Journal of Yeungnam Medical Science

Volume 5(1); June 1988

Reviews

District Health Systems Based on Primary Health Care.: Pock Soo Kang; Yeungnam Univ J Med. 1988;5(1):1-7. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.1

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Abstract PDF: No abstract available.

Ambulatory Procedures in Anorectal Surgery.: Min Chul Shim; Yeungnam Univ J Med. 1988;5(1):9-15. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.9

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Abstract PDF: No abstract available.

Original Articles

A Clinical Study on the Fractures of the Femoral Neck in Children.: Sae Dong Kim, Joo Chul Ihn; Yeungnam Univ J Med. 1988;5(1):17-22. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.17

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Abstract PDF: Fractures of the femoral neck in children are rare and usually the result of severe trauma. The femoral necks in children, in contrast to those of adults, have many anatomic and physiologic differences. Among the late complications encountered are avascular necrosis, coxa vara, premature closure of the proximal capital femoral epiphysis and nonunion. In spite of careful management, significant complication rate often results. Nine cases of fractures of the femoral neck in children which were treated at Yeungnam University Hospital from June 1984 to August 1987 were reviewed. The results obtained are as follows: 1. The main causes of fractures were traffic accidents (5 cases). 2. Among 9 patients, 6 were girls and 3 were boys. 3. According to the classification of Delbet and Colonna, the transcervical fracture (6 cases) was the commonest type. 4. 4 cases were treated by closed reduction and internal fixation, 3 cases were treated by open reduction and internal fixation. 2 cases were treated by skin traction and cast. 5. The results were analyzed according to Ratliff's assessment. 6 cases showed good results, and 3 cases showed poor results. 6. Early diagnosis and good fixation method seemed to be vital to prognosis.

Clinical Evaluation of Microreplantation in the Digital Amputation.: Tae Hoon Lee, Sang Hyeon Woo, See Ho Choi, Jung Hyun Seul; Yeungnam Univ J Med. 1988;5(1):23-32. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.23

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Abstract PDF: Finger injuries are becoming more common with the increasing use of mechanical industrial and household appliances. Among the hand injuries, amputation is the serious disaster to the patient. Recently, application of microsurgical technique to the reattachment of amputated digits has been common clinical procedures. We performed microsurgical replantation to the 75 patients with 102 digits from March in 1986 to February in 1988. The following results were obtained. 1. The most common age distribution was third decade and male to female ratio was about 5:1. 2. The ratio of right to left hand was about 1:1 but the dominant to non-dominant hand was about 2:1. 3. The index finger was most commonly injured and the next was middle finger. 4. The most common type of the injuries was the crushing injury and the most common vector was a kind of pressor. 5. The anesthesia was performed in equal ratio between the general and regional anesthesia. 6. The survival rate of micro-replantation to the injuries of the zone II was 77.8% and zone III was 80%. 7. The functional result after replantation at zone II was better than zone III. 8. Micro-replantation was performed in any case of the type of the injury, the severity of crushing and the ischemic time, and the patients requirement was an important factor.

Radiologic Evaluation of Intraabdomenal Masses in Childhood.: Hyuk Po Kwon, Woo Mok Byun, Mi Soo Hwang, Son Yong Kim, Jae Chun Chang, Bok Hwan Park; Yeungnam Univ J Med. 1988;5(1):33-42. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.33

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Abstract PDF: The abdominal tumors in children are different from those of adult. These tumors are the third most common one, preceded by leukemia and brain tumors, in children under 15 years. X-ray examination is the most important method among diagnostic approaches. The role of diagnostic imaging is to identify the precise anatomic location and extent of pathologic process with the minimal number of imaging procedures. 23 cases of abdominal tumors were reviewed in respect of age incidence, site of origin, radiologic findings. The results are briefly summarized as follows: 1. Neuroblastoma was the most common (6 cases) and wilm's tumor (5 cases), choledocal cyst (4 cases), ovarian mass (3 cases), hydronephrosis (2 cases), were descending order in frequency. 2. The most common site was retroperitoneum (60%) Kidney was the single most common site of origin. 3. Radiologic findings. The most common findings of plain radiography was ill defined soft tissue mass and this method was helpful in the presence of calcification especially in neuroblastoma. Ultrasonographic pattern was anechoic (cystic), echoic or mixed pattern, but this method provide less precise anatomical details, nevertheless Ultrasonography was particularly useful imaging modality for the pediatric abdominal tumors. IVP findings were renal displacement, caliceopelvic system distortion or nonvisualization of kidney, these information was helpful in determining the location of tumors. CT scan showed homogenous or inhomogeneous, cystic or solid, mass with their anatomic location. 4. Ultrasonography was the most widely used specific diagnostic method, but had limited value in detecting the anatomic location of tumors. CT scan was superior to ultrasound for determining the extent of tumors.

Diagnostic Value of Computed Tomography in Acetabular Fracture.: Sun Yong Kim, Bok Hwan Park, Joo Chul Ihn; Yeungnam Univ J Med. 1988;5(1):43-48. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.43

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Abstract PDF: We retrospectively analyzed 22 patients pelvic CT, in whom the acetabular fracture were suspected in plain film. And compared and analyzed the computed tomogram findings and plain radiographic findings. The results were as follows. CT enables better evaluation of shape, extent, and degree of separation of fragment. CT was helpful in detecting the combined fracture and soft tissue injuries. CT showed intraarticular loose bodies, which were invisible on plain film. In patients with pelvic trauma, no necessary changing position during CT examination. CT was useful demonstrates the remnant of intraarticular osseous fragment and adequacy of reduction after surgery.

Analysis of the Results of Blood Cultures, 1984~1987 at Yeungnam University Hospital.: Chung Sook Kim, Chae Hoon Lee, Myung Sook Choi, Chang Ho Cheon, Kyung Dong Kim; Yeungnam Univ J Med. 1988;5(1):49-60. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.49

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Abstract PDF: Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January, 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 8083 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Streptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermenting microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophila was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermenting microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.

The Treatment of Tibial Shaft Fractures by Interlocking Nailing.: Jae Chang Lee, Jae Sung Lee, Myun Hwan Ahn, Sae Dong Kim, Joo Chul Ihn; Yeungnam Univ J Med. 1988;5(1):61-67. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.61

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Abstract PDF: The treatment of tibial shaft fracture has become one of the most controversial subjects in orthopedic surgery. Comminuted, segmental and rotationally unstable fractures or bone defect at fraction site have problems of the fixation. The interlocking nail solve these problems. We have experienced 8 cases of the tibial shaft fractures treated with interlocking nail from 1986 to 1988. Authors analyzed these cases and out own clinical study. The results were as follows. 1. The average bone union rate was about 15 weeks. 2. The interval between operation and crutch walking was 4.3 weeks. 3. The merits of this operation were the short hospitalization and early adaptation of social activity. 4. The advantage is be able to do early ambulation without following muscular atrophy or joint stiffness. 5. The results were assessed on clinical examination and radiographic appearance by Hamza et al. An excellent results were 7 cases and good result was 1 case.

Physico-chemical and Microbiological Analysis of Tap Water in the Apartment in Taegu City.: Seok Bhum Kim, Pock Soo Kang, Jong Hak Chung; Yeungnam Univ J Med. 1988;5(1):69-75. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.69

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Abstract PDF: The drinking water in apartment is stored in reservoir tank and thereafter supplied each household. In case the drinking water in stored too long or insanitary, tap water might change in quality. This study was carried out to evaluate the physic-chemical and microbiological conditions of 36 samples of tap water of apartments compared to 18 samples of tap water of independence houses in Taegu City from May to October, 1987. Main findings are summarized as follows: PH values were within normal range in all samples. Samples less than 0.2ppm in residual chlorine accounted for 16.7% in the apartment and 5.6% in the independence house. Nitrite nitrogen was detected 2.8% of apartment samples only. Among the total of 54 samples, 11.1% of the apartment and independence samples were over the normal value in standard plate count. Samples more than 1.8 of most probable number (MPN) accounted for 27.8% in the apartment and 33.3% in the independence house. In result of test for residual chlorine, nitrite nitrogen, standard plate count, and MPN, the proportion of the samples revealed inappropriate in respect of drinking water standards. In case of all sorts of tests was 2.7% in apartment and nothing in independence houses, in case of 3 sorts of tests was 2.7% in apartment and 5.6% in independence houses, in case of 2 sorts of tests was 8.3% in apartment and 5.6% in independence houses, and in case of only 1 test was 25.0% in apartment and 22.2% in independence houses. Correlation between residual chorine and standard plate count, and between standard plate count and MPN were observed. It was found that the more years since construction of apartment were, the worse tap water was in quality.

Isolation of the Legionella Species from Specimens of Cooling Tower Water.: Jong Hak Chung, Pock Soo Kang, Seok Bhum Kim, Jun Sakong; Yeungnam Univ J Med. 1988;5(1):77-84. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.77

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Abstract PDF: The principal mode of the transmission of Legionnaires disease is an inhalation of the cooling tower water droplets in which Legionellae exist. As a central cooling system is popularized in many public buildings and large buildings nowadays, the number of cooling towers in rapidly increasing. Therefore the possibility of an outbreak of Legionnaires disease is likely increased. To determine the presence of Legionella in cooling tower water as the first step for the prevention of Legionnaires disease, 48 samples of cooling tower water were taken from 24 buildings in Taegu city in July and September 1987. Three samples out of 24 water samples in September yielded Legionella but it was not isolated in the samples of July. Isolated 3 Legionellas were identified as Legionella peumophila. It seems that Legionella from the cooling tower will be isolated more frequently in late summer than early because central cooling system is stopped operation during winter season which in cool. As based on our survey, Legionnaires disease can occur in Taegu city and if it happens it is most likely due to L. pneumophila.

Intraoral Approach and K-Wire Fixation of Zygomatic Tripod Fractures.: See Ho Choi; Yeungnam Univ J Med. 1988;5(1):85-92. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.85

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Abstract PDF: To avoid external facial scar which resulted from ordinary infraorbital and lateral eyebrow incision in surgical treatment of zygomatic tripod fractures, the author used intraoral incision and K-wire fixation method in 37 selected patients. This method contraindicated for the patient with multiple comminuted zygomatic fracture, patient combined with hard palatal fracture, and patient combined with herniated orbital floor fracture. The advantages of this method are simple, no external facial scar, and operate under direct visual field. The postoperative results were satisfactory. Balanced facial symmetry and good cosmetic results were obtained.

Estimation of Glomerular Filtration Rate from Plasma Creatinine and Height in Children.: Jeong Lan Kim, Yong Hoon Park, Jeong Ok Hah; Yeungnam Univ J Med. 1988;5(1):93-100. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.93

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Abstract PDF: In clinical practice, creatinine clearance (Ccr) remains the most commonly used laboratory assessment of glomerular function despite methodological and technical problems of urine collection. Schwartz et al. in 1976, reported that an accurate estimate of glomerular filtration rate (GFR) could be obtained from the simple determinations of plasma creatinine (Per) and body length (L): GFR (ml/min/1.73m2)=kL (cm)/Per (mg/100 ml), (k=constant). The subject of this study were 81 children admitted to our pediatric department from July, 1985 to June, 1987 and they were divided into three groups; group I, from 1 to 5 years old, group II, from 6 to 10 years old, group III, from 11 to 15 years old. The results were as following: 1) Measured creatinine clearance Ccr(M), ml/min/1.73m²) were 109.73±9.97 in group I, 108.26±9.02 in group II, 96.20±4.72 in group III and 105.48±5.23 in all age group. 2) Measured k(k(M)) obtained from CcrM=k Ht/Pcr were 0.49±0.03 in group I, 0.48±0.02 in group II, 0.43±0.02 in group III, and 0.47±0.02 in all age group (Ht; height). 3) Linear equations and correlation coefficient between Ht/Pcr (x) and Ccr (y) were y=0.82x-65.63 (r=0.99) in group I, y=0.61x-23.46(r=0.72) in group II, y=0.18x+54.44 (r=0.54) in group III and y=0.58x-22.13 (r=0.81) in all age group. 4) Ccr(E) was again estimated from linear equations between Ht/Pcr and Ccr(M) and k(E) was calculated with Ht/Pcr and Ccr(E) were 0.48±0.01 in group I, 0.49±0.01 in group II, 0.43±0.01 in group III and 0.47±0.00 in all age group. 5) Consistent values of k(E) and k(M) were highly significant as 95~97.5% in group I and II, 90~95% in group III and 97.5~99% in all age group. In summary, we could estimate GFR with height, plasma creatinine and measured k(k(M)) according to the age in easy and rapid way.

Safe Placement of Urethral Foley Catheter Using Guide Wire in Patient with False Passage.: Young Soo Kim; Yeungnam Univ J Med. 1988;5(1):101-104. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.101

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Abstract PDF: No abstract available.

Effects of Inspiratory Pressure Preset on Alveolar Gas Exchange Using Anesthetic Ventilator.: Il Sook Suh, Hee Ju Kang, Heung Dae Kim; Yeungnam Univ J Med. 1988;5(1):105-110. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.105

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Abstract PDF: The study was undertaken to determine the most adequate tidal volume when used volume preset ventilator during anesthesia. The thirty patients were received controlled mechanical ventilation with constant inspiratory pressure of 10 cmH2O and respiratory frequency of 12/minute. The results were as follows: 1) The PH was 7.39±0.01 and it is within normal limit. 2) The PaCO2 was 34.0±0.6 mmHg and it is a slightly hyperventilatory state. 3) The PaO2 was 228.0±8.2 mmHg. 4) The Buffer base was 20.7±0.3 mEq/L and it is a slightly buffer base deficient state. From the above results. We concluded that if patients were fully relaxed during general anesthesia, it is desirable to maintain the inspiratory pressure of anesthetic mechanical ventilator to 10 cmH2O for adequate alveolar ventilation.

A Study on Obsessin & Lie in College Freshmen.: Jin Sung Kim, Byung Tak Park, Jong Bum Lee, Jung Hoon Lee, Seung Douck Cheung; Yeungnam Univ J Med. 1988;5(1):111-125. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.111

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Abstract PDF: The authors studied obsession, using Derogatis'SCL-90, and lie tendency using MMPI, in the subjects of 2586 male and 1206 female college freshmen of Yeungnam University. The authors collected the reports of self-rating Obsession scale and Lie scale during the periods from January to February, 1988, and applied ANOVA and t-test on obsession and lie scores in order to compare than between various psychosocial factor, and sexes. The results as follows: 1. There was not significant difference in the mean average of total obsession scores between male and female students: male students scored 10.26±5.21 m female students scored 10.54±5.01. 2. High scored items were doubting, indecisiveness, inattention, obsessive thoughts and preoccupation with accuracy. 3. 37 male students (1.4%) showed high obsession scores of 25 or higher, while 9 female students (0.7%) showed the same scores. 4. There was strong tendency toward higher obsession scores in the students who were dissatisfied with their home atmosphere, college, department and familiarity of parents and those who had pessimistic view of self in the past, present of future in both group (respectively P<0.001). The male students who attended the department of fine arts, who grew at the Up& Whose educational fees were paid by brothers & sisters showed higher level of obsession scores (respectively P<0.05, P<0.05, P<0.01). The female students who grew at the Myun & who were self-cook showed higher level of obsession scores (respectively P<0.05). 5. There was not significant difference in the mean averages of total lie scores between male and female students: male students scored 4.73±2.49, female students scored 4.70±2.16. 6. High scored items were NO. 14, 8, 11, 9 and 1 in the table 6. 7. 98 male students (3.7%) showed high lie scores of 70 or high, while 27 female students (2.2%) showed the same scores. 8. There was strong tendency toward higher lie scores in the students who were satisfied with their home atmosphere, college, department and familiarity of parents and those who had optimistic view of self in the past, present or future in both group(respectively P<0.001). The students who attended the department of pharmacy, music, evening programs showed higher level of lie scores (P<0.05).

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