BACKGROUND: There are significant concerns about emerging antibiotic resistance that are largely due to the inappropriate use of antibacterial agents for viral respiratory infections. We explored clinicians' attitude on antibiotic prescription for patients with respiratory tract infections (RTIs) using survey. METHODS: A random, stratified sample of physicians in Seoul, Gyeonggi, and Incheon was surveyed with a mailed questionnaire, and 353 clinicians completed information. A total of 344 were included in the final dataset after excluding incomplete data with missing information (response rate 34.4%). RESULTS: Among 344 physicians, those who would prescribe antibiotics in scenario patient were 39.2%, wait and prescribe 30.5% and not prescribe antibiotics 30.2%. Those who believed antibiotics would help treatment of acute sinusitis were 83.7%, acute pharyngitis 36%, acute tonsillitis 86.3%, acute bronchitis 64% and acute lower respiratory diseases 66.9%. In logistic regression analysis, those who were located in Gyeonggi region and those who believed antibiotics help treatment of tonsillitis and suppurative otitis media would prescribe antibiotics in scenario patient significantly more, whereas those who believe antibiotics help treatment of acute pharyngitis and lower respiratory disease prescribe antibiotics less. CONCLUSIONS: Physicians' attitude to antibiotics in respiratory disease has a significant effect on antibiotic prescription for RTIs. Interventions such as practice guidelines and patient education to optimize antibiotic prescription should take this effect into account.
Anti-Bacterial Agents ; Bronchitis ; Drug Resistance, Microbial ; Humans ; Logistic Models ; Otitis Media, Suppurative ; Palatine Tonsil ; Patient Education as Topic ; Pharyngitis ; Postal Service ; Prescriptions* ; Respiratory Tract Diseases ; Respiratory Tract Infections* ; Sinusitis ; Tonsillitis ; Surveys and Questionnaires

PURPOSE: To evaluate the morphologic characteristics and anatomical variation of the foramen ovale(FO) and its relationship with adjacent foramina. MATERIALS AND METHODS: We evaluated 305 HRCT studies of the temporal bone in patients without having any disease that might alter the foraminal anatomy. This study focused on the variations in presence, shape, size, location and relationship with each other. RESULTS: The shapes of FO were 6 types(ovoid :75.2%, pyriform, elongated, round, polygonal and figure of 8). The average size was 7.4mm 1.3 in long diameter and 4.3mm 0.9 in short diameter. The position of the posterior margin of FO in respective to the line connecting the both mandibular fossa of temporal bone was various(on the line:62.3%, anterior:30.2%, posterior:7.5%). FO had communication with the foramen spinosum (FS) in 4.1% and with the foramen vesalius(FV) in 1.9%. FV was present in 47.5%(bilateral: 26.2%, right:10.2%, left:11.1%). The shapes were round or ovoid. The distance from the midline was 18.9mm 1.7. No data showed statistically significant differences between right and left. There was no inverse relationship between the presence of FV and the size of FO. Three continuous sections in one patient showed variations in the formation of foramen ovale and foramen spinosum ;one pyriform shaped foramen ovale and one foramen spinosum on the lower section, one round shaped foramen ovale and two foramen spinosum on the midsection, assimilation of two foramen spinosum into one elongated foramen spinosum on the upper section. The canaliculus innominatus was observed in 9%. CONCLUSION: Skull base foramina of the middle cranial fossa have various shape, size, location, presence and relationship with each other. It is important to recognize foraminal varients not to misinterprete as disease.
Cranial Fossa, Middle ; Foramen Ovale* ; Humans ; Skull Base* ; Skull* ; Temporal Bone

This study was performed to guide the effective utilization of blood and optimal blood ordering schedule for various elective surgeries, based on the analysis of 1,462 transfused surgical procedures and 5,933 blood units transfused during operation in the period of two years through January, 197 to December, 1988 at Yeungnam University Hospital. The frequency of transfusion, and mean transfused units were evaluated and recommended blood unit for each surgical procedure was proposed. We assure that the successful establishment of this guideline can lead to substantial monetary saving, reduced blood outdating, and a decreased blood bank workload with a more appropriate allocation of the technician's time and effort.
Appointments and Schedules ; Blood Banks

No abstract available.
Antigens, Viral, Tumor* ; Simian virus 40*

The prevalence of low serum urea nitrogen concentrations (<6 mg/dL) in our patient population was 3.8% (452 per 11,911 determinations), representing 372 individual cases. Of these, 323 of the patients' charts were located, reviewed, and classified into disease groups. Malignant tumor was found in 25.1% of the 323 patients, the remaining patients without malignant tumor had various clinical conditions; pregnancy (19.5%), infectious diseases (12.1%), trauma (10.2%), cerebrovascular accident (6.2%), hepatopathy (5.3%), and miscellaneous conditions (21.6%). The prevalence in female and young aged patients under 5 years was considered due to the lower reference range in these groups than in that of female adult groups, and moreover pregnancy in another superimposing factor in the former group. In regards to the causes of this condition, our study corresponded well to the textbook cited etiology of the low serum nitrogen concentration, although malnutrition and hepatopathy were inverted in their incidental order. We postulated, through the present study, that the low serum urea nitrogen concentration is not pathognomonic findings to suggest specific disease or conditions, but rather to reflect patient's general conditions such as hydration, nutrition, or administration of certain drugs.
Adult ; Communicable Diseases ; Female ; Humans ; Malnutrition ; Nitrogen* ; Pregnancy ; Prevalence ; Reference Values ; Stroke ; Urea*

No abstract available.

No abstract available.
Sturge-Weber Syndrome*

Major pathogenic Gramnegative organisms such as P. aeruginosa, Serratia species, E. coli, Enterobacter species which are isolated from the specimens in large medical centers are greatly resistant to the commonly used antibiotics. Gramnegative bacilli, which had been isolated in Yeungnam Uni rersity Hospital during the period from December 1992 to April 1993 and turned out to be resistant to the primary antibiotics susceptibility test for chloramphenicoi, ampicillin, eephaiothin,- geniamicitt, tetracyclin, amikin and tobramycin, were subjected to the secondary antibiotics susceptibility test for aztreonam, ceftazidime, ciprofloxacine, cefotaxime, cefamandole, piperacillin, ticarcillin and sulfamethoxazole trimethopime. Out of 315 tested organisms, 167 organisms (53%) were resistant to all secondary antibiotics in vitro. Antimicrobial activity of ceftazidime (37.1%), aztreonam (11. %), ciprofloxacine (7.9%) against Gram negative bacilli were slightly more active than other antibiotics tested, while cefamandole was not active to all the Gramnegative bacilli tested. According to the specimens, E. coli was the most frequently resistant organisms to the primary antibiotics from urine, A. baumanii, from respiratory system and wounds, and P. aeruginosa from various specimens. In summary, Gram negative bacilli resistant to the primarily applied antibiotics also were resistant to the secondary antibiotics. Rearrangement of the antibiotics disks for the antibiotic susceptibility test should be considered.
Amikacin ; Ampicillin ; Anti-Bacterial Agents* ; Aztreonam ; Cefamandole ; Cefotaxime ; Ceftazidime ; Ciprofloxacin ; Enterobacter ; Piperacillin ; Respiratory System ; Serratia ; Sulfamethoxazole ; Ticarcillin ; Tobramycin ; Wounds and Injuries

Paroxysmal Nocturnal Hemoglobinuria (PNH) is an uncommon hematologic disease characterized by an abnormal sensitivity of blood cells to the lytic action of serum complement. We experienced one case of PNH in Yeungnam University Hospital from May 1983 to May 1989. The patients was followed up without severe complications of 4 years since diagnosis with the only conservative treatments such as washed blood transfusion, adrenal corticosteroids, androgens, folate and iron preparation, intermittently.
Adrenal Cortex Hormones ; Androgens ; Blood Cells ; Blood Transfusion ; Complement System Proteins ; Diagnosis ; Folic Acid ; Hematologic Diseases ; Hemoglobinuria, Paroxysmal* ; Humans ; Iron

This study was carried out to visualize lead by Timm sulphide silver method and to define lead-induced change of duodenal absorptive cells of rat after administration of 0.01% lead acetate with drinking water. Sprague-Dawley rats, weighing 250g, were used, and they were orally administered with 0.01% sodium acetate and sacrificed at 0.5, 1, 1.5 hours and 2, 7, 15, 30, 45, 60 days after administration. A portion of duodenal tissue was observed under light microscope, scanning and transmission electron microscopes after development with Danscher method. The blood lead concentration in experimental group began to increase from the 2nd day after administration, and it increased gradually until the 45th day and decreased at the 60th day. On light microscope, many brown lead granules were observed at the villi tip at the 2nd day. There is mild blunting of villi tip at the 45th day. At the 60th day, most of the villi were mildly shortened and showed lymphangiectasia. On scanning electron microscope, the villi tip was mildly blunted and the extrusion zone became irregular at the 45th day. The depth of creases did not change. At the 60th day, the villi tip was moderately blunted and the extrusion zone was markedly irregular. The depth of creases increased. On transmission electron microscope, at 0.5 hour after oral administration, numerous lead granules were diffusely scattered and were not confined to any specific microorganelles. The lead granules decreased with time. At the 7th 15th day, the intercellular spaces were widened and several vacuoles appeared and the condensation of mitochondrial matrix. There was also ribosomal detachment from RER, and there was neither secondary lysosomes or post-lysosomes. At the 30th and 45th day, secondary lysosomes appeared and the condensation of mitochondrial matrix with early formation of myelin figures was noted. At the 60th day, the intercellular space widening extended to the upper most portion of the cells, and nonspeciqic degenerative changes became severe. In view of above mentioned findings, it can be concluded that passive diffusion as well as active transport was partly involved in the absorption of lead. Most of the changes of microorganelle are compatible with nonspecific degenerative changes which could occur due to impairment of oxidative phosphorylation.
Rats ; Animals