Purpose: To identify an associations between health care workers' uniforms and health care-associated infection. Methods: Electronic databases, including Ovid-Medline, the Cochrane Library, CINAHL, EMBASE, KMbase, and KoreaMed, were searched. The search terms included doctor, nurse, health care worker/staff/assistant, clothing, (white) gown, uniform, (neck)tie, and attire. Only papers published in English and Korean were included. Results: 16 studies were selected from 1,900 references screened. All of the studies were non-comparative studies except for one. Four were conducted with doctors, six with nurses, one with health care workers including physiotherapists and one for medical staff plus visitors in a neonatal intensive care unit. Doctors more frequently changed their uniforms than neckties; therefore, the degree of contamination was more serious in neckties. The cuff zone was more likely to be heavily contaminated than other areas of long-sleeve gowns. Coats become contaminated quickly once worn, and colony counts reached a similar level within the first few hours after wearing them. Wearing a plastic apron or protective clothing did not prevent the bacterial contamination of nurses' uniforms, and the best way to decrease the contamination was changing to newly laundered uniforms before starting every duty. Conclusion: Healthcare workers' uniforms are a potential source of health care-associated infection although there was no robust evidence. The government must establish standards for laundering of uniforms or a requirement for institutions to provide a laundering service for healthcare workers' uniforms.
Park, Joon-Cheol;Lim, Su-Yeon;Jang, Tae-Kyu;Bae, Jin-Gon;Kim, Jong-In;Rhee, Jeong-Ho
Clinical and Experimental Reproductive Medicine
/
v.38
no.1
/
pp.42-46
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2011
Objective: This study was aimed to investigate endometrial histology and to find predictable clinical factors for endometrial disease (hyperplasia or cancer) in women with polycystic ovary syndrome (PCOS). Methods: We investigated the endometrial histology and analyzed the relationship between endometrial histology and clinical parameters, such as LH, FSH, estradiol, testosterone, fasting and 2 hours postprandial glucose and insulin, insulin resistance, body mass index, endometrial thickness, menstrual status from 117 women with PCOS. Statistical analysis was performed with chi square and t-test, p-value<0.05 was considered as statistically significant. And receiver operating characteristic curve was used to find predictable clinical factors for endometrial disease and to decide the cuff off values. Results: In 117 women with PCOS, endometrial histologic profiles are as follows: proliferative phase in 90 women (76.9%), endometrial hyperplasia in 25 women (21.4%), and endometrial cancer in 2 women (1.7%). Of 25 women with endometrial hyperplasia, simple hyperplasia without atypia, complex hyperplasia without atypia and complex hyperplasia with atypia were diagnosed in 15 (12.8%), 6 (5.1%), 4 (3.4%) women, respectively. Age and endometrial thickness were significantly related with endometrial disease, p=0.013 and p=0.001, respectively. At the cut off level of 25.5 years in age, sensitivity and specificity predicting for endometrial disease were 70.4% and 55.6%, respectively (p=0.023). At the cut off level of 8.5 mm in endometrial thickness, sensitivity and specificity were 77.8% and 56.7%, respectively (p=0.000). Conclusion: In women with PCOS, the incidence of endometrial hyperplasia and cancer were 21.4% and 1.7%. The age and endometrial thickness may be used as clinical determining factors for endometrial biopsy.
Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG.
Shoulder pain, injury and discomfort are public health and economic issues world-wide. The function of these joints and the stresses developed during their movement is a major concern to the orthopedic surgeon to study precisely the injury mechanisms and thereby analyze the post-operative progress of the injury. Shoulder is one of the most critical joints in the human anatomy with maximum degrees of freedom. It mainly consists of the clavicle, scapula and humerus; the articulations linking them; and the muscles that move them. In order to understand the behavior of individual muscle during abduction arm movement, an attempt has been made to analyze the stresses developed in the shoulder muscles during abduction arm movement during the full range of motion by using the 3D FEM model. 3D scanning (ATOS III scanner) is used for the 3D shoulder joint cad model generation in CATIA V5. Muscles are added and then exported to the ANSYS APDL solver for stress analysis. Sensitivity Analysis is done for stress and strain behavior amongst different shoulder muscles; deltoid, supraspinatus, teres minor, infraspinatus, and subscapularies during adduction arm movement. During the individual deltoid muscle analysis, the von Mises stresses induced in deltoid muscle was maximum (4.2175 MPa) and in group muscle analysis it was (2.4127MPa) compared to other individual four rotor cuff muscles. The study confirmed that deltoid muscle is more sensitive muscle for the abduction arm movement during individual and group muscle analysis. The present work provides in depth information to the researchers and orthopedicians for the better understanding about the shoulder mechanism and the most stressed muscle during the abduction arm movement at different ROM. So during rehabilitation, the orthopedicians should focus on strengthening the deltoid muscles at earliest.
Journal of the Korean Society of Clothing and Textiles
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v.26
no.8
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pp.1286-1297
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2002
This study was aimed at conducting a survey and analyzing its results on the purchase and wearing conditions and design preference of sports casual wear among women and men in their twenties and thirties according to region, gender, age and income. The survey was administered using a website and was conducted among the persons who purchased sports casual wear more than once a year. The statistical results were analyzed from 497 questionnaires of respondents residing in Seoul, Gyeonggi Province, six metropolitan cities and other cities and provinces. The results of this study were summarized as follows. 1) Results of wearing conditions and preference of sports casual wear : The respondents of the survey answered that they had purchased 1 or 2 clothing items for a year and the order of buying the popular wear ranked sport shirt, jacket, trousers respectively. They chose mostly shades of gray, and the most favored design type were a chin collar, a set-in sleeves, a mixed type of band cuffs and elastic band, side zip-pockets, a full-zip front fastener, alight warm-up hood, and a small front upper chest type logo; 2)Analysis of the differences in purchase and wearing conditions in accordance with region, gender, age and income : The largest proportion of respondents who answered thar had purchased 4 or more clothing items for a year were Seoul residents and in particular the residents south of the Han river. The customers under thirty usually obtained their information about sports casual wear by visiting stores in person. The men obtain a variety of information through printed materials and related Internet sites; 3) Analysis of preferential differences of the detailed partial design : The purchasers in their 20's preferred black white, and gray patterns, however that preference shifted for those in their late 20's and the preference for pastel colors increased. The purchasers in their 20's and mid 30's had a preference for a chin collar and an eight-shaped zip type pockets. The men preferred a band cuff and a detachable hood type but women favored an elastic band and a light warm-up hood type.
CG200745 is a novel inhibitor of histone deacetylases (HDACs), initially developed for treatment of various hematological and solid cancers. Because it is water-soluble, it can be administered orally. We hypothesized that the HDAC inhibitor, CG200745, attenuates cardiac hypertrophy and fibrosis in deoxycorticosterone acetate (DOCA)-induced hypertensive rats. For establishment of hypertension, 40 mg/kg of DOCA was subcutaneously injected four times weekly into Sprague-Dawley rats. All the rats used in this study including those in the sham group had been unilaterally nephrectomized and allowed free access to drinking water containing 1% NaCl. Systolic blood pressure was measured by the tail-cuff method. Blood chemistry including sodium, potassium, glucose, triglyceride, and cholesterol levels was analyzed. Sections of the heart were visualized after trichrome and hematoxylin and eosin stain. The expression of hypertrophic genes such as atrial natriuretic peptide A (Nppa) and atrial natriuretic peptide B (Nppb) in addition to fibrotic genes such as Collagen-1, Collagen-3, connective tissue growth factor (Ctgf), and Fibronectin were measured by quantitative real-time PCR (qRT-PCR). Injection of DOCA increased systolic blood pressure, heart weight, and cardiac fibrosis, which was attenuated by CG200745. Neither DOCA nor CG200745 affected body weight, vascular contraction and relaxation responses, and blood chemistry. Injection of DOCA increased expression of both hypertrophic and fibrotic genes, which was abrogated by CG200745. These results indicate that CG200745 attenuates cardiac hypertrophy and fibrosis in DOCA-induced hypertensive rats.
Journal of the Korean Institute of Landscape Architecture
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v.23
no.2
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pp.124-136
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1995
This study was conducted to find the distinguished pattern of Korean 'Dae'. Therefore, the purpose of this study is to define how the pattern of 'Dae' has been developed and what is the characteristics of the pattern of Korean 'Dae'. The summarized results are as follows; 1. The types of 'Dae'(rock in the nature, a 'Dae' built artificially, a structure) were identified in the era of the three kingdoms. And in the era of the three kingdoms, 'Dae' was regarded as: a mysterious place related with a king, the place where concrete activities of a specific person had occurred in there, and a mountain peak 2. in the era of Koryo , artificial aspect of 'Dae' were emphasized. In addition, the activities occurred in the 'Dae' took concrete shape by kings. 3. The characteristics of the pattern of 'Dae' during Chosen Dynasty are: 1) A type of huge flat rock(27.6%), a type of mounts고 peak and a type of cuff(24.1%), a type of fantastic rock(15.5%), a type of stratified rock(6.9%) were shown 2) The main activities on 'Dae' were play , observation, and rest 3) In the viewpoint of the locational characteristics, 'Dae' were found in the mountains, at the top of the mountain peaks, on high hill, on cliffs, at the riversides, and on the beaches, etc. 4. With consideration on change trend of the number of'Dae' according to literature(time) , the biggest geographical distributions of 'Dae' were shows in Hamkyungdo in noddle of 15th century (Saejongsillockjiriji), in Kangwondo in the middle of 16th century (Sinjeongdonggukyecjiseongram), in Chunrado in middle of 17th century(Donggukyeojiji), and in Kyungsangdo in middle of 18th 19th century(Yeojidoseo, Eubji) 5. Through the whole period of Chosen Dynasty, the geographical distribution of 'Dae' had much in Kyungsangdo and Pyungahndo.
Journal of the Korea Academia-Industrial cooperation Society
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v.10
no.8
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pp.1926-1938
/
2009
In this study, detection system of the blood flow variation rate was implemented using the variation effect of bio electric impedance at time of the blood pressure measurement by means of impedance method. The blood pressure measurement was performed by the oscillometric method. The mean arterial pressure was calculated using maximum amplitude algorithm. The systolic and diastolic pressure were estimated by establishment of the various characteristic ratio according to mean arterial pressure range. Alternative static current source and lock_in amplifier were introduced to impedance measurement. The variation of blood volume was measured using variation bio impedance according to induced cuff pressure at measuring area.
A 17 year-old high school girl was admitted for anterior chest pain. Pulmonary edema and circulatory collapse progressed in spite of the medical treatment and intra-aortic balloon pump. Left ventricular assist device(LVAD, Bio-Pump, Medtronic Bio-Med, USA) was instituted under the impression of acute fulminant myocarditis. The inlet cannula was inserted in the left atrium(LA) via left submammary anterior thoracotomy. Biopsy was taken from left atrial appendage. The outlet cannula inserted to the left femoral artery using PTFE cuff. After 158 hours of extracorporeal circulation, LVAD was able to be weaned successfully with nearly normalized LV motion on echocardiogram, Coxsakievirus was identified with immunochemistry and serum neutralization test. She was discharged without any heart failure symptoms after 23 days of hopitalization.
Free vascularized fibular is the most usuful bony donor of the long bone reconstruction in reconstructive microsurgical field. It has many benifits such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter with long pedicle, minimal donor site morbity too. In that situations of the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transfered. The bony circulation of the fibula has two ways, one from nutrient artery via peroneal artery through nutrient foramen which makes endosteal arterial network inside of the fibula, another way is periosteal network through outside encircling vascular network of the bone which distributed in muscle sleeves of the fibular diaphysis. Authors modified free vascularized fibular bone graft with transverse osteotomy is made from the anterolateral aspect of the fibular shaft just distal to entry of the nutrient artery. This produces two vascularized bone struts that may be folded pararell to each other but that remain connected by the periosteum and muscle cuff surrounding the peroneal artery and veins. The proximal strut is vascularized by both a periosteal and endosteal blood supply, whereas the distal strut is vascularized by a periosteal blood supply alone. This procedure can call "doule barrel" free vascularized fibular graft. We performed 7 cases of doule barrel fashined fibular transplantation on distal femur and proximal tibial large defects. Average bone union time takes 7 months from that procedure. There were no significant bone union time differences between both proximal and distal struts. After solid union of the transfered double barrel fibular graft, there were no stress fracture in our series. We can propose double barrel free vascualized fibular graft is usuful method in that cases with very large bone defect on large long bones especially metaphyseal defects.
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