• Journal of Korean Academy of Nursing
• /
• v.50 no.5
• /
• pp.658-670
• /
• 2020

Purpose: This study aimed to identify the predictors of blood and body fluid exposure (BBFE) in multifaceted individual (sleep disturbance and fatigue), occupational (occupational stress), and organizational (hospital safety climate) factors, as well as infection prevention behavior. We also aimed to test the mediating effect of infection prevention behavior in relation to multifaceted factors and the frequency of BBFE. Methods: This study was based on a secondary data analysis, using data of 246 nurses from the Shift Work Nurses' Health and Turnover study. Based on the characteristics of zero-inflated and over-dispersed count data of frequencies of BBFE, the data were analyzed to calculate zero-inflated negative binomial regression within a generalized linear model and to test the mediating effect using SPSS 25.0, Stata 14.1, and PROCESS macro. Results: We found that the frequency of BBFE increased in subjects with disturbed sleep (IRR = 1.87, p = .049), and the probability of non-BBFE increased in subjects showing higher infection prevention behavior (IRR = 15.05, p = .006) and a hospital safety climate (IRR = 28.46, p = .018). We also found that infection prevention behavior had mediating effects on the occupational stress-BBFE and hospital safety climate-BBFE relationships. Conclusion: Sleep disturbance is an important risk factor related to frequency of BBFE, whereas preventive factors are infection prevention behavior and hospital safety climate. We suggest individual and systemic efforts to improve sleep, occupational stress, and hospital safety climate to prevent BBFE occurrence.

• The Journal of the Korean dental association
• /
• v.22 no.9 s.184
• /
• pp.793-801
• /
• 1984

Though oral microgranisms were among the first to be observed by humans, the interest in oral microbiology lagged. When it became apparent that the oral microflora did influence systemic disease of the body, interest was aroused in the nature and kinds of the microgranisms. The risk of infection in dental procedures is due to the abundant flora of the mouth. This hazard can be reduced to some extent by the use of a local disinfectant. The present studies were undertaken to evaluate and compare the various disinfectants which are commonly used in clinics and hospitals. The results were as follows. 1. The bactericidal activity of the disinfectants mainly depends upon the kinds of the agents, not upon the kinds of the microorganisms. 2. In H₂O₂(3%), the bactericidal activity was greatly related to the contact time. So, at least 4 minitues of contract time was required to use it as an oral antiseptic. 3. In ethyl alcohol (70%), Pseudomonas aeruginosa and Streptococcus salivarius surived a little after 15 seconds of contact time, but, no other colony was discovered after more than 15 seconds of contact time in any kins of microorganisms. 4. Merthiolate (0.1%) showed low antibacterial activity, more in Gram-positive organisms and less in Gram-negative organisms. 5. Benzalkonium chloride (0.1%) and povidone-iodine (10%) showed the most excellent results, revealing no surviving organisms only after 14 seconds of contact time.

• Journal of the Korea Convergence Society
• /
• v.9 no.6
• /
• pp.117-124
• /
• 2018

The purpose of this study was to analyze factors affecting the health behaviors and urinary tract tests of adults and their effects on periodontitis by using raw data from the 6th National Health and Nutrition Survey (1st, 2nd, 3rd year). The subjects were 40 years older who had oral examination and urine tests such as glycosuria and ketonuris. The final 11,036 subjects were analyzed using SPSS. ${\chi}^2-test$ and logistic regression analysis were used to analyze the demographic characteristics, health behaviors, and differences in urine levels and presence or absence of periodontitis. There was statistically significant difference between the urine test values and the incidence of periodontal disease in urine glucose and proteinuria. Risk factors were male, age, income and education level, rural, smoking, obesity, urine glucose. These results suggest that improvement of health behavior and aggressive management of systemic disease factors are necessary and development of management and preventive program of Periodontitis is necessary.

• Clinical and Experimental Pediatrics
• /
• v.53 no.10
• /
• pp.863-871
• /
• 2010

The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. Adenotonsillar hypertrophy is the most common cause of OSAS in children, and obesity, hypotonic neuromuscular diseases, and craniofacial anomalies are other major risk factors. Snoring is the most common presenting complaint in children with OSAS, but the clinical presentation varies according to age. Agitated sleep with frequent postural changes, excessive sweating, or abnormal sleep positions such as hyperextension of neck or abnormal prone position may suggest a sleep-disordered breathing. Night terror, sleepwalking, and enuresis are frequently associated, during slow-wave sleep, with sleep-disordered breathing. Excessive daytime sleepiness becomes apparent in older children, whereas hyperactivity or inattention is usually predominant in younger children. Morning headache and poor appetite may also be present. As the cortical arousal threshold is higher in children, arousals are not easily developed and their sleep architectures are usually more conserved than those of adults. Untreated OSAS in children may result in various problems such as cognitive deficits, attention deficit/hyperactivity disorder, poor academic achievement, and emotional instability. Mild pulmonary hypertension is not uncommon. Rarely, cardiovascular complications such as cor pulmonale, heart failure, and systemic hypertension may develop in untreated cases. Failure to thrive and delayed development are serious problems in younger children with OSAS. Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions.

• Clinical and Experimental Pediatrics
• /
• v.59 no.6
• /
• pp.252-255
• /
• 2016

Purpose: Pneumocystis jirovecii pneumonia occurs in various immunocompromised patients. Despite the prophylaxis strategies in clinical practice, certain patients develop P. jirovecii pneumonia. This study was performed to investigate pediatric cases with P. jirovecii pneumonia in a single center. Methods: We identified pediatric patients younger than 19 years with microbiologically confirmed P. jirovecii pneumonia from January 2000 to February 2014. A retrospective chart review was performed. Results: Fifteen episodes of P. jirovecii pneumonia in 14 patients were identified with median age of 8.3 years (range, 0.4-18.6 years). Among these patients, 11 patients had hematology-oncology diseases, 2 had primary immunodeficiency disorders (one with severe combined immunodeficiency and the other with Wiskott Aldrich syndrome), 1 had systemic lupus erythematosus and 1 received kidney transplant. Four patients were transplant recipients; 1 allogeneic and 2 autologous hematopoietic cell transplant and 1 with kidney transplant. The median absolute lymphocyte count at the diagnosis of P. jirovecii pneumonia was $5,156cells/mm^3$ (range, $20-5,111cells/mm^3$). In 13 episodes (13 of 15, 86.7%), patients were not receiving prophylaxis at the onset of P. jirovecii pneumonia. For treatment, trimethoprim/sulfamethoxazole was given as a main therapeutic agent in all 15 episodes. Steroid was given in 9 episodes (60%). Median treatment duration was 15 days (range, 4-33 days). Overall mortality at 60 days was 35.7% (5 of 14). Conclusion: Majority of our patients developed P. jirovecii pneumonia while not on prophylaxis. Continuous efforts and more data are needed to identify high risk patients who may get benefit from P. jirovecii pneumonia prophylaxis.

• Food Science of Animal Resources
• /
• v.40 no.3
• /
• pp.401-414
• /
• 2020

The emergence and persistence of methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) in livestock animals have been reported as a potential risk factor for transmission to humans. In this study, we investigated the nationwide prevalence and characteristics of MRSA and MSSA in the Korean beef production system, including retail markets, slaughterhouses, and cattle farms. From a total of 1,285 samples, only 5 MRSA strains were isolated: from a farmer (1 ST72 MRSA), a carcass sample from a slaughterhouse (1 ST72 MRSA), and beef cattle (3 ST5 MRSA). In addition, 11 MSSA strains were isolated from beef cattle (n=3), humans (1 farmer, 1 slaughterhouse worker, and 4 retail market workers), and carcass samples (n=1) and slaughterhouse environment (n=1). Although the prevalence of MRSA and MSSA in beef cattle was much lower than that reported in pigs, 5/5 MRSA and 2/11 MSSA strains displayed multiple drug resistance (MDR) phenotypes. Unlike the swine-associated MRSA, no correlation was found between tetracycline/zinc resistance and MDR phenotype. However, MRSA strains had an identical set of staphylococcal enterotoxins and exhibited enhanced levels of resistance to antimicrobial peptides (PMAP-36 and LL-37) compared to the MSSA strains. In conclusion, continued and systemic surveillance of livestock, meat products, and humans in close contact with livestock/meat products is necessary to prevent the transmission of MRSA and MSSA to humans.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.4
• /
• pp.1675-1682
• /
• 2012

Aim: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. Design: The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. Results: 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29; p<0.001); and (2) although not approaching statistical significance $p{\geq}0.200$), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Conclusions: Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.

• Journal of the Computational Structural Engineering Institute of Korea
• /
• v.26 no.6
• /
• pp.415-421
• /
• 2013

In order to extend the service life of a nuclear power plant(NPP) ensuring the structural safety, effective and efficient management of NPP considering structural deteriorations and various natural hazard risks has been treated as a significant tool(IAEA 1998). The systemic efforts is required to prevent the potential loss of NPPs resulting from the natural hazard including earthquakes, hurricane and flooding since the Fukushima accident. Earthquake risk of building structures can be mitigated through appropriate seismic isolation system installation. It has been known that a seismic isolation system can lead to reduction of the deleterious effect on ground motion induced by earthquakes, and structural safety can be improved. In this paper, the NPP life-cycle management is reviewed. Furthermore, effect of seismic isolation on the NPP life-cycle cost analysis with earthquake, and cost-benefit analysis in terms of life-cycle cost when applying the seismic isolation systems to NPP are introduced.

• Parasites, Hosts and Diseases
• /
• v.53 no.1
• /
• pp.95-99
• /
• 2015

Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient's fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.

• Pediatric Infection and Vaccine
• /
• v.20 no.1
• /
• pp.41-45
• /
• 2013

Nontyphoidal Salmonella are gram negative bacilli organism, which may induce systemic infection such as febrile enteritis, bacteremia, and osteomyelitis. Main route of infection is known as food but also possible through reptile, amphibian, and fish raised as pets in the house. There is no known cases report of Salmonella infection through pets in Korea and also rare in the overseas. We report 2 patients who visited Severance children's hospital with chief complaint of fever and diagnosed as nontyphoidal salmonellosis. Each case had a history of raising turtle or tropical fish with possibility of Salmonella infection through these pets. Increasing incidence of raising pet reptile and fish lately, contact precaution and proper prevention and control of Salmonella infection of these pets especially in children under 5 years old are necessary due to higher risk of serious complications of salmonellosis.