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Biomedical subjects

W K Kim

Publications and source records attributed to W K Kim.

At least 73 records · Page 4Linked to original sources
PubMed2000

Prognostic value of hematopoietic chimerism in patients with acute leukemia after allogeneic bone marrow transplantation: a prospective study.

Hematopoietic chimerism as a predictive marker for the relapse of acute leukemia after allogeneic BMT was evaluated in a prospective study. Monthly assays of hematopoietic chimerism were performed from peripheral blood samples by PCR amplification of short tandem repeats or amelogenin loci. Between December 1997 and June 1999, 33 patients enrolled and 30 were evaluable (two early deaths, one lack of informative bands for chimerism evaluation). There were 14 male and 16 female patients (15 AML and 15 ALL) with a median age of 31 years (range 16-46). Mixed chimerism (MC) was observed at least once in 14 of 30 patients (47%). There was no significant difference between 14 patients who showed MC (MC group) and 16 patients who did not show MC (complete chimerism (CC) group) in terms of age, sex, disease status at BMT, donor type, and the number of bone marrow cells infused. There was no significant difference in the neutrophil and platelet engraftment rates between the two groups. After a median follow up of 10.9 months (range 4.3-22.4), five patients in the CC group and two patients in the MC group relapsed (P = 0.27). All five patients who relapsed in the CC group maintained CC up to 1 month prior to clinical relapse. Our study demonstrated that the patients who showed MC post BMT did not have higher risk of relapse of acute leukemia when compared to patients who did not show MC. Sensitive PCR-based assays for hematopoietic chimerism applied on a monthly basis after allogeneic BMT could not predict relapse of acute leukemia.

Adolescent↗
PubMed2000

Veno-occlusive disease of the liver after allogeneic bone marrow transplantation for severe aplastic anemia.

There are few reports about the occurrence of hepatic VOD after BMT for severe aplastic anemia (SAA). We prospectively studied 17 patients with SAA after allogeneic BMT for the occurrence and severity of VOD. Plasma levels of protein C, protein S, antithrombin III, vWF, t-PA and PAI-1 were determined before preparative chemotherapy, on the day of marrow infusion, and on days 7, 14 and 21. VOD occurred in seven patients (41.2%) at a median of day 1 (range, day -2 to 15). Five had mild, and two moderate VOD. Platelet transfusion requirements were higher in the patients with VOD. The plasma levels of natural anticoagulants such as protein C, free protein S and antithrombin III decreased significantly on day 0 from the baseline levels. Plasma levels of t-PA, PAI-1 and vWF increased significantly in the early post-transplant period compared to the baseline levels. The mean plasma levels of t-PA on day 7 (P = 0.016) and PAI-1 on days 0 and 7 (P = 0.016, 0.032) were higher in the patients with VOD. In summary, we observed hypercoagulability and a high incidence of VOD after allogeneic BMT for SAA. Levels of t-PA and PAI-1 were significantly higher in the patients with VOD after BMT.

Adolescent↗
PubMed2000

Synergistic depletion of astrocytic glutathione by glucose deprivation and peroxynitrite: correlation with mitochondrial dysfunction and subsequent cell death.

Previously we reported that immunostimulated astrocytes were highly vulnerable to glucose deprivation. The augmented death was mimicked by the peroxynitrite (ONOO )-producing reagent 3-morpholinosydnonimine (SIN-1). Here we show that glucose deprivation and ONOO- synergistically deplete intracellular reduced glutathione (GSH) and augment the death of astrocytes via formation of cyclosporin A-sensitive mitochondrial permeability transition (MPT) pore. Astrocytic GSH levels were only slightly decreased by glucose deprivation or SIN-1 (200 microM) alone. In contrast, a rapid and large depletion of GSH was observed in glucose-deprived/ SIN-1-treated astrocytes. The depletion of GSH occurred before a significant release of lactate dehydrogenase (a marker of cell death). Superoxide dismutase and ONOO-scavengers completely blocked the augmented death, indicating that the reaction of nitric oxide with superoxide to form ONOO was implicated. Furthermore, nitrotyrosine immunoreactivity (a marker of ONOO-) was markedly enhanced in glucose-deprived/SIN-1 -treated astrocytes. Mitochondrial transmembrane potential (MTP) was synergistically decreased in glucose-deprived/SIN-1-treated astrocytes. The glutathione synthase inhibitor L-buthionine-(S,R)-sulfoximine markedly decreased the MTP and increased lactate dehydrogenase (LDH) releases in SIN-1-treated astrocytes. Cyclosporin A, an MPT pore blocker, completely prevented the MTP depolarization as well as the enhanced LDH releases in glucose-deprived/SIN-1-treated astrocytes.

Animals↗
PubMed2000

Topical and systemic anticoagulation in the treatment of absent or compromised venous outflow in replanted fingertips.

Adequate venous repair is not always possible in fingertip replantation. We have used topical and systemic anticoagulation for fingertip replantation to overcome venous congestion in cases without venous repair or in cases in which there is obstruction of a repaired vein. Our technique consists of continuous external bleeding via a stab incision on the paraungal area and dripping heparinized saline solution at the incision site to maintain external bleeding. From July 1985 to December 1993, 157 fingers in 140 patients with complete amputation of the fingertip were replanted at Korea University Guro Hospital. Of these, 74 fingers in 68 patients were managed by topical and systemic anticoagulation due to the impossibility of repair or obstruction of a repaired vein. The overall survival rate of the fingertip replantations was 76%; that of the topical and systemic anticoagulation group was 64%.

Administration, Topical↗
PubMed2000

Nutritional value of enzyme- or sodium hydroxide-treated feathers from dead hens.

Two feather digestion processes to remove the feathers from the carcasses of dead hens were evaluated for their impact on the nutritional quality of the resulting feather meal. There were three treatments: control (untreated feathers), a feather-digesting enzyme, and NaOH treatment. Both enzyme- and NaOH-treated feathers were easily separated from the hen carcasses. The CP level of enzyme-treated feathers after autoclaving (49.90%) was significantly less than the control and NaOH-treated feathers (94.48 and 87.31%, respectively) because of elevated ether extract levels resulting from skin and abdominal fat release during the 12-h enzyme incubation. Before autoclaving, pepsin digestibilities of enzyme- and NaOH-treated feathers were significantly higher than the control. However, after autoclaving, no significant difference was found in pepsin digestibility between the control and enzyme treatments or control and NaOH treatments. The typical limiting amino acids, methionine, lysine, and histidine, in feathers were present at greater levels in the resulting enzyme-feather meal (E-FM) compared with the NaOH-feather meal (N-FM) or control-feather meal (C-FM) on a percentage of CP basis. Cystine levels, however, were significantly lower in the E-FM and N-FM compared with that of the C-FM. In chick bioassays, no significant differences were found in protein efficiency ratio (PER) and net protein ratio (NPR) among C-FM, E-FM, and N-FM. The AMEn of E-FM (4.52 kcal/g) was significantly higher than the C-FM (3.58) or N-FM (2.79). These findings indicated that although enzyme treatment could improve the nutritional quality of feathers from dead hens, NaOH treatment was a more rapid means of separating feathers from the carcass.

Animal Feed↗
PubMed2000

Recycling dead hens by enzyme or sodium hydroxide pretreatment and fermentation.

This study was conducted to evaluate the recycling of whole dead hens into feed ingredients by enzyme or sodium hydroxide pretreatment and fermentation. Evaluation criteria included nutrient preservation, pathogenic microorganism elimination, and assays of nutritional quality. The pH levels of enzyme- and NaOH-treated hen carcasses decreased from 6.01 and 7.66 to 4.18 and 4.24, respectively, during the 21-d fermentation. Hydrogen sulfide levels were not detected on Days 1 and 3 from the enzyme treatment; however, high levels (800 ppm) were measured from the NaOH treatments. By Day 21, H2S levels of both treatments had decreased to 78 ppm. The control, enzyme, and NaOH treatments before fermentation contained high levels of Escherichia coli and Staphylococcus aureus; however, after fermentation, these potential pathogens were eliminated in the enzyme and NaOH treatments. Levels of CP, EE, and ash of the control product were higher than either the enzyme or NaOH treatment. NaOH reduced pepsin digestibility by 11% compared to the enzyme treatment. In a bioassay, the chicks fed control autoclaved hen meal (CHM) had higher (P < 0.05) feed intake, weight gain, protein efficiency ratio (PER), and net protein ratio (NPR) than enzyme-treated, fermented, and autoclaved hen meal (EHM) or NaOH-treated, fermented, and autoclaved hen meal (NHM). However, the AMEn of the CHM and EHM were higher than the NHM (P < 0.05) when evaluated using mature cockerels. These results indicated that fermentation processing of dead hens reduced the concentration of some nutrients and depressed growth performance when hen meals were fed to young chicks.

Amino Acids↗
PubMed2000

The effects of the number and ratio of repaired arteries and veins on the survival rate in digital replantation.

From January 1990 to December 1998, 631 consecutive single-digit replantations were reviewed retrospectively to determine the essential number of vascular anastomoses and the artery-to-vein ratio for successful finger replantation. The correlations between the number and the ratio of anastomosed vessels and the survival rate were examined according to the amputated digital levels, and all of the correlated results were compared with each other statistically. In zone I, the survival rate of the digits with a vein repaired was higher than that of digits treated with the external bleeding method. In zone II, repairing more arteries than veins led to venous congestion and resulted in a failure of replantation. Thus, the ratio of an equal or greater number of veins repaired to the arteries repaired was an important factor in successful replantation in zone II, which may be due to the large amount of arterial input relative to the small volume of venous drainage via small veins in the replanted digit. In zone III, the equal number of arteries and veins repaired was also an important factor in successful replantation. However, unlike zone II, even when more arteries were repaired than veins, venous congestion occurred rarely because the vein in this area was larger, providing sufficient venous drainage. In zone IV, repair of two veins was needed to yield good results. Because the volume of the amputated part in zone IV was larger than in other zones, it was desirable to repair both arteries, even though repairing one artery yielded good results. In conclusion, it is desirable to repair as many vessels as possible to increase the possibility of a good result. However, digital amputations and their conditions for replantation differ. Therefore, the number and ratio of vessels that need to be repaired should be modified and adjusted in each case.

Amputation, Traumatic↗
PubMed2000

Correlation of electrodiagnostic findings with subjective symptoms in carpal tunnel syndrome.

The records of 138 patients (222 hands) who had been evaluated by preoperative nerve conduction study (NCS) and consecutive self-administered questionnaires were analyzed to determine diagnostic relations in carpal tunnel syndrome. Hands were categorized into six grades (extreme, severe, moderate, mild, minimal, and negative) according to the three modalities: the NCS data of the median sensory nerve, Symptom Severity Scale score, and Functional Status Scale score. The authors evaluated the correlation, independence, homogeneity, and association among parameters, and found the following: (1) the NCS data correlated more significantly (p < 0.05) and was associated more linearly with Symptom Severity Scale score than the Functional Status Scale score; (2) the choice of modality exerted an influence on grading severities, thus grades varied according to the modalities; and (3) the distribution of patients was not homogenous; there were more extremes in NCS, and more severe scores on the Symptom Severity Scale. Patients rated as one homogeneous severity by NCS data may be interpreted into different severities (from negative to extreme) by self-administered questionnaires and vice versa.

Adult↗
PubMed2000

The possible cost effectiveness of peripheral blood stem cell mobilization with cyclophosphamide and the late addition of G-CSF.

The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 microg dose of G-CSF (Neutrogen) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4 g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 10(6)/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses > or = 2.0 x 10(6)/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils > or = 0.5 x 10(9)/L or platelets > 20 x 10(9)/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p<0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.

Adult↗
PubMed2000

Asymptomatic electrophysiologic carpal tunnel syndrome in diabetics: entrapment or polyneuropathy.

Electrophysiologic carpal tunnel syndrome (CTS) is common and is frequently asymptomatic in diabetics. In order to evaluate the clinical significance of asymptomatic electrophysiologic CTS, the nerve conduction studies (NCS) of 48 diabetics with asymptomatic electrophysiologic CTS were compared with those of 56 age and gender-matched controls, as well as 50 patients with symptomatic CTS without diabetes. Nerve conduction velocities of the ulnar, peroneal, and posterior tibial nerves were significantly slower in diabetics with asymptomatic electrophysiologic CTS than in normal controls. Compared to symptomatic non-diabetic CTS, there was also significant slowing of the median and ulnar nerve conduction velocities in asymptomatic diabetic CTS. However, in diabetics with asymptomatic CTS, abnormalities of the distal segment of the median NCS were more prominent compared with those of all the other tested nerves. These findings suggested that asymptomatic electrophysiologic CTS in diabetics is a manifestation of increased vulnerability to the entrapment of the peripheral nerve.

Carpal Tunnel Syndrome↗
PubMed2000

Muscle fiber type disproportion with an autosomal dominant inheritance.

Congenital muscle fiber type disproportion (CFTD) has been described as a form of congenital myopathy characterized by the smallness and marked predominance of type 1 fibers in a muscle biopsy. Clinical manifestations include hypotonia, nonprogressive muscle weakness, joint contractures, and skeletal deformities. However, it has also been noted that the same pathologic alterations appeared in clinically diverse conditions. Recently, we experienced a family, a mother and two children, in which a muscle biopsy showed the mother to have muscle fiber type disproportion. This case was unusual in that there was a significant progression of weakness, an absence of neonatal hypotonia, and other commonly associated musculo-skeletal deformities. In this report, we describe the clinicopathologic features of the family with a brief review about muscle fiber type disproportion.

Adult↗
PubMed1999

S-nitrosation ameliorates homocysteine-induced neurotoxicity and calcium responses in primary culture of rat cortical neurons.

Homocyteine (HC) induces neurotoxicity through overstimulation of N-methyl-D-aspartate (NMDA) receptors in cortical neurons. Due to its high reactivity, the sulfhydryl group of HC may react with nitric oxide (NO). In the present study S-nitrosation decreased the homocysteine-evoked LDH releases from rat cortical neuronal cultures. Like HC, S-nitrosohomocysteine increased the intracellular calcium concentration ([Ca2+]i) via NMDA receptor. However, S-nitrosohomocysteine was much less efficacious than HC for the increase of [Ca2+]i. Elevation of the glycine concentration to 50 microM significantly increased the maximal calcium response of S-nitrosohomocyteine, but not high enough to match that of HC in the presence of the same concentration of glycine. S-nitrosohomocysteine partially decreased the NMDA calcium responses in the presence of 1 and 50 microM glycine, at least in part via the redox-modulatory site(s) of the NMDA receptor. These data indicate that NO ameliorates the potential, adverse properties of HC via S-nitrosylation in the pathogenesis of hyperhomocysteinemia.

Animals↗
PubMed1999

Lead induced thiamine deficiency in the brain decreased the threshold of electroshock seizure in rat.

Many neurological disorders that occur frequently in lead intoxicated animals, have also been observed in thiamine deficient animals. To test whether lead intoxication could decrease the thiamine status and thresholds of electroshock seizure in rats, 3-week-old Wistar rats were treated with lead or lead plus thiamine. For comparison, a thiamine deficient group was included. Thiamine contents and transketolase activity, one of the thiamine dependent enzymes in the brain regions were significantly lowered by lead intoxication and thiamine deficiency. In both cases, thresholds of the electroshock seizure were significantly decreased. Thiamine supplementation reversed these signs and decreased the brain lead concentration in the lead treated group. The results from the present study suggest that the increased seizure susceptibility induced by lead intoxication in rats may be mediated at least in part through the changes of thiamine status.

Animals↗
PubMed1999

Dextromethorphan modulates the AP-1 DNA-binding activity induced by kainic acid.

We have recently reported that dextromethorphan attenuates the neurotoxicity induced by kainic acid in a dose-related fashion. Pretreatments with dextromethorphan (50 mg/kg, p.o. x2) significantly reduced the activator protein-1 DNA-binding activity and the Fos-related antigen-immunoreactive protein induced by kainic acid (10 mg/kg, i.p.) in the CA1, but not the CA3 or the dentate gyrus sector of the rat hippocampus. Paradoxically, dextromethorphan itself caused an elevated activator protein-1 DNA-binding activity and Fos-related antigen-immunoreactive protein in the CA1 region which lasted for at least 4 days. The results suggest that the CA1 area is the critical site for mediating the putative neuroprotective effect induced by dextromethorphan.

Animals↗
PubMed1999

Solid and papillary epithelial neoplasm of the pancreas in children.

Solid and papillary epithelial neoplasm of the pancreas is an uncommon low-grade malignant tumor found predominantly in young females. In this paper, the authors report the tumor's clinical characteristics and the results of surgery in six children. Six cases of solid and papillary epithelial neoplasm of the pancreas pathologically verified at Seoul National University Children's Hospital between 1985 and 1997 were retrospectively analyzed. Four were girls and two were boys, and their mean age at surgery was 11.2 years (range 8-13 years). All patients presented with an abdominal mass and tumor ranging in size from 6.5 x 6.0 cm to 10.5 x 8.0 cm. Five were located in the head and one in the tail of the pancreas; exploration showed that no case involved local invasion or metastasis. All patients underwent complete resection, which involved five pancreaticoduodenectomies and one distal pancreatectomy. No patient died during surgery, and after a mean follow-up period of 5.5 years (range 1.5-12.5 years) all were alive with no recurrences. We believe that the malignancy of this tumor is low grade and that the prognosis is good. For a neoplasm arising anywhere in the pancreas, complete resection is the treatment of choice. Solid and papillary epithelial neoplasm of the pancreas of children shows less female preponderance in children than in adults.

Adolescent↗
PubMed1999

Successful transumbilical embolization of congenitally ruptured hepatoblastoma.

To avoid a high-risk operation on a moribund neonate with a ruptured hepatic tumor, transumbilical embolization of the bleeding tumor was attempted in a 2-day-old neonate. A 3F microferret catheter was advanced through the right umbilical artery. After identifying the left hepatic artery feeding the bleeding tumor, Gelfoam (Upjohn, Kalamazoo, MI) particles were injected. Bleeding was successfully controlled. The infant was able to tolerate enteral feeding when stable. Seventeen days after embolization, elective left hepatic lobectomy was performed. Histological examination showed a fetal epithelial type hepatoblastoma. The baby is 13 months old now and is receiving chemotherapy.

Embolization, Therapeutic↗
PubMed1999

Nitric oxide-enhanced excitotoxicity-independent apoptosis of glucose-deprived neurons.

Glucose deprivation has been shown to elicit neuronal death via extracellular glutamate accumulation. Here we report that immunostimulated glial expression of inducible nitric oxide synthase enhances the apoptotic death of glucose-deprived cerebellar granule cells (CGC) via the excitotoxicity-independent pathway. CGC cultures were immunostimulated by interferon-gamma (100 U/ml) and lipopolysaccharides (1 microg/ml) and 2 days later were challenged by glucose deprivation. Neither a 2-h Glucose deprivation nor a 2-day immunostimulation altered the viability of CGC. A 2-day immunostimulation, however, markedly enhanced the apoptotic death of CGC glucose-deprived for 1 h. The increased apoptotic death of glucose-deprived CGC after immunostimulation was mimicked by the nitric oxide (NO) releasing reagent 3-morpholinosydnonimine (200 microM, 30 min) and was partially prevented by the NO synthase (NOS) inhibitor N(G)-nitroarginine. The enhanced apoptotic death was not blocked by the N-methyl-D-aspartate (NMDA) receptor antagonists D-2-amino-5-phosphovalerate (APV) and dizocilpine (MK-801) or the non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX). Moreover, the NO-induced enhanced apoptotic death occurred without a significant increase of the concentration of glutamate in the bathing medium. Our data indicate that immunostimulated glial cells potentiate the apoptotic death of glucose-deprived CGC in part through the expression of inducible NOS but not through NMDA receptor activation. Potentiation of glucose-deprived CGC death by immunostimulated glial cells may be clinically implicated in the tendency of recurrent ischemic insults to be more severe and fatal than an initial ischemic insult.

Animals↗