PURPOSE: This study was to develop and evaluate a folk play program as a nursing intervention for the elderly with dementia. METHOD: First, a folk play program was developed through a careful study of literature review and field-work. Second, a nonequivalent control group pre-post test was designed. The subjects of the study were the elderly with dementia staying in nursing homes; 15 were in an experimental group adopting a folk play program developed through this study, 18 in the control group on a gymnastics and walking program which is generally used. The 40 min. intervention was conducted 5 times a week for 4 weeks. RESULT: The folk play program improved the cognition(t=6.12, p<.001) and ADL(t=2.92, p=.014) and diminished the frequency of problematic behaviors significantly(t=-6.39, p<.001). There was a significant difference of cognition, ADL, and problematic behaviors between the control and the experimental group before and after the experiment(t=3.38, p=.002; t=2.05, p=.046; t=-7.74, p<.001). CONCLUSION: Compared with the gymnastics and walking program, the folk play program proved to be much more effective in the elderly with dementia in improving their cognition and ADL, as well as in diminishing their problematic behaviors. Therefore, a folk play program should be appliedas an effective and practical Korean nursing intervention for the elderly with dementia.
*Play Therapy ; Male ; Humans ; Female ; Dementia/*psychology/therapy ; *Cognition ; Aged, 80 and over ; Aged ; *Activities of Daily Living

PURPOSE: The purpose of this study was to compare the effect of alcohol gel according to the amount and drying time in health personnel hand hygiene and to promote in their practice adequate and effective hand hygiene. METHODS: The cross-over experimental study was performed with 14 volunteers. Hands were artificially contaminated with 5 mL of 10(8) CFU/mL of Serratia marcescens (ATCC 14756) and four different alcohol gel hand hygiene methods varying by the amount of alcohol gel (2 mL vs. 1 mL) and drying time (complete vs. incomplete) were compared. Samples were collected by glove juice sampling procedures. RESULTS: Mean log reduction values of the four different hand hygiene methods were 2.22+/-0.36, 1.26+/-0.53, 1.49+/-0.60, 0.89+/-0.47 respectively for the 4 groups: adequate amount (2mL) and complete dry (30 seconds rubbing followed by 2 min air-dry), inadequate amount (1 mL) and complete dry, adequate amount and incomplete dry (15 seconds rubbing and no air-dry), and inadequate amount and incomplete dry. The difference was statistically significant in the adequate amount and complete dry group compared to other three groups (p<.001). CONCLUSION: Only alcohol gel hand hygiene with adequate amount and complete drying was satisfactory by U.S. FDA-TFM efficacy requirements for antiseptic hand hygiene products.
Adolescent ; Adult ; Anti-Infective Agents, Local/*pharmacology ; Cross-Over Studies ; Ethanol/chemistry/*pharmacology ; Gels/*chemistry ; Hand Hygiene/*methods ; Humans ; Middle Aged ; Serratia marcescens/*drug effects ; Time Factors ; Young Adult

BACKGROUND: This is a retrospective, descriptive study, evaluating the observed agreement between 1996 & 2002 Centers for Disease Control and Prevention (CDC) definitions of nosocomial pneumonia (NP) for medical intensive care unit (MICU) and surgical intensive care unit (SICU) patients. METHODS: A total of 476 adult patients who were over 15 years of age and had been admitted to the MICU & SICU of a university hospital between August 1, 2005 and August 1, 2007 were enrolled. Data were collected from electronic medical records according to the 1996 & 2002 CDC definitions of NP. RESULTS: According to the 1996 CDC definitions of NP, there were a total of 116 NP cases and incidence rate was 11.6 per 1,000 patient-days; when analyzed with the 2002 CDC definitions of NP, 75 cases met the criteria and the incidence rate was 7.5 per 1,000 patient-days. Kappa value measuring agreement between the two definitions was 0.67 (95% confidence interval 0.601-0.706). When 1996 CDC definitions were compared with 2002 CDC definitions, sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 88.5, 60.3, and 98.6%, respectively. CONCLUSION: Even though the aforementioned NP criteria had been applied to the same study population, the number of patients that met the definitions changed depending on which criteria had been used. Therefore, it is necessary to consider the differences when making a comparison.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity

Purpose: The purpose of this study was to provide multifaceted interventions for nurses and to confirm changes in their knowledge, perception, and actual practice on the adequate storage, conditions, and transportation of culture specimens. Methods: A onegroup pretest-posttest experimental design was conducted with 41 nurses in two general wards of a tertiary acute care hospital in Seoul. Multifaceted interventions including education, feedback, posting guidelines and reminders, and improvement in specimen management accessibility were provided from May 2019 to January 2020. Outcomes were measured before and after the interventions. Knowledge and perception of the nurses were evaluated using self-reported questionnaires and actual practice by observation. Results: After the interventions, the average knowledge score on transportation time was significantly increased (Z = -4.89, p < .001). However, the knowledge score on storage methods was not significantly increased. The perception score was significantly increased (t = -3.19, p = .003). The proportion of specimen storage times, places, and conditions managed properly was significantly increased from 43.0% (46/107) to 77.1% (84/109) (p < .001). The average transportation time of blood samples to the laboratory significantly decreased from 3 hours 36 minutes ( ± 1 hour 52 minutes) to 3 hours 1 minute ( ± 1 hour 41 minutes) (t = 2.51, p = .013). The percentage of blood culture specimens arriving within 2 hours was increased significantly from 22.9% to 39.2% ( χ 2 = 6.90, p = .009). Conclusion The interventions were effective. However, some specimens remained in the ward longer than expected after the interventions. This requires further interventions.

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

Trauma is one of the causes of lymphedema. However, we usually do not consider it as a cause of the lymphedema, thus, we often fail to take care of the patients properly. We report a patient with post traumatic lymphedema and the result of complex decongestive therapy, and reviewed the clinical, lymphoscintigraphic findings and treatment.
Humans ; Lymphedema*

PURPOSE: The aim of this study was to determine the absolute value of the root/crown ratio (R/C ratio) using panoramic radiographs (PRGs) in a healthy Korean population. MATERIALS AND METHODS: In total, 99 patient radiographs (of 50 males and 49 females subjects; aged 16 to 24 years old) were examined, and 2,770 teeth were analyzed. Crown lengths and root lengths were measured with modified Lind's measurements using PACS tools by two examiners in two separate sessions two months apart. All data were analyzed using SPSS. The independent t-test was used to assess for gender differences, and the paired t-test was used to compare both arches with a significance level of P<.05. RESULTS: The mean R/C ratios varied from 1.29 to 1.89 (male: 1.28-1.84; females: 1.31-1.94). The highest R/C ratios were recorded for the mandibular canines (1.89), followed by the maxillary canines (1.79). The lowest R/C ratios were recorded for the maxillary second molars (1.31). In comparison with the maxillary teeth (1.29-1.78), the mandibular teeth yielded the higher R/C ratio (1.47-1.89), and this difference was significant in the females (P<.05). The difference between the genders was not statistically significant, except for the maxillary central incisors, mandibular canines and mandibular first premolars. CONCLUSION: These data may enhance the understanding of the clinical R/C ratio as a useful guideline for determining the status of teeth and the ethnic difference.
Bicuspid ; Crowns ; Female ; Humans ; Incisor ; Male ; Molar ; Tooth*

OBJECT: The goals of radiosurgery include preservation of neurological function and prevention of tumor growth. We document the results of gamma-knife radio-surgery for vestibular schwannoma. METHOD AND OBJECT: Eighty-two patients underwent stereotactic radiosurgery for an vestibular schwannoma from October, 1994 to December, 2000. Sixty-five of these patients were followed up for radiological and clinical evaluation. As pregamma-knife modality, surgical resection were done in 23 patients,and V-P shunt in 2 patients. Initial symptoms were headache(n=45), dizziness(n=16), tinnitus(n=17). While normal facial function(House-Brackmann grade 1) was present in 48 patients(73.8%), other patients showed grade 2 function in 8, grade 3 function in 7,and grade 4 function in 2. The Gardner/Robertson scale was used to code hearing function. Male to female ratio was 1:3. Mean tumor volume was 7.98cm3. Mean dose delivered to the tumor margin was 14.2Gy,and mean maximal dose was 28.3Gy. RESULTS: Mean follow-up duration of 19.9 months. Thirty-five showed decrease(53.8%) in size, 19 patients(29.2%) stationary, 3(4.6%) initial decrease follow up increase, 5(7.6%) initial increase follow up decrease,and 59 patients (90.8%) were well controlled. Two patients experienced transient facial neuropathy, one transient trigeminal neuropathy, and one transient hearing deterioration. After gamma-knife radiosurgery, ventriculoperitoneal shunt was done in 4 patients. CONCLUSIONS: Gamma-knife radiosurgery can be used to treat postoperative residual tumors as well as in patients with concomitant medical problems in patients with preserved hearing function. Gamma-knife radiosurgery is safe and effective method to treat small, medium sized(less than 3cm in extracanalicular diameter), intracanalicular vestibular schwannoma, associated with low rate of cranial neuropathy.
Cranial Nerve Diseases ; Facial Nerve Diseases ; Female ; Follow-Up Studies ; Hearing ; Humans ; Male ; Neoplasm, Residual ; Neuroma, Acoustic* ; Radiosurgery* ; Trigeminal Nerve Diseases ; Tumor Burden ; Ventriculoperitoneal Shunt

BACKGROUND: In this study, four types of effervescent vitamins marketed in Korea were analyzed for their acidity and vitamin content. For this purpose, bovine teeth were immersed in vitamin, and surface microhardness and appearance were measured before and after immersion to evaluate tooth demineralization and erosion.METHODS: Bovine permanent incisors with sound surface enamel were cut to 5×5 mm size, embedded in acrylic resin, and polished using a polishing machine with Sic-paper. The prepared samples were analyzed for pH, vitamin content, and surface hardness before and after immersion using a surface microhardness meter. Demineralization of surface dental enamel was observed using a scanning electron microscope.RESULTS: The average pH of the four effervescent vitamins was less than 5.5; the pH of the positive control Oronamin C was the lowest at 2.76, while that of the negative control Samdasoo was the highest at 6.86. The vitamin content was highest in Berocca and lowest in the DM company Multivitamin. On surface microhardness analysis, surface hardness values of all enamel samples were found to be decreased significantly after 1 and 10 minutes of immersion (p<0.05). After 10 minutes of immersion, there was a significant difference in the decrease in hardness between the experimental groups (p<0.05). Scanning electron microscopy observation showed that dental enamel demineralization after 10 minutes of immersion was the most severe in Oronamin C except for Samdasoo, followed by DM company Multivitamin and VitaHEIM. Immersion in BeroNew and Berocca resulted in similar effects.CONCLUSION: There is a risk of tooth erosion due to decreased tooth surface microhardness when using the four types of effervescent vitamins and vitamin carbonated beverages with pH below 5.5. Therefore, high pH vitamin supplements are recommended to prevent tooth erosion.
Carbonated Beverages ; Dental Enamel ; Hardness ; Hydrogen-Ion Concentration ; Immersion ; Incisor ; Korea ; Microscopy, Electron, Scanning ; Tablets ; Tooth ; Tooth Demineralization ; Tooth Erosion ; Vitamins

OBJECTIVE: Treatment decisions in patients with unruptured aneurysms required detail assessment of the risk. The most important things to prevent the subarachnoid hemorrhage (SAH) are the measuring of risk of rupture of intracranial aneurysm and the decreasing of operation risk at aneurysm neck clipping. METHODS: Between January, 1994, and April, 2003, data regarding a series of 1586 aneurysm operations performed by a single neurosurgeon (J.H.S). Among them 158 patients with unruptured intracranial aneurysm (UIA) were analyzed retrospectively from the medical records and radiological findings (CT, CT angiography, MR angiography & angiography). The type of aneurysm was classified by three categories : Group 1 : incidental (asymptomatic, unruptured), Group 2 : symptomatic unruptured, Group 3 : UIA with SAH from a separate aneurysm. Unoperated cases were excluded. RESULTS: The treated aneurysms were 91 patients with 103 UIAs. Group 1 : 41 patients with 49 UIAs, Group 2 : 5 patients and Group 3 : 45 patients with 49 UIAs. In Group 1 the results of treatment were 0 mortality and below 4% morbidity. The cases with morbidity were a giant aneurysm, old age patient and the UIAs of posterior circulation. CONCLUSION: The UIA with SAH should be treated surgically and/or endovascular therapy. The treatment of the unruptured, asymptomatic incidental intracranial aneurysm was recommended but the patient's age, size and lcoation of aneurysm, and the skill and experience of neurosurgeon were considered honestly and carefully.
Aneurysm* ; Angiography ; Humans ; Intracranial Aneurysm ; Medical Records ; Mortality ; Neck ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage