Journal of Yeungnam Medical Science

Volume 22(2); December 2005

Reviews

Motor Recovery in Stroke Patients.: Sung Ho Jang, Yong Hyun Kwon; Yeungnam Univ J Med. 2005;22(2):119-130. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.119

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Abstract PDF: Stroke is a leading cause of chronic physical disability. The recent randomized controlled trials have that motor function of chronic stroke survivors could be improved through physical or pharmacologic intervention in the stroke rehabilitation setting. In addition, several functional neuroimaging techniques have recently developed, it is available to study the functional topography of sensorimotor area of the brain. However, the mechanisms involved in motor recovery after stroke, are still poorly understood. Four motor recovery mechanisms have been suggested, such as reorganization into areas adjacent to the injured primary motor cortex (M1), unmasking of the motor pathway from the unaffected motor cortex to the affected hand, attribution of secondary motor areas, and recovery of the damaged contralateral corticospinal tract. Understanding the motor recovery mechanisms would provide neurorehabilitation specialists with more information to allow for precise prognosis and therapeutic strategies based on the scientific evidence; this may help promote recovery of motor function. This review introduces several methodologies for neuroimaging techniques and discusses theoretical issues that impact interpretation of functional imaging studies of motor recovery after stroke. Perspectives, for future research are presented.

Cardiac Resynchronization Therapy.: Hyong Jun Kim, Dong Gu Shin; Yeungnam Univ J Med. 2005;22(2):131-140. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.131

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Abstract PDF: Heart failure is a clinical syndrome comprised of a number of symptoms and signs associated with congestion and/or hypoperfusion. Specific pharmacologic therapies have been developed to slow disease progression from early to more advanced stages. Once symptoms have developed, aggressive multimodality interventions are instituted to alleviate symptoms and improve clinical status and quality of life; especially in those patients that present symptoms. Recently, an evolving adjunctive therapeutic modality, that involves using implanted electrical devices: cardiac resynchronization with or without implantable cardioverter defibrillators (ICD). has been used for management. Cardiac resynchronization therapy (CRT) is a proven treatment for selected patients with heart failure-induced conduction disturbances and ventricular dyssynchrony. When used in combination with stable, optimal medical therapy, CRT is designed to reduce symptoms and improve cardiac function by restoring the mechanical sequence of ventricular activation and contraction. This review summarizes the rationale, procedure, clinical trials, and clinical indications for CRT.

Original Articles

Agreement among the Survey Instruments used to Measure Cognitive Functions in the Elderly.: Pock Soo Kang, Kyung Beom Park, Kyeong Soo Lee, Tae Yoon Hwang, Sang Kyu Kim; Yeungnam Univ J Med. 2005;22(2):141-149. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.141

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Abstract PDF: PURPOSE: This study was conducted to assess the level of agreement among survey instruments used to study dementia and to determine the prevalence rate of suspected dementia using different instruments. SUBJECTS AND METHODS: A total 171 subjects older than 65 in Gyeongju-si, Gyeongsangbuk-do, were surveyed from February to October 2003. The age, sex and educational level were examined through interview surveys, and cognitive function was evaluated using three survey instruments including MMSE-K, S-SDQ, and KDSQ. RESULTS: The cognitive function scores obtained with the MMSE-K showed significant difference according to age. For sex and educational level significant differences were observed with all three survey instruments. The kappa index, the level of agreement between the questionnaires, was 0.302 between MMSE-K and S-SDQ, 0.401 between MMSE-K and KDSQ, and 0.762 between KDSQ and S-SDQ. The prevalence rate of suspected dementia based on the criteria suggested by MMSE-K, S-SDQ, and KDSQ was 27.5%, 15.2%, and 17.0% respectively. CONCLUSION: The results of this study suggest that caution is needed when comparing the measured cognitive function scores and analyzing the prevalence of dementia; this is because the prevalence of dementia and cognitive functions vary according to the questionnaires used.

Prognostic Factors in Postpsychotic Depressive Disorder of Schizophrenia.: Jin Sung Kim, Jong Bum Lee, Wan Seok Seo, Bon Hoon Koo, Yi Youg Kim, Jung Youp Kim; Yeungnam Univ J Med. 2005;22(2):150-165. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.150

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Abstract PDF: PURPOSE: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. MATERIALS AND METHODS: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. RESULTS: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20 (25.0%) for the BDI, 16 (20.0%) for the ZDS, 18 (22.5%) for the CDSS and 6 (7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. CONCLUSION: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

Activation and Abnormalities of Cell Cycle Regulating Factor in Head and Neck Squamous Cell Carcinoma Cell Lines: Abnormal Expression of CDKN2 Gene in Laryngeal Squamous Cell Carcinoma.: Si Youn Song, Tae Hee Han, Chang Hoon Bai, Yong Dae Kim, Kei Won Song; Yeungnam Univ J Med. 2005;22(2):166-182. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.166

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Abstract PDF: BACKGROUND
Cyclin-dependent kinase (CDK) inhibitors are family of molecules that regulate the cell cycle. The CDKN2, a CDK4 inhibitor, also called p16, has been implicated in human tumorigenesis. The CDKN2 inhibits the cyclin/CDK complexes which regulate the transition from G1 to S phase of cell cycle. There is a previous report that homozygous deletion of CDKN2 region on chromosome 9p21 was detected frequently in astrocytoma, glioma and osteosarcoma, less frequently in lung cancer, leukemia and ovarian cancer, but not detected in colon cancer and neuroblastoma. However, little is known about the relationship between CDKN2 and laryngeal cancer. Therefore this study was initiated to investigate the role of CDKN2 in human laryngeal squamous cell carcinoma development. MATERIALS AND METHODS: We used 5 human laryngeal carcinoma cell lines whether they have deletions or losses of CDKN2 gene expression by DNA-PCR or RT-PCR, respectively. We examined 8 fresh frozen human laryngeal cancer tissues to detect the loss of heterozygosity (LOH) of CDKN2. PCR was performed by using microsatellite markers of short arm of human chromosome 9 (D9S126, D9S144, D9S156, D9S161, D9S162, D9S166, D9S171, D9S200 and D9SIFNA). For informative cases, allelic loss was scored if the signal of one allele was significantly decreased in tumor DNA when compared to the same allele in normal DNA. RESULTS: The CDKN2 DNA deletion was observed in 3 cell lines. The CDKN2 mRNA expression was observed in only one cell line, which was very weak. LOH was detected in 7 cases (87.5%). CONCLUSION: These results suggest that CDKN2 plays a role in the carcinogenesis of human laryngeal squamous cell carcinoma.

Symptomatic Pneumothorax in the Full-term Neonate.: Woo Kyoung Choi, Chan Eui Hong, Dong Jin Lee, Nam Jin Hur, Young Hwan Lee; Yeungnam Univ J Med. 2005;22(2):183-190. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.183

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Abstract PDF

BACKGROUND
This study was performed to evaluate the incidence and clinical characteristics of symptomatic pneumothorax in the full-term neonate. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 32 symptomatic pneumothorax patients in the full term neonates who admitted to the neonatal intensive care unit in Ulsan Dong Kang General Hospital from January, 2000 to December, 2004. The subjects were divided into two groups according to underlying causes; spontaneous pneumothorax group and secondary pneumothorax group, then each clinical characteristics were assessed. RESULTS: Spontaneous pneumothorax patients were 10 (31%) and secondary pneumothorax patients were 22 (69%). Overall incidence of spontaneous pneumothorax was 0.4%. Most common cause of secondary pneumothorax was pneumonia. Twelve cases (54.5%) among secondary pneumothorax patients were associated with mechanical ventilator care. Clinical characteristics, courses and managements were similar between two groups, but more shorter duration of admission and chest-tube insertion in spontaneous pneumothorax group CONCLUSION: The patient with symptomatic pneumothorax needs careful observation and proper management with or without underlying respiratory diseases

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Clinical feature of neonatal pneumothorax induced by respiratory distress syndrome and pneumonia
Ji-Sun Jung, Sang-Woo Park, Chun-Soo Kim, Sang-Lak Lee, Tae-Chan Kwon
Korean Journal of Pediatrics.2009; 52(3): 310. CrossRef

Evaluation of Computed Tomography and Magnetic Resonance Imaging of Sinonasal Inverted Papilloma.: Chang Hoon Bai, Young Jung Seo, Seok Choon Lee, Seung Min Chen, Un Hoi Baek, Eun Chae Jung, Si Youn Song, Yong Dae Kim; Yeungnam Univ J Med. 2005;22(2):191-198. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.191

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Abstract PDF: BACKGROUND
Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP. MATERIALS AND METHODS: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. RESULTS: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. CONCLUSION: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.

Association between Obesity and Prostate Cancer.: Chang Jun Yoon, Ki Hak Moon, Tong Choon Park; Yeungnam Univ J Med. 2005;22(2):199-210. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.199

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Abstract PDF: BACKGROUND
The role of obesity in prostate cancer etiology remains controversial. The aim of this study was to evaluate the relationship between obesity and prostate cancer risk. MATERIALS AND METHODS: Between January 2000 and June 2005, 286 patients suspected of having prostate cancer underwent prostate biopsy. The clinical records of the 286 study patients were retrospectively reviewed with regard to age, Body Mass Index (BMI), serum PSA, TRUS, and prostate biopsy results. They were stratified by BMI into three groups according to the cutoffs recommended for Asian populations: normal, BMI less than 23 kg/m2; overweight, BMI 23 to 25 kg/m2; and obese, BMI greater than 25 kg/m2. RESULTS: As for BMIs, 132 (46.2%) were normal, 95 (33.2%) overweight and 59 (20.6%) were obese. A total of 99 (34.6%) patients were diagnosed as having prostate cancer. In multivariate logistic regression analyses, no significant association was observed between BMI and prostate cancer detection. CONCLUSION: We initially hypothesized that obesity may be biologically associated with increased prostate cancer development. However, our study did not show a significant association between BMI and prostate cancer.

The Effect of Percutaneous Bilateral Metalic Stent for Hilar Cholangiocarcinoma.: Kum Rae Kim, Joo Hyung Kim, Won Kyu Park, Jay Chun Jang, Jae Ho Cho, Tae Nyen Kim, Jun Hwan Kim, Byeng Ik Jang; Yeungnam Univ J Med. 2005;22(2):211-220. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.211

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Abstract PDF

BACKGROUND
The purpose of this study was to determine the effectiveness of a percutaneously placed self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. MATERIALS AND METHODS: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self- expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. RESULTS: There were 4 cases of Bismuth type II, 21 cases of Bismuth type IIIa, 8 cases of Bismuth type IIIb and 15 cases of Bismuth type IV. Stent placement was technically successful in all patients. All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage rate of 91.1%. There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and Median Survival Time Were 303 Days (Range, 60~815) And 338 Days (Range, 60~1175), Respectively. CONCLUSION: Placement of a percutaneous metallic stent is an effective and safe method for palliation of patients with hilar cholangiocarcinoma.

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A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction
Esther Koh, Gong Yong Jin, Seung Bae Hwang, Eun Jung Choi, Ji Soo Song, Young Min Han, Keun Sang Kwon
Journal of the Korean Society of Radiology.2013; 68(4): 297. CrossRef

Profile of Gene Expression Changes During Doxorubicin Induced Apoptosis of Saos-2.: Jeong Sook Lim, Min Jae Bae, Suk Hwan Baek, Jae Ryong Kim, Jung Hye Kim, Seong Yong Kim; Yeungnam Univ J Med. 2005;22(2):221-240. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.221

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Abstract PDF: BACKGROUND
Doxorubicin has proved to be a useful chemotherapeutic agent especially for osteogenic sarcoma. It induces cancer cell death via apoptosis. MATERIALS AND METHODS: To explore and analyze the changes of gene expression during doxorubicin induced apoptosis on human osteogenic sarcoma, Saos-2 cell, cDNA microarray was performed. After treatment with doxorubicin, total RNA was purified and expressed genes were investigated with a 17k human cDNA microarray. RESULTS: For analysis of the cDNA microarray, the genes were filtered using the sum of the median value of Cy3 and Cy5 signal intensity of greater than 800. Expression of 264 genes was changed by more than 2 fold, and the expression of 35 genes was changed more than 3 fold after treatment with doxorubicin. The genes were primarily related to cell death, cell growth and maintenance, signal transduction, cellular component, transport, and metabolism. CONCLUSION: Treatment with doxorubicin induced expressional change of many genes. Some of the genes might be related with apoptosis directly or indirectly. Further study is now needed to characterize these genes.

Case Reports

A Case of Constitutional Trisomy 8 Mosaicism.: Hee Soon Cho, Chae Hoon Lee, Kyoung Dong Kim, Eun Sil Lee; Yeungnam Univ J Med. 2005;22(2):241-246. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.241

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Abstract PDF

Constitutional trisomy 8 is a relatively rare aneuploidy; most identified cases are mosaic with a normal cell line. The phenotype is highly variable from apparently normal to severe disability. The proportion of abnormal cells is dramatically different between tissues and the severity of the phenotype is not directly related to the level of mosaicism. Therefore, it is very difficult to provide a definitive prognosis. We report here a case of constitutional trisomy 8 mosaicism with agenesis of the corpus callosum, congenital heart disease and micrognathia. The trisomy 8 cell line was not detected by prenatal cytogenetic study. This is the fourth reported case of constitutional trisomy 8 mosaicism in Korea.

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A Case of Trisomy 8 Mosaicism in a Patient with Secondary Amnorreha without Abnormal Phenotype
Hye Sim Kang, Young Soo Son, Sung Yob Kim, Chul Min Park, Soon Sup Shim
Journal of Genetic Medicine.2011; 8(1): 67. CrossRef

A Case of Granulation Tissue of the Tongue in Infant.: Hee Jung Lee, Eun Sil Yun, Joon Hyuk Choi, Kwang Hae Choi; Yeungnam Univ J Med. 2005;22(2):247-252. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.247

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Abstract PDF: Tongue tumors of pediatric patients are the most common soft tissue tumor of pediatric oral and maxillofacial tumors. There are many kind of pediatric tongue lesions such as hemangioma, lymphangioma, papilloma, and cyst. Most of these lesions are benign, but malignant tumors of tongue may be occurred. Therefore, malignancy should be ruled out. Sometimes, tongue lesions are present with dyspnea, dysphagia, dysarthria, bleeding, or cosmetic problem. We experienced a case of chronic inflammatory mass on posterior 1/3 of the tongue in 4 month old female patient. Swallowing difficulty and respiratory distress symptom occurred because of tongue mass effect. The tongue mass was confirmed as granulation tissue by microscopic examination. After excision of tongue mass, she had no problem with swallowing and breathing.

A Case of Protein-losing Enteropathy Treated with High Dose Intravenous Glucocorticoid Therapy in Systemic Lupus Erythematosus.: Kyu Hyung Lee, Chang Mo Kwon, Hyun Do Kim, Dae Young Yun, Jae Yoong Lee, Yeong Hoon Hong, Choong Ki Lee; Yeungnam Univ J Med. 2005;22(2):253-258. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.253

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Abstract PDF

Generalized edema and hypoalbuminemia are relatively common presenting manifestations in many clinical situations. The differential diagnosis of hypoalbuminemia include: Kwashiorkor, synthetic dysfunction of the liver, and excessive protein loss as in nephrotic syndrome. In systemic lupus erythematosus (SLE), hypoalbuminemia and generalized edema are most commonly due to protein loss associated with lupus nephritis; gastrointestinal involvement is uncommon, and therefore protein loss through the gastrointestinal tract is quite rare. We report a case of a protein losing enteropathy (PLE) associated with SLE. The patient was referred to our hospital for generalized edema, arthralgia and facial rash. After clinical evaluation, the patient met the criteria for the SLE diagnosis; hypoalbuminemia with general edema was consistent with a protein losing enteropathy. After two weeks of therapy with parenteral high dose glucocorticoid, the patients was improved in laboratory findings as well as clinical symptoms.

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A Case of Protein Losing Enteropathy as Only Clinical manifestation of Systemic Lupus Erythematosus
Tae Hyun Kim, Yu Hee Choi, Lae Hyung Kang, Hyeong Jin Kim, Jin Ho Jang, Min Wook So
Kosin Medical Journal.2017; 32(1): 84. CrossRef

Langerhans Cell Histiocytosis with Central Diabetes Insipidus: A Case Report.: Jin Ho Kim, Jun Sung Moon, Sun Jung Mun, Ji Eun Lee, Jae Won Choi, Mi Jung Eun, Kyung A Chun, Ihn Ho Cho, Ji Sung Yoon, Kyu Chang Won, Kyung Hee Lee, Duk Seop Shin, Hyoung Woo Lee; Yeungnam Univ J Med. 2005;22(2):259-265. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.259

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Abstract PDF: Central diabetes insipidus (DI) is a syndrome characterized by thirst, polydipsia and polyuria. Langerhans cell histiocytosis is one of the etiologies of DI. Recently we experienced a central DI associated with Langerhans cell histiocytosis. The 44 years old female patient complained right hip pain, polydipsia and polyuria. We carried out water deprivation test. After vasopressin injection, urine osmotic pressure was increased from 109 mOsmol/kg to 327 mOsmol/kg (300%). Brain MRI showed a thickened pituitary stalk and air bubble like lesions sized with 5cm, 7cm was shown on fifth L-spine and right hip bone at hip bone CT. CT guided biopsy revealed abnormal histiocytes proliferation and abundant lymphocytes. The final diagnosis was central DI associated with systemic Langerhans cell histiocytosis invading hip bone, L-spine and pituitary stalk. Desmopressin and etoposide chemotherapy were performed to the patient.

Intratesticular Simple cyst lined by ciliated columnar epithelium: A Case Report.: Ji Yoon Kim, Hwa Soo Lim, Ki Hak Moon, Mi Jin Kim, Jae Ho Cho; Yeungnam Univ J Med. 2005;22(2):266-269. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.266

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Abstract PDF: An intratesticular simple cyst is a rare lesion. The pathogenesis of such lesions is uncertain. Clinically, an intratesticular simple cyst may be difficult to differentiate from a cystic neoplasm. However, preoperative diagnosis is possible using ultrasonography (US). Testis-sparing surgery with simple enucleation of the cyst has a favorable outcome. We report an intratesticular simple cyst in a 48-year-old male who had a non-tender cystic mass in the right testis for 2 years. The diagnosis was made by preoperative US. The patient underwent a testis-sparing surgery. After simple excision of the cyst, histological examination revealed a simple cyst lined by ciliated cuboidal and columnar epithelium.

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