• Journal of Yeungnam Medical Science
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• v.23 no.1
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• pp.36-44
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• 2006

Background: There is controversy regarding whether COX-2 specific inhibitors are associated with elevation of blood pressure. We compared the effects of aspirin, indomethacin, and celecoxib for vascular reactivity induced by phenylephrine. We also tested the effects of indomethacin and NO donor on COX-1 and COX-2 protein expression, as well as nitrite production in culture medium of vascular smooth muscle cells. Materials and Methods: In this experiment, we used the isometric tension study for vascular reactivity. After 45 minutes of pretreatment with aspirin, indomethacin, celecoxib, and phenylephrine induced contractions were tested. COX-1 and COX-2 protein expressions were analyzed by Western blot and nitrite production by the Griess reaction. Results: Although celecoxib pretreatment caused enhanced arterial contraction, aspirin pretreatment induced more potent arterial contraction than celecoxib in the isometric tension study of rabbit femoral artery. COX-1 protein expression was unchanged by indomethacin, SNP and NOR-3; COX-2 protein expression was increased by the addition of indomethacin, SNP, and NOR-3. Especially, NOR-3, a NO donor, significantly increased COX-2 protein expression with unstimulated conditions as well as LPS stimulation. Induction of nitrite production was higher with NOR-3 treatment than SNP treatment with LPS stimulation. Conclusion: These results suggest that aspirin caused more potent vascular contraction than celecoxib and indomethacin. COX-2 expression in VSMC depended on the types of NO donor and LPS stimulation.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.59-66
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• 2001

Background: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. Materials and Methods: From January 1998 to December 1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication. success rate and patient's satisfaction were evaluated. Results: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication. bladder perforation occurred in one patient(2.4%). residual urine sensation developed in seven patients(16.7%), and suprapubic pain was complained in five patients(11.9%), which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instability were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. Conclusion: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence, but a longer follow-up is necessary to determine long term effect.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.51-58
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• 2001

Background: Cholestatic hepatitis is failure of bile to reach the duodenum with hepatocellular damage and no demonstable obstruction of the major bile ducts. The prognosis is usually good with recovery in less than 4 weeks after withdrawal of the offending drug. However, a prolonged course lasting over 3 months is possible and, in rare cases, progression to ductopenia with development of a vanishing bile duct syndrome occurs. A differential diagnosis with other causes of Chronic liver disease is needed. Materials and Methods: From January 1991 through January 2000, 14 patients diagnosed as cholestatic hepatitis by liver biopsy were included. The possible causative drug, clinical features, laboratory findings, and progression of cholestatic hepatitis were evaluated. The semiquantitative study of liver lesions was performed by two independent observers. Results: Causes of cholestatic hepatitis are 5 cases of oriental medicine, 3 cases of anti-tuberculosis medication, 1 case of ticlopidine and antibiotics and 4 cases of unknown causes. The clinical features of cholestatic hepatitis were jaundice, itching, urine color change, and general weakness. During 6 to 30 months, LFT of 5 patients showed prolonged elevation. Elevated total cholesterol ${\geq}$250 mg/dL in 6 patients, pheripheral blood eosinophilia in 5 patients, auto-antibody positive in 6 patients were observed respectively. The biopsies showed intralobular bilirubinostasis with a mixed portal inflammatory infiltration. Conclusion: In cholestatic hepatitis, durations of abnormal LFT are variable regardless of causative drugs. If cholestatic hepatitis progresses toward chronic course, viral hepatitis, primary biliary cirrhosis, and autoimmune hepatitis should be differentially diagnosed and sequential liver biopsies are needed.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.39-50
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• 2001

Background: Power spectrum analysis method is a powerful noninvasive tool for quantifying autonomic nervous system activity. In this paper, we developed a data acquistion system for estimating the activity of the autonomic nervous system by the analysis of heart rate and respiratory rate variability using power spectrum analysis. Materials and methods: For the detection of QRS peak and measurement of respiratory rate from patient's ECG, we used low-pass filter and impedence method respectively. This system adopt an isolated power for patient's safety. In this system, two output signals can be obtained: R-R interval heart rate) and respiration rate time series. Experimental ranges are 30-240 BPM for ECG and 15-80 BPM for respiration. Results: The system can acquire two signals accurately both in the experimental test using simulator and in real clinical setting. Conclusion: The system developed in this paper is efficient for the acquisition of heart rate and respiration signals. This system will play a role in research area for improving our understanding of the pathophysiologic involvement of the autonomic nervous system in various disease states.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.30-38
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• 2001

Background: The purpose of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging for monitoring the response to radiation therapy in metastatic bone marrow of the spines. Materials and Methods: Twenty-one patients with metastatic bone marrow of the spines were examined with MRI. Diffusion-weighted and spin-echo MRI were performed in 10 patients before and after radiation therapy with or without systemic chemotherapy, and performed in 11 patients after radiation therapy alone. Follow up spin-echo and diffusion-weighted MRI were obtained at 1 to 6 months after radiation therapy according to patients' condition. The diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF). Signal intensity changes of the metastatic bone marrows before and after radiation therapy on conventional spin-echo sequence MRI and diffusion-weighted MRI were evaluated. Bone marrow contrast ratios and signal-to-noise ratios before and after radiation therapy of diffusion- weighted MRI were analyzed. Results: All metastatic bone marrow of the spinal bodies were hyperintense to normal bone marrow of the spinal bodies on pretreatment diffusion-weighted MRI and positive bone marrow contrast ratios(p<0.001), and hypointense to normal spinal bodies on posttreatment diffusion-weighted MRI and negative bone marrow contrast ratios(p<0.001). The signal to noise ratios after treatment decreased comparing with those of pretreatment. Decreased signal intensity of the metastatic bone marrows on diffusion-weighted MRI began to be observed at average more than one month after the initiation of the radiation therapy. Conclusion: These results suggest that diffusion-weighted MRI would be an excellent method for monitoring the response to therapy of metastatic bone marrow of the spinal bodies, however, must be investigated in a larger series of patients with longer follow up period.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.123-137
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• 2001

Background: The purpose of this study is to evaluate the accuracy of measurements obtained from 3-dimensional computerized tomography and 3-dimensional cephalogram constructed by using the frontal and lateral cephalogram of six human dry skulls. Materials and Methods: After CT scans and each cephalograms were taken, 3-dimensional coordinates (X, Y, Z) of landmarks were obtained using computer programs. In this study, the accuracy of both methods were determined by means of 14 linear measurements compare with caliper measurements. Results: The standard deviation of landmarks of 3-dimensional CT and 3-dimensional cephalogram were 0.23 mm, and 0.30 mm in X axis, 0.27 mm and 0.25 mm in Y axis, and 0.27 mm and 0.31 mm in Z axis. In both methods, the standard deviation were less than 0.5 mm in all landmarks, and the most of landmarks showed less than 1 mm in range. Concerning the accuracy, the mean difference between 3-dimensional CT and manual measurements was 0.33 mm, and 1.13 mm between 3-dimensional cephalogram and manual measurements. The distance between RGo and LGo showed the largest difference (2.03 mm). There were highly significant, and large correlation with manual measurements in both methods (p<0.01). Conclusion: It is concluded that closeness of repeated measures to each skulls reveal the precision of both methods. Computerized tomography and cephalogram for 3-dimensional measurement of maxillofacial structure are equivalent in quality to caliper measurements.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.112-122
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• 2001

Background: Cleft lip and palate deformity have unknown patterns of maxillofacial growth and development. The maxillofacial growth can be affected either by congenital or environmental factors such as infection and trauma. Surgical repair of cleft lip and palate may interfere the subsequent growth and development of maxillofacial region. The purpose of this study is to evaluate the characteristics of maxillofacial growth patterns in adult cleft lip and palate patients. Materials and Methods: The material for this study consisted of 17 adult male patients with cleft lip and palate. Cephalometric tracing and measurements were done by one investigator. The relationship between 17 cleft lip and palate patients and Korean norms were evaluated statistically. Results: There were statistically differences in Na. perpendicular to point A, SNA angle, effective maxillary length, maxillofacial differencial. Wit's appraisal and upper incisor to point A(p < 0.01). Pogonion to Na. perpendicular also statistically differed(p < 0.05). Other measurements didn't statistically differ. Conclusion: It was evident that in adult cleft lip and palate patients, maxilla was retruded and short. Careful cleft lip and palate repair and treatment are recommended for facilitating normal growth of maxilla.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.94-100
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• 2001

Background: It is doubtful that aging causes deteriorated glucose metabolism and insulin resistance of skeletal muscle. Some researchers had different results about it. So we have studied the mechanism responsible for the abnormal glucose tolerance associated with aging in rapidly growing and matured rats. Materials and Methods: Animals were used S.D. rats. Growing rats were 7 weeks old (BW: 160-190 gm) and matured rats were 28 weeks old (BW: 420-525 gm). Results: Fasting blood glucose and plasma insulin levels were significantly elevated in matured rat compared with growing rats. And during oral glucose tolerance test the glucose level was also significantly elevated in matured rats. These results confirmed an insulin resistant state of aging. Insulin levels at 30 minutes of oral glucose tolerance test was significantly elevated in growing rat. But at 120 minutes it was maintained at higher level in matured rats than in growing rats. It suggested the possibility of increased insulin secretion by initial stimulation of beta-cells in growing rats, and increased secretion and decreased catabolic rate of insulin in matured rats. Glucose uptake rate of soleus muscle in matured rats was lower than that of growing rats, but the difference was not statistically significant. The dose(insulin)-responsive(glucose uptake) curve of soleus muscle was only slightly deviated to the right side. Conclusion: Glucose metabolism of rat skeletal muscle was worsened by aging. The data of glucose uptake experiments suggested the possibility of insulin resistance of skeletal muscle in matured rats. but the mechanism of insulin resistance of skeletal muscle need further studies.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.85-93
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• 2001

Background: The number of glomerulus has been considered one of the etiologic factors especially for focal segmental glomerulosclerosis. However, glomeruli are too many to calculate them correctly. Although the fractionator method has became convinced, in which they used selected sections, not whole kidney sections, with same intervals, it is also very hard to get good results. Because it is still very time-consuming and laborous work which leads to make big observers' biases. Methods and Materials: We designed the index for glomerular number to estimate the tendency of increase or decrease of the number of it in different kidneys and which was evaluated by other conventional methods including fractionator method. Index was based upon the theory by Nyengaard; "the number of glomerulus correlates with the weight of kidney, which is positively correlated with body weight". Calculating formula is the number of glomeruli/surface areas of cortices, which contain calculated glomeruli multiplies by kidney weight/body weight. Results: We applied this index to kidneys of FGS/Kist mouse and those of RFM/Nga mouse. The former is spontaneous glomerulosclerosis model with heavy protein uria and renal failure and the latter is the mother side of FGS/Kist mouse but has no glomerular disease or protein uria. The number of glomerulus of FGS/Kist mouse was decreased by 30% to those of RFM/Nga mouse. Conclusion: This index was useful and reliable for estimating the relative glomerular number between two groups.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.67-74
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• 2001

Background: Meralgia paresthetica(MP) which is characterized by paresthesias and sensory impairment without motor weakness in the anterolateral aspects of the thigh is produced by compression of the lateral femoral cutaneous nerve(LFCN). Even though the diagnosis of MP is mostly based on the clinical symptoms, electrophysiologic study is mandatory to confirm the disease objectively. It has been known that Somatosensory evoked potential(SSEP) study of LFCN is a simple and very useful method to evaluate MP, so we studied SSEP of LFCN in normal adults and offer normal values. Materials and Methods: Thirty six normal adults(23 males and 13 females) ages from 21 to 73 years old($mean{\pm}SD$:$42.06{\pm}15.74$) were studied SSEP of LFCN bilaterally. The stimulation site was anterolateral aspect of thighs and the recording site was Cz'. Results: The mean values($mean{\pm}SD$) of $LP_0$, $SP_0$, $LN_1$ and $SN_1$ of all subjects were 35.10(${\pm}2.42$), 33.80(${\pm}2.4$), 43.68(${\pm}1.88$) and 42.16(${\pm}2.12$) and the mean values($mean{\pm}SD$ of $DP_0$, $DN_1$ and DA(${\mu}V{\pm}SD$ were 1.30(${\pm}1.14$), 1.52(${\pm}1.38$) and 0.32(${\pm}0.33$). Conclusion: For the diagnosis of MP. comparison of latency difference between both sides is more reliable than simple value of latency itself because of individual differences of body types. According to our results. the latency difference should be less than 2 msec and the amplitude difference was less than 1.6 times in normal adults.