Journal of Yeungnam Medical Science

Volume 24(2 Suppl); December 2007

Review Articles

Diagnosis of Malignant Lesion in Patients with Lower Urinary Tract Symptoms: Tong Choon Park; Yeungnam Univ J Med. 2007;24(2 Suppl):S1-11. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S1

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Abstract PDF: Some patients, especially with chronic disease such as diabetes, who suffer from lower urinary tract symptoms (LUTS) just want to take prolonged oral medication (anticholinergics or alpha blockers) without proper evaluation for basic causes. LUTS is commonly occurred by urinary tract infection, several chronic diseases and/or aging itself. However, we should not pass over the fact that LUTS also can be evoked by malignancy. Because there is a higher detection rate of malignancy in patients with microscopic hematuria, urine cytology must be done with ultrasonography, IVP and cystoscopy. In those patients aged over 50 years or high risk group for urothelial carcinoma, it is mandatory to undergo ultrasonography and cystoscopy, even if there is no abnormalities on their urinalysis and urine cytology.

Ankle Fracture: Jong Chul Ahn; Yeungnam Univ J Med. 2007;24(2 Suppl):S12-23. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S12

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Abstract PDF: Ankle fractures are the most common types of fractures treated by orthopaedic surgeons. As a result of a better understanding of the biomechanics of ankle, improvements in fixation techniques, and findings of outcome studies, there has been a gradual evolution in the effective strategics for the treatment of ankle fractures. The goals of treatment continue to be both a healed fracture and an ankle that moves and functions normally without pain. The development of strategies for the treatment of various patterns of ankle injuries revolves around whether these goals can be achieved more predictably with surgical or nonsurgical means. Certain injury patterns have a better outcome after surgical treatment, while other pateerns are better managed without surgery. Surgical treatment is indicated when congruity of the joint cannot be restored with closed method.

Ultrasonography of the Scrotum: Bok Hwan Park, Jae Ho Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S24-35. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S24

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Abstract PDF: Ultrasonography is an important imaging tool in the evaluation of the scrotal structures and various scrotal disorders because of excellent anatomic resolution, easy and speedy applicability, and safety with no inonizing radiation. Furthermore, a blood flow information can be obtained by the use of color Doppler ultrasonography and spectral waveform analysis. It plays a primary role in the detection, characterization, and localization of scrotal masses and fluid collections. Knowledge of characteristic imaging findings enables appropriate, expeditious evaluation of various scrotal disorders. The objective of this article is to familiarize the reader with the ultrasonographic features of various scrotal disorders.

Hybrid Coronary Revascularization: Sung Sae Han; Yeungnam Univ J Med. 2007;24(2 Suppl):S36-48. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S36

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Abstract PDF: Hybrid coronary revascularization combines left internal mammary artery (LIMA) to left anterior descending artery (LAD) grafting integrated with percutaneous coronary intervention (PCI) on stenoses in the non-LAD territories. Hybrid coronary revascularization offers multivessel revascularization with minimal morbidity in high risk patients. Usually hybrid coronary revascularization performs minimally invasive direct coronary artery bypass grafting (MIDCAB) without cardiopulmonary bypass. The concept is now 10 year old. This procedure has been developed from MIDCAB plus percutaneous transluminal coronary angioplasty (PTCA) to totally endoscopic coronary artery bypass grafting (TECAB) procedures plus PTCA and drug-eluting stenting (DES). The hybrid coronary revascularization procedure may be especially useful in complex LAD lesions, restenotic lesions in LAD, acute myocardial infarction in “non-LAD” territory, high-risk elderly patients with multiple comorbidities and patients with severe left ventricular systolic dysfunction who are not ideal candidates for conventional bypass surgery. Hybrid coronary revascularization results according to the literature are very attractive. LIMA patency rates were found to be in the 98% range and restenosis rates in the PCI part of the procedure are in a 12% range.¹⁶⁾ The wider introduction of hybrid revascularization is limited chiefly by the high number of repeat interventions compared with off-pump coronary artery bypass grafting, which occurs because of the target vessel failure rate of percutaneous coronary intervention. Drug-eluting stents substantially decrease the reintervention rate. However, the future role of hybrid coronary revascularization is unclear in patients with multivessel coronary artery disease involving the LAD if comparable results may be attained with multivessel PCI.

Natural Course of Lumbar Spinal Stenosis: Myun Whan Ahn; Yeungnam Univ J Med. 2007;24(2 Suppl):S49-56. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S49

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Abstract PDF: The purpose of this paper is to review the natural course of spinal stenosis in order to establish an optimal therapeutic plan. As the population becomes older, this condition is encountered more frequently. The numbers of detected cases were increased internationally with the diagnositc tools improved. Good knowledge of natural evolution and of the predictive factors influencing the course of the disease is crucial for the selection of methods of treatment. Unfortunately, in contrast with numerous reports of the results of surgical series, few studies have been reported on the natural evolution. However, results of the studies analyzed in this review suggest that a substantial proportion of patients do not automatically deteriorate and will remain unchanged or even improved by medical means. They also suggest that patients with severe baseline symptoms, block stenosis and degenerative spondylolisthesis tend to require surgical decompression.

Barotrauma of the Human Body from SCUBA Diving: Seok Keun Yoon; Yeungnam Univ J Med. 2007;24(2 Suppl):S57-74. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S57

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Abstract PDF: As economical and social status are getting better, many ordinary people are interested in well being and leisure sports, the populations enjoying SCUBA diving are increasing recently. The medical problems from SCUBA diving are also increasing. To provide diving knowledge to the medical Drs. for prevention of barotrauma from SCUBA diving and to provide medical knowledge to SCUBA divers for safer diving, author reviews barotrauma of the human body from SCUBA diving. Review includes diving physics, mechanism, clinical manifestations and prevention of barotrama. Pulmonary barotrauma manifests as pulmonary tissue damage, pneumothorax, mediastinal emphysema with or without arterial gas embolism. Arterial gas embolism is one of the most serious and urgent medical problem from SCUBA diving and it need immediate recompression treatment. Barotrauma in the middle ear is the most common medical problem from SCUBA diving, it manifests as Eustachian tube salpingitis, otitis media with effusion. Inner ear barotrauma may lead permanent sensorineural hearing loss. Barotruma also can be occurred in mask,1)teeth, dry suit, and gastrointestinal tract. Prevention of barotrauma is more important than treatment. Prevention of barotrauma is up to divers, diving instructors and medical Drs. Divers and diving instructors should follow guidelines in diving fitness test, keep physical state always to fit to dive, keep diving skills as sharp and keep physical ability to adjust changeable ocean environment. Medical Drs. are responsible to their decision of medical fitness test, so they should know about diving physic, diving physiology and recent guidelines about medical fitness to dive.

Coordination and Activation of Biotechnology-Related R&D Budget of Korea: Jung Hye Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S75-86. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S75

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Abstract PDF: Importance of science and technology is based on modern society which means knowledge based society. Now, today’s quality of science and technology in Korea says that is ordered as 8th powerful nationality in the world. Research and development budget of our government is over KRW 9.8 trillion dollars in 2007, it is ordered amount of 8th national in the world. First nation is America, followed Japan, Germany, France, England, Italy, China. By the Swiss IMD report, it is evaluated as competitive power of science of our country is 7th order and technology is 6th order in the world. These show brilliant achievement by recent many research products. 1) In order to increase investment efficiency of research & development of government, reorganization of government setups were carried out national innovation system (NIS) in Oct. 2004. Policy of coordination and division of government R&D budget is in force strategy by selection and convergence, total roadmap in mid- and long-term by technological field. The priority order by total roadmap take biological field as first. In the present 2007, government budget of biological field occupied 16.5%, it is developed 17% in next year. Next order is followed the Environment, the Space and the Universe. Strategy of R&D investment of fields of information and electron and field of machinery and the manufacturing industry will be decrease. National R&D investment will be used as an advanced country form. It will be induced to increase a private enterprise. These field will be decrease a weight. Especially, a scientist for life have to effort to development of global new drug by Korea-America FTA (Free Trade Agreement) and we will see what we can do a sense of responsibility and good results.

Management of Perioperative Hypothermia: Il Sook Seo; Yeungnam Univ J Med. 2007;24(2 Suppl):S87-95. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S87

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Anesthesia and surgery commonly cause substantial thermal perturbations. Mild hypothermia (33.0∼36.4℃) results from a combination of anesthetic-induced impairment of thermoregulatory control, a cool operating room environment, and factors unique to surgery that promote excessive heat loss. Perioperative mild hypothermia is extremely common and associated with adverse outcomes such as excessive sympathetic nervous system stimulation, prolonged drug metabolism, impaired platelet activity, impaired immune function and postanesthetic shivering. Prevention of perioperative hypothermia and post-anesthetic shivering improves the outcome in terms of reduced cardiac morbidity and blood loss, improved wound healing and shorter hospital stay. Core temperature monitoring, accompanied by passive and active methods to maintain normothermia, should be part of routine intraoperative monitoring for patients at high risk of perioperative hypothermia, particularly patients undergoing body-cavity surgery, surgery greater than 1 hour duration, younger children and the elderly.

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Effect of the ASPAN Guideline on Perioperative Hypothermia Among Patients With Upper Extremity Surgery Under General Anesthesia: A Randomized Controlled Trial
Sookyung Kang, Soohyun Park
Journal of PeriAnesthesia Nursing.2020; 35(3): 298. CrossRef

Delayed Complications of Regional Anesthesia: Sun Ok Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S96-107. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S96

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Abstract PDF: Regional anesthesia, an attractive choice of anesthesia for the patients with systemic illness such as pulmonary/heart diseases or endocrine dysfunctions, is generally accepted as a safe anesthetic method. However, there are various kinds of complication annoying the physician and the patient following a regional anesthesia. Therefore, physicians and patients must understand the risks in addition to the benefits of regional anesthesia to make an informed consent of anesthetic technique. 1) This review will give an overview of delayed complications following a regional anesthesia.

Ketamine : Refocused Role of Ketamine in Pain Management: Sun Ok Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S108-117. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S108

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Abstract PDF: Ketamine has used as a dissociative anesthetics from 40 years ago. Its mechanism of action is an antagonism of the N-methyl-D-aspartate (NMDA) receptors, which has an important role into the central sensitization during pain states. The role of ketamine, in lower sub-anesthetic doses, has recently gained increasing interest in pain management. There are considerable numbers of trials to use ketamine in acute or chronic pain states. Recently, Hocking et al. summarized their recent reviews of the evidence concerning ketamine’s clinical use on PAIN: Clinical Updates. In this review, the author introduce their summery with personal experience. Based on their summary, the primary role of ketamine in such subanesthetic doses is as an ‘anti-hyperalgesic’, ‘anti-allodynic’ or ‘tolerance-protective’ agent rather than as a primarily ‘analgesic’. However, to support the evidence-based clinical guideline using a ketamine in pain management, there will be needed numerous high-quality studies that access both immediate and long-term outcomes.

Pathologic Features of Small Cell Lymphoid Neoplasms: Won hee Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S118-124. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S118

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Abstract PDF: The category of small sized cell lymphoid neoplasms include chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL), mantle cell lymphoma (MCL), follicular lymphoma, marginal zone lymphoma (MZL) and lymphoplasmacytic lymphoma (LDL) / Waldenstrom macroglobulinemia (WM). The unifying feature for this group of neoplasms is their derivation from mature B cell and are indolent lymphomas mostly. But, their morphological and immunophenotypical findings, cytogenetics and molecular genetics exhibit considerable heterogenic expression. The recent identification about pathologic features of the small cell lymphoid neoplasms might contribute to their better understandings.

Treatment of Advanced Gastric Cancer: Sun-Kyo Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S125-131. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S125

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Abstract PDF: Curative surgery is the most common and desirable treatment for advanced gastric cancer(AGC), but macroscopically curative resection of AGC dose not always mean a curative outcome. For the tailored management of AGC, accurate preoperative stage are made by using abdominal CT, FDG PET and laparoscopy is necessary. In case of T₃/T₄ lesion, neoadjuvant chemotherapy(NAC) and neoadjuvant chemoradiotherapy(NACR) are effective therapeutic approaches with acceptable toxicity without increasing surgical morbidity and mortality. I recommend the use of a multidisciplinary therapeutic strategy for treatment of AGC. Future applications of newer cytotoxic drugs such as oxaliplatin, capecitabine, irinotecan, and docetaxel or targeted therapies may help to improve the management of AGC.

Epidemiology, Risk Factors, and Pathophysiology of Osteoarthritis: Choong-ki Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S132-141. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S132

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Osteoarthritis (OA) is the most prevalent form of arthritis and a major cause of disability in people aged 65 and older. OA is not a single disease; rather, it is a group of overlapping yet distinct diseases with different etiologies but similar pathologic, morphologic, and clinical outcomes. OA occurs when the dynammic equilibrium between the breakdown and reapir of joint tissues is overwhelmed. Systemic and local biomechanical factors contribute to the development of the disease, with systemic factors also making the joint vulnerable and resulting in a greater impact of local joint factors. Systemic risk factors include ethnicity, gender, age, genetic factors, hormonal status, bone density, and nutritional factors. Local biomechanical factors include altered joint biomechanics, prior injuries, the effects of physical activities, sports participation, occupation, developmental abnormalities, and obesity. The normal joint is protected by biomechanical factors such as alignment and muscle strength, the lubrication provided by the synovial fluid, and the shock-absorbing function of bone and cartilage. When these functions are altered, changes occur at both the macroscopic and cellular levels, with derangements in any structure contributing to further joint destruction. 1) Further studies of both risk factor modification and cellular changes in OA will hopefully continue to enhance our understanding of this complex disease and lead to improved outcomes.

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Prevalence of Osteoarthritis and Its Affecting Factors among a Korean Population Aged 50 and Over
Hye-Ryoung Kim, Eun-Jung Kim
Journal of Korean Public Health Nursing.2013; 27(1): 27. CrossRef

Platelet Activating Factor-Acetylhydrolase: Tae-Yoon Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S142-151. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S142

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Abstract PDF: Platelet activating factor (PAF) is a phospholipid with a strong inflammatory mediator. PAF is synthesized in a variety of cells in response to inflammatory stimuli. PAF is degraded by intracellular and extracellular PAF-acetylhydrolases (PAF-AHs) thus providing proper level of PAF. Plasma PAF-AH deficiency is associated with several diseases such as asthma, systemic lupus erythematosus, juvenile rheumatoid arthritis, acute myocardial infarction, diabetes, and membranous nephropathy. Cloning of plasma PAF-AH gene enabled the use of recombinant PAF-AH as a therapeutic tool for these PAF-mediated diseases.

Treatment Options for Early Gastric Cancer: Sang Woon Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S152-158. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S152

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Abstract PDF: Patients with early gastric cancer (EGC) have had a good prognosis with conventional gastrectomy and radical lymph node dissection. The conventional surgery revealed some kinds of early and late complications which may hurt patients seriously. Therefore, treatment options for EGC which preserve patients’ quality of life with maintaining a high level of curability have been developed. In surgeon’s field, these include limited gastrectomy with or without modified lymph node resection, gastrectomy with vagal nerve preservation, pylorus preserving gastrectomy, and laparoscopic gastrectomy. Laparoscopic gastrectomy has introduced a new concept of procedure in the treatment of EGC. Endoscopic mucosal resection (EMR) by endoscopist has also become a standard treatment option for EGC with limited indications. The development of endoscopic submucosal dissection (ESD) expanded the clinical relevance of EMR. Certain treatment options for EGC, such as laparoscopic surgery or EMR, are known to be good options for EGC treatment, but the long-term results should be confirmed by randomized prospective study before becoming standard treatments. At present. these less invasive treatment should be applied under the strict indications.

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