• 제목/요약/키워드: Indwelling catheter

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A Study on Foley Catheter Associated Bacteriuria (유치도뇨관 삽입으로 인한 요감염에 관한 연구)

  • 소희영
    • Journal of Korean Academy of Nursing
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    • v.8 no.2
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    • pp.79-88
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    • 1978
  • Utilizing Foley catheter in therapy of inpatient cause bacteriuria and urinary tract infection that leads to first ranked factor's in hospital infection (nosocomial infection). To protect the patient from such infections, emphasis should be placed on catheterization technique and management of the closed drainage system, this reducing the chances of introducing organisms. This study has been done at Intensive Care Unit of A and B hospitals from May-Oct. 1978 on 20 male and 18 female adult patients. Each patient was screened and found to have nonbacteriuria in clean catch specimen before catheterization. Clean catch specimen via foley catheter were obtained after 48 hours and 96 hours from catheterization. The findings are as follows: A. The occurrence of bacteriuria in patients according to duration of indwelling catheter. 1 213.9% of the patient showed evidence of bacteriuria 48h post catheterization specimen, while 57.9% of the patient showed evidence of bacteriuria 96h post catheterization specimen. 2 25% of male patients had infection 48h post catheterization and 45% displayed bacteriuria post catheterization. 33% of female patients displayed infection 48h post catheterization and 72.2% having infection 96h post catheterization. Statistically there were significant differences between female patients and the duration of insertion. (P < 0.025) B. The occurrence of bacteriuria with the administration of bacteriuria with the ad-ministration of antibiotic in 24 patients was in 41,7%. The occurrence of bacteriuria without the administration of antibiotic in 14 patients was in 92.3%. Statistically there were very significant difference between the administration of the antibiotis and bacteriuria. (P < 0.005) C. Studies were done according to the consciousness level of the patients, 71.4% of those patient who displayed mental disorder developed bacteriuria, while 30.0% of those patient who displayed non mental disorder developed bacteriuria.

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A Case Report of a Stroke Patient Treated with Korean Medicine Diagnosed with a Catheter-associated Urinary Tract Infection Caused by Multidrug-resistant Pseudomonas Aeruginosa (뇌졸중 환자에게 유치도뇨관 삽입 이후 발생한 다제내성 녹농균 요로감염 한방치험 1례)

  • Jang, Chul-yong;Kim, Hyo-rin;Hwang, Gyu-sang;Yu, Keun-jeong;Lee, Su-yeong;Kim, June-hyun;Kim, Min-soo;Shin, Yong-jeen;Shin, Sun-ho
    • The Journal of Internal Korean Medicine
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    • v.37 no.6
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    • pp.1042-1050
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    • 2016
  • This case study reports on the effect of Korean medicine on a catheter-associated urinary tract infection (CAUTI) caused by multidrug-resistant Pseudomonas aeruginosa. An 83-year-old man diagnosed with stroke had dysuria, and it was found that an indwelling urinary catheter led to CAUTI. From laboratory tests, we identified multidrug-resistant Pseudomonas aeruginosa and applied Korean medicine to him. After herbal medication with acupuncture and moxibustion, we studied a urinalysis and urine culture again for follow-up. We found meaningful improvement in bacteriuria and bacterial identification. This case suggests that Korean medicine could have a beneficial effect on urinary tract infections caused by multidrug-resistant Pseudomonas aeruginosa.

A Case of Continuous Ambulatory Peritonitis Dialysis Peritonitis Due to Stenotrophomonas maltophilia Using Antibiotic Combination (항생제 병용요법으로 치료한 Stenotrophomonas maltophilia 복막투석 복막염 1예)

  • Ko, Hee Sung;Choi, Ah Ran;Kim, Tae Hoon;Kyung, Chan Hee;Cho, Jang Ho;Kim, Yong Hoon;Lee, Jung Eun
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.109-111
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    • 2013
  • Continuous ambulatory peritoneal dialysis (CAPD) peritonitis is a major complication of peritoneal dialysis (PD) and leads to the discontinuation of PD. Despite its limited pathogenicity, CAPD peritonitis caused by Stenotrophomonas maltophilia (S. maltophilia), an important nosocomial pathogen that is present in nature and is usually associated with plastic indwelling devices. Infection of S. maltophilia is associated with a poor prognosis, including inability to maintain the CAPD catheter, because of its resistance to multiple antibiotics. We report a case of CAPD peritonitis due to S. maltophilia that was treated successfully using oral Trimethoprim-sulfamethoxazole and intraperitoneal Ticarcillin/clavulanate without removing the dialysis catheter.

Tubularized Penile-Flap Urethroplasty Using a Fasciocutaneous Random Pedicled Flap for Recurrent Anterior Urethral Stricture

  • Lee, Yong-Jig;Lee, Byung-Kwon
    • Archives of Plastic Surgery
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    • v.39 no.3
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    • pp.257-260
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    • 2012
  • This report describes the use of a tubularized random flap for the curative treatment of recurrent anterior urethral stricture. Under the condition of pendulous lithotomy and suprapubic cystostomy, the urethral stricture was removed via a midline ventral penile incision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneous buried interrupted sutures were used to reapproximate the waterproof tubularized neourethra and to coapt with the neourethra and each stump of the urethra, first proximally and then distally. The defect of the penile shaft was covered by advancement of the surrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 month postoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hair growth on the lumen of the neourethra. The patient showed no voiding discomfort 6 months after the operation. The advantages of this procedure are the lack of need for microsurgery, shortening of admission, the use of only spinal anesthesia (no general anesthesia), and a relatively short operative time. The tubularized unilateral penile fasciocutaneous flap should be considered an option for initial flap urethroplasty as a curative technique.

Nontraumatic Pneumothorax -A Review of 56 Cases- (비외상성 기흉의 임상적 고찰)

  • 곽문섭
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.133-140
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    • 1969
  • We observed 56 cases of nontraumatic pneumothorax clinically and statistically, which had been experienced at the deparment of chest surgery. St. Mary`s Hospital,Catholic Medical College in theserecent years. 1] In the underlying pathology of spontaneous pneumothorax, nontuberculous origin [60.7%], especially due to pulmonary emphysema or blebs[17.8%], especially due to pulmonary emphysema or blebs[17. 8%], tended to increase as the reports of foreign countries, but tuberculous origin was still high in our country[39.3%]. Considering the 14 cases, unknown underlying pathology, the most of them might have scattered blebs which were not revealed in chest Roentgen films. 2] The principle treatment done in our clinic was as follows; The patients, below 20% lung collapse were treated by bed rest and abdominal respiration. The patients, between 20% and 40% lung collapse were treated by repeated pleural aspiration or closed thoracotomy followed. The cases,over 40% lung collapse were treated by closed thoracotomy initially. 3] The average duration of indweIling catheter was 3 to 4 days in the closed thoracotomy. We used to not remove the indwelling catheter early to promote pleural adhesion. 4] Sometimes, the closed thoracotomy drainage induces bronchial irritation and asthmatic attacks, especially in old age group accompanying pulmonary emphysema. In these cases, respiratory difficulties and acidosis should be prevented and controlled with medical treatment including steroid therapy.

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Two-Year Hospital-Wide Surveillance of Central Line-Associated Bloodstream Infections in a Korean Hospital

  • Seo, Hye Kyung;Hwang, Joo-Hee;Shin, Myoung Jin;Kim, Su young;Song, Kyoung-Ho;Kim, Eu Suk;Kim, Hong Bin
    • Journal of Korean Medical Science
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    • v.33 no.45
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    • pp.280.1-280.9
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    • 2018
  • Background: Surveillance and interventions of central line-associated bloodstream infections (CLABSIs) had mainly been targeted in intensive care units (ICUs). Central lines are increasingly used outside ICUs. Therefore, we performed a hospital-wide survey of CLABSIs to evaluate the current status and develop strategies to reduce CLBASI rates. Methods: All hospitalized patients with central venous catheters (CVCs) were screened for CLABSIs from January 2014 through December 2015 at a 1,328 bed tertiary care teaching hospital in Korea using an electronic data-collecting system. Clinical information including type of CVC was collected. CLABSI rates were calculated using the definitions of the National Health and Safety Network after excluding mucosal barrier injury laboratory-confirmed bloodstream infection (BSI). Results: A total of 154 CLABSIs were identified, of which 72 (46.8%) occurred in general wards and 82 (53.2%) in ICUs (0.81 and 2.71 per 1,000 catheter days), respectively. Nontunneled CVCs were most common (68.6%) among 70 CLABSI events diagnosed within one week of their maintenance. On the other hand, tunneled CVCs and peripherally inserted central catheters (PICCs) were more common (60.5%) among 114 CLABSI events diagnosed more than a week after maintenance. Whereas the majority (72.2%) of CLABSIs in ICUs were associated with non-tunneled CVCs, tunneled CVCs (38.9%) and PICCs (36.8%) were more common in general wards. Conclusion: CLABSIs are less common in general wards than in ICUs, but they are more often associated with long-term indwelling catheters. Therefore, interventions to prevent CLABSIs should be tailored according to the type of ward and type of catheter.

The Effect of Epidural Dexamethasone after Lumbar Epidural Anesthesia (요부 경막외마취 후 경막외강으로 투여한 Dexamethasone의 효과)

  • Kim, Dong-Hee;Kim, Tae-Jin
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.65-68
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    • 1998
  • Background: Epidural steroid injection(ESI) is often adminstered to treat lower back pain, but its effect iveness on postepidural backache have not yet been determined. Methods: Sixty patients scheduled for cesarean section under epidural anesthesia were randomly assigned to receive, 1 ml of normal saline(Group 1), or 5 mg of dexamethasone (Group 2), epidurally via indwelling catheter after delivery. Results: The incidences of postepidural backache occured significantly more often in Group 1(56.7%) than in Group 2(26.7%)(P<0.05). There was a significant association between postepidural backache and multiple attempts at epidural needle placement. Conclusion: Epidural dexamethasone has a preventive effect on postepidural backache.

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In vitro Retention of Antimicrobial Activity of Ciprofloxacin-incorporated Central Venous Catheters

  • Jeon, Sung-Min;Kim, Mal-Nam
    • Biomedical Science Letters
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    • v.13 no.3
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    • pp.175-182
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    • 2007
  • In vitro ciprofloxacin (CFX)-release study and bioassay using microorganisms were performed to estimate the retention of the antimicrobial activity of the CFX-incorporated central venous catheters (CFX-CVCs). The release experiments were carried out under the optional CFX-release conditions to mimic the in vivo environment. The release of CFX experienced an initial burst followed by a slow and steady matrix-diffusion controlled release. The 1.0CP (polyurethane catheter containing 1.0% (w/w) of CFX) under dynamic condition showed a near zero-order CFX release profile, which is beneficial for the long-tenn antimicrobial activity. The modified Kirby-Bauer method was performed employing S. aureus and E. coli to evaluate the retention of antimicrobial activity of the catheters retrieved from the release experiments. The 1.0CP showed the long-term antimicrobial activity (${\geq}\;21$ days) against both S. aureus and E. coli. These results indicate that 1.0CP is useful as a long-tenn indwelling CVC.

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Introduction of Visceral Pain Model to Test of Visceral Nociception in the Rats (백서의 내장 신경통 연구를 위한 Visceral Pain Model(VPM)의 소개)

  • Lee, Chul-Woo
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.25-30
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    • 1995
  • Anlgesic agents against visceral pain typically rely on a noxious chemical irritation of the peritoneum, e. g., acetic acid and phenylquinone writhing test. While useful, this type of assay depends upon an acute inflammation and the release of local alogens. Further, ethical and scientific constraints prevent repeated assessments in a single animal, thereby compounding the difficulty of assessing tolerance development to analgesic agents. To overcome these constraints, Colburn et al. developed a model for mechanical visceral pain model (VPM) based on a repeatable and reversible duodenal distention in the rat. A chronic indwelling intraduodenal balloon catheter is well tolerated and upon inflation produces a writhing response graded in proportion to distention. This response is inhibited by morphine in a dose dependent manner. We found that a model for visceral pain was thought to be a great value.

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Continuous Caudal Block for Intractable Pain (지속적(持續的) 미추차단(尾椎遮斷)에 의한 동통관리(疼痛管理) 3예(三例))

  • Park, Wyun-Kon;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.85-88
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    • 1989
  • We experienced 3 cases of continuous caudal block. The first case had suffered from severe pain of the external genitalis after urethral injury from a car accident and this was controlled by continuous caudal block. The other 2 cases were a metastaric malignant tumor of the lumbar vertebra from cancer of the cervix and histiocytoma of the breast, and both had suffered from intractable pain of the lower extremity. But lumbar epidural block was impossible because of radiation fibrosis and previous operation scar of the spine. So a continuous caudal block was performed and the pain was controlled effectively. The longest duration was 50 days and there were no problems related catheter indwelling. Pain in the area of the lumbar and sacral nerve distribution can be controlled by continuous caudal block. Here in we reported 3 cases and reviewed the literature.

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