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.

The interactions between the tumor microenvironment and tumor cells determine the behavior of the primary tumors. Whether cancer-associated fibroblasts (CAF) have a tumor progressive or a protective role likely depends on the type of tumor cells and the CAF subpopulation. In the present study, we analyzed the prognostic significance of CAF subpopulations in colorectal cancer (CRC). CAF phenotypes were analyzed in 302 CRC patients by using antibodies against podoplanin (PDPN), alpha-smooth muscle actin (alpha-SMA), and S100A4. The relationship between the CAF phenotypes and 11 clinicopathological parameters were evaluated and their prognostic significance was analyzed from the disease-free and overall survival times. We observed that at the tumor invasive front, PDPN CAFs were present in 40% of the cases, and S100A4 or alpha-SMA CAFs were detected in all the cases. PDPN/S100A4 and alpha-SMA/S100A4 dual-stained CAFs were observed in 10% and 40% of the cases, respectively. The PDPN+ CAFs were associated with 6 favorable clinicopathological parameters and prolonged disease-free survival time. The PDPN-/alpha-SMA(high) CAFs were associated with 6 aggressive clinicopathological parameters and tended to exhibit shorter disease-free survival time. On the other hand, the PDPN-/S100A4(high) CAFs were associated with 2 tumor progression parameters, but not with disease prognosis. The PDPN+ CAF phenotype is distinct from the alpha-SMA or S100A4 CAFs in that it is associated with less aggressive tumors and a favorable prognosis, whereas the PDPN-/alpha-SMA(high) or PDPN-/S100A4(high) CAFs are associated with tumor progression in CRC. These findings suggest that CAFs can be a useful prognostic biomarker or potential targets of anti-cancer therapy in CRC.
Actins/immunology/*metabolism ; Adult ; Aged ; Aged, 80 and over ; Antibodies/immunology ; Carcinoembryonic Antigen/blood ; Colorectal Neoplasms/*diagnosis/mortality/pathology ; Disease-Free Survival ; Female ; Fibroblasts/cytology/metabolism ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Membrane Glycoproteins/immunology/*metabolism ; Middle Aged ; Neoplasm Staging ; Phenotype ; Prognosis ; S100 Proteins/immunology/*metabolism ; Tumor Markers, Biological/metabolism

Anthropometry ; Head ; Manikins

BACKGROUND AND OBJECTIVES: Making the noninvasive diagnosis of coronary artery disease in patients with a permanent pacemaker is difficult because of the inability to interpret electrocardiograms and the low specificity of perfusion scintigraphy. We evaluated the diagnostic accuracy of noninvasive pacemaker stress echocardiography (PASE) as a screening test for coronary artery disease in patients with atypical angina and a permanent pacemaker. SUBJECTS AND METHODS: This a prospective study, and transthoracic stress-pacing echocardiography was performed on 15 patients (9 men and 6 women; age, mean age: 71.1+/-11.0 years) with atypical angina and a permanent pacemaker. All the patients underwent noninvasive pacemaker-stress echocardiography by external programming (pacing the heart rate up to 150 beats per minute). Coronary angiography was performed on the 8 patients with positive PASE results. Significant coronary artery disease was defined as > or =70% stenosis in at least one major coronary artery. RESULTS: The echocardiographic images were interpretable for all the patients. No significant side effects were observed. The left ventricular systolic function was preserved in all the patients (left ventricular ejection fraction; 63.5+/-8%). Only 5 (62.5%) of 8 patients showed significant coronary artery disease, as documented by coronary angiography. CONCLUSION: Noninvasive PASE is a simple, rapid, safe and diagnostically efficient test for detecting coronary artery disease in patients with atypical angina and a permanent pacemaker. Larger studies are necessary to validate our findings.
Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Echocardiography ; Echocardiography, Stress ; Electrocardiography ; Heart Rate ; Humans ; Male ; Mass Screening ; Pacemaker, Artificial ; Perfusion Imaging ; Prospective Studies ; Sensitivity and Specificity

Four trials of external quality assessment in diagnostic hematology were performed in 2007 with average 722 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, hematocrit, red blood cell count, platelet count, blood cell morphology, prothrombin time and activated partial thromboplastin time. The response rate was more than 95.2%. The coefficients of variation in hemoglobin, hematocrit and RBC were stable but variable in platelet count and WBC count according to measuring cell counters. Test results of blood cell morphology showed variation among various cell morphologies.
Blood Cells ; Cell Count ; Erythrocyte Count ; Hematocrit ; Hematology ; Hemoglobins ; Korea ; Leukocyte Count ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time

Four trials of external quality assessment in diagnostic hematology were performed in 2007 with average 722 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, hematocrit, red blood cell count, platelet count, blood cell morphology, prothrombin time and activated partial thromboplastin time. The response rate was more than 95.2%. The coefficients of variation in hemoglobin, hematocrit and RBC were stable but variable in platelet count and WBC count according to measuring cell counters. Test results of blood cell morphology showed variation among various cell morphologies.
Blood Cells ; Cell Count ; Erythrocyte Count ; Hematocrit ; Hematology ; Hemoglobins ; Korea ; Leukocyte Count ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time

BACKGROUND AND OBJECTIVES: Vascular endothelial growth factor (VEGF) is a potent endothelial cell-specific mitogen. This study was undertaken to test the hypothesis that the neointima hyperplasia induced by a balloon injury is inhibited by blocking VEGF and VEGF receptor-1 (VEGFR-1) with anti-VEGF peptides. Materials and Methods: Anti-VEGF RRKRRR peptide (dRK6) and anti-VEGFR-1 peptide (anti-flt-1) were synthesized at Pohang University of Science and Technology, Korea. Male Sprague-Dawley rats, weighing 300-350 g, were subcutaneously injected 0.5 mg/kg of dRK6 or 0.5 mg/kg of anti-flt-1, dissolved in phosphate buffer solution, 2 days before induction of a carotid balloon-injury, and then daily in the same manner post carotid balloon injury for 2 weeks. RESULTS: Neointima formation was suppressed in both the dRK6 and anti-flt-1 groups compared to that in the untreated controls at 2 weeks post carotid balloon-injury (neointimal area; control group 0.44+/-0.09 mm2, dRK6 group 0.25+/-0.05 mm2, anti-flt-1 group 0.19+/-0.05 mm2, p<0.01). Anti-flt-1 peptide and dRK6 reduced the numbers of proliferative bromodeoxyuridine-labeled cells in the neointima (control group 16.4+/-10.6%, dRK6 group 3.7+/-2.1%, anti-flt-1 group 5.9+/-3.4%, p<0.05). In addition, an inflammatory response, as determined by monocyte chemoattractant protein-1 and interleukin-6 upregulation, which was evident in the controls, was inhibited by both dRK6 and anti-flt-1. CONCLUSION: This study suggests anti-vascular endothelial growth factor peptides can reduce the inflammation and neointima formation in balloon injured rat carotid arteries.
Animals ; Carotid Arteries* ; Carotid Artery Injuries ; Chemokine CCL2 ; Endothelial Growth Factors* ; Gyeongsangbuk-do ; Humans ; Hyperplasia ; Inflammation ; Interleukin-6 ; Korea ; Male ; Neointima* ; Peptides* ; Rats* ; Rats, Sprague-Dawley ; Up-Regulation ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor Receptor-1 ; Vascular Endothelial Growth Factors

Four trials of external quality assessment in diagnostic hematology were performed in 2005 with about 500 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, white cell differential count, red blood cell morphology. The response rate was more than 97%. The coefficients of variation in hemoglobin and RBC number was stable but variable in platelet number and WBC number according to measuring cell counts. Test results showed wide variation according to measuring machine and reagents.
Cell Count ; Erythrocyte Count ; Erythrocytes ; Hematology* ; Indicators and Reagents ; Korea* ; Leukocyte Count ; Platelet Count

BACKGROUND: Previous studies showed that increased QT dispersion has been observed during episodes of myocardial ischemia or infarction and identified the patients at risk of arrhythmia or sudden death. The aim of this study was to investigate the relation between QT dispersion and left ventricular (LV) function (systolic and diastolic), dimension and mass as well as to analyze the differences of this relationship according to the extent of angiographic coronary stenosis in patients with coronary artery disease. METHODS: The study population included 262 patients (male 129, female 133;average age 60 years). Echocardiography was done for the measurement of left ventricular function, dimension and mass on admission. Electrocardiography for QT and QTc (corrected QT) dispersion were recorded 25 mm/sec paper speeds before the coronary angiography. Patients were divided into two groups; Group A where angiographic coronary stenosis <50%, and Group B where angiographic coronary stenosis >or =50%. RESULTS: The results were as follows: 1) QT dispersion was higher in those with depressed LV systolic function (EF<55%) than in those with normal LV systolic function among Group A (p<0.05). 2) QT dispersion was higher in those with abnormal IVRT (isovolumic relaxation time) than in those with normal IVRT among Group A (p<0.05). But, there was no correlation between QT dispersion and other diastolic parameters in Group A. 3) QT dispersion was positively correlated with increased LVDd (diastolic left ventricular dimension), LVDs (systolic left ventricular dimension), LAD (left atrial dimension) and IVS (interventricular septum) in those in Group A. But, there found no correlation between QT dispersion and LV dimension parameters in Group B. 4) QT dispersion also had a positive correlation with LV mass in all patients and in those in Group A (all patients p<0.01;Group A p<0.001). But, there found no correlation between QT dispersion and LV mass in Group B. 5) On multiple logistic regression analysis, sex, abnormal IVRT and significant stenosis (> or =50%) of the coronary artery were independent prognostic factors of prolonged QT dispersion (p<0.05). 6) QTc dispersion showed the same result as QT dispersion. CONCLUSION: LV systolic function (EF), some diastolic function (IVRT), dimension (LVDd, LVDs, LAD IVS), and mass are associated with the increased QT dispersion in patients with coronary artery disease, especially minimal angiographic stenosed (<50%) patients. So, we consider echocardiography is an important tool to predict the QT dispersion in patients with coronary artery disease.
Arrhythmias, Cardiac ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Death, Sudden ; Echocardiography* ; Electrocardiography ; Female ; Humans ; Infarction ; Logistic Models ; Myocardial Ischemia ; Relaxation ; Ventricular Function, Left*

Bilateral coronary arteriovenous fistula (CAVF), arising from both the right and left coronary arteries, are rare. We experienced a 44 years old male patient with bilateral CAVF, and coronary atherosclerosis, whose diagnosis was confirmed by coronary angiography. The hemodynamic result revealed minimal left-to-right shunt. Therefore, only percutaneous coronary artery intervention of the coronary artery stenosis was performed. Here, this rare case is reported, with a review of the literature.
Adult ; Arteriovenous Fistula* ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels ; Diagnosis ; Hemodynamics ; Humans ; Male