• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.245-261
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• 1997

Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.155-167
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• 1997

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.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.168-174
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• 1997

Alphafetoprotein(AFP) is a glycoprotein synthesized by the fetus early in gestation by the yolk sac and later by the gastrointestinal tract and liver. The concentration of AFP is highest in fetal serum and amniotic fluid around 13th week, and 32nd week in maternal serum. Some conditions are associated with abnormal maternal serum AFP concentration. For examples, neural tube defects, omphalocele, renal anomalies are associated with elevated maternal serum AFP and fetal death, chromosomal trisomies are associated with low level of maternal serum AFP. So maternal serum AFP screening plays a significant role in assessing candidates for prenatal diagnosis and prenatal counselling in pregnant women. This study evaluates the normal ranges of AFP using enzyme immunoassay in normal pregnant women. We studied 500 normal pregnant women who visited the Department of Obstetrics & Gynecology, Yeungnam Medical Center, Yeungnam University during the period through January, 1993 to September, 1996. The group of the study were selected randomly at various gestational ages from 8 to 41 weeks. The results were summarized as follows: 1. The lowest level of AFP in our study group was 2.1ng/ml at 8 weeks of gestation. Thereafter serum alpha-fetoprotein concentrations rose rapidly to reach a peak value at 32nd week. 2. The mean levels of AFP in the primipara and multipara were $166.37{\pm}12.06ng/ml$, and $223.78{\pm}14.00ng/ml$, respectively, showing stastiscally significant difference between these two groups(p<0.01). 3. The mean levels of AFP between mothers who delivered male and female babies were $192.96{\pm}13.00ng/ml$, and $194.29{\pm}13.84ng/ml$, respectively, without statistically significant difference(p>0.05). 4. The normal ranges of maternal serum AFP according to each gestational week were evaluated.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.123-136
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• 1997

The purpose of this study was to examine the reliability and validity of a Korean form of Childhood Attention Problem(CAP) scale. CAP were administered to 98 normal elementary school students as control group and 98 attention deficit hyperactivity disorder patients. Male students showed high scores than female students in both subscale and total scores, but not statistically significant. There were no significant difference in CAP scale between male students and female students in attention deficit hyperactivity disorder patients. In the reliability test, the test-retest reliability coefficient was highly satisfactory and that of inattention subscale was 0.83, impulsivity subscale was 0.70 and total score was 0.82. In the reliability test by internal consistency, the Cronbach $\alpha$ coefficient was highly satisfactory and that of inattention subscale was 0.91, overactivity subscale was 0.89(p<0.05). The concurrent validity between CAP scale and ADDES-BV scale was 0.85 in attention deficit hyperactivity disorder patient group and 0.73 in normal control group(p<0.05). In discriminant validity test between attention deficit hyperactivity disorder patient group and normal control group, the patient group showed higher score(p<0.05). The total discriminant capacity of the patient group in CAP was 93.4%. In this point of view, CAP scale showed high reliability and validity in applying to Korean subjects and was proved to be the good and simple screening test tool for attention deficit hyperactivity disorder research and can help many young patient to treat early.

• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.139-148
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• 1987

The community health practitioners (CHP) play an important role in primary health care services to the underserved population in rural area. Time and motion study of 26 CHPs in Kyungpook Province was conducted through work diary method for 6 consecutive days from the time they arrived until they left the primary health post(PHP) during the past 3 weeks from November 16 to December 5, 1987. The allocation of activity time by working category, service category, location of activity and CHP's function was analyzed according to the characteristics of CHPs i. e., age, marital status and experience as CHP. The major findings are as follows : The mean activity time per CHP in a week was 2,918 minutes. The length of their working hours was longer for older, married and more experienced CHPs than others. About 80% of the CHP's activities took place within the PHP and only about 20% occured outside of the PHP. Working hours for the outdoor activities were longer for younger, single and less experienced CHPs than others. The allocation of activity time by working category showed 46.3% in the technical work and 18.7% in the administrative work. Working hours for the technical activities were longer for younger, single and less experienced CHPs than others. The percentage of activity time revealed greatest as much as 63.1% for direct patient care in technical work and 61.6% for record keeping in administrative work. Of the total working hours in a week, direct patient care and public health activities accounted for 29.2% and 16.2%, respectively. Of the indoor activities, working hours for direct patient care were longer than those for public health activities. However, of the outdoor activities, working hours for public health activities were longer than those for direct patient care. The allocation of activity time by CHP's function showed 49.7% in management of common disease, 31.8% in management of PHP and technical supervision of village health workers, 9.5% in MCH and family planning, 6.6% in community health management and 2.4% in community approach. Based on these findings, it was found that CHPs were mainly working in the PHP with a majority of their time being spent for direct patient care rather than preventive and promotive health cares. To enhance the preventive and promotive health services of the CHPs and to involve the activities for community development, refresher course for CHPs should be reinforced and supervision mechanism of the CHPs should be established and operated in Gun- and province-level.

• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.113-120
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• 1987

The effect of intravesical formalin instillation as a therapeutic modality for intractable bladder hemorrhage is well known. And despite clear evidence of therapeutic efficacy of intravesical cytotoxic drugs and/or BCG immunotherapy, there have been substantial recurrences during followup after transurethral resection for superficial bladder tumor. If formalin injected at the bed of superficial bladder tumor is able to coagulate and necrotize the tumor, it will be greatly helpful to the patients With recurrent bladder tumor developed during followup. Since this technique is applicable on outpatient basis, an economical as well as a psychological burden of the patients can be reduced considerably. The purpose of this study is to evaluate the effect of submucosal formalin injection on rat bladder wall, 36 healthy adult male Sprague-Dawley rats (weighing 350gm in average) were divided into 3 groups: In Group I (control group), 0.01ml of normal saline was injected submucosally at the left posterolateral wall of the bladder opened under intraperitoneal Nembutal anesthesia ; In Group II and III, 0.01 ml of 10% and 4% formalin, respectively, were administered at the same site as in the Group I, two rats in each group were sacrificed at day 1, 2, and 3, and week 1, 2 and 4 after injection, respectively. Gross and microscopic examination of the cystectomized specimen were done in each group. In the Group II, bladder stones were formed at week I, and in both the Group I and III, stones were seen at week 2 post injection. There was no significant difference III histologic findings of the bladder between the group II and III. Mucosal ulcer and/or prominent mucosal disruption was observed at 24 hours after injection in both Group II and III. Epithelial regeneration began at day 2, and was marked at day 3, and epithelial lining was almost normalized one week after injection. Subepithelial edema, telangiectasia and inflammatory reaction were prominent at 24 hours post formalin injection. Subepithelial edema persisted in moderate degree for 1 week. Telangiectasia and inflammatory reaction were noted for 4 weeks. Mild degree of these findings also appeared In the control group. Fibroblastic proliferation appeared at day 2 and persisted in moderate degree for 4 weeks. There has been no mortality or bladder perforation. These results suggest that clinical application of this technique is feasible for the selected cases of recurrent, solitary superficial bladder tumor. However, optimal dosage of formalin in relation to the size of the lesion remains to be investigated.

• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.121-129
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• 1987

To evealuate the status of hepatitis B virus infection in the mothers and neonates and to determine the maternal-neonatal transmission of hepatitis B virus, 2,276 term pregnant women were screened for the presence of serum HBsAg, at the Department of Obstetrics and Gynecology, Yeungnam University Hospital, during the period of 18 months from Jan. 1986 to Jun. 1987, and the sera of sixty-six HBsAg carrier mothers and their neonates were tested for HBV markers and liver enzymes. The results were as follows : 1. The prevalence rate of asymptomatic HBsAg carrier in the term pregnant women was 4.7%(53/1,279). 2. Positive rates of HBsAg and anti-HBs 10 the sera of sixty-six neonates born to asymptomatic HBsAg carrier mothers were 12.1% and 9.1%, respectively. Transient elevation of SGOT(three to four times of upper normal limit) was detected in one of eight HBsAg-positive neonates and one of six anti-HBs positive neonates. 3. Positive rates of anti-HBc, HBeAg and anti-HBe to the sera of sixty-six asymptomatic HBsAg carrier term pregant women were 93.9%, 45.5% and 50%, respectively. The rates of transmission of maternal anti-HBc, HBeAg and anti-HBe to the neonates were 85.5%(53/62), 90%(27/30) and 87.9%(29/33). respectively. 4. Serum HBsAg was detected in four of thirty neonates born to HBeAg positive HBsAg carrier mother, three of thirty-three neonates born to anti-HBe positive HBsAg carrier mothers, and one of three neonates born to both HBeAg and anti-HBe negative HBsAg carrier mothers.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.102-109
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• 1992

Bone metastases represent an important and frequent clinical problem in patients with advanced cancers. Especially, painful bone metastases are common features in these patients. Radiotherapy is an effective tool for palliative aim of painful metastatic osseous lesions. Various treatment results have been previously reported. The present retrospective study was aimed to evaluate the efficacy of palliative irradiation on pain relief, with the goal of selecting appropriate irradiation dose schedule. Radiotherapy consisted of 5times a week with a various fractional dose between 180 and 400cGy. The response of pain relief and the survival time after completion of radiotherapy are related to total dose and most of the patients have shown a similar response by the end of radiotherapy. The higher dose and the more aggressive multimodality treatment, the better pain control and the longer survival time.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.111-125
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• 1988

The authors studied obsession, using Derogatis'SCL-90, and lie tendency using MMPI, in the subjects of 2586 male and 1206 female college freshmen of Yeungnam University. The authors collected the reports of self-rating Obsession scale and Lie scale during the periods from January to February, 1988, and applied ANOVA and t-test on obsession and lie scores in order to compare than between various psychosocial factors, and sexes. The results as follows: 1. There was not significant difference in the mean average of total obsession scores between male and female students: male students scored $10.26{\pm}5.21$, female students scored $10.54{\pm}5.01$. 2. High scored items were doubting, indecisiveness, inattention, obsessive thoughts and preoccupation with accuracy. 3. 37 male students(1.4%) showed high obsession scores of 25 or higher, while 9 female students(0.7%) showed thd same scores. 4. There was strong tendency toward higher obsession scores in the students who were dissatisfied with their home atmosphere, college, department and familiarity of parents and those who had pessimistic view of self in the past, present or future in both group(respectively P<0.001). The male students who attended the department of fine arts, who grew at the Up & whose educational fees were paid by brothers & sisters showed higher level of obsession scores(respectively P<0.05, P<0.05, P<0.01). The female students who grew at the Myun & who were self-cook showed higher level of obsession scores(respectively P<0.05). 5. There was not significant difference in the mean averages of total lie scores between male and female students: male students scored $4.73{\pm}2.49$, female students scored $4.70{\pm}2.16$. 6. High scored items were NO. 14, 8, 11, 9 and 1 in the table 6. 7. 98 male students(3.7%) showed high lie scores of 70 or high, while 27 female students(2.2%) showed the same scores. 8. There was strong tendency toward higher lie scores in the students who were satisfied with their home atmosphere, college, department and familiarity of parents and those who had optimistic view of self in the past, present or future in both group(respectively P<0.001). The students who attended the department of pharmacy, music, evening programs showed higher level of lie scores(P<0.05).

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.93-100
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• 1988

In clinical practice, creatinine clearance(Ccr) remains the most commonly used laboratory assessment of glomerular function despite methodological and technical problems of urine collection. Schwartz et al. in 1976, reported that an accurate estimate of glomerular filtration rate(GFR) could be obtained from the simple determinations of plasma creatinine(Pcr) and body length(L) : GFR($m{\ell}/min/1.73m^2$=k L(cm)/Pcr(mg/$100m{\ell}$), (k=constant). The subject of this study were ill children admitted to our pediatric department from July, 1985 to June, 1987 and they were divided into three groups; group I, from 1 to 5 years old, group II, from 6 to 10 years old, group III. from 11 to 15 years old. The results were as following ; 1) Measured creatinine clearance($Ccr_M$, $m{\ell}/min/1.73m^2$) were $109.73{\pm}9.97$ in group I, $108.26{\pm}9.02$ in group II, $96.20{\pm}4.72$ in group III and $105.48{\pm}5.23$ in all age group. 2) Measured k($k_M$) obtained from $Ccr_M=k$ Ht/Pcr were $0.49{\pm}0.03$ in group I, $0.48{\pm}0.02$ in group II, $0.43{\pm}0.02$ in group III, and $0.47{\pm}0.02$ in all age group.(Ht ; height) 3) Linear equations and correlation coefficients between Ht/Pcr(x) and Ccr(y) were y=0.822x-65.63(r=0.99) in group I, y=0.61x-23.46(r=0.72) in group II, y=0.18x+54.44(r=0.54) in group III and y=0.58x-22.13(r=0.81) in all age group. 4) $Ccr_E$ was again estiamted from linear equations between Ht/Pcr and $Ccr_M$ and $k_E$ was calculated with Ht/Pcr and $Ccr_E$ were $0.48{\pm}0.01$ in group I, $0.49{\pm}0.01$in group II, $0.43{\pm}0.01$ in group III and $0.47{\pm}0.00$ in all age group. 5) Consistant values of $k_E$ and $k_M$ were highly significant as 95~97.5% in group I and II, 90~95% in group III and 97.5~99% in all age group. In summary, we could estimate GFR with height, plasma creatinine and measured k($k_M$) according to the age in easy and rapid way.