• Journal of Yeungnam Medical Science
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• v.20 no.2
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• pp.105-116
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• 2003

Definitely, treatment for gastric cancer is primarily surgical. Detection in early stage of disease and complete surgical resection is the best way to cure gastric cancer. If surgery is planned, careful preoperative evaluation and corrections of physiologic and psychologic abnormalities are essential to reduce perioperative morbidity or mortality. Basic principle of gastrectomy for gastric cancer is an en bloc resection of tumor with adequate margins of normal tissue and with regional lymph nodes and omental tissues. To complete these principles, regional lymph nodes and all omental tissues should be removed altogether during performing various types of gastric resection. The lymph node dissection is one of the most effective procedures for gastric cancer to achieve curative resection. The basic types of gastric resection are distal subtotal gastrectomy and total gastrectomy according to the condition of primary lesions and the status of lymph node metastases. When the primary lesion is located near the esophagogastric junction, it is sometimes hard for a surgeon to select adequate surgical method. Postoperative quality of life in a patient has become a very important factor to be considered in every step of surgical therapy. With increasing incidence of early gastric cancer, a number of surgical trials for limited surgery or endoscopic procedures have been performed, but the long-term clinical results should be carefully analyzed to define the clinical relevance of these new techniques. For patients with disseminated gastric cancer, a palliative procedure can be performed to improve quality of life of patients and to avoid immediate death due to the cancer-related complications.

• Journal of Yeungnam Medical Science
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• v.20 no.2
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• pp.160-168
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• 2003

Background: Confirm the stability of intervertebral disc sustaining each fused lumbar spine cases, comparing vertical compression, A-P shear force and rotational moment on intervertebral disc of instrumented lumbar spine with simple vertical compression load and follower load using finite element analysis. Materials and Methods: We analyze the stability of intervertebral disc L4-5 supporting fused lumbar spine segments. After performing finite element modelling about L1-L5 lumbar vertebral column and L1-L4 each fusion level pedicle screw system for fused lumbar spine fine element model. Intervertebral discs with complex structure and mechanical properties was modeled using spring element that compensate stiffness and tube-to-tube contact element was employed to give follower load. Performing geometrical non-linear analysis. Results: The differences of intervertebral disc L4-5 behavior under the follower compression load in comparision with vertical compression load are as follows. Conclusion: As a result of finite element interpretation of instrumented lumbar spine, the stability of L4-5 sustaining fused lumbar segment, the long level fused lumbar spine observed hing stability under follower load. This research method can be the basis tool of effects prediction for instrumentation, a invention of a more precious finite element interpretation model which consider the role of muscle around the spine is loaded.

• Journal of Yeungnam Medical Science
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• v.20 no.2
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• pp.152-159
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• 2003

Background : Hyperlipidemia is the one of the major risk factors causing the atherosclerosis of coronary arteries. Treatment of hyperlipidemia with drugs has been confirmed the effects of therapy showing a decreased incidence of coronary artery disease. Simvastatin is a new drug of HMG-CoA reductase inhibitors and the short-term hypolipidemic effects and safety of simvastatin is evaluated in patients with hyperlipidemia. Methods: We studied 63 patients (39 males and 24 females, mean age 58) for 12 weeks whose plasma levels of total cholesterol were higher than 240 mg/dL or higher than 220 mg/dL with ischemic heart disease. Simvastatin was administered 20 mg/day and measured lipid profile at 12 week interval. Result: 1) Simvastatin significantly reduced the level of the plasma total cholesterol(-29.3%), LDL-cholesterol(-36.9%) and triglyceride(-13%)(p<0.05) but the level of HDL-cholesterol was not changed after 12 weeks simvastatin therapy. 2) the clinical symptoms and laboratory examination before and after simvastatin treatment showed no particular abnormal findings in short term follow up. Conclusion: These results suggested that short-term simvastatin therapy in patients with hyperlipidemia seeems to be very effective and safe.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.237-244
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• 1993

A free-floating ball thrombus in the left atrium is a rare complication of the mitral valvular disease. A 53-year-old man was admitted for pain and paresthesia on both legs. On admission he had auscultatory sign of mitral stenosis and mitral regurgitation, and the roentgenogram of his chest revealed a slight pulmonary venous congestion, enlargement of the pulmonary conus and cardiomegaly. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal. An echocardiographic examination revealed a mitral stenosis and a free-floating ball thrombus in the left atrium. We performed the emergent open heart surgery for removal of the ball thrombus and mitral replacement successfully with Duromedics 29 mm valve. The size of thrombus was $39{\times}32{\times}30$ mm.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.166-178
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• 1993

The objectives of this study were to evaluate the effect of methylphenidate on attention deficit hyperactivity disorder (ADHD) and the comorbidity of the disorder, using child attention problem checklist to 56 (male: 38, female: 18) patients from, March 992 to February 1993. The results were as follows: Among 56 subjects, ADHD alone were 20 (335.71%) subjects, and with one additional diagnosis were 31 (55.35%) subjects and with two additional diagnosis were 5 (8.93%) subjects. There was significant improvement on symptoms in the scores rated by teachers in 7th and 28th day after menthlphenidate administration compared to baseline score (P<0.05) and 28th day score showed significant improvement compared to 7th day score (P<0.05) and 28th day score showed significant improvement compared to 7th day score (P<0.05). There was significant improvement on symptoms in the scores rated by parents in 28th day after methylphenidate administration improvement compared with 7th day score. In single administration of methylphenidate in Sunday morning score compared to afternoon score (P<0.05). In the administration of significant improvement on symptoms compared with the Sunday morning rating score of parents (P<0.05) and the 28th day comparison was also showed significant improvement on symptoms in the scores rated by teachers compared with the scores rated by parents on symptoms (P<0.05). Among group comparison, all groups showed significant improvements (P<0.05) except conduct disorder & oppositional defiant group.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.157-165
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• 1993

The authors conducted a clinical observation of 13 cases of pulmonary aspergilloma at Yeungnam University Hospital from March 1983 to March 1992, and the following results were observed : 1) The male to female ratio was 1 : 1.2, and the age distribution was ranged 30 to 67 years old. 2) All cases were symptomatic : hemoptysis, cough, sputum and dyspnea. Especially, hemoptysis was the presenting compliant in 10 patients(77%). 3) The underlying lung disease were pulmonary tuberculosis in 9, COPD in 5 and bronchiectasis in 2, 3 cases were without underlying disease. 4) According to radiographic appearance, 8 cases had the typical crescent sign and 5 cases were seen nodular lesion. And the lesions of 11 cases were located in both upper lung. 5) 10 cases were treated with surgical resection. Among these cases, 8 cases were alieved and 2 cases, died. And other 3 cases were treated with conservative treatment. We suggest that these findings would be helpful for the diagnosis and treatment of pulmonary aspergilloma and further study might be needed to evaluate the prognosis of pulmonary aspergilloma.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.144-156
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• 1993

This study was performed to investigate the effect of octreotide on the contractility of rat vas deferens. The smooth muscle strips isolated from the prostatic portion were myographied in isolated organ bath, Electric field stimulation (monophasic square wave, duration: 1 mSec, voltage : 50 V, frequency : 5 Hz or 30 Hz, train: 10 Sec) produced reproducible contraction. The contraction was composed of two component, first phasic component (FPC) and second tonic component (STC). These contractions were abolished by tetrodotoxin ($1{\mu}M$). Octreotide inhibited the field stimulation induced contractions both FPC and STC concentration-dependently. The FPC was decreased by a desentization of purinergic receptor by pretreatment of mATP, and the STC was decreased by pretreatment of reserpine(3 mg/kg, IP) 24 hours before experiments. Octreotide reduced the field stimulation induced contraction in the presence of mATP and of reserpinized muscle strips. The inhibitory effect of octreotide was more potent at 5 Hz than at 30 Hz. Octreotide did not affect basal ton and exogenous norepinephrine- or ATP-induced contraction. These results suggest that octreotide inhibit the contractility of the isolated rat vas deferens by inhibition of the release of neurotransmitters, both ATP and norepinephrine from adrenergic nerve terminal.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.58-67
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• 1993

The author obtained index of red cell volume distribution width(RDW) and other red cell indices in 210 patients of various hematoncologic conditions and 200 healthy control group using, an automated blood analyzer, Coulter Counter Model S-plus II. This study performed to classify various etiologic anemia based on the MCV and RDW, to evaluate availability to the differential diagnosis in korean anemic distoders somewhat different from etiologies of anemias in foreginers. In the most of cases, the increase or decrease of MCV were always combined the pararell changes of MCH and MCHC. But the values of MCV and RDW were not correlated in control group and patient group. So the terms of heterogenous of homogenous anemia were meaningful morphologic classification than hypochromic or normochromic anemia. The heterogenous microcytic anemia contained iron deficiency anemia. In heterogenous normocytic anemia, myelophthisic anemia, acute leukemia were contained. In heterogenous macrocytic anemia, megaloblastic anemia, hemolytic anemia were contained. The homogenous microcytic anemia was observed in anemia of chronic disorders. In homogenous normocytic anemia, acute blood loss, chronic leukemia, multiple myeloma were contained. The aplastic anemia was belonged to homogenous macrocytic anemia. The diagnostic significance of RDW in hemoglobinopathies is most important. But this study was not contained hemoglobinopathies. Instead RDW was very helpful to differential diagnosis of most common anemias, iron deficiency anemia and anemia due to chronic disorders in Korea.

• Journal of Yeungnam Medical Science
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• v.11 no.2
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• pp.248-261
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• 1994

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 ischemic stroke patients. The central motor conduction time (CMCT) was represented by the difference of latency 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.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.37-47
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• 1993

It is commonly assumed that nasorespiratory function can exert a dramatic effect upon the development of the dentofacial complex. Specially, it has been stated that chronic nasal obstruction leads to mouth breathing, which causes altered tongue and mandibular positions. If this occurs during a period of active growth, the outcome is development of the "adenoid facies". Such patients characteristically manifest a vertically long lower third facial height, narrow alar bases, lip incompetence, a long and narrow maxillary arch and a greater than normal mandibular plane angle. But several authors have reported that so-called adenoid facies is not always associated with adenoids and mouth breathing, and that a particular type of dentition is not always found in mouth breathers with or without adenoids. Some authors have believed adenoids lead to mouth breathing in cases with particular facial characteristics and types of dentition. We assumed that the ability to adapt to individual's neuromuscular complex is various. So, we compared the difference of influence of mouth breathing between childrens who have different facial types. This study included 60 patients and they were divided into three groups by Rickett's facial type. Their dentition and tongue position were compared. The results are as follows. 1. There is a significant difference in arch width of upper molars between different facial types. Especially dolichofacial type patients have narrowest arch width. 2. There is a significant difference in tongue position between different facial types. Especially dolichofacial type patients have lowest positioned tongue.