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Biomedical subjects

S S Kim

Publications and source records attributed to S S Kim.

At least 19 recordsLinked to original sources

Expression, purification, and identification of a novel self-cleavage site of the Nla C-terminal 27-kDa protease of turnip mosaic potyvirus C5.

The gene encoding the C-terminal protease domain (27 kDa) of the nuclear inclusion protein a of turnip mosaic potyvirus C5 was cloned and expressed as a fusion protein with glutathione S-transferase in Escherichia coli XL1-blue. Two forms of the protease (27 and 25 kDa) were purified from the fusion protein by glutathione affinity chromatography and Mono S chromatography and exhibited the specific proteolytic activity when a synthetic undecapeptide, Glu-Pro-Thr-Val-Tyr-His-Gln-Thr-Leu-Asn-Glu, or an in vitro translation product of the polyprotein containing the cleavage site between the nuclear inclusion protein b and the capsid protein, was used as a substrate. The purified proteases showed a Km of 1.15 +/- 0.16 mM and a Vmax of 0.74 +/- 0.091 mumol/mg/min with the synthetic peptide substrate. The 25-kDa protein was found to be generated by the cleavage between Ser223 and Gly224 near the C-terminus of the 27-kDa protease and to retain the specific proteolytic activity. The point mutation of Asp81 or Cys151, two putative active site residues in the 27-kDa protease, to Asn or Ser, respectively, prevented the generation of the 25-kDa protein and diminished the proteolytic activity of the protease drastically, suggesting that the 27-kDa protease cleaves itself between Ser223 and Gly224 to generate the 25-kDa protein.

Amino Acid Sequence

Interaction of intravenous heparin and organic nitrates in acute ischemic syndromes.

We evaluated whether a drug interaction between intravenous nitroglycerin or isosorbide dinitrate and heparin exists. Ninety-six patients with a diagnosis of acute myocardial infarction, unstable angina, or other thromboembolic disorders were divided into 3 groups: group I (control group, n = 35) received intravenous heparin alone; group II (n = 31) received combined intravenous nitroglycerin and heparin; and group III (n = 30) received combined intravenous isosorbide dinitrate and heparin. We determined the mean of 2 separate measurements of heparin dosage requirement, antithrombin III activity, and the dose of intravenous nitroglycerin or isosorbide dinitrate at the time that the ratio of activated partial thromboplastin time (aPTT) to baseline aPTT was 1.5 to 2.0. The mean therapeutic heparin dose standardized to total body weight of each group was 13.8, 15.4, and 15.5 U/kg/hour, respectively. At that time, patients were receiving intravenous nitroglycerin at doses of 58.8 +/- 38.6 micrograms/min or intravenous isosorbide dinitrate at doses of 3.7 +/- 2.0 mg/hour. The mean antithrombin III activity of each group was 22.2, 22.8, and 21.3 mg/dl, respectively. The overall results for groups I, II, and III, and results for the subgroup of patients with acute ischemic syndromes in those groups, did not differ significantly. The heparin dose did not show a significant correlation to the dose of intravenous nitroglycerin (r = -0.26, p > 0.05) nor to that of isosorbide dinitrate (r = 0.30, p > 0.05).

Acute Disease

Combined methotrexate and misoprostol for early induced abortion.

OBJECTIVE: To determine the effectiveness and side effects of and subject satisfaction with an induced abortion by administration of methotrexate and intravaginal misoprostol. SUBJECTS AND DESIGN: Prospective trial of 100 consecutive pregnant women aged 18 years or older at 8 weeks' gestation or less and wanting an abortion. INTERVENTIONS: Intramuscular administration of 50 mg of methotrexate per square meter of body surface area on day 1 and a misoprostol 800-micrograms vaginal suppository on day 3. Administration of misoprostol was repeated the following day if no bleeding occurred after the first dose. PROTOCOL: After pregnancy dating by clinical criteria, subjects were followed up with serum beta-human chorionic gonadotropin (beta-hCG) determinations on days 1, 7, and 14 and a high-sensitivity urine hCG test every 2 weeks until the value was less than 10 IU/L. Subjects completed a daily symptom log and satisfaction questionnaire on day 14. MAIN OUTCOME MEASURES: Complete abortion as defined by vaginal bleeding and a beta-hCG value of less than 10 IU/L without surgical intervention, complications and side effects, and patient satisfaction. RESULTS: Ninety-seven subjects had a complete abortion and one subject had vaginal bleeding and a 94% decrease of her beta-hCG value on day 7 but was subsequently unavailable for follow-up. Two subjects required surgical procedures: one with a continued pregnancy and one for excessive bleeding. No failures or complications occurred in early gestations prior to 45 days from the last menstrual period. Seventy-three percent responded to misoprostol treatment with bleeding within 12 hours and had a mean decrease of 90% in their beta-hCG value on day 7. Twenty-seven percent had no immediate bleeding response to misoprostol administration, began bleeding on day 10 (SD, 8 days), and had a mean decrease of 10% in their beta-hCG value on day 7. Seventy percent reported nausea; 46%, diarrhea; and 23%, vomiting. Ninety-three percent agreed that the procedure was acceptable and 95% would recommend the procedure. CONCLUSIONS: Methotrexate and misoprostol were effective in inducing an abortion up to 8 weeks. Home administration of a compounded misoprostol vaginal suppository was successful. Although gastrointestinal tract side effects were common, women found the procedure and its side effects acceptable.

Abortion, Induced

Analysis of whole-blood cyclosporin G by liquid chromatography in renal transplant recipients.

Cyclosporin G (CsG) is less nephrotoxic than Cyclosporin A (CsA) and is undergoing clinical trials for use as an immunosuppressive agent after renal transplantation. In this study, CsG was measured by a rapid high-performance liquid chromatography (HPLC) technique in blood samples (n = 107) received from renal transplant recipients. The HPLC assay proved to be analytically suitable in that it was sensitive, linear, and precise and had high recovery (102%). However, interference was observed from some potentially co-administered drugs such as calcitriol, ferrous sulfate, hydrazaline, and minoxidil. The HPLC assay for CsG correlated well with a FPIA (Abbott TDx), FPIA = 0.964 (HPLC) + 33.59, r = 0.9819, Sy/x = 36.66 for patients receiving a low dose of CsG (5 mg/kg/day) and a high dose (10 mg/kg/day). Furthermore, the HPLC technique was capable of measuring predictable CsG concentrations when the drug was tapered to lower doses at various stages of the 16 week clinical trial. The HPLC for CsG has the further advantage that the same system and mobile phase can be used to measure CsA while using CsC as the interval standard.

Chromatography, High Pressure Liquid

Compensatory growth of porcine right lungs after chronic rejection of transplanted left lungs.

Neonatal lung hypoplasia is frequently a fatal condition often associated with congenital diaphragmatic hernia. Unilateral lung transplantation rarely has been performed for this indication, although it is a potential solution. It is not known whether the transplant needs to function permanently or to act as a bridge until the native lung develops. It is also not known whether the native lung will grow in the face of an immunosuppressed state and chronic rejection of the transplanted lung. We therefore developed a porcine model of left lung rejection to study this. Infant swine underwent left lung transplantation. Chronic rejection occurred in all, resulting in nonfunction of the transplanted lung. The right lungs of these animals were compared with the right lungs of size-matched and age-matched control animals not given immunosuppressive treatment and not undergoing transplantation. There were no differences in terms of the functional residual capacity, airway compliance, and airway resistance among the groups. There was a significant increase in the pulmonary vascular resistance in the animals with transplanted lungs. There was also a significant increase in the lung weight in these animals. Unilateral pneumonectomies were done in 4 infant pigs to serve as controls. Three of the 4 did not survive the operation because of acute pulmonary failure. In conclusion, the study group exhibited evidence of compensatory growth that was not seen in the control animals, as shown by the increase in lung weight. This suggests that contralateral lung growth occurs in a growing animal, despite the effects of immunosuppression therapy and chronic rejection of the transplanted lung.

Animals

Age-related changes of mRNA expression of amyloid precursor protein in the brain of senescence-accelerated mouse.

APP695 mRNA is only expressed in the brains of SAM. The expression of APP mRNA in SAM P1 mice brains is more marked than that in SAM R1 mice brain. APP mRNA expression was increased with advancing age in all brain regions of SAM P1 mice compared with SAM R1. Especially, the changes of the amount of APP mRNA in the prosencephalon and the mesencephalon are significant at P value of 0.05. We suggest that overexpression of APP mRNA may be related to accelerated aging phenomenon in the SAM brain. This is the first report of age-related increase in the amount of APP mRNA in the SAM brain.

Aging

Biological activity and immunological reactivity of human prolactin mutants.

We examined the biological activity and immunological reactivity of four mutants of human PRL. Two were mutants that changed the ability of human PRL to inhibit rat PRL storage when transfected into a rat pituitary cell line:mutations S34A and N31T. Two mutations were in regions of PRL that are highly conserved. One, des(3-11)-PRL, removed the N-terminal cystine loop that most PRLs, except those from certain fish, have, and no GHs have. The other, S90A, mutated a serine that is present in all PRLs but those from some fish and in all GHs. The immunological properties of des(3-11)-PRL were reduced 10-fold compared to those of wildtype human PRL in a RIA using NIH antihuman PRL-3, AFP C11580; the others were similar to those of wild-type PRL. The biological activity of des(3-11)-PRL was the most affected; activity was reduced about 8-fold compared to that of wild-type PRL in the Nb2 cell assay. The activities of the others were similar to that of the wild type. Serine 90 may be partially buried by loops connecting the alpha-helixes. The mutation of serine 90 did not affect the stability of the molecule in vitro, determined by comparing the red shift in tryptophan fluorescence that occurs with increasing concentrations of urea in S90A and wild-type PRL. The activity of S34A and N31T mutations indicates there is no correlation between biological activity and ability to affect storage. The N-terminal cystine loop may be conserved because it is needed for biological activity, but the conservation of serine 90 in GH and PRL must be determined by other properties, such as spacial requirements.

Amino Acid Sequence

Profound hypotension immediately following insertion of methyl methacrylate during bipolar endoprosthesis in a patient with long-term levodopa-treated paralysis agitans.

Insertion of methyl methacrylate polymer into newly reamed bony cavities has sometimes resulted in profound hypotension, cardiac arrest, or sudden death which are more common in patients with hemodynamic instability or hypovolemia. In paralysis agitans(Parkinson's disease), dramatic worsening of the disease often occurs when another illness or trauma accompanies it. And it is possible that chronic medication with levodopa can cause the loss of ability to support blood pressure. So, it involves some risk to use methyl methacrylate in chronic levodopa-treated paralysis agitans. We present a case of paralysis agitans who demonstrated profound hypotension immediately following insertion of methyl methacrylate polymer in spite of normovolemia and proper anesthetic management.

Aged

Use of a 64 channel computerized cardiac mapping system in arrhythmia surgery.

A multipoint and computerized intraoperative mapping system has been known to be of value in improving the results of surgery for cardiac arrhythmia. It shows great potential as a new tool in the surgical intervention of the more common and lethal types of supraventricular tachyarrhythmias such as atrial flutter and atrial fibrillation. In addition, it also enhances the ability of the investigators to map and ablate the sometimes fleeting automatic atrial tachycardia. The authors developed a 64 channel computerized cardiac mapping system using a microcomputer (Macintosh IIx) and this has been used for basic research in cardiac electrophysiology as well as in arrhythmia surgery. In this system, bipolar electrograms are obtained from 64 different cardiac sites simultaneously at a sampling rate of 1 Ksample/sec and with a continuous and total data storage of up to 30 seconds. When the reference electrode is selected, delay time from the reference point is displayed on a two dimensional diagram of the heart. This system was used in one patient who underwent a surgical ablation of a ventricular tachycardia in whom we observed a ventricular activation sequence involving a variety of rhythms over several minutes. The system design permits easy expansion to a simultaneous sampling from 256 sites. This 64-channel mapping appeared to have the potential to be of great help in our understanding of cardiac arrhythmia as well as in its diagnosis and surgical treatment.

Arrhythmias, Cardiac

Predictive factors for beneficial response to interferon-alfa therapy in chronic hepatitis C.

OBJECTIVES: Interferon is the only established treatment for chronic hepatitis C but the host-dependent or virus-related factors affecting the response rate to interferon therapy are not yet clear. The purpose of this study was to investigate the factors predictive of response to interferon-alfa therapy in chronic hepatitis C. METHODS: Twenty-five consecutive patients with chronic hepatitis C were randomized to three regimens of interferon-alfa: group A (n = 7, 3 MU every day for 3 months), group B (n = 8, 3 MU every other day for 3 months) and group C (n = 10, 3 MU every other day for 6 months). We quantified serum HC RNA levels by competitive reverse transcription-polymerase chain reaction (RT-PCR) and performed HCV genotyping using type-specific primers deduced form the NS5 region of the HCV genome. We also attempted to identify which demographic, biochemical and histologic factors in addition to virus-related factors would significantly predict beneficial response to interferon by multivariate analysis. RESULTS: Sustained responders were 8 (36.4%), nonsustained responders were 2 (9.1%) and nonresponders were 12 (54.5%) of 22 patients who had received complete therapy. The initial HCV RNA level (logarithmic transformed copy numbers per ml of serum) in sustained responders (5.75 +/- 0.39) was significantly lower than that of nonsustained responders (6.80 +/- 0.71) and nonresponders (6.70 +/- 0.52) (p < 0.05). In multivariate multiple logistic regression analysis, the serum HCV RNA level before therapy was only the independent predictor of a sustained response to interferon-alfa therapy (p = 0.001). CONCLUSIONS: Serum HCV RNA level before therapy was the most useful predictor of a sustained response to interferon-alfa therapy for chronic hepatitis C.

Adult

Association of lipoprotein levels with atherosclerotic changes in patients with coronary artery spasm and insignificant coronary artery stenosis.

BACKGROUND: Coronary artery spasm readily occurs at sites of atheromatous plaque. Some lipid profiles are related to the genesis of coronary artery spasm. In Korean patients, it is frequently observed in grossly normal coronary arteries, in contrast to the situation in western patients, who frequently have coronary artery spasm superimposed on significant coronary artery stenosis. Intravascular ultrasound examination has shown that mild or diffuse atherosclerotic changes in patients with focal vasospasm, even in the absence of angiographic coronary disease. OBJECTIVES: We studied prospectively 104 patients in order to find out which lipid profiles were associated with atherosclerotic changes in patients with coronary artery spasm. METHODS: Patients were grouped as follows: group I, control, 50 patients (34 men, 16 women); group II, 35 patients (26 men, 9 women) with significant coronary artery disease; group III, 19 patients (13 men, six women) with significant coronary artery spasm and either no coronary artery stenosis or insignificant stenosis. There was no significant difference in age (group I 55 +/- 1 years, group II 56 +/- 2 years, group III 54 +/- 2 years) or sex among the groups. The following parameters were evaluated: hypertension, cigarette smoking, diabetes mellitus, and lipid profile. RESULTS: The incidence of hypertension in group II patients was higher than in group I or III (P < 0.05). No significant difference was found in the percentage of cigarette smokers and patients with diabetes mellitus among three groups. The lipid profiles of each group were analysed. Group II patients had higher lipoprotein (a) levels (39 +/- 6 mg/dl) than those in group I (21 +/- 3 mg/dl) or group III (13 +/- 3 mg/dl) (P < 0.05). Other lipid profiles were not significantly different among the groups. CONCLUSION: Our results indicate that the atherosclerotic changes in the coronary arteries of group III patients were not associated with lipid profiles, including lipoprotein (a).

Constriction, Pathologic

Anterior spondylodesis for spondylolisthesis: isthmic and degenerative types.

We studied the influence of instability of the spondylolisthetic segment upon anterior interbody fusion (AIF) rates. A one-level AIF of the lumbar spine by the modified extraperitoneal Bailey-Badgley fusion construct was performed in 26 patients with chronic or recurring acute low-back pain and/or other symptoms due to grades I and II spondylolisthesis. Sixteen were degenerative type, and 10 were isthmic type. Seventeen were female and 9, male. The average age was 41.2 years. The number of cases of spondylolisthesis at the level of L4-5 and L5-S1 as 18 and 8, respectively. In the 16 cases of degenerative type, 13 were grade I slip, and 3 were grade II slip, while in the 10 cases of isthmic type, 8 were grade I slip, and 2 were grade II slip. The average postoperative follow-up was 6 years (range 2-10 years). Solid fusion was obtained in 15 (93.8%) of the cases of degenerative spondylolisthesis and in 6 of the cases of isthmic type. Thus, the overall fusion rate was 80.7% (21 cases). However, some graft crumbling and redisplacement developed in 1 of the cases of degenerative type and 6 of the cases of isthmic type. Non-union developed in 4 (57.1%) of those 7 cases of graft crumbling (3 isthmic and 1 degenerative type). Fusion took 7 months on average (range 5-9 months). It is hypothesised that the isthmic-type spondylolisthesis had more instability than the degenerative one. Therefore, AIF in the case of degenerative spondylolisthesis is a useful procedure, while in the isthmic type it is not advisable as a routine procedure.

Adult

Ruptured aneurysm of the sinus of Valsalva in a patient with Behçet's disease.

The vast majority of sinus of Valsalva aneurysm originated from a localized congenital defect of the aortic media and less frequently from infections or degenerative processes affecting the aortic wall. But aneurysm of sinus of Valsalva has not been reported up to the present in a patient with Behçet's disease. We report a 39-year-old woman presenting ruptured aneurysm of the sinus of Valsalva and Behçet's disease.

Adult

Torsade de pointes induced by terfenadine in a patient with long QT syndrome.

Torsade de pointes is a form of polymorphic ventricular tachycardia that is associated with prolongation of the QT interval. Although torsade de pointes is found in many clinical settings, it is mostly drug induced. Similar problems have been described with nonsedating H1-receptor antagonists, such as astemizole and terfenadine. Terfenadine is a widely used antihistamine. The authors report a case of torsade de pointes in a patient with a possible congenital sporadic form of QT interval prolongation who was receiving a therapeutic dose of terfenadine.

Adult

Characteristics of six isoperoxidases from Korean radish root.

Two cationic isoperoxidases (designated C1 and C3) and four anionic isoperoxidases (designated A1, A2, A3n and A3) from Korean radish (Raphanus sativus L.) root have been purified to apparent homogeneity, and some of their enzymatic properties were characterized. All six isoperoxidases are glycoproteins composed of a single polypeptide chain. The M(r)s of C1, C3, A1 and A2 were ca 44,000, while anionic isoperoxidase A3n and A3 have M(r)s of 31,000 and 50,000, respectively. Deglycosylated A2 and C3 by trifluoromethanesulphonic acid treatment showed M(r)s of 37,000 and 40,000, respectively, suggesting that the carbohydrate contents for these isoenzymes are 14 and 9%, respectively. Relative amino acid compositions of four anionic isoperoxidases (designated A1, A2, A3n and A3) and one cationic isoperoxidase C3 were determined. N-Terminal amino acid sequences were determined for A1, A3n and C3, while A2 was found to have a blocked amino terminal residue. Kinetic studies with respect to various synthetic and naturally occurring substrates were also investigated.

Amino Acid Sequence

Mechanism of decrease in heart rate by peripheral dopaminergic D2-receptors.

We performed this study in order to verify the heart rate decrease caused by the D2-receptor on cardiac sympathetic nerve endings and its relation to the concentration of norepinephrine in synaptic clefts. Sprague-Dawley rats were pithed and the heart rate was increased either by electrical stimulation of the cardiac accelerator nerve or by intravenous infusion of norepinephrine, tyramine, or isoproterenol. Increased heart rate by electrical stimulation of cardiac accelerator nerve was dose-dependently lowered by lisuride and its effect was blocked by pretreatment with sulpiride but not with yohimbine and SCH 23390. Also, the heart rate was decreased in a dose-dependent manner by clonidine and this effect was blocked by pretreatment with yohimbine, but not with sulpiride. For increased heart rate by infusion of norepinephrine, tyramine, or isoproterenol, the heart rate lowering effect of lisuride was more marked in the norepinephrine-and tyramine-infusion groups, in which the intrasynaptic concentration of norepinephrine was elevated, compared to the isoproterenol-infusion group, in which intrasynaptic concentration of norepinephrine was not elevated. In conclusion, there is a D2-receptor on the cardiac sympathetic nerve endings which decreases the heart rate and is different from the presynaptic alpha 2-receptor. Also, the heart rate lowering effect via stimulation of the D2-receptor by lisuride was more marked with increased concentration of norepinephrine in the synaptic cleft.

Animals