Journal of Yeungnam Medical Science

Volume 10(1); June 1993

Original Articles

High Frequency Ventilation.: Hyun Woo Lee, Kwan Ho Lee; Yeungnam Univ J Med. 1993;10(1):1-17. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.1

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Abstract PDF: No abstract available.

Intraoperative Pathologic Consultation .: Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1993;10(1):18-27. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.18

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Abstract PDF: No abstract available.

Results of secondary antibiotics susceptibility test for gram negative bacilli resistant to primary susceptibility test in Yeungnam University Hospital.: Chung Sook Kim, Kyung Dong Kim, Chae Hoon Lee; Yeungnam Univ J Med. 1993;10(1):28-36. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.28

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Abstract PDF: Major pathogenic Gramnegative organisms such as P. aeruginosa, Serratia species, E. coli, Enterobacter species which are isolated from the specimens in large medical centers are greatly resistant to the commonly used antibiotics. Gramnegative bacilli, which had been isolated in Yeungnam Uni rersity Hospital during the period from December 1992 to April 1993 and turned out to be resistant to the primary antibiotics susceptibility test for chloramphenicoi, ampicillin, eephaiothin,- geniamicitt, tetracyclin, amikin and tobramycin, were subjected to the secondary antibiotics susceptibility test for aztreonam, ceftazidime, ciprofloxacine, cefotaxime, cefamandole, piperacillin, ticarcillin and sulfamethoxazole trimethopime. Out of 315 tested organisms, 167 organisms (53%) were resistant to all secondary antibiotics in vitro. Antimicrobial activity of ceftazidime (37.1%), aztreonam (11. %), ciprofloxacine (7.9%) against Gram negative bacilli were slightly more active than other antibiotics tested, while cefamandole was not active to all the Gramnegative bacilli tested. According to the specimens, E. coli was the most frequently resistant organisms to the primary antibiotics from urine, A. baumanii, from respiratory system and wounds, and P. aeruginosa from various specimens. In summary, Gram negative bacilli resistant to the primarily applied antibiotics also were resistant to the secondary antibiotics. Rearrangement of the antibiotics disks for the antibiotic susceptibility test should be considered.

The comparison of influence of difficulties in nasal breathing on dentition between different facial types.: Myeong Jin Lee, Chang Kon Lee, Sup Jong Kim, Jin Ho Park, Byung Rho Chin, Hee Kyung Lee; Yeungnam Univ J Med. 1993;10(1):37-47. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.37

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Abstract PDF: It is. commonly assumed that nasorespiratory function can exert a dramatic effect upon the development of the dentofacial complex. Specially, it has been stated that chronic nasal obstruction leads to mouth breathing, which causes altered tongue and mandibular positions. If this occurs during a period of active growth, :the .outcome is development of the "adenoid facies". Such patients characteristically: manifest a vertically long lower third facial height, narrow alar bases, lip incompetence, a long and narrow maxillary arch and a greater than normal mandibular plane angle. But several authors have reported that so-called adenoid facies is not always associated with adenoids and mouth breathing, and that a particular type of dentition is not alwarys found in mouth breathers with or without adenoids. Some authors have believed adenoids lead to mouth breathing in cases with particular facial characteristics and types of dentition. We assumed that the ability to adapt to individual's neuromuscular complex is various. So, we compared the difference of influence of mouth breathing between childrens who have different facial types. This study included 60 patients and they were divided into three groups by Rickett's facial type. Their dentition and tongue position were compared. The results are as follows. 1. There is a significant difference in arch width of upper molars between different facial types. Especially dolichofacial type patients have narrowest arch width. 2. There is a significant difference in tongue position between different facial types. Especially dolichofacial type patients have lowest positioned tongue.

A study on discriminant function of psychoticism in schizophrenics.: Jung Hoon Lee; Yeungnam Univ J Med. 1993;10(1):48-57. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.48

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Abstract PDF: The purpose of this study was to investigate the characteristics of personality dimensions of schizophrenics. Subjects in this study were 71 chronic schizophrenics, 59 acute schizophrenics. and 87 normal persons. All subjects was asked to respond to EPQ(Korean Version Eysenck Personality Questionnaire). Collected data were analyzed by using the statistical techniques of discriminant function analysis, t-test and one-way -variable analysis. The results were as follows : Acute and chronic schizophrenics were higher than normal persons on psychoticism score. However, there was no significant difference between chronic and acute schizophrenics on the psychoticism score. Discriminant analysis was adopted to identify the scales in EPQ that were most effective in discriminating between normals and schizophrenics. Psychoticism of EPQ function was the most effective variable that discriminates between the normals and the schizophrenics.

Modified classification of anemia by RDW.: Hyeong Ki Hwang, Myung Soo Hyun, Bong Sup Shim; Yeungnam Univ J Med. 1993;10(1):58-67. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.58

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Abstract PDF: The author obtained index of red cell volume distribution width(RDW) and other red cell indices in 210 patients of various hematoncologic conditions and 200 healthy control group using, an automated blood analyzer, Coulter Counter Model S-plus II. This study performed to classify various etiologic anemia based on the MCV and RDW, to evaluate availability to the differential diagnosis in korean anemic distoders somewhat different from etiologies of anemias in foreginers. In the most of cases, the increase or decrease of MCV were always combined the pararell changes of MCH and MCHC: But the values of MCV and RDW were not correlated in control group and patient group. So the terms of heterogenous of homogenous anemia were meaningful morphologic classification than hypochromic or normochromic anemia. The heterogenous microcytic anemia contained iron deficiency anemia. In heterogenous normocytic anemia, myelophthisic anemia, acute leukemia were contained. In heterogenous macrocytic anemia, megaloblastic anemia, hemolytic anemia were contained. The homogenous microcytic anemia was observed in anemia of chronic disorders. In homogenous normocytic anemia, acute blood loss, chronic leukemia, multiple myeloma were contained. The aplastic anemia was belonged to homogenous macrocytic anemia. The diagnostic significance of RDW in hemoglobinopathies is most importhant. But this study was not contained hemoglobinopathies. Instead RDW was very helpful to differential diagnosis of most common anemias, iron deficiency anemia and anemia due to chronic disorders in Korea.

Increased carboxyhemoglobin and serum iron concentration as an indicator of increased red cell turnover in preeclampsia.: Sang Heon Kim, Kwang Hee Lee, Mi Sook Kim, Young Gi Lee, Yoon Kee Park, Tae Hyung Lee, Sung Ho Lee; Yeungnam Univ J Med. 1993;10(1):68-76. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.68

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Abstract PDF: Pregnancy induced hypertension is multifaceted syndrome with variable involvement of several key organ systems, so sensitive and specific laboratory tests for predicting severity and prognosis. and early diagnosis of this disease are required. Because heme catabolism results in equimolar production of carboxyhemoglobin, iron and bilirubin, a concomittant rise of these parameters would provide confirmation of increased heme catabolism. Microangiopathic hemolytic anemia may occurs in severe preeclampsia, but it is not known whether increased red cell turnover - occurs with mild preeclampsia as complication. The purpose of this study was to confirm that increased heme catabolism also occurs in patients with mild preeclampsia. The analysis of data was done on 23 cases with mild preeclampsia and 35 normal pregnant women, who were admitted to Yeungnam University Hospital from October 1992 to March 1993. The results were as follows. 1. The mean antepartum serum iron concentration was significantly higher in the group with mild preeclampsia (86.5+/-6.1 microg/dl) than in the controls (53.2+/-5.3 microg/dl). 2. The mean antepartum and postpartum carboxyhemoglobin concentrations were significantly higher in the group with mild preeclampsia (antepartum : 2.55+/-0.42 mg/dl, postpartum 1.21+/-0.4 mg/dl) than the controls (antepartum : 0.61+/-0.2 mg/dl, postpartum 0.53+/-0.2 mg/dl) 3. During postpartum, carboxyhemoglobin concentration in preeclampsia reduced significantly from antepartum level, but there was no difference between antepartum and postpartum carboxyhemoglobin concentrations among controls. 4. Bilirubin concentrations were similiar in both groups

Clinical observation of the bilateral branch vein occlusion.: Young Hoon Park, Duk Kee Hahn, Sang Beon Lee; Yeungnam Univ J Med. 1993;10(1):77-81. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.77

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Abstract PDF: The clinical evaluation was done in eight eyes of four patients with bilateral branch retinal vein occlusion. The onset of age was from 36 to 65 years, and three pa dents were women. Hypertension was the most common associated systemic disease. Retinal neovascularization was complicated in six eyes, and five eyes had vitreous hemorrhage. The vitrectomy was performed in three eyes. We believe that branch retinal vein occlusion associated with hypertension should be followed carefully in the fellow eyes.

Aesthetic facial bone contouring surgery in Koreans.: Sang Hyun Woo, Kyung Ho Lee, Jung Hyun Seul; Yeungnam Univ J Med. 1993;10(1):82-90. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.82

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Abstract PDF: No abstract available.

Medical care expenditure of residents in urban poor area.: In Soo Hwang, Kyeong Soo Lee, Chang Yoon Kim, Pock Soo Kang, Jong Hak Chung; Yeungnam Univ J Med. 1993;10(1):91-102. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.91

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Abstract PDF: This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered q'iestionnaires completed by housewives. The survey was conducted. from , March 1 to May 31; 1992. The mean age was 31. 1 years in the poor area and 37. 1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The averge monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%). while hospital and clinic (37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2,800 Won in the poor area and 6.300 Won in the control area.

Lead level in hair of elementary school children in urban and rural areas.: Yung Woo Byun, Jun Sakong, Chang Yoon Kim, Jong Hak Chung; Yeungnam Univ J Med. 1993;10(1):103-113. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.103

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Abstract PDF: This study was conducted to explore the feasibility of using the lead level in the hair of children as a screening test for lead intoxication of children and as an indicator for environmental pollution. Lead concentration of hair was measured for 268 seven to nine-year-old elementary school children in Taegu city (147 children) and Gampo. town(121 children). The lead level in hair was measured by atomic absorption spectrophotometer equipped with a graphite furnace atomizer. The following information was obtained for all children : sex, age, father's occupation and smoking habits, kinds of hair cleaner, fingernail biting habits, and status of the child's hands and clothing. The mean lead level in hair was 8.7+/-2-9 microg/g in the urban area and 7.7+/-2.2 pg/g in the rural area. There were significant differences between two groups(p(0.01). The difference of lead levels in hair measured by cleanliness of the child's hands (clean : 7.4+/- 2.7 pg/g, dirty : 8.2+/- 2.6 pg/g) and child's clothing(clean : 8.0+/- 2.5 microg/g, dirty : 9.3+/- 2.6 microg/g) were statistically significant, but other factors were not significant. In multiple regression analysis, difference of residency and age were significant variables for lead level in the hair of children. These findings suggest that measurement of lead level in the hair is a useful method for the screening of the lead intoxication of children and monitoring environmental conditions.

The cervical spinal fractures : comparison of the sites and incidences according to the causes and the types of the injuries.: Jae Ho Cho, Kil Ho Cho, Woo Mock Byun, Sun Yong Kim, Bok Hwan Park; Yeungnam Univ J Med. 1993;10(1):114-126. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.114

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Abstract PDF: The fractures of the cervical spine are relatively uncommon, but they may cause serious neurologic deficits temporarily or permanently. So, it is very important to treat the patients early by way of exact evaluation for the sites and the mechanisms of the injuries. The authors reviewed retrospectively 188 cervical spinal fractures in 100 patients from Sep. 1984 to Aug. 1990. Commonly involed levels were C5 and C6 in lower cervical level and C2 in upper cervical level and the sites in each spine were body; lamina and odontoid process. The hyperflexion injury was the most common type of the cervical spinal fractures occupying 53% of all cervical fractures and cause more multipe fractures(2.26 fractures/patient) than in hyperextension (1. 68 fractures/patient). In hyperflexion injuries, body, transverse and spinous process were commonly involved but lamina fracture was relatively common in hyperextension injury. The dislocations associated with fractures were developed most commonly in hyperflexion injury and 70% of these were anterior dislocation and the most commonly involved levels were C5-6 and C6-7. In conclusion, hyperflexion injury needs more close examination for the entire spinal levels than injuries of other mechanisms because it results in more severe fractures with or without dislocation and relatively frequent multiple fractures in different levels.

Analysis of the result and merit of computed tomography guided percutaneous needle aspiration biopsy of focal lung lesion.: You Song Chang, Kil Ho Cho, Woo Mock Byun, Mi Soo Hwang, Bok Hwan Prk; Yeungnam Univ J Med. 1993;10(1):127-134. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.127

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Abstract PDF: Percutaneous needle biopsy of pulmonary lesion with use of fluoroscopic guidance is well estabilished as a diagnostic tool but limited by the small size and inaccessibility of certain lesions. However, percutaneous needle biopsy'has been used increasingly in relation to advance and the salty of smaller biopsy needle and new imaging modalities such as ultrasound and CT. CT, because of its characteristics of high resolution, allows tissue sampling with considerable safty from area that heretofore could not be visualized under fluoroscopy. The authors summarized 44 pulmonary lesions that underwent CT-guided transthoracic biopsy with fine-needle over a 14 month period and analyzed the sensitivity of PTNB. -CT-guided PTNB was done with 20 gauge or 22 gauge Westcott biopoy needle (Mann medical products, USA). A diagnosis was made in 27 of 44 cases (61%) including malignany in 19 of 24 cases and benignancy in 8 of 20 cases. The pulmonary mass lesions were located at the peripheral zone of the lung field in 33 cases and at the central zone in 11 cases. Complications were observed in 2 cases which were pneumothorax and hemoptysis each but specific therapy was not required The sensitivity of PTNB by one session was 61% (27/44). The sensitivity of malignancy was 79% (19/24) and benignancy was 40% (8/20). These results suggest the usefulness of PTNB using fine needles be increased in eariler diagnosis and improved staging of pulmonary nodular lesions without significant complications.

Comparison of the E-test with agar dilution susceptibility test by using bacteroides fragilis.: Hee Sun Kim, Sung Kwang Kim, Hwa Sun Cha; Yeungnam Univ J Med. 1993;10(1):135-143. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.135

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Abstract PDF: The susceptibilities of 45 clinical isolates of bacteroidis fragilis to cefaclor, ciproflxacin and imipenem were determined by new method, E-test (AB Bidisk, Solna, Sweden) and were compared with those from conventional agar dilution method by using brain heart infusion, Mueller-Hinton and Wilk:..s Chalgren agar plates. And the susceptibility of 60 clinical isolates of bacteroides fragilis group (B. fragilis 45 strains, B. distasonis 6 strains, B. ovatus 5 strains, B. thetaiotaomicron 4 strains) to 5 quinolones (ciprofloxacin, enoxacin, norfloxacin, ofloxacin, pefloxacin) were determined by in vitro agar dilution method. Compared with agar dilution MICs for B. fragilis 45 strains, 90.3% of E-test MICs were within +/- 1 dilution of the agar dilutions, and 98.4% were within 2 dilutions. And there were little effect of different medium bases to determine MICs except Mueller-Hinton agar. On Mueller-Hinton agar, B. fragilis showed have or no growth activity. In vitro susceptibility of B. fragilis group to quinolones, most of the test strains showed resistant patterns to quinolones except ofloxacin and there was little difference of susceptibility patterns between species of B. fragilis group.

Effects of octreotide on the contractility of isolated rat vas deferens.: Sun Ae Jang, Oh Cheol Kwon, Jeoung Hee Ha, Kwang Youn Lee, Won Joon Kim; Yeungnam Univ J Med. 1993;10(1):144-156. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.144

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Abstract PDF: This study was performed to investigate the effect of octreotide on the contractility of rat vas deferens. The -smooth muscle strips isolated from the prostatic portion were myographied in isolated organ bath. Electric -field stimulation (monophasic square wave, duration : 1. mSec, voltage : 50 V, frequency : 5 Hz or 30 Hz, train : 10 Sec) produced reproducible contraction. The contraction was composed of two component, first phasic component (FPC) and second tonicc component (STC).. These contractions were abolished by -tetrodotoxin (1 microM). Octreotide inhibited the field stimulation induced contractions both FPC and STC concentration- dependently. The FPC was decreased by a desentization of purinergic receptor by pretreatment of mATP, and the STC was decreased by pr,,creatment of reserpine (3 mg/kg, EP) 24 hours before experiments. Octreotide reduced the field stimulation induced contraction in the presence of mATP and of reserpinized muscle strips. The inhibitory effect of octreotide was more potent at 5 Hz than at 30 Hz. Octreotide did not affect basal ton and exogenous norepinephrine- or ATP-induced contraction. These results suggest that octreotide inhibit the contractility of the isolated rat vas deferens by inhibition of the release of neurotransmitters, both ATP and norepinephrine from adrenergic nerve terminal.

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