A new edition of infection control manual was brought out after months of reviewing the utility of the preceding edition. Using the new manual, a series of study meetings were held with the aim of raising awareness among the personnel of infection prevention.Preventive measures have been changing with rapid advances in medical treatment. The old manual, which had undergone revision repeatedly, was not utilized fully. In view of the situation, questionnaires were distributed to all the members of the hospital staff (n=447) to investigate the reasons why the manual had not been utilized. Although many respondents were of the opinion that the old manual was out of date, too thick, and unreadable, 44.7% said they had used it. 55.3% answered that they had asked their superiors or colleagues out of necessity. Based on these results, we started making a compilation of a new manual, easy to understand and friendly to the users. It took about six months to complete it. Copies of the new manual were given to all the staff members. In the study meetings, various subjects were taken up for discussion, including the definition of nosocominal infection, “universal precaution,” how to effectively wash your hands, how to keep the rest rooms clean, how to wear the gloves and mask, and so forth. We believe that the personnel’s consciousness of infection prevention was further raised by holding the study meetings.
Manuals ; Prevention ; Infection as complication of medical care ; Hospitals ; Infections of musculoskeletal system

We investigated the incidence of surgical site infection and the number of days required for recuperation in patients who used open drains or closed drains after genitourinary tract surgery. As the method of (statistical) examination, Mann-Whitney's U test was used. Enrolled in this study were 14 patients (mean age:66.3 years) using open drains during the period from May to October 2001 (group A) and another 14 patients (mean age:64.9 years) using closed drains during the period from December 2001 to May 2002 (group B). Using gauze and drains, germ culture was made. From cultures it was found that six out of the 14 group A patients (42.8%) had been infected with Staphylococcus epidermidis, enterococcus and/or MRSA (methicillin-resistant Staphylococcus aureus) but that all of the group B patients had been were negative, thus marking a statistically significant difference between the two groups (p<0/01). A check on the duration of the administration of antibiotics showed 7-42 days (mean:24.5 days) for group A as against 4-11 days (mean:6.1 days) for group B. It was also revealed that there was a significant difference (p<0.01) between the two groups in the number of the days when gauze was exchanged:10-31 days (mean:19.1 days) for group A versus 3-10 days (mean:7.9 days) for group B. In many other respects, the closed drainage group was found to be doing well postoperatively compared with the open drainage group.It was also noted that the patients of the open drainage group had run into a lot of difficulties eating, sleeping, excreting and doing daily activities due to bacterial infections.By switching from open drainage to closed drainage in postoperative procedures,our department has succeeded in reducing the incidence of surgical site infections, thus making it possible to obtain a remarkably favorable result in terms of recuperation.
Discharge, Body Substance ; Upper case Bee ; Genitourinary ; Postoperative Period ; Infections of musculoskeletal system

Systemic infection by MRSA (Methicillin-resistant Staphylococcus aureus) is a risk in immunodeficient patients such as those with severe burn injuries. Hozai, formulations with tonic effects, may enhance the immune system and we treated two severe burn patients with MRSA infections using Juzentaihoto, which is a remedy for kikyo (deficiency of vital energy) and kekkyo (ketsu deficiency). Both patients suffered flame burns [85% body surface area (BSA) and 40% BSA] and inhalation injuries committing self-immolation. They contracted MRSA in due course and antibiotics such as Arbekacin or Teicoplanin did not control MRSA. Therefore, Juzentaihoto was administered through a nasogastric tube and both of them were finally cured without complications. Juzentaihoto may be useful against fatigue, anemia, malaise, ulcer, and purulent wounds due to severe burns.
Methicillin-resistant staphylococcus aureus infection ; Physical trauma ; Cases ; Infections of musculoskeletal system ; Burn brand of nitrofurazone

Ultrasonography of the postoperative musculoskeletal system plays an important role in the Epub ahead of print accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery.
Amputation ; Arthroplasty ; Artifacts ; Diagnosis ; Joints ; Magnetic Resonance Imaging ; Muscles ; Musculoskeletal System* ; Postoperative Care ; Soft Tissue Infections ; Soft Tissue Injuries ; Tendons ; Ultrasonography*

Glucocorticoids are widely used for the treatment of various autoimmune, allergy, and neoplastic diseases. While they are indispensable for the treatment of many diseases, they have a lot of adverse effects. The aim of this article is to review the unwanted effects of glucocorticoids, providing information about their prevention. Glucocorticoids affect the balance of electrolytes and metabolism of carbohydrates and lipids. Thus, they can alter the distribution of adipose tissue to form Cushingoid facial and body shape and can precipitate hypertension and atherosclerosis to increase the risk of cardiovascular disorders. Glucocorticoids also affect the musculoskeletal system increasing the risk of osteoporosis, avascular necrosis, and myopathy and also contribute to neurological disorders such as mood change, psychosis, and memory loss. Cataract and glaucoma are common ophthalmological complications of glucocorticoid therapy. Combined use with cytotoxic agents and glucocorticoid will substantially raise the risk of bacterial infection and rate of opportunistic infection, and appropriate prophylaxis will be needed. In addition, glucocorticoids can cause problems of the reproductive system including menstrual disorders and changes in fertility. Although these adverse reactions of glucocorticoids are clear at higher doses, even at low doses, they can produce substantial toxicities. To prevent above adverse events, physicians should monitor the complications of glucocorticoids more cautiously and should reduce the medication meticulously.
Adipose Tissue ; Atherosclerosis ; Bacterial Infections ; Carbohydrates ; Cataract ; Cytotoxins ; Electrolytes ; Fertility ; Glaucoma ; Glucocorticoids ; Hypersensitivity ; Hypertension ; Memory Disorders ; Muscular Diseases ; Musculoskeletal System ; Necrosis ; Nervous System Diseases ; Opportunistic Infections ; Organothiophosphorus Compounds ; Osteoporosis ; Psychotic Disorders