2.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.Diagnostic Accuracy of Contrast-Enhanced Ultrasonography for the Assessment of Small Renal Mass: A Prospective Study
Jae-Wook CHUNG ; Seo Young PARK ; Seunghee WOO ; Yun Ah KIM ; Jun-Koo KANG ; Yun-Sok HA ; Jun Nyung LEE ; Bum Soo KIM ; Tae-Hwan KIM ; Ghil Suk YOON ; Tae Gyun KWON ; See Hyung KIM
Journal of Urologic Oncology 2024;22(2):128-135
Purpose:
We prospectively compared the diagnostic accuracy of kidney dynamic computed tomography (KDCT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasonography (CEUS) for the assessment of small renal mass (SRM) (≤4 cm).
Materials and Methods:
Seventy-six patients with SRM (mean age, 58.4±13.1 years) who underwent renal biopsy (n=11) or nephrectomy (partial or radical) (n=65) were enrolled. All patients underwent KDCT, MRI, and CEUS before renal biopsy or nephrectomy.
Results:
The mean maximal tumor size was 21.0±9.8 mm. The mean R.E.N.A.L nephrometry score was 7.0±1.7. Fifty-six patients had renal cell carcinoma (RCC) (clear cell, 42; papillary, 7; chromophobe, 5; succinate dehydrogenase deficient, 1; unspecified RCC, 1). Twenty patients had a benign tumor (angiomyolipoma, 11; oncocytoma, 3; others, 6). Clinicopathologic variables were comparable in RCC and benign groups. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of KDCT were 89.3%, 10.0%, 73.5%, and 25.0%, respectively. The sensitivity, specificity, PPV, and NPV of MRI were 89.3%, 10.0%, 73.5%, and 25.0%, respectively. The sensitivity, specificity, PPV, and NPV of CEUS were 85.7%, 50.0%, 82.8%, and 55.6%, respectively. The diagnostic accuracy of KDCT, MRI, and CEUS were 68.4%, 68.4%, and 76.3%, respectively. In a subgroup analysis based on clinical tumor size of 10 mm and 20 mm, CEUS also showed the highest diagnostic accuracy.
Conclusions
CEUS had the highest specificity, PPV, and NPV and may help improve the assessment of SRM.
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.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.
8.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.
9.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.
10.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.

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