Journal of Yeungnam Medical Science

Original article

Impact of Controlling Nutritional Status score on short-term outcomes after carotid endarterectomy: a retrospective cohort study: Hee Won Son, Gyeongseok Yu, Seung Jun Lee, Jimi Oh; J Yeungnam Med Sci. 2023;40(3):259-267. Published online October 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00507

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Abstract PDF: Background
Malnutrition and impaired immune responses significantly affect the clinical outcomes of patients with atherosclerotic stenosis. The Controlling Nutritional Status (CONUT) score has recently been utilized to evaluate perioperative immunonutritional status. This study aimed to evaluate the relationship between immunonutritional status, indexed by CONUT score, and postoperative complications in patients undergoing carotid endarterectomy (CEA).
Methods
We retrospectively evaluated 188 patients who underwent elective CEA between January 2010 and December 2019. The preoperative CONUT score was calculated as the sum of the serum albumin concentration, total cholesterol level, and total lymphocyte count. The primary outcome was postoperative complications within 30 days after CEA, including major adverse cardiovascular events, pulmonary complications, stroke, renal failure, sepsis, wounds, and gastrointestinal complications. Cox proportional hazards regression analysis was used to estimate the factors associated with postoperative complications during the 30-day follow-up period.
Results
Twenty-five patients (13.3%) had at least one major complication. The incidence of postoperative complications was identified more frequently in the high CONUT group (12 of 27, 44.4% vs. 13 of 161, 8.1%; p<0.001). Multivariate analyses showed that a high preoperative CONUT score was independently associated with 30-day postoperative complications (hazard ratio, 5.98; 95% confidence interval, 2.56–13.97; p<0.001).
Conclusion
Our results showed that the CONUT score, a simple and readily available parameter using only objective laboratory values, is independently associated with early postoperative complications.

Communication

Yeungnam University type drive-through (YU-Thru) coronavirus disease 2019 (COVID-19) screening system: a rapid and safe screening system: Wan Seok Seo, Seong Ho Kim, Si Youn Song, Jian Hur, Jun Lee, Sunho Choi, Yoojung Lee, Dai Seg Bai; Yeungnam Univ J Med. 2020;37(4):349-355. Published online September 18, 2020; DOI: https://doi.org/10.12701/yujm.2020.00640

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Active and prompt scale-up screening tests are essential to efficiently control the coronavirus disease 2019 (COVID-19) outbreak. The goal of this work was to identify shortcomings in the conventional screening system (CSS) implemented in the beginning of the outbreak. To overcome these shortcomings, we then introduced a novel, independently developed system called the Yeungnam University type drive-through (YU-Thru), and distributed it nationwide in Korea. This system is similar to the drive-throughs utilized by fast food restaurants. YU-Thru system has shortened the time taken to test a single person to 2–4 minutes, by completely eliminating the time required to clean and ventilate the specimen collection room. This time requirement was a major drawback of the CSS. YU-Thru system also reduced the risk of subjects and medical staff infecting one another by using a separate and closed examination system. On average, 50 to 60 tests were conducted per day when using the CSS, while now up to 350 tests per day are conducted with the YU-Thru system. We believe that the YU-Thru system has made an important contribution to the rapid detection of COVID-19 in Daegu, South Korea. Here, we will describe the YU-Thru system in detail so that other countries experiencing COVID-19 outbreaks can take advantage of this system.

Citations

Citations to this article as recorded by

Experience of operating a medical humanities course at one medical school during the COVID-19: a retrospective study
Yu Ra Kim, Hye-won Shin, Young Hwan Lee, Seong-Yong Kim
Journal of Yeungnam Medical Science.2023; 40(2): 179. CrossRef
Lessons Learned From an Analysis of the Emergency Medical Services’ COVID-19 Drive-Through Testing Facilities in Israel
Itay Zmora, Evan Avraham Alpert, Uri Shacham, Nisim Mishraki, Eli Jaffe
Disaster Medicine and Public Health Preparedness.2022; 16(5): 2091. CrossRef
A study on the mental health of students at a medical school during COVID-19 outbreak: a retrospective study
Yu Ra Kim, Hye Jin Park, Bon-Hoon Koo, Ji Young Hwang, Young Hwan Lee
Journal of Yeungnam Medical Science.2022; 39(4): 314. CrossRef

Case Report

Guide wire fracture during percutaneous coronary intervention.: Hak Ro Kim, Tae Hoon Yim, Byung Chul Kim, Ho Jun Lee, Hong Geun Oh, Hyun Sik Ju, Tae Jin Kim, Young Bok Kim; Yeungnam Univ J Med. 2016;33(1):52-55. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.52

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Abstract PDF: Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.

Original Article

Usefulness of the BACTEC MGIT 960 System for Mycobacterial Culture and TB Ag MPT64 Immunochromatographic Assay to Identify Mycobacterium tuberculosis.: Seung Hun Lee, Min Jeong Lee, Jeong Mi Lee, Su Jin Yim, Seung Jun Lee, You Eun Kim, Yu Ji Cho, Yi Yeong Jeong, Ho Cheol Kim, Jong Deog Lee, Sun Joo Kim, Young Sil Hwang; Yeungnam Univ J Med. 2012;29(2):83-88. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.83

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Abstract PDF

BACKGROUND
This study was conducted to evaluate the usefulness of the BACTEC MGIT (Mycobacterium Growth Indicator Tube) 960 system for mycobacteria culture and immunochromatographic assay to identify Mycobacterium tuberculosis (MTB) in positive MGIT culture. METHODS: Mycobacteria-culture-positive cases were retrospectively analyzed from December 2010 to July 2011. The detection rates and the recovery times of the mycobacteria between the Ogawa media and the MGIT were compared. An immunochromatographic assay (ICA) (SD BIO-LINE) was also performed in the positive MGIT culture for identification, and the results were compared with those of the Ogawa media in the Korea National Tuberculosis Association. RESULTS: Among the 261 patients (M:F, 168:93; mean age, 61.6+/-17.16 yrs), 450 specimens (sputa, 365; bronchial washing, 61; and pleural effusion, 24) were found positive with mycobacteria. Mycobacteria were grown both on the MGIT and Ogawa media in 310 cases (68.9%); only on the MGIT in 115 cases (22.6%); and only on the Ogawa media in 25 cases (5.5%) (p<0.05).The recovery time was 28.2+/-8.9 days in the Ogawa media and 11.1+/-5.8 days in the MGIT (p<0.05). Among the 127 cases from the positive MGIT culture, all 92 cases that were confirmed as MTB cases bythe Korea National Tuberculosis Association were identified as MTB by ICA, with 100% sensitivity. CONCLUSION: MGIT increases the detection rate and shortens the recovery time of mycobacteria in clinical respiratory specimens, and the TB Ag MPT64 kit using ICA is useful in identifying MTB in a positive MGIT culture.

Citations

Citations to this article as recorded by

A Low Cost/Low Power Open Source Sensor System for Automated Tuberculosis Drug Susceptibility Testing
Kyukwang Kim, Hyeong Kim, Hwijoon Lim, Hyun Myung
Sensors.2016; 16(6): 942. CrossRef

Case Reports

Three Cases of Primary Thyroid Lymphoma at a Single Institution.: Seung Jun Lee, Ji Yeun Kim, Jung Kyu Park, Sung Woo Kim, Ji Hun Kim, Tae Won Kim, Geun Jin Ha, Ho Sang Shon, Eui Dal Jung, Kyu Jang Won; Yeungnam Univ J Med. 2010;27(2):165-172. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.165

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Abstract PDF: Primary thyroid lymphoma is a relatively rare thyroid tumor and usually a non-Hodgkin type. Its most common histologic type is the diffuse large B cell lymphoma followed by mucosa-associated lymphoid tissue (MALT). It is known to be frequently associated with autoimmune thyroiditis such as Hashimoto's thyroiditis. We report three cases of thyroid lymphoma at a single institution with a review of the literature.

Fibromuscular Dysplasia of the Distal Internal Carotid and Middle Cerebral Artery.: Ju Hyun Kim, Jun Lee; Yeungnam Univ J Med. 2009;26(1):78-83. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.78

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Abstract PDF

Fibromuscular dysplasia is an uncommon condition of idiopathic, non-inflammatory and non-atherosclerotic disease of the musculature of arterial walls. The disease is rare, but it commonly affects young and middle aged women. Isolated intracranial cerebral fibromuscular dysplasia is extremely rare because cerebral fibromuscular dysplasia usually affects extracranial vessels. A 26-year-old woman was admitted with right hemiplegia and global aphasia. Brain MRI and MRA demonstrated acute left middle cerebral artery territory infarction with a multifocal stenosis and dilatation of the left middle cerebra artery and left internal carotid. The characteristic conventional cerebral angiographic findings demonstrated a typical string-of-beads appearance in the left distal internal carotid artery and proximal portion of the left middle cerebral artery, which suggested a medial type fibromuscular dysplasia. We report a case of isolated intracranial fibromuscular dysplasia with left middle cerebral artery territory infarction. Fibromuscular dysplasia should be considered as a stroke risk factors in children and young adults, especially in patients with no known cardiovascular risk factors.

Citations

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Cerebral Infarction and Recovery in a 12-Year-Old Child With Intracranial Fibromuscular Dysplasia
Min Hwan Kim, Jae In Lee, Shin-seung Yang
Brain & Neurorehabilitation.2023;[Epub] CrossRef

Original Article

Relationship between Clinical Grading of Carpal Tunnel Syndrome and Electrophysiological Parameter: Hyun Chul Do, Jun Lee, Se Jin Lee, Mee Young Park, Jung Sang Hah; Yeungnam Univ J Med. 2007;24(2 Suppl):S407-415. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S407

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Abstract PDF: Background
：To investigate the relationship between clinical grading and electrophysiological parameter in carpal tunnel syndrome. Materials and Methods：This studies examined 75 outpatients (100 hands) who were diagnosed as carpal tunnel syndrome at neurologic clinic from March to July in 2006. They were divided into three groups by clinical grading and then each groups were compared with sensory nerve conduction velocity (SNCV) and sensory compound nerve action potential (CNAP) amplitude of I-W, F-W, and P-W segments, motor terminal latency (TL), motor compound muscle action potential (CMAP) amplitude of distal segment, and disto-proximal ratio on the third finger.
Results
：The first group(mild) was 46 (51 hands) patients, second group(moderate) was 29 (35 hands) patients, and the third group (severe) was 14(14 hands) patients. The mean ages were 55.9, 57.4 and 57.0 years in each group, and there were no statistical differences in age and sex between 3 groups. SNCV of I-W, F-W and P-W segments and motor TL were different significantly between 3 groups, but disto-proximal ratio on the third finger was not different significantly(P<0.05). Motor TL was correlated with clinical grading. And also sensory CNAP amplitude of I-W, F-W, and P-W segments, and motor CMAP amplitude of distal segment were different significantly between 3 groups. Especially, sensory CNAP amplitude of P-W segment and motor TL were correlated with higher clinical grading groups(2, 3 groups)(p<0.05).
Conclusion
：SNCV of F-W and P-W segments, motor TL, motor CMAP amplitude of distal segment and sensory CNAP amplitude of each segments were correlated with the clinical grading of carpal tunnel syndrome.

Case Reports

A case of Bilateral Near Blindness Secondary to Isolated Sphenoid Sinus Aspergillosis with Headache.: Jun Pil Yoon, Se Jin Lee, Jun Lee, Ju Hyun Kim, Hyun Doo Noh; Yeungnam Univ J Med. 2007;24(1):79-84. Published online June 30, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.1.79

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Abstract PDF: Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.

A Family of Dentatorubropallidoluysian Atrophy.: Ji Yoon Chung, Mee Young Park, Jun Lee, Jun Pil Yoon, Hyun Jung Park; Yeungnam Univ J Med. 2006;23(1):118-123. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.118

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Abstract PDF: Dentatorubropallidoluysian atrophy (DRPLA) is a rare neurodegenerative disorder usually inherited in an autosomal dominant pattern. DRPLA has been shown to be associated with expansion of an unstable cytosine-adenine-guanine (CAG) trinucleotide repeat in a gene on chromosome 12p. We evaluated a family with DRPLA that affected three members; A 35-year-old female presented with seven year history of gait ataxia, dysarthria and mild cognitive impairment. The MRI of the brain revealed diffuse cerebellar atrophy with an incidental lipoma in the midbrain. Her 30-year-old brother presented with progressive cerebellar ataxia that developed at the age of 20. Her grandmother and mother were reported to have developed ataxia during the late period of their life, and died at the age of 60 and 55, respectively. The demonstration of an expanded CAG repeat in the gene for DRPLA was used to confirm the diagnosis.

A Case of Systemic Lupus Erythematosus Presenting with Amaurosis Fugax without Antiphospholipid Antibodies Syndrome.: Jung Hyun Kim, Jung Sang Hah, Mee Young Park, Se Jin Lee, Jun Lee; Yeungnam Univ J Med. 2006;23(1):113-117. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.113

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Abstract PDF: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that may affect many organ systems including the nervous system. The immune response in patients with SLE can cause inflammation and other damage that can cause significant injury to the arteries and tissues. A 48-year-old woman was admitted to the hospital because of transient monocular blindness. Magnetic resonance imaging and conventional angiography showed severe stenosis of the distal intracranial internal carotid artery. The patient was diagnosed as having SLE but the antiphospholipid antibodies were negative. Amaurosis fugax has not been previously reported as an initial manifestation of SLE in Korea. We report a patient with a retinal transient ischemic attack as the first manifestation of SLE.

A Case of Wernicke's Encephalopathy Associated with Hyperemesis Gravidarum.: Seung Hyun Lee, Se Jin Lee, Yun Kyung Lee, Jung Sang Ha, Jun Lee; Yeungnam Univ J Med. 2004;21(1):91-95. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.91

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Abstract PDF: Wernicke's encephalopathy is an acute-onset illness characterized by mental confusion, ataxia and ophthalmoplegia due to a thiamine deficiency. Immediate administration of thiamine prevents progression of the disease and reverses brain lesions. We have experienced a case of Wernicke's encephalopathy associated with hyperemesis gravidarum. As Wernicke's encephalopathy is mostly associated with chronic alcoholism, the possibility of Wernicke's encephalopathy may be ignored in young women. We emphasize the need for thiamine supplementation in the patient requiring intravenous alimentation such as hyperemesis gravidarum.

Review

Antithrombotic Therapy for Ischemic Stroke.: Jung Sang Hah, Jun Lee; Yeungnam Univ J Med. 2003;20(1):1-12. Published online June 30, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.1.1

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Abstract PDF: Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.

Original Articles

Comparison of the Repetitive Nerve Stimulation Test(RNST) Findings Between in Upper and Lower Extremity Muscles in Myasthenia Gravis.: Yun Seuk Jung, Jun Lee, Se Jin Lee, Jung Sang Hah, Wook Nyeon Kim; Yeungnam Univ J Med. 2000;17(2):129-136. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.129

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Abstract PDF: BACKGROUND
AND PURPOSE: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. MATERIALS AND METHODS: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). RESULTS: There were statistical differences of decremental response(mean+/-SD) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response(mean+/-SD) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. CONCLUSIONS: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.

The Significance of Small Polyp of colon in Koreans.: Soon Uk Kwon, Eun Ju Lee, Jong Ryul Eun, Sun Taek Choi, Hak Jun Lee, Byeong Ik Jang, Tae Nyeun Kim, Moon Kwan Chung; Yeungnam Univ J Med. 2000;17(1):39-48. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.39

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Abstract PDF

BACKGROUND
There are two theories in the development of colon cancer. One is the adenoma-carcinoma sequence theory and the other is the de novo cancer theory. Western countries believe in the adenoma-carcinoma sequence theory, however there are many recent reports from Japan about cancers developing from small adenomas. METHODS: The present study analyzed 408 polyps from 508 cases that were taken by colonoscopic polypectomy at the Departmant of Internal Medicine, Yeung-Nam University Hospital. RESULTS: The percentage of patients who have polyp was 41.3%(210cases out of 526cases) and the peak incidence was noted in patients in their 50's and 60's. There was no difference between the sexes, but we noted significant increase in the incidence of polyps in patients over age of thirty. We found 395 polyps below 1cm and 13 polyps above 1cm. Among 408 polyps, 5 cases cancerous polyps and 3 cases showed polyp size of less than 1cm each. The first case was a polyp of 0.4cm in size with elevated mucosa at the ascending colon. The second was 0.5cm in size with round elevation and hyperemic mucosa in the rectum. The third polyp was 0.6cm in size with tubular elevation at the hepatic flexure. CONCLUSIONS: colon polyp is common disease in Koreans. even small polyps can have cancer tissue, which should be removed if discovered during colonoscopy. We believe that not all colon cancer originates in the manner described by the adenoma-carcinoma sequence theory. However further studies with a larger sample population are needed to determine the exact role colon polyps plays in the development of colon cancer.

Citations

Citations to this article as recorded by

Histologic discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimens of colorectal polyp in actual clinical practice
Moon Joo Hwang, Kyeong Ok Kim, A Lim Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim
Intestinal Research.2018; 16(3): 475. CrossRef

Case Reports

A Case of Becker's Type Congenital Myotonia.: Sung Hwan Yun, Jung Sang Hah, Jun Lee; Yeungnam Univ J Med. 1999;16(1):125-130. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.125

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Abstract PDF: Congenital myotonia is a hereditary disorder of the skeletal muscle. The most characteristic features of the disease are myotonia and variable muscular hypertrophy. Molecular biologic investigations have revealed that mutations in the gene of the human skeletal muscle chloride ion channel protein are a cause of the disease. The Becker's type congenial myotonia is clinically similar to the autosomal dominantly inherited congenital myotonia (Thomsen's disease). Both disorders are characterized electrophysiologically by increased excitability of muscle fibers, reflected in clinical myotonia. In general, Becker's type congenital myotonia is more severe than Thomsen's disease in muscular hypertrophy and weakness. The authors recently experienced a 25-year-old female patient who has no family-related disease history and who has conspicuous muscular hypertrophy and the stiffness with muscles which occurred from the age of 3 or 4. Clinically she showed the authors a percussion myotonia. On electrophysiological study, exercise and repetitive stimulation of the abductor digiti quinti muscle disclosed a decline in the compound muscle action potential. Biopsy of biceps muscle revealed enlargement of muscle fibers with marked nuclear internalization. After the oral taking the Mexiletine, the patient showed a favorable turn a little with her stiffness of muscles. So we authors are reporting one case of Becker's type congenital myotonia with review of literatures.

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.

Original Articles

The Clinical Effect of Sparfloxacin for the Treatment of Acute Respiratory Infection.: Hak Jun Lee, Hye Jung Park, Chang Jin Shin, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1998;15(2):246-253. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.246

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Abstract PDF: Sparfloxacin is a new synthetic quinolone antimicrobial developed at the Research Laboratories of Dainippon Pharmaceutical Co, Ltd. To evaluate the efficacy and safty of sparfloxacin in acute pulmonary infection, we administered sparfloxacina(100mg) twice in a day to 30 patients who had sign and symptoms of acute pulmonary infectious diseases regardless of their underlying lung disease for 7 days. The results were : 1) A total 30 patients were enrolled in the trial. Among them 24 cases(80%) had underlying lung problems such as chronic obstructive pulmonary disease(36.4%), bronchiectasis(36.4%), bronchial asthma(3.3%), lung cancer(3.3%). 2) In 26 cases(86.6%), we observed effective improvement, and 4 cases(13.4%) show mildly effective improvement of symptoms and signs of respiratory infection. 3) In 23 cases(73.4%), we observed bacteriological eradication in culture or decreased the number of bacteria in Gram stain which found dominantly in previous Gram stain. 4) The significant side effect was not noted. The above results suggest that sparfloxacin was effective as a first line therapy in patients with acute respiratory infection.

Comparison of Usefulness of Laboratory Tests in Diagnosis of Myasthenia Gravis.: Seung Kwon Park, Hyun Cheol Do, Min Jung Kim, Seung Yeop Lee, Mee Yeoung Park, Jung Sang Hah, Wook Nyeun Kim, Jun Lee; Yeungnam Univ J Med. 1998;15(1):125-134. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.125

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Abstract PDF: PURPOSE: This study was undertaken to evaluate the clinical usefulness of Tensilon test, repetitive nerve stimulation test(RNST), single fiber EMG(SFEMG) test and acetylcholine receptor antibody(AchR Ab) assay for making diagnosis of myasthenia gravis(MG). METHOD: These tests were performed in 21 MG patients which were classified into 11 ocular, 5 mild generalized, 4 moderate generalized, and 1 chronic severe MG. RESULT: The overall positivity of Tensilon test, SFEMG and AchR Ab was 95%, 87%, and 76% respectively. The overall positivity of RNST was 67%; 38% on flexor carpi ulnaris, 43% on adductor digiti quinti and 62% on orbicularis oculi muscles. The positivity of each test was higher in generalized MG group than in ocular MG group. But we could observe the statistically significant difference only in the RNST(p<0.05). CONCLUSION: Tensilon test showed the highest positivity in all MG groups. So we would like to recommend the Tensilon test for the diagnosis of MG at first, followed by RNST and AchR Ab assay, and SFEMG would be indicated to MG group which showed relatively low postivity in other tests.

The Clinical Study of Clarithromycin for the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease.: Ki Beom Kim, Chang Jin Shin, Hak Jun Lee, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1997;14(1):94-100. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.94

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Abstract PDF: To evaluate the efficacy and safety of clarithromycin in acute exacerbation of chronic obstructive pulmonary disease, we administered clarithromycin(250mg) twice in a day in 30 patients with acute exacerbation of chronic obstructive pulmonary disease from September to November in 1996. Twenty eight eases of 30 patients were cured(93.4%) and 2 cases(6.7%) show clinical improvement. Three cases were improved within 3 days of treatment and 24 cases were improved between 5 days and 12 days of treatment. There were no significant side effects. These results suggest that clarithromycin will be effective as a first line therapy in patients with acute exacerbation of chronic obstructive pulmonary disease.

Detection of Serum Hepatitis B Virus DNA According to HBV Markers in Chronic Hepatitis B Liver Disease.: Dong Jun Lee, Jin Su Choi, Joon Hwan Kim, Heon Ju Lee; Yeungnam Univ J Med. 1997;14(1):155-167. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.155

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Abstract PDF: The identification of serum HBV DNA is very important for the assessment of the disease activity in persistent infection, for the evaluation of the infectivity of an individuals blood. The dot blot, however, has limited sensitivity and sometimes inconsistent with other serological markers and clinical settings. Using the most important recent advance in molecular biology, the polymerase chain reaction(PCR), specific DNA sequences can be amplified more than a million-fold in a few hours and with this technique the detection of the extreme low level of DNA is possible. This study was to determine sensitivity of the PCR for the detection of serum HBV DNA in comparison with dot blot analysis and to investigate the serum HBV DNA status and clinical significance of PCR in patients with chronic HBsAg positive liver disease. The subjects of this study were 17 patients with asymptomatic HBsAg carriers(9 HBeAg positive patients, 8 anti-HBe positive patients), 91 chronic hepatitis B(50 HBeAg positive patients, 41 anti-HBe positive patients), 57 liver cirrhosis(21 HBeAg positive patients, 36 anti-HBe positive patients), 27 hepatocellular carcinoma(10 HBeAg positive patients, 17 anti-HBe positive patients). The results were summerized as following; The detection rates of HBV DNA by dot blot, PCR were 58.9%, 72.2% in HBeAg positive patients, 34.3%, 53.9% in anti-HBe positive patients. The detection rates of HBV DNA by PCR in HBeAg negative patients were 25.0% in asymptomatic HBsAg carriers, 61.0% in chronic hepatitis B, 52.8% in liver cirrhosis, 52.9% in hepatocellular carcinoma. The positive rate for HBV DNA is a significant difference between HBeAg positive and negative asymptomatic HBsAg carriers, but not significantly difference in other groups. In conclusions, this study confirmed that the PCR is much more sensitive than the dot blot analysis in detecting the HBV DNA in the sera of patients with chronic liver disease. The presence of HBV DNA in the serum was detected by PCR with higher sensitivity and it suggested that active viral replication is still going on in most patients with chronic HBsAg positive liver disease irrespective of HBeAg/anti-HBe status, and PCR may be used as a prognostic factor in asymptomatic HBsAg carriers.

Utility of H-reflex in the Diagnosis Cervical Radiculopathy.: Jun Lee, Gun Ju Park, Hyun Cheol Doo, Sung Geon Park, Yun Seog Jeong, Jung Sang Hah; Yeungnam Univ J Med. 1997;14(1):111-122. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.111

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Abstract PDF

H-reflex is a kind of late respons which can be used for the proximal nerve conduction study. Also it is a useful and widely used nerve conduction technique es to look electrically at the monosynaptic reflex. Although recordable from all muscles theoretically, H-reflexes are most commonly recorded from the calf muscles following stimulation of the tibial nerve in the popliteal fossa. But in this study, We tried to establish the normal data and to evaluate the significance of the H-reflex study in cervical radiculopathy. H-reflexes were recorded from flexor carpi radialis (FCR) muscle, extensor carpi radialis (ECR) muscle, brachioradialis (BR) muscle, and abductor digiti minimi (ADM) muscle in 31 normal adults (62 cases) and 12 patients with cervical radiculopathy. The mean values of H-reflex latency in normal control group were 16.16+/- 1.65 msec in FCR; 15.99+/- 1.25 msec in ECR; 16.47+/- 1.59 msec in BR; 24.46+/- 1.42 msec in ADM. And the mean values of side to side difference of H-reflex latency were 0.47+/- 0.48 msec in FCR; 0.68+/- 0.72 msec in ECR; 0.63+/- 0.43 msec in BR; 22.31+/- 1.24 msec in ADM. Mean values of side to side differences of interlatency time were 0.49+/-0.47 msec in FCR; 0.73+/- 0.62 msec in ECR; 0.79+/- 0.71 msec in BR; 0.69+/- 0.44 msec in ADM. Also, there were no significant differences in H-reflex latency between right and left side. H-reflex tests in patient group with cervical radiculopathy revealed abnormal findings in 11 out of 12 patients. These results suggest that H-reflex in the upper extremity would be helpful in the diagnosis of the cervical radiculopathy.

Citations

Citations to this article as recorded by

Retraining Reflexes: Clinical Translation of Spinal Reflex Operant Conditioning
Amir Eftekhar, James J.S. Norton, Christine M. McDonough, Jonathan R. Wolpaw
Neurotherapeutics.2018; 15(3): 669. CrossRef
Abnormal Flexor Carpi Radialis H-Reflex as a Specific Indicator of C7 as Compared With C6 Radiculopathy
Chaojun Zheng, Yu Zhu, Feizhou Lv, Xiaosheng Ma, Xinlei Xia, Lixun Wang, Xiang Jin, Robert Weber, Jianyuan Jiang, Kevin Anuvat
Journal of Clinical Neurophysiology.2014; 31(6): 529. CrossRef
Utility of Flexor Carpi Radialis H-Reflex in Diagnosis of Cervical Radiculopathy
Dariush Eliaspour, Ehsan Sanati, Mohammad Reza Hedayati Moqadam, Seyed Mansoor Rayegani, Mohammad Hasan Bahrami
Journal of Clinical Neurophysiology.2009; 26(6): 458. CrossRef

Case Reports

A Case of Rhabdomyosarcoma in the Liver.: Dong Jun Lee, Ji Sung Yoon, Joon Hwan Kim, Chan Won Park, Jeong Ill Suh, Heon Ju Lee, Ki Kweon Kim; Yeungnam Univ J Med. 1996;13(2):360-366. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.360

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Abstract PDF: Pure primary hepatic rhabdomyosarcoma in adult is very uncommon. There have been only five previous case of primary rhabdomyosarcoma of the adult liver. A case of hepatic ihabdomyosarcoma was diagnosed in a 52 year-old female. She was admitted to the hospital due to the epigastric pain and weight loss. A CT scan of the abdomen showed a large hypodense mass with focal calcification occupies most of the both lobes of the liver. The liver biopsy showed massive liver tumor composed entirely of oval shaped cells showing light microscopic and immunohistochemical evidence of rhabdomyoblastic differentiation. We report a case of hepatic rhabdomyosarcoma with review of literature.

Two Cases of Adenoid Cystic Carcinoma of the Left Main Bronchus and Trachea..: Young Bog Cho, Hak Jun Lee, Ki Beom Kim, Jin Hong Jung, Kwan Ho Lee, Hyun Woo Lee, Mi Jin Kim; Yeungnam Univ J Med. 1996;13(2):347-359. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.347

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Abstract PDF: Adenoid cystic carcinoma is an uncommon histologic variant of adenocarcinoma which usuallyy arises from the salivary, lacrimal, or other exocrine glands. Characteristics of adenoid cystic carcinoma are its potential fo extending long distance submucosally and for perineural invasion. It grows slowly and may have a prolongec course before diagnosis and after treatment. Recently, we have experienced 2 cases of adenoid cystic carcinoma arising from main bronchus and trachea. One case was 58 years old female patient. Her symptoms were productive cough with dyspnea. She ha been history of shortness of breath, wheezing and cough during 4 years, which was initially diagnosed a bronchial asthma. The tumor was located on the left main stem bronchus which was obstructed the lumei nearly complete, by CT demonstration.

Original Articles

A Clinical Study of 52 Patients with Myasthenia Gravis Syndrome.: Gun Ju Park, Jung Sang Hah, Jun Lee, Hyun Cheol Do, Seung Kweun Park, Sang Dug Suh, Byung Soo Kee; Yeungnam Univ J Med. 1996;13(1):86-96. Published online June 30, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.1.86

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Abstract PDF: The authors experienced 52 patients with myasthenia gravis who were diagnosed at the Department of Neurology, Yeungnam University Hospital from August 1985 to January 1996. The following results were obtained through diagnostic evaluation and treatment. 1. The ratio of male to female was 1:1.7 and the most prevalent age group was second decade. 2. The most common initial presentation symptom was ocular(71.2%) and the peak incidence group was stage I (69.3%) according to the modified Osserman's classification. 3. In 16 patients(30.8%), it took more than a year to diagnose due to symptoms which were relapsed and remitting. 4. Of 52 patients, 2 cases were associated with thyroid disease(3.8%) and 2 with insulin-dependent diabetes mellitus(3.8%). 5. All of those who received anticholinesterase and corticosteroid therapy were improved with the exception of 5 cases which were improved after thymectomy and/or plasmapheresis.

Comparision of Heoatitis B Virus Markers in the Serum and the Cerebrospinal Fluid: Sang Dug Suh, Seong Min Kim, Jun Lee, Gun Ju Park, Hyun Cheol Do, Yeung Ju Byun; Yeungnam Univ J Med. 1995;12(2):282-291. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.282

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Abstract PDF: We investigated HBV markers in serum and cerebrospinal fluid of 50 subjects with neurologic disorders or other disorders, who visited Dept. of neurology, college of medicine, Yeungnam University, from April-1 to August-31 1994 and were performed cerebrospinal fluid analysis to investigate the detection rate of HBV markers in cerebrospinal fluid and the possibility of neurologic disorders associated with HBV infection. The results were as follows. The positivity of HBsAg and. HBV prevalence rate in serum were 6 (12.04) and 37 (74.0%). Thf, number of patient with HBsAg, only anti-HBV and no markers were 6 (12.0%), 31 (62.0%) and 13 (26.0%), respectively. The positivity of HBsAg and HBV prevalence rate in cerebrospinal fluid were 3 (6%) and 18 (36.0%). The number of patient with HBsAg, only anti-HBV and no markers were 6 (100.0%), 12 (38.7%) and 0 (0.0%) respectively. The number of patient with virus associated diseases (VAD) and non virus associated diseases (NVAD) were 26 (52%) and 24 (48%). The HBV prevalence rate in serum of VAD and NVAD groups were 88.5% and 58.3% (p<0.05). The HBV prevalence rate in CSF of VAD and NVAD groups were 53.8% and 16.7% (p<0.05). The HBV prevalence rate in serum and CSF of VAD and NVAD groups were 60.9% and 28.6%. As a conclusion, the HBV markers in the CSF were partially detected at the presence of the HBV markers in serum. The prevalence rate of HBV in the CSF was increased at the HBsAg positive in the serum and the CSF was significantly increased at the VAD group than the NVAD group

Case Report

A Case of Bartter's Syndrome with a Seizure Disorder Associated with Subdural Hematoma.: Jae Jun Lee, Han Ku Moon, Yong Hoon Park; Yeungnam Univ J Med. 1994;11(2):388-397. Published online December 31, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.2.388

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Abstract PDF

Bartter's syndrome is a rare tubular disorder characterized by hypokalemic, hypochloremic metabolic alkalosis, hyperreninemic, hyperaldosteronism, hyporesponsiveness to pressor agents and juxtaglomerular apparatus heperplasia. We report a case of Bartter's syndrome of a 5 month-old male infant with subdural hematoma who was confirmed by characteristic clinical, laboratory findings and kidney biopsy.

Citations

Citations to this article as recorded by

Furosemide induced medullary nephrocalcinosis mimicking Bartter syndrome
Sohee Kim, Chanhee Kyung, Yong hoon Kim, Jang ho Cho, Changhyeok Hwang, Jung Eun Lee
Yeungnam University Journal of Medicine.2014; 31(1): 21. CrossRef

Original Articles

Motor Evoked Potential Study with Magnetic Stimulation In Ischemic Stroke Patients.: Seong Min Kim, Sang Dug Suh, Jun Lee, Jung Sang Hah; Yeungnam Univ J Med. 1994;11(2):248-261. Published online December 31, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.2.248

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Abstract PDF: This study was undertaken to evaluate the clinical usefulness of magnetic motor evoked potential (MEP) in the diagnosis of stroke and predicting the motor improvement following stroke. The cortical, cervical and lumbar stimulations were performed in the case of 24 healthy controls and 24 to a target muscle between after transcranial stimulation and after cervical or lumbar stimulation. There was no case showing no response in controls. But in 11 out of 24 ischemic patients, we could not get cortical MEP. Mean CMCT of abductor pollicis brevis muscle was not significantly different in controls and stroke patients in whom MEPs were recorded. There were significant differences between mean CMCT of normal controls and that of stroke patients showing MEPs in AH Muscle. MEP Results from testing the stroke patients were correlated with site of lesion, degree of motor weakness and motor improvement after 1 to 2 months. These results suggest that magnetic MEP is easy and useful in electrophysiological test of central motor pathway and is useful indicator for representing the motor weakness and predicting the motor outcome in acute ischemic stroke patients.

Measurements of Mid-arm Circumference(MAC) and Mid-arm Circumference/Head Circumference(MAC/HC) Ratio as Indices of Nutritional Status in Newborn Infants.: Jae Jun Lee, Kyung Ah Lee, Young Hwan Lee, Son Moon Shin; Yeungnam Univ J Med. 1994;11(1):160-166. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.160

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Abstract PDF: Mid-arm circumference and mid-arm circumference/head circumference ratio(MAC/HC) were measured in 207 AGA(appropriate for gestational age) infants delivered at 26 to 42 weeks of gestation from January 1990 to December 1993 in Yeungnam University Hospital, Taegu, Korea. There were linear relationships between MACs and MAC/HC ratios and gestational age(MAC : y=03181x -2.2069, r=0.81, p<0.001 ; MAC/HC ratio : y=0.049x+0.1128, r=0.62, ; < 0.001). Using standard curves of MAC and MAC/HC ratio according to the gestational age, measurement of MAC or MAC/HC ratio can be a noninvasive, simple method to evaluate the intrauterine growth of newborn infants and the nutritional status of growing premature infants.

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