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Sample records for korean surgical site

  1. [Surgical site infections].

    PubMed

    Sganga, Gabriele

    2014-01-01

    Surgical site infections (SSIs) are recognized as a common surgical complication, occurring in about 2-5% of all surgical procedures. SSIs represent the third most frequent nosocomial infection, accounting for 14-16% of all infections observed in hospitalized patients and up to 38% of those observed among surgical patients. Knowledge of incidence, epidemiology, classification, process of wound healing, and pathogenesis of surgical site infection is of great importance. Given the high economic burden that infections provoke, beyond the increased morbidity and mortality, it appears mandatory to improve our tools in order to reduce their incidence, as a reduction of only 0.1% can result in a considerable saving of economic resources to be allocated to other activities, such as screening and prevention programs.

  2. Surgical Site Infections

    PubMed Central

    Kleinman, Ken; Huang, Susan S.; Murphy, Michael V.; Yokoe, Deborah S.; Platt, Richard

    2017-01-01

    Background: Surgical site infection (SSI) rates are publicly reported as quality metrics and increasingly used to determine financial reimbursement. Objective: To evaluate the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. Research Design: We performed a retrospective cohort study of Medicare beneficiaries who underwent CABG surgery or hip arthroplasty at US hospitals from 2005 to 2011, with outcomes analyzed through March 2012. Nationally validated claims-based surveillance methods were used to assess for SSI within 90 days of surgery. The relationship between procedure volume and SSI rate was assessed using logistic regression and generalized additive modeling. Year-to-year stability of SSI rates was evaluated using logistic regression to assess hospitals’ movement in and out of performance rankings linked to financial penalties. Results: Case-mix adjusted SSI risk based on claims was highest in hospitals performing <50 CABG/year and <200 hip arthroplasty/year compared with hospitals performing ≥200 procedures/year. At that same time, hospitals in the worst quartile in a given year based on claims had a low probability of remaining in that quartile the following year. This probability increased with volume, and when using 2 years’ experience, but the highest probabilities were only 0.59 for CABG (95% confidence interval, 0.52–0.66) and 0.48 for hip arthroplasty (95% confidence interval, 0.42–0.55). Conclusions: Aggregate SSI risk is highest in hospitals with low annual procedure volumes, yet these hospitals are currently excluded from quality reporting. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance. PMID:27517331

  3. 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

  4. Surgical manual of the Korean Gynecologic Oncology Group: ovarian, tubal, and peritoneal cancers

    PubMed Central

    2017-01-01

    The Surgery Treatment Modality Committee of the Korean Gynecologic Oncology Group has determined to develop a surgical manual to facilitate clinical trials and to improve communication between investigators by standardizing and precisely describing operating procedures. The literature on anatomic terminology, identification of surgical components, and surgical techniques were reviewed and discussed in depth to develop a surgical manual for gynecologic oncology. The surgical procedures provided here represent the minimum requirements for participating in a clinical trial. These procedures should be described in the operation record form, and the pathologic findings obtained from the procedures should be recorded in the pathologic report form. Here, we describe surgical procedure for ovarian, fallopian tubal, and peritoneal cancers. PMID:27670260

  5. Pelvic Surgical Site Infections in Gynecologic Surgery

    PubMed Central

    Lachiewicz, Mark P.; Moulton, Laura J.; Jaiyeoba, Oluwatosin

    2015-01-01

    The development of surgical site infection (SSI) remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery. PMID:25788822

  6. [Surgical site infection: clinical and microbiological aspects].

    PubMed

    Sikora, Agnieszka; Kozioł-Montewska, Maria

    2010-01-01

    Surgical site infection (SSI) is one of the most common and serious postoperative complication of modern surgery. It contributes to an increase of morbidity, mortality, prolonged hospitalization and costs of treatment. The optimal strategy in order to reduce wound infections in surgery is SSI knowledge of risk factors associated with a patient, surgery and postoperative care as well as the caution of fundamental recommendations concerning prevention, which include: preparation of patient for surgery, preparation of antiseptic principles for hand skin of the operation team, the proceedings in the case of allegation of infection or colonization within the operation team members, preoperative antibiotic prophylaxis, procedures and aspects of aseptic surgical technique, postoperative care and the rules for monitoring infections in the surgical ward.

  7. Analysis of Malpractice Claims Associated with Surgical Site Infection in the Field of Plastic Surgery

    PubMed Central

    2016-01-01

    Postoperative infections are rare after plastic surgery; however, when present, they can affect the aesthetic outcome. Currently, many malpractice lawsuits are associated with surgical site infection. The present study aimed to analyze malpractice claims associated with surgical site infection in the field of plastic surgery through a review of Korean precedents. We analyzed the type of procedure, associated complications, and legal judgment in these cases. Most claimants were women, and claims were most often related to breast surgery. The common complications related to surgical site infection were deformity, scar, and asymmetry. Among the 40 cases, 34 were won by the plaintiff, and the mean claim settlement was 2,832,654 KRW (USD 2,636.6). The reasons for these judgements were as follows: 1) immediate bacterial culture tests were not performed and appropriate antibiotics were not used; 2) patients were not transferred to a high-level hospital or the infection control department was not consulted; 3) surgical site infection control measures were not appropriate; and 4) surgical procedures were performed without preoperative explanation about surgical site infection. The number of claims owing to surgical site infection after surgery is increasing. Infection handling was one of the key factors that influenced the judgement, and preoperative explanation about the possibility of infection is important. The findings will help surgeons achieve high patient satisfaction and reduce liability concerns. PMID:27822936

  8. Surgical site infections: epidemiology, microbiology and prevention.

    PubMed

    Owens, C D; Stoessel, K

    2008-11-01

    Surgical site infections (SSIs) are defined as infections occurring up to 30 days after surgery (or up to one year after surgery in patients receiving implants) and affecting either the incision or deep tissue at the operation site. Despite improvements in prevention, SSIs remain a significant clinical problem as they are associated with substantial mortality and morbidity and impose severe demands on healthcare resources. The incidence of SSIs may be as high as 20%, depending on the surgical procedure, the surveillance criteria used, and the quality of data collection. In many SSIs, the responsible pathogens originate from the patient's endogenous flora. The causative pathogens depend on the type of surgery; the most commonly isolated organisms are Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus spp. and Escherichia coli. Numerous patient-related and procedure-related factors influence the risk of SSI, and hence prevention requires a 'bundle' approach, with systematic attention to multiple risk factors, in order to reduce the risk of bacterial contamination and improve the patient's defences. The Centers for Disease Control and Prevention guidelines for the prevention of SSIs emphasise the importance of good patient preparation, aseptic practice, and attention to surgical technique; antimicrobial prophylaxis is also indicated in specific circumstances. Emerging technologies, such as microbial sealants, offer the ability to seal and immobilise skin flora for the duration of a surgical procedure; a strong case therefore exists for evaluating such technologies and implementing them into routine clinical practice as appropriate.

  9. Local antimicrobial administration for prophylaxis of surgical site infections.

    PubMed

    Huiras, Paul; Logan, Jill K; Papadopoulos, Stella; Whitney, Dana

    2012-11-01

    Despite a lack of consensus guidelines, local antibiotic administration for prophylaxis of surgical site infections is used during many surgical procedures. The rationale behind this practice is to provide high antibiotic concentrations at the site of surgery while minimizing systemic exposure and adverse effects. Local antibiotic administration for surgical site prophylaxis has inherent limitations in that antibiotics are applied after the incision is made, rather than the current standard for surgical site prophylaxis that recommends providing adequate antibiotic concentrations at the site before the incision. The efficacy and safety of local application of antibiotics for surgical site prophylaxis have been assessed in different types of surgery with a variety of antibiotic agents and methods of application. We identified 22 prospective, randomized, controlled trials that evaluated local application of antibiotics for surgical site prophylaxis. These trials were subsequently divided and analyzed based on the type of surgical procedure: dermatologic, orthopedic, abdominal, colorectal, and cardiothoracic. Methods of local application analyzed included irrigations, powders, ointments, pastes, beads, sponges, and fleeces. Overall, there is a significant lack of level I evidence supporting this practice for any of the surgical genres evaluated. In addition, the literature spans several decades, and changes in surgical procedures, systemic antibiotic prophylaxis, and microbial flora make conclusions difficult to determine. Based on available data, the efficacy of local antibiotic administration for the prophylaxis of surgical site infections remains uncertain, and recommendations supporting this practice for surgical site prophylaxis cannot be made.

  10. Results of surgical treatment on benign anal diseases in Korean HIV-positive patients.

    PubMed

    Oh, Heung-Kwon; Moon, Sang-Hui; Ryoo, Seungbum; Choe, Eun Kyung; Park, Kyu Joo

    2014-09-01

    Perianal diseases are the most common reasons for surgery in HIV-positive patients. This study aimed to evaluate the outcomes of these surgical procedures in Korean patients, focusing on wound healing and postoperative complications. Retrospective analysis was performed on 72 HIV-positive patients who underwent surgery by a single surgeon for benign anal disease between 1998 and 2011. Of these, 68.1% (49/72) of patients received surgery for condyloma acuminata, 19.4% (14/72) for anal fistulas, 6.9% (5/72) for hemorrhoids, and 5.6% (4/72) for perianal abscesses. Patients with condyloma acuminata received surgical excision with electrical coagulation, and all wounds healed completely within 3 months, though 16.3% (8/49) of these patients experienced recurrence. Twelve of the 49 patients (24.5%) who were treated for condyloma acuminata underwent simultaneous operations for concomitant anal fistulas (n = 6), hemorrhoids (n = 4), and perianal abscesses (n = 2). Overall, 3 postoperative complications developed following a total of 94 procedures, and there was no significant increase in complication rate for patients with a low CD4+ T-cell count ( < 200/µL) compared to those with a higher count. The results demonstrate favorable results following perianal surgery in HIV-positive Korean patients.

  11. Antimicrobial resistance development following surgical site infections.

    PubMed

    Călina, Daniela; Docea, Anca Oana; Rosu, Lucica; Zlatian, Ovidiu; Rosu, Alexandra Floriana; Anghelina, Florin; Rogoveanu, Otilia; Arsene, Andreea Letiția; Nicolae, Alina Crenguța; Drăgoi, Cristina Manuela; Tsiaoussis, John; Tsatsakis, Aristides M; Spandidos, Demetrios A; Drakoulis, Nikolaos; Gofita, Eliza

    2017-02-01

    Surgical site infections (SSIs) determine an increase in hospitalization time and antibiotic therapy costs. The aim of this study was to identify the germs involved in SSIs in patients from the Clinical Emergency County Hospital of Craiova (SCJUC) and to assess their resistance to antimicrobials, with comparisons between surgical wards and the intensive care unit (ICU). The biological samples were subjected to classical bacteriological diagnostics. Antibiotic resistance was tested by disc diffusion. We used hierarchical clustering as a method to group the isolates based upon the antibiotic resistance profile. The most prevalent bacterial species isolated were Staphylococcus aureus (S. aureus; 50.72%), followed by Escherichia coli (E. coli; 17.22%) and Pseudomonas aeruginosa; 10.05%). In addition, at lower percentages, we isolated glucose-non-fermenting, Gram-negative bacteria and other Enterobacteriaceae. The antibiotic resistance varied greatly between species; the most resistant were the non-fermenting Gram‑negative rods. E. coli exhibited lower resistance to third generation cephalosporins, quinolones and carbapenems. By contrast, Klebsiella was resistant to many cephalosporins and penicillins, and to a certain extent to carbapenems due to carbapenemase production. The non-fermenting bacteria were highly resistant to antibiotics, but were generally sensitive to colistin. S. aureus was resistant to ceftriaxone (100%), penicillin (91.36%), amoxicillin/clavulanate (87.50%), amikacin (80.00%) and was sensitive to levofloxacin, doxycycline, gentamycin, tigecycline and teicoplanin. The Enterobacteriaceae resistance was only slightly higher in the ICU, particularly to carbapenems (imipenem, 31.20% in the ICU vs. 14.30% in the surgical wards; risk ratio = 2.182). As regards Staphylococcus species, but for non-fermenting bacteria, even if the median was almost the same, the antibiotic resistance index values were confined to the upper limit in the ICU

  12. 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

  13. 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

  14. Early and late surgical site infections in ear surgery.

    PubMed

    Bastier, P L; Leroyer, C; Lashéras, A; Rogues, A-M; Darrouzet, V; Franco-Vidal, V

    2016-04-01

    A retroauricular approach is routinely used for treating chronic otitis media. The incidence of surgical site infections after ear surgery is around 10% in contaminated or dirty procedures. This observational prospective study describes surgical site infections after chronic otitis media surgery with the retroauricular approach and investigated their potential predictive factors. This observational prospective study included patients suffering from chronic otitis media and eligible for therapeutic surgery with a retroauricular approach. During follow-up, surgical site infections were defined as "early" if occurring within 30 days after surgery or as "late" if occurring thereafter. The data of 102 patients were analysed. Concerning early surgical site infections, four cases were diagnosed (3.9%) and a significant association was found with preoperative antibiotic therapy, wet ear at pre-operative examination, class III (contaminated) in the surgical wound classification, NNIS (National Nosocomial Infection Surveillance) index > 1, and oral post-operative antibiotic use. Seven late surgical site infections were diagnosed (7.1%) between 90 and 160 days after surgery and were significantly correlated to otorrhoea during the 6 months before surgery, surgery duration ≤60 minutes, canal wall down technique and use of fibrin glue. Surgical site infections after chronic otitis media surgery seem to be associated with factors related to the inflammatory state of the middle ear at the time of surgery in early infections and with chronic inflammation in late infections.

  15. Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery.

    PubMed

    Ahn, Soon-Hyun; Hong, Hyun Jun; Kwon, Soon Young; Kwon, Kee Hwan; Roh, Jong-Lyel; Ryu, Junsun; Park, Jun Hee; Baek, Seung-Kuk; Lee, Guk Haeng; Lee, Sei Young; Lee, Jin Choon; Chung, Man Ki; Joo, Young Hoon; Ji, Yong Bae; Hah, Jeong Hun; Kwon, Minsu; Park, Young Min; Song, Chang Myeon; Shin, Sung-Chan; Ryu, Chang Hwan; Lee, Doh Young; Lee, Young Chan; Chang, Jae Won; Jeong, Ha Min; Cho, Jae-Keun; Cha, Wonjae; Chun, Byung Joon; Choi, Ik Joon; Choi, Hyo Geun; Lee, Kang Dae

    2017-03-01

    Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.

  16. 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

  17. Epidemiology and prevention of surgical site infections after cardiac surgery.

    PubMed

    Lepelletier, D; Bourigault, C; Roussel, J C; Lasserre, C; Leclère, B; Corvec, S; Pattier, S; Lepoivre, T; Baron, O; Despins, P

    2013-10-01

    Deep sternal wound infection is the major infectious complication in patients undergoing cardiac surgery, associated with a high morbidity and mortality rate, and a longer hospital stay. The most common causative pathogen involved is Staphylococcus spp. The management of post sternotomy mediastinitis associates surgical revision and antimicrobial therapy with bactericidal activity in blood, soft tissues, and the sternum. The pre-, per-, and postoperative prevention strategies associate controlling the patient's risk factors (diabetes, obesity, respiratory insufficiency), preparing the patient's skin (body hair, preoperative showering, operating site antiseptic treatment), antimicrobial prophylaxis, environmental control of the operating room and medical devices, indications and adequacy of surgical techniques. Recently published scientific data prove the significant impact of decolonization in patients carrying nasal Staphylococcus aureus, on surgical site infection rate, after cardiac surgery.

  18. Surgical site infection in patients submitted to heart transplantation

    PubMed Central

    Rodrigues, Jussara Aparecida Souza do Nascimento; Ferretti-Rebustini, Renata Eloah de Lucena; Poveda, Vanessa de Brito

    2016-01-01

    Abstract Objectives: to analyze the occurrence and predisposing factors for surgical site infection in patients submitted to heart transplantation, evaluating the relationship between cases of infections and the variables related to the patient and the surgical procedure. Method: retrospective cohort study, with review of the medical records of patients older than 18 years submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. Results: the sample consisted of 86 patients, predominantly men, with severe systemic disease, submitted to extensive preoperative hospitalizations. Signs of surgical site infection were observed in 9.3% of transplanted patients, with five (62.5%) superficial incisional, two (25%) deep and one (12.5%) case of organ/space infection. There was no statistically significant association between the variables related to the patient and the surgery. Conclusion: there was no association between the studied variables and the cases of surgical site infection, possibly due to the small number of cases of infection observed in the sample investigated. PMID:27579924

  19. Yield and Depth of Burial Hydrodynamic Calculations in Granodiorite: Implications for the North Korean Test Site

    DTIC Science & Technology

    2011-09-01

    computational equation of state (EOS) for granite/ granodiorite and some examples of the models self-consistency. Our study focuses on the North...Yield and Depth of Burial Hydrodynamic Calculations in Granodiorite : Implications for the North Korean Test Site 5a. CONTRACT NUMBER 5b. GRANT...structure, and b) the improvement of the computational equation of state (EOS) for granite/ granodiorite and some examples of the models self-consistency

  20. Preventing surgical-site infections: measures other than antibiotics.

    PubMed

    Chauveaux, D

    2015-02-01

    Surgical-site infections (SSIs) due to intra-operative contamination are chiefly ascribable to airborne particles carrying microorganisms, mainly Staphylococcus aureus, which settle on the surgeon's hands and instruments. SSI prevention therefore rests on minimisation of airborne contaminated particle counts, although these have not been demonstrated to correlate significantly with SSI rates. Maintaining clear air in the operating room classically involves the use of ultra clean ventilation systems combining laminar airflow and high-efficiency particulate air filters to create a physical barrier around the surgical table; in addition to a stringent patient preparation protocol, appropriate equipment, and strict operating room discipline on the part of the surgeon and other staff members. SSI rates in clean surgery, although influenced by the type of procedure and by patient-related factors, are consistently very low, of about 1% to 2%. These low rates, together with the effectiveness of prophylactic antibiotic therapy and the multiplicity of parameters influencing the SSI risk, are major obstacles to the demonstration that a specific measure is effective in decreasing SSIs. As a result, controversy surrounds the usefulness of many measures, including laminar airflow, body exhaust suits, patient preparation techniques, and specific surgical instruments. Impeccable surgical technique and operating room behaviour, in contrast, are clearly essential.

  1. Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery

    PubMed Central

    Ahn, Soon-Hyun; Hong, Hyun Jun; Kwon, Soon Young; Kwon, Kee Hwan; Roh, Jong-Lyel; Ryu, Junsun; Park, Jun Hee; Baek, Seung-Kuk; Lee, Guk Haeng; Lee, Sei Young; Lee, Jin Choon; Chung, Man Ki; Joo, Young Hoon; Ji, Yong Bae; Hah, Jeong Hun; Kwon, Minsu; Park, Young Min; Song, Chang Myeon; Shin, Sung-Chan; Ryu, Chang Hwan; Lee, Doh Young; Lee, Young Chan; Chang, Jae Won; Jeong, Ha Min; Cho, Jae-Keun; Cha, Wonjae; Chun, Byung Joon; Choi, Ik Joon; Choi, Hyo Geun; Lee, Kang Dae

    2017-01-01

    Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers. PMID:28043099

  2. [Penal liability from retained foreign body inside the surgical site].

    PubMed

    Angiò, L G; Ventura Spagnolo, E; Pirrone, G; Cardia, G

    2011-03-01

    The Authors focus on the liability of the surgery team members in the case they inadvertently forget behind in the patient's body a foreign object, which causes injuries and/or death. The Authors underline that, according to the current case law regarding medical malpractice, both the main surgeon and their assistant/subordinate are liable for engaging in a markedly imprudent and/or negligent conduct, such as not double-checking scrupulously the surgical site before its closure in order to highlight forgotten foreign bodies. As well, the Authors underline that either the circulator nurse or the theatre nurse can be considered punishable by law when that medical error occurs, even if they are responsible for the count of the instruments used in the course of the surgery. Conversely, the main surgeon and his or her assistant are always directly responsible, due to the fact that the nurses' count procedure represents merely an additional control measure, without substituting at all the check the surgeons must obligatory conduct on the surgical site. Finally, the Authors point out that, as the count procedure is performed by the members of a surgical team, where a hierarchy-based relationship rules, the main surgeon is the liable for any preventable and avoidable adverse event provoked by the nursing staff as a consequence of the objective responsibility due to culpa in eligendo and culpa in vigilando.

  3. [Cause and prevention of surgical site infection and hypertrophic scars].

    PubMed

    Ogawa, Rei

    2012-03-01

    Surgical site infection (SSI) occurs at the site of surgery within 1 month of an operation or within 1 year of an operation if a foreign body is implanted as part of the surgery. Most SSIs (about 70%) are superficial infections involving the skin and subcutaneous tissues only. The remaining infections are more serious and can involve tissues under the skin, organs, or implanted material. Hypertrophic scars( HSs) occur frequently on particular sites, including the anterior chest wall. The anterior chest wall is frequently subjected to skin stretching caused by the natural daily movements of the body. Most cases of SSIs and HSs can be prevented by (1) suture technique modification to prevent high stretching tension and ischemia, and (2) appropriate wound care after surgery. It would be useful to avoid subjecting wounded skin to sustained mechanical force, thereby permitting the wound to rest and heal normally.

  4. Factors predicting surgical site infection after posterior lumbar surgery

    PubMed Central

    Wang, Tao; Wang, Hui; Yang, Da-Long; Jiang, Li-Qiang; Zhang, Li-Jun; Ding, Wen-Yuan

    2017-01-01

    Abstract This is a retrospective study. The purpose of this study is to explore incidence and risk factors for surgical site infection (SSI) after posterior lumbar surgery. SSI is a common complication after posterior lumbar surgery, bringing mental and physical pain and prolonging hospital stay. However, predisposing factors, as reported less, remain controversial. Patients who underwent posterior lumbar surgery at 3 centers between 2006 and 2016 were included. The possible factors include 3 aspects: demographic variables-age, sex, body mass index (BMI), waist-to-hip radio (WHR), hypertension, diabetes, heart disease, smoking, drinking, steroidal injection, surgical time between June and September, preoperative shower; blood test variables-white blood cell (WBC), neutrophil, red blood cell (RBC), hemoglobin (Hb), total protein (TP), albumin, albumin/globulin (A/G), C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and surgical related variables-operation time, blood loss, operative level, instrumentation, incision length. Factors related with SSI were also performed by multivariate analysis. The prevalence of SSI was 3.00% (267 cases of 8879) had a postoperative wound infection. There were significant difference in WHR (0.92 vs 0.83), WBC (4.31 vs 6.69), TP (58.7 vs 65.2), albumin (36.9 vs 43.2), CRP (2.01 vs 0.57), PCT (0.097 vs 0.067), operation time (217.9 vs 195.7), blood loss (997.1 vs 915.3) and operative level (3.05 vs 2.45) and incision length (24.1 vs 20.0) between SSI group and non-SSI group. >60 years old, female, BMI <18.5 and >30.0, diabetes, male smoking, preoperative steroidal injection, surgical time between June and September, no preoperative shower, instrumentation surgery were risk factors for SSI after posterior lumbar surgery. Many factors, >60 years old, female, BMI, WHR, diabetes, male smoking, preoperative steroidal injection, surgical time between June and September, preoperative shower, WBC, TP, albumin

  5. Risk Factors for Surgical Site Infection Following Major Breast Surgery

    PubMed Central

    Olsen, Margaret A.; Lefta, Mellani; Dietz, Jill R.; Brandt, Keith E.; Aft, Rebecca; Matthews, Ryan; Mayfield, Jennie; Fraser, Victoria J.

    2012-01-01

    Background Surgical site infections following breast surgery result in increased length of hospital stay, antibiotic utilization, and morbidity. Understanding SSI risk factors is essential to develop infection prevention strategies and improve surgical outcomes. Methods A retrospective case-control design was used to determine independent risk factors for surgical site infection in subjects selected from a cohort of patients who had mastectomy, breast reconstruction or reduction surgery between January 1998 and June 2002 at a tertiary-care university affiliated hospital. SSI cases within 1 year after surgery were identified using ICD-9-CM diagnosis codes for wound infection or complication and/or positive wound cultures. The medical records of 57 case patients with breast SSI and 268 randomly selected uninfected control patients were reviewed. Multivariate logistic regression was used to identify independent risk factors for SSI. Results During the 4.5-year study period, 57 patients developed SSIs involving a breast incision and 10 patients developed SSIs involving a donor site incision. Significant independent risk factors for SSI involving the breast incision included insertion of a breast implant or tissue expander (odds ratio (OR) 5.3, 95% confidence interval (CI):2.5–11.1), suboptimal prophylactic antibiotic dosing (OR 5.1, 95% CI: 2.5–0.2 ), transfusion (OR 3.4, 95% CI: 1.3–9.0), mastectomy (OR 3.3, 95% CI: 1.4–7.7), previous chest irradiation (OR 2.8, 95% CI: 1.2–6.5), and current or recent smoking (OR 2.1, 95% CI: 0.9–4.9). Local infiltration of an anesthetic agent was associated with significantly reduced risk of SSI (OR 0.4, 95% CI: 0.1–0.9). Conclusions Suboptimal prophylactic antibiotic dosing is a potentially modifiable risk factor for SSI following breast surgery. Risk of SSI was increased in patients undergoing mastectomy and in patients who had an implant or tissue expander placed during surgery. Knowledge of these risk factors can be

  6. 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

  7. 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…

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

    PubMed

    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. 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

  10. The Effects of Local Warming on Surgical Site Infection

    PubMed Central

    Dellinger, E. Patchen; Weber, James; Swenson, Ron Edward; Kent, Christopher D.; Swanson, Paul E.; Harmon, Kurt; Perrin, Margot

    2015-01-01

    Abstract Background: Surgical site infections (SSI) account for a major proportion of hospital-acquired infections. They are associated with longer hospital stay, readmissions, increased costs, mortality, and morbidity. Reducing SSI is a goal of the Surgical Care Improvement Project and identifying interventions that reduce SSI effectively is of interest. In a single-blinded randomized controlled trial (RCT) we evaluated the effect of localized warming applied to surgical incisions on SSI development and selected cellular (immune, endothelial) and tissue responses (oxygenation, collagen). Methods: After Institutional Review Board approval and consent, patients having open bariatric, colon, or gynecologic-oncologic related operations were enrolled and randomly assigned to local incision warming (6 post-operative treatments) or non-warming. A prototype surgical bandage was used for all patients. The study protocol included intra-operative warming to maintain core temperature ≥36°C and administration of 0.80 FIO2. Patients were followed for 6 wks for the primary outcome of SSI determined by U.S. Centers for Disease Control (CDC) criteria and ASEPSIS scores (additional treatment; presence of serous discharge, erythema, purulent exudate, and separation of the deep tissues; isolation of bacteria; and duration of inpatient stay). Tissue oxygen (PscO2) and samples for cellular analyses were obtained using subcutaneous polytetrafluoroethylene (ePTFE) tubes and oxygen micro-electrodes implanted adjacent to the incision. Cellular and tissue ePTFE samples were evaluated using flow cytometry, immunohistochemistry, and Sircol™ collagen assay (Biocolor Ltd., Carrickfergus, United Kingdom). Results: One hundred forty-six patients participated (n=73 per group). Study groups were similar on demographic parameters and for intra-operative management factors. The CDC defined rate of SSI was 18%; occurrence of SSI between groups did not differ (p=0.27). At 2 wks, warmed

  11. Surgical Site Infection by Methicillin Resistant Staphylococcus aureus– on Decline?

    PubMed Central

    Bhattacharya, Susmita; Jain, Sonia; Chatterjee, Shiv Sekhar; Konar, Jayashree

    2016-01-01

    Introduction Surgical Site Infection (SSI) is the most common healthcare associated infection that could be averted by antibiotics prophylaxis against the probable offending organisms. As Staphylococcus aureus has been playing a substantial role in the aetiology of SSIs, Methicillin Resistant Staphylococcus aureus (MRSA) happens to be a problem while dealing with the postoperative wound infection. Aim To determine the prevalence of SSI caused by MRSA and the antibiotic sensitivity pattern of MRSA. Materials and Methods A cross-sectional study was conducted at Nil Ratan Sircar Medical College, Kolkata, West Bengal from July 2009 to December 2012. A total of 19,359 surgical procedures were done of which 3003 culture positive SSIs have been documented. The clinical samples were collected from patients of both sexes and all ages suspected to be suffering from SSI from different specialities. Samples were processed according to CLSI, 2007 guidelines. The isolated strains of Staphylococcus aureus were screened for MRSA by detection of resistance to Cefoxitin disc (zone of inhibition was ≤21 mm) and slidex staph latex agglutination tests were done on cefoxitin resistant strains to spot phenotypic expression of mec A gene. Then PCR was performed for detection of mecA gene. Antibiotic sensitivity test was done following Kirby Bauer technique. Results In this 3½ year study, 1049 Staphylococcus aureus (34.93%) were reported from 3003 cases of SSI followed by Escherichia coli (20.34%), Klebsiella spp. (18.08%), Pseudomonas spp. (7.99%), Acinetobacter spp. (7.49%) respectively. Among the Staphylococcus aureus, 267 strains were derived as MRSA (25.45%). MRSA were isolated from 167 (62.54%) male patients and 100 (37.45%) female patients having surgical site infections. Inpatients and outpatients distribution of MRSA were 235 (88.01%) and 32 (11.98%) respectively. Majority of the MRSA cases were reported from Surgery (12.49%) and Orthopaedics (11.85%) departments in the age

  12. Surgical Site Infection Complicating Breast Cancer Surgery in Kuwait

    PubMed Central

    Omar, Abeer A.; Al-Mousa, Haifaa H.

    2013-01-01

    Background and Objectives. Surgical site infection (SSI) is the most common postoperative complication associated with breast cancer surgery. The present investigation aimed to determine the SSI rate after breast cancer surgeries and the causative microorganisms. Patients and Methods. All patients who underwent breast surgery in Kuwait Cancer Control Center as a treatment for breast cancer from January 2009–December 2010 were prospectively followed for the development of SSI. Indirect detection was used to identify SSIs through medical record to review and discussion with the treating surgeons. Results. The number of operations was 438. Females represented 434 (99.1%) cases while males constituted only 4 (0.9%) cases. SSIs were diagnosed after 10 operations, all for female cases. Most of the SSIs (8 cases; 80%) were detected after patients were discharged, during outpatient followup. Out of those 5/8; (62.5%) were readmitted for management of SSI. Nine patients (90%) received systemic antibiotic therapy for management of their wound infection. The SSI rate was 2.3%. The main causative organism was Staphylococcus aureus (S. aureus) which was responsible for 40% of infections. Gram negative bacteria were isolated from 40% of the cases. Conclusion. SSI is an important complication following breast cancer surgery. Microbiological diagnosis is an essential tool for proper management of such patients. PMID:24967132

  13. Surgical site infection and prevention guidelines: a primer for Certified Registered Nurse Anesthetists.

    PubMed

    Diaz, Valerie; Newman, Johanna

    2015-02-01

    Each year 500,000 surgical site infections occur in the US. Surgical site infections are the second most common healthcare-associated infections resulting in readmissions, prolonged hospital stays, higher medical costs, and increased morbidity and mortality. Surgical site infections are preventable in most cases by following evidence-based guidelines for hand hygiene, administration of prophylactic antibiotics, and perioperative patient temperature management. As attention to issues of healthcare quality heightens, the demands for positive surgical patient outcomes are intensifying. The Certified Registered Nurse Anesthetist can provide transparent high-quality care by implementing evidence-based guidelines for timely and appropriate antibiotic use, maintenance of normothermia, and hand washing.

  14. Surgical site infections in breast surgery: case-control study.

    PubMed

    Vilar-Compte, Diana; Jacquemin, Benedicte; Robles-Vidal, Carlos; Volkow, Patricia

    2004-03-01

    The purpose of this study was to estimate the frequency of surgical site infections (SSIs) and identify associated risk factors for each type of breast surgery at a cancer hospital. We used a nested case-control design. Between February 1, 2000 and July 31, 2000, all breast surgeries performed were recorded on a daily basis. After hospital discharge, we evaluated patients simultaneously with surgeons three times a week for 30 days or longer. The odds ratio (OR) was estimated using logistic regression analysis. The study followed 280 patients (298 wounds). Altogether, 77 SSIs were detected, for an overall SSI rate of 25.8% (77/298). For excisions, conservative surgery, and radical mastectomies the SSI rates were 1.4%, 18.0%, and 38.3%, respectively. Excisions were excluded ( n = 68) for risk factor analysis. After multivariate analysis, risk factors associated with SSIs were obesity [OR 2.5, 95% confidence interval (CI) 1.2-4.3], concomitant chemotherapy and radiation (OR 2.3, 95% CI 1.2-4.3), radical surgery (OR 3.1, 95% CI 1.1-8.6), insertion of a second drain during the late postoperative period (OR 3.7, 95% CI 1.8-7.8), and drainage duration > or = 19 days (OR 2.9, 95% CI 1.5-5.6). The bacteria most frequently isolated were Pseudomonas aeruginosa ( n = 18 ), Serratia sp. ( n = 18), Staphylococcus aureus ( n = 10), and Staphylococcus epidermidis ( n = 10). Poor compliance with infection control practices and wound management was detected throughout the study period. The overall frequency of SSIs for mastectomies was higher than the reported rates, which was principally related to the more radical surgery required for advanced-stage disease, preoperative irradiation, and inadequate wound and drain care.

  15. Does Minimally Invasive Spine Surgery Minimize Surgical Site Infections?

    PubMed Central

    Patel, Ravish Shammi; Dutta, Shumayou

    2016-01-01

    Study Design Retrospective review of prospectively collected data. Purpose To evaluate the incidence of surgical site infections (SSIs) in minimally invasive spine surgery (MISS) in a cohort of patients and compare with available historical data on SSI in open spinal surgery cohorts, and to evaluate additional direct costs incurred due to SSI. Overview of Literature SSI can lead to prolonged antibiotic therapy, extended hospitalization, repeated operations, and implant removal. Small incisions and minimal dissection intrinsic to MISS may minimize the risk of postoperative infections. However, there is a dearth of literature on infections after MISS and their additional direct financial implications. Methods All patients from January 2007 to January 2015 undergoing posterior spinal surgery with tubular retractor system and microscope in our institution were included. The procedures performed included tubular discectomies, tubular decompressions for spinal stenosis and minimal invasive transforaminal lumbar interbody fusion (TLIF). The incidence of postoperative SSI was calculated and compared to the range of cited SSI rates from published studies. Direct costs were calculated from medical billing for index cases and for patients with SSI. Results A total of 1,043 patients underwent 763 noninstrumented surgeries (discectomies, decompressions) and 280 instrumented (TLIF) procedures. The mean age was 52.2 years with male:female ratio of 1.08:1. Three infections were encountered with fusion surgeries (mean detection time, 7 days). All three required wound wash and debridement with one patient requiring unilateral implant removal. Additional direct cost due to infection was $2,678 per 100 MISS-TLIF. SSI increased hospital expenditure per patient 1.5-fold after instrumented MISS. Conclusions Overall infection rate after MISS was 0.29%, with SSI rate of 0% in non-instrumented MISS and 1.07% with instrumented MISS. MISS can markedly reduce the SSI rate and can be an

  16. 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. PMID:27579234

  17. Prophylactic Antibiotic Choice and Risk of Surgical Site Infection After Hysterectomy

    PubMed Central

    Uppal, Shitanshu; Harris, John; Al-Niaimi, Ahmed; Swenson, Carolyn W.; Pearlman, Mark D.; Reynolds, R. Kevin; Kamdar, Neil; Bazzi, Ali; Campbell, Darrell A.; Morgan, Daniel M.

    2016-01-01

    OBJECTIVE To evaluate associations between prophylactic preoperative antibiotic choice and surgical site infection rates after hysterectomy. METHODS A retrospective cohort study was performed of patients in the Michigan Surgical Quality Collaborative undergoing hysterectomy from July 2012 to February 2015. The primary outcome was a composite outcome of any surgical site infection (superficial surgical site infections or combined deep–organ space surgical site infections). Preoperative antibiotics were categorized based on the recommendations set forth by the American College of Obstetricians and Gynecologists and the Surgical Care Improvement Project. Patients receiving a recommended antibiotic regimen were categorized into those receiving beta-lactam antibiotics and those receiving alternatives to beta-lactam antibiotics. Patients receiving non-recommended antibiotics were categorized into those receiving overtreatment (excluded from further analysis) and those receiving non-standard antibiotics. Multivariable logistic regression models were developed to estimate the independent effect of antibiotic choice. Propensity score matching analysis was performed to validate the results. RESULTS The study included 21,358 hysterectomies. The overall rate of any surgical site infection’ was 2.06% (N=441). Unadjusted rates of ‘any surgical site infection’ were 1.8%, 3.1% and 3.7% for beta-lactam, beta-lactam alternatives and non-standard groups, respectively. After adjusting for patient and operative factors within clusters of hospitals, compared to the beta-lactam antibiotics (reference group), the risk of ‘any surgical site infection’ was higher for the group receiving beta-lactam alternatives (OR 1.7, CI 1.27–2.07) or the non-standard antibiotics (OR 2.0, CI 1.31–3.1). CONCLUSION Compared to women receiving beta lactam antibiotic regimens, there is a higher risk of surgical site infection after hysterectomy among those receiving a recommended beta lactam

  18. Prevalence and Characteristics of Surgical Site Infections Caused by Gram-negative Rod-shaped Bacteria from the Family Enterobacteriacae and Gram-positive Cocci from the Genus Staphylococcus in Patients who Underwent Surgical Procedures on Selected Surgical Wards.

    PubMed

    Tomaszewska-Kowalska, Małgorzata; Kołomecki, Krzysztof; Wieloch-Torzecka, Maria

    2016-10-01

    Surgical site infections on surgical wards are the most common cause of postoperative complications. Prevalence of surgical site infections depends on the surgical specialization. Analysis of the causes of surgical site infections allows to conclude that microorganisms from the patient's own microbiota - Gram-negative rod-shaped bacteria from the family Enterobacteriacae and from the patient's skin microbiota - Gram-positive cocci - Staphylococcus are the most common agents inducing surgical site infections. The aim of the study was to assess prevalence and characteristics of surgical site infections caused by Gram-negative rod-shaped bacteria from the family Eneterobacteriacae and Gram-positive cocci from the genus Staphylococcus in patients who underwent surgical procedures at the Regional Specialist Hospital named after M. Copernika in Łódź on selected surgical wards.

  19. 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.

  20. 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.

  1. Identification of potential surgical site infections leveraging an enterprise clinical information warehouse.

    PubMed

    Santangelo, Jennifer; Erdal, Selnur; Wellington, Linda; Mekhjian, Hagop; Kamal, Jyoti

    2008-11-06

    At The Ohio State University Medical Center (OSUMC), infection control practitioners (ICPs) need an accurate list of patients undergoing defined operative procedures to track surgical site infections. Using data from the OSUMC Information Warehouse (IW), we have created an automated report detailing required data. This report also displays associated surgical and pathology text or dictated reports providing additional information to the ICPs.

  2. Surgical site infection after cardiac surgery: a simplified surveillance method.

    PubMed

    Lucet, Jean-Christophe

    2006-12-01

    We report the results of a 2-year, 7-center program of surveillance of deep sternal wound infection (DSWI) after cardiac surgery. DSWI was defined as the need for reoperation. Stratification data were abstracted from computerized files. The incidence of DSWI was 2.2% (198 of 8,816 cardiac surgery procedures). The risk factors identified were obesity, age, coronary artery bypass grafting, postoperative mechanical ventilation, and early surgical reexploration. The resource efficiency of this simplified surveillance method is discussed.

  3. The RN first assistant: an expert resource for surgical site infection prevention.

    PubMed

    Pear, Suzanne M; Williamson, Theresa H

    2009-06-01

    The role of the RN first assistant (RNFA) has expanded and evolved during the past three decades. Studies that have examined patient care outcomes relative to RNFAs substituting for surgeons as first assistants have noted no resulting adverse consequences, and the use of RNFAs in surgery may improve patient outcomes. This article reports on an intervention to improve surgical outcomes in patients undergoing cardiac surgery that involved replacing surgical residents with RNFAs for the harvesting of saphenous vein grafts. The resulting benefits were a significant decrease in surgical times as well as improvement in surgical site infection rates.

  4. Do antibiotics reduce the frequency of surgical site infections after impacted mandibular third molar surgery?

    PubMed

    Susarla, Srinivas M; Sharaf, Basel; Dodson, Thomas B

    2011-11-01

    Surgical removal of impacted third molars remains the most common procedure performed by oral and maxillofacial surgeons. Given the abundance of host bacteria within the operative sites, surgical site infections are among the most common complications of third molar removal, with an estimated frequency of 1% to 30%. In this setting, significant controversy has surrounded the use of prophylactic antibiotics in the surgical management of impacted third molars. This article provides a comprehensive review of the available data on antibiotic prophylaxis in impacted third molar surgery and offers specific recommendations on antibiotic use.

  5. Does close temperature regulation affect surgical site infection rates?

    PubMed

    Leeds, Ira L; Wick, Elizabeth C; Melton, Genevieve B

    2014-01-01

    The argument for close temperature control, to which regulatory bodies have held health systems in an effort to reduce the burden of hospital-acquired infections, is not fully supported by current evidence. The literature is complex on the topic, and overinterpretation of historical data supporting close temperature regulation does not preclude an important recognition of these early works' contribution to high-quality surgical care. Avoidance of hypothermia through the regular use of active rewarming should be a routine part of safe surgical care. The biochemical basis of emphasizing temperature regulation is sound, and ample evidence shows the frank physiologic derangements seen when biological processes occur at suboptimal temperature. It is also recognized that patients tend to do better when warmed during the perioperative period, suggesting that warming devices are an important and essential adjunct to good perioperative care. Clinicians, researchers, and policymakers must be careful in how they apply these well-supported findings to process metrics in an era of limited resources with increasingly stringent quality guidelines and outcomes measures. Discrete temperature targets in current measures are not supported by the existing literature. Not only do these targets artificially anchor clinicians to temperature values with an inadequate scientific basis but they demand intensive resources from health institutions that could potentially be better used on quality requirements with stronger evidence of their ultimate effect on patient care.

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

    PubMed

    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.

  7. 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.

  8. Forced-Air Warmers and Surgical Site Infections in Patients Undergoing Knee or Hip Arthroplasty.

    PubMed

    Austin, Paul N

    2017-01-01

    The majority of the evidence indicates preventing inadvertent perioperative hypothermia reduces the incidence of many perioperative complications. Among the results of inadvertent perioperative hypothermia are increased bleeding, myocardial events, impaired wound healing, and diminished renal function. Most researchers agree there is an increased incidence of surgical site infections in patients who experience inadvertent perioperative hypothermia. Forced-air warming is effective in preventing inadvertent perioperative hypothermia. Paradoxically, forced-air warmers have been implicated in causing surgical site infections in patients undergoing total knee or hip arthroplasty. The results of investigations suggest these devices harbor pathogens and cause unwanted airflow disturbances. However, no significant increases in bacterial counts were found when forced-air warmers were used according to the manufacturer's directions. The results of one study suggested the incidence of surgical site infections in patients undergoing total joint arthroplasty was increased when using a forced-air warmer. However these researchers did not control for other factors affecting the incidence of surgical site infections in these patients. Current evidence does not support forced-air warmers causing surgical site infections in patients undergoing total knee or hip arthroplasty. Clinicians must use and maintain these devices as per the manufacturer's directions. They may consider using alternative warming methods. Well-conducted studies are needed to help determine the role of forced-air warmers in causing infections in these patients.

  9. Outcomes in head and neck reconstruction by surgical site and donor site

    PubMed Central

    Frederick, JW; Sweeny, L; Carroll, WR; Peters, GE; Rosenthal, EL

    2012-01-01

    Objective Define surgical outcomes of specific donor sites for free tissue transfer in head and neck reconstruction. Design Retrospective cohort review Setting Academic tertiary care center. Patients A review of free tissue transfer procedures performed at a university-based tertiary care facility from October 2004 to April 2011. A total of 1051 patients underwent 6 types of free flaps: fasciocutaneous radial forearm (53%), osteocutaneous radial forearm (16%), rectus abdominus (11%), fibula (10%), anterior lateral thigh (7%), and latissimus dorsi (2%). Main Outcome Measures Demographic data was collected and outcomes measured were: length of hospital stay, flap viability, and major complications (infection, fistula, and hematoma). Results Of the 1051 flaps performed, the most common operative site was oral cavity (40% n=414) followed by hypopharynx/larynx (22%, n=234), cutaneous (20%, n=206), oropharynx (9%, n= 98), mid-face (7%, n= 76), and skull base (2%, n=23). The median hospital stay was 7.9 days (range 1-76) and the overall failure rate was 2.8%. Cutaneous defects required the shortest length of hospitalization (5.8 days, P< .0001), a low free flap failure rate (1.5%, n= 3), and limited major complications (6%, n= 12). Conversely, oropharynx defects were associated with the longest hospitalization (8.9 days). While midface defects had a high incidence of complications (15%, n= 11, P=.10). Defects above the angle of the mandible had higher overall complications when compared to below. Similarly, reconstruction for primary or recurrent cancer had a total failure rate of 2.5% while secondary reconstruction and radionecrosis had a failure rate of 4.0% (P=.29). Additionally, there was no statistical difference between outcomes based on donor site. Conclusions This review demonstrates that certain subsets of patients are at higher risk for complications after free tissue transfer. Patients undergoing free flap reconstruction for cutaneous defects have substantially

  10. Infection prevention and control in the operating theatre: reducing the risk of surgical site infections (SSIs).

    PubMed

    Weaving, Paul; Cox, Felicia; Milton, Sherran

    2008-05-01

    Continuing advances in surgical techniques, asepsis, operating theatre protocols and ventilation systems that ensure an uninterrupted supply of clean air, should allow all patients to undergo both invasive and minimally-invasive procedures with reduced risk. Patients having surgery in the United Kingdom are probably less vulnerable to surgical site infections (SSIs) than ever before--despite persisting concerns about meticillin-resistant Staphylococcus aureus (MRSA) and increasing antibiotic resistance in other organisms such as vancomycin-resistant Enterococci (VRE).

  11. Surgical Outcomes of Balanced Deep Lateral and Medial Orbital Wall Decompression in Korean Population: Clinical and Computed Tomography-based Analysis

    PubMed Central

    Choi, Sang Uk; Kim, Kyoung Woo

    2016-01-01

    Purpose To evaluate the clinical outcomes of balanced deep lateral and medial orbital wall decompression and to estimate surgical effects using computed tomography (CT) images in Korean patients with thyroid-associated ophthalmopathy (TAO). Methods Retrospective chart review was conducted in TAO patients with exophthalmos who underwent balanced deep lateral and medial orbital wall decompression. Exophthalmos was measured preoperatively and postoperatively at 1 and 3 months. Postoperative complications were evaluated in all study periods. In addition, decompressed bone volume was estimated using CT images. Thereafter, decompression volume in each decompressed orbital wall was analyzed to evaluate the surgical effect and predictability. Results Twenty-four patients (48 orbits) with an average age of 34.08 ± 7.03 years were evaluated. The mean preoperative and postoperative exophthalmos at 1 and 3 months was 18.91 ± 1.43, 15.10 ± 1.53, and 14.91 ± 1.49 mm, respectively. Bony decompression volume was 0.80 ± 0.29 cm3 at the medial wall and 0.68 ± 0.23 cm3 at the deep lateral wall. Postoperative complications included strabismus (one patient, 2.08%), upper eyelid fold change (four patients, 8.33%), and dysesthesia (four patients, 8.33%). Postsurgical exophthalmos reduction was more highly correlated with the deep lateral wall than the medial wall. Conclusions In TAO patients with exophthalmos, balanced deep lateral and medial orbital wall decompression is a good surgical method with a low-risk of complications. In addition, deep lateral wall decompression has higher surgical predictability than medial wall decompression, as seen with CT analysis. PMID:27051255

  12. [Prevention of surgical site infection in abdominal surgery. A critical review of the evidence].

    PubMed

    Ruiz Tovar, Jaime; Badia, Josep M

    2014-04-01

    Surgical site infection (SSI) is associated with prolonged hospital stay, increased morbidity, mortality and sanitary costs, and reduced patients quality of life. Many hospitals have adopted guidelines of scientifically-validated processes for prevention of surgical site and central-line catheter infections and sepsis. Most of these guidelines have resulted in an improvement in postoperative results. A review of the best available evidence on these measures in abdominal surgery is presented. The best measures are: avoidance of hair removal from the surgical field, skin decontamination with alcoholic antiseptic, correct use of antibiotic prophylaxis (administration within 30-60 min before incision, use of 1(st) or 2(nd) generation cephalosporins, single preoperative dosis, dosage adjustments based on body weight and renal function, intraoperative re-dosing if the duration of the procedure exceeds 2 half-lives of the drug or there is excessive blood loss), prevention of hypothermia, control of perioperative glucose levels, avoid blood transfusion and restrict intraoperative liquid infusion.

  13. Predictors and costs of surgical site infections in patients with endometrial cancer☆,☆☆

    PubMed Central

    Bakkum-Gamez, Jamie N.; Dowdy, Sean C.; Borah, Bijan J.; Haas, Lindsey R.; Mariani, Andrea; Martin, Janice R.; Weaver, Amy L.; McGree, Michaela E.; Cliby, William A.; Podratz, Karl C.

    2014-01-01

    Objective Technological advances in surgical management of endometrial cancer (EC) may allow for novel risk modification in surgical site infection (SSI). Methods Perioperative variables were abstracted from EC cases surgically staged between January 1, 1999, and December 31, 2008. Primary outcome was SSI, as defined by American College of Surgeons National Surgical Quality Improvement Program. Counseling and global models were built to assess perioperative predictors of superficial incisional SSI and organ/space SSI. Thirty-day cost of SSI was calculated. Results Among 1369 EC patients, 136 (9.9%) had SSI. In the counseling model, significant predictors of superficial incisional SSI were obesity, American Society of Anesthesiologists (ASA) score >2, preoperative anemia (hematocrit <36%), and laparotomy. In the global model, significant predictors of superficial incisional SSI were obesity, ASA score >2, smoking, laparotomy, and intraoperative transfusion. Counseling model predictors of organ/space SSI were older age, smoking, preoperative glucose >110 mg/dL, and prior methicillin-resistant Staphylococcus aureus (MRSA) infection. Global predictors of organ/space SSI were older age, smoking, vascular disease, prior MRSA infection, greater estimated blood loss, and lymphadenectomy or bowel resection. SSI resulted in a $5447 median increase in 30-day cost. Conclusions Our findings are useful to individualize preoperative risk counseling. Hyperglycemia and smoking are modifiable, and minimally invasive surgical approaches should be the preferred surgical route because they decrease SSI events. Judicious use of lymphadenectomy may decrease SSI. Thirty-day postoperative costs are considerably increased when SSI occurs. PMID:23558053

  14. 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

  15. Surgical Site Infiltration for Abdominal Surgery: A Novel Neuroanatomical-based Approach

    PubMed Central

    Janis, Jeffrey E.; Haas, Eric M.; Ramshaw, Bruce J.; Nihira, Mikio A.; Dunkin, Brian J.

    2016-01-01

    Background: Provision of optimal postoperative analgesia should facilitate postoperative ambulation and rehabilitation. An optimal multimodal analgesia technique would include the use of nonopioid analgesics, including local/regional analgesic techniques such as surgical site local anesthetic infiltration. This article presents a novel approach to surgical site infiltration techniques for abdominal surgery based upon neuroanatomy. Methods: Literature searches were conducted for studies reporting the neuroanatomical sources of pain after abdominal surgery. Also, studies identified by preceding search were reviewed for relevant publications and manually retrieved. Results: Based on neuroanatomy, an optimal surgical site infiltration technique would consist of systematic, extensive, meticulous administration of local anesthetic into the peritoneum (or preperitoneum), subfascial, and subdermal tissue planes. The volume of local anesthetic would depend on the size of the incision such that 1 to 1.5 mL is injected every 1 to 2 cm of surgical incision per layer. It is best to infiltrate with a 22-gauge, 1.5-inch needle. The needle is inserted approximately 0.5 to 1 cm into the tissue plane, and local anesthetic solution is injected while slowly withdrawing the needle, which should reduce the risk of intravascular injection. Conclusions: Meticulous, systematic, and extensive surgical site local anesthetic infiltration in the various tissue planes including the peritoneal, musculofascial, and subdermal tissues, where pain foci originate, provides excellent postoperative pain relief. This approach should be combined with use of other nonopioid analgesics with opioids reserved for rescue. Further well-designed studies are necessary to assess the analgesic efficacy of the proposed infiltration technique. PMID:28293525

  16. 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

  17. 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

  18. Diabetes and Risk of Surgical Site Infection: A Systematic Review and Meta-analysis.

    PubMed

    Martin, Emily T; 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 surgical site infection (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). A 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 odds ratio (OR)=1.53 (95% predictive interval [PI], 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% PI, 1.13-4.05) compared with surgeries of other types (P=.001). CONCLUSIONS 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. Infect. Control Hosp. Epidemiol. 2015;37(1):88-99.

  19. Test performance of a local examination at a nonlocal site for evaluation of surgical clerks.

    PubMed

    Dunnington, G; Witzke, D; Hassett, J; Reisner, L; Fulginiti, J; Rubeck, R

    1990-08-01

    Surgical clerkships frequently use locally prepared examinations or nationally available test item banks as an alternative to Surgery Shelf Examinations from the National Board of Medical Examiners (SSNBME) for student evaluation. This study examines performance of a well-designed, item-analyzed local examination (available nationally through the Association for Surgical Education) at a nonlocal site. A 100-item test with a stratified sample from a 442-item bank was administered to 72 third-year students in addition to the SSNBME. The Pearson product moment correlation coefficient between the two examinations was 0.61 (p less than 0.001). Test performance between the local site and nonlocal site was compared by the Kuder-Richardson formula 20 for subtest reliability (internal consistency) and difficulty index (percent correct responses) and the point biserial correlation coefficient (correlation of a student's performance on one item with performance on the rest of the items) for test item analysis. Data show that despite fair correlation with SSNBME, significant deteriorations in both test item performance and reliability occur with the use of a local examination at a nonlocal site. This likely results from problems with content validity at the nonlocal site. Clerkships that use local examinations or national test bank items are strongly advised to evaluate test performance and revise appropriately before using results for formal student evaluation.

  20. The creation and evaluation of an ambulatory orthopedic surgical patient education web site to support empowerment.

    PubMed

    Heikkinen, Katja; Suomi, Reima; Jääskeläinen, Miika; Kaljonen, Anne; Leino-Kilpi, Helena; Salanterä, Sanna

    2010-01-01

    The use and evaluation of Web sites in ambulatory surgery patients' education are rare; hence, innovative approaches to educate these patients should be adopted and evaluated. The aim of this study was to describe the creation of and evaluate the utility and usability of an ambulatory orthopedic surgical patient education Web site. A descriptive study design was used. The evaluators were 72 ambulatory orthopedic surgery patients receiving education through a Web site. The data were collected after education preoperatively and 2 weeks postoperatively. Two instruments were used: "Patients' Evaluation of Education" and "Diary of the Use of the Website." Web site evaluators' scores for utility of the Web site ranged from 57.56 to 87.87 of 100. Utility of the Web site evaluations was significantly higher (P < .05) 2 weeks postoperatively than immediately after the operation. Web site evaluators' scores for usability of the Web site ranged from 85.69 to 88.32. The use of this program as educational material for orthopedic surgery patients was supported by the patients' opinions of the usability and utility of the Web site.

  1. Prevention of wrong-site and wrong-patient surgical errors.

    PubMed

    2013-01-01

    Surgical errors recorded between 2002 and 2008 in a US medical liability insurance database have been analysed. Twenty-five wrong-patient procedures were recorded, resulting in 5 serious adverse events: three unnecessary prostatectomies were performed after prostate biopsy samples were mislabelled; vitrectomy was performed on the wrong patient in an ophthalmology department after confusion between two patients with identical names; and a child scheduled for adenoidectomy received a tympanic drain. There were also 107 wrong-site procedures, with one death resulting from implantation of a pleural drain on the wrong side. Another 38 patients experienced significant harm: 5 patients had surgery on the wrong vertebrae; 4 had chest tubes placed on the wrong side; 4 underwent vascular surgery at the wrong site; and 4 underwent resection of the wrong segment of the intestine. In addition, there were: 4 organ resection errors; 6 wrong-site or wrong-sided limb surgeries; 2 wrong-sided ovariectomies; 2 wrong-sided eye operations; 2 wrong-sided craniotomies; 2 wrong-sided ureteric procedures; 1 wrong-sided maxillofacial operation; and 2 radiation therapy field errors. Most errors were due to poor communication, incorrect diagnosis, or failure to implement a final set of preoperative checks. Other studies conducted in the United Kingdom and the United States have provided similar results, while data are lacking in France. The World Health Organization Surgical Safety Checklist is an effective way of preventing such errors but its adoption by healthcare professionals is variable. In practice, surgical errors involving the wrong patient or wrong body site are preventable. Final pre-operative checks must be applied methodically and systematically.This includes asking the patient to confirm his/her identity and the intended site of the operation. Healthcare staff must be aware of these measures.

  2. Data Management and Site-Visit Monitoring of the Multi-Center Registry in the Korean Neonatal Network

    PubMed Central

    Choi, Chang Won

    2015-01-01

    The Korean Neonatal Network (KNN), a nationwide prospective registry of very-low-birth-weight (VLBW, < 1,500 g at birth) infants, was launched in April 2013. Data management (DM) and site-visit monitoring (SVM) were crucial in ensuring the quality of the data collected from 55 participating hospitals across the country on 116 clinical variables. We describe the processes and results of DM and SVM performed during the establishment stage of the registry. The DM procedure included automated proof checks, electronic data validation, query creation, query resolution, and revalidation of the corrected data. SVM included SVM team organization, identification of unregistered cases, source document verification, and post-visit report production. By March 31, 2015, 4,063 VLBW infants were registered and 1,693 queries were produced. Of these, 1,629 queries were resolved and 64 queries remain unresolved. By November 28, 2014, 52 participating hospitals were visited, with 136 site-visits completed since April 2013. Each participating hospital was visited biannually. DM and SVM were performed to ensure the quality of the data collected for the KNN registry. Our experience with DM and SVM can be applied for similar multi-center registries with large numbers of participating centers. PMID:26566353

  3. ‘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

  4. 'This wound has spoilt everything': emotional capital and the experience of surgical site infections.

    PubMed

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-11-01

    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.

  5. 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.

  6. Orthopedic surgical site infections: analysis of causative bacteria and implications for antibiotic stewardship.

    PubMed

    Norton, Thomas D; Skeete, Faith; Dubrovskaya, Yanina; Phillips, Michael S; Bosco, Joseph D; Mehta, Sapna A

    2014-05-01

    Data that can be used to guide perioperative antibiotic prophylaxis in our era of emerging antibiotic resistance are limited. We reviewed orthopedic surgeries complicated by surgical site infections (SSIs). Eighty percent of 69 arthroplasty and 80 spine fusion SSIs were infected with Gram-positive bacteria; most were staphylococcal species; and more than 25% of Staphylococcus aureus and more than 65% of coagulase-negative staphylococci were methicillin-resistant. Gram-negative bacteria were isolated from 30% of arthroplasty SSIs and 25% of spine fusion SSIs. Resistance to cefazolin was higher than 40%. A significant proportion of SSIs were caused by resistant organisms, and antibiotic guidelines were altered to provide more adequate surgical prophylaxis.

  7. 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

  8. Surgical site infection of scrotal and inguinal lesions after urologic surgery.

    PubMed

    Uehara, Teruhisa; Takahashi, Satoshi; Ichihara, Kohji; Hiyama, Yoshiki; Hashimoto, Jiro; Kurimura, Yuichiro; Masumori, Naoya

    2014-03-01

    To clarify the incidence of surgical site infection (SSI) after urological scrotal and inguinal surgical procedures and the preventive effect of antimicrobial prophylaxis for SSI, retrospective analysis was performed. The patients who underwent scrotal and inguinal operations from 2001 to 2010 were included in this analysis. A first or second generation cephalosporin was administered as antimicrobial prophylaxis just before the start of surgery and no additional prophylaxis was conducted. The surgery was classified into 76 (38%) cases with testicular sperm extraction (TESE), 72 (36%) with radical orchiectomy, 29 (14.5%) with bilateral orchiectomy (surgical castration) and 23 (11.5%) with other scrotal and inguinal operations. The median age and age range were 36 years and 18-81 years, respectively. SSI occurred in 7 (3.5%) cases. The frequencies of SSI were 6.5% in the patients with urological inguinal surgery and 1.6% in those with scrotal surgery. The frequency of SSI in the patients with urological inguinal surgery was not negligible even though it is considered a clean operation, and further analysis is warranted to prevent SSI.

  9. Abdominal surgical site infections: a prospective study of determinant factors in Harare, Zimbabwe.

    PubMed

    Muchuweti, David; Jönsson, Kent U G

    2015-10-01

    Surgical site infections (SSIs) are reported in lower frequencies in the developed countries than in the developing world. A prospective evaluation of risk factors in 285 patients undergoing abdominal surgery procedures in Zimbabwe was therefore undertaken. Overall infection rate was 26%. The age group 30-39 years had the highest number of dirty wounds and the highest rate of human immunodeficiency virus (HIV) infection. Multivariate regression analysis showed a correlation between wound class and SSI (P < 0·05). This was also noted for American Society of Anesthesiologists (ASA) score (P < 0·05). HIV-infected patients had 52% SSIs and non-infected patients had 26% (P < 0·05). Patients receiving blood transfusion had 51% SSIs and those not transfused had 17% (P < 0·01). Patients receiving pre- and intra-operative prophylactic antibiotics had 18% SSIs and those receiving postoperative administration had 37% (P < 0·01). Treatment ranged from dressings only in 11% to surgical intervention in 30% resulting in prolongation of median hospital stay from 8 to 18 days (P < 0·001). Mortality was 7%. High wound class, high ASA score, blood transfusion, HIV infection and delayed use of prophylactic antibiotics were risk factors for SSIs, resulting in surgical interventions, prolonged hospital stay and mortality.

  10. Surveillance of surgical site infections: decade of experience at a Colombian tertiary care center.

    PubMed

    Arias, Cesar A; Quintero, Gustavo; Vanegas, Blanca E; Rico, Clara Luz; Patiño, Jose Felix

    2003-05-01

    A protocol for surveillance of surgical site infections (SSIs) was established in a tertiary care center in 1991 in Bogota, Colombia and followed for 10 years. Wounds were classified according to the Centers for Disease Control guidelines. The National Nosocomial Infection Surveillance and Study of the Efficacy of Nosocomial Infection Control scores for risk factors were included from June 1999. A total of 33027 surgical procedures were followed by the surveillance team. The overall infection rate was 2.6%. Most surgical procedures (70.6%) were classified as clean; 25.3%, 3.8%, and 0.26% were classified as clean/contaminated, contaminated, and dirty, respectively. Infection rates according to wound classification were 1.28%, 3.9%, 15.4%, and 38.4% for clean, clean/contaminated, contaminated, and dirty procedures, respectively. Escherichia coli and coagulase-negative staphylococci were the most frequently isolated microorganisms from SSI: 23.9% and 22.8% of isolates, respectively. A program of surveillance of SSIs has been successfully implemented in a country with limited resources and has maintained the infection rate within international standards.

  11. 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

  12. 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

  13. 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

  14. 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

  15. Incidence and Etiology of Surgical Site Infections in Appendectomies: A 3-Year Prospective Study

    PubMed Central

    Garcell, Humberto Guanche; Arias, Ariadna Villanueva; Sandoval, Cristobal A. Pancorbo; García, Elias Guilarte; Gamboa, Moraima E. Valle; Sado, Adam Bode; Serrano, Ramón N. Alfonso

    2017-01-01

    Objectives Surgical site infections (SSIs) constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period (January 2013 to December 2015) in a community hospital in Qatar, and compare this with external benchmarks. Methods We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control. Information about age, sex, smoking habits, diabetes mellitus status, body mass index, and the result of bacteriologic studies were collected. Results Of a total 603 patients, 22 (3.6%) cases of SSI were reported, with an infection rate of 13.6%, 4.5%, and 1.0% in 2013, 2014, and 2015, respectively. SSIs were observed more frequently in patients with contaminated/dirty wounds (6.6%). About 65% of isolates from the surgical site were multidrug-resistant organisms (Escherichia coli and Klebsiella spp.). Conclusions This study describes the incidence of SSI in appendectomy, which could be used as a benchmark for the facility improvement program. The high frequency of multidrug-resistant organisms in SSIs requires additional studies focused on evaluating the effectiveness of the current preventive practices with a particular reference to antimicrobial prophylaxis. PMID:28042400

  16. Retrospective Multicenter Study on Risk Factors for Surgical Site Infections after Appendectomy for Acute Appendicitis

    PubMed Central

    Giesen, Louis J.X.; van den Boom, Anne Loes; van Rossem, Charles C.; den Hoed, P.T.; Wijnhoven, Bas P.L.

    2016-01-01

    Background Surgical site infections (SSI) are seen in up to 5% of patients after appendectomy for acute appendicitis. SSI are associated with prolonged hospital stay and increased costs. The aim of this multicenter study was to identify factors associated with SSI after appendectomy for acute appendicitis. Methods Patients who underwent appendectomy for acute appendicitis between June 2014 and January 2015 in 6 teaching hospitals in the southwest of the Netherlands were included. Patient, diagnostic, intra-operative and disease-related factors were collected from the patients' charts. Primary outcome was surgical site infection. Multivariable logistic regression was performed to identify independent risk factors for SSI. Results Some 637 patients were included. Forty-two patients developed a SSI. In univariable analysis body temperature >38°C, CRP>65 and complex appendicitis were associated with SSI. After multivariable logistic regression with stepwise backwards elimination, complex appendicitis was significantly associated with SSI (OR 4.09; 95% CI 2.04-8.20). Appendiceal stump closure with a stapler device was inversely correlated with SSI (OR 0.40; 95% CI 0.24-0.97) Conclusions Complex appendicitis is a risk factor for SSI and warrants close monitoring postoperatively. The use of a stapler device for appendiceal stump closure is associated with a reduced risk of SSI. PMID:27631081

  17. Geologic Site Characterization of the North Korean Nuclear Test Site at Punggye-Ri: A Reconnaissance Mapping Redux

    DTIC Science & Technology

    2013-11-30

    geomorphometrics-based analysis, the host rock directly under Mount Manthap is very likely a hard and competent one, more like diorite or more...site area from Mount Changbai and adjacent areas to the northwest (Steinshouer et al., 1997). Best estimates indicate that most rocks in the NK test...for the “Plumbbob Rainier ” experiment in 1957 (left). The DPRK animation layout is plausible, and it employs three different passive containment

  18. Factors predicting surgical site infection after posterior lumbar surgery: A multicenter retrospective study.

    PubMed

    Wang, Tao; Wang, Hui; Yang, Da-Long; Jiang, Li-Qiang; Zhang, Li-Jun; Ding, Wen-Yuan

    2017-02-01

    This is a retrospective study.The purpose of this study is to explore incidence and risk factors for surgical site infection (SSI) after posterior lumbar surgery.SSI is a common complication after posterior lumbar surgery, bringing mental and physical pain and prolonging hospital stay. However, predisposing factors, as reported less, remain controversial.Patients who underwent posterior lumbar surgery at 3 centers between 2006 and 2016 were included. The possible factors include 3 aspects: demographic variables-age, sex, body mass index (BMI), waist-to-hip radio (WHR), hypertension, diabetes, heart disease, smoking, drinking, steroidal injection, surgical time between June and September, preoperative shower; blood test variables-white blood cell (WBC), neutrophil, red blood cell (RBC), hemoglobin (Hb), total protein (TP), albumin, albumin/globulin (A/G), C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and surgical related variables-operation time, blood loss, operative level, instrumentation, incision length. Factors related with SSI were also performed by multivariate analysis.The prevalence of SSI was 3.00% (267 cases of 8879) had a postoperative wound infection. There were significant difference in WHR (0.92 vs 0.83), WBC (4.31 vs 6.69), TP (58.7 vs 65.2), albumin (36.9 vs 43.2), CRP (2.01 vs 0.57), PCT (0.097 vs 0.067), operation time (217.9 vs 195.7), blood loss (997.1 vs 915.3) and operative level (3.05 vs 2.45) and incision length (24.1 vs 20.0) between SSI group and non-SSI group. >60 years old, female, BMI <18.5 and >30.0, diabetes, male smoking, preoperative steroidal injection, surgical time between June and September, no preoperative shower, instrumentation surgery were risk factors for SSI after posterior lumbar surgery.Many factors, >60 years old, female, BMI, WHR, diabetes, male smoking, preoperative steroidal injection, surgical time between June and September, preoperative shower, WBC, TP, albumin, CRP, PCT

  19. Effects of food colouring added to 2% chlorhexidine gluconate and 70% alcohol for surgical site antisepsis.

    PubMed

    Chow, Jason; Ng, Jonathan; Pun, Alvin

    2013-11-01

    Preoperative cleansing of a patient's skin with chlorhexidine gluconate (CHG) in alcohol is superior to cleansing with povidone-iodine for preventing surgical site infection (SSI) after clean-contaminated surgery (Darouilche et al 2010). However, 2% CHG in 70% alcohol, tinted pink, is colourless when applied to limbs for surgery and complete coverage cannot be assured. The purpose of the study was to evaluate the efficacy of food colouring added to CHG in preoperative skin preparation. Two hundred and eight subjects were randomly selected from a population of healthy young adults and were given a questionnaire. They were excluded if they had a known allergy to CHG or food dye, a current infection at the preparation site, or previous preparation with CHG at the site. CHG with food dye additive was applied on the subject's left foot while CHD without the additive was applied on the right. Skin swabs were then taken of both feet and plated on blood agar plates and incubated for 48 hours. Assessment of growth was compared. Patients treated with tinted CHG had around 3.4 times (95% CI: 1.5, 7.8) the risk of a positive bacterial swab compared with those treated with untinted CHG. The efficacy of CHG significantly decreased with food colouring additive. This is consistent with previous studies conducted on similar incompatible substances. In order to have the full efficacy of CHG as a preparation, much thought and care needs to be taken to prevent contamination of the site and substance.

  20. 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.

  1. Staphylococcus aureus and surgical site infections: benefits of screening and decolonization before surgery.

    PubMed

    Humphreys, H; Becker, K; Dohmen, P M; Petrosillo, N; Spencer, M; van Rijen, M; Wechsler-Fördös, A; Pujol, M; Dubouix, A; Garau, J

    2016-11-01

    Surgical site infections (SSIs) are among the most common healthcare-associated infections, and contribute significantly to patient morbidity and healthcare costs. Staphylococcus aureus is the most common microbial cause. The epidemiology of S. aureus is changing with the dissemination of newer clones and the emergence of mupirocin resistance. The prevention and control of SSIs is multi-modal, and this article reviews the evidence on the value of screening for nasal carriage of S. aureus and subsequent decolonization of positive patients pre-operatively. Pre-operative screening, using culture- or molecular-based methods, and subsequent decolonization of patients who are positive for meticillin-susceptible S. aureus and meticillin-resistant S. aureus (MRSA) reduces SSIs and hospital stay. This applies especially to major clean surgery, such as cardiothoracic and orthopaedic, involving the insertion of implanted devices. However, it requires a multi-disciplinary approach coupled with patient education. Universal decolonization pre-operatively without screening for S. aureus may compromise the capacity to monitor for the emergence of new clones of S. aureus, contribute to mupirocin resistance, and prevent the adjustment of surgical prophylaxis for MRSA (i.e. replacement of a beta-lactam agent with a glycopeptide or alternative).

  2. Use of antibacterial sutures for skin closure in controlling surgical site infections: a systematic review of published randomized, controlled trials

    PubMed Central

    Sajid, Muhammad S.; Craciunas, L.; Sains, P.; Singh, K.K.; Baig, M.K.

    2013-01-01

    Objective: The objective of this article is to systematically analyse the randomized, controlled trials that compare the use of antibacterial sutures (ABS) for skin closure in controlling surgical site infections. Methods: Randomized, controlled trials on surgical patients comparing the use of ABS for skin closure in controlling the surgical site infections were analysed systematically using RevMan® and combined outcomes were expressed as odds ratios (OR) and standardized mean differences (SMD). Results: Seven randomized, controlled trials evaluating 1631 patients were retrieved from electronic databases. There were 760 patients in the ABS group and 871 patients in the simple suture group. There was moderate heterogeneity among trials (Tau2 = 0.12; chi2 = 8.40, df = 6 [P < 0.01]; I2 = 29%). Therefore in the random-effects model, the use of ABS for skin closure in surgical patients was associated with a reduced risk of developing surgical site infections (OR, 0.16; 95% CI, 0.37, 0.99; z = 2.02; P < 0.04) and postoperative complications (OR, 0.56; 95% CI, 0.32, 0.98 z = 2.04; P = 0.04). The durations of operation and lengths of hospital stay were similar following the use of ABS and SS for skin closure in patients undergoing various surgical procedures. Conclusion: Use of ABS for skin closure in surgical patients is effective in reducing the risk of surgical site infection and postoperative complications. ABS is comparable with SS in terms of length of hospital stay and duration of operation. PMID:24759666

  3. Novel Closing Method Using Subcutaneous Continuous Drain for Preventing Surgical Site Infections in Radical Cystectomy

    PubMed Central

    Hirose, Yasuhiko; Ando, Ryosuke; Nakane, Akihiro; Etani, Toshiki; Iida, Keitaro; Akita, Hidetoshi; Okamura, Takehiko; Kohri, Kenjiro

    2014-01-01

    To reduce the incidence of surgical site infection (SSI) after radical cystectomy, a new closing method using subcutaneous continuous aspiration drain was developed and compared to the conventional closing method. The new method involved (a) closed aspiration with an indwelling aspiration drain without suture of the subcutaneous fat and (b) covering with hydrocolloid wound dressing after suture of the dermis with 4-0 absorbable thread and reinforcement using strips. The incidence of SSI was significantly improved by using the new method. Furthermore, univariate and multivariate analysis associated with SSI revealed that the new closing method was statistically correlated with 85% reduction of SSI (odds ratio: 0.15, 95% confidence interval: 0.03–0.69).Our new method using continuous aspiration with subcutaneous drain is useful for preventing SSI through removal of effusions and reduction of dead space by apposition of the subcutaneous fat. PMID:24734201

  4. Improving awareness of best practices to reduce surgical site infection: a multistakeholder approach.

    PubMed

    Skoufalos, Alexandria; Clarke, Janice L; Napp, Marc; Abrams, Kenneth J; Berman, Bettina; Armellino, Donna; Schilling, Mary Ellen; Pracilio, Valerie

    2012-01-01

    Surgical site infection (SSI) is recognized as a focus area by the Centers for Medicare and Medicaid Services, the Joint Commission, the Institute for Healthcare Improvement, and the Institute of Medicine. An estimated 47% to 84% of SSIs present after discharge from the hospital or ambulatory care facility and, as a result, go undetected by standard SSI surveillance programs. Evidence-based processes and practices that are known to reduce the incidence of SSIs tend to be underused in routine practice. This article describes a multistakeholder process used to develop an educational initiative to raise awareness of best practices to reduce SSIs. The goal was to create a patient-centric educational initiative that involved an active partnership among all stakeholders-medical professional organizations, hospitals/health systems, health insurers, employers and other purchasers, and consumers/patients-to provide the climate necessary to create and sustain a culture of safety.

  5. Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver

    PubMed Central

    2012-01-01

    Background An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial. Methods Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel® Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered Aquacel® Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery. Results A total of 112 patients (58 in the experimental arm and 54 in the control group) qualified for primary end-point analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5%) than in controls (14.3% center 1, 24.2% center 2, overall 20.4%), but the observed difference was not statistically significant (P = 0.451), even with respect to surgical-site infection grade 1 (superficial) versus grades 2 and 3, or grade 1 and 2 versus grade 3. Conclusions This randomized trial did not confirm a statistically significant superiority of Aquacel® Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery. Trial registration Clinicaltrials.gov: NCT00981110 PMID:22621779

  6. 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.

  7. 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

  8. 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

  9. Origin of Propionibacterium in Surgical Wounds and Evidence-Based Approach for Culturing Propionibacterium from Surgical Sites

    PubMed Central

    Matsen, Frederick A.; Butler-Wu, Susan; Carofino, Bradley C.; Jette, Jocelyn L.; Bertelsen, Alexander; Bumgarner, Roger

    2013-01-01

    Background: To explore the origin of Propionibacterium in surgical wounds and to suggest an optimized strategy for culturing this organism at the time of revision surgery, we studied the presence of this organism on the skin and in the surgical wounds of patients who underwent revision arthroplasty for reasons other than apparent infection. Methods: Specimens were cultured in broth and on aerobic and anaerobic media. The presence and degree of positivity of Propionibacterium cultures were correlated with sex. The results of dermal and deep cultures were correlated. Times to positivity and the yields of each media type and specimen source were investigated. Results: Propionibacterium grew in twenty-three of thirty cultures of specimens obtained preoperatively from the unprepared epidermis over the area where a skin incision was going to be made for a shoulder arthroplasty; males had a greater average degree of positivity than females (p < 0.002). Twelve of twenty-one male subjects and zero of twenty female subjects who had cultures of dermal specimens obtained during revision shoulder arthroplasty had positive findings for Propionibacterium (p = 0.0001). Twelve of twenty male subjects and only one of twenty female subjects had positive deep cultures (p = 0.0004). The positivity of dermal cultures for Propionibacterium was significantly associated with the positivity of deep cultures for this organism (p = 0.0001). If Propionibacterium was present in deep tissues, it was likely that it would be recovered by culture if four different specimens were obtained and cultured for a minimum of seventeen days on three different media: aerobic, anaerobic, and broth. Conclusions: Because the surgical incision of dermal sebaceous glands may be a source of Propionibacterium in deep wounds, strategies for minimizing the risk of Propionibacterium infections may need to be directed at minimizing the contamination of surgical wounds from these bacteria residing in rather than on the

  10. Body Mass Index: Surgical Site Infections and Mortality After Lower Extremity Bypass from the National Surgical Quality Improvement Program 2005-2007

    PubMed Central

    Giles, Kristina A.; Hamdan, Allen D.; Pomposelli, Frank B.; Wyers, Mark C.; Siracuse, Jeffrey J.; Schermerhorn, Marc L.

    2009-01-01

    Objectives Patients undergoing lower extremity bypass are at high risk for surgical site infections (SSI). We examine lower extremity bypasses by graft origin and body mass index (BMI) classification to analyze differences in postoperative mortality and SSI occurrence. Methods The 2005-2007 National Surgical Quality Improvement Program (NSQIP), a multi-institutional risk-adjusted database, was queried to compare perioperative mortality (30-day), overall morbidity, and SSIs after lower extremity arterial bypass for peripheral arterial disease. Bypass was stratified by graft origin as aorto-iliac, femoral, or popliteal. Patient demographics, comorbidities, operative, and post-operative occurrences were analyzed. Results There were 7,595 bypasses performed (1,596 aorto-iliac, 5,483 femoral, and 516 popliteal origin). Mortality was similar regardless of bypass origin (2.8%, 2.4%, & 2.7%, P=.57). Surgical site infections occurred in 11% of overall cases (10%, 11%, & 11%, P=.47). Graft failure was significantly associated with postoperative SSI occurrence (OR 2.4, 95%CI 1.9-3.1, P<.001) as was postoperative sepsis (OR 6.5, 95%CI 5.1-8.3, P<.001). Independent predictors of mortality were age, aorto-iliac bypass origin, underweight, normal weight, or morbid obesity (compared to overweight and obese), end stage renal disease, poor preoperative functional status, preoperative sepsis, chronic obstructive pulmonary disease, hypoalbuminemia, and cardiac disease. Independent predictors of SSI were obesity, diabetes, poor preoperative functional status, a history of smoking, and female gender. Conclusions Surgical site infections occur frequently after lower extremity bypass regardless of bypass origin and are associated with early graft failure and sepsis. Obesity predicts postoperative SSI. Mortality risk was greatest in the underweight followed by morbidly obese and normal weight patients, while overweight and mild-moderate obesity were associated with the lowest mortality

  11. 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.

  12. A Case of Surgical Site Infection Caused by Mycobacterium fortuitum, following Herniorrhaphy

    PubMed Central

    Malini, A; Sangma, Mima Maychet B

    2016-01-01

    Rapidly Growing Mycobacteria (RGM) are opportunistic pathogens found in the environment. Mycobacterium fortuitum, M. chelonae and M.abscessus are the important human pathogens of this group. They cause wound infections, disseminated cutaneous disease, pulmonary infection in patients with cystic fibrosis or bronchiectasis, bone and joint infections and keratitis. Infections due to these Non-Tuberculous Mycobacteria (NTM) are increasingly reported. Post laparoscopic wound infections, mesh site infections and other surgical site infections due to M. fortuitum and M. chelonae have been reported. Usually wound infections due to atypical mycobacteria have delayed onset and do not respond to conventional antibiotics. Identification of RGM can be done by a set of cumbersome biochemical tests, High Performance Liquid Chromatography (HPLC), molecular methods using DNA probes or by Polymerase Chain Reaction (PCR). We here report a case of post-herniorrhaphy wound infection due to M. fortuitum which was identified by molecular method (HAIN mycobacterial species system). This case report underscores the importance of examining Ziehl-Neelsen (ZN) stain of all exudates with sterile culture on day one for non fastidious bacteria. Timely identification can lead to prompt therapy of patients preventing further complications. PMID:28050369

  13. A Case of Surgical Site Infection Caused by Mycobacterium fortuitum, following Herniorrhaphy.

    PubMed

    Madhusudhan, N S; Malini, A; Sangma, Mima Maychet B

    2016-11-01

    Rapidly Growing Mycobacteria (RGM) are opportunistic pathogens found in the environment. Mycobacterium fortuitum, M. chelonae and M.abscessus are the important human pathogens of this group. They cause wound infections, disseminated cutaneous disease, pulmonary infection in patients with cystic fibrosis or bronchiectasis, bone and joint infections and keratitis. Infections due to these Non-Tuberculous Mycobacteria (NTM) are increasingly reported. Post laparoscopic wound infections, mesh site infections and other surgical site infections due to M. fortuitum and M. chelonae have been reported. Usually wound infections due to atypical mycobacteria have delayed onset and do not respond to conventional antibiotics. Identification of RGM can be done by a set of cumbersome biochemical tests, High Performance Liquid Chromatography (HPLC), molecular methods using DNA probes or by Polymerase Chain Reaction (PCR). We here report a case of post-herniorrhaphy wound infection due to M. fortuitum which was identified by molecular method (HAIN mycobacterial species system). This case report underscores the importance of examining Ziehl-Neelsen (ZN) stain of all exudates with sterile culture on day one for non fastidious bacteria. Timely identification can lead to prompt therapy of patients preventing further complications.

  14. Discharge after discharge: predicting surgical site infections after patients leave hospital.

    PubMed

    Daneman, N; Lu, H; Redelmeier, D A

    2010-07-01

    In this population-based retrospective cohort study, we examined the frequency, severity, and prediction of post-discharge surgical site infections (SSIs). We evaluated all patients admitted for their first elective surgical procedure in Ontario, Canada, between 1 April 2002 and 31 March 2008. Procedure and patient characteristics were derived from linked hospital, emergency room and physician claims databases within Canada's universal healthcare system. The 30 day risk of SSI was derived from the initial hospital admission, outpatient consultations, return emergency room visits and readmissions. The cohort included 622 683 patients, of whom 84 081 (13.5%) were diagnosed with SSI, and more than half (48 725) were diagnosed post-discharge. Post-discharge infections were associated with an increased risk of reoperation (odds ratio: 2.28; 95% confidence interval: 2.11-2.48), return emergency room visit (9.08; 8.89-9.27), and readmission (6.16; 5.98-6.35). The most common risk index predicted incremental increases in the risk of in-hospital SSI, but did not predict increases in the risk of post-discharge infection. Patients with post-discharge infections had baseline characteristics more akin to uninfected patients than patients with in-hospital infections. Predictors of post-discharge infection included shorter procedure duration, shorter length of stay, rural residence, alcoholism, diabetes and obesity. Post-discharge SSIs are frequent, severe, scattered over time and location, and hard to predict using common risk indices. They represent an important hidden burden in our healthcare system.

  15. Surgical Site Infections Following Spine Surgery: Eliminating the Controversies in the Diagnosis

    PubMed Central

    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

  16. Preoperative prognostic nutritional index predicts postoperative surgical site infections in gastrointestinal fistula patients undergoing bowel resections

    PubMed Central

    Hu, Qiongyuan; Wang, Gefei; Ren, Jianan; Ren, Huajian; Li, Guanwei; Wu, Xiuwen; Gu, Guosheng; Li, Ranran; Guo, Kun; Deng, Youming; Li, Yuan; Hong, Zhiwu; Wu, Lei; Li, Jieshou

    2016-01-01

    Abstract Recent studies have implied a prognostic value of the prognostic nutritional index (PNI) in postoperative septic complications of elective colorectal surgeries. However, the evaluation of PNI in contaminated surgeries for gastrointestinal (GI) fistula patients is lack of investigation. The purpose of this study was to explore the predictive value of PNI in surgical site infections (SSIs) for GI fistula patients undergoing bowel resections. A retrospective review of 290 GI patients who underwent intestinal resections between November 2012 and October 2015 was performed. Univariate and multivariate analyses were conducted to identify risk factors for SSIs, and receiver operating characteristic cure was used to quantify the effectiveness of PNI. SSIs were diagnosed in 99 (34.1%) patients, with incisional infection identified in 54 patients (18.6%), deep incisional infection in 13 (4.5%), and organ/space infection in 32 (11.0%). receiver operating characteristic curve analysis defined a PNI cut-off level of 45 corresponding to postoperative SSIs (area under the curve [AUC] = 0.72, 76% sensitivity, 55% specificity). Furthermore, a multivariate analysis indicated that the PNI < 45 [odd ratio (OR): 2.24, 95% confidence interval (CI): 1.09–4.61, P = 0.029] and leukocytosis (OR: 3.70, 95% CI: 1.02–13.42, P = 0.046) were independently associated with postoperative SSIs. Preoperative PNI is a simple and useful marker to predict SSIs in GI fistula patients after enterectomies. Measurement of PNI is therefore recommended in the routine assessment of patients with GI fistula receiving surgical treatment. PMID:27399098

  17. 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

  18. A Practical Tool for Surveillance of Surgical-Site Infections: A 5-Year Experience in Orthopedic Surgeries.

    PubMed

    Benenson, Shmuel; Moses, Allon E; Cohen, Matan J; Brezis, Meir; Minster, Naomi; Schwartz, Carmela; Kandel, Leonid; Liebergall, Meir; Mattan, Yoav

    2017-01-10

    Continuous surveillance of surgical-site infection (SSI) is labor intensive. We developed a semiautomatic surveillance system partly assisted by surgeons. Most patients who developed postdischarge SSI were readmitted, which allowed us to limit postdischarge surveillance to this group. This procedure significantly reduced workload while maintaining high sensitivity and specificity for SSI diagnosis. Infect Control Hosp Epidemiol 2017;1-4.

  19. Postoperative recovery after mandibular third molar surgery: a criteria for selection of type of surgical site closure.

    PubMed

    Damodar, Neeliahgari Durga Akhila; Nandakumar, Hanumanthaiah; Srinath, Narashimha Murthy

    2013-01-01

    This study sought to evaluate postoperative recovery after mandibular third molar surgery, with and without the use of sutures. This study utilized 50 healthy subjects (19 females and 31 males, 18-40 years of age) with bilateral impacted third molars. Two impacted teeth were removed from each patient (60 min maximum operating time). For each patient, the surgical site on one side of the mouth was closed for primary healing by using nonresorbable sutures, while the surgical site on the other side of the mouth was left open for secondary healing. Postoperative recovery was assessed by determining pain (using a visual analog scale) and swelling (by measuring anatomical landmarks pre- and postoperatively on Days 2, 5, and 7) Any incidence of socket infection and hemorrhage were considered to be complications. Both statistical analysis and clinical observation showed that the surgical sites with nonresorbable sutures showed greater swelling and a higher intensity of pain than the surgical sites without sutures; however, there were no statistical or clinical differences in pain and swelling postsurgery at Day 7. The results suggest secondary closure (that is, without sutures) after third molar surgery will produce less postoperative discomfort than primary closure (with nonresorbable sutures).

  20. USA300 genotype community-associated methicillin-resistant Staphylococcus aureus as a cause of surgical site infections.

    PubMed

    Patel, Mukesh; Kumar, Ritu A; Stamm, Alan M; Hoesley, Craig J; Moser, Stephen A; Waites, Ken B

    2007-10-01

    Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains are increasingly recovered from nosocomial settings. We conducted a retrospective study of surgical site infections (SSI) during 2004 and 2005 to determine the prevalence of CA-MRSA; 57% of MRSA strains tested belonged to the USA300 genotype. CA-MRSA has become a prominent cause of SSI at our institution.

  1. Derivation of site-specific surface water quality criteria for the protection of aquatic ecosystems near a Korean military training facility.

    PubMed

    Jeong, Seung-Woo; An, Youn-Joo

    2014-01-01

    This study suggested the first Korean site-specific ecological surface water quality criteria for the protection of ecosystems near an artillery range at a Korean military training facility. Surface water quality (SWQ) criteria in Korea address human health protection but do not encompass ecological criteria such as limits for metals and explosives. The first objective of this study was to derive site-specific SWQ criteria for the protection of aquatic ecosystems in Hantan River, Korea. The second objective was to establish discharge criteria for the artillery range to protect the aquatic ecosystems of Hantan River. In this study, we first identified aquatic organisms living in the Hantan River, including fishes, reptiles, invertebrates, phytoplankton, zooplankton, and amphibians. Second, we collected ecotoxicity data for these aquatic organisms and constructed an ecotoxicity database for Cd, Cu, Zn, TNT, and RDX. This study determined the ecological maximum permissible concentrations for metals and explosives based on the ecotoxicity database and suggested ecological surface water quality criteria for the Hantan River by considering analytical detection limits. Discharge limit criteria for the shooting range were determined based on the ecological surface water quality criteria suggested for Hantan River with further consideration of the dilution of the contaminants discharged into the river.

  2. Surgical site infection following cesarean delivery: patient, provider and procedure specific risk factors

    PubMed Central

    SHREE, Raj; Park, Seo Young; Beigi, Richard H.; Dunn, Shannon L.; Krans, Elizabeth E.

    2016-01-01

    Objective To identify risk factors for cesarean delivery (CD) surgical site infection (SSI). Study Design Retrospective analysis of 2739 CDs performed at the University of Pittsburgh in 2011. CD SSI’s were defined using National Healthcare Safety Network (NHSN) criteria. Chi-square and t tests were used for bivariate analyses and multivariate logistic regression was used to identify SSI risk factors. Results Of 2739 CDs, 178 (6.5%) were complicated by SSI. Patients with a SSI were more likely to have Medicaid, have resident physicians perform the CD, an ASA class of ≥3, chorioamnionitis, use tobacco and labor prior to CD. In multivariable analysis, labor (2.35;1.65–3.38), chorioamnionitis (2.24;1.25–3.83), resident teaching service (2.15;1.54–3.00), tobacco use (1.70; 1.04–2.70), ASA class ≥3 (1.61; 1.06–2.39) and CDs performed for non-reassuring fetal status (0.43; 0.26–0.67) were significantly associated with CD SSI. Conclusion Multiple patient, provider and procedure specific-risk factors contribute to CD SSI risk which may be targeted in infection control efforts. PMID:26344010

  3. Analysis of Surgical Site Infection after Musculoskeletal Tumor Surgery: Risk Assessment Using a New Scoring System

    PubMed Central

    Nagano, Satoshi; Yokouchi, Masahiro; Setoguchi, Takao; Sasaki, Hiromi; Shimada, Hirofumi; Kawamura, Ichiro; Ishidou, Yasuhiro; Kamizono, Junichi; Yamamoto, Takuya; Kawamura, Hideki; Komiya, Setsuro

    2014-01-01

    Surgical site infection (SSI) has not been extensively studied in musculoskeletal tumors (MST) owing to the rarity of the disease. We analyzed incidence and risk factors of SSI in MST. SSI incidence was evaluated in consecutive 457 MST cases (benign, 310 cases and malignant, 147 cases) treated at our institution. A detailed analysis of the clinical background of the patients, pre- and postoperative hematological data, and other factors that might be associated with SSI incidence was performed for malignant MST cases. SSI occurred in 0.32% and 12.2% of benign and malignant MST cases, respectively. The duration of the surgery (P = 0.0002) and intraoperative blood loss (P = 0.0005) was significantly more in the SSI group than in the non-SSI group. We established the musculoskeletal oncological surgery invasiveness (MOSI) index by combining 4 risk factors (blood loss, operation duration, preoperative chemotherapy, and the use of artificial materials). The MOSI index (0–4 points) score significantly correlated with the risk of SSI, as demonstrated by an SSI incidence of 38.5% in the group with a high score (3-4 points). The MOSI index score and laboratory data at 1 week after surgery could facilitate risk evaluation and prompt diagnosis of SSI. PMID:24672281

  4. Supplemental Perioperative Oxygen to Reduce Surgical Site Infection After High-Energy Fracture Surgery (OXYGEN Study).

    PubMed

    OʼToole, Robert V; Joshi, Manjari; Carlini, Anthony R; Sikorski, Robert A; Dagal, Armagan; Murray, Clinton K; Weaver, Michael J; Paryavi, Ebrahim; Stall, Alec C; Scharfstein, Daniel O; Agel, Julie; Zadnik, Mary; Bosse, Michael J; Castillo, Renan C

    2017-04-01

    Supplemental perioperative oxygen (SPO) therapy has been proposed as one approach for reducing the risk of surgical site infection (SSI). Current data are mixed regarding efficacy in decreasing SSI rates and hospital inpatient stays in general and few data exist for orthopaedic trauma patients. This study is a phase III, double-blind, prospective randomized clinical trial with a primary goal of assessing the efficacy of 2 different concentrations of perioperative oxygen in the prevention of SSIs in adults with tibial plateau, pilon (tibial plafond), or calcaneus fractures at higher risk of infection and definitively treated with plate and screw fixation. Patients are block randomized (within center) in a 1:1 ratio to either treatment group (FiO2 80%) or control group (FiO2 30%) and stratified by each study injury location. Secondary objectives of the study are to compare species and antibacterial sensitivities of the bacteria in patients who develop SSIs, to validate a previously developed risk prediction model for the development of SSI after fracture surgery, and to measure and compare resource utilization and cost associated with SSI in the 2 study groups. SPO is a low cost and readily available resource that could be easily disseminated to trauma centers across the country and the world if proved to be effective.

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

    PubMed Central

    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

  6. 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

  7. 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.

  8. Laparoscopic Repair Reduces Incidence of Surgical Site Infections for All Ventral Hernias

    PubMed Central

    Arita, Nestor A.; Nguyen, Mylan T.; Nguyen, Duyen H.; Berger, Rachel L.; Lew, Debbie F.; Suliburk, James T.; Askenasy, Erik P.; Kao, Lillian S.; Liang, Mike K.

    2014-01-01

    Background The role of laparoscopic repair of ventral hernias remains incompletely defined. We hypothesize that laparoscopy, compared to open repair with mesh, decreases surgical site infection (SSI) for all ventral hernia types. Methods MEDLINE, EMBASE, and Cochrane databases were reviewed to identify studies evaluating outcomes of laparoscopic versus open repair with mesh of ventral hernias and divided into groups (primary or incisional). Studies with high risk of bias were excluded. Primary outcomes of interest were recurrence and SSI. Fixed effects model was used unless significant heterogeneity, assessed with the Higgins I-square (I2), was encountered. Results There were five and fifteen studies for primary and incisional cohorts. No difference was seen in recurrence between laparoscopic and open repair in the two hernia groups. SSI was more common with open repair in both hernia groups: primary (OR 4.17, 95%CI [2.03–8.55]) and incisional (OR 5.16, 95%CI [2.79–9.57]). Conclusions Laparoscopic repair, compared to open repair with mesh, decreases rates of SSI in all types of ventral hernias with no difference in recurrence. This data suggests that laparoscopic approach may be the treatment of choice for all types of ventral hernias. PMID:25294541

  9. 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

  10. Morbidity associated with 30-day surgical site infection following nonshunt pediatric neurosurgery.

    PubMed

    Sherrod, Brandon A; Rocque, Brandon G

    2017-04-01

    OBJECTIVE Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort. METHODS The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2014 database, including all neurosurgical procedures performed on pediatric patients. Procedures were categorized by Current Procedural Terminology (CPT) codes. CSF shunts were excluded. Deep and superficial SSIs occurring within 30 days of an index procedure were identified. Deep SSIs included deep wound infections, intracranial abscesses, meningitis, osteomyelitis, and ventriculitis. The following outcomes occurring within 30 days of an index procedure were analyzed, along with postoperative time to complication development: sepsis, wound disruption, length of postoperative stay, readmission, reoperation, and death. RESULTS A total of 251 procedures associated with a 30-day SSI were identified (2.7% of 9296 procedures). Superficial SSIs were more common than deep SSIs (57.4% versus 42.6%). Deep SSIs occurred more frequently after epilepsy or intracranial tumor procedures. Superficial SSIs occurred more frequently after skin lesion, spine, Chiari decompression, craniofacial, and myelomeningocele closure procedures. The mean (± SD) postoperative length of stay for patients with any SSI was 9.6 ± 14.8 days (median 4 days). Post-SSI outcomes significantly associated with previous SSI included wound disruption (12.4%), sepsis (15.5%), readmission (36.7%), and reoperation (43.4%) (p < 0.001 for each). Post-SSI sepsis rates (6.3% vs 28.0% for superficial versus deep SSI, respectively; p < 0.001), wound disruption rates (4.9% vs 22.4%, p < 0.001), and reoperation rates (23.6% vs 70.1%, p < 0.001) were significantly greater for patients

  11. Increased Risk of Surgical Site Infection Among Breast-Conserving Surgery Re-Excisions

    PubMed Central

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

    2015-01-01

    Purpose To determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. Methods We established a retrospective cohort of women aged 18–64 years with ICD-9-CM procedure or CPT-4 codes for BCS from 6/29/2004–12/31/2010. Prior insurance plan enrollment of at least 180 days was required to establish the index BCS; subsequent re-excisions within 180 days were identified. SSIs occurring 2–90 days after BCS were identified by ICD-9-CM diagnosis codes. The attributable surgery was defined based on SSI onset compared to the BCS date(s). A chi-square test and generalized estimating equations model were used to compare the incidence of SSI after index and re-excision BCS procedures. Results 23,001 women with 28,827 BCS were identified; 23.2% of women had >1 BCS. The incidence of SSI was 1.82% (418/23,001) for the index BCS and 2.44% (142/5,826) for re-excision BCS (p=0.002). The risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman (odds ratio 1.34, 95% confidence interval, 1.07–1.68). Conclusions Surgeons need to be aware of the increased risk of SSI after re-excision BCS compared to the initial procedure. Our results suggest that risk adjustment of SSI rates for re-excision would allow for better comparison of BCS SSI rates between institutions. PMID:25358666

  12. 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.

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

    PubMed Central

    Davies, BM; Patel, HC

    2016-01-01

    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

  14. Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis.

    PubMed

    Wu, X; Kubilay, N Z; Ren, J; Allegranzi, B; Bischoff, P; Zayed, B; Pittet, D; Li, J

    2017-01-01

    To investigate the effectiveness of antimicrobial-coated sutures compared with non-coated sutures in reducing surgical site infection (SSI) and develop recommendations for World Health Organization (WHO) SSI prevention guidelines. We searched Medline, Embase, Cinahl, Cochrane Central Register of Controlled Trials, and WHO Global Health from 1990-16/02/2015 with language restricted to English, Spanish, and French. Meta-analysis was performed with a random-effects model. Meta-regression analysis assessed whether the effect of antimicrobial coating changed according to the type of suture and surgery. Subgroup analyses were based on types of sutures. Quality of the retrieved evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. Thirteen randomized controlled trials (RCTs) and five observational studies (OBSs) met the inclusion criteria. Antimicrobial sutures significantly reduced SSI risk (for RCTs: OR 0.72, 95 % CI 0.59-0.88, p = 0.001, I(2) = 14 %; for OBSs: OR 0.58, 95 % CI 0.40-0.83, p = 0.003, I(2) = 22 %). Only Vicryl Plus vs Vicryl revealed consistent results in favor of antimicrobial sutures (for seven RCTs: OR 0.62, 95 % CI 0.44-0.88, p = 0.007, I(2) = 3 %; for four OBSs: OR 0.58, 95 % CI 0.37-0.92, p = 0.02, I(2) = 41 %). The effect of antimicrobial coating was similar between different suture, wound, and procedure types. Quality of RCT evidence was moderate, and OBS evidence was very low quality. Triclosan-coated sutures may reduce SSI risk. However, the available evidence is of moderate/low quality, and many studies had conflicts of interest.

  15. Surgical site infection complicating internal fixation of fractures: incidence and risk factors.

    PubMed Central

    Thanni, Lateef O. A.; Aigoro, Nofiu O.

    2004-01-01

    BACKGROUND: There is a dearth of data on surgical site infections (SSIs) complicating internal fixation of fractures from Nigeria. AIMS: To determine the incidence and risk factors for SSIs following internal fixation of fracture. METHODS: A cohort of 90 patients with long bone fractures that were stabilized internally with metallic devices was studied prospectively and retrospectively. RESULTS: The incidence of SSI was 12%. The isolated organisms were Staphylococcus aureus in four patients, Pseudomonas spp. in three, and Escherichia coli in one patient. Diabetes mellitus and perioperative transfusion with allogeneic blood were not predictive of SSI. Duration of operation longer than 120 minutes was a strong predictor (OR 2.25, 95% CL 0.48-10.16). Other risk factors were male sex (OR 2.01, 95% CL 0.44-10.45), injury-operation interval less than six months (OR 2.00, 95% CL 0.22-46.08), fracture fixation with plates and screws (OR 1.51, 95% CL 0.36-6.40), white blood cell count (WBC) less than 5,000 per cumm (OR 1.50, 95% CL 0.15-16.37), preoperative urinary catheterization (OR 1.48, 95% CL 0.00-16.19), and postoperative urinary catheterization (OR 1.24, 95% CL 0.29-5.00). CONCLUSION: The incidence of SSI after internal fixation of long bone fractures in our centers is 12%, and this is within the previously reported range. Use of plates and screws, WBC less than 5,000 per cumm, and perioperative urinary catheterization are important risk factors. PMID:15303412

  16. Incidence of surgical site infection following caesarean section: a systematic review and meta-analysis protocol

    PubMed Central

    Greene, Richard A; Corcoran, Paul; O'Neill, Sinéad M

    2017-01-01

    Introduction Caesarean section (CS) rates have increased globally during the past three decades. Surgical site infection (SSI) following CS is a common cause of morbidity with reported rates of 3–15%. SSI represents a substantial burden to the health system including increased length of hospitalisation and costs of postdischarge care. The definition of SSI varies with the postoperative follow-up period among different health systems, resulting in differences in the reporting of SSI incidence. We propose to conduct the first systematic review and meta-analysis to determine the pooled estimate for the overall incidence of SSI following CS. Methods and analysis We will perform a comprehensive search to identify all potentially relevant published studies on the incidence of SSI following CS reported from 1992 in the English language. Electronic databases including PubMed, CINAHL, EMBASE and Scopus will be searched using a detailed search strategy. Following study selection, full-text paper retrieval, data extraction and synthesis, we will appraise study quality and risk of bias and assess heterogeneity. Incidence data will be combined where feasible in a meta-analysis using Stata software and fixed-effects or random-effects models as appropriate. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ethics and dissemination Ethical approval is not required as this review will use published data. The review will evaluate the overall incidence of SSI following CS and will provide the first quantitative estimate of the magnitude of SSI. It will serve as a benchmark for future studies, identify research gaps and remaining challenges, and emphasise the need for appropriate prevention and control measures for SSI post-CS. A manuscript reporting the results of the systematic review and meta-analysis will be submitted to a peer-reviewed journal and presented at scientific conferences

  17. Risk factors for unavoidable removal of instrumentation after surgical site infection of spine surgery

    PubMed Central

    Tominaga, Hiroyuki; Setoguchi, Takao; Kawamura, Hideki; Kawamura, Ichiro; Nagano, Satoshi; Abematsu, Masahiko; Tanabe, Fumito; Ishidou, Yasuhiro; Yamamoto, Takuya; Komiya, Setsuro

    2016-01-01

    Abstract Surgical site infection (SSI) after spine instrumentation is difficult to treat, and often requires removal of instrumentation. The removal of instrumentation after spine surgery is a severe complication that can lead to the deterioration of activities of daily living and poor prognosis. Although there are many reports on SSI after spine surgery, few reports have investigated the risk factors for the removal of instrumentation after spine surgery SSI. This study aimed to identify the risk factors for unavoidable removal of instrumentation after SSI of spine surgery. We retrospectively reviewed 511 patients who underwent spine surgery with instrumentation at Kagoshima University Hospital from January 2006 to December 2014. Risk factors associated with SSI were analyzed via multiple logistic regression analysis. Parameters of the group that needed instrumentation removal were compared with the group that did not require instrumentation removal using the Mann–Whitney U and Fisher's exact tests. The posterior approach was used in most cases (453 of 511 cases, 88.6%). SSI occurred in 16 of 511 cases (3.14%) of spine surgery with instrumentation. Multivariate logistic regression analysis identified 2 significant risk factors for SSI: operation time, and American Society of Anesthesiologists physical status classification ≥ 3. Twelve of the 16 patients with SSI (75%) were able to keep the instrumentation after SSI. Pseudarthrosis occurred in 2 of 4 cases (50%) after instrumentation removal. Risk factors identified for instrumentation removal after spine SSI were a greater number of past surgeries, low preoperative hemoglobin, high preoperative creatinine, high postoperative infection treatment score for the spine, and the presence of methicillin-resistant Staphylococcus aureus. In these high risk cases, attempts should be made to decrease the risk factors preoperatively, and careful postoperative monitoring should be conducted. PMID:27787365

  18. 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

  19. 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

  20. Particular Features of Surgical Site Infection in Posterior Lumbar Interbody Fusion

    PubMed Central

    Kim, Jin Hak; Kim, Jin Woo; Kim, Go We

    2015-01-01

    Background Previous reports have observed differences only in infection rates between posterolateral fusion and posterior lumbar interbody fusion (PLIF). There have been no reports that describe the particular features of surgical site infection (SSI) in PLIF. In this study, we endeavor to identify the distinguishing characteristics and risk factors of SSI in PLIF. Methods Our study undertook a review of a case series of an institute. Patients who had undergone PLIF consecutively in the author's hospital were reviewed. Two proactive procedures were introduced during the study period. One was irrigation of the autolocal bone, and the other was the intradiscal space irrigation with a nozzle. Infection rate and risk factors were analyzed. For subgroup analysis, the elapsed time to a diagnosis (ETD), clinical manifestations, hematologic findings, and causative bacteria were examined in patients with SSI. Results In a total of 1,831 cases, there were 30 cases of SSI (1.6%). Long operation time was an independent risk factor (p = 0.008), and local bone irrigation was an independent protective factor (p = 0.001). Two cases of referred SSI were included in the subgroup analysis. There were 6/32 (19%) superficial incisional infections (SII), 6/32 (19%) deep incisional infections (DII), and 20/32 (62%) organ/space infections (O/SI). The difference of incidence among three groups was significant (p = 0.002).The most common bacteria encountered were methicillin-resistant Staphylococcus epidermidis followed by methicillin-resistant S. aureus in incisional infections, and no growth followed by S. epidermidis in O/SI. ETD was 8.5 ± 2.3 days in SII, 8.7 ± 2.3 days in DII and 164.5 ± 131.1 days in O/SI (p = 0.013). Conclusions The rate of SSI in PLIF was 1.6%, with the most common type being O/SI. The causative bacteria of O/SI was of lower virulence than in the incisional infection, and thus diagnosis was delayed due to its latent and insidious feature. Contamination of auto

  1. 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

  2. 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

  3. The inter-rater reliability of the diagnosis of surgical site infection in the context of a clinical trial

    PubMed Central

    Nuttall, J.; Evaniew, N.; Thornley, P.; Griffin, A.; Deheshi, B.; O’Shea, T.; Wunder, J.; Ferguson, P.; Randall, R. L.; Turcotte, R.; Schneider, P.; McKay, P.; Bhandari, M.

    2016-01-01

    Objectives The diagnosis of surgical site infection following endoprosthetic reconstruction for bone tumours is frequently a subjective diagnosis. Large clinical trials use blinded Central Adjudication Committees (CACs) to minimise the variability and bias associated with assessing a clinical outcome. The aim of this study was to determine the level of inter-rater and intra-rater agreement in the diagnosis of surgical site infection in the context of a clinical trial. Materials and Methods The Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial CAC adjudicated 29 non-PARITY cases of lower extremity endoprosthetic reconstruction. The CAC members classified each case according to the Centers for Disease Control (CDC) criteria for surgical site infection (superficial, deep, or organ space). Combinatorial analysis was used to calculate the smallest CAC panel size required to maximise agreement. A final meeting was held to establish a consensus. Results Full or near consensus was reached in 20 of the 29 cases. The Fleiss kappa value was calculated as 0.44 (95% confidence interval (CI) 0.35 to 0.53), or moderate agreement. The greatest statistical agreement was observed in the outcome of no infection, 0.61 (95% CI 0.49 to 0.72, substantial agreement). Panelists reached a full consensus in 12 of 29 cases and near consensus in five of 29 cases when CDC criteria were used (superficial, deep or organ space). A stable maximum Fleiss kappa of 0.46 (95% CI 0.50 to 0.35) at CAC sizes greater than three members was obtained. Conclusions There is substantial agreement among the members of the PARITY CAC regarding the presence or absence of surgical site infection. Agreement on the level of infection, however, is more challenging. Additional clinical information routinely collected by the prospective PARITY trial may improve the discriminatory capacity of the CAC in the parent study for the diagnosis of infection. Cite this article: J. Nuttall, N. Evaniew, P. Thornley

  4. 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.

  5. Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.

    PubMed

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

    2017-03-16

    Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for analyzing EHR data is limited and specific efficacy for postoperative complication detection is unclear. Several data imputation methods were used to develop data models for automated detection of three types (i.e., superficial, deep, and organ space) of surgical site infection (SSI) and overall SSI using American College of Surgeons National Surgical Quality Improvement Project (NSQIP) Registry 30-day SSI occurrence data as a reference standard. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values. Missing data imputation appears to be an effective means for improving postoperative SSI detection using EHR clinical data.

  6. Gene-set based genome-wide association analysis for the speed of sound in two skeletal sites of Korean women

    PubMed Central

    Kwon, Ji-Sun; Kim, Sangsoo

    2014-01-01

    The speed of sound (SOS) value is an indicator of bone mineral density (BMD). Previous genome-wide association (GWA) studies have identified a number of genes, whose variations may affect BMD levels. However, their biological implications have been elusive. We re-analyzed the GWA study dataset for the SOS values in skeletal sites of 4,659 Korean women, using a gene-set analysis software, GSA-SNP. We identified 10 common representative GO terms, and 17 candidate genes between these two traits (PGS < 0.05). Implication of these GO terms and genes in the bone mechanism is well supported by the literature survey. Interestingly, the significance levels of some member genes were inversely related, in several gene-sets that were shared between two skeletal sites. This implies that biological process, rather than SNP or gene, is the substantial unit of genetic association for SOS in bone. In conclusion, our findings may provide new insights into the biological mechanisms for BMD. [BMB Reports 2014; 47(6): 348-353] PMID:24286325

  7. A Multi-Disciplinary Review of the Potential Association between Closed-Suction Drains and Surgical Site Infection

    PubMed Central

    Reiffel, Alyssa J.; Barie, Philip S.

    2013-01-01

    Abstract Background Despite the putative advantages conferred by closed-suction drains (CSDs), the widespread utilization of post-operative drains has been questioned due to concerns regarding both efficacy and safety, particularly with respect to the risk of surgical site infection (SSI). Although discipline-specific reports exist delineating risk factors associated with SSI as they relate to the presence of CSDs, there are no broad summary studies to examine this issue in depth. Methods The pertinent medical literature exploring the relationship between CSDs and SSI across multiple surgical disciplines was reviewed. Results Across most surgical disciplines, studies to evaluate the risk of SSI associated with routine post-operative CSD have yielded conflicting results. A few studies do suggest an increased risk of SSI associated with drain placement, but are usually associated with open drainage and not the use of CSDs. No studies whatsoever attribute a decrease in the incidence of SSI (including organ/space SSI) to drain placement. Conclusions Until additional, rigorous randomized trials are available to address the issue definitively, we recommend judicious use and prompt, timely removal of CSDs. Given that the evidence is scant and weak to suggest that CSD use is associated with increased risk of SSI, there is no justification for the prolongation of antibiotic prophylaxis to “cover” an indwelling drain. PMID:23718273

  8. An Inexpensive Modified Primary Closure Technique for Class IV (Dirty) Wounds Significantly Decreases Superficial and Deep Surgical Site Infection.

    PubMed

    Kim, Bradford J; Aloia, Thomas A

    2016-11-01

    Despite the creation of several programs to decrease the incidence of surgical site infection, it remains a common complication that has a significant impact on patient recovery and medical costs. The following is a description and brief outcome report of a modified primary closure technique used for dirty (Class IV) wounds. There were 14 consecutive patients who had a laparotomy with Class IV wounds treated by a single surgeon (TAA) from 2011 to 2015. All patients had a history of cancer and either showed signs suggestive for an acute abdomen and required an emergent exploratory laparotomy or were found to have purulent intraabdominal infection at the time of elective surgery. The operation and "modified primary closure" technique (subcutaneous wound wicks with stapled skin closure) were performed in every case. The modified primary closure technique was utilized in 14 patients with a Class IV wound. There were no 30-day mortalities or readmissions. Wound wicks were slowly advanced out over a 7-day period, and only one patient required subsequent wound packing of a single-wicked area. There were no superficial or deep surgical site infections, or wound dehiscence during the hospital course, or 30-day postoperative period. The modified primary closure technique is efficient and inexpensive and was effective in a series of 14 patients with wounds classified as dirty.

  9. 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

  10. [Evidence of control and prevention of surgical site infection by shoe covers and private shoes: a systematic literature review].

    PubMed

    Santos, Alice Medeiros Lutz; Lacerda, Rúbia Aparecida; Graziano, Kazuko Uchikawa

    2005-01-01

    The study is about shoe cover and private shoe usage and aimed to find scientific evidence on their direct relation in the control of surgical site contamination and/or infection transmitted by floor microorganisms. A systematic review of basic research on shoe covers and private shoes usage was carried out, covering the period from 1950 to 2003, by means of a search in electronic sources, bibliographies of relevant studies and proceedings of scientific events. The analysis was supported by two researchers, both of whom were experienced in this theme and one of them in research methodology. The research methods revealed a diverse range and various problems. Only 4 studies obtained a dispersion of floor microorganisms to the air environment, although not significant, and none of them was directly related to surgical site contamination and/or infection. Results do not suggest direct evidence on their efficacy but there is evidence, nonetheless, that barrier and microorganisms transfer from one specific area to another depend on the type of shoe cover, with lower transfer rates when private shoes and shoe covers are employed. Occupational contamination risk during shoe cover attire and removal is also evident and the decision about continuity of their usage needs to be technically and administratively controlled.

  11. 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.

  12. Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery

    PubMed Central

    Park, Youn Young; Kim, Chang Woo; Park, Sun Jin; Lee, Kil Yeon; Lee, Jung Joo; Lee, Hye Ok

    2015-01-01

    Purpose This study aimed to identify the risk factors for surgical site infections (SSIs) in patients undergoing colorectal cancer surgery and to determine whether significantly different SSI rates existed between the short prophylactic antibiotic use group (within 24 hours) and the long prophylactic antibiotic use group (beyond 24 hours). Methods The medical records of 327 patients who underwent colorectal resection due to colorectal cancer from January 2010 to May 2014 at a single center were retrospectively reviewed, and their characteristics as well as the surgical factors known to be risk factors for SSIs, were identified. Results Among the 327 patients, 45 patients (13.8%) developed SSIs. The patients were divided into two groups according to the duration of antibiotic use: group S (within 24 hours) and group L (beyond 24 hours). Of the 327 patients, 114 (34.9%) were in group S, and 213 (65.1%) were in group L. Twelve patients (10.5%) in group S developed SSIs while 33 patients (15.5%) in group L developed SSIs (P = 0.242). History of diabetes mellitus and lung disease, long operation time, and perioperative transfusion were independent risk factors for SSIs. Conclusion This study shows that discontinuation of prophylactic antibiotics within 24 hours after colorectal surgery has no significant influence on the incidence of SSIs. This study also showed that history of diabetes mellitus and lung disease, long operation time, and perioperative transfusion were associated with increased SSI rates. PMID:26817019

  13. Incidence and Etiology of Surgical Site Infections among Emergency Postoperative Patients in Mbarara Regional Referral Hospital, South Western Uganda

    PubMed Central

    Joel, Bazira; Justina Lucy, Najjuka

    2017-01-01

    Background. This prospective hospital based study was conducted to determine the incidence, risk factors, and causative agents of surgical site infection their susceptibility to among 114 emergency postoperative patients at the Mbarara Regional Referral Hospital between September 2014 and January 2015. Methods. Consented patients were consecutively enrolled and their preoperative, intraoperative, and postoperative data were collected. Follow-ups were done in the surgical outpatient clinics. Wound specimens were collected and processed as per Sops; susceptibility testing was done using the Kirby-Bauer disc diffusion technique. Data was analyzed using STATA 11.0. Results. Overall SSI incidence was 16.4%: 5.9% superficial and 47.1% deep and organ space SSIs each. Klebsiella pneumoniae was the most predominant organism (50%) followed by Staphylococcus aureus (27.8%). E. coli and P. aeruginosa both accounted for 11.1%. Wound class (p = 0.009), anaemia (p = 0.024), low serum albumin (p = 0.046), and property of suture material used (p = 0.006) were significantly associated with SSIs. All organisms had 100% resistance to ampicillin, tetracycline, septrin, and erythromycin. Ciprofloxacin and ceftriaxone are highly sensitive to all organisms. Conclusion. The incidence of SSI in this hospital is very high. Klebsiella pneumoniae is the predominant cause. Ciprofloxacin are very potent antibiotics against organisms that cause SSI. PMID:28168215

  14. Incidence and Etiology of Surgical Site Infections among Emergency Postoperative Patients in Mbarara Regional Referral Hospital, South Western Uganda.

    PubMed

    Lubega, Abubaker; Joel, Bazira; Justina Lucy, Najjuka

    2017-01-01

    Background. This prospective hospital based study was conducted to determine the incidence, risk factors, and causative agents of surgical site infection their susceptibility to among 114 emergency postoperative patients at the Mbarara Regional Referral Hospital between September 2014 and January 2015. Methods. Consented patients were consecutively enrolled and their preoperative, intraoperative, and postoperative data were collected. Follow-ups were done in the surgical outpatient clinics. Wound specimens were collected and processed as per Sops; susceptibility testing was done using the Kirby-Bauer disc diffusion technique. Data was analyzed using STATA 11.0. Results. Overall SSI incidence was 16.4%: 5.9% superficial and 47.1% deep and organ space SSIs each. Klebsiella pneumoniae was the most predominant organism (50%) followed by Staphylococcus aureus (27.8%). E. coli and P. aeruginosa both accounted for 11.1%. Wound class (p = 0.009), anaemia (p = 0.024), low serum albumin (p = 0.046), and property of suture material used (p = 0.006) were significantly associated with SSIs. All organisms had 100% resistance to ampicillin, tetracycline, septrin, and erythromycin. Ciprofloxacin and ceftriaxone are highly sensitive to all organisms. Conclusion. The incidence of SSI in this hospital is very high. Klebsiella pneumoniae is the predominant cause. Ciprofloxacin are very potent antibiotics against organisms that cause SSI.

  15. Microbial colonisation of orthopaedic tourniquets: a potential risk for surgical site infection.

    PubMed

    Sahu, S K; Tudu, B; Mall, P K

    2015-02-01

    Pneumatic tourniquets have been used in orthopaedic surgery to get avascular fields. Sixteen such tourniquets were analysed for microbial colonisation. Samples were taken from two inner and two outer areas of each tourniquet and cultured on sheep blood agar. Eight of these were wiped with Savlon and the rest with Sterillium solution. Post-treatment samples from the same sites were again cultured. After incubation, colonies from each site were identified and counted. It was observed that the tourniquets were colonised with coagulase-negative staphylococci, Staphylococcus aureus, Bacillus, diphtheroids, Pseudomonas, Acinetobacter, enterococci, enterobacteria, and Candida. On treating with Savlon and Sterillium, there was 92.18% and 95.70% reduction in the colony count, respectively.

  16. 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

  17. Is Drain Tip Culture Prognostic of Surgical Site Infection? Results of 1380 Drain Tip Cultures in Total Hip Arthroplasty.

    PubMed

    Takada, Ryohei; Jinno, Tetsuya; Koga, Daisuke; Hirao, Masanobu; Muneta, Takeshi; Okawa, Atsushi

    2015-08-01

    The purpose of this study was to evaluate a prognostic value of drain tip culture for surgical site infection (SSI) after total hip arthroplasty. A total of 1380 closed suction drain tips cultured after removal in primary total hip arthroplasty were included in this study. Drains were removed in 12-72 hours after surgery. Drain tip cultures were positive in 11 cases (0.8%). SSI was found in 4 cases (0.3%), where the drain tip cultures were all negative. The sensitivity of drain tip culture for infection after surgery was 0%, and the specificity was 99.7%. We concluded that, drain tip culture cannot be prognostic for SSI after total hip arthroplasty. Routine use of drain tip culture is not supported.

  18. Staphylococcus aureus screening and decolonization reduces the risk of surgical site infections in patients undergoing deep brain stimulation surgery.

    PubMed

    Lefebvre, J; Buffet-Bataillon, S; Henaux, P L; Riffaud, L; Morandi, X; Haegelen, C

    2017-02-01

    In a controlled before-and-after study in a single centre, it was aimed to determine whether identification of Staphylococcus aureus nasal carriers followed by nasal mupirocin ointment and chlorhexidine soap reduced surgical site infections (SSIs) among 182 patients undergoing deep brain stimulation. In all, 119 patients were included in the control group and 63 in the screening group. There was a significant SSI decrease from 10.9% to 1.6% between the two groups (P<0.04; relative risk: 0.13; 95% confidence interval: 0.003-0.922). There were eight SSIs involving S. aureus in the control group, none in the screening group. No specific risk factors for SSI were identified.

  19. A Quality Improvement Approach to Reducing the Caesarean section Surgical Site Infection Rate in a Regional Hospital.

    PubMed

    O'Hanlon, M; McKenna, C; Carton, E; Diviney, D; Costello, M R; O'Sullivan, L; Fitzsimons, J; Toland, L; Dornikova, G; Curran, R; McCann, C; O'Sullivan, L; Doherty, T; Crowley, C; O'Coigligh, S

    2016-09-09

    Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol. Compliance with choice of antibiotic prophylaxis increased from 89.6% in 2014 to 98.5% in 2015. Compliance with timing also improved. The SSI rate of 7.5% was the lowest recorded to date, with the majority of SSIs (64%) diagnosed after hospital discharge. The level of variation was also reduced. However, the continued presence of variation and possibility of lower infection rates from the literature imply that further improvements are required.

  20. Cost Analysis and Surgical Site Infection Rates in Total Knee Arthroplasty Comparing Traditional vs. Single-Use Instrumentation.

    PubMed

    Siegel, Geoffrey W; Patel, Neil N; Milshteyn, Michael A; Buzas, David; Lombardo, Daniel J; Morawa, Lawrence G

    2015-12-01

    Surgical site infections (SSIs) are a significant complications in total knee arthroplasty (TKA). The purpose of this study was to evaluate if traditional vs. single-use instrumentation had an effect on SSI's. We compared SSI rates and costs of TKAs performed with single-use (449) and traditional (169) TKA instrumentation trays. Total OR Time was, on average, 30 min less when single-use instrumentation was used. SSIs decreased in the single-use group (n=1) compared to the traditional group (n=5) (P=0.006). Single-use instrumentation added $490 in initial costs; however it saved between $480 and $600. Single-use instrumentation may provide a benefit to the patient by potentially decreasing the risk of infection and reducing the overall hospital costs.

  1. Use of surveillance data to identify target populations for Staphylococcus aureus vaccines and prevent surgical site infections: A pilot study

    PubMed Central

    Gustin, Marie-Paule; Giard, Marine; Bénet, Thomas; Vanhems, Philippe

    2015-01-01

    The development of anti-staphylococcal vaccines is nowadays a priority to prevent surgical site infections (SSI). The objective of the present study was to identify a potential target population by assessing surveillance data on surgery patients for possible anti-staphylococcal vaccine administration. Individuals at high risk of SSI by Staphylococcus aureus (SA) were targeted by the French SSI Surveillance Network in south-eastern France between 2008 and 2011. Among 238,470 patients, those undergoing primary total hip replacement appeared to be an interesting and healthy enough population for anti-staphylococcal vaccine testing. These male patients, subjected to multiple procedures and with American Society of Anesthesiologists score >2, had a probability of SA SSI about 21 times higher than females with no severe systemic disease and no multiple procedures. Our study indicates that surveillance data on SSI might be an interesting epidemiological source for planning vaccine trials to prevent nosocomial infections. PMID:25668663

  2. 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.

  3. Prophylactic vacuum sealing drainage (VSD) in the prevention of postoperative surgical site infections in pediatric patients with contaminated laparotomy incisions.

    PubMed

    Chen, Bailin; Hao, Fabao; Yang, Yang; Shang, Qingjuan; Guo, Chunbao

    2017-03-01

    Surgical site infection (SSI) continues to be an issue in abdominal surgery, especially for contaminated (class III) and dirty-infected (class IV) wounds. Vacuum sealing drainage (VSD) was reported effective in the management of various types of wounds or skin grafts. Our goal was to investigate the efficacy of prophylactic VSD to better orient their medicosurgical care of high-risk incisions following laparotomy in a pediatric population.A total of 331 pediatric patients with contaminated (class III) and dirty-infected (class IV) wounds following emergency laparotomy were retrospectively reviewed between January 2005 and January 2013. Among them, 111 cases were placed with prophylactic VSD when incisions were closed. Clinical outcomes, including, overall surgical site complication, device effectiveness, and mean postoperative LOS were evaluated based on VSD usage or not.VSD was applied for an average of 5.8 days (range, 5-7 days), with 3 to 15 mL sucked fluid. The overall SSIs rate was 3% for patients with prophylactic VSD and 17% for patients with convention dressing (OR, 0.27; 95% CI, 0.10-0.71, P = 0.004). In patients with prophylactic VSD, only 1 of 96 wound developed postoperative incision dehiscence, which is significant reduced compared with patients for conventional dressings (OR, 0.12; 95% CI, 0.01-0.95; P = 0.017) (Table 2). It also exhibited a decreased mean postoperative LOS (P < 0.001) for prophylactic VSD over conventional dressings.Our study demonstrated beneficial postoperative clinical effects of prophylactic VSD for high-risk laparotomy incisions following emergency laparotomy, such as shorter length of hospitalization, which may be attributed to the reduced overall SSIs rate.

  4. Prophylactic vacuum sealing drainage (VSD) in the prevention of postoperative surgical site infections in pediatric patients with contaminated laparotomy incisions

    PubMed Central

    Chen, Bailin; Hao, Fabao; Yang, Yang; Shang, Qingjuan; Guo, Chunbao

    2017-01-01

    Abstract Surgical site infection (SSI) continues to be an issue in abdominal surgery, especially for contaminated (class III) and dirty-infected (class IV) wounds. Vacuum sealing drainage (VSD) was reported effective in the management of various types of wounds or skin grafts. Our goal was to investigate the efficacy of prophylactic VSD to better orient their medicosurgical care of high-risk incisions following laparotomy in a pediatric population. A total of 331 pediatric patients with contaminated (class III) and dirty-infected (class IV) wounds following emergency laparotomy were retrospectively reviewed between January 2005 and January 2013. Among them, 111 cases were placed with prophylactic VSD when incisions were closed. Clinical outcomes, including, overall surgical site complication, device effectiveness, and mean postoperative LOS were evaluated based on VSD usage or not. VSD was applied for an average of 5.8 days (range, 5–7 days), with 3 to 15 mL sucked fluid. The overall SSIs rate was 3% for patients with prophylactic VSD and 17% for patients with convention dressing (OR, 0.27; 95% CI, 0.10–0.71, P = 0.004). In patients with prophylactic VSD, only 1 of 96 wound developed postoperative incision dehiscence, which is significant reduced compared with patients for conventional dressings (OR, 0.12; 95% CI, 0.01–0.95; P = 0.017) (Table 2). It also exhibited a decreased mean postoperative LOS (P < 0.001) for prophylactic VSD over conventional dressings. Our study demonstrated beneficial postoperative clinical effects of prophylactic VSD for high-risk laparotomy incisions following emergency laparotomy, such as shorter length of hospitalization, which may be attributed to the reduced overall SSIs rate. PMID:28353606

  5. Second Korean guidelines for the management of Crohn's disease

    PubMed Central

    Park, Jae Jun; Ye, Byong Duk; Kim, Jong Wook; Park, Dong Il; Yoon, Hyuk; Im, Jong Pil; Lee, Kang Moon; Yoon, Sang Nam; Lee, Heeyoung

    2017-01-01

    Crohn's disease (CD) is a chronic, progressive, and disabling inflammatory bowel disease (IBD) with an uncertain etiopathogenesis. CD can involve any site of the gastrointestinal tract from the mouth to the anus, and is associated with serious complications, such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower compared with those in Western countries, but they have been rapidly increasing during the recent decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies have been applied for the treatment of this disease. Concerning CD management, there have been substantial discrepancies among clinicians according to their personal experience and preference. To suggest recommendable approaches to the diverse problems of CD and to minimize the variations in treatment among physicians, guidelines for the management of CD were first published in 2012 by the IBD Study Group of the Korean Association for the Study of Intestinal Diseases. These are the revised guidelines based on updated evidence, accumulated since 2012. These guidelines were developed by using mainly adaptation methods, and encompass induction and maintenance treatment of CD, treatment based on disease location, treatment of CD complications, including stricture and fistula, surgical treatment, and prevention of postoperative recurrence. These are the second Korean guidelines for the management of CD and will be continuously revised as new evidence is collected. PMID:28239314

  6. Placental-site trophoblastic tumor with PET scan-detected surgically treated lung metastasis.

    PubMed

    Nieves, Lucybeth; Hoffman, James; Allen, Gretchen; Currie, John; Sorosky, Joel I

    2008-06-01

    Metastatic placental-site trophoblastic tumor (PSTT) continues to be a diagnostic and management dilemma due to its relative resistance to chemotherapy and the difficulties in diagnosing such a rare tumor. We describe a 35-year-old woman with PSTT presenting with irregular bleeding and a mass in the lung. Dilation and curettage provided the diagnosis of PSTT by frozen section of the specimen. Subsequently, a total abdominal hysterectomy was performed and the patient received three cycles of EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine) Positron emission tomography (PET) scan confirmed a persistent lung nodule that was treated with wedge resection. She is currently in clinical remission. Surgery may have a role in salvaging a patient with persistent PET-positive disease after chemotherapy.

  7. Photograph use on social network sites among South Korean college students: the role of public and private self-consciousness.

    PubMed

    Shim, Minsun; Lee, Min Ju; Park, Sang Hee

    2008-08-01

    This study challenges theories of computer-mediated communication (CMC) that typically assume a lack of visual cues in CMC and conceptualize them as a situational factor. We examine individual differences in photo use on social network sites and link them to the dispositional tendency of self-consciousness (SC). Included were 231 students from one university in South Korea, who owned and maintained Cyworld profiles (called "mini-homepages"). Findings suggest that public SC, but not private SC, was positively associated with the higher frequency of posting photos, replying to comments on the photos, and scrapping photos on their mini-homepages. The frequency of posting specific content types of photos (concerning social relationships or life events) was also determined by participants' public SC but not by private SC. Implications of the findings for CMC theories are discussed.

  8. A Population-Based 16-Year Study on the Risk Factors of Surgical Site Infection in Patients after Bone Grafting

    PubMed Central

    Lee, Fang-Hsin; Shen, Po-Chuan; Jou, I-Ming; Li, Chung-Yi; Hsieh, Jeng-Long

    2015-01-01

    Abstract Bone grafting is a commonly used orthopedic surgical procedure that will provide bone formation in bone defects or regions of defective bone healing. A major complication following bone grafting is a postoperative recipient graft site infection that is associated with substantial mortality and increased use of medical resources. The purpose of the study was to identify the risk factors associated with infection after bone-grafting surgery. Data from 1,303,347 patients listed in the Taiwan National Health Insurance Research Database (NHIRD) and admitted to hospitals from 1997 through 2012 who underwent primary bone grafting (mean age: 46.57 years old; mean length of hospital stay: 8.04 days) were analyzed. The incidence of infection by age, hospital stay, gender, income, chronic disease (tuberculosis [TB]; diabetes mellitus [DM]; acquired immunodeficiency syndrome [AIDS]), fracture complications (nonunion; delayed union fracture), types of graft and hospital was evaluated. Three percent of the patients developed a postoperative recipient graft site infection. Multivariable analysis revealed that patients were more likely to develop a post bone-grafting surgery infection if they were older, had a longer hospital stay, were male, had a lower income, or had comorbid TB, DM, or AIDS. Patients were more likely to develop an infection if they had a nonunion, an alloplast graft, or treated in a local clinic. Our findings should provide a clinically relevant reference for surgeons who perform bone grafting. Patients should be informed of the potential risks. PMID:26632703

  9. 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.

  10. Pre-operative urinary tract infection: is it a risk factor for early surgical site infection with hip fracture surgery? A retrospective analysis

    PubMed Central

    Khalfaoui, Mahdi Y; Veravalli, Karunakar; Evans, D Alun

    2017-01-01

    Objective The aims of the current study were to determine whether pre-operative urinary tract infections in patients presenting acutely with neck of femur fractures resulted in a delay to surgery and whether such patients were at increased risk of developing post-operative surgical site infections. Design A retrospective review of all patients presenting with a neck of femur fracture, at a single centre over a one-year period. The hospital hip fracture database was used as the main source of data. Setting UK University Teaching Hospital Participants All patients (n = 460) presenting across a single year study period with a confirmed hip fracture. Outcome measures The presence of pre-operative urinary tract infection, the timing of surgical intervention, the occurrence of post-operative surgical site infection and the pathogens identified. Results A total of 367 patients were operated upon within 24 hours of admission. Urinary infections were the least common cause of delay. A total of 99 patients (21.5%) had pre-operative urinary tract infection. Post-operatively, a total of 57 (12.4%) patients developed a surgical site infection. Among the latter, 31 (54.4%) did not have a pre-operative urinary infection, 23 (40.4%) patients had a pre-operative urinary tract infection, 2 had chronic leg ulcers and one patient had a pre-operative chest infection. Statistically, there was a strong relationship between pre-operative urinary tract infection and the development of post-operative surgical site infection (p-value: 0.0005). Conclusion The results of our study indicate that pre-operative urinary tract infection has a high prevalence amongst those presenting with neck of femur fractures, and this is a risk factor for the later development of post-operative surgical site infection. PMID:28321316

  11. 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

  12. 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

  13. 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.

  14. Effect of triclosan-coated sutures on surgical site infection after gastric cancer surgery via midline laparotomy

    PubMed Central

    Jung, Kuk Hyun; Oh, Seung Jong; Choi, Kang Kook; Kim, Su Mi; Choi, Min Gew; Lee, Jun Ho; Noh, Jae Hyung; Sohn, Tae Sung; Bae, Jae Moon

    2014-01-01

    Purpose Surgical site infection (SSI) after open abdominal surgery is still a frequently reported nosocomial infection. To reduce the incidence of SSI, triclosan-coated sutures with antiseptic activity (Vicryl Plus) were developed. The aim of this study was to analyze the effect of Vicryl Plus on SSI after gastric cancer surgery via midline laparotomy. Methods A total of 916 patients who underwent gastric cancer surgery at Samsung Medical Center between December 2009 and September 2011 were prospectively collected. We examined the occurrence of SSI (primary endpoint), assessments of wound healing (secondary endpoint). They were evaluated postoperatively on days 3, 7, and 30. Results Of the 916 patients, 122 were excluded postoperatively by screening (out of the study protocol, adverse events, etc.). The remaining 794 patients were enrolled and monitored postoperatively. The cumulative SSI incidence was 11 cases (1.39%; 95% confidence interval [CI], 0.77-2.50) on day 30. Seromas were most frequently detected in wound healing assessments, with a cumulative incidence of 147 cases (18.51%; 95% CI, 15.98-21.39) on day 30. Conclusion The use of triclosan-coated sutures (Vicryl Plus) for abdominal wall closure can reduce the number of SSIs in gastric cancer surgery. PMID:25485239

  15. Clinician-led surgical site infection surveillance of orthopaedic procedures: a UK multi-centre pilot study.

    PubMed

    Morgan, M; Black, J; Bone, F; Fry, C; Harris, S; Hogg, S; Holmes, A; Hughes, S; Looker, N; McIlvenny, G; Nixon, J; Nolan, J; Noone, A; Reilly, J; Richards, J; Smyth, E; Howard, A

    2005-07-01

    The UK Department of Health established the Healthcare-associated Infection (HAI) Surveillance Steering Group in 2000 to develop a strategy for implementing a national programme for HAI surveillance in National Health Service trusts. A subgroup of this committee examined the surveillance of surgical site infections following orthopaedic surgery. This group oversaw a pilot scheme that was set up in 12 hospitals around the UK to explore the feasibility of implementing a system of surveillance that engaged clinical staff in its operation, provided a process for continuous data collection and could be maintained as part of routine hospital operation over time. A minimum data set was established by the subgroup, and Centers for Disease Control and Prevention (CDC) definitions of infection were used. By March 2003, the surveillance had been undertaken continuously in 11 sites for one to two years, depending on the date of implementation. Only one hospital had ceased data collection. The information was collected mainly by clinical staff, with support and co-ordination usually provided by infection control teams. Data on more than 5400 procedures were available for analysis for four core procedures: arthroplasty of the hip and knee; hemi-arthroplasty of the hip; and internal fixation of trochanteric fractures of the femur. The data set permitted the calculation of risk-adjusted rates, allowing comparisons between hospitals and within a hospital over time. The methodology enhanced clinical ownership of the surveillance process, re-inforced infection control as the responsibility of all staff, and provided timely feedback and local data analysis. The use of CDC definitions permitted international comparisons of the data.

  16. Surgical hand antisepsis: the evidence.

    PubMed

    Tanner, Judith

    2008-08-01

    For 150 years members of the surgical team have been washing their hands with solutions designed to remove micro-organisms and therefore reduce surgical site infections in patients. This article discusses the evidence surrounding aspects of surgical hand antisepsis.

  17. Triclosan-coated sutures reduce the risk of surgical site infections: a systematic review and meta-analysis.

    PubMed

    Apisarnthanarak, Anucha; Singh, Nalini; Bandong, Aila Nica; Madriaga, Gilbert

    2015-02-01

    OBJECTIVE To analyze available evidence on the effectiveness of triclosan-coated sutures (TCSs) in reducing the risk of surgical site infection (SSI). DESIGN Systematic review and meta-analysis. METHODS A systematic search of both randomized (RCTs) and nonrandomized (non-RCT) studies was performed on PubMed Medline, OVID, EMBASE, and SCOPUS, without restrictions in language and publication type. Random-effects models were utilized and pooled estimates were reported as the relative risk (RR) ratio with 95% confidence interval (CI). Tests for heterogeneity as well as meta-regression, subgroup, and sensitivity analyses were performed. RESULTS A total of 29 studies (22 RCTs, 7 non-RCTs) were included in the meta-analysis. The overall RR of acquiring an SSI was 0.65 (95% CI: 0.55-0.77; I2=42.4%, P=.01) in favor of TCS use. The pooled RR was particularly lower for the abdominal surgery group (RR: 0.56; 95% CI: 0.41-0.77) and was robust to sensitivity analysis. Meta-regression analysis revealed that study design, in part, may explain heterogeneity (P=.03). The pooled RR subgroup meta-analyses for randomized controlled trials (RCTs) and non-RCTs were 0.74 (95% CI: 0.61-0.89) and 0.53 (95% CI: 0.42-0.66), respectively, both of which favored the use of TCSs. CONCLUSION The random-effects meta-analysis based on RCTs suggests that TCSs reduced the risk of SSI by 26% among patients undergoing surgery. This effect was particularly evident among those who underwent abdominal surgery.

  18. 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

  19. 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

  20. Risk factors for unavoidable removal of instrumentation after surgical site infection of spine surgery: A retrospective case-control study.

    PubMed

    Tominaga, Hiroyuki; Setoguchi, Takao; Kawamura, Hideki; Kawamura, Ichiro; Nagano, Satoshi; Abematsu, Masahiko; Tanabe, Fumito; Ishidou, Yasuhiro; Yamamoto, Takuya; Komiya, Setsuro

    2016-10-01

    Surgical site infection (SSI) after spine instrumentation is difficult to treat, and often requires removal of instrumentation. The removal of instrumentation after spine surgery is a severe complication that can lead to the deterioration of activities of daily living and poor prognosis. Although there are many reports on SSI after spine surgery, few reports have investigated the risk factors for the removal of instrumentation after spine surgery SSI. This study aimed to identify the risk factors for unavoidable removal of instrumentation after SSI of spine surgery. We retrospectively reviewed 511 patients who underwent spine surgery with instrumentation at Kagoshima University Hospital from January 2006 to December 2014. Risk factors associated with SSI were analyzed via multiple logistic regression analysis. Parameters of the group that needed instrumentation removal were compared with the group that did not require instrumentation removal using the Mann-Whitney U and Fisher's exact tests. The posterior approach was used in most cases (453 of 511 cases, 88.6%). SSI occurred in 16 of 511 cases (3.14%) of spine surgery with instrumentation. Multivariate logistic regression analysis identified 2 significant risk factors for SSI: operation time, and American Society of Anesthesiologists physical status classification ≥ 3. Twelve of the 16 patients with SSI (75%) were able to keep the instrumentation after SSI. Pseudarthrosis occurred in 2 of 4 cases (50%) after instrumentation removal. Risk factors identified for instrumentation removal after spine SSI were a greater number of past surgeries, low preoperative hemoglobin, high preoperative creatinine, high postoperative infection treatment score for the spine, and the presence of methicillin-resistant Staphylococcus aureus. In these high risk cases, attempts should be made to decrease the risk factors preoperatively, and careful postoperative monitoring should be conducted.

  1. 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.

  2. Korean women's breast cancer experience.

    PubMed

    Im, Eun-Ok; Lee, Eun Ok; Park, Young Sook

    2002-11-01

    The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) "I did wrong," (b) "I cannot ask male physicians." (c) "I don't want to show the operation site to my husband." and (d) "I do household tasks by myself." The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women's health/illness experience.

  3. Distribution of methicillin-resistant coagulase-positive staphylococci (MRCoPS) in a surgical unit and cystotomy operation sites in a veterinary teaching hospital

    PubMed Central

    FUNGWITHAYA, Punpichaya; BRIKSHAVANA, Pasakorn; CHANCHAITHONG, Pattrarat; PRAPASARAKUL, Nuvee

    2016-01-01

    This study aimed to investigate the spread of methicillin-resistant coagulase-positive staphylococci (MRCoPS) among veterinary staff, hand-touch sites and surgical tissue during cystotomy operations on cats and dogs that were patients, and to analyze the genetic relatedness and antimicrobial resistance profiles of the isolates. Human and environmental samples were obtained from the nasal passageways of 12 surgeons and veterinary assistants and from 29 hand-touch sites of instruments in operative units and subjected to bacterial isolation and enumeration. Swab samples were collected in triplicate from 29 dogs and three cats at the site of incision, from the incision area, from the peritoneum during surgery and from the peritoneum before suture. MRCoPS were identified by mecA gene detection and characterized by their antibiogram profile, SCCmec type and pulsed-field gel electrophoresis. Twenty-four staphylococci were isolated, derived from one veterinary assistant, 12 operating room floor areas and hand-touch sites, three dogs and one cat. Methicillin-resistant S. pseudintermedius (MRSP) was found on an electric clipper and rebreathing circuits in the operating room. Three dogs were positive for MRSP during surgery, and one methicillin-resistant S. aureus (MRSA) was detected in a cat. All MRCoPS were resistant to doxycycline, erythromycin, clindamycin and enrofloxacin, but no patients developed surgical site infections. According to their genotypic patterns, the clones obtained from the environment and human sources differed from the animal clones. Despite intensive hygienic management, a variety of MRCoPS clones were present within the surgical unit and during surgery. PMID:27990009

  4. Distribution of methicillin-resistant coagulase-positive staphylococci (MRCoPS) in a surgical unit and cystotomy operation sites in a veterinary teaching hospital.

    PubMed

    Fungwithaya, Punpichaya; Brikshavana, Pasakorn; Chanchaithong, Pattrarat; Prapasarakul, Nuvee

    2017-02-28

    This study aimed to investigate the spread of methicillin-resistant coagulase-positive staphylococci (MRCoPS) among veterinary staff, hand-touch sites and surgical tissue during cystotomy operations on cats and dogs that were patients, and to analyze the genetic relatedness and antimicrobial resistance profiles of the isolates. Human and environmental samples were obtained from the nasal passageways of 12 surgeons and veterinary assistants and from 29 hand-touch sites of instruments in operative units and subjected to bacterial isolation and enumeration. Swab samples were collected in triplicate from 29 dogs and three cats at the site of incision, from the incision area, from the peritoneum during surgery and from the peritoneum before suture. MRCoPS were identified by mecA gene detection and characterized by their antibiogram profile, SCCmec type and pulsed-field gel electrophoresis. Twenty-four staphylococci were isolated, derived from one veterinary assistant, 12 operating room floor areas and hand-touch sites, three dogs and one cat. Methicillin-resistant S. pseudintermedius (MRSP) was found on an electric clipper and rebreathing circuits in the operating room. Three dogs were positive for MRSP during surgery, and one methicillin-resistant S. aureus (MRSA) was detected in a cat. All MRCoPS were resistant to doxycycline, erythromycin, clindamycin and enrofloxacin, but no patients developed surgical site infections. According to their genotypic patterns, the clones obtained from the environment and human sources differed from the animal clones. Despite intensive hygienic management, a variety of MRCoPS clones were present within the surgical unit and during surgery.

  5. Korean Hemorrhagic Fever.

    DTIC Science & Technology

    1982-05-01

    Medicine Seoul, Korea * S 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SUM ARY Urban rats captured in Seoul and four nearby Korean cities were found to have...rattus, urban Korean cities, 1980. . . . 15 Table 2. Isolation of Hantaan virus from antigen-positive wild house rats, Korea , 1980 .... ........... .. 16...Figures Figure 1. Map of Seoul City, South Korea and metropolitan area showing locations of urban Korean hemorrhagic fever cases, andRattu s positive

  6. Prospects from Korean Reunification

    DTIC Science & Technology

    2008-04-01

    South Korea , China, the United States and, to a lesser extent, Japan and Russia will be examined to determine prospects from Korean reunification...the “tilt” of a unified Korea , and with it, the future Northeast Asian strategic environment. 1 PROSPECTS FROM KOREAN REUNIFCATION Throughout most of...the 20th century, the Korean people have yearned for the establishment of an independent and unified Korea . Before World War II, this was denied to

  7. A case-control study of surgical site infection following operative fixation of fractures of the ankle in a large U.K. trauma unit.

    PubMed

    Korim, M T; Payne, R; Bhatia, M

    2014-05-01

    Most of the literature on surgical site infections following the surgical treatment of fractures of the ankle is based on small series of patients, focusing on diabetics or the elderly. None have described post-operative functional scores in those patients who develop an infection. We performed an age- and gender-matched case-control study to identify patient- and surgery-related risk factors for surgical site infection following open reduction and internal fixation of a fracture of the ankle. Logistic regression analysis was used to identify significant risk factors for infection and to calculate odds ratios (OR). Function was assessed using the Olerud and Molander Ankle Score. The incidence of infection was 4% (29/717) and 1.1% (8/717) were deep infections. The median ankle score was significantly lower in the infection group compared with the control group (60 vs 90, Mann-Whitney test p < 0.0001). Multivariate regression analysis showed that diabetes (OR = 15, p = 0.031), nursing home residence (OR = 12, p = 0.018) and Weber C fractures (OR = 4, p = 0.048) were significant risk factors for infection. A low incidence of infection following open reduction and internal fixation of fractures of the ankle was observed. Both superficial and deep infections result in lower functional scores.

  8. Low skeletal muscle radiation attenuation and visceral adiposity are associated with overall survival and surgical site infections in patients with pancreatic cancer

    PubMed Central

    Bakens, Maikel J. A. M.; Coolsen, Mariëlle M. E.; Rensen, Sander S.; van Dam, Ronald M.; Bours, Martijn J. L.; Weijenberg, Matty P.; Dejong, Cornelis H. C.; Olde Damink, Steven W. M.

    2016-01-01

    Abstract Background Cancer cachexia and skeletal muscle wasting are related to poor survival. In this study, quantitative body composition measurements using computed tomography (CT) were investigated in relation to survival, post‐operative complications, and surgical site infections in surgical patients with cancer of the head of the pancreas. Methods A prospective cohort of 199 patients with cancer of the head of the pancreas was analysed by CT imaging at the L3 level to determine (i) muscle radiation attenuation (average Hounsfield units of total L3 skeletal muscle); (ii) visceral adipose tissue area; (iii) subcutaneous adipose tissue area; (iv) intermuscular adipose tissue area; and (v) skeletal muscle area. Sex‐specific cut‐offs were determined at the lower tertile for muscle radiation attenuation and skeletal muscle area and the higher tertile for adipose tissues. These variables of body composition were related to overall survival, severe post‐operative complications (Dindo–Clavien ≥ 3), and surgical site infections (wounds inspected daily by an independent trial nurse) using Cox‐regression analysis and multivariable logistic regression analysis, respectively. Results Low muscle radiation attenuation was associated with shorter survival in comparison with moderate and high muscle radiation attenuation [median survival 10.8 (95% CI: 8.8–12.8) vs. 17.4 (95% CI: 14.7–20.1), and 18.5 (95% CI: 9.2–27.8) months, respectively; P < 0.008]. Patient subgroups with high muscle radiation attenuation combined with either low visceral adipose tissue or age <70 years had longer survival than other subgroups (P = 0.011 and P = 0.001, respectively). Muscle radiation attenuation was inversely correlated with intermuscular adipose tissue (r p = −0.697, P < 0.001). High visceral adipose tissue was associated with an increased surgical site infection rate, OR: 2.4 (95% CI: 1.1–5.3; P = 0.027). Conclusions Low muscle radiation

  9. Rapid orthodontic treatment after the ridge-splitting technique--a combined surgical-orthodontic approach for implant site development: case report.

    PubMed

    Amato, Francesco; Mirabella, A Davide; Borlizzi, Diego

    2012-08-01

    This article presents a clinical case of bilateral partial edentulism in the posterior mandible with severe horizontal and moderate vertical bone atrophy. A new technique using rapid orthodontics after ridge splitting is presented. The split-crest technique was carried out using piezosurgical instruments in the first molar and second premolar areas to widen the bone crest and open a channel for tooth movement. Immediately after, orthodontic appliances were used to move the first premolars distally and the second molars mesially into the surgical site. The rationale was to facilitate and accelerate orthodontic movement of the teeth, which is otherwise difficult in a cortical knife-edged ridge. The bone defect was filled with the alveolar bone of the adjacent teeth that were moved into the surgically opened path. Adequate bone volume for implant placement was generated in the first premolar area. Implants were then inserted, and the patient was rehabilitated.

  10. 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. ...

  11. Spoken Korean: Book One.

    ERIC Educational Resources Information Center

    Lukoff, Fred

    This text is designed for students planning to learn spoken Korean. Ten lessons and two review sections based on cultural experiences commonly shared by Koreans are included in the text. Grouped in series of five lessons, the instructional materials include (1) basic sentences, (2) word study and review of basic sentences, (3) listening…

  12. Korean Hemorrhagic Fever.

    DTIC Science & Technology

    Korean hemorrhagic fever (KHF) occurred for the first time in Korea , 1951, although it had previously been known to both the Japanese and Russians...After Korean war, the disease has been fixed in the areas of DMZ as an endemic one, and from 100 to 400 cases have been being reportee every year

  13. 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…

  14. [Use of plastic adhesive drapes during surgery may increase the risk of surgical site infections. A survey of a Cochrane review].

    PubMed

    Qvist, Niels; Kolmos, Hans Jørn J

    2009-10-05

    In theory, the products act as a barrier, which hinders the spreading of bacteria from the deeper skin layers and hair follicles to the incision. On the other hand, the use of plastic adhesive drapes may promote bacterial overgrowth due to a >greenhouse effect<. This Cochrane review which is based on seven trials showed that there was no evidence that plastic adhesive drapes reduces the surgical site infection rate and some evidence that they increase infection rates in clean operations. Consequently, their use should be abandoned. Further studies are warranted to determine the effect of other adhesive products currently used.

  15. 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

  16. 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.

  17. An In Vitro Comparison of PMMA and Calcium Sulfate as Carriers for the Local Delivery of Gallium(III) Nitrate to Staphylococcal Infected Surgical Sites

    PubMed Central

    Garcia, Rebecca A.; Tennent, David J.; Chang, David; Wenke, Joseph C.; Sanchez, Carlos J.

    2016-01-01

    Antibiotic-loaded bone cements, including poly(methyl methacrylate) (PMMA) and calcium sulfate (CaSO4), are often used for treatment of orthopaedic infections involving Staphylococcus spp., although the effectiveness of this treatment modality may be limited due to the emergence of antimicrobial resistance and/or the development of biofilms within surgical sites. Gallium(III) is an iron analog capable of inhibiting essential iron-dependent pathways, exerting broad antimicrobial activity against multiple microorganisms, including Staphylococcus spp. Herein, we evaluated PMMA and CaSO4 as carriers for delivery of gallium(III) nitrate (Ga(NO3)3) to infected surgical sites by assessing the release kinetics subsequent to incorporation and antimicrobial activity against S. aureus and S. epidermidis. PMMA and to a lesser extent CaSO4 were observed to be compatible as carriers for Ga(NO3)3, eluting concentrations with antimicrobial activity against planktonic bacteria, inhibiting bacterial growth, and preventing bacterial colonization of beads, and effective against established bacterial biofilms of S. aureus and S. epidermidis. Collectively, our in vitro results indicate that PMMA is a more suitable carrier compared to CaSO4 for delivery of Ga(NO3)3; moreover they provide evidence for the potential use of Ga(NO3)3 with PMMA as a strategy for the prevention and/or treatment for orthopaedic infections. PMID:26885514

  18. Korean Hemorrhagic Fever.

    DTIC Science & Technology

    1980-03-01

    AD-A<m 761 KOREA UNIV SEOUL COLL OF MEDICINE KOREAN HEM0RRHA6IC FEVER.(U) MAR 80 H W LEE UNCLASSIFIED ICFI F/6 6/5 DAM017-79-6-9<*55 NL...I» > I,,iu. •Uli ••-. SUMMARY There were 364 hospitalized cases of Korean hemorrhagic fever (KHF) in 1979 in Korea . Lee et al...STANDARDS-1963-A ?H "LEVEtf® AD <o KOREAN HEMORRHAGIC F EVER A D A 09 47 Final Report HO WANG LEE, M. D. March 1980 i MIL. IIB«I . Mm k iw

  19. Korean Affairs Report.

    DTIC Science & Technology

    2007-11-02

    Korea has fortified all the frontline areas, building underground positions and concealing various weapons. It is even constructing gun positions...also noted that North Korean Frog missiles and self-propelled guns posted just north of the DMZ can hit Seoul directly. North Korean engineer...being major figures in radical student movement. They include U Su- chin , 22, of Songgyung- wan University who is also chairman of the radical student

  20. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    publications contain information primarily from foreign newspapers, periodicals and books, but also from news agency transmissions and broadcasts...Pyongyang Domestic Service, 23 Dec 86) l Commentary on White Paper About Kumgangsan Dam (Cho Tu-ul; Pyongyang Domestic Service, 26 Dec 86) 3 Party...ruin. /8309 CSO: 4110/056 INTER-KOREAN AFFAIRS COMMENTARY ON WHITE PAPER ABOUT KUMGANGSAN DAM SK280105 Pyongyang Domestic Service in Korean 1150

  1. Back to Basics: Surgical Skin Antisepsis.

    PubMed

    Spruce, Lisa

    2016-01-01

    The fundamental basis for preventing surgical site infections is the antiseptic preparation of the skin at the surgical site. All perioperative nurses must learn this skill. The goal of surgical skin antisepsis, frequently referred to as prepping the skin, is to remove soil and transient (ie, temporary) microorganisms living on the skin that could pose a risk for surgical site infections. This Back to Basics article examines the origin of surgical skin antisepsis and the steps perioperative nurses should take to provide the patient with an aseptic surgical site before any surgical or other invasive procedure.

  2. Effects of position change on lumbar pain and discomfort of Korean patients after invasive percutaneous coronary intervention: a RCT study

    PubMed Central

    Cha, Nam Hyun; Sok, Sohyune

    2016-01-01

    [Purpose] This study sought to examine the effects of position change on lumbar pain and discomfort of Korean patients after invasive percutaneous coronary intervention. [Subjects and Methods] The participants consisted of 48 patients (experimental: n=24, control: n=24) who underwent invasive coronary intervention (Percutaneous Coronary Intervention) in K hospital, Seoul, Korea. A randomized controlled trial design was used. Position changes as the experimental treatment were sequenced as follows: supine position for one hour after removal of the catheter; 30-degree bed-elevated lateral position for one hour; 30-degree bed elevation for one hour; and finally 30-degree bed-elevated lateral position for one hour. The thirty degree bed-elevated lateral position was intended to press on the surgical site. Measures used were the general characteristics form, Visual Analogue Scale for lumbar pain, and discomfort scale. [Results] There were significant differences on lumbar pain and discomfort of Korean patients after invasive coronary intervention between the experimental and control groups. [Conclusion] Position change was an effective intervention for decreasing lumbar pain and discomfort of Korean patients after invasive coronary intervention. Health professionals need to consider an array of methods including position change for patients after invasive coronary intervention. PMID:27821926

  3. Koreans in Japan: Their Influence on Korean-Japanese Relations.

    DTIC Science & Technology

    1979-09-01

    realization that their homeland was a far cry from heaven. More and more people came to see 23 the reality, that food and shelter were not readily available...exclusive or militant but are strongly individualistic and perservering , and they are adaptable and disunited. 84 The Korean disposition is attributed to the...District in China are surprised that they maintain the Korean style of living almost completely, speaking Korean, eating Korean food , living in ondol

  4. Preoperative screening/decolonization for Staphylococcus aureus to prevent orthopedic surgical site infection: prospective cohort study with 2-year follow-up.

    PubMed

    Rao, Nalini; Cannella, Barbara A; Crossett, Lawrence S; Yates, Adolph J; McGough, Richard L; Hamilton, Cindy W

    2011-12-01

    We quantified surgical site infections (SSIs) after preoperative screening/selective decolonization before elective total joint arthroplasty (TJA) with 2-year follow-up and 2 controls. Concurrent controls (n = 2284) were patients of surgeons not participating in screening/decolonization. Preintervention controls (n = 741) were patients of participating surgeons who underwent TJA the previous year. Staphylococcus aureus nasal carriers (321/1285 [25%]) used intranasal mupirocin and chlorhexidine baths as outpatients. Staphylococcal SSIs occurred in no intervention patients (0/321) and 19 concurrent controls. If all SSIs occurred in carriers and 25% of controls were carriers, staphylococcal SSI rate would have been 3.3% in controls (19/571; P = .001). Overall SSI rate decreased from 2.7% (20/741) in preintervention controls to 1.2% (17/1440) in intervention patients (P = .009). Preoperative screening/selective decolonization was associated with fewer SSIs after elective TJA.

  5. 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.

  6. Incidence and Risk Factors for and the Effect of a Program To Reduce the Incidence of Surgical Site Infection after Cardiac Surgery

    PubMed Central

    Cohen, Bevin; Hyman, Sandra; Larson, Elaine; Fowler, Dennis L.

    2014-01-01

    Abstract Background: Surgical site infection (SSI) after cardiac surgery (CS) is a serious complication that increases hospital length of stay (LOS), has a substantial financial impact, and increases mortality. The study described here was done to evaluate the effect of a program to reduce SSI after CS. Methods: In January 2007, a multi-disciplinary CS infection-prevention team developed guidelines and implemented bundled tactics for reducing SSI. Data for all patients who underwent CS from 2006–2008 were used to determine whether there was: 1) A difference in the incidence of SSI in white patients and those belonging to minority groups; 2) a reduction in SSI after intervention; and 3) a statistically significant difference in the incidence of SSI in the third quarter of each year as compared with the other quarters of the year. Results: Of 3,418 patients who underwent CS; 1,125 (32.9%) were members of minority groups and 2,293 (67.1%) were white. Eighty (2.3%) patients developed SSI. There was no significant difference in the incidence of SSI in non-Hispanic white patients and all others (2.1% vs. 2.8%, p=0. 42). The incidence of SSI decreased significantly from 2006 (3.0%) to 2007 (2.5%) and 2008 (1.4%), (p=0.03). Surgical site infection occurred more often in the third quarter of each of the years of the study than in other quarters of each year (3.3 vs. 2.0%, p=0.038). Conclusions: Implementation of a program to reduce SSI after CS was associated with a lower incidence of SSI across all racial and ethnic groups and over time, but was not associated with a lower incidence of SSI in the third quarter of each year than in the other quarters. PMID:24800982

  7. 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

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

    PubMed

    von Bormann, Benno; 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.

  9. Laparoendoscopic single-site (LESS) adrenalectomy and partial nephrectomy: current Italian experience with two challenging surgical procedures.

    PubMed

    Cindolo, Luca; Scoffone, Cesare; Salzano, Luigi; Autorino, Riccardo; Mirone, Vincenzo; Schips, Luigi

    2010-10-01

    Since its initial clinical use in urology, there has been an increasing enthusiasm and a growing interest for laparoendoscopic single-site surgery (LESS). Several clinical series have been reported with an estimated cumulative clinical experience of more than four hundred so far. Nowadays, virtually all extirpative and reconstructive urological procedures have been described and shown to be feasible and safe, including advanced reconstructive procedures and major extirpative ones. Among them, adrenalectomy and partial nephrectomy represent highly complex procedures. Initial clinical data have been recently reported to test the safety and efficacy of these interventions in selected patients. Herein, we describe our initial cases of unclamp LESS partial nephrectomy and adrenalectomy. In our opinion, LESS is an established technique within the field of minimally invasive surgery. Even if further studies are needed to demonstrate its actual benefits, early clinical outcomes are encouraging and LESS might represent the way to go in minimally invasive urological surgery.

  10. 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.

  11. A Population-Based 16-Year Study on the Risk Factors of Surgical Site Infection in Patients after Bone Grafting: A Cross-Sectional Study in Taiwan.

    PubMed

    Lee, Fang-Hsin; Shen, Po-Chuan; Jou, I-Ming; Li, Chung-Yi; Hsieh, Jeng-Long

    2015-11-01

    Bone grafting is a commonly used orthopedic surgical procedure that will provide bone formation in bone defects or regions of defective bone healing. A major complication following bone grafting is a postoperative recipient graft site infection that is associated with substantial mortality and increased use of medical resources. The purpose of the study was to identify the risk factors associated with infection after bone-grafting surgery.Data from 1,303,347 patients listed in the Taiwan National Health Insurance Research Database (NHIRD) and admitted to hospitals from 1997 through 2012 who underwent primary bone grafting (mean age: 46.57 years old; mean length of hospital stay: 8.04 days) were analyzed. The incidence of infection by age, hospital stay, gender, income, chronic disease (tuberculosis [TB]; diabetes mellitus [DM]; acquired immunodeficiency syndrome [AIDS]), fracture complications (nonunion; delayed union fracture), types of graft and hospital was evaluated.Three percent of the patients developed a postoperative recipient graft site infection. Multivariable analysis revealed that patients were more likely to develop a post bone-grafting surgery infection if they were older, had a longer hospital stay, were male, had a lower income, or had comorbid TB, DM, or AIDS. Patients were more likely to develop an infection if they had a nonunion, an alloplast graft, or treated in a local clinic.Our findings should provide a clinically relevant reference for surgeons who perform bone grafting. Patients should be informed of the potential risks.

  12. 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…

  13. 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.

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

    PubMed

    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.

  15. Korean Hemorrhagic Fever.

    DTIC Science & Technology

    Korean hemorrhagic fever (KHF) occurred for the first time in Korea , 1951, although it had previously been known to both the Japanese and Russians...After Korean war, the disease has been fixed in the areas of DMZ as an endemic one, and from 100 to 300 cases have been reported every year. The aims...but in 1971 affected the middle districts and in 1972 invaded the southern parts of South Korea . The number of patients and the areas of KHF in 1972

  16. Surgical site infections in liver transplant recipients in the model for end-stage liver disease era: an analysis of the epidemiology, risk factors, and outcomes.

    PubMed

    Freire, Maristela Pinheiro; Soares Oshiro, Isabel C V; Bonazzi, Patricia Rodrigues; Guimarães, Thais; Ramos Figueira, Estela Regina; Bacchella, Telésforo; Costa, Silvia Figueiredo; Carneiro D'Albuquerque, Luiz Augusto; Abdala, Edson

    2013-09-01

    In recipients of liver transplantation (LT), surgical site infection (SSIs) are among the most common types of infection occurring in the first 60 days after LT. In 2007, the Model for End-Stage Liver Disease (MELD) scoring system was adopted as the basis for prioritizing organ allocation. Patients with higher MELD scores are at higher risk for developing SSIs as well as other health care-associated infections. However, there have been no studies comparing the incidence of SSIs in the pre-MELD era with the incidence in the period since its adoption. Therefore, the objectives of this study were to evaluate the incidence, etiology, epidemiology, and outcomes of post-LT SSIs in those 2 periods and to identify risk factors for SSIs. We evaluated all patients who underwent LT over a 10-year period (2002-2011). SSI cases were identified through active surveillance. The primary outcome measure was an SSI during the first 60 days after LT. Risk factors were analyzed via logistic regression, and 60-day survival rates were evaluated via Cox regression. We evaluated 543 patients who underwent LT 597 times. The SSI rates in the 2002-2006 and 2007-2011 periods were 30% and 24%, respectively (P = 0.21). We identified the following risk factors for SSIs: retransplantation, the transfusion of more than 2 U of blood during LT, dialysis, cold ischemia for >400 minutes, and a cytomegalovirus infection. The overall 60-day survival rate was 79%. Risk factors for 60-day mortality were retransplantation, dialysis, and a longer surgical time. The use of the MELD score modified the incidence and epidemiology of SSIs only during the first year after its adoption. Risks for SSIs were related more to intraoperative conditions and intercurrences after LT than to a patient's status before LT.

  17. 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

  18. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    while attempting to put the cart before the horse and trying to make U.S. commitment of the South Korean armed forces to squashing of the uprising...Minister Rajiv Gandhi . This proposal, modeled on the Helsinki Conference for East- West security, is nothing but an Asian version of the Warsaw Pact

  19. Finite Control in Korean

    ERIC Educational Resources Information Center

    Lee, Kum Young

    2009-01-01

    This thesis explores finite control in Korean. An overview of the previous studies of control shows that the mainstream literature on control has consistently argued that referential dependence between an overt matrix argument and an embedded null subject is characteristic of non-finite clauses which contain a PRO subject. Moreover, although some…

  20. Korean Phrase Book.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    This is a brief guide to Korean pronunciation and phrases, prepared for U.S. Navy personnel. Expressions are grouped according to the following headings: (1) emergency expressions; (2) general expressions; (3) personal needs; (4) location and terrain; (5) roads and transportation; (6) communications; (7) letters, numbers, size, time, etc.; (8)…

  1. North Korean Paradoxes. Circumstances, Costs, and Consequences of Korean Unification

    DTIC Science & Technology

    2005-01-01

    paper) 1. Korean reunification question (1945- ) 2. Korea (North)-Economic policy. 3. Korea (North)--Politics and government. 4. Security, International...order@rand.org Preface This monograph, focusing on North Korea , analyzes some of the economic, political, and security issues associated with Korean ...Northeast Asia. iii iv North Korean Paradoxes This research was performed within the International Security and Defense Policy Center of the RAND National

  2. The Role of Topical Antiseptic Agents Within Antimicrobial Stewardship Strategies for Prevention and Treatment of Surgical Site and Chronic Open Wound Infection

    PubMed Central

    Roberts, Christopher D.; Leaper, David J.; Assadian, Ojan

    2017-01-01

    Scope and Significance: The topical use of antiseptics for wound care has a role in an antimicrobial stewardship strategy. However, the details of this role need clarification. Further clinical research into the use of topical antiseptics in wound care would lower the risk of furthering antibiotic resistance and contribute to more effective antibiotic use. As part of this research, experimental and surveillance data are needed on the resistance and tolerance patterns associated with topical antiseptic use in wound infections. Objective: The development of antibiotic resistance presents global challenges in terms of patient harm and increased healthcare costs. The treatment of “at risk” and infected wounds contributes to this conundrum. Synergies between antibiotics and antiseptics and their appropriate combined use need exploration. Approach: A review of available evidence on the appropriateness of antiseptics as a fundamental component of antimicrobial stewardship strategies has been undertaken. Innovation: Opening up new ways of thinking and identifying gaps of knowledge will lead to optimizing justification of antimicrobial choices and combinations. This may lead to changes in practice in terms of solutions for the prevention and treatment of wound infection. Conclusion: Antiseptics are an integral part of antimicrobial stewardship strategies for the prevention and treatment of surgical site and chronic open wound infections. PMID:28224049

  3. [Assessing the effect of subcuticular buried sutures with subcutaneous closed suction drain to prevent surgical site infection in patients undergoing total cystectomy with urinary diversion using intestine].

    PubMed

    Kanamaru, Sojun; Tsuchihashi, Kazunari; Makino, Yuki; Shimizu, Yosuke; Ito, Noriyuki

    2014-11-01

    We assessed the effect of subcuticular buried sutures with subcutaneous closed suction drain to prevent surgical site infection (SSI) in patients undergoing total cystectomy with urinary diversion using the intestine. We reviewed the clinical charts of 43 consecutive patients who underwent total cystectomy with urinary diversion using the intestine from February 2006 to March 2011 at Nishi-Kobe Medical Center. All patients received intravenous prophylactic antibiotics before and throughout surgery as well as for three days after surgery. Skin closure was performed with interrupted vertical mattress sutures with 2-0 nylon on the first 22 patients (mattress group), and with interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous closed suction drain on the remaining 21 patients (subcuticular buried suture with subcutaneous drain; SBD group). SSI occurred in 7 (31.8%) patients in the mattress group, but did not affect any patient in the SBD group. We compared risk factors for SSI between the groups, and found that the method of skin closure was significant risk factor for SSI (P = 0.005). We concluded that interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous suction drain is effective for prevention of SSI in total cystectomy with urinary diversion using the intestine.

  4. Using an Agent-Based Model to Examine the Role of Dynamic Bacterial Virulence Potential in the Pathogenesis of Surgical Site Infection

    PubMed Central

    Gopalakrishnan, Vissagan; Kim, Moses; An, Gary

    2013-01-01

    Objective Despite clinical advances, surgical site infections (SSIs) remain a problem. The development of SSIs involves a complex interplay between the cellular and molecular mechanisms of wound healing and contaminating bacteria, and here, we utilize an agent-based model (ABM) to investigate the role of bacterial virulence potential in the pathogenesis of SSI. Approach The Muscle Wound ABM (MWABM) incorporates muscle cells, neutrophils, macrophages, myoblasts, abstracted blood vessels, and avirulent/virulent bacteria to simulate the pathogenesis of SSIs. Simulated bacteria with virulence potential can mutate to possess resistance to reactive oxygen species and increased invasiveness. Simulated experiments (t=7 days) involved parameter sweeps of initial wound size to identify transition zones between healed and nonhealed wounds/SSIs, and to evaluate the effect of avirulent/virulent bacteria. Results The MWABM reproduced the dynamics of normal successful healing, including a transition zone in initial wound size beyond which healing was significantly impaired. Parameter sweeps with avirulent bacteria demonstrated that smaller wound sizes were associated with healing failure. This effect was even more pronounced with the addition of virulence potential to the contaminating bacteria. Innovation The MWABM integrates the myriad factors involved in the healing of a normal wound and the pathogenesis of SSIs. This type of model can serve as a useful framework into which more detailed mechanistic knowledge can be embedded. Conclusion Future work will involve more comprehensive representation of host factors, and especially the ability of those host factors to activate virulence potential in the microbes involved. PMID:24761337

  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. Lymphopenia at 4 Days Postoperatively Is the Most Significant Laboratory Marker for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery

    PubMed Central

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

    2016-01-01

    Study Design Case control study. Purpose To identify the most significant laboratory marker for early detection of surgical site infection (SSI) using multiple logistic regression analysis. Overview of Literature SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial. Methods We retrospectively reviewed the laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spinal disease from January 2003 to December 2014. Six laboratory markers for early SSI detection were considered: renewed elevation of the white blood cell count, higher at 7 than 4 days postoperatively; renewed elevation of the C-reactive protein (CRP) level, higher at 7 than 4 days postoperatively; CRP level of >10 mg/dL at 4 days postoperatively; neutrophil percentage of >75% at 4 days postoperatively; lymphocyte percentage of <10% at 4 days postoperatively; and lymphocyte count of <1,000/µL at 4 days postoperatively. Results Ninety patients were enrolled; five developed deep SSI. Multivariate regression analysis showed that a lymphocyte count of <1,000/µL at 4 days postoperatively was the sole significant independent laboratory marker for early detection of SSI (p=0.037; odds ratio, 11.9; 95% confidence interval, 1.2–122.7). Conclusions A lymphocyte count of <1,000/µL at 4 days postoperatively is the most significant laboratory marker for early detection of SSI. PMID:27994779

  7. Naval Cooperation After Korean Unification,

    DTIC Science & Technology

    1996-05-01

    Korean Unification _ ’ - < ~ ■::-■;-■’ "’&■ ■ *>’ -■ ■’■ I Analyses for Defense Analyses Center for Korea ... Korea Institute for Defense Analyses (KIDA) held a workshop in Washington, DC, from December 4 to 6, 1995, to examine the prospects for U.S.- Korean ... Korean Navy, coastal missions are certain to continue. Korea will still require defense of its coastlines; regulatory missions to enforce

  8. Efficacy of a dual-ring wound protector for prevention of incisional surgical site infection after Whipple's procedure (pancreaticoduodenectomy) with preoperatively-placed intrabiliary stents: protocol for a randomised controlled trial

    PubMed Central

    Bressan, Alexsander K; Roberts, Derek J; Edwards, Janet P; Bhatti, Sana U; Dixon, Elijah; Sutherland, Francis R; Bathe, Oliver; Ball, Chad G

    2014-01-01

    Introduction Among surgical oncology patients, incisional surgical site infection is associated with substantially increased morbidity, mortality and healthcare costs. Moreover, while adults undergoing pancreaticoduodenectomy with preoperative placement of an intrabiliary stent have a high risk of this type of infection, and wound protectors may significantly reduce its risk, no relevant studies of wound protectors yet exist involving this patient population. This study will evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among adults undergoing pancreaticoduodenectomy with preoperatively-placed intrabiliary stents. Methods and analysis This study will be a parallel, dual-arm, randomised controlled trial that will utilise a more explanatory than pragmatic attitude. All adults (≥18 years) undergoing a pancreaticoduodenectomy at the Foothills Medical Centre in Calgary, Alberta, Canada with preoperative placement of an intrabiliary stent will be considered eligible. Exclusion criteria will include patient age <18 years and those receiving long-term glucocorticoids. The trial will employ block randomisation to allocate patients to a commercial dual-ring wound protector (the Alexis Wound Protector) or no wound protector and the current standard of care. The main outcome measure will be the rate of surgical site infection as defined by the Centers for Disease Control and Prevention criteria within 30 days of the index operation date as determined by a research assistant blinded to treatment allocation. Outcomes will be analysed by a statistician blinded to allocation status by calculating risk ratios and 95% CIs and compared using Fisher's exact test. Ethics and dissemination This will be the first randomised trial to evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among patients undergoing pancreaticoduodenectomy. Results of this study are expected

  9. Korean Dermatological Association.

    PubMed

    Ro, B I

    1998-12-01

    The Korean Dermatological Association (KDA) was founded on October 27, 1945. The first annual meeting was held on November 15, 1947, and meetings have been held twice a year since 1975. The KDA 50th Annual Spring Meeting was on April 15-16, 1998. Korean Journal of Dermatology, the official journal of the KDA, was first published in 1960 and has been published bimonthly since 1978. Annals of Dermatology (Seoul), the English journal, was first published in 1989 and has been published quarterly since 1995. The American residency and specialty board system was introduced in 1954. Board specialty examination of dermatology candidates by the KDA requires four years of residency. Three hundred and twenty residents are now in the training course in the fifty-nine resident training approved hospitals this year. KDA has seven regional dermatological societies; Seoul, Pusan, Taegu, Honam, Chungchong, Jeonbuk, and Kangwon. KDA has had eleven research subcommittees since 1981. There are two associated societies of the KDA; the Korean Society for Investigative Dermatology was founded in 1991, and the Korean Society for Medical Mycology was founded in 1994. The Korea-Japan Joint Meeting of Dermatology has been held every two years since 1979 and the Korea-China Joint Meeting of Dermatology and Mycology has been held since 1996. About three hundred papers were presented at the 49th Annual Autumn Meeting on October 21-23, 1997. These included special lectures, invited lectures, educational lectures, oral presentations, and posters. About five hundred dermatologists participated in that meeting. KDA joined the International League of Dermatological Societies in 1973 with forty-seven members. There are around 1200 members of the KDA including 320 residents in 1998.

  10. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    needed in.the production of var- ious guns and tanks to the South Korean puppets and have had Japanese war munition monopolist enterprises directly...emergency measures or from guns and bayonets. The puppet’s oppressive frenzy is the manifestation of his extreme fear and uneasiness. Today, the...the long-term office of the dictatorial regime and those who can survive only by smashing this scheme. A gun -and-bayonet suppressive offense is the

  11. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    County but also in Kimhwa and Hoeyang Counties. What on earth is the need to build a power station to produce just a few hun - dred thousand kwh at...patriotic act for the country and the nation. A congratulatory speech was made by Kim Tae- chin , an officer of the Korean people’s army, who had been an...resistant, and durable. Therefore, it is very useful in aircraft, rocket parts, special explosive carriers, gun barrels, etc. The fiber is also

  12. Korean Affairs Report.

    DTIC Science & Technology

    2007-11-02

    Ship To Investigate Krill Fishing in Antarctic (YONHAP, 24 Nov 86) , 77 INTERNATIONAL COMMENTARY Daily on U.S.-Beijing, Pyongyang-Moscow Relations...maintenance of friendly relations is the "supreme objective," he added. /12913 CSO: 4100/061 76 S. KOREA/FOREIGN RELATIONS SHIP TO INVESTIGATE KRILL ...the Southern Korean port city of Pusan for the Antarctic Ocean to investigate possibilities of fishing for Krill , the fisheries office announced. The

  13. Korean Affairs Report.

    DTIC Science & Technology

    2007-11-02

    the leadxng role of the party. In order to strengthen and develop our party forever into a chuche-type re- volutionary party, we should abide by...organized by inheriting the Down-With-Imperialism Union, played an important role in the struggle to found a revolutionary party. While vigorously...the role of these party organizations, we extensively organized party organizations in Korean residential areas in the northern border area of our

  14. 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

  15. How do we understand the disagreement in the frequency of surgical site infection between the CDC and Clavien-Dindo classifications?

    PubMed

    Yamamoto, Takanobu; Takahashi, Satoshi; Ichihara, Koji; Hiyama, Yoshiki; Uehara, Teruhisa; Hashimoto, Jiro; Hirobe, Megumi; Masumori, Naoya

    2015-02-01

    To clarify the discrepancy in the incidence and severity of surgical site infections (SSI) for radical cystectomy between reports based on the CDC guideline and those using the Clavien-Dindo classification we evaluated 449 consecutive patients who underwent radical cystectomy for bladder cancer between 1990 and 2012. Of the 115 (25.6%) patients with SSI defined by the CDC guideline, 89 could be analyzed. We compared the SSI rates and severity defined by the CDC guideline and Clavien-Dindo classifications. There were 58 patients with superficial SSI, 16 with deep SSI, and 15 with organ/space SSI according to the CDC guideline. All patients with organ/space SSI were judged as "not having SSI" by the Clavien-Dindo classification. They were classified as having "intestinal prolapse", "intestinal fistula", "abdominal abscess" and "pelvic abscess." There was a significant association between the treatment duration and depth of SSI based on the CDC guideline by Spearman's rank-correlation coefficient (p < 0.001, r = 0.614) and with the grade of complications (p < 0.001, r = 0.632) in the Clavien-Dindo classification. Multivariate analysis showed that patients with grade III SSI in the Clavien-Dindo classification needed a significantly longer treatment duration. It is necessary to be aware that a discrepancy can occur automatically due to the different natures of the definitions. Using the CDC guideline, we can effectively estimate the future treatment period when SSI occurs. With the Clavien-Dindo classification, grade III SSI requires a longer treatment duration.

  16. 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.

  17. Multicenter, Prospective, Longitudinal Study of the Recurrence, Surgical Site Infection, and Quality of Life After Contaminated Ventral Hernia Repair Using Biosynthetic Absorbable Mesh

    PubMed Central

    Rosen, Michael J.; Bauer, Joel J.; Harmaty, Marco; Carbonell, Alfredo M.; Cobb, William S.; Matthews, Brent; Goldblatt, Matthew I.; Selzer, Don J.; Poulose, Benjamin K.; Hansson, Bibi M. E.; Rosman, Camiel; Chao, James J.; Jacobsen, Garth R.

    2017-01-01

    Objective: The aim of the study was to evaluate biosynthetic absorbable mesh in single-staged contaminated (Centers for Disease Control class II and III) ventral hernia (CVH) repair over 24 months. Background: CVH has an increased risk of postoperative infection. CVH repair with synthetic or biologic meshes has reported chronic biomaterial infections and high hernia recurrence rates. Methods: Patients with a contaminated or clean-contaminated operative field and a hernia defect at least 9 cm2 had a biosynthetic mesh (open, sublay, retrorectus, or intraperitoneal) repair with fascial closure (n = 104). Endpoints included overall Kaplan-Meier estimates for hernia recurrence and postoperative wound infection rates at 24 months, and the EQ-5D and Short Form 12 Health Survey (SF-12). Analyses were conducted on the intent-to-treat population, and health outcome measures evaluated using paired t tests. Results: Patients had a mean age of 58 years, body mass index of 28 kg/m2, 77% had contaminated wounds, and 84% completed 24-months follow-up. Concomitant procedures included fistula takedown (n = 24) or removal of infected previously placed mesh (n = 29). Hernia recurrence rate was 17% (n = 16). At the time of CVH repair, intraperitoneal placement of the biosynthetic mesh significantly increased the risk of recurrences (P ≤ 0.04). Surgical site infections (19/104) led to higher risk of recurrence (P < 0.01). Mean 24-month EQ-5D (index and visual analogue) and SF-12 physical component and mental scores improved from baseline (P < 0.05). Conclusions: In this prospective longitudinal study, biosynthetic absorbable mesh showed efficacy in terms of long-term recurrence and quality of life for CVH repair patients and offers an alternative to biologic and permanent synthetic meshes in these complex situations. PMID:28009747

  18. 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

  19. 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…

  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,…

  1. Korean Advanced Course: Volume V.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This is the fifth in a series of seven readers designed for continuation training in the Defense Language Institute's Basic Course in Korean. Twelve articles, drawn from several readers published by the Ministry of Education of the Republic of Korea in 1970, focus on Korean letters, life, and customs. The reader is to be used for development of…

  2. 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…

  3. 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…

  4. 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…

  5. 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

  6. 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…

  7. Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience.

    PubMed

    Sherrod, Brandon A; Arynchyna, Anastasia A; Johnston, James M; Rozzelle, Curtis J; Blount, Jeffrey P; Oakes, W Jerry; Rocque, Brandon G

    2017-02-10

    OBJECTIVE Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) database for the years 2012-2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations. SSI included deep (intracranial abscesses, meningitis, osteomyelitis, and ventriculitis) and superficial wound infections. The authors performed univariate analyses of SSI association with procedure, demographic, comorbidity, operative, and hospital variables, with subsequent multivariate logistic regression analysis to determine independent risk factors for SSI within 30 days of the index procedure. A similar analysis was performed using a detailed institutional infection database from Children's of Alabama (COA). RESULTS A total of 9296 nonshunt procedures were identified in NSQIP-P with an overall 30-day SSI rate of 2.7%. The 30-day SSI rate in the COA institutional database was similar (3.3% of 1103 procedures, p = 0.325). Postoperative time to SSI in NSQIP-P and COA was 14.6 ± 6.8 days and 14.8 ± 7.3 days, respectively (mean ± SD). Myelomeningocele (4.3% in NSQIP-P, 6.3% in COA), spine (3.5%, 4.9%), and epilepsy (3.4%, 3.1%) procedure categories had the highest SSI rates by procedure category in both NSQIP-P and COA. Independent SSI risk factors in NSQIP-P included postoperative pneumonia (OR 4.761, 95% CI 1.269-17.857, p = 0.021), immune disease/immunosuppressant use (OR 3.671, 95% CI 1.371-9.827, p = 0.010), cerebral palsy (OR 2.835, 95% CI 1.463-5.494, p = 0.002), emergency operation (OR 1

  8. 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

  9. Closed-suction drain placement at laparotomy in isolated solid organ injury is not associated with decreased risk of deep surgical site infection.

    PubMed

    Mohseni, Shahin; Talving, Peep; Kobayashi, Leslie; Kim, Dennis; Inaba, Kenji; Lam, Lydia; Chan, Linda S; Coimbra, Raul; Demetriades, Demetrios

    2012-10-01

    The purpose of this study was to investigate the role of intra-abdominal closed-suction drainage after emergent trauma laparotomy for isolated solid organ injuries (iSOI) and to determine its association with deep surgical site infections (DSSI). All patients subjected to trauma laparotomy between January 2006 and December 2008 for an iSOI at two Level I urban trauma centers were identified. Patients with isolated hepatic, splenic, or renal injuries were included. Study variables extracted included demographics, clinical characteristics, intra-abdominal injuries, drain placement, DSSI, septic events, intensive care unit and hospital length of stay, and in-hospital mortality. Diagnosis of DSSI was based on abdominal computed tomography scan demonstrating an intra-abdominal collection combined with fever and elevated white blood cell count. For the analysis, patients were stratified based on injury severity. To identify an independent association between closed-suction drain placement and DSSI, stepwise logistic regression analysis was performed. Overall, 142 patients met the inclusion criteria with 80 per cent (n=114) having severe iSOI. In 47 per cent (n=53) of the patients with a severe injury, an intra-abdominal drain was placed. A drain was placed more often in patients with a blunt trauma with more severe injury defined by Injury Severity Score and abdominal Abbreviated Injury Scale Score and those who underwent splenectomy (P<0.05). There was a three-fold increased risk of DSSI in patients subjected to drain placement (odds ratio, 2.8; 95% confidence interval, 1.0 to 8.2; P=0.046). Subgroup analysis demonstrated those who sustained severe hepatic injury receiving a drain had a significantly increase risk of DSSI (P=0.02). There was no statistical difference in the rate of DSSI based on the presence or absence of an intra-abdominal drain after severe splenic injury (17 vs 18%, P=0.88). The use of intra-abdominal closed-suction drains after iSOI is not

  10. 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

  11. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    maniac unheard of in the world and the South Korean military fascist "regime" is a violent sanguinary "regime". The Chon Tu-hwan group brands the...revision" in its favour. The puppets branded the memorial service as "violence revolution" and "up- rising". This is a premeditated scheme to expand...It is funded by Colorado-based beer tycoon Joseph Coors (he runs the Coors Beer Company). Former National Security advisor to President Reagan

  12. 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).

  13. Prospects from Korean Reunification

    DTIC Science & Technology

    2008-03-29

    Samuel S. Kim (New York, NY: Palgrave Macmillan Press, 2004), 1-2. 2 Seung -Ho Joo, “Korean Foreign Relations Toward The Twenty-First Century...Reunification,” Asian Affairs: An American Review (Winter 1999): 195-207. 53 Seung -Ho Joo, American Asian Review, 131 54 Pollack and Lee, 87. 55 Suk- hee ...S. Kim , The Two Koreas And The Great Powers, 98. 74 Snyder, NBR Analysis, 54. 75 Suk- hee Han, 137-139. 76 Victor D. Cha, “Defensive Realism and

  14. Korean Affairs Report No. 300.

    DTIC Science & Technology

    2007-11-02

    reporter said: 10 The United States has heightened with each passing day the strategic position of the Korean Peninsula, claiming that Korea is "its...people were undergoing all tribulations under the Japanese imperialists’ colonial rule, served the Japanese imperialists as their running dog ...Korea in an attempt to per- petuate the division of Korea and have the South Korean authorities recognized . CSO: 4100/188 25 N. KOREA/POLITICS AND

  15. Standardization of Korean nursing terminology.

    PubMed

    Park, Hyeoun-Ae; Kim, Ji-Hyun; Lee, Ji-Hyun; Lee, Hyang-Yeon; Kim, Jeong-Wha; Kim, Won-Ock; Kim, Ok-Soo; Lee, Young-Whee; Park, Ho-Ran; Choi-Kwon, Smi; Kim, In-Sook; Park, Young-Joo; Park, Young-Im

    2006-01-01

    Korean nursing terminology was standardized to improve sharing and exchange of nursing data and information. English nursing terms were collected from existing nursing terminology, journal articles, nursing records, text books, and nursing/medical dictionaries, translated into Korean and were tested for their validity. More than 9000 terms were standardized and published on a website for further feedback from the users. This study will contribute to communication within the nursing community and with other health care professionals.

  16. 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

  17. 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…

  18. Uncertainties in the North Korean Nuclear Threat

    DTIC Science & Technology

    2010-01-01

    providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world . RAND’s...stigmatize Korean goods, further complicating problems for the Korean economy. And economic disruption can ripple through an economy in devastating ways...the outside world . 1 “N. Korean Poster Seems to Confi rm Succession,” 2009. 4 Uncertainties in the North Korean Nuclear Threat NK Nuclear

  19. Processing of the Korean Eojoel Ambiguity

    ERIC Educational Resources Information Center

    Lee, Yoonhyoung; Nam, Kichun; Gordon, Peter C.

    2009-01-01

    Korean writing is a syllabary where spaces occur between phrases rather than between words. This characteristic of Korean allows different types of information in Korean sentences to be dissociated in ways that are not possible in the languages that have been the focus of most psycholinguistic research, thereby providing new opportunities to…

  20. 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…

  1. Ethnic Attachment among Second Generation Korean Americans.

    ERIC Educational Resources Information Center

    Hong, Joann; Min, Pyong Gap

    1999-01-01

    Describes the levels of second-generation Korean-American adolescents' (n=approximately 237) cultural, social, and psychological dimensions of attachment and examines the major factors highly correlated with two of the dimensions of ethnic attachment: use of the Korean language and Korean friendships. Findings support the view that high levels of…

  2. Contact dermatitis in Korean dental technicians.

    PubMed

    Lee, J Y; Yoo, J M; Cho, B K; Kim, H O

    2001-07-01

    The high risk of occupational contact dermatitis in dental personnel are well accepted throughout the world. There are few reports concerning occupational skin disease in dental personnel in Korea. The purposes of this study were to investigate the frequency, characteristics and causative factors of contact dermatitis in Korean dental technicians. Recording of personal history, physical examination and patch tests with the Korean standard series and dental screening series were performed in 49 dental technicians. Most of the subjects were exposed to a variety of compounds, including acrylics, metals, plaster, alginate, etc. 22 (44.9%) subjects had contact dermatitis, present or past, and the site involved was the hand in all 22. The most common clinical feature of hand dermatitis was itching (77.3%); scaling, fissuring and erythema were other common clinical features. Metals, including potassium dichromate (24.5%), nickel sulfate (18.4%), mercury ammonium chloride (16.3%), cobalt chloride (12.2%) and palladium chloride (10.2%), showed high positive rates in patch test results of 49 dental technicians. 7 positive reactions to the various acrylics were found in 3 subjects. In our study, the frequency and clinical features of the contact dermatitis showed a similarity to other reports, though the patch test results were somewhat different; a higher patch-positive reaction to metals and a relatively lower patch-positive reaction to acrylics than the patch test results reported in Europe.

  3. 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

  4. [Optimizing surgical hand disinfection].

    PubMed

    Kampf, G; Kramer, A; Rotter, M; Widmer, A

    2006-08-01

    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

  5. 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.

  6. Politics in the Korean War

    DTIC Science & Technology

    1994-01-01

    aspect o£ its uniqueness was the open debate between President Truman and General MacArthur con- cernin9 the war’s military and political objectives...NATIONAL DEFENSE UNIVERSITY NATIONAL WAR COLLEG~ POLITICS IN THE KOREAN WAR Course II Essay LTC Paul N. DunnlClass of 1994 COURSE II SEMINAR...to 00-00-1994 4. TITLE AND SUBTITLE Politics in the Korean War 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  7. The incidence and prevalence of pterygium in South Korea: A 10-year population-based Korean cohort study

    PubMed Central

    Choi, Moonjung; Kim, Sung Soo

    2017-01-01

    Although numerous population-based studies have reported the prevalences and risk factors for pterygium, information regarding the incidence of pterygium is scarce. This population-based cohort study aimed to evaluate the South Korean incidence and prevalence of pterygium. We retrospectively obtained data from a nationally representative sample of 1,116,364 South Koreans in the Korea National Health Insurance Service National Sample Cohort (NHIS-NSC). The associated sociodemographic factors were evaluated using multivariable Cox regression analysis, and the hazard ratios and confidence intervals were calculated. Pterygium was defined based on the Korean Classification of Diseases code, and surgically removed pterygium was defined as cases that required surgical removal. We identified 21,465 pterygium cases and 8,338 surgically removed pterygium cases during the study period. The overall incidences were 2.1 per 1,000 person-years for pterygium and 0.8 per 1,000 person-years for surgically removed pterygium. Among subjects who were ≥40 years old, the incidences were 4.3 per 1,000 person-years for pterygium and 1.7 per 1,000 person-years for surgically removed pterygium. The overall prevalences were 1.9% for pterygium and 0.6% for surgically removed pterygium, and the prevalences increased to 3.8% for pterygium and 1.4% for surgically removed pterygium among subjects who were ≥40 years old. The incidences of pterygium decreased according to year. The incidence and prevalence of pterygium were highest among 60–79-year-old individuals. Increasing age, female sex, and living in a relatively rural area were associated with increased risks of pterygium and surgically removed pterygium in the multivariable Cox regression analysis. Our analyses of South Korean national insurance claims data revealed a decreasing trend in the incidence of pterygium during the study period. PMID:28346495

  8. Surgical smoke evacuation systems.

    PubMed

    1997-04-01

    Surgical smoke evacuation systems are high-flow vacuum sources used to capture, at the surgical site, the smoke aerosols and gases generated during the use of lasers and electrosurgical units (ESUs). In this study, we evaluated 16 evacuation systems, from 10 suppliers, designed and marketed for use in the operating room for general surgery. For our testing, we focused on the performance of the systems (particularly their ability to capture smoke particles under simulated surgical conditions) and their ease of use and quality of construction. We also examined the projected costs of each system over a seven-year life cycle. We rated the systems separately for two different evacuation applications (1) general-purpose applications, for which the system would, in many cases, be used with a handheld nozzle (the traditional capture device used with these systems), and (2) ESU-pencil-based evacuation applications only, for which the system would always be used with a pencil-based wand. (We report on ESU-pencil-based smoke evacuation wands in a separate Evaluation in this issue.) While we found most units to be Acceptable, we did rate two units Acceptable-Not Recommended for both applications and one unit Unacceptable for general-purpose applications. In addition to our findings for the evaluated models, this study features several sections providing generic information and guidance about smoke evacuation technology. The Technology Overview describes the basics: what these systems do and how they do it. The Technology Management Guide, "Clearing the Air-Should Surgical Smoke Be Evacuated?," discusses the issues healthcare facilities should consider when determining whether, when, and how surgical smoke should be evacuated. Finally, the Selection, Purchasing, and Use Guide offers guidance on how facilities can most effectively implement this technology, from identifying models that will meet their needs to ensuring that the systems are used properly to provide adequate staff

  9. 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…

  10. Traditional Korean Child Rearing Practices.

    ERIC Educational Resources Information Center

    Han, Myunghee; Washington, Ernest D.

    This study describes traditional Korean child rearing and its relation to personality, social development, and their implications for education. Topics addressed include the family structure, traditional value orientation, the prenatal period, patterns of interaction in infancy, the baby as a vulnerable being, the baby as a spiritual being, the…

  11. 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…

  12. 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...

  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. 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)…

  15. Mussel watch program for organic contaminants along the Korean coast, 2001-2007.

    PubMed

    Choi, Hee Gu; Moon, Hyo Bang; Choi, Minkyu; Yu, Jun; Kim, Sang Soo

    2010-10-01

    The level and extent of organic contaminants along the Korean coast were estimated through the mussel watch program, established in 2001. Mussels and oysters were collected at 20 sites along the Korean coast in 2001 and at 25 sites from 2002 to 2007. The mussel tissues were analyzed for PCBs, organochlorine presticides, PAHs, BTs, and PCDD/Fs. PCBs, PAHs, BTs, and PCDD/Fs were ubiquitous contaminants along the Korean coast, showing mean detection frequencies of more than 95% over 7 years. The concentrations of organic contaminants in mussels along the Korean coast were relatively low or moderate compared with foreign studies. Concentrations of DDTs, PCBs, and PCDD/Fs were below the action or maximum levels for humans established by USFDA and EU. Elevated concentrations above the 85th percentile were found for PCBs, PAHs, BTs, and PCDD/Fs at sites near industrial complexes or big harbors, for HCHs at sites near non-industrial complexes, and for DDTs at sites near both non-industrial and industrial complexes. Using two nonparametric tests to assess temporal trends, the Spearman test revealed that BTs and PCDD/Fs had significant decreasing trends at four sites (Gwangyang Bay, Cheonsu Bay, Garorym Bay, and the Incheon coast) and at six sites (Hupo coast, Guryongpo coast, eastern part of Geojedo, Gunsan coast, Garorym Bay, and Asan Bay), respectively.

  16. Is It Valid to Compare Surgical Site Infections Rates Between Countries? Insights From a Study of English and Norwegian Surveillance Systems.

    PubMed

    Meijerink, Hinta; Lamagni, Theresa; Eriksen, Hanne Merete; Elgohari, Suzanne; Harrington, Pauline; Kacelnik, Oliver

    2017-02-01

    OBJECTIVE To assess whether differences in surveillance methods or underlying populations significantly influence internationally reported national SSI rates by comparing surveillance data from 2 countries. DESIGN Retrospective cohort. SETTING England and Norway. METHODS We assessed the population under surveillance and surveillance methodology to compare SSI rates in 2 countries (September 2012-January 2015) for 4 surgical categories: coronary artery bypass graft (CABG), colon surgery, cholecystectomy, and hip prosthesis (HPRO). We compared the inpatient SSI incidence using logistic regression, adjusting for the following known risk factors: sex, age, ASA score, wound class, postoperative hospital days, and operation duration. Subsequently, we restricted further analyses to the procedures reported by both countries. RESULTS There were important differences in case definitions for superficial infection, so we restricted our analyses to deep incisional and organ-space SSIs. For CABG, the crude odds ratio (OR) for England compared to Norway was 2.4 (95% CI, 1.4-4.4), whereas adjusted OR (aOR) lost significance (aOR, 1.1; 95% CI, 0.57-2.0). For colon surgery the decreased odds (OR, 0.68; 95% CI, 0.56-0.81) remained significant after adjustment (aOR, 0.42; 95% CI, 0.34-0.51). We found no associations for cholecystectomy. For HPRO, the crude OR suggested no significant difference (OR, 1.2; 95% CI, 0.72-2.1), whereas the aOR was significantly lower in England (aOR, 0.45; 95% CI, 0.25-0.81). Including only the subset of procedures reported by both countries yielded comparable results. CONCLUSION Differences in case definitions and population under surveillance in the English and Norwegian SSI surveillance systems affected SSI estimates, making the comparison of crude rates unreliable. Standardized definitions and adjustment for established risk factors are essential for European comparisons to guide related public health actions. Infect Control Hosp Epidemiol 2017;38:162-171.

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

    PubMed

    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.

  18. The Korean Diaspora. Historical and Sociological Studies of Korean Immigration and Assimilation in North America.

    ERIC Educational Resources Information Center

    Kim, Hyung-chan, Ed.

    This anthology presents some results of recent research on Korean immigration to and assimilation in America. The essays address three major questions concerned with problems of immigration and assimilation: (1) What caused the immigration of Koreans to the Hawaiian Islands and the United States mainland? (2) How has the Korean experience in…

  19. 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,…

  20. 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…

  1. 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

  2. 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…

  3. What Makes Koreans Happy?: Exploration on the Structure of Happy Life among Korean Adults

    ERIC Educational Resources Information Center

    Kim, Myoung So; Kim, Hye Won; Cha, Kyeong Ho; Lim, Jeeyoung

    2007-01-01

    The current study explored the perceptions of Korean people about what can make them happy and constructed a comprehensive measurement of happiness of Korean. A total of 61 Korean adults participated in Focused Group Interview (FGI), where they were asked three questions (e.g., What makes you happy? What could make you happier than now? In…

  4. Arms Control in the Korean Peninsula.

    DTIC Science & Technology

    1986-05-01

    defense expenditures of both sides are assessed as follows:4 The South Korean population outnumbers North Korea two to one. This presents difficulties for...99. Kim, Chum-Kon, The Korean War, Seoul, Kwang-Myong Publishing Company Ltd., 1980. The Text of Mutual Defense Treaty between Korea and the USA...AIR WAR COLLEGE RESEARCH REPORT ABSTRACT TITLE: Arms Control in the Korean Peninsula AUTHOR: Kim, Hyon, Colonel, Republic of Korea Air Force - 1

  5. The Economic Implications of Korean Reunification

    DTIC Science & Technology

    2007-11-02

    Korea (ROK) and the Democratic People’s Republic of Korea (DPRK). The eventual reunification of the Korean peninsula will offer many challenges for...in the development of two very different governments and economies. The two Koreas are technically still at war; the Korean War ended with the signing...96 Korea actually began to become industrialized during the last fifteen years of Japanese occupation. The number of Koreans employed in heavy

  6. Air Power in the Korean War

    DTIC Science & Technology

    1998-04-01

    was simply to expel the North Korean communists from the free country in the south called the Republic of Korea . The U.S. national objective was to... Korea reasoning that the forces could best be used elsewhere. During the three years prior to the Korean War, Truman’s policy toward the ROK was...increasing Chinese Communist interests in North Korea .4 On 10 March 1950, Truman was further warned that the North Koreans would “invade sometime in

  7. Operational Art Requirements in the Korean War

    DTIC Science & Technology

    2012-05-17

    Rhee, enough for defense but not enough to precipitate South Korean offensive actions to unify Korea .27 Adding to the tension in the region, the...percent of the Korean Peninsula. The United States decided to intervene in the defense of the South and proceeded to press the United Nations (U.N...the Korean War, these works primarily fall into three broad areas of scholarship: the American strategy concerning Korea and the Cold War

  8. Korean Defense Industry: Threat or Ally?

    DTIC Science & Technology

    1994-02-22

    framework for defense industrial cooperation with Korea . While Senator Dixon eventually dropped his opposition and the Korean Fighter Program is now...US defense firms to transfer technology to Korean firms, the US Government must recognize two realities: first, Korea will develop indigenous...serious Korean competition in the foreseeable future. 8 It does not appear that the Korea defense industry is poised to take away significant market

  9. Time-Dependent Effect of Chlorhexidine Surgical Prep

    DTIC Science & Technology

    2011-10-15

    Time-dependent effect of chlorhexidine surgical prep D.J. Stinner*, C.A. Krueger, B.D. Masini, J.C. Wenke United States Army Institute of Surgical ...2011 by J.A. Child Available online 15 October 2011 Keywords: Chlorhexidine Surgical site infection s u m m a r y Despite continued advances in...preoperative preventive measures and aseptic technique, surgical site infections remain a problem. The purpose of this study was to evaluate the time

  10. Combined Operations in the Korean War

    DTIC Science & Technology

    1989-04-24

    Research Cfice, 1952. Ministry of National Defense , Republic of Korea . The History of United Nations Forces in the Korean War. Volume VI, Seou 1: 1977. ,-,h...committed to repelling the North Korean and Chinese armies from the Republic of Korea (ROK). The Korean War was not anticipated and neither was the extent...Coaal: tior War Early on 25 June Iz)50 the North Korean People- Army =_NKPA launched an overwhelming invasion into the Repu’Tli,: cf Korea . Pres-.i,ent

  11. Korean Unification: The Way Forward

    DTIC Science & Technology

    2009-03-01

    manufacturing plants with an abundance of local labor. Allowing a state that was once part of a unified Korea inside the borders of the DPRK can be the...power station, thermal power plants and a large nuclear power facility.84 While this seven-year plan resulted in a low average GDP growth of 2.88...ranks low in the other variables of the matrix. The financial cost associated with unifying the Korean peninsula will dwarf that of Germany. Prior to

  12. The Korean Question--Revisited.

    DTIC Science & Technology

    1987-03-01

    PAGE D/02Q P REPORT DOCUMENTATION PAGE I&. REPORT SECURITY CLASSIFICATION lb RESTRICTIVE MARKINGS Unclassified 2a. SECURITY CLASSIFICATION AUTHORITY 3 ...CLASSIFICATION OF THIS PAGE All other editions are obsolete *U.S. 02-0rnf6nt PUtncla s fi 0102-LF-014-6602 Unclass’ife * ’ 3 5 33%1C EXECUTIVE SUMMARY THE KOREAN...0. 1 Purpose *............. .........*0*60 3 Approach ....................... .** 3 Scope and Limitations .............. 3 Assumptions

  13. 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…

  14. 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

  15. Korean Physical Society's Physics Camp for High School Girls

    NASA Astrophysics Data System (ADS)

    Park, Youngah; Yoon, Jin-Hee

    2005-10-01

    The Women's Committee of the Korean Physical Society organized physics camps during the summers of 2002, 2003, and 2004 for high school girls. The camps give the girls an opportunity to meet and interact with working physicists and enhance smart-girl networking. About 40 students in 10 teams visited excellent laboratories in universities and research institutes located in diverse areas of the country. The girls explored the work going on in each laboratory for a few days and participated in some basic experiments when possible. Afterward they gathered at the on-site camp for oral and poster presentations about what they learned and what they did in the laboratories they visited. Their presentations were evaluated and prizes awarded for outstanding teams. These camps were successful in terms of attracting many enthusiastic girl students and enhancing their interest in physics. The camps also showed the Korean physics community the importance of this kind of activity. To attract many girl students from various regions of the country, the Korean Physical Society co-organized the physics camp with the WISE (Women in Science and Engineering) Center, which has a network system for girl students interested in science and mathematics. The 2004 KPS-ASML-WISE Physics camp was supported by the ASML Foundation in the Netherlands.

  16. SURGICAL EMERGENCIES

    PubMed Central

    Rossi, Felix R.

    1950-01-01

    Action according to preconceived plans may be life-saving at the scene of accidents involving serious injury to several persons. Severe hemorrhage and respiratory obstruction must be dealt with immediately. As the latter may not be apparent at a glance, it should be looked for specifically. Artificial respiration may be necessary. Spinal puncture is a procedure in first aid which should be carried out at the site of an accident if there are symptoms of cerebral edema or of increased cerebral pressure. Routine plans should be laid to meet the emergency of cardiac arrest on the operating table. The surgeon must be prepared to begin cardiac massage within three minutes in such instances. PMID:18731685

  17. Russian Nonproliferation Policy and the Korean Peninsula

    DTIC Science & Technology

    2006-12-01

    the Committee for Foreign Relation of the Korean Association of Slavic Studies . Dr. Shin received his Ph.D. in political science from the Moscow...President Vladimir Putin and Its Significance for the Republic of Korea), Korean Slavic Studies , Vol. 19, No. 2, 2004, pp. 675-710. 28. Daehan

  18. Rock Music and Korean Adolescent's Antisocial Behavior.

    ERIC Educational Resources Information Center

    Kim, Inkyung; Kwak, Keumjoo; Chang, Geunyoung; Yang, Jinyoung

    The relationship between rock music preference and antisocial behavior among Korean adolescents was examined. The Korean versions of the Sensation Seeking Scale and the Antisocial Behavior Checklist were used to measure sensation seeking motivation and delinquency. Adolescents (N=1,079) were categorized as "rock/metal,""dance,"…

  19. Group Psychodrama for Korean College Students

    ERIC Educational Resources Information Center

    Chae, Soo Eun; Kim, Soo Jin

    2017-01-01

    Psychodrama was first introduced in the Korean literature in 1972, but its generalization to college students did not occur until the 1990s. Despite findings from psychodrama studies with Korean college students supporting psychodrama as effective for developing and maintaining good interpersonal relationships, as well as decreasing anxiety and…

  20. College Psychotherapy at a Korean University

    ERIC Educational Resources Information Center

    Chae, Soo Eun; Choi, Mi Hwa

    2016-01-01

    In the online interview presented in this article, two Korean counselors offer comments to questions regarding issues faced at a Korean University. They reflected on their roles and some of the many topics faced that included: (1) student misunderstanding about counseling needs, and how counseling questionnaires and the counselor helps them; (2)…

  1. 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…

  2. 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.…

  3. Korean Intermediate Course. Selected Newspaper Articles.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    The purpose of this material is to provide reading matter for the last phase of the Defense Language Institute's extended and intermediate courses in Korean. (See ED 024 943 for the Korean Basic Course, Lesson Units 1-112.) The content of this volume is current, introduces important vocabulary not encountered elsewhere in the courses, and calls…

  4. Comparison of surgical effect and postoperative patient experience between laparoendoscopic single-site and conventional laparoscopic varicocelectomy: a systematic review and meta-analysis

    PubMed Central

    Zhang, Zheng; Zheng, Shu-Juan; Yu, Wen; Han, You-Feng; Chen, Hai; Chen, Yun; Dai, Yu-Tian

    2017-01-01

    The present meta-analysis was conducted to compare the clinical effect and patient experience of laparoendoscopic single-site varicocelectomy (LESSV) and conventional laparoscopic varicocelectomy. The candidate studies were included after literature search of database Cochrane Library, PubMed, EMBASE, and MEDLINE. Related information on essential data and outcome measures was extracted from the eligible studies by two independent authors, and a meta-analysis was conducted using STATA 12.0 software. Subgroup analyses were conducted by study design (RCT and non-RCT). The odds ratio (OR) or standardized mean difference (SMD) and their 95% confidence intervals (95% CIs) were used to estimate the outcome measures. Seven articles were included in our meta-analysis. The results indicated that patient who had undergone LESSV had a shorter duration of back to work (overall: SMD = −1.454, 95% CI: −2.502–−0.405, P = 0.007; non-RCT: SMD = −2.906, 95% CI: −3.796–−2.017, P = 0.000; and RCT: SMD = −0.841, 95% CI: −1.393–−0.289, P = 0.003) and less pain experience at 3 h or 6 h (SMD = −0.447, 95% CI: −0.754–−0.139, P = 0.004), day 1 (SMD = −0.477, 95% CI: −0.905–−0.05, P = 0.029), and day 2 (SMD = −0.612, 95% CI: −1.099–−0.125, P = 0.014) postoperatively based on RCT studies. However, the meta-analyses based on operation time, clinical effect (improvement of semen quality and scrotal pain relief), and complications (hydrocele and recurrence) yielded nonsignificant results. In conclusion, LESSV had a rapid recovery and less pain experience over conventional laparoscopic varicocelectomy. However, there was no statistically significant difference between the two varicocelectomy techniques in terms of the clinical effect and the incidence of hydrocele and varicocele recurrence. More high-quality studies are warranted for a comprehensive conclusion. PMID:27212128

  5. 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

  6. 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…

  7. Children Negotiating Korean American Ethnic Identity through Their Heritage Language

    ERIC Educational Resources Information Center

    You, Byeong-keun

    2005-01-01

    This preliminary study provides an interpretive reading of focus group interviews of four Korean American children in the Phoenix metropolitan area. It examines how these Korean American children are negotiating their ethnic identity as Korean Americans while learning Korean as a heritage language. It shows that maintaining heritage language is…

  8. 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…

  9. 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…

  10. 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),…

  11. A Situated Perspective on Bilingual Development: Preschool Korean-English Bilinguals' Utilization of Two Languages and Korean Honorifics

    ERIC Educational Resources Information Center

    Kim, So Jung

    2017-01-01

    In spite of the increasing Korean population, there is still a paucity of studies examining emergent Korean bilingual children's dual-language development within their social contexts. In particular, no existing study has paid attention to the honorific system of Korean, which is one of the most important features in learning the Korean language.…

  12. Second Korean guidelines for the management of ulcerative colitis

    PubMed Central

    Choi, Chang Hwan; Moon, Won; Kim, You Sun; Kim, Eun Soo; Lee, Bo-In; Jung, Yunho; Yoon, Yong Sik; Lee, Heeyoung; Park, Dong Il

    2017-01-01

    Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by a relapsing and remitting course. The direct and indirect costs of the treatment of UC are high, and the quality of life of patients is reduced, especially during exacerbation of the disease. The incidence and prevalence of UC in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Various medical and surgical therapies, including biologics, are currently used for the management of UC. However, many challenging issues exist, which sometimes lead to differences in practice between clinicians. Therefore, the IBD study group of the Korean Association for the Study of Intestinal Diseases established the first Korean guidelines for the management of UC in 2012. This is an update of the first guidelines. It was generally made by the adaptation of several foreign guidelines as was the first edition, and encompasses treatment of active colitis, maintenance of remission, and indication of surgery for UC. The specific recommendations are presented with the quality of evidence and classification of recommendations. PMID:28239313

  13. Micro-surgical endodontics.

    PubMed

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  14. Surgical innovation as sui generis surgical research.

    PubMed

    Lotz, Mianna

    2013-12-01

    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

  15. Korean Affairs Report. No. 297

    DTIC Science & Technology

    2007-11-02

    Korean to South Korea 0300 GMT 4 Jul 83 [Roundtable talk among Madam Yun, announcer Kim Chol-min and moderator Min Hye-kyong, from "Today’s Feature...questions of two disturbs our country’s reunification and of who on earth opposes and wants division? Will you talk about these questions first, Madam Yun... Madam Yun] To note a conclusion first, it is the United States that opposes our country’s reunification and seeks the perpetuation of division. As

  16. 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

  17. Perceived health, life satisfaction, and cardiovascular risk factors among elderly Korean immigrants and elderly Koreans.

    PubMed

    Sin, Mo-Kyung; Chae, Young-Ran; Choe, Myoung-Ae; Murphy, Patrick; Kim, Jeungim; Jeon, Mi-Yang

    2011-03-01

    Acknowledging that changes in sociocultural environment influence health status, the purpose of this study was to compare perceived health, life satisfaction, and cardiovascular health in elderly Korean immigrants and elderly Koreans. In this cross-sectional study, a convenience sample of 88 elderly Korean immigrants and 295 elderly Koreans 65 and older were recruited from Korean communities in the United States and Korea. Respondents' perceived health was measured by self-assessment; life satisfaction was self-assessed using a dichotomous scale of general satisfaction with life; and cardiovascular health status was surveyed by self-report of major diagnosed cardiovascular risk factors (i.e., hypertension, hyperlipidemia, diabetes mellitus) and body mass index measurement for obesity. Despite having better perceived health and life satisfaction, elderly Korean immigrants also had higher prevalence of cardiovascular risk factors. The findings provide health care providers with useful information for effective health assessment of minority immigrants.

  18. Monitoring of organic contaminants in sediments from the Korean coast: Spatial distribution and temporal trends (2001-2007).

    PubMed

    Choi, Hee Gu; Moon, Hyo Bang; Choi, Minkyu; Yu, Jun

    2011-06-01

    Spatial and temporal trends of organic contaminants in sediments along the Korean coast were estimated through a nationwide environmental monitoring program from 2001 to 2007. The concentrations of organic contaminants in sediments along the Korean coast were relatively low or moderate compared with foreign studies. The mean detection frequencies of organic contaminants during the seven years were highest for PAHs and PCDD/Fs, followed by PCBs, DDTs, TBT and HCHs in decreasing order. Based on published sediment quality guidelines, the ecological risks of persistent organic pollutants in sediments along the Korean coast were low, despite exceedances of the ERL at 2-6 sites for DDTs, and the TEL at 9-18 sites for PCDD/Fs. Nonparametric tests to assess temporal trends revealed significant decreasing trends for PCBs and PCDD/Fs at four and three sites, respectively (p<0.05). These results reflect the effects of regulations on the use of those contaminants.

  19. Frequently Asked Questions about Surgical Site Infections

    MedlinePlus

    ... Evaluating Environmental Cleaning Appendices to the Conceptual Program Model for Environmental Evaluation Basic Infection Control and Prevention Plan for Outpatient Oncology Settings Appendices Outpatient Care Guide Tools for Protecting Healthcare Personnel PPE Training ...

  20. [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.

  1. 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 ...

  2. 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,…

  3. Teaching Korean RN-BSN students.

    PubMed

    Campbell, Eleanor T

    2009-01-01

    The author describes the challenges and issues related to teaching small cohorts of foreign-educated Korean registered nurses in the United States. Teaching-learning strategies for educating this ethnic group and other culturally different student cohorts are discussed.

  4. The immigration experience among elderly Korean immigrants.

    PubMed

    Lee, Y-M

    2007-06-01

    The purpose of this preliminary, qualitative study was to describe elderly Korean immigrants' perception of stressors they experienced through immigration and the acculturation process. The methodology used was naturalistic inquiry, a descriptive approach used to elicit the elderly immigrants' own perception of their immigration and acculturation experiences. The six elderly Korean immigrants were interviewed via a semi-structured, open-ended interview guide. The main stressors identified by the subjects as a result of adjusting to life in the United States were language barriers, isolation and loneliness, fear of dependence upon their children, fear of being a burden, financial problems, transportation problems, discrimination, and fear of death. These Korean elders also perceived changes in the traditional family values of respect for elders and support for the aged. The results of this research help to provide an understanding of the immigration and acculturation experiences of elderly Korean immigrants.

  5. Korean women's attitudes toward physical activity.

    PubMed

    Im, Eun-Ok; Choe, Myoung-Ae

    2004-02-01

    In this study attitudes toward physical activity of three groups of Korean women were explored using a feminist qualitative research design. Seventeen healthy Korean women, 11 Korean women at risk of muscular atrophy, and 16 Korean immigrant women were recruited using a purposive sampling method. In-depth interviews using an interview guide were audiotaped and transcribed. Data were analyzed using thematic analysis. The findings indicate that the women viewed physical activity holistically, that death was viewed as the opposite of physical activity, that exercise was differentiated from physical activity, that exercise was connected to health, and that the women rarely participated in exercise because of their busy lives. The findings confirm the importance of considering the psychosocial contexts of attitudes toward health behavior.

  6. Transformation of Child Socialization in Korean Culture.

    ERIC Educational Resources Information Center

    Yi, Soon Hyung

    1993-01-01

    Examines agents of socialization, socialization skills, the influence of Confucian principles, gender socialization, and the differentiation of parental roles in traditional Korean families; and the value of children, the purpose of education, and family orientation in the modern family. (BC)

  7. Infection prevention: the surgical care continuum.

    PubMed

    Barnes, Sue

    2015-05-01

    Lack of careful attention to the increasing complexity of surgical procedures, instrument cleaning and processing, and the transition of surgical and other invasive procedures from the OR to areas outside the traditional hospital OR can contribute to surgical site infection (SSI) risk. Regardless of the location of an intervention, when basic infection prevention measures are applied reliably, even low infection rates can be reduced. To address infection prevention challenges, infection preventionists (IPs) must be well informed regarding infection risk and prevention during surgical and other invasive procedures and the effect a facility type may have on patients' infection risk. The IP must have a solid understanding of surgical asepsis, instrument disinfection, and sterilization to educate and support clinical teams in identifying opportunities for improvement relative to infection prevention.

  8. Unlocking Russian Interests on the Korean Peninsula

    DTIC Science & Technology

    2009-06-01

    and chemical contract, an arrangement that would significantly re- duce South Korean dependence upon natural gas from the Middle East. To minimize...years, the United States has invested vast resources to help keep the North Korean military machine at bay. If American policy is firmly committed to...TransportReview, December 1997, http:// www.jrtr.net/jrtr14/pdf/f30_xu.pdf. 23. Boris Dynkin, “Comments on the Regional Railroad Network and Electric Grid

  9. How Will External Powers Affect Korean Reunification?

    DTIC Science & Technology

    2005-09-01

    34 36. 145 Seung Ham Yang, Woosang Kim , and Yongho Kim , "Russo-North Korean Relations in the 2000s," Asian Survey 44, no. 6 (2004): 796. 146... Seung Ham, Woosang Kim , and Yongho Kim . "Russo-North Korean Relations in the 2000s." Asian Survey 44, no. 6 (2004): 794. Zhao, Quansheng. "China...Russia, China, Japan, Sunshine Policy, Six party talks, Beijing talks, war, collapse, diplomatic reunification, Kim Jong-il 16. PRICE CODE 17

  10. Clear Speech Production and Perception of Korean Stops and the Sound Change in Korean Stops

    ERIC Educational Resources Information Center

    Kang, Kyoung-Ho

    2009-01-01

    The current dissertation investigated clear speech production of Korean stops to examine the proposal that the phonetic targets of phonological categories are more closely approximated in hyperarticulated speech. The investigation also considered a sound change currently underway in Korean stops: younger speakers of the Seoul dialect produce the…

  11. Historic Factors Influencing Korean Higher Education. Korean Studies Series, No. 17.

    ERIC Educational Resources Information Center

    Jeong-kyu, Lee

    This book examines the religious and philosophical factors historically affecting Korean higher education, and the characteristics of contemporary Korean higher education in relation to organizational structure, leadership, and organizational culture. The book is organized into 4 parts, with 11 chapters. Part One focuses on identifying the problem…

  12. 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…

  13. 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…

  14. [Surgical anatomy of the lateral ventricles].

    PubMed

    Lejeune, J-P; Baroncini, M; Peltier, J; Le Gars, D

    2011-01-01

    The lateral ventricle is a deep-seated cavity, overlayed by a cortical mantle which contains eloquent areas, especially on the dominant hemisphere, and surrounded by the optic radiations. The surgical approach requires a thorough preoperative reflexion based on magnetic resonance imaging, in order to understand the site of origin and the vascular pedicles of the tumor. Surgical approaches to the frontal horn, temporal horn and atrium are successively described.

  15. Surgical Lasers In Gynecology

    NASA Astrophysics Data System (ADS)

    Schellhas, Helmut F.; Barnes, Alfonso E.

    1982-12-01

    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  16. 76 FR 45395 - National Korean War Veterans Armistice Day, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-29

    ..., 1950, the Korean peninsula erupted in conflict, becoming the front line of an intensifying Cold War... than ever. We remember our common values and shared suffering during the Korean War, and we continue...

  17. Community Response to Terrorism: The South Korean Model

    DTIC Science & Technology

    2003-09-01

    KOREA Ever since the division of the Korean peninsula at the conclusion of the Second World War, South Koreans have lived with real and imagined...threats from communist North Korea (the Democratic People’s Republic of Korea , or DPRK). The authorities have been unable to prevent all North Korean ...on three lines of defense . First, an authoritarian government kept firm control over Korean society. Second, the police and the ROK army were visibly

  18. Hemorrhagic Fever with Renal Syndrome (Korean Hemorrhagic Fever)

    DTIC Science & Technology

    1988-06-30

    53 INTRODUCTION During the Korean War more than 3,200 United Nations troops in Korea devel6ped a rare hemorrhagic fever which attracted...patients in the Republic of Korea . Year Korean Korean US Total civilian soldiers soldiers 1951 ...... 627 827 1952 .... 833 833 1953 ... ... 455 455...0 RI m HEMORRHAGIC FEVER WITH RENAL SYNDROME ( KOREAN HEMORRHAGIC FEVER) ANNUAL SUMMARY REPORT HO WANG LEE, M.D. June 30, 1988 Door., Supported by U.S

  19. U.S. Security Policy in Asia after Korean Unification

    DTIC Science & Technology

    1997-12-01

    Korean War and the signing of the mutual defense treaty, the United States has maintained forward-deployed forces in Korea . Today the United States has...30 American forward-deployed forces have become less important to the defense of Korea as the capabilities of the South Korean military have...Environment for a United Korea ", The Korean Journal of Defense Analysis Vol. VIII No. 1 (Summer 1996): 81- 82. 81 Amy Woo, "East Asia: China Treads Korean

  20. Hemorrhagic Fever with Renal Syndrome (Korean Hemorrhagic Fever).

    DTIC Science & Technology

    1986-07-23

    13 Table 5. Monthly incidence of HFRS among Korean in the Republic of Korea , 1966-1985 . . . . . . . 14 A Table 6. Incidence of HFRS by...GRANT SUPPORT .. ........ 57.... 5 INTRODUCTION During the Korean War more than 3,000 United Nations .00 troops in Korea developed a rare hemorrhagic...8217;.-.* * S.’ . " 10 ... Table 1. Hospitalized cases of Hemorrhagic fever with renal syndrome patients in the Republic of Korea Year US Korean Korean

  1. Vowel Category Formation in Korean-English Bilingual Children

    ERIC Educational Resources Information Center

    Lee, Sue Ann S.; Iverson, Gregory K.

    2012-01-01

    Purpose: A previous investigation (Lee & Iverson, 2012) found that English and Korean stop categories were fully distinguished by Korean-English bilingual children at 10 years of age but not at 5 years of age. The present study examined vowels produced by Korean-English bilingual children of these same ages to determine whether and when bilinguals…

  2. Structure of Vocational Interests for Korean College Students

    ERIC Educational Resources Information Center

    Tak, Jinkook

    2004-01-01

    The primary purpose of this research was to examine the vocational structure for Korean college students based on Holland's hexagon theory. The secondary purpose of this research was to provide validity data for using the Korean Strong Interest Inventory in Korea. With a sample of 829 Korean college students, using the Strong Interest Inventory…

  3. 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…

  4. 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…

  5. 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…

  6. 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,…

  7. 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

  8. 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 ...

  9. Incontinence Treatment: Surgical Treatments

    MedlinePlus

    ... Bowel Incontinence Signs & Symptoms Symptoms of Incontinence Diarrhea Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding a Doctor ...

  10. 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…

  11. 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…

  12. 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.

  13. 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.

  14. Phylogeography of the Korean pine (Pinus koraiensis) in northeast Asia: inferences from organelle gene sequences.

    PubMed

    Aizawa, Mineaki; Kim, Zin-Suh; Yoshimaru, Hiroshi

    2012-11-01

    Range-wide genetic variation of Korean pine (Pinus koraiensis) was assessed using maternally inherited mtDNA and paternally inherited cpDNA for 16 natural populations throughout northeast Asia in order to study its phylogeographical history during the Quaternary. The cpDNA variation indicated that there was no difference between populations on the Asian continent and those in the Japanese archipelago. In contrast, the mtDNA variation indicated that there was significant difference between the populations from the two regions, with each region having a different lineage. The continental populations exhibited no diversity in the mtDNA examined despite the species' current extensive range and large populations. Conversely, while the Korean pine is rare in Japan, the Japanese populations exhibited greater levels of mtDNA diversity (H (T) = 0.502). The higher mtDNA diversity and evidence from numerous Korean pine macrofossil remains dated to the Pleistocene and recovered various sites in Japan suggest that the Japanese archipelago once served as a refugium to a much larger Korean pine population with a more extensive range than is the case today. The presence of the single mtDNA haplotype across the Asian continent suggests that the present widespread populations could have expanded from a single refugium population after the last glacial periods.

  15. 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.

  16. 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.

  17. Surgical ethics and the challenge of surgical innovation.

    PubMed

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  18. 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…

  19. A sketch of language history in the Korean Peninsula.

    PubMed

    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.

  20. A study of early korean rockets (1377-1600)

    NASA Astrophysics Data System (ADS)

    Chae, Yeon Seok

    The first Korean rocket was fired between 1377 and 1389 and began the Korean development of rockets as a tactical weapon. Although, Korea had successfully demonstrated the use of rockets as firearms in the fifteenth century, there had been no effort to present the historical development of the early Korean rockets in a paper which will be useful to both historians and scientists. The book entitled Kuk Cho Ore Sorye (1474) in the Korean language provided extensive rocket system description, however it required considerable research to interpret them. This paper is the first study of early Korean rockets and launchers. The major effort in this study is directed toward the development of design concepts and details of early Korean rockets. Also, to substantiate support of the historical data presented, some versions of the early Korean rockets were made according to their specifications and fired successfully by the author in 1981.

  1. 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.

  2. [A study on Korean concepts of relaxation].

    PubMed

    Park, J S

    1992-01-01

    Relaxation technique is an independent nursing intervention used in various stressful situations. The concept of relaxation must be explored for the meaning given by the people in their traditional thought and philosophy. Korean relaxation technique, wanting to become culturally acceptable and effective, is learning to recognize and develop Korean concepts, experiences, and musics of relaxation. This study was aimed at discovering Korean concepts, experiences and musics of relaxation and contributing the development of the relaxation technique for Korean people. The subjects were 59 nursing students, 39 hospitalized patients, 61 housewives, 21 rural residents and 16 researchers. Data were collected from September 4th to October 24th, 1991 by interviews or questionnaires. The data analysis was done by qualitative research method, and validity assured by conformation of the concept and category by 2 nursing scientists who had written a Master's thesis on the relaxation technique. The results of the study were summarized as follows; 1. The meaning of the relaxation concept; From 298 statements, 107 concepts were extracted and then 5 categories "Physical domain", "Psychological domain", "Complex domain", "Situation", and "environment" were organized. 'Don't have discomforts, 'don't have muscle tension', 'don't have energy (him in Korean)', 'don't have activities' subcategories were included in "Physical domain". 'Don't have anxiety', 'feel good', 'emotional stability', 'don't have wordly thoughts', 'feel one's brain muddled', 'loss of desire' subcategories were included in "physical domain" 'Comfort body and mind', 'don't have tension of body and mind', 'be sagged' 'liveliness of thoughts' subcategories were included in "Complex domain". 'Rest', 'sleep', 'others' subcategories were included in "Situation domain". And 'quite environment' & 'comfortable environment' subcategories were included in "Environmental domain". 2. The experiences of the relaxation; From 151

  3. Korean War Logistics Eighth United States Army

    DTIC Science & Technology

    1986-05-09

    from defensive to offensive, as CINCUNC directed it to attack north to Pyongyang, capital city of the Democratic People’s Republic of Korea (OPRK), North...weapons to kill the tanks. General Eberle, G-4, FEC, described the urgent need for Bazookas in Korea . ... the Russians provided the North Koreans with T...8217,- ’S~ I6 0 iI. RONIOJ3A2DS PO.;S KOREA APR t gN -I S * ~z T- -:*J *1* Porto3~, r -. r 4< ,Ž . BIBLIOGRAPHY 1. Appleman, Roy E. US Army in the Korean War

  4. Comparing the Ethnic Identity and Well-Being of Adopted Korean Americans with Immigrant/U.S.-Born Korean Americans and Korean International Students

    PubMed Central

    Lee, Richard M.; Yun, Andrea Bora; Yoo, Hyung Chol; Nelson, Kim Park

    2010-01-01

    This study compared the ethnic identity and well-being of Korean Americans who were adopted internationally with immigrant/U.S.-born Korean Americans and Korean international students, as well as the relationship between ethnic identity and well-being for each group. One-hundred and seven college students completed measures of ethnic identity and subjective well-being. Immigrant/U.S.-born Korean Americans had higher ethnic identity scores than the other two groups. Immigrant/U.S.-born Korean Americans also had higher positive affect scores than international students. Ethnic identity was positively correlated with positive affect for all three groups (r’s = .27 – .34), but was negatively correlated with negative affect for international students (r = −.44). Overall, the results suggest that ethnic identity, although slightly lower than non-adopted peers, is relevant to the well-being of adopted Korean American college students. PMID:20694190

  5. 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…

  6. Immigration patterns, social support, and adaptation among Korean immigrant women and Korean American women.

    PubMed

    Kim, Y; Grant, D

    1997-01-01

    There are little empirical data available on the mental health and social functioning of Korean American Women (both native U.S. born and foreign Korean-born U.S. residents, inclusive). State-of-the-art research used to inform social work practice is exploratory descriptive. With the goal of contributing to the social work knowledge base regarding this understudied population, this article uses an emic understanding and approach to examine immigration patterns, social support networks, and issues around adaptation experienced by Korean American women. Issues examined include gender role disruption, limited use of social services, and evidence of depressive symptoms in Korean American women and subsequent risk of substance abuse, suicide, battering, loss of employment, deficits in parenting, and mental health problems. Focus on these areas of functioning suggests the need for development of culturally competent community, family, individual, and organizational-level intervention strategies.

  7. 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.

  8. 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

  9. [Dentistry in Korean during the Japanese occupation].

    PubMed

    Shin, Jae-Eu

    2004-12-01

    The Japanese introduction of dentistry into Korea was for treating the Japanese residing in Korea Noda-Oji was the first Japanese dentist for Japanese people in Korea in 1893, and Narajaki doyoyo, an invited dentist was posted in the Korean headquarter of Japanese army in September, 1905. The imperialist Japan licensed the dental technicians (yipchisa) without limit and controlled them generously so they could practice dentistry freely. This measure was contrary to that in Japan. (In Japan no new dental technician was licensed.) Komori, a dental technician opened his laboratory at Chungmuro in 1902. The dental technician had outnumbered by 1920. In 1907, the first Korean dental technician Sung-Ryong Choi practiced dentistry in Jongno. The imperialist Japan made the regulations for dental technicians to set a limit to the advertisement and medical practice of dental technicians. The first Korean dentists Suk-Tae Ham was register No. 1 in the dentist license. The Kyungsung dental school was established by Nagira Dasoni for the purpose of educating some Korean people that contributed to Japanese colonization. It made progress with the help of Japan, it was was given the approval of the establishment of the professional school in January the 25th, 1929. It was intended to produce Korean dentists in the first place but became the school for Japanese students later on. The association of Chosun dentist, which had been founded by Narajaki doyoyo, was managed by Japanese dentists in favor of the colonial ruling. The Hansung Association of Dentists established in 1925 was the organization made by the necessity of the association for Koreans only. The Japanese forcefully annexed the Association of Hansung Dentists (Koreans only) to the Association of Kyungsung Dentists to avoid collective actions of Korean dentists in the name of 'Naesunilche' -- 'Japan and Korea and one'. Their invading intention was shown in the event of 'decayed tooth preventive day'. Japanese controlled

  10. 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

  11. 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

  12. 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.

  13. Toward Understanding Korean and African American Relations.

    ERIC Educational Resources Information Center

    Chang, Edward Taehan

    1996-01-01

    Presents a lesson plan that examines the economic, cultural, and ideological factors that influence Korean and African American relations. Discusses how the two groups perceive each other and situates the role of race and class in this relationship. Includes informational handouts and discussion questions. (MJP)

  14. Attitudes toward Women in Adolescent Korean Sample.

    ERIC Educational Resources Information Center

    Youn, Gahyun

    Since the 1960s Korean society has been influenced by a variety of Western cultures, resulting in considerable changes in the roles assumed by women, especially related to their increasing employment. However, less than 3% of all managers or administrators are women. The Attitudes Toward Women scale and questionnaires concerning other…

  15. 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

  16. 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…

  17. 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…

  18. Smoking Cessation Failure among Korean Adolescents

    ERIC Educational Resources Information Center

    Kim, Sung Reul; Kim, Hyun Kyung; Kim, Ji Young; Kim, Hye Young; Ko, Sung Hee; Park, Minyoung

    2016-01-01

    The aim of this study was to identify smoking cessation failure subgroups among Korean adolescents. Participants were 379 smoking adolescents who joined a smoking cessation program. A questionnaire and a cotinine urine test were administered before the program began. Three months after the program ended, the cotinine urine test was repeated. A…

  19. 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…

  20. 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,…

  1. Understanding Immigrated Korean Children's Educational Needs

    ERIC Educational Resources Information Center

    Lee, Guang-Lea

    2003-01-01

    Korean children's school experiences as new immigrants to the United States are often emotionally turbulent because of environmental and psychological stresses that result when moving from one culture to another. With some basic knowledge and some suggested approaches, teachers can assist these children, whose numbers are increasing, to have a…

  2. 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…

  3. 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…

  4. Korean. London Oriental and African Language Library.

    ERIC Educational Resources Information Center

    Chang, Suk-Jin

    The grammar of the Korean language presented here is descriptive and structural, and does not align with any particular theory. An introductory chapter gives some background information about the language and related research. Subsequent chapters treat: writing and sound systems, including some sound rules and suprasegmental features; morphology…

  5. Korean: A Guide to the Spoken Language.

    ERIC Educational Resources Information Center

    Department of Defense, Washington, DC.

    This language guide, written for United States Armed Forces personnel, serves as an introduction to the Korean language and presents important words and phrases for use in normal conversation. Linguistic expressions are classified under the following categories: (1) greetings and general phrases, (2) location, (3) directions, (4) numbers, (5)…

  6. 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.

  7. Examining the health information-seeking behaviors of Korean Americans.

    PubMed

    Oh, Kyeung Mi; Kreps, Gary L; Jun, Jungmi; Chong, Elizabeth; Ramsey, Lolita

    2012-08-01

    Many Korean Americans suffer from high levels of cancer incidence and have low cancer screening rates. A significant number of Korean Americans lack adequate information about cancer screening tests. However, little is known about their health behaviors. This article examines exposure to mass media and health information-seeking behaviors for Korean Americans, and their associations with demographic characteristics influencing variations in exposure to the different health information and trust in health information sources. The authors gathered data for this study using a cross-sectional, community-based survey conducted in the Washington, DC, metropolitan area during 2006 and 2007. It was administered to 254 Korean Americans who were 40 years of age or older. This study is part of the first health-related program of research to study exposure to mass media, health and cancer information sources, and seeking preferences and experiences of Korean Americans. Results indicated that Korean ethnic media sources and Internet are important sources used regularly. Age, years of education completed, and English proficiency levels for Korean Americans significantly predicted the likelihood of their Internet use. Low-income Korean Americans with less education were more likely to seek health information in Korean ethnic magazines and newspapers, whereas Korean Americans with higher education and English proficiency were more likely to seek information online. The most trusted source of health information among respondents was from a doctor or other health care professional. Future research should be conducted to determine whether physicians are actually used as a primary source for health information.

  8. 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)

  9. Surgical management of hemorrhoids.

    PubMed

    Agbo, S P

    2011-07-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding.

  10. 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.

  11. 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.

  12. Smart surgical tool.

    PubMed

    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.

  13. 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…

  14. Assessment of organotin and tin-free antifouling paints contamination in the Korean coastal area.

    PubMed

    Lee, Mi-Ri-Nae; Kim, Un-Jung; Lee, In-Seok; Choi, Minkyu; Oh, Jeong-Eun

    2015-10-15

    Twelve organotins (methyl-, octyl-, butyl-, and phenyl-tin), and eight tin-free antifouling paints and their degradation products were measured in marine sediments from the Korean coastal area, and Busan and Ulsan bays, the largest harbor area in Korea. The total concentration of tin-free antifouling paints was two- to threefold higher than the total concentration of organotins. Principal component analysis was used to identify sites with relatively high levels of contamination in the inner bay area of Busan and Ulsan bays, which were separated from the coastal area. In Busan and Ulsan bays, chlorothalonil and DMSA were more dominant than in the coastal area. However, Sea-Nine 211 and total diurons, including their degradation products, were generally dominant in the Korean coastal area. The concentrations of tin and tin-free compounds were significantly different between the east and west coasts.

  15. A feminist critique of breast cancer research among Korean women.

    PubMed

    Im, E O

    2000-08-01

    Studies indicate ethnic differences in incidence, mortality, and survival rate of breast cancer. Despite the low incidence rate of breast cancer among the Korean population, Koreans are reported to be less likely to survive breast cancer. In this article, using a feminist perspective, the reasons why Korean women have been reported to be less likely to survive breast cancer are analyzed through a critical review of research among Korean women. A total of 469 studies (145 unpublished master's theses and doctoral dissertations and 324 articles published in South Korea and in the United States) were reviewed, analyzed, and critiqued in terms of biases present in the research process. Through a feminist critique of the literature, four possible reasons are proposed: androcentric views and assumptions underlying the research, modesty issues imbedded in Korean culture, the victim-blaming tendency of Korean culture, and intense emotions without adequate support.

  16. 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

  17. The Soviet Response to Korean Air Lines Flight 007.

    DTIC Science & Technology

    1985-06-07

    34 Defense & Foreign 22 . .. .*..- Affairs, November 1983, pp. 3 5-3 8 . 17 Steven J. Cimbala, "Why Did the Soviets Attack the Korean Airliner...135 returning to Alaska while the Korean flight continued on towards Petropavlovsk. Ogarkov commented, "It was natural that the Soviet Air Defense ...unable to do so.S4 When Western newspapers began reporting the Korean Air Lines disaster, several interviews were made with US dignitaries and defense

  18. Hemorrhagic Fever with Renal Syndrome (Korean Hemorrhagic Fever)

    DTIC Science & Technology

    1989-07-31

    36 DISTRIBUTION LIST. .................... 40 INTRODUCTION During the Korean War more than 3,200 United Nations troops in Korea developed a rare...hemorrhagic fever, a situa- tion that attracted worldwide attention (1). Since then it has been known as Korean hemorrhagic fever (KHF) in Korea . This...Kyunggido and Kangwondo, northern parts of South Korea . All of the 97 HFRS patients among Korean soldiers occurred in Kyunggido, Kangwondo and Seoul

  19. Chinese Communist Intervention in the Korean War: Miscalculation or Provocation?

    DTIC Science & Technology

    1987-06-05

    Committee. The History of the United Nations Forces in the Korean War. Vol1. 2. Seoul, Korea : Republic of- Korea -Ministry of National Defense , 1973...Douglas MacArthur’s United Nations Coinnd (UNC) reversed the tide In the Korean War. An Impending disaster# the loss of the Republic of Korea # turned into a...80K) - South Korea . Th’e UNC objectives were to capture the Notth Korean capital of Pyongyang# couplete the destruction of the NXPA, and secure a

  20. Korea: Nutrition and Feeding of Korean Armed Forces

    DTIC Science & Technology

    1959-03-01

    03-1959 1 1 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Korea : Nutrition and Feeding of Korean Armed Force 5b. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6...Support and Korean officers and officials concerned with nutrition and feeding, Mr. Kim Chung Yul, Minister for National Defense , made a formal...2. Annex 1, prepared by the Acting UNC Economic Coordinator, sets forth the effect of the above shift on Korean Economy and the ROK defense effort

  1. Hemorrhagic Fever with Renal Syndrome (Korean Hemorrhagic Fever)

    DTIC Science & Technology

    1990-06-29

    DISTRIBUTION LIST .............. .................... 47 5 INTRODUCTION During the Korean War more than 3,200 United Nations troops in Korea developed a...rare hemorrhagic fever, a situa- tion that attracted worldwide attention (1). Since then it has been known as Korean hemorrhagic fever (KHF) in Korea ...Chungchoongnsmdo, and Kangwendo, norLhern parts of South Korea . Almost all HFRS patients among Korean soldiers occurred in Kyunggido aind Ksngwmndo where

  2. Korea: U.S.-Korean Relations -- Issues for Congress

    DTIC Science & Technology

    2005-06-16

    wounded in the Korean War (1950-53). The United States agreed to defend South Korea from external aggression in the 1954 Mutual Defense Treaty. The... Korean Relations — Issues for Congress Updated June 16, 2005 Larry A. Niksch Foreign Affairs, Defense , and Trade Division Report Documentation Page...A 3. DATES COVERED - 4. TITLE AND SUBTITLE Korea : U.S.- Korean Relations -- Issues for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

  3. North Korean Counterfeiting of U.S. Currency

    DTIC Science & Technology

    2009-06-12

    Korean diplomats.15 Counterfeiting of foreign currency is apparently a phenomenon that is not new to the government of North Korea . Seoul’s War...Adventurism: North Korea’s Military-Diplomatic Campaigns,” Korean Journal of Defense Analysis, Vol. XVI, No.2, Fall 2004. Note that the term “Soprano State... Korean National Intelligence Service (NIS) Report to the effect that North Korea forges and circulates U.S. $100 banknotes worth $15 million a year

  4. Joint Vision for the Korean Peninsula -- Can We Get There?

    DTIC Science & Technology

    2012-03-11

    for the Alliance of the United States and the Republic of Korea . The joint statement laid out a shared vision for the Korean Peninsula and the...setting the stage for peaceful reunification, elimination of North Korean nuclear weapons programs and promoting human rights in North Korea . North...Korea’s unpredictability not only poses a threat on the Korean Peninsula but to the entire Northeast Asia region. North Korea is a multifaceted

  5. Logistics of Aircraft Maintenance During the Korean War

    DTIC Science & Technology

    1988-09-01

    reader with the impression there were no major logistics problems during the Korean War. Yet, people who served in Korea during the war testify to the...in the Korean War the Fifth Air Force wing commanders in Korea were vigorously compelled to decide between accomplishing maintenance following the...inter-island air transport. At the start of the war the MATS supported cargo operations in the Korea and Japan area. Three months after the Korean

  6. Post-Unified Korean Foreign Policy Options: Regional Implications

    DTIC Science & Technology

    2002-09-01

    Korean War, the U.S. security policy toward Korea has been instrumental in promoting peace and stability on the peninsula. The strong defense alliance...request the removal of United States troops from the Korean peninsula and the nullification of the United States-South Korea Mutual Defense Treaty...security alliance. However, after the elimination of the North Korean threat, a unified Korea will be able to redefine its foreign policy options

  7. 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

  8. 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

  9. 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

  10. 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

  11. Effects of Psychiatric Symptoms on Attention in North Korean Refugees

    PubMed Central

    Lee, Yu Jin; Jun, Jin Yong; Park, Juhyun; Kim, Soohyun; Gwak, Ah Reum; Lee, So Hee; Yoo, So Young

    2016-01-01

    Objective We investigated the performance of North Korean refugees on attention tasks, and the relationship between that performance and psychiatric symptoms. Methods Sustained and divided attention was assessed using the computerized Comprehensive Attention Test in North Korean refugees and in South Koreans. All participants also completed the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale-Revised and the Dissociative Experiences Scale-II (DES-II). Results The North Korean refugees showed slower reaction times (RTs) on the visual sustained attention task compared to the South Koreans after controlling for age and sex. North Korean refugees had a greater number of omission errors (OEs) on the divided attention task and a higher standard deviation (SD) of RT. Total DES-II scores of the North Korean refugees were associated with the number of OEs and the SD of RT on the sustained attention task, and with the number of OEs on the divided attention task. Conclusion North Korean refugees showed poorer performance on computerized attention tasks. In addition, attention deficit among North Korean refugees was associated with their dissociative experiences. Our results suggest that refugees may have attention deficits, which may be related to their psychiatric symptoms, particularly dissociation. PMID:27757125

  12. Korean Affairs Report, Kulloja, No. 10, October 1984.

    DTIC Science & Technology

    1985-06-04

    air forces in South Korea . The "Mutual Defense Treaty" signed by the South Korean puppet clique.and the U.S. imperialists right after the Korean War...debt" of foreign banks operating in South Korea or the amount of foreign currency loans owed to banks in overseas locations where South Korean ...that South Korea is currently the "debt king" of the world. The major lender of this enormous debt piled up by the South Korean puppets is the

  13. Korean Hemorrhagic Fever (Hemorrhagic Fever with Renal Syndrome (HFRS)).

    DTIC Science & Technology

    1984-07-01

    AD-Ai55 228 KOREAN HEMORRHAGIC FEVER (HEMORRHAGIC FEVER WITH RENAL in. SYNDROME (HFRS))(U) KOREA UNIV SEOUL DEPT OF MICROBIOLOGY H W LEE JUL 84...INTRODUCTION During the Korean War, more than 2,400 United Nations troops stationed in the 38th Parallel in Korea developed a rare disease which had not... Korean hemorrhagic fever patients in urban areas of Seoul. Korean J. Virol. 10: 1-6, 1980. 8. Lee, H. W. New epidemiological findings of HFRS in Korea . J

  14. 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

  15. [Surgical seeding of an anaplastic ependymoma].

    PubMed

    Yamada, Masayuki; Sato, Taku; Kuromi, Yosuke; Matsumoto, Yuka; Oda, Keiko; Kishida, Yugo; Tamura, Takamitsu; Ichikawa, Masahiro; Sakuma, Jun; Saito, Kiyoshi

    2013-12-01

    Ependymomas can relapse at the primary site and disseminate to the spinal cord. Furthermore, extraneural metastases are rare. We present a case of anaplastic ependymoma with extraneural metastasis, possibly caused by surgical seeding. An 18-year-old female was referred to us after experiencing frequent convulsive attacks. At age 9 years, she underwent partial resection of a left frontal anaplastic ependymoma, followed by 45 Gy radiation. At age 15 years, a recurrent tumor was totally removed. Three years later, magnetic resonance images revealed a left frontal recurrent tumor and a new parietal lesion. Our preoperative diagnosis of the parietal tumor was a radiation-induced meningioma. However, intraoperative pathological examinations revealed the lesion to be an anaplastic ependymoma. The tumor, which was located in the epidural space and had invaded extensively into the cranial bone, was gross totally removed. Although extremely rare, surgical seeding of anaplastic ependymomas should be considered as a differential diagnosis for recurrent tumors in the surgical field.

  16. 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.

  17. Robotic surgical simulation.

    PubMed

    Liss, Michael A; McDougall, Elspeth M

    2013-01-01

    Robotic surgery has undergone exponential growth and has ever developing utilization. The explosion of new technologies and regulation have led to challenges in training surgeons who desire this skill set. We review the current state of robotic simulation and incorporation of simulation into surgical training curricula. In addition to the literature review, results of a questionnaire survey study of 21 expert and novice surgeons attending a Urologic Robotic Oncology conference using 3 different robotic skill simulation devices are discussed. An increasing number of robotic surgery simulators have had some degree of validation study of their use in surgical education curricula and proficiency testing. Although simulators are advantageous, confirmation of construct and predictive validity of robotic simulators and their reliability as a training tool will be necessary before they are integrated into the surgical credentialing process.

  18. ISIS Electronics Flying on Korean LEO Satellites

    NASA Astrophysics Data System (ADS)

    Remy, S.; Mosset, E.; Park, Sungwoo

    2014-08-01

    Saft (Defense & Space, France), ASP (Advanced Space Power, Germany) and KARI (Korean Aerospace Research Institute, South Korea) developed an autonomous battery management system to carry out cell packages balancing, by-pass system activation and cell package discharge after failure detection. This high reliability electronics called ISIS (Intelligent Surveillance Integrated System) has been designed, tested and qualified in the frame of the Kompsat-3, Kompsat-5 and Kompsat-3A large LEO Korean KARI Satellites. Kompsat-3 and 3A (4.8 kWh battery) and Kompsat-5 (5.2 kWh battery equipped with a demanding imaging radar system) are powered during daily sun eclipses with respectively one 4P12S or 4P13S VES100 li-ion batteries managed by ISIS system.

  19. Surgical reconstruction of TMJ.

    PubMed

    Ramil Novo, V M; Garcìa, A G; Berini Aytès, L; Escoda, C G

    1999-01-01

    Certain situations and pathological processes that arise with temporomandibular joint destruction can only be resolved with surgical reconstructive procedures in order to attempt a functional and anatomical rehabilitation of this joint. Many of these situations can be surgically treated with the patient's own autologous tissues. However, in some patients reconstruction is complex and the use of autologous tissues is unadvisable whereas reconstruction utilizing alloplastic materials may be an appropriate alternative. The following report describes 4 clinical cases in which autologous grafts or Christensen joint prosthesis are employed in temporomandibular joint reconstruction.

  20. Surgical treatment for epilepsy

    PubMed Central

    Engel, Jerome; Wiebe, Samuel; Radhakrishnan, Kurupath; Palmini, André

    2016-01-01

    Surgical treatment for epilepsy remains highly underutilized: in the United States, there has been no increase in the number of surgical procedures performed annually since 19901; for most patients referred, the average duration of epilepsy is 22 years2; and there has been no change in this delay to surgery3, despite two randomized controlled trials4, 5 and an American Academy of Neurology practice parameter that recommended surgery as the treatment of choice for medically refractory temporal lobe epilepsy6. This session addressed issues relevant to increasing the availability of epilepsy surgery, particularly in countries with limited resources.

  1. Economic Performance and North Korean Regime Legitimacy

    DTIC Science & Technology

    2014-06-01

    PERFORMANCE AND NORTH KOREAN REGIME LEGITIMACY by Patrick J. Moore June 2014 Thesis Advisor: Naazneen Barma Second Reader: Robert Weiner THIS...Advisor Dr. Robert Weiner Second Reader Dr. Mohammed Hafez Chair, Department of National Security Affairs iv THIS PAGE...offers a view of success, the country outside the capital is a much different situation. Victor Cha writes that even in Kaesong, the second -largest city

  2. Korean Conflict, 1950-1953, A Bibliography

    DTIC Science & Technology

    1976-08-12

    the War in Korea. Journal of the Royal United Service J7 Institution 95:601-611 Nov󈧶. 95:601 Chronological list of incidents of the Korean...27 Observations on the performance of our infantry weapons in Korea. UH1 Spaight, J. M. Korea and the Atom Bomb. Journal of the Royal ...against the Chinese Communist forces, the first offensive and the second defensive. Drysdale, LTC D. B. Royal Marines kl Commando. Marine Corps

  3. Operational Lessons Learned in the Korean War

    DTIC Science & Technology

    2011-12-01

    entire peninsula, however, suffers from cold in the winter, Yellow Dust from the Gobi Desert choking the air in the spring, monsoons in midsummer...Republic of Korea in an effort to deter further North Korean aggression. The purpose of this monograph is capture operational lessons learned during the...considers North Korea as a buffer protecting its region of Manchuria. Encroachment of this border by foreign forces is a threat to Chinese sovereignty

  4. Low trihalomethane formation in Korean drinking water.

    PubMed

    Yoon, Jeyong; Choi, Youshik; Cho, Soonhang; Lee, Dongsoo

    2003-01-20

    Organics in water have the potential to generate harmful disinfection by-products (DBPs) such as trihalomethanes (THMs) during the chlorination process. To clarify the regulatory implications of Korean THMs levels which appear to be significantly lower than those in the US where the Stage 1 and 2 D/DBPs rule has been promulgated, the characteristics of THMs formation were investigated on five major river waters in Korea. Water samples were taken from 12 water treatment plants on five major rivers that serve as drinking water sources for more than 90% of the Korean population. Trihalomethane formation potential (THMFP), total organic halide formation potential (TOXFP) and ultraviolet absorbance at 254 nm (UV(254)) were determined and compared with those from US data. A survey of existing data [J Korean Soc Water Qual; 16(4) 2000b 431-443] provided evidence that THMs levels in treated drinking water in Korea were one-third of those reported in the US. The lower THMs levels were mainly attributable to the differences in the level and THMFP of dissolved organic carbon (DOC). The DOC levels and the THMFP normalized to DOC were approximately 60% of those in the US. Results which combined could quantitatively account for the lower THMs levels (i.e. 0.6 x 0.6 approximately 1/3) in Korea. The observed Korean THMs levels were over-predicted by the THMs model () developed in the US. The level of THMFP was found to be similar if normalized for aromaticity as measured by UV(254). These findings suggest that: (i) the case for more stringent THMs control is not likely to be a high priority among issues of drinking water quality in Korea; and (ii) significant variation of THMFP level may exist over different geographic regions; hence (iii) independent THMs models should be developed to make accurate predictions for different regions.

  5. North Korean refugee doctors' preliminary examination scores

    PubMed Central

    2016-01-01

    Purpose Although there have been studies emphasizing the re-education of North Korean (NK) doctors for post-unification of the Korean Peninsula, study on the content and scope of such re-education has yet to be conducted. Researchers intended to set the content and scope of re-education by a comparative analysis for the scores of the preliminary examination, which is comparable to the Korean Medical Licensing Examination (KMLE). Methods The scores of the first and second preliminary exams were analyzed by subject using the Wilcoxon signed rank test. The passing status of the group of NK doctors for KMLE in recent 3 years were investigated. The multiple-choice-question (MCQ) items of which difficulty indexes of NK doctors were lower than those of South Korean (SK) medical students by two times of the standard deviation of the scores of SK medical students were selected to investigate the relevant reasons. Results The average scores of nearly all subjects were improved in the second exam compared with the first exam. The passing rate of the group of NK doctors was 75%. The number of MCQ items of which difficulty indexes of NK doctors were lower than those of SK medical students was 51 (6.38%). NK doctors’ lack of understandings for Diagnostic Techniques and Procedures, Therapeutics, Prenatal Care, and Managed Care Programs was suggested as the possible reason. Conclusion The education of integrated courses focusing on Diagnostic Techniques and Procedures and Therapeutics, and apprenticeship-style training for clinical practice of core subjects are needed. Special lectures on the Preventive Medicine are likely to be required also. PMID:27907983

  6. The Economic Implications of Korean Unification

    DTIC Science & Technology

    2002-06-01

    the two sides agreed to push for a joint Imjin River flood 80 Byung Chul Koh, ed. Korea: Dynamics...background_notes. 82 Byung Chul Koh, Korea: Dynamics of Diplomacy and Unification, 86. 27 control project at an early date. And they were able to...publications/factbook. 85 Byung Chul Koh, Korea: Dynamics of Diplomacy and Unification, 34. 28 idea as the Korean economy slowly recovers from the Asian

  7. [Surgical therapy for entrapment neuropathy].

    PubMed

    Tachibana, Shigekuni

    2012-01-01

    Entrapment neuropathy is not uncommon, and surgical treatment is followed by favorite result. Therefore, to obtain an accurate diagnosis based on precise knowledge of the peripheral nervous system is very important. The most popular and useful symptoms and signs of the entrapment neuropathy is paresthesia, dysesthesia and Tinel's like sign at the lesion site. Nerve conduction study is also valuable for the accurate diagnosis. For the last 30 years, the author operated on 1,399 lesions of entrapment neuropathy. They consist of 877 carpal tunnel syndrome (63%), 284 tarsal tunnel syndrome (20%), 135 ulnar neuropathy at the elbow (10%), 53 piriformis syndrome (4%), 15 thoracic outlet syndrome (1%), and others. From the pathophysiological point to view, except for the carpal tunnel syndrome, several locations and factors come into play producing the entrapment of the nerve. The author would like to stress that the entrapment neuropathy is not severe disease, though, it strongly insult the patient's quality of life.

  8. [Surgical dilemmas. Sinus floor elevation].

    PubMed

    ten Bruggenkate, C M; Schulten, E A J M; Zijderveld, S A

    2008-12-01

    Limited alveolar bone height prevents the placement of dental implants. Sinus floor elevation is an internal augmentation of the maxillary sinus that allows implants to be placed. The principle of this surgical procedure is the preparation of a 'top hinge door', that is raised together with the Schneiderian membrane in the cranial direction. The space which created under this lid is filled with a bone transplant. Autogenous bone is the standard transplant material, despite the fact that a second surgery site is necessary. Under certain circumstances bone substitutes can be used, with a longer healing phase. If sufficient alveolar bone height is available to secure implant stability, simultaneous implantation and sinus floor elevation are possible. Considering the significant anatomical variation in the region of the maxillary sinus, a sound knowledge of the anatomy is of great importance.

  9. 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

  10. 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.

  11. Surgical wound care -- closed

    MedlinePlus

    ... around the incision increases or becomes thick, tan, green, or yellow, or smells bad (pus). Also call if your temperature is above 100°F (37.7°C) for more than 4 hours. Alternative Names Surgical incision care; Closed wound care References Leong M, Phillips LG. ...

  12. 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 ...

  13. Chinese and Korean characters engage the same visual word form area in proficient early Chinese-Korean bilinguals.

    PubMed

    Bai, Jian'e; Shi, Jinfu; Jiang, Yi; He, Sheng; Weng, Xuchu

    2011-01-01

    A number of recent studies consistently show an area, known as the visual word form area (VWFA), in the left fusiform gyrus that is selectively responsive for visual words in alphabetic scripts as well as in logographic scripts, such as Chinese characters. However, given the large difference between Chinese characters and alphabetic scripts in terms of their orthographic rules, it is not clear at a fine spatial scale, whether Chinese characters engage the same VWFA in the occipito-temporal cortex as alphabetic scripts. We specifically compared Chinese with Korean script, with Korean script serving as a good example of alphabetic writing system, but matched to Chinese in the overall square shape. Sixteen proficient early Chinese-Korean bilinguals took part in the fMRI experiment. Four types of stimuli (Chinese characters, Korean characters, line drawings and unfamiliar Chinese faces) were presented in a block-design paradigm. By contrasting characters (Chinese or Korean) to faces, presumed VWFAs could be identified for both Chinese and Korean characters in the left occipito-temporal sulcus in each subject. The location of peak response point in these two VWFAs were essentially the same. Further analysis revealed a substantial overlap between the VWFA identified for Chinese and that for Korean. At the group level, there was no significant difference in amplitude of response to Chinese and Korean characters. Spatial patterns of response to Chinese and Korean are similar. In addition to confirming that there is an area in the left occipito-temporal cortex that selectively responds to scripts in both Korean and Chinese in early Chinese-Korean bilinguals, our results show that these two scripts engage essentially the same VWFA, even at the level of fine spatial patterns of activation across voxels. These results suggest that similar populations of neurons are engaged in processing the different scripts within the same VWFA in early bilinguals.

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. Korean Non Resident Language Refresher Course: 210 Hour Course.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    The materials presented in this intermediate-advanced refresher course in Korean are intended for those who have already had considerable intensive training in spoken and written Korean. Lessons 1-70 (the first seven weeks of the course) aim to "maintain and develop habitual responses in the use of words and sentences dealing with high…

  19. 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…

  20. Evidentials and Interrogatives: A Case Study from Korean

    ERIC Educational Resources Information Center

    Lim, Dong Sik

    2010-01-01

    My aims in this thesis are to establish how evidentiality is grammatically encoded in Korean, and to investigate the semantic nature of evidential morphemes in Korean, which helps us to explain the semantic and pragmatic behavior of evidential markers in non-declarative sentences, such as interrogatives. By doing so, this thesis also shows the…

  1. 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…

  2. Multicultural Teaching Competence of Korean Early Childhood Educators

    ERIC Educational Resources Information Center

    Park, Sungok R.

    2016-01-01

    Discourse among early childhood education researchers increasingly emphasizes the need for teachers to better understand and support diversity in their classrooms. As part of a larger mixed-method study, this qualitative research illuminates Korean early childhood educators' multicultural teaching competence. While Korean classrooms are in…

  3. 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…

  4. Korean and Japanese Women: An Analytic Bibliographical Guide.

    ERIC Educational Resources Information Center

    Koh, Hesung Chun, Ed.

    This book is a selective bibliography and index of materials on Korean and Japanese women, their history, social and cultural patterns, sex roles, family and kinship patterns, and other characteristics. Designed to assist researchers in the systematic selection of information for descriptive or comparative research on Korean and Japanese women,…

  5. Conceptualization of the Constructs in Korean Primary Mathematics.

    ERIC Educational Resources Information Center

    Grow-Maienza, Janice; Beal, Susan; Randolph, Tamara

    This report describes a classroom observation study in Korean primary mathematics classrooms. What was discovered in Korean classrooms was children, through higher level questioning, were being led to conceptualize the constructs and operations. The textbook was focused on the concepts in a concise, coherent and systematic manner similar to what…

  6. 78 FR 46245 - National Korean War Veterans Armistice Day, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ... 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 a... women who showed extraordinary courage through 3 long years of war, fighting far from home to defend...

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. Virtues and Well-Being of Korean Special Education Teachers

    ERIC Educational Resources Information Center

    Kim, So-Young; Lim, Young-Jin

    2016-01-01

    Although much emphasis has been paid to stress and burnout among special education teachers, little attention has been paid to their well-being. This study aimed to examine relations between virtues and well-being among Korean special education teachers. Virtues and well-being of 115 Korean special education teachers were assessed using the…

  13. 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…

  14. 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…

  15. Bilingual Language Acquisition by Korean Schoolchildren in New York City.

    ERIC Educational Resources Information Center

    Shin, Sarah J.; Milroy, Lesley

    1999-01-01

    Examines bilingual language development of young Korean-American children with respect to acquisition of English grammatical morphemes and different plural marking systems of Korean and English. Addresses whether first and second language (L1, L2) learners acquire grammatical features of a given language in the same sequence and whether L2…

  16. 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…

  17. Korean Higher Education Reforms and Changes since the 1990s

    ERIC Educational Resources Information Center

    Oh, Yun Suk

    2011-01-01

    Korean higher education has experienced significant changes since the 1990s. Terms like quality, excellence, competition, efficiency, restructuring, and accountability have become dominant in higher education discourse. These changes are integral parts of higher education reforms implemented by the South Korean government and higher educational…

  18. Korean Elementary School Students' Perceptions of Relationship with Marine Organisms

    ERIC Educational Resources Information Center

    Kim, Jong-Mun; Anderson, David; Scott, Sandra

    2013-01-01

    This exploratory study examined the perceptions of, and relationship with, marine organisms of 81 urban sixth grade Korean students using a specifically designed survey questionnaire. The study outcomes revealed that these Korean students have limited experience with and different levels of connectedness to marine organisms. Viewed through…

  19. Korean Language Maintenance in Los Angeles. Professional Papers K-1.

    ERIC Educational Resources Information Center

    Kim, Kenneth Kong-On; And Others

    Characteristics of the Korean population in Los Angeles, intergenerational cultural problems, and efforts to promote language maintenance are described. The majority of Koreans in Los Angeles have been in the United States less than 10 years. A high percentage are from middle class and professional backgrounds. The traditional hierarchical family…

  20. 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…

  1. 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…

  2. General Intelligence, Visuospatial and Verbal Abilities in Korean Children.

    ERIC Educational Resources Information Center

    Lynn, Richard; Song, Myung Ja

    1994-01-01

    Nine-year olds completed measures of general intelligence, visuospatial ability, and verbal fluency. Subjects were 107 Korean children and 115 British children. Found that Korean children scored higher on general intelligence and visuospatial ability and lower on verbal fluency than British children. (BC)

  3. 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:…

  4. 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…

  5. "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…

  6. 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…

  7. 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…

  8. 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…

  9. Digital Mucous Cyst: A Clinical-Surgical Study

    PubMed Central

    Kim, Eun Jung; Huh, Joon Won

    2017-01-01

    Background It has been suggested digital mucous cysts (DMCs) are associated with osteoarthritis and osteophytes in the elderly, and usually have a communicating pedicle with the joint. Surgical excision is a standard therapy with a high cure rate. Objective The purpose of this prospective study is to evaluate the features of DMCs via clinical, radiological and pathological examination and the efficacy of surgical excision of DMCs. Methods Between 2010 and 2014, 24 Korean patients were treated with the resection of the cyst and the pedicle. Preoperative X-ray and ultrasonography were performed to detect the presence of the osteophyte and the connection to the joint space. Postoperative patients' satisfaction score was assessed by the visual analogue scale (0~10). Results The osteophytes were found in 15.8%. In ultrasonographic findings, there were prominent flow signals between the cyst and the joint space in 13.6%. There were no serious postoperative complications, and recurrences were observed in 16.7%. Mean postoperative satisfaction score was 8.3. Conclusion It seems that preoperative X-ray for osteophytes and ultrasonographic study for connection are not always helpful for the treatment of DMCs, and that the surgical excision with a pedicle ligation and electrocoagulation is an effective treatment modality. PMID:28223749

  10. 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

    2016-02-17

    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.

  11. 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

  12. Baseline characteristics and risk factors of retinal vein occlusion: a study by the Korean RVO Study Group.

    PubMed

    Lee, Joo Yong; Yoon, Young Hee; Kim, Ha Kyoung; Yoon, Hee Seong; Kang, Se Woong; Kim, June-Gone; Park, Kyu Hyung; Jo, Young Joon

    2013-01-01

    We investigated the demographic characteristics and risk factors of Korean patients with naÏve central or branch retinal vein occlusion (CRVO or BRVO). This study enrolled 41 clinical sites throughout Korea and included 557 consecutive patients with retinal vein occlusion (RVO) from May through November 2010. A total of 557 patients with new-onset RVO participated in this study. Two hundred and three (36.4%) patients were diagnosed with CRVO and 354 (63.6%) patients were diagnosed with BRVO. Comparisons between the two groups showed that the prevalence of diabetes mellitus was significantly higher in CRVO patients and hypertension was significantly higher in BRVO patients (P = 0.001 and 0.002, respectively). Poor baseline visual acuity was significantly associated with female and old age in BRVO patients (P = 0.002 and 0.013, respectively), whereas the wide intraretinal hemorrhage (CRVO, P = 0.029; BRVO, P < 0.001) and the macular ischemia (CRVO, P < 0.001; BRVO, P < 0.001) were associated with both groups. The study results show the clinical features of RVO in Korean patients. Hypertension is strongly associated with BRVO and diabetes mellitus is more strongly associated with CRVO in Korean patients with RVO. As the first nationwide study performed by the Korean Retinal Society, the results of this study can be applied to future studies on RVO.

  13. 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.

  14. 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…

  15. 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 behaviors.…

  16. 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…

  17. "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…

  18. 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…

  19. How Does Power Influence on Learning in Korean Organizations? How to Facilitate Learning in Korean Organizations?

    ERIC Educational Resources Information Center

    Kim, Young-Saing

    2006-01-01

    The subject into which this study inquired was the relationship between learning and power in Korean context. This study presents two case studies in two different organizations in Korea. Data were collected through individual in-depth interviews, observation and document analysis. Power semantics, rhetorical visions and informal learning model…

  20. 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

  1. 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,…

  2. 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 act, or…

  3. 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…

  4. Challenges in evaluating surgical innovation

    PubMed Central

    Ergina, Patrick L; Cook, Jonathan A; Blazeby, Jane M; Boutron, Isabelle; Clavien, Pierre-Alain; Reeves, Barnaby C; Seiler, Christoph M

    2010-01-01

    Research on surgical interventions is associated with several methodological and practical challenges of which few, if any, apply only to surgery. However, surgical evaluation is especially demanding because many of these challenges coincide. In this report, the second of three on surgical innovation and evaluation, we discuss obstacles related to the study design of randomised controlled trials and non-randomised studies assessing surgical interventions. We also describe the issues related to the nature of surgical procedures—for example, their complexity, surgeon-related factors, and the range of outcomes. Although difficult, surgical evaluation is achievable and necessary. Solutions tailored to surgical research and a framework for generating evidence on which to base surgical practice are essential. PMID:19782875

  5. Surgical Treatment of Epilepsy

    PubMed Central

    Miller, John W.; Hakimian, Shahin

    2013-01-01

    Purpose of Review: This article outlines indications for neurosurgical treatment of epilepsy, describes the presurgical workup, summarizes surgical approaches, and details expected risks and benefits. Recent Findings: There is class I evidence for the efficacy of temporal lobectomy in treating intractable seizures, and accumulating documentation that successful surgical treatment reverses much of the disability, morbidity, and excess mortality of chronic epilepsy. Summary: Chronic, uncontrolled focal epilepsy causes progressive disability and increased mortality, but these can be reversed with seizure control. Vigorous efforts to stop seizures are warranted. If two well-chosen and tolerated medication trials do not achieve seizure control, an early workup for epilepsy surgery should be arranged. If this workup definitively identifies the brain region from which the seizures arise, and this region can be removed with a low risk of disabling neurologic deficits, neurosurgery will have a much better chance of stopping seizures than further medication trials. PMID:23739107

  6. 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.

  7. 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.

  8. Why are Korean American Physicians Reluctant to Recommend Colorectal Cancer Screening to Korean American Patients? Exploratory Interview Findings

    PubMed Central

    Maxwell, Annette E.; Rick, Albert J.; Cha, Jennifer; Bastani, Roshan

    2009-01-01

    Background Korean Americans have one of the lowest screening rates for colorectal cancer. Although physician recommendation is one of the most important predictors of cancer screening across populations, only few Korean American patients receive such a recommendation. Methods We interviewed 14 Korean American physicians in Los Angeles area who primarily serve Korean Americans to explore why they are reluctant to recommend colorectal cancer screening to their Korean patients. Results Physicians identified barriers attributable to themselves (i.e., lack of knowledge, fear of medicolegal liability), their patients (i.e., patient’s unfamiliarity with the concept of screening), and the health care system (i.e., lack of referral network, poor reimbursement). Discussion Our results suggest the need for multi-faceted interventions directed at the physicians, their patients, and the health care system. Further research is needed to validate our results and to assess the extent to which they apply to physicians from other racial/ethnic groups. PMID:18607728

  9. 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.

  10. The middleman minority characteristics of Korean immigrants in the United States.

    PubMed

    Min, P; Kolodny, A

    1994-12-01

    "This paper examines the middleman minority characteristics of Korean immigrants in the United States. Like middleman groups in other societies, Korean immigrants in the United States are heavily concentrated in small business. A large proportion of Korean-owned businesses distribute merchandise to minority customers on behalf of large corporations. Korean merchants, like other middleman groups, maintain strong ethnic cohesion, which facilitates their commercial activities.... We conclude that Korean immigrants in the United States exhibit middleman minority characteristics."

  11. 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

  12. Surgical Tourniquets in Orthopaedics

    DTIC Science & Technology

    2009-12-01

    Petit described a new screw- like device that tightened a belt to stop arterial blood flow1. With the advent of general anesthesia, Joseph Lister was the...were rated 92% effective and non- pneumatic tourniquets were rated 79% effective33. However, the use of non-pneumatic Petit ( belt ) tourni- quets and...and pressure gradients typically produced by a modern pneumatic surgical tourniquet cuff (A); a non- pneumatic, non-elastic, belt -type military

  13. Surgical management of neurofibromatosis.

    PubMed

    Parsons, Colin M; Canter, Robert J; Khatri, Vijay P

    2009-01-01

    Neurofibromatoses are a complex set of genetic diseases with a wide spectrum of clinical manifestations. Life-threatening complications may develop as the result of tumor progression. Surgical intervention is the only effective means of treatment for progressive pain, disfigurement, functional compromise, and malignancy. In the future, molecular advances should allow for the development of targeted therapies to treat patients who have neurofibromatosis in addition to those who have sporadic tumors. Tumor profiling should allow us to guide therapies and predict responses.

  14. Surgical management of painful peripheral nerves.

    PubMed

    Elliot, David

    2014-07-01

    This article deals with the classification, assessment, and management of painful nerves of the distal upper limb. The author's preferred surgical and rehabilitation techniques in managing these conditions are discussed in detail and include (1) relocation of end-neuromas to specific sites, (2) division and relocation of painful nerves in continuity (neuromas-in-continuity and scar-tethered nerves) involving small nerves to the same sites, and (3) fascial wrapping of painful nerves in continuity involving larger nerves such as the median and ulnar nerves. The results of these treatments are presented as justification for current use of these techniques.

  15. 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.

  16. Language Ideology and Identity in Transnational Space: Globalization, Migration, and Bilingualism among Korean Families in the USA

    ERIC Educational Resources Information Center

    Song, Juyoung

    2010-01-01

    A growing transnational migration trend among (South) Korean families brings heterogeneity to the Korean-American communities in the US in terms of educational practices and identity. Based on interviews with Korean mothers, this study discusses how two groups of Koreans, Korean immigrants and early study abroad sojourners, enacted and adopted…

  17. Assessment of clinical risk factors to validate the probability of osteoporosis and subsequent fractures in Korean women.

    PubMed

    Kim, Yoo Mee; Hyun, Noo-Rie; Shon, Ho-Sang; Kim, Hae-Soon; Park, So-Young; Park, Il-Hyung; Chung, Yoon-Sok; Jung, Hong-Geun; Kim, Do-Hee; Lim, Sung-Kil

    2008-12-01

    This cross-sectional, observational study was designed to identify clinical risk factors of osteoporosis and fractures in Korean women to validate the probability of osteoporosis and subsequent fractures. A total of 1541 Korean women were recruited nationally. Fracture history of any site, risk factors of osteoporosis, and fall-related risk factors were surveyed and physical performance tests were conducted. Peripheral dual-energy X-ray absorptiometry was used to measure calcaneus bone mineral density (BMD). The number of positive responses on the modified 1-min osteoporosis risk test was related to the risk of osteoporosis. The frequency of osteoporosis was higher in those with a height reduction of >4 cm and a reduced body mass index (BMI). Multivariate analysis showed that older age and lower BMI were related to higher relative risk of osteoporosis. Time required to stand up from a chair and questions related to fall injury were significantly related to clinical fracture history of any site. Multivariate analysis showed that the relative risk of fractures at any site was higher in older subjects with a lower T-score and parental hip fracture history. This study shows that age and BMI are the most significant clinical risk factors for osteoporosis and that age, BMD, and parental history of hip fracture are highly applicable risk factors for validating the probability of osteoporotic fractures in Korean women.

  18. Geoacoustic characteristics at the DH-2 long-core sediments in the Korean continental margin of the East Sea

    NASA Astrophysics Data System (ADS)

    Ryang, Woo Hun; Kim, Seong Pil; Hahn, Jooyoung

    2015-04-01

    A long core of 27.2 m was acquired at the DH-2 site (37°34.355'N and 129°19.516'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 316.6 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-2 core site, geoacoustic characteristics of the deeper sedimentary successions were firstly investigated in the Korean continental margin of the western East Sea. The geoacoustic measurements comprise 86 P-wave velocities and 76 attenuation values. These geoacoustic characteristics of the DH-2 long core probably contribute 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, 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 Agency of Defense Development (UD140003DD).

  19. Placental glucose dehydrogenase polymorphism in Koreans.

    PubMed

    Kim, Y J; Paik, S G; Park, H Y

    1994-12-01

    The genetic polymorphism of placental glucose dehydrogenase (GDH) was investigated in 300 Korean placentae using horizontal starch gel electrophoresis. The allele frequencies for GDH1, GDH2 and GDH3 were 0.537, 0.440 and 0.005, respectively, which were similar to those in Japanese. We also observed an anodal allele which was similar to the GDH4 originally reported in Chinese populations at a low frequency of 0.015. An additional new cathodal allele (named GDH6) was observed in the present study with a very low frequency of 0.003.

  20. Characterizing the detectability of emission signals from a North Korean nuclear detonation.

    PubMed

    Werth, David; Buckley, Robert

    2017-04-01

    The detectability of emission sources, defined by a low-level of mixing with other sources, was estimated for various locations surrounding the Sea of Japan, including a site within North Korea. A high-resolution meteorological model coupled to a dispersion model was used to simulate plume dynamics for four periods, and two metrics of airborne plume mixing were calculated for each source. While emissions from several known sources in this area tended to blend with others while dispersing downwind, the North Korean plume often remained relatively distinct, thereby making it potentially easier to unambiguously 'backtrack' it to its source.

  1. Prevention of retained surgical items.

    PubMed

    Feldman, David L

    2011-01-01

    Reduction in retained surgical items is an important part of any operating room patient-safety effort. Any item used in an operation can result in a retained surgical item, but sponges are the most frequent and the abdomen is the most common location. Retained sponges can cause significant morbidity, and the costs associated with both prevention and treatment of retained surgical items, including legal costs, can be considerable. This review will examine counting, teamwork, radiography, and new technology as methods used to prevent retained surgical items. Even though none of these techniques individually is likely to completely prevent retained surgical items, when used together the numbers can be reduced.

  2. 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.

  3. Relationship between Blood Mercury Concentration and Bone Mineral Density in Korean Men in the 2008–2010 Korean National Health and Nutrition Examination Survey

    PubMed Central

    Kim, Yang Hee; Seo, Min Seok; Yim, Hyung Ji; Cho, Mi Ra

    2016-01-01

    Background The results of previous studies on the association between blood mercury (Hg) and bone mineral density (BMD) are inconsistent. We therefore used a large-scale nationwide representative sample of Korean men to investigate the relationship between these two parameters. Methods A nationwide cross-sectional study was conducted using data from the 2008 to 2010 Korean National Health and Nutrition Examination Survey to evaluate the relationship between blood Hg and BMD and the prevalence of osteopenia or osteoporosis in 1,190 men over 50 years of age. BMD was measured by dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed for each body site according to World Health Organization T-score criteria. Results After adjusting for age, body mass index, caloric energy and calcium intake, vitamin D levels, fish consumption, alcohol consumption, smoking, and exercise, quartiles of blood Hg were positively associated with femur neck T-scores in multiple linear regression analysis (β=0.06, P-value=0.03). Compared with the lowest blood Hg quartile, the odds ratios and 95% confidence intervals for diagnosis of osteopenia or osteoporosis in the second and fourth quartiles were 0.63 (0.41–0.99) and 0.57 (0.36–0.91), respectively, in the femur neck after adjusting for the same co-variables. Conclusion High blood Hg levels were associated with reduced odds of decreased femur neck BMD in Korean men. However, subgroup analysis did not show a significant protective effect of blood Hg on osteoporotic fractures. Further research is necessary to clarify the association between blood Hg and BMD. PMID:27688860

  4. Wound infection after arterial surgical procedures.

    PubMed

    van Himbeeck, F J; van Knippenberg, L A; Niessen, M C; van Griethuysen, A J

    1992-09-01

    During the period October 1983 to March 1987, 603 patients who underwent arterial surgical procedures were studied to determine the incidence and treatment of wound infections. Bypass procedures were performed in 395 patients (65.5%), in which autogenous vein was used for 158 grafts (26%), synthetic Dacron for 216 grafts (36%), and umbilical vein for 21 grafts (3.5%). Thrombo-endarterectomies, embolectomies and patch-grafts were performed in 208 patients (34.5%). An Infection Control Nurse examined and registered the wounds. The definition of wound infection used in our study is equivalent to Szilagyi grade II infection. Vascular surgery is classified as clean surgery, the clean wound infection rate being a useful measurement to evaluate preventative measures and surgical technique. Thirty-one patients (5.1%) developed a wound infection as a postoperative complication. The overall incidence of wound complications including haematoma and seroma following arterial reconstruction was 13%. The site of wound infection was predominantly the groin. The most common pathogen was Staphylococcus aureus which was found in 17 patients (2.8%). All infections resolved without further surgical intervention. The influence of possible aetiological factors is considered and the importance of prophylactic antibiotics and good surgical technique is stressed.

  5. [Recent myocardial infarction, cardiogenic shock and unsuccessful coronary angioplasty--the pattern of cooperation between a centre without on-site surgical back-up and a distantly located clinical cardiosurgery centre].

    PubMed

    Janiak, Bartłomiej; Jakubaszko, Jacek; Gorski, Małgorzata; Pelczar, Marek; Szełemej, Roman; Kustrzycki, Wojciech

    2007-03-01

    The case of a 66-year-old male with acute myocardial infarction (AMI) complicated by cardiogenic shock is presented. Because of failed primary PCI, after stabilisation of ischaemia and haemodynamics by medication and IABP he was transferred to a distantly located cardiosurgery unit. This patient underwent successful emergency CABG on the second day after infarction. The problem of transporting a patient with AMI and cardiogenic shock to a distant site and the problem of emergency CABG in such high-risk patients is discussed.

  6. Remembered branches: towards a future of Korean homosexual film.

    PubMed

    Lee, J

    2000-01-01

    Korean cinema has long labored under an imported Confucian homophobia which, through its effects if not its causes, seems to mirror the Western conception of the closet. Recent cinematic developments in Korea, including a queer film festival in Seoul, are slowly but surely beginning to change that. Using as primary texts the recent Korean gay film Broken Branches and the long-forgotten lesbian film Ascetic: Woman and Woman, my essay hopes to serve as a set of introductory remarks on a queer Korean cinema culture whose surface has only just been broached.

  7. Causal attributions of dementia among Korean American immigrants.

    PubMed

    Lee, Sang E; Diwan, Sadhna; Yeo, Gwen

    2010-11-01

    To better understand conceptualizations of dementia, this study explored causal attributions of dementia among 209 Korean Americans, using a self-administered questionnaire in Korean. Findings show that Korean Americans endorsed various causal attributions. Factor analysis yielded 3 dimensions of their attributions including psychological, physical/environmental, and cognitive/social. Bivariate analyses showed that younger age and higher education were related to more physical/environmental attributions, and younger age was related to more cognitive/social attributions. The study provides an understanding of causal attributions of dementia that practitioners need to understand to provide culturally competent practice and highlights a need to customize public education messages by specific ethnic groups.

  8. Isolation and characterization of orf viruses from Korean black goats.

    PubMed

    Oem, Jae-Ku; Chung, Joon-Yee; Kim, Yong-Joo; Lee, Kyoung-Ki; Kim, Seong-Hee; Jung, Byeong-Yeal; Hyun, Bang-Hun

    2013-01-01

    Five cases of orf virus infection in Korean black goats were diagnosed in our laboratory between 2010 and 2011. One orf virus (ORF/2011) was isolated from an ovine testis cell line (OA3.Ts) for use as a vaccine candidate. Sequences of the major envelope protein and orf virus interferon resistance genes were determined and compared with published reference sequences. Phylogenetic analyses revealed that orf viruses from Korean black goats were most closely related to an isolate (ORF/09/Korea) from dairy goats in Korea. This result indicates that the orf viruses might have been introduced from dairy goats into the Korean black goat population.

  9. Air Sanctuaries in Limited War: A Korean War Case Study.

    DTIC Science & Technology

    1986-03-01

    these restrictions, however, FEAF managed to maintain air superiority throughout Korea for the duration of the war. It routinely bombed North Korean air...and National Policy. Vol III, The Korean War, part 2. Washington, Mar 1979. 555p. PERIODICALS Foot, Rosemary. The Sino American Conflict in Korea : The...A07 844 AlR SANCTUARIES IN LIMITED WAR. A KOREAN WAR CASE STWJY i/I (UJ) AIR WAR COLL MAXMd LL AFB AL C M HINKLE MAR 8 AUJ-AWC-86-898

  10. Korean Hemorrhagic Fever (Hemorrhagic Fever with Renal Syndrome (HFRS)).

    DTIC Science & Technology

    1983-08-01

    RD-RI55 255 KOREAN HEMORRHAGIC FEVER (HEMORRHAGIC FEVER WITH RENAL 11 SYNDROME (HFRS))(U) KOREA UNIV SEOUL DEPT OF MICROBIOLOGY H U LEE RUG 83 DRMDi...the first time in Korea (4,13). WHO has recently adapted to call Korean hemorrhagic fever and clinically similar diseases with a different name, HFRS...AD_______ I •. KOREAN HEMORRHAGIC FEVER • (HEMORRHAGIC FEVER WITH RENAL SYNDROME (HFRS)) I Final Report 0 In HO WANG LEE, M.D. August 1983 Supported by U.S

  11. What North Korea wants. [North Korean nuclear policy

    SciTech Connect

    Hayes, P. )

    1993-12-01

    In this article the author draws upon his experiences from his four trips to North Korea, during which he discussed nuclear issues with North Korean leaders, to help explain part of the North Korean reasoning behind its threats to withdraw from the Nuclear Non-Proliferation Treaty and its gyrating nuclear policies. In essence, the author believes that North Korean nuclear policy is a result of Kim Jong Il's attempt to maintain the loyalty and obeisance of the elite. The article describes the political and economic factors which lead to North Korea's confrontation with the International Atomic Energy Agency (IAEA) and then discusses North Korea's immediate nuclear strategy.

  12. [Surgical approaches in rhinoplasty].

    PubMed

    Nguyen, P S; Duron, J-B; Bardot, J; Levet, Y; Aiach, G

    2014-12-01

    In the first step of rhinoplasty, the surgical approach will expose through different types of incisions and dissection planes the osteocartilaginous framework of the nasal pyramid prior to performing actions to reduce or increase the latter. This exposure can be performed by a closed approach or by an external approach--the choice depends on the type of nose and the habits of the surgeon. Far from being opposites, closed and external approaches are complementary and should be known and mastered by surgeons performing rhinoplasty.

  13. [A systematic review of surgical hand antisepsis utilizing an alcohol preparation compared to traditional products].

    PubMed

    Gonçalves, Karen de Jesus; Graziano, Kazuko Uchikawa; Kawagoe, Julia Yaeko

    2012-12-01

    Surgical hand antisepsis aims at preventing surgical site infections, an important cause of postoperative morbidity and mortality and escalating hospital costs. The objectives of this study were to compare the efficacy of alcohol preparations with traditional surgical hand antisepsis products by means of a systematic review of the literature. Primary and secondary studies were included, considering the microbial count or surgical site infection rates as outcomes. The search was performed on the BVS Portal, PubMed, Ask and MEDLINE. Twenty-five studies were selected (two systematic reviews, nineteen experimental and four cohort studies). The alcohol preparations promoted a microbial reduction equal to and/or greater than traditional products in 17 studies, and a lesser reduction in four studies; similar surgical site infection rates were identified. Therefore, there is scientific evidence that support the safety of alcohol preparations for surgical hand antisepsis.

  14. Immunogenicity and Safety of a Live Attenuated Zoster Vaccine (ZOSTAVAX™) in Korean Adults.

    PubMed

    Choi, Won Suk; Choi, Jung-Hyun; Choi, Jun Yong; Eom, Joong Sik; Kim, Sang Il; Pai, Hyunjoo; Peck, Kyong Ran; Sohn, Jang Wook; Cheong, Hee Jin

    2016-01-01

    A live attenuated zoster vaccine (ZOSTAVAX™, Merck & Co., Inc.) was approved by the Korea Ministry of Food and Drug Safety in 2009. However, the immunogenicity and safety of the vaccine has not been assessed in Korean population. This is multi-center, open-label, single-arm study performed with 180 healthy Korean adults ≥ 50 yr of age. The geometric mean titer (GMT) and geometric mean fold rise (GMFR) of varicella zoster virus (VZV) antibodies were measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) at 4 weeks post-vaccination. Subjects were followed for exposure to varicella or herpes zoster (HZ), the development of any varicella/varicella-like or HZ/HZ-like rashes, and any other clinical adverse experiences (AEs) for 42 days post-vaccination. For the 166 subjects included in the per-protocol population, the GMT at Day 1 was 66.9. At 4 weeks post-vaccination, the GMT for this population was 185.4, with a GMFR of 2.8 (95% CI, 2.5-3.1). Of the 180 subjects vaccinated, 62.8% experienced ≥ 1 AE, with 53.3% of subjects reporting injection-site AEs. The most frequently reported injection-site AEs were erythema (45.0%) with the majority being mild in intensity. Overall, 44 (24.4%) subjects experienced ≥ 1 systemic AE, 10 (5.5%) subjects experienced a systemic vaccine-related AE, and 3 (1.7%) subjects experienced ≥ 1 serious AE not related to vaccine. No subjects reported a VZV-like rash. There was no subject of death and no subject discontinued due to an adverse event. A single dose of zoster vaccine induced VZV-specific gpELISA antibody response and was generally well-tolerated in healthy Korean adults ≥50 yr of age (registry at www.clinicaltrial.gov No. NCT01556451).

  15. Detection and molecular characterization of human noroviruses in Korean groundwater between 2008 and 2010.

    PubMed

    Lee, Gyu-Cheol; Jheong, Weon-Hwa; Jung, Gyoo Seung; Oh, Sung-Ae; Kim, Min-jeong; Rhee, Ok-Jae; Park, Sujeong; Lee, Chan Hee

    2012-09-01

    RT-PCR, nucleotide sequencing, and phylogenetic analysis were performed for genotyping and molecular characterization of noroviruses isolated from Korean groundwater. Among 160 samples collected from 80 sites between 2008 and 2010, 14 samples (8.7 %) from 12 sites were positive for noroviruses (NoVs). The percentages of NoV-positive samples in 2008, 2009, and 2010 were 22.2, 3.2, and 0 %, respectively, representing a yearly decrease. GII-positive samples (n = 9, 5.6 %) outnumbered GI-positive samples (n = 5, 3.1 %). The genotypes of the GI NoVs were GI.2, GI.5, and GI.6, and the genotypes of the GII NoVs were all GII.4. One sample, HM623465, was very similar to CUK-3 and CBNU2 and two GII.4 sequences isolated from the stool of Korean gastroenteritis patients. A BLASTN search revealed several nucleotide sequences highly similar to those of NoVs isolated in this study. The original isolation sources for these similar NoVs were mostly stool (n = 731, 80.0 %) and groundwater (n = 135, 14.8 %), and all the countries from which they were isolated were almost in Asia (96.0 %); specifically, China (n = 192, 21.0 %), Japan (n = 383, 41.9 %), Korea (n = 296, 32.4 %), and other Asian countries (n = 6, 0.7 %). These results suggest that Korean groundwater might be contaminated with NoVs from the stool of infected patients and that these NoVs in turn cause new cases of gastroenteritis through a typical fecal-oral route with region-specific circulation. Therefore, it is important to properly treat sewage, which may include waterborne viruses and manage point sources in groundwater for national health and sanitation. In addition, continuous molecular surveillance remains important for understanding circulating NoVs.

  16. 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

  17. [Stomata--surgical standards].

    PubMed

    Wagner, M; Malayeri, V; Seiler, C A; Candinas, D

    2003-01-01

    The placement of an intestinal stoma is still a common procedure despite the recent advantages in intestinal surgery. It is mandatory to apply meticulously sound surgical principles in order to achieve good results. Nevertheless, intestinal stomas are envisioned with a high perioperative morbidity which is mostly caused by surgical inadequacy. This can lead to considerable problems in management of the stoma in the long term and ultimately will affect quality of life of the patient. The cumulative morbidity can be given by 50% with prolaps, hernia, stenosis and necrosis as well as stoma retraction being the most relevant. In contrast, an adequate intestinal stoma will positively affect the quality of life of the patient. The availability of devices developed by the industry and the inauguration of a professional service in certain hospitals simplified the management of patients with a stoma. This significantly improved the standards of care especially regarding preoperative preparation and postoperative management. Thus, most patients are able to maintain an active and socially integrated life with minimal physical and psychical limitations.

  18. [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

  19. Minimally invasive surgical technique for tethered surgical drains

    PubMed Central

    Hess, Shane R; Satpathy, Jibanananda; Waligora, Andrew C; Ugwu-Oju, Obinna

    2017-01-01

    A feared complication of temporary surgical drain placement is from the technical error of accidentally suturing the surgical drain into the wound. Postoperative discovery of a tethered drain can frequently necessitate return to the operating room if it cannot be successfully removed with nonoperative techniques. Formal wound exploration increases anesthesia and infection risk as well as cost and is best avoided if possible. We present a minimally invasive surgical technique that can avoid the morbidity associated with a full surgical wound exploration to remove a tethered drain when other nonoperative techniques fail.

  20. 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).