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Sample records for korean surgical site

  1. Frequently Asked Questions about Surgical Site Infections

    MedlinePlus

    ... Site Infections What is a Surgical Site Infection (SSI)? Can SSIs be treated? What are some of ... a Surgical Site Infection? A surgical site infection (SSI) is an infection that occurs after surgery in ...

  2. Reducing Surgical Site Infections: A Review

    PubMed Central

    Reichman, David E; Greenberg, James A

    2009-01-01

    Infection at or near surgical incisions within 30 days of an operative procedure contributes substantially to surgical morbidity and mortality each year. The prevention of surgical site infections encompasses meticulous operative technique, timely administration of appropriate preoperative antibiotics, and a variety of preventive measures aimed at neutralizing the threat of bacterial, viral, and fungal contamination posed by operative staff, the operating room environment, and the patient’s endogenous skin flora. It is the latter aspect of contamination, and specifically mechanical methods of prevention, on which this review focuses. PMID:20111657

  3. Surgical Site Infections After Pediatric Spine Surgery.

    PubMed

    Floccari, Lorena V; Milbrandt, Todd A

    2016-04-01

    Surgical site infection (SSI) after spinal deformity surgery is a complication in the pediatric population resulting in high morbidity and cost. Despite modern surgical techniques and preventative strategies, the incidence remains substantial, especially in the neuromuscular population. This review focuses on recent advancements in identification of risk factors, prevention, diagnosis, and treatment strategies for acute and delayed pediatric spine infections. It reviews recent literature, including the best practice guidelines for infection prevention in high-risk patients. Targets of additional research are highlighted to assess efficacy of current practices to further reduce risk of SSI in pediatric patients with spinal deformity. PMID:26772947

  4. Resistance profiles in surgical-site infection.

    PubMed

    Lenz, Andreas M; Fairweather, Mark; Cheadle, William G

    2008-08-01

    Surgical-site infections (SSIs) remain a common complication, affecting some 5% of patients undergoing surgical procedures and can sometimes present a major challenge after surgery with life-threatening septic illness. The appearance of organisms that are often resistant to common antibiotic treatment is of great concern. Staphylococcus aureus is the organism most commonly recovered from infected surgical wounds, and usually contaminates wounds from the patients own skin. SSIs occur despite appropriate skin disinfection, sterilization of instruments, use of gown and gloves, appropriate sterile technique and prophylactic antimicrobials. In fact, it is difficult to maintain a sterile field over time, and most wounds become contaminated throughout the course of surgery. Methicillin-resistant S. aureus (MRSA) first arose in the hospital setting, but have more recently evolved in the community. Such community-acquired MRSA are genetically different and seem to be even more virulent owing to genes that encode virulence factors, such as staphylococcal cassette chromosome mec type IV and Panton-Valentine leukocidin. The purpose of this review is to summarize characteristics of frequently isolated bacterial strains from SSIs. The focus will be on Gram-positive organisms because of their increasing prevalence in SSIs and their high potential to develop resistance against several antibiotic agents, including vancomycin. PMID:18651816

  5. Urologist's Practice Patterns Including Surgical Treatment in the Management of Premature Ejaculation: A Korean Nationwide Survey

    PubMed Central

    Yang, Dae Yul; Ko, Kyungtae; Lee, Won Ki; Park, Hyun Jun; Moon, Ki Hak; Kim, Sae Woong; Kim, Soo Woong; Cho, Kang Su; Moon, Du Geon; Min, Kweonsik; Yang, Sang Kuk; Son, Hwancheol; Park, Kwangsung

    2013-01-01

    Purpose According to previous studies, the prevalence of premature ejaculation (PE) in Korea ranges from 11.3% to 33%. However, the actual practice patterns in managing patients with PE is not well known. In this study, we have endeavored to determine how contemporary urologists in Korea manage patients with PE. Materials and Methods The e-mailing list was obtained from the Korean Urological Association Registry of Physicians. A specifically designed questionnaire was e-mailed to the 2,421 urologists in Korea from May 2012 to August 2012. Results Urologists in Korea diagnosed PE using various criteria: the definition of the International Society for Sexual Medicine (63.4%), Diagnostic and Statistical Manual of Mental Disorders (43.8%), International Statistical Classification of Disease, 10th edition (61.7%), or perceptional self-diagnosis by the patient himself (23.5%). A brief self-administered questionnaire, the Premature Ejaculation Diagnostic Tool, was used by only 42.5% of the urologists. Selective-serotonin reuptake inhibitor (SSRI) therapy was the main treatment modality (91.5%) for PE patients. 40.2% of the urologists used phosphodiesterase type 5 inhibitors, 47.6% behavior therapy, and 53.7% local anesthetics. Further, 286 (54.3%) urologists managed PE patients with a surgical modality such as selective dorsal neurotomy (SDN). Conclusions A majority of Korean urologists diagnose PE by a multidimensional approach using various diagnostic tools. Most urologists believe that medical treatment with an SSRI is effective in the management of PE. At the same time, surgical treatment such as SDN also investigated as one of major treatment modality despite the lack of scientific evidence. PMID:24459656

  6. Surgical Adhesive Drape (IO-ban) as Postoperative Surgical Site Dressing

    PubMed Central

    Syed, Hasan R; Snyder, Rita; McGowan, Jason E; Jha, Ribhu T; Nair, Mani N

    2015-01-01

    Study Design: Retrospective chart analysis. Objective: The objective of this study is to describe the senior author’s (MNN) experience applying a widely available surgical drape as a postoperative sterile surgical site dressing for both cranial and spinal procedures. Summary of Background Data: Surgical site infection (SSI) is an important complication of spine surgery that can result in significant morbidity. There is wide variation in wound care management in practice, including dressing type. Given the known bactericidal properties of the surgical drape, there may be a benefit of continuing its use immediately postoperatively. Methods: All of the senior author’s cases from September 2014 through September 2015 were reviewed. These were contrasted to the previous year prior to the institution of a sterile surgical drape as a postoperative dressing. Results: Only one surgical case out of 157 operative interventions (35 cranial, 124 spinal) required operative debridement due to infection. From September 2013 to September 2014, prior to the institution of a sterile surgical drape as dressing, the author had five infections out of 143 operations (46 cranial, 97 spinal) requiring intervention. Conclusion: The implementation of a sterile surgical drape as a closed postoperative surgical site dressing has led to a decrease in surgical site infections. The technique is simple and widely available, and should be considered for use to diminish surgical site infections. PMID:26798570

  7. A Thoracic Surgical Case Presented at the First Academic Meeting of the Chosun (Korean) Medical Association Held in 1947

    PubMed Central

    Kim, Won-Gon

    2016-01-01

    The late Prof. Kyeok Boo Han (1913–2005) was one of the pioneers in the early stages of the establishment of thoracic surgery in Korea. He was in charge of thoracic surgery at Seoul National University Hospital from 1948 to the outbreak of the Korean War in 1950. He presented a thoracic surgical case entitled “Adhesive (constrictive) pericarditis: one surgical case” at the first academic meeting of the Chosun (an old name for Korea) Medical Association, held in 1947. This presentation is considered to be the first thoracic surgical case presented by a Korean surgeon at a domestic medical meeting after the National Liberation from Japanese colonial rule in 1945. In this regard, this study was intended to analyze the content and the meaning of the case, published in a journal in 1948. PMID:27525248

  8. A Thoracic Surgical Case Presented at the First Academic Meeting of the Chosun (Korean) Medical Association Held in 1947.

    PubMed

    Kim, Won-Gon

    2016-08-01

    The late Prof. Kyeok Boo Han (1913-2005) was one of the pioneers in the early stages of the establishment of thoracic surgery in Korea. He was in charge of thoracic surgery at Seoul National University Hospital from 1948 to the outbreak of the Korean War in 1950. He presented a thoracic surgical case entitled "Adhesive (constrictive) pericarditis: one surgical case" at the first academic meeting of the Chosun (an old name for Korea) Medical Association, held in 1947. This presentation is considered to be the first thoracic surgical case presented by a Korean surgeon at a domestic medical meeting after the National Liberation from Japanese colonial rule in 1945. In this regard, this study was intended to analyze the content and the meaning of the case, published in a journal in 1948. PMID:27525248

  9. Nonconcordance with surgical site infection prevention guidelines and rates of surgical site infections for general surgical, neurological, and orthopedic procedures.

    PubMed

    Young, Barnaby; Ng, Tat Ming; Teng, Christine; Ang, Brenda; Tai, Hwei Yee; Lye, David C

    2011-10-01

    Surgical site infection (SSI) is a common and preventable complication of surgery, but the relative importance of individual measures recommended by guidelines has not been determined. Elective general surgical, neurological, and orthopedic procedures requiring antibiotic prophylaxis from a 3-month period were retrospectively studied to determine concordance with SSI prevention guidelines and to identify factors which predicted the development of SSIs. A total of 216 surgeries were reviewed, with 18 SSIs (8.3%). A mean of 1.4 antibiotic prophylaxis errors per surgery were identified, with correct antibiotic type identified for 64%, antibiotic timing for 83%, supplemental antibiotic dosing for 34%, and antibiotic duration of less than 24 h for 44%. Normothermia was present in 79% of surgeries, and normoglycemia was present in 17%. Univariate analysis of the SSI rate identified four significant factors. Antibiotic prophylaxis for less than 24 h postoperatively (odds ratio [OR], 0.213; 95% confidence interval [95% CI]0.060 to 0.757) and neurosurgery (OR, 0.118; 95% CI, 0.15 to 0.903) correlated with a reduced risk of SSI. The mean number of prophylaxis errors (OR, 1.6; 95% CI, 1.02 to 2.4) and a duration of surgical drainage for more than 3 days (OR, 2.679; 95% CI, 1.009 to 7.113) predicted SSI. By multivariate analysis, errors in individual antibiotic prophylaxis measures were not significantly associated with SSI; however, the presence of more than two errors was significant (OR, 4.030; 95% CI, 1.018 to 15.96). A strong correlation was identified between the degree of concordance to SSI prevention guidelines and the SSI rate (P = 0.001, Mantel-Haenszel linear-by-linear association chi-square test). PMID:21825293

  10. Elderly Diabetic Patient with Surgical Site Mucormycosis Extending to Bowel

    PubMed Central

    Patel, Atul K; Vora, Himanshu J; Patel, Ketan K; Patel, Bhavin

    2010-01-01

    Mucormycosis is rare in clinical practice. Most infections are acquired by inhalation; other portals of entry are traumatic implantation and ingestion in immunocompromised host. Mucormycosis is life threatening infection in immunocompromised host with variable moratlity ranging from 15-81% depending upon site of infection. General treatment principles include early diagnosis, correction of underlying immunosuppression and metabolic disturbances, adequate surgical debridement along with amphotericin therapy. We describe surgical site mucormycosis extended to involve large bowel in elderly diabetic patient. PMID:20606975

  11. Elderly diabetic patient with surgical site mucormycosis extending to bowel.

    PubMed

    Patel, Atul K; Vora, Himanshu J; Patel, Ketan K; Patel, Bhavin

    2010-05-01

    Mucormycosis is rare in clinical practice. Most infections are acquired by inhalation; other portals of entry are traumatic implantation and ingestion in immunocompromised host. Mucormycosis is life threatening infection in immunocompromised host with variable moratlity ranging from 15-81% depending upon site of infection. General treatment principles include early diagnosis, correction of underlying immunosuppression and metabolic disturbances, adequate surgical debridement along with amphotericin therapy. We describe surgical site mucormycosis extended to involve large bowel in elderly diabetic patient. PMID:20606975

  12. Performance improvement initiative: prevention of surgical site infection (SSI).

    PubMed

    Ng, Wai Khuan; Awad, Nawal

    2015-01-01

    Mafraq Hospital performs an average of 10,000 surgeries every year. The impact of having high volume high risk surgical procedures calls for the need to ensure safe surgery and a prevention of surgical site infection (SSI). SSI represents a significant portion of healthcare-associated infections (HAIs). The impact on morbidity, mortality, and cost of care has resulted in identifying the need to reduce SSI as a top priority to prevent healthcare associated infections. The good news is that the majority of SSIs are preventable. Mafraq Hospital performs a range of surgical procedures that covers 14 surgical specialties. The infection prevention and control team performs surveillance for SSI for all patients who undergo operative procedure included in Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Operative Procedure Category (40 surgical procedures). Out of the 40 CDC NHSN listed, 33 operative procedures were performed at Mafraq Hospital, of which 17 were reported with SSI for 2013 and 2014. Surgical site infection has implicated an increase average length of stay from seven to 10 additional postoperative hospital days and additional costs of AED 10,000 to AED 100,000/SSI depending on procedure and pathogen. A multidisciplinary team was formed to develop and implement measures to reduce/eliminate surgical site infection, as well as evaluate and monitor compliance. Hence a group of multidisciplinary teams were initiated to analyse the results, find out the gaps, and implement a quality improvement project to correct the deficits. Recommendations for appropriate improvement measures were formed on evidence-based international guidelines from the Institute for Healthcare Improvement (IHI) and CDC. Evidence based practice supports that many of the causes of surgical site infection can be prevented with proper medical attention and care. PMID:26732804

  13. The Prevention of Surgical Site Infection in Elective Colon Surgery

    PubMed Central

    Fry, Donald E.

    2013-01-01

    Infections at the surgical site continue to occur in as many as 20% of elective colon resection cases. Methods to reduce these infections are inconsistently applied. Surgical site infection (SSI) is the result of multiple interactive variables including the inoculum of bacteria that contaminate the site, the virulence of the contaminating microbes, and the local environment at the surgical site. These variables that promote infection are potentially offset by the effectiveness of the host defense. Reduction in the inoculum of bacteria is achieved by appropriate surgical site preparation, systemic preventive antibiotics, and use of mechanical bowel preparation in conjunction with the oral antibiotic bowel preparation. Intraoperative reduction of hematoma, necrotic tissue, foreign bodies, and tissue dead space will reduce infections. Enhancement of the host may be achieved by perioperative supplemental oxygenation, maintenance of normothermia, and glycemic control. These methods require additional research to identify optimum application. Uniform application of currently understood methods and continued research into new methods to reduce microbial contamination and enhancement of host responsiveness can lead to better outcomes. PMID:24455434

  14. The prevention of surgical site infection in elective colon surgery.

    PubMed

    Fry, Donald E

    2013-01-01

    Infections at the surgical site continue to occur in as many as 20% of elective colon resection cases. Methods to reduce these infections are inconsistently applied. Surgical site infection (SSI) is the result of multiple interactive variables including the inoculum of bacteria that contaminate the site, the virulence of the contaminating microbes, and the local environment at the surgical site. These variables that promote infection are potentially offset by the effectiveness of the host defense. Reduction in the inoculum of bacteria is achieved by appropriate surgical site preparation, systemic preventive antibiotics, and use of mechanical bowel preparation in conjunction with the oral antibiotic bowel preparation. Intraoperative reduction of hematoma, necrotic tissue, foreign bodies, and tissue dead space will reduce infections. Enhancement of the host may be achieved by perioperative supplemental oxygenation, maintenance of normothermia, and glycemic control. These methods require additional research to identify optimum application. Uniform application of currently understood methods and continued research into new methods to reduce microbial contamination and enhancement of host responsiveness can lead to better outcomes. PMID:24455434

  15. Prevention of Surgical Site Infections in Joint Replacement Surgery.

    PubMed

    Marculescu, Camelia E; Mabry, Tad; Berbari, Elie F

    2016-04-01

    Prosthetic joint infections (PJI), although rare, represent a serious complication of total joint arthroplasty as they pose not only a direct financial burden to the patient but also an indirect burden related to psychosocial impact that PJI incur on the patient. Treatment of PJI is complex and requires a combined surgical and medical approach. Patients are often subjected to multiple surgical procedures and prolonged courses of antimicrobial therapy. Therefore, all efforts should be directed toward maximizing the prophylactic measures in the peri-operative and post-operative phases in order to prevent the occurrence of surgical site infections. This article explores primarily the prophylactic measures that target the host and the operative theater environment. Implementation of such preventive measures requires a multi-disciplinary approach and is crucial for a successful outcome of the total joint arthroplasty. PMID:26855288

  16. Surgical management of Novacor drive-line exit site infections.

    PubMed

    Pasque, Michael K; Hanselman, Tina; Shelton, Kim; Kehoe-Huck, Beth A; Hedges, Robyn; Cassivi, Stephen D; Ewald, Gregory A; Rogers, Joseph G

    2002-10-01

    Implantable left ventricular assist device (LVAD) drive-line exit site infection, an expected consequence of currently available device use, continues to be a significant limiting factor in long-term support. We theorize that the mechanism behind the establishment of the most chronic exit site infections involves a shearing torsion injury that disrupts the tissue adherence interface with the drive-line. The resulting neo-epithelialized drainage tract prevents permanent clearance of the infection with antibiotics alone. The proposed treatment strategy of established infections involves aggressive surgical excision of the involved exit site. PMID:12400795

  17. [Systematic review of surgical gowns in the control of contamination/surgical site infection].

    PubMed

    Burgatti, Juliane Cristina; Lacerda, Rúbia Aparecida

    2009-03-01

    Surgical scrubs are made with both fabric and non-fabric material. The study aimed to observe whether there is scientific evidence, according to the systematic review, that supports the practice of wearing scrubs in surgeries, according to the material they are made of. Basic intervention studies were considered, which investigated contamination and/or infection of the surgical site with the use of either reusable or single-use surgical scrubs, using people submitted to surgeries as the study population, either in real or simulated situations, at any period, without any language limitations. The strategy of searching electronic databases was used to find studies. With this, difficulties in isolating the object of intervention from countless other factors that can interfere in the outcomes were identified in studies of this type. Two studies (E1 and E2) showed strong evidence for the recommendation. In conclusion, there is no difference in contamination and infection of the surgical site between fabric and non-fabric scrubs. PMID:19437878

  18. An unusual surgical site infection in a liver transplant recipient

    PubMed Central

    Gandhi, Vidhyachandra; Nagral, Aabha; Nagral, Sanjay; Das, Suryasnata; Rodrigues, Camilla

    2010-01-01

    Mycobacterium abscessus is a rare cause of human infection and is difficult to diagnose unless it is suspected. A 45-year-old woman underwent deceased donor liver transplantation following which she developed non-healing surgical site infection, which did not resolve with routine antibiotics for 2 months. The scraping of the wound revealed M abscessus infection. Definitive identification of this species of mycobacterium was possible by its growth characteristics on culture and reverse line blot hybridisation assay. She was treated with clarithromycin and cotrimaxazole as per sensitivity and showed complete recovery from the infection within 6 weeks of starting the drugs, which were continued for 6 months. We believe that this is the first documented case of surgical site infection by M abscessus in a liver transplant recipient. PMID:22778369

  19. Pyoderma gangrenosum in an abdominal surgical site: a case report.

    PubMed

    Ogata, Kenichi; Takamori, Hiroshi; Ikuta, Yoshiaki; Tanaka, Hideyuki; Ozaki, Nobuyuki; Hayashi, Hiromitsu; Ogawa, Katsuhiro; Doi, Koichi

    2015-12-01

    Pyoderma gangrenosum (PG) is an uncommon, ulcerative skin disease that is often associated with systemic diseases. Herein, we report a development of PG in a surgical site after cholecystectomy that was difficult to discriminate from surgical site infection. The patient was a 74-year-old man who had previously been diagnosed with myelodysplastic syndrome (MDS). Laparoscopic cholecystectomy was planned under diagnosis of cholecystolithiasis, but we converted to open cholecystectomy. The surgical wound was partially erythematous 4 days after surgery. In spite of opening the wound, cleansing it with sterile saline, and administration of antibiotics, inflammation spread with erosion. The clinical manifestations and histopathologic features of biopsy specimen indicated that diagnosis of PG associated with MDS was most likely. Administration of glucocorticoids made a rapid response of skin inflammation. The differential diagnosis of postoperative wound healing complications that were unresponsive to conventional wound local care and antibiotic therapy should include PG, especially in patients with systemic diseases such as MDS. PMID:26943446

  20. Re-evaluation of Probable Maximum Tsunamis for Korean Nuclear Power Plant Sites

    NASA Astrophysics Data System (ADS)

    Jin, Sobeom; Hyun, Seung Gyu; Park, Sang ho; Bae, Jae Seok; Cho, Yong-Sik; Yoon, Sung Bum

    2014-05-01

    Most of tsunami-triggering earthquakes occur in subduction zones around the Pacific Ocean area including the East Sea surrounded by Korea, Japan and Russia. In the East Sea, there were three major historical tsunami events occurred in 1964, 1983 and 1993. Among them, the Central East Sea Tsunami occurred in 1983, in special, caused huge losses of human lives and property damage at Korean coastal communities. There are several nuclear power plants under operation and several more plants will be built along the eastern coast of the Korean Peninsula. These historical tsunamis were considered individually to evaluate the probable maximum tsunamis for Korean nuclear power plant sites. Recently, several catastrophic tsunamis have been occurred around the Pacific Ocean rim. Among them, the East Japan Tsunami occurred on March 11, 2011 has attracted social attention due to the accident at Fukushima Dai-ichi nuclear power plant site. The accident is still going on. Therefore, new approach to evaluate the probable maximum tsunamis for the Korean sites is investigated in this study. Joint rupture of historical tsunami sources and hypothetical tsunami sources is employed to define the new source parameters of the probable maximum tsunami. The hypothetical tsunamis are inferred from the seismic gap theories. The numerical model using the modified leap-frog finite difference scheme is used to simulate the propagation of the new probable maximum tsunami across the East Sea and the numerical model simulating the associated run-up process of tsunamis is then employed to estimate the maximum run-up heights. Predicted results will be used to make a measure against unexpected tsunami attacks.

  1. Surgical site infection: poor compliance with guidelines and care bundles.

    PubMed

    Leaper, David J; Tanner, Judith; Kiernan, Martin; Assadian, Ojan; Edmiston, Charles E

    2015-06-01

    Surgical site infections (SSIs) are probably the most preventable of the health care-associated infections. Despite the widespread international introduction of level I evidence-based guidelines for the prevention of SSIs, such as that of the National Institute for Clinical Excellence (NICE) in the UK and the surgical care improvement project (SCIP) of the USA, SSI rates have not measurably fallen. The care bundle approach is an accepted method of packaging best, evidence-based measures into routine care for all patients and, common to many guidelines for the prevention of SSI, includes methods for preoperative removal of hair (where appropriate), rational antibiotic prophylaxis, avoidance of perioperative hypothermia, management of perioperative blood glucose and effective skin preparation. Reasons for poor compliance with care bundles are not clear and have not matched the wide uptake and perceived benefit of the WHO 'Safe Surgery Saves Lives' checklist. Recommendations include the need for further research and continuous updating of guidelines; comprehensive surveillance, using validated definitions that facilitate benchmarking of anonymised surgeon-specific SSI rates; assurance that incorporation of checklists and care bundles has taken place; the development of effective communication strategies for all health care providers and those who commission services and comprehensive information for patients. PMID:24612792

  2. [Prevention of postoperative surgical site infections : Between tradition and evidence].

    PubMed

    Scheithauer, S; Artelt, T; Bauer, M; Waeschle, R M

    2016-05-01

    Postoperative wound infections represent a relevant complication of invasive interventions. Current European prevalence data show that for participating hospitals from Germany (n = 132) surgical site infections represent the most commonly occurring nosocomial infection with 24.3 %. This corresponds to a point prevalence of 1.31 %. It is assumed that approximately 25-33 % of all infections acquired in hospital could be prevented if all possible precautions would be taken. Recent studies have indicated that this rate might be even higher for individual infection entities. Infection control measures can be divided into general measures, which are valid for prevention in many fields and for many infection entities and into specific precautions related to hospital-specific circumstances or specific infection entities. In this article the various hygiene measures and recommendations are presented with respect to the level of evidence. PMID:27146286

  3. Surgical site infection risk factors and risk stratification.

    PubMed

    Florschutz, Anthony V; Fagan, Ryan P; Matar, Wadih Y; Sawyer, Robert G; Berrios-Torres, Sandra I

    2015-04-01

    Preoperative identification of the risk factors for surgical site infection and patient risk stratification are essential for deciding whether surgery is appropriate, educating patients on their individual risk of complications, and managing postoperative expectations. Early identification of these factors is also necessary to help guide both patient medical optimization and perioperative care planning. Several resources are currently available to track and analyze healthcare-associated infections, including the Centers for Disease Control and Prevention's National Healthcare Safety Network. In addition, the Centers for Disease Control and Prevention and the American Academy of Orthopaedic Surgeons are exploring collaborative opportunities for the codevelopment of a hip and/or knee arthroplasty national quality measure for periprosthetic joint infection. PMID:25808971

  4. Data-driven Temporal Prediction of Surgical Site Infection

    PubMed Central

    Soguero-Ruiz, Cristina; Fei, Wang M.E.; Jenssen, Robert; Augestad, Knut Magne; Álvarez, José-Luis Rojo; Jiménez, Inmaculada Mora; Lindsetmo, Rolv-Ole; Skrøvseth, Stein Olav

    2015-01-01

    Analysis of data from Electronic Health Records (EHR) presents unique challenges, in particular regarding nonuniform temporal resolution of longitudinal variables. A considerable amount of patient information is available in the EHR - including blood tests that are performed routinely during inpatient follow-up. These data are useful for the design of advanced machine learning-based methods and prediction models. Using a matched cohort of patients undergoing gastrointestinal surgery (101 cases and 904 controls), we built a prediction model for post-operative surgical site infections (SSIs) using Gaussian process (GP) regression, time warping and imputation methods to manage the sparsity of the data source, and support vector machines for classification. For most blood tests, wider confidence intervals after imputation were obtained in patients with SSI. Predictive performance with individual blood tests was maintained or improved by joint model prediction, and non-linear classifiers performed consistently better than linear models. PMID:26958256

  5. Surgical Site Occurrences of Simultaneous Panniculectomy and Incisional Hernia Repair.

    PubMed

    Warren, Jeremy A; Epps, Matthew; Debrux, Cart; Fowler, James L; Ewing, Joseph A; Cobb, William S; Carbonell, Alfredo M

    2015-08-01

    Horizontal panniculectomy (PAN) offers the advantage of wide exposure for hernia repair with elimination of excess skin and adiposity, at the expense of massive subcutaneous flap creation and its attendant risks. We report our experience with ventral hernia repair (VHR) with PAN compared with patients with hernia repair alone. A prospective database was reviewed retrospectively for all patients undergoing open VHR + PAN. A matched cohort of patients without PAN was used for comparison, resulting in 43 study and 43 control patients. Incidence of surgical site occurrences (SSO), surgical site infection (SSI), and recurrence were analyzed. A total of 43 patients underwent PAN + VHR with mesh. Mean body mass index was 34.3 kg/m(2), with 35 per cent having undergone prior bariatric surgery. Repair techniques included retromuscular (74.4%), preperitoneal (11.6%), intraperitoneal (6.9%), onlay (4.6%), and suture (2.3%). Mesh used was polypropylene (76.7%), polyester (18.6%), bioabsorbable (2.3%), and polytetrafluoroethylene (ePTFE) (2.3%). Component separation was performed in 44.2 per cent of patients. There was a significant difference in total SSO between PAN + VHR and VHR alone (46.5% vs 27.9%; P < 0.001), though the difference for individual SSOs was not significant. There was no difference in SSI between groups (16.3% vs 20.9%; P = 0.776). Mean follow-up was 11.4 months, with recurrence rate of 11.6 per cent in the PAN group and 9.3 per cent in the control group (P = 0.725). Panniculectomy at the time of VHR does not increase the incidence of SSI, though higher rates of skin necrosis and cellulitis were seen. There is no difference in recurrence. This approach is a valid option for patients with excessive abdominal panniculus requiring VHR. PMID:26215237

  6. Surgical site infection in clean-contaminated head and neck cancer surgery: risk factors and prognosis.

    PubMed

    Hirakawa, Hitoshi; Hasegawa, Yasuhisa; Hanai, Nobuhiro; Ozawa, Taijiro; Hyodo, Ikuo; Suzuki, Mikio

    2013-03-01

    Since new treatment strategies, such as chemoradiotherapy, have been introduced for head and neck cancer, a higher number of unknown factors may be involved in surgical site infection in clean-contaminated head and neck cancer surgery. The aim of the present study was to clarify the risk factors of surgical site infection in clean-contaminated surgery for head and neck cancer and the prognosis of patients with surgical site infection. Participants were 277 consecutive patients with head and neck cancer who underwent clean-contaminated surgery for primary lesions at the Aichi Cancer Center over a 60-month period. A total of 22 putative risk factors were recorded in each patient and statistically analyzed to elucidate surgical site infection related factors. Surgical site infection was observed in 92 (32.1 %) of 277 cases. Univariate analysis indicated that alcohol consumption, T classification, neck dissection, reconstructive procedure, and chemoradiotherapy were significantly associated with surgical site infection. Multiple logistic regression analysis identified two independent risk factors for surgical site infection: reconstructive surgery (p = 0.04; odds ratio (OR) 1.77) and chemoradiotherapy (p = 0.01; OR 1.93). In spite of surgical site infection, the five-year overall survival rate of patients with surgical site infection was not significantly different from those without surgical site infection. Although surgical site infection did not impact the overall survival of patients with surgical procedures, head and neck surgeons should pay attention to patients with previous chemoradiotherapy as well as to those with a high risk of surgical site infection requiring reconstructive surgery. PMID:22865106

  7. Preliminary Site Classification using the Geologic Map of the Korean Peninsula

    NASA Astrophysics Data System (ADS)

    Kang, S.; Kim, K.; Suk, B.

    2008-12-01

    Studies of the earthquake ground motion consider the soil properties or the bed rock properties in the upper 30 m. The average shear wave velocity in the upper 30 m defined from borehole data is routinely used for classifying the site conditions. However, it is difficult to classify the site condition using the limited borehole data to cover the whole Korean Peninsula. In the study of Lee et al. (2001), site classification of Taiwan was refined using surface geology from the geologic map, geomorphologic data, and borehole data following the guidelines of National Earthquake Reduction Program (NEHRP). Wald and Allen (2007) defined shear wave velocity using slope of topography or gradient in global scale. They also compared their results in the Taiwan region to those proposed by Lee et al. (2001). In this study, we used geologic map, geomorphologic data, estimated average shear wave velocity from slope of topography, and borehole data to define the site conditions of the Korean Peninsula. We compared our results to the borehole data or seismic site condition data which include seismometer locations and ground conditions. There are some differences between our results and seismic site condition data. The discrepancy is attributed to the relatively large scale geologic map (1:250000) which may not include accurate site condition of the regions. Estimated site conditions of the study, however, agree with those from borehole data when a 1-mile buffering distance is applied to geologic condition boundaries. These results provide useful information for the further study of regional hazard estimation, risk management, and other seismological and geotechnical applications.

  8. Improved Surgical Site Infection (SSI) rate through accurately assessed surgical wounds

    PubMed Central

    John, Honeymol; Nimeri, Abdelrahman; ELLAHHAM, SAMER

    2015-01-01

    Sheikh Khalifa Medical City's (SKMC) Surgery Institute was identified as a high outlier in Surgical Site Infections (SSI) based on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) - Semi-Annual Report (SAR) in January 2012. The aim of this project was to improve SSI rates through accurate wound classification. We identified SSI rate reduction as a performance improvement and safety priority at SKMC, a tertiary referral center. We used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) best practice guidelines as a guide. ACS NSQIP is a clinical registry that provides risk-adjusted clinical outcome reports every six months. The rates of SSI are reported in an observed/expected ratio. The expected ratio is calculated based on the risk factors of the patients which include wound classification. We established a multidisciplinary SSI taskforce. The members of the SSI taskforce included the ACS NSQIP team members, quality, surgeons, nurses, infection control, IT, pharmacy, microbiology, and it was chaired by a colorectal surgeon. The taskforce focused on five areas: pre-op showering and hair removal, skin antisepsis, prophylactic antibiotics, peri-operative maintenance of glycaemia, and normothermia. We planned audits to evaluate our wound classification and our SSI rates based on the SAR. Our expected SSI rates in general surgery and the whole department were 2.52% and 1.70% respectively, while our observed SSI rates were 4.68% and 3.57% respectively, giving us a high outlier status with an odd's ratio of 1.72 and 2.03. Wound classifications were identified as an area of concern. For example, wound classifications were preoperatively selected based on the default wound classification of the booked procedure in the Electronic Medical Record (EMR) which led to under classifying wounds in many occasions. A total of 998 cases were reviewed, our rate of incorrect wound classification

  9. [MRSA-related empyema as thoracic surgical site infection].

    PubMed

    Mizutani, Hisao

    2009-09-01

    The incidence of empyema as a thoracic surgical site infection (SSI) is relating low, but empyema related to MRSA poses an unenviable therapeutic challenge. We review 3 cases of MRSA-related empyema as SSI seem in the last 10 years, and evaluate therapeutic measures. All 3 subjects began being administered vancomycin (VCM) systemically once the diagnosis was established. Subject 1 developed MRSA-related empyema following pulmonary segmentectomy for small-cell lung cancer. The subject was treated following a diagnosis of incisional SSI, with delayed adequate pleural drainage, resulting in treatment difficulties, but was cured without becoming MRSA-negative. Subject 2 developed MRSA-related empyema following pulmonary lobectomy for advanced lung cancer associated with pneumoconiosis. Following bronchoplasty, a chest tube was placed for long-term drainage. The subject did not become MRSA-negative after VCM administration, but became so after linezolid treatment, facilitating a cure. Subject 3, who had secondary pneumothorax, underwent thoracoscopic partial hepatic resection. Intraoperative findings suggested pleural cavity infection, necessitating a prophylactic drain, but MRSA-related pyothorax developed. Fibrinolysis with urokinase effectively cleared up the poor drainage and the subject was cured without becoming MRSA-negative. In conclusion, in controlling MRSA-related empyema as SSI noted that: (1) long-term postperative thoracic drain retention may lead to retrograde infection; (2) surgical procedures reducing the extent of pulmonary resection may effectively prevent pyothorax progression; (3) for poor drainage in advanced pyothorax, fibrinolytic therapy is worth attempting before thoracoscopic surgery; and (4) the timing for discontinuing anti-MRSA drugs should be determined based on the clinical course rather than negative conversion of bacteria. PMID:19860251

  10. Epidemiology of Surgical Site Infection in a Community Hospital Network.

    PubMed

    Baker, Arthur W; Dicks, Kristen V; Durkin, Michael J; Weber, David J; Lewis, Sarah S; Moehring, Rebekah W; Chen, Luke F; Sexton, Daniel J; Anderson, Deverick J

    2016-05-01

    OBJECTIVE To describe the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens METHODS We prospectively collected SSI data at 29 community hospitals in the southeastern United States from 2008 through 2012. We determined the overall prevalence rates of SSI for commonly performed procedures during this 5-year study period. For each year of the study, we then calculated prevalence rates of SSI stratified by causative organism. We created log-binomial regression models to analyze trends of SSI prevalence over time for all pathogens combined and specifically for MRSA. RESULTS A total of 3,988 complex SSIs occurred following 532,694 procedures (prevalence rate, 0.7 infections per 100 procedures). SSIs occurred most frequently after small bowel surgery, peripheral vascular bypass surgery, and colon surgery. Staphylococcus aureus was the most common pathogen. The prevalence rate of SSI decreased from 0.76 infections per 100 procedures in 2008 to 0.69 infections per 100 procedures in 2012 (prevalence rate ratio [PRR], 0.90; 95% confidence interval [CI], 0.82-1.00). A more substantial decrease in MRSA SSI (PRR, 0.69; 95% CI, 0.54-0.89) was largely responsible for this overall trend. CONCLUSIONS The prevalence of MRSA SSI decreased from 2008 to 2012 in our network of community hospitals. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence over the study period. Infect Control Hosp Epidemiol 2016;37:519-526. PMID:26864617

  11. Home laundering of soiled surgical scrubs: surgical site infections and the home environment.

    PubMed

    Belkin, N L

    2001-02-01

    An increasing number of hospitals have implemented programs that permit their operating room (OR) personnel to launder their soiled "scrubs" at home. Not only have they not experienced an increase in the incidence of surgical site infections (SSIs), but they have also found the policy to be financially rewarding. Whereas the Association of periOperative Registered Nurses (AORN) opposes the practice, the Centers for Disease Control and Prevention (CDC) describes it as an unresolved issue. The variances in the positions taken by these two organizations obviously accounts for the differences in positions taken by the infection control community. In the absence of any evidence in the literature, the only alternative is to draw from knowledge and experience to determine whether the practice can be considered clinically effective and does not have a harmful effect on the home environment. On the basis of the results of that examination, it is concluded that the need for having soiled scrubs laundered by a facility-approved laundry is indefensible and simply predicated on the "that's the way we've always done it" syndrome. PMID:11172320

  12. Korean Lunar Lander - Concept Study for Landing-Site Selection for Lunar Resource Exploration

    NASA Astrophysics Data System (ADS)

    Kim, Kyeong Ja; Wöhler, Christian; Hyeok Ju, Gwang; Lee, Seung-Ryeol; Rodriguez, Alexis P.; Berezhnoy, Alexey A.; van Gasselt, Stephan; Grumpe, Arne; Aymaz, Rabab

    2016-06-01

    As part of the national space promotion plan and presidential national agendas South Korea's institutes and agencies under the auspices of the Ministry of Science, Information and Communication Technology and Future Planning (MSIP) are currently developing a lunar mission package expected to reach Moon in 2020. While the officially approved Korean Pathfinder Lunar Orbiter (KPLO) is aimed at demonstrating technologies and monitoring the lunar environment from orbit, a lander - currently in pre-phase A - is being designed to explore the local geology with a particular focus on the detection and characterization of mineral resources. In addition to scientific and potential resource potentials, the selection of the landing-site will be partly constrained by engineering constraints imposed by payload and spacecraft layout. Given today's accumulated volume and quality of available data returned from the Moon's surface and from orbital observations, an identification of landing sites of potential interest and assessment of potential hazards can be more readily accomplished by generating synoptic snapshots through data integration. In order to achieve such a view on potential landing sites, higher level processing and derivation of data are required, which integrates their spatial context, with detailed topographic and geologic characterizations. We are currently assessing the possibility of using fuzzy c-means clustering algorithms as a way to perform (semi-) automated terrain characterizations of interest. This paper provides information and background on the national lunar lander program, reviews existing approaches - including methods and tools - for landing site analysis and hazard assessment, and discusses concepts to detect and investigate elemental abundances from orbit and the surface. This is achieved by making use of manual, semi-automated as well as fully-automated remote-sensing methods to demonstrate the applicability of analyses. By considering given

  13. Language Learning as a Site for Belonging: A Narrative Analysis of Korean Adoptee-Returnees

    ERIC Educational Resources Information Center

    Higgins, Christina; Stoker, Kim

    2011-01-01

    Through analyzing narratives of Korean heritage language (HL) users, this article explores whether and to what degree these language users experience social inclusion and a sense of belonging in Korean society. We expand the field of HL research by investigating the experiences of four Korean-born, US-raised adoptee-returnees who currently reside…

  14. Surgical Site Infections Following Pediatric Ambulatory Surgery: An Epidemiologic Analysis.

    PubMed

    Rinke, Michael L; Jan, Dominique; Nassim, Janelle; Choi, Jaeun; Choi, Steven J

    2016-08-01

    OBJECTIVE To identify surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes. DESIGN Retrospective chart review of pediatric ambulatory surgeries with International Classification of Disease, Ninth Revision (ICD-9) codes for SSI, and a systematic random sampling of 5% of surgeries without SSI ICD-9 codes, all adjudicated for SSI on the basis of an ambulatory-adapted National Healthcare Safety Network definition. SETTING Urban pediatric tertiary care center April 1, 2009-March 31, 2014. METHODS SSI rates and sensitivity and specificity of ICD-9 codes were estimated using sampling design, and risk factors were analyzed in case-rest of cohort, and case-control, designs. RESULTS In 15,448 pediatric ambulatory surgeries, 34 patients had ICD-9 codes for SSI and 25 met the adapted National Healthcare Safety Network criteria. One additional SSI was identified with systematic random sampling. The SSI rate following pediatric ambulatory surgery was 2.9 per 1,000 surgeries (95% CI, 1.2-6.9). Otolaryngology surgeries demonstrated significantly lower SSI rates compared with endocrine (P=.001), integumentary (P=.001), male genital (P<.0001), and respiratory (P=.01) surgeries. Almost half of patients with an SSI were admitted, 88% received antibiotics, and 15% returned to the operating room. No risk factors were associated with SSI. The sensitivity of ICD-9 codes for SSI following ambulatory surgery was 55.31% (95% CI, 12.69%-91.33%) and specificity was 99.94% (99.89%-99.97%). CONCLUSIONS SSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children. Infect Control Hosp Epidemiol 2016;37:931-938. PMID:27121727

  15. Compliance of Perioperative Antibiotic Dosing and Surgical Site Infection Rate in Office-Based Elective Surgery

    PubMed Central

    Davison, Steven P.; Jackson, Monica

    2016-01-01

    Background: A best practice goal to reduce surgical site infection includes administration of antibiotics in the ideal preoperative window. This article evaluates an office surgical suite antibiotic administration rate and compares it with the timing of a local hospital treating a similar patient population. The hypothesis was that similar or better compliance and surgical site infection rates can be achieved in the office-based suite. Methods: A total of 277 office-based surgeries were analyzed for antibiotic administration time before incision and their corresponding surgical site infection rate. Results: Our facility administered timely prophylactic antibiotics in 96% of cases with a surgical site infection rate of 0.36%. This rate was significantly lower than a reported rate of 3.7%. Conclusion: Low infection rates with high antibiotic administration rate suggest that compliance with best possible practice protocols is possible in the outpatient setting.

  16. Cretaceous Vertebrate Tracksites - Korean Cretaceous Dinosaur Coast World Heritage Nomination Site

    NASA Astrophysics Data System (ADS)

    Huh, M.; Woo, K. S.; Lim, J. D.; Paik, I. S.

    2009-04-01

    at least three other unnamed morphotypes are known . A total of 52 clutches containing 390 dinosaur eggs occur in several stratigraphic formations including seven dinosaur egg localities. The other fossils including turtles, crocodiles, fishes, wood fossil, plants, trace fossils and microfossils have also been discovered. The occurrences of Korean dinosaurs in diverse stratigraphic formations and sedimentological setting and in diverse sizes and morphotypes provide an opportunity to study the palaeoecologic and palaeoenvironmental conditions of the sites of the Late Cretaceous dinosaurs. Korea could serve as a global vertebrate ichnological standard for Cretaceous terrestrial sequences, and allow correlation with Japanese marine sequences to the east and classic Chinese sites to the west. The region plays a pivotal role in helping us understand vertebrate evolution and paleoecology on the margins of the Asian continent during the Cretaceous.

  17. Tsunami effects at Korean Nuclear Power Plant Sites by Plate Boundary Earthquakes

    NASA Astrophysics Data System (ADS)

    Jin, Sobeom; Hyun, Seung Gyu; Bae, Jae Seok; Kim, Gun Hyeong; Yoon, Sung Bum

    2015-04-01

    Great earthquakes have occurred at the Nankai Trough due to the subduction of the Philippine Sea plate beneath Honshu, Japan. The 1707 Hoei tsunami associated with the Mw 8.7 earthquake, in particular, was the largest event generated in this area. The Nankai Trough is one of the most earthquake-prone area near Japan. And the tsunami affected to Korea according to a Korean historic literature. In this study, new hypothetical plate boundary earthquakes (Mw 9.6) ruptured simultaneously from the Nankai Trough to the Ryukyu Trench (NTRT) are proposed and applied to evaluate the tsunami effects at the Nuclear Power Plant Sites in Korea. In order to make reasonable tsunami sources the asperity model is adapted. The numerical model using the modified leap-frog finite difference scheme is employed to simulate the propagation of tsunami generated at NTRT. This numerical model considering the dispersion effect and inundation of tsunami is then employed to estimate the maximum tsunami heights. Predicted results will be used to make the measures against unexpected tsunami attacks.

  18. The Effects of Surgical Hand Scrubbing Protocols on Skin Integrity and Surgical Site Infection Rates: A Systematic Review.

    PubMed

    Liu, Liang Qin; Mehigan, Sinead

    2016-05-01

    This systematic review aimed to critically appraise and synthesize updated evidence regarding the effect of surgical-scrub techniques on skin integrity and the incidence of surgical site infections. Databases searched include the Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Embase, and Cochrane Central. Our review was limited to eight peer-reviewed, randomized controlled trials and two nonrandomized controlled trials published in English from 1990 to 2015. Comparison models included traditional hand scrubbing with chlorhexidine gluconate or povidone-iodine against alcohol-based hand rubbing, scrubbing with a brush versus without a brush, and detergent-based antiseptics alone versus antiseptics incorporating alcohol solutions. Evidence showed that hand rubbing techniques are as effective as traditional scrubbing and seem to be better tolerated. Hand rubbing appears to cause less skin damage than traditional scrub protocols, and scrub personnel tolerated brushless techniques better than scrubbing using a brush. PMID:27129749

  19. Impact of the difference in surgical site on the physique in gastrointestinal tract cancer patients

    PubMed Central

    Hara, Tsuyoshi; Kubo, Akira; Kogure, Eisuke; Ishii, Takaya

    2016-01-01

    [Purpose] The purpose of the present study was to observe physical function, physique (only BMI), and nutrition status (evaluated by serum albumin levels) from before surgery to after discharge among perioperative patients with gastrointestinal tract cancer and to examine the effect of difference in surgical site (i.e., stomach, colon, and rectum) in these patients. [Subjects and Methods] The study subjects were 70 patients who underwent surgical treatment for gastrointestinal tract cancer [36 males and 34 females, aged 59.3 ± 11.4 years (mean ± SD)]. The subjects were classified into three levels according to surgical site (stomach, colon, and rectum). We evaluated patients’ physical function, physique, and nutrition status in the three points: before surgery, after surgery, and after discharge. The 6-minute walk distance was measured for physical function. Body mass index was measured for physique. The serum albumin level was measured for nutrition status. [Results] Significant declines in 6-minute walk distance, body mass index, and serum albumin were observed after surgery among the study subjects. In addition, a significant decline in body mass index was observed after discharge compared with before surgery. Regarding body mass index, a significant interaction between surgical site and evaluation times was observed for ANOVA. [Conclusion] These results suggest that BMI after discharge is significantly less than that before surgery and that body mass index changes from before surgery to after surgery are efficacy the difference of surgical site in patients who undergo surgical treatment for gastrointestinal tract cancer. PMID:26957730

  20. Use of mupirocin-chlorhexidine treatment to prevent Staphylococcus aureus surgical-site infections.

    PubMed

    Bertrand, X; Slekovec, C; Talon, D

    2010-05-01

    Evaluation of: Bode LGM, Kluytmans JAJW, Wertheim HFL et al.: Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N. Engl. J. Med. 362, 9-17 (2010). Staphylococcus aureus is the main pathogen responsible for surgical-site infections and nasal carriage is a major risk factor for subsequent infection with this bacteria. Mupirocin is considered to be the topical antibacterial agent of choice for eradication of nasal S. aureus. The paper by Bode et al. provides strong evidence that the combination of a rapid identification of a S. aureus nasal carrier, mupirocin nasal ointment and chlorhexidine gluconate soap, significantly reduces the rate of S. aureus surgical-site infection by nearly 60%. In conclusion, mupirocin nasal ointment use in S. aureus carriers before surgery has numerous advantages with few side effects. PMID:20441543

  1. Surgical Site Infection 18 Months Following Intrathecal Pump Placement Secondary to an Asymptomatic Bowel Injury.

    PubMed

    Deibert, Christopher P; Gandhoke, Gurpreet S; Forsythe, Raquel M; Moossy, John J

    2015-09-01

    Surgical site infections following the implantation of intrathecal drug delivery systems typically present during the first 1 to 2 months following surgery. Surgical site infections occurring outside of this window are rare entities and require special attention to identify the source or underlying cause. In this report, we present a case of pump pocket infection 18 months following implantation due to an asymptomatic and unrecognized bowel injury associated with the catheter. This case highlights the need for a thorough evaluation in a patient with suspected infections more than 2 months after surgery to ensure adequate treatment. PMID:26009935

  2. Antibiotic Susceptibility Pattern of Aerobic and Anaerobic Bacteria Isolated From Surgical Site Infection of Hospitalized Patients

    PubMed Central

    Akhi, Mohammad Taghi; Ghotaslou, Reza; Beheshtirouy, Samad; Asgharzadeh, Mohammad; Pirzadeh, Tahereh; Asghari, Babak; Alizadeh, Naser; Toloue Ostadgavahi, Ali; Sorayaei Somesaraei, Vida; Memar, Mohammad Yousef

    2015-01-01

    Background: Surgical Site Infections (SSIs) are infections of incision or deep tissue at operation sites. These infections prolong hospitalization, delay wound healing, and increase the overall cost and morbidity. Objectives: This study aimed to investigate anaerobic and aerobic bacteria prevalence in surgical site infections and determinate antibiotic susceptibility pattern in these isolates. Materials and Methods: One hundred SSIs specimens were obtained by needle aspiration from purulent material in depth of infected site. These specimens were cultured and incubated in both aerobic and anaerobic condition. For detection of antibiotic susceptibility pattern in aerobic and anaerobic bacteria, we used disk diffusion, agar dilution, and E-test methods. Results: A total of 194 bacterial strains were isolated from 100 samples of surgical sites. Predominant aerobic and facultative anaerobic bacteria isolated from these specimens were the members of Enterobacteriaceae family (66, 34.03%) followed by Pseudomonas aeruginosa (26, 13.4%), Staphylococcus aureus (24, 12.37%), Acinetobacter spp. (18, 9.28%), Enterococcus spp. (16, 8.24%), coagulase negative Staphylococcus spp. (14, 7.22%) and nonhemolytic streptococci (2, 1.03%). Bacteroides fragilis (26, 13.4%), and Clostridium perfringens (2, 1.03%) were isolated as anaerobic bacteria. The most resistant bacteria among anaerobic isolates were B. fragilis. All Gram-positive isolates were susceptible to vancomycin and linezolid while most of Enterobacteriaceae showed sensitivity to imipenem. Conclusions: Most SSIs specimens were polymicrobial and predominant anaerobic isolate was B. fragilis. Isolated aerobic and anaerobic strains showed high level of resistance to antibiotics. PMID:26421133

  3. m b( Pn) Scale for the Korean Peninsula and Site-Dependent Pn Amplification

    NASA Astrophysics Data System (ADS)

    Hong, Tae-Kyung; Lee, Kiwook

    2012-11-01

    The Korean Peninsula is located in the far-eastern Eurasian plate margin where crustal structures vary laterally, causing significant raypath-dependent modulations of crustal phases. The discriminative variations of crustal phases hinder application of conventional local magnitude scales in the continental margin. The mantle-lid phase is less affected by the crustal structures than the crustal phases, providing a better constraint to magnitude estimation. A regional body-wave magnitude scale based on the mantle-lid P wave ( Pn), m b( Pn), is developed for regional events around the Korean Peninsula. The m b( Pn) scale is determined to be m b( Pn) = 0.380 (±0.299) + log A + 2.012 (±0.122) log d, where A is the peak-to-peak Pn amplitude in μm and d is the epicentral distance in km. The m b( Pn) estimates of regional events around the Korean Peninsula are determined. The m b( Pn) estimates are compared with other available magnitude estimates ( m b( Lg), M L). The influence of structures beneath stations on Pn amplification is investigated from inter-station magnitude residuals. A characteristic spatial variation of inter-station magnitude residuals with strengths mostly between -6 and 6 %, but with maximum strengths of ±10 %, is observed. The inter-station magnitude residuals appears to be correlated well with geological and seismic structures in the crust.

  4. Automated Detection of Postoperative Surgical Site Infections Using Supervised Methods with Electronic Health Record Data.

    PubMed

    Hu, Zhen; Simon, Gyorgy J; Arsoniadis, Elliot G; Wang, Yan; Kwaan, Mary R; Melton, Genevieve B

    2015-01-01

    The National Surgical Quality Improvement Project (NSQIP) is widely recognized as "the best in the nation" surgical quality improvement resource in the United States. In particular, it rigorously defines postoperative morbidity outcomes, including surgical adverse events occurring within 30 days of surgery. Due to its manual yet expensive construction process, the NSQIP registry is of exceptionally high quality, but its high cost remains a significant bottleneck to NSQIP's wider dissemination. In this work, we propose an automated surgical adverse events detection tool, aimed at accelerating the process of extracting postoperative outcomes from medical charts. As a prototype system, we combined local EHR data with the NSQIP gold standard outcomes and developed machine learned models to retrospectively detect Surgical Site Infections (SSI), a particular family of adverse events that NSQIP extracts. The built models have high specificity (from 0.788 to 0.988) as well as very high negative predictive values (>0.98), reliably eliminating the vast majority of patients without SSI, thereby significantly reducing the NSQIP extractors' burden. PMID:26262143

  5. Snoring Sounds Predict Obstruction Sites and Surgical Response in Patients with Obstructive Sleep Apnea Hypopnea Syndrome.

    PubMed

    Lee, Li-Ang; Lo, Yu-Lun; Yu, Jen-Fang; Lee, Gui-She; Ni, Yung-Lun; Chen, Ning-Hung; Fang, Tuan-Jen; Huang, Chung-Guei; Cheng, Wen-Nuan; Li, Hsueh-Yu

    2016-01-01

    Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and <10 events/hour) in patients with OSAHS. This prospective cohort study recruited 36 OSAHS patients for 6-hour snoring sound recordings during in-lab full-night polysomnography, drug-induced sleep endoscopy (DISE), and relocation pharyngoplasty. All patients received follow-up polysomnography after 6 months. Fifteen (42%) patients with at least two complete obstruction sites defined by DISE were significantly, positively associated with maximal snoring sound intensity (40-300 Hz; odds ratio [OR], 1.25, 95% confidence interval [CI] 1.05-1.49) and body mass index (OR, 1.48, 95% CI 1.02-2.15) after logistic regression analysis. Tonsil obstruction was significantly, inversely correlated with mean snoring sound intensity (301-850 Hz; OR, 0.84, 95% CI 0.74-0.96). Moreover, baseline tonsil obstruction detected by either DISE or mean snoring sound intensity (301-850 Hz), and AHI could significantly predict the surgical response. Our findings suggest that snoring sound detection may be helpful in determining obstruction sites and predict surgical responses. PMID:27471038

  6. Snoring Sounds Predict Obstruction Sites and Surgical Response in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

    PubMed Central

    Lee, Li-Ang; Lo, Yu-Lun; Yu, Jen-Fang; Lee, Gui-She; Ni, Yung-Lun; Chen, Ning-Hung; Fang, Tuan-Jen; Huang, Chung-Guei; Cheng, Wen-Nuan; Li, Hsueh-Yu

    2016-01-01

    Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and <10 events/hour) in patients with OSAHS. This prospective cohort study recruited 36 OSAHS patients for 6-hour snoring sound recordings during in-lab full-night polysomnography, drug-induced sleep endoscopy (DISE), and relocation pharyngoplasty. All patients received follow-up polysomnography after 6 months. Fifteen (42%) patients with at least two complete obstruction sites defined by DISE were significantly, positively associated with maximal snoring sound intensity (40–300 Hz; odds ratio [OR], 1.25, 95% confidence interval [CI] 1.05–1.49) and body mass index (OR, 1.48, 95% CI 1.02–2.15) after logistic regression analysis. Tonsil obstruction was significantly, inversely correlated with mean snoring sound intensity (301–850 Hz; OR, 0.84, 95% CI 0.74–0.96). Moreover, baseline tonsil obstruction detected by either DISE or mean snoring sound intensity (301–850 Hz), and AHI could significantly predict the surgical response. Our findings suggest that snoring sound detection may be helpful in determining obstruction sites and predict surgical responses. PMID:27471038

  7. Derivation and Validation of the Surgical Site Infections Risk Model Using Health Administrative Data.

    PubMed

    van Walraven, Carl; Jackson, Timothy D; Daneman, Nick

    2016-04-01

    OBJECTIVE Surgical site infections (SSIs) are common hospital-acquired infections. Tracking SSIs is important to monitor their incidence, and this process requires primary data collection. In this study, we derived and validated a method using health administrative data to predict the probability that a person who had surgery would develop an SSI within 30 days. METHODS All patients enrolled in the National Surgical Quality Improvement Program (NSQIP) from 2 sites were linked to population-based administrative datasets in Ontario, Canada. We derived a multivariate model, stratified by surgical specialty, to determine the independent association of SSI status with patient and hospitalization covariates as well as physician claim codes. This SSI risk model was validated in 2 cohorts. RESULTS The derivation cohort included 5,359 patients with a 30-day SSI incidence of 6.0% (n=118). The SSI risk model predicted the probability that a person had an SSI based on 7 covariates: index hospitalization diagnostic score; physician claims score; emergency visit diagnostic score; operation duration; surgical service; and potential SSI codes. More than 90% of patients had predicted SSI risks lower than 10%. In the derivation group, model discrimination and calibration was excellent (C statistic, 0.912; Hosmer-Lemeshow [H-L] statistic, P=.47). In the 2 validation groups, performance decreased slightly (C statistics, 0.853 and 0.812; H-L statistics, 26.4 [P=.0009] and 8.0 [P=.42]), but low-risk patients were accurately identified. CONCLUSION Health administrative data can effectively identify postoperative patients with a very low risk of surgical site infection within 30 days of their procedure. Records of higher-risk patients can be reviewed to confirm SSI status. Infect. Control Hosp. Epidemiol. 2016;37(4):455-465. PMID:26785686

  8. Daily Incision Cleansing with Alcohol Reduces the Rate of Surgical Site Infections: A Pilot Study.

    PubMed

    Vogt, Kelly N; Chadi, Sami; Parry, Neil; Gray, Daryl; Brackstone, Muriel

    2015-11-01

    Surgical site infections (SSIs) represent a significant source of preventable patient morbidity and hospital expense. Our objective was to assess the role of postoperative incisional alcohol cleansing in decreasing the rates of SSI as compared with standard care (control). Patients undergoing clean-contaminated abdominal operations at a single center were included. Prospectively collected data on control patients were compared with patients treated with daily postoperative alcohol-based surgical site cleansing (70% isopropyl alcohol) for the primary outcome of an SSI within the first 30 postoperative days. A total of 93 patients were included, 56 managed with standard care and 37 managed with the addition of daily alcohol cleansing. A significantly lower rate of SSI in the group managed with daily alcohol cleansing was observed (13% vs 32%, P = 0.04). This study suggests a role for adding daily incisional alcohol cleansing to further reduce the rate of SSIs. PMID:26672591

  9. Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

    PubMed Central

    Anderson, Deverick J.; Podgorny, Kelly; Berríos-Torres, Sandra I.; Bratzler, Dale W.; Dellinger, E. Patchen; Greene, Linda; Nyquist, Ann-Christine; Saiman, Lisa; Yokoe, Deborah S.; Maragakis, Lisa L.; Kaye, Keith S.

    2014-01-01

    PURPOSE Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. This document updates “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals,”1 published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.2 PMID:24799638

  10. Geoacoustic model at the DH-1 long-core site in the Korean continental margin of the East Sea

    NASA Astrophysics Data System (ADS)

    Ryang, Woo Hun; Kim, Seong Pil

    2014-05-01

    A long core of 23.6 m was acquired at the DH-1 site (37°36.651'N and 129°19.709'E) in the Korean continental margin of the western East Sea. The core site is located near the Donghae City and the water depth is 357.8 m deep. The long-core sediment was recovered using the Portable Remotely Operated Drill (PROD), a fully contained drilling system, remotely operated at the seafloor. The recovered core sediments were analyzed for physical, sedimentological, and geoacoustic properties mostly at 10~30 cm intervals. Based on the long-core data with subbottom and air-gun profiles at the DH-1 core site, a geoacoustic model was firstly reconstructed including water mass. The geoacoustic model comprises 7 geoacoustic units of the core sediments, based on the measurements of 125 P-wave velocities and 121 attenuations. The P-wave speed was compensated to in situ depth below the sea floor using the Hamilton method. The geoacoustic model DH-1 probably contributes for reconstruction of geoacoustic models reflecting vertical and lateral variability of acoustic properties in the Korean continental margin of the western East Sea. Keywords: long core, geoacoustic model, East Sea, continental margin, P-wave speed Acknowledgements: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2010-0025733) and by the Ministry of Knowledge Economy through the grant of Marine Geology and Geophysical Mapping Project (GP2010-013).

  11. Things Korean.

    ERIC Educational Resources Information Center

    Chang, Roberta

    Presented in this booklet are brief descriptions of items and activities that are symbolic of Korean culture. Some of the items and activities described include traditional Korean clothing and accessories, dolls, fans, a Korean game called "yut," tape recordings of Korean music, a "buhk" (drum), and brass eating utensils. A map of Korea, some…

  12. Reducing the risk of surgical site infections: does chlorhexidine gluconate provide a risk reduction benefit?

    PubMed

    Edmiston, Charles E; Bruden, Benjamin; Rucinski, Maria C; Henen, Cindy; Graham, Mary Beth; Lewis, Brian L

    2013-05-01

    Chlorhexidine gluconate (CHG) has been available as a topical antiseptic for over 50 years, having broad clinical application throughout the health care environment. Evidence-based clinical studies have shown chlorhexidine gluconate to be a safe and effective perioperative skin-prepping agent. Renewed interest has emerged for use of the antiseptic bath/shower to reduce the microbial skin burden prior to hospital admission. Recent clinical studies have documented that multiple applications of 2% or 4% CHG using a standardized protocol results in high skin surface concentrations sufficient to inhibit/kill skin colonizing flora, including methicillin-resistant Staphylococcus aureus. A new focus for the use of CHG in surgical patients involves irrigation of the wound prior to closure with 0.05% CHG followed by saline rinse. Recent laboratory studies suggest that, following a 1-minute exposure, 0.05% CHG produces a >5-log reduction against selective health care-associated pathogens and reduces microbial adherence to the surface of implantable biomedical devices. General, orthopedic, cardiothoracic, and obstetrical surgical studies have documented the safety of selective CHG formulations in elective surgical procedures. The following discussion will address both the evidence-based literature and preliminary findings suggesting that CHG has a broad and safe range of applications when used as an adjunctive interventional strategy for reducing the risk of postoperative surgical site infections (SSI). PMID:23622749

  13. Impact of Obesity on Surgical Site Infection in Colon and Rectal Surgery

    PubMed Central

    Hourigan, Jon Stuart

    2011-01-01

    Obesity affects over 30% of the United States population. Over the past 10 years, there has been increased recognition of the prevalence of obesity and its contribution to worse outcomes among medical and surgical patients. In particular, obesity has been validated as a risk factor for surgical site infection (SSI) among patients undergoing major abdominal surgery with some reports demonstrating an increased risk of SSI as high as sixty percent (60%) among obese patients. For patients undergoing elective colon and rectal surgery, a higher incidence of SSI (up to 45%) has been reported in comparison to outcomes of other surgical procedures. Obesity, as well as numerous other variables, have been implicated as a potential source for this increased incidence. Although the pathophysiology of obesity-related SSI has been suggested (decreased wound oxygen tension, impaired tissue antibiotic penetration, altered immune function, etc.), the true effect of obesity has not been clearly described. The purpose of this review is to examine the growing epidemic of obesity and its specific impact on SSI for both general and colorectal surgical patients. The proposed mechanisms for why obesity increases the risk of SSI will be briefly discussed, as well. PMID:23204944

  14. ‘This wound has spoilt everything’: emotional capital and the experience of surgical site infections

    PubMed Central

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-01-01

    In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to ‘germs’ or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. PMID:25470322

  15. The impact of surgical site occurrences and the role of closed incision negative pressure therapy.

    PubMed

    Willy, Christian; Engelhardt, Michael; Stichling, Marcus; Grauhan, Onnen

    2016-09-01

    Surgical site occurrences are observed in up to 60% of inpatient surgical procedures in industrialised countries. The most relevant postoperative complication is surgical site infection (SSI) because of its impact on patient outcomes and enormous treatment costs. Literature reviews ('SSI', 'deep sternal wound infections' (DSWI), 'closed incision negative pressure wound therapy' (ciNPT) were performed by electronically searching MEDLINE (PubMed) and subsequently using a 'snowball' method of continued searches of the references in the identified publications. Search criteria included publications in all languages, various study types and publication in a peer-reviewed journal. The SSI literature search identified 1325, the DSWI search 590 and the ciNPT search 103 publications that fulfilled the search criteria. Patient-related SSI risk factors (diabetes mellitus, obesity, smoking, hypertension, female gender) and operation-related SSI risk factors (re-exploration, emergency operations, prolonged ventilation, prolonged operation duration) exist. We found that patient- and operation-related SSI risk factors were often different for each speciality and/or operative procedure. Based on the evidence, we found that high-risk incisions (sternotomy and incisions in extremities after high-energy open trauma) are principally recommended for ciNPT use. In 'lower'-risk incisions, the addition of patient-related or operation-related risk factors justifies the application of ciNPT. PMID:27547962

  16. Intrawound vancomycin powder decreases staphylococcal surgical site infections following posterior instrumented spinal arthrodesis

    PubMed Central

    Heller, Aaron; McIff, Terence E.; Lai, Sue-Min; Burton, Douglas C.

    2014-01-01

    Study Design A retrospective historical cohort design. Objective To determine what effect the addition of intrawound vancomycin powder to the prophylactic regimen of posterior instrumented spinal arthrodesis procedures has had on acute surgical site infections. Summary of Background Data Surgical site infections (SSI) are known complications in instrumented spinal arthrodesis procedures, and are predominately caused by Staphylococcus aureus. Recent reports have suggested that placing vancomycin powder into the surgical wound prior to closure prevents surgical site infections in spinal surgery. Risk factors for SSIs in the setting of intrawound vancomycin powder use have not been previously reported on. Methods Surgical site infection rates following 342 posterior instrumented spinal arthrodeses (Oct. 2008 to Sept. 2011) in which intrawound vancomycin powder was used in addition to the standard antimicrobial prophylaxis (Vanco cohort) were compared to 341 posterior instrumented spinal arthrodeses (Apr. 2005 to Oct. 2008) in which no vancomyin powder was added (Non-Vanco cohort). Both two sample t-test and Chi-square test (Fisher’s where appropriate) were used for group comparisons. A sub-analysis of the Vanco cohort was undertaken to identify risk factors for SSIs despite intrawound vancomycin use. Results There was a significant reduction in the number of acute staphylococcal SSIs in the Vanco cohort (1.1%) compared to the Non-Vanco cohort (3.8%) (p=0.029). Deep staphylococcal infections decreased to 0 compared to 7 in the Non-Vanco cohort (2.1%) (p=0.008). Deep MRSA infections decreased to 0 compared to 5 in the Non-Vanco cohort (1.5%) (p=0.031). Sub-analysis of the Vanco cohort identified that being discharged to an inpatient rehabilitation or skilled nursing facility was associated with developing a SSI. Conclusions Intrawound vancomycin powder use has decreased the rate of acute staphylococcal SSIs in our posterior instrumented spine arthrodesis surgeries

  17. Surgical Site Infections in Genital Reconstruction Surgery for Gender Reassignment, Detroit: 1984–2008

    PubMed Central

    Zhao, Jing J.; Palla, Mohan B.; Bogan, Christopher W.; Hayakawa, Kayoko; Tansek, Ryan; Moshos, Judy; Muthusamy, Arunkumar; Kotra, Harikrishna; Lephart, Paul R.; Wilson, Alan N.; Kaye, Keith S.

    2014-01-01

    Abstract Background: Gender reassignment surgery (i.e., male-to-female or female-to-male) entails a series of complex surgical procedures. We conducted a study to explore epidemiologic characteristics of patients who underwent genital reconstruction operations as components of gender reassignment and to analyze risk factors for surgical-site infections (SSIs) following these operations. Methods: The study was a retrospective cohort study conducted from 1984–2008 at Harper University Hospital, a tertiary hospital with 625 beds in Detroit, Michigan. Surgical site infection was defined according to established criteria. Results: Records were available for 82 patients who underwent a total of 1,383 operations as part of genital-reconstruction processes. Thirty-nine (47.6%) of the patients underwent female-to-male reassignment (FTM) and 43 (52.4%) underwent male-to-female reassignment (MTF). The average age of the study cohort was 39.5±9.8 y. Of the patients in the cohort, 56 (68.3%) were Caucasian and 67 (81.7%) were single. The average number of operative encounters per patient was 11.8±4.6 for FTM and 4.9±2.4 for MTF. Forty-three (52.4%) patients developed an SSI at least once during their genital reconstruction process, of whom 34 (87%) were in the FTM group and nine (21%) in the MTF group (p<0.001). Staphylococci were the most common pathogens (61%) isolated in these infections, followed by Enterobacteriaceae (50%), Enterococcus (39%), and Pseudomonas aeruginosa (33.3%). Surgical site infection was associated independently with an increased frequency of operative procedures and operating room encounters. Conclusions: More than 50% of patients who underwent genital reconstruction operations developed an SSI at some point during the genital reconstruction process. Surgical site infections are more common in FTM than in MTF reconstruction operations, and for both FTM and MTF, SSIs are associated independently with an increased frequency of total operative

  18. Normothermia to Prevent Surgical Site Infections After Gastrointestinal Surgery: Holy Grail or False Idol?

    PubMed Central

    Lehtinen, Simon J.; Onicescu, Georgiana; Kuhn, Kathy M.; Cole, David J.; Esnaola, Nestor F.

    2012-01-01

    Objective To analyze the association between perioperative normothermia (temperature ≥36°C) and surgical site infections (SSIs) after gastrointestinal (GI) surgery. Summary of Background Data Although active warming during colorectal surgery reduces SSIs, there is limited evidence that perioperative normothermia is associated with lower rates of SSI. Nonetheless, hospitals participating in the Surgical Care Improvement Project must report normothermia rates during major surgery. Methods We conducted a nested, matched, case-control study; cases consisted of GI surgery patients enrolled in our National Surgical Quality Improvement Program database between March 2006 and March 2009 who developed SSIs. Patient/surgery risk factors for SSI were obtained from the National Surgical Quality Improvement Program database. Perioperative temperature/antibiotic/glucose data were obtained from medical records. Cases/controls were compared using univariate/random effects/logistic regression models. Independent risk factors for SSIs were identified using multivariate/random effects/logistic regression models. Results A total of 146 cases and 323 matched controls were identified; 82% of patients underwent noncolorectal surgery. Cases were more likely to have final intraoperative normothermia compared with controls (87.6% vs. 77.8%, P = 0.015); rates of immediate postoperative normothermia were similar (70.6% vs. 65.3%, respectively, P = 0.19). Emergent surgery/higher wound class were associated with higher rates of intraoperative normothermia. Independent risk factors for SSI were diabetes, surgical complexity, small bowel surgery, and nonlaparoscopic surgery. There was no independent association between perioperative normothermia and SSI (adjusted odds ratio, 1.05; 95% confidence interval, 0.48–2.33; P = 0.90). Conclusions Pay-for-reporting measures focusing on perioperative normothermia may be of limited value in preventing SSI after GI surgery. Studies to define the benefit

  19. Towards optical fibre based Raman spectroscopy for the detection of surgical site infection

    NASA Astrophysics Data System (ADS)

    Thompson, Alex J.; Koziej, Lukasz; Williams, Huw D.; Elson, Daniel S.; Yang, Guang-Zhong

    2016-03-01

    Surgical site infections (SSIs) are common post-surgical complications that remain significant clinical problems, as they are associated with substantial mortality and morbidity. As such, there is significant interest in the development of minimally invasive techniques that permit early detection of SSIs. To this end, we are applying a compact, clinically deployable Raman spectrometer coupled to an optical fibre probe to the study of bacteria, with the long term goal of using Raman spectroscopy to detect infection in vivo. Our system comprises a 785 nm laser diode for excitation and a commercial (Ocean Optics, Inc.) Raman spectrometer for detection. Here we discuss the design, optimisation and validation of this system, and describe our first experiences interrogating bacterial cells (Escherichia coli) in vitro.

  20. Preoperative hair removal and surgical site infections: network meta-analysis of randomized controlled trials.

    PubMed

    Lefebvre, A; Saliou, P; Lucet, J C; Mimoz, O; Keita-Perse, O; Grandbastien, B; Bruyère, F; Boisrenoult, P; Lepelletier, D; Aho-Glélé, L S

    2015-10-01

    Preoperative hair removal has been used to prevent surgical site infections (SSIs) or to prevent hair from interfering with the incision site. We aimed to update the meta-analysis of published randomized controlled trials about hair removal for the prevention of SSIs, and conduct network meta-analyses to combine direct and indirect evidence and to compare chemical depilation with clipping. The PubMed, ScienceDirect and Cochrane databases were searched for randomized controlled trials analysing different hair removal techniques and no hair removal in similar groups. Paired and network meta-analyses were conducted. Two readers independently assessed the study limitations for each selected article according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. Nineteen studies met the inclusion criteria. No study compared clipping with chemical depilation. Network meta-analyses with shaving as the reference showed significantly fewer SSIs with clipping, chemical depilation, or no depilation [relative risk 0.55, 95% confidence interval 0.38-0.79; 0.60, 0.36-0.97; and 0.56, 0.34-0.96, respectively]. No significant difference was observed between the absence of depilation and chemical depilation or clipping (1.05, 0.55-2.00; 0.97, 0.51-1.82, respectively] or between chemical depilation and clipping (1.09, 0.59-2.01). This meta-analysis of 19 randomized controlled trials confirmed the absence of any benefit of depilation to prevent surgical site infection, and the higher risk of surgical site infection when shaving is used for depilation. Chemical depilation and clipping were compared for the first time. The risk of SSI seems to be similar with both methods. PMID:26320612

  1. 5-millimeter Trocar-site Hernias After Laparoscopy Requiring Surgical Repair.

    PubMed

    Pereira, Nigel; Hutchinson, Anne P; Irani, Mohamad; Chung, Eric R; Lekovich, Jovana P; Chung, Pak H; Zarnegar, Rasa; Rosenwaks, Zev

    2016-01-01

    Trocar-site hernias are rare complications of laparoscopic surgery. Although trocar-site hernias occur more often at >10-mm sites, hernias can still develop at 5-mm sites after laparoscopy and can lead to serious complications. The primary objective of this review is to summarize the current medical literature pertaining to the clinical presentation and predisposing risk factors of trocar-site hernias at 5-mm sites after laparoscopy. A total of 295 publications were identified, 17 (5.76%) of which met the inclusion criteria. Twenty-seven patients with trocar-site hernias were identified after laparoscopic cases. The median age (interquartile range) for all adult patients with trocar-site hernias was 63 years (interquartile range, 39.5-66.5 years). Eight of the 18 patients (44.4%) undergoing gynecologic laparoscopy were parous although details of parity were not reported in most publications. Simple manual reduction or laparoscopic reduction with fascial closure (21 patients [84%]) was used more often compared with exploratory laparotomy (4 patients [16%], p < .001) to manage trocar-site hernias. There was no statistical difference in the location of trocar-site hernias (i.e., umbilical [14 patients, 56%] vs nonumbilical/lateral [11 patients, 44%], p = .12). Findings of this review suggest that increased operative times and excessive manipulation can extend 5-mm fascial incisions, thereby increasing the risk of trocar-site hernias. Parous women older than 60 years may have unrecognized fascial defects, which confer a higher risk of trocar-site hernias after laparoscopic surgery, even in the absence of incision manipulation or prolonged surgical duration. Such patients may benefit from closure of 5-mm fascial incisions although prospective data are required to validate the overall generalizability of this management strategy. PMID:26973139

  2. A polymicrobial outbreak of surgical site infections following cardiac surgery at a community hospital in Florida, 2011–2012

    PubMed Central

    Nguyen, Duc B.; Gupta, Neil; Abou-Daoud, Alison; KleKamp, Benjamin G.; Rhone, Chaz; Winston, Tiffany; Hedberg, Trevor; Scuteri, Ana; Evans, Charlotte; Jensen, Bette; Moulton-Meissner, Heather; Török, Thomas; Berríos-Torres, Sandra I.; Noble-Wang, Judith; Kallen, Alexander

    2015-01-01

    We describe an outbreak of 22 sternal surgical site infections following cardiac surgery, including 4 Gordonia infections. Possible operation room environmental contamination and suboptimal infection control practices regarding scrub attire may have contributed to the outbreak. PMID:24679572

  3. Influence of pulsed-xenon ultraviolet light-based environmental disinfection on surgical site infections.

    PubMed

    Catalanotti, Angela; Abbe, Dudley; Simmons, Sarah; Stibich, Mark

    2016-06-01

    This study evaluates the influence of nightly pulsed-xenon ultraviolet light disinfection and dedicated housekeeping staff on surgical site infection (SSI) rates. SSIs in class I procedures were reduced by 46% (P = .0496), with a potential cost savings of $478,055. SSIs in class II procedures increased by 22.9%, but this was not significant (P = .6973). Based on these results, it appears that the intervention reduces SSI rates in clean (class I), but not clean-contaminated (class II) procedures. PMID:26856467

  4. Whole-Genome Sequencing Analysis of Methicillin-Resistant Staphylococcus simulans Causing Surgical Site Infection.

    PubMed

    Chen, Jian; Fang, Qiang

    2016-01-01

    Staphylococcus simulans is a normal part of the microbiota in humans and animals and is rarely associated with human invasive infections. We present here the genome sequence of S. simulans CJ16, which caused the first case of surgical site infection. Adhesion proteins, including fibronectin-binding protein (FnbA), elastin-binding protein (EbpS), and cell wall-anchored protein (SasA, SasF, and SasH), were detected in the genome, which might promote the survival of S. simulans on human skin and pathogenesis of infections. PMID:27313298

  5. Whole-Genome Sequencing Analysis of Methicillin-Resistant Staphylococcus simulans Causing Surgical Site Infection

    PubMed Central

    2016-01-01

    Staphylococcus simulans is a normal part of the microbiota in humans and animals and is rarely associated with human invasive infections. We present here the genome sequence of S. simulans CJ16, which caused the first case of surgical site infection. Adhesion proteins, including fibronectin-binding protein (FnbA), elastin-binding protein (EbpS), and cell wall-anchored protein (SasA, SasF, and SasH), were detected in the genome, which might promote the survival of S. simulans on human skin and pathogenesis of infections. PMID:27313298

  6. Healthcare associated infection: novel strategies and antimicrobial implants to prevent surgical site infection

    PubMed Central

    Leaper, David; McBain, Andrew J; Kramer, Axel; Assadian, Ojan; Sanchez, Jose Luis Alfonso; Lumio, Jukka; Kiernan, Martin

    2010-01-01

    This report is based on a Hygienist Panel Meeting held at St Anne's Manor, Wokingham on 24–25 June 2009. The panel agreed that greater use should be made of antiseptics to reduce reliance on antibiotics with their associated risk of antibiotic resistance. When choosing an antiseptic for clinical use, the Biocompatibility Index, which considers both the microbiocidal activity and any cytotoxic effects of an antiseptic agent, was considered to be a useful tool. The need for longer and more proactive post-discharge surveillance of surgical patients was also agreed to be a priority, especially given the current growth of day-case surgery. The introduction of surgical safety checklists, such as the World Health Organization's Safe Surgery Saves Lives initiative, is a useful contribution to improving safety and prevention of SSIs and should be used universally. Considering sutures as ‘implants’, with a hard or non-shedding surface to which micro-organisms can form biofilm and cause surgical site infections, was felt to be a useful concept. PMID:20819330

  7. A Novel Prevention Bundle to Reduce Surgical Site Infections in Pediatric Spinal Fusion Patients.

    PubMed

    Gould, Jane M; Hennessey, Patricia; Kiernan, Andrea; Safier, Shannon; Herman, Martin

    2016-05-01

    BACKGROUND The Surgical Care Improvement Project bundle emphasizes operative infection prevention practices. Despite implementing the Surgical Care Improvement Project bundle in 2008, spinal fusion surgical site infections (SF-SSI) continued to be prevalent for this low-volume, high-risk surgery. OBJECTIVE To design a combined pre-, peri-, and postoperative bundle (PPPB) that would lead to sustained reductions in SF-SSI rates. DESIGN Quality improvement project, before-after trial with cost-effectiveness analysis. SETTING Children's hospital. PATIENTS All spinal fusion patients, 2008-2015. INTERVENTION A multidisciplinary team developed the PPPB composed of Surgical Care Improvement Project elements plus improved wound care practices, nursing standard of care, dedicated nursing unit, dermatology assessment tool and consultation, nursing education tool using "teach back" technique, and a "Back Home" kit. SF-SSI rates were compared before (2008-2010) and after (2011-February 2015) implementation of PPPB. PPPB compliance was monitored. RESULTS A total of 224 SF surgeries were performed from 2008 to February 2015. Pre-PPPB analysis revealed median time to SF-SSI of 28 days, secondary to skin and bowel flora. Mean 3-year pre-PPPB SF-SSI rate per 100 SF surgeries was 8.2 (8/98) (2008: 13.3 [4/30], 2009: 2.7 [1/37], 2010: 9.7 [3/31]). Mean SF-SSI rate after PPPB was 2.4 (3/126) (January 2011-February 2015); there was a 71% reduction in mean SSI rate (P=.0695). No SF-SSI occurred in neuromuscular patients (P=.008) after PPPB. Compliance with PPPB elements has been 100%. CONCLUSIONS PPPB led to sustained improvement in SF-SSI rates over 50 months. The PPPB could be reproduced for other surgeries. Infect Control Hosp Epidemiol 2016;37:527-534. PMID:26818613

  8. Diabetes and Risk of Surgical Site Infection: A systematic review and meta-analysis

    PubMed Central

    Kaye, Keith S.; Knott, Caitlin; Nguyen, Huong; Santarossa, Maressa; Evans, Richard; Bertran, Elizabeth; Jaber, Linda

    2016-01-01

    Objective To determine the independent association between diabetes and SSI across multiple surgical procedures. Design Systematic review and meta-analysis. Methods Studies indexed in PubMed published between December 1985 and through July 2015 were identified through the search terms “risk factors” or “glucose” and “surgical site infection”. A total of 3,631 abstracts were identified through the initial search terms. Full texts were reviewed for 522 articles. Of these, 94 articles met the criteria for inclusion. Standardized data collection forms were used to extract study-specific estimates for diabetes, blood glucose levels, and body mass index (BMI). Random-effects meta-analysis was used to generate pooled estimates and meta-regression was used to evaluate specific hypothesized sources of heterogeneity. Results The primary outcome was SSI, as defined by the Centers for Disease Control and Prevention surveillance criteria. The overall effect size for the association between diabetes and SSI was OR=1.53 (95% Predictive Interval 1.11, 2.12, I2: 57.2%). SSI class, study design, or patient BMI did not significantly impact study results in a meta-regression model. The association was higher for cardiac surgery 2.03 (95% Predictive Interval 1.13, 4.05) compared to surgeries of other types (p=0.001). Conclusion These results support the consideration of diabetes as an independent risk factor for SSIs for multiple surgical procedure types. Continued efforts are needed to improve surgical outcomes for diabetic patients. PMID:26503187

  9. High prevalence of methicillin resistant staphylococci strains isolated from surgical site infections in Kinshasa

    PubMed Central

    Iyamba, Jean-Marie Liesse; Wambale, José Mulwahali; Lukukula, Cyprien Mbundu; Takaisi-Kikuni, Ntondo za Balega

    2014-01-01

    Introduction Surgical site infections (SSIs) after surgery are usually caused by Staphylococcus aureus and coagulase-negative staphylococci (CNS). In low income countries, methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase-negative staphylococci (MR-CNS) surgical site infections are particularly associated with high treatment cost and remain a source of mortality and morbidity. This study aimed to determine the prevalence and the sensitivity to antibiotics of MRSA and MR-CNS isolated from SSIs. Methods Wound swabs were collected from 130 hospitalized surgical patients in two major hospitals of Kinshasa. S. aureus and CNS strains were identified by standard microbiological methods and latex agglutination test (Pastorex Staph-Plus). The antibiotic susceptibility of all staphylococcal strains was carried out using disk-diffusion method. Results Eighty nine staphylococcal strains were isolated. Out of 74 S. aureus and 15 CNS isolated, 47 (63.5%) and 9 (60%) were identified as MRSA and MR-CNS respectively. Among the MRSA strains, 47 strains (100%) were sensitive to imipenem, 39 strains (89%) to amoxycillin-clavulanic acid and 38 strains (81%) to vancomycin. All MR-CNS were sensitive to imipenem, amoxycillin-clavulanic acid and vancomycin. The isolated MRSA and MR-CNS strains showed multidrug resistance. They were both resistant to ampicillin, cotrimoxazole, erythromycin, clindamycin, ciprofloxacin, cefotaxime and ceftazidime. Conclusion The results of the present study showed a high prevalence of MRSA and MR-CNS. Imipenem, amoxycillin-clavulanic acid and vancomycin were the most active antibiotics. This study suggests that antibiotic surveillance policy should become national priority as MRSA and MR-CNS were found to be multidrug resistant. PMID:25478043

  10. Risk factors for surgical site infection after instrumented fixation in spine trauma.

    PubMed

    Cooper, Kevin; Glenn, Chad A; Martin, Michael; Stoner, Julie; Li, Ji; Puckett, Timothy

    2016-01-01

    Surgical site infection (SSI) represents a significant complication after instrumented fixation in spine trauma. Institutional practice changes have emphasized early fracture correction, shortened intraoperative times, early ambulation, and prompt nutritional supplementation. This retrospective study evaluates the senior author's experience of instrumented spinal trauma SSI occurring at a single Level I trauma center over two equal and contiguous time periods, 2005-2007 (before nutritional supplementation was added to the institutional protocol) and 2008-2010 (after nutritional supplementation was added). This study assessed whether SSI varied depending on the primary surgical site and/or by the chosen approach. Lastly, the incidence of SSI among demographic and other clinical variables was evaluated. In total, 358 patients underwent an index procedure for spinal trauma correction. Fourteen patients developed a SSI requiring reoperation for an incidence of 4.0%. In assessing nutritional supplementation, the probability of infection tended to be lower in the supplemented group (3.7%) than the pre-supplement group (4.3%), but this did not reach significance. The difference in approach for the cervical spine was statistically significant (p=0.045) with rates of infection via posterior approach at 8.1% and no infections via anterior approach. Presence of comorbidities (p=0.03) and time to surgery >3days (p=0.006) were predictors of developing SSI. Benefit is shown from early surgical correction of spinal trauma patients in the reduction of postoperative SSI. Nutritional supplementation may provide a small reduction in infections in the spine trauma population. PMID:26498090

  11. First molecular evidence of intrauterine and surgical-site infections caused by Streptococcus dysgalactiae subsp. equisimilis.

    PubMed

    Lu, Binghuai; Diao, Baowei; Fang, Yujie; Shi, Yanli; Zhu, Fengxia; Li, Dong; Zhang, Shuchen; Cui, Yanchao; Wang, Duochun

    2016-01-01

    S. dysgalactiae subsp. equisimilis (SDSE) is infrequently associated with maternal infections during delivery in pregnant women. A rare case is presented of a woman with intrauterine infection and surgical-site infection due to SDSE after cesarean section, which had colonized her genital tract and, via the ascending pathway, reached her intact fetal membrane. All isolates were identified as Streptococcus Lancefield group G, and their emm genes that coded M protein belonged to stG6.1. The isolates tested negative for a series of streptococcal superantigen virulence genes but positive for nonsuperantigenic virulence genes. In particular, molecular typing using pulsed-field gel electrophoresis analysis disclosed that the three isolates from the different infection sites had identical profiles. Furthermore, multilocus sequence typing indicated that the three isolates belonged to a new sequence typing. Our results indicated that SDSE is potentially pathogenic for pregnant women and newborns if colonized. PMID:27367018

  12. Improving surveillance system and surgical site infection rates through a network: A pilot study from Thailand

    PubMed Central

    Kasatpibal, Nongyao; Nørgaard, Mette; Jamulitrat, Silom

    2009-01-01

    Background: Surveillance of surgical site infections (SSI) provides data upon which interventions to improve patient safety can be based. In Thailand, however, SSI surveillance has not yet been standardized. Objectives: To develop a standardized SSI surveillance system and to monitor SSI rates after introduction of such a system. Methods: We conducted a prospective study among 17,752 patients who underwent surgery in ten hospitals in Thailand from April 2004 to May 2005. The SSI rates were computed and benchmarked with the US rates, reported in terms of standardized infection ratio (SIR). We estimated the incidence rate ratio of surgical site infections by comparing the incidence in the last study period with the incidence in the first study period. Results: The study included 17,869 operations and identified 248 SSIs, yielding an SSI rate of 1.4 infections/100 operations and a corresponding SIR of 0.6 (95% confidence interval [CI] = 0.5–0.7). During the study period the overall SSI rate decreased from 1.8 infections/100 operations to 1.2 infections/100 operations, yielding an incidence rate ratio of 0.65 (95% CI = 0.47–0.89). Conclusion: Our study highlighted that a standardized SSI surveillance in a developing country can be initiated through a network and may be followed by a decrease in SSI rates. PMID:20865088

  13. Bacterial Biofilms on Implanted Suture Material Are a Cause of Surgical Site Infection

    PubMed Central

    Nistico, Laura; Tower, Irene; Lasko, Leslie-Ann; Stoodley, Paul

    2014-01-01

    Abstract Background: Surgical site infection (SSI) has been estimated to occur in up to 5% of all procedures, accounting for up to 0.5% of all hospital costs. Bacterial biofilms residing on implanted foreign bodies have been implicated as contributing or causative factors in a wide variety of infectious scenarios, but little consideration has been given to the potential for implanted, submerged suture material to act as a host for biofilm and thus serve as a nidus of infection. Methods: We report a series of 15 patients who underwent open Roux-en-Y gastric bypass (with musculofascial closure with permanent, multifilament sutures) who developed longstanding and refractory SSIs in the abdominal wall. Explanted suture material at subsequent exploration was examined for biofilm with confocal laser-scanning microscopy (CLSM) and fluorescence in situ hybridization (FISH). Results: All 15 patients at re-exploration were found to have gross evidence of a “slimy” matrix or dense reactive granulation tissue localized to the implanted sutures. Confocal laser-scanning microscopy revealed abundant biofilm present on all sutures examined; FISH was able to identify the presence of specific pathogens in the biofilm. Complete removal of the foreign bodies (and attendant biofilms) resulted in all cases in cure of the SSI. Conclusion: Bacterial biofilms on implanted suture material can manifest as persistent surgical site infections that require complete removal of the underlying foreign body substrata for resolution. PMID:24833403

  14. Analysis of the Risk Factors Affecting the Surgical Site Infection after Cranioplasty Following Decompressive Craniectomy

    PubMed Central

    Kim, Jin Seong; Kim, Sung Kwon; Park, Hyun; Kang, Dong-Ho; Lee, Chul-Hee; Hwang, Soo-Hyun; Jung, Jin-Myung; Han, Jong-Woo

    2015-01-01

    Objective The risk factors for surgical site infections (SSIs) after cranioplasty following decompressive craniectomy remain unclear. The goal of this study was to analyze the risk factors related to developing SSIs after cranioplasty and to suggest valuable predictors. Methods A retrospective review was conducted of patients who underwent cranioplasty following decompressive craniectomy at our institution from January 2011 to December 2014, a total of 78 patients who underwent 78 cranioplasties. Univariate and multivariate logistic regression analyses were carried out to determine possible risk factors related to developing SSIs. We analyzed both patient-specific and surgery-specific factors. Results The overall rate of SSIs was 9.0% (7/78). SSIs after cranioplasty were significantly related to being female, having the primary etiology of traumatic brain injury (TBI) and having had a bilateral cranioplasty in the univariate analysis. Multivariate logistic regression analysis showed that being female [odds ratio (OR) 5.98, p=0.000] and having had a bilateral cranioplasty (OR 4.00, p=0.001) significantly increased the risk of SSIs. Conclusion Based on our data, cranioplasty following decompressive craniectomy is associated with a high incidence of SSI. Being female, having a primary etiology of TBI and having had a bilateral cranioplasty may be risk factors for surgical site infections after cranioplasty. PMID:27169073

  15. Perceived professional needs of Korean science teachers majoring in chemical education and their preferences for online and on-site training

    NASA Astrophysics Data System (ADS)

    Noh, Taehee; Cha, Jeongho; Kang, Sukjin; Scharmann, Lawrence C.

    2004-10-01

    In this study, we investigated the perceived professional needs of Korean science teachers majoring in chemical education, and examined their preferences for online and on-site inservice teacher training programmes. The results were also compared with those of preservice teachers. Participants were 120 secondary school teachers and 67 preservice teachers, whose majors were either chemical education or science education with emphasis in chemistry. A questionnaire consisting of a modified Science Teacher Inventory of Need and a section concerning respondents' demographic information and their use of the Internet was administered. In contrast to previous studies, the perceived needs of Korean inservice and preservice teachers were found to be very strong in all 30 needs assessment items, and their prominent needs were from all seven categories. Preservice teachers indicated significantly greater needs than inservice teachers on several items. Korean teachers generally tended to prefer online inservice to traditional on-site training programmes, although they still preferred on-site types of programmes in areas such as conducting laboratory sessions and demonstrating manipulative skills. Preferences for online programmes tended to be stronger among preservice teachers than inservice teachers, and among non-veteran teachers than in veteran teachers. Educational implications are discussed.

  16. A Prospective Randomized Trial of Open Wound Treatment vs Occlusive Dressings in Elective Surgical Cases with Respect to Surgical Site Infections

    PubMed Central

    Grover, Anmol; Sidhu, D S

    2015-01-01

    Background Surgical wounds heal by primary intention in all the elective and emergency surgical procedures. Current practice is to place dressing over the closed wound before the patient leaves the sterile environment of the operating theatre. Dressing is a material applied to protect a wound and favour its healing. However, to leave wound open in direct contact to environment following any procedure by just applying some ointment on it, the so called open wound treatment is still controversial one. In the present study we have compared open wound treatment vs occlusive dressings in elective surgical cases with respect to surgical site infections. Materials and Methods The present study was conducted on 100 patients admitted for elective general surgery after taking written informed consent. Patients were divided randomly in to two equal groups each comprising of 50 patients. In Group A, patients had occlusive dressing till removal of stitches and in Group B, patients wounds were kept exposed to environment after the surgical procedure. Results In present study we observed total 7% of postoperative wounds were infected of all the clean and clean contaminated wounds we studied. In Group A, patients had occlusive dressing and these patients had 8% infection rate whereas in Group B patients, wounds were kept exposed to environment and these patients had 6% infection rate. Conclusion It is hereby concluded that in the elective surgical cases there is no harm in leaving the wounds open postoperatively. This method not only helps in arresting the infective pathology at a lesser stage but also saves surgeon’s time and patient’s money. PMID:26266164

  17. Post Liposuction Mycobacterium Abscessus Surgical Site Infection in a Returned Medical tourist Complicated by a Paradoxical Reaction During Treatment

    PubMed Central

    Hui, Siong H.; Noonan, Lisa

    2015-01-01

    Rapidly growing mycobacterial skin and soft tissue infections are known to complicate cosmetic surgical procedures. Treatment consists of more surgery and prolonged antibiotic therapy guided by drug susceptibility testing. Paradoxical reactions occurring during antibiotic therapy can further complicate treatment of non-tuberculous mycobacterial infections. We report a case of post liposuction Mycobacterium abscessus surgical site infection in a returned medical tourist and occurrence of paradox during treatment. PMID:26753088

  18. Obesity and the Risk for Surgical Site Infection in Abdominal Surgery.

    PubMed

    Winfield, Robert D; Reese, Stacey; Bochicchio, Kelly; Mazuski, John E; Bochicchio, Grant V

    2016-04-01

    Obesity is a risk factor for surgical site infection (SSI) after abdominal procedures; however, data characterizing the risk of SSI in obese patients during abdominal procedures are lacking. We hypothesized that obesity is an independent risk factor for SSI across wound classes. We analyzed American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data for 2011. We calculated body mass index (BMI), classifying patients according to National Institute of Health (NIH) BMI groups. We excluded records in which height/weight was not recorded and patients with BMI less than 18.5. We examined patients undergoing open abdominal procedures, performing univariate and multivariate analyses to assess the relative contribution of obesity to SSI. Study criteria were met by 89,148 patients. Obese and morbidly obese patients had significantly greater SSI rates in clean and clean-contaminated cases but not contaminated or dirty/infected cases. Logistic regression confirmed obesity and morbid obesity as being independently associated with the overall SSI development, specifically in clean [Obesity odds ratio (OR) = 1.757, morbid obesity OR = 2.544, P < 0.001] and clean-contaminated (obesity OR = 1.239, morbid obesity OR = 1.287, P < 0.001) cases. Obesity is associated with increased risk of SSI overall, specifically in clean and clean-contaminated abdominal procedures; this is independent of diabetes mellitus. Novel techniques are needed to reduce SSI in this high-risk patient population. PMID:27097626

  19. Mitochondrial DNA control region sequences in Koreans: identification of useful variable sites and phylogenetic analysis for mtDNA data quality control.

    PubMed

    Lee, Hwan Young; Yoo, Ji-Eun; Park, Myung Jin; Chung, Ukhee; Shin, Kyoung-Jin

    2006-01-01

    We have established a high-quality mtDNA control region sequence database for Koreans. To identify polymorphic sites and to determine their frequencies and haplotype frequencies, the complete mtDNA control region was sequenced in 593 Koreans, and major length variants of poly-cytosine tracts in HV2 and HV3 were determined in length heteroplasmic individuals by PCR analysis using fluorescence-labeled primers. Sequence comparison showed that 494 haplotypes defined by 285 variable sites were found when the major poly-cytosine tract genotypes were considered in distinguishing haplotypes, whereas 441 haplotypes were found when the poly-cytosine tracts were ignored. Statistical parameters indicated that analysis of partial mtDNA control region which encompasses the extended regions of HV1 and HV2, CA dinucleotide repeats in HV3 and nucleotide position 16497, 16519, 456, 489 and 499 (HV1ex+HV2ex+HV3CA+5SNPs) and the analysis of another partial mtDNA control region including extended regions of HV1 and HV2, HV3 region and nucleotide position 16497 and 16519 (HV1ex+HV2ex+HV3+2SNPs) can be used as efficient alternatives for the analysis of the entire mtDNA control region in Koreans. Also, we collated the basic informative SNPs, suggested the important mutation motifs for the assignment of East Asian haplogroups, and classified 592 Korean mtDNAs (99.8%) into various East Asian haplogroups or sub-haplogroups. Haplogroup-directed database comparisons confirmed the absence of any major systematic errors in our data, e.g., a mix-up of site designations, base shifts or mistypings. PMID:16177905

  20. Post-caesarean section surgical site infections at a Tanzanian tertiary hospital: a prospective observational study.

    PubMed

    De Nardo, P; Gentilotti, E; Nguhuni, B; Vairo, F; Chaula, Z; Nicastri, E; Nassoro, M M; Bevilacqua, N; Ismail, A; Savoldi, A; Zumla, A; Ippolito, G

    2016-08-01

    Few data are available on the determinants and characteristics of post-caesarean section (CS) surgical site infections (SSIs) in resource-limited settings. We conducted a prospective observational cohort study to evaluate the rates, determinants, and microbiological characteristics of post-CS SSI at the Dodoma Regional Referral Hospital (DRRH) Gynaecology and Obstetrics Department in Tanzania. Spanning a three-month period, all pregnant women who underwent CS were enrolled and followed up for 30 days. SSI following CS occurred in 224 (48%) women. Only 10 (2.1%) women received pre-incision antibiotic prophylaxis. Urgent intervention is needed to prevent and control infections and contain the rising rate of post-CS SSI at the DRRH. PMID:27125664

  1. Particular catastrophic antiphospholipid syndrome, on the sole surgical site after breast reduction.

    PubMed

    de Runz, Antoine; Zuily, Stephane; Gosset, Jessica; Wahl, Denis; Simon, Etienne

    2013-11-01

    A 20-year-old woman treated with vitamin K antagonist for antiphospholipid syndrome (APS) (pulmonary embolisms at age 15) was admitted for breast reduction after bridging therapy. At 2 days post-surgery haematomas appeared on the surgical site and anticoagulant therapy was withheld. She developed a skin and breast necrosis leading to the diagnosis of catastrophic APS. Despite medical treatment (anticoagulant therapy, corticosteroids and intravenous immunoglobulins) and surgery, necrosis continued. After 2 weeks of negative-pressure wound therapy (V.A.C.(®) Therapy™) the patient improved, mammary tissues were alive, well vascularised and budding. Breast reconstruction was then initiated. Artificial dermis graft (MatriDerm(®) 2 mm) was applied, and 3 weeks later the apposition of split-thickness skin graft on it. Six months later, results of the surgery were good and the patient was satisfied. PMID:23680115

  2. Study on the Application of Probabilistic Tsunami Hazard Analysis for the Nuclear Power Plant Site in Korean Peninsula

    NASA Astrophysics Data System (ADS)

    Rhee, H. M.; Kim, M.; Sheen, D. H.; Choi, I. K.

    2014-12-01

    The necessity of study on the tsunami hazard assessment for Nuclear Power Plant (NPP) site was suggested since the event of Fukushima in 2011 had been occurred. It has being emphasized because all of the NPPs in Korean Peninsula are located in coastal region. The tsunami hazard is regarded as the annual exceedance probability for the wave heights. The methodology for analysis of tsunami hazard is based on the seismic hazard analysis. The seismic hazard analysis had been performed by using both deterministic and probabilistic method. Recently, the probabilistic method had been received more attention than the deterministic method because the uncertainties of hazard analysis could be considered by using the logic tree approach. In this study, the probabilistic tsunami hazard analysis for Uljin NPP site was performed by using the information of fault sources which was published by Atomic Energy Society of Japan (AESJ). The wave parameter is the most different parameter with seismic hazard. It could be estimated from the results of tsunami propagation analysis. The TSUNAMI_ver1.0 which was developed by Japan nuclear energy safety organization (JNES), was used for the tsunami simulation. The 80 cases tsunami simulations were performed and then the wave parameters were estimated. For reducing the sensitivity which was encouraged by location of sampling point, the wave parameters were estimated from group of sampling points.The probability density function on the tsunami height was computed by using the recurrence intervals and the wave parameters. And then the exceedance probability distribution was calculated from the probability density function. The tsunami hazards for the sampling groups were calculated. The fractile curves which were shown the uncertainties of input parameters were estimated from the hazards by using the round-robin algorithm. In general, tsunami hazard analysis is focused on the maximum wave heights. But the minimum wave height should be considered

  3. Role of Recipient-site Preparation Techniques and Post-operative Wound Dressing in the Surgical Management of Vitiligo

    PubMed Central

    Al-Hadidi, Nour; Griffith, James L; Al-Jamal, Mohammed S; Hamzavi, Iltefat

    2015-01-01

    Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple methods of treatments have emerged to manage vitiligo, including medical and surgical techniques. Among the surgical techniques described in the management of vitiligo are minipunch grafting, split-thickness skin grafting, hair follicle transplantation, suction blister grafting, and cultured and non-cultured autologous melanocyte transplantation. However, prior to grafting optimal recipient-site preparation is needed for graft survival and successful repigmentation outcomes. Similarly, post-operative care of the recipient site is vital to yielding a viable graft irrespective of the transplantation technique employed. This article reviews the multiple methods employed to prepare the recipient site in vitiligo surgeries and the post-surgical conditions which optimize graft viability. A pubmed search was conducted utilizing the key words listed below. PMID:26157306

  4. Role of Recipient-site Preparation Techniques and Post-operative Wound Dressing in the Surgical Management of Vitiligo.

    PubMed

    Al-Hadidi, Nour; Griffith, James L; Al-Jamal, Mohammed S; Hamzavi, Iltefat

    2015-01-01

    Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple methods of treatments have emerged to manage vitiligo, including medical and surgical techniques. Among the surgical techniques described in the management of vitiligo are minipunch grafting, split-thickness skin grafting, hair follicle transplantation, suction blister grafting, and cultured and non-cultured autologous melanocyte transplantation. However, prior to grafting optimal recipient-site preparation is needed for graft survival and successful repigmentation outcomes. Similarly, post-operative care of the recipient site is vital to yielding a viable graft irrespective of the transplantation technique employed. This article reviews the multiple methods employed to prepare the recipient site in vitiligo surgeries and the post-surgical conditions which optimize graft viability. A pubmed search was conducted utilizing the key words listed below. PMID:26157306

  5. Risk of Orthopedic Surgical Site Infections in Patients with Rheumatoid Arthritis Treated with Antitumor Necrosis Factor Alfa Therapy

    PubMed Central

    da Cunha, Bernardo Matos; Maria Henrique da Mota, Licia; dos Santos-Neto, Leopoldo Luiz

    2012-01-01

    Introduction. International guidelines recommend interruption of anti-TNF medications in the perioperative period, but there are no randomized trials to support such recommendation. Objectives. To study literature evidence assessing the risk of surgical site infections in orthopedic surgery patients with RA using anti-TNF drugs, compared to untreated patients or those using conventional DMARD. Methods. Systematic review of cohort studies is concerning surgical site infections in orthopedic procedures in patients with RA. Results. Three studies were selected. Only one was considered of high-quality, albeit with low statistical power. The review resulted in inconclusive data, since the best quality study showed no significant differences between groups, while others showed increased risk of infections in patients using anti-TNF medications. Conclusion. It is unclear whether patients with RA using anti-TNF medications are at increased risk of surgical site infections. Randomized controlled trials or new high quality observational studies are needed to clarify the issue. PMID:22500176

  6. Does Transumbilical Incision Influence Surgical Site Infection Rates of the Laparoscopic Sigmoidectomy and Anterior Resection?

    PubMed

    Yamamoto, Masashi; Tanaka, Keitaro; Asakuma, Mitsuhiro; Kondo, Keisaku; Isii, Masatsugu; Hamamoto, Hiroki; Okuda, Junji; Uchiyama, Kazuhisa

    2015-12-01

    Laparoscopic surgery is widespread and is safe and effective for the management of patients with colorectal cancer. However, surgical site infection (SSI) remains an unresolved complication. The present study investigated the comparative effect of supraumbilical incision versus transumbilical incision (TU) on the incidence of SSI in patients undergoing laparoscopic surgery for colon cancer. Medical records from patients with colorectal cancer who underwent laparoscopic sigmoid and rectosigmoid colon surgeries with either supraumbilical incision (n = 150) or TU (n = 150) were retrospectively reviewed. There was no difference in demographics, comorbidities, or operative variables between the two groups. The transumbilical group and the supraumbilical group were comparable with regards to overall SSI (6.0% vs 4.0%; P = 0.4062), superficial SSI (6.0% vs 3.3%; P = 0.2704), and deep SSI (0% vs 0.7%; P = 0.2385). SSI developed after laparoscopic sigmoid and rectosigmoid colon cancer surgery in 15 (5.0%) of the 300 patients. Of these superficial SSI, all wounds were in the left lower quadrant incision, and the transumbilical port sites did not become infected. Univariate analysis failed to identify any risk factors for SSI. Avoidance of the umbilicus offers no benefit with regard to SSI compared with TU. PMID:26736159

  7. Surgical site infections following spine surgery: eliminating the controversies in the diagnosis.

    PubMed

    Chahoud, Jad; Kanafani, Zeina; Kanj, Souha S

    2014-01-01

    Surgical site infection (SSI) following spine surgery is a dreaded complication with significant morbidity and economic burden. SSIs following spine surgery can be superficial, characterized by obvious wound drainage or deep-seated with a healed wound. Staphylococcus aureus remains the principal causal agent. There are certain pre-operative risk factors that increase the risk of SSI, mainly diabetes, smoking, steroids, and peri-operative transfusions. Additionally, intra-operative risk factors include surgical invasiveness, type of fusion, implant use, and traditional instead of minimally invasive approach. A high level of suspicion is crucial to attaining an early definitive diagnosis and initiating appropriate management. The most common presenting symptom is back pain, usually manifesting 2-4 weeks and up to 3 months after a spinal procedure. Scheduling a follow-up visit between weeks 2 and 4 after surgery is therefore necessary for early detection. Inflammatory markers are important diagnostic tools, and comparing pre-operative with post-operative levels should be done when suspecting SSIs following spine surgery. Particularly, serum amyloid A is a novel inflammatory marker that can expedite the diagnosis of SSIs. Magnetic resonance imaging remains the diagnostic modality of choice when suspecting a SSI following spine surgery. While 18F-fluorodeoxyglucose-positron emission tomography is not widely used, it may be useful in challenging cases. Despite their low yield, blood cultures should be collected before initiating antibiotic therapy. Samples from wound drainage should be sent for Gram stain and cultures. When there is a high clinical suspicion of SSI and in the absence of superficial wound drainage, computed tomography-guided aspiration of paraspinal collections is warranted. Unless the patient is hemodynamically compromised, antibiotics should be deferred until proper specimens for culture are secured. PMID:25705620

  8. Feasibility of a Mobile Phone-Based Surveillance for Surgical Site Infections in Rural India

    PubMed Central

    Sharma, Shailendra; Sharma, Megha; Mahadik, Vijay K.; Lundborg, Cecilia Stålsby

    2015-01-01

    Abstract Objectives: To assess the feasibility of using mobile communication technology in completing a 30-day follow-up of surgical site infection (SSI). Subjects and Methods: SSIs are infections occurring up to 30 days after an operative procedure. This prospective exploratory study was conducted in a cohort of patients who were admitted and operated on in the general surgery wards of a rural hospital in India from October 2010 to June 2011. At the time of discharge, all patients were requested to follow-up in the surgical outpatient clinic at 30 days after surgery. If this was not done, a mobile phone-based surveillance was done to complete the follow-up. Results: The mean age of the 536 operated-on patients was 40 years (95% confidence interval [CI], 38–41 years). The mean duration of hospital stay was 10.7 days (95% CI, 9.9–11.6 days). Most (81%) operated-on patients were from rural areas, and 397 (75%) were male. Among the operated-on patients the ownership of mobile phones was 75% (95% CI, 73–78%). The remaining 25% of patients (n=133) used a shared mobile phone. For 380 patients (74.5%) the follow-up was completed by mobile phones. The SSI rate at follow-up was 6.3% (n=34). In 10 patients, an SSI was detected over the mobile phone. Conclusions: Mobile communication technology is feasible to be used in rural settings to complete case follow-up for SSIs. PMID:25748641

  9. Peri-operative glycaemic control regimens for preventing surgical site infections in adults

    PubMed Central

    Kao, Lillian S; Meeks, Derek; Moyer, Virginia A; Lally, Kevin P

    2010-01-01

    Background Surgical site infections (SSIs) are associated with significant morbidity, mortality, and resource utilization and are potentially preventable. Peri-operative hyperglycaemia has been associated with increased SSIs and previous recommendations have been to treat glucose levels above 200 mg/dL. However, recent studies have questioned the optimal glycaemic control regimen to prevent SSIs. Whether the benefits of strict or intensive glycaemic control with insulin infusion as compared to conventional management outweigh the risks remains controversial. Objectives To summarise the evidence for the impact of glycaemic control in the peri-operative period on the incidence of surgical site infections, hypoglycaemia, level of glycaemic control, all-cause and infection-related mortality, and hospital length of stay and to investigate for differences of effect between different levels of glycaemic control. Search strategy A search strategy was developed to search the following databases: Cochrane Wounds Group Specialised Register (searched 25 March 2009), The Cochrane Central Register of Controlled Trials, The Cochrane Library 2009, Issue 1; Ovid MEDLINE (1950 to March Week 2 2009); Ovid EMBASE (1980 to 2009 Week 12) and EBSCO CINAHL (1982 to March Week 3 2009). The search was not limited by language or publication status. Selection criteria Randomised controlled trials (RCTs) were eligible for inclusion if they evaluated two (or more) glycaemic control regimens in the peri-operative period (within one week pre-, intra-, and/or post-operative) and reported surgical site infections as an outcome. Data collection and analysis The standard method for conducting a systematic review in accordance with the Cochrane Wounds Group was used. Two review authors independently reviewed the results from the database searches and identified relevant studies. Two review authors extracted study data and outcomes from each study and reviewed each study for methodological quality. Any

  10. Agreement among Health Care Professionals in Diagnosing Case Vignette-Based Surgical Site Infections

    PubMed Central

    Lepelletier, Didier; Ravaud, Philippe; Baron, Gabriel; Lucet, Jean-Christophe

    2012-01-01

    Objective To assess agreement in diagnosing surgical site infection (SSI) among healthcare professionals involved in SSI surveillance. Methods Case-vignette study done in 2009 in 140 healthcare professionals from seven specialties (20 in each specialty, Anesthesiologists, Surgeons, Public health specialists, Infection control physicians, Infection control nurses, Infectious diseases specialists, Microbiologists) in 29 University and 36 non-University hospitals in France. We developed 40 case-vignettes based on cardiac and gastrointestinal surgery patients with suspected SSI. Each participant scored six randomly assigned case-vignettes before and after reading the SSI definition on an online secure relational database. The intraclass correlation coefficient (ICC) was used to assess agreement regarding SSI diagnosis on a seven-point Likert scale and the kappa coefficient to assess agreement for superficial or deep SSI on a three-point scale. Results Based on a consensus, SSI was present in 21 of 40 vignettes (52.5%). Intraspecialty agreement for SSI diagnosis ranged across specialties from 0.15 (95% confidence interval, 0.00–0.59) (anesthesiologists and infection control nurses) to 0.73 (0.32–0.90) (infectious diseases specialists). Reading the SSI definition improved agreement in the specialties with poor initial agreement. Intraspecialty agreement for superficial or deep SSI ranged from 0.10 (−0.19–0.38) to 0.54 (0.25–0.83) (surgeons) and increased after reading the SSI definition only among the infection control nurses from 0.10 (−0.19–0.38) to 0.41 (−0.09–0.72). Interspecialty agreement for SSI diagnosis was 0.36 (0.22–0.54) and increased to 0.47 (0.31–0.64) after reading the SSI definition. Conclusion Among healthcare professionals evaluating case-vignettes for possible surgical site infection, there was large disagreement in diagnosis that varied both between and within specialties. PMID:22529980

  11. Surgical and Antimicrobial Treatment of Prosthetic Vascular Graft Infections at Different Surgical Sites: A Retrospective Study of Treatment Outcomes

    PubMed Central

    Elzi, Luigia; Gurke, Lorenz; Battegay, Manuel; Widmer, Andreas F.; Weisser, Maja

    2014-01-01

    Objective Little is known about optimal management of prosthetic vascular graft infections, which are a rare but serious complication associated with graft implants. The goal of this study was to compare and characterize these infections with respect to the location of the graft and to identify factors associated with outcome. Methods This was a retrospective study over more than a decade at a tertiary care university hospital that has an established multidisciplinary approach to treating graft infections. Cases of possible prosthetic vascular graft infection were identified from the hospital's infectious diseases database and evaluated against strict diagnostic criteria. Patients were divided into groups according to the locations of their grafts: thoracic-aortic, abdominal-aortic, or peripheral-arterial. Statistical analyses included evaluation of patient and infection characteristics, time to treatment failure, and factors associated specifically with cure rates in aortic graft infections. The primary endpoint was cure at one year after diagnosis of the infection. Results Characterization of graft infections according to the graft location did show that these infections differ in terms of their characteristics and that the prognosis for treatment seems to be influenced by the location of the infection. Cure rate and all-cause mortality at one year were 87.5% and 12.5% in 24 patients with thoracic-aortic graft infections, 37.0% and 55.6% in 27 patients with abdominal-aortic graft infections, and 70.0% and 30.0% in 10 patients with peripheral-arterial graft infections. In uni- and multivariate analysis, the type of surgical intervention used in managing infections (graft retention versus graft replacement) did not affect primary outcome, whereas a rifampicin-based antimicrobial regimen was associated with a higher cure rate. Conclusions We recommend that future prospective studies differentiate prosthetic vascular graft infections according to the location of the

  12. Rodent burrows in late Pleistocene paleosols at Korean Palaeolithic sites and their implications for paleoclimate changes

    NASA Astrophysics Data System (ADS)

    Lim, H.; Park, S.; Lee, J.; Lee, Y.

    2013-12-01

    Rodent burrows are commonly found at many Paleolithic archaeological sites in Korea. They are nearly straight in horizontal view and gently inclined in lateral view. Burrow diameters are mostly 7 - 10cm, and burrow length may reach a few meters. Vertical penetration depths are generally about 1 m from the surface, and the thickness of the burrow-bearing layer is about 1-2 m. Although no remains (bones, teeth, claws, and coprolites) were found within burrows, they are interpreted to have been produced by rodent-like mammals (probably ground squirrels) based on the size and architecture. According to the previous study, the age of these burrows was constrained to be between ca. 40,000 and 25,000 yr BP by tephrochronology, radiocarbon and optically stimulated luminescence dating results (Lim et al., 2007). However, little is known about the reason why these burrows have disappeared after late Pleistocene time. For this question, two explanations can be considered: extinction or migration. Since same kinds of burrows are still found in the high-latitude regions, such as Mongolia and North America, the possibility of extinction can be ruled out. Therefore, migration seems to be the most likely explanation. Our results show that the destruction of habitat caused by climate change during this period is the main reason for the northward migration of burrowing animals. This study suggests that rodent burrows found in the late Pleistocene paleosols can provide useful information on paleoclimate and paleoenvironmental changes.

  13. Surgical Site Infection After Skin Excisions in Children: Is Field Sterility Sufficient?

    PubMed

    Nuzzi, Laura C; Greene, Arin K; Meara, John G; Taghinia, Amir; Labow, Brian I

    2016-03-01

    Skin excisions are common procedures in children. They may be performed in the clinic using field sterility or the operating room with strict sterile technique. We compared the effect of these locations and the use of antibiotics on the incidence of surgical site infection (SSI) after skin excisions. Patients ages 0-18 years presenting to our department for the excision of lesions from 2006 to 2010 with complete medical records were included in our study. Records were reviewed for demographic characteristics, presentation, perioperative conditions, and postoperative SSI and other wound complications. Analyses were performed to estimate the costs associated with sterility technique and perioperative antibiotic use. We identified 700 patients with a mean age of 9.1 years. Of 872 lesions excised, 0.3% resulted in SSI and 1.8% had other wound complications. The incidence of SSI did not vary according to sterility technique, antibiotic usage, surgeon, age, or lesion size, type, or location. The equipment costs to excise a lesion in the operating room were 200% greater than in the clinic. The incidence of SSI after excision of benign lesions in children did not differ between those performed using clinic field sterility and those using the standard aseptic sterile technique in the operating room. A considerable cost savings could be realized by adopting field sterility for simple excisions performed in the operating room and avoiding routine perioperative antibiotics in pediatric skin excisions. PMID:25727412

  14. Review of Subcutaneous Wound Drainage in Reducing Surgical Site Infections after Laparotomy

    PubMed Central

    Manzoor, B.; Heywood, N.; Sharma, A.

    2015-01-01

    Purpose. Surgical site infections (SSIs) remain a significant problem after laparotomies. The aim of this review was to assess the evidence on the efficacy of subcutaneous wound drainage in reducing SSI. Methods. MEDLINE database was searched. Studies were identified and screened according to criteria to determine their eligibility for meta-analysis. Meta-analysis was performed using the Mantel-Haenszel method and a fixed effects model. Results. Eleven studies were included with two thousand eight hundred and sixty-four patients. One thousand four hundred and fifty patients were in the control group and one thousand four hundred and fourteen patients were in the drain group. Wound drainage in all patients shows no statistically significant benefit in reducing SSI incidence. Use of drainage in high risk patients, contaminated wound types, and obese patients appears beneficial. Conclusion. Using subcutaneous wound drainage after laparotomy in all patients is unnecessary as it does not reduce SSI risk. Similarly, there seems to be no benefit in using it in clean and clean contaminated wounds. However, there may be benefit in using drains in patients who are at high risk, including patients who are obese and/or have contaminated wound types. A well designed trial is needed which examines these factors. PMID:26783556

  15. Factors affecting surgical site infection rate after elective gastric cancer surgery

    PubMed Central

    Özmen, Tolga; Javadov, Mirkhalig; Yeğen, Cumhur S.

    2016-01-01

    Objective Surgical site infection (SSI) is a common complication after surgery and is an indicator of quality of care. Risk factors for SSI are studied thoroughly for most types of gastrointestinal surgeries and especially colorectal surgeries, but accumulated data is still lacking for gastric surgeries. We studied the parameters affecting SSI rate after gastric cancer surgery. Material and Methods Consecutive patients, who underwent elective gastric cancer surgery between June and December 2013, were included. Descriptive parameters, laboratory values and past medical histories were recorded prospectively. All patients were followed for 1 month. Recorded parameters were compared between the SSI (+) and SSI (−) groups. Results Fifty-two patients (mean age: 58.87±9.25 [31–80]; 67% male) were included. SSI incidence was 19%. ASA score ≥3 (p<0.001), postoperative weight gain (p<0.001), smoking (p=0.014) and body mass index (BMI) ≥30 (p=0.025) were related with a higher SSI incidence. Also patients in the SSI (+) group had a higher preoperative serum C-reactive protein level (p=0.014). Conclusion We assume that decreasing BMI to <30, stopping smoking at least 3 weeks before the operation, and preventing postoperative weight gain by avoiding excessive intravenous hydration will all help decrease SSI rate after gastric surgery. PMID:27528811

  16. Reducing the risk of surgical site infection using a multidisciplinary approach: an integrative review

    PubMed Central

    Gillespie, Brigid M; Kang, Evelyn; Roberts, Shelley; Lin, Frances; Morley, Nicola; Finigan, Tracey; Homer, Allison; Chaboyer, Wendy

    2015-01-01

    Purpose To identify and describe the strategies and processes used by multidisciplinary teams of health care professionals to reduce surgical site infections (SSIs). Materials and methods An integrative review of the research literature was undertaken. Searches were conducted in April 2015. Following review of the included studies, data were abstracted using summary tables and the methodological quality of each study assessed using the Standards for Quality Improvement Reporting Excellence guidelines by two reviewers. Discrepancies were dealt with through consensus. Inductive content analysis was used to identify and describe the strategies/processes used by multidisciplinary health care teams to prevent SSI. Results and discussion In total, 13 studies met the inclusion criteria. Of these, 12 studies used quantitative methods, while a single study used qualitative interviews. The majority of the studies were conducted in North America. All quantitative studies evaluated multifaceted quality-improvement interventions aimed at preventing SSI in patients undergoing surgery. Across the 13 studies reviewed, the following multidisciplinary team-based approaches were enacted: using a bundled approach, sharing responsibility, and, adhering to best practice. The majority of studies described team collaborations that were circumscribed by role. None of the reviewed studies used strategies that included the input of allied health professionals or patient participation in SSI prevention. Conclusion Patient-centered interventions aimed at increasing patient participation in SSI prevention and evaluating the contributions of allied health professionals in team-based SSI prevention requires future research. PMID:26508870

  17. Impact of perioperative probiotic treatment for surgical site infections in patients with colorectal cancer

    PubMed Central

    AISU, NAOYA; TANIMURA, SHU; YAMASHITA, YUICHI; YAMASHITA, KANEFUMI; MAKI, KENJI; YOSHIDA, YOICHIRO; SASAKI, TAKAMITSU; TAKENO, SHINSUKE; HOSHINO, SEIICHIRO

    2015-01-01

    The aim of the present study was to estimate the effect of the perioperative administration of probiotics in patients undergoing colorectal cancer (CRC) surgery. The study focused on a total of 156 consecutive surgeries carried out from among all the elective CRC surgeries performed between April 2009 and March 2013. The patients involved in surgeries undertaken between April 2009 and October 2011 were placed in the non-probiotic group (group A, 81 patients) and those involved in surgeries between November 2011 and March 2013 were placed in the probiotic group (group B, 75 patients). Postoperative infectious complications were recorded, and the immune responses and fecal microbiota were determined. A breakdown of infectious complications showed that 21 (13.5%) patients experienced superficial incisional surgical site infections (SSIs), of which 16 patients were from group A (19.8%), and five patients from group B (6.7%) (P=0.016). The ImmuKnow® adenosine triphosphate values peaked on the first postoperative day (POD) in both groups. In group A, the ImmuKnow value of the first POD was increased significantly compared with the preoperative value (P=0.022). In group B, the value of the first POD did not increase compared with the preoperative value (P=0.28). In conclusion, probiotic treatment can reduce superficial incisional SSIs in patients undergoing CRC surgery. Perioperative probiotic treatment can enhance immune responses and improve the intestinal microbial environment. PMID:26622423

  18. Economic Value of Dispensing Home-Based Preoperative Chlorhexidine Bathing Cloths to Prevent Surgical Site Infection

    PubMed Central

    Bailey, Rachel R.; Stuckey, Dianna R.; Norman, Bryan A.; Duggan, Andrew P.; Bacon, Kristina M.; Connor, Diana L.; Lee, Ingi; Muder, Robert R.; Lee, Bruce Y.

    2012-01-01

    OBJECTIVE To estimate the economic value of dispensing preoperative home-based chlorhexidine bathing cloth kits to orthopedic patients to prevent surgical site infection (SSI). METHODS A stochastic decision-analytic computer simulation model was developed from the hospital’s perspective depicting the decision of whether to dispense the kits preoperatively to orthopedic patients. We varied patient age, cloth cost, SSI-attributable excess length of stay, cost per bed-day, patient compliance with the regimen, and cloth antimicrobial efficacy to determine which variables were the most significant drivers of the model’s outcomes. RESULTS When all other variables remained at baseline and cloth efficacy was at least 50%, patient compliance only had to be half of baseline (baseline mean, 15.3%; range, 8.23%–20.0%) for chlorhexidine cloths to remain the dominant strategy (ie, less costly and providing better health outcomes). When cloth efficacy fell to 10%, 1.5 times the baseline bathing compliance also afforded dominance of the preoperative bath. CONCLUSIONS The results of our study favor the routine distribution of bathing kits. Even with low patient compliance and cloth efficacy values, distribution of bathing kits is an economically beneficial strategy for the prevention of SSI. PMID:21515977

  19. Delayed Propionibacterium acnes surgical site infections occur only in the presence of an implant.

    PubMed

    Shiono, Yuta; Ishii, Ken; Nagai, Shigenori; Kakinuma, Hiroaki; Sasaki, Aya; Funao, Haruki; Kuramoto, Tetsuya; Yoshioka, Kenji; Ishihama, Hiroko; Isogai, Norihiro; Takeshima, Kenichiro; Tsuji, Takashi; Okada, Yasunori; Koyasu, Shigeo; Nakamura, Masaya; Toyama, Yoshiaki; Aizawa, Mamoru; Matsumoto, Morio

    2016-01-01

    Whether Propionibacterium acnes (P. acnes) causes surgical-site infections (SSI) after orthopedic surgery is controversial. We previously reported that we frequently find P. acnes in intraoperative specimens, yet none of the patients have clinically apparent infections. Here, we tracked P. acnes for 6 months in a mouse osteomyelitis model. We inoculated P. acnes with an implant into the mouse femur in the implant group; the control group was treated with the bacteria but no implant. We then observed over a 6-month period using optical imaging system. During the first 2 weeks, bacterial signals were detected in the femur in the both groups. The bacterial signal completely disappeared in the control group within 28 days. Interestingly, in the implant group, bacterial signals were still present 6 months after inoculation. Histological and scanning electron-microscope analyses confirmed that P. acnes was absent from the control group 6 months after inoculation, but in the implant group, the bacteria had survived in a biofilm around the implant. PCR analysis also identified P. acnes in the purulent effusion from the infected femurs in the implant group. To our knowledge, this is the first report showing that P. acnes causes SSI only in the presence of an implant. PMID:27615686

  20. Post-discharge surveillance to identify colorectal surgical site infection rates and related costs.

    PubMed

    Tanner, J; Khan, D; Aplin, C; Ball, J; Thomas, M; Bankart, J

    2009-07-01

    A growing number of surveillance studies have highlighted concerns with relying only on data from inpatients. Without post-discharge surveillance (PDS) data, the rate and burden of surgical site infections (SSIs) are underestimated. PDS data for colorectal surgery in the UK remains to be published. This is an important specialty to study since it is considered to have the highest SSI rate and is among the most expensive to treat. This study of colorectal SSI used a 30 day surveillance programme with telephone interviews and home visits. Each additional healthcare resource used by patients with SSI was documented and costed. Of the 105 patients who met the inclusion criteria and completed the 30 day follow-up, 29 (27%) developed SSI, of which 12 were diagnosed after discharge. The mean number of days to presentation of SSI was 13. Multivariable logistic analysis identified body mass index as the only significant risk factor. The additional cost of treating each infected patient was pound sterling 10,523, although 15% of these additional costs were met by primary care. The 5 month surveillance programme cost pound sterling 5,200 to run. An analysis of the surveillance nurse's workload showed that the nurse could be replaced by a healthcare assistant. PDS to detect SSI after colorectal surgery is necessary to provide complete data with accurate additional costs. PMID:19446918

  1. Surgical site infection after caesarean section: space for post-discharge surveillance improvements and reliable comparisons.

    PubMed

    Ferraro, Federica; Piselli, Pierluca; Pittalis, Silvia; Ruscitti, Luca E; Cimaglia, Claudia; Ippolito, Giuseppe; Puro, Vincenzo

    2016-04-01

    Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive. PMID:27196552

  2. Rates of surgical site infection as a performance measure: Are we ready?

    PubMed

    Biscione, Fernando Martín

    2009-11-30

    With the introduction of quality assurance in health care delivery, there has been a proliferation of research studies that compare patient outcomes for similar conditions among many health care delivery facilities. Since the 1990s, increasing interest has been placed in the incorporation of clinical adverse events as quality indicators in hospital quality assurance programs. Adverse post-operative events, and very especially surgical site infection (SSI) rates after specific procedures, gained popularity as hospital quality indicators in the 1980s. For a SSI rate to be considered a valid indicator of the quality of care, it is essential that a proper adjustment for patient case mix be performed, so that meaningful comparisons of SSI rates can be made among surgeons, institutions, or over time. So far, a significant impediment to developing meaningful hospital-acquired infection rates that can be used for intra- and inter-hospital comparisons has been the lack of an adequate means of adjusting for case mix. This paper discusses what we have learned in the last years regarding risk adjustment of SSI rates for provider performance assessment, and identifies areas in which significant improvement is still needed. PMID:21160789

  3. Korean Literature.

    ERIC Educational Resources Information Center

    Pihl, Marshall R.

    While Chinese was, by and large, the formal and public literary language of the Korean court and aristocracy, native Korean literature survived as an oral tradition in the more informal and private realms of life. The Yi Dynasty which lasted until the Japanese annexation of 1910, produced and recorded a rich treasury of Chinese and Korean…

  4. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania

    PubMed Central

    2014-01-01

    Background Surgical site infection (SSI) is the second most common infectious complication after urinary tract infection following a delivery by caesarean section (CS). At Bugando Medical Centre there has no study documenting the epidemiology of SSI after CS despite the large number of CSs performed and the relatively common occurrence of SSIs. Methods This was a prospective cohort study involving pregnant women who underwent a CS between October 2011 and February 2012 at Bugando Medical Centre. A total of 345 pregnant women were enrolled. Preoperative, intraoperative and postoperative data were collected using a standardized questionnaire. Wound specimens were collected and processed as per standard operative procedures; and susceptibility testing was carried out using a disc diffusion technique. Data was analyzed using STATA version 11. Results The overall cumulative incidence of SSI was 10.9% with an incidence rate of 37.5 per 10,000 people/day (95% CI, 26.8-52.4). The median time from CS to the development of SSI was 7 days (interquartile range [IQR] = 6–9 days). Six independent risk factors for post caesarean SSI as identified in this study by multivariate analysis are: hypertensive disorders of pregnancy (HR: 2.5; 95% CI, 1.1-5.6; P = 0.021), severe anaemia (HR: 3.8; 95% CI, 1.2-12.4, P = 0.028), surgical wound class III (HR: 2.4; 95% CI, 1.1-5.0; P = 0.021), multiple vaginal examinations (HR: 2.5; 95% CI, 1.2-5.1; P = 0.011), prolonged duration of operation (HR: 2.6; 95% CI, 1.2-5.5; P = 0.015) and an operation performed by an intern or junior doctor (HR: 4.0; 95% CI, 1.7-9.2; P = 0.001). Staphylococcus aureus was the most common organism (27.3%), followed by Klebsiella pneumoniae (22.7%). Patients with a SSI had a longer average hospital stay than those without a SSI (12.7 ± 6.9 vs. 4 ± 1.7; P < 0.0001) and the case fatality rate among patients with a SSI was 2.9%. Conclusion SSIs are common among women undergoing CSs at Bugando Medical Centre. SSIs

  5. Preoperative chemotherapy and corticosteroids: independent predictors of cranial surgical-site infections.

    PubMed

    Lieber, Bryan A; Appelboom, Geoffrey; Taylor, Blake E; Lowy, Franklin D; Bruce, Eliza M; Sonabend, Adam M; Kellner, Christopher; Connolly, E Sander; Bruce, Jeffrey N

    2016-07-01

    OBJECT Preoperative corticosteroids and chemotherapy are frequently prescribed for patients undergoing cranial neurosurgery but may pose a risk of postoperative infection. Postoperative surgical-site infections (SSIs) have significant morbidity and mortality, dramatically increase the length and cost of hospitalization, and are a major cause of 30-day readmission. In patients undergoing cranial neurosurgery, there is a lack of data on the role of patient-specific risk factors in the development of SSIs. The authors of this study sought to determine whether chemotherapy and prolonged steroid use before surgery increase the risk of an SSI at postoperative Day 30. METHODS Using the national prospectively collected American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database for 2006-2012, the authors calculated the rates of superficial, deep-incisional, and organ-space SSIs at postoperative Day 30 for neurosurgery patients who had undergone chemotherapy or had significant steroid use within 30 days before undergoing cranial surgery. Trauma patients, patients younger than 18 years, and patients with a preoperative infection were excluded. Univariate analysis was performed for 25 variables considered risk factors for superficial and organ-space SSIs. To identify independent predictors of SSIs, the authors then conducted a multivariate analysis in which they controlled for duration of operation, wound class, white blood cell count, and other potential confounders that were significant on the univariate analysis. RESULTS A total of 8215 patients who had undergone cranial surgery were identified. There were 158 SSIs at 30 days (frequency 1.92%), of which 52 were superficial, 27 were deep-incisional, and 79 were organ-space infections. Preoperative chemotherapy was an independent predictor of organ-space SSIs in the multivariate model (OR 5.20, 95% CI 2.33-11.62, p < 0.0001), as was corticosteroid use (OR 1.86, 95% CI 1.03-3.37, p = 0

  6. Stratification of Surgical Site Infection by Operative Factors and Comparison of Infection Rates after Hernia Repair

    PubMed Central

    Olsen, Margaret A.; Nickel, Katelin B.; Wallace, Anna E.; Mines, Daniel; Fraser, Victoria J.; Warren, David K.

    2015-01-01

    Objective The National Healthcare Safety Network does not risk adjust surgical site infection (SSI) rates after hernia repair by operative factors. We investigated whether operative factors are associated with risk of SSI after hernia repair. Design Retrospective cohort study. Patients Commercially-insured enrollees aged 6 months–64 years with ICD-9-CM procedure or CPT-4 codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from 1/1/2004–12/31/2010. Methods SSIs within 90 days after hernia repair were identified by ICD-9-CM diagnosis codes. Chi-square and Fisher’s exact tests were used to compare SSI incidence by operative factors. Results A total of 119,973 hernia repair procedures were included in the analysis. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] versus 0.34% [57/16,524], p=0.020) and incisional/ventral (4.20% [701/16,699] versus 2.03% [14/691], p=0.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] versus 0.44% [247/55,720], p<0.001) and umbilical (1.57% [131/8,355] versus 0.95% [157/16,562], p<0.001), but not incisional/ventral hernia repair (4.01% [224/5,585] versus 4.16% [491/11,805], p=0.645). Conclusions The incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction/necrosis. Our findings suggest that stratification of hernia repair SSI rates by some operative factors may be important to facilitate accurate comparison of SSI rates between facilities. PMID:25695175

  7. Program Strengths and Opportunities for Improvement Identified by Residents During ACGME Site Visits in 5 Surgical Specialties.

    PubMed

    Caniano, Donna A; Hamstra, Stanley J

    2016-05-01

    Background There is limited information about how residents in surgical specialties view program strengths and opportunities for improvement (OFIs). Objective This study aggregated surgical residents' perspectives on program strengths and OFIs to determine whether there was agreement in perspectives among residents in 5 surgical specialties. Methods Resident consensus lists of program strengths and areas for improvement were aggregated from site visits reports during 2012 and 2013 for obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, and surgery programs. Four trained individuals coded each strength or OFI in 1 of 3 categories: (1) factors common to all specialties; (2) program or institutional resources; and (3) factors unique to surgical specialties. Themes were classified as most frequent when listed by residents in more than 20% of the programs and less frequent when listed by residents in less than 20% of the programs. Results This study included a total of 359 programs, representing 27% to 49% of the Accreditation Council for Graduate Medical Education accredited programs in the 5 specialties. The most frequent strengths were progressive autonomy, collegiality, program leadership, and operative volume. Improving research and didactics, increasing faculty teaching and attendance at educational sessions, and increasing the number of nurse practitioners and physician assistants were common OFIs. Conclusions Factors identified as important by surgical residents related to their learning environment, their educational program, and program and institutional support. Across programs in the study, similar attributes were listed as both program strengths and OFIs. PMID:27168889

  8. An intraoperative irrigation regimen to reduce the surgical site infection rate following adolescent idiopathic scoliosis surgery.

    PubMed

    Herwijnen, B van; Evans, N R; Dare, C J; Davies, E M

    2016-05-01

    Introduction The aim of this study was to compare the efficacy of a gentamicin antibiotic intraoperative irrigation regimen (regimen A) with a povidone-iodine intraoperative irrigation regimen (regimen B) and to evaluate the ability of adjunctive local vancomycin powder (regimen C) to reduce the surgical site infection (SSI) rate following idiopathic scoliosis correction. Methods This was a retrospective, single centre, two-surgeon cohort study of paediatric scoliosis procedures involving 118 patients under the age of 18 years who underwent correction for idiopathic scoliosis over a period of 42 months. Patients' baseline characteristics, pseudarthrosis and rates of SSI were compared. Results Baseline characteristics were comparable in all three groups, with the exception of sex distribution. Over a quarter (27%) of patients with regimen B were male compared with 13% and 6% for regimens A and C respectively. Patients were mostly followed up for a minimum of 12 months. The SSI rate for both superficial and deep infections was higher with regimen A (26.7%) than with regimens B and C (7.0% and 6.3% respectively). The SSI rates for regimens B and C were comparable. No patients developed complications related to vancomycin toxicity, metalwork failure or pseudarthrosis. Conclusions Wound irrigation with a povidone-iodine solution reduces SSIs following adolescent idiopathic scoliosis surgery. The direct application of vancomycin powder to the wound is safe but does not reduce the SSI rate further in low risk patients. Additional studies are needed to elucidate whether it is effective at higher doses and in high risk patient groups. PMID:27087324

  9. Does chlorhexidine and povidone-iodine preoperative antisepsis reduce surgical site infection in cranial neurosurgery?

    PubMed

    Davies, B M; Patel, H C

    2016-07-01

    Introduction Surgical site infection (SSI) is a significant cause of postoperative morbidity and mortality. Effective preoperative antisepsis is a recognised prophylactic, with commonly used agents including chlorhexidine (CHG) and povidone-iodine (PVI). However, there is emerging evidence to suggest an additional benefit when they are used in combination. Methods We analysed data from our prospective SSI database on patients undergoing clean cranial neurosurgery between October 2011 and April 2014. We compared the case-mix adjusted odds of developing a SSI in patients undergoing skin preparation with CGH or PVI alone or in combination. Results SSIs were detected in 2.6% of 1146 cases. Antisepsis with PVI alone was performed in 654 (57%) procedures, while 276 (24%) had CHG alone and 216 (19%) CHG and PVI together. SSIs were associated with longer operating time (p<0.001) and younger age (p=0.03). Surgery type (p<0.001) and length of operation (p<0.001) were significantly different between antisepsis groups. In a binary logistic regression model, CHG and PVI was associated with a significant reduction in the likelihood of developing an SSI (adjusted odds ratio [AOR] 0.12, 95% confidence interval [CI] 0.02-0.63) than either agent alone. There was no difference in SSI rates between CHG and PVI alone (AOR 0.60, 95% CI 0.24-1.5). Conclusions Combination skin preparation with CHG and PVI significantly reduced SSI rates compared to CHG or PVI alone. A prospective, randomized study validating these findings is now warranted. PMID:27055411

  10. Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery.

    PubMed

    Tanner, J; Kiernan, M; Hilliam, R; Davey, S; Collins, E; Wood, T; Ball, J; Leaper, D

    2016-04-01

    Introduction In 2010 a care bundle was introduced by the Department of Health (DH) to reduce surgical site infections (SSIs) in England. To date, use of the care bundle has not been evaluated despite incorporating interventions with resource implications. The aim of this study was to evaluate the DH SSI care bundle in open colorectal surgery. Methods A prospective cohort design was used at two teaching hospitals in England. The baseline group consisted of 127 consecutive patients having colorectal surgery during a 6-month period while the intervention group comprised 166 patients in the subsequent 6 months. SSI and care bundle compliance data were collected using dedicated surveillance staff. Results Just under a quarter (24%) of the patients in the baseline group developed a SSI compared with just over a quarter (28%) in the care bundle group (p>0.05). However, compliance rates with individual interventions, both before and after the implementation of the bundle, were similar. Interestingly, in only 19% of cases was there compliance with the total care bundle. The single intervention that showed an associated reduction in SSI was preoperative warming (p=0.032). Conclusions The DH care bundle did not reduce SSIs after open colorectal surgery. Despite this, it is not possible to state that the bundle is ineffective as compliance rates before and after bundle implementation were similar. All studies evaluating the effectiveness of care bundles must include data for compliance with interventions both before and after implementation of the care bundle; poor compliance may be one of the reasons for the lower than expected reduction of SSIs. PMID:26924481

  11. New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report

    PubMed Central

    Ito, Eisaku; Yoshida, Masashi; Nakashima, Keigo; Suzuki, Norihiko; Imakita, Tomonori; Tsutsui, Nobuhiro; Ohdaira, Hironori; Kitajima, Masaki; Suzuki, Yutaka

    2016-01-01

    Introduction Negative pressure wound therapy (NPWT) for abdominal surgical site infection (SSI) is becoming increasingly common, although enterocutaneous fistula (ECF) has been reported as a complication. To avoid ECF, we used computed tomography (CT) woundgraphy to evaluate the relationship between the wound and the intestine, and then safely treated the abdominal SSI with NPWT. Case presentation Following a laparoscopic intersphincteric resection for low rectal neuroendocrine tumor and covering ileostomy, a 59-year-old woman underwent stoma closure. Six days after surgery, we diagnosed SSI. We suspected ECF, because the wound was deep and the pus resembled enteric fluid. However, CT woundgraphy showed that the wound was separated from the abdominal cavity and the intestine by the abdominal rectus muscle. Accordingly, we performed NPWT. SSI was cured and the wound was well granulated. Twenty-three days after surgery, the patient was discharged. Eventually, the wound was completely epithelialized. Discussion Although successful NPWT has been reported for open abdominal wounds, ECF is a common complication. ECF can be prevented by separating the wound from the intestine by the omentum or muscle fascia, protecting the intestinal serosa during surgery, and applying low vacuum pressure. The relationships among the wound, the fascia, and the intestine must be evaluated before abdominal SSI treatment. One good method is CT woundgraphy, which evaluates wound extent and depth, closure of muscle fascia, and the relationship between the wound and the intestine. Conclusion We report a case of CT woundgraphy before NPWT for abdominal SSI. CT woundgraphy is a good candidate for evaluating wound condition. PMID:27002290

  12. Suction Drain Tip Culture after Spine Surgery: Can It Predict a Surgical Site Infection?

    PubMed Central

    Ahn, Jae-Sung; Park, Eugene; Park, Il-Young; Lee, Jae Won

    2015-01-01

    Study Design Retrospective clinical study. Purpose To assess the diagnostic value of suction drain tip culture in patients undergoing primary posterior spine surgery. Overview of Literature To date, the diagnostic value of suction drain tip culture for predicting surgical site infection (SSI) has not been firmly established in orthopedic or spinal surgery. Methods In total, 133 patients who underwent primary posterior spine surgery from January 2013 to April 2015 were included in this retrospective study. Patients diagnosed with infective disease or condition was excluded. The suction drain tip was cut off approximately 5 cm from its far end. The sample was sent to the microbiological laboratory of the hospital for culture analysis. Any signs of infection, such as wound discharge or dehiscence, fever, chills, or chronic pain, were recorded. The culture outcome, identification of bacteria, and postoperative transition of the serum C-reactive protein level were also recorded in all patients. The wounds were followed up for a minimum of 3 months. Results A positive drain tip culture was found in 48 patients (36.1%), of whom, 6 developed SSI. The sensitivity of drain tip culture for SSI after primary posterior spine surgery was 60.0%, and the specificity was 65.9%. The association between the incidence of positive suction tip culture and SSI was not statistically significant. Among the 48 positive drain tip cultures, there was no significant association between the occurrence of SSI and virulence of isolated bacteria. There was no significant association between drain tip culture positivity and the duration of drainage, or between the rate of SSI and duration of drainage. Conclusions Suction drain tip culture analysis is a poor predictor of SSI after primary posterior spine surgery. Routine use of a drain tip culture is not supported by the results of this study. PMID:26713117

  13. Comparative Effectiveness of Skin Antiseptic Agents in Reducing Surgical Site Infections: A Report from the Washington State Surgical Care and Outcomes Assessment Program

    PubMed Central

    Hakkarainen, Timo W; Dellinger, E Patchen; Evans, Heather L; Farjah, Farhood; Farrokhi, Ellen; Steele, Scott R; Thirlby, Richard; Flum, David R

    2015-01-01

    Background Surgical site infections (SSI) are an important source of morbidity and mortality. Chlorhexidine in isopropyl alcohol is effective in preventing central venous-catheter associated infections, but its effectiveness in reducing SSI in clean-contaminated procedures is uncertain. Surgical studies to date have had contradictory results. We aimed to further evaluate the relationship of commonly used antiseptic agents and SSI, and to determine if isopropyl alcohol had a unique effect. Study Design We performed a prospective cohort analysis to evaluate the relationship of commonly used skin antiseptic agents and SSI for patients undergoing mostly clean-contaminated surgery from January 2011 through June 2012. Multivariate regression modeling predicted expected rates of SSI. Risk adjusted event rates (RAERs) of SSI were compared across groups using proportionality testing. Results Among 7,669 patients the rate of SSI was 4.6%. The RAERs were 0.85 (p=0.28) for chlorhexidine (CHG), 1.10 (p=0.06) for chlorhexidine in isopropyl alcohol (CHG+IPA), 0.98 (p=0.96) for povidone-iodine (PVI) and 0.93 (p=0.51) for iodine-povacrylex in isopropyl alcohol (IPC+IPA). The RAERs were 0.91 (p=0.39) for the non-IPA group and 1.10 (p=0.07) for the IPA group. Among elective colorectal patients the RAERs were 0.90 (p=0.48) for CHG, 1.04 (p=0.67) for CHG+IPA, 1.04 (p=0.85) for PVI and 1.00 (p=0.99) for IPC+IPA. Conclusions For clean-contaminated surgical cases, this large-scale state cohort study does not demonstrate superiority of any commonly-used skin antiseptic agent in reducing the risk of SSI, nor does it find any unique effect of isopropyl alcohol. These results do not support the use of more expensive skin preparation agents. PMID:24364925

  14. Impact of wound edge protection devices on surgical site infection after laparotomy: multicentre randomised controlled trial (ROSSINI Trial)

    PubMed Central

    Calvert, Melanie; Bartlett, David C; Gheorghe, Adrian; Redman, Val; Dowswell, George; Hawkins, William; Mak, Tony; Youssef, Haney; Richardson, Caroline; Hornby, Steven; Magill, Laura; Haslop, Richard; Wilson, Sue; Morton, Dion

    2013-01-01

    Objective To determine the clinical effectiveness of wound edge protection devices in reducing surgical site infection after abdominal surgery. Design Multicentre observer blinded randomised controlled trial. Participants Patients undergoing laparotomy at 21 UK hospitals. Interventions Standard care or the use of a wound edge protection device during surgery. Main outcome measures Surgical site infection within 30 days of surgery, assessed by blinded clinicians at seven and 30 days and by patient’s self report for the intervening period. Secondary outcomes included quality of life, duration of stay in hospital, and the effect of characteristics of the patient and operation on the efficacy of the device. Results 760 patients were enrolled with 382 patients assigned to the device group and 378 to the control group. Six patients in the device group and five in the control group did not undergo laparotomy. Fourteen patients, seven in each group, were lost to follow-up. A total of 184 patients experienced surgical site infection within 30 days of surgery, 91/369 (24.7%) in the device group and 93/366 (25.4%) in the control group (odds ratio 0.97, 95% confidence interval 0.69 to 1.36; P=0.85). This lack of benefit was consistent across wound assessments performed by clinicians and those reported by patients and across all secondary outcomes. In the secondary analyses no subgroup could be identified in which there was evidence of clinical benefit associated with use of the device. Conclusions Wound edge protection devices do not reduce the rate of surgical site infection in patients undergoing laparotomy, and therefore their routine use for this role cannot be recommended. Trial registration Current Controlled Trials ISRCTN 40402832 PMID:23903454

  15. Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty

    PubMed Central

    Alfargieny, Randa; Bodalal, Zuhir; Bendardaf, Riyad; El-Fadli, Mustafa; Langhi, Salem

    2015-01-01

    Background: Surgical site infection (SSI) is considered one of the most serious complications in total joint arthroplasty (TJA). This study seeks to analyze the predictive value of preoperative and postoperative nutritional biomarkers for SSI in elective TJA. Methodology: Nutritional markers were gathered retrospectively utilizing patient's records from the orthopedics department at Benghazi Medical Center (BMC). The sample spanned cases admitted during the 20-month period between January 2012 and August 2013 and had undergone either elective total hip replacement or total knee replacement. The collected lab results included a complete blood count, total lymphocyte count (TLC), and serum albumin (S. alb.) levels. The patients were then divided into two groups based on the occurrence of an SSI. Results: A total of 135 total knee (81.5%, n = 110/135) and total hip (18.5%, n = 25/135) replacements were performed at BMC during the study period. Among these cases, 57% (n = 78/135) had patient records suitable for statistical analysis. The average preoperative TLC was 2.422 ×103 cells/mm3 (range = 0.8–4.7 ×103 cells/mm3) whereas that number dropped after the surgery to 1.694 ×103 cells/mm3 (range = 0.6–3.8 ×103 cells/mm3). S. alb. levels showed a mean of 3.973 g/dl (range = 2.9–4.7 g/dl) preoperatively and 3.145 g/dl (range = 1.0–4.1 g/dl) postoperatively. The majority of TJA patients did not suffer any complication (67.4%, n = 91/135) while eight cases (5.9%) suffered from a superficial SSI. Conclusion: Preoperative S. alb. was identified as the only significant predictor for SSI (P = 0.011). Being a preventable cause of postoperative morbidity, it is recommended that the nutritional status (especially preoperative S. alb.) of TJA patients be used as a screening agent and appropriate measures be taken to avoid SSI. PMID:26629466

  16. Wound Edge Protectors in Open Abdominal Surgery to Reduce Surgical Site Infections: A Systematic Review and Meta-Analysis

    PubMed Central

    Mihaljevic, André L.; Müller, Tara C.; Kehl, Victoria; Friess, Helmut; Kleeff, Jörg

    2015-01-01

    Importance Surgical site infections remain one of the most frequent complications following abdominal surgery and cause substantial costs, morbidity and mortality. Objective To assess the effectiveness of wound edge protectors in open abdominal surgery in reducing surgical site infections. Evidence Review A systematic literature search was conducted according to a prespecified review protocol in a variety of data-bases combined with hand-searches for randomized controlled trials on wound edge protectors in patients undergoing laparotomy. A qualitative and quantitative analysis of included trials was conducted. Findings We identified 16 randomized controlled trials including 3695 patients investigating wound edge protectors published between 1972 and 2014. Critical appraisal uncovered a number of methodological flaws, predominantly in the older trials. Wound edge protectors significantly reduced the rate of surgical site infections (risk ratio 0.65; 95%CI, 0.51–0.83; p = 0.0007; I2 = 52%). The results were robust in a number of sensitivity analyses. A similar effect size was found in the subgroup of patients undergoing colorectal surgery (risk ratio 0.65; 95%CI, 0.44–0.97; p = 0.04; I2 = 56%). Of the two common types of wound protectors double ring devices were found to exhibit a greater protective effect (risk ratio 0.29; 95%CI, 0.15–0.55) than single-ring devices (risk ratio 0.71; 95%CI, 0.54–0.92), but this might largely be due to the lower quality of available data for double-ring devices. Exploratory subgroup analyses for the degree of contamination showed a larger protective effect in contaminated cases (0.44; 95%CI, 0.28–0.67; p = 0.0002, I2 = 23%) than in clean-contaminated surgeries (0.72, 95%CI, 0.57–0.91; p = 0.005; I2 = 46%) and a strong effect on the reduction of superficial surgical site infections (risk ratio 0.45; 95%CI, 0.24–0.82; p = 0.001; I2 = 72%). Conclusions and Relevance Wound edge protectors significantly reduce the rate of

  17. Procedure-specific Surgical Site Infection Incidence Varies Widely within Certain National Healthcare Safety Network Surgery Groups

    PubMed Central

    Saeed, Mohammed J; Dubberke, Erik R; Fraser, Victoria J; Olsen, Margaret A

    2015-01-01

    Background The National Healthcare Safety Network (NHSN) classifies surgical procedures into 40 categories. The objective of this study was to determine surgical site infection (SSI) incidence for clinically defined subgroups within 5 heterogeneous NHSN surgery categories. Methods This is a retrospective cohort study using the longitudinal State Inpatient Database. We identified 5 groups of surgical procedures (amputation; biliary, liver and pancreas [BILI]; breast; colon and hernia) using ICD-9-CM procedure codes in community hospitals in California, Florida and New York from January 2009 through September 2011 in persons aged ≥18 years. Each of these 5 categories was classified to more specific surgical procedures within the group. 90-day SSI rates were calculated using ICD-9-CM diagnosis codes. Results There were 62,901 amputation, 33,358 BILI, 72,058 breast, 125,689 colon and 85,745 hernia surgeries in 349,298 people. 90-day SSI rates varied significantly within each of the 5 subgroups. Within the BILI category, bile duct, pancreas and laparoscopic liver procedures had SSI rates of 7.2%, 17.2%, and 2.2%, respectively (p<0.0001 for each) compared to open liver procedures (11.1% SSI). Conclusion 90-day SSI rates varied widely within certain NHSN categories. Risk adjustment for specific surgery type is needed in order to make valid comparisons between hospitals. PMID:25818024

  18. Prophylactic negative pressure wound therapy in colorectal surgery. Effects on surgical site events: current status and call to action.

    PubMed

    Pellino, Gianluca; Sciaudone, Guido; Selvaggi, Francesco; Canonico, Silvestro

    2015-09-01

    Surgical site events, including surgical site infections (SSI), represent a major problem in general surgery. SSI are responsible of nuisance for patients, and can lead to important complications and disability, often needing prolonged postoperative stay with specific treatment and recovery in Intensive Care Units. These justify the higher costs due to SSI. Despite the growing body of evidence concerning SSI in general surgery, literature dealing with SSI after colorectal surgery is scarce, reflecting in suboptimal perception of such a relevant issue by colorectal surgeons and health authorities in Italy, though colorectal surgery is associated with higher rates of SSI. The best strategy for reducing the impact of SSI on costs of care and patients quality of life would be the development of a preventive bundle, similar to that adopted in the US through the colorectal section of the National Surgery Quality Improvement Project of the American College of Surgeons (ACS-NSQIP). This policy has been showed to significantly reduce the rates of SSI. In this scenario, incisional negative pressure wound therapy (NPWT) is likely to play a pivotal role. We herein reviewed the literature to report on the current status of preventive NPWT on surgical wounds of patients undergoing colorectal procedures with primary wound closure, suggesting evidence-based measures to reduce the impact of SSI, and to contain the costs associated with conventional NPWT devices by means of newer available technologies. Some explicative real life cases are presented. PMID:25921360

  19. Pseudoangiomatous stromal hyperplasia (PASH) tumour at the surgical scar site in a patient of carcinoma breast.

    PubMed

    Abrari, Andleeb

    2011-01-01

    A patient on follow-up post surgery for carcinoma breast, presented with a nodule under the surgical scar. The sinister eventuality of recurrent carcinoma was clinically considered first. The lesion was biopsied and the histopathology was diagnostic of pseudoangiomatous stromal hyperplasia tumour. The nodule was excised and the patient's clinical denouement has been uneventful in the 4 months which have elapsed after this event. PMID:22688488

  20. A Journey to Zero: Reduction of Post-Operative Cesarean Surgical Site Infections over a Five-Year Period

    PubMed Central

    Hickson, Evelyn; Harris, Jeanette

    2015-01-01

    Abstract Background: Surgical site infections (SSI) are a substantial concern for cesarean deliveries in which a surgical site complication is most unwelcome for a mother with a new infant. Steps taken pre- and post-operatively to reduce the number of complications may be of substantial benefit clinically, economically, and psychologically. Methods: A risk-based approach to incision management was developed and implemented for all cesarean deliveries at our institution. A number of incremental interventions for low-risk and high-risk patients including pre-operative skin preparations, standardized pre- and post-operative protocols, post-operative nanocrystalline silver anti-microbial barrier dressings, and incisional negative pressure wound therapy (NPWT) were implemented sequentially over a 5-y period. A systematic clinical chart review of 4,942 patients spanning all cesarean deliveries between 2007–2012 was performed to determine what effects the interventions had on the rate of SSI for cesarean deliveries. Results: The percentage of SSI was reduced from 2.13% (2007) to 0.10% (2012) (p<0.0001). There were no substantial changes in the patient population risk factors over this time. As a result of the changes in incision management practice, a total of 92 cesarean post-operative SSIs were avoided: A total cost saving of nearly $5,000,000. Conclusion: Applying a clinical algorithm for assessing the risk of surgical site complication and making recommendations on pre-operative and post-operative incision management can result in a substantial and sustainable reduction in cesarean SSI. PMID:25826622

  1. Development of a surgical site infection (SSI) surveillance system, calculation of SSI rates and specification of important factors affecting SSI in a digestive organ surgical department.

    PubMed

    Kimura, Koji; Sawa, Akihiro; Akagi, Shinji; Kihira, Kenji

    2007-06-01

    We have developed an original system to conduct surgical site infection (SSI) surveillance. This system accumulates SSI surveillance information based on the National Nosocomial Infections Surveillance (NNIS) System and the Japanese Nosocomial Infections Surveillance (JNIS) System. The features of this system are as follows: easy input of data, high generality, data accuracy, SSI rate by operative procedure and risk index category (RIC) can be promptly calculated and compared with the current NNIS SSI rate, and the SSI rates and accumulated data can be exported electronically. Using this system, we monitored 798 patients in 24 operative procedure categories in the Digestive Organs Surgery Department of Mazda Hospital, Mazda Motor Corporation, from January 2004 through December 2005. The total number and rate of SSI were 47 and 5.89%, respectively. The SSI rates of 777 patients were calculated based on 15 operative procedure categories and Risk Index Categories (RIC). The highest SSI rate was observed in the rectum surgery of RIC 1 (30%), followed by the colon surgery of RIC3 (28.57%). About 30% of the isolated infecting bacteria were Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Using quantification theory type 2, the American Society of Anesthesiology score (4.531), volume of hemorrhage under operation (3.075), wound classification (1.76), operation time (1.352), and history of diabetes (0.989) increased to higher ranks as factors for SSI. Therefore, we evaluated this system as a useful tool in safety control for operative procedures. PMID:17760267

  2. Pattern of Bacterial Pathogens and Their Susceptibility Isolated from Surgical Site Infections at Selected Referral Hospitals, Addis Ababa, Ethiopia

    PubMed Central

    Mulugeta, Gebru; Fentaw, Surafael; Mihret, Amete; Hassen, Mulu; Abebe, Engida

    2016-01-01

    Background. The emergence of multidrug resistant bacterial pathogens in hospitals is becoming a challenge for surgeons to treat hospital acquired infections. Objective. To determine bacterial pathogens and drug susceptibility isolated from surgical site infections at St. Paul Specialized Hospital Millennium Medical College and Yekatit 12 Referral Hospital Medical College, Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted between October 2013 and March 2014 on 107 surgical site infected patients. Wound specimens were collected using sterile cotton swab and processed as per standard operative procedures in appropriate culture media; and susceptibility testing was done using Kirby-Bauer disc diffusion technique. The data were analyzed by using SPSS version 20. Result. From a total of 107 swabs collected, 90 (84.1%) were culture positive and 104 organisms were isolated. E. coli (24 (23.1%)) was the most common organism isolated followed by multidrug resistant Acinetobacter species (23 (22.1%)). More than 58 (75%) of the Gram negative isolates showed multiple antibiotic resistance (resistance ≥ 5 drugs). Pan-antibiotic resistance was noted among 8 (34.8%) Acinetobacter species and 3 (12.5%) E. coli. This calls for abstinence from antibiotic abuse. Conclusion. Gram negative bacteria were the most important isolates accounting for 76 (73.1%). Ampicillin, amoxicillin, penicillin, cephazoline, and tetracycline showed resistance while gentamicin and ciprofloxacin were relatively effective antimicrobials. PMID:27446213

  3. Cervical cancer with a rare umbilical metastases in prior surgical site

    PubMed Central

    Kharod, Shivam; Yeung, Anamaria; Fredenburg, Kristianna; Greenwalt, Julie

    2015-01-01

    Introduction Port-site metastasis of cervical cancer is a relatively rare occurrence, and has been reported in the published literature as a pre-terminal event. Presentation of case We present the case of a 52-year-old female who was diagnosed with cervical cancer after presenting to our institution’s hospital with urinary symptoms not relieved by multiple treatments with antibiotics. To fully evaluate the extent of disease, positron emission tomography-computed tomography imaging was obtained, showing an area of mildly increased fluorodeoxyglucose uptake in her umbilicus. While undergoing external-beam radiotherapy treatment for her cervical cancer, she began to experience pain in the umbilicus associated with a mass. A biopsy was taken, revealing metastatic cervical cancer at the site of a previous port-site incision for a cholecystectomy that the patient underwent 18 months before the finding. Discussion Port-site metastasis have been reported following kidney, bladder, and colon cancer resections, with reports of cervical cancer cases being exceedingly rare. Several hypotheses have emerged as potential explanations for port-site metastasis. Conclusion To our knowledge, this represents the first reported case of a port-site metastasis to an incision site created for an unrelated laparoscopic surgery, performed well in advance of the diagnosis of cervical cancer. PMID:26519808

  4. Patient Perspectives on Post-Discharge Surgical Site Infections: Towards a Patient-Centered Mobile Health Solution

    PubMed Central

    Sanger, Patrick C.; Hartzler, Andrea; Han, Sarah M.; Armstrong, Cheryl A. L.; Stewart, Mark R.; Lordon, Ross J.; Lober, William B.; Evans, Heather L.

    2014-01-01

    Background Post-discharge surgical site infections (SSI) are a major source of morbidity, expense and anxiety for patients. However, patient perceptions about barriers experienced while seeking care for post-discharge SSI have not been assessed in depth. We explored patient experience of SSI and openness to a mobile health (mHealth) wound monitoring “app” as a novel solution to address this problem. Methods Mixed method design with semi-structured interviews and surveys. Participants were patients who had post-discharge surgical wound complications after undergoing operations with high risk of SSI, including open colorectal or ventral hernia repair surgery. The study was conducted at two affiliated teaching hospitals, including an academic medical center and a level 1 trauma center. Results From interviews with 13 patients, we identified 3 major challenges that impact patients' ability to manage post-discharge surgical wound complications, including required knowledge for wound monitoring from discharge teaching, self-efficacy for wound monitoring at home, and accessible communication with their providers about wound concerns. Patients found an mHealth wound monitoring application highly acceptable and articulated its potential to provide more frequent, thorough, and convenient follow-up that could reduce post-discharge anxiety compared to the current practice. Major concerns with mHealth wound monitoring were lack of timely response from providers and inaccessibility due to either lack of an appropriate device or usability challenges. Conclusions Our findings reveal gaps and frustrations with post-discharge care after surgery which could negatively impact clinical outcomes and quality of life. To address these issues, we are developing mPOWEr, a patient-centered mHealth wound monitoring application for patients and providers to collaboratively bridge the care transition between hospital and home. PMID:25436912

  5. Capturing orthopaedic surgical site infection data and assessing dental recommendations with respect to total joint arthroplasty.

    PubMed

    Florschutz, Anthony V; Parsley, Brian S; Shapiro, Irving M

    2015-04-01

    Greater documentation of patient history and clinical course is crucial for identifying factors that can influence surgical outcomes. The Centers for Medicare and Medicaid Services have already begun public reporting of hospital data on readmission, complication, and infection rates and will soon launch a website to make physician-specific outcomes data public. The orthopaedic community has the opportunity to lead the way in ensuring that adequate and accurate data is collected to facilitate appropriate comparisons that are based on patients' true risk of complications and the complexity of treatment. Several studies have reported a link between oral pathogens and periprosthetic infection, although it remains unclear whether organisms unique to dental tissues are also present in osteoarthritic joints and tissues affected by periprosthetic joint infection. The American Academy of Orthopaedic Surgeons and the American Dental Association are aware of these concerns and have created guidelines for antibiotic prophylaxis in patients who have undergone total hip or knee arthroplasty and require high-risk dental procedures. Because these guidelines have received considerable criticism, recommendations that are based on scientific and case-controlled clinical studies and provide effective guidance on this important subject are needed. PMID:25808970

  6. Cardiothoracic surgical site phaeohyphomycosis caused by Bipolaris mould, multiple US states, 2008-2013: a clinical description.

    PubMed

    Vallabhaneni, Snigdha; Purfield, Anne E; Benedict, Kaitlin; Luvsansharav, Ulzii; Lockhart, Shawn R; Pham, Cau D; Pascoe, Neil; Heseltine, Gary; Chung, Wendy; Hall, Emily; Brust, Karen B; Wheeler, Charlotte F; Halpin, Alison Laufer; Park, Benjamin J

    2016-03-01

    Bipolaris mould surgical site infections (SSIs) are exceedingly rare. We describe 21 cases of Bipolaris SSIs in pediatric and adult cardiothoracic surgery patients at ten hospitals in Texas, Arkansas, and Florida during 2008-2013. Median case-patient age was 55 years (range: 3 days-82 years), and 19 (90%) were male. Ten (48%) had coronary artery bypass or valve surgery, and seven (33%) had heart transplantation. Fifteen (71%) had more than one cardiothoracic procedure (median: 3, range: 1-11). Thirteen (62%) case-patients (all 5 pediatric patients, and 8 (50%) of 16 adult patients) had delayed sternal closure (chest closed >1 day [median = 8 days; range: 2-22] following the initial cardiothoracic procedure). Thirteen (62%) had mediastinitis. Median time from initial surgery to positive Bipolaris culture was 20 days (range: 6-497). Sixteen (76%) case-patients died. PMID:26705838

  7. Isolated port-site metastasis after surgical staging for low-risk endometrioid endometrial cancer: A case report

    PubMed Central

    MAUTONE, DANIELE; DALL'ASTA, ANDREA; MONICA, MICHELA; GALLI, LETIZIA; CAPOZZI, VITO ANDREA; MARCHESI, FEDERICO; GIORDANO, GIOVANNA; BERRETTA, ROBERTO

    2016-01-01

    Port-site metastases (PSMs) are well-known potential complications of laparoscopic surgery for gynaecologic malignancies. The present case study reports PSM following laparoscopic surgery for Stage IA Grade 1 endometrioid endometrial cancer (EEC). The recurrence developed within 7 months following primary surgery and required surgical excision followed by adjuvant chemo-radio therapy. After 9 months, the patient remains disease-free. PSMs are rare complications following laparoscopic surgery. Amongst the 23 cases of endometrial cancer PSMs reported so far, only 4 followed EEC Stage IA Grade 1–2. The present study reports a rare case of PSM after Stage IA Grade 1 EEC. The clinical and prognostic relevance of PSMs has not been identified so far; and it is not known whether PSMs represent a local recurrence or a systemic recurrence. Surgeons should be aware that even low-risk EEC may be followed by PSMs and should take steps to prevent these rare recurrences. PMID:27347138

  8. Receptor binding sites for substance P in surgical specimens obtained from patients with ulcerative colitis and Crohn disease

    SciTech Connect

    Mantyh, C.R.; Gates, T.S.; Zimmerman, R.P.; Welton, M.L.; Passaro, E.P. Jr.; Vigna, S.R.; Maggio, J.E.; Kruger, L.; Mantyh, P.W.

    1988-05-01

    Several lines of evidence indicate that tachykinin neuropeptides (substance P (SP), substance K (SK), and neuromedin K (NK)) play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. In all cases, specimens were processed for quantitative receptor autoradiography by using /sup 125/I-labeled Bolton-Hunter conjugates of NK, SK, and SP. In colon tissue obtained from ulcerative colitis and Crohn disease patients, very high concentrations of SP receptor binding sites are expressed by arterioles and venules located in the submucosa, muscalairs mucosa, external circular muscle, external longitudinal muscle, and serosa, in contrast to control patients. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations by cells involved in mediating inflammatory and immune responses. These data suggest that SP may be involved in the pathophysiology of inflammatory bowel disease and might provide some insight into the interaction between the nervous system and the regulation of inflammation and the immune response in human inflammatory disease.

  9. Paleomagnetism on the Quaternary marine sediment at the DH-1 long-core site in the Korean continental margin of the East Sea

    NASA Astrophysics Data System (ADS)

    Ryang, Woo Hun; Lee, Byungju

    2014-05-01

    A long core of 23.6 m was acquired in the Korean continental margin of the western East Sea. The core site of the DH-1 is located in the offshore of the Donghae City and the water depth is 357.8 m deep. In this area, the paleomagnetism and magnetostratigraphy were firstly reported using 420 samples collected from the long-core sediments. Based on the inclination distribution of the depositional remanent magnetization, the DH-1 core could be divided into two upper and lower units at the boundary of 1750 cm below seafloor. The upper unit is characterized by a positive polarity, whereas the lower unit by a negative polarity. The boundary of the upper and lower units was interpreted as the Brunhes-Matuyama boundary (778 ka). The chemical components of tephra layer at 2014 cm below seafloor belong to alkaline series, plotted between the tephra components of the Mount Baekdu and Ulleung Island. Key words: magnetostratigraphy, Brunhes-Matuyama boundary, tephra, East Sea Acknowledgements: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2010-0025733) and by the Ministry of Knowledge Economy through the grant of Marine Geology and Geophysical Mapping Project (GP2010-013).

  10. Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT

    PubMed Central

    Chaboyer, Wendy; Anderson, Vinah; Webster, Joan; Sneddon, Anne; Thalib, Lukman; Gillespie, Brigid M.

    2014-01-01

    Obese women undergoing caesarean section (CS) are at increased risk of surgical site infection (SSI). Negative Pressure Wound Therapy (NPWT) is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT) assessed the effect of NPWT on SSI and other wound complications in obese women undergoing elective caesarean sections (CS) and also the feasibility of conducting a definitive trial. Ninety-two obese women undergoing elective CS were randomized in theatre via a central web based system using a parallel 1:1 process to two groups i.e., 46 women received the intervention (NPWT PICO™ dressing) and 46 women received standard care (Comfeel Plus® dressing). All women received the intended dressing following wound closure. The relative risk of SSI in the intervention group was 0.81 (95% CI 0.38–1.68); for the number of complications excluding SSI it was 0.98 (95% CI 0.34–2.79). A sample size of 784 (392 per group) would be required to find a statistically significant difference in SSI between the two groups with 90% power. These results demonstrate that a larger definitive trial is feasible and that careful planning and site selection is critical to the success of the overall study.

  11. Reducing surgical site infection incidence through a network: results from the French ISO-RAISIN surveillance system.

    PubMed

    Astagneau, P; L'Hériteau, F; Daniel, F; Parneix, P; Venier, A-G; Malavaud, S; Jarno, P; Lejeune, B; Savey, A; Metzger, M-H; Bernet, C; Fabry, J; Rabaud, C; Tronel, H; Thiolet, J-M; Coignard, B

    2009-06-01

    Surgical-site infections (SSIs) are a key target for nosocomial infection control programmes. We evaluated the impact of an eight-year national SSI surveillance system named ISO-RAISIN (infection du site opératoire - Réseau Alerte Investigation Surveillance des Infections). Consecutive patients undergoing surgery were enrolled during a three-month period each year and surveyed for 30 days following surgery. A standardised form was completed for each patient including SSI diagnosis according to standard criteria, and several risk factors such as wound class, American Society of Anesthesiologists (ASA) score, operation duration, elective/emergency surgery, and type of surgery. From 1999 to 2006, 14,845 SSIs were identified in 964,128 patients (overall crude incidence: 1.54%) operated on in 838 participating hospitals. The crude overall SSI incidence decreased from 2.04% to 1.26% (P<0.001; relative reduction: -38%) and the National Nosocomial Infections Surveillance system (NNIS)-0 adjusted SSI incidence from 1.10% to 0.74% (P<0.001; relative reduction: -33%). The most significant SSI incidence reduction was observed for hernia repair and caesarean section, and to a lesser extent, cholecystectomy, hip prosthesis arthroplasty, and mastectomy. Active surveillance striving for a benchmark throughout a network is an effective strategy to reduce SSI incidence. PMID:19380181

  12. A Colorectal “Care Bundle” to Reduce Surgical Site Infections in Colorectal Surgeries: A Single-Center Experience

    PubMed Central

    Lutfiyya, Waleed; Parsons, David; Breen, Juliann

    2012-01-01

    Background: Kaiser Sunnyside Medical Center has participated in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) since January 2006. Data on general and colorectal surgical site infections (SSIs) demonstrated a need for improvement in SSI rates. Objective: To evaluate application of a “care bundle” for patients undergoing colorectal operations, with the goal of reducing overall SSI rates. Methods: We prospectively implemented multiple interventions, with retrospective analysis of data using the NSQIP database. The overall, superficial, deep, and organ/space SSI rates were compared before and after implementation of this colorectal care bundle. Results: Between January 2006 and December 2009, there were 430 colorectal cases in our NSQIP report with 91 infections, an overall rate of 21.16%. Between January 2010, when the colorectal care bundle was implemented, and June 2011, there were 195 cases and 13 infections, a 6.67% overall rate. The absolute decrease of 14.49% is significant (p < 0.0001). The rate of superficial SSI decreased from 15.12% to 3.59% (p < 0.0001). The rates for deep and organ/space SSI also showed a decrease; however, this was not statistically significant. The NSQIP observed-to-expected ratio for colorectal SSI decreased from a range of 1.27 to 1.83 before implementation to 0.54 after implementation (fiscal year 2010). Conclusions: Our institution was a NSQIP high outlier in general surgery SSIs and had a high proportion of these cases represented in colorectal cases. By instituting a care bundle composed of core and adjunct strategies, we significantly decreased our rate of colorectal SSIs. PMID:23012593

  13. Does the Application of Incisional Negative Pressure Therapy to High-Risk Wounds Prevent Surgical Site Complications? A Systematic Review

    PubMed Central

    Ingargiola, Michael J.; Daniali, Lily N.; Lee, Edward S.

    2013-01-01

    Purpose: The application of incisional negative pressure wound therapy (INPWT) to clean, closed surgical incisions is a growing clinical practice. A systematic review was conducted to evaluate the effect of INPWT on surgical sites healing by primary intention. The primary outcomes of interest are incidence of complications (infection, dehiscence, seroma, hematoma, skin necrosis, or blistering). Methods: Two independent reviewers performed a search of the Ovid MEDLINE and EMBASE databases from 2006 to 2012 for published articles. Supplemental searches were performed using reference lists and conference proceedings. Studies were selected for inclusion based on predetermined inclusion and exclusion criteria. Data extraction regarding study quality, demographic and clinical characteristics, and outcomes was performed independently, and data on the incidence of infection was combined using a fixed-effects meta-analysis model. Results: Ten (5 randomized controlled trials and 5 observational) studies were included, which investigated the outcomes of 626 incisions on 610 patients. Six studies compared INPWT with sterile dry dressings (SDDs). The literature shows a significant decrease in rates of infection when using INPWT. Results on dehiscence do show a decrease in some studies, but results are inconsistent to make a conclusion. Because of limited studies, it is difficult to make any assertions on seroma, hematoma, and skin necrosis. Conclusions: This systematic review shows possible evidence of a decrease in the incidence of infection with application of INPWT. Looking at other variables such as dehiscence, seroma, hematoma, and skin necrosis show no consistent data and suggest further studies in order for proper recommendations for INPWT. PMID:24106562

  14. Laparo-endoscopic single site surgery in pediatrics: Feasibility and surgical outcomes from a preliminary prospective Canadian experience

    PubMed Central

    Khambati, Aziz; Wehbi, Elias; Farhat, Walid A.

    2015-01-01

    Introduction: Laparo-endoscopic single-site surgery (LESS) is becoming an alternative to standard laparoscopic surgery. Proposed advantages include enhanced cosmesis and faster recovery. We assessed the early post-operative surgical outcomes of LESS surgery utilizing different instruments in the pediatric urological population in Canada. Methods: We prospectively captured data on all patients undergoing LESS at our institution between February 2011 and August 2012. This included patient age, operative time, length of stay, complications and short-term surgical outcomes. Different instruments/devices were used to perform the procedures. Access was achieved through a transumbilical incision. Results: A total of 16 LESS procedures were performed, including seven pyeloplasties, four unilateral and one bilateral varicocelectomies, two simple nephrectomies, one renal cyst decortication and one pyelolithotomy. There was no statistical difference in the operative times, hospital length of stay and cost (pyeloplasty only) in patients undergoing pyeloplasty and varicocelectomy using the LESS technique when compared to an age matched cohort of patients managed with the traditional laparoscopic approach. One pyeloplasty in the LESS group required conversion to open due to a small intra-renal pelvis. There were no immediate or short term post-operative complications; however, one patient experienced a decrease in renal function status post LESS pyeloplasty. Since all procedures were performed by a vastly experienced surgeon at a tertiary center, the generalizability of the results cannot be assessed. Conclusions: There are only a few series that have assessed the role of LESS in pediatric urological surgery. Although our experience is limited by a heterogeneous group of patients with a short follow-up period, the present cohort demonstrates the safety and feasibility of LESS. Further evaluation with randomized studies is required to better assess the role of LESS in pediatric

  15. Judicious use of prophylactic antimicrobials to reduce abdominal surgical site infections in periparturient cows: part 1 - a risk factor review.

    PubMed

    Dumas, S E; French, H M; Lavergne, S N; Ramirez, C R; Brown, L J; Bromfield, C R; Garrett, E F; French, D D; Aldridge, B M

    2016-06-25

    Surgical site infections (SSI) are an uncommon, but significant, consequence of surgical interventions. There are very few studies investigating SSI risk in veterinary medicine, and even fewer in cattle, despite the fact that major surgeries are commonly conducted on livestock. Furthermore, the suboptimal conditions under which such surgeries are frequently performed on livestock could be considered an important risk factor for the development of SSIs. With increasing public concern over the contribution of veterinary-prescribed antimicrobials to the emergence of antimicrobial-resistant bacteria in people, there is widespread scrutiny and criticism of antimicrobial use in livestock production medicine systems. While the causal link between antimicrobial resistance in livestock and people is heavily debated, it is clear that the prevalence of antimicrobial resistance, in any population, is closely correlated with the antimicrobial 'consumption' within that population. As the veterinary profession explores ways of addressing the emergence and selection of antimicrobial-resistant bacteria in food-producing animals, there is a need for veterinarians and producers to carefully consider all areas of antimicrobial use, and employ an evidence-based approach in designing appropriate clinical protocols. This paper aims to review current knowledge regarding the risk factors related to abdominal SSI in periparturient cows, and to encourage practitioners to judiciously evaluate both their standard operating procedures and their use of antimicrobials in these situations. In a second paper, to be published in a subsequent issue of Veterinary Record, these principles will be used to provide specific evidence-based recommendations for antimicrobial use in bovine abdominal surgery. PMID:27339926

  16. Impact of an Automated Surveillance to Detect Surgical-Site Infections in Patients Undergoing Total Hip and Knee Arthroplasty in Brazil.

    PubMed

    Perdiz, Luciana B; Yokoe, Deborah S; Furtado, Guilherme H; Medeiros, Eduardo A S

    2016-08-01

    In this retrospective study, we compared automated surveillance with conventional surveillance to detect surgical site infection after primary total hip or knee arthroplasty. Automated surveillance demonstrated better efficacy than routine surveillance in SSI diagnosis, sensitivity, and predictive negative value in hip and knee arthroplasty. Infect Control Hosp Epidemiol 2016;37:991-993. PMID:27072598

  17. PTEN, RASSF1 and DAPK site-specific hypermethylation and outcome in surgically treated stage I and II nonsmall cell lung cancer patients.

    PubMed

    Buckingham, Lela; Penfield Faber, L; Kim, Anthony; Liptay, Michael; Barger, Carter; Basu, Sanjib; Fidler, Mary; Walters, Kelly; Bonomi, Philip; Coon, John

    2010-04-01

    The primary objective of this study is to identify prognostic site-specific epigenetic changes in surgically treated Stage I and II nonsmall cell lung cancer (NSCLC) patients by quantifying methylation levels at multiple CpG sites within each gene promoter. Paraffin-embedded tumors from stage Ib, IIa and IIb in training and validation groups of 75 and 57 surgically treated NSCLC patients, respectively, were analyzed for p16, MGMT, RASSF1, RASSF5, CDH1, LET7, DAPK and PTEN promoter hypermethylation. Hypermethylation status was quantified individually at multiple CpG sites within each promoter by pyrosequencing. Molecular and clinical characteristics with time to recurrence (TTR) and overall survival (OS) were evaluated. Overall average promoter methylation levels of MGMT and RASSF1 were significantly higher in smokers than in nonsmokers (p = 0.006 and p = 0.029, respectively). Methylation levels of the p16 promoter were significantly higher in squamous cell carcinoma than in adenocarcinoma (p = 0.020). In univariate analysis, hypermethylation of RASSF1 at CpG sites -53 and -48 and PTEN at CpG site -1310 were the significantly associated with shorter TTR (p = 0.002 and p < 0.000, respectively). Hypermethylation of PTEN at -1310 and DAPK at -1482 were most significantly associated with outcome in multivariate analysis. These results show that methylation of specific promoter CpG sites in PTEN, RASSF1 and DAPK is associated with outcome in early stage surgically treated NSCLC. PMID:19795445

  18. Simulation of topographic effects on seismic waves from shallow explosions near the North Korean nuclear test site with emphasis on shear wave generation

    NASA Astrophysics Data System (ADS)

    Rodgers, Arthur J.; Petersson, N. Anders; Sjogreen, Bjorn

    2010-11-01

    We performed high-resolution (8 Hz) three-dimensional simulations of ground motions from shallow explosions in the presence of rough surface topography near the North Korean nuclear test site to study elastic propagation effects with emphasis on theoretical aspects of shear wave generation. Interaction with rough topography causes significant P-to-Rg scattering along the surface with amplification of high-frequency (2-8 Hz) shear waves relative to the flat Earth case. Shear waves of different polarizations are coupled by topographic scattering. Rg precursors composed of P-to-Rg conversions traveling as surface waves have the spectral amplitudes comparable to the P wave, while the Rg phase has the low-frequency (0.5-3 Hz) spectral shape of the Rg from the flat case plus the high-frequency (3-8 Hz) P wave spectra. Motions at near-vertical takeoff angles corresponding to teleseismic propagation are increased or decreased indicating that waves are focused or defocused by topographic features above the source. Topographic roughness has a dramatic effect as short-wavelength features (<2-5 km) are included. Higher frequencies are amplified by topography, including frequencies corresponding to wavelengths shorter than the shortest topographic scale length. Overall topography enhances energy propagating along the surface near the source, amplifies surface waves, and tends to balance SV- and SH-polarized motions, all of which impact shear wave observations used for nuclear explosion monitoring. Further simulation studies could elucidate how the wavefield emerging from a topographically rough area ultimately propagates to regional and/or teleseismic distances.

  19. Surgical site infection prevention: a survey to identify the gap between evidence and practice in University of Toronto teaching hospitals

    PubMed Central

    Eskicioglu, Cagla; Gagliardi, Anna R.; Fenech, Darlene S.; Forbes, Shawn S.; McKenzie, Marg; McLeod, Robin S.; Nathens, Avery B.

    2012-01-01

    Background A gap exists between the best evidence and practice with regards to surgical site infection (SSI) prevention. Awareness of evidence is the first step in knowledge translation. Methods A web-based survey was distributed to 59 general surgeons and 68 residents at University of Toronto teaching hospitals. Five domains pertaining to SSI prevention with questions addressing knowledge of prevention strategies, efficacy of antibiotics, strategies for changing practice and barriers to implementation of SSI prevention strategies were investigated. Results Seventy-six individuals (60%) responded. More than 90% of respondents stated there was evidence for antibiotic prophylaxis and perioperative normothermia and reported use of these strategies. There was a discrepancy in the perceived evidence for and the self-reported use of perioperative hyperoxia, omission of hair removal and bowel preparation. Eighty-three percent of respondents felt that consulting published guidelines is important in making decisions regarding antibiotics. There was also a discrepancy between what respondents felt were important strategies to ensure timely administration of antibiotics and what strategies were in place. Checklists, standardized orders, protocols and formal surveillance programs were rated most highly by 75%–90% of respondents, but less than 50% stated that these strategies were in place at their institutions. Conclusion Broad-reaching initiatives that increase surgeon and trainee awareness and implementation of multifaceted hospital strategies that engage residents and attending surgeons are needed to change practice. PMID:22617541

  20. Prevention of Incisional Surgical Site Infection Using a Subcuticular Absorbable Suture in Elective Surgery for Gastrointestinal Cancer

    PubMed Central

    Bou, Hideki; Suzuki, Hideyuki; Maejima, Kentarou; Uchida, Eiji; Tokunaga, Akira

    2015-01-01

    This study examined whether subcuticular absorbable sutures actually reduce incisional SSI in patients undergoing surgery for gastrointestinal (GI) cancer. Surgical site infection (SSI) is still a source of major complications in digestive tract surgery. Reportedly, incisional SSI can be reduced using subcuticular suturing. We performed subcuticular suturing using a 4-0 absorbable monofilament in patients undergoing elective surgery for GI cancer beginning in 2008. Using an interrupted technique, sutures were placed 1.5-2.0cm from the edge of the wound, with everted subcuticular sutures created at intervals of 1.5-2.0cm. The control group consisted of cases in which the common subcutaneous suture method using clip. One hundred cases were examined in the subcuticular group. The incidence of SSI was 0% in the subcuticular suture group, compared with 13.9% in the control group; this difference was significant. Incisional SSI can be prevented using the devised subcuticular absorbable sutures in patients undergoing elective surgery for GI cancer. PMID:26414820

  1. Abortion - surgical

    MedlinePlus

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... problem. Your pregnancy is harmful to your health (therapeutic abortion). The pregnancy resulted after a traumatic event ...

  2. History of Korean Neurosurgery.

    PubMed

    Hwang, Sung-nam

    2015-08-01

    The year 2012 was the 50th anniversary of the Korean Neurosurgical Society, and in 2013, the 15th World Congress of Neurosurgery took place in Seoul, Korea. Thus, it is an appropriate occasion to introduce the world to the history of the Korean Neurosurgical Society and the foundation, development, and growth of Korean neurosurgery. Historical materials and pictures were collected and reviewed from the history book and photo albums of the Korean Neurosurgical Society. During the last 50 years, the Korean Neurosurgical Society and Korean neurosurgery have developed and grown enormously not only in quantity but also in quality. In every aspect, the turning point from the old to the new era of the Korean Neurosurgical Society and Korean neurosurgery was the year 1980. PMID:25064423

  3. Performance evaluation and validation of ecological indices toward site-specific application for varying benthic conditions in Korean coasts.

    PubMed

    Ryu, Jongseong; Hong, Seongjin; Chang, Won Keun; Khim, Jong Seong

    2016-01-15

    Although several ecological indices have been developed worldwide to assess the ecological quality (EcoQ) status of coastal environments, their applicability remains in question. The present study evaluated the performance of 14 univariate and multivariate indices selected to provide a good description of benthic EcoQ status. We specifically investigated on i) spatial and regional variability, ii) (dis)similarity between ecological indices, and iii) the association of selected indices against heavy metal pollution. Benthic community data were collected from six coastal regions of Korea (n=365) that have varying land-use activity in adjacent inland areas (municipal, industrial, and rural). Abiotic sedimentary parameters were also considered as possible pressures associated with benthic community responses, including grain size, organic carbon content, and heavy metal pollution. The macrozoobenthic biodiversity and EcoQ results generally well reflected the geographical settings and the pollution gradient of heavy metals between regions. Among the six selected indices (H', AMBI, BPI, BQI, EQR, and M-AMBI), BPI appeared to be the most tolerant index, with >90% of locations being classified as "High" to "Good" while EQR showed the clear classification across the EcoQ status range. Significant disagreement between BQI vs. AMBI, BPI vs. M-AMBI, and AMBI vs. M-AMBI were found. Overall, single or limited indices seemed to over- or underestimate the given benthic conditions, warranting the use of site-specific indices at specific areas and/or locations. In conclusion, our study demonstrates the utility of applying different ecological or multivariate indices to infer the general ecological status of specific sites to gauge the extent of sedimentary pollution. PMID:26473716

  4. Perioperative oxygen fraction – effect on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial. Rationale and design of the PROXI-Trial

    PubMed Central

    Meyhoff, Christian S; Wetterslev, Jørn; Jorgensen, Lars N; Henneberg, Steen W; Simonsen, Inger; Pulawska, Therese; Walker, Line R; Skovgaard, Nina; Heltø, Kim; Gocht-Jensen, Peter; Carlsson, Palle S; Rask, Henrik; Karim, Sharaf; Carlsen, Charlotte G; Jensen, Frank S; Rasmussen, Lars S

    2008-01-01

    Background A high perioperative inspiratory oxygen fraction may reduce the risk of surgical site infections, as bacterial eradication by neutrophils depends on wound oxygen tension. Two trials have shown that a high perioperative inspiratory oxygen fraction (FiO2 = 0.80) significantly reduced risk of surgical site infections after elective colorectal surgery, but a third trial was stopped early because the frequency of surgical site infections was more than doubled in the group receiving FiO2 = 0.80. It has not been settled if a high inspiratory oxygen fraction increases the risk of pulmonary complications, such as atelectasis, pneumonia and respiratory failure. The aim of our trial is to assess the potential benefits and harms of a high perioperative oxygen fraction in patients undergoing abdominal surgery. Methods and design The PROXI-Trial is a randomized, patient- and assessor blinded trial of perioperative supplemental oxygen in 1400 patients undergoing acute or elective laparotomy in 14 Danish hospitals. Patients are randomized to receive either 80% oxygen (FiO2 = 0.80) or 30% oxygen (FiO2 = 0.30) during surgery and for the first 2 postoperative hours. The primary outcome is surgical site infection within 14 days. The secondary outcomes are: atelectasis, pneumonia, respiratory failure, re-operation, mortality, duration of postoperative hospitalization, and admission to intensive care unit. The sample size allows detection of a 33% relative risk reduction in the primary outcome with 80% power. Discussion This trial assesses benefits and harms of a high inspiratory oxygen fraction, and the trial may be generalizable to a general surgical population undergoing laparotomy. Trial registration ClinicalTrials.gov identifier: NCT00364741. PMID:18945347

  5. Early Korean War Coverage.

    ERIC Educational Resources Information Center

    Lee, Raymond S. H.

    1978-01-01

    Examines the themes of the war front news reported in certain South Korean and United States newspapers during the first 16 days of the Korean War; attempts to determine significant differences in the themes of war front news between the Korean and United States papers. (Author/GT)

  6. Molecular characterization of Korean rabies virus isolates

    PubMed Central

    Park, Young-Nam; Hong, Gyeong-Soo; Kang, Hee-Kyung; Oh, Yoon-I; Cho, Soo-Dong; Song, Jae-Young

    2011-01-01

    The nucleoprotein (N) and glycoprotein (G) of 11 Korean rabies virus (RABV) isolates collected from animals diagnosed with rabies between 2008 and 2009 were subjected to molecular and phylogenetic analyses. Six isolates originated from domestic animals (cattle and dogs) and five were obtained from wild free-ranging raccoon dogs. The similarities in the nucleotide sequences of the N gene among all Korean isolates ranged from 98.1 to 99.8%, while those of the G gene ranged from 97.9 to 99.3%. Based on the nucleotide analysis of the N and G genes, the Korean RABV isolates were confirmed as genotype I of Lyssavirus and classified into four distinct subgroups with high similarity. Phylogenetic analysis showed that the Korean isolates were most closely related to the non-Korean NeiMeng1025B and 857r strains, which were isolated from rabid raccoon dogs in Eastern China and Russia, respectively. These findings suggest that the Korean RABV isolates originated from a rabid raccoon dog in Northeastern Asia. Genetic analysis of the Korean RABV isolates revealed no substitutions at several antigenic sites, indicating that the isolates circulating in Korea may be pathogenic in several hosts. PMID:21368564

  7. Abortion - surgical

    MedlinePlus

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  8. Surgical site infection after colorectal surgery according to the main anesthetic agent: a retrospective comparison between volatile anesthetics and propofol

    PubMed Central

    Koo, Bon-Wook; Sim, Jun-Bo; Shin, Hyun-Jung; Kim, Duck-Woo; Kang, Sung-Bum; Do, Sang-Hwan

    2016-01-01

    Background Anesthetic agents used for general anesthesia are emerging possible influential factors for surgical site infection (SSI). In this retrospective study, we evaluated the incidence of SSI after colorectal surgery according to the main anesthetic agents: volatile anesthetics vs. propofol. Methods A total 1,934 adult patients, who underwent elective colorectal surgery under general anesthesia between January 2011 and December 2013, were surveyed to evaluate the incidence of SSI: 1,519 using volatile anesthetics and 415 using propofol for main anesthetic agents. Patient, surgery, and anesthesia-related factors were investigated from all patients. Propensity-score matching was performed to reduce the risk of confounding and produced 390 patients in each group. Results Within the propensity-score matched groups, the incidence of SSI was higher in the volatile group compared with the propofol group (10 [2.6%] vs. 2 [0.5%], OR = 5.0 [95% CI = 1.1-2.8]). C-reactive protein was higher in the volatile group than in the propofol group (8.4 ± 5.6 vs. 7.1 ± 5.3 mg/dl, P = 0.001), and postoperative white blood cells count was higher in the volatile group than in the propofol group (9.2 ± 3.2 × 103/µl vs. 8.6 ± 3.4 × 103/µl, P = 0.041). Conclusions The results of this study suggest that intravenous anesthesia may have beneficial effects for reducing SSI in colorectal surgery compared to volatile anesthesia. PMID:27482309

  9. Insulin Treatment Directly Restores Neutrophil Phagocytosis and Bactericidal Activity in Diabetic Mice and Thereby Improves Surgical Site Staphylococcus aureus Infection

    PubMed Central

    Yano, Hidekazu; Fujino, Keiichi; Nakashima, Masahiro; Yamamoto, Yoritsuna; Miyazaki, Hiromi; Hamada, Koji; Ono, Satoshi; Iwaya, Keiichi; Saitoh, Daizoh; Seki, Shuhji; Tanaka, Yuji

    2012-01-01

    Bacterial infections, including surgical site infections (SSI), are a common and serious complication of diabetes. Staphylococcus aureus, which is eliminated mainly by neutrophils, is a major cause of SSI in diabetic patients. However, the precise mechanisms by which diabetes predisposes to staphylococcal infection are not fully elucidated. The effect of insulin on this infection is also not well understood. We therefore investigated the effect of insulin treatment on SSI and neutrophil function in diabetic mice. S. aureus was inoculated into the abdominal muscle in diabetic db/db and high-fat-diet (HFD)-fed mice with or without insulin treatment. Although the diabetic db/db mice developed SSI, insulin treatment ameliorated the infection. db/db mice had neutrophil dysfunction, such as decreased phagocytosis, superoxide production, and killing activity of S. aureus; however, insulin treatment restored these functions. Ex vivo treatment (coincubation) of neutrophils with insulin and euglycemic control by phlorizin suggest that insulin may directly activate neutrophil phagocytic and bactericidal activity independently of its euglycemic effect. However, insulin may indirectly restore superoxide production by neutrophils through its euglycemic effect. HFD-fed mice with mild hyperglycemia also developed more severe SSI by S. aureus than control mice and had impaired neutrophil phagocytic and bactericidal activity, which was improved by insulin treatment. Unlike db/db mice, in HFD mice, superoxide production was increased in neutrophils and subsequently suppressed by insulin treatment. Glycemic control by insulin also normalized the neutrophil superoxide-producing capability in HFD mice. Thus, insulin may restore neutrophil phagocytosis and bactericidal activity, thereby ameliorating SSI. PMID:23027538

  10. Minimal inhibitory concentration of microorganisms causing surgical site infection in referral hospitals in North of Iran, 2011-2012

    PubMed Central

    Alikhani, Ahmad; Babamahmoodi, Farhang; Foroutan Alizadegan, Laleh; Shojaeefar, Arman; Babamahmoodi, Abdolreza

    2015-01-01

    Background: A surgical site infection (SSI) is the most common nosocomial infection after surgery and is the third most common infection in hospitalized patients. The aim of this study was to asses minimum inhibitory concentration (MIC) of the causing agents of SSI and antimicrobial susceptibility patterns. Methods: This cross-sectional study was done in three referral hospitals in North of Iran during 2011-2012. The samples were taken one month after orthopedic, abdominal, cesarean section surgery and coronary artery bypass graft (CABG) in patients with scores compatible to SSIs criteria. The sample was sent for bacteriologic culture and MIC determination for positive cases by broth microdilution method. The data were collected and analyzed. Results: From 103 positive cases S. aureus, E.coli and coagulase negative staphylococci were the most common isolated agents as 29.12%, 23.3% and 21.3%, respectively. S. aureus was sensitive to vancomycin (70%), amikacin (70%) and teicoplanin (76.6%) and cogulase negative staphylococci was sensitive to vancomycin (68.1%) and teicoplanin (72.6%) and E.coli to amikacin (95.83%) and imipenem and meropenem (66.66%). P.aeroginosa showed no sensitivity to cefepime and was sensitive to imipenem (93.75%) and meropenem (81.25%). Conclusion: The most important point is worrisome problem of the increased MIC of S. aureus to vancomycin that causes difficult use in the treatment of staphylococcal SSIs. In spite of resistance of micro-organisms to cephalosporins, gram negative organisms had low MIC to carbapenemes especially P.aeroginosa although the rate of its MIC is increasing. PMID:26221495

  11. Bacteriological Profile of Surgical Site Infections and Their Antibiogram: A Study From Resource Constrained Rural Setting of Uttarakhand State, India

    PubMed Central

    Negi, Vikrant; Pal, Shekhar; Sharma, Munesh Kumar; Sharma, Neelam

    2015-01-01

    Introduction Surgical site infections (SSI) constitute a major public health problem worldwide and are the second most frequently reported nosocomial infections. They are responsible for increasing the treatment cost, length of hospital stay and significant morbidity and mortality. Aim To determine the incidence of SSIs and the prevalence of aerobic bacterial pathogens involved with their antibiogram. Materials and Methods Samples were collected using sterile cotton swabs from 137 patients clinically diagnosed of having SSIs and were processed as per standard microbiological techniques. Antimicrobial susceptibility testing was done using modified Kirby-Bauer disc diffusion method. This cross sectional study was conducted for a period of six months (January 2013 to June 2013) in the Department of Microbiology at a rural tertiary care hospital of Uttarakhand state, India. Results Out of 768 patients, 137 (17.8%) were found to have SSIs and samples were collected from them. Out of total 137 samples, 132 (96.4%) yielded bacterial growth and 139 bacterial isolates were obtained. Staphylococcus aureus (50.4%) was the commonest organism followed by Escherichia coli (23.02%), Pseudomonas aeruginosa (7.9%) and Citrobacter species (7.9%). Antimicrobial profile of gram positive isolates revealed maximum sensitivity to vancomycin, teicoplanin and linezolid, whereas among gram negative isolates meropenem, piperacillin-tazobactam, and amikacin were found to be most sensitive. Conclusion The rate of SSI observed in this study was comparable to other similar studies, however we observed a higher degree of antimicrobial resistance. Adherence to strict infection control measures, maintenance of proper hand hygiene and optimal preoperative, intraoperative and postoperative patient care will surely reduce the incidence of SSIs. PMID:26557520

  12. The ON-Q pain management system in elective gynecology oncologic surgery: Management of postoperative surgical site pain compared to intravenous patient-controlled analgesia

    PubMed Central

    Chung, Dawn; Lee, Yoo Jin; Jo, Mi Hyun; Park, Hyun Jong; Lim, Ga Won; Cho, Hanbyoul; Nam, Eun Ji; Kim, Sang Wun; Kim, Jae Hoon; Kim, Young Tae

    2013-01-01

    Objective The goal of this study was to compare postoperative surgical site pain in gynecologic cancer patients who underwent elective extended lower midline laparotomy and managed their pain with either the ON-Q pain management system (surgical incision site pain relief system, ON-Q pump) or an intravenous patient-controlled analgesia pump (IV PCA). Methods Twenty gynecologic cancer patients who underwent elective extended lower midline laparotomy were divided into two groups. One group received a 72-hour continuous wound perfusion of the local anesthetic ropivacaine (0.5%, study group) into the supraperitoneal layer of the abdominal incision through the ON-Q pump. The other group received intravenous infusion pump of patient-controlled analgesia (fentanyl citrate 20 mg/mL · kg+ondansetron hydrochloride 16 mg/8 mL+normal saline). Postoperative pain was assessed immediately and at 6, 24, 48, 72, and 96 hours after surgery using the visual analogue scale. Results Postoperative surgical site pain scores at 24, 48, and 72 hours after surgery were lower in the ON-Q group than the IV PCA group. Pain scores at 24 hours and 48 hours after surgery were significantly different between the two groups (P=0.023, P<0.001). Overall painkiller administration was higher in the ON-Q group but this difference was not statistically significant (5.1 vs. 4.3, P=0.481). Conclusion This study revealed that the ON-Q pain management system is a more effective approach than IV PCA for acute postoperative surgical site pain relief after extended lower midline laparotomy in gynecologic cancer patients. PMID:24327987

  13. Recurrent surgical site infection of the spine diagnosed by dual (18)F-NaF-bone PET/CT with early-phase scan.

    PubMed

    Shim, Jai-Joon; Lee, Jeong Won; Jeon, Min Hyok; Lee, Sang Mi

    2016-09-01

    We report a case of a 31-year-old man who showed recurrently elevated level of the serum inflammatory marker C-reactive protein (CRP) after spinal operation. He underwent (18)F-flurodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) and dual (18)F-sodium-fluoride ((18)F-NaF) PET/CT with an additional early-phase scan to find a hidden inflammation focus. Only mildly increased (18)F-FDG was found at the surgical site of T11 spine on (18)F-FDG PET/CT. In contrast, dual (18)F-NaF bone PET/CT with early-phase scan demonstrated focal active inflammation at the surgical site of T11 spine. After a revision operation of the T11 spine, serum CRP level decreased to the normal range without any symptom or sign of inflammation. Inflammatory focus in the surgical site of the spine can be detected with using dual (18)F-NaF bone PET/CT scan with early-phase scan. PMID:27388912

  14. Evidence-Based Update to the U.S. Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection: Developmental Process.

    PubMed

    Berríos-Torres, Sandra I

    2016-04-01

    Recommendations in the "Guideline for Prevention of Surgical Site Infection, 1999" were based on experts' selective interpretation of the scientific evidence. Effective 2009, the U.S. Centers for Disease Control and Prevention (CDC) and its Healthcare Infection Control Practices Advisory Committee (HICPAC) updated their guideline development process. This is a narrative summary of the updated process focusing on key changes and challenges specific to the Guideline for Prevention of Surgical Site Infection. The guideline development process now incorporates evidence-based methodology and provides explicit links between the evidence and the recommendations using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. There is also participation by professional surgical societies, an updated guideline structure (core and procedure-specific sections), additional planned related manuscripts (introductions to the guideline and research opportunities), and new proposed venues for publication. The new CDC and HICPAC "Guideline for the Prevention of Surgical Site Infection" represents a substantial advancement from recommendations for infection control practices based on expert opinion to evidence-based practices. The new structure is meant to facilitate future updates, in particular, those addressing specialty or procedure-specific surgical site infection prevention questions. Increased presence by the surgical community through the professional surgical societies' engagement in the guideline development process, lead authorship of related manuscripts, and proposed publication in the surgical literature not only increase adherence by the surgical community, but also promote an ongoing collaboration with public health and other partners in a multidisciplinary approach to SSI prevention. PMID:26891203

  15. Incidence of Surgical Site Infection Following Mastectomy With and Without Immediate Reconstruction Using Private Insurer Claims Data

    PubMed Central

    Olsen, Margaret A.; Nickel, Katelin B.; Fox, Ida K.; Margenthaler, Julie A.; Ball, Kelly E.; Mines, Daniel; Wallace, Anna E.; Fraser, Victoria J.

    2015-01-01

    Objective The National Healthcare Safety Network classifies breast operations as clean procedures with an expected 1–2% surgical site infection (SSI) incidence. We assessed differences in SSI incidence following mastectomy with and without immediate reconstruction in a large, geographically diverse population. Design Retrospective cohort study. Patients Commercially-insured women aged 18–64 years with ICD-9-CM procedure or CPT-4 codes for mastectomy from 1/1/2004–12/31/2011. Methods Incident SSIs within 180 days after surgery were identified by ICD-9-CM diagnosis codes. The incidence of SSI after mastectomy +/− immediate reconstruction was compared by the chi-square test. Results From 2004–2011, 18,696 mastectomy procedures among 18,085 women were identified, with immediate reconstruction in 10,836 (58%) procedures. The 180-day incidence of SSI following mastectomy with or without reconstruction was 8.1% (1,520/18,696). Forty-nine percent of SSIs were identified within 30 days post-mastectomy, 24.5% between 31–60 days, 10.5% between 61–90 days, and 15.7% between 91–180 days. The incidence of SSI was 5.0% (395/7,860) after mastectomy-only, 10.3% (848/8,217) after mastectomy plus implant, 10.7% (207/1,942) after mastectomy plus flap, and 10.3% (70/677) after mastectomy plus flap and implant (p<0.001). The SSI risk was higher after bilateral compared with unilateral mastectomy with (11.4% vs. 9.4%, p=0.001) and without (6.1% vs. 4.7%, p=0.021) immediate reconstruction. Conclusions SSI incidence was two-fold higher after mastectomy with immediate reconstruction than after mastectomy alone. Only 49% of SSIs were coded within 30 days after operation. Our results suggest stratification by procedure type will facilitate comparison of SSI rates after breast operations between facilities. PMID:26036877

  16. Predominance of multi-drug resistant bacterial pathogens causing surgical site infections in Muhimbili national hospital, Tanzania

    PubMed Central

    2014-01-01

    Background Surgical site infections (SSIs) remain a common and widespread problem contributing to a significant morbidity and mortality, attributed partly by the increase in antimicrobial resistance among the etiological agents. This study was done to determine the spectrum of bacterial isolates and their susceptibility patterns causing SSIs at Muhimbili National Hospital, Tanzania. Methods This descriptive cross sectional study was conducted between September, 2011 and February, 2012. Pus swabs or pus were cultured on blood agar (Oxoid, UK) and MacConkey agar (Oxoid, UK) and incubated aerobically at 37°C for 18–24 hours. Bacterial identification was done using API 20E and VITEK and antimicrobial susceptibility was determined by Kirby Bauer disc diffusion. Results Of the 100 patients, from whom wound swabs were collected, 90 (90%) had positive aerobic bacterial growth. A total of 147 pathogenic bacteria were isolated, including 114 (77.5%) gram negative and 33(22.5%) gram positive organisms. The most prevalent bacterial species were Pseudomonas aeruginosa (16.3%), followed by Staphylococcus aureus (12.2%) and Klebsiella pneumoniae (10.8%). Of the 18 S. aureus , 8 (44%) were methicillin resistant Staphylococcus aureus (MRSA) and three of them (17%) were carrying both MRSA and induced clindamycin resistance (ICR). Extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae were observed in 23 (79.3%) of the 29 isolates tested. Majority of Escherichia coli 12 (92.3%) and K. pneumoniae 11 (69%) isolates were ESBL producers. About 63% (93/147) were multiple-drug resistance (MDR) isolates, and the overall MDR among Gram positive and Gram negative bacteria was 60.6% (20/33) and 61.4%, (73/114), respectively. The prevalence of MDR for E. coli, A. baumannii and P. stuartii was 100% each. Majority (97%) of the Gram negative bacteria were resistant to more than four categories (classes) of antibiotics. Conclusion A high proportion (63%) of the isolates causing

  17. A case report of the use of nanocrystalline silver dressing in the management of acute surgical site wound infected with MRSA to prevent cutaneous necrosis following revision surgery.

    PubMed

    Bhattacharyya, Mayukh; Bradley, Helen

    2008-03-01

    The authors report the use of nanocrystalline silver (Acticoat 7, Smith and Nephew, London, UK) in an acute surgical wound to prevent localized skin necrosis due to infection, thereby avoiding skin grafting as a secondary procedure. Two patients were successfully treated with Acticoat 7 dressings without using systemic antimicrobials after developing methicillin-resistant Staphylococcus aureus infection in the surgical site. Despite a history of smoking and incision through scar tissues, the wound did not progress into deep infection nor was there recurrence of infection at 2 years follow-up. The intention was to use this particular dressing to assess the effect of silver on infected keratinocytes in an acute wound environment. It is possible that the use of Acticoat 7 may reduce the bacterial loading at the wound site, thereby decreasing a propensity for skin necrosis caused by the infective process. This case report demonstrates that the acute surgical wound with impending cutaneous necrosis due to localized infection may be treated without oral antimicrobials. PMID:18372271

  18. Development of the Biopen: a handheld device for surgical printing of adipose stem cells at a chondral wound site.

    PubMed

    O'Connell, Cathal D; Di Bella, Claudia; Thompson, Fletcher; Augustine, Cheryl; Beirne, Stephen; Cornock, Rhys; Richards, Christopher J; Chung, Johnson; Gambhir, Sanjeev; Yue, Zhilian; Bourke, Justin; Zhang, Binbin; Taylor, Adam; Quigley, Anita; Kapsa, Robert; Choong, Peter; Wallace, Gordon G

    2016-03-01

    We present a new approach which aims to translate freeform biofabrication into the surgical field, while staying true to the practical constraints of the operating theatre. Herein we describe the development of a handheld biofabrication tool, dubbed the 'biopen', which enables the deposition of living cells and biomaterials in a manual, direct-write fashion. A gelatin-methacrylamide/hyaluronic acid-methacrylate (GelMa/HAMa) hydrogel was printed and UV crosslinked during the deposition process to generate surgically sculpted 3D structures. Custom titanium nozzles were fabricated to allow printing of multiple ink formulations in a collinear (side-by-side) geometry. Independently applied extrusion pressure for both chambers allows for geometric control of the printed structure and for the creation of compositional gradients. In vitro experiments demonstrated that human adipose stem cells maintain high viability (>97%) one week after biopen printing in GelMa/HAMa hydrogels. The biopen described in this study paves the way for the use of 3D bioprinting during the surgical process. The ability to directly control the deposition of regenerative scaffolds with or without the presence of live cells during the surgical process presents an exciting advance not only in the fields of cartilage and bone regeneration but also in other fields where tissue regeneration and replacement are critical. PMID:27004561

  19. Korean Basic Course.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    These 11 volumes of the Korean Basic Course comprise 112 lesson units designed to train native English language speakers to Level 3 proficiency in comprehension and speaking and Level 2 proficiency in reading and writing Korean. (Level 5 on this scale is native-speaker level.) Intended for classroom use in the Defense Language Institute intensive…

  20. A comparison of clinical and surgical outcomes between laparo-endoscopic single-site surgery and traditional multiport laparoscopic surgery for adnexal tumors

    PubMed Central

    Lee, In Ok; Yoon, Jung Won; Chung, Dawn; Yim, Ga Won; Nam, Eun Ji; Kim, Sunghoon; Kim, Sang Wun

    2014-01-01

    Objective The purpose of this study was to compare clinical and surgical outcomes between laparo-endoscopic single-site (LESS) surgery and traditional multiport laparoscopic (TML) surgery for treatment of adnexal tumors. Methods Medical records were reviewed for patients undergoing surgery for benign adnexal tumors between January 2008 and April 2012 at our institution. All procedures were performed by the same surgeon. Clinical and surgical outcomes for patients undergoing LESS surgery using Glove port were compared with those patients undergoing TML surgery. Results A review of 129 patient cases undergoing LESS surgery using Glove port and 100 patient cases undergoing TML surgery revealed no significant differences in the baseline characteristics of the two groups. The median operative time was shorter in the LESS group using Glove port at 44 minutes (range, 19-126 minutes) than the TML group at 49 minutes (range, 20-196 minutes) (P=0.0007). There were no significant differences between in the duration of postoperative hospital stay, change in hemoglobin levels, pain score or the rate of complications between the LESS and TML groups. Conclusion LESS surgery showed comparable clinical and surgical outcomes to TML surgery, and required less operative time. Future prospective trials are warranted to further define the benefits of LESS surgery for adnexal tumor treatment. PMID:25264529

  1. Occupational stress and related factors among surgical residents in Korea

    PubMed Central

    Kang, Sanghee; Jo, Hye Sung; Lee, Ji Sung; Kim, Chong Suk

    2015-01-01

    Purpose The application rate for surgical residents in Korea has continuously decreased over the past few years. The demanding workload and the occupational stress of surgical training are likely causes of this problem. The aim of this study was to investigate occupational stress and its related factors in Korean surgical residents. Methods With the support of the Korean Surgical Society, we conducted an electronic survey of Korean surgical residents related to occupational stress. We used the Korean Occupational Stress Scale (KOSS) to measure occupational stress. We analyzed the data focused on the stress level and the factors associated with occupational stress. Results The mean KOSS score of the surgical residents was 55.39, which was significantly higher than that of practicing surgeons (48.16, P < 0.001) and the average score of specialized professionals (46.03, P < 0.001). Exercise was the only factor found to be significantly associated with KOSS score (P = 0.001) in univariate analysis. However, in multiple linear regression analysis, the mean number of assigned patients, resident occupation rate and exercise were all significantly associated with KOSS score. Conclusion Surgical residents have high occupational stress compared to practicing surgeons and other professionals. Their mean number of assigned patients, resident recruitment rate and exercise were all significantly associated with occupational stress for surgical residents. PMID:26576407

  2. New surgical techniques and surgical site infections.

    PubMed Central

    Gordon, S. M.

    2001-01-01

    Technologic advances in surgery include a trend toward less invasive procedures, driven by potential benefits to patients and by health-care economics. These less invasive procedures provide infection control personnel opportunities for direct involvement in outcomes measurement. PMID:11294710

  3. Lessons of the North Korean crisis

    SciTech Connect

    Mazarr, M.J.

    1993-07-01

    The crisis involving North Korea`s suspected nuclear weapon program is over, at least for now. Pyongyang has agreed to suspend its decision to withdraw from the nuclear Non-Proliferation Treaty (NPT) and to assume its obligations allowing continued International Atomic Energy Agency (IAEA) inspections of its nuclear facilities, although it has yet to accept IAEA {open_quotes}special{close_quotes} inspections of suspect nuclear sites. In exchange, North Korea obtained a few specific commitments from the United States - nuclear non-aggression, for example - as well as hints of longer-term benefits such as high-level US-North Korean talks extending to other topics, the cancellation of the US-South Korean {open_quotes}Team Spirit{close_quotes} military exercise, the right to reciprocal inspections in South Korea and an influx of South Korean and Japanese investment, provided North Korea meets its obligations under the NPT.

  4. Prevention of Surgical Site Infection After Ankle Surgery Using Vacuum-Assisted Closure Therapy in High-Risk Patients With Diabetes.

    PubMed

    Zhou, Zhen-Yu; Liu, Ya-Ke; Chen, Hong-Lin; Liu, Fan

    2016-01-01

    Patients with diabetes have a high risk of surgical site infection (SSI) after ankle surgery. The aim of the present study was to investigate the efficacy of vacuum-assisted closure (VAC) in the prevention of SSI after ankle surgery compared with the efficacy of standard moist wound care (SMWC). A retrospective study was performed of unstable ankle fractures for surgical fixation in patients with diabetes from January 2012 to December 2014. VAC and SMWC were used for surgical incision coverage. The primary outcome was the incidence of SSI, and the secondary outcomes were the length of hospital stay and crude hospital costs. The data from 76 patients were analyzed, with 22 (28.95%) in the VAC group and 54 (71.05%) in the SMWC group. The incidence of SSI was 4.6% in the VAC group compared with 27.8% in the SMWC group (chi-square 5.076; p = .024), and the crude odds ratio for SSI in the VAC group was 0.124 (95% confidence interval 0.002 to 0.938). The length of hospital stay was lower in the VAC group than in the SMWC group (12.6 ± 2.7 days and 15.2 ± 3.5 days, respectively; t = 3.122, p = .003). The crude hospital costs were also lower in the VAC group than in the SMWC group (Chinese yuan 8643.2 ± 1195.3 and 9456.2 ± 1106.3, respectively; t = 2.839, p = .006). After logistic regression analysis, the adjusted odds ratio for the total SSI rate comparing VAC and SMWC was 0.324 (95% confidence interval 0.092 to 0.804; p = .021). Compared with SMWC, VAC can decrease the SSI rate after ankle surgery in patients with diabetes. This finding should be confirmed by prospective, randomized controlled clinical trials. PMID:26603948

  5. The Development of Statistical Models for Predicting Surgical Site Infections in Japan: Toward a Statistical Model-Based Standardized Infection Ratio.

    PubMed

    Fukuda, Haruhisa; Kuroki, Manabu

    2016-03-01

    OBJECTIVE To develop and internally validate a surgical site infection (SSI) prediction model for Japan. DESIGN Retrospective observational cohort study. METHODS We analyzed surveillance data submitted to the Japan Nosocomial Infections Surveillance system for patients who had undergone target surgical procedures from January 1, 2010, through December 31, 2012. Logistic regression analyses were used to develop statistical models for predicting SSIs. An SSI prediction model was constructed for each of the procedure categories by statistically selecting the appropriate risk factors from among the collected surveillance data and determining their optimal categorization. Standard bootstrapping techniques were applied to assess potential overfitting. The C-index was used to compare the predictive performances of the new statistical models with those of models based on conventional risk index variables. RESULTS The study sample comprised 349,987 cases from 428 participant hospitals throughout Japan, and the overall SSI incidence was 7.0%. The C-indices of the new statistical models were significantly higher than those of the conventional risk index models in 21 (67.7%) of the 31 procedure categories (P<.05). No significant overfitting was detected. CONCLUSIONS Japan-specific SSI prediction models were shown to generally have higher accuracy than conventional risk index models. These new models may have applications in assessing hospital performance and identifying high-risk patients in specific procedure categories. Infect. Control Hosp. Epidemiol. 2016;37(3):260-271. PMID:26694760

  6. Importance of methicillin-resistant Staphylococcus aureus eradication in carriers to prevent postoperative methicillin-resistant Staphylococcus aureus surgical site infection.

    PubMed

    Pofahl, Walter E; Ramsey, Keith M; Nobles, Delores L; Cochran, M Kathy; Goettler, Claudia

    2011-01-01

    Although infrequent, postoperative methicillin-resistant Staphylococcus aureus (MRSA) surgical site infection (SSI) is associated with significant morbidity and cost. Previous studies have identified the importance of MRSA screening to diminish the risk of postoperative MRSA SSI. The current study quantifies the importance of eradication of the MRSA carrier state to prevent MRSA SSI. Beginning February 2007, all admissions to an 800-bed tertiary care hospital were screened for MRSA by nasal swab using rapid polymerase chain reaction-based testing. Patients found to be nasal carriers of MRSA were treated with 2 per cent mupirocin nasal ointment and 4 per cent chlorhexidine soap before surgery. The subset of patients undergoing procedures that are part of the Surgical Care Improvement Project (SCIP) were followed for MRSA SSI (n = 8980). The results of preoperative MRSA screening and eradication of the carrier state were analyzed. Since the initiation of universal MRSA screening, 11 patients undergoing SCIP procedures have developed MRSA SSI (0.12%). Of these, six patients (55%) had negative preoperative screens. Of the five patients with positive preoperative screens, only one received treatment to eradicate the carrier state. In patients who develop MRSA SSI, failure to treat the carrier state before surgery results in MRSA SSI. PMID:21396301

  7. Knowledge, Practice, and Associated Factors towards Prevention of Surgical Site Infection among Nurses Working in Amhara Regional State Referral Hospitals, Northwest Ethiopia

    PubMed Central

    Teshager, Freahiywot Aklew; Engeda, Eshetu Haileselassie; Worku, Workie Zemene

    2015-01-01

    Knowledge and practice of nurses about surgical site infections (SSIs) are not well studied in Ethiopia. This paper contains findings about Northwest Ethiopian nurses' knowledge and practice regarding the prevention of SSIs. The main objective of the study was to assess knowledge, practice, and associated factors of nurses towards the prevention of SSIs. The study was done using a questionnaire survey on randomly selected 423 nurses who were working in referral hospitals during the study period. The study showed that more than half of the nurses who participated in the survey had inadequate knowledge about the prevention of SSIs. Moreover, more than half of them were practicing inappropriately. The most important associated factors include lack of training on evidence based guidelines and sociodemographic variables (age, year of service, educational status, etc.). Training of nurses with the up-to-date SSIs guidelines is recommended. PMID:26788549

  8. Analysis of Postoperative Thoracolumbar Spine Infections in a Prospective Randomized Controlled Trial Using the Centers for Disease Control Surgical Site Infection Criteria

    PubMed Central

    Takemoto, Richelle C.; Lonner, Baron S.; Andres, Tate M.; Park, Justin J.; Ricart-Hoffiz, Pedro A.; Bendo, John A.; Goldstein, Jeffrey A.; Spivak, Jeffrey M.; Errico, Thomas J.

    2016-01-01

    Introduction Wound infections following spinal surgery place a high toll on both the patient and the healthcare system. Although several large series studies have examined the incidence and distribution of spinal wound infection, the applicability of these studies varies greatly since nearly every study is either retrospective and/or lacks standard inclusion criteria for defining surgical site infection. To address this void, we present results from prospectively gathered thoracolumbar spine surgery data for which the Centers for Disease Control (CDC) criteria were stringently applied to define a surgical site infection (SSI). Methods A prospective randomized trial of 314 patients who underwent multilevel thoracolumbar spinal surgery with instrumentation followed by postoperative drain placement was completed (Takemoto et al., 2015). The trial consisted of two antibiotic arms: one for 24-hours, and the other for the duration of the drain; no differences were found between the arms. All infections meeting CDC criteria for SSI were included. Results A total of 40 infections met CDC criteria for SSI, for an overall incidence of 12.7%. Of these, 20 (50%) were culture-positive. The most common organism was Staphylococcus aureus (4 total: methicillin-sensitive=2; methicillin-resistant=2), followed by coagulase-negative Staphylococcus (3 cases), Propionibacterium acnes and Escherichia coli (2 cases each). Six infections grew multiple organisms, most commonly involving coagulase-negative staphylococcus and enterococcus. Conclusions Our findings indicate that thoracolumbar SSI occurs at the higher end of the range cited in the literature (2-13%), which is largely based on retrospective data not subjected to the inclusivity of SSI as defined by the CDC. The three most common organisms in our analysis (S. aureus, P. acnes, E. coli) are consistent with previous reports. Staphylococcus aureus continues to be the most common causative organism and continued vigilance and

  9. Pure oxygen ventilation during general anaesthesia does not result in increased postoperative respiratory morbidity but decreases surgical site infection. An observational clinical study

    PubMed Central

    Suksompong, Sirilak; Weiler, Jürgen; Zander, Rolf

    2014-01-01

    Background. Pure oxygen ventilation during anaesthesia is debatable, as it may lead to development of atelectasis. Rationale of the study was to demonstrate the harmlessness of ventilation with pure oxygen. Methods. This is a single-centre, one-department observational trial. Prospectively collected routine-data of 76,784 patients undergoing general, gynaecological, orthopaedic, and vascular surgery during 1995–2009 were retrospectively analysed. Postoperative hypoxia, unplanned ICU-admission, surgical site infection (SSI), postoperative nausea and vomiting (PONV), and hospital mortality were continuously recorded. During 1996 the anaesthetic ventilation for all patients was changed from 30% oxygen plus 70% nitrous oxide to 100% oxygen in low-flow mode. Therefore, in order to minimize the potential of confounding due to a variety of treatments being used, we directly compared years 1995 (30% oxygen) and 1997 (100%), whereas the period 1998 to 2009 is simply described. Results. Comparing 1995 to 1997 pure oxygen ventilation led to a decreased incidence of postoperative hypoxic events (4.3 to 3.0%; p < 0.0001) and hospital mortality (2.1 to 1.6%; p = 0.088) as well as SSI (8.0 to 5.0%; p < 0.0001) and PONV (21.6 to 17.5%; p < 0.0001). There was no effect on unplanned ICU-admission (1.1 to 0.9; p = 0.18). Conclusions. The observed effects may be partly due to pure oxygen ventilation, abandonment of nitrous oxide, and application of low-flow anesthesia. Pure oxygen ventilation during general anaesthesia is harmless, as long as certain standards are adhered to. It makes anaesthesia simpler and safer and may reduce clinical morbidity, such as postoperative hypoxia and surgical site infection. PMID:25320681

  10. Resident and Faculty Perceptions of Program Strengths and Opportunities for Improvement: Comparison of Site Visit Reports and ACGME Resident Survey Data in 5 Surgical Specialties.

    PubMed

    Caniano, Donna A; Yamazaki, Kenji; Yaghmour, Nicholas; Philibert, Ingrid; Hamstra, Stanley J

    2016-05-01

    Background Resident and faculty views of program strengths and opportunities for improvement (OFIs) offer insight into how stakeholders assess key elements of the learning environment. Objective This study sought (1) to assess the degree to which residents and faculty in 359 programs in 5 surgical specialties (obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, and surgery) were aligned or divergent in their respective views of program strengths and OFIs; and (2) to evaluate whether responses to selected questions on the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey correlated with strengths or OFIs identified by the residents during the site visit. Methods Faculty and resident lists of program strengths and OFIs in site visit reports for 2012 and 2013 were aggregated, analyzed, and compared to responses on the Resident Survey. Results While there was considerable alignment in resident and faculty perceptions of program strengths and OFIs, some attributes were more important to one or the other group. Collegiality was valued highly by both stakeholder groups. Responses to 2 questions on the ACGME Resident Survey were associated with resident-identified OFIs in site visit reports pertaining to aspects of the didactic program and responsiveness to resident suggestions for improvement. Conclusions The findings offer program leadership additional insight into how 2 key stakeholder groups view elements of the learning environment as program strengths or OFIs and may serve as useful focal areas for ongoing improvement activities. PMID:27168915

  11. Surgical Airway

    PubMed Central

    Patel, Sapna A; Meyer, Tanya K

    2014-01-01

    Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”. PMID:24741501

  12. Korean Basic Course. Volume I.

    ERIC Educational Resources Information Center

    Park, B. Nam

    Volume I of the Korean Basic Course provides introductory materials for the student who wishes to achieve a working command of the language currently spoken by an estimated 40 to 43 million people on the Korean Peninsula and in Japan, Manchuria, and the Soviet Union. The linguistic content is based on the speech of educated Koreans in Seoul, the…

  13. Surgical Simulation

    PubMed Central

    Sutherland, Leanne M.; Middleton, Philippa F.; Anthony, Adrian; Hamdorf, Jeffrey; Cregan, Patrick; Scott, David; Maddern, Guy J.

    2006-01-01

    Objective: To evaluate the effectiveness of surgical simulation compared with other methods of surgical training. Summary Background Data: Surgical simulation (with or without computers) is attractive because it avoids the use of patients for skills practice and provides relevant technical training for trainees before they operate on humans. Methods: Studies were identified through searches of MEDLINE, EMBASE, the Cochrane Library, and other databases until April 2005. Included studies must have been randomized controlled trials (RCTs) assessing any training technique using at least some elements of surgical simulation, which reported measures of surgical task performance. Results: Thirty RCTs with 760 participants were able to be included, although the quality of the RCTs was often poor. Computer simulation generally showed better results than no training at all (and than physical trainer/model training in one RCT), but was not convincingly superior to standard training (such as surgical drills) or video simulation (particularly when assessed by operative performance). Video simulation did not show consistently better results than groups with no training at all, and there were not enough data to determine if video simulation was better than standard training or the use of models. Model simulation may have been better than standard training, and cadaver training may have been better than model training. Conclusions: While there may be compelling reasons to reduce reliance on patients, cadavers, and animals for surgical training, none of the methods of simulated training has yet been shown to be better than other forms of surgical training. PMID:16495690

  14. Feasibility of subcutaneous gentamicin and pressurized irrigation as adjuvant strategies to reduce surgical site infection in colorectal surgery: results of a pilot study.

    PubMed

    Dineen, Sean P; Pham, Thai H; Murray, Bryce W; Parker, Betty J; Hartless, Kathleen; Anthony, Thomas; Huerta, Sergio

    2015-06-01

    Surgical site infections (SSIs) remain a common and costly morbidity after colorectal surgery. This rate remains high even in the setting of strict adherence to Surgical Care Improvement Project Protocols. The aim of our pilot study was to determine the feasibility and safety of subcutaneous gentamicin injection or pressurized irrigation as adjuncts to reduce SSI. A total of 132 patients who underwent colorectal surgery at the VA North Texas Health Care System were prospectively assigned to a pressurized irrigation group (n = 44), a preincision gentamicin injection group (n = 48), or control (n = 40). The primary objective was to assess safety and feasibility of these strategies. Patient demographics were matched among groups. Univariate and multivariate analyses were performed to identify possible predictions of SSI in this cohort. The rate of SSI in the control group was 25 per cent, 13.5 per cent in the pressurized irrigation group, and 12.5 per cent in the gentamicin group (P = 0.26). Combined, the intervention groups had a 13 per cent SSI versus 25 per cent control (P = 0.09). Operative time was not increased by the interventions and no intraoperative complications specifically related to the interventions were noted. Postoperative complications were not different between groups. Both albumin and body mass index were associated with SSI. Body mass index was and independent predictor of SSI (P = 0.006). In conclusion, this pilot study demonstrates the feasibility of the interventions described. There was no detrimental effect of either intervention. There was trend toward a reduction in SSI in the intervention group, which warrants further investigation. PMID:26031269

  15. Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section

    PubMed Central

    Bizoń, Magdalena; Cendrowski, Krzysztof; Sawicki, Włodzimierz

    2016-01-01

    Abstract Background: Surgical site infections (SSI) occur in 1.8%–9.2% of women undergoing cesarean section (CS) and lead to greater morbidity rates and increased treatment costs. The aim of the study was to evaluate the efficacy and cost-effectiveness of dialkylcarbamoyl chloride (DACC) impregnated dressings to prevent SSI in women subject to CS. Methods: Randomized, controlled trial was conducted at the Mazovian Bródno Hospital, a tertiary care center performing approximately 1300 deliveries per year, between June 2014 and April 2015. Patients were randomly allocated to receive either DACC impregnated dressing or standard surgical dressing (SSD) following skin closure. In order to analyze cost-effectiveness of the selected dressings in the group of patients who developed SSI, the costs of ambulatory visits, additional hospitalization, nursing care, and systemic antibiotic therapy were assessed. Independent risk factors for SSI were determined by multivariable logistic regression. Results: Five hundred and forty-three women undergoing elective or emergency CS were enrolled. The SSI rates in the DACC and SSD groups were 1.8% and 5.2%, respectively (p = 0.04). The total cost of SSI prophylaxis and treatment was greater in the control group as compared with the study group (5775 EUR vs. 1065 EUR, respectively). Independent risk factors for SSI included higher pre-pregnancy body mass index (adjusted odds ratio [aOR] = 1.08; [95% confidence interval [CI]: 1.0–1.2]; p < 0.05), smoking in pregnancy (aOR = 5.34; [95% CI: 1.6–15.4]; p < 0.01), and SSD application (aOR = 2.94; [95% CI: 1.1–9.3]; p < 0.05). Conclusion: The study confirmed the efficacy and cost-effectiveness of DACC impregnated dressings in SSI prevention among women undergoing CS. PMID:26891115

  16. Meta-Analysis of Prevention of Surgical Site Infections following Incision Closure with Triclosan-Coated Sutures: Robustness to New Evidence

    PubMed Central

    Edmiston, Charles E.; Leaper, David

    2014-01-01

    Abstract Background: A systematic literature review (SLR) and meta-analysis of surgical site infections (SSIs) after surgical incision closure with triclosan-coated sutures (TS) compared with non-antibacterial coated sutures (NTS) published previously by the authors suggested that fewer SSIs occurred in the TS study arm. However, the results were vulnerable to the removal of one key randomized controlled trial (RCT) because of insufficient data. Furthermore, recently published RCTs highlighted the need for an update of the SLR to challenge the robustness of results. Methods: The protocol for the new SLR included more stringent tests of robustness than used initially and the meta-analysis was updated with the results of two new RCTs as well as the count of patients and SSIs by U.S. Centers for Disease Control and Prevention (CDC) incision class. Results: The updated SLR included 15 RCTs with 4,800 patients. No publication bias was suggested in the analysis. The predominant effect estimated a relative risk of 0.67 (95% CI: 0.54–0.84, p=0.00053) with an overall lower frequency of SSI in the TS arm than in the NTS arm. Results were robust to sensitivity analysis. Conclusions: The two additional peer-reviewed double-blind RCTs of this update confirmed the predominant effect found in the authors' previous meta-analysis and established the robustness of conclusions that were lacking previously. This SLR and meta-analysis showed that the use of triclosan antimicrobial sutures reduced the incidence of SSI after clean, clean-contaminated, and contaminated surgery. The two additional peer-reviewed double blind RCTs reinforced the evidence level of this SLR (CEBM level 1a). PMID:24738988

  17. Depression and Korean American immigrants.

    PubMed

    Park, So-Youn; Bernstein, Kunsook Song

    2008-02-01

    Koreans are a relatively new and fast-growing immigrant group in the United States. Research has shown that immigration experiences are associated with depression, whereas acculturation and social support are moderating factors. Korean culture is informed by Confucianism, which emphasizes family integrity, group conformity, and traditional gender roles, and has influenced how Korean immigrants conceptualize depression, express depressive symptoms, and demonstrate help-seeking behavior. An understanding of Korean patterns of manifesting and expressing depression will be helpful to provide culturally appropriate mental health services to Korean American immigrants. PMID:18207052

  18. Surgical revolutions.

    PubMed

    Toledo-Pereyra, Luis H

    2008-01-01

    Many surgical revolutions distinguish the history and evolution of surgery. They come in different sizes and exert a variable effect on the development and practice of the discipline. As science and technology rapidly evolve, so too does the creation of new paradigms, ideas and innovations or discoveries for the improvement of the surgical sciences. Surgical revolutions are not new, and have existed for centuries even though they have been more frequently recognized since the middle of the 19th century, 20th century and down to the present. Surgical revolutionaries are indispensable in the conception and completion of any surgical revolution. However, scientific and technological advances have supported the culmination of each revolution. PMID:18615311

  19. Genotyping of Korean isolates of infectious hematopoietic necrosis virus (IHNV) based on the glycoprotein gene

    USGS Publications Warehouse

    Kim, W.-S.; Oh, M.-J.; Nishizawa, T.; Park, J.-W.; Kurath, G.; Yoshimizu, M.

    2007-01-01

    Glycoprotein (G) gene nucleotide sequences of four Korean isolates of infectious hematopoietic necrosis virus (IHNV) were analyzed to evaluate their genetic relatedness to worldwide isolates. All Korean isolates were closely related to Japanese isolates of genogroup JRt rather than to those of North American and European genogroups. It is believed that Korean IHNV has been most likely introduced from Japan to Korea by the movement of contaminated fish eggs. Among the Korean isolates, phylogenetically distinct virus types were obtained from sites north and south of a large mountain range, suggesting the possibility of more than one introduction of virus from Japan. ?? 2007 Springer-Verlag.

  20. Evaluating the cost of adult voluntary medical male circumcision in a mixed (surgical and PrePex) site compared to a hypothetical PrePex-only site in South Africa

    PubMed Central

    Kim, Hae-Young; Lebina, Limakatso; Milovanovic, Minja; Taruberekera, Noah; Dowdy, David W.; Martinson, Neil A.

    2015-01-01

    Background Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC) in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. Objective To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only site in South Africa. Design We evaluated the overall unit cost of VMMC at a mixed site where PrePex VMMC procedure was added to routine forceps-guided scalpel-based VMMC in Soweto, South Africa. We abstracted costs and then modeled these costs for a hypothetical PrePex-only site, at which 9,600 PrePex circumcisions per year could be done. We examined cost drivers and modeled costs, varying the price of the PrePex device. The healthcare system perspective was used. Results In both sites, the main contributors of cost were personnel and consumables. If 10% of all VMMC were by PrePex at the mixed site, the overall costs of the surgical method and PrePex were similar – US$59.62 and $59.53, respectively. At the hypothetical PrePex-only site, the unit cost was US$51.10 with PrePex circumcisions having markedly lower personnel and biohazardous waste management costs. In sensitivity analysis with the cost of PrePex kit reduced to US$10 and $2, the cost of VMMC was further reduced. Conclusions Adding PrePex to an existing site did not necessarily reduce the overall costs of VMMC. However, starting a new PrePex-only site is feasible and may significantly reduce the overall cost by lowering both personnel and capital costs, thus being cost-effective in the long term. Achieving a lower cost for PrePex will be an important contributor to the scale-up of VMMC. PMID:26679407

  1. Surgical Technologists

    MedlinePlus

    ... in place during the procedure, or set up robotic surgical equipment. Technologists also may handle specimens taken ... sterilization techniques, how to set up technical or robotic equipment, and preventing and controlling infections. In addition ...

  2. Surgical Mesh

    MedlinePlus

    ... Device Safety Safety Communications Surgical Mesh: FDA Safety Communication Share Tweet Linkedin Pin it More sharing options ... Prolapse and Stress Urinary Incontinence More in Safety Communications Information About Heparin Preventing Tubing and Luer Misconnections ...

  3. Perioperative Allogeneic Blood Transfusion Is Associated With Surgical Site Infection After Abdominoperineal Resection-a Space for the Implementation of Patient Blood Management Strategies.

    PubMed

    Kaneko, Kensuke; Kawai, Kazushige; Tsuno, Nelson H; Ishihara, Soichiro; Yamaguchi, Hironori; Sunami, Eiji; Watanabe, Toshiaki

    2015-05-01

    Allogeneic blood transfusion (ABT) has been reported as a major risk factor for surgical site infection (SSI) in patients undergoing colorectal surgery. However, the association of ABT with SSI in patients undergoing abdominoperineal resection (APR) and total pelvic exenteration (TPE) still remains to be evaluated. Here, we aim to elucidate this association. The medical records of all patients undergoing APR and TPE at our institution in the period between January 2000 and December 2012 were reviewed. Patients without SSI (no SSI group) were compared with patients who developed SSI (SSI group), in terms of clinicopathologic features, including ABT. In addition, data for 262 patients who underwent transabdominal rectal resection at our institution in the same period were also enrolled, and their data on differential leukocyte counts were evaluated. Multivariate analysis showed that intraoperative transfusion was an independent predictive factor for SSI after APR and TPE (P = 0.004). In addition, the first-operative day lymphocyte count of patients undergoing APR, TPE, and transabdominal rectal resection was significantly higher in nontransfusion patients compared with transfusion ones (P = 0.026). ABT in the perioperative period of APR and TPE may have an important immunomodulatory effect, leading to an increased incidence of SSI. This fact should be carefully considered, and efforts to avoid allogeneic blood exposure while still achieving adequate patient blood management would be very important for patients undergoing APR and TPE as well. PMID:26011197

  4. Perioperative Allogeneic Blood Transfusion Is Associated With Surgical Site Infection After Abdominoperineal Resection—a Space for the Implementation of Patient Blood Management Strategies

    PubMed Central

    Kaneko, Kensuke; Kawai, Kazushige; Tsuno, Nelson H.; Ishihara, Soichiro; Yamaguchi, Hironori; Sunami, Eiji; Watanabe, Toshiaki

    2015-01-01

    Allogeneic blood transfusion (ABT) has been reported as a major risk factor for surgical site infection (SSI) in patients undergoing colorectal surgery. However, the association of ABT with SSI in patients undergoing abdominoperineal resection (APR) and total pelvic exenteration (TPE) still remains to be evaluated. Here, we aim to elucidate this association. The medical records of all patients undergoing APR and TPE at our institution in the period between January 2000 and December 2012 were reviewed. Patients without SSI (no SSI group) were compared with patients who developed SSI (SSI group), in terms of clinicopathologic features, including ABT. In addition, data for 262 patients who underwent transabdominal rectal resection at our institution in the same period were also enrolled, and their data on differential leukocyte counts were evaluated. Multivariate analysis showed that intraoperative transfusion was an independent predictive factor for SSI after APR and TPE (P = 0.004). In addition, the first–operative day lymphocyte count of patients undergoing APR, TPE, and transabdominal rectal resection was significantly higher in nontransfusion patients compared with transfusion ones (P = 0.026). ABT in the perioperative period of APR and TPE may have an important immunomodulatory effect, leading to an increased incidence of SSI. This fact should be carefully considered, and efforts to avoid allogeneic blood exposure while still achieving adequate patient blood management would be very important for patients undergoing APR and TPE as well. PMID:26011197

  5. The Cost-Effectiveness of Wound-Edge Protection Devices Compared to Standard Care in Reducing Surgical Site Infection after Laparotomy: An Economic Evaluation alongside the ROSSINI Trial

    PubMed Central

    Gheorghe, Adrian; Roberts, Tracy E.; Pinkney, Thomas D.; Bartlett, David C.; Morton, Dion; Calvert, Melanie

    2014-01-01

    Background Wound-edge protection devices (WEPDs) have been used in surgery for more than 40 years to reduce surgical site infection (SSI). No economic evaluation of WEPDs against any comparator has ever been conducted. The aim of the paper was to assess whether WEPDs are cost-effective in reducing SSI compared to standard care alone in the United Kingdom. Methods and Findings An economic evaluation was conducted alongside the ROSSINI trial. The study perspective was that of the UK National Health Service and the time horizon was 30 days post-operatively. The study was conducted in 21 UK hospitals. 760 patients undergoing laparotomy were randomised to either WEPD or standard care and 735 were included in the primary analysis. The main economic outcome was cost-effectiveness based on incremental cost (£) per quality adjusted life year (QALY) gained. Patients in the WEPD arm accessed health care worth £5,420 on average and gained 0.02131 QALYs, compared to £5,130 and 0.02133 QALYs gained in the standard care arm. The WEPD strategy was more costly and equally effective compared to standard care, but there was significant uncertainty around incremental costs and QALYs. The findings were robust to a range of sensitivity analyses. Conclusions There is no evidence to suggest that WEPDs can be considered a cost effective device to reduce SSI. Their continued use is a waste of limited health care resources. PMID:24748154

  6. A Cross-Cultural Comparison of Korean and American Social Network Sites: Exploring Cultural Differences in Social Relationships and Self-Presentation

    ERIC Educational Resources Information Center

    Cho, Seong Eun

    2010-01-01

    National culture is being challenged as societies evolve from their homogeneous origins. The theoretical base of this study uses two cultural dimensions, individualism-collectivism (Hofstede, 2001) and high-and low-context cultures (Hall, 1976), to unpack the effects of national culture on social network sites (SNSs). This study explores cultural…

  7. The Effect of Preoperative Subcutaneous Fat Thickness on Surgical Site Infection Risk in Patients Undergoing Colorectal Surgery: Results of a Multisite, Prospective Cohort Study.

    PubMed

    Nakagawa, Hiromi; Ohno, Kaori; Ikeda, Shunya; Muto, Masaki

    2016-08-01

    Surgical site infection (SSI) is one of the most frequent postoperative complications among patients undergoing elective colorectal surgery. A multisite, prospective cohort study was conducted to investigate whether the thickness of subcutaneous fat (TSF) influences the occurrence of SSI in patients undergoing colorectal surgery. Participants included patients scheduled to receive colorectal laparotomy for colorectal cancer and who were under the care of a wound ostomy continence nurse at 17 participating general hospitals in Japan. Patients were not eligible to participate if they had undergone emergency surgery, reoperation, or laparoscopic surgery. Demographic, wound, and surgical data and American Society of Anesthesiologists (ASA) scale scores were collected and assessed, along with nutritional status, TSF, body mass index, and risk factors for SSI (ie, length of surgery and wound classification). The incidence of SSI and nutritional conditions was assessed weekly for 30 days after surgery. Of the 155 participants (mean age 68.9 ± 10.8 years, 53 [34.2%] of whom were women), 90 (58.1%) underwent rectal surgery, and the remaining 65 underwent colon surgery. Seventy-two (72, 46.5%) of the 155 patients underwent colostomy surgery; 24 (15.5%) developed a SSI. The mean onset of SSI was 7.3 ± 2.9 days after surgery and commonly observed in the stoma group when the ASA score was 3 or higher (P = 0.02). Patients who developed SSI resumed oral dietary intake later than those without SSI (7.4 days versus 4.6 days, P = 0.02). Multivariate analysis indicated TSF >15 mm (P = 0.01), Alb level <3.5 g/dL at postoperative days 14 (P = 0.03) and 21 (P = 0.02), and total protein level <6.8 g/dL at postoperative day 7 (P = 0.02) were statistically significantly correlated with SSI occurrence. These results suggest preoperative TSF and preoperative and postoperative serum albumin levels are independent risk factors for SSI in patients undergoing colorectal surgery, confirming

  8. Derivation of the Korean radwaste scaling factor

    SciTech Connect

    Kwang Yong Jee; Hong Joo Ahn; Se Chul Sohn; Sun Ho Han; Ki Seop Choi

    2007-07-01

    The concentrations of several radionuclides in low and intermediate level radioactive waste (LILW) drums have to be determined before shipping to disposal facilities. A notice, by the Ministry of Science and Technology (MOST) of the Korean Government, related to the disposal of LILW drums came into effect at the beginning of 2005, with regards to a radionuclide regulation inside a waste drum. MOST allows for an indirect radionuclide assay using a scaling factor to measure the inventories due to the difficulty of nondestructively measuring the essential {alpha} and {beta}-emitting nuclides inside a drum. That is, a scaling factor calculated through a correlation of the {alpha} or {beta}-emitting nuclide (DTM, Difficult-To-Measure) with a {gamma}-emitting nuclide (ETM, Easy-To-Measure) which has systematically similar properties with DTM nuclides. In this study, radioactive wastes, such as spent resin and dry active waste which were generated at different sites of a PWR and a site of a PHWR type Korean NPP, were partially sampled and analyzed for regulated radionuclides by using radiochemical methods. According to a reactor type and a waste form, the analysis results of each radionuclide were classified. Korean radwaste scaling factor was derived from database of radionuclide concentrations. (authors)

  9. [Surgical treatment of eyelid tumors].

    PubMed

    Serra, J M; Valiente, E; Paloma, V; Samayoa, V; Ordiales, G; Mesa, F

    1989-01-01

    Our surgical protocol for reconstruction of eyelid's defects after tumor excision is presented. Each technique is applied depending on the site and extension of the lesion and also on the pathologic characteristics of the tumor. PMID:2490181

  10. Delayed wound healing and postoperative surgical site infections in patients with rheumatoid arthritis treated with or without biological disease-modifying antirheumatic drugs.

    PubMed

    Tada, Masahiro; Inui, Kentaro; Sugioka, Yuko; Mamoto, Kenji; Okano, Tadashi; Kinoshita, Takuya; Hidaka, Noriaki; Koike, Tatsuya

    2016-06-01

    Biological disease-modifying antirheumatic drugs (bDMARDs) have become more popular for treating rheumatoid arthritis (RA). Whether or not bDMARDs increase the postoperative risk of surgical site infection (SSI) has remained controversial. We aimed to clarify the effects of bDMARDs on the outcomes of elective orthopedic surgery. We used multivariate logistic regression analysis to analyze risk factors for SSI and delayed wound healing among 227 patients with RA (mean age, 65.0 years; disease duration, 16.9 years) after 332 elective orthopedic surgeries. We also attempted to evaluate the effects of individual medications on infection. Rates of bDMARD and conventional synthetic DMARD (csDMARD) administration were 30.4 and 91.0 %, respectively. Risk factors for SSI were advanced age (odds ratio [OR], 1.11; P = 0.045), prolonged surgery (OR, 1.02; P = 0.03), and preoperative white blood cell count >10,000/μL (OR, 3.66; P = 0.003). Those for delayed wound healing were advanced age (OR, 1.16; P = 0.001), prolonged surgery (OR, 1.02; P = 0.007), preoperative white blood cell count >10,000/μL (OR, 4.56; P = 0.02), and foot surgery (OR, 6.60; P = 0.001). Risk factors for SSI and medications did not significantly differ. No DMARDs were risk factors for any outcome examined. Biological DMARDs were not risk factors for postoperative SSI. Foot surgery was a risk factor for delayed wound healing. PMID:27129711

  11. Improving Surveillance for Surgical Site Infections Following Total Hip and Knee Arthroplasty Using Diagnosis and Procedure Codes in a Provincial Surveillance Network.

    PubMed

    Rusk, Alysha; Bush, Kathryn; Brandt, Marlene; Smith, Christopher; Howatt, Andrea; Chow, Blanda; Henderson, Elizabeth

    2016-06-01

    OBJECTIVE To evaluate hospital administrative data to identify potential surgical site infections (SSIs) following primary elective total hip or knee arthroplasty. DESIGN Retrospective cohort study. SETTING All acute care facilities in Alberta, Canada. METHODS Diagnosis and procedure codes for 6 months following total hip or knee arthroplasty were used to identify potential SSI cases. Medical charts of patients with potential SSIs were reviewed by an infection control professional at the acute care facility where the patient was identified with a diagnosis or procedure code. For SSI decision, infection control professionals used the National Healthcare Safety Network SSI definition. The performance of traditional surveillance methods and administrative data-triggered medical chart review was assessed. RESULTS Of the 162 patients identified by diagnosis or procedure code, 46 (28%) were confirmed as an SSI by an infection control professional. More SSIs were identified following total hip vs total knee arthroplasty (42% vs16%). Of 46 confirmed SSI cases, 20 (43%) were identified at an acute care facility different than their procedure facility. Administrative data-triggered medical chart review with infection control professional confirmation resulted in a 1.1- to 1.7-fold increase in SSI rate compared with traditional surveillance. SSIs identified by administrative data resulted in sensitivity of 90% and specificity of 99%. CONCLUSION Medical chart review for cases identified through administrative data is an efficient supplemental SSI surveillance strategy. It improves case-finding by increasing SSI identification and making identification consistent across facilities, and in a provincial surveillance network it identifies SSIs presenting at nonprocedure facilities. Infect Control Hosp Epidemiol 2016;37:699-703. PMID:27018968

  12. Correlation of mupirocin resistance with biofilm production in methicillin-resistant Staphylococcus aureus from surgical site infections in a tertiary centre, Egypt.

    PubMed

    Barakat, Ghada I; Nabil, Yasmin M

    2016-03-01

    The aim of this study was to detect mupirocin-resistant isolates from pus/wound swabs taken postoperatively in a tertiary centre in Egypt and to determine their ability to form biofilm in order to establish its correlation with mupirocin resistance. This was a prospective study including 513pus/wound swabs from patients suffering from postoperative surgical site infections over the period July 2013-January 2015. Samples were cultured and isolates were identified by coagulase activity, DNase test, mannitol fermentation by mannitol salt agar followed by API Staph 32. Oxacillin agar screen test, agar dilution test for mupirocin, and mupA gene detection by PCR were performed for all methicillin-resistant Staphylococcus aureus (MRSA) isolates. Biofilm detection was carried out by the microtitre plate and Congo red agar methods. Of the 161 S. aureus isolates identified, 73 (45.3%) were MRSA, among which 82.2% were mupirocin-susceptible and 17.8% were mupirocin-resistant. Among the resistant isolates, 38.5% showed low-level resistance and 61.5% were high-level mupirocin-resistant. The mupA gene was detected in 75.0% of high-level mupirocin-resistant strains and in none of the low-level mupirocin-resistant strains. Among the mupirocin-susceptible isolates, 95.0% were biofilm-producers and 5.0% did not produce biofilm. All mupirocin-resistant isolates produced biofilm. Moreover, 15.3% of high-level mupirocin-resistant strains were negative for the mupA gene but showed evidence of biofilm formation. In conclusion, biofilm formation may be suggested to play a role in mupirocin resistance besides the presence of a genetic element encoding abnormal isoleucyl-tRNA synthetase, however further studies are needed to confirm these findings. PMID:27436387

  13. The effect of hospital infection control policy on the prevalence of surgical site infection in a tertiary hospital in South-South Nigeria

    PubMed Central

    Brisibe, Seiyefa Fun-Akpa; Ordinioha, Best; Gbeneolol, Precious K.

    2015-01-01

    Background: Surgical site infections (SSIs) are a significant cause of morbidity, emotional stress and financial cost to the affected patients and health care institutions; and infection control policy has been shown to reduce the burden of SSIs in several health care institutions. This study assessed the effects of the implementation of the policy on the prevalence of SSI in the University of Port Harcourt Teaching Hospital, Nigeria. Patients and Methods: A review of the records of all Caesarean sections carried out in the hospital, before and 2 years after the implementation of the infection control policy was conducted. Data collected include the number and characteristics of the patients that had Caesarean section in the hospital during the period and those that developed SSI while on admission. Results: The proportion of patients with SSI decreased from 13.33% to 10.34%, 2 years after the implementation of the policy (P-value = 0.18). The implementation of the policy did not also result in any statistically significant change in the nature of the wound infection (P-value = 0.230), in the schedule of the operations (P-value = 0.93) and in the other predisposing factors of the infections (P-value = 0.72); except for the significant decrease in the infection rate among the un-booked patients (P-value = 0.032). Conclusion: The implementation of the policy led to a small decrease in SSI, due to the non-implementation of some important aspects of the WHO policy. The introduction of surveillance activities, continuous practice reinforcing communications and environmental sanitation are recommended to further decrease the prevalence of SSI in the hospital. PMID:26229228

  14. The North Korean nuclear dilemma.

    SciTech Connect

    Hecker, Siegfried S.

    2004-01-01

    The current nuclear crisis, the second one in ten years, erupted when North Korea expelled international nuclear inspectors in December 2002, then withdrew from the Nuclear Nonproliferation Treaty (NPT), and claimed to be building more nuclear weapons with the plutonium extracted from the spent fuel rods heretofore stored under international inspection. These actions were triggered by a disagreement over U.S. assertions that North Korea had violated the Agreed Framework (which froze the plutonium path to nuclear weapons to end the first crisis in 1994) by clandestinely developing uranium enrichment capabilities providing an alternative path to nuclear weapons. With Stanford University Professor John Lewis and three other Americans, I was allowed to visit the Yongbyon Nuclear Center on Jan. 8, 2004. We toured the 5 MWe reactor, the 50 MWe reactor construction site, the spent fuel pool storage building, and the radiochemical laboratory. We concluded that North Korea has restarted its 5 MWe reactor (which produces roughly 6 kg of plutonium annually), it removed the 8000 spent fuel rods that were previously stored under IAEA safeguards from the spent fuel pool, and that it most likely extracted the 25 to 30 kg of plutonium contained in these fuel rods. Although North Korean officials showed us what they claimed was their plutonium metal product from this reprocessing campaign, we were not able to conclude definitively that it was in fact plutonium metal and that it came from the most recent reprocessing campaign. Nevertheless, our North Korean hosts demonstrated that they had the capability, the facility and requisite capacity, and the technical expertise to produce plutonium metal. On the basis of our visit, we were not able to address the issue of whether or not North Korea had a 'deterrent' as claimed - that is, we were not able to conclude that North Korea can build a nuclear device and that it can integrate nuclear devices into suitable delivery systems. However

  15. Are Korean Patients Different from Other Ethnic Groups in Total Knee Arthroplasty?

    PubMed Central

    Kim, Dong-Kyoon; Seo, Min-Chul; Song, Sang-Joon

    2015-01-01

    Most of the implants used for total knee arthroplasty (TKA) in Asian patients have been produced based on anthropometry of Western people. Since anatomic features and life styles are different between Western and Eastern people, there would be ethnic differences in terms of conformity of implants to the patient's anatomy or clinical results after TKA. Therefore, surgeons in Asia are particularly interested in related surgical techniques and implant designs used in TKA for improved clinical results and patient satisfaction. In this review, we investigated the anthropometric differences of Koreans from Westerners. Koreans are of shorter stature, less weight, and smaller skeletal structure and have a higher incidence of constitutional varus alignment of the lower extremity. Moreover, compared to Westerner TKA populations, the proportion of female patients was large and primary osteoarthritis was prevalent in preoperative diagnosis in Korean TKA patients. Culturally, Koreans have life styles that demand high flexion positions of the knee such as squatting, kneeling, and cross-legged sitting. Although there were no notable differences in the complication and revision rates following TKA between Westerners and Koreans, the incidence of postoperative deep vein thrombosis and pulmonary thromboembolism was lower in Koreans than Westerners. We hope that further research on implant designs and more interest in TKA will improve outcomes in Korean patients. PMID:26675374

  16. REMODELING CHARACTERISTICS AND COLLAGEN DISTRIBUTION IN BIOLOGICAL SCAFFOLD MATERIALS EXPLANTED FROM HUMAN SUBJECTS AFTER ABDOMINAL SOFT TISSUE RECONSTRUCTION: AN ANALYSIS OF SCAFFOLD REMODELING CHARACTERISTICS BY PATIENT RISK FACTORS AND SURGICAL SITE CLASSIFICATIONS

    PubMed Central

    Cavallo, Jaime A.; Roma, Andres A.; Jasielec, Mateusz S.; Ousley, Jenny; Creamer, Jennifer; Pichert, Matthew D.; Baalman, Sara; Frisella, Margaret M.; Matthews, Brent D.; Deeken, Corey R.

    2014-01-01

    OBJECTIVE The study purpose was to evaluate the associations between patient characteristics or surgical site classifications and the histologic remodeling scores of biologic meshes biopsied from abdominal soft tissue repair sites in the first attempt to generate a multivariable risk prediction model of non-constructive remodeling. INTRODUCTION Host characteristics and surgical site assessments may predict remodeling degree for biologic meshes used to reinforce abdominal tissue repair sites. METHODS Biologic meshes were biopsied from the abdominal tissue repair sites of n=40 patients during an abdominal re-exploration, stained with hematoxylin and eosin, and evaluated according to a semi-quantitative scoring system for remodeling characteristics [cell types (CT), cell infiltration (CI), extracellular matrix (ECM) deposition, scaffold degradation (SD), fibrous encapsulation (FE), and neovascularization (NEO)] and a mean composite score (CR). Biopsies were stained with Sirius Red & Fast Green, and analyzed to determine the collagen I:III ratio. Based on univariate analyses between subject clinical characteristics or surgical site classification and the histologic remodeling scores, cohort variables were selected for multivariable regression models using a p-value ≤0.200. RESULTS The model selection process for CI score yielded 2 variables: age at mesh implantation and mesh classification (c-statistic=0.989). For CR score, the model selection process yielded 2 variables: age at mesh implantation and mesh classification (r2=0.449). CONCLUSION These preliminary results constitute the first steps in generating a risk prediction model that predicts the patients and clinical circumstances most likely to experience non-constructive remodeling of abdominal tissue repair sites with biologic mesh reinforcement. PMID:24374547

  17. Remodeling characteristics and collagen distribution in synthetic mesh materials explanted from human subjects after abdominal wall reconstruction: an analysis of remodeling characteristics by patient risk factors and surgical site classifications

    PubMed Central

    Cavallo, Jaime A.; Roma, Andres A.; Jasielec, Mateusz S.; Ousley, Jenny; Creamer, Jennifer; Pichert, Matthew D.; Baalman, Sara; Frisella, Margaret M.; Matthews, Brent D.

    2014-01-01

    Background The purpose of this study was to evaluate the associations between patient characteristics or surgical site classifications and the histologic remodeling scores of synthetic meshes biopsied from their abdominal wall repair sites in the first attempt to generate a multivariable risk prediction model of non-constructive remodeling. Methods Biopsies of the synthetic meshes were obtained from the abdominal wall repair sites of 51 patients during a subsequent abdominal re-exploration. Biopsies were stained with hematoxylin and eosin, and evaluated according to a semi-quantitative scoring system for remodeling characteristics (cell infiltration, cell types, extracellular matrix deposition, inflammation, fibrous encapsulation, and neovascularization) and a mean composite score (CR). Biopsies were also stained with Sirius Red and Fast Green, and analyzed to determine the collagen I:III ratio. Based on univariate analyses between subject clinical characteristics or surgical site classification and the histologic remodeling scores, cohort variables were selected for multivariable regression models using a threshold p value of ≤0.200. Results The model selection process for the extracellular matrix score yielded two variables: subject age at time of mesh implantation, and mesh classification (c-statistic = 0.842). For CR score, the model selection process yielded two variables: subject age at time of mesh implantation and mesh classification (r2 = 0.464). The model selection process for the collagen III area yielded a model with two variables: subject body mass index at time of mesh explantation and pack-year history (r2 = 0.244). Conclusion Host characteristics and surgical site assessments may predict degree of remodeling for synthetic meshes used to reinforce abdominal wall repair sites. These preliminary results constitute the first steps in generating a risk prediction model that predicts the patients and clinical circumstances for which non

  18. Korean Advanced Course, Volume I.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This is the first of 7 readers for continuation training in Korean after the completion of the "Korean Basic Course" prepared by the Defense Language Institute. Units 1-11 are practical situation dialogues written for the course and center on topics related to sports, social events, police administration, and dialects. Interviews with key…

  19. Korean Advanced Course: Volume II.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This is the second of seven readers, prepared by the Defense Language Institute, for continuation training in Korean after the Basic Course. The 20 reading lessons, printed in Korean script, have been drawn from several readers published by the Ministry of Education of the Republic of Korea in 1970. Each unit concludes with a set of questions and…

  20. Classifying Korean Adolescents' Career Preparedness

    ERIC Educational Resources Information Center

    Lee, In Heok; Rojewski, Jay W.; Hill, Roger B.

    2013-01-01

    Latent class analysis was used to examine the career preparation of 5,227 11th-grade Korean adolescents taken from the Korean Education Longitudinal Study of 2005 (KELS:2005). Three career preparedness groups were identified, to reflecting Skorikov's ("J Vocat Behav" 70:8-24, 2007) conceptualization of career preparedness: prepared, confused, and…

  1. Korean/Korean American Adolescents' Responses to Young Adult Fiction and Media Created by Korean/Korean Americans

    ERIC Educational Resources Information Center

    Kim, Eunhyun

    2010-01-01

    Multicultural children's and young adult literature provides readers with various opportunities: to mirror their lives and reflect the meanings of their own experiences; to gain insight on social issues as well as personal issues; and to enhance cross-cultural awareness. How might Korean/Korean American youth cope with everyday life as a minority…

  2. Voices of Korean American Women.

    ERIC Educational Resources Information Center

    Harris-Hastick, Eda F.

    1996-01-01

    Addresses issues of race, gender, and the immigrant experience, focusing on Korean-American women. Highlights myths and stereotypes surrounding Asian Americans and issues of immigrant adaptation and survival. Presents excerpts from a conversation among three Korean-American women, discussing issues related to race relations and the traditional…

  3. Korean Heritage Language Maintenance and Language Ideology

    ERIC Educational Resources Information Center

    Jeon, Mihyon

    2008-01-01

    This paper explores ways in which language ideology is linked to maintenance of Korean as a heritage language by Koreans in America. The data for this ethnographic study come from three separate sources: 1) a Korean language program at an American university; 2) a community-based ESL program for Korean seniors; and 3) a recently immigrated Korean…

  4. The Korean Americans. The New Americans Series.

    ERIC Educational Resources Information Center

    Hurh, Won Moo

    The history and culture of Korean immigrants to the United States are described in the following chapters: (1) "Korean Ethnic Roots: The Land, History, People, and Culture"; (2) "Korean Immigration to the United States: A Historical Overview"; (3) "Economic Adjustment"; (4) "Cultural and Social Adaptation"; (5) "Family Life"; (6) "Korean Ethnic…

  5. The United States Enters the Korean Conflict. Teaching with Documents.

    ERIC Educational Resources Information Center

    National Archives and Records Administration, Washington, DC.

    After World War II the United States centered its foreign policy on the containment of communism, at home and abroad. Although it was aimed primarily at containing the spread of communism in Europe, the policy also extended to Asia. Asia proved to be the site of the first major battle waged in the name of containment: the Korean War. Dividing…

  6. Efficiency of Local Antiseptic Alkosol (Ethanol, Isopropanol-30g and Ortophenilphenol) and Povidone Iodide on the Incidence Of Surgical Site Infection After Inguinal Hernioplasty

    PubMed Central

    Djozic, Harun; Pandza, Haris; Hasukic, Sefik; Custovic, Samir; Pandza, Berina; Krupalija, Amina; Beciragic, Edin

    2016-01-01

    Background: The risk of wound infection after elective inguinal hernia repair depends on several factors. One of the most important factors is the preoperative skin preparation. The use of antisepsis is performed to reduce the risk of surgical site infections (SSIs) and to remove causing organisms. This work compares two different agent forms for preoperative skin preparation to prevent SSIs. Objectives: The objective of the study is comparing the effects of two different agents used for preoperative skin preparation and prevention of SSIs. Material and methods: 100 adult patients were divided and randomized into two groups, each containing 50 patients. Both groups included patients that are scheduled for elective Lichtenstein inguinal hernia repair. The first group includes patients whose skin preparations were done with povidone iodine (PI) only. The second group included patients that are treated with two antiseptics; Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide. Alkosol is applied before the induction of anesthesia. The povidone iodide is applied after Alkosol has evaporated. The presence of bacterial growth in the wound was determined 24 and 48 hours after operation. Swabs were used to take samples, which were then cultivated to check for bacterial growth. The presence of infection was also determined by the following criteria: pain or tenderness, induration, erythema, local warmth of the wound etc. Results: The surgeon or clinician declared that after 24 hours the wound was infected in 20 patients in the control group and in 22 patients after 48 hours. In the Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide group infection was declared in only 3 patients after 24 hours. Discussion: Compared to the use of providone only, the use of Alkosol (96% ethanol, isopropanol-30g and ortophenilphenol-0.1g) and povidone iodide has many advantages and was associated with lower rates of SSIs

  7. Lymphopenia and Elevated Blood C-Reactive Protein Levels at Four Days Postoperatively Are Useful Markers for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery

    PubMed Central

    Shigematsu, Hideki; Koizumi, Munehisa; Nakajima, Hiroshi; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Tanaka, Yasuhito

    2016-01-01

    Study Design Case-control study. Purpose To identify the characteristics of candidate indexes for early detection of surgical site infection (SSI). Overview of Literature SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial for the welfare of the patient postoperation. Methods We retrospectively reviewed laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spine disease. The sensitivity and specificity of six laboratory markers for early detection of SSI were calculated: greater elevation of the white blood cell count at day 7 than at day 4 postoperatively, greater elevation of the C-reactive protein (CRP) level at day 7 than at day 4 postoperatively, a CRP level of >10 mg/dL at 4 days postoperatively, neutrophil percentage of >75% at 4 days postoperatively, a lymphocyte percentage of <10% at 4 days postoperatively, and a lymphocyte count of <1,000/µL at 4 days postoperatively. Statistical analysis was via Fisher's exact test and a p-value of <0.05 was considered significant. Results In total, 85 patients were enrolled. Of these, five patients developed deep SSI. The sensitivity and specificity of each index were as follows: index 1, 20.0% and 77.5%; index 2, 20.0% and 83.8%; index 3, 40.0% and 97.5%; index 4, 40.0% and 86.3%; index 5, 0% and 96.3%; and index 6, 80.0% and 80.0%. A significant difference was noted for indexes 3 and 6. Conclusions A CRP level of >10 mg/dL at 4 days postoperatively would be useful for definitive diagnosis of SSI, and a lymphocyte count of <1,000/µL at 4 days postoperatively would be a useful screening test for SSI. Although laboratory markers for early detection of SSI have been frequently reported, we believe that it is important to understand the characteristics of each index for a precise diagnosis. PMID:27114760

  8. Systematic review and meta-analysis of sutures coated with triclosan for the prevention of surgical site infection after elective colorectal surgery according to the PRISMA statement

    PubMed Central

    Sandini, Marta; Mattavelli, Ilaria; Nespoli, Luca; Uggeri, Fabio; Gianotti, Luca

    2016-01-01

    Abstract Background: Several randomized clinical trials (RCTs) conducted to evaluate the effect of triclosan-coated suture on surgical site infection (SSI) yield to controversial results. The primary purpose of this systematic review and meta-analysis was to analyze the available RCTs, comparing the effect of triclosan-coated suture with uncoated suture on the incidence of SSI after elective colorectal operations. As secondary endpoint of the analysis, we considered length of hospital stay after surgery. Methods: We performed a systematic literature review through Medline, Embase, Pubmed, Scopus, Ovid, ISI Web of Science, and the Cochrane Controlled Trials Register searching for RCTs published from 1990 to 2015. To conduct these meta-analyses, we followed the guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Study inclusion criteria were as follows: parallel-group RCTs in adult populations reporting the closure of the abdominal wall after elective colorectal operation with triclosan-coated suture or noncoated suture, and reporting the outcomes considered in the meta-analysis. Results: Six trials including 2168 patients (1102 treated and 1066 controls) provided data on SSIs. The overall rate was 11.7% (129/1102) in the triclosan group and 13.4% (143/1066) in the control group (odds ratio 0.81, 95% confidence interval [CI] 0.58–1.13, P = 0.220). Heterogeneity among studies was moderate (I2 = 44.9%). No evidence of publication bias was detectable. Five RCTs (1783 patients; 914 treated and 689 controls) described hospital length of stay with no significant effect (mean difference: −0.02, 95% CI −0.11 to −0.07, P = 0.668). The I2 test for heterogeneity was 0% (P = 0.836). Moderator analyses showed no significant differences were detected in analyses comparing the suture materials (polydioxanone vs polyglactin). In open-label trials, the odds ratio for SSI risk was 0.62 (95% CI 0.20–1.93, P = 0

  9. Korean atomic bomb victims.

    PubMed

    Sasamoto, Yukuo

    2009-01-01

    After colonizing Korea, Japan invaded China, and subsequently initiated the Pacific War against the United States, Britain, and their allies. Towards the end of the war, U.S. warplanes dropped atomic bombs on Hiroshima and Nagasaki, which resulted in a large number of Koreans who lived in Hiroshima and Nagasaki suffering from the effects of the bombs. The objective of this paper is to examine the history of Korea atomic bomb victims who were caught in between the U.S., Japan, the Republic of Korea (South Korea) and the Democratic People's Republic of Korea (North Korea). PMID:20521424

  10. Korean peninsula: A northeast Asian security concern. Individual study project

    SciTech Connect

    Blackburn, N.G.

    1993-03-22

    North and South Korea have not responded to the New World Order-that Communism is dead and the Cold War Era is over. When the Berlin Wall collapsed and Germany became one nation, Korea emerged as the only divided country remaining in the world. Today, the Korean Peninsula remains divided by ideology, mutual mistrust of national leadership, the 155-mile DMZ, US military presence, conflicting approaches to national reunification, and the North Korean nuclear issue. Thus, the traditional Cold War animosities and political, economic, military paradigms remain entrenched in a divided Korean peninsula. The US Intelligence Community has identified an extensive nuclear center at Yongbyon, 50 miles north of Pyongyang, North Korea's capital, which appears to be a nuclear reactor and reprocessing site. The threat of a nuclear-armed North Korea is a serious regional security concern that will not be taken lightly by such countries as Japan, China, Russia, South Korea, and the United States.

  11. Surgical attire and the operating room: role in infection prevention.

    PubMed

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear. PMID:25187588

  12. The establishment of KORCC (KOrean Renal Cell Carcinoma) database

    PubMed Central

    Hong, Sung Kyu; Lee, Sangchul; Kook, Ha Rim; Lee, Eunsik; Kim, Hyeon Hoe; Kwak, Cheol; Ku, Ja Hyeon; Jeong, Chang Wook; Lee, Ji Youl; Hong, Sung Hoo; Kim, Yong-June; Hwang, Eu Chang; Kwon, Tae Gyun; Kim, Tae-Hwan; Kang, Seok Ho; Kim, Sung Han; Chung, Jinsoo

    2016-01-01

    Purpose The purpose of this article is to report establishment of the 1st Web-based database (DB) system to collect renal cell carcinoma (RCC) data in Korea. Materials and Methods The new Web-based DB system was established to collect basic demographic and clinicopahtological characteristics of a large cohort of patients with RCC in Korea. Data from a total of 6,849 patients were collected from 8 tertiary care hospitals that agreed to participate in organizing the Korean Renal Cell Carcinoma (KORCC) study group as of 1 July 2015. Basic demographic and clinicopathological characteristics were collected. The data of patients who underwent surgical treatments were analyzed to characterize Korean RCC. Results We established the 1st Web-based DB of Korean RCC, a database comprising renal mass management cases from multiple centers in Korea. The data of 5,281 patients who underwent surgical management (mean follow-up, 32 months) were analyzed. The most common symptom was incidentally detected renal mass (76.9%). Clinical T1a was the most common (54.3%) stage and mean tumor size was 4.8±4.2 cm. Radical nephrectomy accounted for 62.7% of cases and an open approach was used in 50.7% and 52.2% of radical and partial nephrectomies, respectively. The 5-year overall, cancer-specific and recurrence-free survival rates were 88.1%, 92.2%, and 88.0%, respectively. Conclusions We report the 1st establishment of a Web-based DB system to collect RCC data in Korea. This DB system will provide a solid basis for the characterization of Korean RCC. PMID:26966726

  13. The Korean Neonatal Network: An Overview

    PubMed Central

    Chang, Yun Sil; Park, Hyun-Young

    2015-01-01

    Currently, in the Republic of Korea, despite the very-low-birth rate, the birth rate and number of preterm infants are markedly increasing. Neonatal deaths and major complications mostly occur in premature infants, especially very-low-birth-weight infants (VLBWIs). VLBWIs weigh less than 1,500 g at birth and require intensive treatment in a neonatal intensive care unit (NICU). The operation of the Korean Neonatal Network (KNN) officially started on April 15, 2013, by the Korean Society of Neonatology with support from the Korea Centers for Disease Control and Prevention. The KNN is a national multicenter neonatal network based on a prospective web-based registry for VLBWIs. About 2,000 VLBWIs from 60 participating hospital NICUs are registered annually in the KNN. The KNN has built unique systems such as a web-based real-time data display on the web site and a site-visit monitoring system for data quality surveillance. The KNN should be maintained and developed further in order to generate appropriate, population-based, data-driven, health-care policies; facilitate active multicenter neonatal research, including quality improvement of neonatal care; and ultimately lead to improvement in the prognosis of high-risk newborns and subsequent reduction in health-care costs through the development of evidence-based neonatal medicine in Korea. PMID:26566355

  14. Clinical characteristics of Peutz-Jeghers syndrome in Korean polyposis patients.

    PubMed

    Choi, H S; Park, Y J; Youk, E G; Yoon, K A; Ku, J L; Kim, N K; Kim, S M; Kim, Y J; Moon, D J; Min, J S; Park, C J; Bae, O S; Yang, D H; Jun, S H; Chung, E S; Jung, P M; Whang, Y; Park, J G

    2000-02-01

    Peutz-Jeghers syndrome is an autosomal dominant inherited disorder characterized by hamartomatous polyps in the small bowel and mucocutaneous pigmentation. Patients with Peutz-Jeghers syndrome often present as surgical emergencies with complications of the polyps, such as intussusception, bowel obstruction, and bleeding. Recently an increased risk of malignancies has also been reported. This study was initiated to determine the clinical features of Peutz-Jeghers syndrome in Korean patients, with special attention to the development of malignancies. Thirty patients with Peutz-Jeghers syndrome were investigated; their median age was 23.5 years, and symptoms appeared at a median age of 12.5 years. Family history was positive in one-half of cases, and mucocutaneous pigmentation was observed in almost all patients (93%). The jejunoileum was the most frequent site of the polyps, and there were generally 10-100 polyps. Multiple laparotomies were performed in a substantial portion of the patients, due mainly to polyp-induced bowel obstruction, and the surgical interventions were begun at a relatively young age (average 21.4 years). Four cases of small-bowel cancer and one case of breast cancer were detected in probands, at a relatively young age (mean 36 years). Cancers of the small bowel, stomach, colon, breast and cervix were diagnosed in the first relatives of the probands. Close follow-up from an early age should thus be performed in patients with Peutz-Jeghers syndrome as they are at high risk of surgical emergency and development of malignancy. PMID:10766089

  15. Korean and Korean American Adolescents' Responses to Literature: Impact of Narratives and Interpretive Community

    ERIC Educational Resources Information Center

    Kim, Eunhyun

    2014-01-01

    How might Korean/Korean American youth cope with everyday life as a minority or a model minority if they had early and consistent exposure to literature depicting the mirrored experiences of Korean/Korean Americans? This study employed qualitative methods and an interpretive approach which enhance understanding of the life experiences, literary…

  16. Residual bone height measured by panoramic radiography in older edentulous Korean patients

    PubMed Central

    Liang, Xiang Hua; Kim, Young-Mi

    2014-01-01

    PURPOSE The aim of this study was to obtain statistical data on the residual bone height at different natural tooth positions by panoramic radiography in edentulous Korean patients aged 60-90 years. MATERIALS AND METHODS The study included the diagnostic panoramic radiographs of 180 randomly selected edentulous patients without systemic diseases affecting bone. The radiographic selection criteria included absence of obvious facial asymmetry, clearly visible anatomic structures, and no surgical and fracture history. The panoramic radiographs of 79 patients met these criteria and were used in the analysis. The same researcher processed all the radiographs by using a standardized method. The height of the residual bone was measured at 18 predetermined sites (7 in the maxilla and 11 in the mandible) on digitized and printed radiographs by using a Digimatic caliper, triangle, and ruler. Gender- and age-related differences were statistically analyzed by using the t-test and rank-sum test (α=0.05). RESULTS The maxillary residual bone height did not show significant gender-related differences, but male patients had significantly higher residual bone in the mandible(P<.05). No significant height differences at the measured sites were noted among the 60s, 70s, and 80s age groups. CONCLUSION Dentists should pay greater attention to older female edentulous patients because they are more prone to rapid residual bone resorption. Residual bone resorption may not be affected by age. PMID:24605207

  17. Koreans in America. In America Series.

    ERIC Educational Resources Information Center

    Patterson, Wayne; Kim, Hyung-chan

    The immigration of Koreans to the United States is traced from 1903, and the contributions Korean Americans have made to the United States are identified in this book which is part of a series for children. The number of Korean immigrants, small for many years, increased dramatically with the easing of government restrictions in the 1960s, until,…

  18. Korean Culture and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Kang-Yi, Christina D.; Grinker, Roy R.; Mandell, David S.

    2013-01-01

    This paper reviews the literature on early child development among Koreans, with a focus on autism spectrum disorders (ASD). The literature review of 951 abstracts in English, 101 abstracts in Korean and 27 full articles published from 1994 to 2011 was performed to understand the presentation of and response to ASD in Korean culture. Based on…

  19. Korean Books and FRBR: An Investigation

    ERIC Educational Resources Information Center

    Kim, Jeong-Hyen; Moon, Ji-Hyun

    2010-01-01

    Purpose: The purpose of this study is to investigate the characteristics of Korean books by analysing their "work types" based on the Functional Requirements for Bibliographic Records (FRBR) model. Design/methodology/approach: A total of 1,000 Korean books were randomly chosen from the Korean National Bibliography (KNB) 2008 at the National…

  20. Korean Experience and Achievement in Higher Education

    ERIC Educational Resources Information Center

    Lee, Jeong-Kyu

    2001-01-01

    The purpose of this paper is to introduce the transition of Korean education reform and to weigh Korean experience and achievement in contemporary higher education. The paper first of all illustrates a historical perspective on higher education in light of educational reform. Secondly, this study reviews the achievements of Korean higher education…

  1. Select Bibliography of the Korean War.

    ERIC Educational Resources Information Center

    Sandler, Stanley

    2000-01-01

    Discusses various resources on the history of the Korean War that include, but are not limited to, works from the North Korean perspective, "standard" accounts from a western perspective that identify U.S. and South Korean shortcomings, and works on the secrecy around U.S. special operations. Provides a detailed bibliography. (CMK)

  2. Receptor Binding Sites for Substance P, but not Substance K or Neuromedin K, are Expressed in High Concentrations by Arterioles, Venules, and Lymph Nodules in Surgical Specimens Obtained from Patients with Ulcerative Colitis and Crohn Disease

    NASA Astrophysics Data System (ADS)

    Mantyh, Christopher R.; Gates, Troy S.; Zimmerman, Robert P.; Welton, Mark L.; Passaro, Edward P.; Vigna, Steven R.; Maggio, John E.; Kruger, Lawrence; Mantyh, Patrick W.

    1988-05-01

    Several lines of evidence indicate that tachykinin neuropeptides [substance P (SP), substance K (SK), and neuromedin K (NK)] play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. Surgical specimens of colon were obtained from patients with ulcerative colitis (n = 4) and Crohn disease (n = 4). Normal tissue was obtained from uninvolved areas of extensive resections for carcinoma (n = 6). In all cases, specimens were obtained <5 min after removal to minimize influences associated with degradation artifacts and were processed for quantitative receptor autoradiography by using 125I-labeled Bolton--Hunter conjugates of NK, SK, and SP. In the normal colon a low concentration of SP receptor binding sites is expressed by submucosal arterioles and venules and a moderate concentration is expressed by the external circular muscle, whereas SK receptor binding sites are expressed in low concentrations by the external circular and longitudinal muscle. In contrast, specific NK binding sites were not observed in any area of the human colon. In colon tissue obtained from ulcerative colitis and Crohn disease patients, however, very high concentrations of SP receptor binding sites are expressed by arterioles and venules located in the submucosa, muscularis mucosa, external circular muscle, external longitudinal muscle, and serosa. In addition, very high concentrations of SP receptor binding sites are expressed within the germinal center of lymph nodules, whereas the concentrations of SP and SK binding sites expressed by the external muscle layers are not altered significantly. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations (1000-2000 times normal) by cells

  3. 21 CFR 878.4370 - Surgical drape and drape accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... site of surgical incision from microbial and other contamination. The device includes a plastic wound protector that may adhere to the skin around a surgical incision or be placed in a wound to cover...

  4. Military confidence building on the Korean Peninsula: possible first steps toward cooperation

    SciTech Connect

    Vannoni, M.

    1997-05-01

    The Korean Peninsula is one of the world`s most tense military confrontational sites. Nearly 2 million North Korean, South Korean, and U.S. troops face each other along the 255-km long military demarcation line. Confidence building measures (CBMs), particularly military ones, that address the security needs of both countries could decrease the danger of conflict and help create an environment where a peace regime might be negotiated. In spite of the present high level of mutual distrust, steps can still be taken to prepare for future development and implementation of CBMs. This paper defines some simple and specific first steps toward CBMs that might be useful on the Korean Peninsula.

  5. Challenges of Discourses on "Model Minority" and "South Korean Wind" for Ethnic Koreans' Schooling in Northeast China

    ERIC Educational Resources Information Center

    Fang, Gao

    2009-01-01

    The educational success of ethnic Koreans in China has been achieved through Mandarin-Korean bilingual education, with the Korean language as the medium of instruction. Using the data collected as part of an ethnographic research on Korean elementary school students in a national Korean school in China, this article examines the relation between…

  6. Simulation in Surgical Education

    PubMed Central

    de Montbrun, Sandra L.; MacRae, Helen

    2012-01-01

    The pedagogical approach to surgical training has changed significantly over the past few decades. No longer are surgical skills solely acquired through a traditional apprenticeship model of training. The acquisition of many technical and nontechnical skills is moving from the operating room to the surgical skills laboratory through the use of simulation. Many platforms exist for the learning and assessment of surgical skills. In this article, the authors provide a broad overview of some of the currently available surgical simulation modalities including bench-top models, laparoscopic simulators, simulation for new surgical technologies, and simulation for nontechnical surgical skills. PMID:23997671

  7. Electronic surgical record management.

    PubMed

    Rockman, Justin

    2010-01-01

    This paper explores the challenges surgical practices face in coordinating surgeries and how the electronic surgical record management (ESRM) approach to surgical coordination can solve these problems and improve efficiency. Surgical practices continue to experience costly inefficiencies when managing surgical coordination. Application software like practice management and electronic health record systems have enabled practices to "go digital" for their administrative, financial, and clinical data. However, surgical coordination is still a manual and labor-intensive process. Surgical practices need to create a central and secure record of their surgeries. When surgical data are inputted once only and stored in a central repository, the data are transformed into active information that can be outputted to any form, letter, calendar, or report. ESRM is a new approach to surgical coordination. It enables surgical practices to automate and streamline their processes, reduce costs, and ensure that patients receive the best possible care. PMID:20480775

  8. Korean Basic Course. Volume Two.

    ERIC Educational Resources Information Center

    Park, B. Nam

    Volume Two of the Korean Basic Course contains Units 29 through 47. Most units consist of (1) a basic dialog, (2) notes on the basic dialog, (3) additional vocabulary and phrases, (4) grammar notes, (5) drills, (6) a supplementary dialog for comprehension, (7) a narrative for comprehension and reading, and (8) exercises. Two of the last units…

  9. Structural Case Assignment in Korean

    ERIC Educational Resources Information Center

    Koak, Heeshin

    2012-01-01

    In this dissertation, I aim to provide a theory on the distribution of structural Case in Korean. I propose the following Structural Case Assignment Hypothesis (SCAH) regarding the assignment of structural Case: "Structural Case is assigned by phase heads (C: nominative; v: accusative) to every argument in the c-command domain of the phase…

  10. Postpartum nursing for Korean mothers.

    PubMed

    Schneiderman, J U

    1996-01-01

    Growing numbers of Korean-Americans require US health care workers to become knowledgeable of and sensitive to the cultural beliefs and customs of Korean patients. To further such understanding, health behaviors related to infant care and family involvement in the postpartum period were observed in a Los Angeles, California, hospital located in a Korean community. Notable in unassimilated Korean families were the power of the mother-in-law to assume control of decisions regarding infant care and the tendency of new mothers to defer to their mothers-in-law rather than ask nurses for advice. There is a cultural perception that the new mother is sick and unable to handle her infant. Other practices identified include a special diet of seaweed soup, avoidance of cold (including the rejection of ice packs against pain), resistance to breast feeding, preference for a male child, and modesty in the presence of men. In some cases, clinical considerations conflicted with cultural traditions. Respectful teaching, in nonverbal ways if there is a language barrier, and modeling of infant care techniques are recommended. Disregard for childbirth-associated cultural traditions on the part of medical staff can only increase the stress for the infant and family. PMID:8857400

  11. Two Causative Constructions in Korean.

    ERIC Educational Resources Information Center

    Choi, Dong-Ik

    1993-01-01

    Two types of causative constructions in Korean behave differently both syntactically and semantically. This paper presents the syntactic differences between syntactic causative constructions and morphological causative constructions in terms of merger process of argument structures, and in the Case assignment in the two constructions in terms of…

  12. Beginning Korean. Yale Linguistic Series.

    ERIC Educational Resources Information Center

    Martin, Samuel E.; Lee, Young-Sook C.

    A "model of structural linguistic analysis as well as a teaching tool," this text is designed to give the student a comprehensive grasp of the essentials of modern Korean in 25 lessons, with 5 review lessons, leading to advanced levels of proficiency. It is intended to be used by adult students working either in classes or by themselves, with the…

  13. Asian Pacific Perspectives: Korean Americans.

    ERIC Educational Resources Information Center

    Los Angeles Unified School District, CA.

    These instructional materials on Korean Americans for elementary students were developed through the K.E.Y.S. project (Knowledge of English Yields Success). Information is included about early immigrants, the second generation, student groups, war brides, recent immigrants, and third and fourth generations. A chart of traditional and modified…

  14. Revised dietary guidelines for Koreans.

    PubMed

    Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

    2008-01-01

    With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet. PMID:18296301

  15. Black raspberry: Korean vs. American

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This fact sheet shows Korean black raspberry (Rubus coreanus) fruit, flower, and leaf features that distinguish them from their Rubus relatives, black raspberry (R. occidentalis) native to America. Common names with fruit characteristics, including berry size and pigment fingerprints, are summarized...

  16. Cultural Identity in Korean English

    ERIC Educational Resources Information Center

    Chang, Bok-Myung

    2010-01-01

    This study aims to investigate the cultural identity of Korean English and to make the intercultural communications among non-native speakers successful. The purposes of this study can be summarized as follows: 1) to recognize the concept of English as an International Language (EIL), 2) to emphasize cross-cultural understanding in the globalized…

  17. Korean Basic Course: Area Background.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    Designed to serve as an introduction to some aspects of Korean culture and civilization, this text consists largely of lectures on various topics prepared by staff members of the Defense Language Institute. The major section on the Republic of South Korea includes information on: (1) the historical setting; (2) the politico-military complex; (3)…

  18. A KOREAN-ENGLISH DICTIONARY.

    ERIC Educational Resources Information Center

    MARTIN, SAMUEL E.; AND OTHERS

    ALTHOUGH THE PURPOSE OF THIS DICTIONARY IS TO "GIVE A FULL AND ACCURATE PORTRAYAL OF THE BASIC NATIVE KOREAN VOCABULARY," SOME OF THE COMMON AND USEFUL CHINESE AND EUROPEAN LOANWORDS HAVE BEEN INCLUDED AS WELL. THE AUTHORS (SAMUEL E. MARTIN, YANG HA LEE, AND SUNG-UN CHANG) HAVE FOLLOWED THE HANKUL SPELLING CONVENTIONS OF THE "UNIFIED SYSTEM" AND…

  19. New palatal distraction device by both bone-borne and tooth-borne force application in a paramedian bone anchorage site: surgical and occlusal considerations on clinical cases.

    PubMed

    Cortese, Antonio; Savastano, Germano; Amato, Massimo; Cantone, Antonio; Boschetti, Ciro; Claudio, Pier Paolo

    2014-03-01

    Maxillary constriction is a very common pathology with implications on dental occlusion, temporomandibular joint dysfunction, nasal breathing, and impairment on the smile and face esthetic.New techniques for expansion of the maxillary bones are particularly useful in relation to the new esthetic ideals of smile and face beauty.To achieve a bodily expansion of the maxillary bones, we developed a new rigid palatal distractor device with both tooth-borne and paramedian bone-borne anchorages to achieve a safe and simple anchorage site suitable also for orthodontic appliances.The reported cases show good results, with bodily maxillary expansion and cross-bite correction without any problems or complications. Substantial advantages of this new device and technique, in comparison with other commonly used palatal distractors, consisting of bodily maxillary movements, avoidance of relapse risks, and safe and simple screw insertion site for bone anchorage also suitable for orthodontic movements, are discussed. PMID:24577304

  20. Participation motivation and competition anxiety among Korean and non-Korean wheelchair tennis players

    PubMed Central

    Jeong, Irully; Park, Sunghee

    2013-01-01

    The purpose of this study was to examine differences in participation motivation and competition anxiety between Korean and non-Korean wheelchair tennis players and to identify relations between participation motivation and competition anxiety in each group. Sixty-six wheel-chair tennis players who participated in the 2013 Korea Open Wheel-chair Tennis Tournament in Seoul completed the Participation Motivation Survey and the Competitive State Anxiety Inventory II. Data were analyzed by a frequency analysis, descriptive statistics, Pearson’s correlation analysis, and independent samples t-test to identify participants’ demographic characteristics, differences in participation motivation, competition anxiety between Korean and non-Korean players, and correlations between participation motivation and competition anxiety in each group. Korean players reported significantly higher motivation in purification compared to non-Korean players, whereas non-Korean players reported significantly higher motivation in enjoyment. In addition, non-Korean players demonstrated higher cognitive anxiety and self-confidence compared to Korean players. Moreover, the physical anxiety of Korean players was negatively correlated with learning, health-fitness, and enjoyment motivation. On the other hand, only self-confidence was significantly related to learning motivation and enjoyment motivation in non-Korean players. Thus, the results presented herein provide evidence for the development of specialized counseling programs that consider the psychological characteristics of Korean wheelchair tennis players. PMID:24409429

  1. Korean Adoptee Identity: Adoptive and Ethnic Identity Profiles of Adopted Korean Americans

    ERIC Educational Resources Information Center

    Beaupre, Adam J.; Reichwald, Reed; Zhou, Xiang; Raleigh, Elizabeth; Lee, Richard M.

    2015-01-01

    Adopted Korean adolescents face the task of grappling with their identity as Koreans and coming to terms with their adoptive status. In order to explore these dual identities, the authors conducted a person-centered study of the identity profiles of 189 adopted Korean American adolescents. Using cluster analytic procedures, the study examined…

  2. Korean American College Students' Language Practices and Identity Positioning: "Not Korean, but Not American"

    ERIC Educational Resources Information Center

    Kang, Hyun-Sook

    2013-01-01

    This article explores the intersection between language practices and ethnic identity for 8 second-generation Korean American learners who were participating in a Korean-as-a-foreign-language (KFL) class at a U.S. university. This study aims to examine the fluid nature of ethnic identity by examining how Korean heritage learners negotiate,…

  3. Learning Korean Language in China: Motivations and Strategies of Non-Koreans

    ERIC Educational Resources Information Center

    Gao, Fang

    2010-01-01

    The ethnographic research reported in this article documents how a group of non-Korean families, whose children are participating in a Korean bilingual school in Northeast China, construct their motivations and strategies of learning Korean language. The main motivation of expectancy of further education opportunities and success in future career…

  4. Abortion - surgical - aftercare

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  5. [SURGICAL HAND WASHING: HANDSCRUBBING OR HANDRUBBING].

    PubMed

    Santacatalina Mas, Roser; Peix Sagues, Ma Teresa; Miranda Salmerón, Josep; Claramunt Jofre, Marta; López López, Alba; Salas Marco, Elena

    2016-02-01

    The importance of protocols for preoperative antisepsis of the hands is given by the risk of transferring bacteria from the hands of the surgical team to the patient during surgery and it is relationship with infection of surgical wound site (SSI). Careful surgical scrub reduces the number of bacteria on the skin, but does not eliminate them completely, remaining transient microorganisms on hands after the surgical scrub. There fore if micropuncture in surgical gloves occurs, the correct preoperative preparation of hands and double gloving will be essential to reduce the risk of bacterial transmission to patients. The protocols for surgical hand antisepsis are two: Surgical scrub with antiseptic soap (hand scrubbing). Surgical scrub by rubbing alcohol (handrubbing). The hand antisepsis by rubbing with an alcohol solution has proved to be significantly more effective compared to soap solutions. We must also see that in surgical hand antisepsis with soap, you must rinse them with water. And often hospitals' taps and keys are contaminated by Pseudomonas spp., including P. aeuinosa. PMID:27101645

  6. Protocol for a randomised controlled trial comparing aqueous with alcoholic chlorhexidine antisepsis for the prevention of superficial surgical site infection after minor surgery in general practice: the AVALANCHE trial

    PubMed Central

    Heal, C F; Charles, D; Hardy, A; Delpachitra, M; Banks, J; Wohlfahrt, M; Saednia, Sabine; Buettner, P

    2016-01-01

    Introduction Surgical site infection (SSI) after minor skin excisions has a significant impact on patient morbidity and healthcare resources. Skin antisepsis prior to surgical incision is used to prevent SSI, and is performed routinely worldwide. However, in spite of the routine use of skin antisepsis, there is no consensus regarding which antiseptic agents are most effective. The AVALANCHE trial will compare Aqueous Versus Alcoholic Antisepsis with Chlorhexidine for Skin Excisions. Methods and analysis The study design is a prospective, randomised controlled trial (RCT) with the aim of investigating the impact of two different antiseptic preparations on the incidence of superficial SSI in patients undergoing minor skin excisions. The intervention of 0.5% chlorhexidine gluconate (CHG) in 70% alcohol will be compared with that of 0.5% CHG in aqueous solution. The trial will be conducted in four Australian general practices over a 9-month period, with 920 participants to be recruited. Consecutive patients presenting for minor skin excisions will be eligible to participate. Randomisation will be on the level of the patient. The primary outcome is superficial SSI in the first 30 days following the excision. Secondary outcomes will be adverse effects, including anaphylaxis, skin irritation, contact dermatitis and rash and patterns of antibiotic resistance. Ethics and dissemination The study has been approved by the James Cook University Human Research Ethics Committee (HREC). Findings will be disseminated in conference presentations and journals and through online electronic media. Discussion RCTs conducted in general practice differ from hospital-based projects in terms of feasibility, pragmatism and funding. The success of this trial will be cemented in the fact that the research question was established by a group of general practitioners who identified an interesting question which is relevant to their clinical practice and not answered by current evidence. Trial

  7. Too Korean to be White and Too White to Be Korean: Ethnic Identity Development among Transracial Korean American Adoptees

    ERIC Educational Resources Information Center

    Hoffman, Joy; Pena, Edlyn Vallejo

    2013-01-01

    The purpose of this grounded theory study was to explore how lived experiences affect ethnic identity development of transracial Korean American adoptees raised by White parents with the intent of informing higher education practice. Participants included 12 recently college-graduated transracial Korean American adoptees who were raised in the…

  8. The application of evidence-based measures to reduce surgical site infections during orthopedic surgery - report of a single-center experience in Sweden

    PubMed Central

    2012-01-01

    Background Current knowledge suggests that, by applying evidence-based measures relating to the correct use of prophylactic antibiotics, perioperative normothermia, urinary tract catheterization and hand hygiene, important contributions can be made to reducing the risk of postoperative infections and device-related infections. The aim of this study was to explore and describe the application of intraoperative evidence-based measures, designed to reduce the risk of infection. In addition, we aimed to investigate whether the type of surgery, i.e. total joint arthroplasty compared with tibia and femur/hip fracture surgery, affected the use of protective measures. Method Data on the clinical application of evidence-based measures were collected structurally on site during 69 consecutively included operations involving fracture surgery (n = 35) and total joint arthroplasties (n = 34) using a pre-tested observation form. For observations in relation to hand disinfection, a modified version of the World Health Organization hand hygiene observation method was used. Results In all, only 29 patients (49%) of 59 received prophylaxis within the recommended time span. The differences in the timing of prophylactic antibiotics between total joint arthroplasty and fracture surgery were significant, i.e. a more accurate timing was implemented in patients undergoing total joint arthroplasty (p = 0.02). Eighteen (53%) of the patients undergoing total joint arthroplasty were actively treated with a forced-air warming system. The corresponding number for fracture surgery was 12 (34%) (p = 0.04). Observations of 254 opportunities for hand hygiene revealed an overall adherence rate of 10.3% to hand disinfection guidelines. Conclusions The results showed that the utilization of evidence-based measures to reduce infections in clinical practice is not sufficient and there are unjustifiable differences in care depending on the type of surgery. The poor adherence to hand

  9. Development of the Korean Career Indecision Inventory.

    ERIC Educational Resources Information Center

    Tak, Jinkook; Lee, Ki-Hak

    2003-01-01

    Five analyses using Korean college students (n=283, 700, 844, 306, 315) were conducted to develop the Korean Career Indecision Inventory. Five factors emerged consistently and were confirmed by factor analysis: lack of career information, lack of necessity recognition, lack of self-identity, indecisiveness, and external barriers. Reliability and…

  10. Korean Education and Foreign Assistance Programs.

    ERIC Educational Resources Information Center

    Korean Central Education Research Inst., Seoul.

    Since the problems facing Korean education arise from very complicated factors, it was felt that the objective views of foreign observers would undoubtedly be of great help in efforts to solve them. In this connection, the Central Education Research Institute held a Seminar on Korean Education with the participation of foreign agencies in Korea…

  11. Culture and the Korean Kindergarten Curriculum.

    ERIC Educational Resources Information Center

    Lee, Ki Sook

    1996-01-01

    Suggests that Korea's cultural changes and trends are reflected in the country's kindergarten curriculum. Provides an overview of traditional Korean early childhood education and the historical evolution of kindergarten curriculum. Discusses the modern national kindergarten curriculum and its relationship to Korean culture and concludes that…

  12. Culture and the Korean Kindergarten Curriculum.

    ERIC Educational Resources Information Center

    Lee, Ki Sook

    This paper examines the relationship between Korean culture and the historical development of its kindergarten (preschool) curriculum. After reviewing the values that were emphasized in traditional Korean society, focusing on ethics, loyalty and filial piety, propriety, and gender roles, the paper provides examples of how these values influences…

  13. The Cultural Negotiations of Korean Immigrant Youth

    ERIC Educational Resources Information Center

    Yeh, Christine J.; Ma, Pei-Wen; Madan-Bahel, Anvita; Hunter, Carla D.; Jung, Sunna; Kim, Angela B.; Akitaya, Kyoko; Sasaki, Kiyoko

    2005-01-01

    The authors investigated the process of cultural adjustment among 13 Korean immigrant youths using consensual qualitative research (C. E. Hill, B. J. Thompson, & E. N. Williams, 1997). Results indicate that Korean youth are expected to negotiate and shift their identities to meet differing expectations across various interpersonal contexts.…

  14. Processing of Compound Words by Adult Korean-English Bilinguals

    ERIC Educational Resources Information Center

    Ko, In Yeong

    2011-01-01

    The purpose of this dissertation study is to investigate how Korean-English bilinguals process compound words in both English and Korean. The major research question is: when Korean-English bilinguals process Korean or English compound words, what information is used to segment compound words into their constituents and, in particular, does…

  15. Bullying Involvement of Korean Children in Germany and in Korea

    ERIC Educational Resources Information Center

    Bae, Hwa-ok

    2016-01-01

    This study compared bullying involvement of Korean or Korean-German children living in Germany with children in Korea, and examined children's perceptions of school environment associated with bullying involvement of the children. This study included 105 Korean or Korean-German children living in the Bayern State of Germany as the study sample and…

  16. Effective population size of korean populations.

    PubMed

    Park, Leeyoung

    2014-12-01

    Recently, new methods have been developed for estimating the current and recent changes in effective population sizes. Based on the methods, the effective population sizes of Korean populations were estimated using data from the Korean Association Resource (KARE) project. The overall changes in the population sizes of the total populations were similar to CHB (Han Chinese in Beijing, China) and JPT (Japanese in Tokyo, Japan) of the HapMap project. There were no differences in past changes in population sizes with a comparison between an urban area and a rural area. Age-dependent current and recent effective population sizes represent the modern history of Korean populations, including the effects of World War II, the Korean War, and urbanization. The oldest age group showed that the population growth of Koreans had already been substantial at least since the end of the 19th century. PMID:25705160

  17. Production of Korean Case Particles in a Korean-English Bilingual Child with Specific Language Impairment: A Preliminary Study

    ERIC Educational Resources Information Center

    Lee, Soyoung; Gorman, Brenda K.

    2009-01-01

    The purpose of this study was to investigate the use of Korean case particles in a Korean-English bilingual child with specific language impairment (SLI). The child's production of four types of Korean case particles were compared to those of three typically developing children during probe and storytelling tasks. The Korean-English bilingual…

  18. Korean Immigrant Mothers' Perspectives: The Meanings of a Korean Heritage Language School for Their Children's American Early Schooling Experiences

    ERIC Educational Resources Information Center

    Kim, Jinhee

    2011-01-01

    This study examines what a Korean heritage language school means to Korean immigrant families and their children, considering Korean immigrant mothers' perspectives on American early schooling. As part of an ethnographic research project on Korean-American children's peer culture in a heritage school, seven mothers, two guardians (grandmothers),…

  19. Comparing Judgements of Social, Behavioural, Emotional and School Adjustment Functioning for Korean, Korean American and Caucasian American Children

    ERIC Educational Resources Information Center

    Jung, Woo Sik; Stinnett, Terry A.

    2005-01-01

    Social, emotional, behavioural and school adjustment functioning among Korean, Korean American and Caucasian American children was examined with the Behavior Assessment System for Children (BASC) Self-Report of Personality (SRP) and the Parent Rating Scale (PRS). One hundred and twenty Korean, Korean-American and Caucasian-American children, ages…

  20. Using PGD to reduce surgical infection risk.

    PubMed

    Archyangelio, Annesha; Shakhon, Amritpal

    Patients with spinal injuries are at increased risk of surgical site infection due to increased numbers of comorbidities and prolonged surgical procedures. This article describes the impact of a patient group direction that was used in a pre-operative assessment clinic to provide Staphylococcus aureus decolonisation to patients with a spinal injury who required prophylaxis. A post-implementation audit revealed that, in the main, staff and patients adhered to the direction, and infection rates were reduced. PMID:27089755

  1. Exploring Cultural Variation in Eye Movements on a Web Page between Americans and Koreans

    ERIC Educational Resources Information Center

    Yang, Changwoo

    2009-01-01

    This study explored differences in eye movement on a Web page between members of two different cultures to provide insight and guidelines for implementation of global Web site development. More specifically, the research examines whether differences of eye movement exist between the two cultures (American vs. Korean) when viewing a Web page, and…

  2. Teacher Research in South Korean Early Childhood Education: New Initiative as Professional Development

    ERIC Educational Resources Information Center

    Kim, Mina; Kang, Bokyung

    2012-01-01

    This study was designed to explore how Korean preschool and kindergarten teachers understand teacher research and utilize it in professional development. Two teachers, two site directors, and one district supervisor were interviewed in South Korea. Data were collected in multiple ways: (1) open-ended individual interviews; (2) participants'…

  3. Evaluation of analgesic effect of two different doses of fentanyl in combination with bupivacaine for surgical site infiltration in cases of modified radical mastoidectomy: A double blind randomized study

    PubMed Central

    Bhandari, Geeta; Shahi, Kedar Singh; Parmar, Nitish Kumar; Asad, Mohammad; Joshi, Hemchandra Kumar; Bhakuni, Rajni

    2013-01-01

    Background: Limited evidence supports the efficacy of peripheral route fentanyl and local anesthetic combination for postoperative analgesia. Our study was therefore designed to demonstrate the analgesic efficacy of two different doses of fentanyl in combination with bupivacaine for surgical site infiltration in patients undergoing modified radical mastoidectomy (MRM). Materials and Methods: 60 patients undergoing MRM under general anesthesia were randomly allocated into two groups, first group receiving 0.5% bupivacaine at a dose of 2 mg/kg body weight with 50 μg fentanyl and second group receiving bupivacaine 0.5% at a dose of 2 mg/kg body weight with 100 μg fentanyl as infiltration of operative field in and around the incision site, after the incision and just before completion of surgery. In postoperative period pain, nausea-vomiting and sedation was recorded at 0 hr, 2, 4, 6, 12 and 24 hrs. Results: Both the combinations of bupivacaine and fentanyl (Group I and Group II) were effective for postoperative analgesia. In both the groups the Visual Analogue Scale (VAS) score was less than 3 at each time interval. None of the patients required rescue analgesia. The comparison of VAS scores at different intervals showed that group II had lower VAS scores at all time points. Conclusions: Fentanyl and bupivacaine combinations in doses of 50 and 100 μg along with 0.5% bupivacaine at a fixed dose of 2 mg/kg body weight are effective in the management of postoperative pain. Patients who received 100 μg fentanyl (Group II) had lower VAS scores as compared to the patients who received 50 μg fentanyl (Group I) with similar side effects. PMID:25885841

  4. Asian values scale: comparisons of Korean and Korean-American high school students.

    PubMed

    Lee, Sang Bok

    2006-02-01

    This study was intended to examine mean differences on the Asian Values Scale between Korean and Korean-American high school students. For 199 Korean and 217 second generation Korean-American high school students, means on emotional self-control and collectivism were significantly different. A two-sample t test on the mean scores of Korean high school students (M=4.5, SD=0.6) and second-generation Korean-American high school students (M=3.9, SD=0.5) indicated significant differences (p<.001). This present study contrasts directly with Kim, Atkinson, and Yang's past findings of no differences between first- and second-generation Asian college students. PMID:16673975

  5. Talus fractures: surgical principles.

    PubMed

    Rush, Shannon M; Jennings, Meagan; Hamilton, Graham A

    2009-01-01

    Surgical treatment of talus fractures can challenge even the most skilled foot and ankle surgeon. Complicated fracture patterns combined with joint dislocation of variable degrees require accurate assessment, sound understanding of principles of fracture care, and broad command of internal fixation techniques needed for successful surgical care. Elimination of unnecessary soft tissue dissection, a low threshold for surgical reduction, liberal use of malleolar osteotomy to expose body fracture, and detailed attention to fracture reduction and joint alignment are critical to the success of treatment. Even with the best surgical care complications are common and seem to correlate with injury severity and open injuries. PMID:19121756

  6. American Pediatric Surgical Association

    MedlinePlus

    ... Curricula Membership + Members Join APSA Careers Surgical Practice Management In Memoriam About APSA + APSA Mission Awards APSA Leadership Committees Alliances APSA Foundation Third-Party Advertising Disclaimer ...

  7. Preventive Health Services Utilization Among Korean Americans.

    PubMed

    Kim, Kyeongmo; Casado, Banghwa Lee

    2016-01-01

    This study examined the use of preventive health services among Korean American adults. Data were drawn from a cross-sectional survey of 212 Korean Americans in the Chicago, Illinois, metropolitan area. Guided by the Andersen's behavioral model, the authors examined whether predisposing (age, gender, marital status, household size, education), enabling (income, health insurance, English proficiency, citizenship, social network), and need (health status) factors are predictive of Korean Americans' preventive health services utilization. A binomial logistic regression showed that younger age, male, noncitizen, low income, no insurance, a larger family network, and better perceived health were associated with decreased odds of using preventive health services. PMID:27171558

  8. Deriving DICOM surgical extensions from surgical workflows

    NASA Astrophysics Data System (ADS)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  9. The mobile Army surgical hospital (MASH): a military and surgical legacy.

    PubMed Central

    King, Booker; Jatoi, Ismalil

    2005-01-01

    Operation Iraqi Freedom was perhaps the last military campaign that will ever utilize the services of a mobile Army surgical hospital (MASH). The Army has now essentially replaced the MASH with combat surgical hospitals (CSH) and forward surgical teams (FST). MASH units were designed as mobile, flexible, forward-deployed military hospitals, providing care for the wounded near the frontlines of the battlefield. These hospitals not only saved thousands of lives during war but also greatly influenced the delivery of trauma and critical care in civilian hospitals. The MASH was made popular by the television series of the 1970s, depicting the 4077th during the Korean War. Although a comical series, these television episodes provided viewers with a glimpse of life in a MASH during time of war. This article chronicles the history of the MASH from its inception during World War II to recent experiences in Operation Iraqi Freedom. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 p656-a PMID:15926641

  10. Surgical Technology Program Guide.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Vocational Education.

    This surgical technology program guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a surgical technology program. The program guide is designed to relate primarily to the development of those skills needed by individuals in the field to provide services in the…

  11. Dominant Language Influence in Acquisition and Attrition of Binding: Interpretation of the Korean Reflexive "Caki"

    ERIC Educational Resources Information Center

    Kim, Ji-Hye; Montrul, Silvina; Yoon, James

    2010-01-01

    This study investigates how the dominant language of Korean heritage speakers (English) influences Korean (minority language) in the domain of binding interpretations by comparing the performance of Korean immigrants in English dominant context with that of incomplete learners of Korean and L2 learners of Korean. Four groups (10 Korean immigrants,…

  12. Current Developments in Sino-Korean Studies

    ERIC Educational Resources Information Center

    Hashimoto, Mantaro J.

    1977-01-01

    This article examines and evaluates studies in the field of Sino-Korean linguistics appearing primarily since 1955. Discussions focus on how studies were developed, the current state, and what problems exise. A bibliography is included. (CHK)

  13. Korean Translation of the AANCART Questionnaire

    PubMed Central

    Choi, Sue

    2006-01-01

    The project described herein is the preparation of a culturally and linguistically appropriate Korean version of a core questionnaire developed by the Asian American Network for Cancer Awareness, Research and Training. This version will assist in the design of interventions related to cancer for the Korean American population in the future. Following an extensive literature search, procedures recommended by various studies were incorporated into the translation process. Two final Korean versions were pilot tested to evaluate which way of asking a particular question was better, as perceived by respondents. The findings from this project helped enhance the linguistic and cultural competencies in both instruments. A cognitive walk-through interview achieved by probing after each question led respondents to offer feedback about the questions, resulting in a further review and revision of the questionnaire. The next step will be to administer the final Korean version of the two instruments to a large random sample. PMID:17344935

  14. Evaluation of peripheral blood and abdominal fluid variables as predictors of intestinal surgical site failure in dogs with septic peritonitis following celiotomy and the placement of closed-suction abdominal drains.

    PubMed

    Guieu, Liz-Valérie S; Bersenas, Alexa M; Brisson, Brigitte A; Holowaychuk, Marie K; Ammersbach, Melanie A; Beaufrère, Hugues; Fujita, Hiroshi; Weese, J Scott

    2016-09-01

    OBJECTIVE To evaluate peripheral blood and abdominal fluid variables as predictors of intestinal surgical site failure in dogs with septic peritonitis following celiotomy and closed-suction abdominal drain (CSAD) placement. DESIGN Prospective study. ANIMALS 26 dogs with septic peritonitis that underwent celiotomy and CSAD placement. PROCEDURES Abdominal fluid and blood samples were collected prior to surgery and daily thereafter until CSAD removal. Abdominal fluid was collected through the CSAD. Analysis of all samples included pH, PCO2, PO2, PCV, WBC count, and total solids, glucose, lactate, and electrolyte concentrations. Abdominal fluid samples also underwent cytologic evaluation and bacterial culture, and the volume of fluid removed through the drain was recorded daily. The blood-to-fluid glucose and lactate differences, fluid-to-blood lactate ratio and blood-to-fluid WBC and neutrophil ratios were determined daily. Dogs were categorized into 2 groups on the basis of whether they had an uneventful recovery (UR) or developed postoperative septic peritonitis (POSP). RESULTS 23 dogs had a UR and 3 developed POSP. On the third day after surgery, the abdominal fluid WBC count was significantly lower and the blood-to-fluid WBC and neutrophil ratios were significantly higher for dogs in the POSP group, compared with those for dogs in the UR group. None of the other blood and abdominal fluid variables assessed differed significantly between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE Results failed to identify any objective predictive indicators for POSP in dogs with CSADs. Use of blood-to-fluid WBC and neutrophil ratios as predictive indicators for POSP requires further investigation. PMID:27556266

  15. Phonological Development of Word-Initial Korean Obstruents in Young Korean Children

    ERIC Educational Resources Information Center

    Kim, Minjung; Stoel-Gammon, Carol

    2011-01-01

    This study investigates the acquisition of word-initial Korean obstruents (i.e. stops, affricates and fricatives). Korean obstruents are characterized by a three-way contrast among stops and affricates (i.e. fortis, aspirated and lenis) and a two-way fricative contrast (i.e. fortis and lenis). All these obstruents are voiceless word-initially.…

  16. Korean Year 3 Children's Environmental Literacy: A Prerequisite for a Korean Environmental Education Curriculum

    ERIC Educational Resources Information Center

    Chu, Hye-Eun; Lee, Eun Ah; Ko, Hee Ryung; Shin, Dong Hee; Lee, Moon Nam; Min, Byeong Mee; Kang, Kyung Hee

    2007-01-01

    The purpose of this study was to investigate Korean children's environmental literacy levels and the variables that affect their environmental literacy. An instrument, the Environment Literacy Instrument for Korean Children (ELIKC), was developed that measures four different dimensions (knowledge, attitude, behaviour, and skills) using 69 items…

  17. Acculturative Stress and Coping: Gender Differences among Korean and Korean American University Students

    ERIC Educational Resources Information Center

    Lee, Diane Sookyoung; Padilla, Amado M.

    2014-01-01

    In this study we examined acculturative stress and coping among 86 students of Korean heritage at an American university. Participants indicated their stress levels on 3 scales of cultural adaptation: discrimination, language and cultural ties, and social distance. Findings show that self-identified Korean students displayed higher levels of…

  18. Multiscale Surgical Telerobots

    SciTech Connect

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L

    2002-01-23

    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  19. Surgical progress: surgical management of infective endocarditis.

    PubMed Central

    Mills, S A

    1982-01-01

    Infective endocarditis of bacterial or fungal origin may arise in either the left or the right heart and can involve both natural and prosthetic valves. The diagnosis is based primarily upon clinical criteria and positive blood cultures, but serial electrocardiograms, fluoroscopy, and two-dimensional echocardiograms may also be helpful. The initial treatment should consist of antibiotic therapy and is itself often adequate in effecting cure. However, careful observation during antibiotic treatment is mandatory, since the development of congestive heart failure due to valvular obstruction or destruction can be an indication for surgical intervention. Other surgical indications include a failure to respond to antibiotic therapy, pulmonary or systemic emboli, evidence of abscess involving the valvular ring (particularly prevalent with prosthetic valve endocarditis), Brucella infection, and the onset of conduction disturbances. The goals of surgical treatment are removal of infective tissue, restoration of valve function, and correction of associated mechanical disorders. The results are surprisingly good, especially for a condition of this severity. Images Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:7065743

  20. Surgical wound infection surveillance.

    PubMed

    Lee, J T

    2003-12-01

    Measuring the frequency of a defined outcome flaw for a series of patients undergoing operative procedures generates information for performance evaluation. Such data influence decisions to improve care if used responsibly. Wound infection (WI), bacterial invasion of the incision, is the most common infectious complication of surgical care and WI prevention has value because the complication affects economic, patient satisfaction, and patient functional status outcomes. WI frequency, one kind of surgical outcome flaw rate, is traditionally used to judge one aspect of surgical care quality. At the author's institution, global WI surveillance was conducted without interruption for 20 years. Results for 85,260 consecutive inpatient operations performed during the period showed that secular changes in infection rates occurred but were not necessarily caused by surgical care quality decrements. PMID:14750065

  1. Biocompatibility of surgical implants

    NASA Technical Reports Server (NTRS)

    Kaelble, D. H.

    1979-01-01

    Method of selecting biocompatible materials for surgical implants uses fracture mechanic relationships and surface energies of candidate materials in presence of blood plasma. Technique has been used to characterize 190 materials by parameters that reflect their biocompatibility.

  2. Guide to Surgical Specialists

    MedlinePlus

    ... may also deal with the liver, urinary, and female reproductive systems if they are involved with primary intestinal disease. ... The focus for this specialty is on the female reproductive system, including performing surgical procedures, managing the care of ...

  3. Hernia Surgical Mesh Implants

    MedlinePlus

    ... Surgical Clinics of North America; 83(5):1045-51, v-vi. 2 . http://www.facs.org/public_ ... FDA Contact FDA Browse by Product Area Product Areas back Food Drugs Medical Devices Radiation-Emitting Products ...

  4. Surgical Treatments for Fibroids

    MedlinePlus

    ... Clinical Trials Resources and Publications Surgical Treatments for Fibroids Skip sharing on social media links Share this: ... If you have moderate or severe symptoms of fibroids, surgery may be the best treatment for you. ...

  5. Urogynecologic Surgical Mesh Implants

    MedlinePlus

    ... Boston Scientific's urogynecologic surgical mesh may contain counterfeit raw material. We are examining these allegations to determine any ... are currently not aware that the alleged counterfeit raw material contributes to adverse events associated with these products. ...

  6. Smart surgical tool

    NASA Astrophysics Data System (ADS)

    Huang, Huan; Yang, Lih-Mei; Bai, Shuang; Liu, Jian

    2015-02-01

    A laser-induced breakdown spectroscopy (LIBS) guided smart surgical tool using a femtosecond fiber laser is developed. This system provides real-time material identification by processing and analyzing the peak intensity and ratio of atomic emissions of LIBS signals. Algorithms to identify emissions of different tissues and metals are developed and implemented into the real-time control system. This system provides a powerful smart surgical tool for precise robotic microsurgery applications with real-time feedback and control.

  7. Religious Factors Historically Affecting Premodern Korean Elite/Higher Education.

    ERIC Educational Resources Information Center

    Lee, Jeong-Kyu

    1998-01-01

    The purpose of this document is to analyze the historical influences of Confucianism and Buddhism on Korean culture and to explore the religions' impact on Korean higher education. Three questions comprised the research: 1) What are the characteristics of Buddhism and Confucianism in Korean cultural history? 2) How did Buddhism have an effect on…

  8. Pedagogical Significance of Morphological Awareness in Korean and English

    ERIC Educational Resources Information Center

    Jong, Young Ok; Jung, Chae Kwan

    2015-01-01

    This study investigated whether Korean children understand the internal structure of compound words in Korean and English and whether there is a relationship between their performance in tasks that measure their understanding of the morphological structure of compounds in Korean and English. This study also examined the effects of gender, grade,…

  9. Syllable and Letter Knowledge in Early Korean Hangul Reading

    ERIC Educational Resources Information Center

    Cho, Jeung-Ryeul

    2009-01-01

    This study examined the development of Korean consonant-vowel (CV) syllable identification, consonant and vowel letter knowledge, and their relationships to phonological awareness and the reading of regular Hangul words among Korean kindergartners as a 6-month longitudinal study. Results showed that Korean children identified CV syllables better…

  10. Culture-Loaded Expressions in Korean EFL Students' Compositions.

    ERIC Educational Resources Information Center

    Choe, Yongjae Paul

    2001-01-01

    Discusses the inevitability of native culture-loaded expressions in Korean English-as-a-Foreign-Language students' compositions. Cultures, both native and target play a major role in forming ideas in any communicative situation. Thus, Korean EFL students' compositions all reveal without exception the traits of Korean culture. (Author/VWL)

  11. Korean Cultural Influences on the Millon Clinical Multiaxial Inventory III.

    ERIC Educational Resources Information Center

    Gunsalus, Ae-Jung Chang; Kelly, Kevin R.

    2001-01-01

    Investigates the effect of Korean culture on the results of the Millon Clinical Multiaxial Inventory-III (MCMI-III) by comparing profiles of 147 Korean and 132 American college students. Results indicate that MCMI-III personality profile differences exist between Korean and American college students. Discusses implications for mental health…

  12. Evidence for the VP Constituent from Child Korean.

    ERIC Educational Resources Information Center

    Cho, Young-mee Yu; Hong, Ki-Sun

    An examination of children's sentence structure in Korean argues for a verb phrase (VP) constituent in child grammar, but suggests that this does not necessarily support its existence in adult Korean grammar. Korean children, it is noted, generally restrict their sentences to one word order, subject-object-verb, despite the existence of another…

  13. Gender, Acculturation, Food Patterns, and Overweight in Korean Immigrants

    ERIC Educational Resources Information Center

    Jasti, Sunitha; Lee, Chang Hyun; Doak, Colleen

    2011-01-01

    Objective: To describe acculturation, food patterns, overweight, and gender differences among Korean immigrants in the United States. Methods: A cross-sectional exploratory survey assessed acculturation, food frequencies, and weight status of 195 Korean immigrants. Results: Acculturated Korean immigrants (score greater than or equal to] 2.5) were…

  14. Text Structure of Korean Speakers' Argumentative Essays in English.

    ERIC Educational Resources Information Center

    Choi, Yeon Hee

    1988-01-01

    Examines text structure of argumentative writing in English by Korean speakers as compared with native speakers'(NS) writing in Korean and NS writing in English. Interactive text analysis showed English essays had a clear structural pattern that the Korean essays lacked. Sample essays and questionnaires are included in Appendix. (Author/LMO)

  15. The Meaning of Korean Women's Career-Leaving Experience

    ERIC Educational Resources Information Center

    Lee, Yu-Jin

    2010-01-01

    What is the meaning of Korean women's career-leaving experience? To answer this question, this study adopted a hermeneutic phenomenology approach. My intention was to search for the deeper meaning of Korean women's career-leaving experience from their perspective. Ten Korean women who had left their careers due to their domestic roles in their…

  16. Shifting Human Resources in South Korean Science and Technology.

    ERIC Educational Resources Information Center

    Choi, Hyaeweol

    1999-01-01

    Discusses how the changing status of South Korea in the world economy has affected the movement of Korean human resources in science and technology. Examines trends in overseas study by Korean graduate students, the migration of highly educated personnel, and the recent repatriation of Korean scientists and engineers. (SV)

  17. Lexical Use in Interlanguage of Korean EFL Learners

    ERIC Educational Resources Information Center

    Cha, Mi Yang

    2009-01-01

    Lexical use seems to represent one of the major problems Korean learners face in learning English. One of the factors attributable to the learners' lexical problems may be in large part due to the use of the Korean language as a medium of instruction in teaching English. Fifty native Korean students took part in this research. They were of 20 male…

  18. Adenotonsillar hypertrophy as a risk factor of dentofacial abnormality in Korean children.

    PubMed

    Kim, Dong-Kyu; Rhee, Chae Seo; Yun, Pil-Young; Kim, Jeong-Whun

    2015-11-01

    No studies for the role of adenotonsillar hypertrophy in development of dentofacial abnormalities have been performed in Asian pediatric population. Thus, we aimed to investigate the relationship between adenotonsillar hypertrophy and dentofacial abnormalities in Korean children. The present study included consecutive children who visited a pediatric clinic for sleep-disordered breathing due to habitual mouth breathing, snoring or sleep apnea. Their palatine tonsils and adenoids were graded by oropharyngeal endoscopy and lateral cephalometry. Anterior open bite, posterior crossbite, and Angle's class malocclusions were evaluated for dentofacial abnormality. The receiver-operating characteristic curve analysis was used to identify age cutoffs to predict dentofacial abnormality. A total of 1,083 children were included. The presence of adenotonsillar hypertrophy was significantly correlated with the prevalence of dentofacial abnormality [adjusted odds ratio = 4.587, 95% CI (2.747-7.658)] after adjusting age, sex, body mass index, allergy, and Korean version of obstructive sleep apnea-18 score. The cutoff age associated with dentofacial abnormality was 5.5 years (sensitivity = 75.5%, specificity = 67%) in the children with adenotonsillar hypertrophy and 6.5 years (sensitivity = 70.6%, specificity = 57%) in those without adenotonsillar hypertrophy. In conclusion, adenotonsillar hypertrophy may be a risk factor for dentofacial abnormalities in Korean children and early surgical intervention could be considered with regards to dentofacial abnormality. PMID:25490975

  19. A Targeted E-Learning Program for Surgical Trainees to Enhance Patient Safety in Preventing Surgical Infection

    ERIC Educational Resources Information Center

    McHugh, Seamus Mark; Corrigan, Mark; Dimitrov, Borislav; Cowman, Seamus; Tierney, Sean; Humphreys, Hilary; Hill, Arnold

    2010-01-01

    Introduction: Surgical site infection accounts for 20% of all health care-associated infections (HCAIs); however, a program incorporating the education of surgeons has yet to be established across the specialty. Methods: An audit of surgical practice in infection prevention was carried out in Beaumont Hospital from July to November 2009. An…

  20. Korean and American music reduces pain in Korean women after gynecologic surgery.

    PubMed

    Good, Marion; Ahn, Sukhee

    2008-09-01

    American music has been found to relieve pain in adults in several countries but has not been tested in Korea. Korean women have reported that they would like American music as well as Korean folk songs and religious music sung in Korean. The study purpose was to pilot-test the effects of music on pain after gynecologic surgery in Korean women and to compare pain relief between those who chose American or Korean music. Using a quasiexperimental pretest-posttest design, 73 South Korean women on a preoperative unit were assigned by day of the week to receive music (n = 34; 47%) or no music (n = 39; 53%). The music group chose among Korean (ballads and religious and popular songs) and American (soft slow piano and orchestra) music and heard it for 15 minutes at four time points (postoperatively), whereas the controls rested in bed. They marked VAS Sensation and Distress of Pain scales before and after each test. The two groups were similar on pretest pain. When controlling for pretest pain, MANCOVA indicated that there was significantly less posttest pain in those with music plus analgesics than those with analgesics alone at three of the four tests: p = .04 to .001. Two-thirds in the music group (n = 21; 62%) chose Korean music and one-third (n = 13; 38%) chose American, with no difference in pain: both were effective. In addition to analgesics, music can be used to reduce postoperative pain in Korean women. Patients selected music that was appealing to them. Nurses in many countries can consider music of the country and seek individual preferences to use in addition to analgesics for postoperative pain. PMID:18706380

  1. The Formation of the South Korean Identity through National Curriculum in the South Korean Historical Context: Conflicts and Challenges

    ERIC Educational Resources Information Center

    So, Kyunghee; Kim, Jungyun; Lee, Sunyoung

    2012-01-01

    This study explores how the South Korean identity has been formed and transformed by examining the Korean national curriculum in its historical context. The study first examines how the Korean identity, previously formed by traditional ethnic values, has been transformed during the period of national modernization. It then describes the efforts to…

  2. Errors in Inflectional Morphemes as an Index of Linguistic Competence of Korean Heritage Language Learners and American Learners of Korean

    ERIC Educational Resources Information Center

    Kim, So-Young

    2013-01-01

    This study examined the linguistic competence in Korean of Korean heritage language learners (HLLs), compared to English-speaking non-heritage language learners (NHLLs) of Korean. It is unclear and controversial as to whether heritage languages learners are exposed to early but are interrupted manifest as L1 competence or share more…

  3. 3D Surgical Simulation

    PubMed Central

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  4. The application of cooperative monitoring techniques to a conceptual limited deployment zone in the Korean peninsula

    SciTech Connect

    Vannoni, M.; Duggan, R.

    1996-10-01

    The Korean peninsula is the site of a tense military confrontation. Relations between North and South Korea improved during the early 1990`s but the process is now frozen. Confidence building measures, particularly military ones, that address the security needs of both countries would decrease the danger of conflict and help create an environment for direct negotiations. The Korean Institute for Defense Analysis (KIDA) analyzed current security conditions and options. Their scenario includes a conceptual agreement to establish Limited Force Deployment Zones (LDZ) along the current demilitarized zone (DMZ) to increase mutual security. The Cooperative Monitoring Center (CMC) of Sandia National Laboratories, in collaboration with KIDA, developed a strategy, with examples, for cooperatively monitoring the agreement. A cooperative monitoring regime requires consideration of the agreement`s terms, the geographic, logistic, military, and political factors of the Korean environment, and the capability of technology to monitor the terms. This paper assesses the applicability of cooperative monitoring to Korea, describes the monitoring strategy for the Korean enhanced DMZ scenario, and describes the applicable technologies and procedures.

  5. Identification of Korean-specific SNP markers from whole-exome sequencing data.

    PubMed

    Kim, Sung Min; Yoo, Seong Yeon; Nam, Soo Hyun; Lee, Jae Moon; Chung, Ki Wha

    2016-05-01

    Analysis of large numbers of single-nucleotide polymorphisms (SNPs) can increase individual discrimination power, and, particularly, it can supply important evidence for kinship or ethnic identification. We identified 300 Korean-specific SNPs from 306 Korean whole-exome sequencing (WES) data. Functionally significant SNPs (variants in splicing site, missense, nonsense, and exonic indels) were filtered out from the variant pool, and SNPs with minor allele frequencies (MAFs) of <0.3 in the 1000 Genomes (1000G) database but >0.3 in the Korean population were selected. Genotypes obtained from WES were confirmed by the Sanger sequencing method. The identified markers were evenly distributed throughout the autosomal chromosomes. All the SNPs were in the Hardy-Weinberg equilibrium with a mean MAF of 0.415 (0.161 in 1000G). The mean heterozygosities were 0.476 (observed) and 0.470 (experimental). The combined power of discrimination was very high. Korean MAFs in most SNPs were similar to those for the Chinese and Japanese populations, but were significantly higher than those for several other ethnic populations. These selected SNPs will be used to develop forensic markers and are expected to be widely used for additional individual identification, ethnic discrimination, and linkage analysis for kinship tests. PMID:26862047

  6. Breast Cancer Screening Beliefs among Older Korean American Women

    PubMed Central

    Eun, Young; Lee, Eunice E.; Kim, Mi Ja; Fogg, Louis

    2011-01-01

    Korean American women’s breast cancer screening rates are low, and the rates among older Korean American women are even lower. This article describes health beliefs related to older Korean American women’s screening behaviors, comparing them to beliefs of younger Korean American women. The 73 women age 65 and older had significantly different health beliefs than the 114 women between ages 40 and 64. Further, older women’s perceptions of the seriousness of the disease and benefits of and barriers to taking action to prevent the disease predated their screening behaviors. Interventions to change the health beliefs of older Korean American women are suggested. PMID:19715259

  7. Surgical bleeding in microgravity

    NASA Technical Reports Server (NTRS)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  8. Total antioxidant capacity of the Korean diet

    PubMed Central

    Han, Jeong-Hwa; Lee, Hye-Jin; Cho, Mi Ran; Chang, Namsoo; Kim, Yuri; Oh, Se-Young

    2014-01-01

    BACKGROUND/OBJECTIVES The objective of this study was to measure and/or estimate the total antioxidant capacity of the Korean diet. MATERIALS/METHODS Eighty-one plant foods that were expected to exhibit rather high antioxidant activities were selected from the Korean diet using the Fifth Korean National Health and Nutrition Survey (KNHANES V). These foods were categorized into 11 food groups: cereals, potatoes, legumes, nuts, vegetables, kimchies, mushrooms, fruits, fruit juices, sea weeds, and oils. The foods were mixed in the proportions specified in traditional Korean recipes and analyzed. The measured indicators for antioxidant capacities were total phenolics, 2,2-diphenyl-1-picrylhydrazyl (DPPH), oxygen radical absorbance capacity (ORAC), and Trolox equivalent antioxidant capacity (TEAC). RESULTS Total phenolics were high in the fruit juices, nuts, vegetables, and fruits; and the average DPPH, ORAC, and TEAC values were high in the vegetables, fruits, fruit juices, and nuts. The correlation coefficient between the content of total phenolics of each food and the in vitro antioxidant capacity was relatively high at 0.851. The intake of total phenolics per capita per day in the Republic of Korea was estimated to be 127 mg. The total dietary antioxidant capacity (TDAC) values, which were obtained from the total antioxidant capacity of each food, taking into account the intake of each food, were 20,763, 54,335, and 876.4 µmol of Trolox equivalents using the DPPH, ORAC, and TEAC methods, respectively. The food group that contributed the most to the Korean TDAC was cereals at 39.7%, followed by fruits and vegetables at 27.8% and 13.9%, respectively. The contribution of legumes, nuts, fruit juices, and mushrooms was quite minimal at less than 2% each. CONCLUSIONS The content of total phenolics and the antioxidant capacity of the Korean diet are significantly correlated and the high contributing food groups are cereals, fruits, and vegetables. PMID:24741403

  9. Postoperative Surgical Infection After Spinal Surgery in Rheumatoid Arthritis.

    PubMed

    Koyama, Kensuke; Ohba, Tetsuro; Ebata, Shigeto; Haro, Hirotaka

    2016-05-01

    Individuals with rheumatoid arthritis are at higher risk for infection than the general population, and surgical site infection after spinal surgery in this population can result in clinically significant complications. The goal of this study was to identify risk factors for acute surgical site infection after spinal surgery in patients with rheumatoid arthritis who were treated with nonbiologic (conventional) disease-modifying antirheumatic drugs (DMARDs) alone or with biologic DMARDs. All patients treated with biologic agents were treated with nonbiologic agents as well. The authors performed a retrospective, single-center review of 47 consecutive patients with rheumatoid arthritis who underwent spinal surgery and had follow-up of 3 months or longer. The incidence of surgical site infection was examined, and multivariate logistic regression analysis was performed to test the association of surgical site infection with putative risk factors, including the use of biologic agents, methotrexate, and prednisolone, as well as the duration of rheumatoid arthritis, the presence of diabetes, patient age, length of surgery, and number of operative levels. After spinal surgery, 14.89% (7 of 47) of patients had surgical site infection. Use of methotrexate and/or prednisolone, patient age, diabetes, duration of rheumatoid arthritis, length of surgery, number of operative levels, and use of biologic DMARDs did not significantly increase the risk of infection associated with spinal surgery. All patients who had surgical site infection had undergone spinal surgery with instrumentation. The findings show that greater attention to preventing surgical site infection may be needed in patients with rheumatoid arthritis who undergo spinal surgery with instrumentation. To the authors' knowledge, this is the first study to show that the use of biologic agents did not increase the incidence of surgical site infection after spinal surgery in patients with rheumatoid arthritis

  10. Surgical prosthetic treatment

    PubMed Central

    Carulli, Christian; Matassi, Fabrizio; Civinini, Roberto; Villano, Marco; Innocenti, Massimo

    2010-01-01

    Fragility fractures typically occur in elderly patients related principally to osteoporosis. A significative percentage of these fractures have to be treated surgically but comorbilities are often present, and need to be grossly stabilized before surgery. However, there is for these fractures a high rate of morbidity and mortality at short-term. Moreover, patients affected by a fragility fracture are at risk for another fragility fracture later in life. The Authors present an overview of the main patterns of proximal femoral fractures, underlining the peculiar features and choices of surgical treatment, and relating to specific indications and results of each treatment. PMID:22461289

  11. [Pulmonary Echinococcosis: Surgical Aspects].

    PubMed

    Eichhorn, M E; Hoffmann, H; Dienemann, H

    2015-10-01

    Pulmonary cystic echinococcosis is a very rare disease in Germany. It is caused by the larvae of the dog tapeworm (echinococcus granulosus). The liver is the most affected organ, followed by the lungs. Surgery remains the main therapeutic approach for pulmonary CE. Whenever possible, parenchyma-preserving lung surgery should be preferred over anatomic lung resections. To ensure best therapeutic results, surgery needs to be performed under precise consideration of important infectiological aspects and patients should be treated in specialised centres based on interdisciplinary consensus. In addition to surgical aspects, this review summarises special infectiological features of this disease, which are crucial to the surgical approach. PMID:26351761

  12. Surgical forceps techniques.

    PubMed

    Malden, N

    2001-01-01

    This paper considers two new elevator and dental forceps techniques for the atraumatic removal of teeth to avoid a surgical procedure where possible. The techniques described should be applicable in relatively well defined but commonly occurring situations. The two techniques involve the unconventional use of conventional dental extraction forceps, with the aim of facilitating removal of the retained roots of certain teeth: the first for incisors, canines and premolars and the second for lower first molars. The term 'surgical forceps technique's is tentatively put forward as a description of these hybrid procedures. PMID:11819949

  13. Suppression of Surgeons' Bacterial Hand Flora during Surgical Procedures with a New Antimicrobial Surgical Glove

    PubMed Central

    Kramer, Axel; Ouriel, Kenneth; Suchomel, Miranda; McLaws, Mary-Louise; Rottman, Martin; Leaper, David; Assadian, Afshin

    2014-01-01

    Abstract Background: Perforations of surgical gloves are common and increase with the duration of glove wear. Skin flora, re-grown after pre-operative disinfection of the hands, may contaminate a surgical site. An antimicrobial surgical glove with chlorhexidine on its inner surface has been developed. We hypothesized that by suppressing the re-growth of skin flora during the complete course of a surgical procedure, antimicrobial gloves may reduce the risk of surgical site contamination in the event of an intra-operative glove breach. Methods: We conducted a randomized, double-blind, single-center trial, to measure any differences in the bacterial skin populations of surgeons' hands during surgical procedures done with antimicrobial and non-antimicrobial surgical gloves [ISRCTN71391952]. In this study, 25 pairs of gloves were retrieved from 14 surgeons who donned them randomly on their dominant or non-dominant hand. The number of bacteria retrieved from glove fluid was measured and expressed as colony forming units (CFU)/mL. Results: The median cfu/mL of antimicrobial gloves was 0.00 (LQ: 0.00 CFU/mL; UQ: 0.00 cfu/mL), with a mean log10 cfu/mL=0.02 (range: 0.00–0.30). The median CFU/mL of non-antimicrobial gloves was 54.00 (LQ: 3.00 cfu/mL; UQ: 100.00 cfu/mL) with a mean log10 CFU/mL=1.32 (range: 0.00–2.39). After a mean operating time of 112 min, the difference in the log10 CFU/mL was 1.30 (p<0.001). Conclusions: A new antimicrobial surgical glove suppressed surgeons' hand flora during operative procedures. In the event of a glove breach, the use of such a glove may have the potential to prevent bacterial contamination of a sterile surgical site, thereby decreasing the risk of surgical site infection (SSI) and increasing patient safety. Further clinical studies are needed to confirm this concept. PMID:24116857

  14. Environmental quality of Korean coasts as determined by modified Shannon-Wiener evenness proportion.

    PubMed

    Yoo, Jae-Won; Lee, Yong-Woo; Ruesink, Jennifer L; Lee, Chang-Gun; Kim, Chang-Soo; Park, Mi-Ra; Yoon, Kon-Tak; Hwang, In-Seo; Maeng, Jun-Ho; Rosenberg, Rutger; Hong, Jae-Sang

    2010-11-01

    The coast of the Korean peninsula experiences a range of human impacts, including pollution, shipping, reclamation, and aquaculture, that have motivated numerous local studies of macrobenthic organisms. In this paper, 1,492 subtidal stations were compiled from 23 studies (areas) to evaluate environmental quality on a broader scale. A common index in biomonitoring, Shannon-Wiener evenness proportion (SEP), could not incorporate azoic or single-species samples. This shortcoming was overcome by developing an inverse function of SEP (ISEP), which was positively correlated with independent measures of water quality available for nine sites and was not biased by the size of the sampling unit. Additionally, at Shihwa Dike, where samples were collected before and after reinstating a tidal connection with the ocean, ISEP values improved over time, as expected. Thus, it is now possible to assign Korean subtidal sites to seven ISEP "grades" and to use their values and trends to guide coastal management. PMID:19862634

  15. Korean American Adolescent Depression and Parenting

    PubMed Central

    Kim, Eunjung; Cain, Kevin C.

    2010-01-01

    PROBLEM Korean American adolescents tend to experience more mental health problems than adolescents in other ethnic groups. METHODS The goal of this study was to examine the association between Korean American parent-adolescent relationships and adolescents’ depressive symptoms in 56 families. FINDINGS Thirty-nine percent of adolescents reported elevated depressive symptoms. Adolescents’ perceived low maternal warmth and higher intergenerational acculturation conflicts with fathers were significant predictors for adolescent depressive symptoms. CONCLUSIONS The findings can be used to develop a family intervention program, the aim of which would be to decrease adolescent depressive symptoms by promoting parental warmth and decreasing parent-adolescent acculturation conflicts. PMID:18429840

  16. A Sketch of Language History in the Korean Peninsula

    PubMed Central

    Lee, Sean

    2015-01-01

    Among 7100 languages spoken on Earth, the Koreanic language is the 13th largest, with about 77 million speakers in and around the Korean Peninsula. In comparison to other languages of similar size, however, surprisingly little is known about the evolution of the Koreanic language. This is mainly due to two reasons. The first reason is that the genealogical relationship of the Koreanic to other neighboring languages remains uncertain, and thus inference from the linguistic comparative method provides only provisional evidence. The second reason is that, as the ancestral Koreanic speakers lacked their own writing system until around 500 years ago, there are scant historical materials to peer into the past, except for those preserved in Sinitic characters that we have no straightforward way of interpreting. Here I attempt to overcome these disadvantages and shed some light on the linguistic history of the Korean Peninsula, by analyzing the internal variation of the Koreanic language with methods adopted from evolutionary biology. The preliminary results presented here suggest that the evolutionary history of the Koreanic language is characterized by a weak hierarchical structure, and intensive gene/culture flows within the Korean Peninsula seem to have promoted linguistic homogeneity among the Koreanic variants. Despite the gene/culture flows, however, there are still three detectable linguistic barriers in the Korean Peninsula that appear to have been shaped by geographical features such as mountains, elevated areas, and ocean. I discuss these findings in an inclusive manner to lay the groundwork for future studies. PMID:26024377

  17. Correlates of Perceived Smoking Prevalence Among Korean American Emerging Adults.

    PubMed

    Cerrada, Christian J; Unger, Jennifer B; Huh, Jimi

    2016-10-01

    Perceived smoking prevalence, a strong predictor of actual smoking behavior, may be influenced by the ethnicity and gender of the reference group presented to Korean American emerging adults. Self-identifying Korean and Korean Americans aged 18-25 (N = 475), were invited to complete a 15-20 min online survey about their attitudes towards smoking. Predictors of perceived smoking prevalence were evaluated separately for four reference groups: Caucasian Americans, Korean Americans in general, Korean American men, and Korean American women. Respondents' smoking status was associated with perceived smoking prevalence for all reference groups except Caucasian Americans, even among light smokers. Father's smoking status was associated with perceived smoking prevalence for Korean American men, only among females respondents. Findings suggest that ethnicity and gender of both the reference group and respondents influence smoking rate estimates. Tailoring intervention content to the target population's gender and ethnicity may be a way to enhance smoking prevention strategies. PMID:27075031

  18. Koreans in Japan: A minority's Changing Relationship with Schools

    NASA Astrophysics Data System (ADS)

    Okano, Kaori H.

    2004-03-01

    Koreans form the largest ethnic minority group in Japan. The present study explores the situation of Korean pupils in Japanese schools by analyzing recent changes in four areas:(1) governmental and school-level policies, (2) school-level programs targeted at Korean children, (3) Korean pupils' academic achievements and (4) their micro-level encounter with schooling. It shows that Japanese schools are now more willing to accommodate special needs of Koreans in mainstream schooling and that Korean students experience schooling more positively than was the case in their parents' generation. The study argues that their relationship with Japanese schools has undergone a significant transformation at least partially because of such changes, even as the shifting nature of the relationship has a long-term influence on Koreans' beliefs about schools. Central government policies are seen as having adjusted in reply to existing school practices, themselves representing a response to classroom reality and local civil movements.

  19. Liberation psychological implications for pastoral care of Korean military wives.

    PubMed

    Chang, Bocheol

    2010-01-01

    Native Korean women frequently suffer poverty, sexual violence, and Confucian gender discrimination. Once in America Korean military wives also experience racial and sexual oppression, intercultural familial conflicts and violence, and identity crisis and lead to feelings of isolation and non-belonging, a sense of anomie. Korean American pastors tend to understate and oversimplify the complexity of psychological and spiritual suffering of Korean military wives and overemphasize individual faith development as a solution. Liberation psychology evolved from an awareness of similar dehumanizing realities. The context-based perspective of liberation psychology offers a model to interpret and assist in the psychological and spiritual healing of Korean military wives. The healing power of conscientization offered in Liberation psychology for oppressed individuals encourages self-awakening suggesting it as an ideal interventional model to help Korean military wives and would be a useful approach for Korean American pastors. PMID:21404760

  20. Stitches (Surgical Sutures)

    MedlinePlus

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  1. Spectrum of Surgical Presentation of Eosinophilic Enteritis

    PubMed Central

    Shetty, Spoorthy Sudhakar; Shetty, Charan Kishor

    2015-01-01

    Eosinophilic enteritis is a rare disorder presenting mostly with diarrhea, malabsorption, abdominal pain, weight loss, and hypersensitivity. Surgical manifestation of eosinophilic gastrointestinal disorders depends on the site and extent of involvement. In our case series of four patients two of them had ileocaecal masses with recurrent subacute intestinal obstruction with past history of intake of antitubercular drugs for 9 months. On histopathological examination both of them proved to have eosinophilic enterocolitis. Thus it is a clinical dilemma to differentiate between these two conditions. The other two patients presented as acute abdomen with perforation and intussusception. All four patients were treated surgically. Postoperatively they recovered well with no symptoms on one year follow-up. In Indian setup tuberculosis being rampant there may be under reporting or wrongly diagnosed cases of eosinophilic enteritis. Thus a strong clinical suspicion and awareness of this clinical entity are essential among surgical community. PMID:25960910

  2. Spectrum of surgical presentation of eosinophilic enteritis.

    PubMed

    Shetty, Spoorthy Sudhakar; Shetty, Charan Kishor

    2015-01-01

    Eosinophilic enteritis is a rare disorder presenting mostly with diarrhea, malabsorption, abdominal pain, weight loss, and hypersensitivity. Surgical manifestation of eosinophilic gastrointestinal disorders depends on the site and extent of involvement. In our case series of four patients two of them had ileocaecal masses with recurrent subacute intestinal obstruction with past history of intake of antitubercular drugs for 9 months. On histopathological examination both of them proved to have eosinophilic enterocolitis. Thus it is a clinical dilemma to differentiate between these two conditions. The other two patients presented as acute abdomen with perforation and intussusception. All four patients were treated surgically. Postoperatively they recovered well with no symptoms on one year follow-up. In Indian setup tuberculosis being rampant there may be under reporting or wrongly diagnosed cases of eosinophilic enteritis. Thus a strong clinical suspicion and awareness of this clinical entity are essential among surgical community. PMID:25960910

  3. The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination

    PubMed Central

    2016-01-01

    Purpose: This study aimed at characterizing Korean nurses’ occupational responsibilities to apply the results for improvement of the Korean Nursing Licensing Examination. Methods: First, the contents of nursing job were defined based on a focus group interview of 15 nurses. Developing a Curriculum (DACOM) method was used to examine those results and produce the questionnaire by 13 experts. After that, the questionnaire survey to 5,065 hospital nurses was done. Results: The occupational responsibilities of nurses were characterized as involving 8 duties, 49 tasks, and 303 task elements. Those 8 duties are nursing management and professional development, safety and infection control, the management of potential risk factors, basic nursing and caring, the maintenance of physiological integrity, medication and parenteral treatments, socio-psychological integrity, and the maintenance and improvement of health. Conclusion: The content of Korean Nursing Licensing Examination should be improved based on 8 duties and 49 tasks of the occupational responsibilities of Korean nurses. PMID:27270987

  4. Vowel production in Korean, Korean-accented English, and American English

    NASA Astrophysics Data System (ADS)

    Lee, Jimin; Weismer, Gary

    2005-09-01

    The current study compares vowel formant frequencies and durations produced by ten native speakers of Korean, those same speakers producing American English vowels, and ten native speakers of American English. The Korean speakers were chosen carefully to have a minimum of 2 years, and maximum of 5 years residence in the United States; all speakers were between the ages of 22 and 27. In addition, the native speakers of Korean were chosen, by means of a small-scale dialect-severity experiment, from a larger pool of speakers to achieve some homogeneity in their mastery of English phonetics. The full vowel systems of both languages were explored, and a rate condition was included (conversational versus fast) to test the hypothesis that the English vowel space is modified by rate differently for native speakers of Korean who produce English, versus native speakers of English. Results will be discussed in terms of language- and rate-induced adjustments of the vowel systems under study.

  5. Working Papers on Asian American Studies: Annotated Bibliography on Koreans in America.

    ERIC Educational Resources Information Center

    Kim, Christopher

    This classified annotated bibliography on Koreans in America includes references on the following topics: (1) Korean American directories, (2) immigration history, (3) deportation cases, (4) Korean students in the U.S., (5) Korean Americans in the Asian American Movement, (6) state and federal legislation affecting Koreans in America, (7) Korean…

  6. Culture Camp, Ethnic Identity, and Adoption Socialization for Korean Adoptees: A Pretest and Posttest Study

    ERIC Educational Resources Information Center

    Baden, Amanda L.

    2015-01-01

    This study explores the impact of racial-ethnic socialization on adopted South Korean children and adolescents who attended a sleepaway Korean culture camp for one week. This camp provided racial-ethnic socialization experiences via exposure to camp counselors, staff, and teachers who were Korean Americans, Korean nationals, and Korean adult…

  7. Anatomical characterisation of surgical procedures in the Read Thesaurus.

    PubMed Central

    Price, C.; Bentley, T. E.; Brown, P. J.; Schulz, E. B.; O'Neil, M.

    1996-01-01

    Each concept in the surgical operations chapter of the Read Thesaurus has been analysed to determine its anatomical site component. The underlying structure of this chapter and its relationship to the anatomy chapter are explored. The defined anatomical sites have been included as atomic maps in the Read Code template table, one of the key component files of the Thesaurus, relevant features of which are described. The analysis methodology is outlined and the value of an anatomically characterised surgical procedure terminology is discussed together with the implications of semantically defining a wider range of characteristics of surgical procedures. PMID:8947638

  8. Surgical Instrument Restraint in Weightlessness

    NASA Technical Reports Server (NTRS)

    Campbell, Mark R.; Dawson, David L.; Melton, Shannon; Hooker, Dona; Cantu, Hilda

    2000-01-01

    Performing a surgical procedure during spaceflight will become more likely with longer duration missions in the near future. Minimal surgical capability has been present on previous missions as the definitive medical care time was short and the likelihood of surgical events too low to justify surgical hardware availability. Early demonstrations of surgical procedures in the weightlessness of parabolic flight indicated the need for careful logistical planning and restraint of surgical hardware. The consideration of human ergonomics also has more impact in weightlessness than in the conventionall-g environment. Three methods of surgical instrument restraint - a Minor Surgical Kit (MSK), a Surgical Restraint Scrub Suit (SRSS), and a Surgical Tray (ST) were evaluated in parabolic flight surgical procedures. The Minor Surgical Kit was easily stored, easily deployed, and demonstrated the best ability to facilitate a surgical procedure in weightlessness. Important factors in this surgical restraint system include excellent organization of supplies, ability to maintain sterility, accessibility while providing secure restraint, ability to dispose of sharp items and biological trash, and ergonomical efficiency.

  9. Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents

    PubMed Central

    2016-01-01

    We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2±3.7) and adolescent with complicated grief (3.2±6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ2=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents. PMID:26770046

  10. Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents.

    PubMed

    Han, Doug Hyun; Lee, Jung Jae; Moon, Duk-Soo; Cha, Myoung-Jin; Kim, Min A; Min, Seonyeong; Yang, Ji Hoon; Lee, Eun Jeong; Yoo, Seo Koo; Chung, Un-Sun

    2016-01-01

    We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2 ± 3.7) and adolescent with complicated grief (3.2 ± 6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents. PMID:26770046

  11. Surgical Technician Curriculum.

    ERIC Educational Resources Information Center

    EASTCONN Regional Educational Services Center, North Windham, CT.

    This curriculum guide, developed for 10-month postsecondary programs in Connecticut, outlines a program for training surgical technicians. The program is divided into two components, didactic and clinical. Following a list of six general objectives of the program, the guide provides a curriculum outline by major areas with the number of hours…

  12. Surgical Technology Curriculum.

    ERIC Educational Resources Information Center

    Connecticut State Dept. of Education, Hartford. Div. of Vocational-Technical Schools.

    This curriculum guide contains materials for a 10-month postsecondary program to educate qualified adults to function as surgical technicians in association with surgeons and nurses in operating rooms and delivery rooms. The program provides for both a didactic and a clinical component. Contents include general information, a listing of major…

  13. Improving surgical weekend handover

    PubMed Central

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting. PMID:26734294

  14. Surgical wound care - open

    MedlinePlus

    Surgical incision care; Open wound care ... your wound again with sutures, you need to care for it at home, since it may take ... Your health care provider will tell you how often to change your dressing . To prepare for the dressing change: Clean your ...

  15. The Human Microbiome and Surgical Disease

    PubMed Central

    Morowitz, Michael J.; Babrowski, Trissa; Carlisle, Erica M.; Olivas, Andrea; Romanowski, Kathleen S.; Seal, John B.; Liu, Donald C.; Alverdy, John C.

    2015-01-01

    Objective The purpose of this review article is to summarize what is currently known about microbes associated with the human body and to provide examples of how this knowledge impacts the care of surgical patients. Background Pioneering research over the past decade has demonstrated that human beings live in close, constant contact with dynamic communities of microbial organisms. This new reality has wide-ranging implications for the care of surgical patients. Methods and Results Recent advances in the culture-independent study of the human microbiome are reviewed. To illustrate the translational relevance of these studies to surgical disease, we discuss in detail what is known about the role of microbes in the pathogenesis of obesity, gastrointestinal malignancies, Crohn disease, and perioperative complications including surgical site infections and sepsis. The topics of mechanical bowel preparation and perioperative antibiotics are also discussed. Conclusions Heightened understanding of the microbiome in coming years will likely offer opportunities to refine the prevention and treatment of a wide variety of surgical conditions. PMID:21422915

  16. The Acculturation of Parenting Cognitions: A Comparison of South Korean, Korean Immigrant, and European American Mothers

    PubMed Central

    Cote, Linda R.; Kwak, Keumjoo; Putnick, Diane L.; Chung, Hyun Jin; Bornstein, Marc H.

    2016-01-01

    A three-culture comparison – native South Korean, Korean immigrants to the United States, and native European American mothers – of two types of parenting cognitions – attributions and self-perceptions – was undertaken to explore cultural contributions to parenting cognitions and their adaptability among immigrant mothers. Attributions and self-perceptions of parenting were chosen because they influence parenting behavior and children’s development and vary cross-culturally. One hundred seventy-nine mothers of 20-month-old children participated: 73 South Korean, 50 Korean immigrant, and 56 European American. Korean mothers differed from European American mothers on four of the five types of attributions studied and on all four self-perceptions of parenting, and these differences were largely consistent with the distinct cultural values of South Korea and the United States. Generally, Korean immigrant mothers’ attributions for parenting more closely resembled those of mothers in the United States, whereas their self-perceptions of parenting more closely resembled those of mothers in South Korea. This study provides insight into similarities and differences in cultural models of parenting, and information about the acculturation of parenting cognitions among immigrants from South Korea. PMID:26912926

  17. Constraints on Noun Incorporation in Korean.

    ERIC Educational Resources Information Center

    Khym, Hangyoo

    1997-01-01

    A study of the noun incorporation phenomenon in Korean suggests that noun incorporation occurs at D-structure and obeys the Head Movement Constraint syntactically, and the Theme-Only Constraint semantically. First, the structure of "sunrise"-type words is identified, showing that before derivation through nominalization of the affix "-i,"…

  18. Korean-American Entrepreneurs. CELCEE Digest.

    ERIC Educational Resources Information Center

    Park, Sung

    For many Korean Americans, the American dream of building a better future in the United States for their families is realized through a focus on entrepreneurship. Their formula for entrepreneurial success is simple and effective: (1) identifying a business opportunity; and (2) working hard to turn the opportunity into a business success. Korean…

  19. Cultural Perspectives on Korean American Cancer Control

    PubMed Central

    Koh, Hesung Chun

    2006-01-01

    This paper emphasizes the importance of sociocultural research for successful ethnic-based cancer control. The article first delineates some demographic characteristics of Korean Americans and then describes six subcultural groups within this population, illuminating that Korean Americans are a diverse people. The author emphasizes that any cancer control program needs to acknowledge these cultural differences in selecting the target population, identifying intervention strategies, and training a team of health-care professionals, as well as in determining psychological factors related to cancer. The author also suggests that the traditional Korean American notion of health, the preventive approach to illness by using food as medicine, the traditional classification of body types, and the sasang theory for the treatment of illness are all important factors worthy of further research. Finally, the synchronistic and holistic approach to health common among Korean Americans is described by citing recent studies of cancer control that combine the use of Western medicine together with proper physical exercise, diet control, and psychological and family counseling. PMID:17031420

  20. Population pharmacokinetics of levofloxacin in Korean patients.

    PubMed

    Kiem, Sungmin; Ryu, Sung-Mun; Lee, Yun-Mi; Schentag, Jerome J; Kim, Yang-Wook; Kim, Hyeon-Kuk; Jang, Hang-Jae; Joo, Yong-Don; Jin, Kyubok; Shin, Jae-Gook; Ghim, Jong-Lyul

    2016-08-01

    Levofloxacin (LVFX) has different effects depending on the area under the concentration-time curve (AUC)/minimum inhibitory concentration (MIC) ratio. While AUC can be expressed as dose/clearance (CL), we measured serial concentrations of LVFX in Koreans and tried to set a Korean-specific equation, estimating the CL of the antibiotic. In total, 38 patients, aged 18-87 years, received once daily intravenous LVFX doses of 500 mg or 250 mg, depending on their renal function. Four plasma samples were obtained according to a D optimal sampling design. The population pharmacokinetic (PK) parameters of LVFX were estimated using non-linear mixed-effect modeling (NONMEM, ver. 7.2). The CL of LVFX was dependent on creatinine clearance (CLCR) as a covariate. The mean population PK parameters of LVFX in Koreans were as follows: CL (l/hour) = 6.19 ×  (CLCR/75)(1.32). The CL of LVFX in Koreans is expected to be lower than that in Western people. PMID:25976699

  1. American Colleges See Potential in Korean Partnerships

    ERIC Educational Resources Information Center

    Fischer, Karin

    2008-01-01

    For colleges in the United States seeking a foothold in South Korea's formerly insular higher-education sector, the lure seems to be part location, part alumni lobbying, and part desire to be part of the country's rapid transformation. The South Korean government's newfound openness to overseas universities is helping persuade American college…

  2. Proper Human Relationships: Korean Principals' Leadership Styles.

    ERIC Educational Resources Information Center

    Bryant, Miles; Son, Jong Ho

    In an attempt to better understand the values that Korean educational administrators associate with leadership, researchers surveyed a random sample of 292 subjects in South Korea in the spring of 2000. Using several well-tested instruments, the researchers were able to report findings of relevance to scholars interested in cultural influences on…

  3. Korean Kimchi Chemistry: A Multicultural Chemistry Connection

    ERIC Educational Resources Information Center

    Murfin, Brian

    2009-01-01

    Connecting science with different cultures is one way to interest students in science, to relate science to their lives, and at the same time to broaden their horizons in a variety of ways. In the lesson described here, students make kimchi, a delicious and popular Korean dish that can be used to explore many important chemistry concepts,…

  4. Temporal Phenomena in the Korean Conjunctive Constructions

    ERIC Educational Resources Information Center

    Kim, Dongmin

    2015-01-01

    The goal of this study is to characterize the temporal phenomena in the Korean conjunctive constructions. These constructions consist of three components: a verbal stem, a clause medial temporal suffix, and a clause terminal suffix. This study focuses on both the temporality of the terminal connective suffixes and the grammatical meanings of the…

  5. Syllable Transposition Effects in Korean Word Recognition

    ERIC Educational Resources Information Center

    Lee, Chang H.; Kwon, Youan; Kim, Kyungil; Rastle, Kathleen

    2015-01-01

    Research on the impact of letter transpositions in visual word recognition has yielded important clues about the nature of orthographic representations. This study investigated the impact of syllable transpositions on the recognition of Korean multisyllabic words. Results showed that rejection latencies in visual lexical decision for…

  6. Japanese/Korean Linguistics, Volume 8.

    ERIC Educational Resources Information Center

    Silva, David J., Ed.

    A collection of research in Japanese and Korean linguistics includes: "Repetition, Reformulation, and Definitions: Prosodic Indexes of Elaboration in Japanese" (Mieko Banno); "Projection of Talk Using Language, Intonation, Deictic and Iconic Gestures and Other Body Movements" (Keiko Emmett); "Turn-taking in Japanese Political Debate: Syntax,…

  7. Job Information Deprivation in the United States: A Case Study of Korean Immigrants.

    ERIC Educational Resources Information Center

    Kim, Kwang Chung; And Others

    1981-01-01

    Analyzes the methods of job information acquisition used by recent Korean immigrants. Indicates the Koreans most frequently use personal contact with other Koreans. Reviews findings from the perspective of labor market segmentation. (Author/MK)

  8. Spacecraft surgical scrub system

    NASA Technical Reports Server (NTRS)

    Abbate, M.

    1980-01-01

    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  9. Postthrombotic Syndrome: Surgical Possibilities

    PubMed Central

    Khanna, Ajay K.; Singh, Shivanshu

    2012-01-01

    Postthrombotic syndrome (PTS) is a late outcome of deep vein thrombosis characterized by cramping pain, swelling, hyperpigmentation, eczema, lipodermatosclerosis, and ulceration in the leg due to increased venous outflow resistance and reflux venous flow. Newer surgical and endovascular interventions have a promising result in the management of postthrombotic syndrome. Early surgical or endovascular interventions in appropriately selected patients may decrease the incidence of recurrent ulceration and skin changes and provide a better quality of life. Duplex and IVUS (intravenous ultrasound) along with venography serve as cornerstone investigative tools for assessment of reflux and obstruction. Venous obstruction, if present, should be addressed earlier than reflux. It requires endovenous stenting, endophlebectomy, or open bypass procedures. Venous stripping, foam sclerotherapy, radiofrequency, or laser ablation are used to abolish superficial venous reflux. Valvuloplasty procedures are useful for incompetent but intact deep venous valves, while transposition or axillary vein autotransplantation is done for completely destroyed valves. PMID:22084674

  10. Surgical management of presbyopia

    PubMed Central

    Torricelli, André AM; Junior, Jackson B; Santhiago, Marcony R; Bechara, Samir J

    2012-01-01

    Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages. PMID:23055664

  11. Mentoring in surgical training.

    PubMed

    Rashid, Prem; Narra, Maruthi; Woo, Henry

    2015-04-01

    Surgical mentors have helped trainees develop fulfilling and academically productive careers, while supervisors are formally assigned to impart skills and oversee training. This paper reviews the comparative roles of the supervisor and mentor and how they overlap, while exploring the impact of the 'unknown' mentor. While the supervisor's role in directing the student is formally recognized, the mentee will personally select a mentor who successfully models the career and life balance to which the mentee aspires. The unknown mentor is known only to the mentee. The mentee's commitment to communicating with both mentor and supervisor is crucial to success. Better processes can be used to guide the mentor relationship. Confusion between the two roles - mentor and supervisor - is due to their complementary nature as well as an overlap in roles. Both remain essential to the growth and development of the surgical trainee. The unknown mentor could give detached advice and guidance to the student, while acting as a positive role model. PMID:25649003

  12. Guideline implementation: Surgical attire.

    PubMed

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:25645036

  13. Robotic surgical training.

    PubMed

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey. PMID:23528718

  14. Allergy to Surgical Implants.

    PubMed

    Pacheco, Karin A

    2015-01-01

    Surgical implants have a wide array of therapeutic uses, most commonly in joint replacements, but also in repair of pes excavatum and spinal disorders, in cardiac devices (stents, patches, pacers, valves), in gynecological implants, and in dentistry. Many of the metals used are immunologically active, as are the methacrylates and epoxies used in conjunction with several of these devices. Allergic responses to surgical components can present atypically as failure of the device, with nonspecific symptoms of localized pain, swelling, warmth, loosening, instability, itching, or burning; localized rash is infrequent. Identification of the specific metal and cement components used in a particular implant can be difficult, but is crucial to guide testing and interpretation of results. Nickel, cobalt, and chromium remain the most common metals implicated in implant failure due to metal sensitization; methacrylate-based cements are also important contributors. This review will provide a guide on how to assess and interpret the clinical history, identify the components used in surgery, test for sensitization, and provide advice on possible solutions. Data on the pathways of metal-induced immune stimulation are included. In this setting, the allergist, the dermatologist, or both have the potential to significantly improve surgical outcomes and patient care. PMID:26362550

  15. [Surgical treatment of syringomyelia].

    PubMed

    Abe, T; Okuda, Y; Nagashima, H; Isojima, A; Tani, S

    1995-12-01

    Eighty cases of surgically treated syringomyelia were retrospectively reviewed. The cases were classified into following 4 types, type 1: syringomyelia with Chiari malformation (54 cases), type 2: syringomyelia with basal arachnoiditis (15 cases), type 3: syringomyelia with an obstruction of the foramen Magendie (1 case), and type 4: syringomyelia with spinal arachnoiditis (14 cases). Foramen magnum decompression (FMD) was performed in patients with type 1, in type 2 fourth ventricle-subarachnoid shunt was additionally performed. Gardner's operation was performed in patients with type 3. Syrinx-peritoneal shunt was performed in patients with type 4. Surgical procedures for syringomyelia which we selected were thought to be appropriate, based on postoperative syrinx collapse rate in MRI. However, postoperative clinical course was much different in each type of syringomyelia after the collapse of syrinx had been equally achieved. Neurological disorders were stopped in deterioration after surgery in all cases of type 1. However, motor weakness was still deteriorated in half cases of type 2, and in 60% of type 4. When clinical severity of the patients with type 1 and 2, based on the distribution of dissociated sensory loss and motor weakness, were classified into 5 grades. The rate of improvement of patient's symptoms and signs was higher in the lower grades. We concluded that a surgical treatment for syringomyelia was essentially a preventive one, therefore it should be done in early stage of disorders. PMID:8752412

  16. Surgical management of soft tissue sarcomas

    SciTech Connect

    Arlen, M.; Marcove, R.C.

    1987-01-01

    This volume reflects the latest thinking in surgical and adjuvant forms of therapy that can be offered to the sarcoma patient. Based on their analysis of sarcoma patients, the authors stress management based on site of origin, and discuss tumors on and about the shoulder girdle, hip joint, extremity, retroperitoneum, etc. Coverage includes methods for limb preservation; techniques for regional node resection; indications and methods for arterial perfusion, cryosurgery and isotope implantation; pre- and post-operative immunotherapy chemotherapy and radiation therapy.

  17. 2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

    PubMed Central

    Yoon, Yeonyee E.; Hong, Yoo Jin; Kim, Hyung-Kwan; Kim, Jeong A; Na, Jin Oh; Yang, Dong Hyun

    2014-01-01

    Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. PMID:25469078

  18. 2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

    PubMed Central

    Yoon, Yeonyee E.; Hong, Yoo Jin; Kim, Hyung-Kwan; Kim, Jeong A; Na, Jin Oh; Yang, Dong Hyun

    2014-01-01

    Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. PMID:25469139

  19. Characteristics of Body Composition and Muscle Strength of North Korean Refugees during South Korean Stay

    PubMed Central

    Cho, Sun Wook; Koh, Eun Sil; Kim, Si Eun; Kim, Seok Joong

    2015-01-01

    Background The aim of this study was to investigate the changes of body composition and muscle strength of North Korean refugees (NKRs) according to their duration of stay in South Korea. Methods NKRs who volunteered and were living in South Korea, aged 20 to 75 years were recruited. Body compositions were analyzed by bioelectrical impedance analysis. Muscle strength was measured with the hand grip test. Demographic and migration information was obtained with a questionnaire. Results A total of 158 volunteers were recruited at a mean age of 48.3±11.4 years. The mean time from when they escaped from North Korea and arrived in South Korea was 5.8±4.3 years. Height, weight, and body surface area were significantly smaller in all NKRs compared to South Korean controls, except for women aged over 50 years. In females of younger ages (<50 years), NKRs with more than a 4-year stay in South Korea had a higher weight and fat mass than that of those who had a shorter stay (less than 4 years) in South Korea. All NKRs had a weaker grip strength than that of the age-matched controls from South Korea. Conclusion The NKRs showed relatively smaller physiques and weaker muscle strength than that of the South Korean controls. In younger female NKRs, shorter South Korean stay group showed small body weight and fat mass than that of longer South Korean stay group. Specific health support programs might be needed. PMID:26485471

  20. The retained surgical sponge.

    PubMed Central

    Kaiser, C W; Friedman, S; Spurling, K P; Slowick, T; Kaiser, H A

    1996-01-01

    OBJECTIVE. A review was performed to investigate the frequency of occurrence and outcome of patients who have retained surgical sponges. METHODS. Closed case records from the files of the Medical Professional Mutual Insurance Company (ProMutual, Boston, MA) involving a claim of retained surgical sponges were reviewed for a 7-year period. RESULTS. Retained sponges occurred in 40 patients, comprising 48% of all closed claims for retained foreign bodies. A falsely correct sponge count after an abdominal procedure was documented in 76% of these claims. Ten percent of claims involved vaginal deliveries and minor non-body cavity procedures, for which no sponge count was performed. Total indemnity payments were $2,072,319, and defense costs were $572,079. In three cases, the surgeon was deemed responsible by the court despite the nursing staff's admitting liability and evidence presented that the surgeon complied completely with the standard of care. A wide range of indemnity payments was made despite a remarkable similarity of outcome in the patients studied. CONCLUSIONS. Despite the rarity of the reporting of a retained surgical sponge, this occurrence appears to be encountered more commonly than generally is appreciated. Operating teams should ensure that sponges be counted for all vaginal and any incisional procedures at risk for retaining a sponge. In addition, the surgeon should not unquestioningly accept correct count reports, but should develop the habit of performing a brief but thorough routine postprocedure wound/body cavity exploration before wound closure. The strikingly similar outcome for most patients would argue for a standardized indemnity payment being made without the need for adversarial legal procedures. PMID:8678622

  1. Surgical Simulation and Competency.

    PubMed

    Kim-Fine, Shunaha; Brennand, Erin A

    2016-09-01

    Simulation in surgical training is playing an increasingly important role as postgraduate medical education programs navigate an environment of increasing costs of education, increased attention on patient safety, and new duty hour restrictions. In obstetrics and gynecology, simulation has been used to teach many procedures; however, it lacks a standardized curriculum. Several different simulators exist for teaching various routes and aspects of hysterectomy. This article describes how a formal framework of increasing levels of competencies can be applied to simulation in teaching the procedure of hysterectomy. PMID:27521885

  2. Cloning and deliberation: Korean consensus conference.

    PubMed

    Kim, Myung-Sik

    2002-12-01

    This article addresses the 2nd Korean consensus conference on cloning that was held by the Korean National commission for UNESCO in 1999. It notes that the citizens participated directly and handled the important social agenda through deliberative process. The consensus conference is another democratic form derived from preference aggregative democracy in the sense that it basically depends on public judgment of the citizens. Compared to other models (elitist or preference aggregative), it has some advantages: 1. It can solve the problem of political legitimacy. 2. It can check the partiality of expert groups in biotechnology and ethics. 3. It enables us to make informed, responsible decisions. 4. It results in education of citizens' preference. However, we need to expand the deliberative model. First, we need institutional efforts on behalf of future generations because cloning relates to them. Second, we should not include the value of life which cannot be expressed in the form of argument or discourse. PMID:12870502

  3. Analysis of the discoid meniscus in Koreans.

    PubMed

    Seong, S C; Park, M J

    1992-01-01

    Discoid meniscus is a relatively common disorder of the knee in Koreans. Its arthroscopic treatment is one of the most technically demanding procedures of this field. The purposes of this study were to define the clinical features of the discoid meniscus in Koreans and to suggest an adequate arthroscopic technique. We performed arthroscopic meniscectomy on 37 knees with a lateral discoid meniscus. The average length of follow up was 21 months. The presence of synovial hypertrophy in the knee with discoid was significantly higher than that with a non-discoid meniscal lesion. A medial midpatellar portal for the arthroscope is advisable for clean arthroscopic surgery in this situation. We obtained satisfactory results through the partial resection of the discoid meniscus, leaving the normal semilunar-shaped meniscus intact as much as possible. PMID:1738712

  4. Psycholinguistic Evidence for Inverse Scope in Korean.

    PubMed

    Lee, Sunyoung; O'Grady, William

    2016-08-01

    We use experimental data to shed light on the ongoing question of whether Korean allows inverse scope interpretation in sentences containing an indefinite subject and a universally quantified direct object (e.g., 'Someone bought each loaf of bread at the bakery'). The results of an off-line acceptability judgment task (n = 38) and an online self-paced reading task (n [Formula: see text] 22) indicate that inverse scope interpretations are in fact permitted in Korean as a secondary option, as is also the case in English. We argue that the dispreference for the inverse scope reading reflects processing considerations related to burden on working memory. PMID:26022290

  5. Progressive Macular Hypomelanosis in Korean Patients: A Clinicopathologic Study

    PubMed Central

    Hwang, Seon Wook; Hong, Soon Kwon; Kim, Sang Hyun; Park, Jeong Hoon; Seo, Jong Keun; Sung, Ho Suk

    2009-01-01

    Background Progressive macular hypomelanosis is characterized by ill-defined, non-scaly, hypopigmented macules primarily on the trunk of the body. Although numerous cases of progressive macular hypomelanosis have been reported, there have been no clinicopathologic studies of progressive macular hypomelanosis in Korean patients. Objective In this study we examined the clinical characteristics, histologic findings, and treatment methods for progressive macular hypomelanosis in a Korean population. Methods Between 1996 and 2005, 20 patients presented to the Department of Dermatology at Busan Paik Hospital with acquired, non-scaly, confluent, hypopigmented macules on the trunk, and with no history of inflammation or infection. The medical records, clinical photographs, and pathologic findings for each patient were examined. Results The patients included 5 men and 15 women. The mean age of onset was 21.05±3.47 years. The back was the most common site of involvement. All KOH examinations were negative. A Wood's lamp examination showed hypopigmented lesions compared with the adjacent normal skin. A microscopic examination showed a reduction in the number of melanin granules in the lesions compared with the adjacent normal skin, although S-100 immunohistochemical staining did not reveal significant differences in the number of melanocytes. Among the 20 patients, 7 received topical drug therapy, 6 were treated with narrow-band ultraviolet B phototherapy, 4 received oral minocycline, and 3 did not receive any treatment. Conclusion Most of the patients with progressive macular hypomelanosis had asymptomatic ill-defined, non-scaly, and symmetric hypopigmented macules, especially on the back and abdomen. Histologically, the number of melanocytes did not differ significantly between the hypopigmented macules and the normal perilesional skin. No effective treatment is known for progressive macular hypomelanosis; however, narrow-band ultraviolet B phototherapy may be a useful

  6. [Surgical indications in coexisting cataracts and glaucoma].

    PubMed

    Collignon-Brach, J D; Ravet, O; Robe-Collignon, N

    2000-01-01

    Cataract surgery in glaucoma patients remains a controversial subjects. Indication of surgery depends on a lot of clinical parameters: diagnosis, state, evolution of glaucoma as well as compliance with medical treatment--surgical procedures of cataract and glaucoma--sites of the surgery--use of antifibrosis agents and surgeon's experience. As cataract extraction alone decreases the intraocular pressure in open angle glaucoma and mainly in uncomplicated closed angle glaucoma and trabeculectomy alone reduces the intraocular pressure more than combined surgery with less complications we recommended the following surgical options: Cataract extraction alone in patients with controlled open angle glaucoma and in patients with closed angle glaucoma. A two step procedure: filtering surgery followed by cataract extraction in patients with poorly controlled open angle glaucoma or mixed closed angle glaucoma. Ambulatory surgery and topical anesthesia permit a two stages surgery with less inconveniences. A combined procedure in patients with a chronic closed angle glaucoma where filtering procedure alone is associated with important complications. Actually, the best surgical cataract procedure is phacoemulsification with a small supero-corneal incision and implantation of a foldable intraocular lens. The best filtering procedure remains trabeculectomy, or the new non penetrating trabecular surgery for experimented surgeons, in the superior quadrant. In the future new surgical procedures and new safe and non toxic pharmacologic drugs which modulate wound healing could be found in order to increase the efficacity and indications of combined surgery. PMID:11262885

  7. Validation of a Korean MMPI-2 Hwa-Byung scale using a Korean normative sample.

    PubMed

    Ketterer, Holly; Han, Kyunghee; Weed, Nathan C

    2010-07-01

    The psychometric properties of a recently developed measure of Hwa-Byung (HB), a Korean culture bound syndrome, using an updated version of the Korean Minnesota Multiphasic Personality Inventory-2, were examined in Korean normative sample. Confirmatory factor analyses indicated that both the first-order four-factor model and the single second-order factor model fit the data well, but the latter may be superior because of its parsimony. The HB scale correlated modestly with age, sex, SES, and problems with family and finance. However, it showed substantial correlations with spouse ratings items that were identified a priori as prospective HB correlates, indicating excellent concurrent validity. The limitations of the study and the need for future studies employing HB patients were discussed. PMID:20658881

  8. The Korean Version of the Pediatric Symptom Checklist: Psychometric Properties in Korean School-aged Children.

    PubMed

    Han, Doug Hyun; Woo, Jungmin; Jeong, Jae Hoon; Hwang, Sunyung; Chung, Un-Sun

    2015-08-01

    Psychosocial problems increase the risk for mental health problems and increase the need for health care services in children and adolescents. Primary care practice is a valuable avenue for identifying the need for more specialized mental health care. We hypothesized that Korean version of the pediatric symptom checklist (PSC) would be a useful tool for early detection of psychosocial problems in children and adolescents in Korea and we aimed to suggest cut-off scores for detecting meaningful psychosocial problems. A total of 397 children with their parents and 97 child patients with their parents were asked to complete the PSC Korean version and the child behavior checklist (CBCL). The internal reliability and test-retest reliability of the PSC as well as the cut-off score of the PSC was determined via receiver operating characteristic analysis of the CBCL score, clinical group scores and non-clinical group scores. The internal consistency of the PSC-Korean version was excellent (Cronbach's alpha = 0.95). The test-retest reliability was r = 0.73 (P < 0.001). Using clinical CBCL scores (total score, externalizing score, internalizing score, respectively ≥ 60) and presence of clinical diagnosis, the recommended cut-off score of the PSC was 14. Using 494 Korean children aged 7-12 yr, the current study assessed the reliability and validity of a Korean version of the PSC and suggested a cut-off for recommending further clinical assessment. The present results suggest that the Korean version of the PSC has good internal consistency and validity using the standard of CBCL scores. PMID:26240496

  9. Trichoscopic Findings of Hair Loss in Koreans

    PubMed Central

    Park, Jin; Kim, Joo-Ik; Kim, Han-Uk; Yun, Seok-Kweon

    2015-01-01

    Background Trichoscopic findings of hair loss have been well described for the differential diagnosis of alopecia; however, critical findings were not thoroughly investigated or compared among all ethnic groups, including Asians. Objective We aimed to find any characteristic trichoscopic findings in Korean alopecia patients and to verify whether those findings are closely related to previously reported observations. Methods Three hundred and twenty-seven patients with hair loss of various causes and 160 normal scalps were analyzed. Trichoscopic examination was performed with a polarized-light handheld dermoscope. Results A total of 35 patterns of trichoscopic features were represented, and certain features were significantly common or observed exclusively in a particular type of alopecia as follows: yellow dots, exclamation mark hairs, and proximal tapering hairs (alopecia areata), trichoptilosis and pointed hairs (trichotillomania), corkscrew hairs, septate hyphae hairs, and comma hairs (tinea capitis), diffuse white area, fibrotic white dots, and tufting hairs (primary cicatricial alopecia), hair diameter diversity and peripilar sign (androgenetic alopecia), and short nonvellus hairs (telogen effluvium). Conclusion The characteristic trichoscopic features for the differential diagnosis of alopecia in Koreans, shown as follicular, perifollicular, and hair shaft patterns, are similar to those of Caucasians; however, the frequencies of the pigment patterns are different between Koreans and Caucasians because of the contrast effect of the skin and hair color. Therefore, racial difference should be considered in the trichoscopic evaluation for differential diagnosis. PMID:26512168

  10. Raising children in America: Korean parents' experiences.

    PubMed

    Choi, H; Dancy, B L; Lee, J

    2013-08-01

    This qualitative description study was designed to describe Korean American parents' perceptions of challenges and difficulties they encounter while raising their children in the USA. A convenience sampling of 21 parents of adolescents aged 11-14 years recruited from the Midwest Korean American community participated in the study. Data were collected using in-depth, face-to-face interviews, which took place in agreed-upon, convenient locations. All interviews were audiotaped and transcribed in Korean and the transcripts were translated into English. Qualitative content analysis revealed that the main stresses that parents encountered while raising their children in the USA were inability to advocate for children, feeling uneasy and insecure about incompatible American culture, ambivalence towards children's ethnic identities, and feeling alienated. In relation to these stresses, parents often felt inadequate, ashamed, guilty, regretful and powerless. The findings demonstrated the importance of understanding parents' feelings that are deeply embedded in the conflicted parent-child relationships and their perceptions of being parents in the USA. The present study highlights the need for and importance of providing intervention programmes for parents, particularly programmes that would empower parents, strengthen parent-child relationships and address ways to integrate two very different cultures while upholding ethnic identity and pride. PMID:22295897

  11. Surgical approaches for liver metastases in carcinoid tumors

    PubMed Central

    Saeed, Ahmad; Buell, Joseph

    2015-01-01

    Liver is the commonest site for metastasis in patients with neuroendocrine tumors (NETs); it occurs in 45-95% of patients. Available treatment options include surgical resection, liver transplantation, chemotherapy and biotherapy. Surgery is the gold standard for curative therapy. Typically, a multidisciplinary approach is a cornerstone for decision making while dealing with this aggressive disease. This review will focus on the performance and safety of open, laparoscopic, and liver transplant surgical approaches in NETs patients with liver metastases. PMID:26425458

  12. Surgical treatments for osteoarthritis.

    PubMed

    de l'Escalopier, Nicolas; Anract, Philippe; Biau, David

    2016-06-01

    There are two main surgical treatments for osteoarthritis: conservative treatments, where the damaged cartilage is left in place, and radical treatments, where the cartilage is replaced by an artificial endoprosthesis; this latter procedure is termed joint arthroplasty. These treatments are only offered to symptomatic patients. Arthrodesis is yet another surgical intervention in cases of osteoarthritis. It will sacrifice the joint's articular function and is performed on small osteoarthritic joints, such as wrists and ankles, for instance. Osteoarthritis symptoms are usually the consequence of an imbalance between the load applied to a joint and the surface available to support that load. Therefore, conservative treatments will either tend to decrease the load exerted on the joint, such as in a tibial valgus osteotomy for instance, or to improve the articular surface supporting that load. Sometimes, both can be provided at the same time; the peri-acetabular osteotomy for hip dysplasia is an example of such a procedure. Conservative treatments are usually offered to young patients in order to delay, if not avoid, the need for a joint prosthesis. They are usually performed before osteoarthritis appears or at an early stage. Joint arthroplasties have overwhelmingly excellent functional results and today's research is directed towards providing rapid recovery, very long-term stability, and the assurance of a good functionality in extreme conditions. However, complications with joint arthroplasties can be serious with little, if any, reasonable salvage solution. Therefore, these procedures are offered to patients who have failed adequate medical treatment measures. PMID:27185463

  13. Surgical quality in colorectal cancer

    PubMed Central

    Plummer, Joseph M.; Williams, Nadia; Leake, Pierre-Anthony; Ferron-Boothe, Doreen; Meeks-Aitken, Nicola; Mitchell, Derek I.; McFarlane, Michael E.; East, Jeffery

    2015-01-01

    Objective To determine the quality of surgical management offered to patients with colorectal cancer (CRC) as measured by adequacy of nodal resections and compare variations across the major hospitals in Jamaica. Method Data was obtained from the CRC Registry of patients diagnosed and treated surgically for CRC during the 3-year period commencing January 1, 2011. Variables analyzed included tumor site, stage and number of lymph nodes resected across hospitals. Results During the period under review 60% (349) of 586 patients had resections and formed the basis of this study. Of these 49% were treated at the UHWI, 27% from the KPH and STH, 15% from CRH and MRH and 8% from a private laboratory (DPS). Patient distribution was similar at UHWI compared to the others with mean age (61 vs 62) and with slightly more women having surgery (53% Vs 54%) (UHWI vs Others). For tumor grade, margin status, lymphovascular and depth of invasion (majority T3) there was no difference between UHWI and the other sites, although a smaller percentage of tumors treated at UHWI had Crohn's like reaction (p = 0.01). There was a larger proportion of sigmoid cancer at UHWI while the reverse trend was seen in cancers of the rectum (p = 0.027). The tumors treated at UHWI have a larger median number of regional nodes when compared to the other facilities (14 vs 10; p < 0.001) and also more likely to have positive nodes, as were women and younger patients. Comparison across facilities revealed that the proportion of tumors classed as well differentiated, circumferential margin involvement, and having lymphovascular invasion were higher for specimens processed at the private facility (p = 0.021, 0.035, 0.01 respectively). Histopathology reports of tumors treated at UHWI and DPS had median 14 and 18 nodes respectively while at NPH laboratory and CRH they were 9 and 10 respectively (p < 0.001), whilst those of the ascending, descending, sigmoid colon and rectum had median 15, 11, 13, 11

  14. Complete mitochondrial genomes of Korean lamprey (Lethenteron morii) and American brook lamprey (L. appendix).

    PubMed

    Pu, Jiafei; Ren, Jianfeng; Zhang, Zhe; Jia, Liang; Buchinger, Tyler; Li, Weiming

    2016-05-01

    The complete mitogenomes of two lampreys with complex taxonomic histories, the Korean lamprey (Lethenteron morii) and the American brook lamprey (L. appendix) were determined. Three-nt length difference between two genomes occurred on tRNA-Ser2 and control region 2. Except for 3 indel sites, there are 58 variable sites between two genomes which occurred on 11 of the 13 protein-coding genes (aside from COX3 and ND3) and 2 of rRNAs, tRNAs, control regions and intergenic regions. Among these sites, 15 sites are non-synonymous substitution sites occurred on 8 protein-coding genes including COX1-COX2, ND1-ND2, ND4-ND6 and ATPase6. Control region 1 contains 4 consecutive 39-nt repetitive strings and a 26-nt repetitive string in control region 2 is repeated 3.8 times in both lampreys. The observed level of similarity between nucleotide sequences (99.62%) implies the Korean lamprey and American brook lamprey are very close relatives and should be assigned into the same taxonomic genus. PMID:25319284

  15. A Korean Space Situational Awareness Program : OWL Network

    NASA Astrophysics Data System (ADS)

    Park, J.; Choi, Y.; Jo, J.; Moon, H.; Im, H.; Park, J.

    2012-09-01

    We are going to present a brief introduction to the OWL (Optical Wide-field patroL) network, one of Korean space situational awareness facilities. Primary objectives of the OWL network are 1) to obtain orbital information of Korean domestic LEOs using optical method, 2) to monitor GEO-belt over territory of Korea, and 3) to alleviate collisional risks posed to Korean satellites from space debris. For these purposes, we are planning to build a global network of telescopes which consists of five small wide-field telescopes and one 2m class telescope. The network of small telescopes will be dedicated mainly to the observation of domestic LEOs, but many slots will be open to other scientific programs such as GRB follow-up observations. Main targets of 2m telescope not only include artificial objects such as GEO debris and LEO debris with low inclination and high eccentricity, but also natural objects such as near Earth asteroids. We expect to monitor space objects down to 10cm in size in GEO using the 2m telescope system. Main research topics include size distribution and evolution of space debris. We also expect to utilize this facility for physical characterization and population study of near Earth asteroids. The aperture size of the small telescope system is 0.5m with Rechey-Cretian configuration and its field of view is 1.75 deg x 1.75 deg. It is equipped with 4K CCD with 9um pixel size, and its plate scale is 1.3 arcsec/pixel. A chopper wheel is employed to maximize astrometric solutions in a single CCD frame, and a de-rotator is used to compensate field rotation of the alt-az type mount. We have designed a compact end unit in which three rotating parts (chopper wheel, filter wheel, de-rotator) and a CCD camera are integrated, and dedicated telescope/site control boards for the OWL network. The design of 2m class telescope is still under discussion yet is expected to be fixed in the first half of 2013 at the latest. The OWL network will be operated in a fully

  16. Different lymph node staging systems in patients with gastric cancer from Korean

    PubMed Central

    Lee, Jin Won; Ali, Bandar; Park, Cho Hyun; Song, Kyo Young

    2016-01-01

    Abstract To investigate whether the log odds of positive lymph nodes (LODDS) system is a more accurate prognostic tool than the number-based (pN) or ratio-based (rN) lymph node staging system in Korean patients with gastric cancer (GC). The LODDS is a recently proposed staging modality in surgical oncology. However, it is unclear whether LODDS is superior to the pN or rN system in terms of predicting the prognosis of GC patients who underwent radical gastrectomy with extended lymphadenectomy and had a greater number of retrieved lymph nodes. Clinicopathological data from 3929 patients who had undergone curative gastrectomy for GC were reviewed. In addition, overall survival rates according to pN and rN classification stratified by the LODDS were analyzed. A multivariate analysis of survival rate was performed using a Cox proportional hazard model. pN, rN, and LODDS were significantly correlated with 5-year survival rate. Spearman correlation test showed no correlation between LODDS and number of lymph nodes retrieved. The receiver operating characteristic (ROC) curves showed that the 3 staging systems had comparable prognostic accuracy (P < 0.05). Survival analysis according to pN and rN classification stratified by the LODDS staging system demonstrated that LODDS is superior to pN and rN. The LODDS is independently and significantly associated with the OS of Korean patients with GC, and its prognostic value is superior to that of the other lymph node staging systems in Korean patients. PMID:27336871

  17. Robotic Surgical Training in an Academic Institution

    PubMed Central

    Chitwood, W. Randolph; Nifong, L. Wiley; Chapman, William H. H.; Felger, Jason E.; Bailey, B. Marcus; Ballint, Tara; Mendleson, Kim G.; Kim, Victor B.; Young, James A.; Albrecht, Robert A.

    2001-01-01

    Objective To detail robotic procedure development and clinical applications for mitral valve, biliary, and gastric reflux operations, and to implement a multispecialty robotic surgery training curriculum for both surgeons and surgical teams. Summary Background Data Remote, accurate telemanipulation of intracavitary instruments by general and cardiac surgeons is now possible. Complex technologic advancements in surgical robotics require well-designed training programs. Moreover, efficient robotic surgical procedures must be developed methodically and safely implemented clinically. Methods Advanced training on robotic systems provides surgeon confidence when operating in tiny intracavitary spaces. Three-dimensional vision and articulated instrument control are essential. The authors’ two da Vinci robotic systems have been dedicated to procedure development, clinical surgery, and training of surgical specialists. Their center has been the first United States site to train surgeons formally in clinical robotics. Results Established surgeons and residents have been trained using a defined robotic surgical educational curriculum. Also, 30 multispecialty teams have been trained in robotic mechanics and electronics. Initially, robotic procedures were developed experimentally and are described. In the past year the authors have performed 52 robotic-assisted clinical operations: 18 mitral valve repairs, 20 cholecystectomies, and 14 Nissen fundoplications. These respective operations required 108, 28, and 73 minutes of robotic telemanipulation to complete. Procedure times for the last half of the abdominal operations decreased significantly, as did the knot-tying time in mitral operations. There have been no deaths and few complications. One mitral patient had postoperative bleeding. Conclusion Robotic surgery can be performed safely with excellent results. The authors have developed an effective curriculum for training teams in robotic surgery. After training, surgeons

  18. Surgical sterilization of free-ranging wolves.

    PubMed Central

    Spence, C E; Kenyon, J E; Smith, D R; Hayes, R D; Baer, A M

    1999-01-01

    The objective of the study was to determine whether surgical sterilization of both males and females in wolf pairs alters basic wolf social and territorial behaviors. Wolves were located from the air by snow-tracking methods and were tranquilizer-darted from a helicopter. Surgeries were performed either in a tent at the capture site or in a heated building in a nearby village. Six vasectomies and seven uterine horn ligations were performed in January and February of 1996 and 1997. Two females died: one likely related to the capture procedure, the other of a peritonitis unrelated to the surgery. One wolf had a litter. None of the wolves have shown changes in behavioral patterns. Surgical sterilization can be effective, but other, less invasive, fertility control techniques should be investigated. PMID:10065320

  19. The Syntax of Inaudible Noun Phrases in Korean

    ERIC Educational Resources Information Center

    Kim, Ock-Hwan

    2012-01-01

    In this dissertation, I examine the interpretation of NP-ellipsis (henceforth, NPE) in Korean. Some unexpected interpretive and grammatical contrasts arise in Korean between pro-forms such as "caki" "self" and "ku" "'3.S.M" (~"he") in object position and their null counterparts in NPE…

  20. Language Ideologies and Bilingual Education: A Korean-American Perspective

    ERIC Educational Resources Information Center

    Jeon, Mihyon

    2007-01-01

    This paper is an ethnographic record of an ongoing journey during which I have tried to understand the kinds of language ideologies that my students and I have constructed about the Korean language. My students are mainly Korean-American university students who have never successfully achieved native fluency in their heritage language, although…

  1. Cultural Influences on Caregiving Burden: Cases of Koreans and Americans.

    ERIC Educational Resources Information Center

    Lee, Yoon-Ro; Sung, Kyu-Taik

    1998-01-01

    Compares cultural influences on caregiver burdens of Korean adult children and American adult children caring for parents with dementia. Identifies culturally specific values, norms, and customs associated with low or high burden. Findings show low burden for Korean caregivers and high burden for American caregivers. (MKA)

  2. Historic Factors Affecting Educational Administration in Korean Higher Education.

    ERIC Educational Resources Information Center

    Lee, Jeong-Kyu

    1999-01-01

    An official of the Korean Education Department Institute analyzes the effect of historic factors on current educational administration in Korea. He suggests that Confucianism, Shinto-Confucianism, Christianity, and Western ideas mainly dominate current Korean educational administration's organizational structure, culture, and leadership, while…

  3. Development and Initial Psychometrics of the Korean Mood State Inventory

    ERIC Educational Resources Information Center

    Lee, Sang Min; Moon, Kyoung-Suk; Puig, Ana; Cho, Eunsoo; Lee, Sun Young; Back, Sun Hee; Woo, Yeon Kyoung

    2008-01-01

    The authors describe the development and psychometric properties of the Korean Mood State Inventory (KMSI), which is designed to measure the mood states of Korean college students. Factor structure, concurrent validity, and internal consistency of the KMSI scores are reported. Implications, limitations, and recommendations for future research are…

  4. Segmental Properties of Input to Infants: A Study of Korean

    ERIC Educational Resources Information Center

    Lee, Soyoung; Davis, Barbara L.; MacNeilage, Peter F.

    2008-01-01

    Segmental distributions of Korean infant-directed speech (IDS) and adult-directed speech (ADS) were compared. Significant differences were found in both consonant and vowel patterns. Korean-speaking mothers using IDS displayed more frequent labial consonantal place and less frequent coronal and glottal place and fricative manner. They showed more…

  5. Cultural Validation of the Maslach Burnout Inventory for Korean Students

    ERIC Educational Resources Information Center

    Shin, Hyojung; Puig, Ana; Lee, Jayoung; Lee, Ji Hee; Lee, Sang Min

    2011-01-01

    The purpose of this study was to examine the factorial validity of the MBI-SS in Korean students. Specifically, we investigated whether the original three-factor structure of the MBI-SS was appropriate for use with Korean students. In addition, by running multi-group structural equation model analyses with factorial invariance tests simultaneously…

  6. Identifying Balanced Action Learning: Cases of South Korean Practices

    ERIC Educational Resources Information Center

    Cho, Yonjoo; Bong, Hyeon-Cheol

    2010-01-01

    Despite considerable commitment to the application of action learning as leadership and organization development by a large number of Korean organizations, few identified empirical studies of action learning practices have been reported. The purpose of this study was to conduct case studies of South Korean action learning practices to examine…

  7. Eye Movements and Parafoveal Processing during Reading in Korean

    ERIC Educational Resources Information Center

    Kim, Young-Suk; Radach, Ralph; Vorstius, Christian

    2012-01-01

    Parafoveal word processing was examined during Korean reading. Twenty-four native speakers of Korean read sentences in two conditions while their eye movements were being monitored. The boundary paradigm (Rayner, 1975) was used to create a mismatch between characters displayed before and after an eye movement contingent display change. In the…

  8. Korean Percussion Ensemble ("Samulnori") in the General Music Classroom

    ERIC Educational Resources Information Center

    Kang, Sangmi; Yoo, Hyesoo

    2016-01-01

    This article introduces "samulnori" (Korean percussion ensemble), its cultural background, and instructional methods as parts of a classroom approach to teaching upper-level general music. We introduce five of eight sections from "youngnam nong-ak" (a style of samulnori) as a repertoire for teaching Korean percussion music to…

  9. The Experience of Korean Immigrant Grandmothers with Their Grandchildren

    ERIC Educational Resources Information Center

    Kim, Soohong

    2010-01-01

    The purpose of this study was to explore the following research question: "What is the experience of Korean immigrant grandmothers in their relationships with their adolescent, U.S. born grandchildren?" In the United States, the situation of Korean immigrant grandparents is complicated because they live in two cultures. Immigrant…

  10. Deconstruction of Cultural Dominance in Korean EFL Textbooks

    ERIC Educational Resources Information Center

    Song, Heejin

    2013-01-01

    This article examines patterns of cultural representations embedded in Korean EFL textbooks, using a content analysis to investigate how different cultures are reflected in textbooks and whether or not cultural biases are present. In the revised Korean national English curriculum that has been implemented since 2009, English is viewed as a…

  11. Age-Related Differences in Academic Burnout of Korean Adolescents

    ERIC Educational Resources Information Center

    Lee, Jayoung; Puig, Ana; Lea, Eunkyoung; Lee, Sang Min

    2013-01-01

    Korean adolescents experience considerable stress because of an educational system that focuses primarily on college entrance examinations, pressure for academic achievement, and a competitive atmosphere in school. The main purpose of this study was to explore age differences in the construct of Korean adolescents' academic burnout. Once…

  12. Binding Interpretations of Anaphors by Korean Heritage Speakers

    ERIC Educational Resources Information Center

    Kim, Ji-Hye; Montrul, Silvina; Yoon, James

    2009-01-01

    This study investigates the potential incomplete acquisition of binding interpretations in Korean-English bilinguals by asking whether and how the majority language of these bilinguals (English) influences their family or heritage language (Korean), especially when exposure to and use of English starts very early. The experiment tested the…

  13. 76 FR 45395 - National Korean War Veterans Armistice Day, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-29

    ... Independence of the United States of America the two hundred and thirty-sixth. (Presidential Sig.) [FR Doc...#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8695 of July 26, 2011 National Korean War..., 1950, the Korean peninsula erupted in conflict, becoming the front line of an intensifying Cold...

  14. 78 FR 46245 - National Korean War Veterans Armistice Day, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ... States of America the two hundred and thirty- eighth. (Presidential Sig.) [FR Doc. 2013-18540 Filed 7-30... Documents#0;#0; ] Proclamation 9000 of July 25, 2013 National Korean War Veterans Armistice Day, 2013 By the... anniversary of the end of the Korean War--a conflict that defined a generation and decided the fate of...

  15. 75 FR 45035 - National Korean War Veterans Armistice Day, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-30

    .... (Presidential Sig.) [FR Doc. 2010-18987 Filed 7-29-10; 11:15 am] Billing code 3195-W0-P ... Proclamation 8543--National Korean War Veterans Armistice Day, 2010 Executive Order 13548--Increasing Federal... President ] Proclamation 8543 of July 26, 2010 National Korean War Veterans Armistice Day, 2010 By...

  16. Risk Factors for Suicide Attempts among Korean Adolescents

    ERIC Educational Resources Information Center

    Kim, Hun Soo; Kim, Hyun Sil

    2008-01-01

    This study examined the rate of suicide attempts and relevant variables and identified risk factors for suicide attempts among Korean adolescents. A cross-sectional study was performed using an anonymous, self-report questionnaire. A total of 2,100 Korean adolescents, including 1,321 student adolescents and 779 delinquent adolescents, were…

  17. Multivocal Post-Diasporic Selves: Entangled in Korean Dramas

    ERIC Educational Resources Information Center

    Choi, Julie

    2012-01-01

    I interrogate my personal diaries documenting my life in New York, Beijing, Tokyo, and Sydney over a 20-year period. Taking bearings from Bakhtinian thoughts, I explore the emergence of my post-diasporic identity as a second generation Korean American through watching South Korean dramas. By conversing with journals kept over a 20-year period, I…

  18. Studies on Korean in Community Schools. Technical Report #22.

    ERIC Educational Resources Information Center

    Lee, Dong Jae, Ed.; Cho, Sookeun, Ed.; Lee, Miseon, Ed.; Song, Min Sun, Ed.; O'Grady, William, Ed.

    The papers in this volume, all written in Korean, focus on language teaching and learning in Korean community schools. Drawing on innovative experimental work and research in linguistics, education, and psychology, the contributors address issues of importance to teachers, administrators, and parents. Topics covered include: childhood…

  19. Correlates of Korean Hangul Acquisition among Kindergartners and Second Graders

    ERIC Educational Resources Information Center

    Cho, Jeung-Ryeul; McBride-Chang, Catherine

    2005-01-01

    In two separate studies, 100 South Korean kindergartners and 100 second graders were administered tests of speed of processing and phonological-processing skills as well as a Korean Hangul reading test. Speed of processing tasks were significantly correlated with most of the reading-related tasks but not with Hangul reading itself. Across studies,…

  20. Connectedness of Korean Adolescents: Profiles and Influencing Factors

    ERIC Educational Resources Information Center

    Shin, HaeJin; Yu, Kumlan

    2012-01-01

    The purpose of the present study was to identify profiles of Korean adolescent connectedness across multiple contexts (e.g., family, school, neighborhood, etc.), using cluster analysis. In addition, this study examined how the profiles of Korean adolescent connectedness are discriminated by demographic and adjustment-related variables. Data were…

  1. Issues of Validity of SAT Subject Test: Korean with Listening

    ERIC Educational Resources Information Center

    Lee, Saekyun H.; Han, Hyunjoo

    2007-01-01

    This study investigated some issues regarding the validity of the Scholastic Achievement Test (SAT) Subject Test: Korean with Listening. The SAT Korean has been administered just once a year since its inception in 1997. As of March 2006, it had been administered nine times. However, SAT foreign language tests are not as rigorously researched as…

  2. Favourable Teaching Approaches in the South Korean Secondary Classroom

    ERIC Educational Resources Information Center

    Jambor, Zoltan Paul

    2009-01-01

    Korean education certainly has its strong points as its fifteen year olds produce outstanding results in the area of mathematics and are the world's most literate bunch. However, South Korean high schools are insufficiently preparing students for an often learner centered and creative system of education that often necessitates students to be…

  3. Korean Science Teachers' Understanding of Creativity in Gifted Education

    ERIC Educational Resources Information Center

    Seo, Hae-Ae; Lee, Eun Ah; Kim, Kyung Hee

    2005-01-01

    With the passing of Korea's Gifted Education Act, creativity has come to the forefront in considering the future of Korea's economic prosperity in the global economy (Korean Educational Development Institute, 2003). The purpose of this study was to examine the understanding of creativity among Korean science teachers of gifted students. Sixty…

  4. Korean Communities in America: Past, Present, and Future.

    ERIC Educational Resources Information Center

    Yu, Eui-Young

    1983-01-01

    Presents a general introduction to the past, present, and future of the Koreans of America. Focuses on immigration rates and distribution, social and economic characteristics, news media, religion, and social relations with other ethnic and racial groups. Offers recommendations for Koreans' survival and success as a racial minority. (KH)

  5. New Challenges to Korean Universities: Increase of Older Students

    ERIC Educational Resources Information Center

    Chae, Jae-Eun

    2010-01-01

    This article explores the implications of the recent increase in older students at Korean universities dominated by younger students. A case study design is used to gain an in-depth understanding of experiences of older students in a Korean university. Semi-structured interviews of twelve older students, three professors, two administrators, and…

  6. Contrastive Rhetorical Study on Korean and English Research Paper Introductions.

    ERIC Educational Resources Information Center

    Lee, Sun

    2000-01-01

    Investigates differences in the rhetorical organization of research article introductions between Korean academic writing and English academic writing based on Swales' Create a Research Space model (1990). Twelve published articles written by Korean national scholars and American scholars are compared, and eight term papers by Korean…

  7. Koreans in the Hood: Conflict with African Americans.

    ERIC Educational Resources Information Center

    Kim, Kwang Chung, Ed.

    The essays in this collection examine relationships between the Korean American and African American communities in Los Angeles, Chicago, and New York. The contrast between the economic power and lack of political power of Korean Americans and the political power and lack of economic power of African Americans is traced. Essays 2-5 cover Los…

  8. Validity of DIBELS Early Literacy Measures with Korean English Learners

    ERIC Educational Resources Information Center

    Vanderwood, Michael L.; Nam, Jeanie E.; Sun, Jennifer W.

    2014-01-01

    The purpose of this study was to examine the validity of two Dynamic Indicators of Basic Early Literacy Skills (DIBELS) early literacy measures with first-grade Korean speaking English Learners (ELs). A total of 30 first-grade Korean ELs were screened three times during the year using early literacy measures from DIBELS. A sample of students was…

  9. Sociocultural Barriers to Lung Cancer Screening Among Korean Immigrant Men.

    PubMed

    Sin, Mo-Kyung; Ha, Ara; Taylor, Vicky

    2016-08-01

    Lung cancer is a commonly occurring cancer among Korean American men. Korean Americans have lower rates of cancer screening participation than other Asian American sub-groups. However, little is known about factors that influence the cancer screening behavior of Korean immigrants. The purpose of this study was to explore facilitators of and barriers to lung cancer screening (i.e., low dose CT of the chest) among Korean immigrant men, using qualitative individual interviews and focus groups. A convenience sample of 24 Korean men who were immigrants, Washington State residents, able to speak Korean, aged 55-79, and eligible for lung cancer screening (based on current guidelines) were recruited from Korean churches and senior centers. Five focus groups (that included between two and five men) and nine individual interviews were conducted. Content analysis was used to analyze the qualitative data. Facilitators of lung cancer screening included perceptions about positive aspects of the health care system in South Korea, recommendations from others (physicians, family members, and community organizations), existing health problems and respiratory symptoms, interest in health, and the health consequences of aging. Barriers included costs of health care in the US, lack of time, lack of knowledge (about lung cancer and screening), attitudes about prevention, and lack of physician recommendation. This study adds new knowledge to a field where little information is available. It also lays the groundwork for developing culturally relevant lung cancer screening interventions for Korean Americans and the health care providers who serve them. PMID:26846627

  10. Written Corrective Feedback: The Perception of Korean EFL Learners

    ERIC Educational Resources Information Center

    Chung, Bohyon

    2015-01-01

    This paper reports on the perception of Korean EFL learners toward feedback types on their written errors. The survey was administered using an adopted questionnaire from previous studies (Ishii 2011; Leki, 1991). This further allows a comparison of Korean EFL learners' attitudes with the responses to an identical questionnaire by Japanese EFL…

  11. Korean and American Teachers' Praising Styles and Teaching Practices

    ERIC Educational Resources Information Center

    Bang, Hyeyoung; Kim, Jungsub

    2016-01-01

    Praising is a crucial part of teaching performance that greatly impacts student performance and self-esteem. South Korean teachers are traditionally known to possess authoritarian attributes, whereas U.S. teachers have contradictory beliefs in terms of why and how to use praise. We used Q methodology among 16 American and 22 Korean teachers to…

  12. Motivation and Foreign Language Learning in Korean EFL Context.

    ERIC Educational Resources Information Center

    Kang, Dong-Ho

    This paper argues that understanding the source and development of student motivation for learning English as a Foreign Language (EFL) is very important for educational purposes. The purpose of this study of 234 Korean 9th graders was to identify the following: (1) Korean students' orientations and motivations for learning English; (2) what kinds…

  13. A Study of Korean EFL Learners' WTC and Motivation

    ERIC Educational Resources Information Center

    Liu, Yachao; Park, Hyesook

    2012-01-01

    The major purpose of this study was to investigate the relationship among Willingness to Communicate (WTC), motivation and English proficiency within a population of Korean college students learning English as a foreign language (EFL). Based on previous studies, questionnaires were used to collect data. Two hundred one Korean college students of…

  14. Development and Validation of the Korean Rape Myth Acceptance Scale

    ERIC Educational Resources Information Center

    Oh, Euna; Neville, Helen

    2004-01-01

    The purpose of this investigation was to develop a culturally relevant rape myth acceptance scale for Koreans. Three studies on the Korean Rape Myth Acceptance Scale (KRMAS) with approximately 1,000 observations provide initial validity and reliability. Specifically, results from exploratory and confirmatory factor analyses support four subscales:…

  15. Haplogroup Classification of Korean Cattle Breeds Based on Sequence Variations of mtDNA Control Region

    PubMed Central

    Kim, Jae-Hwan; Lee, Seong-Su; Kim, Seung Chang; Choi, Seong-Bok; Kim, Su-Hyun; Lee, Chang Woo; Jung, Kyoung-Sub; Kim, Eun Sung; Choi, Young-Sun; Kim, Sung-Bok; Kim, Woo Hyun; Cho, Chang-Yeon

    2016-01-01

    Many studies have reported the frequency and distribution of haplogroups among various cattle breeds for verification of their origins and genetic diversity. In this study, 318 complete sequences of the mtDNA control region from four Korean cattle breeds were used for haplogroup classification. 71 polymorphic sites and 66 haplotypes were found in these sequences. Consistent with the genetic patterns in previous reports, four haplogroups (T1, T2, T3, and T4) were identified in Korean cattle breeds. In addition, T1a, T3a, and T3b sub-haplogroups were classified. In the phylogenetic tree, each haplogroup formed an independent cluster. The frequencies of T3, T4, T1 (containing T1a), and T2 were 66%, 16%, 10%, and 8%, respectively. Especially, the T1 haplogroup contained only one haplotype and a sample. All four haplogroups were found in Chikso, Jeju black and Hanwoo. However, only the T3 and T4 haplogroups appeared in Heugu, and most Chikso populations showed a partial of four haplogroups. These results will be useful for stable conservation and efficient management of Korean cattle breeds. PMID:26954229

  16. Haplogroup Classification of Korean Cattle Breeds Based on Sequence Variations of mtDNA Control Region.

    PubMed

    Kim, Jae-Hwan; Lee, Seong-Su; Kim, Seung Chang; Choi, Seong-Bok; Kim, Su-Hyun; Lee, Chang Woo; Jung, Kyoung-Sub; Kim, Eun Sung; Choi, Young-Sun; Kim, Sung-Bok; Kim, Woo Hyun; Cho, Chang-Yeon

    2016-05-01

    Many studies have reported the frequency and distribution of haplogroups among various cattle breeds for verification of their origins and genetic diversity. In this study, 318 complete sequences of the mtDNA control region from four Korean cattle breeds were used for haplogroup classification. 71 polymorphic sites and 66 haplotypes were found in these sequences. Consistent with the genetic patterns in previous reports, four haplogroups (T1, T2, T3, and T4) were identified in Korean cattle breeds. In addition, T1a, T3a, and T3b sub-haplogroups were classified. In the phylogenetic tree, each haplogroup formed an independent cluster. The frequencies of T3, T4, T1 (containing T1a), and T2 were 66%, 16%, 10%, and 8%, respectively. Especially, the T1 haplogroup contained only one haplotype and a sample. All four haplogroups were found in Chikso, Jeju black and Hanwoo. However, only the T3 and T4 haplogroups appeared in Heugu, and most Chikso populations showed a partial of four haplogroups. These results will be useful for stable conservation and efficient management of Korean cattle breeds. PMID:26954229

  17. Neuronavigation. Principles. Surgical technique.

    PubMed

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques. PMID:20108488

  18. "My Heart Beats in Two Places": Immigration Stories in Korean-American Picture Books

    ERIC Educational Resources Information Center

    Yi, Joanne H.

    2014-01-01

    This article examines the impact of immigration on Korean children through a content and literary analysis of 14 children's picture books. A majority of published children's literature dealing with the subject of Korean Americans or Korean immigration contains culturally specific themes common to the Korean immigration experience. These…

  19. Native and Nonnative Rater Behavior in Grading Korean Students' English Essays

    ERIC Educational Resources Information Center

    Lee, Hee-Kyung

    2009-01-01

    The purpose of the study is to investigate rating behavior between Korean and native English speaking (NES) raters. Five Korean English teachers and five NES teachers graded 420 essays written by Korean college freshmen and completed survey questionnaires. The grading data were analyzed with FACETS program. The results revealed Korean raters'…

  20. Teaching Korean Rhythms in Music Class through Improvisation, Composition, and Student Performance

    ERIC Educational Resources Information Center

    Yoo, Hyesoo; Kang, Sangmi

    2014-01-01

    The purpose of this article is to introduce the characteristics of Korean rhythmic patterns and provide effective ways to teach Korean rhythms based on the theoretical and pedagogical approaches derived from 5,000 years of Korean musical tradition. First, we have provided the fundamental principles of Korean rhythms that represent the culture from…

  1. Participation Patterns of Korean Adolescents in School-Based Career Exploration Activities

    ERIC Educational Resources Information Center

    Rojewski, Jay W.; Lee, In Heok; Hill, Roger B.

    2014-01-01

    Variations in the school-based career exploration activities of Korean high school students were examined. Data represented 5,227 Korean adolescents in Grade 11 contained in the Korean Education Longitudinal Study of 2005, a nationally representative longitudinal database administered by the Korean Educational Development Institute. Latent class…

  2. Korean-English Dual Language Immersion: Perspectives of Students, Parents and Teachers

    ERIC Educational Resources Information Center

    Lee, Jin Sook; Jeong, Eunsook

    2013-01-01

    This qualitative study examines the experiences of Korean-American students, parents and teachers in a newly instituted 50/50 Korean-English dual language immersion programme, where the majority of the students are of Korean descent. Based on home and school observations, as well as interviews with six Korean-American students and their parents…

  3. Clinical Effect of Acupotomy Combined with Korean Medicine: A Case Series of a Herniated Intervertebral Disc.

    PubMed

    Kim, Hyun-ji; Jeon, Ju-hyun; Kim, Young-il

    2016-02-01

    The aim of this study is to evaluate the effect of acupotomy for treating patients with a herniated intervertebral disc (HIVD). This case series includes five HIVD patients who were treated at the Department of Acupuncture and Moxibustion, Daejeon University Dunsan Korean Hospital, Daejeon, Korea, from January 2015 to April 2015. Acupotomy was performed three times over a 2-week period, along with Korean medical treatment. The outcomes were evaluated by using a numeric rating scale (NRS), physical examination, the Oswestry Low Back Pain Disability Index (ODI), the Short-Form 36-Item Health Survey (SF-36), and the Surgical Safety Checklist. The NRS and physical examination results, as well as the ODI scores, were improved in all cases. No significant differences were noted on the SF-36. No patients had any adverse effects. This study, with its findings of encouraging responses in reducing low back pain and radiating pain and in recovering the kinetic state of soft tissue, supports the potential use of acupotomy for the treatment of patients suffering from HIVD. PMID:26896075

  4. The Influences of Immigration on Health Information Seeking Behaviors among Korean Americans and Native Koreans

    ERIC Educational Resources Information Center

    Oh, Kyeung Mi; Zhou, Qiuping; Kreps, Gary; Kim, Wonsun

    2014-01-01

    Korean Americans (KAs) have low screening rates for cancer and are often not well informed about their chronic diseases. Reduced access to health-related information is one reason for gaps in knowledge and the widening health disparities among minority populations. However, little research exists about KAs' health information seeking…

  5. Being a Korean Studying Koreans in an American School: Reflections on Culture, Power, and Ideology

    ERIC Educational Resources Information Center

    Lim, Minjung

    2012-01-01

    Recent debates on situated knowledge highlight the issue of the researcher's position in the research process, challenging the traditional assumption of the insider/outsider dichotomy. Drawing on my fieldwork among Korean immigrant parents in an American school, I describe my shifting positions in negotiation and scrutinize the ways my reflexivity…

  6. Exploring Korean Heritage Language Learners' Anxiety: "We Are Not Afraid of Korean!"

    ERIC Educational Resources Information Center

    Jee, Min Jung

    2016-01-01

    This study investigated Korean heritage language (KHL) learners' foreign language classroom anxiety, reading anxiety and writing anxiety using the Foreign Language Classroom Anxiety Scale (FLCAS) by Horwitz, Horwitz and Cope, the Foreign Language Reading Anxiety Scale (FLRAS) by Saito, Garza and Horwitz and the Writing Apprehension Test (WAT) by…

  7. Characteristics of Korean Phonology: Review, Tutorial, and Case Studies of Korean Children Speaking English

    ERIC Educational Resources Information Center

    Ha, Seunghee; Johnson, Cynthia J.; Kuehn, David P.

    2009-01-01

    A significant number of bilinguals in English-speaking countries speak Korean as their first language. One such country is the United States (U.S.). As the U.S. becomes increasingly diverse, providing more effective services for culturally and linguistically diverse children is a critical issue and growing challenge for speech-language…

  8. "No One Speaks Korean at School!": Ideological Discourses on Languages in a Korean Family

    ERIC Educational Resources Information Center

    Song, Kwangok

    2016-01-01

    This study examined how a Korean family with temporary immigrant status in the United States employed ideological discourses on languages to make sense of their experiences. The parents initially accepted but later rejected ideologies on children's learning of English. English-as-a-legitimate-language ideology in the United States and…

  9. Sub-Syllabic Processing in Young Korean-English Bilinguals: Semivowel Placement Differences between Korean and English

    ERIC Educational Resources Information Center

    Baek, Seunghyun

    2014-01-01

    This study investigated the sub-syllabic awareness of two groups of 86 Korean kindergarteners learning English as a foreign language (EFL) or English as a second language (ESL). In addition, it explored the cross-language transfer of sub-syllabic units between Korean and English by taking into account their lexical abilities with respect to the…

  10. Korean Born, Korean-American High School Students' Entry into Understanding Race and Racism through Social Interactions and Conversations

    ERIC Educational Resources Information Center

    Palmer, John D.; Jang, Eun-Young

    2005-01-01

    This paper explores how a group of Korean born, Korean-American high school students came to understand race and racism in the US through social interactions and conversations, with particular attention paid to the locality of time, space and people engaged. Therefore, we explore not only how race and racism are socially constructed in the lives…

  11. Impact factor of Korean Journal of Pediatrics on Korean Medical Citation Index and Science Citation Index of Web of Science

    PubMed Central

    Choi, Sun Hee; Han, Man Yong; Rha, Yeong Ho; Lee, Young Jin

    2011-01-01

    Purpose The total number of times a paper is cited, also known as the impact factor (IF) of a medical journal, is widely implied in evaluating the quality of a research paper. We evaluated the citation index data as an IF of Korean J Pediatr in Korean Medical Citation Index (KoMCI) and JCI of Web of Science. Methods We calculated the IF of Korean J Pediatr at KoMCI supervised by Korean Association of Medical Journal Editors. And we estimated the IF of Korean J Pediatr by the JCI of Web of Science although it was never officially reported. Results The IF of Korean J Pediatr on KoMCI has increased from 0.100 in the year 2000, to 0.205 in 2008, and 0.326 in 2009. Although the IF of Korean J Pediatr was 0.006 in 2005, 0.018 in 2006, 0.028 in 2008, 0.066 in 2009, and 0.018 in 2010 according to the JCI of Web of Science, the number of citations are steadily increasing. Conclusion Understanding and realizing the current status will be a stepping stone for further improvement. The next objective of the Korean J Pediatr is to become registered in the SCI or SCIE. Increasing the IF according to the JCI of Web of Science is crucial in order to achieve this goal. PMID:21738548

  12. A Critical Content Analysis of Korean-to-English and English-to-Korean Translated Picture Books

    ERIC Educational Resources Information Center

    Chang, Mi-Kyoung

    2013-01-01

    This study explores cultural representations and cultural adaptations made by translators in translated children's picture books. This study has two focuses. In the first part of this study, which is a critical content analysis, I examine the cultural representations depicted in Korean-to-English and English-to-Korean translated picture books,…

  13. Korean Students' Stories from an Aotearoa New Zealand High School: Perceived Affordances of English and Korean Language Use

    ERIC Educational Resources Information Center

    Kitchen, Margaret

    2014-01-01

    This article is informed by van Lier's ecological approach to linguistics in considering the affordances Korean-born students perceived in using Korean or English language in an Aotearoa New Zealand high school setting. Here, I regard affordances as the students' perceptions of their languages as linguistic resources enabling them to…

  14. Use of Traditional Korean Medicine by Patients with Musculoskeletal Disorders

    PubMed Central

    Wang, Bo-Ram; Choi, In Young; Kim, Kwang-Jum; Kwon, Young Dae

    2013-01-01

    Background South Korea has maintained a dual healthcare delivery system that incorporates both traditional Korean and Western medicine. In this research, we identified the determinants of the frequency of using traditional Korean medicine among musculoskeletal patients, who are known to be the most frequent users of complementary and alternative medicine. Methods In this research, we reviewed 2 consecutive years of nationally representative survey data from the 2008 and 2009 Korea Health Panel Survey. We analyzed the utilization of outpatient services by musculoskeletal patients within 12 months of the 2009 survey date. A two-part model was used because some patients did not use traditional Korean medicine and skewness was present in the data on traditional Korean medicine use. In the first part, logistic regression analysis was performed to investigate the use of traditional Korean medicine. In the second part, multiple regression analysis was performed to analyze the frequency of traditional Korean medicine usage among the subjects who visited traditional Korean medical institutions. Results The frequency of traditional Korean medicine usage was positively associated with ages of 40–49 years and over 60, restrictions on daily life, a greater number of chronic diseases, not being hospitalized, and more frequent visits (more than five times) to conventional hospitals or clinics for musculoskeletal disorders. Conclusions The important determinants of the frequency of traditional Korean medicine usage were age, activity restrictions, the number of chronic diseases, hospitalization history, and the number of visits to conventional hospitals for musculoskeletal disorders. The results contribute to our understanding of the characteristics of traditional Korean medicine users and may be used as a basic resource for related policymaking by government officials and medical professionals. PMID:23658811

  15. Korean medicine in Kazakhstan: Ideas, practices and patients.

    PubMed

    Penkala-Gawecka, Danuta

    2002-01-01

    Since the 1990s, after gaining independence by the Republic of Kazakhstan, various complementary therapies have grown rapidly there. Korean medicine in its several forms belongs among them. There is an important population of Korean deportees from Stalinist times, but this paper will show that the various forms of Korean medicine practised in Almaty, Kazakhstan's former capital, do not primarily cater for ethnic Koreans. Rather, as the paper demonstrates, it is important to see that there are different forms of Korean medicine attractive to clientele from different strata of society. Thus, there are, apart from the most traditional treatment practised at the Korean-Kazakhstani clinic in Almaty, two other newly invented modifications of Korean medicine: soo-jok and soo-ji . The paper embeds Korean medicine into the context of the drastic deterioration of the state health care system and general dissatisfaction with its services, on the one hand, and a generally supportive attitude of government authorities to complementary medicine, on the other. My empirical data suggest that in Kazakhstan people of different ethnic background, sex, age and education choose complementary therapies. The growing popularity of these therapies is not only attributed to public confidence in the methods that are perceived as 'traditional' but more importantly to the extremely difficult economic conditions which have made people search for cheaper treatment. The paper presents data that are critical of a purely culturalist interpretation of explaining the arrival of Korean medicine in Kazakhstan and suggests that it is the political economy of Korean medicine as a non-costly therapy which has made it attractive to a wide range of clients. PMID:26869122

  16. Anisakiasis: Report of 15 Gastric Cases Caused by Anisakis Type I Larvae and a Brief Review of Korean Anisakiasis Cases

    PubMed Central

    Sohn, Woon-Mok; Na, Byoung-Kuk; Kim, Tae Hyo; Park, Tae-Joon

    2015-01-01

    The present study was performed to report 15 anisakiasis cases in Korea and to review the Korean cases reported in the literature. Total 32 Anisakis type I larvae were detected in the stomach of 15 patients by the endoscopy. Single worm was detected from 12 cases, and even 9 larvae were found from 2 cases. Epigastric pain was most commonly manifested in almost all cases, and hemoptysis and hematemesis were seen in 1 case each. Symptom manifestations began at 10-12 hr after eating fish in 73.3% cases. Endoscopy was performed 1-2 days after the symptom onset in most cases. The common conger, Conger myriaster, was the probable infection source in 7 cases. In the review of Korean anisakiasis cases, thus far, total 645 cases have been reported in 64 articles. Anisakis type I larva was the most frequently detected (81.3%). The favorable infection site of larvae was the stomach (82.4%). The common conger was the most probable source of human infections (38.6%). Among the total 404 cases which revealed the age and sex of patients, 185 (45.8%) were males, and the remaining 219 (54.2%) were female patients. The age prevalence was the highest in forties (34.7%). The seasonal prevalence was highest in winter (38.8%). By the present study, 15 cases of gastric anisakiasis are added as Korean cases, and some epidemiological characteristics of Korean anisakiasis were clarified. PMID:26323845

  17. Prediction of ground motion and dynamic stress change in Baekdusan (Changbaishan) volcano caused by a North Korean nuclear explosion

    NASA Astrophysics Data System (ADS)

    Hong, Tae-Kyung; Choi, Eunseo; Park, Seongjun; Shin, Jin Soo

    2016-02-01

    Strong ground motions induce large dynamic stress changes that may disturb the magma chamber of a volcano, thus accelerating the volcanic activity. An underground nuclear explosion test near an active volcano constitutes a direct treat to the volcano. This study examined the dynamic stress changes of the magma chamber of Baekdusan (Changbaishan) that can be induced by hypothetical North Korean nuclear explosions. Seismic waveforms for hypothetical underground nuclear explosions at North Korean test site were calculated by using an empirical Green’s function approach based on a source-spectral model of a nuclear explosion; such a technique is efficient for regions containing poorly constrained velocity structures. The peak ground motions around the volcano were estimated from empirical strong-motion attenuation curves. A hypothetical M7.0 North Korean underground nuclear explosion may produce peak ground accelerations of 0.1684 m/s2 in the horizontal direction and 0.0917 m/s2 in the vertical direction around the volcano, inducing peak dynamic stress change of 67 kPa on the volcano surface and ~120 kPa in the spherical magma chamber. North Korean underground nuclear explosions with magnitudes of 5.0-7.6 may induce overpressure in the magma chamber of several tens to hundreds of kilopascals.

  18. Prediction of ground motion and dynamic stress change in Baekdusan (Changbaishan) volcano caused by a North Korean nuclear explosion.

    PubMed

    Hong, Tae-Kyung; Choi, Eunseo; Park, Seongjun; Shin, Jin Soo

    2016-01-01

    Strong ground motions induce large dynamic stress changes that may disturb the magma chamber of a volcano, thus accelerating the volcanic activity. An underground nuclear explosion test near an active volcano constitutes a direct treat to the volcano. This study examined the dynamic stress changes of the magma chamber of Baekdusan (Changbaishan) that can be induced by hypothetical North Korean nuclear explosions. Seismic waveforms for hypothetical underground nuclear explosions at North Korean test site were calculated by using an empirical Green's function approach based on a source-spectral model of a nuclear explosion; such a technique is efficient for regions containing poorly constrained velocity structures. The peak ground motions around the volcano were estimated from empirical strong-motion attenuation curves. A hypothetical M7.0 North Korean underground nuclear explosion may produce peak ground accelerations of 0.1684 m/s(2) in the horizontal direction and 0.0917 m/s(2) in the vertical direction around the volcano, inducing peak dynamic stress change of 67 kPa on the volcano surface and ~120 kPa in the spherical magma chamber. North Korean underground nuclear explosions with magnitudes of 5.0-7.6 may induce overpressure in the magma chamber of several tens to hundreds of kilopascals. PMID:26884136

  19. Prediction of ground motion and dynamic stress change in Baekdusan (Changbaishan) volcano caused by a North Korean nuclear explosion

    PubMed Central

    Hong, Tae-Kyung; Choi, Eunseo; Park, Seongjun; Shin, Jin Soo

    2016-01-01

    Strong ground motions induce large dynamic stress changes that may disturb the magma chamber of a volcano, thus accelerating the volcanic activity. An underground nuclear explosion test near an active volcano constitutes a direct treat to the volcano. This study examined the dynamic stress changes of the magma chamber of Baekdusan (Changbaishan) that can be induced by hypothetical North Korean nuclear explosions. Seismic waveforms for hypothetical underground nuclear explosions at North Korean test site were calculated by using an empirical Green’s function approach based on a source-spectral model of a nuclear explosion; such a technique is efficient for regions containing poorly constrained velocity structures. The peak ground motions around the volcano were estimated from empirical strong-motion attenuation curves. A hypothetical M7.0 North Korean underground nuclear explosion may produce peak ground accelerations of 0.1684 m/s2 in the horizontal direction and 0.0917 m/s2 in the vertical direction around the volcano, inducing peak dynamic stress change of 67 kPa on the volcano surface and ~120 kPa in the spherical magma chamber. North Korean underground nuclear explosions with magnitudes of 5.0–7.6 may induce overpressure in the magma chamber of several tens to hundreds of kilopascals. PMID:26884136

  20. The influences of immigration on health information seeking behaviors among Korean Americans and Native Koreans.

    PubMed

    Oh, Kyeung Mi; Zhou, Qiuping Pearl; Kreps, Gary; Kim, Wonsun

    2014-04-01

    Korean Americans (KAs) have low screening rates for cancer and are often not well informed about their chronic diseases. Reduced access to health-related information is one reason for gaps in knowledge and the widening health disparities among minority populations. However, little research exists about KAs' health information seeking behaviors. Guided by the Structural Influence Model, this study examines the influence of immigration status on KAs' trust in health information sources and health information seeking behaviors. Cross-sectional surveys were conducted in the Washington, D.C., metropolitan area as well as in the Gwangju metropolitan city in South Korea during 2006-2007. Two hundred and fifty-four KAs and 208 native Koreans who were 40 years of age or older completed the surveys. When comparing native Koreans to KAs, we found KAs were 3 times more likely to trust health information from newspapers or magazines (odds ratio [OR] = 3.13; 95% confidence interval [CI] = 1.49-6.54) and 11 times more likely to read the health sections of newspapers or magazines (OR = 11.35; 95% CI = 3.92-32.91) in multivariate adjusted models. However, they were less likely to look for health information from TV (OR = 0.29; 95% CI = 0.12-0.72) than native Koreans. Our results indicate that immigration status has profound influences on KAs' health information seeking behaviors. Increasing the availability of reliable and valid health information from printed Korean language magazines or newspapers could have a positive influence on increasing awareness and promoting screening behaviors among KAs. PMID:23943681

  1. Training of breast surgical oncologists.

    PubMed

    Teshome, Mediget; Kuerer, Henry M

    2016-06-01

    Breast surgical oncology is a defined sub-specialty of general surgery with focus on the surgical management of breast disease and malignancy within a multidisciplinary context. Much of the training of breast surgical oncologists in the United States exists within a fellowship training structure with oversight and approval by the Society of Surgical Oncology (SSO). Rapid continuous changes in breast oncology practice have further substantiated dedicated expertise in breast surgical oncology. Training programs are structured to develop proficiency in fellows for advanced surgical techniques and clinical decision-making as well as exposure to the multidisciplinary aspects of breast cancer management. Components of a successful program include an intense multidisciplinary curriculum, engagement in clinical research and attention to strong mentorship. National curriculum and training requirements as well as supplemental resources assist in standardizing the fellowship experience. As surgical training and the field of breast oncology continues to evolve, so do fellowship training programs to ensure high quality breast surgical oncologists equipped to deliver high quality evidence based patient care while continuing to drive future research and trainee education. PMID:27197510

  2. Controversies in the management of endometrial cancer: a survey of the Korean Gynecologic Oncology Group

    PubMed Central

    Lee, Jung-Yun; Kim, Kidong; Kang, Sokbom; Seong, Seok Ju; Kim, Jae Weon; Kim, Byoung-Gie

    2015-01-01

    Objective To identify current practice patterns for unresolved issues in the surgical and adjuvant management of endometrial cancer in Korea. Methods We designed and conducted a survey of all 218 active members of the Korean Gynecologic Oncology Group to try to identify how they would manage various case scenarios for endometrial cancer. Data were collected using an Internet survey database. Results A total of 108 members (49.5%) responded to the survey. Laparoscopy (81.6%) was the most commonly used mode of surgery in early-stage endometrial cancer. Of all the respondents, 19.8% stated that lymphadenectomy could be omitted and 21.7% recommended selective lymphadenectomy based on sentinel biopsy or frozen results for patients with presumed stage IA/grade 1 disease. On the other hand, 71.9% of respondents recommended para-aortic lymphadenectomy for patients with presumed stage IB/grade 1 disease and 86.4% recommended this treatment for presumed stage IB/grade 3 disease. The majority of respondents performed adjuvant therapy for stage IB/grade 2 (91.7%), IB/grade 3 (99.0%), and stage II (89.6%). Whole pelvic radiotherapy and vaginal brachytherapy were the most frequently used options among these patients. All respondents administered adjuvant therapy when node metastasis was found, and concurrent chemoradiotherapy (53.2%) was the most preferred option for stage IIIC1 disease. Conclusion There is broad variation in both the surgical and adjuvant treatment of endometrial cancer among Korean gynecologic oncologists. PMID:26404123

  3. Seismological analysis of the fourth North Korean nuclear test

    NASA Astrophysics Data System (ADS)

    Hartmann, Gernot; Gestermann, Nicolai; Ceranna, Lars

    2016-04-01

    The Democratic People's Republic of Korea has conducted its fourth underground nuclear explosions on 06.01.2016 at 01:30 (UTC). The explosion was clearly detected and located by the seismic network of the International Monitoring System (IMS) of the Comprehensive Nuclear-Test-Ban Treaty (CTBT). Additional seismic stations of international earthquake monitoring networks at regional distances, which are not part of the IMS, are used to precisely estimate the epicenter of the event in the North Hamgyong province (41.38°N / 129.05°E). It is located in the area of the North Korean Punggye-ri nuclear test site, where the verified nuclear tests from 2006, 2009, and 2013 were conducted as well. The analysis of the recorded seismic signals provides the evidence, that the event was originated by an explosive source. The amplitudes as well as the spectral characteristics of the signals were examined. Furthermore, the similarity of the signals with those from the three former nuclear tests suggests very similar source type. The seismograms at the 8,200 km distant IMS station GERES in Germany, for example, show the same P phase signal for all four explosions, differing in the amplitude only. The comparison of the measured amplitudes results in the increasing magnitude with the chronology of the explosions from 2006 (mb 4.2), 2009 (mb 4.8) until 2013 (mb 5.1), whereas the explosion in 2016 had approximately the same magnitude as that one three years before. Derived from the magnitude, a yield of 14 kt TNT equivalents was estimated for both explosions in 2013 and 2016; in 2006 and 2009 yields were 0.7 kt and 5.4 kt, respectively. However, a large inherent uncertainty for these values has to be taken into account. The estimation of the absolute yield of the explosions depends very much on the local geological situation and the degree of decoupling of the explosive from the surrounding rock. Due to the missing corresponding information, reliable magnitude-yield estimation for the

  4. Surgical procedures for voice restoration

    PubMed Central

    Nawka, Tadeus; Hosemann, Werner

    2005-01-01

    Surgical procedures for voice restoration serve to improve oral communication by better vocal function. They comprise of phonomicrosurgery, with direct and indirect access to the larynx; laryngoplasty; laryngeal injections; and surgical laryngeal reinnervation. The basis for modern surgical techniques for voice disorders is the knowledge about the ultrastructure of the vocal folds and the increasing experience of surgeons in voice surgery, while facing high social and professional demands on the voice. Vocal activity limitation and participation restriction has become more important in the artistic and social areas. A number of surgical methods that have been developed worldwide for this reason, are presented in this article. Functional oriented surgery has to meet high standards. The diagnostics of vocal function has to be multi-dimensional in order to determine the indication and the appropriate surgical intervention. PMID:22073062

  5. Hemispheric asymmetries in reading Korean: task matters.

    PubMed

    Vaid, J; Park, K

    1997-06-01

    Native Korean readers were studied in a visual half-field paradigm. Subjects were to make speeded judgments on Hangul (syllabic) and Hanzza (logographic) scripts based on phonetic or visual properties of the stimuli. A task by visual field interaction was obtained indicating that, for both scripts, responses on the phonetic task were faster in the right visual field, whereas no visual field differences were found on the visual task. Script type did not interact with visual field. The results support a task-based account of hemispheric differences in verbal processing. PMID:9184098

  6. Stigma of Mental Illnesses as Perceived by North Korean Defectors Living in South Korea

    PubMed Central

    Ahn, Ji-Hoon; Choi, Hye-Jin; Jeon, Jin-Yong; Song, In-Gyu; Bae, Jae-Nam

    2015-01-01

    Objective This study aims to provide the information of the stigmas of mental illness such as psychosis, alcoholism, attempt suicide, and depression among North Korean defectors. Methods We examined stigma for the mental illnesses of 639 North Korean defectors aged 19 to 65 years who live in the Settlement Support Center for North Korean Refugees. The stigmas of mental illnesses were assessed using the Perceived Devaluation-Discrimination Scale We directly compared the stigma level between North Korean defectors and the general population of South Korea. Results North Korean defectors had higher perceived stigmas of psychosis and alcoholism and lower perceived stigmas of depression than South Koreans. Perceived stigma associated with attempted suicide was similar for North Korean defectors and South Koreans. Only marital status in sociodemographic variables had associations with higher perceived stigma of psychosis, alcoholism, and depression in the North Korean defectors. North Korean defectors, who spent more than one year in transit country, had associations with lower perceived stigma of psychosis and alcoholism. North Korean defectors, who had the experience of compulsory repatriation to North Korea or North Korean family in South Korea, had an association with higher perceived stigma of depression. Conclusion North Korean defectors had higher perceived stigmas of psychosis and alcoholism and lower perceived stigmas of depression than South Koreans. Further studies are needed to document serial changes in stigmas for mental illnesses associated with the receipt of education at the Settlement Support Center for North Korean defectors. PMID:25670940

  7. [Surgical treatment of lipodystrophies].

    PubMed

    De Mey, A

    1996-09-01

    Esthetic body contouring has become the most common esthetic surgical procedure since the advent of liposuction. The interest in this surgery led us to focus on the physiology of adipose tissue that behaves differently according to its localisation. Besides, a better knowledge of the anatomy of the subcutaneous tissue has helped us to treat the deep and superficial adipose deposits more effectively. Many technical refinements have been proposed in order to improve the results and decrease the risks. Local infiltration allows us to remove large amounts of fat with a minimal blood loss. Syringe aspiration is less traumatic and avoids the purchase of an expensive suction pump. However, although the technique of suction lipectomy looks simple, this procedure can induce important local complications (contour deformities, skin waves, ...) and general complications (pulmonary embolism, fat embolism, cardio-pulmonary decompensation). A rigorous technique, performed by a well trained surgeon in an adequate medical environment is essential to obtain the best results with suction lipectomy. In order to correct excesses of skin on the abdomen or the thighs after an important weight loss, skin excisions will be necessary. In there cases, the scars are often wide and sometimes difficult to hide. PMID:8927853

  8. Surgical force detection probe

    NASA Technical Reports Server (NTRS)

    Tcheng, Ping; Roberts, Paul; Scott, Charles; Prass, Richard

    1991-01-01

    The development progress of a precision electro-mechanical instrument which allows the detection and documentation of the forces and moment applied to human tissue during surgery (under actual operation room conditions), is reported. The pen-shaped prototype probe which measures 1/2 inch in diameter and 7 inches in length was fabricated using an aerodynamic balance. The aerodynamic balance, a standard wind tunnel force and moment sensing transducer, measures the forces and the moments transmitted through the surgeon's hand to the human tissue during surgery. The prototype probe which was fabricated as a development tool was tested successfully. The final version of the surgical force detection probe will be designed based on additional laboratory tests in order to establish the full scale loads. It is expected that the final product will require a simplified aerodynamic balance with two or three force components and one moment component with lighter full scale loads. A signal conditioner was fabricated to process and display the outputs from the prototype probe. This unit will be interfaced with a PC-based data system to provide automatic data acquisition, data processing, and graphics display. The expected overall accuracy of the probe is better than one percent full scale.

  9. [Choledochal cysts: surgical treatment].

    PubMed

    Gogolja, D; Visnjić, S; Milić, Z; Tomić, K; Car, A; Roić, G; Fattorini, I

    2000-03-01

    The excision of the choledochal cyst with bile drainage through intestinal conduit is a standard operative procedure in the surgical management of choledochal cysts. During the last eight years five patients have been treated with this operation at the University Children's Hospital in Zagreb. All the patients were girls aged from two months to twelve years. The classical triad of pain, jaundice and abdominal mass was observed in only one patient, an eight-year-old girl. The only symptom in infancy was jaundice. Diagnosis was made by abdominal ultrasound, bibliography, CT scan with hepatotropic contrast and in older children by ERCP. Four cysts were type Todani I, and one cyst was Todani type II. The complete excision of the choledochal cyst with the Roux-Y jejunal conduit without antireflux valve was performed. There was neither operative morbidity nor mortality. Three months postoperatively the control ultrasonography and liver laboratory tests were without abnormalities. The routine control which followed did not show episodes of cholangitis, lithiasis, lipid malabsorption, blood clotting abnormalities or growth failure. The complete excision of the cyst with Roux-Y hepaticoenterostomy is an operative treatment with good results in infancy and childhood. PMID:10932533

  10. Tranexamic Acid in Anesthetic Management of Surgical Procedures.

    PubMed

    Mayeux, Jessica; Alwon, Kathy; Collins, Shawn; Hewer, Ian

    2016-06-01

    Blood loss during surgical procedures poses a grave risk to the patient, but transfusion is costly and associated with adverse outcomes. Antifibrinolytics, however, offer an economical and effective means of decreasing blood loss associated with surgical procedures. Tranexamic acid (TXA) is an antifibrinolytic that blocks lysine-binding sites of fibrinogen and fibrin, preventing the breakdown of existing clots. This journal course reviews extensive research demonstrating that antifibrinolytics such as TXA decrease blood loss and in some studies reduce allogeneic transfusion requirements. In addition, this journal course addresses concerns that use of antifibrinolytics increases embolic events, reviews research that demonstrates TXA does not increase the incidence of vascular occlusive events, and describes methods of TXA use in cardiac and orthopedic surgical procedures, neurosurgery, and obstetrics. The Certified Registered Nurse Anesthetist should consider the possibility, on a case-by-case basis, of using TXA in surgical procedures to reduce blood loss with minimal adverse effects. PMID:27501656

  11. Evaluating the optimal timing of surgical antimicrobial prophylaxis: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Surgical site infections are the most common hospital-acquired infections among surgical patients. The administration of surgical antimicrobial prophylaxis reduces the risk of surgical site infections . The optimal timing of this procedure is still a matter of debate. While most studies suggest that it should be given as close to the incision time as possible, others conclude that this may be too late for optimal prevention of surgical site infections. A large observational study suggests that surgical antimicrobial prophylaxis should be administered 74 to 30 minutes before surgery. The aim of this article is to report the design and protocol of a randomized controlled trial investigating the optimal timing of surgical antimicrobial prophylaxis. Methods/Design In this bi-center randomized controlled trial conducted at two tertiary referral centers in Switzerland, we plan to include 5,000 patients undergoing general, oncologic, vascular and orthopedic trauma procedures. Patients are randomized in a 1:1 ratio into two groups: one receiving surgical antimicrobial prophylaxis in the anesthesia room (75 to 30 minutes before incision) and the other receiving surgical antimicrobial prophylaxis in the operating room (less than 30 minutes before incision). We expect a significantly lower rate of surgical site infections with surgical antimicrobial prophylaxis administered more than 30 minutes before the scheduled incision. The primary outcome is the occurrence of surgical site infections during a 30-day follow-up period (one year with an implant in place). When assuming a 5% surgical site infection risk with administration of surgical antimicrobial prophylaxis in the operating room, the planned sample size has an 80% power to detect a relative risk reduction for surgical site infections of 33% when administering surgical antimicrobial prophylaxis in the anesthesia room (with a two-sided type I error of 5%). We expect the study to be completed within three

  12. Development of Safe Food Handling Guidelines for Korean Consumers.

    PubMed

    Kang, Hee-Jin; Lee, Min-Woo; Hwang, In-Kyeong; Kim, Jeong-Weon

    2015-08-01

    The purpose of this study was to develop guidelines for Korean consumers with regard to safe food handling practices at home by identifying current food handling issues. Korean consumers' behaviors regarding their safe food handling were identified via survey questionnaires that included items on individual hygiene practices, prepreparation steps when cooking, the cooking process, and the storage of leftover foods. The subjects were 417 Korean parents with elementary school children living in Seoul and Gyeonggi Province in the central area of Korea. The survey results revealed gaps between the knowledge or practices of Korean consumers and scientific evidence pertaining to safe food handling practices. Based on these findings, a leaflet on safe food handling guidelines was developed in accordance with Korean food culture. These guidelines suggest personal hygiene practices as well as fundamental principles and procedures for safe food handling from the stage of food purchase to that of keeping leftover dishes. A pilot application study with 50 consumers revealed that the guidelines effectively improved Korean consumers' safe food handling practices, suggesting that they can serve as practical educational material suitable for Korean consumers. PMID:26219368

  13. Credentialing of surgical skills centers.

    PubMed

    Sachdeva, Ajit K

    2011-01-01

    Major imperatives regarding quality of patient care and patient safety are impacting surgical care and surgical education. Also, significant emphasis continues to be placed on education and training to achieve proficiency, expertise, and mastery in surgery. Simulation-based surgical education and training can be of immense help in acquiring and maintaining surgical skills in safe environments without exposing patients to risk. Opportunities for repetition of tasks can be provided to achieve pre-established standards, and knowledge and skills can be verified using valid and reliable assessment methods. Also, expertise and mastery can be attained through repeated practice, specific feedback, and establishment of progressively higher learning goals. Simulation-based education and training can help surgeons maintain their skills in infrequently performed procedures and regain proficiency in procedures they have not performed for a period of time. In addition, warm-ups and surgical rehearsals in simulated environments should enhance performance in real settings. Major efforts are being pursued to advance the field of simulation-based surgical education. New education and training models involving validation of knowledge and skills are being designed for practicing surgeons. A competency-based national surgery resident curriculum was recently launched and is undergoing further enhancements to address evolving education and training needs. Innovative simulation-based surgical education and training should be offered at state-of-the-art simulation centers, and credentialing and accreditation of these centers are key to achieving their full potential. PMID:21549986

  14. The Surgical Treatment of Mycetoma

    PubMed Central

    Suleiman, Suleiman Hussein; Wadaella, EL Sammani; Fahal, Ahmed Hassan

    2016-01-01

    Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors’ experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan. PMID:27336736

  15. Korean Studies on Blood Stasis: An Overview

    PubMed Central

    Jung, Jeeyoun; Lee, Ju Ah; Yun, Kyung-Jin

    2015-01-01

    Blood stasis is one of the important pathological concepts in Korean medicine. We analyzed the Korean studies concerning blood stasis. We searched for articles in eight electronic databases from their inception to September, 2014. We included reviews, clinical studies, and preclinical studies that had studied blood stasis and excluded articles in which blood stasis was not mentioned or in which the original authors had not explained blood stasis. Of 211 total included studies, 19 were reviews, 52 were clinical studies, and 140 were preclinical articles. “Stagnant blood within the body” was the most frequently mentioned phrase of the traditional concept of blood stasis. Traumatic injury was the most frequently studied disease/condition in the clinical studies. In the preclinical studies, coagulopathy was studied most frequently, followed by hyperviscosity, hyperlipidemia, inflammation, neoplasm, ischemic brain injury, and atherosclerosis. Hyeolbuchukeo-tang and Angelicae Gigantis Radix were the most frequent formula and single herb, respectively, used in the blood stasis researches. The results showed that blood stasis was mainly recognized as disorder of circulation and many studies showed the effectiveness of activating blood circulating herbs for diseases and pathologies such as traumatic injury or coagulopathy. Further studies are needed in the pathologic mechanisms and various diseases of blood stasis. PMID:25821483

  16. Factors influencing BMI classifications of Korean adults

    PubMed Central

    Chang, Ae Kyung; Choi, Jin Yi

    2015-01-01

    [Purpose] This study aimed to identify factors influencing the BMI classifications of 3,583 Korean adults using data from the fifth Korean National Health and Nutrition Examination Survey. [Subjects and Methods] Measures included lifestyle factors, physiologic factors, perceived health state, stress, subjective body recognition, health-related quality of life, and weight control behavior. [Results] Body perception scores were lower with underweight and higher with overweight and obesity than with a healthy weight. There was a lower proportion of underweight men and a higher proportion of overweight or obese men than women. Instances of Alcohol Use Identification Scores (AUDIT) ≥ 9 were proportionately lower with underweight and more with overweight or obesity relative to an AUDIT score < 9 with healthy weight. Hemoglobin A1c and systolic blood pressure were higher with obesity than with healthy weight. The total cholesterol level was greater with overweight and obesity than with healthy weight. [Conclusion] These results suggest that obesity intervention for adults should be based on age and sex and should include drinking habits and physical activity. PMID:26157264

  17. Activities of the korean institute of tuberculosis.

    PubMed

    Ryoo, Sungweon; Kim, Hee Jin

    2014-12-01

    The Korean National Tuberculosis Association (KNTA) set up the Korean Institute of Tuberculosis (KIT) in 1970 to foster research and technical activities pertaining to tuberculosis (TB). The KNTA/KIT had successfully conducted a countrywide TB prevalence survey from 1965 to 1995 at 5-year intervals. The survey results (decline in TB rates) established Korea as a country that had successfully implemented national control programs for TB. The KIT developed the Korea Tuberculosis Surveillance System and the Laboratory Management Information System, both of which were transferred to the Korea Centers for Disease Control and Prevention after its establishment. The KIT functions as a central and supranational reference TB laboratory for microbiological and epidemiological research and provides training and education for health-care workers and medical practitioners. Recently, the KIT has expanded its activities to countries such as Ethiopia, Laos, and Timor-Leste to support TB control and prevention. The KIT will continue to support research activities and provide technical assistance in diagnosing the infection until it is completely eliminated in Korea. PMID:25861580

  18. Lessons from Korean Capsule Endoscopy Multicenter Studies

    PubMed Central

    Kim, Kyeong Ok

    2012-01-01

    Since its development, video capsule endoscopy (VCE) introduced a new area in the study of small bowel disease. We reviewed and discussed current issues from Korean capsule endoscopy multicenter studies. Main results are as follows: First, there was no significant difference in diagnostic yield according to the method of bowel preparation. Second, VCE represents a reliable and influential screening measure in patients with chronic unexplained abdominal pain and this technique could successfully alter the clinical course especially for patients with small bowel tumor. Third, the inter-observer variation in the expert group was lower than that in trainee group. Fourth, studies about the spontaneous capsule passage after retention showed 2.5% of retention rate and the size of lumen was an important factor of spontaneous passage. We need larger scale studies on the effect of bowel preparation methods on the diagnostic yield and further studies about the learning curve or unique capsule endoscopic findings for small intestinal diseases in Korean patients. PMID:22977821

  19. Radiological Analysis of Ponticulus Posticus in Koreans

    PubMed Central

    2009-01-01

    Purpose Since there has been little reporting on the prevalence or morphologic characteristics of ponticulus posticus in Asians, we retrospectively reviewed cervical 3-dimensional CT scan images and plain radiographs which had been ordered by neurosurgeons or orthopaedic surgeons for evaluation of cervical spine problems to investigate the prevalence and morphologic features of the ponticulus posticus in Koreans. Patients and Methods The presence and types of ponticulus posticus were investigated on 200 consecutive cervical 3-D CT scans. Results Thirty-one patients, 48 ponticulus posticus, complete or partial, bilateral or unilateral, were identified on the 200 cervical 3-D CT scans; therefore, the prevalence was 15.5% in our patient population. In plain radiographs analysis, the prevalence was 6.95%. Conclusion The ponticulus posticus is a relatively common anomaly in Koreans. Therefore, proper identification of this anomaly on preoperative lateral radiographs should alert surgeons to avoid using the ponticulus posticus as a starting point for a lateral mass screw. Because of its size and shape have wide variation, 3-D CT scanning should be considered before lateral mass screw placement into the posterior arch if its presence is suspected or confirmed on radiographs. PMID:19259347

  20. Safety climate practice in Korean manufacturing industry.

    PubMed

    Baek, Jong-Bae; Bae, Sejong; Ham, Byung-Ho; Singh, Karan P

    2008-11-15

    Safety climate survey was sent to 642 plants in 2003 to explore safety climate practices in the Korean manufacturing plants, especially in hazardous chemical treating plants. Out of 642 plants contacted 195 (30.4%) participated in the surveys. Data were collected by e-mail using SQL-server and mail. The main objective of this study was to explore safety climate practices (level of safety climate and the underlying problems). In addition, the variables that may influence the level of safety climate among managers and workers were explored. The questionnaires developed by health and safety executive (HSE) in the UK were modified to incorporate differences in Korean culture. Eleven important factors were summarized. Internal reliability of these factors was validated. Number of employees in the company varied from less than 30 employees (9.2%) to over 1000 employees (37.4%). Both managers and workers showed generally high level of safety climate awareness. The major underlying problems identified were inadequate health and safety procedures/rules, pressure for production, and rule breaking. The length of employment was a significant contributing factor to the level of safety climate. In this study, participants showed generally high level of safety climate, and length of employment affected the differences in the level of safety climate. Managers' commitment to comply safety rules, procedures, and effective safety education and training are recommended. PMID:18060692

  1. Violence against surgical residents.

    PubMed Central

    Barlow, C B; Rizzo, A G

    1997-01-01

    Violence against hospital personnel is underreported (less than one in five assaults), and accurate statistics as to the rate of violence against hospital personnel are thus difficult to establish. In the psychiatric discipline, an abundance of information has been published regarding violence in the health care setting, but few studies have examined violence outside psychiatric hospitals or by patients not diagnosed with psychiatric ailments. Using a survey that elicits information about workplace violence, we sought to gauge the prevalence of violent acts affecting general hospital workers who treat victims of violence on a daily basis. The survey was completed by a cohort of surgical staff nationwide (475 responses from 57 residency programs). Two hundred and eighty residents reported having witnessed one or more physical attacks, and 179 reported having been attacked. Violent acts were more likely to be committed in a public hospital than a private institution (P = 0.05). As shown in previous research, most attacks occurred in the emergency room (P = 0.01); the wards and parking lot were next in frequency. Women residents were more likely than men to call hospital security to intervene in a potentially violent situation (P = 0.04), and junior residents (postgraduate years 1-4) were more likely to be attacked than senior residents (> or = 5 years) (P = 0.04). The attacker was most likely to be a young black male between ages 19 and 30 (P = 0.01). We found no statistical relationship between the attacker and the victim regarding sex or race. Of the 475 respondents, 470 reported that they carry a gun themselves or know someone in the hospital environment who carries a gun. Images Figure 1. PMID:9291743

  2. Developing perspectives on Korean nursing theory: the influences of Taoism.

    PubMed

    Shin, K R

    2001-10-01

    Nursing theory provides a systematic explanation and description of nursing phenomena. Western nursing theories have widely influenced Korean nursing. And yet, although nursing theory has universal aspects, the differences in philosophy and culture that are unique to each country need to be considered. This inquiry seeks to investigate the Korean cultural heritage, which integrates Confucianism, Buddhism, and Taoism, and how it provides a unique worldview of human beings, the universe, health, and nursing. Essential principles and therapies consistent with Taoist philosophy are also identified. This framework is proffered as the basis for establishing understanding between Korean nurses and patients. PMID:11873374

  3. A hypothesized model of Korean women's responses to abuse.

    PubMed

    Choi, Myunghan; Harwood, Jake

    2004-07-01

    Many abused married Korean women have a strong desire to leave their abusive husbands but remain in the abusive situations because of the strong influence of their sociocultural context. The article discusses Korean women's responses to spousal abuse in the context of patriarchal, cultural, and social exchange theory. Age, education, and income as component elements share common effects on the emergent variable, sociostructural power. Gender role attitudes, traditional family ideology, individualism/collectivism, marital satisfaction, and marital conflict predict psychological-relational power as a latent variable. Sociostructural, patriarchal, cultural, and social exchange theories are reconceptualized to generate the model of Korean women's responses to abuse. PMID:15189642

  4. Surgical Skills Beyond Scientific Management.

    PubMed

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice. PMID:26090737

  5. Surgical Skills Beyond Scientific Management

    PubMed Central

    Whitfield, Nicholas

    2015-01-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel’s attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel–Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice. PMID:26090737

  6. Development of the two Korean adult tomographic computational phantoms for organ dosimetry

    SciTech Connect

    Lee, Choonsik; Lee, Choonik; Park, Sang-Hyun; Lee, Jai-Ki

    2006-02-15

    Following the previously developed Korean tomographic phantom, KORMAN, two additional whole-body tomographic phantoms of Korean adult males were developed from magnetic resonance (MR) and computed tomography (CT) images, respectively. Two healthy male volunteers, whose body dimensions were fairly representative of the average Korean adult male, were recruited and scanned for phantom development. Contiguous whole body MR images were obtained from one subject exclusive of the arms, while whole-body CT images were acquired from the second individual. A total of 29 organs and tissues and 19 skeletal sites were segmented via image manipulation techniques such as gray-level thresholding, region growing, and manual drawing, in which each of segmented image slice was subsequently reviewed by an experienced radiologist for anatomical accuracy. The resulting phantoms, the MR-based KTMAN-1 (Korean Typical MAN-1) and the CT-based KTMAN-2 (Korean Typical MAN-2), consist of 300x150x344 voxels with a voxel resolution of 2x2x5 mm{sup 3} for both phantoms. Masses of segmented organs and tissues were calculated as the product of a nominal reference density, the prevoxel volume, and the cumulative number of voxels defining each organs or tissue. These organs masses were then compared with those of both the Asian and the ICRP reference adult male. Organ masses within both KTMAN-1 and KTMAN-2 showed differences within 40% of Asian and ICRP reference values, with the exception of the skin, gall bladder, and pancreas which displayed larger differences. The resulting three-dimensional binary file was ported to the Monte Carlo code MCNPX2.4 to calculate organ doses following external irradiation for illustrative purposes. Colon, lung, liver, and stomach absorbed doses, as well as the effective dose, for idealized photon irradiation geometries (anterior-posterior and right lateral) were determined, and then compared with data from two other tomographic phantoms (Asian and Caucasian), and

  7. A Validation Study of the Korean-Ruminative Response Scale in Korean Adolescents

    PubMed Central

    Shin, Kyoung Min

    2015-01-01

    Objective We aimed to evaluate the psychometric properties of Korean version of Ruminative Response Scale (K-RRS) for Korean adolescents. Methods A community sample of 1220 adolescents was recruited from middle schools and high schools. Exploratory factor analyses and confirmatory factor analyses were conducted, and additional analyses were performed to assess the reliability and validity of the K-RRS. Results An exploratory factor analysis of a sample of adolescents (n=550) yielded a three factor structure: 'depressive rumination', 'reflective pondering', and 'brooding'. Confirmatory factor analyses of another sample of adolescents (n=530) supported the three-factor model for the K-RRS. The K-RRS was found to have good internal consistency and construct validity. Conclusion Our results suggest that K-RRS is a valid measurement to assess rumination in adolescents, as well as in adults. PMID:26508962

  8. Surgical Procedures for Vestibular Dysfunction

    MedlinePlus

    ... Rated Nonprofit! Volunteer. Donate. Review. Surgical Procedures for Vestibular Dysfunction When is surgery necessary? When medical treatment ... organ (cochlea) is also sacrificed with this procedure. Vestibular nerve section A vestibular nerve section is a ...

  9. Essential Tremor (ET): Surgical Options

    MedlinePlus

    ... the ventral intermediate nucleus (VIM) nucleus of the thalamus, located deep in the brain. The wire connects ... ET, DBS of the VIM nucleus of the thalamus is the most commonly used surgical procedure to ...

  10. Adult ESL Korean Readers' Responses about Their Reading in L1 Korean and L2 English

    ERIC Educational Resources Information Center

    Kim, Misun

    2010-01-01

    In this research study I explore: (a) beliefs Korean ESL readers have about reading in L1 and L2 prior to the Retrospective Miscue Analysis (RMA) sessions, (b) how their beliefs about reading affect the way they read in L1 and L2 and their evaluation of themselves as readers in L1 and L2 reading, and (c) change of their beliefs about reading and…

  11. Surgical Treatment for Falcotentorial Meningiomas.

    PubMed

    Hong, Chang Ki; Hong, Je Beom; Park, Hunho; Moon, Ju Hyung; Chang, Jong Hee; Lee, Kyu Sung; Park, Seoung Woo

    2016-07-01

    Among intracranial meningiomas, falcotentorial meningiomas, occurring at the junction of the falx cerebri and tentorial dural folds, are extremely rare. Because of their deep location, they are surrounded by critical structures, and have been regarded as one of the most challenging lesions for surgical treatment. In this study, we describe our surgical strategy for falcotentorial meningiomas and provide a review of our experience. PMID:27189300

  12. Surgical exposures of the hand.

    PubMed

    Watt, Andrew J; Chung, Kevin C

    2014-11-01

    Surgical approaches to the hand are commonly executed in the treatment of fractures, ligament injuries, and less commonly in the resection of bony tumors. Careful design and execution of these surgical approaches translates into superior functional and aesthetic outcomes. We have provided a thorough review of commonly used approaches to the hand by evaluating each of these approaches in the context of core principles including safety, versatility, preservation of stability, and aesthetic outcomes. PMID:25440073

  13. Surgical Treatment for Falcotentorial Meningiomas

    PubMed Central

    Hong, Chang Ki; Hong, Je Beom; Park, Hunho; Moon, Ju Hyung; Chang, Jong Hee; Lee, Kyu Sung

    2016-01-01

    Among intracranial meningiomas, falcotentorial meningiomas, occurring at the junction of the falx cerebri and tentorial dural folds, are extremely rare. Because of their deep location, they are surrounded by critical structures, and have been regarded as one of the most challenging lesions for surgical treatment. In this study, we describe our surgical strategy for falcotentorial meningiomas and provide a review of our experience. PMID:27189300

  14. Innovation in pediatric surgical education.

    PubMed

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees. PMID:25976147

  15. Intermittent exotropia: Surgical treatment strategies

    PubMed Central

    Kelkar, Jai Aditya; Gopal, Santhan; Shah, Rachana B; Kelkar, Aditya S

    2015-01-01

    Surgical management of intermittent exotropias (IXTs) is ambiguous, with techniques of management varying widely between institutions. This review aims to examine available literature on the surgical management of IXT. A literature search was performed using PubMed, Web of Knowledge, LILACS, and the University of Liverpool Orthoptic Journals and Conference Transactions Database. All English-language papers published between 1958 and the present day were considered. PMID:26458472

  16. Numerical Experiments for Storm Surge Inundation in Korean Coastal Area

    NASA Astrophysics Data System (ADS)

    Yoon, J.; Shim, J.; Jun, K.

    2012-12-01

    predicted inundation regimes and depths were compared with measurements from a tidal gage each area and inundation map by field measurements after the event. Comparisons of the numerical results and measured data show a good correlation. The numerical model adopted in this study is expected to be a useful tool for analysis of storm surges, and for predicting inundation regimes due to coastal flooding. Many coastal cities including low-lying areas were flooded during strong typhoon. So it is necessary to consider detailed evacuation planning, including hazard map, preparation of evacuation site, and sustainable city planning against storm surge inundation problems. For this study, we used 201 typhoons passing through Korea during the past 55 years since 1950. Typhoon wind model was used to estimate wind forcing and air pressure data for each typhoon. We estimated the spatial statistical analysis for inundation level as each return period. And finally we suggested the example of coastal hazard map in the Korean coast(Masan, yeosu and Busan city).

  17. [Effect of climate change on net primary productivity of Korean pine (Pinus koraiensis) at different successional stages of broad-leaved Korean pine forest].

    PubMed

    Qiu, Yang; Gao, Lu-Shuang; Zhang, Xue; Guo, Jing; Ma, Zhi-Yuan

    2014-07-01

    Pinus koraiensis in broad-leaved Korean pine forests of Changbai Mountain at different successional stages (secondary poplar-birch forest, secondary coniferous and broad-leaved forest and the primitive Korean pine forest) were selected in this paper as the research objects. In this research, the annual growth of net primary productivity (NPP) (1921-2006) of P. koraiensis was obtained by combining the tree-ring chronology and relative growth formulae, the correlation between NPP of P. koraiensis and climatic factors was developed, and the annual growth of NPP of P. koraiensis at different successional stages in relation to climatic variation within different climate periods were analyzed. The results showed that, in the research period, the correlations between climatic factors and NPP of P. koraiensis at different successional stages were different. With increasing the temperature, the correlations between NPP of P. koraiensis in the secondary poplar-birch forest and the minimum temperatures of previous and current growing seasons changed from being significantly negative to being significantly positive. The positive correlation between NPP of P. koraiensis in the secondary coniferous and broad-leaved forest and the minimum temperature in current spring changed into significantly positive correlation between NPP of P. koraiensis and the temperatures in previous and current growing seasons. The climatic factors had a stronger hysteresis effect on NPP of P. koraiensis in the secondary coniferous and broad-leaved forest, but NPP of P. koraiensis in the primitive Korean pine forest had weaker correlation with temperature but stronger positive correlation with the precipitation of previous growing season. The increases of minimum and mean temperatures were obvious, but no significant variations of the maximum temperature and precipitation were observed at our site. The climatic variation facilitated the increase of the NPP of P. koraiensis in the secondary poplar

  18. Surgical strategy for low rectal cancers.

    PubMed

    Dumont, F; Mariani, A; Elias, D; Goéré, D

    2015-02-01

    The two goals of surgery for lower rectal cancer surgery are to obtain clear "curative" margins and to limit post-surgical functional disorders. The question of whether or not to preserve the anal sphincter lies at the center of the therapeutic choice. Histologically, tumor-free distal and circumferential margins of>1mm allow a favorable oncologic outcome. Whether such margins can be obtained depends of TNM staging, tumor location, response to chemoradiotherapy and type of surgical procedure. The technique of intersphincteric resection relies on these narrow margins to spare the sphincter. This procedure provides satisfactory oncologic outcome with a rate of circumferential margin involvement ranging from 5% to 11%, while good continence is maintained in half of the patients. The extralevator abdominoperineal resection provides good oncologic results, however this procedure requires a permanent colostomy. A permanent colostomy alters several domains of quality of life when located at the classical abdominal site but not when brought out at the perineal site as a perineal colostomy. PMID:25455959

  19. Coverage of Unification Issue in North and South Korean Papers.

    ERIC Educational Resources Information Center

    Chang, Won H.

    1981-01-01

    Concludes that while the North Korean press gives more space to stories concerning the unification of the two Koreas than does the South, it is also more hostile and less varied in its coverage of the issue. (FL)

  20. Monitoring of trace metals in coastal sediments around Korean Peninsula.

    PubMed

    Hwang, Dong-Woon; Kim, Seong-Gil; Choi, Minkyu; Lee, In-Seok; Kim, Seong-Soo; Choi, Hee-Gu

    2016-01-15

    Spatial distributions and temporal variations of trace metals in Korean coastal sediments were investigated by determining seven metals (As, Cd, Cr, Cu, Hg, Pb, and Zn) in sediment collected from 71 stations between 2004 and 2010 (n=491). High metal concentrations were found in the southeastern coast, where there are many cities and industrial complexes, indicating that metal concentrations in Korean coastal sediment are significantly influenced by human activities associated with urbanization and industrialization. However, metal concentrations in sediment did not markedly vary temporally, which was because the coast is managed sustainably and because of the characteristics of the sediment environments. Based on the sediment quality guidelines and geoaccumulation index, Korean coastal sediments are practically unpolluted with Cd, Cr, Cu, Hg, Pb and Zn but moderately polluted with As. More intensive monitoring is required to determine the potential As sources and to understand the As geochemical cycles in Korean coastal sediments. PMID:26639653

  1. Phylogenetic Analysis of Astrovirus and Kobuvirus in Korean Dogs

    PubMed Central

    CHOI, Sarah; LIM, Seong-In; KIM, Yong Kwan; CHO, Yoon-Young; SONG, Jae-Young; AN, Dong-Jun

    2014-01-01

    ABSTRACT Astroviruses and kobuviruses are frequently found in mammalian feces, including that of humans. The present study examined fecal samples from 91 Korean dogs suffering from diarrhea. Canine astroviruses (CAstVs) and canine kobuviruses (CKoVs) were identified in 2 (2.1%) and 46 (50.6%) dogs, respectively. Nucleotide sequence analysis coupled with phylogenetic analysis using the neighbor-joining method showed that CAstVs clustered into four genetically diverse groups. Two Korean CAstVs belonged to group 2 alongside strains isolated in Italy and France. Twelve of the Korean CKoVs belonged to a single clade, along with strain UK003 identified in the UK and six CKoVs identified in the USA. Thus, the results suggest that the Korean strain of CAstV is closely related to strains isolated in Europe. Surely, CKoV in South Korea could identify the circulation among dogs population. PMID:24784439

  2. An overview of Korean astronaut’s space experiments

    NASA Astrophysics Data System (ADS)

    Lee, J. H.; Kim, Y. K.; Yi, S. Y.; Kim, K. S.; Kang, S. W.; Choi, G. H.; Sim, E. S.

    2010-10-01

    The paper presents an overview of the scientific space experiments in the Korean Astronaut Program (KAP) that were conducted on the International Space Station (ISS), beginning with launch of the Soyuz TMA-12 spacecraft with the first Korean astronaut and two Russian astronauts on April 8, 2008 and returning to Earth on April 19, 2008. During the 10 days aboard the ISS, the Korean astronaut successfully completed thirteen scientific experiments in biology, life science, material science, earth science, and system engineering, five educational space experiments, and three kinds of international collaboration experiments. These experiments were the first Korean manned space experiments and these missions were the first steps toward the manned space exploration by Korea. In this paper, we briefly discuss the descriptions, conduct, and results of the space experiments and discuss future plans. In addition, the lessons learned with respect to the performing of these manned space experiments on the ISS are presented.

  3. Developing Korean-specific equations of stature estimation.

    PubMed

    Jeong, Yangseung; Jantz, Lee Meadows

    2016-03-01

    This study aims to develop Korean-specific equations for stature estimation and compare their performance to existing techniques. Due to a lack of appropriate reference samples in Korea, equations were generated using a hybrid method on 113 Korean unknown skeletons. In this approach, estimates using the anatomical method [1] were regarded as actual stature. Results revealed that new equations produced more accurate and precise estimates than previous techniques. In addition, due to consistent body proportions of Korean populations through time and space, new equations are applicable to Korean skeletons regardless of their temporal and geographic origins. For obtaining statures at death, particularly in a forensic context, an age correction factor, 0.0426 cm/year, should be applied. PMID:26833426

  4. Patterns of Political Socialization in North Korean Schools

    ERIC Educational Resources Information Center

    Kim, Hyung-Chan

    1973-01-01

    Considers the government's use of the schools in North Korea and its instructional programs as a means of political indoctrination that aims at shaping and remolding North Korean youth into communists. (Author/RK)

  5. Comparison of Korean and European women professional golfers' training time and perceptions of ideal training time.

    PubMed

    Kim, Myung-Soo; Kim, Soon-Mi; Kim, Soon-Young; Kim, Sung-Hee

    2010-08-01

    The purpose of this study was to compare Korean and European female professional golfer's reported practice hours and their different understandings about golf training. 55 Korean and 21 European female professional golfers were asked questions about average actual practice days per week, average actual practice hours per day, ideal practice days per week, and ideal practice hours per day. All the women participated in the Korean Female Masters Golf Tournament at the Korean Cyprus Golf course from 6-8 November in 2009. Korean female professional golfers reported practicing more hours, but both the Korean and European golfers reported actually practicing more hours than their ideal practice hours. PMID:21058589

  6. Smoking Topography in Korean American and White Men: Preliminary Findings

    PubMed Central

    Chung, Sangkeun; Kim, Sun S; Kini, Nisha; Fang, Hua J; Kalman, David; Ziedonis, Douglas M.

    2013-01-01

    Introduction This is the first study of Korean Americans’ smoking behavior using a topography device. Korean American men smoke at higher rates than the general U.S. population. Methods Korean American and White men were compared based on standard tobacco assessment and smoking topography measures. They smoked their preferred brand of cigarettes ad libitum with a portable smoking topography device for 24 hours. Results Compared to White men (N = 26), Korean American men (N = 27) were more likely to smoke low nicotine-yield cigarettes (p < 0.001) and have lower Fagerstrom nicotine dependence scores (p = 0.04). Koreans smoked fewer cigarettes with the device (p = 0.01) than Whites. Controlling for the number of cigarettes smoked, Koreans smoked with higher average puff flows (p = 0.05), greater peak puff flows (p = 0.02), and shorter interpuff intervals (p < 0.001) than Whites. Puff counts, puff volumes, and puff durations did not differ between the two groups. Conclusions This study offers preliminary insight into unique smoking patterns among Korean American men who are likely to smoke low nicotine-yield cigarettes. We found that Korean American men compensated their lower number and low nicotine-yield cigarettes by smoking more frequently with greater puff flows than White men, which may suggest exposures to similar amounts of nicotine and harmful tobacco toxins by both groups. Clinicians will need to consider in identifying and treating smokers in a mutually aggressive manner, irrespective of cigarette type and number of cigarette smoked per day. PMID:24068611

  7. Smoking habits and nicotine dependence of North Korean male defectors

    PubMed Central

    Kim, Sei Won; Lee, Jong Min; Ban, Woo Ho; Park, Chan Kwon; Yoon, Hyoung Kyu; Lee, Sang Haak

    2016-01-01

    Background/Aims: The smoking rates and patterns in the North Korean population are not well known. More than 20,000 North Korean defectors have settled in South Korea; thus, we can estimate the current North Korean smoking situation using this group. Methods: All North Korean defectors spend their first 3 months in a South Korean facility learning to adapt to their new home. We retrospectively analyzed the results from a questionnaire conducted among North Korean male defectors in this facility from August 2012 to February 2014. Results: Of 272 men, 84.2% were current smokers, 12.5% were ex-smokers, and 3.3% were non-smokers. The mean age of this group was 35.9 ± 11.3 years, and smoking initiation occurred at a mean age of 18.2 ± 4.7 years. Among the subjects, 78.1% had a family member who smoked. Of the 221 current smokers, 67.4% responded that they intended to quit smoking. Fagerström test and Kano test for social nicotine dependence (KTSND) results for current smokers were 3.35 ± 2.26 and 13.76 ± 4.87, respectively. Question 9 on the KTSND (doctors exaggerate the ill effects of smoking) earned a significantly higher score relative to the other questions and a significantly higher score in current smokers compared with non-smokers. Conclusions: The smoking rate in North Korean male defectors was higher than that indicated previously. However, interest in smoking cessation was high and nicotine dependence was less severe than expected. Further investigation is needed to identify an efficient method for North Korean smokers to stop smoking. PMID:26951917

  8. Site development interim removable dental prosthesis.

    PubMed

    Pasquinelli, Kirk L; Sze, Alexander J; Matosian, Alex J

    2016-07-01

    Transitioning a patient with partial edentulism through hard and soft tissue grafting to an implant restoration with an interim removable dental prosthesis (IRDP) presents a challenge to the restorative dentist. The management of grafted sites requires care, and without the appropriate design, an IRDP may impede surgical outcomes and place the graft at risk for displacement or necrosis. A site development IRDP (SDIRDP) for a grafted site must fulfill restorative goals and promote the surgical objectives for site development. A technique is described for fabricating an SDIRDP that facilitates surgical procedures and maintains prosthetic goals. PMID:26831920

  9. Hwa-byung. A community study of Korean Americans.

    PubMed

    Lin, K M; Lau, J K; Yamamoto, J; Zheng, Y P; Kim, H S; Cho, K H; Nakasaki, G

    1992-06-01

    One hundred nine Korean American community subjects were interviewed regarding their experiences with hwa-byung (HB), a Korean folk illness label commonly used by Koreans with a myriad of physiological and psychological complaints. During these interviews, standard instruments were also used to assess their depressive and somatic symptoms. The results indicated that a relatively high proportion (12%) of the subjects labeled themselves as having suffered from HB. While no apparent sociodemographic differences were found between HB and non-HB subjects, significantly more HB subjects fulfilled the diagnosis of DSM-III major depression and also had previous diagnoses of depression. The HB subjects also had significantly higher scores for the total, depressive, and somatic subscales and 16 of the 20 individual items of the Center for Epidemiologic Studies-Depression Scale. These data confirm previous observations of substantial overlap between HB and DSM-III major depression among Koreans and Korean Americans, and suggest that HB may be a culturally patterned way of expression for Koreans experiencing major depression and related conditions. The clinical and theoretical implications of these findings are also discussed. PMID:1593273

  10. First Generation Korean American Parents’ Perceptions of Discipline

    PubMed Central

    Kim, Eunjung; Hong, Seunghye

    2007-01-01

    Nurses not only need to be familiar with the professional guidelines of discipline and but also be aware of variances in styles of acceptable discipline across cultural groups. The goal of this study was to explore cultural influences in relation to (1) first generation Korean American parents’ perceptions of common discipline strategies in the United States and (2) discipline strategies commonly used among first generation Korean American parents. Inductive content analysis was used to analyze interview data from seven first generation Korean American parents. Derived themes indicated that parents considered spanking/hitting and less hugging/kissing as Korean style and time out, using a sticker chart, hugging/kissing, removing/adding privileges, and giving chores as American style. Recent immigrant parents were not familiar with common positive discipline strategies in the United States. As they adapted to the mainstream society, they discontinued what they perceived to be negative aspects of Korean style and adopted positive aspects of American style. They were sensitive to children’s views on discipline and they experienced communication difficulties with children. These findings indicated that Korean American parents’ perceptions on discipline strategies were shaped by living in two cultures and were different from the western viewpoints. PMID:17292135

  11. Islands and Non-islands in Native and Heritage Korean

    PubMed Central

    Kim, Boyoung; Goodall, Grant

    2016-01-01

    To a large extent, island phenomena are cross-linguistically invariable, but English and Korean present some striking differences in this domain. English has wh-movement and Korean does not, and while both languages show sensitivity to wh-islands, only English has island effects for adjunct clauses. Given this complex set of differences, one might expect Korean/English bilinguals, and especially heritage Korean speakers (i.e., early bilinguals whose L2 became their dominant language during childhood) to be different from native speakers, since heritage speakers have had more limited exposure to Korean, may have had incomplete acquisition and/or attrition, and may show significant transfer effects from the L2. Here we examine islands in heritage speakers of Korean in the U.S. Through a series of four formal acceptability experiments comparing these heritage speakers with native speakers residing in Korea, we show that the two groups are remarkably similar. Both show clear evidence for wh-islands and an equally clear lack of adjunct island effects. Given the very different linguistic environment that the heritage speakers have had since early childhood, this result lends support to the idea that island phenomena are largely immune to environmental influences and stem from deeper properties of the processor and/or grammar. Similarly, it casts some doubt on recent proposals that islands are learned from the input. PMID:26913017

  12. Overview of the Development of the Korean Exposure Factors Handbook

    PubMed Central

    Jo, Soo-Nam; Kim, So-Yeon; Myung, Hyung-Nam

    2014-01-01

    A set of exposure factors that reflects the characteristics of individual behavior capable of influencing exposure is essential for risk and exposure assessment. In 2007, the Korean Exposure Factors Handbook was, therefore, issued, driven by the need to develop reliable exposure factors representing the Korean population. The purpose of this study was to overview the development process of the Korean Exposure Factors Handbook and major recommended exposure values for the Korean population to allow information exchanges and comparison of recommended values among nations. The researchers reviewed the domestic data that could be used in the development of exposure factors, confirmed a knowledge gap, and set a priority of development by phases. A methodology to measure exposure factors was established to develop measuring techniques and test their validity. Data were processed or a survey was conducted according to the availability of data. The study thus produced recommended values for 24 exposure factors grouped by general exposure factors, food ingestion factors, and activity factors by setting up a database of exposure factors and carrying out statistical analysis. The study has significantly contributed to reducing the potential uncertainty of the risk and exposure assessment derived by the application of foreign data or research findings lacking representativeness or grounds by developing a set of exposure factors reflecting the characteristics of the Korean people. It will be necessary to conduct revisions in light of the changing statistical values of national data and the exposure factors based on Korean characteristics. PMID:24570801

  13. First-generation Korean-American parents' perceptions of discipline.

    PubMed

    Kim, Eunjung; Hong, Seunghye

    2007-01-01

    Nurses not only need to be familiar with professional guidelines of discipline and but also need to be aware of variances in styles of acceptable discipline across cultural groups. The goal of this study was to explore cultural influences in relation to (1) first-generation Korean-American parents' perceptions of common discipline strategies in the United States, and (2) discipline strategies commonly used among first-generation Korean-American parents. Inductive content analysis was used to analyze interview data from seven first-generation Korean-American parents. Derived themes indicated that parents considered spanking/hitting and less hugging/kissing as Korean style, and time-out, use of sticker charts, hugging/kissing, removing/adding privileges, and giving chores as American style. Recent immigrant parents were not familiar with common positive discipline strategies in the United States. As they adapted to mainstream society, they discontinued what they perceived to be negative aspects of Korean style and adopted positive aspects of American style. They were sensitive to children's views on discipline, and they experienced communication difficulties with children. These findings indicated that Korean-American parents' perceptions of discipline strategies were shaped by living in two cultures and were different from western viewpoints. PMID:17292135

  14. Islands and Non-islands in Native and Heritage Korean.

    PubMed

    Kim, Boyoung; Goodall, Grant

    2016-01-01

    To a large extent, island phenomena are cross-linguistically invariable, but English and Korean present some striking differences in this domain. English has wh-movement and Korean does not, and while both languages show sensitivity to wh-islands, only English has island effects for adjunct clauses. Given this complex set of differences, one might expect Korean/English bilinguals, and especially heritage Korean speakers (i.e., early bilinguals whose L2 became their dominant language during childhood) to be different from native speakers, since heritage speakers have had more limited exposure to Korean, may have had incomplete acquisition and/or attrition, and may show significant transfer effects from the L2. Here we examine islands in heritage speakers of Korean in the U.S. Through a series of four formal acceptability experiments comparing these heritage speakers with native speakers residing in Korea, we show that the two groups are remarkably similar. Both show clear evidence for wh-islands and an equally clear lack of adjunct island effects. Given the very different linguistic environment that the heritage speakers have had since early childhood, this result lends support to the idea that island phenomena are largely immune to environmental influences and stem from deeper properties of the processor and/or grammar. Similarly, it casts some doubt on recent proposals that islands are learned from the input. PMID:26913017

  15. German and Korean mothers' sensitivity and related parenting beliefs

    PubMed Central

    Ziehm, Jeanette; Trommsdorff, Gisela; Heikamp, Tobias; Park, Seong-Yeon

    2013-01-01

    This study contributes to a differentiated understanding of maternal sensitivity in cultural and situational context. We investigated differences and similarities in German and Korean mothers' maternal sensitivity. We interviewed 92 German and 100 Korean mothers of first graders about their preference for proactive (anticipating children's needs) or reactive sensitivity (responding to children's direct cues) in different scenarios. Related parenting beliefs were assessed by asking the mothers to explain the reasons why they would prefer specific parenting behaviors. Results revealed significant cultural differences in reactive vs. proactive sensitivity preferences. Overall, German mothers were more likely to indicate that a mother should respond reactively and less likely to report that a mother should act proactively than were Korean mothers. Korean mothers gave preference to both reactive and proactive sensitivity depending on the scenario. With regard to parenting beliefs, analyses revealed that German and Korean mothers who preferred reactive sensitivity mainly explained their choices as attempts to encourage children's development of independence. In contrast, Korean and German mothers with a preference for proactive sensitivity were more likely to report that mothers would assist their children due to their immaturity in dealing with emotional distress. Results are discussed in the framework of the different meanings and functions of maternal sensitivity for socialization in different cultural contexts. PMID:23986740

  16. Overview of the development of the Korean exposure factors handbook.

    PubMed

    Jang, Jae-Yeon; Jo, Soo-Nam; Kim, So-Yeon; Myung, Hyung-Nam

    2014-01-01

    A set of exposure factors that reflects the characteristics of individual behavior capable of influencing exposure is essential for risk and exposure assessment. In 2007, the Korean Exposure Factors Handbook was, therefore, issued, driven by the need to develop reliable exposure factors representing the Korean population. The purpose of this study was to overview the development process of the Korean Exposure Factors Handbook and major recommended exposure values for the Korean population to allow information exchanges and comparison of recommended values among nations. The researchers reviewed the domestic data that could be used in the development of exposure factors, confirmed a knowledge gap, and set a priority of development by phases. A methodology to measure exposure factors was established to develop measuring techniques and test their validity. Data were processed or a survey was conducted according to the availability of data. The study thus produced recommended values for 24 exposure factors grouped by general exposure factors, food ingestion factors, and activity factors by setting up a database of exposure factors and carrying out statistical analysis. The study has significantly contributed to reducing the potential uncertainty of the risk and exposure assessment derived by the application of foreign data or research findings lacking representativeness or grounds by developing a set of exposure factors reflecting the characteristics of the Korean people. It will be necessary to conduct revisions in light of the changing statistical values of national data and the exposure factors based on Korean characteristics. PMID:24570801

  17. Hereditary Cerebellar Ataxias: A Korean Perspective

    PubMed Central

    Kim, Ji Sun; Cho, Jin Whan

    2015-01-01

    Hereditary ataxia is a heterogeneous disorder characterized by progressive ataxia combined with/without peripheral neuropathy, extrapyramidal symptoms, pyramidal symptoms, seizure, and multiple systematic involvements. More than 35 autosomal dominant cerebellar ataxias have been designated as spinocerebellar ataxia, and there are 55 recessive ataxias that have not been named systematically. Conducting genetic sequencing to confirm a diagnosis is difficult due to the large amount of subtypes with phenotypic overlap. The prevalence of hereditary ataxia can vary among countries, and estimations of prevalence and subtype frequencies are necessary for planning a diagnostic strategy in a specific population. This review covers the various hereditary ataxias reported in the Korean population with a focus on the prevalence and subtype frequencies as the clinical characteristics of the various subtypes. PMID:26090078

  18. The Austrialian National Chinese Japanese Korean Project

    NASA Technical Reports Server (NTRS)

    Groom, Linda

    1994-01-01

    Providing access to Asian-language materials has always been a problem for libraries. There are particular difficulties in acquiring Asian materials, in cataloguing them and providing access, and in incorporating them in library systems. There is, however, an urgent and growing need for access to Asian materials. Part of the response of the Australian library community to the difficulties and to the increasing need has been the Australian National CJK (Chinese, Japanese and Korean) Project. The CJK Project is a co-operative project involving seven Australian universities and the National Library of Australia. Membership is expected to grow to include other Australian research libraries, some public research libraries and some overseas libraries.

  19. New Bioactive Compounds from Korean Native Mushrooms

    PubMed Central

    Kim, Seong-Eun; Hwang, Byung Soon; Song, Ja-Gyeong; Lee, Seung Woong; Lee, In-Kyoung

    2013-01-01

    Mushrooms are ubiquitous in nature and have high nutritional attributes. They have demonstrated diverse biological effects and therefore have been used in treatments of various diseases, including cancer, diabetes, bacterial and viral infections, and ulcer. In particular, polysaccharides, including β-glucan, are considered as the major constituents responsible for the biological activity of mushrooms. Although an overwhelming number of reports have been published on the importance of polysaccharides as immunomodulating agents, not all of the healing properties found in these mushrooms could be fully accounted for. Recently, many research groups have begun investigations on biologically active small-molecular weight compounds in wild mushrooms. In this mini-review, both structural diversity and biological activities of novel bioactive substances from Korean native mushrooms are described. PMID:24493936

  20. Current health issues in Korean adolescents

    PubMed Central

    2011-01-01

    During the adolescent period, they experience rapid physical, emotional, cognitive developments while they establish their lifestyle and habitual routines that strongly influence adult health and life. Recent rapid economic growth in Korea, and the earlier onset of physical, sexual, and psychological maturation of adolescents, has resulted in changes in the health status of adolescents from many years ago. Risk-taking behaviors such as drinking alcohol, smoking, and sexual experiences are critical issues that affect the health of, adolescents. Therefore, it is important for pediatricians to note the that risk-taking behaviors of adolescents in Korea that are caused by individual psychosocial factors. This review article illustrates the current health status of Korean adolescents and provides an overview of risk-taking behaviors, to inform pediatricians about some of the key issues. PMID:22232620