Journal of Yeungnam Medical Science

Volume 9(2); December 1992

Original Articles

Ophthalmology
Surgical Treatment for Vitreous Hemorrhage Associated with Branch Retinal Vein Occlusion.: Duk Kee Hahn, Young Hoon Park; Yeungnam Univ J Med. 1992;9(2):211-217. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.211

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Abstract PDF: No abstract available.

Orthopedics and Sports Medicine
Erythrocyte sedimentation rate and C-reactive protein values in patients with hip arthroplasty.: Se Dong Kim, Dong Chul Lee, Dong Gu Park; Yeungnam Univ J Med. 1992;9(2):218-223. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.218

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Abstract PDF: Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured in 46 patients treated with uncomplicated primary hip replacements, 39 total tip replacements and 7 bipolar hip replacements. In uncomplicated primary hip replacements, ESR levels were slightly elevated preoperatively and were variable postoperatively. But CRP was normal before surgery and elevated in postoperative course, but back to normal within three weeks in most cases. Early success of hip arthroplasty is in indicated by normalization of CRP within three weeks, regardless of ESR. Since ESR seems to react somewhat differently from the CRP, both methods are useful in the monitoring of complications after hip arthroplasty.

Pathology and Forensic Medicine
Ultrastructural changes of fat-storing cells in experimental hepatic fibrosis.: Mi Jin Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1992;9(2):224-238. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.224

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Abstract PDF: Hepatic fibrosis was induced in Sprague-Dawley rate to evaluate the ultrastructural changes of fat-storing cells (Ito cells). For experimental induction of liver fibrosis, the rats were administered intraperitoneally with 0.5 ml of 50% Ccl4 solution per Kg body weight, twice weekly for 12 weeks. The rats were sacrificed every week. The liver tissues were examined under light and electron microscopes. And the immunohistochemical study of desmin was also performed. The results were summarized as follows: Light microscopic findings: The cellular infiltrations was inflammatory cells and Kupffer cells developed from 1 week after Ccl4 injection, and were the most severe in 4 weeks. The strong immunoreactivity for desmin was also evident in 4 weeks. The centrilobular necrosis and fibrosis developed from 2 weeks after injection, and the necrosis persisted until 8 weeks. The progress of fibrosis was accompanied by decreases in cellular infiltration and reactivity for desmin, and increased gradual nodular formation was also observed. The cirrhosis was developed after 10 weeks. Electron microscopic findings: An increase in number of fat-storing cells was observed from 1 week after injection. Transitional cells characterized by a depletion of lipid droplets and a hypertrophy of the rER appeared after 2 weeks. The number of transitional cells with abundant collagen fibers in the extracellular spaces increased in 4 weeks. With progression of fibrosis the number of fat-strong cells decreased and proliferating fibroblasts with dilated rER were observed. According to these results it was revealed that there was an apparent transition from fatstrong cells to transitional cells and to fibroblasts. These cells had a few similar characteristics and may belong to the same cell population. Thus it was suggested that fatstrong cells might play an important role in hepatic fibrosis.

Pediatrics, Perinatology, and Child Health
The clinical observations in childhood asthma.: Kih Yeon Song, Yong Hyoun Park, Jin Gon Jun, Young Hwan Lee, Chun Dong Kim; Yeungnam Univ J Med. 1992;9(2):239-247. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.239

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Abstract PDF: A clinical analysis was done on 134 cases with bronchial asthma who were admitted to the Department of Pediatrics Yeungnam University from May 1987 to October 1991. The results were as follows: 1) The peak age of bronchial asthma was under 2 years. The sex ratio of male to female was 2.9:1. 2) The outbreak of bronchial asthma was most common in fall, especially in September. 3) The past history of other allergic diseases were present in 22.4% of patients (30/134 cases), and the previous bronchiolitis in infancy were experienced in 12.7% of patients (17/134 cases). 4) According to the skin test for allergens done by RAST, the most common allergens were Mites and House dust. 5) Eosinophilia (T.E.C>250/min) was found in 29.1%t of patients, and elevated lgE level (>200 IU/ml) was found in 63.2% of patients. 6) No significant differences in the serum lgE level were found between male and female patients. No significant differences in the serum lgE level were found between asthma patients with and without other allergic diseases. 7) The serum lgE level of school aged patients was significant higher than that of preschool aged (p<0.01).

Microbiology
Analysis of genes involved in the pathogenesis of intracellularly survival bacteria.: Tae Il Jeon, Tae Yoon Lee, Sung Kwang Kim; Yeungnam Univ J Med. 1992;9(2):248-255. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.248

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Abstract PDF: Eight bacterial strains were examined whether they have phoP/phoQ genes which were known to be involved in the intracellular survival of Salmonella typhimurium. The phoP/phoQ operon were known to sense the stimuli of the genes involved in the adaptation of the environment. Using 514-basepairs EcoRV DNA fragment of phoP region of Salmonella typhimurium as a probe, dot blot hybridization were performed. Chromosomal DNAs of Klebsiella pneumonia, Pseudomonas aeruginosa, Serratia marscescens, Enterobacter cloacae, Salmonella typhimurium, Escherichia coli, Shigella dysenteriae, and Listeria monocytogenes were examined by DNA hybridization assay. Against our expectation, intracellular pathogen, L. monocytogenes, did not have similar DNA sequences to phoP/phoQ of S. typhimurium, while E, coli, S. dysenteriae, and E. cloacae showed the positive signal even though they were not intracellular pathogens. This result suggested that the phoP/phoQ operon was absent in intracellular pathogenic bacterias other than S. typhimurium. Rather it was found in phylogenetically closer bacterias to S. typhimurium, which were not able to survive in intracellular environment. Some different mechanism, which is not dependent on phoP/phoQ operon, could be involved in the intracellular survival of L. monocytogenes.

Psychiatry and Mental Health
Comparison of the depression and anxiety between the elderly in the home for the aged and those in the community.: Hyo Seok Seo, Sung Duk Jung, Chang Su Kim; Yeungnam Univ J Med. 1992;9(2):256-268. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.256

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Abstract PDF

This survey was conducted from January 1991 to May 1991. Two hundred and eight residents in 4 government supported homes for the aged and hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale (CADS) and somatization symptom check list (SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of the total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and unsatisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.

Citations

Citations to this article as recorded by

Factors Influencing Depression among Elderly Patients in Geriatric Hospitals
Young Ju Jee, Yun Bok Lee
Journal of Physical Therapy Science.2013; 25(11): 1445. CrossRef

Radiology, Radiotherapy & Diagnostic Imaging
The analysis of ultrasonographic findings in breast carcinoma.: Jin Wook Lee, Mi Soo Hwang, Bok Hwan Park; Yeungnam Univ J Med. 1992;9(2):269-274. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.269

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Abstract PDF: Authors retrospectively analyzed ultrasonographic findings of 12 cases of breast carcinomas which were proven pathologically at Yeungnam University Hospital from March 1992 to August 1992. Classically, breast carcinomas were described as irregular and lobulated hypoechoic solid masses with inhomogeneous internal echoes and frequent attenuation of the sound beam. And other additional ultrasonographic findings were echogenic rim, disruptions of superficial layer, microcalcification, skin thickening and so on. In our studies, not all of these findings of breast carcinomas were found in each case, but most of these findings were noted. However, several studies have demonstrated considerable overlap in the ultrasonographic appearance of benign lesions and carcinoma. Thus, accurate sonographic determination of the type of solid mass is not possible with current ultrasonographic imaging techniques and criteria. For more accurate diagnosis of breast lesions, sonographic and other imaging techniques are interpreted together.

Psychiatry and Mental Health
Anxiety and depression of the Korean residents in China.: Jeong Kyu Sakong, Seung Douk Cheung, Chang Su Kim, Cheol Gu Kim, Bong Jin Kim; Yeungnam Univ J Med. 1992;9(2):275-287. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.275

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Abstract PDF: In order to survey the reality of anxiety and depression among the Koreans residing in china, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionnaires, named Combined self-rating anxiety depression scale (CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows: There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were 29.70±7.03, while those of Chinese were 29.45±9.01. The score of the CADS above 50 (clinically significant level) was seen in 12 (2.54%) Koreans and 21 (4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the compatison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libldo. The Chinese marked significantly higher in facial flushing, anxiousness, dissastisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship (p<0.01 respectively), with past history of psychiatric hospitalization (Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image (p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness (p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education (p<0.01 respectively). In place of growth, The Koreans showed not much difference in the areas while more Chinese grew up un large cities (p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking (p<0.01 respectively), In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars (p<0.01 respectively). There were no significant difference between two groups about religion.

Biochemistry
The role of G protein in the activation of phospholipase C from bovine brain.: Jung Hye Kim, Dong Jin Lee, Yeung Ju Byun; Yeungnam Univ J Med. 1992;9(2):288-301. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.288

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Abstract PDF: The objective of the present study was to identify the characteristics of phospholipase C (PLC) isozymes purified from bovine brain and to investigate their interrelationship with G protein. The purified PLC isozymes β, γ and δ were obtained and the characteristics of PLC activity on various concentrations of free Ca²⁺ were observed. The activity of PLC was increased with increasing Ca²⁺ concentration and the activity PLC δ was increased higher in the presence of phosphatidyl choline (PC) than in the absence of PC. For vesicle formation as the structure of cell membrane, cholic acid and deoxycholic acid as detergent on phosphatidylinositol bisphosphate (PIP₂) substrate containing PC were used, and then the activity of PLC isozymes were increased with increasing concentration of cholate, from 0.2% to 1% and were increased slightly in deoxycholate. In the PIP₂ containing phospholipid and glycolipid as brain extract, the activity of PLC isozymes were checked in 0.2-1% cholic acid. The activities of PLC isozymes were continuously increased up to 1% cholic acid. The quantitation of PLC isozymes from several bovine organs by radioimmunoassay was made. Brain was the most sufficient organ in terms of amount of PLC β and δ. A large amount of PLC δ was existed in adrenal gland. The binding capacity of GTPrS and G protein was observed and other observations of the binding effect of GTPrS-G protein and PLC monoclonal Ab-Protein A from tissue homogenate with PLC were made. From the observation the binding capacity was revealed the range of 0.11-1.49%. The effects of each type of G protein on the percent activity of purified PLC isozymes were observed. From the observation, activities of isozymes were increased in Goa & Gmix, and the activities of PLC β and δ were increased in Gβγ and Gia. Activities of PLC β and γ were decreased in Gta but PLC δ increased.

Orthopedics and Sports Medicine
Clinical observation and treatment of fracture-dislocation of talus.: Dong Chul Lee, Se Dong Kim, Hae Hoon Jung; Yeungnam Univ J Med. 1992;9(2):302-311. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.302

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Abstract PDF: Talus is an important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 years. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down (8 cases), and next traffic accident (2 cases), sports injury (1 case). 3. According to Marti-Weber classification, 1 case was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results (by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved (74%), but in the subtalar joint it was decreased (43%)

Radiation Oncology
Radiation therapy of nasopharyngeal cancers.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1992;9(2):312-320. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.312

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Abstract PDF: Radiotherapeutically, nasopharyngeal caner is an important disease in Korea. Because of its blind anatomic location, early detection is relatively uncommon. Clinically, most of cases are locally advanced and nodal involvements are common. Recently better understanding of nature of the disease and improvement of radio – therapy technique permit better treatment result, including locoregional control and survival rate, and minimal normal tissue damages comparing with previously published date. We analyzed 31 patients of pathologically proven and previously untreated naso – pharyngeal carcinoma with different treatment techniques, retrospectively. Minimal and maximal follow up period of the survivor is 6 months and 68 months, respectively. Thirteen patients with squamous cell carcinoma are included in this analysis. The median age is 49 years (range from 20 to 64 years). Twenty two patients are stage III. Eleven patients are treated with radiotherapy alone and 20 are treated with combined modalities treatment. The degree of response after radiotherapy are categorized by 3-classes, i,e. complete response, partial response. In spite of similarities of complete response rate and 1-year survival rate between two different treatment techniques, those patients with undifferentiated carcinoma appear to benefit from the adjuvant chemotherapy. In addition, systemic failure is more suggest that adjuvant therapy in the radiotherapeutic management of nasopharyngeal cancer needs additional research according to histologic types and future extensive clinical trials.

Thoracic and Cardiovascular Surgery
Surgical treatment of atrial septal defect in adult patients.: Dong Hyup Lee, Jung Cheul Lee, Sung Sae Han; Yeungnam Univ J Med. 1992;9(2):321-326. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.321

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Abstract PDF: The study consisted of all patients over 35yerars old undergoing surgical repair of atrial septal defect for the period from June 1985, to August 1992. The following results were observed. 1. ASD was closed with patch in 11 (73%) patients. 2. The relationship of pulmonary artery systolic pressure to Qp/Qs ratio was not significant. 3. Before operation 6 patients were in NYHA functional class II. 8 were in class III, After operation 8 patients were in class I, 6 were in class II. 4. Atrial fibrillation has persisted in 3 patients and returned regular rhythm in 1 patient after surgery. 5. There was no operative mortality and we had good surgical results regardless of patient's age.

Pediatrics, Perinatology, and Child Health
A study of cisplatin nephrotoxicity.: Young Hee Hwang, Kyoung A Lee, Son Moon Shin, Young Hoon Park, Jeong Ok Hah, Chun Dong Kim, Young Hwan Lee; Yeungnam Univ J Med. 1992;9(2):327-333. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.327

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Abstract PDF: To evaluate the nephrotoxicity of cisplatin, serum levels of sodium, potassium, chloride, calcium, phosphorous, magnesium, BUN, creatinine and creatinine clearance were measured before and after administration of cisplatin in 18 cases of patients with malignant neoplasm. The results were as follows: 1) Serum calcium, magnesium, potassium and BUN levels were changed after cisplatin administration, but those changes were not statistically significant. 2) The mean value of creatinine clearance was not decreased significantly after treatment with cisplatin. 3) Acute renal failure was developed in one case, and four cases of hypocalcemia, hypomagnesemia were also detected after administration of cisplatin.

Thoracic and Cardiovascular Surgery
Clinical observation of aortic dissection.: Byeong Ik Jang, Jin Ho Park, Dong Ku Shin, Yeoung Jo Kim, Bong Sup Shim, Hyun Woo Lee, Su Hyen Kim, Sung Sae Han; Yeungnam Univ J Med. 1992;9(2):334-341. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.334

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Abstract PDF: A clinical review of 34 cases of aortic dissection which were admitted to Yeungnam University hospital between March 1983 and April 1992. The results are as follows: 1. The peak incidence was in 5th, 6th decade and male to female ratio was 1.83:1. 2. The most common cause of aortic dissection was atherosclerosis and hypertension (79%). 3. The most common presenting symptom was pain (73%). but dyspnea, palpable mass, murmur, shock were also observed. 4. Abnormal electrocardiographic finding was myocardial ischemia in 6 cases, arrhythmia in 5 cases, LVH in 5 cases. 5. The X-ray findings showed abnormal aortic contour in 10 cases but normal X-ray finding was observed in 63% of DeBaKey Type III. 6. The most common diagnostic procedure was echocardiogram and abdominal Ultrasonography. 7. The mortality of all cases was 20%, operation mortality was 18% but no death of medically treatment in medical indication.

Gastroenterology and Hepatology
Gastric mucosal damage by bile acid.: Hyun Hong Cho, Jeong Ill Suh, Keyong Hee Lee, Tae Nyeun Kim, Moon Kwan Chung, Hyun Woo Lee, Won Hee Choi, Chang Heon Yang; Yeungnam Univ J Med. 1992;9(2):342-350. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.342

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Abstract PDF: To investigate the effect of bile acid on gastric mucosa, we performed biologic test using Sprague-Dawley rat. Mixture solution of TDCA 15mM and Hcl of pH 3 was given into stomach to one group and HCl of pH 3 was given into stomach to another group. The significant gastric mucosal change was vasodilation and edema, that was disappeared progressively. These findings suggest the bile acid and damage gastric mucosa.

Pathology and Forensic Medicine
Histopathologic consideration of hepatocellular carcinoma.: Hae Joo Nam, Dong Suk Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1992;9(2):351-358. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.351

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Abstract PDF: Hepatocellular carcinoma represents approximately 90% of the primary liver cancers. Recently, its incidence tends to be increased. Thirsty seven cases from 1986 to 1991 diagnosed as hepatocellular carcinoma by resection were analyzed to know their histopathologic feature and related clinical findings. The average age at the time of resection was 53.1 years, with frequent occurrence in third and fourth decades. Microscopically, the trabecular type was the most frequent growth pattern (35.1%) and classic hepatocyte-like cell type was the most frequent cell type (75.7%). The tumors are mainly moderately differentiated and frequently associated with liver cirrhosis. In comparison of cytological differentiation with liver cirrhosis, there was a tendency for well-differentiated tumors to arise in cirrhotic livers more often than poorly differentiated tumors, and the tendency was statistically significant. But differentiation and tumor size did not show significant correlation. Also statistically significant correlations were not observed between the level of alpha-fetoprotein and tumor size, and between the level of alpha-fetoprotein and differentiation.

Obstetrics, Gynecology, and Reproductive Medicine
Effect of diazepam on the oxytocin induced contraction of the isolated rat uterus.: Yoon Kee Park, Sung Ho Lee, Oh Cheol Kwon, Jeoung Hee Ha, Kwang Youn Lee, Won Joon Kim; Yeungnam Univ J Med. 1992;9(2):359-381. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.359

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Abstract PDF: This study was designed to investigate the effect of diazepam on the spontaneous contraction and oxytocin induced contraction of the isolated rat uterus. Female rat (Sprague-Dawley) pretreated with oophorectomy and 4 days administration of estrogen. Weighing about 200 g, was sacrificed by cervical dislocation, and the uteruses were isolated. A longitudinal muscle strip was placed in temperature controlled (37℃) muscle chamber containing Locke's solution and myographied isometrically. Diazepam inhibited the spontaneous contraction and oxytocin induced contraction of the isolated rat uterus in a concentration-dependent manner. GABA, muscimol, a GABA A receptor agonist, bicuculline, a competitive GABA A receptor antagonist, picrotoxin, a non competitive GABA A receptor antagonist, baclofen, a GABA B receptor agonist, and delta-aminovaleric acid, a GABA B receptor antagonist, did not affect on the spontaneous and oxytocin induced contraction of the isolated rat uterus. The inhibitory actions of diazepam on the spontaneous and oxytocin induced contraction were not affected by all the GABA receptor agonists and antagonists, but exceptionally potentiated by bicuculline. This potentiation-effect by bicuculline was not antagonized by muscumol. In normal calcium PSS, addition of calcium restored the spontaneous contraction preinhibited by diazepam and recovered the contractile of oxtrocin preinhibited by diazepam. A23187, a calcium inophore, enhanced the restoration of both the spontaneous and oxytocin induced contraction by addition of calcium. In calcium-free PSS, diazepam suppressed the restoration of spontaneous motility by addition of calcium but allowed the recovery of spontaneous motility to a considerable extent. Diazepam could not inhibit some development of contractility by oxytocin in calcium-free PSS, but inhibited the increase in contractility by subsequent addition of calcium. These results suggest that the inhibitory action of diazepam on the rat uterine motility does not depend on or related to GABA receptors and that diazepam inhibits the extracellular calcium influx to suppress the spontaneous and oxytocin induced contractilities.

Pharmacology, Drug Therapy, and Toxicology
Inhibitory of γ-aminobutyric acid on the contractility of isolated rat vas deferens.: Ki Young Ahn, Oh Cheol Kwon, Jeoung Hee Ha, Kwang Youn Lee, Won Joon Kim; Yeungnam Univ J Med. 1992;9(2):382-395. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.382

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Abstract PDF: GABA is an inhibitory neurotransmitter in central nervous system and produce sedative, antianxiety and muscle relaxing effects via GABA(A) receptor or GABA(B) receptor. Recently it is known that GABA is widely distributed throughout peripheral organs and may play a physiological role in certain organ. The vas deferens is innervated by species-difference. These study, therefore, was performed to investigate the mode and the mechanism of action of GABA on the norepinephrine-, ATP- and electric stimulation-induced contraction of vas deferens of rat. Sprague-Dawley rats were sacrificed by cervical dislocation. The smooth muscle strips were isolated from the prostatic portion and were mounted in the isolated muscle bath. PSS in the bath was aerated with 95/5%-O₂/CO₂ at 33℃. Muscle tensions were measured by isometric tension transducer and were recorded by biological recording system. 1. GABA, muscimol, a GABA(A) agonist, and baclofen, a GABA(B) agonist inhibited the electric field stimulation (EFS, 0.2Hz, 1mSec, 80V, monophasic square wave)-induced contraction with a rank order of potency of GABA greater than baclofen greater than muscimol. 2. The inhibitory effect of GABA was antagonized by delta aminovaleric acid (DAVA), a GABA(B) antagonist, but not by bicuculline, a GABA(A) intagonist. 3. The inhibitory effect of baclofen was antagonized by DAVA, but the effect of muscimol was not antagonized by bicuculline. 4. Exogenous norepinephrine (NE) and ATP contracted muscle strip concentration dependently, but the effect of acetylcholine was negligible and GABA did not affect the NE-and ATP-induced contractions. 5. GABA, baclofen and muscimol did not affect basal tone, and GABA did not affect the NE-and ATP-induced contractions. 6. EFS-induced contraction was inclucling 2 distinctable components. The first phasic component was inhibited by beta gamma-methylene ATP (mATP), a desensitizing agent of APT receptor and the second tonic component was reduced by pretreatment of reserpine (3 mg/Kg, IP). 7. GABA inhibited the EFS-induced contraction of reserpinized strips, but not the mATP-treated strips. These results suggest that in the prostatic portion of the rat vas deferens, adrenergic and purinergic neurotransmissions are exist, and GABA inhibits the release of ATP via presynaptic GABA(B) receptor on the excitatory neurons.

Dermatology
Antimycotic susceptibility testing of trichophyton rubrum by microculture method.: Moo Woong Lee, Jong Chul Kim, Jong Soo Choi, Ki Hong Kim; Yeungnam Univ J Med. 1992;9(2):396-406. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.396

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Abstract PDF: Various susceptibility tests have been used to determine minimal inhibition concentration (MIC) of dermatophytes. They have limitations to apply practically because they need long time to determine MiC. Authors examined MIC of T. rubrum to ketoconazole and itraconazole using 96- well microplate and 24-well macroplate by method of Granade and Artis and tried to check the possibility of this method on clinical application. Nine strains of T. rubrum from patients with dermatophytosis were used. Evaluations of the factors affecting MIC were also tried. The results as follows. 1. Effect of inoculation density on determination time and MIC: Determination of MIC were possible in 4th days after inoculation at higher inoculation density (aborbance 2.0, 1.0) compared to 6th days at lower inoculation density (absorbance 0.5, 0.25). 2. Effect of incubation temperature on MIC: When incubating at 37℃, MIC were below 0.006-0.04µg/ml to ketoconazole and below 0.006-0.04µg/ml to itraconazole while at 25℃ 0.08-5.68µ8/ml to ketoconazole and 0.006-0.71µg/ml to itraconazole. Significant reduction of MIC was observed at 37℃ compared to 25℃. 3. Effect of container size on determination time and MIC: When incubating in 96–well microplate and 24-well macroplate, determination of MIC was possible in 4th to 6th days after inoculation in broth-containig 96-well microplate compared to 8th to 12th days in broth-containing 24-well macroplate. But no difference in MIC was observed between different container size. 4. Effect of media on MIC: When using broth as media, MIC were below 0.006-5.68µg/ml to ketoconazole, below 0.006-0.36µg/ml to itraconazole in broth-containg 24-well macroplate. When using agar as media, MIC were below 0.006-5.68 µg/ml to ketoconazole, below 0.006-5.68 µg/ ml to itraconazole in agar-containing 24-well macroplate. 5. These findings confirm that determination of MIC of dermatophtes by method of Granade and Artis is fast and simple technique for antifungal susceptibility test.

Gastroenterology and Hepatology
Intrafamilial transmission of HCV: comparison with HBV.: Heon Ju Lee; Yeungnam Univ J Med. 1992;9(2):407-415. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.407

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Abstract PDF: Among 85 patients with anti-HCV positive chronic liver disease, only 21.2% have past history of blood transfusion and over half the cases, they do not have any suspicious risk factors for HCV infection. 3 of 85 families show anti-HCV positive family members. On the other hand, 40 of 60 patients with HBsAg positive chronic liver disease show HBsAg positive family members. In Korea, HBV is transmitted mainly through vertical and intrafamilial infection but HCV disease might be rather horizontal and sporadic than vertical. To define the evident source of infection in sporadic hepatitis C, first of all, simple test with high sensitivity and specificity for diagnosis of HCV infection would be needed.

Case Reports

Urology
2 cases of male urethral diverticulum combined with stone.: Hyun Chul Shin, Young Soo Kim, Tong Choon Park; Yeungnam Univ J Med. 1992;9(2):416-421. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.416

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Abstract PDF: Male urethral diverticulum is uncommon lesion, furthermore calculus formation within the male urethral diverticulum is very rare. Generally, urethral diverticula are classified as congenital and acquired. The majority of male urethral diverticula are acquired and approximately 10 to 20 per cent are congenital. Acquired urethral diverticula in the male may arise from many sources, including infection (prostatic abscess, infection of periurethral glands, hematoma or schistosomiasis), obstruction (stricture, impacted stone, Cunningham clamp or condom catheter) and trauma (instrumentation, external injury and pelvic fracture). Calculi formation is more common in the acquired diverticulum owing to stagnation of urine and infection. These calculi in the diverticulum usually are solitary and may attain considerable size with predisposing factors, 1) a ureteral or bladder calculus that is lodged in the urethra 2) urethral trauma or stricture, 3) calcification around a foreign body or hair. The treatment of urethral diverticulum combined with stone is excision of the diverticula with removal of stone. We treated two cases of urethral diverticulum combined with stone in the male, and report with review of literature.

Plastic and Reconstructive Surgery
The treatment of congenital cutis aplasia.: Young Ha Kim, Gyu Ho Cha, Jae Ho Jung, Kyung Ho Lee, Jung Hyun Seul; Yeungnam Univ J Med. 1992;9(2):422-426. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.422

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Abstract PDF: One case of congenital cutis aplasia is presented. The defect involved includes full-thickness skin defect of scalp and cranium. The patient was treated with debridement of dirty necrosed crust which covered exposed dura mater and with double opposing rotation flap including pericranium for bone regeneration. The donor site was covered with skin graft from right thigh. During operation, the superficial temporal artery was found to be short and weak. And after operation, the margin of flap were congested and finally necrotized. The necrotic wound was treated with conservative management. The vascular impairment is thought to be main course of congenital cutis aplasia. So we conclude that the treatment of choice is conservative management or careful flap surgery for coverage of defect area.

Pediatrics, Perinatology, and Child Health
A case of infantile nephrotic syndrome.: Kyung A Lee, Son Mun Shin, Yong Hoon Park; Yeungnam Univ J Med. 1992;9(2):427-435. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.427

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Abstract PDF: We have experienced a case of infantile nephritic syndrome confirmed by renal biopsy in a 13-month-old female patient who showed and develop mental retardation and persistent proteinuria. She revealed mild eyelid edema, joint laxity, delayed speech development and adrenal cortical calcification on the radiologic study. Renal biopsy showed microcystic tubular change, micro-glomeruli and marked mesangial proliferation.

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