1.Comparison of Two Surveillance Methods for Detecting Nosocomial Infections in a Neonatal Intensive Care Unit.
Og Son KIM ; Sung Won YOON ; Eun Jung SHIN ; Kyong Ran PECK ; Won Sup OH ; Jae Hoon SONG
Korean Journal of Nosocomial Infection Control 2004;9(1):27-36
BACKGROUND: The aim of this study was to evaluate the sensitivity of a clinicians' self-report method for the detection of nosocomial infections (NIs) in comparison with a total surveillance method in a neonatal intensive care unit (NICU). METHODS: Two surveillance methods were concurrently performed in the NICU of a university hospital during 5 months in 2003. Clinicians' self-report surveillance (CSRS) was based on the retrospective verification of monthly reports of positive bacteriologic results by NICU clinicians. Total surveillance (TS) was done prospectively by an infection control nurse based on chart review and laboratory data. RESULTS: One hundred fifty nine patients accounting to 2759 patient-days were included in the study. Twenty-seven NIs among 26 patients were identified by TS. The sensitivity of CSRS compared to TS was 14.8% (4 of 27 NIs). The specificity was 98.5% (131 of 133 non-NIs). Kappa measures of agreement were -0.309. CONCLUSIONS: Our results confirm that the retrospective review of charts and laboratory data by clinicians lacks sensitivity and agreement for the surveillance of nosocomial infections.
Cross Infection*
;
Humans
;
Infant, Newborn
;
Infection Control
;
Intensive Care, Neonatal*
;
Prospective Studies
;
Retrospective Studies
;
Sensitivity and Specificity
2.Breast hamartoma: 3 case report.
Ki Keun OH ; Hee Sung HWANG ; Choon Sik YOON ; Jin Sik MIN ; Kyong Sik LEE ; Hyeon Joo JEONG
Journal of the Korean Radiological Society 1991;27(1):77-81
No abstract available.
Breast*
;
Hamartoma*
3.Comparison of Endoscopic Variceal Ligation versus Combined Ligation and Sclerotherapy for Bleeding Esophageal Varices.
Kyong Han SHIN ; June Sung LEE ; Jung Hwan YOON ; Chul Joo HAN ; Hyo Suk LEE ; Chung Yong KIM
The Korean Journal of Hepatology 1998;4(2):143-150
BACKGROUND/AIMS: Combined esophageal variceal ligation and sclerotherapy has been hypothesized to be more effective for the control of bleeding esophageal varices than ligation alone. The present study was to compare the combined therapy with ligation alone in terms of variceal eradication, rebleeding, complication and survival rates in patients with bleeding esophageal varices. METHODS: Thirty-eight patients with bleeding esophageal varices were randomly assigned to receive ligation alone in 20 patients or the combined therapy in 18 patients. The clinical and endoscopic characteristics of patients in the ligation group were similar to those of patients in the combination group. In the combination group, 1-3 mL of ethanolamine was injected proximal to each ligated site. Treatments were repeated every 2- to 3-month until varices were eradicated. RESULTS: No significant differences were found between the ligation and combination groups in variceal eradication rates (70% vs. 72%), numbers of endoscopic sessions required to achieve eradication (3.5+/-0.33 vs. 3.3+/-0.31), rebleeding rates (30% vs. 28%) or 2-yr cumulative survival rates (95% vs. 75%). There were significantly more complications in the combination group (25% vs. 89%, p=0.001). CONCLUSION: Ligation alone is recommended rather than the combined ligation and sclerotherapy because of its lower complication rates.
Esophageal and Gastric Varices*
;
Ethanolamine
;
Hemorrhage*
;
Humans
;
Ligation*
;
Sclerotherapy*
;
Survival Rate
;
Varicose Veins
4.Comparison of Endoscopic Variceal Ligation versus Combined Ligation and Sclerotherapy for Bleeding Esophageal Varices.
Kyong Han SHIN ; June Sung LEE ; Jung Hwan YOON ; Chul Joo HAN ; Hyo Suk LEE ; Chung Yong KIM
The Korean Journal of Hepatology 1998;4(2):143-150
BACKGROUND/AIMS: Combined esophageal variceal ligation and sclerotherapy has been hypothesized to be more effective for the control of bleeding esophageal varices than ligation alone. The present study was to compare the combined therapy with ligation alone in terms of variceal eradication, rebleeding, complication and survival rates in patients with bleeding esophageal varices. METHODS: Thirty-eight patients with bleeding esophageal varices were randomly assigned to receive ligation alone in 20 patients or the combined therapy in 18 patients. The clinical and endoscopic characteristics of patients in the ligation group were similar to those of patients in the combination group. In the combination group, 1-3 mL of ethanolamine was injected proximal to each ligated site. Treatments were repeated every 2- to 3-month until varices were eradicated. RESULTS: No significant differences were found between the ligation and combination groups in variceal eradication rates (70% vs. 72%), numbers of endoscopic sessions required to achieve eradication (3.5+/-0.33 vs. 3.3+/-0.31), rebleeding rates (30% vs. 28%) or 2-yr cumulative survival rates (95% vs. 75%). There were significantly more complications in the combination group (25% vs. 89%, p=0.001). CONCLUSION: Ligation alone is recommended rather than the combined ligation and sclerotherapy because of its lower complication rates.
Esophageal and Gastric Varices*
;
Ethanolamine
;
Hemorrhage*
;
Humans
;
Ligation*
;
Sclerotherapy*
;
Survival Rate
;
Varicose Veins
5.A Pseudoepidemic of Alcaligenes xylosoxidans Due to Contaminated Buffer Solution.
Og Son KIM ; Sung Won YOON ; Kyong Ran PERK ; Sun Young PARK ; Nam Yong LEE ; Jae Hoon SONG
Korean Journal of Nosocomial Infection Control 2003;8(1):13-21
Background: A clinician reported unusually high incidence of A. xylosoxidans isolation from aspirated tissues in outpatient clinic. Methods: A. xylosoxidans isolates from January 2002 to June 2002 were investigated. The infection control nurse reviewed medical records and observed the procedures of tissue aspiration and culture at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from dye, aspiration gun, slide alcohol sponge, tray, sink. water of sink, buffer solution, microscope, computer, and telephone. Results: A. xyloxosidans was isolated from twenty-four patients during 6 months. None of 24 cases had any typical signs or symptoms of infections by A. xylosoxidans. Observation of tissue aspiration and culture procedure revealed that buffer solution was used for prevention of specimen drying after tissue aspiration. Culture of the buffer solution yielded a heavy growth of A. xylosoxidans from four out of ten specimens. A. xylosoxidans was not isolated from any other investigational specimens. Conclusions: This was supposed to represent pseudoepidemic. Contaminated buffer solution was documented as the cause of this pseudoepidemic. The usage of buffer solution was stopped. During the follow-up period of 2 months, no additional A. Xylosoxidans was cultured from aspirated tissues.
Alcaligenes*
;
Ambulatory Care Facilities
;
Follow-Up Studies
;
Humans
;
Incidence
;
Infection Control
;
Medical Records
;
Methods
;
Porifera
;
Telephone
;
Water
6.Application of robots in general surgery
Jin Kyong KIM ; Seung Yoon YANG ; Sung Hyun KIM ; Hyoung-Il KIM
Journal of the Korean Medical Association 2021;64(10):678-687
Application of robotic surgery in the field of general surgery has been increasing. This paper is an overview of the current uses and future perspectives of robotic surgery in four major divisions—endocrine, upper gastrointestinal, hepato-biliary-pancreatic (HBP), and colorectal surgery.Current Concepts: In endocrine surgery, cosmetic advantage is the highest priority when selecting a surgical approach for thyroidectomy. Currently, the transaxillary route is the most common approach. The introduction of the single-port system could maximize the advantages of this technique. In upper gastrointestinal surgery, the use of robots has the advantage of better retrieval of lymph nodes, less bleeding, earlier discharge, and less complications than the laparoscopic approach. However, a more prospective comparative trial is required to confirm those findings. In the HBP field, the indications of robotic surgery have expanded, starting with cholecystectomy to more challenging procedures, such as donor hepatectomy and pancreaticoduodenectomy. Meticulous dissection using robots could provide benefits to patients. In colorectal surgery, robotic surgery is an excellent technical tool for minimally invasive surgeries for rectal cancers, especially in male patients with narrow, deep pelvises. However, further studies are required to confirm the impact of robotic surgery on rectal cancers.Discussion and Conclusion: Robots are used to provide optimal surgical outcomes. Investigating new technologies and innovative surgical procedures is the highly important for a surgeon in the era of minimally invasive surgery.
7.Rate of Nasal Colonization of Methicillin-Resistant Staphylococcus aureus at Admission to a Medical Intensive Care Unit.
Og Son KIM ; Sung Won YOON ; Young Jin KANG ; Yeon Kyong KIM ; Nam Yong LEE ; Jang Ho LEE ; Misook OUI ; Yong Ae CHO ; Young Hee SUNG ; Gee Young SUH ; Kyong Ran PECK ; Doo Ryeon CHUNG ; Jae Hoon SONG
Korean Journal of Nosocomial Infection Control 2007;12(1):42-49
BACKGROUND: The purpose of this study was to survey the nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) among the patients admitted in a medical intensive care unit (MICU) and analyze risk factors associated with the colonization. METHODS: The study was carried out on patients admitted into the MICU in a 1,250-bed tertiary care university hospital from January through December 2006. Nasal surveillance cultures were obtained from patients within 24 hours of admission to the unit. Data were analyzed retrospectively by the review of medical records. RESULTS: A total of 312 patients were screened with active nasal cultures; 36 patients (11.6%) were positive for MRSA. Of these, 22 (7.1%) were positive in the nasal cultures only and 14 (4.5%) were positive in the cultures of other specimens (13, sputum; 1, joint fluid) in addition to the nasal swabs. Among the risk factors for MRSA nasal colonization were sex (man), route of admission (from other ICUs or wards), a history of ICU admission during the recent 12 months, and prolonged hospital days in ICU. CONCLUSION: MRSA nasal carrier rate was found higher in this study than in those reported in the literature. Most of the patients colonized with MRSA in the nostril were not colonized with the organism elsewhere in the body. Whether or not active surveillance for MRSA should be performed would depend on the nasal colonization rate of the patients at the time of admission to the ICU.
Colon*
;
Humans
;
Intensive Care Units*
;
Critical Care*
;
Joints
;
Medical Records
;
Methicillin Resistance*
;
Methicillin-Resistant Staphylococcus aureus*
;
Retrospective Studies
;
Risk Factors
;
Sputum
;
Tertiary Healthcare
8.Comparison of Handwashing Perception and Compliance between Direct Patient Contact and Indirect Contact Groups among Hospital Employees.
Og Son KIM ; Sung Won YOON ; Kyong Ran PECK ; Won Sup OH ; Jae Hoon SONG ; Eun Jung SHIN ; Young Hee SUNG ; Nam Yong LEE
Korean Journal of Nosocomial Infection Control 2006;11(1):35-41
Backgound: The aim of this study was to compare the levels of perception of and compliance with handwashing between the groups of direct patient contact and indirect contact in a tertiary-care university hospital. METHODS: A cross-sectional study was conducted in a university hospital with 4,500 employees. A questionnaire, containing questions on demographic data and the perception of and compliance with handwashing, was distributed to and collected from a total of 1,087 employees from June 25 to July 10, 2005. RESULTS: The study subjects washed their hands an average of 11.2 times (range, 1-100) per day: nurses washed their hands more frequently than others. The average duration of handwashing by employees was 18.8 seconds. Those in the direct patient contact group scored significantly higher points than did those in the indirect contact group in both perception (P<.021) of and compliance (P<.001) with handwashing. CONCLUSION: Education for handwashing is needed direction employees who have indirect contact with patients to improve their compliance with handwashing.
Compliance*
;
Cross-Sectional Studies
;
Education
;
Hand
;
Hand Disinfection*
;
Humans
;
Surveys and Questionnaires
9.Comparative Study of Gastric Polypectomy by Various Methods.
Byung Chul YOON ; Poong Ryul LEE ; Kyong Wook YIM ; Sook Hyang CHUNG ; Jae Jun KIM ; Hyun Chae CHUNG ; In Sung SONG ; Kyoo Wan CHOI ; Chung Yong KIM
Korean Journal of Gastrointestinal Endoscopy 1993;13(1):51-56
The gastric polyps may be premalignant lesions and they should be removed as possible. The gastric polyps can be remoued by various endoscopic methods. The safety and therapeutic effectiveness of snare polypectomy, neodymium YAG laser therapy and electrocutery were compared in a total number of 106 patients who were diagnosed as benign polyps by means of endoscopic biopsy.Safety was evaluated by the rate of complications such as perforation and bleeding, and therapeutic effectiveness was evaluated by the average numbers of treatment session of each modality. Average numbers of treatment session of snare polypectomy, laser therapy and electrocautery were 1.04, 1.38 and l.44, respectively. Average numbers of treatment session of snare polypectomy were significantly (p<0.05) lower than those of other two methods. Perforation was not occurred in any group. Bleeding rates after snare polypectomy, laser therapy and electrocautery were 17.4%, 1.0% and 3.8%, respectively. Bleeding was significantly (p<0,05) more frequent after snare polypectomy than after other two methods. In conclusion therapeutic effectiveness was best in snare polypectomy but complication was most frequent after snare polypectomy. There was no difference between laser therapy and electrocautery for therapeutic effectiveness and safety. Therfore, laser therapy and electrocautery caa be used for the removal of flat adenoma, alternatively.
Adenoma
;
Electrocoagulation
;
Hemorrhage
;
Humans
;
Laser Therapy
;
Lasers, Solid-State
;
Neodymium
;
Polyps
;
SNARE Proteins
10.Comparative Study of Gastric Polypectomy by Various Methods.
Byung Chul YOON ; Poong Ryul LEE ; Kyong Wook YIM ; Sook Hyang CHUNG ; Jae Jun KIM ; Hyun Chae CHUNG ; In Sung SONG ; Kyoo Wan CHOI ; Chung Yong KIM
Korean Journal of Gastrointestinal Endoscopy 1993;13(1):51-56
The gastric polyps may be premalignant lesions and they should be removed as possible. The gastric polyps can be remoued by various endoscopic methods. The safety and therapeutic effectiveness of snare polypectomy, neodymium YAG laser therapy and electrocutery were compared in a total number of 106 patients who were diagnosed as benign polyps by means of endoscopic biopsy.Safety was evaluated by the rate of complications such as perforation and bleeding, and therapeutic effectiveness was evaluated by the average numbers of treatment session of each modality. Average numbers of treatment session of snare polypectomy, laser therapy and electrocautery were 1.04, 1.38 and l.44, respectively. Average numbers of treatment session of snare polypectomy were significantly (p<0.05) lower than those of other two methods. Perforation was not occurred in any group. Bleeding rates after snare polypectomy, laser therapy and electrocautery were 17.4%, 1.0% and 3.8%, respectively. Bleeding was significantly (p<0,05) more frequent after snare polypectomy than after other two methods. In conclusion therapeutic effectiveness was best in snare polypectomy but complication was most frequent after snare polypectomy. There was no difference between laser therapy and electrocautery for therapeutic effectiveness and safety. Therfore, laser therapy and electrocautery caa be used for the removal of flat adenoma, alternatively.
Adenoma
;
Electrocoagulation
;
Hemorrhage
;
Humans
;
Laser Therapy
;
Lasers, Solid-State
;
Neodymium
;
Polyps
;
SNARE Proteins