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Sample records for korean surgical site

  1. Frequently Asked Questions about Surgical Site Infections

    MedlinePlus

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

  2. Modifiable risk factors for surgical site infection.

    PubMed

    Moucha, Calin S; Clyburn, Terry A; Evans, Richard P; Prokuski, Laura

    2011-01-01

    Multiple risk factors for orthopaedic surgical site infection have been identified. Some of these factors directly affect the wound-healing process, whereas others can lead to blood-borne sepsis or relative immunosuppression. Modifying a patient's medications; screening for comorbidities, such as HIV or diabetes mellitus; and advising the patient on options to diminish or eliminate adverse behaviors, such as smoking, should lower the risk for surgical site infections.

  3. Surgical site markers: potential source of infection.

    PubMed

    Driessche, Ann Marie

    2012-01-01

    Observing licensed independent practitioners mark surgical sites with all types of marking pens is a concern related to the potential spread of infections from patient to patient. The practice of using the same marking pen to mark a surgical site has been questioned as a source of cross contamination. A literature review was done on recent studies and best practice recommendations to determine whether marking pens can act as fomites for nosocomial infections. The review indicated that surgical site markers, ink pens, and aging permanent marking pens can be a source for cross-infection with methicillin-resistant Staphylococcus aureus, other bacteria, fungus, or virus. The type of marking pens used and the act of using the same marking pen from patient to patient could contribute to nosocomial infections. The literature reviewed recommends a single time use of a surgical marking pen. Interventions to prevent cross contamination and postoperative surgical site infections are a major concern in the care of the orthopaedic patient. PMID:23168939

  4. Surgical site markers: potential source of infection.

    PubMed

    Driessche, Ann Marie

    2012-01-01

    Observing licensed independent practitioners mark surgical sites with all types of marking pens is a concern related to the potential spread of infections from patient to patient. The practice of using the same marking pen to mark a surgical site has been questioned as a source of cross contamination. A literature review was done on recent studies and best practice recommendations to determine whether marking pens can act as fomites for nosocomial infections. The review indicated that surgical site markers, ink pens, and aging permanent marking pens can be a source for cross-infection with methicillin-resistant Staphylococcus aureus, other bacteria, fungus, or virus. The type of marking pens used and the act of using the same marking pen from patient to patient could contribute to nosocomial infections. The literature reviewed recommends a single time use of a surgical marking pen. Interventions to prevent cross contamination and postoperative surgical site infections are a major concern in the care of the orthopaedic patient.

  5. Pelvic surgical site infections in gynecologic surgery.

    PubMed

    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.

  6. Surgical Site Infections After Pediatric Spine Surgery.

    PubMed

    Floccari, Lorena V; Milbrandt, Todd A

    2016-04-01

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

  7. Contributing factors to surgical site infections.

    PubMed

    Harrop, James S; Styliaras, John C; Ooi, Yinn Cher; Radcliff, Kristen E; Vaccaro, Alexander R; Wu, Chengyuan

    2012-02-01

    Surgical site infections (SSIs) are the most common nosocomial infections. These complications lead to revision surgery, delayed wound healing, increased use of antibiotics, and increased length of hospital stay, all of which have a significant impact on patients and the cost of health care. Such intraoperative factors as proper skin preparation, adherence to sterile technique, surgical duration, and traffic in the operating room contribute more to SSIs than do patient-related risk factors such as diabetes mellitus, obesity, and preexisting colonization with methicillin-resistant Staphylococcus aureus. Surgeons have a responsibility to understand the current evidence regarding the factors that affect the rates of SSIs so as to provide the highest level of patient care.

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

    PubMed Central

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

    2013-01-01

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

  9. 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

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

    PubMed

    Kim, Won-Gon

    2016-08-01

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

  11. 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

  12. Necessity of Surgical Site Closed Suction Drain for Pterional Craniotomy

    PubMed Central

    Choi, Su Yong; Yoon, Sung Min; Yoo, Chan Jong; Kim, Young Bo; Kim, Woo Kyung

    2015-01-01

    Objective The aim of this study was to assess the benefit of using a prophylactic surgical site closed suction drain in pterional craniotomy. Materials and Methods A retrospective review was conducted on 607 consecutive patients who underwent a pterional craniotomy for treatment of intracranial anterior circulation aneurysms over a 5-year period. Between January 2000 and December 2004, 607 patients were divided into two groups, those who had a prophylactic suction drain during closure of the surgical site (drain group, DG) and those who did not (non-drain group, NDG). Head computed tomography (CT) was taken routinely on postoperative day (POD) 1, 7, and 14. Patients' demographics, incidence of surgical site complications, and courses of surgical site healing which were evaluated radiologically by the thickness of the surgical site myocutaneous layer, were analyzed between DG and NDG. Results Patients' demographics and characteristics did not differ significantly between the two groups. The head CT showed that the degree of changes in the postoperative surgical site thickness was 148% at POD 1, 209% at POD 7, and 198% at POD 14 in DG, and 118% at POD 1, 152% at POD 7, and 158% at POD 14 in NDG compared to the preoperative value. Postoperative surgical site hematoma was 7.9% (22/274) in DG and 2.4% (8/333) in NDG. Conclusion Prophylactic use of an epidural and/or subgaleal closed suction drain does not appear to be necessary for prevention of postoperative surgical site hematoma as well as for promotion of surgical site healing in pterional craniotomy. PMID:26523255

  13. 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.

  14. Surgical site infection prevention: the operating room environment.

    PubMed

    Clyburn, Terry A; Evans, Richard P; Moucha, Calin S; Prokuski, Laura

    2011-01-01

    Surgical site infections can complicate orthopaedic procedures and contribute to morbidity, mortality, and health care costs. Extensive literature has been published on this topic; however, the quality of data using standards of evidence-based medicine is variable with a lack of well-controlled studies. A review of the literature concerning measures to prevent surgical site infections in the operating room environment may be helpful in preventing such infections.

  15. Surgical site infection prevention and control: an emerging paradigm.

    PubMed

    Evans, Richard P; Clyburn, Terry A; Moucha, Calin S; Prokuski, Laura

    2011-01-01

    Examining the current state of infection in orthopaedic surgery provides tools and techniques to reduce the risks of nosocomial infections and prevent and treat infections from drug-resistant organisms. It is important for surgeons to recognize modifiable surgical risk factors and be aware of the importance of preoperative patient screening in reducing surgical site infections. The latest evidence-based data from scientific exhibits, instructional course lectures, and the Orthopaedic Knowledge Online continuing medical education module gathered during the past 5 years by the American Academy of Orthopaedic Surgeons Patient Safety Committee are useful in understanding and controlling the increasing and vital problem of surgical site infection.

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

    PubMed

    Ng, Wai Khuan; Awad, Nawal

    2015-01-01

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

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

    PubMed

    Ng, Wai Khuan; Awad, Nawal

    2015-01-01

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

  18. Preoperative drug dispensing as predictor of surgical site infection.

    PubMed Central

    Kaye, K. S.; Sands, K.; Donahue, J. G.; Chan, K. A.; Fishman, P.; Platt, R.

    2001-01-01

    The system used by the National Nosocomial Infection Surveillance (NNIS) program to measure risk of surgical site infection uses a score of 3 on the American Society of Anesthesiologists (ASA)-physical status scale as a measure of underlying illness. The chronic disease score measures health status as a function of age, sex, and 29 chronic diseases, inferred from dispensing of prescription drugs. We studied the relationship between the chronic disease score and surgical site infection and whether the score can supplement the NNIS risk index. In a retrospective comparison of 191 patients with surgical site infection and 378 uninfected controls, the chronic disease score and ASA score were highly correlated. The chronic disease score improved prediction of infection by the NNIS risk index and augmented the ASA score for risk adjustment. PMID:11266295

  19. Operating theatre quality and prevention of surgical site infections.

    PubMed

    Spagnolo, A M; Ottria, G; Amicizia, D; Perdelli, F; Cristina, M L

    2013-09-01

    Surgical site infections (SSI) account for 14% to 17% of all hospital-acquired infections and 38% of nosocomial infections in surgical patients. SSI remain a substantial cause of morbidity and death, possibly because of the larger numbers of elderly surgical patients or those with a variety of chronic and immunocompromising conditions, and emergence of antibiotic-resistant microorganisms. Factors causing surgical site infection are multifarious. Several studies have identified the main patient-related (endogenous risk factors) and procedure-related (external risk factors) factors that influence the risk of SSI. The rate of surgical wound infections is strongly influenced by operating theatre quality, too. A safe and salubrious operating theatre is an environment in which all sources of pollution and any micro-environmental alterations are kept strictly under control. This can be achieved only through careful planning, maintenance and periodic checks, as well as proper ongoing training for staff Many international scientific societies have produced guidelines regarding the environmental features of operating theatres (positive pressure, exchanges of filtered air per hour, air-conditioning systems with HEPA filters, etc.) and issued recommendations on healthcare-associated infection, including SSI, concerning surveillance methods, intervention to actively prevent SSI and approaches to monitoring the implementation of such strategies. Therefore, the prevention of SSI requires a multidisciplinary approach and the commitment of all concerned, including that of those who are responsible for the design, layout and functioning of operating theatres. PMID:24783890

  20. Operating theatre quality and prevention of surgical site infections.

    PubMed

    Spagnolo, A M; Ottria, G; Amicizia, D; Perdelli, F; Cristina, M L

    2013-09-01

    Surgical site infections (SSI) account for 14% to 17% of all hospital-acquired infections and 38% of nosocomial infections in surgical patients. SSI remain a substantial cause of morbidity and death, possibly because of the larger numbers of elderly surgical patients or those with a variety of chronic and immunocompromising conditions, and emergence of antibiotic-resistant microorganisms. Factors causing surgical site infection are multifarious. Several studies have identified the main patient-related (endogenous risk factors) and procedure-related (external risk factors) factors that influence the risk of SSI. The rate of surgical wound infections is strongly influenced by operating theatre quality, too. A safe and salubrious operating theatre is an environment in which all sources of pollution and any micro-environmental alterations are kept strictly under control. This can be achieved only through careful planning, maintenance and periodic checks, as well as proper ongoing training for staff Many international scientific societies have produced guidelines regarding the environmental features of operating theatres (positive pressure, exchanges of filtered air per hour, air-conditioning systems with HEPA filters, etc.) and issued recommendations on healthcare-associated infection, including SSI, concerning surveillance methods, intervention to actively prevent SSI and approaches to monitoring the implementation of such strategies. Therefore, the prevention of SSI requires a multidisciplinary approach and the commitment of all concerned, including that of those who are responsible for the design, layout and functioning of operating theatres.

  1. Reducing surgical site infection in arthroplasty of the lower limb

    PubMed Central

    Johnson, R.; Jameson, S. S.; Sanders, R. D.; Sargant, N. J.; Muller, S. D.; Meek, R. M. D.; Reed, M. R.

    2013-01-01

    Objectives To review the current best surgical practice and detail a multi-disciplinary approach that could further reduce joint replacement infection. Methods Review of relevant literature indexed in PubMed. Results Surgical site infection is a major complication following arthroplasty. Despite its rarity in contemporary orthopaedic practice, it remains difficult to treat and is costly in terms of both patient morbidity and long-term health care resources. Conclusions Emphasis on education of patients and all members of the health-care team and raising awareness in how to participate in preventative efforts is imperative. PMID:23610703

  2. 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

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

    PubMed Central

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

    2010-01-01

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

  4. Molecular diagnosis of Raoultella planticola infection of a surgical site.

    PubMed

    Wolcott, R; Dowd, S

    2010-08-01

    Raoultella planticola has been rarely diagnosed in clinical specimens. A case of a polymicrobial surgical site infection primarily caused by R. planticola in a 66-year-old Caucasian male with a fractured left tibia after an open reduction internal fixation of his left ankle is described and confirms this organism to be an opportunistic human pathogen. This pathogen was diagnosed with rapid clinical molecular pathogen diagnostic methods, which allowed an appropriate therapy to be implemented, thereby improving prognosis.

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

  6. 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.

  7. 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. PMID:25623269

  8. [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.

  9. Site of impaction of ureteric calculi requiring surgical intervention.

    PubMed

    El-Barky, Ehab; Ali, Yusuf; Sahsah, Mohammed; Terra, Ali A; Kehinde, Elijah O

    2014-02-01

    Textbooks describe three narrowest anatomic sites in the ureter as the most likely places for ureteral calculi to lodge, these are: the pelvi-ureteric junction (PUJ), the point where the ureters cross over the iliac vessels and the ureterovesical junction (UVJ). The purpose of this study is to determine whether calculi causing ureteric obstruction and requiring surgical treatment are found mostly at these three narrowest anatomic points of the ureter. Three hundred consecutive patients with impacted ureteric calculi who required surgical intervention were studied. The location of the impacted calculus on the day of surgical intervention was categorized according to nine predetermined levels outlined in a designed diagram based on findings on non-contrast CT of kidneys, ureters and bladder. Two peaks in stone distribution in the ureters were encountered; the first was above the ischial spine in the proximal part of the lower third ureter (84 patients, 28%), while the second was at the level between L3 and L4 lumbar vertebrae (66 patients, 22%). Overall, the location of impacted calculi was as follows, 53, 34, 10 and 3% in the lower third ureter, upper third ureter, PUJ and mid ureter, respectively. This study demonstrates two peaks of calculi distribution in the ureter where ureteric calculi become impacted: the upper ureter below the PUJ and a second in the lower ureter, more proximal than the UVJ. There was an absence of the peak in stone location over the iliac vessels, that is, the mid ureter.

  10. Surgical Site Infection Reduction Program: Challenges and Opportunities.

    PubMed

    Shea, Kevin G; Styhl, Alexandra C; King, Howard A; Hammons, Jerrie; Clapp, Melissa

    2015-01-01

    Surgical site infections (SSIs) make up about 23% of hospital-acquired infections and may cost up to 10 billion dollars annually in direct medical expenses. St. Luke's Health System of Boise, Idaho implemented a committee to reduce its incidence of SSIs, focusing on the orthopaedic and neurosurgical departments. After identifying risk factors associated with patient medical comorbidities, operating room practices, and type of procedure, Project Zero recommended changes. The implementation of a preoperative clinic and protocol management of environmental and procedural factors reduced the hospitals rate by 50%. Project Zero continues to research best practices for clean room management and preventative care, striving to reach the overall goal of zero infections. PMID:26049307

  11. 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

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

    PubMed

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

    2013-03-01

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

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

    ERIC Educational Resources Information Center

    Higgins, Christina; Stoker, Kim

    2011-01-01

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

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

    PubMed

    Mizutani, Hisao

    2009-09-01

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

  15. 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

  16. 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

  17. Risk control of surgical site infection after cardiothoracic surgery.

    PubMed

    Segers, P; de Jong, A P; Kloek, J J; Spanjaard, L; de Mol, B A J M

    2006-04-01

    The purpose of this prospective study was to investigate whether a risk control programme based on risk assessment, new treatment modalities and the presence of a surveillance programme reduces the incidence of surgical site infections (SSI). Between January 2001 and December 2003, 167 patients were treated for a total of 183 SSIs. Data were collected on pre-operative risk factors, intra-operative data and postoperative recovery, including complications, infecting organisms, SSI treatment techniques and length of hospital stay. In this series, the total incidence of SSI was 5.6%. The mean age of affected patients was 65.1 years with a range of 20-87 years. Mean intensive care and hospital stay for SSI was 3.6 days and 18.8 days, respectively. Total mortality was 4.8%. Many risk factors were encountered, some of which were associated with a high morbidity. The majority of SSIs were treated by topical negative pressure therapy (N=81), which gave few side-effects and good clinical results. After starting the surveillance programme, a steady decline in prevalence was observed from 8.9% to 3.9%. This series adds to the evidence that SSI after cardiothoracic surgery is a major but mainly preventable cause of morbidity and mortality. Risk factor assessment, application of novel treatment modalities and an adequate surveillance system all increased patient safety.

  18. 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.

  19. Comparison of Two Computer Algorithms To Identify Surgical Site Infections

    PubMed Central

    Apte, Mandar; Landers, Timothy; Furuya, Yoko; Hyman, Sandra

    2011-01-01

    Abstract Background Surgical site infections (SSIs), the second most common healthcare-associated infections, increase hospital stay and healthcare costs significantly. Traditional surveillance of SSIs is labor-intensive. Mandatory reporting and new non-payment policies for some SSIs increase the need for efficient and standardized surveillance methods. Computer algorithms using administrative, clinical, and laboratory data collected routinely have shown promise for complementing traditional surveillance. Methods Two computer algorithms were created to identify SSIs in inpatient admissions to an urban, academic tertiary-care hospital in 2007 using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes (Rule A) and laboratory culture data (Rule B). We calculated the number of SSIs identified by each rule and both rules combined and the percent agreement between the rules. In a subset analysis, the results of the rules were compared with those of traditional surveillance in patients who had undergone coronary artery bypass graft surgery (CABG). Results Of the 28,956 index hospital admissions, 5,918 patients (20.4%) had at least one major surgical procedure. Among those and readmissions within 30 days, the ICD-9-CM-only rule identified 235 SSIs, the culture-only rule identified 287 SSIs; combined, the rules identified 426 SSIs, of which 96 were identified by both rules. Positive and negative agreement between the rules was 36.8% and 97.1%, respectively, with a kappa of 0.34 (95% confidence interval [CI] 0.27–0.41). In the subset analysis of patients who underwent CABG, of the 22 SSIs identified by traditional surveillance, Rule A identified 19 (86.4%) and Rule B identified 13 (59.1%) cases. Positive and negative agreement between Rules A and B within these “positive controls” was 81.3% and 50.0% with a kappa of 0.37 (95% CI 0.04–0.70). Conclusion Differences in the rates of SSI identified by computer

  20. Comparisons of Prognosis between Surgically and Clinically Diagnosed Idiopathic Pulmonary Fibrosis Using Gap Model: A Korean National Cohort Study.

    PubMed

    Lee, Sang Hoon; Kim, Song Yee; Kim, Dong Soon; Kim, Young Whan; Chung, Man Pyo; Uh, Soo Taek; Park, Choon Sik; Jeong, Sung Hwan; Park, Yong Bum; Lee, Hong Lyeol; Shin, Jong Wook; Lee, Eun Joo; Lee, Jin Hwa; Jegal, Yangin; Lee, Hyun Kyung; Kim, Yong Hyun; Song, Jin Woo; Park, Moo Suk

    2016-03-01

    Although a multidisciplinary approach has become an important criterion for an idiopathic pulmonary fibrosis (IPF) diagnosis, lung biopsies remain crucial. However, the prognosis of patients with surgically diagnosed IPF (sIPF) is uncertain. We aimed to investigate the prognosis of patients with clinically diagnosed IPF (cIPF) and sIPF. In this retrospective observational study, the Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of patients with IPF from January 1, 2003 to December 31, 2007. Patients were recruited from 54 universities and teaching hospitals across the Republic of Korea. IPF diagnoses were established according to the 2002 American Thoracic Society (ATS)/European Respiratory Society criteria (ERS) guideline. A total of 1685 patients with IPF (1027 cIPF and 658 sIPF) were enrolled. Patients with sIPF were significantly younger, predominantly female, and nonsmokers (all P < 0.001). sIPF group had significantly better initial pulmonary function. The proportion of computed tomography-based honeycomb findings of patients with cIPF was higher than in those with sIPF (P < 0.001). A Kaplan-Meier analysis showed that the sIPF group had a better prognosis (P = 0.001). A survival analysis showed that age, pulmonary function parameters, pulmonary oxygen tension, honeycombing change, and combined lung cancer had a significant influence on patient prognosis. However, there was no significant difference in prognosis between the cIPF and sIPF groups after adjusting for GAP (gender, age, physiology) stage. The patients with sIPF had better clinical features than those with cIPF. However, after adjusting for GAP stage, the sIPF group showed similar prognoses as the cIPF group. This study showed that after adjusting for GAP stage, the prognosis of patients with IPF is the same regardless of the diagnostic method used. PMID:26986154

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

    PubMed

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

    2016-08-01

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

  2. 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

  3. Changes in Surgical Site Infections after Living Donor Liver Transplantation

    PubMed Central

    Yamamoto, Masaki; Takakura, Shunji; Iinuma, Yoshitsugu; Hotta, Go; Matsumura, Yasufumi; Matsushima, Aki; Nagao, Miki; Ogawa, Kohei; Fujimoto, Yasuhiro; Mori, Akira; Ogura, Yasuhiro; Kaido, Toshimi; Uemoto, Shinji; Ichiyama, Satoshi

    2015-01-01

    Surgical site infections (SSIs) are a major threat for liver transplant recipients. We prospectively studied SSIs after living donor liver transplantation (LDLT) at Kyoto University Hospital from April 2001 to March 2002 (1st period) and from January 2011 to June 2012 (2nd period). We investigated the epidemiology of SSIs after LDLT and determined the differences between the two periods. A total of 129 adult recipients (66 during the 1st period and 63 during the 2nd period) and 72 pediatric recipients (39 and 33) were included in this study. The SSI rates for each period were 30.3% (1st period) and 41.3% (2nd period) among the adult recipients and 25.6% and 30.3% among the pediatric recipients. The overall rates of 30-day mortality among adult transplant recipients with SSIs were 10.0% (1st period) and 3.9% (2nd period). No pediatric recipient died from SSIs after LDLT in either period. The incidence of Enterococcus faecium increased from 5.0% to 26.9% in the adults and from 10.0% to 40.0% in the pediatric patients. Extended-spectrum β-lactamase-producing Enterobacteriaceae were emerging important isolates during the 2nd period. For this period, a univariate analysis showed that ABO incompatibility (P = 0.02), total operation duration (P = 0.01), graft-to-recipient body weight ratio (GRWR [P = 0.04]), and Roux-en-Y biliary reconstruction (P<0.01) in the adults and age (P = 0.01) and NHSN risk index (P = 0.02) in the children were associated with SSI development. In a multivariate analysis, lower GRWR (P = 0.02) and Roux-en-Y biliary reconstruction (P<0.01) in the adults and older age (P = 0.01) in the children were independent risk factors for SSIs during the 2nd period. In conclusion, SSIs caused by antibiotic resistant bacteria may become a major concern. Lower GRWR and Roux-en-Y biliary reconstruction among adult LDLT recipients and older age among pediatric LDLT recipients increased the risk of developing SSIs after LDLT. PMID:26322891

  4. 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.

  5. Variables associated with remission in spinal surgical site infections

    PubMed Central

    Uçkay, Ilker; Faundez, Antonio; Douissard, Jonathan; Kuczma, Paulina; Suvà, Domizio; Zingg, Mathieu; Hoffmeyer, Pierre; Dominguez, Dennis E.; Racloz, Guillaume

    2016-01-01

    Background There is few medical literature regarding factors associated with remission after surgical and medical treatment of postoperative spine infections. Methods Single-centre case-control study 2007–2014. Cluster-controlled Cox regression model with emphasis on surgical and antibiotic-related parameters. Results Overall, we found 66 episodes in 48 patients (49 episodes with metalwork) who had a median follow-up of 2.6 years (range, 0.5 to 6.8 years). The patients had a median of two surgical debridements. The median duration of antibiotic therapy was 8 weeks, of which 2 weeks parenteral. Clinical recurrence after treatment was noted in 13 episodes (20%), after a median interval of 2 months. In 53 cases (80%), the episodes were considered as in remission. By multivariate analyses, no variable was associated with remission. Especially, the following factors were not significantly related to remission: number of surgical interventions [hazard ratio (HR) 0.9; 95% confidence interval (CI), 0.8–1.1]; infection due to Staphylococcus aureus (HR 0.9; 0.8–1.1), local antibiotic therapy (HR 1.2; 0.6–2.4), and, duration of total (HR 1.0; 0.99–1.01) (or just parenteral) (HR 1.0; 0.99–1.01) antibiotic use. Conclusions In patients with post-operative spine infections, remission is achieved in 80%. The number of surgical debridement or duration of antibiotic therapy shows no association with recurrence, suggesting that individual risk factors might be more important than the duration of antibiotic administration. PMID:27683709

  6. Variables associated with remission in spinal surgical site infections

    PubMed Central

    Uçkay, Ilker; Faundez, Antonio; Douissard, Jonathan; Kuczma, Paulina; Suvà, Domizio; Zingg, Mathieu; Hoffmeyer, Pierre; Dominguez, Dennis E.; Racloz, Guillaume

    2016-01-01

    Background There is few medical literature regarding factors associated with remission after surgical and medical treatment of postoperative spine infections. Methods Single-centre case-control study 2007–2014. Cluster-controlled Cox regression model with emphasis on surgical and antibiotic-related parameters. Results Overall, we found 66 episodes in 48 patients (49 episodes with metalwork) who had a median follow-up of 2.6 years (range, 0.5 to 6.8 years). The patients had a median of two surgical debridements. The median duration of antibiotic therapy was 8 weeks, of which 2 weeks parenteral. Clinical recurrence after treatment was noted in 13 episodes (20%), after a median interval of 2 months. In 53 cases (80%), the episodes were considered as in remission. By multivariate analyses, no variable was associated with remission. Especially, the following factors were not significantly related to remission: number of surgical interventions [hazard ratio (HR) 0.9; 95% confidence interval (CI), 0.8–1.1]; infection due to Staphylococcus aureus (HR 0.9; 0.8–1.1), local antibiotic therapy (HR 1.2; 0.6–2.4), and, duration of total (HR 1.0; 0.99–1.01) (or just parenteral) (HR 1.0; 0.99–1.01) antibiotic use. Conclusions In patients with post-operative spine infections, remission is achieved in 80%. The number of surgical debridement or duration of antibiotic therapy shows no association with recurrence, suggesting that individual risk factors might be more important than the duration of antibiotic administration.

  7. 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.

  8. 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.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Bertrand, X; Slekovec, C; Talon, D

    2010-05-01

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

  11. Efficacy of Antibiotics Sprayed into Surgical Site for Prevention of the Contamination in the Spinal Surgery

    PubMed Central

    Suh, Bo-Kyung; Moon, Seong-Hwan; Kim, Tae-Hwan; Oh, Jae Keun; Kwon, Yong Shin; Park, Jung-Seob

    2015-01-01

    Study Design Retrospective study. Purpose To evaluate the effect of intraoperative wound application of vancomycin on preventing surgical wound contamination during instrumented lumbar spinal surgery. Overview of Literature Postoperative infection is the one of the most devastating complications of lumbar surgery. There are a few reports showing the benefits of intraoperative wound application of vancomycin during spinal surgery. However, there is no report about the effectiveness of local vancomycin instillation in prevention of surgical wound contamination. Methods Eighty-six patients underwent instrumented lumbar spinal surgery. Mean patient age was 65.19 years (range, 23-83 years). There were 67 females and 19 males. During surgery, vancomycin powder was applied into the surgical site before closure in 43 patients (antibiotic group) and vancomycin powder was not applied into the surgical site before closure in 43 patients (control group). The tip of the surgical drain was cultured to evaluate surgical wound contamination. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured on the first, third, seventh, and fourteenth day after the operation. Results We found two patients with a positive culture from the tip of surgical drains in the antibiotic group, and one patient with a positive culture from the tip of the surgical drain in the control group. Postoperative ESR and CRP levels did not show significant differences between the two groups. On the third postoperative day, ESR in patients of the antibiotic group was more significantly decreased than that in patients of the control group, while CRP level did not show a significant difference between the two groups. Conclusions There was no evidence to suggest that intraoperative vancomycin application is effective in decreasing the risk of postoperative wound infection after instrumented posterior lumbar fusion surgery. PMID:26240708

  12. Surveying the surveillance: surgical site infections excluded by the January 2013 updated surveillance definitions.

    PubMed

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

    2014-05-01

    The updated 2013 Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for surgical site infections (SSIs) reduced the duration of prolonged surveillance from 1 year to 90 days and defined which procedure types require prolonged surveillance. Applying the updated 2013 SSI definitions to cases analyzed using the pre-2013 surveillance definitions excluded 10% of previously identified SSIs.

  13. Is there a relationship between preoperative shaving (hair removal) and surgical site infection?

    PubMed

    Jose, Binu; Dignon, Andrée

    2013-01-01

    The preoperative preparation of patients for surgery has traditionally included the routine hair removal at the operating site as a part of cleanliness. This literature review will investigate the relationship between preoperative hair removal and surgical site infection. It aims to identify the best method of hair removal to reduce the infection if hair removal is necessary, and to apply the evidence findings into nursing practice.

  14. Surgical treatment approaches and reimbursement costs of surgical site infections post hip arthroplasty in Australia: a retrospective analysis

    PubMed Central

    2013-01-01

    Background The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify current treatment approaches in Queensland, Australia, show success rates and quantify the costs of different treatments. Methods Data for patients undergoing primary THA and treatment for infection between January 2006 and December 2009 in Queensland hospitals were extracted from routinely used hospital databases. Records were linked with pathology information to confirm positive organisms. Diagnosis and treatment of infection was determined using ICD-10-AM and ACHI codes, respectively. Treatment costs were estimated based on AR-DRG cost accounting codes assigned to each patient hospital episode. Results A total of n=114 patients with deep surgical site infection were identified. The majority of patients (74%) were first treated with debridement, antibiotics and implant retention (DAIR), which was successful in eradicating the infection in 60.3% of patients with an average cost of $13,187. The remaining first treatments were 1-stage revision, successful in 89.7% with average costs of $27,006, and 2-stage revisions, successful in 92.9% of cases with average costs of $42,772. Multiple treatments following ‘failed DAIR’ cost on average $29,560, for failed 1-stage revision were $24,357, for failed 2-stage revision were $70,381 and were $23,805 for excision arthroplasty. Conclusions As treatment costs in Australia are high primary prevention is important and the economics of competing treatment choices should be carefully considered. These currently vary greatly across international settings. PMID:23497364

  15. Preventing surgical site infections after bariatric surgery: value of perioperative antibiotic regimens

    PubMed Central

    Chopra, Teena; Zhao, Jing J; Alangaden, George; Wood, Michael H; Kaye, Keith S

    2010-01-01

    Bariatric surgery for obesity has emerged as an effective and commonly used treatment modality. This paper reviews the surgical site infections (SSIs) that occur post bariatric surgery and SSI prevention. The benefit of bariatric surgery resulting in profound weight loss brings with it consequences in the form of postoperative complications that can have profound effects on morbidity and mortality in these patients. This paper sets out to define different types of SSIs that occur following bariatric surgery and to discuss existing literature on the critical aspects of SSI prevention and the appropriate use of surgical antimicrobial prophylaxis for bariatric surgery. PMID:20545596

  16. Perspectives in prevention and treatment of surgical site infection - a narrative review of the literature.

    PubMed

    Leaper, David; Fry, Donald; Assadian, Ojan

    2013-11-01

    Health care-associated infections (HCAIs) are infections acquired through contact with any aspect of health care. They can cause minor complications or serious disability or death, and can involve a wide variety of resistant or emergent organisms. Surgical site infections make up approximately one-fifth of HCAIs, and at least 5% of patients undergoing open surgery develop an SSI. Surgical site infections are probably the most preventable HCAI but have received the least attention; although that is changing with increased surveillance and public awareness of published data of individual specialty and hospital incidence rates. Surgical site infection continues to be a complication of surgical care. These infections span a continuum of severity with some being quite innocent and easy to manage, while others are life-threatening. Considerable evidence provides direction in the prevention of SSI (eg, systemic antibiotic prophylaxis) but many preventive strategies need better definition, with additional clinical studies. When SSI occurs, the clinician needs to quickly recognize it and tailor management to the specific needs of the patient. In general, drainage, debridement, and specific antibiotics for the putative pathogen are the hallmarks of management. .

  17. Surgical site infections after gracilis free flap reconstruction for facial paralysis.

    PubMed

    Lee, Linda N; Susarla, Srinivas M; Henstrom, Douglas K; Hohman, Marc H; Durand, Marlene L; Cheney, Mack L; Hadlock, Tessa A

    2012-08-01

    Compared with other free tissue transfer procedures, the gracilis free muscle transfer (GFMT) for facial reanimation is unique in that the recipient site is typically uninvolved by malignancy or infection. In this study, the authors examined the incidence, bacteriology, and outcomes of surgical site infection (SSI) after gracilis free muscle transfer for facial reanimation. From 2003 to 2011, 105 patients underwent 107 GFMT operations, with 6 SSIs. All cases of infection occurred in patients receiving clindamycin, levofloxacin, and/or cefazolin perioperatively. None of the patients who received ampicillin-sulbactam developed an SSI. Surgical site cultures grew oral flora, including α-hemolytic streptococci, Haemophilus parainfluenzae, Fusobacterium and Neisseria species, and coagulase-negative staphylococci. Notably, there were no methicillin-resistant Staphylococcus aureus (MRSA) infections. These data may have implications for the optimal perioperative antibiotic choice in facial reanimation cases. Further study is needed to determine the ideal antibiotic regimen for this category of free flap surgeries.

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

    NASA Astrophysics Data System (ADS)

    Ryang, Woo Hun; Kim, Seong Pil

    2014-05-01

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

  19. Things Korean.

    ERIC Educational Resources Information Center

    Chang, Roberta

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  2. 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

  3. 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

  4. The effect of preoperative skin preparation products on surgical site infection.

    PubMed

    Young, Heather L; Reese, Sara; Knepper, Bryan; Miller, Amber; Mauffrey, Cyril; Price, Connie S

    2014-12-01

    Skin preparation products contribute to surgical site infection (SSI) prevention. In a case-control study, diabetes was associated with increased SSI (adjusted odds ratio [OR], 5.74 [95% confidence interval (CI), 1.22-27.0]), while the use of chlorhexidine gluconate (CHG) plus isopropyl alcohol versus CHG alone was found to be protective (adjusted OR, 2.64 [95% CI, 1.12-6.20]).

  5. Influence of a total joint infection control bundle on surgical site infection rates.

    PubMed

    Fornwalt, Lori; Ennis, David; Stibich, Mark

    2016-02-01

    Quality improvement initiatives combined with pulsed xenon ultraviolet room disinfection were implemented to reduce surgical site infections (SSIs) in patients undergoing total joint procedures. After 12 months, knee SSIs were reduced from 4 to 0 (P = .03) and hip SSIs were reduced from 3 to 0 (P = .15) for a combined prevention of 7 SSIs (P = .01) and a savings of $290,990.

  6. 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.

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

    PubMed

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

    2013-05-01

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

  8. '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. PMID:25470322

  9. ‘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

  10. '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.

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

    PubMed

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

    2016-09-01

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

  12. Clinical and microbiological aspects of biofilm-associated surgical site infections.

    PubMed

    Edmiston, Charles E; McBain, Andrew J; Roberts, Christopher; Leaper, David

    2015-01-01

    While microbial biofilms have been recognized as being ubiquitous in nature for the past 40 years, it has only been within the past 20 years that clinical practitioners have realized that biofilm play a significant role in both device-related and tissue-based infections. The global impact of surgical site infections (SSIs) is monumental and as many as 80 % of these infections may involve a microbial biofilm. Recent studies suggest that biofilm- producing organisms play a significant role in persistent skin and soft tissue wound infections in the postoperative surgical patient population. Biofilm, on an organizational level, allows bacteria to survive intrinsic and extrinsic defenses that would inactivate the dispersed (planktonic) bacteria. SSIs associated with biomedical implants are notoriously difficult to eradicate using antibiotic regimens that would typically be effective against the same bacteria growing under planktonic conditions. This biofilm-mediated phenomenon is characterized as antimicrobial recalcitrance, which is associated with the survival of a subset of cells including "persister" cells. The ideal method to manage a biofilm-mediated surgical site wound infection is to prevent it from occurring through rational use of antibiotic prophylaxis, adequate skin antisepsis prior to surgery and use of innovative in-situ irrigation procedures; together with antimicrobial suture technology in an effort to promote wound hygiene at the time of closure; once established, biofilm removal remains a significant clinical problem.

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  14. Microbial pathogenesis of bacterial biofilms: a causative factor of vascular surgical site infection.

    PubMed

    Frei, Elisabeth; Hodgkiss-Harlow, Kelley; Rossi, Peter J; Edmiston, Charles E; Bandyk, Dennis F

    2011-11-01

    Vascular surgical site infection (SSI) is caused by pathogenic bacterial strains whose preferred mode of growth is within a surface biofilm. Bacterial biofilm formation can develop within hours to days in a wound and produces a recalcitrant infectious process especially in the presence of a prosthetic graft. The initial steps of biofilm formation are bacterial adhesion to biologic or inert surgical site structures followed by organism production of exopolysaccaride matrix which encases developing bacteria colonies to produce a protective microenvironment. As the biofilm matures, a dynamic process of organism cell-to-cell signaling occurs with varying growth modes of sessile bacteria within the biofilm and the release of planktonic bacteria with the potential to spread and expand the biofilm-mediated infection. The prevalence of staphyloccocal strains causing vascular SSI is best understood when viewed as a biofilm-mediated infection with virulence factors related to specific cell surface adhesion proteins and bacteria-derived matrix production. Nonhealing surgical sites following lower limb revascularization, the late appearance of prosthetic graft infection caused by Staphylococcus epidermidis, and the development of groin site tracts after aortofemoral bypass grafting are clinical examples of a biofilm-mediated SSI. A mature biofilm within a wound or coating a prosthetic device exhibits resistance to host defenses and selected antibiotics, impairs wound healing, and is a perpetual irritant to that host by inciting a chronic inflammatory process. By understanding the microbial pathogenesis of biofilm formation, strategies to treat and prevent biofilm-mediated infection can be developed and utilized to reduce vascular SSIs.

  15. 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

  16. Preoperative prealbumin level as a risk factor for surgical site infection following elective spine surgery

    PubMed Central

    Salvetti, David J.; Tempel, Zachary J.; Gandhoke, Gurpreet S.; Parry, Philip V.; Grandhi, Ramesh M.; Kanter, Adam S.; Okonkwo, David O.

    2015-01-01

    Background: Nutritional status is a critical factor in patient outcomes in a variety of medical contexts. In the surgical fields, there is substantial evidence suggesting that clinical outcomes including infection risk and surgical efficacy may be affected by preoperative nutritional status. The purpose of this study is to evaluate preoperative serum prealbumin levels, the currently preferred serum biomarker of nutritional deficiency, in relation to the risk of developing a surgical site infection. Methods: A retrospective case–control series was conducted comparing prospectively collected preadmission serum prealbumin levels to the risk for surgical site infection following elective spine surgery. The analysis was conducted under an approved institutional quality assurance protocol. Patients were identified by querying the department billing codes for deep wound washouts over a 3-year period. A cohort of 32 patients with preoperative prealbumin levels who underwent spine surgery complicated by postoperative deep tissue infection was identified. This was compared against a case–control cohort of 74 patients who underwent spine surgery and did not experience postoperative infection. Clinical variables included demographic information, body mass index, smoking, diabetes, steroid use, length of the procedure, and length of hospital stay. The data were analyzed using multivariate Cox regression. Results: Two variables: Preoperative prealbumin < 20 and diabetes were both statistically significant predictors for the risk of developing a postoperative infection with hazard ratios of 2.12 (95% confidence interval [CI]: 1.03–4.37) and 2.22 (95% CI: 1.04–4.75), respectively. Conclusions: Our results reinforce the relationship between preoperative nutritional status and outcomes in elective spine surgery. The data indicate that preoperative prealbumin levels may be useful in risk stratification. Further study is needed to determine whether nutritional supplementation

  17. 5-millimeter Trocar-site Hernias After Laparoscopy Requiring Surgical Repair.

    PubMed

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

    2016-01-01

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

  18. Computer-assisted surgery: double surgical guides for immediate loading of implants in maxillary postextractive sites.

    PubMed

    De Santis, Daniele; Malchiodi, Luciano; Cucchi, Alessandro; Canton, Luciano Claudio; Trevisiol, Lorenzo; Nocini, Pier Francesco

    2010-11-01

    Implant-supported prostheses are a predictable treatment of totally edentulous patients. Progresses in implantology allowed realizing prostheses that are supported by immediately loading implants. Implants can be inserted in the healed site as fresh extraction sites, without differences about long-term results. Using computer-assisted surgery, it is possible to insert implants in a predetermined position and to create a prostheses, which can be immediately fixed on the implants. Patients have major comfort and an immediate aesthetic and functional result. The use of computer-assisted surgery in fresh extraction sites is a procedure that has not been evaluated because of technical difficulties: teeth extraction eliminates references for surgical guides. The absence of guidelines to treat dentulous areas is often likely caused by lack of computer-assisted surgery: we attempted to use this procedure to replace residual teeth with an immediate implant prosthetic rehabilitation. The aim of this clinical report was to show the possibility to apply computer-assisted surgery in dentulous patient using a double surgical template: one before extraction and the other after extraction of selected teeth.

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

    PubMed

    Chen, Jian; Fang, Qiang

    2016-01-01

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

  20. 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

  1. Who bears the cost of healthcare-acquired surgical site infection?

    PubMed

    Graves, N; Halton, K; Doidge, S; Clements, A; Lairson, D; Whitby, M

    2008-07-01

    The aim of this study was to estimate the economic costs of healthcare-acquired surgical site infection (HA-SSI) and show how they are distributed between the in-hospital and post-discharge phases of care and recovery. A quantitative model of the epidemiology and economic consequences of HA-SSI was used, with data collected from a prospective cohort of surgical patients and other relevant sources. A logical model structure was specified and data applied to model parameters. A hypothetical cohort of 10 000 surgical patients was evaluated. We found that 111 cases of infection would be diagnosed in hospital and 784 cases would first appear after discharge. Of the total costs incurred, either 31% or 67% occurred during the hospital phase, depending on whether production losses incurred after discharge were included. Most of the costs incurred by the hospital sector arose from lost bed-days and only a small proportion arose from variable costs. We discuss the issues relating to the size of these costs and provide data on where they are incurred. These results can be used to inform subsequent cost-effectiveness analyses that evaluate the efficiency of programmes to reduce the risks of HA-SSI.

  2. 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.

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

    PubMed

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

    2010-09-01

    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.

  4. Interventional studies for preventing surgical site infections in sub-Saharan Africa – A systematic review

    PubMed Central

    Aiken, Alexander M.; Karuri, David M.; Wanyoro, Anthony K.; Macleod, Jana

    2012-01-01

    Background There is a great need for safe surgical services in sub-Saharan Africa, but a major difficulty of performing surgery in this region is the high risk of post-operative surgical site infection (SSI). Methods We aimed to systematically review which interventions had been tested in sub-Saharan Africa to reduce the risk of SSI and to synthesize their findings. We searched Medline, Embase and Global Health databases for studies published between 1995 and 2010 without language restrictions and extracted data from full-text articles. Findings We identified 24 relevant articles originating from nine countries in sub-Saharan Africa. The methodological quality of these publications was diverse, with inconsistency in definitions used for SSI, period and method of post-operative follow-up and classification of wound contamination. Although it was difficult to synthesise information between studies, there was consistent evidence that use of single-dose pre-operative antibiotic prophylaxis could reduce, sometimes dramatically, the risk of SSI. Several studies indicated that alcohol-based handrubs could provide a low-cost alternative to traditional surgical hand-washing methods. Other studies investigated the use of drains and variants of surgical technique. There were no African studies found relating to several other promising SSI prevention strategies, including use of checklists and SSI surveillance. Conclusions There is extremely limited research from sub-Saharan Africa on interventions to curb the occurrence of SSI. Although some of the existing studies are weak, several high-quality studies have been published in recent years. Standard methodological approaches to this subject are needed. PMID:22510442

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  7. Surgical Site Infections Due to Rapidly Growing Mycobacteria in Puducherry, India

    PubMed Central

    Ragunathan, Latha; Sakthivel, Sulochana; Sasidar, A.R.; Muralidaran; Venkatachalam, G. K.

    2015-01-01

    Background: Rapidly growing Mycobacteria are increasingly recognized, nowadays as an important pathogen that can cause wide range of clinical syndromes in humans. We herein describe unrelated cases of surgical site infection caused by Rapidly growing Mycobacteria (RGM), seen during a period of 12 months. Materials and Methods: Nineteen patients underwent operations by different surgical teams located in diverse sections of Tamil Nadu, Pondicherry, Karnataka, India. All patients presented with painful, draining subcutaneous nodules at the infection sites. Purulent material specimens were sent to the microbiology laboratory. Gram stain and Ziehl-Neelsen staining methods were used for direct examination. Culture media included blood agar, chocolate agar, MacConkey agar, Sabourauds agar and Lowenstein-Jensen medium for Mycobacteria. Isolated microorganisms were identified and further tested for antimicrobial susceptibility by standard microbiologic procedures. Results: Mycobacterium fortuitum and M.chelonae were isolated from the purulent drainage obtained from wounds by routine microbiological techniques from all the specimens. All isolates analyzed for antimicrobial susceptibility pattern were sensitive to clarithromycin, linezolid and amikacin but were variable to ciprofloxacin, rifampicin and tobramycin. Conclusion: Our case series highlights that a high level of clinical suspicion should be maintained for patients presenting with protracted soft tissue lesions with a history of trauma or surgery as these infections not only cause physical but also emotional distress that affects both the patients and the surgeon. PMID:25954616

  8. 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

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

    PubMed Central

    Hui, Siong H.; Noonan, Lisa

    2015-01-01

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

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

    PubMed

    Hui, Siong H; Noonan, Lisa; Chavada, Ruchir

    2015-12-22

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

  11. The role of other stakeholders than the surgeon in relation to surgical site infections following total joint replacement.

    PubMed

    Stuyts, Bart; Van den Eeden, Elke; Fennema, Peter

    2015-12-01

    In contemporary orthopaedics, surgical site infections (SSIs) can have significant negative consequences for both patients and the healthcare system overall. To date, most efforts at combating the risk of SSIs have focused on the role of the surgeon, yet recent data suggest that a more expansive approach is warranted. The current review offers an overview of the most-relevant factors associated with SSIs in orthopaedic surgery, and the crucial role that the full surgical staff can play in addressing them.

  12. 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.

  13. Surgical Site Infections in Breast Surgery: The Use of Preoperative Antibiotics for Elective, Nonreconstructive Procedures

    PubMed Central

    2016-01-01

    Background. Antibiotic prophylaxis for surgical site infections (SSIs) for breast surgery is widespread, but the benefit in clean surgical cases is not well defined. Methods. A retrospective analysis of 855 patients undergoing elective, nonreconstructive breast operations was performed, with 401 patients receiving no antibiotics and 454 patients receiving a single dose of preoperative antibiotic. Results. Administration of a preoperative antibiotic did not decrease the SSI rate. In this community-based study, antibiotic use practices varied considerably by surgeon. In univariate analyses, SSI rates appeared to increase with prophylactic antibiotic use (12% SSI with antibiotics versus 4% without, p < 0.0001), likely because the use of underdosed antibiotics was associated with higher rates of SSI (13.2% SSI with cefazolin 1 gram, p < 0.0001, and 15.4% SSI with clindamycin 300 mg or less, p = 0.0269). Methicillin-resistant Staphylococcus aureus was the most common isolate from SSI cultures, 31.8% (7 of 22). In multivariable analyses, increased risk of SSI was associated with BMI > 25 kg/m2 (OR: 1.08, 95% CI: 1.04–1.11, p < 0.0001). Conclusion. The administration of a single dose of preoperative antibiotic did not decrease the rate of SSI in this large series of patients undergoing clean breast operations. BMI >25 kg/m2 and the use of an inadequate dose of antibiotics for prophylaxis may increase risk of SSI. PMID:27800185

  14. 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.

  15. 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

  16. [Prevention of surgical site infection for orthopaedic surgery in rheumatoid arthritis].

    PubMed

    Saitoh, Masakatsu; Matsushita, Kazuhiko

    2016-06-01

    Rheumatoid arthritis (RA) is considered to be a risk factor of surgical site infection(SSI). RA patients have higher rates of nasal and oral carriage, which can cause endogenous infections. The decolonization strategy and good oral care may decrease the rate of SSI in RA patients. In the perioperative management of medications, methotrexate can be used continuously during the perioperative period. Biological agents should be withheld for an appropriate period considering the half-lives of each agent. If possible, withholding them for at least a week prior to and after surgery is preferred. Whether biological agents increase the rate of SSI in orthopaedic surgery is unclear. Several reports have indicated that biological agents can increase the risk of SSI in total joint replacements. This warrants attention. PMID:27311191

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

    PubMed

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

    2016-08-01

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

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

    PubMed

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

    2016-08-01

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

  19. Patient, Surgery, and Hospital Related Risk Factors for Surgical Site Infections following Total Hip Arthroplasty

    PubMed Central

    Triantafyllopoulos, Georgios; Memtsoudis, Stavros; Poultsides, Lazaros A.

    2015-01-01

    Surgical site infections (SSI) following total hip arthroplasty (THA) have a significantly adverse impact on patient outcomes and pose a great challenge to the treating surgeon. Therefore, timely recognition of those patients at risk for this complication is very important, as it allows for adopting measures to reduce this risk. This review discusses literature reported risk factors for SSI after THA. These can be classified into patient-related factors (age, gender, obesity, comorbidities, history of infection, primary diagnosis, and socioeconomic profile), surgery-related factors (allogeneic blood transfusion, DVT prophylaxis and coagulopathy, duration of surgery, antibiotic prophylaxis, bearing surface and fixation, bilateral procedures, NNIS index score, and anesthesia type), and hospital-related factors (duration of hospitalization, institution and surgeon volume, and admission from a healthcare facility). All these factors are discussed with respect to potential measures that can be taken to reduce their effect and consequently the overall risk for infection. PMID:26075298

  20. [Uncommon abdominal sites of hydatid disease. Our experience with the surgical treatment of 15 cases].

    PubMed

    Mosca, Francesco; Portale, Teresa Rosanna; Persi, Achille; Stracqualursi, Antonio; Puleo, Stefano

    2004-01-01

    The aim of this retrospective study is to report on a series of 15 patients with abdominal hydatid disease in uncommon sites submitted to surgery in our unit over the period 1974-2003. Eight women and 7 men (mean age: 48.4 years) were included in the study. The hydatid cysts were located in the peritoneum in 8 patients, in the spleen in 5, in the kidney in 1 and in the retroperitoneum in 1. In 4 cases the peritoneal cysts were solitary, while 4 patients in this subgroup presented multiple cysts and 2 had concomitant liver hydatidosis. The splenic cysts were solitary in 2 cases, associated with a hepatic cyst in 2 and with a lung cyst in 1. The renal and retroperitoneal cysts were both solitary. The diagnosis was made at operation in 3 cases, while in 12 patients it was made by serological tests, ultrasonography and/or CT. All patients were operated on: we performed a total cystectomy in 7 patients with peritoneal cysts and in the patient with a retroperitoneal location, splenectomy in the 5 splenic cysts and a partial cystectomy with external drainage of the residual cavity in 1 peritoneal cyst and in the renal location. The postoperative course was regular with no mortality and no major morbidity in 14 patients, while 1 patient submitted to splenectomy developed a subphrenic abscess that required surgical drainage. Two recurrences occurred in patients with peritoneal cysts 71 and 20 months, respectively, after the first operation and these were managed by total cystectomy. The diagnosis of uncommon abdominal sites of hydatid disease is more accurate today because of the new imaging techniques, which are often able to show specific radiological signs of hydatid disease. The treatment of choice is surgical and complete removal of the cyst is the gold standard, but its feasibility is related to the location of the cyst.

  1. 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

  2. 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

  3. 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.

  4. Factors Associated With Surgical Site Infection Following Gastric Surgery in Japan.

    PubMed

    Morikane, Keita; Honda, Hitoshi; Suzuki, Satowa

    2016-10-01

    BACKGROUND Surgical site infection (SSI) following gastric surgery has not been well documented. OBJECTIVE To describe and assess factors associated with SSI following gastric surgery in Japan using a Japanese national database for healthcare-associated infections. DESIGN A retrospective nationwide surveillance-based study. SETTING Japanese healthcare facilities. METHODS Data on gastric surgeries performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance. Gastric surgery was divided into 3 types of procedures: total gastrectomy (GAST-T), distal gastrectomy (GAST-D), and other types of gastric surgery (GAST-O). The incidence of and factors associated with SSI following gastric surgery were assessed by the 3 types of procedures. RESULTS The cumulative incidence of SSI following gastric surgery was 8.8% (3,156/36,052). The incidence of SSI following GAST-T (12.4%) was significantly higher than that following GAST-D (7.01%) or GAST-O (7.84%). Besides the 4 conventional risk factors for predicting SSI, additional risk factors were identified. Male sex was significantly associated with SSI following all types of gastric surgery, but the effect of the association was substantially different (adjusted odds ratio, 1.52, 1.47, and 1.28 for GAST-T, GAST-D, and GAST-O, respectively). The effect of an emergency operation was similar. Age was also identified as a risk factor, but the most suitable modification of age as a variable differed. CONCLUSIONS The incidence and factors associated with SSI following 3 types of gastric surgery differed. To accurately compare hospital performance in SSI prevention following gastric surgery, dividing surgical procedures in the surveillance system into 3 types should be considered. Infect Control Hosp Epidemiol 2016;1-6.

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

    PubMed

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

    2014-01-01

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

  6. Incidence of surgical site infections and accompanying risk factors in Vietnamese orthopaedic patients.

    PubMed

    Thu, L T A; Dibley, M J; Ewald, B; Tien, N P; Lam, L D

    2005-08-01

    A cohort study of surgical site infections (SSIs) was conducted in 582 orthopaedic surgical patients at Cho Ray Hospital, a reference hospital in Ho Chi Minh City, Vietnam, in order to determine the incidence and analyse risk factors for SSIs in this population. The SSI incidence rate was 12.5% (73 of 582); 3.6% incisional SSIs, 6.8% deep incisional SSIs and 2.1% organ/space SSIs. The incidence increased from 2% in clean wounds to 44.6% in dirty wounds, or 1.3% in patients with a National Nosocomial Infections Surveillance (NNIS) risk index of 0 to 75% in patients with an NNIS risk ratio of 3. In multi-variate analysis, having a dirty wound [odds ratio (OR) 8.7; 95% confidence intervals (CI) 4.6--16.4], American Society of Anesthesiologists' score >2 (OR 3.9; 95%CI 1.8-8.8), procedures with external fixation (OR 2.9; 95%CI 1.4-5.9), emergency surgery with motor-vehicle-related trauma (OR 2.1; 95%CI 1.2-3.9), or duration of procedure >2h (OR 2.1; 95%CI 1.1-4.2) were independent risk factors for SSI. Lack of appropriate prophylaxis was of borderline significance (OR 3.2; 95%CI 0.9-11.1, P=0.06). Among 76 patients with SSIs, 22 patients were discovered during postdischarge follow-up. These late SSIs had age as an additional risk factor (OR 2.8; 95%CI 1.1-7.2). Our data show that SSIs were frequent and differed widely by wound class. The NNIS risk index was predictive of SSI for this population. With a high number of motor vehicle accidents in Vietnam, the majority of orthopaedic operations are trauma related. Emergency surgery for injuries sustained in these accidents, and procedures with external fixation were especially prone to infections.

  7. 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

  8. Comparison of Costs of Surgical Site Infection and Endometritis after Cesarean Section Using Claims and Medical Record Data

    PubMed Central

    Olsen, Margaret A.; Butler, Anne M.; Willers, Denise M.; Gross, Gilad A.; Fraser, Victoria J.

    2012-01-01

    We used administrative and clinical data from a case-control study to calculate the costs of surgical site infection and endometritis after cesarean section. Attributable costs determined by generalized least squares with the two data sources were similar, suggesting that administrative data can be used to calculate infection costs. PMID:20583923

  9. A novel method of surgical site infection surveillance after cardiac surgery by active participation of stake holders.

    PubMed

    Noman, Fatima; Mahmood, Syed Faisal; Asif, Shaheen; Rahim, Noureen; Khan, Ghufranullah; Hanif, Bashir

    2012-06-01

    We describe a comprehensive surveillance system involving infection control practitioners, surgeons, administrative staff, and patients aimed at improving the postdischarge surveillance of surgical site infections. The system was able to detect 22 infections out of 538 procedures, 95% of which were detected during the postdischarge period.

  10. 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

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

    PubMed

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

    2016-01-01

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

  12. 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

  13. 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.

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

    PubMed Central

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

    2015-01-01

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

  15. The Use of Gentamicin-Impregnated Collagen Sponge for Reducing Surgical Site Infection after Spine Surgery

    PubMed Central

    Han, Jin-Sol; Jin, Sung-Won; Lee, Seung-Hwan; Kim, Bum-Joon; Kim, Sang-Dae; Lim, Dong-Jun

    2016-01-01

    Objective Surgical site infection (SSI) is the one of the most frequent complications in hospitalized patients, and it extends hospital stays and causes extra morbidities. To reduce SSI after spine surgery, we applied the gentamicin-impregnated collagen sponge (Collatamp G) during the operation and analyzed the results retrospectively. Methods Between October 2012 and December 2015, we collected data who applied the Collatamp G in spine surgery at a single institution. Demographic data of patients and another possible risk factors of SSI were also included, and we assessed the correlation between the risk factors and the developing of SSI by reviewing electronic medical records retrospectively. Results Three percent of all patients (10 of 280) developed the SSI and only 0.8% of patients who applied Collatamp G developed SSI (1 of 119). Otherwise, 5% of patients who did not apply Collatamp G developed SSI (9 of 161) (p=0.034). We also analyzed the correlation between SSI and other potential risk factors but nothings showed statistical correlation with SSI. Conclusion In this study, there were statistically significant results that SSI rate was decreased in the group of patients using Collatamp G in spine surgery generally. However, further studies are required to resolve some limitations in the future. PMID:27799992

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

    PubMed

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

    2016-04-01

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

  17. 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.

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

    PubMed

    Caniano, Donna A; Hamstra, Stanley J

    2016-05-01

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

  19. Attributable Costs of Surgical Site Infection and Endometritis After Low Transverse Cesarean Section

    PubMed Central

    Olsen, Margaret A.; Butler, Anne M.; Willers, Denise M.; Gross, Gilad A.; Hamilton, Barton H.; Fraser, Victoria J.

    2012-01-01

    BACKGROUND Accurate data on costs attributable to hospital-acquired infections are needed in order to determine their economic impact and the cost-benefit of potential preventive strategies. OBJECTIVE Determine the attributable costs of surgical site infection (SSI) and endometritis (EMM) after cesarean section using two different methods. DESIGN Retrospective cohort. SETTING Barnes-Jewish Hospital, a 1250-bed academic tertiary care hospital. PATIENTS 1,605 women who underwent low transverse cesarean section from 7/1999 – 6/2001. METHODS Attributable costs of SSI and EMM were determined by generalized least squares (GLS) and propensity score matched-pairs using administrative claims data to define underlying comorbidities and procedures. For the matched-pairs analyses, uninfected control patients were matched to patients with SSI or with EMM based on their propensity to develop infection, and the median difference in costs calculated. RESULTS The attributable total hospital cost of SSI calculated by GLS was $3,529 and by propensity score matched-pairs was $2,852. The attributable total hospital cost of EMM calculated by GLS was $3,956 and by propensity score matched-pairs was $3,842. The majority of excess costs were associated with room and board and pharmacy costs. CONCLUSIONS The costs of SSI and EMM were lower than SSI costs reported after more extensive operations. The attributable costs of EMM calculated using the two methods were very similar, while the costs of SSI calculated using propensity score matched-pairs were lower than the costs calculated by GLS. The difference in costs determined by the two methods needs to be considered by investigators performing cost analyses of hospital-acquired infections. PMID:20102279

  20. Nationwide surveillance of antimicrobial susceptibility patterns of pathogens isolated from surgical site infections (SSI) in Japan.

    PubMed

    Takesue, Yoshio; Watanabe, Akira; Hanaki, Hideaki; Kusachi, Shinya; Matsumoto, Tetsuro; Iwamoto, Aikichi; Totsuka, Kyoichi; Sunakawa, Keisuke; Yagisawa, Morimasa; Sato, Junko; Oguri, Toyoko; Nakanishi, Kunio; Sumiyama, Yoshinobu; Kitagawa, Yuko; Wakabayashi, Go; Koyama, Isamu; Yanaga, Katsuhiko; Konishi, Toshiro; Fukushima, Ryoji; Seki, Shiko; Imai, Shun; Shintani, Tsunehiro; Tsukada, Hiroki; Tsukada, Kazuhiro; Omura, Kenji; Mikamo, Hiroshige; Takeyama, Hiromitsu; Kusunoki, Masato; Kubo, Shoji; Shimizu, Junzo; Hirai, Toshihiro; Ohge, Hiroki; Kadowaki, Akio; Okamoto, Kohji; Yanagihara, Katsunori

    2012-12-01

    To investigate the trends of antimicrobial resistance in pathogens isolated from surgical site infections (SSI), a Japanese surveillance committee conducted the first nationwide survey. Seven main organisms were collected from SSI at 27 medical centers in 2010 and were shipped to a central laboratory for antimicrobial susceptibility testing. A total of 702 isolates from 586 patients with SSI were included. Staphylococcus aureus (20.4 %) and Enterococcus faecalis (19.5 %) were the most common isolates, followed by Pseudomonas aeruginosa (15.4 %) and Bacteroides fragilis group (15.4 %). Methicillin-resistant S. aureus among S. aureus was 72.0 %. Vancomycin MIC 2 μg/ml strains accounted for 9.7 %. In Escherichia coli, 11 of 95 strains produced extended-spectrum β-lactamase (Klebsiella pneumoniae, 0/53 strains). Of E. coli strains, 8.4 % were resistant to ceftazidime (CAZ) and 26.3 % to ciprofloxacin (CPFX). No P. aeruginosa strains produced metallo-β-lactamase. In P. aeruginosa, the resistance rates were 7.4 % to tazobactam/piperacillin (TAZ/PIPC), 10.2 % to imipenem (IPM), 2.8 % to meropenem, cefepime, and CPFX, and 0 % to gentamicin. In the B. fragilis group, the rates were 28.6 % to clindamycin, 5.7 % to cefmetazole, 2.9 % to TAZ/PIPC and IPM, and 0 % to metronidazole (Bacteroides thetaiotaomicron; 59.1, 36.4, 0, 0, 0 %). MIC₉₀ of P. aeruginosa isolated 15 days or later after surgery rose in TAZ/PIPC, CAZ, IPM, and CPFX. In patients with American Society of Anesthesiologists (ASA) score ≥3, the resistance rates of P. aeruginosa to TAZ/PIPC and CAZ were higher than in patients with ASA ≤2. The data obtained in this study revealed the trend of the spread of resistance among common species that cause SSI. Timing of isolation from surgery and the patient's physical status affected the selection of resistant organisms.

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

    PubMed Central

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

    2016-01-01

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

  2. A heparin binding site Arg79Cys missense mutation in the SERPINC1 gene in a Korean patient with hereditary antithrombin deficiency.

    PubMed

    Yoo, Jong-Ha; Maeng, Ho-Young; Kim, Hee-Jin; Lee, Kyung-A; Choi, Jong-Rak; Song, Jaewoo

    2011-01-01

    We describe a case of heparin binding site Arg79Cys mutation in the gene encoding antithrombin, SERPINC1, in a Korean patient with hereditary antithrombin (AT) deficiency. The patient was a 34-year-old Korean man who presented with deep vein thrombosis (DVT) in his right leg without precipitating factors. On outpatient evaluation, coagulation tests without anticoagulation revealed a decreased AT III activity level at 48%, but normal AT III antigen level at 103%, indicating type II AT deficiency. Family studies revealed that his father (62 years of age) had decreased AT activity (48%) but had normal AT antigen levels (116%), indicating that the proband had a paternally inherited type II AT deficiency. Direct sequencing of the SERPINC1 gene in the patient and his father revealed a heterozygotic missense mutation, a cytosine to thymine substitution at nucleotide position 235 in exon 2 of the SERPINC1 gene (p.Arg79Cys). To our knowledge, this is the first report of Arg79Cys heterozygote mutation in family members with venous thromboembolism.

  3. Prevalence of modifiable surgical site infection risk factors in hip and knee joint arthroplasty patients at an urban academic hospital.

    PubMed

    Pruzansky, Jason S; Bronson, Michael J; Grelsamer, Ronald P; Strauss, Elton; Moucha, Calin S

    2014-02-01

    Surgical site infections after hip and knee arthroplasty can be devastating if they lead to periprosthetic joint infection. We examined the prevalence of the modifiable risk factors for surgical site infection described by the American Academy of Orthopaedic Surgery Patient Safety Committee. Our study of 300 cases revealed that only 20% of all cases and 7% of revision cases for infection had no modifiable risk factors. The most common risk factors were obesity (46%), anemia (29%), malnutrition (26%), and diabetes (20%). Cases with obesity or diabetes were associated with all histories of remote orthopedic infection, 89% of urinary tract infections, and 72% of anemia cases. The high prevalence of several modifiable risk factors demonstrates that there are multiple opportunities for perioperative optimization of such comorbidities.

  4. 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

  5. Mitigation of Staphylococcus aureus-mediated surgical site infections with ir photoactivated TiO2 coatings on Ti implants.

    PubMed

    Aboelzahab, Asem; Azad, Abdul-Majeed; Dolan, Shawn; Goel, Vijay

    2012-05-01

    Surgical site infections caused by methicillin-resistant and methicillin-susceptible Staphylococcus aureus (MRSA, MSSA) lead to patient hospitalization for an extended period coupled with concomitant hospitalization resources and cost. The detrimental effect resulting from the onset of these infections poses great health risks, leading to death in some instances. Titanium dioxide (TiO(2) ) is endowed with the unique capability of photoactivity which has been extensively exploited in antibacterial activities. It has been shown to be very effective in its bactericidal efficacy against infection-causing bacterial strains, namely, E. coli and S. aureus. In this study, the use of IR-photoactivated TiO(2) nanocoatings on titanium implants to mitigate the onset of surgical site infections is described. TiO(2) coatings were created on implantable materials by way of an aqueous plasma electrodeposition technique and were used to mitigate the harmful bacterial growth upon brief activation by an infrared (IR) laser source. The necrosis of S. aureus cells was found to exceed 90% within 30 min. following a 30s exposure of the titania-coated model implants (Ti mesh and plate). Promising potential of antibacterial coatings in mitigating surgical site infections has been shown.

  6. Predictive factors for surgical site infection in head and neck cancer surgery: A case-control study.

    PubMed

    Henry, J S; Buffet-Bataillon, S; Deberge, S; Jegoux, F

    2014-01-01

    Surgical Site Infection (SSI) after head and neck cancer surgery may be life threatening and induces increasing in healthcare cost. The objective of this present study was to identify predictive factors associated to surgical site infection in head and neck cancer surgery. Numerous predictive factors were analyzed with univariate case-control method, then with multivariate method. This retrospective study included 71 patients who have been hospitalized in our department during 2010 for a head and neck cancer surgery. The incidence of surgical site infection was 15.5%. The T3-T4 stages were identified as an independent predictive factor (p = 0.04). Our study does not find other predictive factor for a SSI. The NNIS index (National Nosocomial Infections Surveillance), used by the Center for disease control and prevention as predictive factor, was not valid in our study. A specific predictive index should include the tumor stage for Head and Neck Cancer surgery and should be taken into account for the management of a preventive antibiotic treatment.

  7. Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania

    PubMed Central

    2011-01-01

    Background Surgical site infection (SSI) continues to be a major source of morbidity and mortality in developing countries despite recent advances in aseptic techniques. There is no baseline information regarding SSI in our setting therefore it was necessary to conduct this study to establish the prevalence, pattern and predictors of surgical site infection at Bugando Medical Centre Mwanza (BMC), Tanzania. Methods This was a cross-sectional prospective study involving all patients who underwent major surgery in surgical wards between July 2009 and March 2010. After informed written consent for the study and HIV testing, all patients who met inclusion criteria were consecutively enrolled into the study. Pre-operative, intra-operative and post operative data were collected using standardized data collection form. Wound specimens were collected and processed as per standard operative procedures; and susceptibility testing was done using disc diffusion technique. Data were analyzed using SPSS software version 15 and STATA. Results Surgical site infection (SSI) was detected in 65 (26.0%) patients, of whom 56 (86.2%) and 9 (13.8%) had superficial and deep SSI respectively. Among 65 patients with clinical SSI, 56(86.2%) had positive aerobic culture. Staphylococcus aureus was the predominant organism 16/56 (28.6%); of which 3/16 (18.8%) were MRSA. This was followed by Escherichia coli 14/56 (25%) and Klebsiella pneumoniae 10/56 (17.9%). Among the Escherichia coli and Klebsiella pneumoniae isolates 9(64.3%) and 8(80%) were ESBL producers respectively. A total of 37/250 (14.8%) patients were HIV positive with a mean CD4 count of 296 cells/ml. Using multivariate logistic regression analysis, presence of pre-morbid illness (OR = 6.1), use of drain (OR = 15.3), use of iodine alone in skin preparation (OR = 17.6), duration of operation ≥ 3 hours (OR = 3.2) and cigarette smoking (OR = 9.6) significantly predicted surgical site infection (SSI) Conclusion SSI is common among

  8. Outcomes of nonemergent percutaneous coronary intervention with and without on-site surgical backup: a meta-analysis.

    PubMed

    Singh, Param Puneet; Singh, Mukesh; Bedi, Updesh Singh; Adigopula, Sasikanth; Singh, Sarabjeet; Kodumuri, Vamsi; Molnar, Janos; Ahmed, Aziz; Arora, Rohit; Khosla, Sandeep

    2011-01-01

    Despite major advances in percutaneous coronary intervention (PCI) techniques, the current guidelines recommend against elective PCI at hospitals without on-site cardiac surgery backup. Nonetheless, an increasing number of hospitals without on-site cardiac surgery in the United States have developed programs for elective PCI. Studies evaluating outcome in this setting have yielded mixed results, leaving the question unanswered. Hence, a meta-analysis comparing outcomes of nonemergent PCI in hospitals with and without on-site surgical backup was performed. A systematic review of literature identified four studies involving 6817 patients. Three clinical end points were extracted from each study and included in-hospital death, myocardial infarction, and the need for emergency coronary artery bypass grafting. The studies were homogenous for each outcome studied. Therefore, the combined relative risks (RRs) across all the studies and the 95% confidence intervals (CIs) were computed using the Mantel-Haenszel fixed-effect model. A two-sided alpha error less than 0.05 was considered to be statistically significant. Compared with facilities with on-site surgical backup, the risk of in-hospital death (RR, 2.7; CI, 0.6-12.9; P = 0.18), nonfatal myocardial infarction (RR, 1.3; CI, 0.7- 2.2; P = 0.29), and need of emergent coronary artery bypass grafting (RR, 0.46; CI, 0.06- 3.1; P = 0.43) was similar in those lacking on-site surgical backup. The present meta-analysis suggests that there is no difference in the outcome with regard to risk of nonfatal myocardial infarction, need for emergency coronary artery bypass grafting, and the risk of death in patients undergoing elective PCI in hospitals with and without on-site cardiac surgery backup.

  9. 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

  10. 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

  11. Inflammatory markers as predictors of surgical site infection after elective colorectal cancer surgery.

    PubMed

    Ortega-Deballon, Pablo; Lagoutte, Nicolas; Facy, Olivier

    2014-08-01

    We raise some doubts regarding the methods, results and conclusions obtained by Takakura et al. in their article published in the August's issue of the journal about the use of inflammatory markers as early predictors of surgical infection after colorectal cancer surgery. PMID:24824798

  12. Standard abdominal wound edge protection with surgical dressings vs coverage with a sterile circular polyethylene drape for prevention of surgical site infections (BaFO): study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Postoperative surgical site infections cause substantial morbidity, prolonged hospitalization, costs and even mortality and remain one of the most frequent surgical complications. Approximately 14% to 30% of all patients undergoing elective open abdominal surgery are affected and methods to reduce surgical site infection rates warrant further investigation and evaluation in randomized controlled trials. Methods/design To investigate whether the application of a circular plastic wound protector reduces the rate of surgical site infections in general and visceral surgical patients that undergo midline or transverse laparotomy by 50%. BaFO is a randomized, controlled, patient-blinded and observer-blinded multicenter clinical trial with two parallel surgical groups. The primary outcome measure will be the rate of surgical site infections within 45 days postoperative assessed according to the definition of the Center for Disease Control. Statistical analysis of the primary endpoint will be based on the intention-to-treat population. The global level of significance is set at 5% (2 sided) and sample size (n = 258 per group) is determined to assure a power of 80% with a planned interim analysis for the primary endpoint after the inclusion of 340 patients. Discussion The BaFO trial will explore if the rate of surgical site infections can be reduced by a single, simple, inexpensive intervention in patients undergoing open elective abdominal surgery. Its pragmatic design guarantees high external validity and clinical relevance. Trial registration http://www.clinicaltrials.gov NCT01181206. Date of registration: 11 August 2010; date of first patient randomized: 8 September 2010 PMID:22587425

  13. 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

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

    PubMed

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

    2007-06-01

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

  15. The Current State of Screening and Decolonization for the Prevention of Staphylococcus aureus Surgical Site Infection After Total Hip and Knee Arthroplasty.

    PubMed

    Weiser, Mitchell C; Moucha, Calin S

    2015-09-01

    The most common pathogens in surgical site infections after total hip and knee arthroplasty are methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and coagulase-negative staphylococci. Patients colonized with MSSA or MRSA have an increased risk for a staphylococcal infection at the site of a total hip or knee arthroplasty. Most colonized individuals who develop a staphylococcal infection at the site of a total hip or total knee arthroplasty have molecularly identical S. aureus isolates in their nares and wounds. Screening and nasal decolonization of S. aureus can potentially reduce the rates of staphylococcal surgical site infection after total hip and total knee arthroplasty.

  16. 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

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

    NASA Astrophysics Data System (ADS)

    Ryang, Woo Hun; Lee, Byungju

    2014-05-01

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

  18. Effectiveness of the closed method utilizing iodophors in the degermination of hands and arms of the surgical team and operative sites.

    PubMed

    Smith, E B

    1980-03-01

    A closed method utilizing the E-Z Prep Tray and the E-Z Scrub with iodophors is an effective means of degerming the hands and arms of surgical team members and the patients' operative sites. Fifty unselected surgical cases were evaluated bacteriologically, pre-preparation, post-preparation, and post-operatively. The data indicated that bacterial colony counts decreased, and the postoperative wound infection rate decreased to two percent.

  19. 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.

  20. [Long-term survival after surgical resection of a cancer of unknown primary site-a case report].

    PubMed

    Tsukao, Yukiko; Moon, Jeong Ho; Kobayashi, Kenji; Hyuga, Satoshi; Chono, Teruhiro; Watanabe, Risa; Matsumoto, Takashi; Takemoto, Hiroyoshi; Takachi, Ko; Nishioka, Kiyonori; Aoki, Taro; Uemura, Yoshio

    2013-11-01

    We report a case of long-term survival after combination chemotherapy and surgical resection of a cancer of unknown primary site[ CUPs]. A septuagenarian female was identified as having high blood levels of carcinoembryonic antigen (CEA) during follow-up monitoring of asthma. Endoscopy and imaging studies including computed tomography (CT) and positron emission tomography (PET)-CT revealed a malignant lymph node adjacent to the abdominal aorta; however, no other lesion was detected. Therefore, we performed CT-guided biopsy and diagnosed the lesion to be a lymph node metastasis of poorly differentiated adenocarcinoma. As we considered this as a systemic disease, the patient received 2 courses of combination chemotherapy with 5-fluorouracil( 5-FU)/cisplatin( CDDP) and achieved a partial response (PR). Later, the patient received S-1 therapy as second-line chemotherapy and S-1/irinotecan( CPT-11) as third-line chemotherapy in an outpatient clinic. However, the tumor continued to grow, and therefore, we decided to perform surgical resection. Histopathological examination of the resected specimen yielded a diagnosis of metastatic adenocarcinoma of the lymph node. The patient has been well without any signs of recurrence for more than 9 years since surgery. As CUPs is generally associated with poor prognosis, this case raises the possibility that combination therapy might improve convalescence.

  1. 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.

  2. 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.

  3. 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

  4. 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. PMID:26231077

  5. 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.

  6. Optimization of cone beam CT exposure for pre-surgical evaluation of the implant site

    PubMed Central

    Dawood, A; Brown, J; Sauret-Jackson, V; Purkayastha, S

    2012-01-01

    Objectives The aim of this study was to investigate the possibility of reducing patient X-ray dose in the course of implant site evaluation. Methods Retrospective practice-based study using a Morita F170 Accuitomo cone beam CT (CBCT) scanner with variable exposure parameters and operating a small cylindrical field of view of 4 cm diameter and 4 cm height. 6 experienced dental surgeons scored the image quality of dental scans on a 5-point scale for adequacy in providing the required information in 2 categories: bone height from alveolar crest to the relevant anatomical structure and bone width. Results Lower-dose protocols only marginally affected the preference of the reviewers of the resulting images. Conclusions There is potential to reduce patient dose very significantly in CBCT examinations for implant site evaluation. PMID:22184628

  7. 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

  8. Clinical relevance of surgical site infection as defined by the criteria of the Centers for Disease Control and Prevention.

    PubMed

    Henriksen, N A; Meyhoff, C S; Wetterslev, J; Wille-Jørgensen, P; Rasmussen, L S; Jorgensen, L N

    2010-07-01

    Surgical site infection (SSI) is a common complication after abdominal surgery and the Centers for Disease Control and Prevention (CDC) criteria are commonly used for diagnosis and surveillance. The aim of this study was to evaluate whether SSI diagnosed according to CDC is clinically relevant (CRSSI) and whether there is agreement between evaluations according to the CDC criteria, the ASEPSIS score (Additional treatment, presence of Serous discharge, Erythema, Purulent exudate, Separation of the deep tissues, Isolation of bacteria and duration of Stay) and CRSSI. We included 54 patients diagnosed with SSI and a matched control group (N=46) without SSI according to the CDC criteria after laparotomy. Two blinded experienced surgeons evaluated the hospital records and determined whether patients had CRSSI, based on the following criteria: antibiotic treatment, surgical intervention, prolonged hospital stay or referral to an intensive care unit for SSI. The rate of CRSSI was 38 of 54 (70%) in patients with CDC-diagnosed SSI and none in patients without a CDC-diagnosed SSI. Sixty-one percent of the CDC-diagnosed SSIs were superficial, of which 48% were considered clinically relevant. There was substantial agreement between the CDC criteria and CRSSI [kappa=0.69; 95% confidence interval (CI): 0.55-0.83] and fair agreement between the ASEPSIS score and the CDC criteria (kappa=0.23; 95% CI: 0-0.49) and between the ASEPSIS score and CRSSI (kappa=0.39; 95% CI: 0.17-0.61). The CDC criteria represent a suitable standard definition for monitoring and identifying SSI, even if some cases of less clinically significant superficial SSI are included.

  9. Korean Thanksgiving. Chusongnal.

    ERIC Educational Resources Information Center

    Los Angeles Unified School District, CA.

    This bilingual reader in Korean and English is intended for elementary school children in a bilingual education setting. Pen-and-ink drawings illustrate the story about a family's celebration of a traditional Korean Thanksgiving. (NCR)

  10. History of Korean Neurosurgery.

    PubMed

    Hwang, Sung-nam

    2015-08-01

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

  11. Molecular characterization of Korean rabies virus isolates

    PubMed Central

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

    2011-01-01

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

  12. A novel splice-site mutation c.42-2A>T (IVS1-2A>T) of SERPINC1 in a Korean family with inherited antithrombin deficiency.

    PubMed

    Jang, Moon Ju; Lee, Jeong-Guil; Chong, So Young; Huh, Ji Young; Jang, Mi-Ae; Kim, Hee-Jin; Oh, Doyeun

    2011-12-01

    Inherited antithrombin (AT) deficiency (OMIM 107300) is an autosomal dominant disorder and causes a 20-fold increase in the risk of venous thromboembolism. Herein, we describe a case of a novel splice-site mutation in the SERPINC1 gene in a Korean patient with inherited AT deficiency. The patient was a 35-year-old woman who presented with deep vein thrombosis (DVT) and pulmonary embolism and was without a recent history of any precipitating factors. The obtaining of her family history revealed that her mother had an ischemic stroke and a pulmonary embolism and her two sisters both had an episode of DVT during pregnancy. DNA sequencing of SERPINC1 revealed the novel variant IVS1-2A>T (c.42-2A>T), a substitution in intron 1, in the proband and her daughter. The mutation IVS1-2A>T eliminates the acceptor splice-site of intron 1. The present case is the first novel splice-site mutation of SERPINC1 in a Korean family with inherited AT deficiency.

  13. Pre-educational intervention survey of healthcare practitioners' compliance with infection prevention measures in cardiothoracic surgery: low compliance but internationally comparable surgical site infection rate.

    PubMed

    Tartari, E; Mamo, J

    2011-04-01

    Surgical site infections (SSIs) are challenging problems leading to significant postoperative morbidity and mortality and may reflect the level of adherence to infection control policies. We used a structured observational method to collect data about infection control practices among surgeons, anaesthetists, nurses, cardiopulmonary bypass technicians and orderlies practising in the cardiac operating theatre during open heart surgery at Mater Dei Hospital. To prevent bias, we did not disclose the actual procedures observed to the surgical team members, but participants knew they were being observed for infection control practices. We measured the 30-day SSI rate by post-discharge telephonic surveillance among surviving open heart surgery patients who had consented to the survey. We observed practices during 30 randomly chosen operations and found higher levels of inadequate practices related to environmental disinfection, hand hygiene, operating room traffic and surgical attire of non-scrubbed personnel (anaesthesiologists and cardiopulmonary bypass technicians). In all, 140 of 155 patients who underwent open heart surgery were followed up, achieving a response rate of 91.5%. Superficial and deep SSI rates were 16.4% and 4.3% respectively, including both sternal and harvest site infections. We found poor compliance with infection control practices by non-scrubbed personnel involved in cardiac surgery and observed a high surgical site infection rate, the majority being leg wound infections following saphenous vein harvesting. PMID:21334097

  14. Agreement among Healthcare Professionals in Ten European Countries in Diagnosing Case-Vignettes of Surgical-Site Infections

    PubMed Central

    Birgand, Gabriel; Lepelletier, Didier; Baron, Gabriel; Barrett, Steve; Breier, Ann-Christin; Buke, Cagri; Markovic-Denic, Ljiljana; Gastmeier, Petra; Kluytmans, Jan; Lyytikainen, Outi; Sheridan, Elizabeth; Szilagyi, Emese; Tacconelli, Evelina; Troillet, Nicolas; Ravaud, Philippe; Lucet, Jean-Christophe

    2013-01-01

    Objective Although surgical-site infection (SSI) rates are advocated as a major evaluation criterion, the reproducibility of SSI diagnosis is unknown. We assessed agreement in diagnosing SSI among specialists involved in SSI surveillance in Europe. Methods Twelve case-vignettes based on suspected SSI were submitted to 100 infection-control physicians (ICPs) and 86 surgeons in 10 European countries. Each participant scored eight randomly-assigned case-vignettes on a secure online relational database. The intra-class correlation coefficient (ICC) was used to assess agreement for SSI diagnosis on a 7-point Likert scale and the kappa coefficient to assess agreement for SSI depth on a three-point scale. Results Intra-specialty agreement for SSI diagnosis ranged across countries and specialties from 0.00 (95%CI, 0.00–0.35) to 0.65 (0.45–0.82). Inter-specialty agreement varied from 0.04 (0.00–0.62) in to 0.55 (0.37–0.74) in Germany. For all countries pooled, intra-specialty agreement was poor for surgeons (0.24, 0.14–0.42) and good for ICPs (0.41, 0.28–0.61). Reading SSI definitions improved agreement among ICPs (0.57) but not surgeons (0.09). Intra-specialty agreement for SSI depth ranged across countries and specialties from 0.05 (0.00–0.10) to 0.50 (0.45–0.55) and was not improved by reading SSI definition. Conclusion Among ICPs and surgeons evaluating case-vignettes of suspected SSI, considerable disagreement occurred regarding the diagnosis, with variations across specialties and countries. PMID:23874690

  15. Surgical site infections following craniotomy focusing on possible post-operative acquisition of infection: prospective cohort study.

    PubMed

    Sneh-Arbib, O; Shiferstein, A; Dagan, N; Fein, S; Telem, L; Muchtar, E; Eliakim-Raz, N; Rubinovitch, B; Rubin, G; Rappaport, Z H; Paul, M

    2013-12-01

    Neurosurgery is characterized by a prolonged risk period for surgical site infection (SSI), mainly related to the presence of cerebrospinal fluid (CSF) drains. We aimed to examine factors associated with post-neurosurgical SSIs, focusing on post-operative factors. A prospective cohort study was conducted in a single center over a period of 18 months in Israel. Included were adult patients undergoing clean or clean-contaminated craniotomy, including craniotomies with external CSF drainage or shunts. SSIs were defined by the Centers for Disease Control and Prevention (CDC) criteria for healthcare-associated infections. All patients were followed up for 90 days and those with foreign body insertion for 1 year. We compared patients with and without SSI. A multivariable regression analysis for SSI was conducted including uncorrelated variables significantly associated with SSI. A total of 502 patients were included, with 138 (27.5%) undergoing emergent or urgent craniotomy. The overall SSI rate was 5.6% (28 patients), of which 3.2% (16 patients) were intracerebral. Non-elective surgery, external CSF drainage/monitoring devices, re-operation, and post-operative respiratory failure were independently associated with subsequent SSI. External CSF devices was the only significant risk factor for intracerebral SSIs (p < 0.001). Internal shunts or other foreign body insertions were not associated with SSIs. A phenotypically identical isolate to that causing the SSI was isolated from respiratory secretions prior to the SSI in 4/9 patients with microbiologically documented intracerebral SSIs. Patients with SSIs had longer hospital stay, poorer functional capacity on discharge, and higher 90-day mortality. We raise the possibility of post-operative infection acquisition through external CSF devices. Standard operating procedures for their maintenance are necessary.

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

    PubMed Central

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

    2015-01-01

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

  17. The effect of triclosan coated sutures on rate of Surgical Site Infection after hip and knee replacement: a protocol for a double-blind randomised controlled trial

    PubMed Central

    2014-01-01

    Background 187,000 hip and knee joint replacements are performed every year in the National Health Service (NHS). One of the commonest complications is surgical site infection (SSI), and this represents a significant burden in terms of patient morbidity, mortality and cost to health services around the world. The aim of this randomised controlled trial (RCT) is to determine if the addition of triclosan coated sutures to a standard regimen can reduce the rate of SSI after total knee replacement (TKR) and total hip replacement (THR). Methods 2400 patients due to undergo a total hip or knee replacement are being recruited into this two-centre RCT. Participants are recruited before surgery and randomised to either standard care or intervention group. Participants, outcome assessors and statistician are blind to treatment allocation throughout the study. The intervention consists of triclosan coated sutures vs. standard non-coated sutures. The primary outcome is the Health protection Agency (HPA) defined superficial surgical site infection at 30 days. Secondary outcomes include HPA defined deep surgical site infection at 12 months, length of hospital stay, critical care stay, and payer costs. Discussion To date there are no orthopaedic randomised controlled trials on this scale assessing the effectiveness of a surgical intervention, particularly those that can be translated across the surgical specialities. The results from this trial will inform evidence-based recommendations for suture selection in the management of patients undergoing total hip or knee replacement. If triclosan coated sutures are found to be an effective intervention, implementation into clinical practice could improve long-term outcomes for patients undergoing hip and knee replacement. Trial registration Current Controlled Trials ISRCTN 17807356. PMID:25027459

  18. 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. ...

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

    PubMed

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

    2016-09-01

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

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

    PubMed

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

    2016-03-01

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

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

    PubMed

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

    2016-03-01

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

  2. 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…

  3. Lessons of the North Korean crisis

    SciTech Connect

    Mazarr, M.J.

    1993-07-01

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

  4. 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

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

    PubMed Central

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

    2015-01-01

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

  6. New surgical techniques and surgical site infections.

    PubMed Central

    Gordon, S. M.

    2001-01-01

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

  7. Role of culture of postoperative drainage fluid in the prediction of infection of the surgical site after major oncological operations of the head and neck.

    PubMed

    Candau-Alvarez, A; Linares-Sicilia, M J; Dean-Ferrer, A; Pérez-Navero, J L

    2015-02-01

    Infection of the surgical site after major oncological operations of the head and neck increases mortality and morbidity. The aim of this prospective pilot study was to assess the efficacy of culturing the exudate from the drain after cervical neck dissection to see if it predicted such infection. We studied 40/112 patients with squamous cell cancer of the head and neck who were treated during the last two years and met our inclusion criteria. Six patients developed infections (15%). Reconstruction with pedicled rather than local or microvascular flaps, duration of operation of over 7 hours, the presence of a tracheostomy, and bilateral neck dissection were considered risk factors (p=0.01). Culture of drainage fluid on postoperative day 3 that grew no pathogens predicted that the site would not become infected, with a negative predictive value of 96%.

  8. 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

    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

  9. 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

  10. Surgical smoke.

    PubMed

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown. PMID:19892630

  11. Rapid tests for the detection of the Mycobacterium abscessus subsp. bolletii strain responsible for an epidemic of surgical-site infections in Brazil.

    PubMed

    Matsumoto, Cristianne Kayoko; Chimara, Erica; Ramos, Jesus Pais; Campos, Carlos Eduardo Dias; Caldas, Paulo Cesar de Souza; Lima, Karla Valeria Batista; Lopes, Maria Luiza; Duarte, Rafael Silva; Leão, Sylvia Cardoso

    2012-12-01

    A single strain of Mycobacterium abscessus subsp. bolletii, characterised by a particular rpoB sequevar and two highly related pulsed field gel electrophoresis patterns has been responsible for a nationwide outbreak of surgical infections in Brazil since 2004. In this study, we developed molecular tests based on polymerase chain reaction restriction-enzyme analysis (PRA) and sequencing for the rapid identification of this strain. Sequences of 15 DNA regions conserved in mycobacteria were retrieved from GenBank or sequenced and analysed in silico. Single nucleotide polymorphisms specific to the epidemic strain and located in enzyme recognition sites were detected in rpoB, the 3' region of the 16S rDNA and gyrB. The three tests that were developed, i.e., PRA-rpoB, PRA-16S and gyrB sequence analysis, showed 100%, 100% and 92.31% sensitivity and 93.06%, 90.28% and 100% specificity, respectively, for the discrimination of the surgical strain from other M. abscessus subsp. bolletii isolates, including 116 isolates from 95 patients, one environmental isolate and two type strains. The results of the three tests were stable, as shown by results obtained for different isolates from the same patient. In conclusion, due to the clinical and epidemiological importance of this strain, these tests could be implemented in reference laboratories for the rapid preliminary diagnosis and epidemiological surveillance of this epidemic strain. PMID:23295745

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

    PubMed

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

    2011-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  14. 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

  15. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis.

    PubMed

    Rubin, Lorry G; Papsin, Blake

    2010-08-01

    therapy is inappropriate for children with implants with acute otitis media. If feasible, tympanocentesis should be performed for acute otitis media, and the material should be sent for culture, but performance of this procedure should not result in an undue delay in initiating antimicrobial therapy. For patients with suspected meningitis, cerebrospinal fluid as well as middle-ear fluid, if present, should be sent for culture. Empiric antimicrobial therapy for meningitis occurring within 2 months of implantation should include an agent with broad activity against Gram-negative bacilli (eg, meropenem) plus vancomycin. For meningitis occurring 2 months or longer after implantation, standard empiric antimicrobial therapy for meningitis (eg, ceftriaxone plus vancomycin) is indicated. For patients with meningitis, urgent evaluation by an otolaryngologist is indicated for consideration of imaging and surgical exploration.

  16. Surgical correction of brachymetatarsia.

    PubMed

    Bartolomei, F J

    1990-02-01

    Brachymetatarsia describes the condition of an abnormally short metatarsal. Although the condition has been recorded since antiquity, surgical options to correct the deformity have been available for only two decades. Most published procedures involve metaphyseal lengthening with autogenous grafts from different donor sites. The author discusses one such surgical technique. In addition, the author proposes specific criteria for the objective diagnosis of brachymetatarsia. PMID:2406417

  17. 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.

  18. 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…

  19. 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

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

    PubMed Central

    Edmiston, Charles E.; Leaper, David

    2014-01-01

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

  1. Surgical Airway

    PubMed Central

    Patel, Sapna A; Meyer, Tanya K

    2014-01-01

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

  2. 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…

  3. The North Korean nuclear dilemma.

    SciTech Connect

    Hecker, Siegfried S.

    2004-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Surgical tracheotomy.

    PubMed

    Rowshan, Henry H; Baur, Dale A

    2010-03-01

    Tracheotomy is a surgical procedure that dates back to early history and medical advancement. The oral and maxillofacial surgeon routinely operates around the airway and should be able to master this procedure by adhering to the surgical principles outlined in this article.

  6. Prevention of surgical site infection in lower limb skin lesion excisions with single dose oral antibiotic prophylaxis: a prospective randomised placebo-controlled double-blind trial

    PubMed Central

    Smith, Samuel C; Heal, Clare F; Buttner, Petra G

    2014-01-01

    Objectives To determine the effectiveness of a single perioperative prophylactic 2 g dose of cephalexin in preventing surgical site infection (SSI) following excision of skin lesions from the lower limb. Design Prospective double-blinded placebo-controlled trial testing for difference in infection rates. Setting Primary care in regional North Queensland, Australia. Participants 52 patients undergoing lower limb skin lesion excision. Interventions 2 g dose of cephalexin 30–60 min before excision. Main outcome measures Incidence of SSI. Results Incidence of SSI was 12.5% (95% CI 2.7% to 32.4%) in the cephalexin group compared with 35.7% (95% CI 18.6% to 55.9%) in the placebo group (p=0.064). This represented an absolute reduction of 23.21% (95% CI −0.39% to 46.82%), relative reduction of 65.00% (95% CI −12.70% to 89.13%) and number-needed-to-treat of 4.3. Conclusions Administration of a single 2 g dose of cephalexin 30–60 min before skin lesion excision from the lower limb may produce a reduction in the incidence of infection; however, this study was underpowered to statistically determine this. Trial registration number ACTRN12611000595910. PMID:25079934

  7. 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

  8. 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

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

    PubMed

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

    2016-08-01

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

  10. Who Is the Authentic Korean American? Korean-Born Korean American High School Students' Negotiations of Ascribed and Achieved Identities

    ERIC Educational Resources Information Center

    Palmer, John D.

    2007-01-01

    This article investigates the identity negotiations of a group of Korean-born Korean American (KBKA) high school students. One of the major tensions that arise from within the Korean American community is who should be considered an "authentic" member. Therefore, in this article I illustrate (a) the way American-born Korean Americans' (ABKAs')…

  11. Surgical Technologists

    MedlinePlus

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

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

    PubMed

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

    2015-12-01

    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.

  13. 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

  14. 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…

  15. Demonstratives and Number in Korean.

    ERIC Educational Resources Information Center

    Ree, Joe J.

    It is a generally held view that Korean lacks articles and that the category "number" in this language is unproductive. That is, the nouns in Korean can be used freely as definite and indefinite, and as singular and plural, without overt grammatical markers. Contrary to this view, the claim is made in this paper that non-unique nouns, i.e., nouns…

  16. 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…

  17. 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…

  18. Classifying Korean Adolescents' Career Preparedness

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  19. Chinese Koreans complete demographic transition.

    PubMed

    Gu, Q; Zhao, F

    1992-02-01

    The 1990 national census disclosed that there were 1,920,597 Koreans in China. There number increased 21% from 1,110, 000 in 1953 to 1,350,000 in 1964. The transition to low birth rate, low mortality rate, and low growth rate started in the mid-1960s and it was completed by 1974. Chinese Korean population increased form 1,350,000 in 1964 to 1,770,000 in 1982, and to 1,920,000 in 1990. Between 1982 and 1990, the average annual growth rate of the Han population, with the promotion of the 1-child policy, was 1.3%, while that of the Korean population who were allowed to have 2 children was only 1.0%. The total fertility rate (TFR) of Korean women in Yanbian Korean Autonomous Prefecture decreased from 4.7 in 1965 to 1.9 in 1974, to 1.8 in 1981, and to 1.6 in 1983, and increasing to 1.9 in 1989. 89-90% of women were primiparas between 1973 and 1983. In 1989 in Jilin Province 71% of Korean women were primiparas, 26% were secundiparas, and 3% were tertiparas or had higher parity. The decelerated population growth of the Korean nationality is attributed to the popularization of compulsory education. Primary school became compulsory in 1952 and junior high school in 1958. The illiteracy rate of Koreans was only 11% in 1982, 21% lower than that of the Han nationality and 32% lower than that of other ethnic groups in China. The rate declined further to 7% in 1987. The illiteracy rate of Korean women in reproductive age was only 3%, while the national illiteracy rate of such women was 30%, and that of women in ethnic groups was 46%. The marriage age of Korean women was 20 in 1966 increasing to 23 by 1973 with the birth interval of over 5 years.

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

    PubMed

    Barakat, Ghada I; Nabil, Yasmin M

    2016-03-01

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

  1. Gentamicin/Collagen Sponge Use May Reduce the Risk of Surgical Site Infections for Patients Undergoing Cardiac Operations: A Meta-Analysis

    PubMed Central

    Herwaldt, Loreen A.; Perencevich, Eli N.; Schweizer, Marin L.

    2014-01-01

    Abstract Objective: A meta-analysis of all published randomized controlled trials of the effectiveness of gentamicin/collagen sponges for preventing surgical site infections (SSIs). Background: Despite routine use of systemic prophylactic antimicrobial agents, SSIs continue to be associated with substantial morbidity. Results conflict of studies of the efficacy of gentamicin/collagen sponges for preventing SSIs. However, many of these studies have assessed sponge use in only a single specific type of operation. The general effect of sponge use among different types of operations has not been previously assessed. Methods: The PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched for articles appearing from 1990 through January 2012 that were related to gentamicin/collagen sponge use and SSIs. Summary estimates were obtained through a random effects model. After reviewing 714 article abstracts and reviewing 22 articles in detail, we pooled the odds ratios (OR) for 13 independent study populations (cardiac, n=4; colorectal, n=4; pilonidal sinus, n=2; hernia, n=2; gastrointestinal, n=1) in which the association between prophylactic use of gentamicin/collagen sponges and SSIs was assessed. Results: Pooling of the results of all studies included in the review in a random effects model showed a significant protective effect of prophylactic use of gentamicin/collagen sponges against SSI (pooled OR: 0.66; 95% confidence interval [CI]: 0.45, 0.97; n=13). However, when the data were stratified by type of operation, a significant protective effect was observed in cardiac procedures (pooled OR: 0.59; 95% CI: 0.37, 0.96; n=4) but not in colorectal procedures (pooled OR: 0.74; 95% CI: 0.29–1.92; n=4). Conclusion: Use of gentamicin/collagen sponges was associated with a reduced risk of SSI following cardiac operations but not following colorectal procedures. PMID:24773201

  2. 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.

  3. Evaluation of routinely reported surgical site infections against microbiological culture results: a tool to identify patient groups where diagnosis and treatment may be improved

    PubMed Central

    2009-01-01

    Background Surgeons may improve their decision making by assessing the extent to which their initial clinical diagnosis of a surgical site infection (SSI) was supported by culture results. Aim of the present study was to evaluate routinely reported SSI by surgeons against microbiological culture results, to identify patient groups with lower agreement where decision making may be improved. Methods 701 admissions with SSI were reported by surgeons in a university medical centre in the period 1997-2005, which were retrospectively checked for microbiological culture results. Reporting a SSI was conditional on treatment being given (e.g. antibiotics) and was classified by severity. To identify specific patient groups, patients were classified according to the surgery group of the first operation during admission (e.g. trauma). Results Of all reported SSI, 523 (74.6%) had a positive culture result, 102 (14.6%) a negative culture result and 76 (10.8%) were classified as unknown culture result (due to no culture taken). Given a known culture result, reported SSI with positive culture results less often concerned trauma patients (16% versus 26%, X2 = 4.99 p = 0.03) and less severe SSI (49% versus 85%, X2 = 10.11 p < 0.01) suggesting that a more conservative approach may be warranted in these patients. The trauma surgeons themselves perceived to have become too liberal in administering antibiotics (and reporting SSI). Conclusion Routine reporting of SSI was mostly supported by culture results. However, this support was less often found in trauma patients and less severe SSI, thereby giving surgeons feedback that diagnosis and treatment may be improved in these cases. PMID:19900294

  4. Triclosan-coated sutures reduce surgical site infection after open vein harvesting in coronary artery bypass grafting patients: a randomized controlled trial†

    PubMed Central

    Thimour-Bergström, Linda; Roman-Emanuel, Christine; Scherstén, Henrik; Friberg, Örjan; Gudbjartsson, Tomas; Jeppsson, Anders

    2013-01-01

    OBJECTIVES The incidence of surgical site infection (SSI) after open vein harvesting in coronary artery bypass grafting (CABG) patients ranges in different studies between 2 and 20%. Triclosan is an antibacterial substance that reduces the growth of bacteria by inhibiting fatty acid synthesis. We hypothesized that wound closure with triclosan-coated sutures would reduce SSI after open vein harvesting. METHODS An investigator-initiated prospective randomized double-blind single-centre study was performed with 374 patients, randomized to subcutaneous and intracutaneous leg-wound closure with either triclosan-coated sutures (Vicryl Plus® and Monocryl Plus®, Ethicon, Somerville, NJ, USA) (n = 184) or identical sutures without triclosan (n = 190) from the same manufacturer. All patients were followed up after 30 days (clinical visit) and 60 days (telephone interview). Primary endpoint was SSI within 60 days after surgery according to the definition of Center for Disease Control. Predefined secondary endpoints included culture-proven and antibiotic-treated SSI. RESULTS The primary endpoint occurred in 23 patients (12.5%) with triclosan-coated sutures and in 38 patients (20.0%) in the group without triclosan (P = 0.0497, risk ratio 0.63, (95% confidence interval 0.39–1.00). Corresponding figures for culture-proven infections were 7.6 vs 12.1%, (P = 0.15), and for antibiotic-treated infections, 10.9 vs 18.4%, (P = 0.039). Staphylococcus aureus and coagulase-negative staphylococci were the most common pathogens in both groups. Insulin-treated diabetes and vein-harvesting time were associated with SSI after vein harvesting. CONCLUSIONS Leg-wound closure with triclosan-coated sutures in CABG patients reduces SSIs after open vein harvesting. (ClinicalTrials.gov number NCT01212315). PMID:23435526

  5. 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

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

    PubMed

    Barakat, Ghada I; Nabil, Yasmin M

    2016-03-01

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

  7. 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…

  8. 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).

  9. Korean atomic bomb victims.

    PubMed

    Sasamoto, Yukuo

    2009-01-01

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

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

    SciTech Connect

    Blackburn, N.G.

    1993-03-22

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

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

    PubMed Central

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

    2016-01-01

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

  12. Proportions of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus in Patients with Surgical Site Infections in Mainland China: A Systematic Review and Meta-Analysis

    PubMed Central

    Yang, Zhirong; Wang, Jing; Wang, Weiwei; Zhang, Yuelun; Han, Lizhong; Zhang, Yuan; Nie, Xiaolu; Zhan, Siyan

    2015-01-01

    Background Sufficient details have not been specified for the epidemiological characteristics of Staphylococcus aureus (S. aureus) and methicillin-resistant Staphylococcus aureus (MRSA) among surgical site infections (SSIs) in mainland China. This systematic review aimed to estimate proportions of S. aureus and MRSA in SSIs through available published studies. Methods PubMed, Embase and four Chinese electronic databases were searched to identify relevant primary studies published between 2007 and 2012. Meta-analysis was conducted on the basis of logit-transformed metric for proportions of S. aureus and MRSA, followed by pre-defined subgroup meta-analysis. Random-effects meta-regression was also conducted to explore the impact of possible factors on S. aureus proportions. Results 106 studies were included, of which 38 studies involved MRSA. S. aureus accounted for 19.1% (95%CI 17.2-21.0%; I2 = 84.1%) of all isolates in SSIs, which was roughly parallel to 18.5% in the United States (US) (P-value = 0.57) but significantly exceeded those calculated through the surveillance system in China (P-value<0.001). In subgroup analysis, S. aureus in patients with thoracic surgery (41.1%, 95%CI 26.3-57.7%; I2 = 74.4%) was more common than in those with gynecologic surgery (20.1%, 95%CI 15.6-25.6%; I2 = 33.0%) or abdominal surgery (13.8%, 95%CI 10.3-18.4%; I2 = 70.0%). Similar results were found in meta-regression. MRSA accounted for 41.3% (95%CI 36.5-46.3%; I2 = 64.6%) of S. aureus, significantly lower than that in the US (P-value = 0.001). MRSA was sensitive to vancomycin (522/522) and linezolid (93/94), while 79.9% (95%CI 67.4-88.4%; I2 = 0%) and 92.0% (95%CI 80.2-97.0%; I2 = 0%) of MRSA was resistant to clindamycin and erythromycin respectively. Conclusion The overall proportion of S. aureus among SSIs in China was similar to that in the US but seemed higher than those reported through the Chinese national surveillance system. Proportions of S. aureus SSIs may vary with

  13. 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

  14. 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

  15. Caring for childbearing Korean women.

    PubMed

    Howard, J Y; Berbiglia, V A

    1997-01-01

    This article examines the traditional and modern cultural elements that may influence the health behaviors of the childbearing Korean woman and suggests ways to provide culturally sensitive care. The first author, born and raised in Korea, shares her reflections of culture and examples of clinical situations in Korea. Implications for nursing care are addressed through specific cultural prescriptions. Do's and don'ts are presented to foster culturally appropriate care for Korean childbearing women.

  16. Surgical antiseptics.

    PubMed

    Sebben, J E

    1983-11-01

    The skin cannot be sterilized because approximately 20% of the resident flora are beyond the reach of surgical scrubs and antiseptics. The goal of surgical preparation of the skin with antiseptics is to remove transient and pathogenic microorganisms on the skin surface and to reduce the resident flora to a low level. Four antiseptics which have been popular over the past two decades are discussed. Benzalkonium chloride is somewhat unstable on the skin and is too prone to contamination to be in general use. Hexachlorophene is not recommended due to narrow spectrum and risks secondary to percutaneous absorption. The iodophors are excellent antiseptics, but recent studies raise questions about effectiveness and contamination. Chlorhexidine is a very safe and effective antiseptic. Comparison studies with chlorhexidine, hexachlorophene, and iodophors show chlorhexidine to be the most effective agent. Chlorhexidine can be toxic to the middle ear and irritating to the eyes with direct contact. Caution should be used in these areas with chlorhexidine and other antiseptics.

  17. Surgical heuristics.

    PubMed

    Patkin, Michael

    2008-12-01

    Heuristics are rules of thumb. Rarely described in surgical or other publications, they are an essential part of safe and expert performance. This study translates such implicit or procedural knowledge into explicit or declarative knowledge, with a view to improving both training and retraining of surgeons in the steps of dissection. Tools used include ordinary observation accompanied by introspection, and study of operative videos. Validation of the value of such heuristics is yet to be achieved.

  18. 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

  19. 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…

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

    PubMed

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

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

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

    PubMed

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

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

  2. Surgical treatment of advanced melanoma.

    PubMed

    Hussussian, Christopher J

    2010-01-01

    Primary surgical treatment should be considered for patients with metastatic melanoma. Because of the poor response of melanoma to chemotherapy or radiation therapy, surgery can be the best approach to quickly eliminate detectable disease and return the patient to normal activities. In properly selected patients, surgery can lead to significant palliation and prolongation of survival. This article reviews the principles of patient selection and the potential benefits of surgical management of melanoma metastatic to various sites. Novel adjuvant therapies are being developed to augment the benefits of surgical treatment of advanced melanoma in the future.

  3. Korean Geodetic VLBI Project

    NASA Astrophysics Data System (ADS)

    Kondo, T.; Kim, T.; Han, S.; Kwak, Y.; Oh, H.; Yi, S.; Bae, M.; Kim, K.; Moon, J.; Park, J.

    2009-04-01

    A permanent geodetic VLBI station with a 22-m diameter antenna will be newly constructed in Korea by the National Geographic Information Institute, Korea (NGII) for the project named Korea VLBI system for Geodesy (KVG) that aims at maintaining the Korean geodetic datum accurately. The KVG has started officially since October, 2008. The construction of all system will be completed by the end of 2011. In Korea, the Korea Astronomy and Space Science Institute (KASI) has already promoted Korean VLBI Network (KVN) project dedicated to radio astronomy since 2001, and three 21-m diameter antennas have been constructed at Seoul, Ulsan, and Jeju Island. Although their receivers have not yet been fully installed, the antenna is designed to be able to receive 22, 43, 86, and 129 GHz bands simultaneously. In parallel with the KVN project, the National Geographic Information Institute, Korea (NGII) has been planning to construct their own VLBI antenna dedicated to geodetic measurements since 2001 to maintain the Korean Geodetic Datum accurately on the International Terrestrial Reference Frame (ITRF). It also aims at a fundamental station in East Asia and will contribute to the better determination of the ITRF there. A grand design for KVG project realizing NGII's plan has been proposed by the Ajou University under the collaborations with the National Institute of Information and Communications Technology, Japan (NICT), National Astronomical Observatory, Japan (NAO), and the Geographical Survey Institute, Japan (GSI). The design of KVG antenna follows the VLBI2010 except for receiving frequencies and the diameter; VLBI2010 is the guideline for next generation's geodetic VLBI system compiled by the International VLBI Service for Geodesy and Astrometry (IVS). The antenna is designed to be able to receive 2, 8, 22, and 43 GHz bands simultaneously in order to carry out geodetic VLBI observations not only with current geodetic VLBI stations equipped with 2/8 GHz receivers but also

  4. Korean Folk Music in Your Curriculum

    ERIC Educational Resources Information Center

    Bowman, Barbara G.

    2008-01-01

    Koreans are a growing minority in the United States. Worldwide, it is believed that more than seventy million people speak Korean, approximately as many as who speak Italian. The music of Korea offers a delightful addition to the general music classroom. There are several reasons why Korean music is not readily accessible to most general music…

  5. Korean Books and FRBR: An Investigation

    ERIC Educational Resources Information Center

    Kim, Jeong-Hyen; Moon, Ji-Hyun

    2010-01-01

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

  6. 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…

  7. 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.

  8. 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

  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. 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…

  11. Two Causative Constructions in Korean.

    ERIC Educational Resources Information Center

    Choi, Dong-Ik

    1993-01-01

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

  12. 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…

  13. 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…

  14. National Identity in Korean Curriculum

    ERIC Educational Resources Information Center

    Kim, Hyojeong

    2004-01-01

    The concept of national identity has evolved during the last half century within the Korean social studies curriculum. There have been seven curricular revisions since the first national curriculum was released in 1955. Each time the concept of national identity was changed with the biggest changes to this concept within the last two iterations of…

  15. Cultural Identity in Korean English

    ERIC Educational Resources Information Center

    Chang, Bok-Myung

    2010-01-01

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

  16. 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...

  17. Korean Basic Course: Area Background.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

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

  18. A KOREAN-ENGLISH DICTIONARY.

    ERIC Educational Resources Information Center

    MARTIN, SAMUEL E.; AND OTHERS

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

  19. 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.

  20. 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…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Kang, Hyun-Sook

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Gao, Fang

    2010-01-01

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

  4. 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

  5. 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…

  6. Simulation in Surgical Education

    PubMed Central

    de Montbrun, Sandra L.; MacRae, Helen

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Hoffman, Joy; Pena, Edlyn Vallejo

    2013-01-01

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

  8. 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.

  9. Korean Education and Foreign Assistance Programs.

    ERIC Educational Resources Information Center

    Korean Central Education Research Inst., Seoul.

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

  10. 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," or "ballad" based…

  11. 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.…

  12. 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)…

  13. Small Business Among Koreans in Los Angeles.

    ERIC Educational Resources Information Center

    Bonacich, Edna; And Others

    The purpose of this paper is to describe the character of small business among Koreans in Los Angeles, to examine the means by which Koreans are able to enter small business in an economy which clearly is moving in the opposite direction, and to consider why it is that immigrant small business should flourish within monopoly capitalism. Korean…

  14. 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.

  15. Koreans in Japan: A Minority's Changing Relationship with Schools

    ERIC Educational Resources Information Center

    Okano, Kaori H.

    2004-01-01

    Koreans form the largest ethnic minority group in Japan. The present study explores the situation of Korean pupils in Japanese schools by analyzing recent changes in four areas:(1) governmental and school-level policies, (2) school level programs targeted at Korean children, (3) Korean pupils' academic achievements and (4) their micro-level…

  16. 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…

  17. 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…

  18. 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

  19. Transcatheter closure of patent ductus arteriosus and atrial septal defect without on-site surgical backup: a two-year experience in an African community.

    PubMed

    Animasahun, B A; Johnson, Adeyemi; Ogunkunle, O O; Idowu, O A; Bode-Thomas, F; Maheshwari, Sunita; Omokhodion, S I; Njokanma, O F

    2014-01-01

    Congenital heart disease contributes significantly to the health burden of children in Nigeria. Interventions for congenital heart disease have been available in the developed world since the first report on device closure of patent ductus arteriosus (PDA) in 1967 by Porstmann. However, this did not start in Nigeria until October 2010. This study aimed to document the profiles of the patients who had undergone interventions for congenital heart diseases since the availability of the procedure, the challenges encountered, and the prospects associated with the interventions at the study site. All the patients referred to undergo interventions for congenital heart disease at the study center between October 2010 and 2012 were studied. The profile of the patient, including diagnosis at referral, indication for interventions, and interventions performed, were documented. The patients ranged in age from 3 to 62 years (mean age, 13.54 ± 17.7 years), and the male-to-female ratio was 1:3. The diagnosis at referral included PDA in 10 (83 %) of the 12 patients and secundum atrial septal defect in 2 patients (17 %). They all had transcatheter closure of the defects. Interventional procedures for congenital heart diseases currently are available locally, but the high degree of manpower training required, the cost, and the local availability of consumables are major factors limiting their use. Regional and international collaboration could be mutually beneficial.

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

    ERIC Educational Resources Information Center

    Lee, Soyoung; Gorman, Brenda K.

    2009-01-01

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

  1. 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),…

  2. 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…

  3. 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 ...

  4. 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

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

    PubMed

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

    2016-02-01

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

  6. 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.

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

    PubMed

    Lee, Sang Bok

    2006-02-01

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

  8. Multifractal analysis of the Korean agricultural market

    NASA Astrophysics Data System (ADS)

    Kim, Hongseok; Oh, Gabjin; Kim, Seunghwan

    2011-11-01

    We have studied the long-term memory effects of the Korean agricultural market using the detrended fluctuation analysis (DFA) method. In general, the return time series of various financial data, including stock indices, foreign exchange rates, and commodity prices, are uncorrelated in time, while the volatility time series are strongly correlated. However, we found that the return time series of Korean agricultural commodity prices are anti-correlated in time, while the volatility time series are correlated. The n-point correlations of time series were also examined, and it was found that a multifractal structure exists in Korean agricultural market prices.

  9. Preventive Health Services Utilization Among Korean Americans.

    PubMed

    Kim, Kyeongmo; Casado, Banghwa Lee

    2016-01-01

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

  10. 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.

  11. Analysis of the occupational stress of Korean surgeons: a pilot study

    PubMed Central

    Kang, Sang-Hee; Lee, Ji-Sung; Ji, Woong-Bae; Yoo, Byoung-Eun; You, Ji-Young

    2013-01-01

    Purpose Surgeons serve one of the most challenging and stressful professions. Ineffective control of occupational stress leads to burnout of the surgeon. The aim of this study was to obtain preliminary data on the sources and the degree of stress of surgeons and to determine the feasibility of the survey. Methods A total of 63 surgeons in our three affiliated hospitals were enrolled in this study. Fifty-five questions were used to assess the demographics, characteristics and Korean occupational stress scale (KOSS), which were prepared and validated by the National Study for Development and Standardization of Occupational Stress. Results Forty-seven of the 63 surgeons participated in this study (74.6%). The mean KOSS score of the survey was 50.9 ± 8.55, which was significantly higher than that of other professions (P < 0.01). Drinking and smoking habits were not related to the KOSS score. Doing exercise was related to a low KOSS score in terms of low KOSS total score (P < 0.01). Average duty hours (P < 0.01) and night duty days per week (P = 0.01) were strongly related to higher KOSS in the linear regression analysis. Conclusion This is the first study to evaluate job stress of surgeons in Korea. This study showed that Korean Surgeons had higher occupational stress than other Korean professions. A larger study based on this pilot study will help generate objective data for occupational stress of Korean Surgeons by performing a survey of the members of the Korean Surgical Society. PMID:23646310

  12. 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,…

  13. 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.

  14. Current Developments in Sino-Korean Studies

    ERIC Educational Resources Information Center

    Hashimoto, Mantaro J.

    1977-01-01

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

  15. Using PGD to reduce surgical infection risk.

    PubMed

    Archyangelio, Annesha; Shakhon, Amritpal

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

  16. Surgical site infections in cardiac surgery: microbiology.

    PubMed

    Söderquist, Bo

    2007-09-01

    Coagulase-negative staphylococci (CoNS) are the most common bacteria isolated from infections following cardiac surgery. CoNS display various virulence factors, such as toxins, adhesive proteins and biofilm production. The Staphylococcus epidermidis surface (Ses) protein I and the ica operon encoding the polysaccharide intercellular adhesin (PIA) are discussed in more detail. Although several of these virulence factors are prevalent among CoNS isolates causing sternal wound infections, they do not represent a prerequisite for causing an infection and that emphasizes that host factors may be as important.

  17. Surgical research IV.

    PubMed

    Toledo-Pereyra, Luis H

    2010-08-01

    Harvey W. Cushing (1869-1939) is the only surgeon represented in Surgical Research IV and one of the most accomplished American contributors to surgical research in general and to neurological and endocrine surgery research in particular. Other surgical research leaders of the 19th and 20th centuries who preceded Harvey Cushing have been introduced before. First, we highlighted the "importance of medical and surgical research" as the basic elements in the advancement of medicine and surgery could be considered as Surgical Research I. Second, in Surgical Research II, we presented William Beaumont, Samuel Gross, and William Halsted as the most important participants of the first wave of American surgical researchers. Next, in Surgical Research III, we considered surgeon researchers who moved ahead in the field of surgery with their research initiatives at the time, including John B. Murphy, the Mayo Brothers William J. and Charles H. Mayo, and George W. Crile. With Harvey Cushing, we enter an era of surgical research associated with neurosurgery and endocrine surgery as part of Surgical Research IV. PMID:20690841

  18. 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…

  19. 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…

  20. 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…

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

    ERIC Educational Resources Information Center

    Kim, Minjung; Stoel-Gammon, Carol

    2011-01-01

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

  2. 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…

  3. Talus fractures: surgical principles.

    PubMed

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

    2009-01-01

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

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

    PubMed

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

    2016-09-01

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

  5. A systematic review and meta-analysis including GRADE qualification of the risk of surgical site infections after prophylactic negative pressure wound therapy compared with conventional dressings in clean and contaminated surgery

    PubMed Central

    De Vries, Fleur E.E.; Wallert, Elon D.; Solomkin, Joseph S.; Allegranzi, Benedetta; Egger, Matthias; Dellinger, E. Patchen; Boermeester, Marja A.

    2016-01-01

    Abstract Objective: Systematically review and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) studies on prophylactic negative pressure wound therapy (pNPWT) to prevent surgical site infections (SSIs). Introduction: pNPWT has been suggested as a new method to prevent wound complications, specifically SSIs, by its application on closed incisional wounds. Methods: This review was conducted as part of the development of the Global Guidelines for prevention of SSIs commissioned by World Health Organization in Geneva. PubMed, Embase, CENTRAL, CINAHL, and the World Health Organization database between January 1, 1990 and October 7, 2015 were searched. Inclusion criteria were randomized controlled trials and observational studies comparing pNPWT with conventional wound dressings and reporting on the incidence of SSI. Meta-analyses were performed with a random effect model. GRADE Pro software was used to qualify the evidence. Results: Nineteen articles describing 21 studies (6 randomized controlled trials and 15 observational) were included in the review. Summary estimate showed a significant benefit of pNPWT over conventional wound dressings in reducing SSIs in both randomized controlled trials and observational studies, odds ratio of 0.56 (95% confidence interval, 0.32–0.96; P = 0.04) and odds ratio of 0.30 (95% confidence interval, 0.22–0.42; P < 0.00001), respectively. This translates into lowering the SSI rate from 140 to 83 (49–135) per 1000 patients and from 106 to 34 (25–47) per 1000 patients, respectively. In stratified analyses, these results were consistent in both clean and clean-contaminated procedures and in different types of surgery, however results were no longer significant for orthopaedic/trauma surgery. The level of evidence as qualified with GRADE was however low. Conclusions: Low-quality evidence indicates that prophylactic NPWT significantly reduces the risk of SSIs. PMID:27603360

  6. 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

  7. 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.

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

    ERIC Educational Resources Information Center

    Choe, Yongjae Paul

    2001-01-01

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

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

    ERIC Educational Resources Information Center

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

    2001-01-01

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

  10. 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…

  11. 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...#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8695 of July 26, 2011 National Korean War... than ever. We remember our common values and shared suffering during the Korean War, and we continue...

  12. 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…

  13. 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…

  14. 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…

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

    ERIC Educational Resources Information Center

    Lee, Jeong-Kyu

    1998-01-01

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

  16. Syllable and Letter Knowledge in Early Korean Hangul Reading

    ERIC Educational Resources Information Center

    Cho, Jeung-Ryeul

    2009-01-01

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

  17. 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,…

  18. Language used by Korean and Korean American children to describe emotional reactions to illness and hospitalization.

    PubMed

    Park, Jeong-Hwan; Foster, Roxie; Sufen Cheng

    2009-04-01

    Most children experience emotional distress during hospitalization. However, existing instruments for assessing emotional status in hospitalized children have limitations. To address this, the authors determine the language that Korean and Korean American children use to describe emotions that may relate to illness and hospitalization. Using a descriptive exploratory design, projective method, and card sort, the study is conducted in six Korean ethnic churches in the Midwest metropolitan area of United States and uses a convenience sample consisting of 94 children, ages 7 to 12 years. Fifteen English emotion words and 13 Korean emotion words are chosen by at least 50% of the Korean-American and Korean children, and children's emotional responses are expressed differently in Korean and English. Health care providers should be cautious about direct translation, because cultural nuances can convey different meanings in another language. In preparation for the rapid growth of minority children in the United States, health care providers should understand cultural perspectives related to minority children's experiences of health and illness and provide linguistically and culturally appropriate care.

  19. Acoustic characteristics of Korean stops in Korean child-directed speech

    NASA Astrophysics Data System (ADS)

    Kim, Minjung; Stoel-Gammon, Carol

    2005-04-01

    A variety of cross-linguistic studies have documented that the acoustic properties of speech addressed to young children include exaggeration of pitch contours and acoustically salient features of phonetic units. It has been suggested that phonetic modifications of child-directed speech facilitate young children's speech perception by providing detailed phonetic information about the target word. While there are several studies reporting vowel modifications in speech to infants (i.e., hyper-articulated vowels), there has been relatively little research about consonant modifications in speech to young children (except for VOT). The present study examines acoustic properties of Korean stops in Korean mothers' speech to their children aged 29 to 38 months (N=6). Korean tense, lax, and aspirated stops are all voiceless in word-initial position, and are perceptually differentiated by several acoustic parameters including VOT, f0 of the following vowel, and the amplitude difference of the first and second harmonics at the voice onset of the following vowel. This study compares values of these parameters in Korean motherese to those in speech to adult Koreans from same speakers. Results focus on the acoustic properties of Korean stops in child-directed speech and how they are modified to help Korean young children learn the three-way phonetic contrast.

  20. 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…

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

    ERIC Educational Resources Information Center

    So, Kyunghee; Kim, Jungyun; Lee, Sunyoung

    2012-01-01

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

  2. Surgical treatment of snoring & obstructive sleep apnoea.

    PubMed

    Ephros, Hillel D; Madani, Mansoor; Yalamanchili, Sumitra C

    2010-02-01

    Obstructive sleep apnoea (OSA) syndrome is a potentially serious disorder affecting millions of people around the world. Many of these individuals are undiagnosed while those who are diagnosed, often exhibit poor compliance with nightly use of continuous positive airway pressure (CPAP), a very effective nonsurgical treatment. Various surgical procedures have been proposed to manage and, in some cases, treat OSA. In this article we review methods used to assess the sites of obstruction and a number of surgical procedures designed to address OSA. Effective surgical management of OSA depends upon developing a complete database and determining different levels of obstruction, which may include nasal, nasopharyngeal, oropharyngeal, and hypopharyngeal/retrolingual, or a combination of these sites. A systematic approach to clinical evaluation, treatment planning and surgical management is recommended and is likely to result in more predictable outcomes. Surgical treatment may involve various procedures that are performed in different stages depending on the patient's sites of obstruction. The most commonly performed procedures include nasal reconstruction, uvulopalatopharyngoplasty (UPPP), advancement genioplasty, mandibular osteotomy with genioglossus advancement, and hyoid myotomy and suspension. In more severe cases, maxillomandibular advancement (MMA) with advancement genioplasty may be indicated. Even after appropriate surgical treatment, some patients may demonstrate continued obstruction with associated symptoms. Published indications for surgical treatment include an elevated respiratory disturbance index (RDI) with excessive daytime somnolence (EDS), oxygen desaturations below 90 per cent, medical co-morbidities including hypertension and arrhythmias, anatomic abnormalities of the upper airway and failure of medical treatment. The success of surgery in OSA is generally measured by achieving a (RDI) of less than 5, improvement of oxygen nadir to 90 per cent or

  3. 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.

  4. Anthropometry of Korean female industrial workers.

    PubMed

    Fernandez, J E; Malzahn, D E; Eyada, O K; Kim, C H

    1989-05-01

    This paper presents the results of an anthropometric survey conducted on Korean female workers in the garment industry. The data was collected as part of a project to modify work stations that utilized equipment from other countries. A set of 23 body dimensions were taken from a sample of 101 workers (aged 18-28 years). The anthropometric measurements are presented and compared with those of the Western and Japanese female. The results indicate that the body dimensions of the Korean female are different from those of both the Western and the Japanese female. The ratio of sitting height to standing height for the Korean female is closer to that of the Western female than it is the Japanese female.

  5. 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.

  6. Total antioxidant capacity of the Korean diet

    PubMed Central

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

    2014-01-01

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

  7. Surgical progress: surgical management of infective endocarditis.

    PubMed Central

    Mills, S A

    1982-01-01

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

  8. A Sketch of Language History in the Korean Peninsula

    PubMed Central

    Lee, Sean

    2015-01-01

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

  9. 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.

  10. Korean American Adolescent Depression and Parenting

    PubMed Central

    Kim, Eunjung; Cain, Kevin C.

    2010-01-01

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

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

    PubMed

    Chang, Bocheol

    2010-01-01

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

  12. A Database of Gene Expression Profiles of Korean Cancer Genome.

    PubMed

    Kim, Seon-Kyu; Chu, In-Sun

    2015-09-01

    Because there are clear molecular differences entailing different treatment effectiveness between Korean and non-Korean cancer patients, identifying distinct molecular characteristics of Korean cancers is profoundly important. Here, we report a web-based data repository, namely Korean Cancer Genome Database (KCGD), for searching gene signatures associated with Korean cancer patients. Currently, a total of 1,403 cancer genomics data were collected, processed and stored in our repository, an ever-growing database. We incorporated most widely used statistical survival analysis methods including the Cox proportional hazard model, log-rank test and Kaplan-Meier plot to provide instant significance estimation for searched molecules. As an initial repository with the aim of Korean-specific marker detection, KCGD would be a promising web application for users without bioinformatics expertise to identify significant factors associated with cancer in Korean. PMID:26523133

  13. Surgical management of primary retroperitoneal hydatid cyst.

    PubMed

    Singh, Hardev; Walia, Darshanjit Singh; Samra, Navdeep Singh; Kaur, Sarbarinder; Gill, Daljit Singh; Mahna, Vijay Kumar

    2005-06-01

    Hydatid disease is caused by the cystic stage of infestation by Echinococcus granulosus. Most hydatid cysts occur in the liver followed in frequency by the lung but no site is immune. Hydatid disease of the retroperitoneum is a rare condition. A case study is described here of a 30-year-old female with diagnosis of hydatid cyst of retroperitoneum which was treated surgically.

  14. Surgical Treatments for Fibroids

    MedlinePlus

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

  15. American Pediatric Surgical Association

    MedlinePlus

    ... Us Login The Hendren Project Resources Research Continuing Education Residents / Fellows Membership About APSA American Pediatric Surgical Association One Parkview Plaza, Suite 800 Oakbrook Terrace, IL 60181 USA Phone: +1-847-686-2237 Fax: +1-847- ...

  16. Guide to Surgical Specialists

    MedlinePlus

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

  17. Hernia Surgical Mesh Implants

    MedlinePlus

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

  18. Urogynecologic Surgical Mesh Implants

    MedlinePlus

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

  19. Disruptive visions: surgical education.

    PubMed

    Satava, R M

    2004-05-01

    Technological change, decreased financial support for medical education, and social oversight (in the form of the "To Err Is Human" report, HIPPA, and reduced work hours) are forcing a rethinking of the traditional model of surgical education to improve patient safety. New approaches to evaluating surgical competence, such as objective assessment, in combination with new technologies, such as the Internet and surgical simulators, provide the tools to effect a revolution in surgical education and training. Competency based upon quantifiable criteria measures must replace the traditional subjective assessment. The implementation requires accurately defining the elements of training, establishing new quantifiable metrics, stringently measuring performance against criterion, and reporting outcomes throughout the career of a surgeon.

  20. 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.

  1. 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. PMID:9409069

  2. 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…

  3. 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.

  4. Laparoscopic adrenalectomy: Surgical techniques

    PubMed Central

    Mellon, Matthew J.; Sethi, Amanjot; Sundaram, Chandru P.

    2008-01-01

    Since its first description in 1992, laparoscopic adrenalectomy has become the gold standard for the surgical treatment of most adrenal conditions. The benefits of a minimally invasive approach to adrenal resection such as decreased hospital stay, shorter recovery time and improved patient satisfaction are widely accepted. However, as this procedure becomes more widespread, critical steps of the operation must be maintained to ensure expected outcomes and success. This article reviews the surgical techniques for the laparoscopic adrenalectomy. PMID:19468527

  5. 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

  6. 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

  7. Laparoscopic gastric bypass vs sleeve gastrectomy in obese Korean patients

    PubMed Central

    Park, Ji Yeon; Kim, Yong Jin

    2015-01-01

    AIM: To compare the mid-term outcomes of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in obese Korean patients. METHODS: All consecutive patients who underwent either LSG or LRYGB with primary to treat morbid obesity between January 2011 and December 2012 were retrospectively reviewed. Patients with a body mass index (BMI) ≥ 30 kg/m2 with inadequately controlled obesity-related comorbidities (e.g., diabetes, obstructive sleep apnea, hypertension, or obesity-related arthropathy) or BMI ≥ 35 kg/m2 were considered for bariatric surgery according to the International Federation for the Surgery of Obesity-Asia Pacific Chapter Consensus statements in 2011. The decision regarding the procedure type was made on an individual basis following extensive discussion with the patient about the specific risks associated with each procedure. All operative procedures were performed laparoscopically by a single surgeon experienced in upper gastrointestinal surgeries. Baseline demographics, perioperative surgical outcomes, and postoperative anthropometric data from a prospectively established database were thoroughly reviewed and compared between the two surgical approaches. RESULTS: One hundred four patients underwent LSG, and 236 underwent LRYGB. Preoperative BMI in the LSG group was significantly higher than that of the LRYGB group (38.6 kg/m2 vs 37.2 kg/m2, P = 0.024). Patients with diabetes were more prevalent in the LRYGB group (18.3% vs 35.6%, P = 0.001). Operating time and hospital stay were significantly shorter in the LSG group compared with the LRYGB group (100 min vs 130 min, P < 0.001; 1 d vs 2 d, P = 0.003), but the incidence of perioperative complications was similar between the groups (P = 0.351). The mean percentage of excess weight loss (%EWL) was 71.2% for LRYGB, while it was 63.5% for LSG, at mean follow-up periods of 18.0 and 21.0 mo, respectively (P = 0.073). The %EWL at 1, 3, 6, 12, 18, 24, and 36 mo was equivalent

  8. 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…

  9. Dietary Reference Intakes for Koreans (KDRIs).

    PubMed

    Paik, Hee Young

    2008-01-01

    For more than 40 years, Recommended Dietary Allowances for Koreans (KRDA) were used as references for nutrient intake. In 2002, the Korean Nutrition Society organized a committee to revise the KRDA, which were transformed into the new Dietary Reference Intakes for Koreans (KDRIs) in 2005. KDRIs include Estimated Average Requirements (EAR), Recommended Intake (RI), Adequate Intake (AI) and Tolerable Upper Intake Level (UL) for protein, essential amino acids and micronutrients, Estimated Energy Requirement (EER) for energy and Acceptable Macronutrients Distribution Ranges (AMDR) for macronutrients. Evidence-based methods were used to determine the reference value (s) and the levels of nutrient intake for each nutrient. The KDRIs expanded significantly the number of nutrients and the basic concepts of nutrient recommendations compared to the previously used KRDA. In addition, a new food guide, depicted as Food Tower for Koreans, was developed and appended to the KDRIs publication. Continued efforts are needed to facilitate the application of KDRIs as well as to improve the understanding of the concepts. Additional modifications will be made as more scientific data become available.

  10. Japanese/Korean Linguistics, Volume 8.

    ERIC Educational Resources Information Center

    Silva, David J., Ed.

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

  11. 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…

  12. 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…

  13. Constraints on Noun Incorporation in Korean.

    ERIC Educational Resources Information Center

    Khym, Hangyoo

    1997-01-01

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

  14. 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

  15. 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…

  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. 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,…

  18. Korean Teachers' Attitudes toward Academic Brilliance

    ERIC Educational Resources Information Center

    Lee, Seon-Young; Cramond, Bonnie; Lee, Jongyeun

    2004-01-01

    This is a replication of a study designed by Tannenbaum (1962) and repeated by Cramond and Martin (1987) measuring U.S. attitudes toward intelligence by having respondents rate 8 hypothetical students who varied in their combinations of athleticism, effort, and academic ability. This study investigated 132 Korean preservice and in-service…

  19. 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…

  20. 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…

  1. 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)

  2. 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

  3. 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.

  4. [Electoro-surgical device].

    PubMed

    Matsumura, Yuji

    2009-07-01

    Electro-surgical device is an essential instrument for bloodless surgery after the 1st introduction by Harvey Cushing in 1926. Basal mechanisms of electric scalpels (monopolar and bipolar), current waveforms (cut, coagulation and blend), high-frequency currents and electrical shocks were commented. After 1990s, several new electro-surgical devices such as argon beam coagulator, bipolar scissors and vessel sealing system (LigaSure) were developed and introduced in chest surgery. Argon beam coagulator is useful in sealing and hemostasis of bleeding from chest walls after extrapleural dissections. Bipolar scissors can seal small vessels less than diameter 2 mm and is useful in mediastinal lymphnode dissections. Vessel sealing system is able to seal and cut vessels up to diameter 7 mm. LigaSure V is the most suitable instrument for thymic vein handling in thoracoscopic thymectomy. Clinical applications of these new surgical devices in chest surgery are discussed. PMID:20715684

  5. Surgical prosthetic treatment

    PubMed Central

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

    2010-01-01

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

  6. [Pulmonary Echinococcosis: Surgical Aspects].

    PubMed

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

    2015-10-01

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

  7. Stitches (Surgical Sutures)

    MedlinePlus

    ... Notice This Site and third parties who place advertisements on this Site may collect and use information ... Site and other websites in order to provide advertisements about goods and services of interest to you. ...

  8. 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.

  9. 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

  10. 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

  11. 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

  12. 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.

  13. The Human Microbiome and Surgical Disease

    PubMed Central

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

    2015-01-01

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

  14. Surgical wound care - open

    MedlinePlus

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

  15. Surgical treatment of constipation.

    PubMed

    Błachut, K; Bednarz, W; Paradowski, L

    2004-01-01

    Constipation is a common symptom in clinical practice. Definition of constipation includes abnormal bowel frequency, difficulty during defecation and abnormal stool consistency. There are many classifications of constipation based on constipation etiology (constipation in healthy people caused by life style, constipation as a symptom of digestive tract diseases, secondary constipation in the course of systemic disorders or associated with drugs) and/or constipation mechanisms (functional, mechanical). The numerous disorders leading to constipation make often diagnostic management difficult and complicated. Treatment of constipation includes dietary and behavioral approaches, pharmacologic therapy and in selected patient surgical treatment. Surgical treatment is recommended in young patients with severe slow transit constipation refractory to conservative treatment. Confirmation of indication to surgical treatment requires studies of colonic and anorectal function (colonic transit studies, anorectal manometry, studies of defecation). Preferred surgical technique is colectomy with ileorectal anastomosis. Authors reported good results and patient satisfaction in 50-100 percent of cases. Postoperative complications include intestinal obstruction, abdominal pain, flatulence, diarrhea. PMID:15631313

  16. Ancient Egyptian surgical heritage.

    PubMed

    Saber, Aly

    2010-12-01

    Egyptian medicine influenced the medicine of neighboring cultures, including the culture of ancient Greece. From Greece, its influence spread onward, thereby affecting Western civilization significantly. The oldest extant Egyptian medical texts are six papyri: The Edwin Smith Surgical Papyrus and the Ebers Medical Papyrus are famous. PMID:21208098

  17. Hwabyung: the construction of a Korean popular illness among Korean elderly immigrant women in the United States.

    PubMed

    Pang, K Y

    1990-12-01

    The cultural construction of Hwabyung, a Korean culture-bound syndrome, is explored among a sample of 20 elderly Korean immigrant women in the United States. Hwabyung results when distressed emotions associated with the specifically Korean way of perceiving and reacting to intolerable and tragic life situations cause bodily symptoms by interfering with the harmony of "Ki" (vital energy). Korean elderly immigrants report a broad range of symptoms associated with Hwabyung; they less frequently report the epigastric mass, which had been considered the cardinal symptom by cosmopolitan and traditional medical writers. Hwabyung is treated holistically with psychosocial support from family, spiritual comfort, home and popular remedies, traditional Korean medicine, and biomedical treatments. Hwabyung provides a way of conceptualizing and resolving emotional distress through somatization among Korean elderly immigrant women.

  18. 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

  19. Characterization of Korean native goat lactoferrin.

    PubMed

    Nam, M S; Shimazaki, K; Kumura, H; Lee, K K; Yu, D Y

    1999-06-01

    We purified lactoferrin from the colostrum of the Korean native goat (Capra hircus) by ion-exchange chromatography using CM-Toyopearl 650M followed by affinity chromatography on AF-Heparin Toyopearl 650M. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analysis suggested the molecular mass of Korean native goat lactoferrin is 82 kDa with an iron saturation of 30% as estimated by spectroscopic analysis. Circular dichroism analysis shows goat lactoferrin molecule contains 24.5%, alpha-helix; 36.0%, beta-structure; 13.5%, beta-turn and 26.0%, unordered structure. Heparin binding affinity is the same as that of bovine lactoferrin, but lower than that of human lactoferrin. An analysis using synthetic peptides shows that the peptide from residue 22 to 31--WQRRMRKLGA--exerts a positive heparin-binding ability.

  20. Psycholinguistic Evidence for Inverse Scope in Korean.

    PubMed

    Lee, Sunyoung; O'Grady, William

    2016-08-01

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

  1. A review of wide surgical excision of hidradenitis suppurativa

    PubMed Central

    2012-01-01

    Background Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disorder that involves the infundibular terminal follicles in areas rich of apocrine glands. It can be associated with fistulating sinus, scarring and abscesses formation. Hidradenitis suppurativa is a challenging aspect and requires a proper treatment plan which may involve different specialties. We present herein the option of surgical treatment involving wide surgical excision and methods of reconstruction as well as the rate of recurrence. Furthermore, review of the literature regarding surgical treatment of hidradenitis suppurativa is provided. Methods A retrospective analysis reviewed 50 operative procedures for 32 patients in 5 anatomical sites. These anatomical sites have been divided to 23 sites involving the axilla, 17 sites involving the inguinal region and 8 sites involving the perianal/perineal area, 1 site involving the gluteal region and 1 site involving the trunk region. Results Twenty six patients (81, 25 %) showed no recurrence after surgery and the average time of hospital stay period was 5 days. Recurrence was observed only in 6 patients (18, 75 %). Conclusion Elimination of the acute inflammatory process should occur in advance, including the use of antibiotics and minor surgeries such as abscess drainage with proper irrigations. After stabilizing the acute phase, wide surgical excision is recommended. Herein, planning of surgical reconstruction should be initiated to achieve the best outcome and consequently decreasing the risk of recurrence and complications after surgery. PMID:22734714

  2. Raising children in America: Korean parents' experiences.

    PubMed

    Choi, H; Dancy, B L; Lee, J

    2013-08-01

    This qualitative description study was designed to describe Korean American parents' perceptions of challenges and difficulties they encounter while raising their children in the USA. A convenience sampling of 21 parents of adolescents aged 11-14 years recruited from the Midwest Korean American community participated in the study. Data were collected using in-depth, face-to-face interviews, which took place in agreed-upon, convenient locations. All interviews were audiotaped and transcribed in Korean and the transcripts were translated into English. Qualitative content analysis revealed that the main stresses that parents encountered while raising their children in the USA were inability to advocate for children, feeling uneasy and insecure about incompatible American culture, ambivalence towards children's ethnic identities, and feeling alienated. In relation to these stresses, parents often felt inadequate, ashamed, guilty, regretful and powerless. The findings demonstrated the importance of understanding parents' feelings that are deeply embedded in the conflicted parent-child relationships and their perceptions of being parents in the USA. The present study highlights the need for and importance of providing intervention programmes for parents, particularly programmes that would empower parents, strengthen parent-child relationships and address ways to integrate two very different cultures while upholding ethnic identity and pride.

  3. Heredity of acne in Korean patients.

    PubMed

    Cho, Eun Byul; Ha, Ji Min; Park, Eun Joo; Kim, Kwang Ho; Kim, Kwang Joong

    2014-10-01

    Acne is a chronic inflammatory disease of the pilocebaceous unit that presents with various spectrum and severity. Genetic backgrounds and environmental factors are also considered to be relevant, but few studies have focused on Korean patients. A cross-sectional epidemiologic study on family history of Korean acne patients was performed to analyze family history of acne, and to compare the severity and characteristics of acne in association with family history. A total of 221 patients were enrolled, 98 male (44.3%) and 123 female (55.7%). Patients were grouped as patients with (A+) or without (A-) family history of acne. In a second analysis, patients with any experience of acne treatment were evaluated. Severity of acne was measured with Burton's grading system and Korean Acne Grading System (KAGS). Female patients had a higher tendency to have family history than males (P = 0.002). Group A+ had statistically significant earlier onset of acne (P = 0.002). In inexperienced patients, patients with family history showed a relatively earlier onset (P = 0.084). This study confirmed the role of heredity in acne. Family history of acne is associated with earlier onset of the disease, and more non-inflammatory lesions.

  4. Antimicrobial effect of Korean propolis against the mutans streptococci isolated from Korean.

    PubMed

    Kim, Min Jung; Kim, Chun Sung; Kim, Byung-Hoon; Ro, Sang-Bok; Lim, Yun Kyong; Park, Soon-Nang; Cho, Eugene; Cho, Engene; Ko, Jang-Hyuk; Kwon, Soon-Sung; Ko, Yeong-Mu; Kook, Joong-Ki

    2011-02-01

    The aim of this study was to determine the optimal concentration of Korean propolis against clinical isolates of mutans streptococci (MS) from Koreans. The antimicrobial activity was evaluated using the minimum inhibitory concentration (MIC) and time-kill curves against mutans streptococci. The MIC(90) values of propolis for MS were 35 μg/ml. Propolis had a bacteriostatic effect on Streptococcus mutans ATCC 25175(T) and bactericidal effects on Streptococcus sobrinus ATCC 33478(T) at > 2 × MIC (70 μg/ml). These results suggest that the propolis can be used in the development of oral hygiene products for the prevention of dental caries.

  5. [Surgical procedures for bone neoplasms in children].

    PubMed

    Woźniak, W

    1991-01-01

    The treatment of 40 patients with bone tumors have been presented. The primary tumors were located in the following sites: femur (14), tibia (8), fibula (4), humerus (4), scapula (1), clavicle (2), pelvis (5), hand (1). Investigated group were: osteosarcoma (18), Ewing's sarcoma (14), chondrosarcoma (2), fibrosarcoma (1), synovial sarcoma (1), chondroblastoma (4). In the most frequent malignant bone tumors, osteosarcoma and Ewing's sarcoma, unified management was adapted. The treatment was initiated with multidrug chemotherapy and followed by surgery or radiotherapy (Ewing's sarcoma) of the primary site. Surgery was performed in 30 cases: 19 mutilating operations because of the broad local invasion, 11 conservative surgical procedures (limb -- salvage operations). Satisfactory oncological and functional effect can be achieved after limb-salvage surgical procedures in the cases of localized, especially semimalignant bone tumors. PMID:1369876

  6. Brachymetatarsia. A new surgical approach.

    PubMed

    Martin, D E; Kalish, S R

    1991-01-01

    Although most practitioners are familiar with brachymetatarsia, it is a relatively uncommon clinical entity presenting for surgical correction. Traditional methods of surgical correction have been successful for the most part; however, a number of potentially devastating complications exist with these procedures. The authors present a review of the deformity, including the historical surgical techniques, and introduce a new surgical approach that minimizes the risk of complication. PMID:1993972

  7. Complete mitochondrial genomes of Korean lamprey (Lethenteron morii) and American brook lamprey (L. appendix).

    PubMed

    Pu, Jiafei; Ren, Jianfeng; Zhang, Zhe; Jia, Liang; Buchinger, Tyler; Li, Weiming

    2016-05-01

    The complete mitogenomes of two lampreys with complex taxonomic histories, the Korean lamprey (Lethenteron morii) and the American brook lamprey (L. appendix) were determined. Three-nt length difference between two genomes occurred on tRNA-Ser2 and control region 2. Except for 3 indel sites, there are 58 variable sites between two genomes which occurred on 11 of the 13 protein-coding genes (aside from COX3 and ND3) and 2 of rRNAs, tRNAs, control regions and intergenic regions. Among these sites, 15 sites are non-synonymous substitution sites occurred on 8 protein-coding genes including COX1-COX2, ND1-ND2, ND4-ND6 and ATPase6. Control region 1 contains 4 consecutive 39-nt repetitive strings and a 26-nt repetitive string in control region 2 is repeated 3.8 times in both lampreys. The observed level of similarity between nucleotide sequences (99.62%) implies the Korean lamprey and American brook lamprey are very close relatives and should be assigned into the same taxonomic genus.

  8. Surgical management of presbyopia

    PubMed Central

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

    2012-01-01

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

  9. 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.

  10. Postthrombotic Syndrome: Surgical Possibilities

    PubMed Central

    Khanna, Ajay K.; Singh, Shivanshu

    2012-01-01

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

  11. 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.

  12. Hepatic surgical anatomy.

    PubMed

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros

    2004-04-01

    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  13. 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

  14. Surgical lessons from the lake.

    PubMed

    Kothari, Shanu N

    2014-12-01

    After circumnavigating Lake Michigan during a sabbatical in the summer of 2011, the lessons learned from this experience and the surgical parallels between boating and life as a surgeon will be discussed. Topics will include the use of surgical checklists, teamwork and communication, leadership, and surgical mentorship. PMID:25440476

  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. Robotic surgical training.

    PubMed

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

    2013-01-01

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

  17. Robotic surgical training.

    PubMed

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

    2013-01-01

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

  18. Louis Pasteur surgical revolution.

    PubMed

    Toledo-Pereyra, Luis H

    2009-01-01

    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  19. 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.

  20. Different lymph node staging systems in patients with gastric cancer from Korean

    PubMed Central

    Lee, Jin Won; Ali, Bandar; Park, Cho Hyun; Song, Kyo Young

    2016-01-01

    Abstract To investigate whether the log odds of positive lymph nodes (LODDS) system is a more accurate prognostic tool than the number-based (pN) or ratio-based (rN) lymph node staging system in Korean patients with gastric cancer (GC). The LODDS is a recently proposed staging modality in surgical oncology. However, it is unclear whether LODDS is superior to the pN or rN system in terms of predicting the prognosis of GC patients who underwent radical gastrectomy with extended lymphadenectomy and had a greater number of retrieved lymph nodes. Clinicopathological data from 3929 patients who had undergone curative gastrectomy for GC were reviewed. In addition, overall survival rates according to pN and rN classification stratified by the LODDS were analyzed. A multivariate analysis of survival rate was performed using a Cox proportional hazard model. pN, rN, and LODDS were significantly correlated with 5-year survival rate. Spearman correlation test showed no correlation between LODDS and number of lymph nodes retrieved. The receiver operating characteristic (ROC) curves showed that the 3 staging systems had comparable prognostic accuracy (P < 0.05). Survival analysis according to pN and rN classification stratified by the LODDS staging system demonstrated that LODDS is superior to pN and rN. The LODDS is independently and significantly associated with the OS of Korean patients with GC, and its prognostic value is superior to that of the other lymph node staging systems in Korean patients. PMID:27336871

  1. 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…

  2. Eye Movements and Parafoveal Processing during Reading in Korean

    ERIC Educational Resources Information Center

    Kim, Young-Suk; Radach, Ralph; Vorstius, Christian

    2012-01-01

    Parafoveal word processing was examined during Korean reading. Twenty-four native speakers of Korean read sentences in two conditions while their eye movements were being monitored. The boundary paradigm (Rayner, 1975) was used to create a mismatch between characters displayed before and after an eye movement contingent display change. In the…

  3. To Compete, South Korean Universities Step Up Use of English

    ERIC Educational Resources Information Center

    Brender, Alan

    2005-01-01

    South Korean universities are aggressively promoting the use of English on their campuses and encouraging students to study English abroad, in a bid to strengthen their international standing and attract more foreign students. The South Korean government increased its efforts to attract more foreign students in 2005 by doing more overseas…

  4. 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…

  5. Correlates of Korean Hangul Acquisition among Kindergartners and Second Graders

    ERIC Educational Resources Information Center

    Cho, Jeung-Ryeul; McBride-Chang, Catherine

    2005-01-01

    In two separate studies, 100 South Korean kindergartners and 100 second graders were administered tests of speed of processing and phonological-processing skills as well as a Korean Hangul reading test. Speed of processing tasks were significantly correlated with most of the reading-related tasks but not with Hangul reading itself. Across studies,…

  6. 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…

  7. Interlanguage Pragmatic Features of Japanese and Korean Learners of English.

    ERIC Educational Resources Information Center

    Park, Kyung-Ja; Nakano, Michiko

    2001-01-01

    Focuses on the interlanguage pragmatic strategies used by Japanese and Korean learners of English. Data was collected from a project carried out jointly by Korean and Japanese university students. Observation, analysis, and discussion of student data suggest that interspeaker understanding and sensitivity to pragmatic variables of the target…

  8. 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…

  9. Gender Effect on Reading Comprehension with Korean EFL Learners

    ERIC Educational Resources Information Center

    Pae, Tae-Il

    2004-01-01

    This paper examines the effect of gender on English reading comprehension for Korean EFL (English as a Foreign Language) learners. The gender effect was measured using a DIF (Differential Item Functioning) methodology. Specifically, gender DIF was investigated for a random sample of 14,000 Korean examinees (7,000 males and 7,000 females) who took…

  10. 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…

  11. 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…

  12. Historic Factors Affecting Educational Administration in Korean Higher Education.

    ERIC Educational Resources Information Center

    Lee, Jeong-Kyu

    1999-01-01

    An official of the Korean Education Department Institute analyzes the effect of historic factors on current educational administration in Korea. He suggests that Confucianism, Shinto-Confucianism, Christianity, and Western ideas mainly dominate current Korean educational administration's organizational structure, culture, and leadership, while…

  13. 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…

  14. 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…

  15. New Challenges to Korean Universities: Increase of Older Students

    ERIC Educational Resources Information Center

    Chae, Jae-Eun

    2010-01-01

    This article explores the implications of the recent increase in older students at Korean universities dominated by younger students. A case study design is used to gain an in-depth understanding of experiences of older students in a Korean university. Semi-structured interviews of twelve older students, three professors, two administrators, and…

  16. 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... back, and fought their way north through hard mountains and bitter cold. We remember ordinary men...

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. Deconstruction of Cultural Dominance in Korean EFL Textbooks

    ERIC Educational Resources Information Center

    Song, Heejin

    2013-01-01

    This article examines patterns of cultural representations embedded in Korean EFL textbooks, using a content analysis to investigate how different cultures are reflected in textbooks and whether or not cultural biases are present. In the revised Korean national English curriculum that has been implemented since 2009, English is viewed as a…

  5. Segmental Properties of Input to Infants: A Study of Korean

    ERIC Educational Resources Information Center

    Lee, Soyoung; Davis, Barbara L.; MacNeilage, Peter F.

    2008-01-01

    Segmental distributions of Korean infant-directed speech (IDS) and adult-directed speech (ADS) were compared. Significant differences were found in both consonant and vowel patterns. Korean-speaking mothers using IDS displayed more frequent labial consonantal place and less frequent coronal and glottal place and fricative manner. They showed more…

  6. 75 FR 45035 - National Korean War Veterans Armistice Day, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-30

    .... (Presidential Sig.) [FR Doc. 2010-18987 Filed 7-29-10; 11:15 am] Billing code 3195-W0-P ... Proclamation 8543--National Korean War Veterans Armistice Day, 2010 Executive Order 13548--Increasing Federal... President ] Proclamation 8543 of July 26, 2010 National Korean War Veterans Armistice Day, 2010 By...

  7. 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…

  8. 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…

  9. Connectedness of Korean Adolescents: Profiles and Influencing Factors

    ERIC Educational Resources Information Center

    Shin, HaeJin; Yu, Kumlan

    2012-01-01

    The purpose of the present study was to identify profiles of Korean adolescent connectedness across multiple contexts (e.g., family, school, neighborhood, etc.), using cluster analysis. In addition, this study examined how the profiles of Korean adolescent connectedness are discriminated by demographic and adjustment-related variables. Data were…

  10. 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…

  11. Immigrant Parents' Involvement in American Schools: Perspectives from Korean Mothers

    ERIC Educational Resources Information Center

    Sohn, Soomin; Wang, X. Christine

    2006-01-01

    The purpose of this study is to investigate Korean immigrant mothers' perspectives on their involvement in American schools. In-depth interviews were conducted with six mothers. The findings indicated that the Korean mothers confronted difficulties while contacting teachers and participating in school activities. These difficulties included…

  12. 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:…

  13. Haplogroup Classification of Korean Cattle Breeds Based on Sequence Variations of mtDNA Control Region.

    PubMed

    Kim, Jae-Hwan; Lee, Seong-Su; Kim, Seung Chang; Choi, Seong-Bok; Kim, Su-Hyun; Lee, Chang Woo; Jung, Kyoung-Sub; Kim, Eun Sung; Choi, Young-Sun; Kim, Sung-Bok; Kim, Woo Hyun; Cho, Chang-Yeon

    2016-05-01

    Many studies have reported the frequency and distribution of haplogroups among various cattle breeds for verification of their origins and genetic diversity. In this study, 318 complete sequences of the mtDNA control region from four Korean cattle breeds were used for haplogroup classification. 71 polymorphic sites and 66 haplotypes were found in these sequences. Consistent with the genetic patterns in previous reports, four haplogroups (T1, T2, T3, and T4) were identified in Korean cattle breeds. In addition, T1a, T3a, and T3b sub-haplogroups were classified. In the phylogenetic tree, each haplogroup formed an independent cluster. The frequencies of T3, T4, T1 (containing T1a), and T2 were 66%, 16%, 10%, and 8%, respectively. Especially, the T1 haplogroup contained only one haplotype and a sample. All four haplogroups were found in Chikso, Jeju black and Hanwoo. However, only the T3 and T4 haplogroups appeared in Heugu, and most Chikso populations showed a partial of four haplogroups. These results will be useful for stable conservation and efficient management of Korean cattle breeds. PMID:26954229

  14. "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…

  15. Native and Nonnative Rater Behavior in Grading Korean Students' English Essays

    ERIC Educational Resources Information Center

    Lee, Hee-Kyung

    2009-01-01

    The purpose of the study is to investigate rating behavior between Korean and native English speaking (NES) raters. Five Korean English teachers and five NES teachers graded 420 essays written by Korean college freshmen and completed survey questionnaires. The grading data were analyzed with FACETS program. The results revealed Korean raters'…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. "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…

  3. 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…

  4. Clinical Effect of Acupotomy Combined with Korean Medicine: A Case Series of a Herniated Intervertebral Disc.

    PubMed

    Kim, Hyun-ji; Jeon, Ju-hyun; Kim, Young-il

    2016-02-01

    The aim of this study is to evaluate the effect of acupotomy for treating patients with a herniated intervertebral disc (HIVD). This case series includes five HIVD patients who were treated at the Department of Acupuncture and Moxibustion, Daejeon University Dunsan Korean Hospital, Daejeon, Korea, from January 2015 to April 2015. Acupotomy was performed three times over a 2-week period, along with Korean medical treatment. The outcomes were evaluated by using a numeric rating scale (NRS), physical examination, the Oswestry Low Back Pain Disability Index (ODI), the Short-Form 36-Item Health Survey (SF-36), and the Surgical Safety Checklist. The NRS and physical examination results, as well as the ODI scores, were improved in all cases. No significant differences were noted on the SF-36. No patients had any adverse effects. This study, with its findings of encouraging responses in reducing low back pain and radiating pain and in recovering the kinetic state of soft tissue, supports the potential use of acupotomy for the treatment of patients suffering from HIVD. PMID:26896075

  5. 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,…

  6. 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

  7. 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…

  8. 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…

  9. Prediction of ground motion and dynamic stress change in Baekdusan (Changbaishan) volcano caused by a North Korean nuclear explosion.

    PubMed

    Hong, Tae-Kyung; Choi, Eunseo; Park, Seongjun; Shin, Jin Soo

    2016-01-01

    Strong ground motions induce large dynamic stress changes that may disturb the magma chamber of a volcano, thus accelerating the volcanic activity. An underground nuclear explosion test near an active volcano constitutes a direct treat to the volcano. This study examined the dynamic stress changes of the magma chamber of Baekdusan (Changbaishan) that can be induced by hypothetical North Korean nuclear explosions. Seismic waveforms for hypothetical underground nuclear explosions at North Korean test site were calculated by using an empirical Green's function approach based on a source-spectral model of a nuclear explosion; such a technique is efficient for regions containing poorly constrained velocity structures. The peak ground motions around the volcano were estimated from empirical strong-motion attenuation curves. A hypothetical M7.0 North Korean underground nuclear explosion may produce peak ground accelerations of 0.1684 m/s(2) in the horizontal direction and 0.0917 m/s(2) in the vertical direction around the volcano, inducing peak dynamic stress change of 67 kPa on the volcano surface and ~120 kPa in the spherical magma chamber. North Korean underground nuclear explosions with magnitudes of 5.0-7.6 may induce overpressure in the magma chamber of several tens to hundreds of kilopascals. PMID:26884136

  10. 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

  11. Prediction of ground motion and dynamic stress change in Baekdusan (Changbaishan) volcano caused by a North Korean nuclear explosion.

    PubMed

    Hong, Tae-Kyung; Choi, Eunseo; Park, Seongjun; Shin, Jin Soo

    2016-01-01

    Strong ground motions induce large dynamic stress changes that may disturb the magma chamber of a volcano, thus accelerating the volcanic activity. An underground nuclear explosion test near an active volcano constitutes a direct treat to the volcano. This study examined the dynamic stress changes of the magma chamber of Baekdusan (Changbaishan) that can be induced by hypothetical North Korean nuclear explosions. Seismic waveforms for hypothetical underground nuclear explosions at North Korean test site were calculated by using an empirical Green's function approach based on a source-spectral model of a nuclear explosion; such a technique is efficient for regions containing poorly constrained velocity structures. The peak ground motions around the volcano were estimated from empirical strong-motion attenuation curves. A hypothetical M7.0 North Korean underground nuclear explosion may produce peak ground accelerations of 0.1684 m/s(2) in the horizontal direction and 0.0917 m/s(2) in the vertical direction around the volcano, inducing peak dynamic stress change of 67 kPa on the volcano surface and ~120 kPa in the spherical magma chamber. North Korean underground nuclear explosions with magnitudes of 5.0-7.6 may induce overpressure in the magma chamber of several tens to hundreds of kilopascals.

  12. Anisakiasis: Report of 15 Gastric Cases Caused by Anisakis Type I Larvae and a Brief Review of Korean Anisakiasis Cases

    PubMed Central

    Sohn, Woon-Mok; Na, Byoung-Kuk; Kim, Tae Hyo; Park, Tae-Joon

    2015-01-01

    The present study was performed to report 15 anisakiasis cases in Korea and to review the Korean cases reported in the literature. Total 32 Anisakis type I larvae were detected in the stomach of 15 patients by the endoscopy. Single worm was detected from 12 cases, and even 9 larvae were found from 2 cases. Epigastric pain was most commonly manifested in almost all cases, and hemoptysis and hematemesis were seen in 1 case each. Symptom manifestations began at 10-12 hr after eating fish in 73.3% cases. Endoscopy was performed 1-2 days after the symptom onset in most cases. The common conger, Conger myriaster, was the probable infection source in 7 cases. In the review of Korean anisakiasis cases, thus far, total 645 cases have been reported in 64 articles. Anisakis type I larva was the most frequently detected (81.3%). The favorable infection site of larvae was the stomach (82.4%). The common conger was the most probable source of human infections (38.6%). Among the total 404 cases which revealed the age and sex of patients, 185 (45.8%) were males, and the remaining 219 (54.2%) were female patients. The age prevalence was the highest in forties (34.7%). The seasonal prevalence was highest in winter (38.8%). By the present study, 15 cases of gastric anisakiasis are added as Korean cases, and some epidemiological characteristics of Korean anisakiasis were clarified. PMID:26323845

  13. Prediction of ground motion and dynamic stress change in Baekdusan (Changbaishan) volcano caused by a North Korean nuclear explosion

    NASA Astrophysics Data System (ADS)

    Hong, Tae-Kyung; Choi, Eunseo; Park, Seongjun; Shin, Jin Soo

    2016-02-01

    Strong ground motions induce large dynamic stress changes that may disturb the magma chamber of a volcano, thus accelerating the volcanic activity. An underground nuclear explosion test near an active volcano constitutes a direct treat to the volcano. This study examined the dynamic stress changes of the magma chamber of Baekdusan (Changbaishan) that can be induced by hypothetical North Korean nuclear explosions. Seismic waveforms for hypothetical underground nuclear explosions at North Korean test site were calculated by using an empirical Green’s function approach based on a source-spectral model of a nuclear explosion; such a technique is efficient for regions containing poorly constrained velocity structures. The peak ground motions around the volcano were estimated from empirical strong-motion attenuation curves. A hypothetical M7.0 North Korean underground nuclear explosion may produce peak ground accelerations of 0.1684 m/s2 in the horizontal direction and 0.0917 m/s2 in the vertical direction around the volcano, inducing peak dynamic stress change of 67 kPa on the volcano surface and ~120 kPa in the spherical magma chamber. North Korean underground nuclear explosions with magnitudes of 5.0-7.6 may induce overpressure in the magma chamber of several tens to hundreds of kilopascals.

  14. 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.

  15. CYP1A2 polymorphism and theophylline clearance in Korean non-smoking asthmatics

    PubMed Central

    Yim, Eun-Young; Kang, Hye-Ryun; Jung, Jae-Woo; Sohn, Seong-Wook

    2013-01-01

    Background Theophylline is mainly metabolized by cytochrome P450 (CYP) 1A2 and CYP2E1 which show inter-individual variations. However, the underlying mechanism remains unknown in humans. We investigated the relationship between differences in theophylline clearance and genetic polymorphisms in the CYP1A2 and CYP2E1 gene in 89 Korean asthmatic patients. Methods Polymerase chain reaction (PCR) was performed on the 5'-flanking region of those genes. PCR products were directly sequenced and confirmed using the SNaP shot method. We determined whether the detected SNPs affected gene transcription using electrophoretic mobility shift assay (EMSA). Theophylline clearance (mL/kg/h) was assessed by using a Bayesian approach. Results Genetic polymorphisms were identified at 7 sites in the CYP1A2 gene and at 10 sites in the CYP2E1. Among them, subjects with genotypes (GA+AA) of the -3860G>A polymorphism were found to show higher theophylline clearance than those with genotypes GG (29.11 ± 0.91 mL/kg/h vs. 26.12 ± 0.80 mL/kg/h, p = 0.014). This polymorphic site was revealed to be a protein binding site by conducting EMSA on nuclear hepatocyte extracts. Conclusion In conclusion, increased theophylline clearance was significantly related to the -3860G>A polymorphism, which could be associated with increased CYP1A2 inducibility in Korean non-smoking asthmatics. PMID:24260728

  16. 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.

  17. [Surgical indications in coexisting cataracts and glaucoma].

    PubMed

    Collignon-Brach, J D; Ravet, O; Robe-Collignon, N

    2000-01-01

    Cataract surgery in glaucoma patients remains a controversial subjects. Indication of surgery depends on a lot of clinical parameters: diagnosis, state, evolution of glaucoma as well as compliance with medical treatment--surgical procedures of cataract and glaucoma--sites of the surgery--use of antifibrosis agents and surgeon's experience. As cataract extraction alone decreases the intraocular pressure in open angle glaucoma and mainly in uncomplicated closed angle glaucoma and trabeculectomy alone reduces the intraocular pressure more than combined surgery with less complications we recommended the following surgical options: Cataract extraction alone in patients with controlled open angle glaucoma and in patients with closed angle glaucoma. A two step procedure: filtering surgery followed by cataract extraction in patients with poorly controlled open angle glaucoma or mixed closed angle glaucoma. Ambulatory surgery and topical anesthesia permit a two stages surgery with less inconveniences. A combined procedure in patients with a chronic closed angle glaucoma where filtering procedure alone is associated with important complications. Actually, the best surgical cataract procedure is phacoemulsification with a small supero-corneal incision and implantation of a foldable intraocular lens. The best filtering procedure remains trabeculectomy, or the new non penetrating trabecular surgery for experimented surgeons, in the superior quadrant. In the future new surgical procedures and new safe and non toxic pharmacologic drugs which modulate wound healing could be found in order to increase the efficacity and indications of combined surgery. PMID:11262885

  18. 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

  19. A case of colonic lymphoid tissue invasion by Gymnophalloides seoi in a Korean man

    PubMed Central

    Seo, Min; Chun, Hokyung; Ahn, Geunghwan; Jang, Kee-Taek; Guk, Sang-Mee

    2006-01-01

    A 65-year old Korean man, living in Mokpo-city, Jeollanam-do, Republic of Korea, visited a local clinic complaining of right upper quadrant pain and indigestion. At colonoscopy, he was diagnosed as having a carcinoma of the ascending colon, and thus, a palliative right hemicolectomy was performed. Subsequently, an adult fluke of Gymnophalloides seoi was incidentally found in a surgical pathology specimen of the lymph node around the colon. The worm was found to have invaded gut lymphoid tissue, with characteristic morphologies of a large oral sucker, a small ventral sucker, and a ventral pit surrounded by strong muscle fibers. This is the first reported case of mucosal tissue invasion by G. seoi in the human intestinal tract. PMID:16514288

  20. 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."

  1. Surgical treatment of osteomyelitis.

    PubMed

    Cierny, George

    2011-01-01

    Chronic osteomyelitis is refractory to nonsurgical treatment due to a resilient, infective nidus that harbors sessile, matrix-protected pathogens bound to substrate surfaces within the wound. Curative treatment mandates physical (surgical) removal of the biofilm colony, adjunctive use of antibiotics to eliminate residual phenotypes, and efforts to optimize the host response throughout therapy. Patient selection, therapeutic options, and the treatment format are determined by the Cierny/Mader staging system, while reconstruction is governed by the integrity/stability of the affected bone(s) and quality/quantity parameters of the soft-tissue envelope.

  2. Chronic Post Surgical Pain

    PubMed Central

    2011-01-01

    Chronic post-surgical pain (CPSP) is a recognised adverse consequence of surgery; surgery is common, therefore the population at risk is considerable. Putative risk factors for CPSP include genetic predisposition, demographic, clinical (pain history, type of surgery, anaesthesia, acute pain severity), and psychological factors (vulnerability vs resilience). Evidence of prevention is limited: long-term benefit from pre-emptive/perioperative analgesia has not been demonstrated consistently. Large scale prospective studies with detailed pre, intra and postoperative multifactorial assessments are required to refine understanding of the aetiology and prognosis of CPSP. PMID:26526062

  3. [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.

  4. Surgical management of an erupted complex odontoma occupying maxillary sinus

    PubMed Central

    Arunkumar, K. V.; Vijaykumar; Garg, Nitin

    2012-01-01

    The occurrence of complex odontomas is not considered to be rare in the jaws. But the occurence of large odontomas obscuring the maxillary sinus, or erupting into the oral cavity are considered to be rare. The prognosis is good with surgical excision and recurrence is nil. Most of the times the surgical site can be closed primarily, but sometimes requires local flaps to achieve tension free closure. Here, we report such a case treated by surgical excision trans orally followed soft tissue defect reconstruction with pedicled palatal island flap. PMID:23482681

  5. Surgical approaches for liver metastases in carcinoid tumors

    PubMed Central

    Saeed, Ahmad; Buell, Joseph

    2015-01-01

    Liver is the commonest site for metastasis in patients with neuroendocrine tumors (NETs); it occurs in 45-95% of patients. Available treatment options include surgical resection, liver transplantation, chemotherapy and biotherapy. Surgery is the gold standard for curative therapy. Typically, a multidisciplinary approach is a cornerstone for decision making while dealing with this aggressive disease. This review will focus on the performance and safety of open, laparoscopic, and liver transplant surgical approaches in NETs patients with liver metastases. PMID:26425458

  6. 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

  7. 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…

  8. Surgical quality in colorectal cancer

    PubMed Central

    Plummer, Joseph M.; Williams, Nadia; Leake, Pierre-Anthony; Ferron-Boothe, Doreen; Meeks-Aitken, Nicola; Mitchell, Derek I.; McFarlane, Michael E.; East, Jeffery

    2015-01-01

    Objective To determine the quality of surgical management offered to patients with colorectal cancer (CRC) as measured by adequacy of nodal resections and compare variations across the major hospitals in Jamaica. Method Data was obtained from the CRC Registry of patients diagnosed and treated surgically for CRC during the 3-year period commencing January 1, 2011. Variables analyzed included tumor site, stage and number of lymph nodes resected across hospitals. Results During the period under review 60% (349) of 586 patients had resections and formed the basis of this study. Of these 49% were treated at the UHWI, 27% from the KPH and STH, 15% from CRH and MRH and 8% from a private laboratory (DPS). Patient distribution was similar at UHWI compared to the others with mean age (61 vs 62) and with slightly more women having surgery (53% Vs 54%) (UHWI vs Others). For tumor grade, margin status, lymphovascular and depth of invasion (majority T3) there was no difference between UHWI and the other sites, although a smaller percentage of tumors treated at UHWI had Crohn's like reaction (p = 0.01). There was a larger proportion of sigmoid cancer at UHWI while the reverse trend was seen in cancers of the rectum (p = 0.027). The tumors treated at UHWI have a larger median number of regional nodes when compared to the other facilities (14 vs 10; p < 0.001) and also more likely to have positive nodes, as were women and younger patients. Comparison across facilities revealed that the proportion of tumors classed as well differentiated, circumferential margin involvement, and having lymphovascular invasion were higher for specimens processed at the private facility (p = 0.021, 0.035, 0.01 respectively). Histopathology reports of tumors treated at UHWI and DPS had median 14 and 18 nodes respectively while at NPH laboratory and CRH they were 9 and 10 respectively (p < 0.001), whilst those of the ascending, descending, sigmoid colon and rectum had median 15, 11, 13, 11

  9. A modular wireless in vivo surgical robot with multiple surgical applications.

    PubMed

    Hawks, Jeff A; Rentschler, Mark E; Farritor, Shane; Oleynikov, Dmitry; Platt, Stephen R

    2009-01-01

    The use of miniature in vivo robots that fit entirely inside the peritoneal cavity represents a novel approach to laparoscopic surgery. Previous work demonstrates that both mobile and fixed-based robots can successfully operate inside the abdominal cavity. A modular wireless mobile platform has also been developed to provide surgical vision and task assistance. This paper presents an overview of recent test results of several possible surgical applications that can be accommodated by this modular platform. Applications such as a biopsy grasper, stapler and clamp, video camera, and physiological sensors have been integrated into the wireless platform and tested in vivo in a porcine model. The modular platform facilitates rapid development and conversion from one type of surgical task assistance to another. These self-contained surgical devices are much more transportable and much lower in cost than current robotic surgical assistants. These devices could ultimately be carried and deployed by non-medical personnel at the site of an injury. A remotely located surgeon could use these robots to provide critical first response medical intervention.

  10. Validation of the ECOS-16 Questionnaire in Koreans with Osteoporosis

    PubMed Central

    Son, Seung Min; Goh, Tae Sik; Kim, Taek Hoon; Noh, Eun Yeong

    2016-01-01

    Study Design Prospective study. Purpose To evaluate the reliability and validity of the adapted Korean version of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (ECOS-16). Overview of Literature The validity of the Korean version of ECOS-16 has not been completely demonstrated. Methods Translation/retranslation of the English version of ECOS-16, and full cross-cultural adaptation were performed. The Korean version of a visual analog scale measure of pain, and the Korean versions of ECOS-16 and of the previously validated short form-36 (SF-36) were mailed to 158 consecutive patients with osteoporosis. Factor analysis and reliability assessment using kappa statistics of agreement for each item, intraclass correlation coefficient, and Cronbach's α were done. Construct validity was evaluated by comparing responses to ECOS-16 with responses to SF-36 using Pearson's correlation coefficient. Results Factor analysis extracted three factors. All items had a kappa statistics of agreement >0.6. The ECOS-16 showed good test/re-test reliability (0.8469) and internal consistency of Cronbach's α (0.897). The Korean version of ECOS-16 showed significant correlation with SF-36 total scores and with single SF-36 domains scores. Conclusions The adapted Korean version of the ECOS-16 was successfully translated and showed acceptable measurement properties. It is considered suitable for outcome assessments in Korean patients with osteoporosis. PMID:27790315

  11. 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.

  12. 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).

  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. Surgical Scar Revision: An Overview

    PubMed Central

    Garg, Shilpa; Dahiya, Naveen; Gupta, Somesh

    2014-01-01

    Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods. PMID:24761092

  15. Robotic Surgical Training in an Academic Institution

    PubMed Central

    Chitwood, W. Randolph; Nifong, L. Wiley; Chapman, William H. H.; Felger, Jason E.; Bailey, B. Marcus; Ballint, Tara; Mendleson, Kim G.; Kim, Victor B.; Young, James A.; Albrecht, Robert A.

    2001-01-01

    Objective To detail robotic procedure development and clinical applications for mitral valve, biliary, and gastric reflux operations, and to implement a multispecialty robotic surgery training curriculum for both surgeons and surgical teams. Summary Background Data Remote, accurate telemanipulation of intracavitary instruments by general and cardiac surgeons is now possible. Complex technologic advancements in surgical robotics require well-designed training programs. Moreover, efficient robotic surgical procedures must be developed methodically and safely implemented clinically. Methods Advanced training on robotic systems provides surgeon confidence when operating in tiny intracavitary spaces. Three-dimensional vision and articulated instrument control are essential. The authors’ two da Vinci robotic systems have been dedicated to procedure development, clinical surgery, and training of surgical specialists. Their center has been the first United States site to train surgeons formally in clinical robotics. Results Established surgeons and residents have been trained using a defined robotic surgical educational curriculum. Also, 30 multispecialty teams have been trained in robotic mechanics and electronics. Initially, robotic procedures were developed experimentally and are described. In the past year the authors have performed 52 robotic-assisted clinical operations: 18 mitral valve repairs, 20 cholecystectomies, and 14 Nissen fundoplications. These respective operations required 108, 28, and 73 minutes of robotic telemanipulation to complete. Procedure times for the last half of the abdominal operations decreased significantly, as did the knot-tying time in mitral operations. There have been no deaths and few complications. One mitral patient had postoperative bleeding. Conclusion Robotic surgery can be performed safely with excellent results. The authors have developed an effective curriculum for training teams in robotic surgery. After training, surgeons

  16. 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

  17. 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.

  18. [Transsexualism: indication and surgical treatment].

    PubMed

    Biemer, E; Kockott, G; Hartung, R

    1979-09-01

    After the diagnosis of transsexuality is well definated and recognized in most western countries, the surgical transformation of the genital area is performed. Before surgical treatment an exact psychiatric clarification is absolutely essential. The operation is the last part of a long treatment. The surgical result in the more common female transsexual is quite reasonable. The treatment of the fewer male transsexuals is not solved completely, especially the reliable techniques for penis reconstructions are not very sufficient.

  19. Activities of the Korean Institute of Tuberculosis

    PubMed Central

    Ryoo, Sungweon; Kim, Hee Jin

    2014-01-01

    The Korean National Tuberculosis Association (KNTA) set up the Korean Institute of Tuberculosis (KIT) in 1970 to foster research and technical activities pertaining to tuberculosis (TB). The KNTA/KIT had successfully conducted a countrywide TB prevalence survey from 1965 to 1995 at 5-year intervals. The survey results (decline in TB rates) established Korea as a country that had successfully implemented national control programs for TB. The KIT developed the Korea Tuberculosis Surveillance System and the Laboratory Management Information System, both of which were transferred to the Korea Centers for Disease Control and Prevention after its establishment. The KIT functions as a central and supranational reference TB laboratory for microbiological and epidemiological research and provides training and education for health-care workers and medical practitioners. Recently, the KIT has expanded its activities to countries such as Ethiopia, Laos, and Timor-Leste to support TB control and prevention. The KIT will continue to support research activities and provide technical assistance in diagnosing the infection until it is completely eliminated in Korea. PMID:25861580

  20. Korean Studies on Blood Stasis: An Overview

    PubMed Central

    Jung, Jeeyoun; Lee, Ju Ah; Yun, Kyung-Jin

    2015-01-01

    Blood stasis is one of the important pathological concepts in Korean medicine. We analyzed the Korean studies concerning blood stasis. We searched for articles in eight electronic databases from their inception to September, 2014. We included reviews, clinical studies, and preclinical studies that had studied blood stasis and excluded articles in which blood stasis was not mentioned or in which the original authors had not explained blood stasis. Of 211 total included studies, 19 were reviews, 52 were clinical studies, and 140 were preclinical articles. “Stagnant blood within the body” was the most frequently mentioned phrase of the traditional concept of blood stasis. Traumatic injury was the most frequently studied disease/condition in the clinical studies. In the preclinical studies, coagulopathy was studied most frequently, followed by hyperviscosity, hyperlipidemia, inflammation, neoplasm, ischemic brain injury, and atherosclerosis. Hyeolbuchukeo-tang and Angelicae Gigantis Radix were the most frequent formula and single herb, respectively, used in the blood stasis researches. The results showed that blood stasis was mainly recognized as disorder of circulation and many studies showed the effectiveness of activating blood circulating herbs for diseases and pathologies such as traumatic injury or coagulopathy. Further studies are needed in the pathologic mechanisms and various diseases of blood stasis. PMID:25821483

  1. Factors influencing BMI classifications of Korean adults.

    PubMed

    Chang, Ae Kyung; Choi, Jin Yi

    2015-05-01

    [Purpose] This study aimed to identify factors influencing the BMI classifications of 3,583 Korean adults using data from the fifth Korean National Health and Nutrition Examination Survey. [Subjects and Methods] Measures included lifestyle factors, physiologic factors, perceived health state, stress, subjective body recognition, health-related quality of life, and weight control behavior. [Results] Body perception scores were lower with underweight and higher with overweight and obesity than with a healthy weight. There was a lower proportion of underweight men and a higher proportion of overweight or obese men than women. Instances of Alcohol Use Identification Scores (AUDIT) ≥ 9 were proportionately lower with underweight and more with overweight or obesity relative to an AUDIT score < 9 with healthy weight. Hemoglobin A1c and systolic blood pressure were higher with obesity than with healthy weight. The total cholesterol level was greater with overweight and obesity than with healthy weight. [Conclusion] These results suggest that obesity intervention for adults should be based on age and sex and should include drinking habits and physical activity.

  2. 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. PMID:11133136

  3. Korean American mother and daughter communication on women's health topics.

    PubMed

    Park, Wansoo; Grindel, Cecelia Gatson

    2007-01-01

    The purpose of this study was to explore communication patterns about health behaviors and lifestyles between Korean mothers and daughters living in the United States. Demographic and general health information was also collected. Semi-structured interviews were conducted with nine Korean mother and daughter dyads. Korean mothers talked with their daughters about healthy diets and exercise but relied on daughters' schools to provide much of their daughters'health education information related to growth and developmental changes and women's health issues such as screening and HIV prevention practice. Intervention models to enhance mother/daughter health communication and to improve mothers' self care need to be investigated.

  4. 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.

  5. Surgical videos online: a survey of prominent sources and future trends.

    PubMed

    Dinscore, Amanda; Andres, Amy

    2010-01-01

    This article determines the extent of the online availability and quality of surgical videos for the educational benefit of the surgical community. A comprehensive survey was performed that compared a number of online sites providing surgical videos according to their content, production quality, authority, audience, navigability, and other features. Methods for evaluating video content are discussed as well as possible future directions and emerging trends. Surgical videos are a valuable tool for demonstrating and teaching surgical technique and, despite room for growth in this area, advances in streaming video technology have made providing and accessing these resources easier than ever before.

  6. Recent surgical management of gliomas.

    PubMed

    Sanai, Nader; Berger, Mitchel S

    2012-01-01

    Refinement of neurosurgical technique has enabled safer operations with more aggressive outcomes. One cornerstone of modern-day practice is the utilization of intraoperative stimulation mapping. In addition to identifying critical motor pathways, this technique can be adapted to reliable identify language pathways, as well. Given the individual variability of cortical language localization, such awake language mapping is essential to minimize language deficits following tumor resection. Our experience suggests that cortical language mapping is a safe and efficient adjunct to optimize tumor resection while preserving essential language sites, even in the setting of negative mapping data. However, the value of maximizing glioma resections remains surprisingly unclear, as there is no general consensus in the literature regarding the efficacy of extent of glioma resection in improving patient outcome. While the importance of resection in obtaining tissue diagnosis and to alleviate symptoms is clear, a lack of Class I evidence prevents similar certainty in assessing the influence of extent of resection. Beyond an analysis of modern intraoperative mapping techniques, we examine every major clinical publication since 1990 on the role of extent of resection in glioma outcome. The mounting evidence suggests that, despite persistent limitations in the quality of available studies, a more extensive surgical resection is associated with longer life expectancy for both low-grade and high-grade gliomas.

  7. Development of the two Korean adult tomographic computational phantoms for organ dosimetry

    SciTech Connect

    Lee, Choonsik; Lee, Choonik; Park, Sang-Hyun; Lee, Jai-Ki

    2006-02-15

    Following the previously developed Korean tomographic phantom, KORMAN, two additional whole-body tomographic phantoms of Korean adult males were developed from magnetic resonance (MR) and computed tomography (CT) images, respectively. Two healthy male volunteers, whose body dimensions were fairly representative of the average Korean adult male, were recruited and scanned for phantom development. Contiguous whole body MR images were obtained from one subject exclusive of the arms, while whole-body CT images were acquired from the second individual. A total of 29 organs and tissues and 19 skeletal sites were segmented via image manipulation techniques such as gray-level thresholding, region growing, and manual drawing, in which each of segmented image slice was subsequently reviewed by an experienced radiologist for anatomical accuracy. The resulting phantoms, the MR-based KTMAN-1 (Korean Typical MAN-1) and the CT-based KTMAN-2 (Korean Typical MAN-2), consist of 300x150x344 voxels with a voxel resolution of 2x2x5 mm{sup 3} for both phantoms. Masses of segmented organs and tissues were calculated as the product of a nominal reference density, the prevoxel volume, and the cumulative number of voxels defining each organs or tissue. These organs masses were then compared with those of both the Asian and the ICRP reference adult male. Organ masses within both KTMAN-1 and KTMAN-2 showed differences within 40% of Asian and ICRP reference values, with the exception of the skin, gall bladder, and pancreas which displayed larger differences. The resulting three-dimensional binary file was ported to the Monte Carlo code MCNPX2.4 to calculate organ doses following external irradiation for illustrative purposes. Colon, lung, liver, and stomach absorbed doses, as well as the effective dose, for idealized photon irradiation geometries (anterior-posterior and right lateral) were determined, and then compared with data from two other tomographic phantoms (Asian and Caucasian), and

  8. Neuronavigation. Principles. Surgical technique.

    PubMed

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  9. Surgical education in Mexico.

    PubMed

    Cervantes, Jorge

    2010-05-01

    Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital. PMID:19603225

  10. Neuronavigation. Principles. Surgical technique.

    PubMed

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques. PMID:20108488

  11. Metabolic syndrome related health inequalities in Korean elderly: Korean National Health and Nutrition Examination Survey (KNHAES).

    PubMed

    Kim, Hak-Seon

    2014-11-19

    While the prevalence of metabolic syndrome is increasing, little is presently known about this syndrome in Korean elderly. This study aimed to group metabolic risk factors and to examine the associations between groups of health living conditions and metabolic syndrome using data from the Korean National Health Examination and Nutritional Assessment (KNHANES). A total of 1,435 subjects aged over 65 years old with both biochemical and dietary data information were obtained from the 4th and 5th KNHANES (2007-2012). Using stratified and multistage probability sample data, five components of metabolic syndrome were adopted to identify health inequalities. Our findings show that groups of health living conditions such as dietary pattern, body image, muscle mass, and fat mass were differentially associated with metabolic syndrome risk factors. Future studies are necessary to examine the underlying mechanisms of individual health living conditions to better understand the role of metabolic risk factors in metabolic syndrome in elderly.

  12. 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

  13. Clinical implementation of a scrubless chlorhexidine/ethanol pre-operative surgical hand rub.

    PubMed

    Marchand, Richard; Theoret, Sylvie; Dion, Danielle; Pellerin, Michel

    2008-06-01

    The objective of surgical scrubbing is to reduce the bioburden on the hands of the surgical team in hope that if gloves are punctured or torn, the number of bacteria released at the operation site will be minimal and therefore reduce the risk of site infection. Long procedures with scrubbing and soaping can, however, be counterproductive because with repetition they tend to cause skin abrasions, damages and injuries without further reducing the risk of bacterial release. Within a general review of OR processes, it was decided to substitute to the standard surgical scrub a "new" scrubless pre-op surgical hand rub procedure. This article summarizes the results.

  14. Korean version of child perceptions questionnaire and dental caries among Korean children.

    PubMed

    Shin, Hye-Sun; Han, Dong-Hun; Shin, Myung-Seop; Lee, Hyun-Jin; Kim, Mi-Sun; Kim, Hyun-Duck

    2015-01-01

    Although dental caries has been a major oral health problem for children, the association between dental caries and oral health related quality of life has been still controversial. This study aims to evaluate the association between the Korean version of the Child Perceptions Questionnaire (K-CPQ) and dental caries among Korean children. Eight hundred one school children aged 8 to 14 years participated in this study. After the K-CPQ was validated we performed an association study. The K-CPQ was self-reported. Dental caries were evaluated by dentists using the World Health Organization Index. Correlation analyses (intraclass correlation coefficient, Cronbach's alpha and Pearson's correlation coefficient [r]) and linear regression models (partial r) including age, gender and type of school were applied. Untreated deciduous dental caries was associated with the K-CPQ(8-10) overall score (partial r = 0.15, P <0.05). The link was highlighted in the domains of functional limitation and emotional well-being. Filled teeth due to caries (FT) was associated with the K-CPQ11-14 overall domain (partial r = 0.14, P = 0.002) as well as with the oral symptoms domain (partial r = 0.16, P = 0.001). This association was highlighted among public school children. Our data indicate that K-CPQ was independently associated with dental caries. The K-CPQ could be a practical tool to evaluate the subjective oral health among Korean children aged 8 to 14.

  15. Management of Sport Injuries with Korean Medicine: A Survey of Korean National Volleyball Team

    PubMed Central

    Hwang, Eui-Hyoung; Kwon, Ojin

    2016-01-01

    The purpose of this study was to report the current state of Korean medicine (KM) treatment on sports injury by implementing survey with volleyball team medical doctors participating in 2013-2014 season. Six KM doctors completed a questionnaire that includes injury parameters: type, location, situation, and pain scores. We collected 166 injury cases from 94 Korean male and female national volleyball players. Knee (25.9%), low back (13.3%), elbow, and ankle (8.4%) injuries were most common. Joint (41.6%) and muscle (30.7%) were major injured tissues. KM team medical doctors utilized acupuncture (40.4%), chuna manual therapy (16.0%), physical therapy (15.2%), taping (9.0%), and cupping (7.8%) to treat volleyball injuries. Any types of medications were used infrequently. Additional physical and exercise therapy were preferred after receiving acupuncture (both 46.9%). This study presented the preliminary injury profile of Korean elite volleyball players. Injury and treatment parameters could be useful to build advanced KM model in sport medicine.

  16. Management of Sport Injuries with Korean Medicine: A Survey of Korean National Volleyball Team

    PubMed Central

    Hwang, Eui-Hyoung; Kwon, Ojin

    2016-01-01

    The purpose of this study was to report the current state of Korean medicine (KM) treatment on sports injury by implementing survey with volleyball team medical doctors participating in 2013-2014 season. Six KM doctors completed a questionnaire that includes injury parameters: type, location, situation, and pain scores. We collected 166 injury cases from 94 Korean male and female national volleyball players. Knee (25.9%), low back (13.3%), elbow, and ankle (8.4%) injuries were most common. Joint (41.6%) and muscle (30.7%) were major injured tissues. KM team medical doctors utilized acupuncture (40.4%), chuna manual therapy (16.0%), physical therapy (15.2%), taping (9.0%), and cupping (7.8%) to treat volleyball injuries. Any types of medications were used infrequently. Additional physical and exercise therapy were preferred after receiving acupuncture (both 46.9%). This study presented the preliminary injury profile of Korean elite volleyball players. Injury and treatment parameters could be useful to build advanced KM model in sport medicine. PMID:27651819

  17. Management of Sport Injuries with Korean Medicine: A Survey of Korean National Volleyball Team.

    PubMed

    Yang, Changsop; Lee, Eunyoung; Hwang, Eui-Hyoung; Kwon, Ojin; Lee, Jun-Hwan

    2016-01-01

    The purpose of this study was to report the current state of Korean medicine (KM) treatment on sports injury by implementing survey with volleyball team medical doctors participating in 2013-2014 season. Six KM doctors completed a questionnaire that includes injury parameters: type, location, situation, and pain scores. We collected 166 injury cases from 94 Korean male and female national volleyball players. Knee (25.9%), low back (13.3%), elbow, and ankle (8.4%) injuries were most common. Joint (41.6%) and muscle (30.7%) were major injured tissues. KM team medical doctors utilized acupuncture (40.4%), chuna manual therapy (16.0%), physical therapy (15.2%), taping (9.0%), and cupping (7.8%) to treat volleyball injuries. Any types of medications were used infrequently. Additional physical and exercise therapy were preferred after receiving acupuncture (both 46.9%). This study presented the preliminary injury profile of Korean elite volleyball players. Injury and treatment parameters could be useful to build advanced KM model in sport medicine. PMID:27651819

  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. 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).

  20. Developing Korean-specific equations of stature estimation.

    PubMed

    Jeong, Yangseung; Jantz, Lee Meadows

    2016-03-01

    This study aims to develop Korean-specific equations for stature estimation and compare their performance to existing techniques. Due to a lack of appropriate reference samples in Korea, equations were generated using a hybrid method on 113 Korean unknown skeletons. In this approach, estimates using the anatomical method [1] were regarded as actual stature. Results revealed that new equations produced more accurate and precise estimates than previous techniques. In addition, due to consistent body proportions of Korean populations through time and space, new equations are applicable to Korean skeletons regardless of their temporal and geographic origins. For obtaining statures at death, particularly in a forensic context, an age correction factor, 0.0426 cm/year, should be applied.

  1. Theories and Messages in South Korean Antismoking Advertising.

    PubMed

    Ha, Jin Hong; Aikat, Debashis Deb; Jung, Eun Hwa

    2015-01-01

    This study evaluated antismoking advertisements in South Korean television by drawing upon a Health Communication article by Cohen, Shumate, and Gold (2007) and on Gold, Cohen, and Shumate's (2008) typology. This study examined the theories and messages in South Korean antismoking advertisements. First, South Korean antismoking advertisements primarily targeted adults. In addition, the advertisements for adults normally used statistical evidence, whereas those for adolescents often used testimonial evidence. In terms of the type of performance, narration was often used in advertisements for both adults and adolescents. Second, the most prevalent persuasive health message used social norms, whereas the most prevalent affective appeal used fear appeals. Third, antismoking advertisements in South Korea mentioned more benefits of not smoking than barriers to not smoking. This study also identified the message difference in the U.S. and South Korean antismoking advertisements. PMID:25297054

  2. Patterns of Political Socialization in North Korean Schools

    ERIC Educational Resources Information Center

    Kim, Hyung-Chan

    1973-01-01

    Considers the government's use of the schools in North Korea and its instructional programs as a means of political indoctrination that aims at shaping and remolding North Korean youth into communists. (Author/RK)

  3. Training of breast surgical oncologists.

    PubMed

    Teshome, Mediget; Kuerer, Henry M

    2016-06-01

    Breast surgical oncology is a defined sub-specialty of general surgery with focus on the surgical management of breast disease and malignancy within a multidisciplinary context. Much of the training of breast surgical oncologists in the United States exists within a fellowship training structure with oversight and approval by the Society of Surgical Oncology (SSO). Rapid continuous changes in breast oncology practice have further substantiated dedicated expertise in breast surgical oncology. Training programs are structured to develop proficiency in fellows for advanced surgical techniques and clinical decision-making as well as exposure to the multidisciplinary aspects of breast cancer management. Components of a successful program include an intense multidisciplinary curriculum, engagement in clinical research and attention to strong mentorship. National curriculum and training requirements as well as supplemental resources assist in standardizing the fellowship experience. As surgical training and the field of breast oncology continues to evolve, so do fellowship training programs to ensure high quality breast surgical oncologists equipped to deliver high quality evidence based patient care while continuing to drive future research and trainee education. PMID:27197510

  4. Comparison of Korean and European women professional golfers' training time and perceptions of ideal training time.

    PubMed

    Kim, Myung-Soo; Kim, Soon-Mi; Kim, Soon-Young; Kim, Sung-Hee

    2010-08-01

    The purpose of this study was to compare Korean and European female professional golfer's reported practice hours and their different understandings about golf training. 55 Korean and 21 European female professional golfers were asked questions about average actual practice days per week, average actual practice hours per day, ideal practice days per week, and ideal practice hours per day. All the women participated in the Korean Female Masters Golf Tournament at the Korean Cyprus Golf course from 6-8 November in 2009. Korean female professional golfers reported practicing more hours, but both the Korean and European golfers reported actually practicing more hours than their ideal practice hours. PMID:21058589

  5. Risk factors for surgical infection.

    PubMed

    Leaper, D J

    1995-06-01

    In the last century remarkable advances have been made in surgery, associated with the lowest recorded rates of infection or sepsis. Many surgical practices are time honoured but have little scientific basis to prevent postoperative infection whereas some local and systemic factors are well recognized and can be modified to lower infection risks. Surgical skill is not easily measurable but shorter operations in experienced hands leaving the minimum of tissue damage, haematoma or dead space have the lowest infection rates in general surgery: < 2% in clean and < 10% in contaminated operations. Adequate surgical scrub, appropriate suture materials and antibiotic prophylaxis, perioperative correction of dehydration and poor nutrition are examples of effective therapy which can be conformed to by all surgeons. Other factors, such as the use of wound guards, drains and surgical dressings are less easy to estimate for effectiveness or be sure that they could be changed or left out of surgical ritual.

  6. Surgical procedures for voice restoration

    PubMed Central

    Nawka, Tadeus; Hosemann, Werner

    2005-01-01

    Surgical procedures for voice restoration serve to improve oral communication by better vocal function. They comprise of phonomicrosurgery, with direct and indirect access to the larynx; laryngoplasty; laryngeal injections; and surgical laryngeal reinnervation. The basis for modern surgical techniques for voice disorders is the knowledge about the ultrastructure of the vocal folds and the increasing experience of surgeons in voice surgery, while facing high social and professional demands on the voice. Vocal activity limitation and participation restriction has become more important in the artistic and social areas. A number of surgical methods that have been developed worldwide for this reason, are presented in this article. Functional oriented surgery has to meet high standards. The diagnostics of vocal function has to be multi-dimensional in order to determine the indication and the appropriate surgical intervention. PMID:22073062

  7. A comparison of the Korean minorities in China and Japan.

    PubMed

    Min, P G

    1992-01-01

    "This article compares the Korean minorities in China and Japan in their differential levels of cultural autonomy and ethnic identity....In explaining the differential levels of ethnicity between the two Korean minority groups, this paper focuses on the basic differences in minority policy between the two countries; the difference in the context of migration; the existence or absence of a territorial base; and the differential levels of influence from Korea."

  8. Tranexamic Acid in Anesthetic Management of Surgical Procedures.

    PubMed

    Mayeux, Jessica; Alwon, Kathy; Collins, Shawn; Hewer, Ian

    2016-06-01

    Blood loss during surgical procedures poses a grave risk to the patient, but transfusion is costly and associated with adverse outcomes. Antifibrinolytics, however, offer an economical and effective means of decreasing blood loss associated with surgical procedures. Tranexamic acid (TXA) is an antifibrinolytic that blocks lysine-binding sites of fibrinogen and fibrin, preventing the breakdown of existing clots. This journal course reviews extensive research demonstrating that antifibrinolytics such as TXA decrease blood loss and in some studies reduce allogeneic transfusion requirements. In addition, this journal course addresses concerns that use of antifibrinolytics increases embolic events, reviews research that demonstrates TXA does not increase the incidence of vascular occlusive events, and describes methods of TXA use in cardiac and orthopedic surgical procedures, neurosurgery, and obstetrics. The Certified Registered Nurse Anesthetist should consider the possibility, on a case-by-case basis, of using TXA in surgical procedures to reduce blood loss with minimal adverse effects. PMID:27501656

  9. First-generation Korean-American parents' perceptions of discipline.

    PubMed

    Kim, Eunjung; Hong, Seunghye

    2007-01-01

    Nurses not only need to be familiar with professional guidelines of discipline and but also need to be aware of variances in styles of acceptable discipline across cultural groups. The goal of this study was to explore cultural influences in relation to (1) first-generation Korean-American parents' perceptions of common discipline strategies in the United States, and (2) discipline strategies commonly used among first-generation Korean-American parents. Inductive content analysis was used to analyze interview data from seven first-generation Korean-American parents. Derived themes indicated that parents considered spanking/hitting and less hugging/kissing as Korean style, and time-out, use of sticker charts, hugging/kissing, removing/adding privileges, and giving chores as American style. Recent immigrant parents were not familiar with common positive discipline strategies in the United States. As they adapted to mainstream society, they discontinued what they perceived to be negative aspects of Korean style and adopted positive aspects of American style. They were sensitive to children's views on discipline, and they experienced communication difficulties with children. These findings indicated that Korean-American parents' perceptions of discipline strategies were shaped by living in two cultures and were different from western viewpoints. PMID:17292135

  10. German and Korean mothers' sensitivity and related parenting beliefs

    PubMed Central

    Ziehm, Jeanette; Trommsdorff, Gisela; Heikamp, Tobias; Park, Seong-Yeon

    2013-01-01

    This study contributes to a differentiated understanding of maternal sensitivity in cultural and situational context. We investigated differences and similarities in German and Korean mothers' maternal sensitivity. We interviewed 92 German and 100 Korean mothers of first graders about their preference for proactive (anticipating children's needs) or reactive sensitivity (responding to children's direct cues) in different scenarios. Related parenting beliefs were assessed by asking the mothers to explain the reasons why they would prefer specific parenting behaviors. Results revealed significant cultural differences in reactive vs. proactive sensitivity preferences. Overall, German mothers were more likely to indicate that a mother should respond reactively and less likely to report that a mother should act proactively than were Korean mothers. Korean mothers gave preference to both reactive and proactive sensitivity depending on the scenario. With regard to parenting beliefs, analyses revealed that German and Korean mothers who preferred reactive sensitivity mainly explained their choices as attempts to encourage children's development of independence. In contrast, Korean and German mothers with a preference for proactive sensitivity were more likely to report that mothers would assist their children due to their immaturity in dealing with emotional distress. Results are discussed in the framework of the different meanings and functions of maternal sensitivity for socialization in different cultural contexts. PMID:23986740

  11. Overview of the Development of the Korean Exposure Factors Handbook

    PubMed Central

    Jo, Soo-Nam; Kim, So-Yeon; Myung, Hyung-Nam

    2014-01-01

    A set of exposure factors that reflects the characteristics of individual behavior capable of influencing exposure is essential for risk and exposure assessment. In 2007, the Korean Exposure Factors Handbook was, therefore, issued, driven by the need to develop reliable exposure factors representing the Korean population. The purpose of this study was to overview the development process of the Korean Exposure Factors Handbook and major recommended exposure values for the Korean population to allow information exchanges and comparison of recommended values among nations. The researchers reviewed the domestic data that could be used in the development of exposure factors, confirmed a knowledge gap, and set a priority of development by phases. A methodology to measure exposure factors was established to develop measuring techniques and test their validity. Data were processed or a survey was conducted according to the availability of data. The study thus produced recommended values for 24 exposure factors grouped by general exposure factors, food ingestion factors, and activity factors by setting up a database of exposure factors and carrying out statistical analysis. The study has significantly contributed to reducing the potential uncertainty of the risk and exposure assessment derived by the application of foreign data or research findings lacking representativeness or grounds by developing a set of exposure factors reflecting the characteristics of the Korean people. It will be necessary to conduct revisions in light of the changing statistical values of national data and the exposure factors based on Korean characteristics. PMID:24570801

  12. First Generation Korean American Parents’ Perceptions of Discipline

    PubMed Central

    Kim, Eunjung; Hong, Seunghye

    2007-01-01

    Nurses not only need to be familiar with the professional guidelines of discipline and but also be aware of variances in styles of acceptable discipline across cultural groups. The goal of this study was to explore cultural influences in relation to (1) first generation Korean American parents’ perceptions of common discipline strategies in the United States and (2) discipline strategies commonly used among first generation Korean American parents. Inductive content analysis was used to analyze interview data from seven first generation Korean American parents. Derived themes indicated that parents considered spanking/hitting and less hugging/kissing as Korean style and time out, using a sticker chart, hugging/kissing, removing/adding privileges, and giving chores as American style. Recent immigrant parents were not familiar with common positive discipline strategies in the United States. As they adapted to the mainstream society, they discontinued what they perceived to be negative aspects of Korean style and adopted positive aspects of American style. They were sensitive to children’s views on discipline and they experienced communication difficulties with children. These findings indicated that Korean American parents’ perceptions on discipline strategies were shaped by living in two cultures and were different from the western viewpoints. PMID:17292135

  13. First-generation Korean-American parents' perceptions of discipline.

    PubMed

    Kim, Eunjung; Hong, Seunghye

    2007-01-01

    Nurses not only need to be familiar with professional guidelines of discipline and but also need to be aware of variances in styles of acceptable discipline across cultural groups. The goal of this study was to explore cultural influences in relation to (1) first-generation Korean-American parents' perceptions of common discipline strategies in the United States, and (2) discipline strategies commonly used among first-generation Korean-American parents. Inductive content analysis was used to analyze interview data from seven first-generation Korean-American parents. Derived themes indicated that parents considered spanking/hitting and less hugging/kissing as Korean style, and time-out, use of sticker charts, hugging/kissing, removing/adding privileges, and giving chores as American style. Recent immigrant parents were not familiar with common positive discipline strategies in the United States. As they adapted to mainstream society, they discontinued what they perceived to be negative aspects of Korean style and adopted positive aspects of American style. They were sensitive to children's views on discipline, and they experienced communication difficulties with children. These findings indicated that Korean-American parents' perceptions of discipline strategies were shaped by living in two cultures and were different from western viewpoints.

  14. Islands and Non-islands in Native and Heritage Korean

    PubMed Central

    Kim, Boyoung; Goodall, Grant

    2016-01-01

    To a large extent, island phenomena are cross-linguistically invariable, but English and Korean present some striking differences in this domain. English has wh-movement and Korean does not, and while both languages show sensitivity to wh-islands, only English has island effects for adjunct clauses. Given this complex set of differences, one might expect Korean/English bilinguals, and especially heritage Korean speakers (i.e., early bilinguals whose L2 became their dominant language during childhood) to be different from native speakers, since heritage speakers have had more limited exposure to Korean, may have had incomplete acquisition and/or attrition, and may show significant transfer effects from the L2. Here we examine islands in heritage speakers of Korean in the U.S. Through a series of four formal acceptability experiments comparing these heritage speakers with native speakers residing in Korea, we show that the two groups are remarkably similar. Both show clear evidence for wh-islands and an equally clear lack of adjunct island effects. Given the very different linguistic environment that the heritage speakers have had since early childhood, this result lends support to the idea that island phenomena are largely immune to environmental influences and stem from deeper properties of the processor and/or grammar. Similarly, it casts some doubt on recent proposals that islands are learned from the input. PMID:26913017

  15. The Austrialian National Chinese Japanese Korean Project

    NASA Technical Reports Server (NTRS)

    Groom, Linda

    1994-01-01

    Providing access to Asian-language materials has always been a problem for libraries. There are particular difficulties in acquiring Asian materials, in cataloguing them and providing access, and in incorporating them in library systems. There is, however, an urgent and growing need for access to Asian materials. Part of the response of the Australian library community to the difficulties and to the increasing need has been the Australian National CJK (Chinese, Japanese and Korean) Project. The CJK Project is a co-operative project involving seven Australian universities and the National Library of Australia. Membership is expected to grow to include other Australian research libraries, some public research libraries and some overseas libraries.

  16. Hereditary Cerebellar Ataxias: A Korean Perspective

    PubMed Central

    Kim, Ji Sun; Cho, Jin Whan

    2015-01-01

    Hereditary ataxia is a heterogeneous disorder characterized by progressive ataxia combined with/without peripheral neuropathy, extrapyramidal symptoms, pyramidal symptoms, seizure, and multiple systematic involvements. More than 35 autosomal dominant cerebellar ataxias have been designated as spinocerebellar ataxia, and there are 55 recessive ataxias that have not been named systematically. Conducting genetic sequencing to confirm a diagnosis is difficult due to the large amount of subtypes with phenotypic overlap. The prevalence of hereditary ataxia can vary among countries, and estimations of prevalence and subtype frequencies are necessary for planning a diagnostic strategy in a specific population. This review covers the various hereditary ataxias reported in the Korean population with a focus on the prevalence and subtype frequencies as the clinical characteristics of the various subtypes. PMID:26090078

  17. Surgical force detection probe

    NASA Technical Reports Server (NTRS)

    Tcheng, Ping; Roberts, Paul; Scott, Charles; Prass, Richard

    1991-01-01

    The development progress of a precision electro-mechanical instrument which allows the detection and documentation of the forces and moment applied to human tissue during surgery (under actual operation room conditions), is reported. The pen-shaped prototype probe which measures 1/2 inch in diameter and 7 inches in length was fabricated using an aerodynamic balance. The aerodynamic balance, a standard wind tunnel force and moment sensing transducer, measures the forces and the moments transmitted through the surgeon's hand to the human tissue during surgery. The prototype probe which was fabricated as a development tool was tested successfully. The final version of the surgical force detection probe will be designed based on additional laboratory tests in order to establish the full scale loads. It is expected that the final product will require a simplified aerodynamic balance with two or three force components and one moment component with lighter full scale loads. A signal conditioner was fabricated to process and display the outputs from the prototype probe. This unit will be interfaced with a PC-based data system to provide automatic data acquisition, data processing, and graphics display. The expected overall accuracy of the probe is better than one percent full scale.

  18. Oncogenes and surgical pathology.

    PubMed

    Bartow, S A

    1987-08-01

    The discovery of oncogenes began with identification of genetic material in viruses capable of causing neoplasia in animals. Through processes of "transduction" and "insertional mutagenesis," RNA/retroviruses may (1) alter directly, (2) alter expression of, or (3) move pieces of host cellular genome in ways that they become potential agents of neoplastic transformation. The pieces of host cellular genome, either affected in situ by viral gene insertion or transduced by the virus, are known as oncogenes. Approximately 20 oncogenes have been identified. Although they have yet to be proven to be sufficient or necessary for neoplastic transformation, the evidence for their playing a part in the transformation process is mounting. The functions of the protein products of the various oncogenes are closely related to those of proteins involved in normal cell regulatory and cycle activities. Study of the oncogene products and their functions serves to elucidate the basic character of neoplasia. The functional classes of oncogenes with specific examples of genomic amplification, altered mRNA or protein product expression, or mutational deletion associated with human neoplasia are reviewed herein. Since the techniques for detecting oncogene DNA and mRNA alterations are rapidly becoming a part of our diagnostic armamentarium, surgical pathologists should be prepared for the imminent use of such molecular techniques and information in diagnosis and prognosis of human neoplasia.

  19. Synthetic surgical gloves.

    PubMed

    2002-06-01

    Surgical gloves are used by healthcare workers to protect them against bloodborne pathogens and other potential infectants and to prevent wound contamination in patients. In response to the increasing prevalence of allergies to natural rubber latex (NRL) among patients and medical staff, the trend toward purchasing gloves made of synthetic materials is on the rise. However, latex continues to dominate the market, and some people still perceive synthetic gloves as providing less protection and being less comfortable than NRL gloves. For this Update Evaluation, we present our findings for three newly evaluated glove models from three manufacturers and summarize our findings for the seven previously evaluated models that are still on the market. (Our earlier Evaluation was published in the February-March 2000 Health Devices.) As in the previous Evaluation, our ratings are based on the gloves' barrier effectiveness--that is, their resistance to viral penetration and their durability--and comfort. We also compared these characteristics of the synthetic gloves to those of NRL gloves. We found that all the evaluated gloves offer adequate barrier protection but that their level of comfort varies considerably. We rate three models Preferred, five models Acceptable, and two models Not Recommended. PMID:12116503

  20. Attraction Effects in Honorific Agreement in Korean

    PubMed Central

    Kwon, Nayoung; Sturt, Patrick

    2016-01-01

    Previous studies have suggested that sentence processing is mediated by content-addressable direct retrieval processes (McElree, 2000; McElree et al., 2003). However, the memory retrieval processes may differ as a function of the type of dependency. For example, while many studies have reported facilitatory intrusion effects associated with a structurally illicit antecedent during the processing of subject-verb number or person agreement and negative polarity items (Pearlmutter et al., 1999; Xiang et al., 2009; Dillon et al., 2013), studies investigating reflexives have not found consistent evidence of intrusion effects (Parker et al., 2015; Sturt and Kwon, 2015; cf. Nicol and Swinney, 1989; Sturt, 2003). Similarly, the memory retrieval processes could be also sensitive to cross-linguistic differences (cf. Lago et al., 2015). We report one self-paced reading experiment and one eye-tracking experiment that examine the processing of subject-verb honorific agreement, a dependency that is different from those that have been studied to date, in Korean, a typologically different language from those previously studied. The overall results suggest that the retrieval processes underlying the processing of subject-verb honorific agreement in Korean are susceptible to facilitatory intrusion effects from a structurally illicit but feature-matching subject, with a pattern that is similar to subject-verb agreement in English. In addition, the attraction effect was not limited to the ungrammatical sentences but was also found in grammatical sentences. The clear attraction effect in the grammatical sentences suggest that the attraction effect does not solely arise as the result of an error-driven process (cf. Wagers et al., 2009), but is likely also to result from general mechanisms of retrieval processes of activating of potential items in memory (Vasishth et al., 2008). PMID:27630594