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Effects for kangaroo care: systematic review & meta analysis (캥거루 케어가 미숙아와 어머니에게 미치는 효과 : 체계적 문헌고찰 및 메타분석)

  • Lim, Junghee;Kim, Gaeun;Shin, Yeonghee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.599-610
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    • 2016
  • This paper reports the results of a systematic review (SR) and meta-analysis research to compare the effect of Kangaroo care, targeting mothers and premature infants. A randomized clinical trial study was performed until February 2015. The domestic literature contained the non-randomized clinical trial research without restriction according to the level of the study design. A search of the Ovid-Medline, CINAHL, PubMed and KoreaMed, the National Library of KOREA, the National Assembly Library, NDSL, KISS and RISS. Through the KMbase we searched and combined the main term ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((kangaroo OR kangaroo OR kangaroo) AND (care OR nursing care OR management OR skin contact)) was made; these were all combined with a keywords search through the selection process. They were excluded in the final 25 studies (n=3051). A methodology checklist for randomized controlled trials (RCTs) designed by SIGN (Scottish Intercollegiate Guidelines Network) was utilized to assess the risk of bias. The overall risk of bias was regarded as low. In 16 studies that were evaluated as a grade of "++", 9 studies were evaluated as a grade of "+". As a result of meta-analysis, kangaroo care regarding the effects of premature mortality, severe infection/sepsis had an insignificant effect. Hyperthermia incidence, growth and development (height and weight), mother-infant attachment, hypothermia incidence, length of hospital days, breast feeding rate, sleeping, anxiety, confidence, and gratification of mothering role were considered significant. In satisfaction of the role performance, depression and stress presented contradictory research results for individual studies showing overall significant difference. This study has some limitations due to the few RCTs comparing kangaroo care in the country. Therefore, further RCTs comparing kangaroo care should be conducted.

Awareness of Zoonoses among Cattle Slaughterhouse Workers in Korea (소 도축 관련 종사자의 인수공통감염증 인지도 조사)

  • Lim, Hyun-Sul;Yoo, Seok-Ju;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.101-112
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    • 2009
  • Objectives: Cattle slaughterhouse workers are known as the high risk group for the zoonoses. We surveyed the awareness of zoonoses among cattle slaughterhouse workers to suggest direction of education and public relations. Methods: We evaluated the epidemiological characteristics of zoonoses and the process of cattle slaughtering. We designed different questionnaires for the workers involved in slaughtering, the handlers of residual products, the inspectors and their assistants, and the grading testers and their assistants respectively. We visited 73 cattle slaughterhouses and 62 residual products handle houses across the country and conducted a questionnaire survey of the general characteristics and the awareness of zoonoses. The data collected was evaluated using the SPSS 17.0 statistical package. Results: The awareness rate of brucellosis, Q fever and Enterohemorrhagic Escherichia coli (EHEC) were 83.9%, 18.5%, 62.7% among cattle slaughterhouse workers. The awareness rate of zoonoses among the workers involved in slaughtering and the handlers of residual products was lower than other workers. The awareness rate of zoonoses tended to increase as the school career. In the correct awareness rate of the transmission of zoonoses, 'transmission by tick bite', 'person to person' and 'air transmission' were lower than other transmission items. The most common reason why cattle slaughterhouse workers think that it is difficult to prevent zoonoses was the ignorance of how to prevent. Conclusions: An educational program is needed for the cattle slaughterhouse workers on zoonoses especially Q fever. And publicity activities about prevention of infection are needed for high risk groups.

Spontaneous Resolution Rate and Predictive Factors of Resolution in Children with Primary Vesicoureteral Reflux (소아에서 일차성 방광요관역류의 자연소실율 및 관련 인자)

  • Kang, Eun-Young;Kim, Min-Sun;Kwon, Keun-Sang;Park, Eun-Hye;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.74-82
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    • 2007
  • Purpose : To analyze the clinical characteristics, spontaneous resolution rate and predictive factors of resolution in children with primary vesicoureteral reflux(VUR). Methods : Between October 1991 and July 2003, 149 children diagnosed with primary VUR at Chonbuk National University Hospital were reviewed retrospectively. All of the patients were maintained on low-dose antibiotic prophylaxis and underwent radionuclide cystograms at 1 year intervals over 3 years after the initial diagnosis of VUR by voiding cystourethrogram was made. Results : The median time to resolution of VUR was 24 months and the total 3 year-cumulative resolution rate of VUR was 61.7%. The following variables were associated with resolution of VUR according to univariate analysis-; age<1 year, male gender, mild grade of reflux, unilateral reflux, congenital hydronephrosis as clinical presentation at time of diagnosis of VUR, absence of focal defects in the renal scan at diagnosis, absence of recurrent UTI, renal scars and small kidney during follow-up. After adjustment by Cox regression model, five variables remained as independent predictors of VUR resolution; age<1 yew, relative risk 1.77(P<0.05), VUR grade I+II 2.98(P<0.05), absence of renal scars 2.23(P<0.05), and absence of small kidney 5.20(P<0.01) during follow-up. Conclusion : In this study, spontaneous resolution rate of VUR, even high grade reflux, is high in infants during medical management, and it was related to age, reflux grade at diagnosis, absence of renal scars and small kidney during follow-up. Therefore early surgical intervention should be avoided and reserved for the selected groups.

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Coronary Artery Bypass Grafting in Elderly Patients Older Than 75 Years (75세 이상 고령환자의 관상동맥우회로술)

  • Yoo Dong Gon;Kim Chong Wook;Park Chong Bin;Choo Suk Jung;Lee Jae Won;Song Meong Gun;Song Hyun
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.123-131
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    • 2005
  • Background: The number of elderly patients undergoing coronary artery bypass grafting (CABG) is increasing. Elderly patients are at increased risk for a variety of perioperative complications and mortality. We identified determinants of operative complications and mortality in elderly patients undergoing CABG. Material and Method: Between January 1995 and July 2003, 91 patients older than 75 years underwent isolated CABG at Asan Medical Center. There were 67 men and 24 women with mean age of $77.0\pm2.4$ years. Thirty clinical or hemodynamic variables hypothesized as predictors of operative mortality were evaluated. Result: CABG was performed under emergency conditions in 5 patients. The internal thoracic artery was used in 85 patients and 10 patients received both internal thoracic arteries. The mean number of distal anastomosis was 3.7 per patient. Operative mortality was $3.3\%$. Twenty-two patients had at least one major postoperative complication. Low cardiac output syndrome was the most common complication, followed by reoperation for bleeding, pulmonary dysfunction, perioperative myocardial infarction, stroke, acute renal failure, ventricular arrhythmia, upper gastrointestinal bleeding, infection, and delayed sternal closure. None were the predictors of mortality. Renal failure, peripheral vascular disease, emergency operation, recent myocardial infarction, congestive heart failure, New York Heart Association (HYHA) class III or IV, Canadian Cardiovascular Society (CCS) angina scale III or IV, and low left ventricle ejection fraction below $40\%$ were univariate predictors of overall complications. Actuarial probability of survival was $94.9\%,\;89.8\%,\;and\;83.5\%$ at postoperative 1, 3 and 5 years respectively. During the follow-up period $93.3\%$ of patients were in NYHA class I, or II and $91.1\%$ were free from angina. Conclusion: Although operative complication is increased, CABG can be performed with an acceptable operative mortality and excellent late results in patients older than 75 years.

Serum HBsAg and Anti-HBs Positive Rate among a City Health Center Visitors (일개 도시 보건소 이용자들의 혈청 HBsAg 및 Anti-HBs 양성률)

  • Shin, Mal-Sook;Hwang, Tae-Yoon;Kim, Chang-Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.508-517
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    • 1997
  • Hepatitis B virus(HBV) infection is one of the major health problems in Korea and HBsAg positive rate was known to be about $5\sim15%$ in general population. This study was conducted to identify the positive rates of serum HBsAg and anti-HBs among community population regarded as having hish HBV vaccination rate than in previous decade, using EIA(Enzyme immunoassay) method, in Seo-Gu, Taegu, Korea. The study subjects were 1,160 who visited Seo-Gu Health Center for check-up serologic markers of hepatitis 3. The data were obtained from the serologic test for hepatitis markers and questionnaire survey was conducted to obtain the general characteristics, vaccination history, past history of hepatitis and other liver disease, and exposure history to risk factors of hepatitis of the study subjects. The positive rates of HBsAg and anti-HBs were 5.2% and 62.4% respectively. The positive rates of HBsAg for male and female were 6.6% and 4.3% respectively. The age was divided into two groups as group I (less than 15 years old), group II (more than 16 years old) according to the hypothesis that these two groups might be different in HBV vaccination rate. HBV vaccination rates for group I and II were 83.1% and 52.3%. The positive rates of HBsAg for group I and II were 2.6% and 6.5%. The positive rates of HBsAg for the vaccinated people of the group I and II were 2.2% and 3.5%, the positive rates of anti-HBs for the vaccinated people of the group I and II were 70.1% and 71.1% respectively. The most significant factor in positive rate of HBsAg was 'hepatitis carrier in family'. Multiple logistic regression analysis revealed that 'hepatitis history' and 'hepatitis carrier in family' were significant variables for positivity of HBsAg, and 'hepatitis B vaccination' was only a significant variable for positivity of anti-HBs.

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A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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Periprosthetic Fracture around Tumor Prosthesis, Comparison of Results with or without Cortical Strut Onlay Allograft (종양인공관절 주위 골절의 피질골 지주 중첩 동종골 이식술 유무에 따른 결과 비교)

  • Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.42-50
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    • 2021
  • Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

Etiology and Risk Factors of Community-Acquired Pneumonia in Hospitalized Children During the COVID-19 Pandemic in South Korea (국내 코로나19 판데믹 기간 발생한 입원을 요하는 소아청소년 지역사회폐렴의 원인과 위험 인자)

  • Hae Min Kang;Seung Ha Song;Bin Ahn;Ji Young Park;Hyunmi Kang;Byung Ok Kwak;Dong Hyun Kim;Joon Kee Lee;Soo-Han Choi ;Jae Hong Choi;Eun Hwa Choi;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.20-32
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    • 2023
  • Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children's Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%. A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions: Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.

Cytologic Screening for Cervical Cancer and Factors Related to Cervical Cancer (대구시(大邱市) 기혼(旣婚) 여성(女性)의 자궁경부암(子宮頸部癌) 유병률(有病率)과 그 관련요인(關聯要因))

  • Jeon, Yong-Jae;Lee, Chi-Young;Chun, Byung-Yeol;Kam, Sin;Yeh, Min-Hae
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.428-440
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    • 1991
  • This study was conducted to estimate the prevalence rate of cervical cancer and to investigate its risk factors. 5,417 asymptomatic married women were screened from March, 1984 to December, 1990 in Taegu city. Of 5,417 examinees, 3,817 (70.46%) were normal, 1,542 (28.7%) showed inflammatory change, 51 (0.94%) were dysplasia and 7 (0.13%) were carcinoma in situ or invasive carcinomas. The prevalence of abnormal finding (dysplasia, carcinoma in situ or invasive carcinoma) was 1,070 per 100,000 population. The prevalence of dysplasia was 940 per 100,000 and that of carcinoma in situ or invasive carcinoma was 130 per 100,000. Age-adjusted prevalence rate for abnormal finding adjusted with standard population of Taegu city was estimated to be 850 per 100,000. The prevalence of cervical cancer was significantly increased with age (P<0.05). The prevalence of cervical cancer was significantly decreased with age at marriage and educational level (P<0.05). The history of induced abortion and the number of pregnancies were significantly associated with the prevalence of cervical cancer (p<0.05), whereas, the number of parity was not. Age at marriage was significantly associated with the prevalence of cervical cancer after stratification by age (p<0.05). However, the level of education, parity, induced abortion, number of pregnancies were not significant. Inflammation and human papiloma virus infection were associated with cervical cancer with odds ratio of 13.48 (95% confidence interval $7.80{\sim}23.40$) and 474.29 (95% confidence interval $196.80{\sim}1143.10$), respectively. In conclusion, for early detection of cervical cancer it should be recommended to perform mass cytological screening. In particular, regular and periodic cytologic screening, starting at age 25, for cervical cancer should be recommended for those women who have frequent cervical inflammation and for those women married before age of 20.

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The Actual Management State of Trial Contact Lenses and Lens Care Products in Local Optical Shops (안경원의 시험착용 콘택트렌즈 및 관리용품 관리 실태)

  • Park, Mijung;Lee, Unjung;Kim, So Ra
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.4
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    • pp.391-401
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    • 2011
  • Purpose: In the present study, the actual management state of trial contact lenses and lens care products in local optical shops was surveyed and analyzed to reduce the risk of lens complication possibly induced by neglecting lens care. Methods: The feeling of contact lens wearers during the wear of trial contact lenses was surveyed. Futhermore, the actual management state of trial contact lenses such as cosmetic lens and RGP lens and lens care products was also investigated by surveying opticians who trade contact lenses in local optical shops. Results: It was found that consumers trusted the sanitary conditions of the lens since trial cosmetic contact lens and RGP lens were cleaned before and after trails by over 98% of opticians in local optical shops. For trial cosmetic lens, cleaning with normal saline, multipurpose solution for soft lens and combination of saline and multipurpose solution were 38.5%, 40.5% and 21%, respectively, before trials. After trials, cosmetic lenses were cleaned with normal saline, multipurpose solution for soft lens and a combination of saline and multipurpose solution were 13%, 75%, and 12%, respectively. On the other hand, cleaning with normal saline, multipurpose solution for RGP lens and combination of saline and multipurpose solution were 28.5%, 38.5% and 33%, respectively, before trying trial RGP lens. After trials, RGP lenses were cleaned with normal saline, multipurpose solution for RGP lens and a combination of saline and multipurpose solution were 2.5%, 70%, and 27.5%, respectively, indicating that relatively many opticians followed the lens cleaning regimen. In local optical shops, the cleaning trial cosmetic lens was mainly conducted at every 10 days or a month and the washing cycle of cosmetic lens case was in a month or 2~3 months. The cleaning interval of trial RGP lens was primarily in a month or 2~3 months. For those lens cases, more than 75% of opticians washed them with a surfactant and then rinsed with cold water. The storing periods of lens care products were primarily in a week for saline and in a month and 2~3 months indicating that storing period of lens care products was relatively well-kept in local optical shops. Conclusions: It is thought that the concern about any microbial infection is not that high since trial contact lenses and lens care products were generally well-managed by opticians in local optical shops from the results above. However, better public eye health and better public confidence in opticians may be possible if further strengthen in avoidance of lens cleaning with saline, keep of cleaning cycles within 2 weeks and rinsing of lens cases with hot water happens.