Showing papers by "Yonsei University published in 1990"

A New Look at Filial Piety: Ideals and Practices of Family-Centered Parent Care in Korea

Abstract: This paper presents results of the analysis of 817 stories about Koreans who exemplify filial piety, a dominant value of East Asian nations. Corollaries were identified, such as types of care and services provided to elderly parents, motives for filial piety, kinds of emphases given in filial duties, and sacrifices endured for parents. The most outstanding dimensions underlying filial piety were respect, responsibility, family harmony and sacrifice. Findings provide both conceptual and practical tools for understanding and practicing filial piety.

The incidence of deep vein thrombosis after cementless and cemented knee replacement

Abstract: The incidence of deep vein thrombosis in 244 patients who had total knee replacement has been studied. In 120 the prosthesis was cemented and in 124 it was cementless. In all cases the replacement was primary and a porous-coated prosthesis with a porous-coated central tibial stem was used. Deep vein thrombosis was diagnosed by venography, and pulmonary embolism by perfusion scanning. The incidence of deep vein thrombosis in the cementless knees (23.8%) and in the cemented (25%) was approximately the same. The only significant predisposing factors for deep vein thrombosis in both groups were obesity, prolonged postoperative immobilisation, previous venous disease and hyperlipidaemia.

Clinical study of Marjolin's ulcer

Abstract: Marjolin's ulcer is the malignant lesion which develops in a burn scar or chronic fistula. Due to the low prevalence of this lesion, there has been disagreement regarding its clinical features, methods of treatment, and prognosis. We evaluated 19 cases of patients who had been admitted to Severance Hospital from Jan. 1970 to Dec. 1985. The results were as follows: The previous lesion was a burn scar in 52% of the cases and a fistula of chronic osteomyelitis in 32%. The mean latent period was 31.5 years. The initial symptoms were increased pain (74%), discharge with foul odor (68%) and bleeding (58%). Upon histological examination, all of the cases were squamous cell carcinoma. The rate of metastasis at the time of diagnosis was 32%. Of the 16 patients treated by surgery, local recurrence was noted in 4 cases. Three of these cases were patients who had been treated by excision and split thickness skin graft. The time interval for local recurrence ranged from 6 months to 11 months (average 8.8 months). In conclusion, the squamous cell carcinoma of marjolin's ulcer seems to have a worse prognosis than other squamous cell carcinomas and it requires aggressive treatment. The burn scar or chronic fistula that occurs in elderly patients especially requires more adequate treatment and close observation.

Lobar bronchioloalveolar carcinoma: "angiogram sign" on CT scans.

Abstract: The authors reviewed computed tomographic (CT) scans of 12 patients with lobar bronchioloalveolar carcinoma. Seven patients had consolidation of the entire lobe, and five patients had segmental consolidation. After contrast material was administered intravenously, the consolidated lung typically appeared on the scan as an area of homogeneous low attenuation, within which were enhanced branching pulmonary vessels (the CT angiogram sign). To evaluate the specificity of this sign in the discrimination of bronchioloalveolar carcinoma, CT scans of 26 patients who had lobar consolidation from other diseases were randomly mixed with the CT scans of 11 patients with bronchioloalveolar carcinoma. Two independent observers who were unfamiliar with the cases classified 10 and nine of the 11 patients with bronchioloalveolar carcinoma, respectively, as positive for bronchioloalveolar carcinoma by applying the CT angiogram sign, and classified as negative 25 and 23 of the 26 patients without bronchioloalveolar carcinoma, respectively, for an overall specificity of 92.3%. The angiogram sign appeared on the CT scan because of the low-attenuating consolidation, which was caused by the production of mucin or other fluid and the intact bronchovascular framework within the tumor.

Tuberculous bronchial stenosis: CT findings in 28 cases.

Abstract: Bronchial stenosis is a complication of tuberculous parenchymal or lymph node disease and may adversely affect its treatment. Findings on plain radiographs may be nonspecific or simulate malignancy. The purpose of this study was to evaluate the role of CT in diagnosing this abnormality. We reviewed the findings in 28 patients who underwent CT to evaluate bronchial stenosis proved by bronchoscopy. Eighteen had evidence of tuberculosis on bronchial biopsy. In the other 10 the biopsy findings were nonspecific, but tuberculous lesions were elsewhere in the thorax. Twelve patients (43%) had CT findings of concentric bronchial stenosis, uniform thickening of the bronchial wall, and involvement of a long segment of the bronchi. In 14 patients (50%), CT showed obliteration of bronchial outlines by adjacent lymphadenopathy, parenchymal consolidation, and absence of intraluminal air. In two patients, the abnormality was not visible on CT. Our experience shows that CT is useful for identifying bronchial stenosis caused by tuberculosis. However, the findings vary, and in more than half of the patients concentric narrowing and uniform thickening of the bronchi are not seen.

Purification and Properties of Arginase from Soybean, Glycine max, Axes

Abstract: Arginase (EC 3.5.3.1) was purified to homogeneity from cytosol of soybean, Glycine max, axes by chromatographic separations on Sephadex G-200, DEAE-sephacel, hydroxyapatite, and arginine-affinity columns. The molecular weight of the enzyme estimated by pore gradient gel electrophoresis was 240,000, while sodium dodecyl sulfate polyacrylamide gel electrophoresis gave a single band at the molecular weight of 60,000. The optimal pH for activity was 9.5 and the Km value was 83 millimolar. The enzyme was stimulated by polyamines such as putrescine.

The gastric juice urea and ammonia levels in patients with Campylobacter pylori.

Abstract: The authors studied gastric juice ammonia and urea nitrogen levels to determine how they are altered by gastric Campylobacter pylori (CP) infection. Patients with chronic gastritis (20), peptic ulcer (24), hepatic cirrhosis (10), chronic renal failure (13), or gastric remnant (20) were included. Endoscopic biopsy specimens stained with the Warthin-Starry stain were evaluated for the presence of CP. Blood and gastric juice analysis was performed for 11 of the patients with chronic renal failure and 37 patients from the remaining groups. CP was identified in gastric biopsies from 50 of 87 (57.5%) patients, including 87.5% with peptic ulcer and 40-50% of those with chronic gastritis, cirrhosis, chronic renal failure, or gastric remnant. CP infection had no effect on blood urea nitrogen or blood ammonia levels in any group of patients. The urea nitrogen level of gastric juice was higher in patients with chronic renal failure than in other groups but was not related to CP infection. CP infection was associated with a significant increase in gastric juice ammonia levels, both in patients with chronic renal failure (23.3 mmol/L vs. 2.90 mmol/L; [P less than 0.05]) and in other groups (5.48 mmol/L vs. 1.26 mmol/L [P less than 0.0001]). The authors conclude that elevation of gastric juice ammonia level is an indicator of gastric CP infection.

Histopathologic study of cutaneous lesions in Behçet's syndrome.

Abstract: Light microscopic studies of 55 patients with complete and incomplete types of Behcet's syndrome were reviewed. We reported here 39 skin biopsies from 30 patients with cutaneous lesions of oral, and genital ulcers, folliculitis, erythema multiforme, and thrombophlebitis. Leukocytoclastic vasculitis was seen in 5 of 12 (42%) cases of oral ulcers and 2 of 7 (29%) of genital ones. Lymphocytic vasculitis was demonstrated in 3 of 12 (25%) cases of oral ulcers and 4 of 7 (57%) of genital ulcers. However, the vasculitis was observed only locally in the areas with moderate or severe inflammation. From the biopsy specimens of our cases with fully developed mucocutaneous lesions of Behcet's syndrome, it appears that the forms of vasculitis that are often emphasized in the literature are a phenomenon secondary to the intense inflammation seen in such cutaneous lesions.

Mössbauer study of Cu0.5Fe0.5Cr2S4.

Abstract: ${\mathrm{Cu}}_{0.5}$${\mathrm{Fe}}_{0.05}$${\mathrm{Cr}}_{2}$${\mathrm{S}}_{4}$ has been studied by M\"ossbauer spectroscopy and x-ray diffraction. The crystal structure is found to be a cubic spinel with the lattice parameter ${a}_{0}$=9.922 A\r{}. The temperature dependence of both the magnetic hyperfine field and magnetization is explained by the N\'eel theory of ferrimagnetism using three exchange integrals: ${J}_{\mathrm{Fe}\mathrm{\ensuremath{-}}\mathrm{Cr}/{k}_{B}=\mathrm{\ensuremath{-}}}$13.7 K, ${J}_{\mathrm{Fe}\mathrm{\ensuremath{-}}\mathrm{Fe}/{k}_{B}=\mathrm{\ensuremath{-}}}$8.3 K, and ${J}_{\mathrm{Cr}\mathrm{\ensuremath{-}}\mathrm{Cr}/{k}_{B}}$=8.7 K.

Brain tumors diagnosed in the first year of life in five Far-Eastern countries. Statistical analysis of 307 cases.

Abstract: A statistical survey is presented of brain tumors diagnosed in the first year of life (from five Far-Eastern countries) in relation to the racial differences in tumor types, congenital factors, and general clinical features. Of the 307 cases collected, 262 were verified histologically, and astrocytomas comprised 23.3%, medulloblastomas 17.2%, ependymomas 11.1%, choroid plexus papillomas 10.7%, teratomas 8.4%, primitive neuroectodermal tumors 4.2%, meningiomas 2.3%, and others 22.9%. There were statistically significant racial differences in comparison with the worldwide survey done by the International Society for Pediatric Neurosurgery Education Committee (1987) on the same subject. In the Far-Eastern population, medulloblastoma and teratoma were more common (P<0.05), whereas astrocytoma was less frequent (P<0.01) than reported in the worldwide survey. The malformative factors were suggested in 18 cases in which various associated congential anomalies were observed. Vascular anomalous lesions, mostly in the extracranial organs, were most common, comprising 61.1% of the associated malformations. Hereditary factors were less commonly demonstrated in these tumors than were anomalies in the major congenital central nervous system. Among the 307 cases, there was one instance (0.3%) of nearly identical tumors occurring in twin brothers. The specific clinical manifestations of brain tumors involving the immature brain were again apparent in this survey, as were the poor survival rates and poor functional prognosis.

UV Treatment of Generalized Prurigo Nodularis

Abstract: A 55-year-old man was first seen in tbe Department of Dermatology in June 1988 for treatment of prurigo nodularis of 1 year duration (case 1). Allhougb tbe lesion was treated witb a topical and intralesional corticosteroid and antihistamine oral medication, new lesions spread to tbe trunk and extremities. When he came to our phototherapy clinic, more than 100 pruritic nodules were scattered over bis body (Fig. 1), and the severe pruritus disturbed bis sleep. We decided to use UVB treatment initially. Tbe radiation source used was an Ultralite V4472-1V (National Biological Corp., Atlanta, GA). The exposure schedule, in multiples of our patient's initial minimal erytbemogenic dose (40 mj/cm^), was tbe same as in Adrian's report.' Treatments were given tbree times a week. After several UVB treatments, there were no more new lesions and tbe pruritus decreased. When we bad completed 24 UVB treatments (total dose: 6234 mj/cm^), most of tbe pruritic nodules bad disappeared as well as tbe itching sensation (Fig. 2). To treat tbe remaining few large pruritic nodules resistant to UVB and intralesional corticosteroid treatment, we used 8-metboxypsoralen (8-MOP) topical PUVA tbree times per week for 2 montbs (total dose: 240 j/cm^). Tbe result of topical PUVA for tbe remaining lesions was excellent (Fig. 3). New prurigo nodularis lesions and tbe itching sensation after termination of the UV treatment were well controlled by application of a weak potency steroid ointment and antibistamine oral medication.

Production of monoclonal antibodies to lipoarabinomannan-B and use in the detection of mycobacterial antigens in sputum.

Abstract: Tuberculosis has traditionally been confirmed by AFB staining or culturing Mycobacterium tuberculosis from clinical specimens. However, because of the low sensitivity of the sputum smear examination and of the delayed report in culturing, the conventional methods for detection of M. tuberculosis have not been always satisfactory. In an attempt to develop an alternate tool, this study was initiated to produce monoclonal antibodies (MAb) to lipoarabinomannan B (LAM-B) antigen and to use the antibodies in detecting mycobacteria. In this study, five monoclonal antibodies specific to LAM-B were produced; LAM701 (IgG3), LAM138 (IgM), LAM204 (IgM), LAM302 (IgM), and LAM604 (IgM). A sandwich enzyme-linked immunosorbent assay (ELISA) was developed for detecting LAM-B and other mycobacterial antigens using the monoclonal antibodies. With the MAb LAM701, the minimal detectable concentration was 1.0 ng/ml for LAM-B, and 1.0 microgram/ml for M. tuberculosis whole cells, respectively. When 14 clinical specimens proven to contain AFB by smear staining or culture were examined, ten (71.4%) were positive by the sandwich ELISA; in contrast, sputum smear examination gave positive results in only six (42.9%) specimens. Meanwhile, none of 25 specimens with no evidence of AFB were positive by the sandwich ELISA using the MAb LAM701. Although further evaluations are required, this study suggests that the monoclonal antibodies to LAM-B may be useful in detecting mycobacteria from clinical specimens.

Hydride Generation Atomic Absorption Determination of Tellurium Species in Environmental Samples with in Situ Concentration in a Graphite Furnace

Abstract: An ultrasensitive method is described for the measurement of picogram amounts of tellurium species in environmental samples. The method involves selective Te(IV) reduction by sodium borohydride to hydrogen telluride, trapping in situ in a modified graphite furnace, and subsequent atomic absorption detection. The total amount of Te is determined after Te(VI) reduction to Te(IV) by boiling in hydrochloric acid. The difference between the amounts of Te(IV) and total-Te is taken as the amount of Te(VI). The absolute detection limit ranges from 2 to 4pg of tellurium. The precision of the method is 5.1% for 20pg and 2.5% for 200pg of tellurium. Analytical results are presented for natural waters, aerosol particles, geological and biological materials.

An experimental study on prevention of postlaminectomy scar formation.

Abstract: In repeat lumbar surgery for failed back syndrome, well organized fibrous scar tissue is often noted, binding together the dura, nerve roots, and paraspinal muscles. An animal experimental study was done to investigate the prevention of scar formation after lumbar laminectomy by using dacron and sodium hyaluronate. The experimental animals consisted of three groups: 1) control group, 2) D group (covering the laminectomy defect with dacron sheet), and 3) H group (covering the laminectomy defect with sodium hyaluronate gel). Animals were sacrificed at varying intervals (3-12 weeks) and the lumbar spines were evaluated with histologic preparations. Scar adhesion to the dura was most significantly suppressed in the D group, followed by the H group and the control group.

Pharmacokinetics of intravitreally injected liposome-encapsulated tobramycin in normal rabbits.

Abstract: Bacterial endophthalmitis, which is a devastating complication of intraocular surgery or eye trauma, has a poor prognosis. Intravitreal injection of antimicrobial agents has become a part of the standard treatment of endophthalmitis. The authors investigate the pharmacokinetics of intravitreal liposome-encapsulated tobramycin as a possible method of prolonging the duration of therapeutic concentrations. Tobramycin was encapsulated into liposomes of phosphatidylcholine, phosphatidic acid, and alpha-tocopherol by the reverse phase evaporation method. The final liposomal suspension contained tobramycin, 7.0 mg/ml, 60.5% encapsulated. One eye received an intravitreal injection of either liposome-encapsulated tobramycin (LET), tobramycin phosphated-buffered saline (TS) or a mixture of tobramycin and liposome-encapsulated saline (TEL), and the results were as follows: 1. Concentrations of free tobramycin were significantly lower with LET than with TS or TEL at 1 hour after intravitreal injection. 2. Concentrations of free and total tobramycin were significantly higher with LET than with TS or TEL at 5 and 8 days after intravitreal injection. Concentrations of free tobramycin with TS were lower than the minimal inhibitory concentration(MIC) of tobramycin for Pseudomonas aeruginosa at 8 days after intravitreal injection, while those with LET were higher than the MIC of tobramycin for Pseudomonas aeruginosa 18 days after injection.

Medical students' attitudes toward psychiatry in a Korean medical college.

Abstract: One hundred fifty four senior medical students responded to a questionnaire regarding attitudes toward psychiatry. A majority of students were favorable about psychiatric education, psychiatric consultation, and psychoanalysis. Students with more interest in psychiatry as a career showed both positive and negative views about psychiatry. They were more aware of psychiatry's drawbacks: psychiatrists' low income and other physicians' criticism. Future surgeons were more negative about psychiatry than were other physicians. Psychiatric programs should be organized not only for improving the negative views of the students who are choosing psychiatry, but for enhancing positive views of those who will not enter psychiatry. From this perspective, consultation-liaison psychiatry deserves an expansion of its role in the clinical clerkship.

An experimental study of healing of the partially severed flexor tendon in chickens.

Abstract: There is a lack of clinical and experimental studies of the treatment of incompletely transected tendons. The controversy concerning the source of flexor tendon nutrients is of important clinical concern in healing of the injured tendon; thus, the flexor tendon blood supply has cited as a reason for using specific tendon suture techniques, and as a rationale for preserving the superficialis tendon and its vincula during tendon repair surgery. Our knowledge of the normal physiology of digital flexor tendons and the mechanism of their healing process is deficient. The aim of this study was to investigate the relative importance of the synovial fluid and the blood supply respectively for the healing of partially severed flexor tendons. We observed the sequential histological and vascular changes which occur in healing of the partial lacerations in the dorsal and plantar aspects of the tendons. We observed the vascularities of the two partially severed tendon groups after injection of microfil and india ink through the femoral artery. In the healing process there was no sequential histological difference between the dorsal and the plantar severed tendons. The vascularity patterns of the healing tendons were significantly increased and the hypervascularity of dorsal severed tendons was greater than that of plantar severed tendons. Partially severed tendons were completely healed without surgical repair with dense collagen fibers without adhesion in most cases. We concluded from this study that the blood vessels appeared to play a significant role in the healing of the severed flexor tendons. An intact synovial environment did not seem to be required for healing of the severed tendon. It is not necessary to surgically repair the partially severed tendon for prevention of rupture and adhesion.

Children's Attitudes Toward the Elderly in Korea and the United States

Abstract: Children's attitudes toward the elderly in the cultures of Seoul, Korea, those of children of Korean heritage in the United States, and Anglo children in the United States were assessed. Two subtests, the Word Association and Semantic Differential of Children's Attitudes Toward the Elderly (The CATE) were used to assess attitudes toward the elderly. The results suggest that children's attitudes toward the elderly are complex and multidimensional. Children of Korean heritage in the United States rated the old more positively on the total score of the SD. These children, as did the Anglo children, rated the old as healthier and cleaner than did children in Seoul. Children of Korean heritage and those in Seoul viewed elders more frequently as right, good and friendly.

Male breast cancer--a 20-year review of 16 cases at Yonsei University.

Abstract: Sixteen cases of male breast cancer seen over a 20-year period were reviewed. The causes of cancer of the male breast are no better understood, but major alterations in hormonal environment could be a significant factor. Some clinical characteristics correspond well with the results of other series. The median age at presentation was 61.7 years. The most frequent initial symptom was a painless mass, and the incidences of nipple discharge, central tumor location, and axillary node involvement were high. Males also had a higher incidence of local advancement which was associated with a longer delay in seeking treatment and small breast tissue. The pathologic type was infiltrating ductal type in all cases except one, and all cases showed favorable nuclear grade. Estrogen receptor analysis was performed from the tumor of 2 patients. Both of them showed a high receptor level. There was no locoregional relapse in 5 patients who received adjuvant radiotherapy in contrast to the 2 relapses in 3 patients who underwent surgery alone. And three of the five patients who received radiotherapy suffered from systemic metastasis which suggested the important role of adjuvant chemotherapy as well as radiotherapy. In light of the encouraging results about adjuvant chemotherapy in the treatment for female breast cancer with axillary lymph node involvement, it would be desirable to extend this policy to male breast cancer.

A clinicopathological study of Kimura's disease and epithelioid hemangioma.

Abstract: The clinicopathological features of 9 cases of Kimura's disease and 5 cases of epithelioid hemangioma(EH) were reviewed. Patients with Kimura's disease presented with multiple or solitary large tumors occurring in the thigh, arms as well as parotid gland. Histologically, the lesions were characterized by numerous lymphoid follicles with proliferation of post-capillary venules lined by plump endothelium and a marked eosinophilic infiltration. Patients with EH were older than those with Kimura's disease and presented papular nodular lesions, less than 1 cm in size. Microscopically, there was proliferation of blood vessels lined by epithelioid endothelium with infiltration by lymphocytes and eosinophils. Although there may occasionally be clinicopathological overlap between Kimura's disease and EH, we consider that these two disorders can be recognized as separate entities.