PubMed Health⌕ Search

Biomedical subjects

M S Oh

Publications and source records attributed to M S Oh.

At least 19 recordsLinked to original sources
PubMed2002

Basic rules of parenteral fluid therapy.

The following basic rules of parenteral fluid therapy are formulated with the aim of alleviating concern and confusion about i.v. fluid orders that are experienced by most physicians: Don't be generous with fluid; in determining the water intake, one must know the usual water output through the kidney, skin and lung; one must know the quantities of the electrolytes and nutrients that are being given, and know the initial volume of distribution (usually the ECF); one must know the aim of fluid therapy; one must not give and remove the same substance at the same time; one must be aware that hypertonic saline contains less water for a given amount of Na than isotonic saline; one must be familiar with different i.v. solutions and i.v. additives; one must be aware that the kidney does not manufacture water or electrolytes except for bicarbonate; for short-term fluid therapy, divalent ions (Ca, Mg, and P) do not need replacement; one should think about COP-wedge gradient in determining the type of fluid to be given.

Blood Pressure↗
PubMed2001

Purification and structural analysis of the hepatitis B virus preS1 expressed from Escherichia coli.

The preS1 of hepatitis B virus (HBV) is located at the outermost part of the envelope protein and possesses several functionally important regions such as hepatocyte receptor-binding site and virus-neutralizing epitopes. As the first step to understand the structure-function relationship for the preS1 antigen, we have purified the preS1 and performed its structural characterization by circular dichroism (CD) spectroscopy. The preS1 was purified to near homogeneity from bacterially expressed glutathione S-transferase (GST)-preS1 fusion protein by two-step purification, affinity chromatography on glutathione-agarose column, and cation-exchange chromatography on Mono S column. The CD analysis showed that the purified preS1, which was largely unstructured in aqueous solution, acquired a significant (16%) alpha-helical structure when analyzed in 50% trifluoroethanol or 20 mM SDS. The results suggest that the preS1 assumes a mainly unstructured conformation and may form induced secondary structures upon binding to target proteins or under hydrophobic environment.

Amino Acid Sequence↗
PubMed2001

New xenicane diterpenoids from the gorgonian Acalycigorgia inermis.

Eight diterpenes and norditerpenes including five new xenicane metabolites (4--8) have been isolated from the gorgonian Acalycigorgia inermis. The structures of these compounds have been determined by combined spectroscopic analysis. The new compounds exhibited significant cytotoxicity against a human leukemia cell-line.

Animals↗
PubMed2001

Integrative physiology of basal water permeability in the distal nephron: implications for the syndrome of inappropriate secretion of antidiuretic hormone.

Patients who drink more electrolyte-free water than they can excrete may develop hyponatremia. A subgroup of hyponatremic patients has a reduced excretion of electrolyte-free water and a low rate of excretion of solutes even though vasopressin is not detected in their plasma. Basal water permeability in the distal nephron, by permitting a limited volume of electrolyte-free water to be reabsorbed, offers a way to help explain these findings. Basal water permeability will also be considered from the perspective of integrative physiology in evolutionary and developmental biology settings. Its possible clinical importance will be explored in patients with chronic hyponatremia who have a low distal volume delivery. These patients may develop osmotic demyelination if a large solute load leads to a very rapid excretion of electrolyte-free water.

Capillary Permeability↗
PubMed2000

Isolation and characterization of polymorphic cDNAs partially encoding ADP-glucose pyrophosphorylase (AGPase) large subunit from sweet potato.

cDNA clones encoding sweet potato AGPase large subunit (iAGPLI) from the cDNA library constructed from the tuberous root were isolated. Two clones were characterized and named iAGPLI-a and iAGPLI-b. They were 1,661 bp and 1,277 bp in length and contained partial open reading frames of 450 and 306 amino acids, respectively. Both nucleic acid and amino acid sequence identities between iAGPLI-a and iAGPLI-b were 83.8% and 97.3%, respectively. Based on the amino acid sequence analysis, iAGPLI-a and iAGPLI-b share the highest sequence identity (81%) with potato AGPase large subunit. The iAGPLI-a and iAGPLI-b genes were expressed predominantly in the stem and weakly in the tuberous root, and no transcript was expressed in other tissues. The sweet potato genome contains several copies of the iAGPLI gene.

Amino Acid Sequence↗
PubMed2000

Light chain of natural antibody plays a dominant role in protein antigen binding.

Examinations of the contribution and the specificity of heavy (H) and light (L) chains of natural antibodies to antigen binding may help us to better understand antigen recognition and the development of naive B cells. We previously generated natural Fab antibody fragments reactive to preS1 of HBV using a naive, non-immunized Fab antibody library derived from peripheral B cells of a normal healthy volunteer. We now constructed expression vectors for the Fd (VH + CH1), L chain, and scFv fragments using the sequences encoding parental Fabs as a source of natural antibody genes. The recombinant antibody fragments were expressed as inclusion bodies in E. coli BL21 (DE) cells. When denatured and then refolded, the antibody fragments retained their binding properties. Recombinant L chains and scFvs exhibited three- to 40-fold higher affinities (in the order of 10(7) M(-1)) over the parental Fabs, whereas the affinities of Fds (in the order of 10(5) M(-1)) were much lower compared to the parental Fabs. The results obtained from sandwich ELISA revealed that the L chains bound the virus more efficiently than Fds. Additional experiments were performed to evaluate the specificity of the recombinant fragments for surface proteins of HBV. Fds and L chains were reactive towards HBsAg and the preS2 peptide as well as preS1 and showed patterns of epitope recognition quite different from those of parental Fabs. The data presented here demonstrate that the prominence of the L chain in determining protein binding activity is a property of natural antibodies and is quite unlike the antibodies induced by immunization, and that the specificity of Fab is not determined by the individual antibody chain but by the correct pairing of H and L chain.

Antibody Affinity↗
PubMed2000

Correlation between radiology resident rotation performance and examination scores.

RATIONALE AND OBJECTIVES: The authors' purpose was to determine whether there is a relationship between subjective assessment of radiology resident performance on individual rotations and objective assessment of radiology resident performance on the American College of Radiology (ACR) in-training and American Board of Radiology (ABR) written examinations. MATERIALS AND METHODS: Records of 81 radiology residents completing their residency between 1991 and 2000 were reviewed. Mean scores from all rotation evaluation forms obtained during the study period were calculated for each residency year. The means of the overall raw scores and percentiles obtained on the annual ACR in-training examinations during the first 3 years of residency and of the written portion of the ABR examination taken during the 4th year of residency were also determined. Rotation evaluation scores were then compared to examination scores obtained during the same year of residency, and correlation coefficients were obtained. RESULTS: In the 2nd, 3rd, and 4th years of radiology residency, there is positive correlation between rotation evaluation scores and overall scores from the corresponding ACR in-training examination and written portion of the ABR examination taken during the same year. In contrast, in the 1st year of residency, resident rotation evaluation scores do not correlate with ACR in-training examination scores. CONCLUSION: Residents who are perceived as doing well on their rotations after the 1st year of residency are more likely to do well on standardized written examinations.

Analysis of Variance↗
PubMed2000

How well does applicant rank order predict subsequent performance during radiology residency?

RATIONALE AND OBJECTIVES: Residency selection committees expend substantial time and resources on assessing the quality of residency applicants to derive an appropriate rank order for the National Residency Matching Program. The authors determined whether there is a relationship between the rank number or rank percentile of applicants selected for a residency training program and subsequent radiology residency performance. MATERIALS AND METHODS: Records of radiology residents completing their residency between 1991 and 1998 were reviewed. Available rank numbers and rank percentiles for each resident were compared with subsequent performance, as assessed subjectively by 4th-year radiology rotation evaluation forms and retrospective recall of four senior faculty members and objectively by numerical and percentile scores on the written portion of the American Board of Radiology (ABR) examinations. Correlation coefficients were obtained for each comparison. RESULTS: Rank number and rank percentile were not significantly correlated with 4th-year resident rotation evaluations or ABR written examination scores or percentiles. A small correlation existed between rank order and retrospective evaluation of resident performance by the four senior faculty. CONCLUSION: Applicant rank number and rank percentile do not correlate with subsequent radiology residency performance as assessed on rotation evaluation forms or the ABR written examinations.

Forecasting↗
PubMed2000

The importance of race in medical student performance of an AIDS risk assessment interview with simulated patients.

INTRODUCTION: This study was done to ascertain the effect of race on medical student-patient communication. The primary hypothesis was that interviewing performance scores would be higher when race of student and race of simulated patient instructor (SPI) were concordant than when they were discordant. METHODS: Data obtained from student interactions with four Caucasian and four African American female SPIs participating in a case involving an AIDS risk assessment interview were analysed. Performance was assessed using two instruments: an 8-item behaviourally anchored interviewing skills scale and a 14-item checklist reflecting content relevant to sexual behaviour and AIDS risk. SPI groups were comparable and SPIs were trained to a high level of inter-rater reliability. Students (24 African American and 180 non-African American) were assigned to SPIs based on the spelling of the student's name. Performance was scored independently at the conclusion of each interview by both the SPI and the student her/himself. RESULTS: African American students had lower scale scores than non-African American students in interactions with Caucasian (but not African American) SPIs; and all student scores, both on the skills scale and the content checklist, were higher with African American than with Caucasian SPIs (as assessed by both SPI and student). Women students had higher scores than men. CONCLUSIONS: Race of SPI has an influence on student performance of an AIDS risk assessment interview. Further studies focusing on racial interactions in the medical interview are required. It appears that race of SPI may need to be accounted for in the development and interpretation of SPI-based clinical competence exams.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Cerebral salt-wasting syndrome. We need better proof of its existence.

It is widely believed that the cerebral salt-wasting syndrome (CSWS) exists as an entity distinct from the syndrome of inappropriate ADH secretion, and that it is characterized by evidence of severe renal salt wasting that results in volume depletion and hyponatremia. Proof of the existence of CSWS as an entity requires documentation of renal salt wasting and volume depletion. The present review has been undertaken to examine the evidence that the CSWS is a separate entity. In this effort, we have discussed various methods of documentation of volume depletion, and then reviewed reported cases of CSWS to determine whether volume depletion and renal salt wasting have been clearly demonstrated. Our review has led us to conclude that not one case of purported CSWS has demonstrated clear evidence of volume depletion and renal salt wasting. If renal salt wasting had been proven in these cases, we would conclude that the likely site of renal salt transport was the proximal tubule. The proximal site of salt transport defect has been suggested by the absence of hyperreninemia and hypokalemia, which would be a distinguishing feature of Bartter's syndrome and Gitelman's syndrome.

Animals↗
PubMed1998

D-lactic acidosis. A review of clinical presentation, biochemical features, and pathophysiologic mechanisms.

This report describes a case of d-lactic acidosis observed by the authors and then reviews all case reports of d-lactic acidosis in the literature in order to define its clinical and biochemical features and pathogenetic mechanisms. The report also reviews the literature on metabolism of d-lactic acid in humans. The clinical presentation of d-lactic acidosis is characterized by episodes of encephalopathy and metabolic acidosis. The diagnosis should be considered in a patient who presents with metabolic acidosis and high serum anion gap, normal lactate level, negative Acetest, short bowel syndrome or other forms of malabsorption, and characteristic neurologic findings. Development of the syndrome requires the following conditions 1) carbohydrate malabsorption with increased delivery of nutrients to the colon, 2) colonic bacterial flora of a type that produces d-lactic acid, 3) ingestion of large amounts of carbohydrate, 4) diminished colonic motility, allowing time for nutrients in the colon to undergo bacterial fermentation, and 5) impaired d-lactate metabolism. In contrast to the initial assumption that d-lactic acid is not metabolized by humans, analysis of published data shows a substantial rate of metabolism of d-lactate by normal humans. Estimates based on these data suggest that impaired metabolism of d-lactate is almost a prerequisite for the development of the syndrome.

Acidosis, Lactic↗
PubMed1998

Acid production in chronic hemodialysis patients.

This study examines endogenous acid production in a group of stable chronic hemodialysis patients with no residual renal function who were admitted to the chronic hemodialysis unit of Mount Sinai Hospital. Net acid production was estimated by the change in body bicarbonate content, which occurs in the interdialytic period. The body bicarbonate content at any time was measured by multiplying the concentration of blood bicarbonate by the apparent bicarbonate space at that time. The apparent bicarbonate space was determined by the change in blood bicarbonate concentration induced by the intravenous administration of a known amount of sodium bicarbonate. Daily sulfuric acid production was also estimated from the reduction in body sulfate content during dialysis. The interdialytic net acid production was measured at approximately 28 mEq/d, a value much lower than that predicted from the protein catabolic rate. This reduced acid production can be explained by reduced sulfuric acid and organic acid production. The mechanism of reduced sulfuric acid production is unknown. Reduced organic acid production is explained partly by the absence of renal excretion of metabolizable organic anions, leaving only the nonmetabolizable fraction as the main source of acid in the interdialytic period.

Acids↗
PubMed1998

Acute hyponatremia in the perioperative period: insights into its pathophysiology and recommendations for management.

Our purpose is to review the topic of acute postoperative hyponatremia by focusing on pertinent aspects of the physiology of water and solute excretion. Four areas will be highlighted: an examination of the source of addition of electrolyte-free water, an exploration of the basis for the very large natriuresis that occurs during cerebral salt wasting following neurosurgery, possible reasons to explain why acute postoperative hyponatremia may pose a greater risk for young women [Ayus and Arieff 1996, Ayus et al. 1992, Arieff 1986, Wijdick et al. 1991], and issues related to treatment of acute hyponatremia.

Acute Disease↗
PubMed1997

Roles of transmembrane prolines and proline-induced kinks of the lutropin/choriogonadotropin receptor.

The lutropin/choriogonadotropin receptor is a seven-helix transmembrane (TM) receptor. A unique feature of TM helices is the content of Pro, which generally is absent in alpha helices of globular proteins. Because Pro disrupts helices and introduces a approximately 26 degrees kink, it has been speculated that Pro plays a crucial role in the structure of TM helices, exoloops, and cytoloops of TM receptors. To examine the roles of the five TM Pros of the lutropin/choriogonadotropin receptor, these residues were individually substituted. Mutant receptors were examined for surface expression, hormone binding, and cAMP induction. Surface expression was monitored after introducing the flag epitope into the receptors. Flag epitopes slightly affected cAMP induction but not hormone binding or surface expression of receptors as monitored by immunofluorescence microscopy and 125I-anti-flag antibody. The results indicate that Pro479 in TM 4 and Pro598 in TM 7 play important yet contrasting roles. Pro479 is crucial for hormone binding at the cell surface but not after solubilization of the receptor. This is more likely due to the Pro side chain than the Pro-induced kink. Pro598 is important for surface expression. The kinks of Pro463 of TM 4, Pro562 of TM 6, or Pro591 of TM 7 are not important because the substitution of Phe for these residues did not significantly impact surface expression, hormone binding, and cAMP induction.

Amino Acid Sequence↗
PubMed1995

Glycosylation, dimerization, and heparin affinity of lipoprotein lipase in 3T3-L1 adipocytes.

The relationship between glycosylation, dimerization, and heparin affinity of lipoprotein lipase (LPL) was studied in 3T3-L1 adipocytes. Three forms of LPL subunits were found in normal cells; totally endo H-resistant (57 kDa), partially sensitive (54 kDa), and totally sensitive (51 kDa) forms. LPL in normal cells was active, dimeric, and showed high affinity for heparin. LPL in cells treated with tunicamycin, preventing the transfer of N-linked oligosaccharide chain, was unglycosylated (51 kDa) and inactive. LPL proteins were found as an aggregate, and had low affinity for heparin. After treatment with castanospermine, an inhibitor of ER glucosidase I, 80% of LPL activity was inhibited. Most of LPL proteins were totally endo H-sensitive, present as an aggregate, and had low affinity for heparin. LPL in cells treated with deoxymannojirimycin, an inhibitor of Golgi mannosidase I, was active, dimeric, and had high affinity for heparin as in normal cells. But LPL subunits were all endo H-sensitive. These results suggest that core glycosylation and subsequent removal of glucose residue is required, but processing after Golgi mannosidase I is not necessary for dimerization and acquisition of high heparin affinity of LPL.

3T3 Cells↗
PubMed1995

Acid-base balance in chronic peritoneal dialysis patients.

Endogenous acid production has never been measured directly in dialysis patients and an empiric formula is used to estimate acid production from their protein catabolic rate. We have studied acid-base balance in 19 stable CAPD patients attending the peritoneal dialysis clinic of Mount Sinai Hospital. They obtained a 24 hour collection of peritoneal dialysis fluid and urine while consuming their usual diet and performing their usual activities. Total alkali gain was calculated from net GI alkali absorption plus urinary net acid excretion plus alkali gain from dialysate, while total acid production was measured directly from the urinary and dialysate excretions of sulfate and organic anions. Net GI alkali absorption was estimated from the difference between cations (Na + K+Ca + Mg) and anions (Cl + 1.8P) in the 24 hour dialysate and urine collections minus the daily total amount of lactate infused. All of our patients had a normal or high serum bicarbonate concentration, which was stable with time. Total alkali gain was virtually identical to total acid production (54.2 vs. 52.4 mEq/day) which suggests that these patients were in neutral acid-base balance. Net GI alkali absorption (22.7 mEq/day) was one of the same range as that of chronic renal failure patients not on dialysis and represented almost one half of the total daily alkali gain. The daily acid production of 52.4 mEq/day was numerically equal to 84% of the protein catabolic rate expressed as g/day, which is similar to the predicted value of 77% of PCR reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗