• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.29-38
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• 1987

The authors studied anxiety-depression using New Anxiety-Depression Scale (NADS) in the subjects of 2.564 male and 1,252 female college freshmen of Yeungnam University. The authors collected the reports of NADS during the periods from January to February 1987, and applied NAOVA and t-test on anxiety depression scores in order to compare them between various psychosocial factors and sexes. The results are as follows : There was significant difference in the mean average of total scores between male and female students : male students scored $33.41{\pm}8.76$ and female students scored $35.34{\pm}9.02$ (P<0.001). The anxiety-depression scores relating to the items of sleep disturbance, apprehension, facial flushing and fatigue were relatively scored higher in both groups. One hundred and thirty nine male students (5.4%) showed seriously higher degree of anxiety-depression scores of 50 or more, while eighty eight female students (7.0%) showed the sane scores. There was a strong tendency toward higher anxiety-depression scores in the students who were dissatisfied with their home atmosphere, colleges, departments, familiarity of parents am those who had pessimistic views of self image in the past, presents and future in both groups (P<0.001).

• Journal of Yeungnam Medical Science
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• v.37 no.4
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• pp.321-328
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• 2020

Background: This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery. Methods: A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding. Results: The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.9%; three strokes and one systemic embolization) and three major bleeding events (1.4%) were observed. The high CHA₂DS₂-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA₂DS₂-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events. Conclusion: Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.90-97
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• 2016

Background: We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. Methods: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. Results: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). Conclusion: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.189-196
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• 1992

Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.137-148
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• 1992

The purpose of this study was to evaluate the influence of phenobarbital(PB) on hepatotoxic effect of carbon tetrachloride($CCl_4$) which induces centrilobular necrosis in liver. Rats were injected intraperitoneally $CCl_4$ dissolved in olive oil by a dose of 0.4mg/kg. For change related to PB pretreatment, rats were injected $CCl_4$ 0.4mg/kg after PB pretreatment. The liver samples were taken in 6, 12, 24, 48, 72, and 120 hours after $CCl_4$ and/or FB injection. Extracted liver tissue was examined with light and electron microscopes. The results were sumarized as follows : 1. Light microscopic findings : In $CCl_4$ group, centrilobular necrosis developed from 6 hours after injection, was the most severe in 48 hours, and recovered after 72 hours. In addition to necrosis, fatty change and pale cell change were accompanied. In PB-$CCl_4$ group, necrosis occurred from 6 hours after $CCl_4$ injection and continued to 72 hours, and the degree of necrosis was more severe than that of $CCl_4$ group and pale cell change was decreased. 2. Electron microscopic findings: In $CCl_4$ group, the early principal change was clumping and vesicular dilatation of endoplasmic reticulum. In PB-$CCl_4$ group, the degenerative change of endoplasmic reticulum was aggrevated and the mitochondria also revealed severe degenerative change. According to the results, it was revealed that $CCl_4$ hepatotoxicity primarily began with the damage of endoplasimic reticulum, then damage of other cell organelles and cell necrosis followed, and these cytotoxic effects were aggrevated by PB pretreatment.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.75-89
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• 1992

The development of multi drug-resistant tumor cell population is a major problem in the chemotherapy of human cancer. These cells are often cross resistant to unrelated drugs and the precise mechanisms of multidrug resistant phenotype of tumor cells has not been fully elucidated. Cisplatin resistant tumor cell(SNU-1/$Cis_5$) was induced from human stomach cancer cell line(SNU-1) in vitro. Growth profiles of survival cells were observed during 5 days by thiazolyl blue (MTT) assay. To investigate the cross resistance of various anticancer drugs in SNU-1 and SNU-1/$Cis_5$, We compared the value of $IC_{50}$ - drug concentration at 50% survival of control and gained relative resistances (RR). The RR for SNU-1/$Cis_5$ were as follows; vinblastine, > 43.0 ; epirubicin, 22.9 ; dactinomycin, 16.0 ; etoposide, 15.0 ; vincristine, 9.2 ; adriamycin, 5.7 ; aclarubicin, 5.3. But 5-fluorouracil, methotrexate, daunorubicin have not cross resistance with cisplatin. Resistant inhibition values of $10{\mu}M$ verapamil for SNU-1/$Cis_5$ were as follows; vincristine, 13.1 ; epirubicin, 10.0 ; etoposide, 6.3 ; vinblastine, 4.4 ; dactinomycin, 3.6 ; daunorubicin, 2.4. Membrane proteins of 51,400 and 81,300 daltons were identified by radioiodination with SDS-PAGE, which might represented the drug resistance.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.156-166
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• 1992

The authors studied anxiety, using Zung's self-rating anxiety scale(SAS), in the subjects of 127 male and 38 female patients with anxiety disorder. The authors investigated 165 patients in Yeungnam university hospital from January, 1987 to June, 1991. In order to analyze the data on anxiety scores Pearson's product moment coefficient correlation method and factor analysis were carried out by SPSS/PC+ program. The results were as follows : There was significant difference in the mean averages of total anxiety scores among patients with anxiety, disorder and male and female college freshmen: patients with anxiety disorder scored $42.40{\pm}7.74$, male students scored $32.91{\pm}5.70$, female students scored $34.48{\pm}6.00$. The anxiety scores relating to the items of body aches & pains, fatigue, anxiousness, panic, and urinary frequency were relatively high in patients with anxiety disorder. The anxiety scores on the items of restlessness, apprehension, dyspnea, sweating, and insomnia were relatively low in patients with anxiety disorder. Twenty-nine anxiety disorder group(17.5%) showed significantly high anxiety scores of 50 or over. The inter-rater reliability of Zung's self-rating anxiety scale was 0.71.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.149-155
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• 1992

55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients(36 male and 19 female) ranged in age from 3 to 72years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases(9.4%), atelectasis in 4(7.5%), transient urine leak in 2(3.8%), delayed bleeding in 2(3.8%) and urinary retention in 2(3.8%), Postoperative residual stones were identified in 15(27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases(87.3%) became stone free, The recurrence of stone was noted in 2 out of 48 patients during the short followup period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.130-136
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• 1992

Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their enumerous complications. Thirty patients with fractures of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to November 1991. The following results were observed. 1. The average age was 37.3 years and the number of male was three times of the female. The most common cause was traffic accident. 2. Twenty cases out of thirty one were closed fractrure and the remaining 11 were open. The comminuted and segmental fractures were 18(57.7%) in number and the most common fracture site was the middle one third(53%). 3. Average interval from injury to operation was 7.6 days and 19 cases showed associated injuries. 4. The mean duration of the bone union was 18.9 weeks and 2 cases showed the delayed union. 5. Twelve complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.121-129
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• 1992

The effect of exercise on plasma insulin, free fatty acid, and glucose uptake and glycogen concentration in soleus, and intravenous glucose tolerance of streptozotocin treated, diabetic Sprague-Dawley rats were studied. Diabetic-trained animals were Subjected to a regular program of treadmill running for 4 weeks. Seventy-two hours after the last training session, basal and insulin-stimulated glucose uptake was studied in incubated strips(about 20mg) of soleus muscle in vitro. Glucose tolerance was measured with intravenous infusion of 0.5g glucose/kg body weight. In diabetic rats, training was associated with increased glucose uptake in basal and maximal insulin concentrations, decreased fasting glucose concentrations, and increased muscle glycogen levels, but there were no changes in glucose tolerance curve and plasma insulin concentrations. These results suggest that regular running program for 4 weeks improve responsiveness of insulin on soleus muscle, but fails to cause improvement of impaired intravenous glucose tolerance in mild degree streptozotocin induced diabetic rats.