Journal of Yeungnam Medical Science

Volume 11(1); June 1994

Reviews

Insulin Resistance in the Peripheral Tissue.: Suck Kang Lee, Jong Yeon Kim; Yeungnam Univ J Med. 1994;11(1):1-15. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.1

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Abstract PDF: No abstract available.

Driving of Motor Vehicles of the Epileptic Patients.: Yeung Ju Byun, Mee Young Park, Jung Sang Ha; Yeungnam Univ J Med. 1994;11(1):16-29. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.16

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Abstract PDF: No abstract available.

Original Articles

A Study for Reducing Pain from Injection of Lidocaine Hydrochloride.: Jae Ho Jeong, Kyung Ho Lee; Yeungnam Univ J Med. 1994;11(1):30-34. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.30

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Abstract PDF: Local anesthetics produce pain during infiltration into skin. The relationship between local anesthetic-induced pain and pH of the local anesthetic solution has not been fully investigated. Commercial preparation of local anesthetics are prepared as acidic solutions of the salts to promote solubility and stability. And the acidity of local anesthetic solition may be related with the pain during infiltration of the solutione. So, we tried to neutralize the lidocaine hydrochloride solution which is one of the most frequently used local anesthetic agent. Sodium bicarbonate was used for neutralization. Sodium bicarbonate was mixed with lidocaine hydrochloride until the resulting pH of the solution become 7.4 which is identical to the acidity of body fluid. To identify the effect of neutralized lidocaine solution, we had a course of double blind test to 6 volunteers. Both forearm of each volunteer were injected with neutralized lidocaine and plain one and the degree of pain was estimated by each volunteers. According to subjective description by the volinteers, everyone felt neutralized lidocaine injection site was less painful than plain lidocaine. We concluded that we could reduce pain from infiltration of lidocaine hydrochloride by neutralization of the anesthetic solution with sodium bicarbonate.

Congenital Ileal Atresia in Newborn.: Young Soo Heo, Chang Sig Kim, Son Moon Shin; Yeungnam Univ J Med. 1994;11(1):35-41. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.35

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Abstract PDF: Newborns with ileal atresia frequently present with abdominal distension, bilious vomiting, and failure to pass meconium. Diagnosis is usually established on plain x-ray of the abdomen by the findings of distended small bowel loops and air-fluid levels. In the period of October 1988 to February 1994, 8 patients with congenital ileal atresia were operated and the following results were obtained. 1. Eight patients were comprise of 4 males and 4 females, the ratio of male and female was 1 : 1. 2. Six patients(75%) had been admitted to our hospital during three days of life. 3. Congenital ileal atresia was in 8 cases : Type I in two(25%), Type II in two(25%), Type III a in three(37.5%), Type III b in one(12.5%). 4. There was one premature patient who was small for gestational age. 5. Overall, abdominal distension and bilious vomiting occurring in seven patients, were frequent presenting complaints. 6. Diagnosis was possible with clinical symptom and simple abdomen. 7. Operative treatment was undertaken as soon as the diagnosis was made. In seven cases a primary end-to-end anastomosis was performed after resection of dilated proximal loop. 8. A total of four associated congenital anomalies were found in one patient. 9. Postoperative complications occurred in three cases(37.5%).

Splenectomy in Hereditary Spherocytosis in Childhood.: Young Soo Heo, Chang Sig Kim, Byung Soo Do, Bo Yang Suh, Jeong Ok Hah; Yeungnam Univ J Med. 1994;11(1):42-48. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.42

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Abstract PDF

Among the erythrocyte membrane defects, hereditary spherocytosis is the most common. The erythrocyte membrane defect results from a deficiency of spectrin, the most important structural protein in red cell. Hereditary spherocytosis often presents with hemolytic anemia, jaundice, moderate splenomegaly. Diagnosis is established by the presence of spherocytes in the peripheral blood, reticulocytosis, an increased osmotic fragility, and a negative Coombs test. In children, splenectomy is usually performed after age 6 years but can be done at a younger age if warranted by the severity of the anemia and the need for frequent transfusions. In the period December 1987 to Agust 1993, 9 patients with hereditrary spherocytosis underwent splenectomy and the following results were obtained. 1. Nine patients were comprised of five males and four females. 2. Five patients(55.6%) had been admitted to our hospital during age 6-10 years. 3. Four of the nine patients had autosomal dominant inheritance with variable expression. The other five patients had no known inheritance. 4. The diagnosis of the spherocytosis was based on the increased osmotic fragility and increased autohemolysis of the erythrocytes, as well as on the appearance of spherocytes in the peripheral blood smear. 5. In all cases splenectomy was performed. Two patients had concomitant gall stones and choledocholithiasis, respectively. One patient with concomitant gall stones underwent simultaneous cholecystectomy and splenectomy. The other patients associated with choledocholithiasis underwent splenectomy, cholecystectomy, choledocholithotomy, and T-tube drainage. 6. Complete hematologic recovery was obtained by the splenectomy in all cases. 7. Postoperative complication was not occurred.

Citations

Citations to this article as recorded by

A histopathological study of spectrum of splenic lesions- An eleven year analysis of clinical and pathological aspects of splenectomy specimens in a tertiary care hospital
Namratha R, Vijaya B, Karthika Bhadran
Indian Journal of Pathology and Oncology.2022; 9(3): 220. CrossRef

The Role of Jugular Venous Oxyhemoglobin Saturation Monitoring During Cardic Surgery.: Sae Yeon Kim, Dae Lim Jee; Yeungnam Univ J Med. 1994;11(1):49-54. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.49

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Abstract PDF: Postoperative brain damage is one of most serious complications of cardiopulmonary bypass (CPB). To prevent brain damage during CPB, adequate cerebral perfusion for cerebral oxygen demand should be maintained. This study monitored jugular venous oxyhemoglobin saturation (SjO₂), which reflects the overall balance of cerebral oxygen supply and demand, intermittently in 10 patients undergoing cardiac surgery. At the initiation of CPB, in spite of a significant decrease in mean arterial pressure, SjO₂ did not change, and it was stable during the hypothermic period of CPB. But a significan reduction in SjO₂ was observed during the rewarming period, and SjO₂ had an inverse linear correlation with esophageal temperature. Furthermore, the percent decrease of SjO₂ was related to rewarming speed. Therefore, therapeutic approaches for SjO₂ desaturation include slower rewarming, increasing cerebral blood flow, decreasing the cerebral metabolic rate for oxygen, increasing oxygen content, and increasing perfusion flow rate.

Cliniclal Experiences of Trabeculectomy with Mitomycin C.: Soon Cheol Cha; Yeungnam Univ J Med. 1994;11(1):55-62. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.55

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Abstract PDF: The use of intraoperative application of Mitomycin C at the filtration site has been known to improve the surgical outcome in glaucomatous eyes with high risk for failure of trabeculectomy. The author performed trabeculectomies with intraoperative Mitomycin C on 25 eyes of 20 patients with poor surgical prognosis to study the efficacy and safety of this technique in glaucomatous patients with high risk for failure of trabeculectomy. After the preparation of a scleral flap, 0.2mg/ml sulution of Mitomycin C was applied between Tenon's capsule and the sclera for 2 minutes. The exposed area was then irrigated with 200 ml of balanced salt solution. The follow-up period was from 1 to 7 months (mean 3.8 months). The mean preoperative intraocular pressure (IOP) was 38.6±6.6mmHg. The mean final postoperative IOP was 11.7±3.8mmHg. Twenty three (88%) of the 25 eyes were successfully controlled with the IOP of less than or equal to 20 mmHg wthout glaucoma medication. There were early postoperative complications of hyphema in 5 eyes (20%), shallow anterior chamber in 4 eyes(16%), punctate keratopathy in 3 eyes (12%), aqueous leaking from conjunctival wound in 2 eyes (8%), encapsulated bled in 1 eye (4%) and choroidal detachment in 1 eye (4%), and 4 eyes had long term hypotony lasting more than 2 months. Although Mitomycin C is simple to use and effective adjunct to trabeculectomy, further study will be needed to determine the mechanism of action, indication, dosage and optimal exposure time of Mitomycin C.

Significance of Dexamethasone Suppression Test in Patients with Stroke.: Wook Nyeon Kim, Seong Min Kim, Byung Soo Kee, Mee Yeong Park, Jung Sang Hah, Yeung Ju Byun; Yeungnam Univ J Med. 1994;11(1):63-71. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.63

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Abstract PDF: The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. There tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control (p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results (p<0.01). 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Significantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.

Therapeutic Results of Radiotherapy in Nonsmall Cell Lung Cancers.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1994;11(1):72-81. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.72

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Abstract PDF: Total 55 patients with nonsmall cell lung cancer treated with radiation therapy at Department of Therapeutic Radiology, Yeungnam University Hospital, between May-1 1986 and April-30 1993 were retrospectively analyzed by clinical characteristics, failure patterns follow up duration and survival ratio according to prognostic factors. Obtained results were as follows : 1. Male to female ratio was 17.3 2. Sixth and seventh decades were predominant age group. 3. The patients were 8 in stage I-II, 34 in stage IIIA, 13 in stage IIIb, respectively. 4. Forty five patients out of 55 were squamous cell carcinoma. 5. Primary tumor were originated from upper lobe bronchi predominantly. 6. The size of the primary tumor, lymph node involvement and the degree of differentiation were important in evaluation of prognosis. 7. In conclusion, for patients with poor prognostic factors systemic chemotherapy and multidisciplinary approach were recommended for better treatment outcome and improvement of survival.

A Study on the Serologic Parameters in Petients with Anemia of Chronic Renal Failure-According to Erythropoietin Treatment: Jong Sik Lim, Ho Jung Kang, Won Jong Park, Jun Young Do, Kyeung Woo Yun; Yeungnam Univ J Med. 1994;11(1):82-93. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.82

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Abstract PDF: Clinical study was carried out on the 64 hemodialysis patients (HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obtained. In hematologic parameters, MCH was 28.8±2.0 pg, and MCV was 92.4±4.7 fl. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were 657.4±292.0 ng/ml in men and 511.5±370 g in women. Mean values of serum iron were 145.5±63.7 µg/dl. Mean values of transferrin saturation was 61.6±28.4%. Serum ferritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoietin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoietin treatment group (p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test (LFT0 hemodialysis group than normal LFT group (p<0.05). Transfusion amounts revealed positive correlation with ferritin (r=0.4675), transferrin saturation (r=0.3823) and iron (r=0.3386) (p<0.05). In conclusion, erythropoietin treatment can reduce requirement of blood transfusion and transfusion related side effects such as iron overload, hemosiderosis and hemochromatosis.

A Study of Relation Between Symptoms and Low Blood pressure.: Soo Young Kim, Seung Pil Jung; Yeungnam Univ J Med. 1994;11(1):94-100. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.94

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Abstract PDF: To establish whether an association exists between low blood pressure and common symptoms such as fatigue, dizziness, headache, and palpitation, we analysed the data of health center in Yeungnam medical college from January 1993 to June 1993. Total 1,133 subjects were taken and results were analysed by combined stratification and logistic regression. The results were as followed : 1. True confounders were sex, age, and body mass index. 2. No association was found between low blood pressure and all symptoms. 3. Positive associations were found between high blood pressure and self reported palpitation and headache, which persisted after adjusted for confounders. The results suggest that low blood pressure and all neurasthenic symptoms such as fatigue, palpitation, headache and dizziness have no association, but the validity is limited.

Estimation of Glomerular Filtration Rate(GFR) Using (99m)Tc-DTPA Renal Scan and the Parameters for Renal Function.: Ihn Ho Cho, Hyun Dae Yoon, Kyu Chang Won, Chan Woo Lee, Hyoung Woo Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):101-108. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.101

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Abstract PDF: Many previously described nuclear medicine procedures to assess glomerular filtration rate have some problems because numerous blood sample is to be taken and they don't measure each separate renal function. Gates described isotopic method for the measurement of global and unilateral GFR based on the fractional renal uptake of (99m)Tc-DTPA 2 to 3 minutes after its intravenous injection. We evaluated GFR using (99m)Tc-DTPA in 57 people according to Gates method and compared with creatinine clearance. A good correlation was observed between creatinine clearance and GRF calculated by Gates' formula with an r value of 0.9(P<0.05). And also the relationship between parameters of (99m)Tc-DTPA renal scan images and GFR was taken. They were significantly correlated with GFR calculated by Gates' formula : r value 0.66 between relative intensity of peak renal to peak aortic activity(pK/pA) and GFR, -0.42 between time between aortic and kidney peak(A-K) and GFR and -0.48 between parenchymal renal activity at 25 min compared to peak kidney activity(25K/pK) and GRF. In conclusion, the determination of GFR according to Gates' formula shows good and reproducible of GRF with rapidity and simplicity. And the parameters from the renal scan images can use to estimate the renal function.

Prevalene of Secondary Hypertension in Yeungnam University Hospital.: Jun Young Kweon, Kyo Won Choi, Dong Gu Sin, Hyoung Woo Lee, Kyeung Woo Yu, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):109-114. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.109

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Abstract PDF: We studied the incidence and results of treatment of secondary hypertension in Yeungnam University Hospital. Nineteen hundred fifty patients with hypertension were included from march 1990 to march 1994. We analysed the prevalence of secondary hypertension and results of treatment. The incidence of secondary hypertension in Yeungnam University Hospital was six percent. The most common underlying causes of secondary hypertension was renal parenchymal disease. Patients with three forms of potentially reversible secondary hypertension, namely, renovascular hypertension, endocrine disease, exogenous hormone, were assed to determine whether surgery or withdrawal of the exogenous hormane had led to an improvement in blood pressure control. The incidence of secondary hypertension in Yeungnam University Hospital was low(6%), but some of these are curable. Thus it is very inportant that evaluate the secondary hypertension.

Effect of Recombinant Human Erythropoietin in the Anemia of Prematurity : a Pilot Study.: Kyung Ah Lee, Son Moon Shin, Yong Hoon Park, Jeong Ok Hah; Yeungnam Univ J Med. 1994;11(1):115-126. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.115

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Abstract PDF: The recent availability of recombinant human erythropoietin has opened new perspectives in the management of a variety of anemias. Clinical trials have been initiated in several countries using different approaches and methodology. We randomly assigned twelve premature infants(gestational age < 32 week) at high risk of requiring erythrocyte transfusion for anemia of prematurity with either subcutaneous recombinant human erythropoietin or a placebo. Treatment with rHuEPO was initiated at a dose of 100 units/kg day for 3 days a week. All patients were given supplemental oral iron therapy at a dose of 3 mg/kg per day, as tolerated and oral vitamin E at a dose of 25 units per day. Treated and control babies did not differ with respect to weight, hematocrit, overall mean reticulocyte count or rate of growth respectively. However, reticulocyte counts increased earlier in patients given rHuEPO. We conclude that rHuEPO administration is safe and feasible at the dose studied.

Gynecologic Application of the Pelviscopic Surgery.: Seok Bong Koh, Jae Yeoul Lee, Young Gi Lee, Yoon Kee Park, Doo Jin Lee, Tae Hyung Lee, Sung Ho Lee; Yeungnam Univ J Med. 1994;11(1):127-134. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.127

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Abstract PDF: The aim of this study was to identify the usefulness of pelviscopy in treatment besides its diagnostic value. The advantages of pelviscopic surgery are low cost, rapid recovery, good cosmetic effect, low incidence of complication and postoperative adhesion. So most of the pelvic exploration in gynecologic patients are replaced by the pelviscopic surgery these days. Pelviscopic surgery was performed on 136 patients at the Department of Obstetrics and Gynecology, College of Medicine, Yenungnam University from May 1991 to July 1993. The results obtained were as follows : The age distribution of the patients was from 19 to 55 with age of 31.2 years, and the mean parity was 0.96, the most common indication of pelviscopic surgery was tubal pregnancy(66.9%), the second most common indications was ovarian cyst(10.3%) and the other indications were endometriosis, corpus iuteum cyst rupture, parovarian cyst, foreign body, tubal ligation, hydrosalpinx, uterine myoma and in 16.3%. The mean duration of hospitalization was 2.1 days without specific complications. According to these results, it was postulated that the pelviscopic surgery was a useful operative tool in gynecologic treatment and its application could be extended to many other areas of gynecology with safety by the development of surgical techniques and instruments.

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