Background: Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes. Methods: Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals. Results: Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals. Conclusion We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.

Purpose: Several previous studies and case reports have reported ethanol-induced symptoms in patients receiving anticancer drugs containing ethanol. Most docetaxel formulations contain ethanol as a solvent. However, there are insufficient data on ethanol-induced symptoms when docetaxel-containing ethanol is administered. The primary purpose of this study was to investigate the frequency and pattern of ethanol-induced symptoms during and after docetaxel administration. The secondary purpose was to explore the risk factors for ethanol-induced symptoms. Materials and Methods: This was a prospective, multicenter, observational study. The participants filled out ethanol-induced symptom questionnaire on the day of chemotherapy and the following day. Results: Data from 451 patients were analyzed. The overall occurrence rate of ethanol-induced symptoms was 44.3% (200/451 patients). The occurrence rate of facial flushing was highest at 19.7% (89/451 patients), followed by nausea in 18.2% (82/451 patients), and dizziness in 17.5% (79/451 patients). Although infrequent, unsteady walking and impaired balance occurred in 4.2% and 3.3% of patients, respectively. Female sex, presence of underlying disease, younger age, docetaxel dose, and docetaxel-containing ethanol amount were significantly associated with the occurrence of ethanol-induced symptoms. Conclusion The occurrence of ethanol-induced symptoms was not low in patients receiving docetaxel-containing ethanol. Physicians need to pay more attention to the occurrence of ethanol-induced symptoms and prescribe ethanol-free or low-ethanol-containing formulations to high-risk patients.

Purpose: Quality of life (QOL) has become important in the trend of emphasizing patient satisfaction. This study aimed to evaluate the QOL in patients who underwent laparoscopic or robotic gastrectomy for gastric cancer. Methods: A prospective trial was performed involving patients who underwent laparoscopic or robotic gastrectomy for primary gastric cancer at 11 hospitals in Korea. Within this comparative trial, QOL, postoperative pain, and long-term complications were exanimated. The quality-of-life questionnaire (QLQ)-C30 and QLQ-STO22 developed by the European Organization for Research and Treatment of Cancer were used for the QOL survey. We compared the data after dividing it into several types of characteristics as follows; device (robotic or laparoscopic), operation type, pathological stage, and sex.Biased components were extracted by logistic regression analysis. Propensity score matching was applied to the data set with the biased components. Results: In total, 434 patients (211 for laparoscopic surgery and 223 for robotic surgery) were enrolled, out of which 321 patients who responded to both preoperative and postoperative surveys were selected for analysis. Robotic gastrectomy was not different from laparoscopic gastrectomy with respect to postoperative QOL. Distal gastrectomy showed better scores than total gastrectomy in terms of role functioning, social functioning, fatigue, nausea/vomiting, pain, dyspnea, constipation, financial difficulties, dysphagia, eating restrictions, anxiety, taste, and body image. Male patients showed better scores on the 19 scales compared to female patients. Conclusion Robotic and laparoscopic approaches for gastric cancer surgery did not differ from each other with respect to QOL. Distal gastrectomy resulted in better QOL than total gastrectomy.

Plain radiographs of an 88-year-old woman who had experienced vomiting and abdominal distention for 3 days revealed a severely obstructed ileus, and abdominopelvic computed tomography revealed an incarcerated Morgagni hernia. The endoscope was passed through the constrictions from the diaphragmatic indentations and a thin catheter was placed for decompression. The obstructive ileus regressed markedly after the procedure; the patient underwent elective laparoscopic repair of the hernia 1 week later. This is believed to be the first case of endoscopic preoperative decompression for an incarcerated Morgagni hernia.
Aged, 80 and over ; Catheters ; Colonoscopy ; Constriction ; Decompression ; Endoscopes ; Female ; Hernia ; Hernia, Diaphragmatic ; Humans ; Ileus ; Vomiting

Various venous approaches are available for chemoport insertion. The subclavian vein and jugular vein are commonly used. The cephalic vein has several advantages for chemoport insertion. The authors introduce chemoport insertion using cephalic vein. Operation methods were as follows: patient was placed in supine position. Under local anesthesia, the incision was made in the infraclavicular portion, dissection was performed along the deltopectoral groove and the cephalic vein was identified and isolated. Dissection was performed between the subcutaneous fat layer and the muscle layer to make space for chemoport placement. The cephalic vein was incised and the catheter was introduced to the cephalic vein directly and examined by fluoroscopy. Chemoport insertion using cephalic vein is a useful method of chemoport insertion.
Anesthesia, Local ; Catheters ; Fluoroscopy ; Humans ; Jugular Veins ; Muscles ; Subclavian Vein ; Subcutaneous Fat ; Supine Position ; Veins

PURPOSE: In general, laparoscopic surgery has many advantages such as the improved cosmesis and the reduced pain, postoperative recovery and hospital stay. We evaluated the minimal invasive technique for the treatment of radiologically irreducible intussusceptions. METHODS: From January 1997 to April of 2007, the medical records of patients who underwent operation due to radiologically irreducible intussusceptions were reviewed. Age, gender, body weight, clinical symptoms, duration of symptoms, operation time, time to pass flatus, day of starting an oral diet, length of the hospital stay and complications were compared between the conventional surgery group and the laparoscopic group. RESULTS: 86 cases were enrolled in this study. 9 patients (10.5%) underwent laparoscopic surgery and 86 patients (89.5%) underwent conventional surgery. There were no differences between the two groups in terms of age, gender, body weight, duration of symptoms, clinical symptoms, operative time and the surgical morbidity. Postoperative flatus passing, starting the postoperative diet and the length of the hospital stay were significantly reduced in the laparoscopic group. CONCLUSION: The laparoscopic approach is one of the effective treatments for radiologically irreducible intussusceptions.
Body Weight ; Diet ; Flatulence ; Humans ; Intussusception ; Laparoscopy ; Length of Stay ; Medical Records ; Operative Time ; Pain, Postoperative

PURPOSE: Splenic flexure mobilization in an anterior resection is a subject of controversy, but a tension-free anastomosis is needed in case of a low anterior resection or a coloanal anastomosis. Classical splenic flexure mobilization by means of the lesser sac opening is technically difficult in the laparoscopic era. METHODS: This study retrospectively analyzed the medical records and operation videos of 16 patients who underwent laparoscopic splenic flexure mobilization in Our Lady of Mercy Hospital, The Catholic University of Korea by using a medial approach. The operation procedure is as follows: Under general anesthesia, the patient was placed in the Trendelenburg position, after making pneumoperitoneum, the inferior mesenteric artery (IMA) and the inferior mesenteric vein (IMV) were ligated and divided. A medial-to-lateral mesocolon dissection was done, and the pancreas was dissected from the mesocolon of the transverse colon; then, the greater omentum was dissected. RESULTS: The mean age was 60 years old, and the male- to-female sex ratio was 9:7. The mean operation time was 293 minutes. The mean distal margin was 5.3 cm, and the mean number of harvested lymph nodes was 15. An anterior resection was done in 2 cases, a low anterior resection is 10 cases, and a coloanal anastomosis in 4 cases. The mean time from ligation of the IMA to splenic flexure mobilization was 45 minutes. There was no mortality or morbidity. CONCLUSIONS: Laparoscopic medial splenic flexure mobilization is a technically feasible and safe method.
Anesthesia, General ; Colon, Transverse* ; Head-Down Tilt ; Humans ; Korea ; Laparoscopy ; Ligation ; Lymph Nodes ; Medical Records ; Mesenteric Artery, Inferior ; Mesenteric Veins ; Mesocolon ; Middle Aged ; Mortality ; Omentum ; Pancreas ; Peritoneal Cavity ; Pneumoperitoneum ; Retrospective Studies ; Sex Ratio

OBJECTIVE: Authors investigated magnetic resonance imaging (MRI) and histological characteristics of photothrombotic infraction rat model (PIRM) on long term basis to provide a basis for further research. METHOD: Photothrombotic ischemia was induced in male Sprague-Dawley rats using Rose-bengal dye (20 mg/kg) and cold light. MRI was performed 1, 6, 12, 24 hours, 3, 7 days, 2, 3, 4, 6, and 8 weeks after photothrombosis and obtained T1- & T2-weighted and contrast-enhanced images. Also, T2* images were obtained after superparamagnetic iron oxide injection. After MRI, animals were sacrificed and the brain sections were stained for routine immunohistopathology. RESULTS: MRI and histological analysis revealed well induced lesion in the cortex and showed biological course of infarction. However, PIRM showed rapid development of infarction lacking collateral circulation. Infarction size reached maximum 12 hours after induction, progressively decreasing over 4 weeks. Interstitial and cytotoxic edema were evident at 6, 12, 24 hours, but decreasing afterwards. Neurogenic inflammation appeared on 3rd day and reached maximum on 5~7th day. Arachnoid membrane was characteristically invaded with inflammatory cells and later thickened with fibrosis. CONCLUSION: This study showed PIRM is ideal model to study subacute and chronic stages of cerebral infarction.
Animals ; Arachnoid ; Brain ; Cerebral Infarction* ; Collateral Circulation ; Edema ; Fibrosis ; Humans ; Infarction ; Iron ; Ischemia ; Magnetic Resonance Imaging* ; Male ; Membranes ; Models, Animal ; Neurogenic Inflammation ; Rats, Sprague-Dawley ; Thrombosis*

Pulmonary sequestration is a rare congenital malformation during embryouic development which results in a cystic mass of nonfunctioning lung tissue. A diagnosis of a pulmonary sequestration has traditionally relied upon identifying the pathological arterial vessels by arteriography, computed tomography, and magnetic resonance imaging. We reported a case of pulmonary sequestration diagnosed by Doppler sonography and subsequent CT angiography. A 21-year-old-woman admitted to hospital for an investigation of recurrent pneumonia with left lower chest pain. A doppler ultrasound sonography showed an aberrant blood supply from the descending thoracic aorta to the left lower chest lesion. The pulmonary sequestration was confirmed by the subsequent CT angiograph.
Female ; Humans

We present a case with rare complication of percutaneous vertebroplasty with polymethylmethacrylate (PMMA). A pulmonary embolus was detected in a 79-year-old woman with osteoporotic compression fracture after percutaneous verteroplasty. Chest radiography, computed tomography, and ventilation perfusion lung scan con-firmed pulmonary infarction and the presence of PMMA in the pulmonary arteries. She was treated with anticoagulants and responded favorably. Although venous leakage of PMMA has shown to be not uncommon, only a few cases of symptomatic pulmonary embolism have been reported. Adequate preparation of PMMA, optimal injection technique, and confirmation with biplane fluoroscopy are mandatory to minimize this type of complication.
Aged ; Anticoagulants ; Embolism ; Female ; Fluoroscopy ; Fractures, Compression ; Humans ; Lung ; Perfusion ; Polymethyl Methacrylate* ; Pulmonary Artery ; Pulmonary Embolism* ; Pulmonary Infarction ; Radiography ; Thorax ; Ventilation ; Vertebroplasty*