Journal of Yeungnam Medical Science

Volume 16(1); June 1999

Reviews

Non-traumatic Avascular Necrosis of the Femoral Head.: Se Dong Kim; Yeungnam Univ J Med. 1999;16(1):1-9. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.1

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Abstract PDF: Avascular necrosis of the femoral head is a debilitating disease that leads to destruction of the hip joint in patients who are in the third, fourth, or fifth decade of life. The total societal cost is so high because these patients are generally young, hold jobs, and have a considerable life expectancy. Therefore, we have to delay or eliminate the need for total hip replacement as possible as we can. The purpose of this review id to provide a current perspective of avascular necrosis of the femoral head.

New Spectra in Female Sexology in Korea.: Min Whan Koh; Yeungnam Univ J Med. 1999;16(1):10-14. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.10

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Abstract PDF: The World Association for Sexology (WAS) will adopt a Declaration of Sexual Right as basic and fundamental human lights August this year in Hong Kong. Two years ago WAS has been developing a declaration of Sexual Rights in order to further promote sexual health and protect the sexual rights of everyone. Undoubtedly sexuality is one of the most intriguing subject in the area of human behavior abd psychology, and has been so since antiquity. The influence of sexual factors of human on all aspects of the society has been immense. The varieties of marriage, from traditional to the open marriage model are presented in front of our sight. The influences of women's movement in Korea, which has produced sexual, psychological, economic, political, familial and social changes look so small and the changes are not that much in America. But the profound effects of the woman's movement affect on Korean society being realized as man's view of woman and woman's view of herself undergo constant change and revaluation. With increased sexual awareness on the part of the public owing to mass media, for example AH-U-SEONG aired in TV and with increased emphasis on sexual matters in daily life, more and more physicians are being asked to deal with and manage sex-related problems in thei daily practice. Yet, despite the obvious need for informed sexual counseling, doctors are often uncomfortable about sexual matters and many physicians have no special expertise in this area. So physicians concerned in sexology especially such as gynecologists, urologists, psychiatrists and endocrinologists must realize well about sex-related knowledge which is needed for counseling the patient as medical consumer and gap between reality and ideality in sexual diagnosis and treatment. Establishment of management system for the people who have sexual problems is strongly needed to promote sexual health and protect the sexual rights of everyone and for the Sexual Rights as basic and fundamental human rights.

The Role of the Epithelial Cell in Bronchial Asthma.: Jin Hong Chung; Yeungnam Univ J Med. 1999;16(1):15-24. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.15

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Abstract PDF: Although traditionally viewed as a physical barrier between the host and a variety of inhaled irritants and pathogens, it has become clear that the epithelium has a much broader functional scope. Epithelial cells are metabolically active and can play an important role in the regulation of the allergic inflammatory response. This review preview provides a consideration of the role of the epithelial cell as both a "target" for exogenous and endogenous stimuli and as an "effector" cell that is capable of producing a variety of products that can influence the inflammatory response in the airways.

Brain Benzodiazepine-like Molecules and Stress-anxiety Response.: Jeoung Hee Ha; Yeungnam Univ J Med. 1999;16(1):25-33. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.25

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Abstract PDF: Benzodiazepines(BZDs) are among the widely prescribed drugs in the world. They are potent anxiolytic, antiepileptic, hypnotic, and muscle relaxing agents. There is an emerging model of the role of several neural systems in anxiety and their relation to the mechanism of action of BZDs. It has been postulated that BZD drugs exert their anxiolytic action by regulating GABAergic transmission in limbic areas such as the amygdala, in the posterior hypothalamus, and in the raphe nuclei. The involvement of the amygdala in the behaviors triggered by fear and stress has been suggested by many previous studies. In this review, reports about regulatory effects of endogenous BZD receptor ligands on the perception of anxiety and memory consolidation were summerized. These findings further support the contention that BZD receptor ligands modulate memory consolidation of averse learning tasks by influencing the level of stress and/or anxiety that accompanies a learning experience. The findings suggest that the decrease in the limbic levels of BZD-like molecules seen after the various behavioral procedures represent a general response to stress and/or anxiety, since it occurs in proportion to the level of stress and/or anxiety that accompany these tasks. In addition, these findings further support the hypothesis that the GABAA/BZD receptor complex in limbic structures plays a pivotal role in the stress and anxiety.

Original Articles

The Effects of Hyperglycemia and Hyperlipidemia on Muscle Glycogen Utilization during Exercise in rats.: Jong Chul Ahn, Dong Woo Lee, Oog Jin Shon, Seuk Kang Lee; Yeungnam Univ J Med. 1999;16(1):34-42. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.34

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Abstract PDF: The effects of hyperglycemia and hyperlipidemia on utilization of muscle glycogen during 45 minutes treadmill running(26 m/min, 8 % grade) were evaluated in Sprague Dawley rats, and the charateristic of the 4 different type of muscles, soleus, white and red gastrocnemius, and plantaris, on glycogen utilization were simultameously investigated. Hyperglycemia, 145-165 mg/dL, was induced by oral glucose ingestion, and hyperlipidemia, 444 uEq/L, was induced by combined treatment of intraperitoneal heparine injection and oral 10 % intralipose ingestion. During the hyperglycemic trial, the glycogen utilization of plantaris muscle was decreased by 13 % at 45 minutes duration of treadmill running comparing to the control trial(p<0.05), and the glycogen utilization of white gastrocnemius was also decreased. The sparing tendency of soleus and red gastrocnemius by 5-13 % was observed at 30 and 45 minutes of treadmill running in hyperglycemic trial. There was no glycogen sparing effect of hyperlipidemia in the soleus, red gastrocnemius and plantaris muscle subjected in this experiment during exercise. However, only a slight sparing tendency of white gastrocnemius muscle was observed. In summary, the glycogen sparing effect of hyperglycemia during exercise was observed in plantaris and white gastrocnemius muscles in rats. However, there was no glycogen sparing effect of hyperlipidemia in the 4 hindlimb muscles. It was observed that the glycogen sparing effect of hyperglycemia is more prominant in fast glycolytic muscle fiber.

The clinical relevance of nm23 protein expression in resected gastric cancer patient.: Sun Kyo Song, Hong Jin Kim, Sang Woon Kim; Yeungnam Univ J Med. 1999;16(1):43-51. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.43

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Abstract PDF: The aim of present study was to elucidate whether the expression of nm23 protein might be of clinical value as prognostic factor in gastric cancer. The expression of nm23 protein was analyzed using immunohistochemical method in formalin-fixed and paraffin-embedded tissue samples of 76 gastric carcinoma patients. The cytoplasmic immunoreactivity of nm23 protein were detected in 53.9%(41/76). When the immunoreactivity of nm23 protein with TNM status and other histopathologic findings were compared by using Chi-Square test, nm23 was found to have correlations with the lymph node metastasis(p=0.04), the number of metastatic lymph node, and the invasion of lymphatic vessels(p=0.007). But, it has no correlation with TNM status. The conventional prognostic factors such as the depth of invasion, lymph node metastasis, distant metastasis, Borrmann type, size of tumor, and the curability of operation was found to have strong correlation with the survival time(p<0.003). But, the expression of nm23 protein was not significantly correlated with that in survival analysis. These results showed that the expression of nm23 protein is not a useful prognostic indicator in gastric cancer.

The Preventive Effect of Antenatal Administration of Ambroxol on the Neonatal Respiratory Distress Syndrome.: Eun Sil Lee, Kyung Ah Kim, Son Moon Shin, Min Whan Koh, Tae Hyung Lee; Yeungnam Univ J Med. 1999;16(1):52-59. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.52

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Abstract PDF: This study was conducted to evaluate the effect of antenatal ambroxol administration to the mothers who were imminent preterm delivery on preventing the neonatal respiratory distress syndrome. Forty-two preterm newborn infants who were delivered at Yeungnam University Hospital from January 1996 to December 1997 were divided into two groups, twenty-one ambroxol-treated group and twenty-one control group. Six cases of respiratory distress syndromes developed from 21 ambroxol-treated infants. but thirteen cases of RDS developed from 21 control infants. It indicated significant reduction of occurrence of RDS by antenatal administration of ambroxol (p<0.05). There were no differences in the occurrence of adverse effects of ambroxol in mothers between two groups, ambroxol-treated and control groups. There was also no difference between pre- and post-treatment hematologic and biochemical parameters in ambroxol-treated group. In conclusion, when premature delivery is expected, administration of ambroxol before delivery enhances lung maturation in premature newborn infants and prevents the occurrence of respiratory distress syndromes without significant adverse effects.

Causative organisms of neonatal sepsis.: Kyung Ah Kim, Son Moon Shin, Han Gu Moon, Young Hoon Park; Yeungnam Univ J Med. 1999;16(1):60-68. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.60

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Abstract PDF

A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factor in neonatal sepsis, localized infection in neonate, causative organism in nosocomial infection and the most common causative organism in neonatal sepsis in Korea. Clinical and bacteriological data were collected from thirty seven neonatal units through retrospective review of the medical records of the newborn infants who were confirmed as neonatal sepsis by isolating organisms from blood culture during one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997 and 20,869 neonates were admitted to the neonatal units. During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1 and 303 cases(42.1%) were born prematurely. The main pathogens of early onset sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative Staphylococcus( 14.4%). Gram negative bacilli including Enterobacter spp (7.2%), E.coli(5.1%), Klepsiella(4.5%), Pseudomonas(3.7%) Enterobacter faecium(3.6%) constitute 24.1%. Only two cases of group B beta-hemolytic Streptococcus were isolated. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases (1.0%) of Candida sepsis. Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%). S. epidermidis(22.0%) and S. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.

Citations

Citations to this article as recorded by

Characteristics of Microorganisms Isolated from Blood Cultures at a University Hospital Located in an Island Region During 2003~2007
Sung Ha Kang, Young Ree Kim
Korean Journal of Clinical Microbiology.2008; 11(1): 11. CrossRef
Microorganisms Isolated from Blood Cultures and Their Antimicrobial Susceptibility Patterns At a University Hospital During 1994-2003
Eun-Mi Koh, Sang-Guk Lee, Chang Ki Kim, Myungsook Kim, Dongeun Yong, Kyungwon Lee, June Myung Kim, Dong Soo Kim, Yunsop Chong
Annals of Laboratory Medicine.2007; 27(4): 265. CrossRef

Antihypertensive effect and safety of imidapril on the patient with essential hypertension.: Gue Ru Hong, Jun Ho Bae, Dae Jin Jun, Jong Seon Park, Dong Gu Shin, Young Jo Kim, Bong Sup Sim; Yeungnam Univ J Med. 1999;16(1):69-75. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.69

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Abstract PDF: Imidapril(Tanatril(R)), a newly developed ACE inhibitor, has been used to treat hypertension and congestive heart failure. This study was designed to assess the antihypertensive effect and safety of Imidapril(Tanatril(R)) in patient with essential hypertension. 5-10mg of imidapril(Tanatril(R)) was administered once day in 30 patients with essential hypertension and followed up to 8 weeks. We tested the drug's effectiveness, safety, and the incidence of imidapril induced dry coughs. After 8 weeks of treatment with Imidapril, 76.2%(16/21) of patient showed lowered blood pressure and 47.6% showed normal blood pressure. The overall incidence of adverse effects was 33.3%(7/21). and among these adverse effects. dry cough was shown in only 9.5%. Thus, concluded that imidapril(Tanatril(R)) is as safe and effective as other ACE inhibitors. especially with imidapril showing very little incidence of dry cough compared to other ACE inhibitors.

Ascitic Fluid Analysis for the Differentiation of Malignancy-Related and Nonmalignant Ascites.: Eun Young Lee, Byeoung Deok Kim, Jae Hyuk Choi, Sang Yeop Lee, Hun Mo Ryu, Kyung Hee Lee, Myung Soo Hyun; Yeungnam Univ J Med. 1999;16(1):76-84. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.76

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Abstract PDF: The differentiation between Malignancy-Related Ascites(MRA) and Non-Malignant Ascites (NMA) is important for further diagnostic and therapeutic procedures. Althought many parameters were investigated, none has provided a complete distinction between MRA and NMA. We investigated several ascitic fluid parameters to determine the differential power, and to ifferentiate malignant-related from nonmalignant-related ascites with a sequence of sensitive parameters followed by specific parameters. For the present sturdy, 80 patients with ascites were divided into two groups: MRA and NMA. The MRA group was consisted of 27 patients with proven malignancy by image study, biopsy, and follow up; 21 of these patients had peritoneal carcinomatosis, but the remaining 6 showed no evidence of peritoneal carcinomatosis. The NMA group was consisted of 53 patients with no evidence of malignancy; among these patients, one had SLE, and others had liver cirrhosis. The samples of blood and ascites were obtained simultaneously, and then the levels of ascites cholesterol, CEA, protein, LDH, cytology, albumin gradient, ascites/serum concentration ratios of LDH(LDH A/S), and ascites/serum concentration ratios of protein(protein A/S) were measured. Applying cut-off limits for determined parameters, we estimated the diagnostic efficacy of each parameter. Among the eight parameters investigated, ascites fluid cholesterol yielded the best sensitive value of 93%(cut-off value 30mg/dl), and cytologic examination and the protein A/S(cut-off value 0.5) showed the most specific value of 100% and 96%, respectively. Based on the above result, the diagnostic sequence with cholesterol as a sensitive parameter, followed by the combination of cytologic examination and protein A/S as specific parameters, was tested in 80 patients. This diagnostic sequence identified 81.5% of patients with malignancy, and all patients with peritoneal carcinomatosis were classified as malignancy-related ascites. In spite of many limitations, this proposed diagnostic sequence may permit a cost-effective and simple differentiation of malignacy-related ascites from nonmalignant ascites

Comparison OF Northgate SD-3 and Modulith SLX Lithotriptors: Treatment Results with 2,000 Renal and Ureteral Stones.: Jun Young Lee, Hee Chang Jung, Ki Hak Moon, Chul Kyu Cho, Tong Choon Park; Yeungnam Univ J Med. 1999;16(1):85-93. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.85

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Abstract PDF: Some reports have shown a decreased effectiveness of extracorporeal shock wave lithotripsy(ESWL) with newer lithotriptors. We compared the treatment results of ESWL with a second generation Northgate SD-3 and a third generation Modulith SLX device. A total of 2,000 patients underwent ESWL treatments for single urinary calculus between September, 1988 and July, 1998. The 1,241 patients were treated with Northgate SD-3 between September, 1988 and December, 1995. The 759 patients were treated with Modulith SLX between January, 1996 and July 1998. The treatment results were compared using the chi-square test to determine statistical significance. The overall success rate, success rate according to the location and size, the mean number of sessions, complication rate and retreatment rate were obtained, according to lithotriptor. The overall success rate was 90.6% with Northgate SD-3 and 89.1% with Modulith SLX. With Northgate SD-3 and modulith SLX. the success rate according to the location was 91.0%(579/636), 88.1%(236/268) in the kidney, 93.2%(517/555), 89.9%(258/287) in upper ureter; 83.3%(10/12) and 94.4%(167/177) in middle and lower ureter; 47.4%(18/38) and 55.6%(15/27) in staghorn stone, respectively, The success rate According to the size of stone with Northgate SD-3 and Modulith SLX for stone with the size under 10mm was 96.1% (612/637) and 93.1%(470/505); from 11mm to 20mm was 87.3%(421/482) and 86.4%(165/191); from 21mm to 30mm, 77.5%(62/80) and 67.5%(23/34); and for stone larger then 31mm was 69%(29/42) and 62.1%(18/29), respectively, Mean number of sessions for successful fragmentation was 1.21 and 1.69, respectively, with Northgate SD-3 and Modulith SLX. Retreatment rate was 16.7% and 17.5%, respectively. The complications after treatment were severe pain(6.2% with Northgate SD-3 vs. 2.0% with Modulith SLX), steinstrasse(3.4% vs. 1.9%), fever(1.2% vs. 0.5%) and perirenal hematoma(0.2% vs. 0%) in order of frequency. There was no significant difference in the effectiveness between of Northgate SD-3 and Modulith SLX. However, a statistically significant difference was observed between the two lithotriptors. We concluded that ESWL with Modulith SLX is more safe compared to Northgate SD-3.

Clinical Experience of Nephron Sparing Surgery for Renal Tumor with a Normal Opposite Kidney.: Jun Young Lee, Jung Hyun Kim, Kang Min Lee, Ki Hak Moon, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1999;16(1):94-100. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.94

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Abstract PDF: The aims of this retrospective study were to determine whether a nephron sparing surgery might be feasible in patients with a small solid renal tumor. Materials and methods: Between 1988 and 1999, 21 patients with radiologically detectable small solid renal tumor underwent enucleoresection, wedge resection and polar segmental nephrectomy. The mean age of the 11 men and 10 women in this study was 43 years (range 14 to 68). According to the preoperative radiological diagnosis, 15 among the 21 patients were considered to have renal cell carcinoma, 4 were considered to have angiomyolipoma, and the remaining 2 patients were difficult to differentiate as renal tumors radiologically. Among 15 patients considered to have renal cell carcinoma, 14 were found to have renal cell carcinoma and the remaining one patient was diagnosed as having oncocytoma on pathologic examination. Radiological determination of angiomyolipoma in four patients was confirmed to be correct on pathological examination. The 2 patients whose radiological diagnose wasdificult were founf to have cavernous hemangioma and angiomyolipoma. One patient with renal cell carcinoma developed arteriocaliceal fistula, the only immediate complication in this series, and underwent nephrectomy on postoperative 10th day. The mean follow-up duration for the 14 patients with renal cell carcinoma was 18.6 months(range:1-103). There were no other tumor involvement in the resection margins following the nephron sparing surgery. These results suggest that nephron sparing surgery provides an effective treatment for patients with a single, small, unilateral, localized renal tumor. Longer follow-up is suggested for more definite verification of the role of nephron sparing surgery.

Dual-Isotope SPECT Imaging with Thallium-201 and Technetium-99m MIBI in Detecting Coronary Artery Disease.: Gyu Gwang Lee, Ihn Ho Cho, Hyoung Woo Lee, Jong Sun Park, Kyu Chang Won, Dong Gu Sin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 1999;16(1):101-107. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.101

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Abstract PDF: We evaluated the results of sequential SPECT dual-isotope imaging with Tl-201 and Tc-99m MIBI in 24 patients, all of whom also had coronary angiography within the past one month. Coronary angiography showed that 12 patients had no CAD, 4 patients had one-vessel CAD, 7 patients had two-vessel CAD and 1 patient had three-vessel CAD. Serial studies of resting Tl-201 and dipyridamole stress Tc-99m MIBI were completed within 2 hours. When more then 50% of coronary artery narrowing was considered significant. The overall sensitivity and specification of CAD detection were 91.7%. The sensitivity of CAD detection in patients with one-vessel and multi-vessel diseases was 75% and 100%, respectively. Therefore, sequential dual-isotope SPECT demonstrated high sensitivity and specificity of CAD detection. In conclusion, sequential dual-isotope imaging is feasible and can be completed in a short time and may therefore enhance laboratory throughput and patient convenience.

Case Reports

Clear cell sarcoma: 1 case report.: Joon Hyuk Choi, Hae Jeong Choi, Mi Jin Kim, Duk Seop Shin, Kil Ho Cho; Yeungnam Univ J Med. 1999;16(1):108-113. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.108

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Abstract PDF: Clear cell sarcoma is a rare soft tissue sarcoma that occurs tendons and aponeuroses, usually of the lower extremities in young adult. The exact histogenesis is not definitely established, We experienced a case of 58 year-old female who presented with a 3.2x2.2cm sized mass located in the subcutaneous tissue on the left lower thigh. The mass was well circumscribed and grayish firm. Two small satellite nodules were also seen. Histologically the tumor was composed of round to fusiform cells with clear or pale eosinophilic cytoplasm and separated into compact nests or short fascicles by delicated fibrous septa. The melanin pigments and hemosiderin were seen. Tumor cells showed positive reaction for S-100 protein and HMB-45. The ultrastructural examination showed abundant mitochondria and melanosomes.

A Case of Leber's Hereditary Optic Nouropathy Showing 11778 Point Mutation of Mitochondrial DNA.: Yun Seok Jung, Seung Kwon Park, Seung Yeop Lee, Jung Sang Hah, Mee Yeoung Park, Se Jin Lee, Jun Lee; Yeungnam Univ J Med. 1999;16(1):114-118. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.114

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Abstract PDF: Leber's hereditary optic neuropathy(LHON) is an optic nerve disease that causes blindness and is associated with maternally inherited mitochondrial DNA(mt DNA) mutations. The most common mitochondrial DNA mutation among LHON patients is a point mutation at the nucleotide 11778 in the subunit 4 of complex I. In one 45-year old male LHON patient with bilateral optic neuropathy, we investigated the presence of a point mutation of mitochondrial DNA and identified a single guanine to adenine transition mutation in the mitochondrial DNA at nucleotide point 11778.

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