BACKGROUND: Although enriched broth cultures have been recommended as an adjuvant to the direct plating of tissue and body fluid specimens, the cost-effectiveness of broth cultures has been questioned in regard with the clinical significance of "broth only isolates(BOI)". The purpose of this study was to investigate the usefulness of thioglycollate broth(THIO) cultures. METHODS: We reviewed retrospectively results in the culture specimens of body fluids, tissue biopsies, and puses received during the month of July 1997. All specimens were inoculated into THIO in addition to agar plates. We reviewed the medical records of culture-positive patients to determine the clinical significance and relevance of their isolates. Clinically significant isolates were defined as those for which an appropriate antimicrobial therapy was done except one judged as contaminants by clinicians and clinically relevant isolates as the clinically significant one isolated first. RESULT: Of 2,008 specimens, 512(25.4%) from 365 patients grow 561 isolates 464 plate isolates and 97 BOI. Two hundred eighty nine(62.3%) of the 464 isolates from plate cultures were clinically significant, compared to only 12(12.4%) of 97 BOI (P<0.05). Only four (4.1%) BOI were clinically relevant, including one Pseudomonas aerugiosa from ascites. one Klebsiella pneumoniae and two Staphylococcus aureus from tissue specimens. CONCLUSION: A routine use of enriched broth culture rarely recover clinically relevant isolates. Considering the laboratory and medical costs of the recovery of contaminants and clinically irrelevant isolates, the enrichment broth cultures should be used more selectively.
Agar ; Ascites ; Biopsy ; Body Fluids ; Humans ; Klebsiella pneumoniae ; Medical Records ; Pseudomonas ; Retrospective Studies ; Staphylococcus aureus

No abstract available.
Humans ; Schools, Medical*

BACKGROUND: Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. METHODS: The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. RESULTS: The PEFR measured with MPFM was significantly related to the PEFR and FEV1 measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r=0.92 p<0.001; for FEV1, r=0.78 ; p<0.001). The accuracy of MPFM was within 10%(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being I 6.5L/min(percentage of difference being 2.90%) or 1 0.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or -20.49~ + 9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p>0.05) and the coefficient of variation(2.4 1.2%) of PEFR measured with MPFM was significantly lower than that( 5.2 3.5%) with standard pneurnotachygraph in normal (p<0.05). CONCLUSION: This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.
Asthma ; Diagnosis ; Flowmeters ; Peak Expiratory Flow Rate ; Respiratory Function Tests

Pure ovarian choriocarcinoma of germ cell origin is exceedingly rare neoplasm, and even the presence of choriocarcinomatous elements admixed with other neoplastic germ cell elements is rare. In the most cases, the tumor is admixed with other neoplastic germ cell elemeats, and their presence is diagnostic of noagsatational choriocarcinoma, except for the remote of the tumor being a geatational choriocarcinoma metasttic to an ovarian germ cell tumor. We have experienced a case of nongestational ovarian choriocarcinoma in 10 year dld woman. So we report this case with a brief review of its literatures.
Choriocarcinoma* ; Female ; Germ Cells ; Humans ; Neoplasms, Germ Cell and Embryonal ; Pregnancy

The objective of this study was to investigate the relationship between insomnia severity, depression, anxiety, and anxiety sensitivity and to find out the explanatory variables that account for the insomnia severity among depression, anxiety, and anxiety sensitivity in general population. 95 mentally healthy volunteers who visit health promotion center of Kangbuk Samsung hospital for their regular medical examination were requested to complete Athens Insomnia Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Anxiety Sensitivity Index. Association between total scores of Athens Insomnia scale and other variables (total scores of Beck Depression Inventory excluded item 16, total scores of State Anxiety, total scores of Trait Anxiety, and total scores of Anxiety Sensitivity Scale) was assessed individually with partial correlations adjusted by age and then together using multiple regression analysis. The total scores of Athens Insomnia Scale were significantly associated with total scores of Beck Depression Inventory excluded item 16(r = 0.541, p<0.001), total scores of Trait Anxiety(r = 0.642, p<0.001), total scores of State Anxiety(r = 0.267, p<0.05), and total scores of Anxiety Sensitivity Index(r = 0.312, p<0.01). Total scores of trait anxiety showed the highest correlation with the total scores of Athens Insomnia Scale and was the significant predictor to total scores of Athens Insomnia Scale among the other predictor variables (p<0.001). These results show that insomnia severity is positively correlated with depression, anxiety, and anxiety sensitivity. The correlation was strongest with trait anxiety. In addition, our results suggest that trait anxiety is associated with insomnia severity in general populations.
Anxiety* ; Depression* ; Health Promotion ; Healthy Volunteers ; Sleep Initiation and Maintenance Disorders*

BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
Compliance ; Coronary Care Units* ; Delivery of Health Care* ; Effect Modifier, Epidemiologic* ; Hand Hygiene* ; Health Personnel ; Hospitals, General ; Humans ; Intensive Care Units* ; Nursing ; Seoul ; Thoracic Surgery*

We looked for and discussed the changes of curricula of medical course of 31 medical schools during the period of 1984 and 1993. The data used in this study were Educational State Report of Korean Med ical Schools published from Dean Association of Korean Medical Schools in 1984 and 1992-1993. The significant findings were as follows. 1. There were great variability in number of subjects and in time for lecture and exercise in each subject among 31 medical schools. 2. There were a great deal of changes during the period of 1984 and 1993. There were increased tendency in number of subjects and especially block lectures. Schools which had 1-4 subjects vanished in curriculum were most frequent among 22 schools during 9 years. Name of most frequent subjects in block lecture were clinico-patholo gical conference, reproductive medicine, hematology, oncology and cardiology in 1993. 3. Subjects which were transferred to pre-medical program were classified to two groups. One group was traditional basic medical subjects such anatomy, physiology and biochemistry, the other group was newly introduced subjects such as molecular biology and cell biology as basic medical subjects. 4. The data were suggested that long time was needed to stabilized in newly introduced subjects of clinical medicine such as neurology and plastic surgery. Time for lecture and exercise of these subjects shows increasing tendency in schools established before 1978, but decreasing tendency in schools established after 1978.
Biochemistry ; Cardiology ; Clinical Medicine ; Curriculum* ; Hematology ; Humans ; Lectures ; Molecular Biology ; Neurology ; Physiology ; Reproductive Medicine ; Schools, Medical ; Surgery, Plastic

We have investigated and discussed the changes of scholarship, tuition and educational facilities in national medical colleges and private medical colleges for the period of 1984 and 1993. The data an alysed in this study were cited from the third edition and the seventh edition and raw data for the eighth edition of the Educational State Report of Korean Medical Schools which were issued by the Deans' Association of Korean Medical Schools. The significant findings were as follows: 1. In all investigated medical college libraries, the number of seats and medical books and the sorts of medical journals have increased, particularly the average budgets for medical journals have increased over 3 times in 1993 compare to 1994. 2. Between 1984 and 1993, total budget for scholarship have been increased out average benefit rate have been decreased from 38.6% to 34.3%. But the average benefit doubled its amount. 3. Average tuition in national medical college was about 52% of that in private medical college in 1993. In national medical colleges, average tuition for premedical course was 10% costly than medical course but it was just opposite to private medical colleges. 4. Between 1984 and 1993, Audio-visual aids have increased in number a little bit but there was nothing significant changes between national and private medical college. 5. Eighty one percent of investigated medical colleges have animal laboratory for research but only 15.6% of medical colleges have specific pathogen free rooms in the animal laboratories. 6. In 1993, the space in medical college buildings was occupied 29.6% by student education facilities, 25.8% by research space for professors and 10.5% by medical library. The average area for student educations was 42.4m2, for professors research was 32.2m2 and for library was 11.4m2 per a student.
Animals ; Audiovisual Aids ; Budgets ; Education ; Fellowships and Scholarships* ; Humans ; Libraries, Medical ; Schools, Medical ; Specific Pathogen-Free Organisms

No abstract available.
Humans ; Needles* ; Peritonsillar Abscess*

Airway hyperresponsiveness is a consistent feature of asthma. Since the airway smooth muscle is hyperresponsive to a number of different stimuli operating through many different mechanisms, it is attractive to speculate that the abnormality may reside in the airway smooth muscle itself. Animal model of asthma is needed to unravel possible mechanisms underlying airway hyperresponsiveness and also to develop new therapeutic approaches. However, there are few reports showing that airway smooth muscle from animal asthma model is indeed hyperresponsive. In addition, sensitizing and provoking doses of allergen were different each other ambng the studies on animal asthma model. The aim of this study was to determine an appropriate sensitizing and provoking dose of allergen to induce a maximum airway hyperresponsiveness. Eighty-four male Sprague-Dawley rats were actively sensitized with a subcutaneous injection of 0, 10, or 1000/gg ovalbumin(OA) and 14 days later they were provoked with 0, 1, or 5 % OA aerosols. One day after the provocation, serum levels of OA-specific IgE, cell numbers in bronchoalveolar lavage fluid (BALF), and in vitro isometric contractile responses of the isolated tracheal smooth muscle(TSM) to 120 mM KC1, acetylcholine(ACh, 0.1~ 1000/micro meter), electrical field stimulation (EFS, 0.5~100Hz), serotonin(5-HT, 0.014 100/micro meter), and OA(10, 50, or 250 micro gram/ml) were measured. The results were as follows; 1) When 38 OA-sensitized rats were exposed to OA aerosols in vivo early asthmatic responses(EAR) were observed in 20(52.6%) rats. In vitro isometric contractile forces of TSM from rats with EAR were stronger than those from rats without EAR. 2) The maximal contractile responses to KC1 and EFS were significantly higher in rats only sensitized with OA compared with those in controls. The maximal response to ACh was significantly related to OA-specific serum IgE level(r=0.40, p%0.05), and the latter was in turn significantly related to the BALF eosinophil count(r=0.67, p<0.01). 3) When 10 microgram OA-sensitized rats were analyzed, the maximal response to KC1, ACh, EFS, and 250 micro gram/ml OA were lower in OA-provoked rats compared to those in saline-provoked control rats, in which 5% OA-provoked rats had a lower response than 1% OA-provoked rats. 4) The sensitivity of TSM to ACh was significantly higher in 10/micro gram OA-sensitized & OA-provoked rats, and the sensitivity to EFS was also significantly higher in 10/~g OA-sensitized & 5% OA-provoked rats compared to that in controls(p<0.05). 5) There was a significant correlation between the sensitivity of TSM to EFS and the counts of eosinophil or of lymphocytes in BALF(for eosinophil, r=-0.30; p<0.05, for lymphocyte, r=-0.35; p<0.05), or OA-specific serum IgE level(r=-0.46, p<0.01) in OA-sensitized & OA-provoked rats. This relationship was maintained in the data obtained only from 10 micro gram OA-sensitized & 5% OA-provoked rats. 6) The ratio of EFS-sensitivity to ACh-sensitivity was significantly lower in OA-sensitized & OA-provoked rats compared to that in controls or rats only sensitized with OA(p%0.05). 7) The Schultz-Dale phenomenon occurred in an in vitro dose-dependent manner. However, the inhaled provocation with OA in vivo resulted in a decrease in the contractile response to OA in vitro. There was a significant correlation between OA-specific serum IgE level and isometric response to 250 micro gram/ml OA(r=0.36, p<0.01). These results suggest that sensitization and provocation in vivo with OA in rats induces hypersensitivity of airway smooth muscle to cholinergic stimuli through an allergic inflammatory mechanism. The sensitivity was highest when sensitized to 10 micro gram OA and exposed to 5% OA aerosols.
Aerosols ; Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Cell Count ; Ear ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Injections, Subcutaneous ; Lymphocytes ; Male ; Models, Animal ; Muscle, Smooth* ; Rats* ; Rats, Sprague-Dawley