Fungi have been recognized as a significant cause of external otitis and it may be the primary pathogen or be part of a mixed infection. In the immunocompromised host, fungus is capable of producing infection in inner ear or middle ear. Otomycoses are most frequently caused by Aspergillus spp. and Candida sap. There are few reports that Aspergillus species other than A. fumigatus, A. niger and f. flavus have caused chronic otitis media. We report two cases of chronic otitis media caused by Aspergillus ferrous in Korea. One case is a 7-year-old girl who had recurrent serous otorrhea and otalgia for 4 years, was reattended otolaryngology clinics with otorrhea of 3 days durations and another is a 6-year-old girl who had serous otorrhea for 2 months and 3 day fever, was attended otolaryngology clinics with them. Microscopic appearance and colony morphology from ear discharge cultures revealed A. ferrous. The infection responded well to topical ketoconazole therapy. This report should help to raise medical personnel's awareness of such human opportunistic fungal ear infections.
Aspergillus* ; Candida ; Child ; Coinfection ; Ear ; Ear, Inner ; Ear, Middle ; Earache ; Female ; Fever ; Fungi ; Humans ; Immunocompromised Host ; Ketoconazole ; Korea ; Niger ; Otitis Externa ; Otitis Media* ; Otitis* ; Otolaryngology ; Otomycosis

BACKGROUND: Various molecular methods such as polymerase chain reaction (PCR) and DNA hybridization have been introduced to diagnose the hepatitis B more accurately. Recently, Hybrid Capture Assay (HCA) was developed, which uses the signal amplification solution hybridization capture assay with chemiluminescent detector. So we evaluated the sensitivity and clinical utility of the HCA and PCRs for the detection of hepatitis B virus DNA (HBV DNA) and compared these results with serologic markers. METHODS: We analysed the 50 samples from the hepatitis B patients using enzyme immunoassay, HCA and nested PCRs with two different primer sets. The primers of PCR I and PCR II were targeted to pol and core region respectively. RESULTS: In 18 cases, HBV DNA were detected by HCA in which the positive rates by PCR I and PCR II were 55.6%, and 88.9%, respectively. And in 32 cases in which HBV DNA by HCA was negative, the positive rates by PCR I and PCR II were 6.2% and 31.3%, respectively. In 44 cases which were positive for HBsAg, the positive rates for HBV DNA were 38.6% by HCA, 27.3% by PCR I, and 56.8% by PCR II. In cases positive for HBeAg, the positive rates were 93.3% by HCA, 60.0% by PCR I and 80.0% by PCR II. In cases positive for anti-HBe and negative for HBeAg, the positive rates were 10.3% by HCA, 10.3% by PCR I, and 44.8% by PCR II. CONCLUSIONS: Both HCA and PCR compensated each other yet as to the accurate investigation of the viral replication in patients with hepatitis B and the sensitivity was better in HBV PCR with primers to core region than to pol region.
DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Polymerase Chain Reaction*

PURPOSE: This study was done to examine the influence of nursing service quality and medical service satisfaction on intent to revisit the hospital, and to identify mediating effects of medical service satisfaction between nursing service quality and intent to revisit the hospital. METHODS: This study was a cross-sectional survey. Participants were 390 hospitalized patients at one general hospital in Gyeonggi Province. Data were collected from July 21 to September 10, 2010 and analyzed using SPSS/PC version 18.0. RESULTS: The score for nursing service quality continuously improved but the scores for medical service satisfaction and intent to revisit the hospital did not changed significantly after estimated. Factors influencing intent to revisit the hospital were nursing service quality, medical service satisfaction, 'same religion', and 'Christian', and the explanation power of these four factors was 79.7%. Medical service satisfaction had a partial mediating effect between nursing service quality and intent to revisit the hospital. CONCLUSION: Findings indicate that nursing service quality is a very important factor to improve both medical service satisfaction and intent to revisit the hospital. Nursing managers should develop strategies to improve nursing service quality.
Consumer Satisfaction ; Cross-Sectional Studies ; Hospitals, General ; Humans ; Negotiating ; Nursing Services

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause of nosocomial infection and a molecular typing is necessary for proper epidemiologic investigations of sources and moles of spread in an outbreak. An nosocomial outbreak of MRSA in a neonatal intensive care unit at Ewha Womans University Mokdong Hospital was suspected. To investigate the clonality of isolates and control the spread of nosocomial outbreak, we performed plasmid restriction analysis of MRSA isolates from patients and medical staffs. METHODS: We studied 7 MRSA strains (umbilicus 4, blood 1, urine 1 and pus 1) from patients in a neonatal intensive care unit and the MRSA strains from nares and hands surveillance cultures of 26 medical staffs (4 medical doctors and 22 nurses). All MRSA strains were tested for antimicrobial susceptibility and plasmic analysis after EcoRI restriction. We analyzed the plasmid patterns of MRSA isolated from patients and compared with those from medical staffs. RESULTS: Ten MRSA strains (from 7 nares and 3 hands) were isolated from surveillance cultures of 26 medical staffs. Seven out of 10 MRSA strains from medical staffs revealed identical pattern of antibiogram which was the same pattern in all 7 MRSA strains from seven patients. Plasmid restriction patterns were classified 6 groups from A to F showing 2-10 bands. Six out of 7 MRSA strains from the patients showed group A(A1 5, A31) and 5 out of 10 MRSA strains from the medical staffs showed group A(A1 1, A21, A32, A41) and remainders showed different plasmid restriction analysis patterns. CONCLUSIONS: These results suggest that plasmid restriction analysis is a rapid, inexpensive, and good discriminating molecular typing of MRSA outbreak and is useful for the epidemiologic investigation of MRSA outbreaks in the clinical laboratory.
Cross Infection ; Disease Outbreaks ; Female ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Staff ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Microbial Sensitivity Tests ; Molecular Epidemiology* ; Molecular Typing ; Plasmids* ; Suppuration

Recently, continuous epidural catheter insertion is common practice not only in anesthesia but also in pain clinic. Meningitis is rare but serious complication of epidural analgesia. Acute bacterial meningitis occurred in a 82-year-old female patient with thoracic herpes zoster after continuous thoracic epidural analgeia. An MRI of thoracic region did not show an epidural abscess or granulation tissue. Gram stain and culture of the epidural catheter tip and the CSF yielded Staphylococcus aureus. Immediate treatment with antibiotics and supportive therapy was instituted and then the patient discharged without neurologic sequalae.
Aged, 80 and over ; Analgesia, Epidural* ; Anesthesia ; Anti-Bacterial Agents ; Catheters ; Epidural Abscess ; Female ; Granulation Tissue ; Herpes Zoster ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Pain Clinics ; Staphylococcus aureus

Dysembryoplastic neuroepithelial tumor(DNET) is a recently described rare tumor that occurs most frequently in the temporal lobe of the brain and is characterized by long-standing, intractable complex partial seizures in children. The authors experienced one case of DNET occurring in a 13-year old boy, who had refractory complex partial seizure for 7 years. CT scan revealed nonenhancing low density mass in the left temporal lobe. MR images demonstrated a well-marginated cortical mass with very low signal intensity on TIWI and multinodular appearance of high signal intensity on T2WI. A few small enhancing foci within the mass were noted on contrast enhanced MR images. DNET, a rare tumor, should be considered in the differential diagnosis of neoplasm which causes seizure and is distinguished from other tumors because of its benign course. Differentiation between DN ETand other tumors by CT and MR findings is very difficult. But, our case showed the multinodular pattern on T2W image, which may be helpful feature in the differential diagnosis.
Adolescent ; Brain ; Child ; Diagnosis, Differential ; Humans ; Male ; Neoplasms, Neuroepithelial* ; Seizures ; Temporal Lobe ; Tomography, X-Ray Computed

Currently, breast cancer ranks third among women's cancers, and as its incidence is increasing, the incidence age is also becoming lower. Therefore it is necessary to address breast cancer for women in their twenties. As there is no way presently to prevent breast cancer, it is imperative that women take available interventions against predisposing factors. It is thus advisable that women acquire the necessary skills to recognize their own health status. The purposes of this study were to identify the effects of education on breast self-examination (BSE) through supportive education among college women during the period from August 2000 to February 2001, and to attempt to design an effective BSE educational program. The first class was implemented through lectures, pamphlets, videotapes, breast palpation on cloths, demonstration and practice for identification of breast masses through palpation using breast model. Supportive education was implemented bimonthly to the experimental group, and effects of the education between experimental and control groups were compared 6 months later. The results of this study are summarized as follows: 1. The effects on supportive education of college women in BSE 1) The mean score of retained knowledge about breast cancer and BSE was 30.88 in the experimental group, and 29.66 in the control group and significantly greater in the experimental group than in the control group (t= -2.062, p= 0.041). 2) Frequency of BSE practice was significantly greater in the experimental group than in the control group(X2=0.045, p=0,012). 3) The mean accuracy score in BSE practice was 19.10 in the experimental group, and 18.29 in the control group; accuracy was higher in the experimental group than in the control(t= -2.035, p= 0.444). 4) The mean score of self-efficacy was 35.05 in the experimental group, and 31.22 in the control group. The experimental group mean score was higher(t=-3.016, p=0.003). 2. There was a statistically significant correlation between self-efficacy and accuracy of BSE(r= 0.447, p=0.000), knowledge of breast cancer and BSE(r= 0.306, p=0.000) and frequency of BSE(r=0,259, p=0,002) but no significant correlation between knowledge of breast cancer and BSE and frequency of BSE (r=0.071, p=0.403). On the basis of this study, periodic supportive education can increase knowledge of breast cancer and BSE, frequency of BSE, accuracy of BSE and self-efficacy. Suggestions: 1. There is a need to compare the effects of individual programs to acquire BSE behaviors in the young. 2. Further research is needed to test the continuity of the effects of BSE education.
Breast Neoplasms ; Breast Self-Examination* ; Breast* ; Causality ; Education* ; Female ; Humans ; Incidence ; Lectures ; Palpation ; Pamphlets ; Videotape Recording

We investigated a unilocular mammary cyst occurring in a two and a half year old male baby. The cyst was lined by simple columnar epithelium and filled with a milky secretory material. These histologic features were consistent with galactocele. The child had enlarged left breast since birth, but it seemed to be noncontributory as the child had neither endocrine abnormalities nor perinatal disorders. Galactocele is an uncommon breast lesion usually occuring in females following lactation. It is rarely a cause of breast enlargement.
Child ; Male ; Female ; Humans ; Cysts

The limitation so direct or indirect laryngoscopy and laryngogram in detemining the exact site and anatomiclocation of laryngeal carcinoma were well documented by many authors. As compared with laryngoscopy and laryngogram, CT study for laryngeal cancer is more exact and accurate method demonstrating anatomic sites of involvement, invasion into deep soft tissue spaces of endolarynx, destruction of laryngeal cartilages and cervical metastasis. Fourteen laryngeal cancer patients proven by laryngoscopic biopsy were further examined by computed tomography for staging. The authors compared laryngoscopic findings with those of computed tomography, and their clinical, surgical and computed tomographic findings were analysed. The results were as follows; 1. All patients were proved as squamous cell carcinoma. They were 12 males and 2 females aged over 50 yrs. 2. Common clinical symptoms were hoarseness, dysphagia and swallowing difficulty. The pirmary anatomic sites determined by CT were 8 transglottic, 2 glottic, 2 supraglottic and 1 pyriform sinus respectively. They were 2 T1. 7 T2, 1 T3, 3 T4 by TNM systems, respectivly. (One case was difficult to evaluate exactly). 3. Invasion into deep soft tissue spaces of endolarynx, cartilage destruction, and neck metastasis were relatively predominant in transglottic caracinomas. 4.CT was superior in evaluating tumor invasion, especially into deep soft tissue spaces of endolarynx, laryngeal cartilages and metastasis ot soft tissue and lymph nodes of neck. However CT had some limitation in determining primary site of laryngeal cancer.
Biopsy ; Carcinoma, Squamous Cell ; Cartilage ; Deglutition ; Deglutition Disorders ; Female ; Hoarseness ; Humans ; Laryngeal Cartilages ; Laryngeal Neoplasms ; Laryngoscopy ; Lymph Nodes ; Male ; Methods ; Neck ; Neoplasm Metastasis ; Pyriform Sinus

BACKGROUND: Korea is an endemic area of viral hepatitis B with a rate of 5~10% carrier state. Therefore, hepatitis B vaccination is performed nationwide. But 5~15% of healthy individuals fail to respond adequately to the vaccine and an approved guideline for the nonresponders has not been developed yet. This study is designed to identify risk factors for those who lack anti-HBs after hepatitis B vaccination and to document the results of a double-dose revaccination in such nonresponders to the primary vaccination. METHODS: From Feb. 1996 to Aug, 1997, we assessed 51 healthy subjects(HBs Ag negative, anti-HBs negative, anti-HBc negative and a normal LFT). All subjects were vaccinated with Hepavax- B, 1.0ml, 24 by a rapid schedule(0, 1, and 2 months) and 27 by a standard schedule(0, 1, and 6 months). Anti-HBs titers were evaluated 3 months after the third vaccine and assessed the nonre-sponders (anti-HBs titer<2mIu/ml) and the hyporesponders(2~10mK/ml). All 13 nonresponders were revaccinated with 2ml of Hepavax-B 3 months after the primary vaccination. Anti-HBs titers were evaluated 1 month later. RESULTS: The differences in age(p<0.01) and smoking amount(p<0.05) between the responders and the hypo and the nonresponders were statistically significant. There were more males and higher body mass index in the hypo and the nonresponders but not statistically significant. The seroconversion rate after the double-dose vaccination was 92.3%(12/13) with an average titer of 5K08mlU/ ml(1-132.4mIU/ml). CONCLUSIONS: Increase in age and smoking amount were the risk factors of the nonresponders after the primary vaccination. Most of the hypo and the nonresponders to the primary vaccination responded adequately to the double-dose revaccination.
Body Mass Index ; Carrier State ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization, Secondary* ; Korea ; Male ; Risk Factors* ; Smoke ; Smoking ; Vaccination