The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.
Cell Line ; Coculture Techniques ; Collagen Type I ; Fibroblasts ; Humans ; Keratins ; Models, Theoretical ; Mouth Mucosa* ; Mucous Membrane ; Polydioxanone* ; Research Personnel ; Skin ; Tensile Strength ; Tissue Donors ; Transplants

BACKGROUND: The influenza is a contagious respiratory illness caused by influenza viruses. The primary target groups recommended for annual vaccination are healthcare workers and households which have frequent contact with persons at high risk and can transmit influenza to those persons at high risk. Members of these groups should be vaccinated against the flu so that they can avoid getting infected with continuously mutating influenza viruses. We assessed healthcare workers' knowledge and attitudes regarding influenza vaccination in order to help promote the vaccination rate. METHODS: This survey was carried out in two hospitals affiliated with the Catholic University School of Medicine, from December 2004 to January 2005. Of the 3,023 questionnaires distributed, 2,023 could be evaluated. RESULTS: The most frequently cited reason for receiving influenza vaccine was self-protection against influenza (55.4%). The most common reasons for not receiving influenza vaccine are personal health problems such as concurrent flu, pregnancy or breast-feeding (29.2%). There is no significant difference in the frequency of side effect between two groups receiving and not receiving vaccine. The most frequent side effect of influenza vaccination is flu-like syndrome; People receiving vaccine have more significant knowledge than those people not receiving vaccine about efficacy of flu vaccination, risk of influenza infection of healthcare workers and their need of flu vaccination. CONCLUSION: In order to promote the vaccination rate, education targeting people at high risk need to keep continuous and facilitate access to vaccination.
Delivery of Health Care* ; Education ; Family Characteristics ; Humans ; Influenza Vaccines ; Influenza, Human* ; Orthomyxoviridae ; Pregnancy ; Vaccination* ; Surveys and Questionnaires

BACKGROUND: Serratia marcescens proliferates well in a humid environment or soil and is recently considered as an important pathogen for the severe nosocomial infections. this organism is spreads easily by hand-to-hand transmission, and contaminates medical equipment used for invasive procedures, working environment, medications, and soap. METHODS: We investigated the source of an outbreak of bloodstream infections by S. marcescens isolated that occurred during the period from July to December, 2004, at a university hospital in Gyeonggi Province and attempted to intervene in the outbreak and control it. RESULTS: From July to December, 2004, S. marcescens grew from 296 blood culture from 283 patients. The medical charts of the patients were reviewed, and surveillance cultures were taken to identify the outbreak of nosocomial infections and risk factors. Only four cases of infection were identified and all remaining positive blood cultures were due to contamination. Nine isolates randomly selected from the 296 S. marcescens showed an identical pulsed-field gel electrophoresis pattern. To identify the source of infection, environmental culture and hand cultures of the related medical workers were carried out, but S. marcescens was not isolated. CONCLUSION: As the result of aggressive infection control activities, such as re-education on environmental management methods, hand washing techniques, and blood culture sampling techniques, no more S. marcescens had been grown in blood culture since January, 2005.
Cross Infection ; Electrophoresis, Gel, Pulsed-Field ; Gyeonggi-do ; Hand ; Hand Disinfection ; Humans ; Infection Control ; Risk Factors ; Serratia marcescens ; Serratia* ; Soaps ; Soil

Purpose: The objective of this study was to analyze the results of several noninvasive prenatal tests (NIPTs) from a single center and confirm their efficacy and reliability. In addition, we aimed to confirm the changes in the number of invasive tests performed after introducing NIPT. Materials and Methods: NIPT data from a large single center from March 2014 to November 2018 were analyzed. Karyotyping was confirmed based on chorionic villus sampling, amniocentesis, or postnatal cord/peripheral blood sampling. Data on maternal age, gestational age, fetal fraction, and ultrasonographic results were analyzed. As the secondary outcome, the number of amniocentesis cases before and after the introduction of NIPT was compared. Results: Overall, 1,591 single pregnancy cases that underwent NIPT were enrolled. The mean maternal age was 36.05 (22-45) years. The average gestational age and fetal fraction were 12+1 (9+3 to 27+1) weeks and 10.95% (3.6% to 31.3%), respectively. A total of 1,544 cases (97.0%) were reported to have negative NIPT results and 40 (2.5%) had positive NIPT results. The sensitivity and specificity of the overall abnormalities in NIPT were 96.29% and 99.36%, respectively. The positive predictive value (PPV) and negative predictive value were 72.22% and 99.93% respectively. The mean number of amniocentesis cases were 21.7 per month (21.7±3.9), which significantly decreased from 31.5 per month (31.5±4.8) before conducting NIPT as a screening test. Conclusion NIPT is currently a useful, powerful, and safe screening test. In particular, trisomy 21 is highly specific due to its high PPV. NIPT can reduce the potential risks of procedure-related miscarriages during invasive testing.

PURPOSE: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy. METHODS: This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, chi-square-test and logistic regression analyses were used for data analysis. RESULTS: The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (< or =7 days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (< or =7 scores) (OR=4.71, 95% CI=1.64-13.50). CONCLUSION: The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.
Adult ; Aged ; Case-Control Studies ; *Craniotomy ; Drainage ; Female ; Glasgow Coma Scale ; Humans ; Intensive Care Units ; Length of Stay ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection/*epidemiology/etiology

Background: The number of elderly people with comorbidities who experience dysphagia associated with geriatric disorders, such as stroke, Parkinson’s disease, and Alzheimer’s dementia, is increasing. Consequently, the demand for long-term prescriptions of powdered medications is expected to rise. Most patients procure repackaged prescription medications from pharmacies; however, the guidelines regarding their expiration dates are unclear. Objectives: The aim of this study was to assess awareness among adults regarding the expiration dates and drug stability issues associated with repackaged prescription medications, including powdered medications. Methods: A questionnaire with 16 components was designed and distributed online (August 1-September 1, 2019) to adults aged 19 years or older. Statistical analyses, including descriptive analysis and chi-square test, were conducted on the obtained data. A p-value <0.05 was considered significant. Results: Data from 254 respondents were analyzed; 191 (75.20%) respondents worked in non-healthcare-related fields. A significant number of healthcare workers recognized the stability issues associated with powdered medications (p<0.001). However, a large proportion of healthcare workers were not aware of the expiration dates (p>0.05). Conclusions More than half of the total respondents, including healthcare workers, were not familiar with the appropriate expiration dates of repackaged prescription medications. The establishment of evidence-based guidelines regarding drug expiration dates and the dissemination of awareness among patients are required. Furthermore, clinical practices including repackaging or pulverizing medications for long-term prescriptions should be avoided owing to the associated drug stability issues.

Objective: It is uncertain why a b-value range of 1500–2000 s/mm2 is optimal. This study was aimed at qualitatively and quantitatively analyzing the optimal b-value range of synthetic diffusion-weighted imaging (sDWI) for evaluating prostatic index lesions. Materials and Methods: This retrospective study included 92 patients who underwent DWI and targeted biopsy for magnetic resonance imaging (MRI)-suggested index lesions. We generated sDWI at a b-value range of 1000–3000 s/mm2 using dedicated software and true DWI data at b-values of 0, 100, and 1000 s/mm2 . We hypothesized that lesion conspicuity would be best when the background (i.e., MRI-suggested benign prostatic [bP] and periprostatic [pP] regions) signal intensity (SI) is suppressed and becomes homogeneous. To prove this hypothesis, we performed both qualitative and quantitative analyses.For qualitative analysis, two independent readers analyzed the b-value showing the best visual conspicuity of an MRIsuggested index lesion. For quantitative analysis, the readers assessed the b-value showing the same bP and pP region SI.The 95% confidence interval (CI) or interquartile range of qualitatively and quantitatively selected optimal b-values was assessed, and the mean difference between qualitatively and quantitatively selected b-values was investigated. Results: The 95% CIs of optimal b-values from qualitative and quantitative analyses were 1761–1805 s/mm2 and 1640– 1771 s/mm2 (median, 1790 s/mm2 vs. 1705 s/mm2 ; p = 0.003) for reader 1, and 1835–1895 s/mm2 and 1705–1841 s/mm2 (median, 1872 s/mm2 vs. 1763 s/mm2 ; p = 0.022) for reader 2, respectively. Interquartile ranges of qualitatively and quantitatively selected optimal b-values were 1735–1873 s/mm2 and 1573–1867 s/mm2 for reader 1, and 1775–1945 s/mm2 and 1591–1955 s/mm2 for reader 2, respectively. Bland-Altman plots consistently demonstrated a mean difference of less than 100 s/mm2 between qualitatively and quantitatively selected optimal b-values. Conclusion b-value range showing a homogeneous background signal may be optimal for evaluating prostatic index lesions on sDWI. Our qualitative and quantitative data consistently recommend b-values of 1500–2000 s/mm2 .

Background: The number of elderly people with comorbidities who experience dysphagia associated with geriatric disorders, such as stroke, Parkinson’s disease, and Alzheimer’s dementia, is increasing. Consequently, the demand for long-term prescriptions of powdered medications is expected to rise. Most patients procure repackaged prescription medications from pharmacies; however, the guidelines regarding their expiration dates are unclear. Objectives: The aim of this study was to assess awareness among adults regarding the expiration dates and drug stability issues associated with repackaged prescription medications, including powdered medications. Methods: A questionnaire with 16 components was designed and distributed online (August 1-September 1, 2019) to adults aged 19 years or older. Statistical analyses, including descriptive analysis and chi-square test, were conducted on the obtained data. A p-value <0.05 was considered significant. Results: Data from 254 respondents were analyzed; 191 (75.20%) respondents worked in non-healthcare-related fields. A significant number of healthcare workers recognized the stability issues associated with powdered medications (p<0.001). However, a large proportion of healthcare workers were not aware of the expiration dates (p>0.05). Conclusions More than half of the total respondents, including healthcare workers, were not familiar with the appropriate expiration dates of repackaged prescription medications. The establishment of evidence-based guidelines regarding drug expiration dates and the dissemination of awareness among patients are required. Furthermore, clinical practices including repackaging or pulverizing medications for long-term prescriptions should be avoided owing to the associated drug stability issues.

Objective: It is uncertain why a b-value range of 1500–2000 s/mm2 is optimal. This study was aimed at qualitatively and quantitatively analyzing the optimal b-value range of synthetic diffusion-weighted imaging (sDWI) for evaluating prostatic index lesions. Materials and Methods: This retrospective study included 92 patients who underwent DWI and targeted biopsy for magnetic resonance imaging (MRI)-suggested index lesions. We generated sDWI at a b-value range of 1000–3000 s/mm2 using dedicated software and true DWI data at b-values of 0, 100, and 1000 s/mm2 . We hypothesized that lesion conspicuity would be best when the background (i.e., MRI-suggested benign prostatic [bP] and periprostatic [pP] regions) signal intensity (SI) is suppressed and becomes homogeneous. To prove this hypothesis, we performed both qualitative and quantitative analyses.For qualitative analysis, two independent readers analyzed the b-value showing the best visual conspicuity of an MRIsuggested index lesion. For quantitative analysis, the readers assessed the b-value showing the same bP and pP region SI.The 95% confidence interval (CI) or interquartile range of qualitatively and quantitatively selected optimal b-values was assessed, and the mean difference between qualitatively and quantitatively selected b-values was investigated. Results: The 95% CIs of optimal b-values from qualitative and quantitative analyses were 1761–1805 s/mm2 and 1640– 1771 s/mm2 (median, 1790 s/mm2 vs. 1705 s/mm2 ; p = 0.003) for reader 1, and 1835–1895 s/mm2 and 1705–1841 s/mm2 (median, 1872 s/mm2 vs. 1763 s/mm2 ; p = 0.022) for reader 2, respectively. Interquartile ranges of qualitatively and quantitatively selected optimal b-values were 1735–1873 s/mm2 and 1573–1867 s/mm2 for reader 1, and 1775–1945 s/mm2 and 1591–1955 s/mm2 for reader 2, respectively. Bland-Altman plots consistently demonstrated a mean difference of less than 100 s/mm2 between qualitatively and quantitatively selected optimal b-values. Conclusion b-value range showing a homogeneous background signal may be optimal for evaluating prostatic index lesions on sDWI. Our qualitative and quantitative data consistently recommend b-values of 1500–2000 s/mm2 .