Journal of Yeungnam Medical Science

Volume 16(2); December 1999

Reviews

Management of Preterm Labor.: Woon Ki Park; Yeungnam Univ J Med. 1999;16(2):141-154. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.141

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Abstract PDF: Premature birth is the single largest cause of perinatal mortality and morbidity in nonanomalous infants in developing countries. Advances in neonatal care have lead to increased survival and reduced short and long term morbidity for preterm infants. but the rate of preterm birth has actually increased. This review provides recent multifactorial approaches to treatment and prevention of preterm birth.

Recent Advances in the Drug Therapy of Osteoporosis.: Hyoung Woo Lee; Yeungnam Univ J Med. 1999;16(2):155-168. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.155

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Abstract PDF: Osteoporosis is one of the most important public health problems facing the aging population. Drug therapy for osteoporosis can be divided operationally into two main categories: drugs that inhibit bone resorption, and thus reduce bone turnover, and those that stimulate bone formation, exerting an anabolic effect. Antiresorptive agents such as estrogens, calcitonin, and bisphosphonates are most effective in the prevention of osteoporosis. Formation-stimulating agents such as sodium fluoride or monofluorophosphate, parathyroid hormone fragments, and anabolic steroids are of potential value in the treatment of established osteoporosis, where bone mass s already low and benefit from antiresorptive drug is likelyto be small. Recently, raloxifene, a selective estrogen receptor modulator, has become available in various countries for clinical use in the treatment of involutional osteoporsis . This paper will review the use of these drugs in postmenopausal woman.

Original Articles

Cervicography as a Screening Test for Cervical Cancer.: Doo Jin Lee, Sung Ho Lee; Yeungnam Univ J Med. 1999;16(2):169-180. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.169

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BACKGROUND
Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screeningg test of cervical cancer. MATERIALS AND METHODS: Cervicography was taken from 482 women at department of obstetrics and gymecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999, of the 482 women, 172women were excluded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology(Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. RESULTS: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chromic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05) The sensitivity of cytology and cervicography were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13.3%)(p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%)(p<0.05). CONCLUSION: It seems inappropriate to use cervicography as a single scerrning test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.

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Physico-Chemical Characterization of Bioactive Mixed Ligand Complexes of Antimony with 3,5-Diarylsubstituted Pyrazolinates and O,O’-Alkylene Dithiophosphates
Kanchan Lata Singh, Afshan Siddiqui, Kajal Singh, U.N. Tripathi
Chemistry & Chemical Technology.2019; 13(4): 407. CrossRef

The Effects of Nitric Oxide Inhibitor on Hyperdynamic Circulation in Portal Hypertensive Rats.: Pill Young Kim, Byeong Ik Jang, Tae Nyeun Kim, Moon Kwan Chung; Yeungnam Univ J Med. 1999;16(2):181-192. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.181

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Abstract PDF: BACKGROUND
Nitric oxide, a vasodilator synthesized from L-arginine by vascular endothelial cells. accounts for the biological activity of endothelium derived relaxing factor. Previous studies demonstrated that nitric oxide inhibitor. N'-Nitro-L-Arginine(NNA)diminished the hyperdynamic splanchnic and systemic circulation in portal hypertensive rats. The present study was done to determine the role of nitric oxide in the development of hyperdynamic circulations in the prehepatic portal hypertensive rat model produced by partial portal vein ligation. METHODS: The portal hypertensive rats were divided into water ingestion group and NNA ingestion group. After partial portal vein ligation. NNA ingestion group and water ingestion group received NNA, 1mg/kg/day and plain water through the mouth for 14 days, respectively. Cardiac output, mean arterial pressure, organ blood flow and porto-systemic shunting were measured by radioisotope microsphere methods. Vascular resistances were calculated by standard equation. RESULTS: There were significant decreases in mean arterial pressure, increases in cardiac output and cardiac index, and decreases in total systemic and splanchnic vascular resistance in portal hypertensive rats compared to normal control froup(p<0.01). Compared to the water ingestion group, significantly increased mean arterial pressure wit decreased cardiac output and cardiac index were dexeloped in the NNA ingestion group. Total systemic and splanchnic vascular resistance were significantly increased in the NNA ingestion group compared to water ingestion group(p<0.05). But, there was no significant difference in portal pressure between the two groups. CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic circulation in prehepatic portal hypertensive rat model was attenuated by ingestion of NNA. Nitric oxide may play an important role in the development of hyperdynamic circulation with splanchnic vaodilation in chronic portal hypertension.

Development of Multichannel On-line Thermometry System.: Sei One Shin, Hyun Jin Shin, Myung Se Kim, Sung Kyu Kim; Yeungnam Univ J Med. 1999;16(2):193-199. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.193

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Abstract PDF: BACKGROUND
Measurement of body temperature is an important parameter inpatient management in many clinical condition. Failure to reach minimal acceptable and has necessitated the application of additional therapy. The authors developed a new, simple, accurate thermometry system, which could be used to undertake precise temperature measurement for various clinical conditions. MATERIALS AND METHODS: A new thermometry system using a specially designed temperature detecting and display system was developed. This system contains a temperature detecting sensor(LM 35CZ), which enables multiple serual checking of heat, data collection and processing computer, and 3-dimensional display system. It provides realtime volumetric visualization of temperature of a defined volume and stores and prints the data. RESULTS: With this system, temperature can be measured at multiple interesting sites simultaneously , demonstrated as a 3-dimensional temperature distribution and stored. In well-controlled, systematic experiments a significant correlation has been observed between standard temperature using this system at carious measuring points. CONCLUSION: This thermonetry system is a real-time measurement system, which can demonstrate 3-dimensional heat distribution in experimental phantom and human body and can be used for diagnosing abnormal conditions. In addition, this system reduces the nursing staff work load, providing them more time for long term care to patients.

The Relationship Between Chewing Ability and Health Status in the Long-lived Elderly of Kyungpook Area.: Hee Kyung Lee, Young Kwon Lee; Yeungnam Univ J Med. 1999;16(2):200-207. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.200

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BACKGROUND
The objective of this study is to evaluate the effect of the dental and general health in relation to the state of dentition and chewing ability by survering oral condition and anthropometric measure in order to provide primary statistics for the development of a program which may lead to an improvement in the long-lived elderly health status in a rural community. MATERIALS AND METHODS: The subjects of this study were 97 rural long-lived elderly(27 males and 70 females) who were over 85 years-old (average age of subjects are 88.14+/-3.20 year old) in Sungju-Gun. Kyungpook Province. Data were collected by using questionnaires and direct measurement of anthropometrics, and oral examination from all 97 subjects on July, 1999. RESULTS: The following results were obtained: 1. 53.6% of all subjects believe that they are healthy. The average values of height, weight, BMI, body fat, lean body fat and total water were 148.8+/-11.2cm, 46.9+/-10.5kg, 21.2+/-3.5kg/m2, 26.7+/-6.9%, 73.0+/-7.1%, and 53.4+/-5.2%, respectively. 2. The average number of teeth remaining in the subjects were 3.50+/-571: the number of maxillary teeth remaining were 1.08+/-2.88; and the number of mandibular teeth remaining were 2.41+/-3.76. The maximum number of teeth remaining among subjects were 22 teeth, and the fully edentulous(no natural teeth) people were 76.3%. The oral conditions of the subjects were 52.6% using denture, 23.7% using natural teeth and 23.7% masticating edentulous ridge without denture. 3. In terms of oral condition in self-assessment of health, digestive ability, and chewing ability : On self-assessment of health, 47.1% of those wearing denture group responded as feeling food, 56.5% of those of edentulous without denture, and 65.2% in group of matural teeth only. On self-assessment of digestive ability, 82.4% of those in group of denture responded as feeling food, 65.2% of those in group of no teeth and no denture, and 73.9% of those in group of natural teeth only. On self-assessment of chewing ability, 90.2% of those in the group wearing a denture, 60.9% of those in the group of no teeth and no denture, and 65.2% of those in the group of natural teeth only. 4. In terms of oral condition in anthropometric measurements; The height. weight, body fat, lean body mass, and total water according to oral conditions were 150.0+/-10.7cm, 49.0+/-10.9kg, 26.9+/-6.6%, 72,7+/-7.0%, 53.2+/-5.1%, respectively, in group wearing a denture, 142.7+/-6.0cm, 43.2+/-5.5kg, 29.5+/-7.2%, 70.8+/-6.9%, 51.8+/-5.0%, respectively, in the group of no teeth and no denture, and 152.3+/-14.1cm, 45.9+/-12.6kg, 23.4+/-6.0%, 75.9+/-6.9%, 55.6+/-5.1%, respectively, in the group of natural teeth only. CONCLUSION: The subjective measurements of good health were higher denture user, and natural teeth.

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Difference in food and nutrient intakes in Korean elderly people according to chewing difficulty: using data from the Korea National Health and Nutrition Examination Survey 2013 (6th)
Song Hee Kwon, Hae Ryun Park, Young Mi Lee, Soo Youn Kwon, Ok Sun Kim, Hee Young Kim, Young Suk Lim
Nutrition Research and Practice.2017; 11(2): 139. CrossRef
Correlation with subjective oral health status and food preference in elderly people
Chung-Soon Park, In-Ja Kim, So-Young Park
Journal of Korean society of Dental Hygiene.2015; 15(6): 973. CrossRef
Demand for Elderly Food Development: Relation to Oral and Overall Health -Focused on the Elderly Who Are Using Senior Welfare Centers in Seoul-
Geum-Yong Lee, Jung-Ah Han
Journal of the Korean Society of Food Science and Nutrition.2015; 44(3): 370. CrossRef
A study of chewing ability According to malocclusion and orthodontic treatment
Hong-Sik Kim, Soo-Chul Park, Nam-Joong Kim
Journal of Korean Acedemy of Dental Technology.2013; 35(1): 67. CrossRef
Characteristics of the dietary intake of Korean elderly by chewing ability using data from the Korea National Health and Nutrition Examination Survey 2007-2010
Ji Eun Park, Hee Jung An, Sung Ug Jung, Yoonna Lee, Cho-il Kim, Young Ai Jang
Journal of Nutrition and Health.2013; 46(3): 285. CrossRef
The effects of dental prostheses to the quality of life among the elderly
Ik-Gang Hur, Tae-Yong Lee, Jin-Keun Dong, Song-Hee Hong
The Journal of Korean Academy of Prosthodontics.2010; 48(2): 101. CrossRef

A Clinical study on the Hypercalcemia in Primary Bronchogenic Carcinoma.: Hye Jung Park, Kyeong Cheol Shin, Young Chul Moon, Jin Hong Chung, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):208-218. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.208

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Abstract PDF: BACKGROUND
Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic desorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advenced atage with obvious bulky tumor and carry a poor prognosis. MATERIALS AND METHODS: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level> or =10.5 mg/dL, and symptons which could possibly be attributed to hypercalcemia. In this retrospective study, we evalluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics RESULTS: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance statusm and bone ore frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. CONCLUSION: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of drath and should be treated aggressively to prevent sudden deterioration or death.

The Clinical Effects of Cefpirome for the Treatment of Acute Lower Respiratory Infection.: Kyeong Cheol Shin, Young Hoon Hong, Eun Young Lee, Ki Do Park, Sung Dong Kim, Jin Hong Chung, Choong Ki Lee, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):219-227. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.219

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Abstract PDF: BACKGROUND
In contrast to a healthy person, patients who have acute lower pespiratory tract infection with underlying pulmonary diseases have various pathogens, a rapidly progressie downhill course, and a poor response to prior antimicrobial therapy. Broad spectrum antivacterial therapy is needed for full evaluation. MATERIALS AND METHODS: To evaluate the efficacy and safety of cefpirome, we administered 1gm cefpirome, twice a day to 30 patients who had signs and symptoms of acute lower repiratory infection regardless of their underlying disease, except to those who had an allergic history to antibiotics or severe systemic diseases. RESULTS: The results were as follows : 1) Among 30 cases, 21 cases(70.0%) showed excellent improvement, and 7 cases(23.3%) showed good improvement in their symptoms and signs of acute lower respiratory infection. 2) In 14 cases with isolated pathogens, we observed bacteriologic eradication in 11 cases(78.6%). 3) Significant side effects were not found CONCLUSION: Above results suggest that cefpirome was effective as a monotherapy in patients with acute lower respriatory infection, especially on those with as underlying chronic obstructive pulmonary disease(COPD).

Clinical Aspects in Patients with Thyrotoxic Periodic Hypokalemic Paralysis.: Sang Yob Nam, Jae Hong Kim, Jung Hyn Oh, Jin Chul Park, Hyun Dae Yoon, Kyu Chang Won, Ihn Ho Cho, Hyoung Woo Lee, Cha Kyung Sung; Yeungnam Univ J Med. 1999;16(2):228-236. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.228

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Abstract PDF: BACKGROUND
Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However. the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clnical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center (YUMC) during the past decade. METHODS: The medical records of 997 YUMC patients, seen between 1986 and 1996, with dignosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyrodism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, compasons were made on age. sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. RESULTS: the prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfuntional state of the throid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their throid hormon levels were significantly more increased than those of the patients without hypokalemia. interestingly, our study shows the recurrence of paralysis after treatment. CONCLUSION: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyrodism. The interactive roles of thyroid hormon. Na-K pump. and genetically inherited defect in the celluar membrance potential of the skeletal muscle can be speculated. Further investigation will be neede to firmly establish the mechanism of thyrotoxic periodic paraysis.

Optimization of Correction Factor for Linearization with Tc-99m HM PAO and Tc-99m ECD Brain SPECT.: Ihn Ho Cho, Kohei Hayashida, Kyu Chang Won, Hyoung Woo Lee, Hiroshi Watabe, Norihiko Kume, Chikao Uyama; Yeungnam Univ J Med. 1999;16(2):237-243. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.237

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An Investingation of Psychological Factors in Patients with Functional Dyspepsia.: Jin Sung Kim, Dai Seog Bai, Kwang Heun Lee, Jeong Ill Suh; Yeungnam Univ J Med. 1999;16(2):244-254. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.244

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OBJECTIVES
This subjects investigated the psychological characteristics of patients with functional dyspepsia. METHODS: The subjects included ninety patients with functional dyspepsia and sixty four psychiatric out-patients. We administered Minnesota Multiphasic Personality Inventory (MMPI) and Illness Behavior Questionnaire(IBQ). RESULTS: There were no significant differences between the patients with functional dyspepsia and the psychiatric out-patients by MMPI. Two groups both showed a higher distribution in hypochondriasis, depression, hysteria subscales than in any other subscales. The patients with functional dyspepsia showed lower scores in disease conviction and affective disturbance subscales in IBQ subscales were similar between the patients with functional dyspepsia and the psychiatric out-patients. The patients with functional dyspepsia were divided into three groups for the Multivariate cluster analysis: normal(group 1), similar to psychiatric out-patient(group 2), and severe neurotic(group 3). The severe neurotic group showed higher scores in hypochondriasis, depression, hysteria, psychathenia, and schizophrenia subscales in MMPI and showed significant different scores in affective disturbance, disease conviction, psychological and somatic concerns, affective disturbance, denial, and irritability subscales in IBQ. CONCLUSION: If patients with functional dyspepsia show severe neurotic behavior, such as those in(group 3), they would need appropriate psychiatric intervention.

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The Relationship Between Children's Temperament and Character to Functional Gastrointestinal Disorders
Eun Ju Lee, Hyung Joong Kim, Sun Haeng Lee, Gyu Tae Chang
The Journal of Korean Oriental Pediatrics.2015; 29(1): 60. CrossRef

The Psychiatric Consideration on the Mind in the Treatise of Awakening Mahayana Faith.: Jin sung Kim; Yeungnam Univ J Med. 1999;16(2):255-269. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.255

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Abstract PDF: BACKGROUND
The author investigated the structural theory of the mind. the origin of psychopathology. the resolving stage of the psychopathology. and nature of the true mind in the human mind. METHODS: the author reviewed the "Awakening of Faith in the Mahayana"by Mamyung and "The Commentary on the Treatise of Awakening Mahayana Faith" and "Expository Notes on the Treatise of Awakening Mahayana Faith" by Wonhyo. RESULTS: The author of the Treatise insistod on bellieving the true mind in the human being. Also in the treatise, Alayavijnana explained the harmonized mind of the true mind and the ignorant mind. The ignorant mind as the source of fundamental ignorance. which results in peripheral ignorance arising from the ego in relation with the extenal world. Also, he explains the origin of ignorance and encourages to abandon the deep attachment to ignorance. The developing and resolving stages of ignorance are similar to the developing and resolving stage of psychopathology. CONCLUSION: The author insists on the psychiatric application of the mind theory in the "Awakening of Faith in the Mahayana", "The Commentary on the Treatise of Awakening Mahayana Faith". and "Expository Notes on the Treatise of Awakening Mahayana Faith". Also. the author encourages deep faith of the true human mind.

Detection Rate of Extended-Spectrum beta-Lactamase Producers in Klebsiella pneumoniae and Escherichia coli Isolated at Yeungnam University Medical Center.: Chae Hoon Lee, Ho Chan Lee, Kyung Dong Kim, Tae Su Lee; Yeungnam Univ J Med. 1999;16(2):270-276. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.270

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Abstract PDF: BACKGROUND
Extended-spectrum beta-lactamases(ESBL) are enzymes that confer resistance to oxyimino-beta-lactams as well as to penicillins and cephalosporins. Strains of Klebsiella pneumoniae and Escherichia coli that produce ESBL have been increasingly prevalent in many countries. The purpose of this study was to investigate the ESBL production rate of K. pneumoniae and E. coli at the in Yeungnam University Medical Center. MATERIALS AND METHODS: Thirty-one isolates of K. pneumoniae and twenty-five isolates of E. coli were examined for ESBL by double disk synergy test, using 20/10microgram ticarcillin/clavulanic acid and 30microgram oxymino-beta-lactam(ceftazidime, ceftriaxone and aztreonam) disks. RESULTS: Fifty-two percent of K. pneumoniae and sixteen percent of E. coli isolates revealed double disk synersism. Majority of ESBL-producing strains(fifty-five percent) were isolated from patients in the intensive care unit. CONCLUSION: ESBL production of K. pneumoniae and E. coli were also common at the Yeungnam Univercity Medical Center and pose a serious problem for antimicrobial therapy.

Analysis of Arrival Information and Status of the Patients in Emergency Department.: Sam Beom Lee, Byung Soo Do; Yeungnam Univ J Med. 1999;16(2):277-282. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.277

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Abstract PDF: BACKGROUND
For effective and systematic management of patients in the emergency department (ED), the data on patient arrival and status in DE of Yeungnam University Hospital were evaluated, MATERIALS AND METHODS: During the seven days form Apr. 1 to. 7 , 1998, the general patient information such as onset time and place, factors associated with transportation. causes of admission, cared department and patient disposition were recorded. RESULTS: Total of 464 patients visited the ED during the seven days, and the mean number of patients per day was 66.3 Male to female ratio was 1:0.71. Daily staying patients were 17.3 and 83.6 patients were cared totally each day. The methods of transportation and distribution of patients according to region and event were as follows: visit by walk (57.3%), transportation by car(58.0%),place of event in residence(85.3%), regional distribution in Taegu(81.5%), and direct visit(97.4%). Cause of admission due to diseases was 74.6%. The percentages of department which cared the patients were internal medicine 26.6%, pediatrics 16.8%, orthopedics 8.6%, neurology 8.2%, neurosurgery 7.8% and other department including emergency medicine 8.2%, respectively. Patient dispositions were admission 38.4%, discharge 61.0% and death on arrival(DOA) 0.6%, but referred-patient-to -another-hospital was zero. CONCLUSION: Improvements in several aspects of ED's caring system such as "fast tracking" system and reinforcement of disease and trauma caring system, would be helpful for effective management of emergency patients.

Clinical Presentation of th patients with Non-traumatic Chest Pain in Emergency Department.: Jun Young Chung, Sam Beom Lee, Byung Soo Do, Jong Seon Park, Dong Gu Shin, Young Jo Kim; Yeungnam Univ J Med. 1999;16(2):283-295. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.283

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Abstract PDF: BACKGROUND
Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were 1.1+/-0.9 in non-cardiac diseases, 1.4+/-1.1 in cardiac diseases and 1.7+/-1.1 in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. CONCLUSION: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

MR Imaging of Uterine Malignant Mixed Mullerian Tumor: Comparison with Endometrial Carcinoma.: Jae Ho Cho, Jeen Woo Kim, Jay Chun Chang, Bok Hwan Park, Jung Sik Kim; Yeungnam Univ J Med. 1999;16(2):296-301. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.296

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Abstract PDF: BACKGROUND
Generally, it is difficult to differentiate uterine malignant mixed Mullerian Tumor(MMMT) from endometrial carcinom in radiological and clinical aspects. Our purpose is to investigate MR findings that distinguishes MMMT from endometrial carcinoma. MATERIALS AND METHODS: We retrogradely evaluated the magnetic resonance imaging findings of pathologically proven 5 cases of malignant mixed Mullerian Tumor(MMMT) and 13 endometrial carcinomas to know the differential points of these two tumors originating in the endometrial cavity. The size of the mass, presence or absence of myometrial or uterine cervical invasion, growth pattern of the mass, signal intensity and degree and pattern of contrast enhancement were analyzed and compared. RESULTS: The length of the long axis of the MMMT was 1.5-9.0cm(average, 5.7cm) but that of the endometrial carcinoma was 0.5-6.0cm(average, 2.5cm). Invasion of uterine cervix which was found in 3 MMMT cases, dilated the endometrial cavity and the lumen of the uterin cervix and showed the pattern of growing into the external os. Invasion of uterine cervix was found in only one case of endometrial carcinoma. The presence or absence of myometrial invasion, the signal intensity and homogeneity on T1-and T2-weighted images, and the degree and patterns of contrase enhancement showed no significant difference. CONCLUSION: Any specific finding to differentiate MMMT from endometrial carcinoma was not ascertained. However, MMMT can be suspected if the size of the endometrial mass is greater than 5cm and if the mass dilates the enocervical canal and invades the uterine cervix.

Gastroesophageal Reflux in Peptic Ulcer Patients.: Joong San Suh, Jong Hyeok Kim, Moon Kwan Chung; Yeungnam Univ J Med. 1999;16(2):302-308. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.302

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Abstract PDF: BACKGROUND
It is well known fact to the patients of duodenal ulcer that their condition is frequently accompanied with reflux esophagitis. Therefore this condition is called an "acid-related disorder" because it is commonly associated with increased acidity. But there has been disputes on the effect of Helicobacter pylori eradication in these two conditions and whether H. pylori infection may have a protective role in reflux esophagitis. Only few reports have dealt with the prevalence of reflux esophagitis and gastroesophageal reflux in patients with peptic ulcer. The aim of this study is to estimate the prevalence of gastroesophageal reflux and to analyze the pattern ofthe pathologic reflux in peptic ulcer patients. MATERIALS AND METHODS: The study population consisted of 57 patients with endoscopically confirmed duodenal and/or gastric ulcer who all underwent 24hr ambulatory esophageal pH monitoring. RESULTS: The prevalnace of gastroesophageal reflux in peptic ulcer patients was 54.2% and 54.5% in gastric ulcer, and 62.5% in duodenal ulcer, 50% in combined ulcer, respectively. The prevalence of gastroesophageal reflux in the control group was 22.7%. CONCLUSION: We discovered significantly higher prevalence of gastroesophageal reflux in patients with peptic ulcer disease than in those without it. In conclusion, the presence or absence of gastroesophageal reflux must be considered in the setting of peptic ulcer disease management.

Impact of Hemodialysis on Left Ventricular Performance: A Doppler Echocardiographic Study.: Dong Oh Kang, Du Ha Lee, Hyun Seo Kim, Hyun Su Kim, Sung Rok Kim, Jong Seon Park; Yeungnam Univ J Med. 1999;16(2):309-317. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.309

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Abstract PDF: BACKGROUND
Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function, we performed M-mode and Doppler echocardiopraphic studies before and after hemodialysis. METHODS: The study population consisted of 30 patients(15 patients were male, mean age 45+/-10 years) with CRF on maintenance henodialysis. They have normal left ventricular systolic function(Fractional shortening > 30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction(EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxaion time(IVRT), deceleration time(DT), and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance(IMP) was calculated from each of the Doppler velocity indices. RESULTS: The weight reduction after hemodialysis was 2.1+/-1.0kg(p<0.0001). After hemodialysiss, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant in IVRT and IMP(p<0.05, p<0.0001) were noted. CONCLUSTION: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And and increased IMP suggests that diastolic function may be aggravated after gemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.

The Effects of Anticholinesterase Drugs on Gastric Motility.: Hyoung Chul Choi, Jong Ho Kim, Jeoung Hee Ha, Kwang Yoon Lee, Won Joon Kim, Dong Suk Kwak, Sung Hee Kim, Phil Hyun Song, Ji Hyun Yeo; Yeungnam Univ J Med. 1999;16(2):318-325. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.318

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Abstract PDF: BACKGROUND
Anticholinesterase drug inhibits acetylcholinesterase(AChE), induce accumulation of acetylcholine(ACh) near cholinergic receptors and cholinergic stimulation. This experiment was performed to study the effects of anticholinesterase drugs on gastric motility and the effect of ethanal on anticholinesterase drug-induced motility change. MATERIALS AND METHODS: After excision of stomach, 2x10mm circular musele strips were made, which were then fixed to the isolated muscle chamber. An isometric tension transducer was used to measure the contraction change of the gastric smooth muscle strips after drug addition. RESULTS: Fenthion, and irreversible anticholinesterase drug, increased ACh induced contraction of gastric smooth muscle strips and PAM, a cholinesterase activator, antagnized this action. Physostigmine, a reversible anticholinesterase drug, also increased the ACh induced contraction. The gastric motility was decreased by PAM. Ethanol, which is known to induce smooth muscle relaxation, inhibited the increase of contraction by fenthion. CONCLUSION: These results indicate that irreversible and reversible anticholinesterase drugs increase gastric motility and antagonized by cholinesterase activating drugs. And when exposed to both ethanol and anticholinesterase drug, gastric motility was decreased by the smooth muscle relaxation effect by ethanal.

The Effects of Ethanol on Cholinesterase Inactivation by Organophosphorous.: Hyoung Chul Choi, Jong Ho Kim, Jeoung Hee Ha, Kwang Yoon Lee, Won Joon Kim, Hyun Jae Woo, Chang Uk Huh, Soo Min Son, Eun Jin Chun; Yeungnam Univ J Med. 1999;16(2):326-332. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.326

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Abstract PDF: BACKGROUND
In korea the agricultural community widely uses organophosphorous, and organophosphorous poisonings are increasing every year. We compared change in activity of acetylcholinesterase and pseudocholinesterase by organophosphorous and by the interaction of ethanol and organophosphorous. We also compared the effect of reversible anticholinesterase drugs, physostigmine and neostigmine. The object of this study is to investigate the effects of several anticholinesterase drugs and on how ethanol influences the activity of cholinesterase. MATERIALS AND METHODS: Fifteen male university students were randomly selected, and blood samples were taken from the antecubital vein. The acetylcholinesterase in the RBC and the pseudocholinesterase in the serum were extracted and separated. The enzyme activity change was measured by the electrometric method. After adding acetylcholine, the pH change was measured with a pH meter. RESULTS AND CONCLUSION: Our results indicated that reversible anticholinesterase drugs decreased the cholinesterase activity more efficiently than organophosphorous. The acetyl cholinesterase and pseudocholinosterase activity were decreased by ethanol. When ethanol was added, oxime a cholinesterase activator, increased acetylcholinesterase activity but dose not increased pseudocholinesterase activity.

The Characteristics of Blood Pressure Control in Chronic Renal Failure Patients Treated with Peritoneal Dialysis.: Hang Jae Jung, Sung Hwa Bae, Jun Bum Park, Kyoo Hyang Jo, Young Jin Kim, Jun Young Do, Kyung Woo Yoon; Yeungnam Univ J Med. 1999;16(2):333-341. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.333

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Abstract PDF: BACKGROUND
AND METHODS: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). RESULTS: The results were as follows: 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantlydecreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.005). 3) After changing the modality from hemodialysis to peritoneal dialysis. MAP(mmHg, from 107.1+/-4.5 to 98.6+/-8.8, p<0.05), antihypertensive drug requirements(from 5.6+/-2.6, to 2.0+/-2.5, p<0.01) and erythropoietin dosages(Uint/week, from 4600+/-2660 to 2000+/-1630, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V. weekly creatinine clearance) was not revealed. CONCLUSION: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.

Screening Examination of Breast Cancer: Review of the Recommended Guidelines.: Myung Ho Shin, Mi Soo Hwang, Bok Hwan Park; Yeungnam Univ J Med. 1999;16(2):342-346. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.342

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Abstract PDF: BACKGROUND
Delays in breast cancer diagnosis may occur in young women due to a low index of suspicion. The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest a reasonable guideline for breast cancer screening examination. MATERIALS AND MATHODS: Among 820 patients, 102 patients were under 35 years and 122 patients were above 60 years of age. We reviewed medical records, mammograms and/or ultrasonography of 49 patients under 35 years and 48 patients above 60 years of age with pathologically-proven breast cancer. Pathological reports were as follows: Invasive ductal carcinoma(IDC) was present 61.2% of patients in the young age group and ductal carcinoma in situ(DCIS) in 16.3%. IDC was present in 66.6% of the patients in the old age group, and DCIS in 8.33%. We analyzed mammography and ultrasonography to evaluate their usefullness in detecting breast cancer in patients under 35 years and over 60 years of age. RESULTS: The mammographic results are as follows: 1) detection rate of lesion: 83.8%(under 35yrs), 100%(over 60yrs) 2) sensitivity of cancer: 67.6%(under 35yrs), 91.2%(over 60yrs) The ultrasonographic results are as follows: 1) detection rate of lesion: 100% 2) sensitivity of cancer: 87.2%(under 35yrs), 96.7%(over 60yrs) The breas cancer detection rate in women under 35 years old was comparable to that of women above 60 years old in our study. CONCLUSION: A striking histologic finding in the two groups was a higher incidence of nuclear Grade II and III tumors. This finding correlates with the reported increased incidence of high grade tumors inyoung women and may correlae with the poorer prognosis of breast cancer in young patients. We conclude that early screening examination is helpful for early detection of breast cancer in women under age 35.

The Effects of Catheter Revision and Mupirocin on Exit Site Infection/Peritonitis in CAPD Patients.: Jun Beom Park, Jung Mee Kim, Jun Hyuk Choi, Kyu Hyang Jo, Hang Jae Jung, Yeung Jin Kim, Jun Yeung Do, Kyung Woo Yoon; Yeungnam Univ J Med. 1999;16(2):347-356. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.347

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Abstract PDF: BACKGROUND
Exit site/tunnel infection causes cosiderable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. MATERIALS AND METHODS: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI, we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were T1 symptoms(purulent discharge, abscess lesion around exit site), we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. RESULTS: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt.mon and 0 per 21.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus(26 of 54 isolated cases, 48%), followed by the Methicillin resistant S. auresu(MRSA) (13 cases, 24%). Seven patients(5: MRSA, 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining required catheter removal due to persistent MRSA infection with re-insertion at the same time. But, there was no more ESI in these 3 patients who were received management to relapse (The mean duration: 14.0 months). The rates of ESI were significantly reduced after using mupirocin than before(1 per 12.7 vs 34.0 pt.mon, p<0.01). CONCLUSION: In summary, revision technique can be regarded as an effective method for refractory ESI/T1 before catheter removal. Also local mupirocin ointment can play a significant role in the prevention of ESI.

Health of Apartment Guards and Associated Factors.: Sang Kyu Kim, Joon Sakong, Jong Hak Chung, Chi Ho Kim, Sang Keun Bae, Yun Jin Jang; Yeungnam Univ J Med. 1999;16(2):357-363. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.357

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Abstract PDF

OBJECTIVES
The purpose of this investigation was to study the health status of apartment guards and associated factors. MATERIALS AND METHODS: This investigation was conducted for 1 month starting from August, 1997. Study population in this cross-sectional survey consisted of 182 guards of apartments located throughout the district of Taegu. Each subject completed a questionnaire about his general characteristics, health behaviors, job descriptions, subjective GIT symptoms and somatization and depression using Symptom Checklist-90-Reversion (SCL-90-R) by self administrated questionnaire and personal interview). RESULTS: Study subjects had one or more GIT symptoms(53.3%), somatization symptoms(83.5%) and depression symptoms(79.7%). The mean scores of GIT, somatization and depression symptoms were not different among the age groups and based on marital status, respectively, but, significantly different by education level(p<0.05). The mean scores of GIT, somatization and depression symptoms were not different among the age groups and hased on marital status, respectively, but, significantly different by regular diet and by the subject's health status(p<0.05). The mean scores of GIT, somatization and depression symptoms were not different by duration of shift work, by job tenure and by the number of managed houses but, those of somatization and depression symptoms were significantly different by level of job satisfaction(p<0.05). CONCLUSION: The health statuses of guards at apartments were different from other shift workers because of health worker effects and characteristics of their jobs.

Citations

Citations to this article as recorded by

The effect of long working hours on cerebrovascular and cardiovascular disease; A case‐crossover study
Kyong‐sok Shin, Yun kyung Chung, Young‐Jun Kwon, Jun‐Seok Son, Se‐hoon Lee
American Journal of Industrial Medicine.2017; 60(9): 753. CrossRef
Effects of sleep quality and occupational stress on health-related quality of life among a university's security workers
Gun Woo Park, Su-Jin Goh, Dong Ha Kim, Hye Lim Kim, Jin Kwan Park, Soo-Young Yu, Du Young Jeong, Jin-Hee Chun, Soon-Young Hwang, Sung-Il Cho
Korean Journal of Health Education and Promotion.2015; 32(3): 73. CrossRef
Risk Factor Evaluation of Musculoskeletal Symptoms for Guards
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Journal of the Ergonomics Society of Korea.2011; 30(3): 419. CrossRef

Case Reports

A Case of Telangiectatic Osteosarcoma of the Skull Base.: Yong Jin Kim, Hoon Kyu Oh; Yeungnam Univ J Med. 1999;16(2):364-368. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.364

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Abstract PDF: A rare case of telangiectatic osteosarcoma of the sphenoid bone was reported. The patient was a 27-year-old male and had suffered from left eye protrusion and diplopia for three months. Radiologically, a lobulated osteolytic lesion was located between sphenoid and left temporal bone. Pathologically, the tumor had multiloculated blood filled cystic vascular spaces and osteoid formation by malignant spindle osteoblast cells. The differential diagnosis of this rare entity from aneurysmal bone cyst was important radiologically and pathologically. This case is the second case of telangietatic osteosarcoma of the sphenoid bone followed by a case of Whitehead RE and Melhem ER in 1998.

Chordoma: A Clinicopathologic Review of 4 Cases.: Joon Hyuk Choi, Young Kyung Bae, Mi Jin Kim, Duk Seop Shin, Kil Ho Cho; Yeungnam Univ J Med. 1999;16(2):369-375. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.369

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Abstract PDF: Chordoma is a slow-growing malignant neoplasm arising from the remnants of the primitive notochord. It accounts for 1 to 4% of all malignant bone tumors. It occurs exclusively along the spinal axis. Authors experienced four cases of chordoma occurred in the sacrococcygeal region. There were two male and two female patients, with a mean age of 63.5 years(range. 57~75 years). Tissue was obtained by wide excision in two patients, by incisional biopsy in one patient and by needle biopsy in the other. Adjuvant radiation theraphy was performed on all the patients after their biopsy. The mean diameter of the tumors was 7.6cm(range, 5.5 to 13.0cm). Grossly, tumor was multilobulated, soft and myxoid gelatinous mass. Microscopically, the tumor showed lobulated feature divided by fibrous septa within it. There were physaliphorous cells with vacuolated bubbly cytoplasm. And small uniform, round, and non-vacuolated tumor cells were also present. On immunohistochemical stain, all the cases were immunoreactive for cytokeratin, epithelial membrane antigen(EMA) and vimentin, respectively. One of the 4 cases was positive for S-100 protein. All the cases were negative for CEA.

Suprameatal Transvaginal Urethrolysis in Urethral Obstruction Associated with Anti-incontinence Surgery: A Case Report.: Jin Wook Yoo, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1999;16(2):376-379. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.376

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Abstract PDF: We report our experience with a case of urethrolysis using a transvaginal suprameatal approach without lateral perforation of the urethropelvic ligament. A 43-year-old woman suffered from voiding difficulties such as hesitancy, frequency, urgency, decreased urinary flow, residual urine sensation after Marshall-Marchetti-Krantz operation concurrent with hysterectomy. The results of multidisciplinary work-ups of urethral obstruction such as history, vaginal examination, voiding cystourethrography, urodynamic study, showed that she had urethral obstruction due to a previous operation. Since clean intermittent catheterization and alpha-blocker therapy did not improve her symptoms, suprameatal transvaginal urethrolysis was performed to resolve the symptoms. Postoperative follow-up for 5 months showed that the patient remained free from voiding difficulty in their life. We believe that suprameatal transvaginal urethrolysis is worth attempting for urethral obstruction associated with anti-incontinence surgery.

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