Background: Hand hygiene is considered the simplest and most cost-effective method of infection prevention. Regular observation and feedback on hand hygiene compliance are key strategies for its enhancement. This study evaluated the effectiveness of hand hygiene surveillance, including direct observation and feedback, by comprehensively analyzing the reported hand hygiene compliance within the Korean National Healthcare-Associated Infections Surveillance System from 2019 to 2022. Methods: Participating medical institutions included general hospitals and hospitals with infection control departments that consented to participate. Hand hygiene surveillance was conducted using direct observation. Collected data, including healthcare workers, clinical areas, hand hygiene moments, and hand hygiene compliance, were recorded to calculate hand hygiene compliance rates. Additionally, the volume of alcohol-based hand sanitizers used per patient per day was investigated as an indirect indicator of hand hygiene compliance. The study was conducted from July 2019 to December 2022. Results: Hand hygiene compliance increased from 87.2% in Q3 2019 to 89.9% in 2022. Nurses and medical technologists showed the highest compliance rates, whereas doctors showed the lowest compliance rates. Intensive care units excelled in compliance, whereas emergency de partments lagged. Compliance was highest after patient contact and lowest when the patient’s surroundings were touched. Larger hospitals consumed more alcohol-based hand sanitizers than smaller hospitals did. Conclusion This study confirmed an improvement in hand hygiene compliance through sustained surveillance, indicating its contribution not only to preventing infection transfer within healthcare facilities but also to fostering a culture of hand hygiene in the country.

Background: Alcohol consumption has been considered as a modifiable risk factor for dementia development and alcohol-related brain damage may further impair cognitive abilities in dementia patients. This study aimed to find out the differences in cognitive function according to current alcohol drinking in patients with self-perceived memory decline, including subjective cognitive decline (SCD), mild cognitive impairment (MCI) and early Alzheimer-type dementia (ATD). Methods: From May 2018 to December 2019, retrospective chart review was performed in patients who visited CHA Bundang Medical Center for cognitive decline. A two-way analysis of variance with interaction test were used to analyze the impact of alcohol consumption on cognitive function between groups. Results: A total of 147 patients was classified into three groups of SCD (n=30), MCI (n=53), and ATD (n=64), and each group was divided into two subgroups of alcohol users and alcohol non-users, according to the current status of alcohol consumption. Between SCD, MCI and ATD groups, scores of clock drawing test and Go/No-go test were significantly lower in current alcohol users of ATD groups compared to the SCD and MCI groups (p<0.05). Conclusions These results suggest that current alcohol consumption has detrimental effects especially on the frontal/executive function in early ATD patients. Considering the association between frontal/executive function and ADL, our finding suggests that cessation of alcohol intake may be a therapeutic strategy to prevent ADL deterioration in patients with ATD.

OBJECTIVES: The purpose of this study was to develop a systematic and standardized「The Survey on School Foodservice Program」that can identify the current status of school meals on the nationwide level. METHODS: This study was carried out in six steps of the analysis of report/investigation data related to school foodservice in metropolitan and provincial offices of education, analysis of preceding research related to the actual status of school foodservice, field verification of the actual condition of the school foodservice site, development of a draft of「The Survey on School Foodservice Program」, pilot study of a draft of 「The Survey on School Foodservice Program」, and suggestions of a final model of「The Survey on School Foodservice Program」from August to December, 2017. Statistical analysis was performed for frequency analysis and descriptive analysis using the SPSS program ver. 23. RESULTS: A draft of「The Survey on School Foodservice Program」was developed by analyzing the current status of report/research data on school meals in metropolitan and provincial offices of education, analyzing the preceding research on school meals, and identifying the actual conditions at school foodservice sites. To verify the validity of the school foodservice survey questionnaire, 1,031 schools were sampled from a total of 10,251 schools and the pilot test of ‘2017 School Foodservice Survey’ was conducted. The final model of「The Survey on School Foodservice Program」consisted of 12 survey sections, 29 survey categories, and 433 survey items, and the survey cycle was set for one year and three years for each survey item. CONCLUSIONS: Based on the objective statistical data through「The Survey on School Foodservice Program」, it is possible to develop the school foodservice policy, which will help establish the reliability of the school meals.
Education ; Humans ; Meals ; Pilot Projects

OBJECTIVES: The purpose of this study was to develop a systematic and standardized「The Survey on School Foodservice Program」that can identify the current status of school meals on the nationwide level. METHODS: This study was carried out in six steps of the analysis of report/investigation data related to school foodservice in metropolitan and provincial offices of education, analysis of preceding research related to the actual status of school foodservice, field verification of the actual condition of the school foodservice site, development of a draft of「The Survey on School Foodservice Program」, pilot study of a draft of 「The Survey on School Foodservice Program」, and suggestions of a final model of「The Survey on School Foodservice Program」from August to December, 2017. Statistical analysis was performed for frequency analysis and descriptive analysis using the SPSS program ver. 23. RESULTS: A draft of「The Survey on School Foodservice Program」was developed by analyzing the current status of report/research data on school meals in metropolitan and provincial offices of education, analyzing the preceding research on school meals, and identifying the actual conditions at school foodservice sites. To verify the validity of the school foodservice survey questionnaire, 1,031 schools were sampled from a total of 10,251 schools and the pilot test of ‘2017 School Foodservice Survey’ was conducted. The final model of「The Survey on School Foodservice Program」consisted of 12 survey sections, 29 survey categories, and 433 survey items, and the survey cycle was set for one year and three years for each survey item. CONCLUSIONS: Based on the objective statistical data through「The Survey on School Foodservice Program」, it is possible to develop the school foodservice policy, which will help establish the reliability of the school meals.
Education ; Humans ; Meals ; Pilot Projects

BACKGROUND: Kinetin is a plant hormone that regulates growth and differentiation. Keratinocytes, the basic building blocks of the epidermis, function in maintaining the skin barrier. OBJECTIVE: We examined whether kinetin induces skin barrier functions in vitro and in vivo. METHODS: To evaluate the efficacy of kinetin at the cellular level, expression of keratinocyte differentiation markers was assessed. Moreover, we examined the clinical efficacy of kinetin by evaluating skin moisture, transepidermal water loss (TEWL), and skin surface roughness in patients who used kinetin-containing cream. We performed quantitative real-time polymerase chain reaction to measure the expression of keratinocyte differentiation markers in HaCaT cells following treatment. A clinical trial was performed to assess skin moisture, TEWL, and evenness of skin texture in subjects who used kinetin-containing cream for 4 weeks. RESULTS: Kinetin increased involucrin, and keratin 1 mRNA in HaCaT cells. Moreover, use of a kinetin-containing cream improved skin moisture and TEWL while decreasing roughness of skin texture. CONCLUSION: Kinetin induced the expression of keratinocyte differentiation markers, suggesting that it may affect differentiation to improve skin moisture content, TEWL, and other signs of skin aging. Therefore, kinetin is a potential new component for use in cosmetics as an anti-aging agent that improves the barrier function of skin.
Antigens, Differentiation* ; Cell Culture Techniques ; Epidermis ; Humans ; In Vitro Techniques ; Keratin-1 ; Keratinocytes* ; Kinetin* ; Plants ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Skin Aging ; Skin* ; Treatment Outcome ; Water

PURPOSE: This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy. MATERIALS AND METHODS: We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups. RESULTS: A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI. CONCLUSION: We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.
Breast Neoplasms* ; Breast* ; Case-Control Studies* ; Disease-Free Survival ; Drug Therapy* ; Humans ; Lymph Nodes ; Lymphatic Irradiation ; Lymphedema ; Mastectomy, Segmental* ; Neoplasm Metastasis ; Propensity Score ; Radiation Pneumonitis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence

PURPOSE: The purpose of this study was to evaluate the impact of postmastectomy radiotherapy (PMRT) on loco-regional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) in pT1-2N1 patients treated with taxane-based chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical data of pathological N1 patients who were treated with modified radical mastectomy and adjuvant taxane-based chemotherapy in 12 hospitals between January 2006 and December 2010. RESULTS: We identified 714 consecutive patients. The median follow-up duration was 69 months (range, 1 to 114 months) and the 5-year LRRFS, DFS, and OS rates were 97%, 94%, and 98%, respectively, in patients who received PMRT (PMRT [+]). The corresponding figures were 96%, 90%, and 96%, respectively, in patients who did not receive PMRT (PMRT [–]). PMRT had no significant impact on survival. Upon multivariable analysis, only the histological grade (HG) was statistically significant as a prognostic factor for LRRFS and DFS. In a subgroup analysis of HG 3 patients, PMRT (+) showed better DFS (p=0.081). CONCLUSION: PMRT had no significant impact on LRRFS, DFS, or OS in pT1-2N1 patients treated with taxane-based chemotherapy. PMRT showed a marginal benefit for DFS in HG 3 patients. Randomized studies are needed to confirm the benefit of PMRT in high risk patients, such as those with HG 3.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Radiotherapy* ; Recurrence ; Retrospective Studies*

PURPOSE: Asthma is a heterogeneous disease characterized by various types of airway inflammation and obstruction. Therefore, it is classified into several subphenotypes, such as early-onset atopic, obese non-eosinophilic, benign, and eosinophilic asthma, using cluster analysis. A number of asthmatics frequently experience exacerbation over a long-term follow-up period, but the exacerbation-prone subphenotype has rarely been evaluated by cluster analysis. This prompted us to identify clusters reflecting asthma exacerbation. METHODS: A uniform cluster analysis method was applied to 259 adult asthmatics who were regularly followed-up for over 1 year using 12 variables, selected on the basis of their contribution to asthma phenotypes. After clustering, clinical profiles and exacerbation rates during follow-up were compared among the clusters. RESULTS: Four subphenotypes were identified: cluster 1 was comprised of patients with early-onset atopic asthma with preserved lung function, cluster 2 late-onset non-atopic asthma with impaired lung function, cluster 3 early-onset atopic asthma with severely impaired lung function, and cluster 4 late-onset non-atopic asthma with well-preserved lung function. The patients in clusters 2 and 3 were identified as exacerbation-prone asthmatics, showing a higher risk of asthma exacerbation. CONCLUSIONS: Two different phenotypes of exacerbation-prone asthma were identified among Korean asthmatics using cluster analysis; both were characterized by impaired lung function, but the age at asthma onset and atopic status were different between the two.
Adult* ; Asthma ; Clothing ; Cluster Analysis* ; Eosinophils ; Follow-Up Studies ; Humans ; Inflammation ; Lung ; Methods ; Phenotype

We developed an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for the determination of acetaminophen concentration in human plasma. Following protein precipitated extraction, the analytes were separated and analyzed using an UPLC-MS/MS in the multiple reaction monitoring (MRM) mode with the respective [M+H]+ ions, m/z 152.06 → 110.16 for acetaminophen and m/z 180.18 → 138.12 for phenacetin (internal standard, IS). The method showed a linear response from 1 to 100 µg/mL (r > 0.9982). The limit of quantitation for acetaminophen in plasma was 1 µg/mL. The intra- and inter-day accuracy ranged in the ranges of 94.40–99.56% and 90.00–99.20%, respectively. The intra- and inter-day precision ranged in the ranges of 2.64–10.76% and 6.84–15.83%, respectively. This method was simple, reliable, precise and accurate and can be used to determine the concentration of acetaminophen in human plasma. Finally, this fully validated method was successfully applied to a pharmacokinetic study of acetaminophen in healthy volunteers following oral administration.
Acetaminophen* ; Administration, Oral ; Healthy Volunteers ; Humans* ; Ions ; Mass Spectrometry ; Phenacetin ; Plasma*

BACKGROUND: Dihydrotestosterone (DHT) induces androgenic alopecia by shortening the hair follicle growth phase, resulting in hair loss. We previously demonstrated how changes in the microRNA (miRNA) expression profile influenced DHT-mediated cell death, cell cycle arrest, cell viability, the generation of reactive oxygen species (ROS), and senescence. Protective effects against DHT have not, however, been elucidated at the genome level. OBJECTIVE: We showed that epigallocatechin gallate (EGCG), a major component of green tea, protects DHT-induced cell death by regulating the cellular miRNA expression profile. METHODS: We used a miRNA microarray to identify miRNA expression levels in human dermal papilla cells (DPCs). We investigated whether the miRNA expression influenced the protective effects of EGCG against DHT-induced cell death, growth arrest, intracellular ROS levels, and senescence. RESULTS: EGCG protected against the effects of DHT by altering the miRNA expression profile in human DPCs. In addition, EGCG attenuated DHT-mediated cell death and growth arrest and decreased intracellular ROS levels and senescence. A bioinformatics analysis elucidated the relationship between the altered miRNA expression and EGCG-mediated protective effects against DHT. CONCLUSION: Overall, our results suggest that EGCG ameliorates the negative effects of DHT by altering the miRNA expression profile in human DPCs.
Aging ; Alopecia ; Cell Cycle Checkpoints ; Cell Death ; Cell Survival ; Computational Biology ; Dihydrotestosterone ; Genome ; Hair ; Hair Follicle ; Humans* ; MicroRNAs* ; Reactive Oxygen Species ; Tea