggested that the mouse ES assay could be used for testing contact materials and DNA-modifying agents. More studies are needed to refine and enhance the sensitivity of the ES cell assay for routine use in assisted reproductive technology clinics.

Animals↗

PubMed2002

Health-related quality of life associated with irritable bowel syndrome: comparison with other chronic diseases.

BACKGROUND: Despite the rapidly growing body of literature on health-related quality of life (HRQoL). placing the results in a context that is meaningful to clinicians and patients is often overlooked. OBJECTIVE: This study sought to quantify the impact of irritable bowel syndrome (IBS) on HRQoL by comparing the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) scores of IBS patients with normative US data and with the scores of patients having other chronic gastrointestinal (GI) and non-GI disorders. METHODS: Two IBS reference groups were identified from the published literature: a largely untreated community sample of health maintenance organization (HMO) members (N = 92) and a sample of patients with IBS recruited through clinics and in the community (N = 140). SF-36 scores for these groups were compared with published US population norms (N = 2474) and with published scores for 3 other IBS samples (N = 464); a sample with other chronic GI disorders (dyspepsia [N = 126], gastroesophageal reflux disease [GERD] [N = 516]); and samples with other chronic episodic disorders (asthma [N = 375], migraine [N = 303], panic disorder [N = 73], rheumatoid arthritis [N = 693]). RESULTS: The scores of patients in both IBS reference groups were significantly lower on several SF-36 domains than those of the US normative population (P < 0.003). Scores on several SF-36 scales were also significantly lower in the IBS reference groups compared with the GERD, asthma, and migraine samples (P < 0.003). Depending on the IBS sample used, scores did not differ or were higher compared with those in the sample with dyspepsia. Relative to the samples with panic disorder and rheumatoid arthritis, the IBS groups had significantly higher scores on most SF-36 domains (P < 0.003). Scores for the HMO reference group were generally higher than those for the clinic/community reference group. CONCLUSIONS: Based on the results of this analysis, IBS is associated with impairment of HRQoL relative to US population norms and to populations with GERD, asthma, or migraine. HRQoL appears to be greater in patients with IBS than in those with panic disorder or rheumatoid arthritis, although the relative symptom severity in these samples was not known.

Activities of Daily Living↗

PubMed2000

Medical errors: how the US Government is addressing the problem.

November's Institute of Medicine (IOM) report on medical errors has sparked debate among US health policy makers as to the appropriate response to the problem. Proposals range from the implementation of nationwide mandatory reporting with public release of performance data to voluntary reporting and quality-assurance efforts that protect the confidentiality of error-related data. Any successful safety program will require a national effort to make significant investments in information technology infrastructure, and to provide an environment and education that enables providers to contribute to an active quality-improvement process.

Journal Article↗

PubMedDate not supplied

Impact of anemia on hospitalization time, charges, and mortality in patients with heart failure.

OBJECTIVES: Although anemia is known to influence clinical outcomes in heart failure (HF) patients, little is known about its impact on economic outcomes. A retrospective analysis was performed to determine the impact of hemoglobin (Hb) level on hospital length of stay (LOS), total charges, and hospital mortality in HF patients. METHODS: Claims data were drawn from 21 teaching and nonteaching hospitals for patients hospitalized between October 1, 2000 and September 30, 2001. The impact of Hb on LOS, charges, and hospital mortality was determined using multivariate analyses. Two-stage least squares regression methods were used to assess the potential endogeneity of the economic outcomes (LOS and total charges) and Hb level. RESULTS: Of the 8569 patients in the analysis, 40.2% had Hb < 12 g/dl and 73.8% were > or = 70 years of age. Hemoglobin had significant independent effects on all three outcomes. A 1 g/dl increase in Hb was associated with a 5.1% reduction in LOS (P < 0.001), a 4.3% decrease in charges (P < 0.001), and an 8.7% reduction in mortality risk (P < 0.001). The impact of Hb on all outcomes was greatest in younger HF patients. CONCLUSIONS: This analysis demonstrates that higher Hb is associated with reductions in LOS, charges, and mortality in hospitalized HF patients. Further clinical studies are necessary to validate the cost effectiveness of pharmacologic intervention in anemic HF patients and its impact on patient care.

Adolescent↗

PubMedDate not supplied

Resource use and patient care associated with chronic kidney disease in a managed care setting.

OBJECTIVE: To describe the resource utilization and care of chronic kidney disease (CKD) patients in a managed care plan. METHODS: This was a retrospective claims analysis of a nationwide managed care medical and pharmacy database from September 1, 1998, to July 31, 2001. Twenty-seven health plans in 19 states distributed across the Northeast, Southeast, Midwest, and Southwest United States were represented in this analysis. CKD patients were identified using ICD-9 CM, CPT-4, and HCPCS codes indicative of dialysis. Patients continuously enrolled for at least 6 months before and 3 months after an initial dialysis event were included in the study. Health care charges and associated clinical information were assessed during 3 time periods: predialysis was from the sixth through the second month before initial dialysis, peridialysis was 30 days before and 30 days after initial dialysis, and postdialysis was the second and third month after initial dialysis. The main outcome measures were total health care charges, primary diagnoses, and diagnosis- related groups (DRGs). RESULTS: The per-patient-per-month charges were 4,265 dollars in the predialysis period (average for 5 months), 35,292 dollars in the peridialysis period (average for 2 months), and 15,399 dollars in the postdialysis period (average for 2 months). The most common primary diagnosis categories during all time periods were chronic renal failure and congestive heart failure. Similarly, the most common DRGs were related to renal and heart failure. A total of 38.2% of patients did not have an initial nephrologist visit until the first dialysis event. Treatments with nutritional supplements and medications such as angiotensin-converting enzyme inhibitors and erythropoietin were found to be suboptimal. CONCLUSION: CKD patients generate significant medical charges during the predialysis period and after initiation of dialysis. Further investigations are warranted to assess the impact of active management of CKD patients on CKD-related health care expenditures in kidney disease.

Adolescent↗

PubMedDate not supplied

Satisfaction with onychomycosis treatment. Pulse versus continuous dosing.

The purpose of this study, which involved two dermatology clinics and two podiatric medical clinics, was to determine whether a difference exists in patient-reported satisfaction and compliance between continuous terbinafine therapy and pulse-dose itraconazole therapy for the treatment of toenail onychomycosis. Patients in this multicenter, open-label, cross-sectional study had previously completed treatment with either oral terbinafine or oral itraconazole for toenail onychomycosis. Patients were interviewed by telephone to assess clinical outcomes, compliance, and satisfaction with treatment; clinical data were collected by medical chart review. Patients reported significantly greater ease and convenience of treatment and higher overall satisfaction with continuous terbinafine therapy compared with pulse-dose itraconazole therapy.

Adolescent↗