Journal of Yeungnam Medical Science

Volume 2(1); December 1985

Reviews

Classification and Treatment of Epiphyseal Growth Plate Injury.: Jong Chul Ahn; Yeungnam Univ J Med. 1985;2(1):1-4. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.1

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Abstract PDF: No abstract available.

Complications of Subarachnoid Hemorrhage.: Soo Ho Cho, Yong Chul Chi; Yeungnam Univ J Med. 1985;2(1):5-9. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.5

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Abstract PDF: No abstract available.

Original Articles

A Clinical Analysis Femur Neck Fracture in Elderly Patients.: Joo Chul Ihn, Myun Hwan Ahn, Jae Sung Seo; Yeungnam Univ J Med. 1985;2(1):11-22. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.11

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Abstract PDF: Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture in itself were noted, but we have analyzed 18 femur neck fracture of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slipdown accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. Undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with preexisting disease in the same hip joint (total hip replacement).

Cryosurgery in the Treatment of Keloids.: Yung Sik Jung, See Ho Choi, Jung Hyun Seul, Tae Sook Lee; Yeungnam Univ J Med. 1985;2(1):23-30. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.23

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Abstract PDF: Keloids are abnormally healed skin wounds that develop in the subpapillary layer of the dermis. They are a lesion with wide, raised and deep scars. They exceed the original dimensions of the wound and grow mounds upon mounds of collagen in a pseudotumor fashion. Their treatment may take several forms such as surgery, intralesional injection of steroid, compression, superficial irradiation, and combination therapy. However, absolute method is nothing until now. Recently, the cryosurgery shows relatively good effect in treatment, so we tried the clinical experience with cryosurgery in the treatment of keloids. Material and methods: During the past 2 years, we treated 20 individuals of the keloids with severe itching and pain. The age ranged from 5 to 45 years old. Only 6 cases were biopsied before and after cryotherapy. The cryosurgery set we used was Toitu model CR 201 N₂O gas (tip temperature in 80℃) and was applied directly on the lesion about 4 to 5 minutes with slight compression. After cryosurgery in keloids, the following results were obtained: 1. It is both quick and easy method. 2. It is causes little or no pain and no loss of blood. 3. Integumentary normalization is rapid. The new scar tissue is smaller, and more elastic and soft. 4. The pain, itching and paresthesia commonly associated with keloid is usually disappeared. 5. Other treatment can be used after cryosurgery. 6. Histologic picture after cryosurgery is similar with the result of steroid injection. 7. The mechanism of the cryosurgery in keloids is the result of the direct tissue destroying action and cryoimmunologic reaction.

Surgical Treatment of Pressure Sores.: Yung Sik Jung, Tae Hoon Lee, Jung Hyun Seul, See Ho Choi; Yeungnam Univ J Med. 1985;2(1):31-38. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.31

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Abstract PDF: No abstract available.

Analgesic Effects of Lumbar Epidural Narcotics for Relief of Upper Abdominal Post-operative Pain.: Il Sook Seo, Bon Up Koo; Yeungnam Univ J Med. 1985;2(1):39-44. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.39

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Abstract PDF: To assess the effect of postoperative pain control of upper abdominal surgery through lumbar epidural narcotic injection, the 3rd or 4th lumbar epidural puncture was done, and were injected 1 mg of morphine (Group I) or 10 mg of demerol (Group II) mixed with 10 ml of normal saline into the epidural space, after operation of the cholecystectomy in 10 patients and antrectomy and vagotomy, subtotal or total gastrectomy in 10 patients. Time interval of the postoperative analgesic effect between morphine and demerol groups were compared. The results of this study were as follows: 1. In the group I, average analgesic duration was 29.4 hours. 2. In the group II, average analgesic duration was 4.0 hours. It is concluded that postoperative pain control of upper abdominal surgery through the lumbar epidural narcotic injection was effective, and morphine injection was more effective than demerol.

The Effect for Intracranial Pressure during Laryngoscopy and Endotracheal Intubation.: Heung Dae Kim, Yong Chul Chi; Yeungnam Univ J Med. 1985;2(1):45-51. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.45

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Abstract PDF: It is well known that intracranial pressure (ICP) and mean arterial pressure (MAP) are increased by laryngoscopy and endotracheal intubation during induction of general anesthesia, and it may be very dangerous in neurosurgical patients who had increased ICP. Therefore, this study was performed to know the range of ICP increase during induction of the conventional general anesthesia with intubation following thiopental and succinylchohne injections. Intracranial pressure and MAP were measured in 13 patients who underwent craniotomy. All the patients were monitored cerebral epidural ICP and intraarterial pressure preoperatively. The results were as follow: 1. Intracranial pressure was increased of 7.1±7.23 mmHg. 2. Arterial pressure was increased of 43.5±25.46 mmHg. 3. Cerebral perfusion pressure was increased of 33.3±27.53 mmHg. It is stressed that certain procedures are necessary to prevent from further increase of ICP due to induction of general anesthesia in patients with increased ICP.

Meanings of Stereoview in Cerebral Angiogram.: Soo Ho Cho, Yong Chul Chi; Yeungnam Univ J Med. 1985;2(1):53-57. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.53

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Abstract PDF: Many pictures must be taken for the presumption of the stereorelation of the cerebral artery, which obtained with ordinary cerebral angiography. And it is very difficult to understand the stereoimage and required many experiences. But it is able to presume the stereorelationship in only brief eye's training without the aid of the stereoscope using the prism. For the stereoview, we need the paired angiograms obtained only straight and tilting the X-ray tube. In practice, with this stereoview in cerebral angiogram, we could know the directions of the aneurysmal neck and fundus with the stereorelationship of the cerebral artery and indeed helps us greatly in operation field. In addition, we might guess the location and stereorelationships of the feeding artery and draining vein in arteriovenous malformation and other vascular tumors and it was great aid in diagnosis and operation. Now we present the methods of the pictures for the stereoview in cerebral angiogram and the methods for eye's training.

The Effect of Tension Band Wiring in the Treatment of the Olecranon Fracture.: Joo Chul Ihn, Jong Chul Ahn, Sae Dong Kim, Myun Whan Ahn, Jae Sung Seo; Yeungnam Univ J Med. 1985;2(1):59-63. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.59

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Abstract PDF: Treatment of the olecranon fractures by prolonged immobilization often results in limited elbow motion. With the use of tension band wiring, anatomical reduction was obtainable, and only a short period of immobilization was needed. We reviewed the cases of 17 patients who underwent surgical treatment of the olecranon fracture. All patients were treated by tension band wiring. In the overall series, we were able to obtain 53 percent excellent, 30 percent good, and 18 percent fair results.

Histopathological Studies on Carcinomas of the Stomach in the Taegu Area.: Suk Jae Hong, Tae Sook Lee, Won Hee Choi, Kyung Chul Lee; Yeungnam Univ J Med. 1985;2(1):65-69. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.65

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Abstract PDF: For evaluation on the histopathologic studies, and age and sex distribution of the gatric carcinomas in the Taegu Area, the gastrectomized and gastroscopic biopsy materials were collected at the Department of Pathology, College of Medicine, Yeungnam University, and the analyzed results were as follows: 1. In total of 350 cases of gastroscopic biopsy materials adenocarcinomas are 344 cases (98.3%), squamous cell carcinomas and undifferentiated carcinomas are only 6 cases (1.7%). In adenocarcinomas the most of all are tubular type, 215 cases (61.4%). In age distribution the highest is the 50th age group, and 120 cases (34.3%), the next 60th, 81 cases (23.1%), 40th, 76 cases (21.7%), respectively. 2. In total of 130 cases of gastrectomized materials adenocarcinomas are 127 cases (97.7%), and are the highest incidence, the next, carcinomas originated from chronic peptic ulcer of the stomach, and are 3 cases (2.3%). In adenocarcinomas the highest are tubular type, 86 cases (66.2%), the next, signet ring cell type, 20 cases (15.4%). The highest age incidence of the age group is 50th, and the next, 60th, 40th, 30th, 70th and 10th age group, respectively.

Antiepileptic Therapy for Latent Epilepsy.: Choong Suh Park, Yeung Joo Byun, Jung Sang Ha; Yeungnam Univ J Med. 1985;2(1):71-75. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.71

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Abstract PDF: The clinical state with EEG pattern similar to interval discharge of epileptics is named as latent epilepsy, which does not necessarily mean that the patient will develop epilepsy later. However, since there is possibility of developing epilepsy on later date, antiepileptic mainly dilantin was tried to control the abnormal EEG. Since January to October 1985, total 580 headache cases with more than moderately abnormal EEG visited the Neurology Clinic. Among them 162 cases with interval seizure pattern (ISP) of epilepsy were selected for the study. The main ISP was 1. diffuse theta and/or delta bursts and 2. spikes. Since the study in only analysis of clinical treatment of 162 cases without previous planning based on financial aid, about 30% of the patients did not return after the 1st EEG examination, in 42% failed to follow the EEG after the treatment and only remaining 28% of the cases were studied. Among 29 patients who were treated with Dilantin 100mg tid po, 16 improved and 13 not. Of the 13, 4 showed partial improvement and partial progression. Case1. In 4 weeks of antiepileptic therapy (AR), spikes disappeared but in 2 months developed bursts. Case2. In 17days of AR, spikes and bursts disappeared but in 3 months bursts reccured. Case3. In 1 week of AR, bursts disappeared but spikes developed. Case4. In 3 months of AR, no change of spikes and bursts and she discontinued the AR. In 6 months she developed grandma seizure. Eighteen cases, treated with other drugs except antiepileptics, all showed improvement. The other drugs were vincaprol, polygammalon, aronamin, ATP and hydergine. The improved cases had spikes more often than theta bursts. In view of the small number of the cases due to dropping most patients out of present study, it is considered meaningless to perform statistical analysis. Further well planned study with more patients is to be expected.

A Study on the Development of R-R Interval Analyzer using Microcomputer (1).: Joon Ha Lee, Soo Bong Choi; Yeungnam Univ J Med. 1985;2(1):77-80. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.77

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Abstract PDF: The R-R interval analyzer was developed to measure the autonomic nervous system function using microcomputer. The system based on 8 bit microcomputer including bandpass filter, R-wave detector and clock generator in order to obtain the mean value, standard deviation, total time, CV value, maximum value and minimum value in the specific view point of R-R interval variation. The pattern of R-R interval change after resting, voluntary standing and deep breathing can be analyzed in normal subjects and diabetics with autonomic nervous dysfunction. The amplitude of the R-R interval variation showed sensitive pattern for normal subjects at resting, standing and deep breathing. On the contrary, the periodicities of amplitude for abnormal subjects with autonomic nervous dysfunction showed dull pattern. It was suggested that R-R interval analyzer is a good detection method for dysfunction of autonomic nervous system.

Transurethral Dormia Dislodging in Patients with Lower Ureteral Stone.: Eun Gill Kim, Jun Kyu Suh, Young Soo Kim, Tong Choon Park; Yeungnam Univ J Med. 1985;2(1):81-85. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.81

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Abstract PDF: Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial. Herein we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 46 mm, and 33% in 610 mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained in the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And in the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.

Ultrasonographic Features of Intra-abdominal Abscess.: Kil Ho Cho, Kyung Hee Jung, Mi Soo Hwang, Jae Chun Chang, Koing Bo Kwun, Hyun Sik Min; Yeungnam Univ J Med. 1985;2(1):87-93. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.87

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Abstract PDF: Intraabdominal abscess usually causes distress with fever, leukocytosis, pain and toxicity. Diagnosis of intraabdominal abscess is occasionally difficult and it has high morbidity. However radiologic method, such as ultrasonography, CT scan, or RI scan are helpful to early detection of intraabdominal abscess. Among these methods, ultrasonography is a noninvasive technique and performed without discomfort to patient. And also differential diagnosis between cystic and solid lesion is very easy and sequential ultrasonography in same patient is valuable for the evaluation of treatment effect. We analyzed the ultrasonic features of 48 cases with intraabdominal abscesses and the results are as follows; 1. In total 48 cases, the intraabdominal abscesses were 30 cases, the retroperitoneal abscesses, 5 cases, and the visceral abscesses, 13 cases. 2. The causes of the intraabdominal abscesses were perforating appendicitis (25 cases), postoperative complications (5 cases), pyogenic and amebic hepatic abscesses (13 cases), and the other (5 cases). 3. Round or oval shaped lesions were 26 cases (54%), irregular shape, 18 cases (38%), and multiple abscess formation in 4 cases (8%). 4. The size of the lesions were between 5 and 10cm in diameter in 54% of total 48 cases, and the most frequent feature of the echo pattern of the lesions was cystic with or without internal echogenicity (69%).

Drugs Most Frequently used in OPD of Yeungnam University Hospital: March to August, 1985.: Kwang Youn Lee, Won Joon Kim, Sung Hoon Kim; Yeungnam Univ J Med. 1985;2(1):95-102. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.95

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Abstract PDF: This report offers descriptive data about the drugs utilized in outpatient department (OPD) of Yeungnam University Hospital (YUH) in the period of March to August in 1985. The data in this report were produced by the computerized totalization of the number of mentions of individual drugs included in the prescriptions. The 100 drug entries that were most frequently recorded are listed in rank order. The listing is arbiturarily restricted to the drugs that were prescribed as single preparations, the drugs of basis of compound preparations and the drugs of adjuvant or corrective of compound preparations that have significant therapeutic effects either by generic names. And in addition, the listing also involves the compound preparations used in relatively large frequency, and the individual components of which have the unique pharmacological actions each other by proprietary names. And all routes of administrations were allowed. The 10 drugs most frequently named are diazepam, aluminum compounds, acetaminophen, isoniazid, metoclopramide, polaramine®, carboxymethylcystein, ephedrine, codeine and caroverine in order. The 521, 855 drug mentions listed as above are described by the chief therapeutic usage that each is intended to apply generally. The drugs which account the largest proportion of total mentions were those acting on the central nervous system (20.57%), including tranquillizers and sedative hypnotics (11.71%), analgesic antipyretics (5.55%), antidepressants (2.15%) etc. Gastrointestinal drugs and smooth muscle preparations (18.64%) included antacids and antiulcer drugs (9.24%), antiemetics (3.57%), spasmolytics (3.14%) and others. Respiratory drugs (16.11%) included expectorants and cough preparations (10.99%) and bronchodilators (5.12%). Chemotherapeutic agents (15.12%) included the antiTbc drugs (7.09%) most frequently, and the penicillins (3.33%) accounted the largest proportion among the antibiotics. Cardiovascular drugs (5.64%) included cardiac drugs and coronary vasodilator (4.12%) and antihypertensives and vasodilators (1.06%). And antiinflammatory drugs (4.33%), vitamins of single preparations (3.76%), hormones and their antagonists (3.29%), common cold preparations (3.12%), diuretics (2.81%), drugs supporting liver function (2.02%), drugs affecting autonomic nervous system (1.89%) including antiglaucomas, atropine and cerebral vasodilators, antihistamine drug (1.02%) and disinfectants (0.74%) were following in order. The data in the report were compared to those reported by H. Koch, et al. in United States (US), 1981 as “Drugs Most Frequently Used in Office Practice : National Ambulatory Medical Case Survey, 1981.” Cardiovascular drugs prescribed in YUH were much less in proportion than in US (10.56%), but gastrointestinal drugs accounted the larger proportion than in US (3.72%). Expectorants and preparations in YUH also accounted the larger proportion than in US (2.74%). In conclusion, in the period of March to August, 1985, OPD of YUH prescribed the CNS drugs including diazepam most frequently, and gastrointestinal, respiratory and chemotherapeutic drugs in next orders. It is supposed that the eating habits of Koreans and a unique atmospheric condition in Taegu as a basin were some important factors that affected the proportions of drugs acting on gastrointestinal and respiratory tracts.

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