• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1094-1104
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• 1997

Background : Spontaneous pneumothoraces(SP) are divided into primary spontaneous pneumothoraces (PSP) which develop in healthy individuals without underlying pulmonary disorders and secondary spontaneous pneumothoraces(SSP) which occur in those who have underlying disorders such as tuberculosis or chronic obstructive lung diseases. Yet there is no established standard therapeutic approach to this disorder, i.e., from the spectrum of noninvasive treatment such as clinical observation with or without oxygen therapy, to aggressively invasive thoracoscopic bullectomy or open thoracotomy. Although chest tube thoracostomy has been most widely used, the patients should overcome pain in the initiation of tube insertion or during indwelling it potential infection and subcutaneous emphysema. Thus smaller-caliber tube has been challenged for the treatment of pneumothorax. Previously, we studied the therapeutic efficacy of 8 French catheter for spontaneous pneumothorax. But there has been few data for effectiveness of small-caliber catheterization in comparison with that of chest tube. In this study, we intended to observe the long-term effectiveness of 8 French catheter for the treatment of spontaneous pneumothoraces in comparison with that of chest tube thoracostomy. Method : From January, 1990 to January, 1996, sixty two patients with spontaneous pneumothoraces treated at Chung-Ang University Hospital were reviewed retrospectively. The patients were sub-divided into a group treated with 8 French catheter(n=23) and the other one with chest tube insertion(n=39). The clinical data were reviewed(age, sex, underlying pulmonary disorders, past history of pneumothorax, size of pneumothorax, follow-up period). And therapeutic effect of two groups was compared by treatment duration(duration of indwelling catheter or tube), treatment-associated complications and recurrence rate. Results : The follow-up period(median) of 8 French catheter group and chest tube group was 28 and 22 months, which had no statistical significance. Ther was no statistically significant difference of clinical characteristics between two groups with SP, PSP, SSP. The indwelling time of 8 French catheter group was $6.2{\pm}3.8$ days, which was significantly shorter than that of chest tube group in SP, $9.1{\pm}7.5$ days(p=0.047). In comparison of treatment-related complication in PSP, 8 French catheter group as 6.25% of complication showed lower tendency than the other group as 23.8% (p=0.041 ; one-tailed, p=0.053; two-tailed). The recurrence rate in each group of SP was 17.4%, 10.3%, which did not show any statistically significant difference. Conclusion : Treatment with 8 French catheter resulted in shorter indwelling time in sponteous pneumothorax, and lower incidence of treatment-related complication in primary spontaneous pneumothorax. And the recurrence rate in each of treatment group showed no statistically significant difference. So, we can recommend the 8 French small-caliber catheter for the initial therapy for spontaneous pneumothorax for the replacement of conventional chest tube thoracostomy. But further prospective study with more subjects of spontaneous pneumothorax will be needed for the evaluation of effectiveness of 8 French cateter.

• The Journal of the Korea Contents Association
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• v.17 no.7
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• pp.344-357
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• 2017

The purpose of this study was to analyze reflected status of evidence-based guideline on nursing textbook for prevention of catheter-associated urinary tract infections (CAUTIs). The subjects were 14 fundamental nursing textbooks consisting of 7 theoretical and 7 practical books published from March 2012 to March 2017. The evidence-based guideline was consisted of ninety-one recommendations for prevention of CAUTIs which were comprehensively collected from five guidelines. Collected data were analyzed using descriptive statistics. Reflected rate on theoretical and practical fundamental nursing textbooks were 23.0% and 15.2% respectively. The most reflected domains in theoretical and practical textbooks was catheter management and catheter insertion respectively. Sixteen out of 91 individual recommendations with more than 50% consistency rate were identified, and eight (50.0%) recommendations on the catheter maintenance area were identified. Lastly nine inconsistent recommendations were identified. And the most frequent discrepancies were indwelling catheterization for management of urinary incontinence, followed by regular changing indwelling catheter, clamping prior to removal and perineal care. In conclusion, we found that recommendations for the CAUTIs guidelines were poorly reflected on text books. Further revising fundamental nursing textbook should correct the discrepancies between textbooks and the guidelines.

• Neonatal Medicine
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• v.25 no.4
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• pp.196-201
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• 2018

Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various problems, including mechanical, infectious, and thrombotic complications in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extravasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chyloperitoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperitoneum develops in newborns with an indwelling catheter. UVC positions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.308-311
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• 1995

The incidence of contamination of epidural catheters used for pain control was investigated. To prevent epidural infection, all patients with epidural catheters had taken amoxacillin 1.5gm/day orally. Of the cultures of catheters catched from 303 patients undergoing continuous epidrual catheterization, 5 catheters (1.7%) were found to be contaminated; cervical 1/86 (1.2%), thoracic 1/27 (3.7%), and lumbar 3/190 (1.6%). Staphylococcus epidermidis was the most common etiologic agent (60%). To prevent epidural infection, sterilization of the skin around the epidural catheter and prophylactic use of broad-spectrum antibiotics are thought to be beneficial.

• The Korean Journal of Pain
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• v.4 no.1
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• pp.26-30
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• 1991

Continuous epidural analgesia is widely used in pain management. We investigates the incidence of contamination of epidural catheters used in epidural catheters for pain control. The tips of epidural catheters were examined for bacterial growth after use. In culture from 250 patients undergoing continuous epidural catheterization, 33(13.2%) catheters were found to be contaminated: staphylococcus epidermis 66.9%; staphylococcus aureus 12.1%; alpha streptococcus 12.1%; and others 9.1%. One significant epidural infection occured. One of the most common causes of the epidural infection during long time epidural block is the transmission of the microorganism from the contaminated skin to the epidural space along the epidural catheter. To prevent epidural infection, sterilization of the skin around the epidural catheter is essential.

• Clinical and Experimental Pediatrics
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• v.64 no.3
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• pp.123-129
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• 2021

Background: The use of indwelling central venous access devices (CVADs) in children can result in complications such as infection, occlusion, and dislodgement. Purpose: To evaluate whether reinforcing CVAD care bundles by using a regular direct feedback system could reduce such complications in children. Methods: The intervention in this retrospective interrupted time-series study was initiated in January 2019. The study was divided into the preintervention (October-December 2018), 3-month postintervention (January-March 2019), and 6-month postintervention (April-June 2019) phases. Risk difference and Poisson regression analyses were used to illustrate the effectiveness of the intervention. Results: The hospital-wide central line-related bloodstream infection rate decreased from 10.0/1,000 catheter-days to 4.5/1,000 catheter-days at 3-month postintervention (P=0.39) and to 1.4/1,000 catheter-days at 6-month postintervention (P=0.047). The central line occlusion rate significantly decreased from 30% to 12.8% (P=0.04) and 8.3% (P=0.002) at 3 and 6 months, respectively. Approximately 7% of CVADs became dislodged during the preintervention phase versus 8.5% (P=0.364) and 3.3% (P=0.378) at 3 and 6 months, respectively. Conclusion: Reinforcing CVAD care bundles with direct feedback could significantly decrease CVAD-associated complications in terms of infection at 6-month postintervention, and occlusion at 3- and 6-month postintervention. Thus, reinforcement and regular direct feedback might improve care quality in children with CVADs.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.96-100
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• 2005

Objective: The brain computed tomography(CT) is an important tool throughout the clinical course of chronic subdural hematoma(CSDH). In CT findings, the density of CSDH is different in each case. We analyze management options and results according to the density of CSDH. Methods: Seventy one patients with CSDH, who had been managed in our institute from August 2001 to December 2003, were reviewed retrospectively. The authors divided the patients into six groups according to the density of hematoma; Group A-hypodense rather than the brain parenchyma, group B-isodense, group C-hyperdense, group D-mixed with hypodense and hyperdense, group E-mixed with isodense and hypodense and group F-mixed with isodense and hypersdense. In each group, the operation method, the duration of the indwelling catheter and prognosis were analyzed. Results: The patients who showed mixed density were 39 and, those who showed single density were 32. All the patients underwent burr hole drainage for the primary choice. There was only two cases that needed additional craniotomy. The average duration of indwelling catheter was $5.40{\pm}1.91$ days. Statistically the duration was not different in each group(p-value<0.05, $x^2$ test). Three cases recurred, one in group C, another in group D, and the last in group E. It had no statistical significance due to low incidence of recurrence. Conclusion: We conclude that burr hole drainage is an acceptable primary treatment option for CSDH even though the density of hematoma is different in every single case.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.1041-1049
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• 2023

Objectives: The aim of this study is to describe the effects of treatment with traditional Korean medicine on a patient with voiding dysfunction caused by cerebral infarction. Methods: The patient was treated with herbal medicine, moxibustion, acupuncture, and electroacupuncture. The effects of these treatments were evaluated using the Korean version of the Modified Barthel Index and a post-void residual volume. Results: In this study, the Korean medicine Dangguishaoyao-san-hap-Jeoryeong-tang resulted in improvements in this patient with post-stroke urinary retention and successful removal of the indwelling catheter. Conclusion: The results suggest that traditional Korean medicine may be effective in ameliorating dysfunction caused by cerebral infarction.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.410-419
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• 1996

Background : Spontaneous pneumothorax have been managed with a variety of methods. The technique most frequently used is chest tube drainage. Small caliber catheters were first used in the management of pneumothorax complicating the percutaneous needle aspiration lung biopsy, and the try to treat spontaneous pneumothorax also has been reported. However, the value of small caliber catheters in spontaneous pneumothorax has not been fully evaluated. So, we tried to elucidate the efficacy of 8 French catheter in the management of spontaneous pneumothorax. Method : From January, 1990, to April, 1994, 44 patients with spontaneous pneumothorax treated at Chung-Ang university hospital were reviewed. The patients were sub-divide into 8 French catheter insertion group (n=21) and chest tube insertion group (n=23). We compared the presence of underlying lung disease, the extent of the collapse, the duration of indwelling catheter and complication between two groups. Results : 1) The duration of indwelling showed no significant difference between 8 French catheter group and chest tube. But, complication after insertion as subcutaneous emphysema was developed in only chest tube group. (p<0.05) 2) In the primary spontaneous pneumothorax, all case of the pneumothorax of which size was less than 50% showed complete healing with 8 French catheter insertion. Whereas the success rate in patients with large pneumothorax (more than 50%) was tended to be dependent on the age. 3) In the patients with secondary spontaneous pneumothorax who were managed with 8 French catheter, the success rate was trended to be high if the underlying disease of pneumothorax was not COPD and if the patient was young. Conclusion : These results show that 8 French catheter insertion probably was effective in the pneumothorax less than 50%, the primary spontaneous pneumothorax, young age or secondary pneumothorax not associated with COPD.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.4
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• pp.438-448
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• 2008

Purpose: The purpose of this study was to identify nursing activities and to analyze patient outcomes related to indwelling urinary catheterization. Method: A review was done of 628 medical records from five units for patients admitted between January 1 and June 30, 2006. Twelve nurses who worked in the same units were interviewed. Results: In the interviews, nurses reported considering several non-invasive interventions prior to catheterization but there were no medical records of this activity. Results from the in-depth interviews showed that infection control activities such as urinary bag management were conducted but again there were no medical records. Seventy-five percent of the catheters were removed without prescription. In the medical records there were no notes for approximately 15%, on the time of first voiding and 80%, on volume of first voiding after removal of catheter. There was a significant difference in hospitalization days between the group catheterized for 5 days or less and the group catheterized for 6 days or more. Conclusion: Results indicate a need to close the gap between recorded and described activities and between current and best evidence based practice. Further study is needed to develop a standard recording system and guidelines related indwelling catheterization to decrease the gaps identified in this research.