Background: This report presents annual data from the surgical site infection (SSI) module of the Korean National Healthcare-associated Infections Surveillance System (KONIS) from July 2021 to June 2022. Methods: Surveillance of 20 surgeries (e.g., stomach, colon, rectal, gallbladder surgery, knee replacement, hip replacement, craniotomy, ventricular shunts, spinal fusion, laminectomy, cardiac artery bypass grafting - incision in the chest site only and incisions both the chest and donor site, cardiac, prostatectomy, abdominal hysterectomy, vaginal hysterectomy, appendectomy, thoracic, cesarean section, and head and neck surgeries) associated with SSI was performed between July 1, 2021, and June 30, 2022, according to the KONIS Manual 2020. Results: A total of 133,281 surgical cases were collected and 1,100 SSIs were identified, resulting in a SSI rate of 0.83%. The SSI rates for 30-day surveillance surgeries were 1.9% for stomach, 2.82% for colon, 1.88% for rectal, 0.29% for gallbladder, 0.25% for lumbar laminectomy, 0.33% for cesarean section, 0.67% for abdominal hysterectomy, 0.74% for vaginal hysterectomy, 0.23% for prostatectomy, 1.39% for appendectomy, and 0.06% for thoracic surgeries. Neck surgery could not be analyzed due to no reported cases. The SSI rates for the 90-day surveillance surgeries were 0.16% for knee replacement, 0.54% for hip replacement, 0.89% for spinal fusion, 0.70% for craniotomy, 0.92% for ventricular shunt, 1.13% for cardiac, 1.80% for cardiac artery bypass grafting (chest only incision), and 1.64% for cardiac artery bypass grafting (chest and leg incision) surgeries. In total, 608 strains were isolated and cultured from 1,286 infections. Conclusion Compared with the incidence of SSI (1.06%) in 2018, the overall incidence decreased, and most site-specific infection rates decreased or remained the same.

BACKGROUND AND OBJECTIVES: The relationship between operator volume and outcomes of percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) has not been fully investigated. We aimed to investigate the relationship between operator PCI volume and in-hospital outcomes after primary PCI for STEMI. METHODS: Among the total of 44,967 consecutive cases of PCI enrolled in the Korean nationwide, retrospective registry (K-PCI registry), 8,282 patients treated with PCI for STEMI by 373 operators were analyzed. PCI volumes above the 75th percentile (>30 cases/year), between the 75th and 25th percentile (10–30 cases/year), and below the 25th percentile (<10 cases/year) were defined as high, moderate, and low-volume operators, respectively. In-hospital outcomes including mortality, non-fatal myocardial infarction (MI), stent thrombosis, stroke, and urgent repeat PCI were analyzed. RESULTS: The average number of primary PCI cases performed by 373 operators was 22.2 in a year. In-hospital mortality after PCI for STEMI was 571 cases (6.9%). In-hospital outcomes by operator volume showed no significant differences in the death rate, cardiac death, non-fatal MI, and stent thrombosis. However, the rate of urgent repeat PCI tended to be lower in the high-volume operator (0.6%) than in the moderate-(0.7%)/low-(1.5%) volume operator groups (p=0.095). The adjusted odds ratios for adverse in-hospital outcomes were similar in the 3 groups. Multivariate analysis also showed that operator volume was not a predictor for adverse in-hospital outcomes. CONCLUSIONS In-hospital outcomes after primary PCI for STEMI were not associated with operator volume in the K-PCI registry.

Abstract: Edible offal is easily contaminated by Escherichia coli (E. coli) and fluoroquinolone (FQ)-resistant E. coli is considered a serious public health problem, thus, this study investigated the genetic characteristics of FQ-resistant E. coli from edible offal. A total of 22 FQ-resistant E. coli isolates were tested. A double mutation in each gyrA and parC led the highest MIC. Four (18.2%) isolates carried plasmid-mediated quinolone resistance genes. The fimH, eaeA, escV, astA, and iucC genes were confirmed. Seventeen isolates (77.3%) were positive for plasmid replicons. The isolates showed high genetic heterogeneity based on pulsed-field gel electrophoresis patterns.

BACKGROUND AND OBJECTIVES: The relationship between operator volume and outcomes of percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) has not been fully investigated. We aimed to investigate the relationship between operator PCI volume and in-hospital outcomes after primary PCI for STEMI.METHODS: Among the total of 44,967 consecutive cases of PCI enrolled in the Korean nationwide, retrospective registry (K-PCI registry), 8,282 patients treated with PCI for STEMI by 373 operators were analyzed. PCI volumes above the 75th percentile (>30 cases/year), between the 75th and 25th percentile (10–30 cases/year), and below the 25th percentile (<10 cases/year) were defined as high, moderate, and low-volume operators, respectively. In-hospital outcomes including mortality, non-fatal myocardial infarction (MI), stent thrombosis, stroke, and urgent repeat PCI were analyzed.RESULTS: The average number of primary PCI cases performed by 373 operators was 22.2 in a year. In-hospital mortality after PCI for STEMI was 571 cases (6.9%). In-hospital outcomes by operator volume showed no significant differences in the death rate, cardiac death, non-fatal MI, and stent thrombosis. However, the rate of urgent repeat PCI tended to be lower in the high-volume operator (0.6%) than in the moderate-(0.7%)/low-(1.5%) volume operator groups (p=0.095). The adjusted odds ratios for adverse in-hospital outcomes were similar in the 3 groups. Multivariate analysis also showed that operator volume was not a predictor for adverse in-hospital outcomes.CONCLUSIONS: In-hospital outcomes after primary PCI for STEMI were not associated with operator volume in the K-PCI registry.
Cohort Studies ; Death ; Hospital Mortality ; Humans ; Mortality ; Multivariate Analysis ; Myocardial Infarction ; Odds Ratio ; Percutaneous Coronary Intervention ; Retrospective Studies ; Stents ; Stroke ; Thrombosis ; Treatment Outcome

Human anisakiasis is a disease caused by an infestation of the third stage larvae of family anisakidae. The ingested larvae invade the gastrointestinal wall, causing clinical symptoms that include abdomen pain, nausea, and vomiting. Although enteric anisakiasis is extremely rare, it can induce intestinal obstruction. We report a case in which emergency surgery was needed due to intestinal obstruction that coincided with symptoms related to anisakiasis, along with a brief literature review.
Abdomen ; Anisakiasis* ; Emergencies ; Humans ; Intestinal Obstruction ; Jejunum* ; Larva ; Nausea ; Vomiting

OBJECTIVE: We compared the results of two surgical techniques by retrospective study of 60 elderly patients (65 years or older) who underwent either decompression alone or fusion for the treatment of two-level or more lumbar spinal stenosis. METHODS: During the period of 2003 and 2008, two-level or more decompression alone or fusion was performed for lumbar spinal stenosis by three surgeons at our institution. Patients were allocated to two groups by surgical modality, namely, to a decompression group (31 patients) or a fusion group (29 patients). Overall mean age was 71.1 years (range, 65-84) and mean follow-up was 5.5 years (range, 3-9). A retrospective review of clinical, radiological, and surgical data was conducted. RESULTS: No significant difference between the two groups was found with respect to age, follow-up period, surgical levels, or preoperative condition. At the last follow-up, correction of lumbar lordotic angle (determined radiologically) was better in the fusion group. However, clinical outcomes including visual analogue scale, Oswestry Disability Index, and the Odom's criteria were not significantly different in the two groups. On the other hand, surgical outcomes, such as, operation time, estimated blood loss, and surgical complications were significantly better in the decompression alone group. CONCLUSION: Our findings suggest that decompressive laminectomy alone achieves good outcomes in patients with two-level or more lumbar spinal stenosis, associated with an advanced age, poor general condition, or osteoporosis.
Aged ; Decompression ; Follow-Up Studies ; Hand ; Humans ; Laminectomy ; Osteoporosis ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis

OBJECTIVE: This study was conducted to compare radiologic changes and clinical outcomes in adjacent level of percutaneous pedicle screws with those of conventional (open) pedicle screws. METHODS: From January 2007 to December 2009, 51 patients underwent L3-5 decompression and spinal fusion. Percutaneous pedicle screws were used in 22 patients, and open pedicle screws were used in the remaining patients. For estimation of instability, we performed measurements of change in the lordotic and adjacent segment angles. A retrospective evaluation of the patients' data and several assessment scales was conducted for determination of clinical outcomes. RESULTS: The radiological examinations revealed no significant differences, except the L2-3 sagittal angle change. The upper adjacent level angle change in the open group was larger than that in the percutaneous group. In the percutaneous group, the sagittal angle changed from 9.7+/-3.0degrees to 11.25+/-3.6degrees during the follow-up periods, and in the open group, the sagittal angle changed from 10.8+/-4.1degrees to 13.6+/-4.5degrees. Radiological instability was observed in 5 patients (17%) in the open group and in 2 patients (9%) in the percutaneous group. Both groups showed similar clinical outcomes. CONCLUSION: We suggest that open screws have a greater tendency to cause degenerative change in the upper segment than percutaneous screws. This may be because percutaneous screw fixation causes minimal injury to supporting structures and preserves adjacent facet joints.
Decompression ; Follow-Up Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Spinal Fusion ; Weights and Measures ; Zygapophyseal Joint

OBJECTIVE: This study was conducted to compare radiologic changes and clinical outcomes in adjacent level of percutaneous pedicle screws with those of conventional (open) pedicle screws. METHODS: From January 2007 to December 2009, 51 patients underwent L3-5 decompression and spinal fusion. Percutaneous pedicle screws were used in 22 patients, and open pedicle screws were used in the remaining patients. For estimation of instability, we performed measurements of change in the lordotic and adjacent segment angles. A retrospective evaluation of the patients' data and several assessment scales was conducted for determination of clinical outcomes. RESULTS: The radiological examinations revealed no significant differences, except the L2-3 sagittal angle change. The upper adjacent level angle change in the open group was larger than that in the percutaneous group. In the percutaneous group, the sagittal angle changed from 9.7+/-3.0degrees to 11.25+/-3.6degrees during the follow-up periods, and in the open group, the sagittal angle changed from 10.8+/-4.1degrees to 13.6+/-4.5degrees. Radiological instability was observed in 5 patients (17%) in the open group and in 2 patients (9%) in the percutaneous group. Both groups showed similar clinical outcomes. CONCLUSION: We suggest that open screws have a greater tendency to cause degenerative change in the upper segment than percutaneous screws. This may be because percutaneous screw fixation causes minimal injury to supporting structures and preserves adjacent facet joints.
Decompression ; Follow-Up Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Spinal Fusion ; Weights and Measures ; Zygapophyseal Joint

PURPOSE: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. MATERIALS AND METHODS: During 1998~1999, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. RESULTS: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered 3~4 times. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). CONCLUSION: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.
Brachytherapy ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Cisplatin ; Drug Therapy ; Endoscopy ; Esophageal Neoplasms* ; Esophagitis ; Female ; Fluorouracil ; Humans ; Korea* ; Male ; Photons ; Radiotherapy ; Republic of Korea ; Tomography, X-Ray Computed

OBJECTIVE: Having a reliable and reproducible measurement technique to measure the sagittal contour in vertebral fractures is paramount to clinical decision making. This study is designed to determine the most reliable measurement technique in osteoporotic vertebral compression fracture. METHODS: Fifteen lateral radiographs of thoracic and lumbar fractures were selected and measured on two separate occasions by three spine surgeons using six different measurement techniques (Centroid, Harrison Posterior Tangent Methods and 4 different types of modified Cobb method). The radiograph quality was assessed and the center beam location was determined. Statistical analysis including ANOVA for repeated measures was carried out using the SAS software (v 8.0). RESULTS: The inter and intraobserver variance of the Cobb method 4 and Harrison posterior tangent method were significantly lower than the other four methods. The intraobserver correlation coefficients were the most consistent using the Cobb method 4 (0.982), which was followed by the Harrison posterior tangent (0.953) and Cobb methods 1 (0.874). The intraobserver agreement (% of repeated measures within 5 degrees of the original measurement) ranged from 42% to 98% for each technique for all three observers, with the Cobb method 4 showing the best agreement (97.8%) followed by the Harrison posterior tangentmethod (93.7%). CONCLUSION: The Cobb method-4 and Harrison posterior tangent methods, when applied to measuring the kyphosis, are reliable and have a similar small error range. The Cobb method 4 shows the best overall reliability. However, the centroid method and Cobb method using a fractured endplate do not produce an accurate result due to inter and intraobserver differences in determining the baseline.
Decision Making ; Fractures, Compression* ; Kyphosis ; Osteoporosis ; Spine