• Journal of Yeungnam Medical Science
• /
• v.9 no.1
• /
• pp.149-155
• /
• 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
• /
• v.9 no.1
• /
• pp.130-136
• /
• 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
• /
• v.9 no.1
• /
• pp.121-129
• /
• 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.

• Journal of Yeungnam Medical Science
• /
• v.9 no.1
• /
• pp.110-120
• /
• 1992

The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate, 30 patients, who belonged to physical status II or III of ASA classification, were selected randomly and divided with two groups as follows : G1(N=15) : Not-administrated furosemide(control group) G2(N=15) : Administrated furosemide(Experimental group). All patients were premedicated with Hydroxyzine(1mg/kg, IM) and were performed continous epidural anesthesia with 2% lidocaine(1-1.5mg/segment). For irrigating solution, 5% D-sorbitol was used and Hartman's solution were given for maintenance fluid and fixed the height of irrigating container to 60 cm from symphysis pubis. With the starting of operation, 20mg furosemide was administrated to experimental group. The blood samples for the values of $Na^+$, $K^+$, Glucose and BUN were performed at the periods of preoperation, 10 min, 20 min, 30 min after the starting of operation and immediate postoperation. Based these data, serum osmolality and effective osmolality were calculated. The results were as follows : 1. The sodium concentration of control group was decreased statistically significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value(p<0.05). But that of experimental Group was not changed significantly. 2. The serum osmolality and effective osmolality were decreased statistically significantly at 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value(p<0.05). But those of experimental group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraopertively. And so we recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.

• Journal of Yeungnam Medical Science
• /
• v.5 no.1
• /
• pp.33-42
• /
• 1988

The abdominal tumors in children are different from those of adult. These tumors are the third most common one, preceded by leukemia and brain tumors, in children under 15 years. X-ray examination is the most important method among diagnostic approaches. The role of diagnostic imaging is to identify the precise anatomic location and extent of pathologic process with the minimal number of imaging procedures. 23 cases of abdominal tumors were reviewed in respect of age incidence, site of origin, radiologic findings. The results are briefly summarized as follows : 1. Neuroblastoma was the most common(6 cases) and wi1m's tumor(5 cases), choledocal cyst(4 cases), ovarian mass(3 cases), hydronephrosis(2 cases), were descending order in frequency. 2. The most common site was retroperitoneum(60%). Kidney was the single most common site of origin. 3. Radiologic findings. The most common findings of plain radiography was ill defined soft tissue mass and this method was helpful in the presence of calcification especially in neuroblastoma. Ultrasonographic pattern was anechoic(cystic), echoic or mixed pattern, but this method provide less precise anatomical details, nevertheless ultrasonography wes paticullary useful imaging modality for the pediatric abdominal tumors. IVP findings were renal displacement, caliceopelvic system distortion or nonvisualization of kidney, these information was helpful in determining the location of tumors. CT scan showed homogenous or inhomogenous, cystic or solid, mass with their anatomic location. 4. Ultrasonography was the most widely used specific diagnostic method, but had limited value in detecting the anatomic location of tumors. CT scan was superior to ultrasound for determining the extent of tumors.

• Journal of Yeungnam Medical Science
• /
• v.4 no.1
• /
• pp.75-80
• /
• 1987

The positive rate for serum anti-HBs was analized among 424 of HB vaccinated and 2035 of non-vaccinated cases at the Yeungnam University Hospital, Computed Automated Med-screening Center. Most of them from Kyungbook province and they had the last HB vaccination in the periods of 3 to 42months prior to this study. The followings were obtained. 1. The positive rates for serum HBsAg were 0.7% in the vaccinees, 9.6% in the non-vaccinated and 8.0% in the whole cases. 2. The positive rates for serum anti-HBs were 66.3% in the vaccinees, 47.9% in the non-vaccinated and 51.0% in the whole cases. 3. The positive rates for serum anti-HBs were 51.4% in the cases with one time of vaccination and 68.6% in the cases with two times of vaccination. on the vasis of these findings the positive rate for serum anti-HBs among the vaccinees was significantly higher than thau of non-vaccinated(P<0.05). The positive rate for seaum anti-HBs shortly after vaccination was higher than that of present our study which was made relatively long period after vaccination. As the reason a natural decrease of the titers of the serum anti-HBs can be postulated as one of the contributing factors for the discrepancy. In order to keep the serum antibody of perfect protectivity against HBV, it may be better to check the serum anti-HBs just after vaccination, follow up and take booster injection when it is needed.

• Journal of Yeungnam Medical Science
• /
• v.4 no.1
• /
• pp.65-74
• /
• 1987

This study deals with the changes in the concentrations of blood glucose and electrolytes during open heart surgery. Blood glucose and electrolytes in connection with age, disease and anesthetic period were measured in 25 patients about to undergo heart surgery which were performed between June 1986 and August 1986 in Yeungnam University Hospital. Because glucose solution is commonly used as priming solution, and the priming solution is hyperglycemic and hyperosmolar, glucose level of priming solution in this study was adjusted to 100-200mg% level to minimize hyperglycemic and hyperosmolar effect. The following results were obtained. 1. Glucose level of priming solution before extracorporeal circulation was $151.6{\pm}3.13mg%$. 2. With body cooling, blood glucose level was elevated. As duration of extracorporeal circulation is prolonged, blood glucose level was elevated more, but no difference between age and diseases were observed. On warming, blood glucose level was progressively lowered. 3. Despite the low serum potassium level during by pass, the potassium level was progressively elevated following by-pass, cut the serum potassium level was low compared to control values. Elevated calcium level was maintained during by pass.

• Journal of Yeungnam Medical Science
• /
• v.5 no.1
• /
• pp.49-60
• /
• 1988

Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January. 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 808:3 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Strptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermentating microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophilia was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermentating microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.

• Journal of Yeungnam Medical Science
• /
• v.4 no.1
• /
• pp.105-121
• /
• 1987

The authors studied anxiety-depression using New Anxiety-Depression Scale(NADS), in the subjects of 3,499male and 1,335 female college freshmen of Yeungnam University. The authors collected the reports of NADS during the periods from January to February, 1986, and applied ANOVA and t-test on anxiety-depression scores in order to compare them between various psychosocial factors, and sexs. The results are as follows : There was significant difference in the mean awerages of total scores between male and female students: male students scored $31.49{\pm}6.57$ female students scored $33.37{\pm}6.84$ (P<0.001) The anxiety-depression scores relating to the items of sleep disturbance, apprehension, decreased libido and fatigue were relatively higher in both groups. Ninety-nine male students(2.8%) showed seriously high degree anxiety-depression scores of 50 or higher, while forty female students(3.0%) showed the same scores. There was a strong tendency toward higher anxiety-depression scores in the students who were dissatisfied with their home atmosphere, colleges, departments and familiarity of parents, and those who had pessimistic views of self image in the past, present, or fartare in both groups (P<0.001) The students whose maturation locations were below city level, showed higher level of anxiety-depression scores in both groups (P<0.05) NADS and SAS, SDS, and Leeds scale were correlated significantly in 0.64, 0.61, and 0.77 of correlation coefficient.

• Journal of Yeungnam Medical Science
• /
• v.4 no.1
• /
• pp.49-57
• /
• 1987

To evaluate whether mast cells are involved in developing pathologic feature of psoriasis, 60 biopsy specimens of patients with psoriasis were analysed. They had not been treated for at least 1 week before skin biopsy. Histological findings in early and fully developed lesions and numbers of mast cells in their dermal papillae were investigated. The result were as follows : 1. In epidermal changes of psoriatic lesions, parakeratosis and acanthosis revealed different findings between early lesions and fully developed lesions. While early lesions revealed mounds of parakeratosis and mild to moderate acanthosis, fully developed lesions revealed confluent parakeratosis and moderate to severe acanthosis. In dermal changes of psoriatic lesions, papillomatosis revealed different findings between early developed lesions and fully developed lesions. While early lesions revealed normal to mode-rate papillomatosis, fully developed lesions revealed moderate to severe papillomatosis. 2 Degree of acanthosis is related to the degree of papillomatosis. The more increase in the degree of acanthosis, papillomatosis, and parakeratosis, mast cell numbers in dermal papillae were more increased. 3. Mast cell numbers in dermal papillae were more increased in fully developed lesions than early lesions. 4. These findings suggest that mast cell may play an active role in developing pathologic finding of psoriasis.