Journal of Yeungnam Medical Science

Volume 6(1); June 1989

Reviews

Multiple Organ Failure Syndrome : MOF.: Koing Bo Kwun; Yeungnam Univ J Med. 1989;6(1):1-7. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.1

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Abstract PDF: No abstract available.

Signal Transduction.: Jung Hee Kim; Yeungnam Univ J Med. 1989;6(1):9-19. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.9

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Abstract PDF: No abstract available.

Original Articles

A Clinical Study of Mycoplasma Pneumoniae Pneumonia.: Mi Hwa Kang, Jin Gon Jun; Yeungnam Univ J Med. 1989;6(1):21-29. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.21

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Abstract PDF: A clinical study was made on 71cases of Mycoplasma Pneumoniae Pneumonia from March, 86 to February, 89. The results were as follows; 1. Among the 315 cases of pneumonia, the incidence of mycoplasma infection was 22.5% 2. The peak incidence of age was between 5 to 9years of age (53.5%) 3. The sex ratio of male to female was 1.3:1 4. Monthly distribution showed relatively high frequency from October to January (59.2%) 5. Most common clinical symptoms were cough (98.6%) and then followed by fever (49.3%), coryza (19.7%). Rales were the most common finding (95.7%) and followed by pharyngeal injection (49.3%) and wheezing (18.3%) 6. The leukocyte counts in peripheral blood were most common in the range of 5000-10000/mm³ (47.9%) and the ESR was increased in 57.7%, and positive CRP cases were 87.3% 7. The most common radiologic finding of pulmonary infiltration was interstitial infiltration (45.1%) and then followed by disseminated lobular (39.4%) and lobar pneumonia (15.5%) 8. There are a few cases associated disease or complication: otitis media (5.6%), hepatitis (4.2%) acute glomerulonephritis, bronchial asthma and sinusitis (2.8%), thrombocytopenia (1.4%)

An Outbreak of Tsutsugamushi Disease in Vicinity of Taegu City and Kyungpook Province in 1988.: Young Su Kweon, Jong Ho Kim, Kwan Ho Lee, Myung Su Hyun, Moon Kwan Chung, Hyun Woo Lee, Myung Weon Shon; Yeungnam Univ J Med. 1989;6(1):31-41. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.31

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Abstract PDF: Since the first cases of tsutsugamushi disease reported in Korea in 1986, many cases has been reported and its occurrence has been increasing. Only 2 cases has been reported in Taegu city and Kyungpook area. We experienced an outbreak of 26 cases of tsutsugamushi disease in this area and their clinical manifestations are; 1. The outbreak occurred in September to November in 1988 and its peak occurrence was in October. 2. Mean age was 52 years old (18 to 69 years old) and peak incidence was in the 6th decade. 3. Major symptoms and abnormal signs are fever/chills (88%), myalgia (65%), headache (54%), nausea and vomiting (31%), and abdominal pain (27%). The eschar was detected on lower part of body in most of cases, and more frequently in male (M:F 100 vs 58%). 4. Patients were treated with tetracyclines (TC) and/or chlorampenicol (CM) and mean duration of defervescence from initiation of antibiotic therapy was 2.1days with TC and 2.5 days with CM. 5. Complications are 2 cases of meningitis and 1 case of shock, and all cases were recovered without any sequelae. As above, tsutsugamushi disease occurs in Taegu city and Kyung Pook area as other part of Korea and clinical manifestations are similar to other reports.

Duodenal Obstruction due to Peptic Ulcer in Children.: Young Soo Huh, Won Jong Lee, Wook Dong Kim, Bo Yang Suh, Kwoing Bo Kwun; Yeungnam Univ J Med. 1989;6(1):43-46. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.43

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Abstract PDF: Primary peptic ulcer disease in not known to be the result of underlying illness or trauma. These are most frequently duodenal or prepyloric. Since clinical features of peptic ulcer in children can easily be confused with many other disorders, the diagnosis is usually made when one of the more dramatic presentations, such as perforation, bleeding and obstruction. Recently, we experienced 2 cases of duodenal obstruction due to peptic ulcer in children. So, we report it with review of references.

Progress of Experimental Trichophyton Verrucosum Infection in Guinea Pig.: Hyun Sug Kim, Jong Su Choi, Ki Hong Kim; Yeungnam Univ J Med. 1989;6(1):47-57. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.47

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Abstract PDF: T. verrucosum Infection has been reported for the first time in 1986 in Korea and has been increasing progressively. To evaluate the progress of clinical and histopathological change of dermatophytosis caused by T. verrucosum, inoculation study, using T. verrucosum isolated from infected human (human strain) and from infected cattle (cattle strain), was done in 24 male albino Hartley guinea pig. Their clinical and histopathological changes were evaluated. In addition, comparison for the growth rate between human strain and cattle strain on Sabouraud's glucose agar was made. The results were as follows: 1. Growth rate on Sabouraud's glucose agar: Cattle strain showed significantly more rapid growth rate than human strain on Sabouraud's glucose rate at 25℃ and 37℃. And cattle strain showed more rapid growth rate at 37℃ than 25℃. But human strain showed no significant difference of growth rate at both temperature. 2. Clinical findings: Initial erythema, scale and crust were developed about 8th after inoculation. All three findings reached maximum severity about 12th to 16th day and disappeared about 30th to 34th day after inoculation. There was no significant difference in progress of erythema, scale and crust between cattle strain and human strain. 3. Histopathological findings: Although mild acanthosis was noticed on the 3rd day after inoculation, the other findings including parakeratosis, intraepidermal abscess, spongiosis and vascular change, cellular infiltration were found on 9th day after inoculation. They reached maximum severity on the 12th day and lasted to the 25th day after inoculation. After that, all three findings were decreased gradually between 29th day and 33th day. On the PAS staining, hyphae and spores were found on the 6th day and disappeared on the 21th day after inoculation. 4. In trichophyton skin test, all of the 24 guinea pigs became positive within average 9.83±1.17 days These findings suggested that dermatophytosis caused by T.verrucosum induced rapid cell mediated immunity and contributed to rapid resolution of the lesion.

Antibacterial Activity of Ceftizoxime Against Gram Negative Enteric Bacteria in vitro and in vivo.: Woo Mok Byun, Jae Chun Chang, Bok Hwan Park, Hee Sun Kim, Sung Kwang Kim; Yeungnam Univ J Med. 1989;6(1):59-68. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.59

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Abstract PDF: Ceftizoxime sodium is a new synthetic β-lactam antibiotic combining potent antibacterial activity with high stability to a wide range of bacterial β-lactamase. This experiment was achieved to evaluate the antibacterial activities of ceftizoxime sodium against. Gram negative enteric bacteria isolated from in outpatient visiting Yeungnam university hospital and to study the emergence of drug induced bacterial variants which resist to ceftizoxime in vitro. The antibacterial activity of the ceftizoxime was compared with that of antibiotics and its effect on population of normal intestinal flora in mice was observed. The results are summarized as follows: 1. Highly effective antibacterial activity of ceftizoxime against Gram negative enteric bacilli was demonstrated and this antibacterial activity was superior to that of ampicillin. 2. Several test strains shows multiple antibiotic resistance. Among 15 strains of Escherichia coli, 1 strain was resistant to ampicillin, cefadroxil, gentamicin, tetracycline, and 2 strains were resistant to ampicillin, cefadroxil, tetracycline, five strains of Escherichia coli and Enterobacter cloacae was resistant to ampicillin, tetracycline and Shigella dysenteriae was resistant to ampicillin, gentamicin, tetracycline. 3. The frequency of in vitro emergence of resistant variants among ceftizoxime sensitive bacteria in the presence of increasing concentrations of the compound was found to be low. 4. Plasmid was isolated in 6 of 9 strains (6 strains of Escherichia coli, Shigella dysenteriae, Enterobacter cloacae and Salmonella typhi). That showed different antibiotic resistance. They were 5 strains of Escherichia coli and 1 strain of Shigella dysenteriae. However, plasmid could not be considered as a hallmark for antibiotic resistance by this Further studies with curing experiment are to be accomplished for this purpose. 5. Changes in the bacterial count of normal intestinal flora following 25 mg/kg/day administration of ceftizoxime over 5 consecutive days were not significant. In conclusion, ceftizoxime appeared to be a drug of choice in the treatment of Gram negative enteric bacilli infection.

Clinical Evaluation of Exudative Pleural Effusion.: Kyeong Soon Kwon, Chang Heon Yang, Kwan Ho Lee, Yeung Hyun Lee, Jae Chun Chung, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(1):69-80. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.69

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Abstract PDF: From December 1987 to September 1988, clinical evaluation were performed at the Yeungnam University Hospital on 138 patients with exudative pleural effusion comparing with biochemical, bacteriologic, cytologic and pathologic studies. The results were as follows 1. Among these 138 cases, Incidence of tuberculosis was 57.3%, neoplasm 26.8%. High tendency in malignant pleural effusion occurred in elder age. 2. In tuberculosis pleural effusion, the rate of positive smear and culture for acid-fast bacilli in the pleural fluid was 3.7% and positive biopsy for granuloma 75%. 3. In malignant pleural effusion, the rate of positive cytology for cancer cell in the fluid was 42% and positive biopsy 60%. 4. Analysis in tuberculosis and malignancy showed the tendency of high pH, WBC, protein and of low glucose, but there were clinically not significant in differentiating malignant pleural effusion from tuberculous pleural effusion. 5. Among 23 cases in which the pleural tissue findings were chronic nonspecific reaction pathologically, tuberculosis (52.2%), malignancy (26%), and idiopathic (21.8%) eventually in follow up studies.

Intraocular Pressure Changes in the Uneventful Extra-capsular Cataract Extraction and Extra-capsular Cataract Extraction with Vitreous Loss followed by Anterior Chamber Lens Implantation.: Young Hoon Park, Kyoo Won Lee, Duk Kee Hahn; Yeungnam Univ J Med. 1989;6(1):81-86. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.81

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Abstract PDF: These days the posterior chamber lens implantation following the extracapsular cataract extraction has become the standard procedure except those patients who cannot take it in one reason or another. In past, however, the anterior chamber lens implantation was popular for sometimes. Even now in those patient complicated by vitreous loss, the anterior chamber lens implantation following anterior vitrectomy is indicated in some cases. We have become interested in the difference of the intraocular pressure change in the patients who underwent the uneventful extra-capsular cataract extraction followed by anterior chamber lens implantation in routine manner and in those whose extra-capsular cataract extraction were complicated by vitreous loss and eventually needed the anterior vitrectomy before the anterior chamber lens implantation. We reviewed the medical records of 15 cases of the former group and 11 cases of the latter one in 1986 through 1988. There was some difference in the postoperative pressure in the two groups, but it was not statistically significant.

Clinical Evaluation of Dose Distribution in High Dose Rate Intracavitary Irradiation in the Treatment of Cervical Cancer.: Sei One Shin, Myung Se Kim; Yeungnam Univ J Med. 1989;6(1):87-98. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.87

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Abstract PDF: Clinical estimation of bladder and rectal doses from high dose rate intracavitary irradiation in carcinoma of the cervix uteri has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Simulation films with contrast media are used to image the bladder and rectum, and dose rates are estimated at various interesting points with the aid of treatment planning computer, NEC Therac-2300. Fifty-three patients have been reviewed in order to ascertain the correlation between radiation dose at interesting points in the bladder and rectum and the dose at Point A and B. The dose ratio between doses at Point A and interesting points in an important clinical factor in evaluating the treatment planning. This also serves as documentation of the dose to normal structures within the treatment volume. Authors conclude that obtained data are within acceptable ranges and routine simulation films of the bladder and rectum after administration of contrast media with dose calculations at interesting points provide important information for optimizing radiotherapy planning in the treatment of cervical carcinoma without increased time and effort or patient's discomfort.

The Clinical Value of the 24-hour Ambulatory ECG Monitoring in Patients with Chronic Atrial Fibrillation.: Chang Heon Yang, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(1):99-107. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.99

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Abstract PDF: 24-hour ambulatory ECG monitoring has been examined for the evaluation of heart rate and longest pause in 34 patients with chronic atrial fibrillation (20 patients treated with digoxin and 14 patients without treatment). Following results were obtained: 1. In 34 patients, the mean of average heart rates was 75.7±13.8/minute, fastest heart rates 148.0±32.4/minute, slowest heart rates 48.1±8.4/minute, difference between fastest and slowest heart rates in individual patients 99.9±29.0/minute and longest pauses 2.95±1.06seconds. The longest pauses of more than 4.0 seconds occurred in 4 of the 34 patients and made an exception of comparison groups. 2. In 27 of the 34 patients, ventricular premature contractures were developed and in 11 of 27, mainly occurred less than 100/24 hours and aberrant conduction occurred in all patients. 3. In 20 patients treated with digoxin (0.25 mg/day), the mean of average heart rates was 78.4±13.7/minute, fastest heart rates 152.5±33.1/minute, slowest heart rates 48.9±8.5/minute, difference between fastest and slowest heart rates in individual patients 103.6±31.7/minute and longest pauses 2.55±0.50 seconds. 4. In 10 patients without treatment, the mean of average heart rates was 78.0±10.7/minute, fastest heart rates 154.5±26.8/minute, slowest heart rates 50.6±7.1/minute, difference between fastest and slowest heart rates in individual patients 103.9±22.2/minute and longest pauses 2.66±0.39 seconds. 5. The difference of heart rates and longest pauses between patients with treatment and without treatment were statistically not significant (P>0.05). In summary, authors seemed to consider that 24-hour ambulatory ECG was useful and safe method for clinical evaluation of patients with chronic atrial fibrillation.

Serum Angiotensin-Coverting Enzyme Levels in Coal Worker's Pneumoconiosis.: Kyung Dong Kim, Myung Sook Choi, Chae Hoon Lee, Chung Sook Kim, Eun Kyung Bae; Yeungnam Univ J Med. 1989;6(1):109-119. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.109

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Abstract PDF: We measured fasting Serum Angiotensin-Converting Enzyme (SACE) in 100 healthy controls and 75 coal worker's pneumoconiosis (CWP) patients by a commercial kits (ACEcolor®, Fujirio Inc., Japan) and evaluated this manual method. The linear range extends to an activity of 80U/L. Precision on a commercial control serum (ACE control-N®, Sigma Co.) with a mean value of 9.47U/L yielded a within-run and between-run CVs are 5.6% (N=15) and 6.9% (N=14) respectively. Save in 75 CWP was 20.3±5.7U/L (mean±s.d.); higher than in healthy controls (13.4±3.9U/L, P<0.01). No correlation was found between SACE, sex, and age. The results suggest that the measurement for SACE and follow-up SACE in coal workers may be a useful diagnostic tools for CWP.

Interpretation of Blood Gas Analysis During Hypothermic Cardiopulmonary Bypass.: Sun Ok Song; Yeungnam Univ J Med. 1989;6(1):121-131. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.121

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Abstract PDF: The temperature-corrected values of blood gas analysis were compared to uncorrected values in 40 cases of open heart surgery under moderate hypothermic cardiopulmonary bypass. The results were as follows. 1. The corrected value of pH was significantly higher than uncorrected value, and it's relationship was ΔpH=-0.015 ΔTemp+0.005 (r=0.81, P<0.01). 2. The corrected value of PCO₂ was lower than uncorrected value, and it's relationship was ΔPCO₂=1.11 ΔTemp+1.81 (r=0.50, P<0.01). 3. The corrected value of PO₂ was lower than uncorrected value, and it's relationship was ΔPO₂=5.21 ΔTemp-1.45 (r=0.32, P<0.01). But there was no clinical significance. 4. The corrected values of HCO₃-, base excess, CO₂ content and oxygen saturation were similar with uncorrected values. In summary, the values of pH and PCO₂ were significantly changed by temperature-correction. Because of the neutral point of water (pH=pOH) rise as temperature falls and it change in parallel with the changes in blood pH, a corrected pH of 7.4, PaCO₂ of 40 mmHg during deep hypothermia would reflect a profound respiratory acidosis. Therefore, the use of the uncorrected value at 37℃ is more preferable and valid means of assessing acid-base management regardless of actual patient temperature.

Augumentation Rhinoplasty Using Autogenous Cranial Bone Graft.: Jeong Cheol Kim, Sang Hyun Woo, Jae Ho Jeong, See Ho Choi, Jung Hyun Seul; Yeungnam Univ J Med. 1989;6(1):133-140. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.133

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Abstract PDF: Augumentation rhinoplasty using autogenous cranial bone graft (outer table) can be used more successfully than other methods. In patients with congenital or posttraumatic severe saddle nose deformity and lateral deviation, cranial bone graft is an excellent method of augumentation. The advantages of cranial bone graft compared with traditional method of bone graft are summarized as follows; 1. Easy to reach donor site 2. Abundance of material 3. Little pain and functional disability 4. Shorter hospitalization period 5. Inconspicuous donor scar 6. No secondary deformity of donor site 7.Appropriate curvature can be obtained by proper selection of donor site. With the above advantages, we conclude that augumentation rhinoplasty using split cranial bone graft is a good method in correction of congenital or posttraumatic deformity of nose.

Roentgraphic Cephalometric Standard for Maxillofacial Normals with Ideal Occlusion in Korean Adults.: Byung Rho Chin; Yeungnam Univ J Med. 1989;6(1):141-149. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.141

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Abstract PDF: The purpose of this study was to aid the case analysis and diagnosis of the maxillofacial deformities for orthognathic surgery. The applied method for analysis was a Cephalometrics Orthognathic Surgery (COGS) by Burstone. Lateral cephalograms werer obtained from 59 subjects over 21 years old, that consisted of 30 males and 29 females with normal occlusion, acceptable profile. The results were as follows: 1. The author made the tables of means, standard deviations in each item, sex. 2. The author performed whether there was significance (P<0.05) between the registered male and female's measurement in each item.

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