On strains of dematophytes isolated from superficial fungal infection patients, susceptibility tests were undertaken to topical antifungal agents (econazole, clotrimazole, siccanin, and tolnaftate). Minimal inhibitory concentration of the drugs was cletermined after 4 days incubation at room temperature on Sabourauds dextroes agar. Diverse susceptibility pattern was observed among different fungal species. Minor variability of susceptibilities was noted within the same species except for Trichophyton rubrum to econazole and tolnaftate in which a marked variation of susceptibilities was noted, Among drug tested, tolnaftate showed the most strong antifungal action, and Trichophyton mentagrophytes was the least sensitive species to all drugs. Minimal inhibitory concentration levels of each drug are as follows; clotrimazole was in the range of 2-8 mcg/ml., econazole was in the range of 0.06-2 mcg/rnl., siccanin was in the range of 05-2 mcg/ml., and tolnaftate was in the range of 0.01-0.25 mcg/ml.

PURPOSE: We designed this study to evaluate the incidence of spinal cord injury and the results of surgical treatment of lower cervical spine injury, and to suggest a rational treatment guideline according to the stages of Allen's mechanistic classification of the lower cervical spine injury. MATERIALS AND METHODS: We reviewed the medical records and roentgenograms of 66 patients (49 men and 17 women), who were treated surgically for acute fracture and dislocation of the lower cervical spine since March. 1991 to March. 1996. These patients ranged in age from 17 to 68 years (average age- 38 years). We used Allen's mechanistic classification to analyze fractures in the lower cervical spine injury. We divided neurologic status by complete, incomplete, root injury and no neurologic deficit group, Surgical treatment was performed for those with unstable fracture/dislocation, progressive neurologic deficit with conservative care, neurologic deficit with spinal cord compression by fracture fragment or extruded disc material. Surgical approach was determined according to the site of lesion. We analyzed the surgical treatment results according to neurologic recovery, radiologic bone union and complications, We used chisquare test for statistical analysis of neurologic improvement between the different surgical treatments. RESULTS: Twenty-nine cases were distractive-flexion (DF) phylogeny, 19 cases were compressive-flexion (CF), 2 cases were vertical-compression (VC), 8 cases were compressive-extension (CE), and 8 cases were distractive-extension (DE) phylogeny. For definitive surgical treatments we performed anterior cervical discectomy and fusion (ACDF) in 25, ACDF with anterior stabilizaiton in 30, posterior fusion in 5, and circumferential fusion in 6. There was no neurologic recovery in complete cord injury. There were 32 cases of incomplete cord injury all 8 anterior cord syndromes had no neurologic recovery, among 22 patients with central cord syndrome 18 had neurolgic recovery in various degrees and 2 with Brown-Seguard syndrome showed significant neurologic recovery. In nerve root injury, all patients had complete neurologic recovery. There was no radiologic nonunion at all and it took 10.3 weeks in average for radiologic bone union. There were neurogenic bladder, bed sore, local kyphosis, duodenal ulcer, respiratory infection, persistent neck pain and superficial wound infection in complications. Summary and CONCLUSIONS: In extension (CE, DE) injuries with neurologic deficit, anterior approach should be recommended because the major pathology is located in the anterior structure of the cervical spine. In flexion (DF and CF) injuries with major posterior osteoligamentous disruption, posterior approach could fix the posterior structures. Anterior decompression and fusion should be followed whenever anterior pathology is compressing the spinal cord or nerve root. Posterior open reduction and fusion is necessary whenever there is unreduced facet joint dislocation with or with out neurologic deficit. To prevent the late local kyphosis and persistent neurologic deficit with neck pain after prolonged external immobilization with ACDF, anterior stabilization with a plate and screw system is necessary to augment the surgical treatment of the unstable lower cervical spine injury which necessitates anterior decompression.
Central Cord Syndrome ; Classification ; Decompression ; Diskectomy ; Dislocations ; Duodenal Ulcer ; Humans ; Immobilization ; Incidence ; Kyphosis ; Male ; Medical Records ; Neck Pain ; Neurologic Manifestations ; Pathology ; Phylogeny ; Pressure Ulcer ; Spinal Cord ; Spinal Cord Compression ; Spinal Cord Injuries ; Spine* ; Urinary Bladder, Neurogenic ; Wound Infection ; Zygapophyseal Joint

This study was made in order to investigate the present status of superficial dermatophytoses and some changes on the frequency of the diseases, sex distributions and varieties of the causative organisms. The survey was made by 1486 out-patients of dermatology clinic of National Medical Center from May to August in 1978. Following results are obtained: 1. The incidence of superficial fungal infections including Tinea versicolor is 22. 2% and Tinea versicolor alone is 2. 8% among total l486 out-patients. 2. The ratio of male to female patients is 190:140 and shows more prevalence in male. 3. The age group from 20 to 29 shows the highest incidence and 38. 3% of all patients with superficial fungal infection falls in this age group. 4. Tinea pedis reveals the commonest disease and others in decreasing frequency are Tinea corporis, Onychomycosis, Tinea manus, Tinea corporis, Candidiasis and Tinea capitis. 5. Coexisting fungal infection is found in 60 patients and is most prevalent in the age group from 40 to 49, related to the ratio of age specific coexisting cases to each age group patients. 6. Tinea pedis with Onychomycosis reveals the most prevalent coexisting superficial fungal infection and others in decreasing frequencies are Tinea pedis with Tinea manus, Tinea pedis with Tinea cruris, Tinea cruris witb Tinea corporis and so on. 7. Positive rate of KOH mount among 362 scrapings is 64. 7% and Tinea cruris shows the highest positive rate (86. O%.) and Tinea corporis the next (78. 6%). 8. 187 strains are isolated by Sabourauds dextrose agar, 140 from positive KOH scrapings and 47 from negative KOH scrapings. a. Trichophyton rubrum is the most common organism of superficial dermatophytosis (43 8%) b, Microsporum species reveal the most common organism of Tinea capitis (80%).
Agar ; Candidiasis ; Dermatology ; Female ; Glucose ; Humans ; Incidence ; Male ; Microsporum ; Onychomycosis ; Outpatients ; Prevalence ; Sex Distribution ; Tinea Capitis ; Tinea Pedis ; Tinea Versicolor ; Tinea* ; Trichophyton

PURPOSE: Ventriculoperitoneal (VP) shunt insertion is an important treatment modality in children with hydrocephalus. VP shunt infection is a major complication and an important factor that determines the surgery outcome. This 15-year study was performed to evaluate the epidemiology of VP shunt infections in pediatric patients treated at our center. METHODS: A retrospective review of medical records was performed in patients 18 years old or younger who underwent VP shunt insertion surgery from April 1995 to June 2010. RESULTS: Three hundred twenty-seven VP shunt surgeries were performed in a total of 190 pediatric patients (83 females, 107 males). The median age of the patients was 2.4 years (range, 0.02-17.9 years). Having a malignant brain tumor was the most frequent cause for VP shunt insertion. The shunt infection rate was 6.7% (22/327) per 100 operations and 9.5% (18/190) per 100 patients, and the incidence rate was 0.45 infection cases per 100 shunt operations-year. The most common pathogen was coagulase-negative staphylococcus (n=7) followed by methicillin resistant Staphylococcus aureus (n=1). Ten cases were treated with vancomycin and beta-lactam antibiotic (cephalosporin or carbapenem) combination therapy and 7 cases were treated with vancomycin monotherapy. The median duration of antibiotic treatment was 26 days (range, 7 to 58 days). Surgical intervention was performed in 18 cases (18/22, 81.8%). CONCLUSION: Epidemiologic information regarding VP shunt infections in pediatric patients is valuable that will help guide proper antibiotic management. Additional studies on the risk factors for developing VP shunt infections are also warranted.
Brain Neoplasms ; Child ; Epidemiologic Studies ; Female ; Humans ; Hydrocephalus ; Incidence ; Medical Records ; Methicillin Resistance ; Retrospective Studies ; Risk Factors ; Staphylococcus ; Staphylococcus aureus ; Vancomycin ; Ventriculoperitoneal Shunt

PURPOSE: The purposes of this study were to investigate the prevalence of insomnia and to compare sleep patterns, demographic characteristics, and obstacles for sleep between women with and without insomnia. METHODS: This was a descriptive study. Study participants were 1,679 Korean women aged over 20 years. Information on symptoms of insomnia, sleep patterns, and related factors was assessed by questionnaire. Symptoms of insomnia included difficulties in initiating and maintaining sleep and early morning awakening. RESULTS: This study found that 32.0% of the study participants had insomnia, subjects with insomnia had bad sleep patterns compared to comparison group, lower educational level and menopause were closely related to insomnia, and noise, temperature, lighting, presence of bed partner, intake of caffeine, frequent urination, and pain or itching were associated with insomnia. CONCLUSION: This study suggests that insomnia is prevalent in women and closely associated with education level and menopausal status.
Caffeine ; Education ; Female ; Humans ; Menopause ; Noise ; Prevalence* ; Pruritus ; Sleep Initiation and Maintenance Disorders* ; Urination ; Surveys and Questionnaires

PURPOSE: The present study was designed to understand the conceptual definition and attributes of the clinical critical thinking ability(CCTA) in nursing and to grasp the characteristics of clinical critical thinking abilities. METHODS: The data were analyzed using the Hybrid model of Schwartz-Barcott and Kim(2000). RESULTS: Having the skills and dispositions to think critically, CCTA refers to something that implies the cognizant ability to interpret contextual meanings, analyze the relationships between materials or circumstances, draw out the best conclusions, predict things using relevant information and evaluate the reliability of information and the strength of inference on the one hand and the emphatic disposition to be curious, open-minded, intellectually integral, systematic and creative and to reflect on things in contextual terms on the other. CONCLUSION: CCTA is characterized by clinical circumstances, such as guessing the reasons for facts, predicting things, connecting theory to practice and approaching individual situation in total terms as well as by the Korean circumstances, such as taking another person's perspective. Hence, this study proposes developing the tools to measure the clinical critical thinking ability and the strategies to improve the clinical critical thinking ability and seeking to verify their validity, on the basis of the findings.
Chimera ; Clinical Competence ; Concept Formation ; Hand ; Hand Strength ; Problem Solving ; Thinking

The purpose of this pilot study was to identify the effects of hand moxibustion therapy to decrease pain and relieve coldness of the body in women who had a hysterectomy. The conceptual framework of this study was derived from Ying-Yang, Khi and other corresponding theories. The data were collected from February to May 1997. A Graphic Rating scale was used to measure the degree of pain and Digital Infrared Thermographic Imaging(D.I.T.I) was used to examine the degree of coldness. The subjects were women who resided in Seoul and had a hysterectomy within five years. An experimental group was composed of five women who received moxibustion and a control group was composed of five who did not. The research procedure began with having both the experimental group and control group describe their general characteristics and the degree of pain they perceived. Then, Digital Infrared Thermographic Imaging(D.I.T.I) was conducted. Moxibustion was only given to the experimental group on both hands twice every day for a total of five weeks. Their perception of pain and D.I.T.I were examined weekly. The control group received no therapy. After finishing therapy, the perception of pain and D.I.T.I for both groups were also measured. According to this study, moxibustion therapy resulted in a change of body temperature on the right shoulder joint(p=0.00074), abdomen(p= 0.0047), waist(p=0.0068) and hands(p=0.0317) respectively. Also, the study results showed significant decrease (p=0.0001) in pain over time and significant improvement over body coldness.
Body Temperature ; Female ; Hand* ; Humans ; Hysterectomy* ; Moxibustion* ; Pilot Projects ; Seoul ; Shoulder

PURPOSE: The purpose of this study was to identify the effects of the tailored group exercise program on perceived health status, physical strength, depression and cognitive function in seniors. METHODS: The subjects were 42 seniors of the experimental group and 28 seniors of the control group. The exercise program tailored by physical fitness was carried out for 16 weeks. The dependent variables were measured by Perceived Health Status Scale, The Senior Fitness Test, MMSE-K, and GDS-K. The collected data were analyzed by Fisher's exact test, Chi-square test and t-test, and ANCOVA using the SAS program. RESULTS: In terms of physical strength and depression there was significant difference among groups. Perceived health status and cognitive function were not significant different among groups. CONCLUSION: In this study, the tailored exercise program was effective and safe for the elderly, and resulted in improving physical and psychological health status in the elderly. This demonstrated that the tailored group exercises program on the basis of the subject's fitness, played an essential role in maintaining and improving the health.
Aged ; Depression ; Exercise ; Humans ; Phenothiazines ; Physical Fitness

PURPOSE: The purpose of this study was to describe the using pattern of alternative therapies in the elderly. Method: 197 subjects, persons who were more than 60 years old, we interviewed. We modified and complemented Shin's(2000) instrument in accordance with purpose of this study. Data were analyzed statistically by using SAS program. RESULTS: 1. It was shown that 66.84% of subjects have utilized one or more types of alternative therapy. 2. It was shown that the most frequently used types are acupuncture (48.83%), and ethmoid bone therapy (42.75%). 3. Acupuncture was shown to be the most satisfactory type of therapy (14.50%). 4. There was a significant difference in the use ratio by sex; female 73.47% and male 60.20%. 5. Among users of alternative therapies, the most frequent responses to each question were as follows; 1. Motive of Use - "for complete cure of symptoms" (32.31%). 2. Side effects - "no side effects" (95.97%). CONCLUSION: We found that elderly persons used alternative therapies more frequently than others perpulations. Diet therapy and Hand therapy were most commonly used in older people. Although the elderly use alternative therapy, they cannot place confidence in its scientific reliability. Therefore, we need to examine the effects of alternative therapy.
Acupuncture ; Aged* ; Complement System Proteins ; Complementary Therapies ; Diet Therapy ; Ethmoid Bone ; Female ; Hand ; Humans ; Male ; Middle Aged

PURPOSE: The purpose of this study was to describe the using pattern of alternative therapies in the elderly. Method: 197 subjects, persons who were more than 60 years old, we interviewed. We modified and complemented Shin's(2000) instrument in accordance with purpose of this study. Data were analyzed statistically by using SAS program. RESULTS: 1. It was shown that 66.84% of subjects have utilized one or more types of alternative therapy. 2. It was shown that the most frequently used types are acupuncture (48.83%), and ethmoid bone therapy (42.75%). 3. Acupuncture was shown to be the most satisfactory type of therapy (14.50%). 4. There was a significant difference in the use ratio by sex; female 73.47% and male 60.20%. 5. Among users of alternative therapies, the most frequent responses to each question were as follows; 1. Motive of Use - "for complete cure of symptoms" (32.31%). 2. Side effects - "no side effects" (95.97%). CONCLUSION: We found that elderly persons used alternative therapies more frequently than others perpulations. Diet therapy and Hand therapy were most commonly used in older people. Although the elderly use alternative therapy, they cannot place confidence in its scientific reliability. Therefore, we need to examine the effects of alternative therapy.
Acupuncture ; Aged* ; Complement System Proteins ; Complementary Therapies ; Diet Therapy ; Ethmoid Bone ; Female ; Hand ; Humans ; Male ; Middle Aged