PURPOSE: The purpose of this study was to describe the perception and practice of hospital infection control of nursing staff in long-term care hospitals by the level of supplementation of nurses. METHODS: The participants were 212 nurses and nurse assistants in 13 long-term care hospitals in a metropolitan city and the data were gathered by self-reported questionnaires during August 2011 and analyzed by SPSS/WIN program. RESULTS: The beds per a nurse were 15, and the proportion of nurses among nursing staff in long-term care hospitals was about 33%. In general, the level of infection control in practice was lower than that of perception. The highest perception and practice domain was 'Management of disinfection/contamination', and the lower level domains were 'Personal hygiene' and 'Hand washing' There were statistically significant differences in the hospital infection control of perception and practice depending on age, education, career in long-term care hospital, job position, the quantity of beds, nurse, and nurse assistant, beds per a nurse and proportion of nurses in hospitals. CONCLUSION: According to these results, the systematic and continual education on hospital infection control of the nursing staff in long-term hospitals should be carried out. In addition, the policy to add more nurses into long-term care hospitals must be implemented.
Cross Infection ; Humans ; Infection Control ; Long-Term Care ; Nursing Staff ; Surveys and Questionnaires

No abstract available.
Cystatin C* ; Hemoglobin A, Glycosylated* ; Humans

No abstract available.
Adipokines ; Diabetes, Gestational ; Female ; Humans ; Insulin Resistance ; Insulin ; Pregnancy ; Pregnant Women

Objectives: This study aimed 1) to investigate high school students’ reliability on COVID-19 responses in schools and private academies and 2) to identify the differences in COVID-19 prevention practice. Methods: This cross-sectional survey collected data from 200 high school respondents, using an anonymous online questionnaire designed by the Yonsei Global Health Center, from July 2 to 17, 2020 in this study. Chi-square tests were conducted to analyze the differences in preventative practices and practice rates between schools and private academies. Binary logistics regression analysis was conducted to identify the factor affecting the reliability of COVID-19 response. Results: These high school students reliabilityed the schools’ COVID-19 response more than the private academy. In addition, students who studied only at school did more COVID-19 prevention practices than students who studied both at school and academy. There was a significant difference in avoiding public transportation (p=.028), sitting in one row while having a meal (p=.011) in the practice rates depending on the schools’ COVID-19 response. A significant difference in Covering the mouth when coughing and sneezing (p-.041) was also found in the practice rates depending on the private academies’ COVID-19 response. Conclusion The reason why schools were more reliable than private academies was that there are health teachers. Because schools are supervised by the ministry of education, the Ministry of education and local government need to work together to manage and monitor the COVID-19 response in the academies through cooperation between two organizations. In addition, it is necessary to arrange a temporary circulation health teacher who will provide the COVID-19 prevention education at the academies.

The role of amino acids in culture media for IVF-ET was examined in a total of 76 cycles. Patients received clomiphene citrate (CC) followed by hMG or GnRH-a combined with gonadotropins (FSH/hMG) for controlled ovarian hyperstimulation. Severe male (<4 x10(6) motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. No significant differences were found in age, duration of infertility, follicle size, the level of E2 on the day of hCG injection, the mean number of oocytes retrieved, total motile sperm count, fertilization rate and the mean number of embryos transferred between bHTF (without amino acids) and mHTF (with amino acids) groups. However, total ampules of gonadotropins were higher (p<0.01) in mHTF group than bHTF group. Significantly (p<0.05) more clinical pregnancies were recorded in mHTF group (13/30) compared with bHTF group (9/46). The multiple pregnancy rates were 11.1% in bHTF group and 77% in mHTF group. There were one ectopic pregnancy in mHTF group and one heterotopic pregnancy in bHTF group. Abortion rates were 22.2% in bHTF group and 7.7% in mHTF, respectively The ongoing pregnancy or livebirth .ate was significantly (p<0.05) higher in mHTF group (12/30) than bHTF group (7/46). These results suggest that the addition of amino acids in culture media is essential for culture of zygotes in vitro and adjustment of energy substrates in phosphate-free culture media appears to be beneficial for human IVF-ET procedure.
Abortion, Induced ; Age Factors ; Amino Acids* ; Clomiphene ; Culture Media ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Gestational Sac ; Gonadotropins ; Humans* ; Infertility ; Male ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Multiple ; Sperm Count ; Ultrasonography ; Zygote

PURPOSE: We tried to find the patients characteristics of parasternal recunence, to classify the parasternal recunence according to the radiological and clinical features, and to evaluate the efficacy of local radiotherapy. MATERIALS AND METHODS: Between August 1987 and April 1997, twenty one patients with parastemal recurrence of breast cancer after surgery with or without adjuvant chemotherapy were treated with radiotherapy. Age distribution at initial operation was ranged from 31 to 79 years(median 48 years). Sixteen(76.2%) cancers were in the right breast and five(23.8%) were in the left. The pathologic types were infiltrative ductal carcinoma in 18 patients and medullary carcinoma in 3 patients. Eight patients had stage I, three had stage IIa, six had stage IIb, one had stage IIIa diseases and we had no information about the initial stage of the other 3 patients. Parasternal recurrence were diagnosed by biopsy in 7 patients, and the other 14 recurrences were diagnosed by clinical and radiologic findings such as chest CT, whole body bone scan. All the patients were treated with radiation for the parasternal recurrent tumors. In addition, five patients also received chemotherapy(FAC or Taxol based protocol) and one patient also received partial resection before radiotherapy. Radiotherapy was delivered with Co-60 gamma-ray or 4~6 MV X-ray or electron beam to both supraclavicular lymph nodes and parasternal areas with total doses of 3000~6480 cGy(median 6100 cGy). RESULTS: The range of interval between curative resection and parasternal recurrence were 4~110 months(median 34 months). The main symptoms of the parasternal recurrence were a painless mass(n=10). The duration of symptom before diagnosis ranged from one to 36 months(median 7 months). Among 21, five patients(23.8%) presented distant metastses at the diagnosis of parasternal recurrences. The parasternal recurrences were classified into three groups according to radiologic and clinical findings; the recurrent tumors originated from sternum and invaded into adjacent tissues(Group 1, n=5), tumors originated from intemal mammary lymph nodes and invaded into sternum or parasternal tissues(Group 2, n=6), tumors originated from medial chest wall and invaded into sternum or parasternal tissues(Group 3, n=10). In nineteen patients(19/21; 90.5%) there was complete response of parasternal recurrence following radiotherapy. Although the follow up period was relatively short(3~78 montbs, median 14 months), there were no local recurrence in radiation field in 19 patients with complete response. Among the 16 patients without distant metastases at diagnosis of parasternal recurrence, nine patients were alive without any evidence of disease. CONCLUSION: Chest CT scan is necessary and effective in patients with parastemal discomfort, pain, swelling or palpable mass after mastectomy. And we found that radiotherapy was very effective for the local treatment of parasternal recunence in terms of symptom palliation and local control of tumor. Although we classified the parasternal recurrence into three groups, we could not reach any conclusive results because of short follow up duration and insufficient patients number.
Age Distribution ; Biopsy ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Medullary ; Chemotherapy, Adjuvant ; Diagnosis ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mastectomy ; Neoplasm Metastasis ; Paclitaxel ; Radiotherapy ; Recurrence* ; Sternum ; Thoracic Wall ; Tomography, X-Ray Computed

BACKGROUND: The aim of this study was to evaluate adipokines concentration and insulin resistance according to maternal age or obesity at pregnancy and weight change at diagnosed gestational diabetes mellitus (GDM) in pregnant women with GDM. METHODS: This study included 57 pregnant women who were diagnosed with GDM at 24 to 28 weeks of gestation. The subjects were classified into two or three groups according to pre-pregnancy body mass index (BMI, < 25 kg/m² vs. ≥25 kg/m²), maternal age at pregnancy (< 35 years old vs. ≥35 years old), and weight change during pregnancy at screening for GDM (weight change below, within, and in excess of the recommended range). They were respectively compared in each group. RESULTS: Leptin, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA2-%B were increased in the group with pre-pregnancy BMI ≥25 kg/m². Leptin and HOMA-IR were positively correlated with BMI both before pregnancy and at screening for GDM. There were no significant correlations between HOMA-IR and adipokines. HOMA-IR showed positive correlation with HOMA2-%B and negative correlation with HOMA2-%S. CONCLUSION: Leptin and HOMA-IR at diagnosed GDM were increased in the GDM patients with obesity before pregnancy. They were positively correlated with BMI both before pregnancy and at screening for GDM. The effect of maternal age at pregnancy and weight change during pregnancy at GDM screening on adipokines and insulin resistance might be less pronounced than the effect of maternal obesity.
Adipokines* ; Body Mass Index ; Diabetes, Gestational* ; Female ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Leptin ; Mass Screening ; Maternal Age ; Obesity ; Pregnancy ; Pregnant Women*

PURPOSE: This study was performed to identify the histopathologic feature by the reevaluation of the pathologic specimen of the cervical tumors and to evaluate the clinical findings and the treatment results of the patients with small cell carcinoma of the cervix treated by radiotherapy. MATERIALS AND METHODS: 2890 patients with cervical carcinoma received radiotherapy at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between October 1981 and April 1995. Of the 2890 patients in this data base, sixty were found to have small cell carcinomas (2.08%). Among them thirty six patients were transferred from other hospitals, the biopsy specimens of those patients were not available. So we could review the slides of the other twenty four patients who were diagnosed at our hospital. Twenty four patients with small cell carcinoma of the cervix were analyzed retrospectively based on the assessment of H & E staining and other four immunohistochemical stains for neuroendocrine differentiation (neuron specific enolase, chromogranin, synaptophysin and Grimelius stain). And we also evaluate the patients and tumor characteristics, response to radiation, patterns of failures, 5 year overall and disease free survival rates. RESULTS: Thirteen tumors were neuroendocrine carcinomas (13/24=54.2%) and eleven tumors were squamous carcinomas, small cell type (11/24= 47.8%) based on the assessment of H & E staining and other four neuroendocrine marker studies. So we classified the patients two groups as neuroendocrine carcinoma and small cell type of squamous carcinoma. Among the 13 neuroendocrine carcinomas, five were well to moderately differentiated tumors and the other eight were poorly differentiated or undifferentiated ones. The median age was 54 years old (range 23-79 years). Eight patients had FIGO stage IB disease, 12 had stage II, 3 had stage III and one had stage IV disease. Pelvic lymph node metastases were found in five patients(20.8%), three of them were diagnosed by surgical histologic examination and the other two were diagnosed by CT scan. There was no difference between two histopathologic groups in terms of patients and tumor characteristics, response to radiation, 5 year overall and disease free survival rates. However the distant metastases rate was higher in neuroendocrine carcinoma patients (6/13:46.2%) than in small cell type of squamous carcinoma patients (2/11:18.2%), but there was no statistically significant difference because of the small number of patients (P>0.05). CONCLUSION: More than half of the small cell carcinoma of the cervix patients were neuroendocrine carcinoma (13/24 : 54.1%) by reevaluation of the biopsy specimen of the cervical tumors. The tendency of distant metastases of the neuroendocrine carcinoma was greater than those of the small cell type of squamous carcinoma (46.2% vs. 18.2%). But there were no differences in the patients and tumor characteristics and other clinical treatment results in both groups. These data suggest that radical local treatment such as radiotherapy or radical surgery combined with combination systemic cytotoxic chemotherapy might provide these patients with the best chance for cure.
Biopsy ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell* ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Coloring Agents ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Phosphopyruvate Hydratase ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Synaptophysin ; Tomography, X-Ray Computed

PURPOSE: MDM-2 is an oncoprotein that inhibits p53 tumor-suppressor protein. These abnor malities have a role in tumorigenesis through inactivation of p53 function. To determine the clini copathological and prognostic value of MDM2 abnormalities in gastric adendegrees Carcinoma, MDM-2& p53 protein expression were analysed in surgically resected materials of gastric adendegrees Carcinoma. MATERIALS AND METHODS: Fifty cases which had got follow-up after surgical resection were immunohistdegrees Chemically studied with p53 and MDM-2 antibodies. We defined variable clinico pathologic factors for expression of p53 and MDM-2 protein and analysed their relationships. RESULTS: Immunohistdegrees Chemical stain revealed expression of MDM-2 protein as a 52.0% (26/50) and p53 protein 20.0% (10/50), respectively. But their expressions were not assdegrees Ciated with clinicopathological factors such as T-factor, N-factor, stage, histology and differentiation. Overall, p53-negative patients seemed to have a better prognosis regardless of MDM-2 protein status (P= 0.057). MDM-2 protein status was considered to have no play as a prognostic factor. CONCLUSION: In the gastric adendegrees Carcinoma, p53 protein expression seemed to have a inverse relationship with clinical outcomes but MDM-2 protein expression, which was observed more frequently than those of p53, seemed not to be prognostic indicator.
Antibodies ; Carcinogenesis ; Follow-Up Studies ; Humans ; Prognosis ; Proto-Oncogene Proteins c-mdm2 ; Stomach Neoplasms

Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents 4.1% of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49years(range, 27~79years) and the peak incidence was in the group 50 to 59years of age. More half of the patients were postmenopausal (46/76=60.5%). Most patients(76%)had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage Iib was 43.4%. There were 4 major histologic subtypes: pure adenocarcinoma(48/76=63.2%), adenosquamous carcinoma(20/76=26.3%), papillary (5/76=6.6%) and clear cell carcinoma(3/76=3.9%). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was 68%, and the 5-year survival rates for stage Ib, II and III were 90%, 66% and 54%, respectively. Control of pelvic tumors was achieved in 938%, 90.2% and 50.0% of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.
Adenocarcinoma* ; Cervix Uteri* ; Female ; Humans ; Incidence ; Prognosis ; Radiation Oncology ; Retrospective Studies ; Survival Rate ; Uterine Hemorrhage