The objective of this study is to present a new approaches of development systems of test items that will be applied to the National Medical Licensing Examinations. In order to relate all elements of the evaluation process in building a new system, we used the systems approach to problem-solving which involves the development of an overall plan incorporating the interrelated parts of an evaluation process in a sequential pattern. The method we have applied focuses on valid and relevant test items of each subject as an outcome. We have designed the six individual programs that would be a part of whole processes which consists of three different phases such as before-test, test and after-test. The six programs involves sequentially planning of test, requesting test item development, construc ting MCQ, managing test item bank, preparation of test sheets, and test item analysis. One of the characteristic feature of new system is running test item development committees which are made up of subject-matter specialists who together with the nation-wide specialists who are primarily responsible to construct test items, and also with education specialists to refine the structures of each test items.
Education ; Licensure* ; Running ; Specialization ; Tolnaftate

With isolated strams of dermatophytes, susceptibility tests were undertaken to antifungal drugs, and the results of both tests by inoculation of fungal suspensions and, fungal mats were compared, also the combined actior.s of drugs against isolated strains were evaluated, Diverse susceptibiIity patterns were observed among different fungal species, however, no arminor susceptibility differences were detected among strains of same species. Among drugs tested, tolnaftate showed the most strong antifungal ar.tion, and Ep, floccoaum was the most and T. mentagrophytes was the least sensitive species to drugs. MIC levels by mats inoculation were generally far higher than that of fungal suspension, particularly with tolnaftate it was several hundred folds higher by fungal mats inoculatian. Combined actions of drugs were generelly elevated against test strains, when miconazole cornbined with tolnaftate, the action was synergistic against T. mentagrophytes, and when tolnaftate combined with griseofulvin or siccarin cornbined with griseofulvin, thactions were elevated to T. rubrum.
Arthrodermataceae* ; Griseofulvin ; Miconazole ; Suspensions ; Tolnaftate

BACKGROUND: The management of penetrating neck injuries presents a difficult problem. Although many authors have stated that surgical exploration should be mandatory for all neck injuries that penetrate platysma, recent reports from many centers now claim selective exploration. The aim of this study was to review a policy of selective neck exploration based on clinical presentation, anatomic location, and the result of diagnostic studies. METHOD: We reviewed retrospectively medical records of 66 patients who were admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating neck injuries from Jan. 1990 to Dec. 1996. RESULTS: Forty-one patients(62%) were underwent immediate neck exploration, while the remaining 25 patients(38%) were admitted and observed. Three had esophagoscopy, four had esophagogram, and three had direct laryngoscopy, all of which revealed normal result except one patient had blood tinged larynx on laryngoscopy. Results of 12 neck explorations(29%) were negative. There was no delayed diagnosis during conservative treatment. There was no mortality. CONCLUSION: We concluded that selective exploration of penetrating neck injuries is both safe and resonable.
Delayed Diagnosis ; Esophagoscopy ; Humans ; Laryngoscopy ; Larynx ; Medical Records ; Mortality ; Neck Injuries* ; Neck* ; Retrospective Studies ; Tolnaftate

We studied germination activities of fungus conidiospores in active growth phase using the hanging slide culture method, then investigated the inhibitory effects of two antifungal agents(Tolnaftate and Clotrimazole) on germination activities. The fungal strains used in this study were Trichophyton (T.) rubrum, T. mentagrophytes and Candida (C.) albicans. Each strain was cultured on the Sabouraud's glueose agar plate and examined daily for detection of active growth phase of conidiospores (blastospores in C. albicans). After the conidiospores reached to active growth phase the activated spores were inoculated in one drop of Sabouraud's glucose broth on the cover glass and the hanging slide cultures were performed. The mean hermination rates of T. rubrum and T. nentagrophytes were 87.5% and 78% respectively in 72 hours. In C.albicans the average germination rate was 85.7% after cultivation for 24 hours, this germination rate was much faster than that of T.rubrum and T.mentagrophytes. For detection of miniman inhibitory concentration (MIC) of the antifungal agents to germination activities the antifungal agents were diluted with Sabouraud's glucose broth to various concentration and hanging slide culture was performed with the media containing the antifungal remedies. The minimal concentration of antifungal agents in which the conidiospores could completely not be germinated was denoted to minimal inhibitory concentration. The MIC of Tolnaftate to T.rubrum and T.mentagrophytes were 0.0.1ug/ml. The MIC of Cloirimazole to T. rubrum and T.mentagrophytes were 0.1ug/ml and to C. albicans was 1ug/ml. This results were similar to the previous reports by other investigators. This is a new method that could be applicated for evaluation of antifungal activities of antifungal agents.
Agar ; Antifungal Agents* ; Candida ; Fungi ; Germination* ; Glass ; Glucose ; Humans ; Research Personnel ; Spores ; Tolnaftate ; Trichophyton

Unilateral pulmonary artery agenesis is a rare congenital malformation usually associated with other cardiovascular anomaly such as Tetralogy of Fallot. Isolated pulmonary artery agenesis is very rare, and usually asymptomatic. It is usually highly suspected by routine chest X-ray, and associated symptoms are hemoptysis, blood tinged sputum, repeated pulmonary infection, and dyspnea on exertion. We have recently experienced the right pulmonary artery agenesis in 27 year-old male patient, complaining of minimal hemoptysis and sustained blood tinged sputum. He was successfully treated by right pneumonectomy, so we report this case with the review of associated literature.
Adult ; Dyspnea ; Hemoptysis ; Humans ; Male ; Pneumonectomy ; Pulmonary Artery* ; Sputum ; Tetralogy of Fallot ; Thorax ; Tolnaftate

Hydroa vacciniforme is a rare, chronic disease that is characterized by recur rent erythema and vesicles on uncovered skin within several days of sun exposure and is followed by healing with scarring. We have experienced a case of hydroa vacciniforme which involved the cornea, and we performed a penetra ting keratoplasty with a good result. We report this case with a review of the literature.
Chronic Disease ; Cicatrix ; Cornea ; Corneal Transplantation ; Erythema ; Hydroa Vacciniforme* ; Keratoplasty, Penetrating ; Skin ; Solar System ; Tolnaftate

A case of neurogenic pulmonary edema (NPE) occured during operation of brain tumor in the sit- ting position is reported. NPE is a common complication of brain insults. It is characterized clinically by an acute fulminant course, marked pulmonary vascular congestion, protein rich edema fluid, and intra alveolar hemorrhage. The mechanisms involved in the development of NPE are briefly discussed.
Brain Neoplasms* ; Brain* ; Edema ; Estrogens, Conjugated (USP) ; Hemorrhage ; Neurosurgery ; Pulmonary Edema* ; Tolnaftate

We experienced an extremely rare case of lipoid pneumonia combined with empyema. A 53-year-old patient was admitted because of chilling sensation and blood tinged sputum. Simple X-ray and computered tomography(CT) showed a huge homogeneous opacification in the left lower lung field. This patient was diagnosed as endogenous type lipoid pneumonia by a computed tomography guided needle biopsy; decortication and left lower lobectomy are performed. We diagnosed it as endogenous type lipoid pneumonia because it revealed a foreign body reaction and lipid laden macrophage on the pathologic examination.
Biopsy, Needle ; Empyema ; Foreign-Body Reaction ; Humans ; Lung ; Macrophages ; Middle Aged ; Pneumonia* ; Sensation ; Sputum ; Tolnaftate

Over a period of recent two years, 100 patients who had localized pulmonary lesions and underwent percutaneousneedle aspiration and biopsy, were analized. There were 56 malignancies and 44 benign and 79% respectively.Differentiation of malignancy vs. benignity was possible in 89% of cases obviating unnecessary exploratorythoracotomy for diagnostic purpose, Five cases were misinterpreted and eight cases were non-diagnostic oncytology. Inadequate materail was obtained in two cases; one was due to hardness of the mass, which, later,confirmed as chondrosarcoma, and the other was too samll(0.8x1.0cm) to be visible on lateral view. Theobainenability of the tissue was 98%. 14(14%) patients developed pneumothorax; one of them required treatment andthe reminder showed spontaneous resporption. (Transient neglibigle blood tinged sputum was found in 16(16%)cases.) The method, problems and complications are discussed. Authors recommend the percutaneous needle aspirationand biopsy as the initial procedure in diagnostic work-up of pulmonary coin lesions, especially when they aresmaller, more peripheral and metastatic neoplasm is neoplasm is suspected.
Biopsy ; Biopsy, Needle ; Chondrosarcoma ; Hardness ; Humans ; Methods ; Needles ; Pneumothorax ; Solitary Pulmonary Nodule ; Sputum ; Tolnaftate

A 70-year-old man was referred to the department of pulmonology due to blood tinged sputum and an abnormal chest X-ray. The chest X-ray and CT scans revealed a lobulated contour mass-like lesion in the left upper lung field. The bronchoscopic examination showed a whitish and polypoid mass occluding the left upper lobe bronchus. A biopsy specimen from the lesion revealed many aspergillus hyphae. Intravenous and oral itraconozole were administered over a 4 weeks period. Several months later, the size of the mass on chest X-ray increased and a percutaneous lung biopsy revealed a sarcomatoid carcinoma. We reported a case of lung cancer that was obscured by an endobronchial aspergilloma with a review of the relevant literature.
Aged ; Aspergillus ; Biopsy ; Bronchi ; Humans ; Hyphae ; Lung Neoplasms* ; Lung* ; Pulmonary Medicine ; Sputum ; Thorax ; Tolnaftate ; Tomography, X-Ray Computed