Purpose: The purpose of this study was to investigate factors influencing the intention of hand hygiene implementation based on the theory of planned behavior among caregivers in long-term care facilities (LTCF). Methods: A descriptive cross-sectional survey was conducted with 231 caregivers who are employed in LTCF. Data were collected from April, in 2020 until April, in 2021. Results: Nursing caregivers working at LTCF tend to have a high level of interest in and awareness of the importance of hand hygiene. Levels of behavioral beliefs, normative beliefs, attitude toward behavior, and subjective norms were relatively high, but control beliefs and perceived control levels were relatively low. For variables that affect intention of hand hygiene, behavioral beliefs (β=0.23, p<.001) and normative beliefs (β=0.18, p=.003) significantly affected hand hygiene compliance intentions in belief factors, while subjective norm (β=0.23, p<.001) and attitude toward behavior (β=0.11, p=.047) significantly affected hand hygiene compliance intentions in key factors. with a total explanatory power of 28.2% (F=23.53, p<.001). Conclusion As in the result, hand hygiene compliance rate can be enhanced by multilateral hand hygiene promotion programs and education that can increase levels of behavior beliefs, normative beliefs, subjective norms, and attitude toward behavior, which are significant variables in the nursing caregivers’ hand hygiene compliance intentions.

Renal cell carcinoma, intimately associated with a sarcomatous component, is a rare malignant renal tumor. There is disagreement whether these represent true sarcomas or are sarcomatoid metaplasia. Therefore, this sarcomatous component is at times still a troublesome problem for pathologists. In March, 1986, we experienced a case of renal cell carcinoma associated with rhabdomyosarcomatous component in 47 year-old woman who had a rapidly enlarged, palpable abdominal mass. Grossly, a spherical renal cell carcinoma, 17x14x10 cm, in upper and middle portions of the right kidney showed extension through the renal capsule into the perirenal fat. Area of myxoid change was evident in the reanl cell carcinoma, with extensive hemorrhagic necrosis. Microscopically, in the myxoid area, there was malignant spindle cell proliferation in which many rhabdomyoblasts showing distinct cross striation could be demonstrated. This rhabdomyosarcomatous component intermixed with renal cell carcinoma of clear cell type could be also identified in the focal area.
Female ; Humans

No abstract available.
Biopsy, Fine-Needle* ; Carcinoma, Papillary* ; Giant Cells* ; Thyroid Gland*

In order to investigate pathogenic genes and genetic relationships of Y. pseudotuberculosis strains, We isolated 9 strains of Y. pseudotuberculosis from 380 spring water sites in Seoul from 2000 to 2003. All isolates were distributed to the northeast area in Seoul. The isloates were analyzed for chromosomal virulence gene (inv) and plasmid-borne genes (yadA and lcrF) using PCR to assume pathogenicity. As a result, all isolates were positive for the inv gene, but only five isolates (55.6%) were positive for the yadA and lcrF genes. RAPD and PCR-ribotyping were tested and all isolates were grouped with 90% similarity. RAPD revealed 4 clusters and PCR-ribotyping revealed 2 clusters. The result of this experiments confirmed the view that RAPD had better powerful discrimination than PCR-ribotyping and RAPD typing was effective to distinguish between various strains of Y. pseudotuberculosis from spring water.
Discrimination (Psychology) ; Molecular Typing* ; Polymerase Chain Reaction ; Seoul* ; Virulence ; Yersinia pseudotuberculosis* ; Yersinia*

Regarding therapies for treatment of corneal wounds, ex vivo corneal culture is the most effective for minimizing expensive animal studies. Eighteen porcine enucleated eyes were soaked in 0.2% povidone iodine solution for disinfection prior to cornea excision. Subsequently, corneas were excised from whole eyes and filled with an agar/medium mixture. Corneas were transferred into culture dishes, after which culture medium was added until the limbus was covered. Cultures were then placed onto a plate rocker to mimic blinking action, followed by incubation at 37degrees C and 5% CO2. Corneas were harvested on Days 0, 3, and 7 after incubation, and optical coherence tomography (OCT) was performed on Day 7. Two eyes from each group were fixed in 2% glutaraldehyde/4% paraformaldehyde for low vacuum scanning electron microscopy (LV-SEM), and four eyes from each group were fixed in 10% neutral-buffered formalin for histological analysis. OCT results showed that central corneal thickness significantly increased by Day 7 compared to Day 0 (P<0.05). Using LV-SEM, gaps between endothelial cells were detected on Day 7 of ex vivo culture. In the histological evaluation, four to five stratified squamous cell layers, wing cells, and basal cells in the epithelium as well as flat-shaped keratocytes in the stroma were found on Day 0. By Day 7, stratified squamous cells and basal cells had decreased in number, and slightly round-shaped keratocytes were observed; however, the number of keratocytes was similar to that on Day 0. In this short-term ex vivo culture, epithelium and endothelium were sensitive to culture, whereas stroma and keratocytes were well maintained. An additional deswelling method will be needed to obtain more successful results in porcine corneal ex vivo culture.
Animals ; Blinking ; Cornea* ; Disinfection ; Endothelial Cells ; Endothelium ; Epithelium ; Formaldehyde ; Microscopy, Electron, Scanning ; Povidone-Iodine ; Tomography, Optical Coherence ; Vacuum ; Wounds and Injuries ; Wings, Animal

OBJECTIVES: Despite remarkable development of pharmacotherapy for schizophrenia, some patients continuously have had violence problems. The violence of psychotic patients is recently becoming the focus of the attention. The aim of this study is to investigate the influence of Cognitive Behavioral Therapy (CBT) on patients with schizophrenia having violence related history. METHODS: 15 Patients with schizophrenia spectrum disorder of crime history were treated with individual CBT for 12 sessions, and assessed with 4 scales (Korean version of Aggression Questionnaire, Korean version of the Barratt Impulsiveness Scale-11-Revised, Beck Cognitive Insight Scale and Positive and Negative Syndrome Scale) to evaluate anger, impulse, insight and clinical symptoms respectively at baseline and post treatment. The comparison group consisted of 15 patients with schizophrenia spectrum disorder of crime history. They were also assessed with the same scales during the same period. RESULTS: Although impulsivity is not changed significantly after treatment, but there was significant improvement in clinical symptom, insight and aggression, especially self-reflectiveness and anger respectively. CONCLUSION: CBT can be one of the good therapeutic tools for patients with schizophrenia having violence problems in that it reduces aggression and enhances insight of patients with schizophrenia spectrum disorder.
Aggression ; Anger ; Case-Control Studies* ; Cognitive Therapy* ; Crime* ; Drug Therapy ; Humans ; Impulsive Behavior ; Surveys and Questionnaires ; Schizophrenia* ; Violence ; Weights and Measures

OBJECTIVE: To find out the factors affecting medication discontinuation in patients with overactive bladder (OAB) symptoms. METHODS: The clinical data of 125 patients with OAB symptoms who had taken antimuscarinics and behavioral therapy were retrospectively reviewed. Antimuscarinics related outcomes were evaluated by an independent observer with telephone interview. All patients were asked about duration of medication and reason of continuation or discontinuation of antimuscarinics. To determine pre-treatment factors predicting self-report discontinuation of antimuscarinics, variables of only those with P-values <0.25 on the univariate analysis were included in the Cox proportional hazard modeling. RESULTS: Mean follow-up was 39.6 months and the proportion of discontinuation of antimuscarinics was 60.0% (75/125). The mean duration of medication was 21.2 months in the continuation group and 3.3 months in the discontinuation group. The reasons of discontinuation of antimuscarinics were improved OAB symptoms (46.7%), tolerable OAB symptoms (33.3%), no change of OAB symptoms (1.3%), side-effects (8.0%) and no desire to take long-term medication (10.7%). The variables affecting remaining cumulative probability of antimuscarinics were age, history of anti-incontinence surgery or vaginal surgery, and having stress predominant urinary incontinence on urodynamic study. CONCLUSION: The lower rate of cumulative continuation of antimuscarinics encourages us to give a more detailed counseling and education to the patients with OAB symptoms before prescription. And explorations about newer agent and non-pharmacologic treatment with good efficacy and lower side-effects are needed.
Counseling ; Education ; Follow-Up Studies ; Humans ; Interviews as Topic ; Muscarinic Antagonists ; Prescriptions ; Proportional Hazards Models ; Retrospective Studies ; Urinary Bladder, Overactive* ; Urinary Incontinence ; Urodynamics

PURPOSE: The renal histological and hemodynamic changes and the expressions of hypoxia inducible factor-1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) were evaluated according to the differential renal function (DRF) during total ureteral obstruction (TUO) in a rabbit model. MATERIALS AND METHODS: In forty-nine control (5) and 16 experimental rabbits (16 in TUO 3 days, 13 in TUO 7 days and 15 in TUO 14 days), the renal blood flow (RBF) and 99mTc-DTPA renal scan were measured both before and after TUO. The cut-off of the DRF group was 40%. The histological changes and expressions of HIF-1alpha and VEGF were evaluated using H&E and immunohistochemical stain, respectively. RESULTS: The entire control group demonstrated more than 40% DRF. Contrary to the control group, the DRF was less than 40% in 4 (25%), 7 (53%) and 6 rabbits (40%) in TUO 3, 7 and 14 day groups, respectively. The postobstructive compared to preobstructive RBF was decreased in each group. The RBF was more decreased in the lower than the higher DRF group (more than 40%) in all of the experimental groups. Abnormal histological changes were more prominent in the experimental groups, and increased with the obstruction time. However, there was no difference in relation to the DRF. The expressions of HIF-1alpha and VEGF were more prominent in the experimental and lower DRF groups. CONCLUSIONS: During acute TUO, the decreased RBF and hypoxia may play a role in preservation of the DRF.
Anoxia* ; Hemodynamics ; Hypoxia-Inducible Factor 1 ; Rabbits ; Renal Circulation ; Ureter* ; Ureteral Obstruction* ; Vascular Endothelial Growth Factor A*

Varicella zoster virus (VZV) infection in the head and neck may manifest as various clinical symptoms and signs which depend on the combination of involved multiple cranial nerves. Involvements of cranial nerve IX and X by VZV are very rare compared to cranial nerve V, VII, and VIII. We present a case of VZV infection of multiple mucosal erosions in the pharynx and larynx, which was confined to the left side without any associated motor dysfunction. VZV infection was confirmed by polymerase chain reaction on the eruptional mucosal lesions and blood. The patient was treated with an antiviral agent, leading to a complete recovery of multiple mucosal lesions after 2 weeks without any sequela.
Chickenpox* ; Cranial Nerves ; Glossopharyngeal Nerve ; Head ; Herpesvirus 3, Human* ; Humans ; Larynx* ; Neck ; Pharynx* ; Polymerase Chain Reaction ; Trigeminal Nerve ; Vagus Nerve ; Vocal Cord Paralysis* ; Vocal Cords*

Immunoglobulin G4-related disease (IgG4-RD) can involve multiple sites throughout the body. The most commonly affected sites in the head and neck are the salivary and lacrimal glands, respectively. Very few cases of IgG4-RD manifesting in the tonsils have been reported. Herein, we report the imaging findings of a 49-year-old female with pathologically confirmed IgG4-RD after a right-side tonsillectomy. The lesion showed diffuse homogeneous enhancement and appeared isointense and slightly hyperintense on T1- and T2-weighted magnetic resonance imaging, respectively. Diffusion restriction was also observed, which was considered to be due to the large number of IgG4-rich plasmacytes, and could vary depending on the degree of fibrosis. As distinguishing IgG4-RD from other diseases based solely on imaging is challenging, it is important to consider differential diagnosis, and clinical considerations are essential.