PubMed Health⌕ Search

Biomedical subjects

K D Kim

Publications and source records attributed to K D Kim.

At least 19 recordsLinked to original sources

The three-dimensional microstructure of the trabecular bone in the mandible.

This study investigated the three dimensional (3D) trabecular microstructure of the alveolar and basal bone in the mandible using micro-CT and compared the morphometric values of the different sites. Ten specimens were prepared and scanned using a micro-CT system. Both the alveolar and basal trabecular bone of the premolar region in the mandible were measured for the structural analysis. Cross-sectional 1024x1024 pixel images were created. From the two-dimensional (2D) images produced, 3D structural images were reconstructed. After scanning the specimen, the volumes of interest (VOI) of the alveolar and basal bone regions were selected from the 3D reconstruction images, and the structural parameters such as bone volume fraction, bone surface density, trabecular thickness, trabecular separation, trabecular number and structural model index were analyzed. The trabecular structure showed a marked variation within the sites of the specimen, especially in the basal trabecular bone inferior to the mandibular canal. In both the alveolar and basal bone regions, a mixture of both plate-like and rod-like structures was observed. The alveolar region showed a more compact, plate-type trabecular structure than the basal regions. In parametric comparison with the basal bone, the alveolar bone generally had a higher bone volume fraction, bone trabecular thickness and trabecular number, and lower bone surface density, trabecular separation and structural model index. The alveolar bone consisted of a compact bone structure with a large amount of thick plate-type trabecular bone, which was effectively resistant to the masticatory forces. As the measurements were made closer to the basal bone, a loose structure was observed with lower bone volume and fewer, thin, rod-like trabeculae.

Adult↗

Inflammatory orbital pseudotumor with infratemporal fossa extension mimicking temporomandibular joint dysfunction.

Inflammatory orbital pseudotumor is a benign space-occupying lesion of unknown origin that involves all or part of the fatty tissue within the orbit. Occasionally the disease may extend into the middle cranial, the pterygopalatine, and the infratemporal fossa through the various foramina of the orbit, although extension into the infratemporal fossa is very rare. We present a case which extends into the infratemporal fossa through the inferior orbital fissure, resulting in presenting symptoms mimicking temporomandibular joint dysfunction.

Adult↗

Knowledge and attitudes of Korean parents towards their son's circumcision: a nationwide questionnaire study.

OBJECTIVE: To evaluate knowledge about the foreskin and circumcision, and to understand the attitudes of parents to circumcision in Korea, where circumcision in childhood is widely practised with no particular religious or medical background. SUBJECTS AND METHODS: A nationwide study involving questionnaires was conducted on 5500 parents with at least one son attending elementary school. Responses were obtained from one of the parents. RESULTS: The response rate was 76.1% (4183); circumcision was most common in boys when aged 11 years, followed by neonatal circumcision. Of the parents, 91.3% believed that circumcision is necessary, while 2.1% believed it to be unnecessary. The principal reasons given for circumcision were 'to improve penile hygiene' (82.4%), followed by 'to improve future sexual potency' (7.5%). Among those who did not believe circumcision to be necessary, the most common reason was the expectation of spontaneous retraction of the prepuce with age (55.1%). Most (88.4%) of the parents believed that smegma is not a clean material, and is infected by microorganisms. Most parents (80.6%) thought that circumcision would prevent genital tract infection of the future spouse. Peer pressure was one of the most influential factors in deciding upon circumcision; 41.9% of the parents were anxious that their child might be ridiculed by his peer group unless he was circumcised, while 27.4% of the parents believed that their child might be ridiculed if he was circumcised. Mothers were more positive about circumcision than fathers (P < 0.05). Parents with a higher education and higher socio-economic status were also more positive about circumcision (P < 0.05). Mothers were prone to emphasize improved sexual potency (P < 0.05). There was no significant difference in response between urban and rural areas. CONCLUSION: This study indicates that common beliefs held by parents about the prepuce or circumcision differ significantly from current medical knowledge, and these beliefs have a major influence on the practice of circumcision in Korea. More clinical research on the natural history of the foreskin is needed, and it is critical that both children and parents are informed about the potential benefits and disadvantages of circumcision.

Adolescent↗

Cloning and characterization of a type II integral transmembrane protein gene, Itm2c, that is highly expressed in the mouse brain.

An Itm2C cDNA encoding a member of the mouse type II integral transmembrane protein (Itm2) was cloned from a mouse 13.5 days' post-coitum (dpc) embryonic head cDNA library. The nucleotide sequence and protein prediction analyses indicate that the membrane topology of the mouse Itm2c is a type II integral transmembrane protein with the N-terminus being intracellular and C-terminus, which is considered as either an extracellular or a luminal organelle domain. The predicted protein consists of 269 amino acids with a calculated Mr of 30,482 and a theoretical pI of 8.83. A putative N-glycosylation site was identified at amino acid 171, Asn. The single N-glycosylation site is conserved in the three members of the family in both mice and humans. The amino acid sequence of Itm2C is 41 and 49% identical to those of mouse Itm2A and Itm2B, respectively. A single approximately 2.1 kb transcript was detected with different levels in all of the tissues examined by Northern blot analysis. The Itm2c was highly expressed in both adult and postimplantation embryonic brains, although weak or moderate signals were also detected in other adult tissues. Among the tissues examined, RT-PCR analyses in various adult tissue shows that the Itm2c expression is highest in the adult brain. The results from this study suggest that the cloned Itm2c is a member of the Itm2 family that is specifically expressed in adult brains, unlike other members.

Amino Acid Sequence↗

Apoptosis-linked gene 2 binds to the death domain of Fas and dissociates from Fas during Fas-mediated apoptosis in Jurkat cells.

Apoptosis-linked gene 2 (ALG-2) is a member of the family of Ca(2+)-binding proteins with penta-EF-hand and is essential for the execution of apoptosis by various signals including Fas activation. We studied the regulation of ALG-2 during Fas-mediated apoptosis in Jurkat cells. The 22-kDa ALG-2 protein is cleaved and becomes a 19-kDa protein after Fas activation. The appearance of 19-kDa ALG-2 protein increases for 4 h after treatment with 200 ng/ml of anti-Fas Ab treatment and gradually degrades afterward. Confocal microscopic analysis showed that ALG-2 translocated from the plasma membrane to the cytosol during Fas-mediated apoptosis. Therefore, we examined if ALG-2 interacts with Fas. The protein-protein interaction of ALG-2 with Fas was demonstrated using yeast two-hybrid assays as well as in vitro GST pull-down assay. Endogenous ALG-2 was immunoprecipitated with anti-Fas Ab in Jurkat cells without Fas activation. However, the endogenous ALG-2 was no longer immunoprecipitated with anti-Fas Ab 2 h after anti-Fas Ab treatment. This study, for the first time, presents a direct molecular connection of ALG-2 to apoptosis by its direct interaction with Fas, and enlists ALG-2 as a new member of posttranslationally modified proteins during Fas-mediated apoptotic process.

Apoptosis↗

alpha(6) Integrin is the main receptor of human papillomavirus type 16 VLP.

The present study was performed to determine the specific receptor of type HPV-16 using recombinant human papillomavirus-like particle (HPV-16 L1-VLP). The expression levels of alpha(6), beta(1), and beta(4) integrins were determined and compared with the amount of HPV-VLP binding in ten cell lines by flow cytometry. Our results show that the amount of VLP binding and the expression level of alpha(6) integrin are correlated, which was confirmed by an inhibition experiment using antibodies and by immunocytochemistry. Both the expression level of alpha(6) integrin and the amount of HPV-VLP binding were high in cervical cancer cell lines, as the type HPV-16 is the main cause of cervical cancer. The degree of binding of HPV-VLP matched the alpha(6) integrin expression level in cell lines but was not correlated with beta(1) and beta(4) levels, which suggests that alpha(6) integrin is the main receptor of HPV type 16.

Animals↗

Computer-assisted thoracic pedicle screw placement: an in vitro feasibility study.

STUDY DESIGN: In this cadaveric study, a computer-assisted image guidance system was tested for accuracy of thoracic pedicle screw placement. OBJECTIVES: Evaluate the system's accuracy for thoracic pedicle screw placement in vitro. SUMMARY OF BACKGROUND DATA: The effective use and reliability of pedicle screw instrumentation in providing short-segment stabilization and correction of deformity is well known in the lumbar spine. Pedicle screw placement in the thoracic spine is difficult because of the small dimensions of the thoracic pedicles and risk to the adjacent spinal cord and neurovascular structures. Investigators have shown the improved accuracy of computer-assisted lumbar pedicle screw placement; but the accuracy of computer-assisted thoracic pedicle screw placement, which is becoming more widely used, has not been shown. METHODS: In five human cadavers, 120 thoracic pedicle screws were placed with computer-assisted image guidance. The largest clinically feasible screw was used based on the cross-sectional dimensions of each pedicle. The accuracy was assessed by postoperative computed tomography and visual inspection. RESULTS: The overall pedicle cortex violation was 23 of 120 pedicles (19.2%). Nine violations (7.5%) were graded as major and 14 (11.7%) as minor. A marked and progressive learning curve was evident with the perforation rates that decreased from 37.5% in the first cadaver to 4.2% in the last two cadavers. CONCLUSIONS: Accurate thoracic pedicle screw placement is feasible with computer-assisted surgery. However, as with any other new surgical technology, the learning curve must be recognized and incorporated into the necessary fundamental knowledge and experience for these procedures.

Bone Screws↗

Image-guided thoracic pedicle screw placement: a technical study in cadavers and preliminary clinical experience.

OBJECT: Thoracic pedicle screw fixation is effective and reliable in providing short-segment stabilization. Although the procedure is becoming more widely used, accurate insertion of the screws is difficult due to the small dimensions of thoracic pedicles, and the associated risk is high due to the proximity of the spinal cord. In previous studies authors have shown the accuracy of image-guided lumbar pedicle screw placement, but there have been no reported investigations into the accuracy of image-guided thoracic pedicle screw placement. The authors report their experience with such an investigation. METHODS: To evaluate the accuracy of image-guided thoracic pedicle screw placement in vitro and in vivo, thoracic pedicle screws were placed with an image-guidance system in five human cadavers and 10 patients. In cadavers, the accuracy of screw placement was assessed by postoperative computerized tomography and visual inspection and in patients by postoperative imaging studies. Of the 120 pedicle screws placed in five cadavers pedicle violation occurred in 23 cases (19.2%); there was one pedicle violation (4.2%) in each of the last two cadavers. Of the 45 pedicle screws placed in 10 patients, pedicle violations occurred in three (6.7%). CONCLUSIONS: In comparison with historical controls, the accuracy of thoracic pedicle screw placement is improved with the use of an image-guidance system. It allows the surgeon to visualize the thoracic pedicle and the surrounding structures that are normally out of the surgical field of view. The surgeon, however, must be aware of the limitations of an image-guidance system and have a sound basic knowledge of spinal anatomy to avoid causing serious complications.

Aged↗

Isolation of neuronal precursors from differentiating P19 embryonal carcinoma cells by neuronal T alpha 1-promoter-driven GFP.

The induction of pluripotent P19 embryonal carcinoma (EC) cells with retinoic acid results in their differentiation into cells that resemble neurons, glia, and fibroblasts. To isolate and enrich the developing neurons from heterogeneously differentiating P19 EC cells, we used a recently introduced protocol combining the expression of green fluorescent protein (GFP) driven by a tissue-specific promoter and fluorescence-activated cell sorting. Cells were transfected with the gene for GFP, which is under the control of the neuronal T alpha 1 tubulin promoter. After four days of retinoic acid treatment, GFP was specifically detected in cells undergoing neuronal differentiation. Sorting of fluorescent differentiating P19 EC transfectants yielded populations highly enriched in neuronal precursors and neurons. Immunoreactivity for nestin and neurofilament was observed in 80 and 25% of the sorted cell population, respectively. These results demonstrate that differentiated neuronal precursor cells can be efficiently isolated from differentiating pluripotent embryonic cells in vitro, suggesting that this method can reproducibly provide homogeneous materials for further studies on neurogenesis.

Antineoplastic Agents↗

Dendritic cell-tumor coculturing vaccine can induce antitumor immunity through both NK and CTL interaction.

Immunization of dendritic cells (DC) pulsed with tumor antigen can activate tumor-specific cytotoxic T lymphocytes (CTL) that are responsible for protection and regression. We show here that immunization with bone marrow-derived DC cocultured with tumor cells can induce a protective immunity against challenges to viable tumor cells. In this study, we further investigated the mechanism by which the antitumor activity was induced. Immunization of mice with DC cocultured with murine colon carcinoma. CT-26 cells, augmented CTL activity against the tumor cells. Concomitantly, an increase in natural killer (NK) cell activity was also detected in the same mice. When DC were fixed with paraformaldehyde prior to coculturing with tumor cells, most of the CTL and NK cell activity diminished, indicating that DC are involved in the process of presenting the tumor antigen(s) to CTL. NK cell depletion in vivo produced markedly low tumor-specific CTL activity responsible for tumor prevention. In addition, RT-PCR analysis confirmed the high expression of INF-gamma mRNA in splenocytes after vaccination with DC cocultured with tumors, but low expression in splenocytes from NK-depleted mice. Most importantly, the tumor protective effect rendered to DC by the coculturing with CT-26 cells was not observed in NK-depleted mice, which suggests that DC can induce an antitumor immune response by enhancing NK cell-dependent CTL activation. Collectively, our results indicate that NK cells are required during the priming of cytotoxic T-cell response by DC-based tumor vaccine and seem to delineate a mechanism by which DC vaccine can provide the desired immunity.

Adenocarcinoma↗

Multiple cemento-ossifying fibroma: report of an 18-year follow-up.

Multiple cemento-ossifying fibroma is a very rare jaw lesion. A unique case is reported involving a 43-year-old Korean woman with rapidly growing, multiple cemento-ossifying fibromas in all four quadrants over an 18-year period which resulted in severe facial deformity and orbital compression.

Adult↗

Inhibition of glucocorticoid-mediated, caspase-independent dendritic cell death by CD40 activation.

Glucocorticoids (GC) are potent anti-inflammatory and immunosuppressive agents that act on a variety of immune cells, including T cells, monocytes/macrophages, osteoclasts, and dendritic cells (DC). However, the mechanism(s) by which GC exert anti-inflammatory effects is still largely unknown. It is already well known that GC treatment inhibits DC maturation and interleukin (IL)-12 production by DC. In this study, we investigated the apoptosis induction of DC by a synthetic GC, dexamethasone (Dex). The stimulation with Dex resulted in DC apoptosis in a dose- and time-dependent manner as it was measured by determining annexin V-positive cells and mitochondrial potential. In contrast, monocytes that are precursor cells of DC are resistant to Dex-mediated apoptosis. The Dex-induced apoptosis of DC was independent of caspase activation because it was not inhibited by the broad caspase inhibitor, Z-VAD-fmk. It is interesting that agonistic CD40 antibody completely inhibited Dex-induced cell death, whereas other inflammatory stimuli did not show the same effect, suggesting that CD40 signaling may selectively modulate GC-mediated DC apoptosis. Taken together, our findings revealed an important role of GC and CD40 signaling in the regulation of immune responses in which DC play a key role in the inflammatory process of various immunomediated diseases.

Anti-Inflammatory Agents↗

Imaging-guided costotransversectomy for thoracic disc herniation.

The surgical management of thoracic disc disease remains challenging. Outcomes after laminectomy had been poor, and modern posterolateral, lateral, and anterior approaches have evolved to replace this older procedure. Each has its own set of complications, and all are hampered, to varying degrees, by the limited visualization of the ventral disc space and spinal cord during decompression. The authors present their early experience with computer-assisted image guidance as an adjunctive tool for preoperative planning and navigation in the treatment of thoracic disc disease. Five consecutive patients underwent image-guided costotransversectomies between January 1999 and April 2000. The levels of herniation were T8-9 in three and T7-8 and T5-6, respectively, in the other two. There were four centrolateral herniations and one midline herniation. Three discs were soft and two hard. Two patients had previously undergone failed disc excisions. All patients had axial pain and myeloradiculopathies preoperatively. Three were unable to walk. Four patients enjoyed good or excellent outcomes, with return of ambulation. One patient experienced only mild improvement in her severe paraparesis. Image-guidance was invaluable in planning the corpectomy and aiding visualization in situations in which the dura or disc were obscured; its use allowed successful surgical excisions in the most challenging circumstances.

Adult↗

Review of spinal pseudomeningoceles and cerebrospinal fluid fistulas.

Spinal pseudomeningoceles and cerebrospinal fluid (CSF) fistulas are uncommon extradural collections of CSF that may result from inadvertent tears in the dural-arachnoid layer, traumatic injury, or may be congenital in origin. Most pseudomeningoceles are iatrogenic and occur in the posterior lumbar region following surgery. The true incidence of iatrogenic pseudomeningoceles following laminectomy or discectomy is unknown; however, the authors of several published reports suggest that the incidence of lumbar pseudomeningoceles following laminectomy or discectomy is between 0.07% and 2%. Pseudomeningoceles are often asymptomatic, but patients may present with recurrence of low-back pain, radiculopathy, subcutaneous swelling, or with symptoms of intracranial hypotension. Very rarely, they present with delayed myelopathy. Although magnetic resonance imaging is the neurodiagnostic study of choice, computerized tomography myelography and radionuclide myelographic study may be helpful diagnostic tools in some cases. Analysis of suspect fluid for Beta2 transferrin may be a useful adjunctive study. Treatment options include close observation for spontaneous resolution, conservative measures such as bed rest and application of an epidural blood patch, lumbar subarachnoid drainage, and definitive surgical repair.

Diskectomy↗

Mesenchymal hamartomas of the chest wall in infancy: radiologic and pathologic correlation.

Mesenchymal hamartoma of the chest wall is a rare tumor with about 53 reported cases in the English literature. We reviewed six chest wall mesenchymal hamartomas in four patients, including two cases with multiple lesions, with specific focus on the radiologic and pathologic correlation. All cases occurred in neonates or infants with ages ranging from seven hours to seven months. They were diagnosed with plain chest radiographs (n=6), ultrasonography (n=2), chest CT scan (n=6), whole body bone scan (n=2) and MRI (n=3). All cases except a small one without cystic change showed the typical features of mesenchymal hamartoma radiographically and pathologically. Radiologically they were well-circumscribed masses with solid and cystic components with multiple fluid-fluid levels in association with single or multiple rib destruction or change. The CT scan showed the typical findings of chest wall hamartoma, and the MR showed heterogeneous signal intensities of the mass on T1- and T2-weighted images. The MR also revealed more concisely a secondary aneurysmal bone cyst formation with multiple fluid-fluid levels on the T2-weighted image. Microscopically, they showed alternating areas of cartilaginous islands and primitive appearing mesenchymal proliferation, which corresponded well with the solid component on the radiologic findings. The areas of bone formation and blood-filled cystic spaces matched the calcified or ossified densities and the cystic components, respectively. A small case without cystic change showed peculiar radiological and pathological findings resembling an osteochondroma. In conclusion, mesenchymal hamartoma of the chest wall in infancy is quite rare and sometimes can be misdiagnosed as malignancy due to the bone-destroying radiographic appearance and the highly cellular and mitotically active microscopic features, unless the radiologists and pathologists are aware of the characteristic clinical, radiological, and pathological findings. Imaging studies can usually make a correct diagnosis with good correlation to the pathologic findings.

Female↗