1.Effect of COVID-19 on the treatment process of ischemic stroke patients in emergency department according to having COVID-19-related symptoms or not: a retrospective multicenter cohort study
Seyong PARK ; Joonbum PARK ; Youngjoo LEE ; Hye Young JANG ; Young Shin CHO ; Heajin CHUNG ; Sang Il KIM ; Beom Sok SEO ; Young Wha SOHN ; Sung Oh LEE
Journal of the Korean Society of Emergency Medicine 2024;35(6):384-393
Objective:
This was a retrospective investigation conducted to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the treatment and outcomes of patients with ischemic stroke.
Methods:
Data were collected over one year for the COVID-19 and pre-COVID-19 (control) groups, from May 1, 2020, to April 30, 2021, when COVID-19 was prevalent in Korea, and from May 1, 2018 to April 30, 2019, before the COVID-19 outbreak, respectively. Adult patients diagnosed with acute cerebral infarction at three emergency medical centers during the study period were included. COVID-19-positive patients (i.e., those with COVID-19 symptoms but those who tested positive) were excluded from this study to ensure only the evaluation of delays in stroke treatment due to the pandemic.
Results:
During the COVID-19 pandemic, of the total of 82,558 patients who visited the emergency centers, 710 were diagnosed with ischemic stroke. The study observed that the pandemic caused process delays for these patients, resulting in longer wait times for brain CT scans (P=0.010, P<0.001) and emergency room stays (P=0.0055, P<0.001) during the COVID-19 period. However, the length of time for administration of tissue plasminogen activator remained relatively constant. Notably, the 28-day mortality rate was considerably higher for patients with COVID-19-related symptoms during the pandemic (13.6% vs 3.1%; P=0.006). A cumulative risk analysis revealed an increased mortality risk for patients with COVID-19 related symptoms (P=0.005).
Conclusion
This study showed the need to improve emergency care procedures during pandemics to ensure prompt treatment of ischemic stroke. Preparation and resource allocation for ischemic stroke patients with COVID-19 symptoms are crucial.
3.Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series
Beomsoo KIM ; Young-Sin CHOI ; Jun-Koo KANG ; Yun-Sok HA ; Seock Hwan CHOI ; Bum Soo KIM ; Hyun Tae KIM ; Eun Sang YOO ; Tae Gyun KWON ; Jae-Wook CHUNG ; Tae-Hwan KIM
Urogenital Tract Infection 2024;19(3):97-103
Purpose:
This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital.
Materials and Methods:
From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process.
Results:
P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests.
Conclusions
This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.
4.Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series
Beomsoo KIM ; Young-Sin CHOI ; Jun-Koo KANG ; Yun-Sok HA ; Seock Hwan CHOI ; Bum Soo KIM ; Hyun Tae KIM ; Eun Sang YOO ; Tae Gyun KWON ; Jae-Wook CHUNG ; Tae-Hwan KIM
Urogenital Tract Infection 2024;19(3):97-103
Purpose:
This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital.
Materials and Methods:
From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process.
Results:
P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests.
Conclusions
This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.
5.Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series
Beomsoo KIM ; Young-Sin CHOI ; Jun-Koo KANG ; Yun-Sok HA ; Seock Hwan CHOI ; Bum Soo KIM ; Hyun Tae KIM ; Eun Sang YOO ; Tae Gyun KWON ; Jae-Wook CHUNG ; Tae-Hwan KIM
Urogenital Tract Infection 2024;19(3):97-103
Purpose:
This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital.
Materials and Methods:
From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process.
Results:
P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests.
Conclusions
This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.
6.Effect of COVID-19 on the treatment process of ischemic stroke patients in emergency department according to having COVID-19-related symptoms or not: a retrospective multicenter cohort study
Seyong PARK ; Joonbum PARK ; Youngjoo LEE ; Hye Young JANG ; Young Shin CHO ; Heajin CHUNG ; Sang Il KIM ; Beom Sok SEO ; Young Wha SOHN ; Sung Oh LEE
Journal of the Korean Society of Emergency Medicine 2024;35(6):384-393
Objective:
This was a retrospective investigation conducted to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the treatment and outcomes of patients with ischemic stroke.
Methods:
Data were collected over one year for the COVID-19 and pre-COVID-19 (control) groups, from May 1, 2020, to April 30, 2021, when COVID-19 was prevalent in Korea, and from May 1, 2018 to April 30, 2019, before the COVID-19 outbreak, respectively. Adult patients diagnosed with acute cerebral infarction at three emergency medical centers during the study period were included. COVID-19-positive patients (i.e., those with COVID-19 symptoms but those who tested positive) were excluded from this study to ensure only the evaluation of delays in stroke treatment due to the pandemic.
Results:
During the COVID-19 pandemic, of the total of 82,558 patients who visited the emergency centers, 710 were diagnosed with ischemic stroke. The study observed that the pandemic caused process delays for these patients, resulting in longer wait times for brain CT scans (P=0.010, P<0.001) and emergency room stays (P=0.0055, P<0.001) during the COVID-19 period. However, the length of time for administration of tissue plasminogen activator remained relatively constant. Notably, the 28-day mortality rate was considerably higher for patients with COVID-19-related symptoms during the pandemic (13.6% vs 3.1%; P=0.006). A cumulative risk analysis revealed an increased mortality risk for patients with COVID-19 related symptoms (P=0.005).
Conclusion
This study showed the need to improve emergency care procedures during pandemics to ensure prompt treatment of ischemic stroke. Preparation and resource allocation for ischemic stroke patients with COVID-19 symptoms are crucial.
7.Progression-directed therapy in patients with oligoprogressive castration-resistant prostate cancer
Jun Nyung LEE ; Mi Young KIM ; Jae Hoon KANG ; Jun-Koo KANG ; Jae-Wook CHUNG ; Yun-Sok HA ; Seock Hwan CHOI ; Bum Soo KIM ; Hyun Tae KIM ; Tae-Hwan KIM ; Eun Sang YOO ; See Hyung KIM ; Tae Gyun KWON
Investigative and Clinical Urology 2024;65(2):132-138
Purpose:
Oligoprogressive lesions are observed in a subset of patients who progress to castration-resistant prostate cancer (CRPC), while other lesions remain controlled by systemic therapy. This study evaluates the impact of progression-directed therapy (PDT) on these oligoprogressive lesions.
Materials and Methods:
This retrospective study included 40 patients diagnosed with oligoprogressive CRPC. PDT was performed for treating all progressive sites using radiotherapy. Fifteen patients received PDT using radiotherapy for all progressive sites (PDT group) while 25 had additional first-line systemic treatments (non-PDT group). In PDT group, 7 patients underwent PDT and unchanged systemic therapy (PDT-A group) and 8 patients underwent PDT with additional new line of systemic therapy on CRPC (PDT-B group). The Kaplan–Meier method was used to assess treatment outcomes.
Results:
The prostate specific antigen (PSA) nadir was significantly lower in PDT group compare to non-PDT group (p=0.007). A 50% PSA decline and complete PSA decline were observed in 13 patients (86.7%) and 10 patients (66.7%) of PDT group and in 18 patients (72.0%) and 11 patients (44.0%) of non-PDT group, respectively. The PSA-progression free survival of PDT-B group was significantly longer than non-PDT group. The median time to failure of first-line systemic therapy on CRPC was 30.2 months in patients in PDT group and 14.9 months in non-PDT group (p=0.014). PDT-B group showed a significantly longer time to progression than non-PDT group (p=0.025). Minimal PDT-related adverse events were observed.
Conclusions
PDT can delay progression of disease and enhance treatment efficacy with acceptable tolerability in oligoprogressive CRPC.
10.Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series
Beomsoo KIM ; Young-Sin CHOI ; Jun-Koo KANG ; Yun-Sok HA ; Seock Hwan CHOI ; Bum Soo KIM ; Hyun Tae KIM ; Eun Sang YOO ; Tae Gyun KWON ; Jae-Wook CHUNG ; Tae-Hwan KIM
Urogenital Tract Infection 2024;19(3):97-103
Purpose:
This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital.
Materials and Methods:
From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process.
Results:
P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests.
Conclusions
This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.

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