Journal of Yeungnam Medical Science

Volume 6(2); December 1989

Review

Pharmacologic Treatment of Essential Hypertension.: Bong Sup Shim; Yeungnam Univ J Med. 1989;6(2):1-11. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.1

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Original Articles

The Effects of Diazepam on the Carbachol Induced Contraction of the Isolated Rat Ileum.: Jung Ok Kim, Oh Cheol Kwon, Jeoung Hee Ha, Kwang Youn Lee, Won Joon Kim; Yeungnam Univ J Med. 1989;6(2):13-22. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.13

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Abstract PDF: To investigate the effect of diazepam on the contractility of the intestinal smooth muscle, longitudinal muscle strip isolated from rat ileum was prepared for myography in isolated organ bath. 1) Basal tone of ileal muscle was reduced by diazepam concentration-dependently. 2) Higher concentrations (30 and 100 microM) of diazepam inhibited (p<0.05, p<0.001) The carbachol-induced contraction in a concentration-dependent manner; but lower concentration of diazepam (10 microM) enhanced (p<0.05). 3) Histamine-induced contraction was inhibited by pretreatment with diazepam in a concentration-dependent manner. 4) Ca⁺⁺-induced tension recovery in calcium-free solution was inhibited in the presence of diazepam concentration-dependently. These results suggest diazepam reduces the contractility of the longitudinal muscle isolated from rat ileum via interference with influx of calcium into the muscle cells.

Incidence of the chlamydial conjunctivitis in the newborn period.: Son Moon Shin, Mi Wha Kang; Yeungnam Univ J Med. 1989;6(2):23-28. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.23

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Abstract PDF: After application of silver nitrate on every newborn, the incidence of gonococcal conjunctivitis was markedly decreased. But recently neonatal conjunctivitis due to chlamydial infection is increasing, so clinical observation was made on 26 newborn infants who showed eye discharge from June 1st to August 31st 1989. The results were as follows. 1. The incidence of chlamydial infection among neonatal conjunctivitis was 34.6%. 2. The most common age at diagnosis was 6-15days of life and there was no secual preponderance. 3. There was no significant difference on clinical symptoms between chlamydial conjunctivitis and other conjunctivitis. 4. Of 26 infants examined, 16 cases revealed no growth on routine bacterial culture. Of the organism cultured, P. aeruginosa was the most common agent (19.2%) and followed by S. aureus (11.5%) and S. epidermidis (7.6%). In one case of chlamydial conjunctivitis, there was concurrent S. aureus infections. 5. On this study, Giemsa stain did not give significant diagnostic aid of chlamydial conjunctivitis.

Clinical evaluation on 5 cases of lead Poisoning.: Jung Mi Lee, Hyung Woo Lee, Myung Soo Hyun, Moon Kwan Chung, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(2):29-38. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.29

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Abstract PDF: 5 cases of lead poisoning were investigated clinically. Of the 5 patients, 4 were male and 1 was female. The causes of lead poisoning in 3 cases were ingestion of herb drug pills and in 2 cases were occupational poisoning. Chief complain at admission in 4 cases were ill defined colicky abdominal pain and constipation. Only 1 case complained of dizziness and palpitation without gastrointestinal symptom. On peripheral blood, normocytic normochromic anemia (mean Hgb 9.2 gm/dl), reticulocytosis (mean 4.7%) and basophilic stippling were found in 100% of patients. Bone marrow aspiration was done in 4 cases. Erythroid hyperplasia and basophilic stippling were found in all 4 cases. Mean M:E ratio was 0.7:1. The lead concentration in serum was increased in 4 cases (80%) of patients. Lead concentration, delta aminolevulinic acid concentration in 24 hours collected urine were increased in 5 patients (100%).

The Comparison of Histopathology of Cats Received Conventional Mechanical Ventilation and High Frequency Oscillation Ventilation.: Kwan Ho Lee, Young Jo Kim, Jae Chun Chung, Hyun Woo Lee, Hae Joo Nam, Tae Sook Lee; Yeungnam Univ J Med. 1989;6(2):39-46. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.39

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Abstract PDF: The tracheobronchial histopathologic findings in 7 healthy cats used with high frequency oscillation ventilation (HFOV) were compared with those in 6 cats used with conventional mechanical ventilation (CMV). 4-point, 9-variable scoring system was used to evaluate the injury in the trachea, right & left main bronchi and parenchyma. The following results were obtained; 1) The tracheobronchial tree received HFOV had no significant damage compared with CMV (P>0.05). 2) Intraepithelial mucus loss and emphysema were slightly more prominent in CMV groups. As above results; the tracheobronchial histopathologic difference was not prominent between CMV and HFOV groups received with relatively short period, however, the cellular of function and barotrauma may be more prominent in CMV groups. From now on, as causes of tracheobronchial injury in HFV, interaction between humidification and mechanical trauma considers further study.

Factors influencing arterial CO² tension in cats during high frequency oscillation ventilation.: Jun Young Do, Jae Yick Lee, Kwan Ho Lee, Yeung Jo Kim, Jae Chun Chung, Hyun Woo Lee, Suck Kang Lee; Yeungnam Univ J Med. 1989;6(2):47-55. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.47

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Abstract PDF: High frequency ventilation (HFV) is a new ventilatory technique that uses very small tidal volume (less than the anatomic dead space) and high frequency, and classified 4 distinct types according to frequency and mode of gas delivery. The mechanism of gas transport of high frequency oscillation ventilation (HFOV) is somewhat different to other types of HFV. To evaluate the determinants of PaCO² in HFOV, a study was done with a HFOV on 9 cats, and the results are: 1) PaCO² was not correlated with frequency at the constant stroke volume (6 voltage) and bias flow (6 L/minutes). 2)PaCO² was correlated with stroke volume but not with bias flow under the constant frequency (15 Hz/min) and bias flow (3 to 6 L/min). From above results, the main determinant of PaCO² on artificial ventilation with HFOV was stroke volume, but further study between flow, the site of delivery to the airway and humidification of bias flow and CO² elimination is required in future research.

Analgesic Effects of Epidural Clonidine.: Ill Sook Suh, Dae Pal Park; Yeungnam Univ J Med. 1989;6(2):57-62. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.57

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Abstract PDF: Clonidine, α2-adrenergic agonist, applied spinally or epidurally has been shown to be effective in blocking noxious stimuli in human applications. The purpose of this study is to evaluate the analgesic effect of epidurally administered clonidine. In 40 patients undergoing hemorrhoidectomy or anal fistulectomy, 1.33% lidocaine 15ml (Group I) or 1.33% lidocaine mixed with 75µg clonidine (Group II) administered epidurally through sacral hiatus. Intraoperative changes of vital signs and duration of postoperative analgesic effects were observed. The results were as follows: 1) In the group I, average analgesic duration was 2.42 hours. 2) In the group II, average analgesic duration was 7.32 hours. 3) After epidural clonidine injection, the decrease in heart rate and blood pressure was not significant without sedation. 4) Postoperatively, any complaints related clonidine were not reported. In conclusion, postoperative pain control with epidural clonidine was effective.

A Study on the Design of High-Frequency Jet Ventilator Using PLL system.: Joon Ha Lee, Jae Chun Chung; Yeungnam Univ J Med. 1989;6(2):63-70. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.63

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Abstract PDF: This paper describes to design and to examine the mechanical characteristics of high frequency jet ventilator. The device consists of Phase lock loop (PLL) system, solenoid valve driving control part and Air regulating system. This study is carried out by changing several factors such as endotracheal tube (E.T. tube) diameter, injector cannula diameter, 1%, and frequency (breaths/min.) having direct effects on the gas exchange as well as parameters of the entrained gas by venturi effect, so as to measure the tidal volume and minute volume. This system characteristics were as follows: 1) Frequency: 6-594 bpm 2) Inspiration time: 1-99% 3) Variance of input air pressure: 1-30 PSI

Microvascular Anastomosis Using Horizontal Mattress Suture Technique.: Sang Hyun Woo, Jeong Cheol Kim, Yung Sik Jung, See Ho Choi, Won Hee Choi; Yeungnam Univ J Med. 1989;6(2):71-78. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.71

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Abstract PDF: Horizontal Mattress Suture Technique on Microvascular Anastomosis of rat (body weight: 200-250 gm) femoral artery was evaluated. The present study was conducted to compare the horizontal mattress suture with simple interrupted suture on the suture time, patency rate of the sutured vessels, and the histological changes of surgical site of the vessel wall during wound healing period. The mean suture time of the vessel wall with horizontal mattress suture technique was 15 min 49 sec ± 2.14, which is significantly shorter than that of simple interrupted suture technique. The patency rate of the sutured vessel in both groups was statistically not different each other till post-operative 3rd day but patency rate of horizontal mattress suture was higher than that of simple interrupted suture at post-operative 3rd week. The histological findings such as intimal noss, medial degeneration and intimal regeneration were similar in both groups.

CT findings of the Mediastinal tumors.: Ho Son Chung, Sang Jin Lee, Mi Young Son, Hyuk Po Kwon, Mi Soo Hwang, Son Yong Kim, Jae Chun Chang, Bok Hwan Park; Yeungnam Univ J Med. 1989;6(2):79-90. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.79

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Abstract PDF: Computerized Tomography is now well established and important noninvasive method of diagnosting mediastinal mass lesions because of its superior imaging of their size, location and internal composition. Authors analyzed and present CT findings of 30 surgically proven mediastinal tumors and cysts that were studied and treated at the Yeungnam University Hospital during recent 6 years. The most common tumor was thymoma (9 cases), and teratoma (6 cases), lymphoma (6 cases), bronchogenic cyst (4 cases), neurogenic tumor (4 cases), pericardial cyst (1 case) were next in order of frequency. There were 5 cases of thymoma showing homogenous solid density mass, 2 cases were malignant thymoma and myasthenia gravis was present in 2 cases. A case of thymolipoma and a case of thymic carcinoma were included. All teratomas were cystic masses but pathognomonic fat, and calcified density were seen only in 4 cases. 5 cases were located in anterior mediastinum and 1 case was in posterior mediastinum. Lymphoma (3 Hodgkin's and 3 non-Hodgkin's) appeared as irregular lobulated mass in anterior mediastinum. Neurogenic tumor (2 ganglioneuroma and 2 neurilemmoma) appeared as homogenous density mass located in posterior mediastinum. Among the 4 bronchogenic cysts, 2 were located in retrotracheal area, 1 was located in subcarinal and 1 was in parathoracic area. One case of pericardial cyst was oval shaped cystic mass located in left pericardiac border.

Treatment of Traumatic Carotid-Cavernous Fistulas using Debrun's Detachable Balloons.: Sang Jin Lee, Son Yong Kim, Mi Soo Hwang, Jae Chun Chang, Bok Hwan Park; Yeungnam Univ J Med. 1989;6(2):91-101. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.91

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Abstract PDF: The goal of therapy in patients with traumatic carotid-cavernous fistulas is to occlude the fistula preferably while maintaining the carotid blood flow. Since the introduction of the concepts of detachable balloon technique to occlude arteriovenous fistulas, the technique has become the treatment of choice in the management of traumatic carotid-cavernous fistulas. The major symptoms of traumatic CCFs are (1) pulsating exophthalmos, (2) orbital and cephalic bruit and murmur, (3) headache, (4) chemosis, (5) extraocular palsies, and (6) visual failure. Traumatic CCFs are combined with multiple associated lesion. We tried the occlusion of fistulas using Goldvalve balloons in 8 consecutive cases of traumatic CCF and the result of our experience is reported. Transarterial approach with manually-tied latex balloons is tried in all cases and the fistulas was successfully occluded in all cases. In 5 cases, the internal carotid artery was preserved and the arterial lumen was occluded along with fistula opening in cases. In one case, surgical ligation was done because of symptoms recurred and incomplete occlusion of fistula. We experienced hemiparesis as a major complication in one case during occlusion tolerance test, which was remitted spontaneously. The results of Debrun balloon treatment were relatively excellent. We consider that the first choice of treatment of traumatic CCF is occlusion of the fistula by a detachable balloons.

Histopathologic Change of External Abdominal Irradiation on Urinary Bladder of Mice at Total Dose and Intervals.: Kyoung Ae Kim, Myung Se Kim; Yeungnam Univ J Med. 1989;6(2):103-111. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.103

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Abstract PDF: The object of this study was to determine the radiation effect on the urinary bladder and to establish the basic date for optimal fraction schedule on the whole abdominal irradiation of the mice. Although radiation damage of the urinary bladder is one of the dose-limiting factor for treatment of lower abdominal cancer, such as uterine cervical or rectal cancer, systematic histopathological study of total dose and recovery duration is very rare, especially in conventional fractionation regimen of clinical use. Authors used 198 mice and analyzed histopathological findings according to total dose (40&50 GY) and recovery duration (1-15 weeks after completion of irradiation) The results were summarized as follows: 1. No definite difference of radiosensitivity was noted between male and female group. 2. Most of mucosal injuries were recovered within 14 weeks in 40 GY irradiated group. 3. Vascular injury and change of connective tissue were prominent and persisted even mild degree until 15 weeks after completion of irradiation in 50 GY irradiated group. 4. Although follow up duration of this study (105 days) was not enough to compare life span of mice, this study emphasized that precious schedule for treatment planning was necessary for preventing or reducing of late complication.

A Study on the Dose Distribution for Total Body Irradiation using Co-60 Teletherapy Unit.: Sung Kyu Kim, Sei One Shin, Myung Se Kim; Yeungnam Univ J Med. 1989;6(2):113-119. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.113

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Abstract PDF: In recent years there has been a growing interest in total body, hemibody, total lymphoid irradiation. For refractory leukemia or lymphoma patients, various techniques and dose regimens were introduced, including high dose total body irradiation for destruction of leukemic or bone marrow cells and immunosuppression prior to bone marrow transplantation, and low dose total body irradiation for treatment of lymphocytic leukemias or lymphomas. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. Purposes of this paper are to discuss calibrating Cobalt Unit in 3m distance using Rando Phantom, to compare calculated dose, calibrated dose, and compensating filters for homogeneous dose distribution in the head and neck, the lung and the pelvis. Results were following. 1. Measured dose on the lung was 6% higher than on the abdomen. Measured dose on the head (10%) and neck (18%) were higher than the abdomen because of thinness. Pelvic dose was measured 12% less than the abdomen. Those date suggest that compensating filter was essential. 2. Measured dose according to distance was 3% less than calculated dose which suggest that all doses in clinical use should be compared with calculated dose for minimizing error.

Radiation Effect on Airway Obstruction from Lung Cancer.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1989;6(2):121-125. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.121

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Abstract PDF: Total 21 patients with airway obstruction from lung cancer treated with radiotherapy at Department of Therapeuctic Radiology, Yeungnam University College of Medicine, between April 1986 and December 1988 are retrospectively analyzed by means of roentgenologic findings. Obtained results are as follows. 1. 15 out of 21 patients (71%) showed complete or partial response. 2. Patients with small cell lung cancer showed 100% response in spite of low dose (30 GY/10 fractions.) 3. Patients with non-small cell lung cancer treated with 50 GY or over showed better response than below 45 GY or below. 4. There is no relationship between the response and site of airway obstruction. These date suggested that high dose irradiation is more effective in the management of airway obstruction from lung cancer and meticulous radiotherapy planning with appropriate protection of normal lung and critical organs should be investigated in order to maximize radiation effect and minimize side effect, complication or sequelae.

Surgical Treatment of the Upshoot and Downshoot in Duane's Retraction Syndrome.: Myung Mi Kim; Yeungnam Univ J Med. 1989;6(2):127-132. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.127

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Abstract PDF: The upshoot and downshoot in Duane's retraction syndrome is believed to be related to a leash effect from the lateral rectus muscle. When the eye is rotated into the adducted position, the lateral rectus muscle slips over the globe, producing the up-and downshoot on adduction. The splitting of the ends of the lateral rectus into a Y configuration prevents the rotation of the globe up or down by stabilizing the muscle's position on the eye. Three patients with Duane's retraction syndrome demonstrated abnormal vertical movement on adduction and underwent a Y-splitting on the lateral rectus. In all patients, marked decrease in the up-and downshoot in noted after surgery.

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