• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.279-294
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• 1996

This study was carried out to develop a Korean language version of Zung's self-rating anxiety scale(SAS) from august, 1994 to September, 1996. The subjects consisted of 205 normal control subjects from the general population group, and 97 subjects with anxiety disorders. These 97 subjects were chosen from a group by the structured clinical interview for DSM-IV of in patients and out patients. Both normal control subjects and anxiety disorder subjects were drawn utilizing a cluster of sampling methods. In order to analyze the data on anxiety scores, Pearson's product moment correlation coefficient method was carried out, as well as reliability, factor analysis and discriminant function analysis, utilizing the SPSS/PC+ program. The results obtained were as follows: The mean average of the total anxiety scores were 32.36 + 6.35 for the normal control subjects and 50.53 + 7.67 for anxiety disorder subjects. Test-retest reliability(coefficient r=0.98, p < 0.001), and internal consistency(coefficient r=0.96, p < 0.001) were satisfactory. Factor analysis using oblique technique rotation yielded four factors. The normal control subjects scored higher concerning the symptoms such as sweating, restlessness, apprehension, insomnia and dyspnea, and lower for faintness, mental disintegration, paresthesia, dizziness and tremor. On the other hand, for the anxiety disorders, apprehension, restlessness, sweating, dyspnea and insomnia scored higher, and lower for faintness, paresthesia, nightmare, dizziness and tremor.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.243-250
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• 1996

Extravasation of toxic chemotherapeutic agents cause severe skin ulceration and necrosis which often need secondary surgical intervention. Still, there were not established antidote agent in case of extravasation with mitomycin-c. Dimethyl sulfoxide is known as an effective chemical scavenger of toxic hydroxyl free radical and sodium thiosulfate also was demonstrated significant protector from mitomycin-c induced ulceration by a few experimental studies. Author investigated necrotic area of mitomycin-c injected site and compare to the effectiveness of topical treatment with dimethyl sulfoxide and intradermal injection of sodium thiosulfate according to starting times, forty five mice were divided into 3 groups. Control group(n=5) had no treatment after subcutaneous injection of mitomycin-c. Experimental group I and II were 20 mice treated dimethyl sulfoxide and sodium thiosulfate, respectively. Depending on the starting time of treatment, group I and II were subdivided into 1, 2, 3 and 4 as immediate, 6 hours, 12 hours and 24 hours after mitomycin-c injection. Histologic studies of the necrotic area and survival area after treatment were performed using hematoxylin-eosin staining. The mean necrotic area of group I was significantly decreased depending on the starting time of treatment compared with control group(p<0.01). The results means there was no necrosis area which was treated with topical sodium thiosulfate within 6 hours, and it showed also significant decrease of necrosis area within 24 hours. There was also no necrosis area in group II-1 and significant decrease of necrosis area II-2 and III-3. But, effctiveness of intradermal injection of sodium thiosulfate was not found in group II-4 which was started after 24 hours. Hisotolgic findings showed a bland coagulative necrosis without inflammatory changes and no granulation tissue. The significant difference that cytoplasmic loss of subcutaneous fat and decrease number of hair follicles between two groups resulted from the methods of treatment by topical application and intradermal injection. In conclusion, immediate treatments with topical dimethyl sulfoxide or intradermal injection of sodium thiosulfate signifcantly prevents necrosis by extravasation of mitomycin-c.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.199-210
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• 1996

Infantile hypertrophic pyloric stenosis(IHPS), which occurs three of 1,000 live births, is a major cause of nonbilious vomiting of early infancy but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1993 to October 1996, 35 infants with IHPS were surgically treated and the following results were obtained. 1. Thirty-five patients comprised 32 males and 3 females, and the ratio of male to female was 10.7:1. 2. The most prevalent age group was between 2 weeks and 8 weeks. 3. Of 35 infants, first born babies were 23 cases(65.7%). 4. Breast feeding was in 23 cases(65.7%). 5. The body weight percentile at admission was lower than 50 percentile in all 35 cases. 6. Onset of symptoms was predominantly between 1week and 2 weeks in 11 cases(31.4%). 7. All had a history of nonbilious vomting, generally projectile in nature. 8. In the measured serum electrolytes, hypokalemia was noted in 9 cases(25.7%), hypochloremia was observed in 14 cases(40.0%). 9. In the preoperative ultrasonography, the average muscle thickness, diameter, and length of the pylorus were 6.2mm, 12.1mm, and 17.9mm, respectively. 10. Among 35 cases, significant sonographic criteria of IHPS, muscle thickness of 5mm or more, were noted in 26 cases(83.9%). 11. A total of seven associated anomalies were noted in six patients. 12. All 35 cases were treated with Fredet-Ramstedt pyloromyotomy. 13. There were postoperative complications of wound infection in 2 cases. Intermittent nonprojectile vomiting was presented in 8 cases(22.9%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.44-53
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• 1992

We compared the efficacy of each modality of treatment group in reducing the frequency of coronary artery abnormalities and changes of clinical courses in children with kawasaki disease in the children of 81 cases who were admitted in pediatric department of Yeungnam University Hospital from September 1985 to August 1990, Group A(37 cases)-aspirin alone, Group B(44 cases)-intravenous gammaglobulin(400mmg/kg/day) for 5 consecutive days, plus aspirin. We studied the frequency of echocardiographic abnormalities, the duration of fever, and changes in the total white blood cell counts, platelet counts, ESR and CRP value at 1, 2 and 3 weeks of the illness and compared the results between the two groups. The results were as follows, 1) There as no significant intergroup difference in age and sex ratio. 2) The duration of the febrile period after the initiation of the therapy was significant shorter in group B($2.5{\pm}1.2$ days) than in group A:($5.2{\pm}3.5$ days)(p<0.01). 3) No significant difference was noticed in the WBC and platelet counts in two groups as measured at admission day, 1 and 2 weeks of the illness. However, at 3weeks of illness significant difference was noted. 4) The CRP values measured at 1, 2 and 3 weeks after treatment were significantly lower in group B($2.42{\pm}1.8$, $2.00{\pm}1.2$, $1.16{\pm}1.0$) than in group A($7.22{\pm}5.3$, $5.25{\pm}3.9$, $1.85{\pm}1.2$) respectively(p<0.01). 5) In 2D- Echocardiogram, coronary artery dilataton was more frequent in Group A than in Group B at 6month of illness(p<0.01). In conclusion, intravenous gammaglobulin therapy was effective in the shortening of the duration of fever and in the antiinflammatory action and somewhat effective in prevention of coronary artery aneurysm.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.90-101
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• 1992

In rat kidney, the changes in concentrations of nucleotides and their derivatives during ischemia induced by renal artery ligation was measured quantitatively with high performance liquid chromatography(HPLC). After the ligation of renal artery for 60minutes, the concentrations of the nucleotides and derivatives were measured. In ischemic tissue, IDP was significantly decreased from $217.4{\pm}12.68{\mu}g$ in control to $80.7{\pm}18.39{\mu}g$ (p<0.01) ; ATP, $307.2{\pm}56.63{\mu}g$ to $47.6{\pm}5.95{\mu}g$ (p<0.01) ; ADP+AMP, $227.1{\pm}7.98{\mu}g$ to $61.4{\pm}3.92{\mu}g$(P<0.01); $NAD^+$, $217.9{\pm}4.49{\mu}g$ to $126.6{\pm}10.44{\mu}g$(P<0.01) ; GTP, $202.5{\pm}23.76{\mu}g$ to $117.7{\pm}14.24{\mu}g$ (P<0.05) ; GMP, $54.5{\pm}9.03{\mu}g$ to $23.7{\pm}0.46{\mu}g$(p<0.05), and inosine, $16.6{\pm}3.45{\mu}g$ to $7.8{\pm}0.87{\mu}g$ (P<0.05). But hypoxanthine and xanthine were significantly increased from $113.0{\pm}15.58{\mu}g$ to $159.7{\pm}12.07{\mu}g$ (P<0.05) and from $87.7{\pm}6.77{\mu}g$ to $173.1{\pm}12.52{\mu}g$ (P<0.01). In ischemic kidney, concentration of ATP was decreased to 39.9% of control at 10 minutes, 19.8% at 30 minutes, and 15.5% at 60 minutes, and ADP+AMP were decreased to 70.3% of control at 10 minutes, 67.3% at 30 minutes, and to 27.0% at 60 minutes, but hypoxanthine and xanthine were increased to 121.5% and 127.1% at 10 minutes, 126.0% and 174.4% at 30 minutes, and 141.4% and 197.3% at 60 minutes Total adenosine nucleotides were decreased to 20.3% of control during 60 minutes of ischemia, but hypoxanthine and xathine were increased to 157.5 % of control. These results suggest that the changes in the concentration of nucleotides and their metabolic derivatives are useful indices of the extents of tissue ischemia in rat kidney.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.29-43
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• 1992

A case-control study was conducted to investigate the association between the risk of cancer and selenium concentration in blood and toenails. Seventy three patients and two hundreds eighty three controls were, selected at the Yeungnam University Hospital between May and September in 1991. The selected cases were patients who had been hospitalized for stomach or colon cancer at the Depertment of General Surgery. The controls were people who visited to check physical examination at the Automated Mediscreening Center. The selenium concentration in whole blood and toenails were measured by atomic absorption spectrophotometer equipped with graphite furnace atomizer. The following information was ascertained for all cancer patients and controls : sex, age, body mass index, blood pressure, total serum cholesterol, and history of smoking and drinking. The mean selenium concentration in blood and toenail for all cancer patients were $143.6{\pm}10.8{\mu}g/l$ and $1.04{\pm}0.62{\mu}g/g$ and for the controls, $167.0{\pm}14.5{\mu}g/l$ and $1.15{\pm}0.55{\mu}g/g$, respectively. The difference in blood and toenail selenium concentrations of the two cancer sites was not statistically significant. Metastasis did not influence the concentration of selenium in blood and toenails. In the multiple logistic regression analysis, the blood selenium concentration($_aOR$: 0.888, 95% CI : 0.860-0.918), age, BMI and total serum cholesterol were significant variables for risk of cancer, but the selelenium concentration in toenail was not shown to be a significant variable in this regression analysis. The coefficient for blood selenium concentration adjusted for age, sex, diastolic blood pressure, total serum cholesterol, body mass index and smoking was -0.1184(p<0.01). These findings suggest that low selenium concentration is associated with gastrointestinal cancers. Further epidemiologic studies including important variables such as other antioxidant micronutrients will be necessary.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.54-67
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• 1992

The author studied the mental status of 497 patients admitted in non-psychiatric wards and 42 patients diagnosed as mental disorders by DSM-III-R criteria and admitted in three general hospitals located in Pusan city, using NADS and PSCS. The assessment were obtained from October, 1991 to March, 1992 and the results as follows: The mean ${\pm}$ SD of Anxiety-Depression scores were $34.4{\pm}10.4$ in non-psychiatric patients and $50.0{\pm}18.3$ in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. The mean ${\pm}$ SD of Psychosis scores were $3.9{\pm}4.4$ in non-psychiatric patients and $20.3{\pm}9.8$ in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. In the psychosocial factors, dissatisfaction in family atmosphere and acquaintanceship with parellts(P<0.001, relatively), pessimistic in future, present and past self-images(P<0.001, relatively), and yes in previous psychiatric treatment of admission(P<0.01, relatively) had common significant relationships to Anxiety-Depression and Psychosis scores. There were correlationships between NADS scores and PSCS scores(${\gamma}$ = 0.74), past and present self-images(${\gamma}$ = 0.45), present and future self images(${\gamma}$ = 0.45), past and future self-images(${\gamma}$ = 0.34) and family atmosphere and acquaintanceship with parents(${\gamma}$ = 0.49). The regression analysis revealed that present self-image, acquaintanceship with parents, future self-image, past self-image, and family atmosphere, in order of significance were to be descriptive or predicable variances for Anxiety-Depression status. The discriminant analysis according to Anxiety-Depression scores showed that the cases of incorrect classification were 22 for non-psychiatric patient group and 2 for psychiatric patient group.

• Journal of Yeungnam Medical Science
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• v.13 no.1
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• pp.59-77
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• 1996

A survey was conducted to study perception and attitudes of examinees of health screening center towards items, cost and procedures of health examination and degree of satisfaction with health examination, from March 2 to May 31, 1995. The study population was 468 examinees received health examination at Health Screening & Diagnosis Center of Yeungnam University Hospital. A questionnaire method was used to collect data. The followings are summaries of findings : Examinees were predominantly male(77.4%); had college education(68.6%), and held white-collar workers(57.8%). Statistical significance of association between frequency of periodic health examination and other variables were tested by chi-square test. Examinees who have higher degree of concern regarding health and those who practice more exercise for health maintenance received health examination more frequently. The majority expressed that health examination is very beneficial and effective in terms of prevention and early detection of diseases. Also the majority revealed that they are satisfied with health examination. The majority expressed that procedures and time spent for health examination are adequate; interval of health examination is one year; and additional examination items are cerebral examination, neurological examination and gastrofibercope. The majority revealed that they want more information about chronic degenerative diseases and health maintenance and promotion. In conclusion, the study revealed that examinees seemed to have more positive perceptions and attitudes towards health examination.

• Journal of Yeungnam Medical Science
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• v.13 no.1
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• pp.32-45
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• 1996

The AIDS is a serious health problem worldwide today and also in Korea. Increasing knowledge and modification of behavior by health education is an important goal of human immunodeficiency virus(HIV) prevention strategies. And school health education is an important part of health education. This study was conducted to evaluate the knowledge and attitude about AIDS in teachers and professors in Taegu City and to provide the basic data for school health education. A self-administered questionnaire was given to 1,124 teachers and professors from April to June 1992. Indeed, the majority of the teachers and professors have a lot of knowledges about AIDS, but many of them also have misconceptions. The level of knowledge about AIDS was positively associated with attitude toward infected students. The sources of knowledge about AIDS were mainly TV, newspapers and magazines, but a few of the subjects obtained their knowledge from health education programs. This study suggests that the reinforcement of health education for the teachers, professors and students he needed to provide the accurate knowledge on AIDS and adequate knowledge sources and materials for school health education on AIDS should be developed.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.211-224
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• 1996

The patients of developmental dislocation of the hip(DDH) are almost found after walking age because of early diagnosis of DDH in younger children is not easy. A controversy still exists as to the relative value of closed and operative management in the treatment of a child who has reached walking age. This study is a report of the results of 16 patients(17 cases) in developmental dislocation of the hip who have visited our hospital at the age of 9 months to 3 years old, and have been followed more than 12 months (12-112 months) on review of plain radiographs and arthrograms. The results were as follows : 1. The age at diagnosis was 16.4 months(9-31 months) in average. The methods of treatment were conservative for 8 cases, and operation for 4 cases and secondary operation for 5 cases who were failed with conservative therapy. 2. By Severin's radiologic grade, the result was good in 4 cases, fair in 3 cases and poor in 1 case in conservative treatment. In operative treatment, fair was in 2 cases and poor in 2 cases. In secondary operative patients who were failed with conservative therapy, good was in 2 cases, fair in 2 cases and poor in 1 case. 3. Avascular necrosis of femoral head was developed in 3 cases. 4. In the good reduction as determined by arthrogram according to Race and Herring, we can get a favorable result in conservative treatment, and in the poor reduction as determined by arthrogram, the better result in operative treatment can be expected.