• Title/Summary/Keyword: Indwelling

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A Case of Bacillus licheniformis Bacteremia Associated with Bronchoscopy (기관지 내시경 후에 발생한 Bacillus Licheniformis 균혈증)

  • Hong, Tae Won;Kim, Hyo Youl;Jee, Myeong Gwan;Choi, Joung Wook;Youg, Suk Joong;Shin, Kye Chul;Lee, Won Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.553-556
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    • 2004
  • Bacillus species are aerobic, gram-positive, spore forming rods, and they are usually found in the surrounding environment. If they are isolated in the clinical specimen, they are generally considered as contaminants rather than a true pathogen. Infection with Bacillus licheniformis is usually associated with the immunocompromised state, trauma, an indwelling intravenous catheter or an intravenous drug abuser. This infection is easily controlled by removal of the catheter and surgical debridement of the local infected tissue as well as an appropriate antimicrobial therapy. We reported here on a case of Bacillus licheniformis bacteremia associated with a bronchoscopic procedure in an immune competent patient.

Surgical Repair of the Traumatic Urethral Transection with Urethrocutaneous Fistula in a Pung-san Dog (풍산 개에서 발생한 외상성 요도 절단과 요도 피부 누공의 수술적 교정)

  • Lee, Jae-Hoon;Kim, Song-Ho;Yang, Wo-Jong;Kang, Eun-Hee;Chang, Hwa-Seok;Chung, Dai-Jung;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.27 no.3
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    • pp.295-298
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    • 2010
  • A five-year-old, castrated male, Pung-san dog was referred to Konkuk University Veterinary Teaching Hospital with trauma and persistent hemorrhage in the inguinal region. The dog had a history of being wounded by a wild boar at 5 days prior to presentation. Rupture of the membranous urethra and urethrocutaneous fistula were demonstrated by the retrograde positive contrast urethrography. A urinary catheter was placed to identify the urethra and urethrocutaneous fistula. The necrotic tissues and damaged tissues by urine leakage around urethrocutaneous fistula were debrided. An urethral anastomosis over an indwelling catheter was performed. The dog maintained normal urination without other complications including dysuria and hematouria at the follow-up evaluation after 1 month postoperatively. A retrograde urethrogram repeated at 2 months after surgery showed no urethral stricture.

Purification and Characterization of the Staphylococcus epidermidis Urease (Staphylococcus epidermidis urease의 정제 및 생화학적 특성에 관한 연구)

  • Min, Seon-Hee;Lee, Mann-Hyung
    • Journal of Life Science
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    • v.17 no.4 s.84
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    • pp.581-586
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    • 2007
  • Staphylococcus epidermidis is a coagulase-negative, gram-positive bacterium that normally inhabits the human skin. S. epidermidis is also known to be an opportunistic pathogen in infections of various indwelling medical devices. This report describes purification and characterization of the urease of S. epidermidis urease, which may act as a virulence factor. The urease from S. epidermidis was purified 1,127 fold by using DEAE-Sepharose, Phenyl-Sepharose, Mono-Q and Superdex HR200 column chromatography. The specific activity of the purified enzyme was 993.8 U/mg. Michaelis constant($K_m$) of the enzyme was estimated to be 8.5 mM urea by using Lineweaver-Burke double reciprocal plot. The native molecular weight of the urease was shown to be 255 kD by using Superose 6HR gel filtration chromatography and the purified enzyme contained 2.2 nickel ions per catalytic unit. The overall stoichiometry of the enzyme subunits appears to be $(\alpha\beta\gamma)_3$, which is consistent with the enzymes from other bacteria sources.

Tracheoesophageal Shunt Voice in Total Laryngectomee (후두 전 절제 환자에서 음성재활을 위한 기관식도발성)

  • Wang, Soo-Geun;Jang, Sun-Mi
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.21-27
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    • 2008
  • Total laryngectomy is the most useful procedure tor advanced laryngopharyngeal cancer, but it remains the major problem such as loss of voice. Voice restoration is essential for every patients who undergo a total laryngectomy. Ideal voice rehabilitation methods can resolve three factors. First, every laryngectomee can produce voice sufficient for communication, second every patient should be allowed to use both hands freely during phonation, and last, the voice restoration methods should be easy and safe without complication during and after treatment. Among various voice rehabilitation procedures during or after total laryngectomy, it can be divided electronic and pneumatic methods. In pneumatic methods, there are also divided both pulmonary air and non-pulmonary air methods. The non-pulmonary air methods include esophageal speech, buccal speech, and pharyngeal speech. Pulmonary air methods are divided into surgical and non-surgical such as pneumatic speech aid. In the surgical methods, there are neoglottic operation, tracheopharyngeal shunt, and tracheopharyngeal shunt operations. Recently, tracheoesophageal shunt with or without prosthesis are being recognized the most effective method. Blom-Singer low pressure prosthesis, Panje button, and Provox are well known types of prosthesis in the tracheoesophageal shunt operation. Amatsu method is a kind of famous tracheoesophageal shunt method without using prosthesis. Authors tried to review the published articles for evaluation of effectiveness and problems of tracheoesophageal shunt operation with or without prosthesis. In conclusion, indwelling type of prosthesis and pharyngeal myotomy and plexus neurectomy are recommended for higher success rate during tracheoesophageal puncture procedure. More over, Amatsu method is also one of the recommended voice rehabilitation procedure during total laryngectomy. In this situation, pharyngeal myotomy and plexus neurectomy may be helpful for better fluent communication.

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Chest Tube Drainage of the Pleural Space: A Concise Review for Pulmonologists

  • Porcel, Jose M.
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.106-115
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    • 2018
  • Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (${\leq}14F$) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains. Chest tube insertion should be guided by imaging, either bedside ultrasonography or, less commonly, computed tomography. The so-called trocar technique must be avoided. Instead, blunt dissection (for tubes >24F) or the Seldinger technique should be used. All chest tubes are connected to a drainage system device: flutter valve, underwater seal, electronic systems or, for indwelling pleural catheters (IPC), vacuum bottles. The classic, three-bottle drainage system requires either (external) wall suction or gravity ("water seal") drainage (the former not being routinely recommended unless the latter is not effective). The optimal timing for tube removal is still a matter of controversy; however, the use of digital drainage systems facilitates informed and prudent decision-making in that area. A drain-clamping test before tube withdrawal is generally not advocated. Pain, drain blockage and accidental dislodgment are common complications of small-bore drains; the most dreaded complications include organ injury, hemothorax, infections, and re-expansion pulmonary edema. IPC represent a first-line palliative therapy of malignant pleural effusions in many centers. The optimal frequency of drainage, for IPC, has not been formally agreed upon or otherwise officially established.

A Study of Clients with Total Laryngectomy for the Adaptation of Daily Activities - Functional Status, Self-esteem and Depression - (후두전적출자의 일상생활 적응을 위한 연구 - 기능상태, 자아존중감 및 우울 -)

  • Han, Hye-Jin;Park, Jin-Hee;Park, Ho-Ran;Moon, Young-Im
    • Journal of Korean Public Health Nursing
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    • v.19 no.2
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    • pp.274-283
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    • 2005
  • Purpose: To survey the functional status, self-esteem and depression of a community of indwelling clients with total laryngectomy, and to evaluate the correlation among these three variances. Methods: From May 2002 to October 2002, 76 clients who had undergone total laryngectomy more than three months ago were surveyed with using Baker's functional status in head & neck cancer-self report, Rosenberg's self rating self-esteem scale and Zung's self rating depression scale. Results: 1. The functionaI status score was $48.67{\pm}10.12$. The subjects aged 70 years or older had significantly higher scores than the subjects aged $50{\sim}59$ years. The group of clients who were operated on more than five years ago showed higher scores than the patients operated on within a year. 2. The self-esteem score was $30.47{\pm}6.44$. 3. The depression score was $47.26{\pm}8.01$. The subjects who bad three family members and the subjects who had five family members had significantly higher scores than the subjects who had two family members. 4. A significant correlation found between the functional status and self-esteem. Significant negative correlations were found between the functional status and depression and also between self-esteem and depression. Conclusion: Remarkable correlations were observed among functional status, self-esteem and depression. Nurses should consider the status of layngectomy patients and pay more attention to their pre- and post- operative nursing care and rehabilitation.

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A Study on The Common Form of Timber Framework of Folk House in Yeosu City (여수지역 재래 민가(在來 民家) 가구(架構) 구성의 공통형에 관한 연구)

  • Park, Chan;Watanabe, Masahiro;Kim, Jeong-Gyun
    • Journal of the Korean Institute of Rural Architecture
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    • v.19 no.4
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    • pp.67-75
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    • 2017
  • This paper overall and systematically investigates of basic design know-how on commonly indwelling timber framework in a folk house in Yeosu area. in other words, Setting the goal of 'investigates of common form of timber framework', and for this goal, surveyed and analyzed for folk house a lot of findable in Yeosu area. As a result, elicits for four types plural common form((1) 4 front 'kan' - a hipped roof construction - front 'toi'/3 'ryang' - no central pillar/side beam type, (2) 4 front 'kan' - a hipped roof construction - front 'toi'/3 'ryang' - one side central pillar/central side beam type, (3) 4 front 'kan' - a hipped roof construction - front/back 'toi'/2'kozu'5'ryang' - no central pillar/side beam type, (4) 4 front 'kan' - a hipped roof construction - front/back 'toi'/'2kozu'5'ryang' - one side central pillar/central side beam type). Common form is at that time, so commonly located in the head of the technician that a form that play an exemplary role in design, or it is concretely assumed for commonly aimed form. in other words, Common form is come into existence on premise for basic design data. Documentation of folk house design know-how is done through this, and the base design and specification of korean private house is written in the contents divided into by areas.

Effects of Body Position and Time after Feeding on Gastric Residuals in LBW Infants

  • Hwang, Sun-Kyung;Ju, Hyun-Ok;Kim, Young-Soon;Lee, Hwa-Za;Kim, Young-Hae
    • Journal of Korean Academy of Nursing
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    • v.33 no.4
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    • pp.488-494
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    • 2003
  • Purpose. To examine the effects of body position and time after feeding on gastric residuals in low birth weight infants(LBW). Methods. A repeated measures design was conducted. Twenty LBW infants being fed via indwelling nasogastric tubes were randomly assigned to one of 5 different position orderings. In each position, gastric residuals were measured at 30, 60, 90, 120, 150, and 180 minutes after feeding. Results. In comparisons of gastric residuals with position and time, the main effects of position and time were statistically significant (F=5.038, p=0.001; F=429.763, p < 0.001, respectively), but the interaction between position and time was found not to be significant. In pairwise comparisons, the gastric residuals were more reduced in the right anterior oblique and prone positions compared with the left lateral position (p < 0.05) and the differences across time periods were significant (p < 0.001). Conclusions. The body position after feeding has a significant affect on gastric residuals over time in LBW infants. The right anterior oblique or prone position is recommended rather than left lateral position after feeding. Knowledge of the proper position and the pattern of gastric emptying over time after feeding may lead to the development of evidence-based nursing care.

A Study on Learning Experiences and Self-Confidence of Core Nursing Skills in Nursing Practicum among Final Year Nursing Students (졸업학년 간호학생의 핵심기본간호술 학습경험과 수행자신감 조사연구: 실습교과를 중심으로)

  • Han, Aekyung;Cho, Dong Sook;Won, Jongsoon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.2
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    • pp.162-173
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    • 2014
  • Purpose: This study was done to identify learning experiences and self-confidence and to analyze nursing students' self-confidence according to learning experiences for core nursing skills (CNS). Method: Participants were 502 final year nursing students. Data were collected using a structured questionnaire and analyzed using descriptive statistics and t-test. Results: Over 60% of participants had practiced 15 items of the 24 CNS in the basic nursing lab (BNL). In clinical practice (CP), they had practiced five items but experienced only one item in a simulation lab (SL). Items with the highest confidence level were vital signs (4.69) followed by blood sugar test (4.60), pulse oximeter (4.38), and oral medication (4.12). Items with the lowest confidence level were blood transfusion (2.17) followed by enema (2.64) and indwelling catheterization (2.67). The group with CNS experience in the practice curriculum was generally more confident than the group with no experience. Self-confidences in some skills was significantly different depending on availability of SL, credits for BNL and CP, and presence of preceptors. Conclusion: Results indicate a need to develop practice education strategies such as changing the CP to practice-centered learning with preceptors and including well-designed SL to increase confidence of nursing students.

A Case of Septic Pulmonary Embolism Associated with MRSA Infective Endocarditis (메치실린 내성 황색포도상구균 세균성 심내막염에 의한 패혈성 폐색전증 1예)

  • Lee, Ki-Jong;Kim, Nha-Young;Kim, Ja-Seon;Yun, Han-Kyeol;Oh, Mi-Jung;Kim, Do-Hoon;Cho, Sang-Kyun;Ryu, Han-Young;Bae, Young-A;Kim, Dae-Bong;Shin, Mi-Kyung;Chin, Jae-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.2
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    • pp.124-128
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    • 2010
  • Septic pulmonary embolism is the process in which an infected thrombus becomes detached from its site of origin and lodges in a pulmonary artery, and is usually associated with infective endocarditis, especially right-sided, or infection-associated with indwelling catheters, peripheral septic thrombophlebitis, and periodontal diseases, etc. Here, we report a case of septic pulmonary embolism associated with tricuspid valve infective endocarditis. A 23-year-old female was admitted to our hospital, due to fever, sore throat, and myalgia. In her past medical history, she had undergone a surgical operation for closure of a ventricular septal defect, but was informed that the operation resulted in an incomplete closure. The initial chest radiograph demonstrated multiple rounded, parenchymal nodules in various sizes; several nodules had central lucency suggesting cavitations. Echocardiography demonstrated a large vegetation attached to the septal tricuspid valve leaflet, extending from right ventricular inflow tract to outflow tract. Computed tomography of thorax revealed bilateral peripheral nodules and wedge-shaped consolidation at various sizes, mostly accompanied by cavitations.