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Biomedical subjects

H T Kim

Publications and source records attributed to H T Kim.

At least 109 records · Page 6Linked to original sources
PubMed1989

A study on the recent trend and risk factors of cerebrovascular disease.

Six hundred eighty seven cases of cerebrovascular disease, confirmed by C-T scan, were evaluated at Hanyang University Hospital from January 1985, to December 1988, and the following results were obtained. 1) The incidence of cerebral infarction was markedly increased in the last 5 years. 2) Cerebral hemorrhage showed a peak age of incidence in the fifties, cerebral infarction in the sixties. 3) Among the preceding diseases at the onset of cerebrovascular disease, hypertension was the most common. 4) Total lipid, Total-cholesterol/HDL-cholesterol ratio were significantly higher in cerebral infarction than in cerebral hemorrhage. 5) Triglyceride concentration and total cholesterol concentration were also higher in cerebral infarction than those of cerebral hemorrhage, but statistically not significant. 6) In cerebral infarction HDL-cholesterol concentration was significantly lower than that of cerebral hemorrhage. (p less than 0.01.) 7) In cerebral infarction, hematocrit and hemoglobin concentration were significantly higher, respectively, than those of cerebral hemorrhage.

Adult↗
PubMed1987

Effects of chronic dietary beer and ethanol consumption on experimental colonic carcinogenesis by azoxymethane in rats.

Epidemiological studies have shown an association between consumption of alcoholic beverages, particularly beer, and carcinoma of the large bowel, especially the rectum. We studied the effects of chronic dietary beer and ethanol consumption on experimental colonic carcinogenesis, fecal bile acid and neutral sterol levels, fecal bacterial flora, and colonic epithelial DNA synthesis. Ten-week-old male Fischer 344 rats were pair fed throughout the study with Lieber-DeCarli-type liquid diets providing comparable total carbohydrates, proteins, fats, and calories. The diets provided 23 or 12% of calories as alcohol in beer (Hi-Beer and Lo-Beer groups), 18 or 9% of calories as reagent ethanol (Hi-EtOH and Lo-EtOH groups), or no alcohol (control group). After 3 weeks of dietary acclimatization, 10 weekly s.c. injections of the bowel carcinogen azoxymethane, 7 mg/kg, were given (weeks 1-10). At necropsy in week 26, the high alcohol groups (Hi-Beer and Hi-EtOH) showed a significantly reduced incidence of tumors in the right colon (42 and 46% versus 81% in control, P less than 0.01 and P = 0.02) but no effect on left colonic tumorigenesis. By contrast, the low alcohol groups (Lo-Beer and Lo-EtOH) showed a trend toward increased incidence and proportion of tumors in the left colon (incidence of 42 and 35% versus 15% in control, P = 0.06 for Lo-Beer; 28 and 30% of tumors in left colon versus 11%, P = 0.08 and P = 0.07) but no effect on right colonic tumorigenesis. Numbers of right colonic tumors were inversely correlated with alcohol consumption of all rats (r = -0.350, P less than 0.001), but left colonic tumors were not correlated. Fecal bile acid and neutral sterol levels, fecal bacterial counts, and colonic epithelial DNA synthesis did not correlate with the effects of alcohol consumption on colonic tumorigenesis. Our findings suggest that: modulation of experimental colonic tumorigenesis by chronic dietary beer and ethanol consumption was due to alcohol rather than other beverage constituents; tumorigenesis in the right and left colon was affected differentially by the levels of alcohol consumption, reflecting complex interactions among the potential mechanisms for alcohol effects in the model used.

Alcohol Drinking↗
PubMedDate not supplied

E2F decoy oligodeoxynucleotides on neointimal hyperplasia in canine vein graft.

Double-stranded DNA with high affinity to E2F as a decoy cis-element blocks the activation of genes mediating the cell cycle, resulting in effective suppression of the smooth muscle cell proliferation that causes intimal hyperplasia. To evaluate the effect of the E2F decoy to suppress neointimal hyperplasia autogenous venous bypass grafts were performed in dogs after incubation with heparin (group 1), with E2F decoy oligodeoxynucleotides (ODN) (groups 2 and 3), or with a random ODN (group 4) using a Japan-liposomeal method based on a hemagglutinating virus. The intimal and medial cross-sectional surface area of the anastomotic site was measured at 4 months after bypass surgery in groups 1, 3, and 4 by computerized planimetry and at 4 weeks in group 2 to compare the intimal/medial (I/M) area ratios. Autogenous vein grafts treated with E2F decoy showed a significant reduction in I/M area ratio (0.26 +/- 0.11) compared with the heparin-treated control group (1.49 +/- 0.29) or the mismatched ODN-treated group (1.61 +/- 0.28; P = .000). There was no difference in the I/M area ratio according to experimental periods (groups 2 vs 3: 0.26 +/- 0.11 vs 0.37 +/- 0.32; P = .446) or the anastomotic sites (proximal vs distal; P = .934). In conclusion, an E2F decoy can suppress neointimal hyperplasia in autogenous vein grafts, which may prolong patency by reducing graft stenosis.

Anastomosis, Surgical↗
PubMedDate not supplied

Location of acetabular deficiency and associated hip dislocation in neuromuscular hip dysplasia: three-dimensional computed tomographic analysis.

Forty-one hips in 24 patients with neuromuscular disease (NMD) were studied using three-dimensional computed tomography (3DCT). The location of the acetabular deficiency was posterior (37%), anterior (29%), midsuperior (15%), and mixed (19%) (anterosuperior, posterosuperior, and global). Although subtle morphologic changes occurred in the entire acetabulum, the major acetabular deficiency coincided with the direction of the subluxation or dislocation. The location of the acetabular deficiency that develops in cerebral palsy is not always posterosuperior, as suggested by other authors. The pattern of spasticity that results in muscle imbalance around the hip joint and changes in proximal femur architecture causes hip subluxation or dislocation, which may be either, posterior, anterior, or midsuperior. 3DCT studies are required to analyze accurately and understand acetabular deficiency in childhood NMD. These image data also allow more accurate planning for surgery in neuromuscular hip dysplasia.

Acetabulum↗
PubMedDate not supplied

Genu valgum in children with coxa vara resulting from hip disease.

Three patients with chronic hip disease and progressive coxa vera deformity also had an unrecognized compensatory ipsilateral genu valgum until the primary hip deformity had been corrected operatively. This unrecognized genu valgum may become subtly worse in a growing child because of lateralization of the mechanical axis of the lower extremity with respect to the knee joint. Operative correction of coxa vara acutely moves the mechanical axis farther laterally, causing the occult genu valgum to become clinically apparent. The genu valgum may subtly worsen over time in a growing child because of lateralization of the lower extremity mechanical axis with respect to the knee joint, with the resulting abnormal Hueter-Volkmann forces across the physis causing progressive genu valgum. Recognition of occult genu valgum before correcting coxa vara in children allows the surgeon the better to advise the family about the need for possible subsequent operations on the knee.

Adolescent↗
PubMedDate not supplied

"Functional retroversion" of the femoral head in Legg-Calvé-Perthes disease and epiphyseal dysplasia: analysis of head-neck deformity and its effect on limb position using three-dimensional computed tomography.

We studied femoral head and neck deformity in Legg-Calvé-Perthes disease (LCPD) and epiphyseal dysplasia using three-dimensional computed tomography (3DCT) in 17 patients (22 hips). The deformed femoral head can be divided into two portions: (i) the portion that protrudes anterolaterally and inferiorly (false head), often blocking internal rotation (lower margin is radiographic "sagging rope" sign) and (ii) the posteromedial superior portion (true head), representing the original articulating femoral head. This remodeled segment is retroverted in relation to the anterolateral segment resulting in "functional retroversion," which causes an externally rotated gait. This position also produces "functional coxa vara" measured by the relationship with the greater trochanter. These studies contradict previous reports of increased anteversion in LCPD and explain the paradox of supposed increased anteversion on radiograph in a child who walks with the limb externally rotated.

Adolescent↗
PubMedDate not supplied

Surgical correction of "functional retroversion" and "functional coxa vara" in late Legg-Calvé-Perthes disease and epiphyseal dysplasia: correction of deformity defined by new imaging modalities.

We studied six patients with severe femoral head deformity treated surgically by valgus-flexion-internal-rotation femoral osteotomy plus simultaneous acetabuloplasty based on the concept of "functional retroversion" and "functional coxa vara" of the deformed femoral head in late severe Legg-Calvé-Perthes disease and epiphyseal dysplasia. The combined procedure achieves the following: (i) corrects the "functional coxa vara" and hinge abduction (valgus osteotomy); (ii) establishes a more normal articulation between the posteromedial portion of the true femoral head and the acetabulum, while moving the anterolateral protruding portion of the femoral head away from the anterolateral acetabular margin (valgus-flexion osteotomy); (iii) corrects external-rotation deformity of the distal limb (internal-rotation osteotomy); (iv) improves joint congruity and anterolateral femoral-head coverage in hips with associated acetabular dysplasia (acetabuloplasty).

Adolescent↗
PubMedDate not supplied

The morphology of residual acetabular deficiency in childhood hip dysplasia: three-dimensional computed tomographic analysis.

Seventy hips (in 48 patients) in children with residual dysplasia resulting from developmental dysplasia of the hip (DDH) were evaluated by using three-dimensional computed tomographic (3DCT) imaging to clarify the nature and degree of acetabular and femoral head deformity. We noted four types of dysplastic acetabulae: type I, subtle deficiency of the acetabulum with a mild break in Shenton's line (24%); type II, anterosuperior deficiency (29%); type III, midsuperior deficiency (38%); and type IV, global deficiency (9%). In untreated DDH with complete dislocation, the deficiency was predictably midsuperior (type III). Isolated posterosuperior deficiency, which is common in neuromuscular conditions, was not seen in these normal children with DDH. The 3DCT method used produced a topographic "contact map" that replicates the contact relation between the acetabulum and the femoral head. Analyzing the femoral head-acetabular contact relation and the type of acetabular deficiency allows the surgeon to plan better surgical correction of hip dysplasia in children.

Acetabulum↗
PubMedDate not supplied

Congenital coxa vara: computed tomographic analysis of femoral retroversion and the triangular metaphyseal fragment.

Three patients with congenital coxa vara studied with two- and three-dimensional computed tomographic (2DCT and 3DCT) methods are reported. In all cases, the femoral retroversion was documented and subsequently corrected by proximal femoral osteotomy. In two patients with isolated coxa vara, the physeal-femoral neck angle was decreased as seen in slipped capital femoral epiphysis in adolescents. Our studies suggest that the triangular metaphyseal fragment reflects a Salter-Harris type II separation pattern through the defective femoral neck. The epiphysis and attached triangular fragment slip from the normal superoanterior portion of the neck in an inferior-posterior direction. The treating surgeon should be aware of the often marked femoral retroversion component present in severe congenital coxa vara. This knowledge allows surgical planning for corrective osteotomies that will better normalize hip mechanics. A combination of marked valgus and flexion with internal rotation of the distal fragment are required to fully correct the deformity.

Acetabulum↗
PubMedDate not supplied

Acetabular development after closed reduction of developmental dislocation of the hip.

The purpose of this study was to identify predictive factors that would best indicate possible future acetabular dysplasia after closed reduction of developmental dysplasia of the hip (DDH). We studied 32 hips for a mean of 13.5 years, during which time radiographs were analyzed annually. Overall results were evaluated using the modified Severin classification. Using the combined predictive factors of center-head distance discrepancy (CHDD) and sourcil orientation in patients between 4 and 5 years of age, we found that (a) remodeling of the acetabulum was possible when the CHDD was < 6% and the orientation of the sourcil was horizontal; (b) careful follow-up was needed when the CHDD was < 6% and the sourcil was upward or when the CHDD was > or = 6% and the sourcil was horizontal, (c) surgery was recommended to prevent residual acetabular dysplasia when the CHDD was > or = 6% and the sourcil was upward.

Acetabulum↗
PubMedDate not supplied

Diagnosing childhood acetabular dysplasia using the lateral margin of the sourcil.

The purpose of this study was to evaluate the lateral edge of the acetabulum and locate the most accurate marking point on a plain radiograph when measuring the acetabular index (AI) and the center-edge (CE) angle. We studied the radiographs of 53 patients with unilateral developmental dysplasia of the hip (DDH), all of whom were treated by closed reduction. In addition to plain radiographs, eight patients had magnetic resonance imaging (MRI) studies, 16 had three-dimensional computed tomography (3-DCT) studies, and six underwent arthrographic studies. We found that the most lateral bony margin of the acetabular roof on plain radiograph represents the anterolateral portion of the acetabulum. The lateral end of the sourcil indicates the lateral margin of the mid-superior portion of the acetabulum. To reduce intra- and interobserver errors, we suggest that when measuring the AI and the CE angle, physicians clearly indicate in the medical records which of the two marking points was used.

Acetabulum↗