PURPOSE: This study was conducted to identify the effects of organizational culture for the infection control and self-efficacy on compliance with standard precautions of emergency room nurses. METHODS: This cross-sectional descriptive study was conducted from 1st July to 3rd August, 2017. The participants were 200 nurses working in emergency rooms. The data was collected using structured self-report questionnaires. RESULTS: The average scores for the organizational culture for infection control, self-efficacy and compliance with standard precautions were 5.54, 3.65, and 4.31, respectively. The organizational culture for infection control (r=.59, p<.001) and self-efficacy (r=.28, p<.001) were found to have a positive, meaningful correlation with compliance with the standard precautions. Multiple regression analysis showed that compliance with standard precautions was significantly affected by the organizational culture for infection control (β=0.55, p<.001) and self-efficacy (β=0.13, p=.033). CONCLUSION: The results for this study indicate that the organizational culture for infection control and self-efficacy were highly influential factors affecting compliance with standard precautions of emergency room nurses. Therefore, in order to improve the nurses' use of the standard precautions, it was necessary to develop and evaluate a program that considers the environmental factors and self-efficacy.
Compliance ; Emergencies ; Emergency Nursing ; Emergency Service, Hospital ; Infection Control ; Organizational Culture

Sustainable practices of school foodservices are gaining more attentions. The study aimed to investigate dietitians' performance levels of sustainable practices in school foodservice settings in Gyeonggi Provinces. Using a survey method was used, and data were collected from 358 participants (response rate 59.7%) to be analyzed using the SPSS program. The evaluation tool for sustainable practices of school foodservices consisted of four sections and 34 criteria with 100 points. Employment status of the respondents was as follows: nutrition teachers 40.9%, dietitians (permanent) 45.1%, and temporary position dietitians 13.2%. Dietitians' performance for sustainable practices marked 65.67 points out of 100 (performance rate 66%) and were in the following order by section: sustainable foodservice management criteria (69%), support activities (69%), planning and evaluation (68%), and outcome management (52%). Regarding sub-sections, criteria that acquired higher performance rates were labelling of food origin (99%), use of seasonal vegetables and fruits (98%), food waste management by contract dealer (98%), and planning for reducing of food waste and solid waste (91%). Meanwhile, criteria that showed the lowest scores were installing water conservation devices on equipment (19%), operating food donation programs for communities (21%), use of sensor lights for electricity conservation (24%), planning for annual energy conservation (40%), and implementation of education programs for foodservice workers on sustainable activities (42%). Performance scores differed according to school levels and working experience of dietitians, indicating that dietitians at elementary school foodservices or with work experience of 15 to 20 years showed higher performance than those at high schools or with less than 5 years of work experience (P < 0.001, P < 0.05). Based on the results, action plans for improvement were suggested.
Attention ; Education ; Electricity ; Employment ; Fruit ; Gyeonggi-do ; Humans ; Nutritionists ; Seasons ; Solid Waste ; Surveys and Questionnaires ; Vegetables ; Waste Management ; Water

Purpose: Although surgical management of Hirschsprung disease (HD) is effective in most patients, some patients experience long-term postoperative complications, and require redo pull-through (PT). The present study evaluated clinical outcomes of redo PT in HD patients at a single center. Methods: Patients with HD who underwent redo PT procedures between 2003 and 2019 were retrospectively reviewed. Results: Thirteen patients were included. Five (38.5%) had undergone initial PT surgery at our center and 8 (61.5%) at other centers. Redo PT procedures were transanal endorectal PT in 12 patients (92.3%) and the posterior sagittal approach in 1 patient (7.7%). Indications for redo PT included pathologic misdiagnosis in 8 patients (61.5%); stricture in 2 (15.4%); and rectal stenosis, obstructing Duhamel pouch and remnant septum in 1 each (7.7%). At a median follow-up of 68 months (range, 3–227 months) after redo PT, 8 patients (61.5%) had normal bowel function, 2 (15.4%) had incontinence, and 1 (7.7%) had constipation. Conclusion Redo PT procedures could be an effective approach for improving obstructive symptoms in HD patients with anatomic or pathologic reasons following primary PT. Careful selection of patients and discreet indications for redo PT are crucial.

BACKGROUND/OBJECTIVES: Increased mass of adipose tissue in obese persons is caused by excessive adipogenesis, which is elaborately controlled by an array of transcription factors. Inhibition of adipogenesis by diverse plant-derived substances has been explored. The aim of the current study was to examine the effects of the aqueous methanol extract of laver (Porphyra yezoensis) on adipogenesis and apoptosis in 3T3-L1 adipocytes and to investigate the mechanism underlying the effect of the laver extract. MATERIALS/METHODS: 3T3-L1 cells were treated with various concentrations of laver extract in differentiation medium. Lipid accumulation, expression of adipogenic proteins, including CCAAT enhancer-binding protein alpha, peroxisome proliferator-activated receptor gamma, fatty acid binding protein 4, and fatty acid synthase, cell viability, apoptosis, and the total content and the ratio of reduced to oxidized forms of glutathione (GSH/GSSG) were analyzed. RESULTS: Treatment with laver extract resulted in a significant decrease in lipid accumulation in 3T3-L1 adipocytes, which showed correlation with a reduction in expression of adipogenic proteins. Treatment with laver extract also resulted in a decrease in the viability of preadipocytes and an increase in the apoptosis of mature adipocytes. Treatment with laver extract led to exacerbated depletion of cellular glutathione and abolished the transient increase in GSH/GSSG ratio during adipogenesis in 3T3-L1 adipocytes. CONCLUSION: Results of our study demonstrated that treatment with the laver extract caused inhibition of adipogenesis, a decrease in proliferation of preadipocytes, and an increase in the apoptosis of mature adipocytes. It appears that these effects were caused by increasing oxidative stress, as demonstrated by the depletion and oxidation of the cellular glutathione pool in the extract-treated adipocytes. Our results suggest that a prooxidant role of laver extract is associated with its antiadipogenic and proapoptotic effects.
3T3-L1 Cells ; Adipocytes* ; Adipogenesis* ; Adipose Tissue ; Apoptosis* ; Carrier Proteins ; Cell Survival ; Glutathione ; Humans ; Methanol* ; Oxidative Stress ; PPAR gamma ; Transcription Factors

As animal welfare issue becomes important, the European Union bans conventional cages for laying hens from 2012. So the alternative housing systems like floor pens, aviaries or free range systems have been suggested. From 2011 to 2014, we monitored 20 welfare-oriented laying hen farms in South Korea to figure out serological status of major viral diseases. During this period, total 3,219 blood samples were collected from the randomly selected chickens to test and evaluate the hemagglutination inhibition titers for low pathogenic avian influenza, Newcastle disease and egg drop syndrome '76. A total of 2,926 blood samples were tested through enzyme linked immunosorbent assay (ELISA) to assess the serological status of infectious bronchitis (IB). The distribution of ELISA titers for IB was various from almost 0 to 20,000 through the all weeks of age. Also, the antibody coefficient of variation for most of the diseases in this study was higher than those of typical cage layers. As this study was the first surveillance for major avian viral diseases of the animal welfare-oriented farms in South Korea, the results obtained from this study will help to determine what information and resources are needed to maintain better biosecurity and to improve the health and welfare of laying hen flocks.
Agriculture ; Animal Welfare ; Animals ; Bronchitis ; Chickens ; Enzyme-Linked Immunosorbent Assay ; European Union ; Hemagglutination ; Housing ; Influenza in Birds ; Korea ; Newcastle Disease ; Ovum ; Sentinel Surveillance ; Virus Diseases

As animal welfare issue becomes important, the European Union bans conventional cages for laying hens from 2012. So the alternative housing systems like floor pens, aviaries or free range systems have been suggested. From 2011 to 2014, we monitored 20 welfare-oriented laying hen farms in South Korea to figure out serological status of major viral diseases. During this period, total 3,219 blood samples were collected from the randomly selected chickens to test and evaluate the hemagglutination inhibition titers for low pathogenic avian influenza, Newcastle disease and egg drop syndrome '76. A total of 2,926 blood samples were tested through enzyme linked immunosorbent assay (ELISA) to assess the serological status of infectious bronchitis (IB). The distribution of ELISA titers for IB was various from almost 0 to 20,000 through the all weeks of age. Also, the antibody coefficient of variation for most of the diseases in this study was higher than those of typical cage layers. As this study was the first surveillance for major avian viral diseases of the animal welfare-oriented farms in South Korea, the results obtained from this study will help to determine what information and resources are needed to maintain better biosecurity and to improve the health and welfare of laying hen flocks.

Purpose: Hiatal hernia in children is a rare condition, and there is limited knowledge available about the disease itself. There is currently no agreement or consensus on the treatment of hiatal hernia in the pediatric population due to lack of evidence. In this study, we were to assess our experience with hiatal hernia, including the characteristics of our patients, surgical outcomes, and factors that influence the outcomes. Methods: We retrospectively reviewed the medical records of 49 patients below the age of 18 years who underwent hiatal hernia repair at the Asan Medical Center between 2006 and 2021. We analyzed and compared the general characteristics and surgical outcomes based on the presence of recurrence and coexisting congenital diseases. Results: Hiatal hernia progression was found to be associated with various medical conditions; however, no significant differences in patient characteristics or surgical outcomes between those with and without comorbidities were observed.There were no significant differences in patient characteristics or outcomes between the initial and redo operations. Fundoplication was performed in 19 patients (36.7%) during the initial operation and in 7 patients (87.5%) during repeat hiatal hernia repair. Conclusion The presence of an underlying disease didn’t influence the treatment and progression of hiatal hernia. Furthermore, there were no significant differences in the clinical course between patients with recurrent hiatal hernia and those experiencing it for the first time. Additionally, the impact of fundoplication on the recurrence of hiatal hernia in pediatric patients was found to be minimal.

Recent studies described the epsilon 4 allele of apoE confers a two-to fourfold increased risk for late-onset Alzheimer's disease (LOAD), but LOAD pathology does not all fit neatly around apo E. Therefore, the goal of this study was to find the association between Alzheimer and apo E4 genotype in the 107 elderly between 50 to 64 years old who visited to FHWC of Sungshin Women's University. We conducted the questionnaire survey (general & 24 hr dietary recall), anthropometerics (BP, waist & BMI) and blood biochemistry (FBS & lipid profiles). LDL-c and HOMA-IR were calculated by Friedwald's and Matthew's formulas. The apo E genotyping was performed by PCR-RFLP method and subjects were divided into three allele groups (epsilon 3; wild, epsilon 2 & epsilon 4; mutants). The apo E allele frequencies were 7.0% for the epsilon 2, 83.6% for the epsilon 3 and 9.3% for the epsilon 4. In comparison with biochemistry characteristics by apo E genotype, FBS was significantly higher in epsilon 4 (129.2 +/- 6.8) than that in the others (epsilon 2: 117 +/- 7.4, epsilon 3: 107.3 +/- 2.2)(p < 0.01). More than forty percents of epsilon 4 group shown the dyslipidemia [high TG (> 150 mg/dl) & low HDL (< 40 mg/dl: male symbol or < 50 mg/dl: female symbol )]. The cytokines levels such as IL-1beta, IL-6 and TNF-alpha were not different among three apoE alleles. After the adjusting sex, age & dietary fiber, LDL-c level was significantly higher in epsilon 4 (108.3 +/- 7.7) than that in epsilon 2 (100.4 +/- 8.4)(p < 0.05). According to food intake and the recipe on the basis of 24 hr dietary recall, the elderly with epsilon 4 allele took higher intake frequency of the light -colored vegetable (radish, onion & cabbage) and pan-fried foods (sauteed beef and vegetables, stir-fried vienna with vegetables) than the others. We knew that the elderly with epsilon 4 allele had been restricted the calories intakes with high dietary fiber (33.6 + 2.5 g/d) to maintain the normal level of FBS and LDL-c. On next study, the prevalence of Alzheimer's disease in this population who has epsilon 4 allele on the condition of calories restriction will be continually follow-up.
Aged ; Alleles ; Alzheimer Disease ; Apolipoprotein E4* ; Apolipoproteins E ; Biochemistry ; Cytokines ; Dietary Fiber ; Dyslipidemias ; Eating ; Female ; Gene Frequency ; Genotype* ; Humans ; Interleukin-6 ; Male ; Middle Aged* ; Onions ; Pathology ; Prevalence ; Surveys and Questionnaires ; Tumor Necrosis Factor-alpha ; Vegetables

PURPOSE: Spontaneous neonatal gastric perforation is a rare but fatal disease with unclear etiology. In this study, we reviewed its clinical manifestations, outcomes, and discussed the etiology and prognostic factors. METHODS: There were 12 neonates with gastric perforation in our hospital from 1989 to 2015. Their medical records were reviewed retrospectively including birth record, associated disease, site and size of perforation, type of surgical management, clinical outcome. Also, the prognostic factors were analyzed. RESULTS: The median gestational age and birth weight was 32 weeks (range, 26-43 weeks; preterm birth rate, 66.7%) and 1,883 g (range, 470-4,400 g), respectively. Five patients had associated gastrointestinal anomalies including esophageal atresia and tracheoesophageal fistula (two patients), midgut volvulus, non-rotation and microcolon, and meconium plug syndrome. The median age at surgery was six days after birth (range, 2-13 days), and the median weight at surgery was 1,620 g (range, 510-3,240 g). Upper third part of stomach was the most frequently involved location of perforation. The size of perforation varied from pin point to involving the whole greater curvature. Primary repairs were done in seven cases, and in five cases, resections of necrotic portion were needed. Mortality rate was 33.3% (n=4), morbidity (re-operation) rate was 16.7% (n=2). The causes of death were sepsis (n=3), and heart failure from Ebstein anomaly (n=1). The median hospital stay was 92.5 days (range, 1-176 days). The factors mentioned as prognostic factors in previous studies showed no significant relations to the mortality and morbidity in our study. CONCLUSION: There were improvements of outcomes in patients with large size perforation. As previous studies, we assume these improvements were possible due to the improvements of critical care medicine. Given that rare incidence, a multi-center study can help us get a better understanding of this disease, and a better outcome.
Birth Certificates ; Birth Weight ; Cause of Death ; Critical Care ; Ebstein Anomaly ; Esophageal Atresia ; Gestational Age ; Heart Failure ; Humans ; Incidence ; Infant, Newborn ; Intestinal Volvulus ; Length of Stay ; Meconium ; Medical Records ; Mortality ; Parturition ; Premature Birth ; Retrospective Studies ; Sepsis ; Stomach ; Tracheoesophageal Fistula

Background: CDKN2A is a tumor suppressor gene that encodes the cell cycle inhibitor protein p16. Homozygous deletion of the CDKN2A gene has been associated with shortened survival in isocitrate dehydrogenase (IDH)–mutant gliomas. This study aimed to analyze the prognostic value of p16 and to evaluate whether p16 immunohistochemical staining could be used as a prognostic marker to replace CDKN2A genotyping in diffuse gliomas. Methods: p16 immunohistochemistry was performed on tissue microarrays of 326 diffuse gliomas with diagnoses that reflected IDH-mutations and 1p/19q codeletion status. The results were divided into three groups (negative, focal expression, overexpression) according to the presence and degree of p16 expression. Survival analysis was performed to assess the prognostic value of p16 expression. Results: A loss of p16 expression predicted a significantly worse outcome in all glioma patients (n=326, p<.001), in the IDH-mutant glioma patients (n=103, p=.010), and in the IDH-mutant astrocytoma patients (n=73, p=.032). However, loss of p16 expression did not predict the outcome in the IDH-wildtype glioma patients (n=223, p=.121) or in the oligodendroglial tumor patients with the IDH-mutation and 1p/19q codeletion (n=30, p=.457). Multivariate analysis showed the association was still significant in the IDH-mutant glioma patients (p=.008; hazard ratio [HR], 2.637; 95% confidence interval [CI], 1.295 to 5.372) and in the IDH-mutant astrocytoma patients (p=.001; HR, 3.586; 95% CI, 1.649 to 7.801). Interestingly, patients who presented with tumors with p16 overexpression also had shorter survival times than did patients with tumors with p16 focal expression in the whole glioma (p< .001) and in IDH-mutant glioma groups. (p=.046). Conclusions This study suggests that detection of p16 expression by immunohistochemistry can be used as a useful surrogate test to predict prognosis, especially in IDH-mutant astrocytoma patients.