Biomedical subjects

Seung-Ho Kim

Publications and source records attributed to Seung-Ho Kim.

28 records · Page 2Linked to original sources

PubMed2003

Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up.

BACKGROUND: The purpose of this study was to evaluate prospectively the surgical outcomes of arthroscopic repair of anterior capsulolabral lesions with use of suture anchors in a large series of patients who were followed for two to six years. METHODS: We evaluated the results of arthroscopic Bankart repair with use of suture anchors and nonabsorbable sutures in 167 patients with traumatic recurrent anterior instability of the shoulder. The mean age at the time of the operation was twenty-five years. Preoperatively and at the time of follow-up (at a mean of forty-four months), the patients were assessed with three objective outcome measurement tools (the Rowe score, the University of California at Los Angeles [UCLA] shoulder rating scale, and the American Shoulder and Elbow Surgeons [ASES] score) and two subjective measurement tools (pain and function visual analog scales). The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated. RESULTS: All shoulder scores improved after surgery (p < 0.001). According to the Rowe scale, 130 patients (78%) had an excellent score; twenty-nine (17%), a good score; six (4%), a fair score; and two (1%), a poor score. Overall, the rate of postoperative recurrence of instability was 4% (one dislocation, two subluxations, and four positive results on the anterior apprehension test). Postoperative recurrence was related to an osseous defect of >30% of the entire glenoid circumference. In the patients with recurrent postoperative instability, the episodes were less frequent than they had been preoperatively and shoulder function was related to activity level. A revision arthroscopic Bankart repair stabilized three of the four shoulders in which it was performed. One hundred and fifty-two patients (91%) returned to >/=90% of their preinjury activity level. The mean loss of external rotation (and standard deviation) was 2.0 degrees +/- 4.0 degrees. CONCLUSIONS: We found that, in contrast to previous reports on the results of arthroscopic repair, arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.

Activities of Daily Living↗

PubMed2002

Platelet-agglutinating protein p37 from a patient with thrombotic thrombocytopenic purpura has characteristics similar to prethrombin 2.

Thrombotic thrombocytopenic purpura (TTP) is characterized by widespread platelet thrombi in arterioles and capillaries. Unusually large or multimeric von Willebrand factor, as well as one or more platelet-agglutinating factors, have been implicated in the pathogenesis of TTP. But, the actual mechanisms of platelet agglutination have not been satisfactorily explained. Recent studies suggested the 37-kDa platelet-agglutinating protein (PAP) p37 to be partially responsible for the formation of platelet thrombi in patients with TTP. We studied mobility in SDS-PAGE, the sequence of N-terminal amino acid residues, DNA and antigenic characteristics of PAP p37, which might be related to the pathogenesis of TTP. PAP p37 was purified from the plasma of a 31-year-old male Korean patient with acute TTP. The findings are as follows: (1) We compared PAP p37 with thrombin through the use of SDS-PAGE, either with or without beta-mercaptoethanol. PAP p37 did not appear to be cleaved between the A- and B-chains of prethrombin 2. However, thrombin did cleave between those of prethrombin 2, but linked with disulfide bridge. (2) N-terminal 21 amino acid sequence of PAP p37 was T-F-G-S-G- E-A-D-X-G-L-R-P-L-F-E-K-K-S-L-E. It appeared to be identical to that of 285-305 amino acid residues of human prothrombin (prethrombin 2). (3) No prothrombin gene DNA mutation was revealed. (4) The antigenicity of PAP p37 was similar to thrombin, which was a result of the competitive binding against the anti-thrombin antibody. With these results, we conclude that PAP p37 has similar characteristics to prethrombin2.

Adult↗

PubMed2002

Relationship between acrylamide concentration and enzymatic activity in an improved single fibrin zymogram gel system.

Based on the zymography analysis, Bacillus sp. DJ-4 (screened from Doen-Jang, a Korean traditional fermented food) secretes seven extracellular fibrinolytic enzymes (EFEs; 68, 64, 55, 45, 33, 27, and 13 kDa) in culture broth. These seven EFEs were analyzed by newly applied SDSfibrin zymography combined with gradient polyacrylamide (SDS-FZGP). This improved gel system was used with a 5-20% acrylamide gradient in a fibrin zymogram gel for the separation of proteins with molecular masses from below 10 kDa to over 100 kDa on one gel plate. Using this system, high molecular weight bands (HMWBs) were clearly and sharply resolved. We also examined the relationship between an acrylamide concentration and the enzymatic activity of EFE using densitometric analysis.

Acrylamide↗

PubMed2002

Differential arthroscopic portal placement for rotator cuff repair.

We report an effective technique of arthroscopic portal placement for rotator cuff repair of the shoulder. The differential portals are placed depending on the location of the tear. After the glenohumeral arthroscopic examination, the subacromial bursoscopy is performed through the same posterior skin portal. With the rotator cuff tear in view, a spinal needle is inserted to the center of the tear, 3 cm from the lateral margin of the acromion (middle working portal). Another spinal needle is then inserted into the posterior lip of the tear, 1 cm from the lateral margin of the acromion (rear viewing portal). The rear viewing portal provides a good downward en-face view of the tear, and the middle working portal allows better access to the anterior and posterior margins of the cuff tear than the usual posterior and lateral portals do. This differential portal placement with respect to the location of the rotator cuff tear ensures superior access for arthroscopic repair of rotator cuff tears.

Arthroscopy↗

PubMed2002

Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique.

PURPOSE: The purpose of this study was to compare the results of open and arthroscopic Bankart repair using suture anchors in traumatic anterior glenohumeral instability. Variables measured were recurrence rate, range of motion, and return to preinjury activity. TYPE OF STUDY: Case control study. METHODS: Eighty-nine shoulders in 88 patients with traumatic unilateral anterior shoulder instability were evaluated using Rowe and University of California Los Angeles scores, recurrence, return to activity, and range of motion by an independent examiner at an average of 39 months after either an arthroscopic or open Bankart repair using suture anchors. The arthroscopic technique included a minimum of 3 anchors in most patients and a routine incorporation of capsular plication and proximal shift. Of the 89 shoulders, 30 shoulders (30 patients) underwent open Bankart repair and 59 shoulders (58 patients) underwent arthroscopic Bankart repair. RESULTS: Twenty-six shoulders (86.6%) in the open repair group showed excellent or good results, and 54 (91.5%) shoulders in the arthroscopic repair group showed excellent or good results. The arthroscopic group revealed slightly higher scores in the Rowe (P =.041) and UCLA scores (P =.026). Two patients (6.7%) in the open repair group and 2 (3.4%) in the arthroscopic repair group had experienced at least 1 episode of redislocation after the surgery. One patient (3.3%) in the open repair group and 4 (6.8%) in the arthroscopic repair group demonstrated mild apprehension. The overall residual instability was 10% in the open repair group and 10.2% in the arthroscopic repair group. There were no significant differences in the loss of external rotation and return to prior activity between the 2 groups (P >.05). Residual instability occurred more frequently in patients with fewer anchors. CONCLUSIONS: Arthroscopic suture anchor capsulorraphy showed similar results to the open Bankart procedure.

Adolescent↗

PubMed2002

A water-infusion system with two reservoirs at different levels.

To provide a continuous supply of fluid during arthroscopic surgery, we suggest an infusion system with 2 reservoirs placed at different heights. The lower bag serves as a water reservoir, which allows more time for the circulating nurse to complete the task of exchanging the emptied water bag.

Arthroscopy↗

PubMed2002

Results of arthroscopic treatment of superior labral lesions.

BACKGROUND: The purpose of this study was to evaluate the results of arthroscopic repair of isolated superior labral lesions of the shoulder. METHODS: We evaluated thirty-four patients at a mean of thirty-three months (range, twenty-four to forty-nine months) following arthroscopic repair of an isolated superior labral lesion of the shoulder with suture anchors. The outcome of treatment was evaluated with the University of California at Los Angeles shoulder score and on the basis of the patient's ability to return to prior activities. There were thirty male patients and four female patients with a mean age of twenty-six years (range, sixteen to thirty-five years). Thirty patients were involved in athletic activities, and eighteen of them were engaged in overhead sports. RESULTS: Repair of the superior labral lesion resulted in a satisfactory University of California at Los Angeles shoulder score for thirty-two patients (94%) and an unsatisfactory score for two. Thirty-one patients (91%) regained their preinjury level of shoulder function. The shoulder score and the return to activity were correlated with the type of sports activity (r = 0.291, p < 0.0001 and r = 0.373, p = 0.010, respectively. Patients participating in overhead sports had significantly lower shoulder scores and a lower percentage of return to their preinjury level of shoulder function compared with patients who were not engaged in overhead activity (p = 0.024 and 0.015, respectively). CONCLUSIONS: Arthroscopic repair of an isolated superior labral lesion is successful in a majority of patients. However, the results in patients who participate in overhead sports are not as satisfactory as those in patients who are not involved in overhead sports.

Adolescent↗

PubMed2002

Effect of induced and spontaneous hypothermia on survival time of uncontrolled hemorrhagic shock rat model.

We examined the hypothesis that mild hypothermia (rectal temperature 34 degrees C) results in the same survival time, whether induced spontaneously or intentionally, during untreated, lethal, uncontrolled hemorrhagic shock in rats. Sixty-four Sprague-Dawley male rats were randomly assigned to normothermia (Nth) (n=19), spontaneous mild hypothermia (Sp.Hth) (n=25) or controlled mild hypothermia (Con.Hth) (n=20) groups. After blood withdrawal of 3 mL/100 g over 15 minutes, followed by 75% tail amputation under spontaneous breathing and light anesthesia by i.p. injection of pentobarbital sodium, rats were observed without fluid resuscitation or hemostasis for 180 minutes or until death. The initial temperature of the Nth group was artificially maintained throughout the experiment. For the mild hypothermia groups, the Sp.Hth group was exposed to ambient temperature while the Con. Hth group was actively cooled to a target rectal temperature of 34 degrees C. In the Con.Hth group, all rats except one died before 180 minutes. All rats in the Nth group died within 38 minutes, and within 67 minutes in the Sp.Hth group. The average survival time was shortest in the Nth group at 20.3 +/- 5.3 minutes, followed by the Sp.Hth group at 30.1 +/- 13.5 minutes, and the Con.Hth group at 81.9 +/- 39.8 minutes (p < 0.01). Tail bleed out volume was 0.51 +/- 0.19, 0.26 +/- 0.15 and 0.19 +/- 0.12 mL/100 g in the Nth, Sp.Hth and Con.Hth groups, respectively (p < 0.05). In conclusion, spontaneous mild hypothermia did not prolong the survival time as much as controlled mild hypothermia in the rat model for untreated, lethal, uncontrolled hemorrhagic shock.

Animals↗

PubMedDate not supplied

Arthroscopic revision Bankart repair: a prospective outcome study.

PURPOSE: The clinical outcome of the revision surgery for the failed Bankart repair is not well known. The purpose of this study was to prospectively analyze a series of patients with recurrent instability after primary Bankart repair that were revised arthroscopically using a suture-anchor technique. TYPE OF STUDY: Prospective, nonrandomized outcome study. METHODS: Twenty-three patients with failed Bankart repair were treated with arthroscopic surgery and were followed up for a mean of 36 months (range, 24-52 months; SD, 9 months). There were 21 men and 2 women with the mean age of 24 years (range, 17-34 years; SD, 4.4 years). Eight patients had previously received an open Bankart repair (5 transosseous-suture technique, 3 suture-anchor technique), and 15 had received an arthroscopic repair (10 transglenoid multiple-suture technique, 5 suture-anchor technique). The revision surgery included repair of the anterior labrum using suture anchors and nonabsorbable sutures, capsular plication, and proximal shift of the inferior capsule with or without closure of the rotator interval. The characteristics of the patients, possible modes of failure, surgical findings, shoulder scores (University of California at Los Angeles [UCLA] scale, Simple Shoulder Test, and Rowe score), and clinical outcome were evaluated. RESULTS: Recurrent instability developed at a mean of 21 months (range, 11-39 months; SD, 8 months) after the initial stabilization. A possible cause of failure in 5 patients was a nonanatomic repair, with the labral tissue fixed proximal or medial to the glenoid margin. At the follow-up, 15 patients had excellent results, 4 good, 3 fair, and 1 poor, according to the UCLA scale. The mean Rowe score improved from 87.3 (range, 30-100; SD, 12.6) to 91.2 (range, 40-100; SD, 14.2) (P =.023). The Simple Shoulder Test responses improved from 8 yes responses preoperatively to 11 postoperatively. Eighteen patients achieved an activity return of more than 90% of preinjury level. Five patients had recurrence after revision surgery (1 frank dislocation, 2 subluxation, 2 positive anterior apprehension sign). Engagement in contact sports was correlated with the recurrence (r =.683, P =.003). With the number available, no significant difference could be detected in the outcome between the types of the primary surgery. Arthroscopic revision Bankart repair did not result in any additional loss of external rotation compared with the contralateral side (P =.723). The most predictable factor for the functional return was preoperative range of external rotation (r =.793, P =.001). CONCLUSIONS: Arthroscopic revision Bankart surgery using suture anchors can provide a satisfactory outcome, including a low recurrence rate and reliable functional return, in carefully selected patients.

Adolescent↗

PubMedDate not supplied

Arthroscopic capsulolabroplasty for posteroinferior multidirectional instability of the shoulder.

BACKGROUND: Arthroscopic treatment of posteroinferior multidirectional instability of the shoulder is not well documented. PURPOSE: To evaluate pathologic lesions of posteroinferior multidirectional instability and the results of arthroscopic capsulolabroplasty. STUDY DESIGN: Prospective nonrandomized clinical trial. METHODS: Thirty-one patients with posteroinferior multidirectional instability were prospectively evaluated after arthroscopic capsulolabroplasty (mean follow-up, 51 months). Labral lesion and height were measured in the MRI arthrogram and arthroscopic examination. RESULTS: All patients had a labral lesion and variable capsular stretching in the posteroinferior aspect. There were 11 type I labral lesions (incomplete detachment), 12 type II (the Kim's lesion: incomplete and concealed avulsion), 6 type III (chondrolabral erosion), and 2 type IV (flap tear). All patients with type II and III lesions had chondrolabral retroversion, with lost labral height in the MRI arthrogram and arthroscopic examination. Twenty-one patients had an excellent Rowe score, nine had good scores, and one had a fair score. Thirty patients had stable shoulders, and one had recurrent instability. All patients had improved shoulder scores and function and pain scores. CONCLUSIONS: Symptomatic patients with posteroinferior multidirectional instability had posteroinferior labral lesions, including retroversion of the posteroinferior labrum, which were previously unrecognized. Restoration of the labral buttress and capsular tension by arthroscopic capsulolabroplasty successfully stabilized shoulders with posteroinferior multidirectional instability.

Adult↗