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Biomedical subjects

W Y Kim

Publications and source records attributed to W Y Kim.

At least 19 recordsLinked to original sources
PubMed2006

Iron status and its association with pregnancy outcome in Korean pregnant women.

OBJECTIVE: The purpose of this study was to assess the prevalence of iron deficiency anemia among Korean pregnant women and to assess the association between maternal hemoglobin (Hb) level and pregnancy outcome. DESIGN: A longitudinal study. SETTING: Ewha Womans University Hospital, Seoul, Korea. SUBJECTS: A total of 248 normal pregnant women of 24-28 weeks gestation and 190 babies born to the pregnant subjects. METHODS: Maternal anthropometry, blood parameters and pregnancy outcomes were measured. RESULTS: Mean Hb, serum iron concentration, transferrin saturation and total iron binding capacity of the subjects were 11.4 g/dl, 89.4 microg/dl, 18.7% and 484.6 microg/dl, respectively, and 30.2% of the subjects were anemic judged by Hb concentration of <10.5 g/dl. When subjects were classified into tertile groups based on Hb levels, the lowest tertile (HbT1) group had significantly lower concentrations of cord serum iron and albumin than those in the highest tertile (HbT3) group. Newborn infants from the HbT1 group had significantly higher rates of preterm delivery, low birth weight and low Apgar scores than those in other groups. Logistic regression analysis showed that maternal serum albumin and Hb level were the most important predictive variables for low birth weight. CONCLUSIONS: A substantial proportion of Korean pregnant women were at risk of anemia. Infants born to women with a low Hb level showed a lower birth weight, height and Apgar scores.

Adult↗
PubMed2006

Eleven-year results of the ABG I hip replacement.

The ABG I uncemented hip prosthesis has demonstrated an unacceptably high failure rate and poor functional outcome in our patients. A prospective review was performed of 38 implanted hips with a mean follow-up of 11 years. Sixteen hips have been revised or are candidates for revision hip surgery, due principally to polyethylene wear and pelvic osteolysis. Contributing factors were likely to be the poor wear characteristics of the polyethylene liners--which were gamma irradiated in air--and the thinness of these liners. Of further concern were the poor pain and function scores in the remaining hips [mean Harris Hip Scores (HHS) of 70 (SD 22) at 11-year follow-up]. The influence of the surgical learning curve on clinical results may have been an important factor. Undersized femoral components were associated with poor pain and functional scores in five patients with HHS < 60. All ABG I hip implants must remain under careful, long-term review.

Adult↗
PubMed2006

The relationship between acetabular retroversion and osteoarthritis of the hip.

Excessive acetabular cover secondary to a retroverted acetabulum causes pincer impingement, which may cause early osteoarthritis of the hip. Our aim was to determine if there was a relationship between acetabular version and osteoarthritis of the hip. Using image processing and analysis software we studied 117 CT images of the hip in patients aged less than 65 years who had undergone a CT virtual colonoscopy. The mean CT joint space of the 18 hips with acetabular retroversion was narrower compared with the 99 hips with normal acetabular alignment (p < 0.0001). A correlation of r = 0.46 (p < 0.01) was found between right hip acetabular version and the mean right hip joint space and of r = 0.31 (p = 0.02) between left hip acetabular version and the mean left hip joint space. Acetabular retroversion is associated with radiological evidence of osteoarthritis of the hip. An understanding of the mechanical basis of osteoarthritis of the hip allows early treatment of the underlying structural abnormality and prevents progression of the degenerative condition.

Acetabulum↗
PubMed2006

Training opportunities in the management of paediatric fractures: a district general hospital perspective.

INTRODUCTION: Increasing subspecialisation, the introduction of reforms to surgical training, centralisation of hospitals and the reduction of working hours brought about by the European Working Time Directive (EWTD) has direct implications on the training of surgeons in the UK. The aim of this study was to determine the range and number of procedures performed for paediatric orthopaedic fractures, degree of supervision and possible implications for training. PATIENTS AND METHODS: A retrospective review of procedures for paediatric orthopaedic fractures performed in a district general hospital in a year was conducted. RESULTS: A total of 210 paediatric fracture procedures were performed, including 99 distal radius/ulna procedures, 28 shaft radius/ulna, 25 supracondylar procedures, 15 hand fracture procedures, 14 tibial shaft procedures. Middle grade/registrars and senior house officers performed 188 (89.5%) of all procedures. Consultant supervision was documented in 29 (13.8%) of all procedures performed. The number and type of common, as well as unusual, injuries was documented. The educational value of a training post may only be confirmed by reliable data which would provide an indication of operative opportunities and degree of supervision available to a trainee. CONCLUSIONS: This study provided a model upon which all operative training opportunities in the orthopaedic department is documented. It is suggested that such data should form the basis of the establishment of training posts within a region. To maintain the high standard of orthopaedic training in the UK, the maintenance of such posts, number of trainees and seniority of trainees appointed to any hospital within a training region should be on the basis of data such as reported in this study.

Child↗
PubMed2005

Functional treatment of acute metatarsal fractures: a prospective randomised comparison of management in a cast versus elasticated support bandage.

A randomised controlled trial was performed in 50 patients with acute isolated minimally displaced lesser metatarsal fractures in order to compare plaster immobilisation with elasticated support bandage treatment. Patients treated with elasticated support bandage had significantly higher AOFAS mid-foot scores at 3-months follow-up and complained of less pain throughout the treatment period. There was no difference between the two groups in time to independent mobility, mid-foot circumference, analgesic requirements and radiological union at 3 months. As plaster casts are associated with serious complications, which were encountered in these studies, we conclude that minimally displaced metatarsal fractures are better treated without a cast.

Adolescent↗
PubMed2005

The removal of forearm plates in children.

Routine removal of forearm plates in children remains controversial. The aim of the study was to assess if risks of complications associated with removal of forearm plates in children warrant routine removal of these plates. A total of 43 children (mean age 10.6 years old at time of fracture fixation) who had forearm plates removed after fracture fixation in our unit over a 10-year period were reviewed. There were three cases of re-fractures (two in the same child), all of which occurred following an episode of trauma and the use of Dynamic Compression Plates (DCP). One case of superficial infection was successfully treated with oral antibiotics. Low rates of complications from routine removal of metal work after forearm plating in children may be achieved.

Adolescent↗
PubMed2005

Non traumatic dislocation of the patella in children: the case for a dysplastic aetiology.

Congenital dislocation of the patella may be a phenotype, which has several genotypes, i.e. it may be congenital or acquired. This hypothesis is suggested with three illustrative case studies. Risk factors predictive of the development of irreducible dislocation of the patella in infancy are suggested. As there is a spectrum of possible aetiologies, 'late' diagnosis and a number of 'risk' factors but a common pathology, the word 'congenital' is not always appropriate. We suggest 'Developmental dysplasia and dislocation of the patella (DDDP)' is a more appropriate term for this rare condition.

Child, Preschool↗
PubMed2004

A new biomechanical model for the functional assessment of knee osteoarthritis.

The severity of symptoms in osteoarthritis (OA) of the knee can be difficult to assess. A new method for assessing medial compartment OA of the knee is proposed. The purpose of this study was to determine if a relationship exists between the severity of OA and single limb stance knee adduction moment (SSKAM). Fourteen patients with medial compartment OA of the knee were tested and compared with 14 age-matched volunteers. WOMAC OA index scores were documented. Biomechanical data were collected from a single Kistler force platform and a six-camera ProReflex motion analysis system, and the knee adduction moments were calculated. A significant difference in the maximum, minimum and mean adduction moments was found between the two groups, and a correlation of r=0.66 for WOMAC physical function subscale, r=0.63 for the WOMAC pain subscale and r=0.63 for the sum of the subscales and mean SSKAM was found. Single limb stance adduction moments provide additional, objective information in the assessment of medial compartment OA of the knee. It may be useful in the selection of patients for surgery and for evaluating various treatment modalities for medial compartment OA of the knee.

Adult↗
PubMed2004

Congenital and irreducible non-traumatic dislocation of the patella--a modified soft tissue procedure.

Many procedures have been described for the correction of congenital dislocation of the patella. Most operations entail extensive soft tissue releases through curved skin incisions. A modification of the Langenskiold and Ritsila procedure is described. The main alterations include a limited and straight anterior skin incision, a fashioning of a 'buckle' of the transferred distal-patellar tendon to a distally based flap and the transposition of an extensive medial rotation flap. This report describes the early results (mean=19 months) of the modified procedure in three cases of congenital lateral dislocation of the patella.

Child↗
PubMed2003

Displaced supracondylar humeral fractures in children: results of a national survey of paediatric orthopaedic consultants.

Several aspects of the management of displaced supracondylar fractures in children remain controversial. Displaced supracondylar humeral fractures (Type III) in children have traditionally been considered orthopaedic emergencies. Recent studies have suggested that closed Type III supracondylar fractures without vascular compromise may be treated in a delayed manner without compromise to functional and cosmetic outcome. Debate continues over the fixation method of choice in these difficult fractures. A postal questionnaire of 121 practising paediatric orthopaedic consultants in the UK was performed to explore these issues. Seventy-seven replies were obtained (63.6%). The 54.5% of the respondents managed displaced supracondylar fractures without vascular compromise in a delayed manner (more than 8h from presentation). The incidence, initial assessment and factors which influence the timing of surgery of these fractures are discussed. The fixation method of choice reported was closed reduction and the use of smooth Kirshner wires (93.4%). Of these, crossed pin fixation is used by 83.9% of respondents and 9.7% employed laterally placed wires. The majority of consultants (69.7%) considered the operative treatment of these fractures a consultant-led procedure. This survey has established an overview of the current practices of paediatric orthopaedic consultants in the UK in the management of these difficult fractures.

Bone Nails↗
PubMed2001

Coronary magnetic resonance angiography for the detection of coronary stenoses.

BACKGROUND: An accurate, noninvasive technique for the diagnosis of coronary disease would be an important advance. We investigated the accuracy of coronary magnetic resonance angiography among patients with suspected coronary disease in a prospective, multicenter study. METHODS: Coronary magnetic resonance angiography was performed during free breathing in 109 patients before elective x-ray coronary angiography, and the results of the two diagnostic procedures were compared. RESULTS: A total of 636 of 759 proximal and middle segments of coronary arteries (84 percent) were interpretable on magnetic resonance angiography. In these segments, 78 (83 percent) of 94 clinically significant lesions (those with a > or = 50 percent reduction in diameter on x-ray angiography) were also detected by magnetic resonance angiography. Overall, coronary magnetic resonance angiography had an accuracy of 72 percent (95 percent confidence interval, 63 to 81 percent) in diagnosing coronary artery disease. The sensitivity, specificity, and accuracy for patients with disease of the left main coronary artery or three-vessel disease were 100 percent (95 percent confidence interval, 97 to 100 percent), 85 percent (95 percent confidence interval, 78 to 92 percent), and 87 percent (95 percent confidence interval, 81 to 93 percent), respectively. The negative predictive values for any coronary artery disease and for left main artery or three-vessel disease were 81 percent (95 percent confidence interval, 73 to 89 percent) and 100 percent (95 percent confidence interval, 97 to 100 percent), respectively. CONCLUSIONS: Among patients referred for their first x-ray coronary angiogram, three-dimensional coronary magnetic resonance angiography allows for the accurate detection of coronary artery disease of the proximal and middle segments. This noninvasive approach reliably identifies (or rules out) left main coronary artery or three-vessel disease.

Adult↗
PubMed2001

Pharmacological preconditioning with low-dose cyclosporine or FK506 reduces subsequent ischemia/reperfusion injury in rat kidney.

BACKGROUND: Ischemia/reperfusion (I/R) injury in the early posttransplant period is closely associated with delayed recovery of graft function, increased acute rejection, and late allograft dysfunction. Pharmacological preconditioning with low-dose cyclosporine (CsA) or FK506 was performed to induce ischemic tolerance in rat kidney with I/R injury. METHODS: Low-dose CsA (3 mg/kg, administered i.v.) or FK506 (0.3 mg/kg i.v.) were used to induce ischemic tolerance in Sprague-Dawley rats, and the induction of heat shock protein (hsp) 70 by CsA or FK506 was evaluated overtime. Rats were pretreated with CsA or FK506 6 hr before I/R injury when hsp70 was maximally expressed, and were killed 24 hr later. The effect of pharmacological preconditioning on subsequent I/R injury was evaluated in terms of renal function, histopathology score, assays for apoptosis (DNA fragmentation analysis, TUNEL staining, expressions of pro-apoptotic genes, and caspase activity), and the expression of inflammatory cytokine genes (interleukin-1 and tumor necrosis factor-alpha). RESULTS: Preconditioning with low-dose CsA or FK506 significantly improved renal function and renal histology, compared to rats with I/R injury. Apoptotic cell death (typical DNA laddering and increased TUNEL-positive cells) in rat kidneys with I/R injury, was decreased by pretreatment with low-dose CsA or FK506. Increased expression of pro-apoptotic genes (Fas, Fas-ligand, caspase 1 and 3) and activated caspases in ischemic rat kidneys were decreased after CsA or FK506 pretreatment. CONCLUSIONS: Pretreatment with low-dose CsA or FK506 prevents subsequent I/R injury, and this effect may be related to the induction of hsp70. Pretreatment of renal donors with low-dose CsA or FK506 may result in an improvement in immediate posttransplant function.

Animals↗