Journal of Yeungnam Medical Science

Volume 1(1); December 1984

Reviews

Arthroscopy of the Knee Joint.: Joo Chul Ihn; Yeungnam Univ J Med. 1984;1(1):5-12. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.5

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Abstract PDF: No abstract available.

Diagnosis and Management of Acute Renal Failure in Surgical Patient.: Koing Bo Kwun; Yeungnam Univ J Med. 1984;1(1):13-23. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.13

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Abstract PDF: Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acute renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as FENa+ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilizing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetics renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/L is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

Original Articles

Clinical Analysis of C.N.S. Cysticercosis.: Soo Ho Cho, Choong Bae Moon, Byung Yon Choi; Yeungnam Univ J Med. 1984;1(1):25-34. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.25

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Abstract PDF: During last 10 years we experienced 25 cases of C.N.S. cysticercosis. Now clinical analysis and evaluation of our cases were made and the results are followings; 1. Prevalence in man and women are nearly same and about 70% of cases are distributed between 20-50 years old. 2. According to Nieto's classification, mostly are ventricular (44%) and parenchymal type (36%). 3. Clinical manifestations were IICP (92%), focal neurological deficits (68%), seizure (48%), altered mental status (36%) and others listed on table 7. 4. In ventricular type, IICP and cerebellar dysfunction signs were predominated but seizure and focal neurological deficits were commonly seen in parenchymal type. 5. Subcutaneous cysticercus nodules were palpated in 32% of cases. 6. Positive stool ova was observed in 29% of cases. 7. Radiologic studies revealed as followings: 16% of cases showed abnormal findings on plain film, 84% on angiography, 94% on ventriculography and 100% on computed tomography and myelography. Computed tomography looks like most helpful diagnostic method for C.N.S. cysticercosis, they usually revealed lucent cystic lesion, hydrocephalic findings and contrast enhancement. 8. Suboccipital craniectomy, craniotomy with removal of parenchymal cyst or laminectomy were done according to location and types of lesion. 72% of operated cases revealed good results and mortality was 4% of cases.

Urokinase Therapy in Cerebral Thrombosis.: Choong Suh Park; Yeungnam Univ J Med. 1984;1(1):35-39. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.35

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Abstract PDF: Since opening of the Yeungnam University Hospital in June 1983 till end of 1984, total 30 cases of cerebral thrombosis were analyzed clinically. Among the 30. 17 cases were given Urokinase from 60,000 to 240,000 units daily for 2-46 days. The interval from the onset to the inititiation of therapy varied from 1 hour to 17 days. Ten cases showed marked recovery and 6 cases moderate improvement. One case, in which only 120,000 units daily were administered, showed stationary course. The interval of the Urokinase untreated 13 cases was from 3 days to 18 months. Six cases were sationary, whereas 7 cases showed mild improvement. Age, sex, past history, associated diseases, and the laboratory findings are shown in the tables. Conclusion is that the earlier the therapy started, the higher the dosage used, the better of the results is obtained.

Comparative Genetic Characterization of Plasmids of Agrobacterium Species Isolated in Korea.: Jung Hye Kim, Yong Bum Koo, Ki Young Lee, Jae Kyu Chung; Yeungnam Univ J Med. 1984;1(1):41-48. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.41

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Abstract PDF: The soil bacterium Agrobacterium tumefaciens is a plant pathogen that causes crown gall tumors by infecting the wounded dicotyledonous plants and subsequent integration of bacterial DNA into plant nuclear DNA. Virulent A. tumefaciens strains harbor a large Ti (tumor–inducing) plasmid that carries genes essential for tumorigenesis. In the present study, 13 strains (Malus pumila Mill; A₁₋₃, Populus monilifera; W₁₋₆, Populus tomentiglandlosa; P₁₋₃ and Rosa species; R₁) of Agrobacterium isolated in korean crown gall tumors and plasmids were observed in 6 strains (W₂, W₃, W₆, P₁, P₃ and A₂). The test for crown gall tumor formation was resulted only in ATCC15955 and KW2 strains inoculated into the stem of sun flower and the development was observed for 4 and 6 weeks after inoculation. Above two Ti plasmids (pTi) were purified by cesium chloride-ethidium bromide density gradient centrifugation and digested with restriction enzyme and fragments of pTiATCC15955 and pTiKW₂ observed by EcoR I ; 25&27, Hind III ; 23&21, BamH I ; each 20 and Hpa I ; 12&27. And sizes of pTiATCC15955 and and pTiKW₂ calculated as 200 and 87 kbases. Octopine was isolated from tumor tissue (W₁₋₆ and P₁₋₃) and these strains confirmed as octopine type.

Studies on Identification and Drug Resistance of Atypical Mycobacteria Isolated from Patients with Pulmonary Tuberculosis.: Dong Hyun Chung, Sung Kwang Kim, Joo Deuk Kim; Yeungnam Univ J Med. 1984;1(1):49-58. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.49

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Abstract PDF: The differential diagnosis of atypical mycobacteriosis caused by atypical mycobacteria (with the exception of Mycobacterium tuberculosis, Mycobacterium bovis, and Mycobacterium leprae) which are widly distributed in soil and water, from pulmonary tuberculosis is possible only when atypical mycobacteria are isolated and identified. In this investigation, attempts were made to isolate atypical mycobacteria from persons registered as tuberculosis patients in the Anyang Health Center in Anyang City, Kyungki province, Korea. Biological and biochemical tests were performed for the atypical mycobacteria isolated from these patients, also retrospective analysis of clinical and X-ray findings of the patients with bacteriologically confirmed atypical mycobacteriosis were done. The results can be summarized as follows; 1. 103 strains of mycobacteria were isolated among 334 sputum samples from patients. 2. Among the isolated mycobacteria, 10 strains (9.7%) were found to be an atypical mycobacteria and 93 strains (90.3%) were tubercle bacilli of human type. 3. On the basis of Runyon's grouping of atypical mycobacteria, there were 3 strains (30.0%) of scotochromogen and nonphotochromogen respectively, 4 strains (40.0%) of rapid grower, and no photochromogen. 4. By biochemical tests, 3 strains of scotochromogen were identified as Mycobacterium scroful-aceum (2 strains) and Mycobacterium szulgai (1 strain) 3 strains of nonphotochromogen were Mycobacterium avium-complex (2 strains) and Mycobacterium terriae (1 strain), and 4 strains of rapid grower were Mycobacterium fortuitum (3 strains) and Mycobacterium chelonae. 5. In drug sensitivity tests, all 10 strains isolated atypical mycobacteria showed resistance to various concentration of INH and SM and low concentration (10 mcg, 40 mcg and 50 mcg) of EB, TH, and CS, and were sensitive to only high concentration (20 mcg and 100 mcg) of EB, TH, CS, and RFP. 6. In analysis of clinical findings by the patients with bacteriologically confirmed atypical mycobacteriosis, it was found that clinical symptoms of these patients appeared not to be mild than those of patients with pulmonary tuberculosis. The patients with atypical mycobacteriosis had been treated for pulmonary tuberculosis for a long time and they showed no improvement.

Effect of Betamethasone on Pulmonary Surfactant Activity in Unilateral Pneumonectomized Rabbits.: Suck Kang Lee, Young Man Lee; Yeungnam Univ J Med. 1984;1(1):59-66. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.59

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Abstract PDF: Although it is well established that steroid is effective for treatment of neonatal respiratory distress syndrome (NRDS), the action mechanism of steroid on NRDS is not well known. Several authors have insisted that steroid increases secretion of pulmonary surfactant from type II pneumocyte, but others have insisted that steroid does not affect the secretory function of the type II pneumocyte. And some authors have suggested that steroid may cause compositional change of pulmonary surfactant phospholipid. From these aspects, it is desirable to confirm the effect of steroid on the secretory function of the type II pneumocyte. In order to know the effect of steroid on pulmonary surfactant activity, phospholipid phosphorus of lung lavage was measured and composition of pulmonary surfactant phospholipid of lung lavage was analyzed by thin layer chromatography (TLC) in control (c), pneumonectomized (PN), and pneumonectomized with betamethasone treated (PNS) rabbits. And lung weight and lung weight-body weight ratio were measured in each experimental group also. In PN group, right lung pneumonectomy was performed as PN group, and one day after the surgery, betamethasone was injected for four days intramusculary (4 mg/day) and rabbits were sacrificed. The experiment yielded following results. PNS group's lung weight was significantly (p<0.01) heavier than C group's, but in comparison with PN group's it showed no significant change. PNS group's L/B ratio was significantly (p<0.05) higher than C group's, but compared with PN group's it showed no significant change. The value of phospholipid phosphorus content of PNS group was significantly (p<0.01) higher than that of C group. Even if the value of phospholipid phosphorus content in PNS group was not significantly higher than that of PN group, it showed increasing tendency compared with that of PN group. And in an analysis of the thin layer chromatogram, quantity (µmol/gm of wet weight lung) of phosphatidylcholine in PNS group decreased significantly (p<0.05) compared with C and PN group. From these results, it may be suggested that though steroid inhibits cellular hyperplasia in the compensatory growing lung, it auguments the secretory function of type II pneumocyte and causes compositional change of pulmonary surfactant phospholipid.

The Content Analysis of the Earliest Memories and Dreams of Psychiatric Disorders.: Byung Tak Park; Yeungnam Univ J Med. 1984;1(1):67-87. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.67

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Abstract PDF: The earliest memories and dreams have been investigated in many aspects; biological, psychological, statistical, and psychotherapeutic, in psychiatric field. The approach methods to these psychic contents are innumerable according to the schools, the collector's attitudes to these materials, the collecting methods and the variable factors of the reporter. In this study the author attempted to compare the distribution of the aggression and dependency themes in these psychic contents among groups of different sexes and clinical diagnoses. In this purpose the author devised new scales, the Aggression and the Dependency Scales for the earliest memories and dreams which are composed of 12-theme classes, according to 3 aspects of the ego attitudes and 4 degrees of the intensity of drives. The scales were tested on a series of the earliest memories and dreams from 100 male medical students by two raters. The interrater reliabilities, measured by kappa method, were all significant at better than the .001 level. The author collected the reports of the earliest memories and dreams from 293 schizophrenics (161 males and 132 females) and 301 neurotics (164 males and 137 females) who were either out-patients or inpatients of 5 general hospitals and 2 private neuropsychiatric clinics and from 310 controls (169 males and 141 females) who were either students, housewives or employees in Taegu area during the periods from March to August, 1980 and from April to August, 1983. The author compared the contents of the earliest memories and dreams from these 3 clinical groups on the newly devised scales and the results could be summarized as follows; In general, the contents of the earliest memories showed more differences among diagnostically different groups, while the contents of dreams showed more differences among sexually different groups. The dependency themes were more frequent than the aggression thems in all groups. The aggression themes were more frequent in dreams than in the earliest memories. Of the earliest memory themes, the distribution of the aggression themes was different among clinical groups, i.e., most frequent in schizophrenics, next in neurotics, and least in controls. The distribution of the dependency themes was in reverse order. Attitudes of being attacked were more frequent in schizophrenics. Observing attitudes of dependency need were more frequent in neurotics while gratifying attitudes were more frequent in controls. Highest degrees of aggression and dependency were more frequent in neurotics. In the distribution of the dream themes, there were some differences among male and female schizophrenics. Aggression themes, especially active and the highest degree of aggression, were more frequent in male schizophrenics, while dependency themes, especially frustrated themes, were more frequent in female schizophrenics. Among 3 clinical groups, observing attitudes of dependency need were more frequent in female groups, while gratifying attitudes were more frequent in male groups.

Effects of Starvation and Perioperative Fluid Therapy on the Blood Glucose Concentrations during Anesthesia in Children.: Ill Sook Suh, Sun Ok Song, Dae Pal Park; Yeungnam Univ J Med. 1984;1(1):89-93. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.89

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Abstract PDF: This study included 38 children patients of less than 4 years old and 18 kg body weight. After 8 hours of starvation, the children were divided into 2 groups: Group I received Hartmann's solution and Group II received Hartmann's dextrose solution. In both groups, the rates of infusion were 10 ml/kg/hr before and during operation and blood samples were collected just before and 1 hr after induction of anesthesia, respectively. The results were as follows; 1) In the Group I, blood glucose concentration just before induction was decreased than control values that was checked at ward, and 1 hr value after induction was significantly increased then control values. 2) In the Group II, blood glucose concentration was increased just before and 1hr after induction than control values significantly respectively. 3) In the blood glucose concentration 1 hr after induction, difference between Group I and Group II was not significant. 4) In children, duration of starvation about 8 hrs did not significant influence on blood glucose concentration although dextrose was not administered.

Effects of Manually Controlled Ventilation on Gas Exchange during General Anesthesia.: Jung Kook Suh, Ill Sook Suh, Heung Dae Kim; Yeungnam Univ J Med. 1984;1(1):95-100. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.95

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1 Crossref

Abstract PDF

In the beginning of anesthetic training, one of the clinical practices that anesthetists have to learn is manually controlled ventilator techniques. The popularity of manually controlled ventilatory techniques has been gradually decreased with increased use for anesthetic ventilators. However it is important and basic for the anesthetists to master manually controlled ventilator techniques skillfully. Recently, we analyzed the arterial blood gas in 30 cases before and during general anesthesia, and studied the effects of the manually controlled ventilation on the pulmonary gas exchange. The results were as follow; 1) Mean value of PaCO₂ during the manually controlled ventilation, 29.9±2.0 mmHg was decreased statistically comparing with that of PaCO₂ before the anesthesia, 39.8±2.8 mmHg. 2) Mean values of pH and HCO₃⁻ during the manually controlled ventilation were 7.48±0.03, 22.2±2.4 mEq/1, respectively and values before the anesthesia were 7.41±0.02, 25.2±1.8 mEq/1, respectively. 3) Mean value of PaO₂ and O₂ saturation during the manually controlled ventilation were 270.0±28.8 mmHg, 99.6±0.2%, respectively and values before the anesthesia were 92.5±4.0 mmHg, 96.9±1.0%, respectively. These results indicates that manually controlled ventilation at our department of anesthesiology produced mild hyperventilatory state. However these were no significant changes in cerebral blood flow and other biochemical parameters.

Citations

Citations to this article as recorded by

Influence of Pre-operative Fasting Time on Blood Glucose in Older Patients
Misuk Hong, Haesang Yoon
Journal of Korean Academy of Nursing.2011; 41(2): 157. CrossRef

The Effect of Hypobaric Priming Solutions on Extracorporeal Circulation during Open Heart Surgery.: Sun Ok Song, Jung Kook Suh, Heung Dae Kim; Yeungnam Univ J Med. 1984;1(1):101-106. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.101

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Abstract PDF: Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.

Morphologic Study of Renal Arteries in Rats Fed High-salt Diet.: Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1984;1(1):107-113. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.107

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Abstract PDF: To evaluate the morphologic changes of the renal arteries in the condition of high-salt diet, we scheduled the control group which fed routine animal diet added 0.06% of Sodium chloride, low-salt group which fed with 2.0% of sodium chloride, and high-Salt group which fed with 8.0% of sodium chloride. The experimental animals were sacrificed every two weed until 20 weeks of final experimental week. The results obtained were as follow; 1. Slight intimal thickening of the renal arteries is observed from 16th experimental week and continued the end of the experiment in the rats of control group. 2. In low-salt group slight intimal thickening of the renal arteries is observed from 12th experimental week and continued to the end of the experiment. 3. In high-salt group the intimal thickening began from 6th experimental week and its degree was hasten with week, and provoked moderate to high degree of lesion at the end of the experiment. Medial proliferation and degeneration of the intima and media, though their quality is mild, also associated at the end of the experiment.

Clinical Significance of the Routine "Dipstick" Urinalyses in Pediatric Inpatients.: Yong Hoon Park, Jin Gon Jun; Yeungnam Univ J Med. 1984;1(1):115-120. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.115

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Abstract PDF: To find clinical significance of routine “dipstick” urinalysis on admission, we analyzed the results of the “dipstick” urinalyses performed in 844 patients admitted to the pediatric department of Yeungnam University hospital from May 1, 1983 to October 31, 1984. Ketonuria, proteinuria, hematuria and glucosuria were found in 9.5%, 4.9%, 2.4% and 1.1% of the patients respectively. There were no significant differences by sex, age and presence of fever. However, proteinuria and ketonuria were found more frequently in the patients with dehydration (p<0.05). All of the patients with proteinuria and ketonuria showed negative results on follow up. However, among 13 patients with hematura, 9 patients showed negative results and 4 patients had persistent hematuria on follow up. These 4 patients were found to have chronic pyelonephritis (2), asymptomatic urinary tract infection (1) and benign recurrent hematuria (1). This routine “dipstick” urinalysis on admission seems to be simple test which is useful in detecting unrecognized kidney and other urinary tract disease.

Evaluation of the Mental Health Status of the Aged by Zung's Self-rating Anxiety Scale.: Jung Hoon Lee, Byung Tak Park, Seung Douk Cheung, Pock Soo Kang, Jong Hak Chung; Yeungnam Univ J Med. 1984;1(1):121-128. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.121

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Abstract PDF: The authors studied on anxiety, using Zung's self-rating anxiety scale (SAS), on the subjects of 329 men and 522 women of 60 years old and older. This study was carried out for 8 months from November 1983 to June 1984 in the area of Seoul, Taegu and Kyungsan Gun, Kungpook province. The results showed that there was no significant difference in the means of total anxiety scores between the two groups of men and women. The anxiety scores in items of sweating, apprehension, dyspnea, restlessness and insomnia were relatively high in both groups. The scores of faintness, panic, fear, tremor and facial flushing were low in both groups. Among 329 men, 48 (14.6%) showed rather serious anxiety level of score 50 or higher, while 153 of 522 women (29.4%) showed the same score. Among these psychosocial factors, supporter, living, place, religion and security system are significantly related with anxiety scores in both groups (p<0.01).

Case Report

Organized Expanding Spontaneous Intracerebral Hematoma.: Byung Yearn Choi, Choong Bae Moon, Soo Ho Cho; Yeungnam Univ J Med. 1984;1(1):129-134. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.129

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Abstract PDF: The authors report a case of massive spontaneous intracerebral hematoma in a infant, caused by bleeding from cryptic vascular malformation associated with vitamin K dependant factor deficiency. The bleeding was initiated by vitamin K dependant factor deficiency, then 3 weeks later hematoma was expanded by rebleeding from malformed vessel after PT and PTT had been returned to normal values. The well circumscribed organized old hematoma with fresh expanded bleeding component within a huge rusty colored cystic fluid cavity was recognized in operative field and pathological ground.

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