• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.614-624
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• 1999

The purpose of this study is to determine the effectiveness of routine meatal care on the reduction of catheter-associated urinary tract infection (UTI). The study was carried out on 30 patients with foley catheters in an intensive care unit of a general hospital from September 30 to April 1, 1998. Participants were both male and female. Data were collected from each patients by urinary specimen obtained with aseptic collection technique at the 3rd and the 7th day of the experiment after giving daily mental care with 10% betadine for periods ranging from 1st to 7th day to the experimental group but not to the control group. The results are as follows : 1. The rate of urinary tract infection within the experimental group was 0.0%, at the 3rd day of the experiment and 20.0% at the 7th day, but that of the control group was 20.0% at the 3rd day and 7% at the 7th day. There was a significant difference in urinary tract infection rate between the two groups at the 3rd day but no significant difference at the 7th day. 2. In the control group, the rate of UTI was 0.7% for male and 13.3% for female at the 3rd day, and 6.7% for male and 40% for female at the 7th day. In the experimental group, the rate of UTI was 6.7% for male and 0.0% for female at the 3rd day and 13.3% for male and 20% for female at the 7th day of experiment. There was a no significant difference between male and female. 3. By comparing the rate of UTI to the length of time the urinary catheter was in place, the longer the catheter was in place the more significant was the rate of UTI. 4. Microorganisms isolated in the control group were bacteria for 7 cases and fungus for 3 cases but in the experimental group, only 2 cases of bacteria were isolated.

• Journal of Korean Neurosurgical Society
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• v.54 no.2
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• pp.75-80
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• 2013

Objective : Aneurysms arising from the proximal segment of the anterior cerebral artery (A1) are rare and challenging to treat. The aim of this study was to report our experience with endovascular treatment of A1 Aneurysms. Methods : From August 2007 through May 2012, eleven A1 aneurysms in eleven patients were treated endovascularly. Six aneurysms were unruptured and 5 were ruptured. One patient with an unruptured A1 aneurysm presented with subarachnoid hemorrhage due to rupture of an anterior communicating artery aneurysm. Procedural data, clinical and angiographic results were reviewed retrospectively. Results : All of the aneurysms were successfully treated with coil embolization. Six were treated with a simple technique while the remaining 5 required adjunctive technique : double catheters (n=2), balloon-assisted (n=2), and stent-assisted (n=1). The immediate angiographic control showed a complete occlusion in all cases. Procedure-related complication occurred in only one patient : parent artery occlusion, which was not clinically significant. All patients had excellent clinical outcomes but one patient was discharged with a slight disability. No neurologic deterioration or bleeding was seen during the follow-up period in this cohort of patients. Follow-up angiography (mean, 20 months) was available in ten patients and revealed stable occlusion in all cases. Conclusion : Endovascular treatment is a feasible and effective therapeutic modality for A1 aneurysms. Tailored microcatheter shaping and/or adjunctive techniques are necessary for successful aneurysm embolization because of the projection and location of A1 aneurysms.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.131-136
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• 2006

Background: The aim of this study was to clarify the role of spinal groups II and III metabotropic glutamate receptors (mGluRs) with respect to postoperative pain at the spinal level. In addition, the nature of the pharmacological interaction between groups II and III mGluRs agonists and morphine was determined. Methods: Catheters were inserted into the intrathecal space of male SD rats. To induce postoperative pain, an incision was made in the plantar surface of the hind paw. A pharmacological characteristic for the interaction between groups II and III mGluRs agonists and morphine was evaluated using a fixed-dose analysis. Results: None of intrathecal group II and III mGluRs agonists modified the withdrawal threshold of the incisional pain. The administration of intrathecal morphine resulted in an increase of a dose dependent withdrawal threshold. A fixed-dose analysis revealed that the group III mGluRs agonist, ACPT-III, increased the antinociceptive action of morphine, while the group II mGluRs agonist, APDC, had no effect the antinociception of morphine. Conclusions: These results suggest that group II and III mGluRs may not play a direct modulatory role in the processing of postoperative pain at the spinal level. However, agonizing group III mGluRs may indirectly contributable to the potentiation of morphines antinociception in the spinal cord. Thus, the combination of morphine and a group III mGluRs agonist may be useful in the management of spinal postoperative pain.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.159-164
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• 2008

Purpose: Microvascular free tissue transfer has become a reliable technique for the reconstruction of complex wounds. Occasionally, unexpected intraoperative thrombosis and/or spasm of recipient artery might be annoying problems even for the technically competent microvascular surgeons. If such problems are not treated properly, they will inevitably cause to flap failure. Methods: From January 2006 to February 2007, soft tissue reconstructions by free tissue transfers were performed on 21 patients having complex defects in the lower extremity. Although segmental revision and various pharmacologic agents were repeatedly applied, arterial occlusions were not managed in 6 cases. For removal of thrombi and release of spasm, Fogarty No. 2 or No. 3 catheters were inserted into the lumen to the proximal recipient artery. Its balloon was then inflated after passing through a resistant area. Next, the catheter was gently withdrawn backward. Results: After the Fogarty catheter was inserted two or three times, the pulsatile arterial flow was restored. When the catheter was inserted into the lumen, a feeling of resistance existed in a 5-10cm more proximal portion that could not be easily accessed from the vascular end. After the reestablishment of blood flow, successful anastomoses were achieved and immediate rethrombosis or spasm did not occur. No long-term sequelae associated with balloon trauma to the arterial wall were observed. Conclusion: The use of the Fogarty catheter can be an effective method in treating pedicle thrombosis and spasm. This is a very simple and rapid technique that offers microvascular surgeons another option to increase the success rate of microvascular anastomosis in free tissue transfers.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.116-119
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• 2008

Transcatheter interventions are widely used for diagnosis and treatment of congenital heart disease. Complications associated with transcatheter interventions are uncommon. However, when they occur they are most often self-limited. Rarely, however, serious catheter related complications occur that may require emergent surgical intervention. In this case, the right common iliac artery was disrupted during transcatheter balloon valvuloplasty during the treatment of congenital aortic stenosis in a 2-week-old baby. After immediate surgical intervention with bleeding control using two balloon catheters the baby did well. Here we report this case and review the medical literature.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.225-230
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• 1997

Background: Authors modified the traditional continuous axillary brachial plexus block technique of Selander for purpose of increasing success rate and decreasing complications by use of commercial epidural anesthesia set. Method: Thirty-nine patients scheduled for upper extremity operations were injected with 40 ml of anesthetic solution by axillary perivascular technique, using 23~25G immobile needle at 2 cm from the pectoralis major. Tuohy needle was immediately introduced at 4 cm from the pectoralis major and pierced the expanded neurovascular sheath at an angle of 30 degree to the skin. The "pop" was well noted well. Needle was advanced 0.5 to 3.0 cm and epidural catheter introduced through the needle. After removal of needle, occlusive dressing was done. Tip of catheter and spread of solution were demonstrated by fluoroscopy with contrast dye after completion of procedure. Result: Catheter insertion was successful at first attempt for all case. Total length of insertion was from 6 to 13($10.0{\pm}1.7$) cm. Tip of catheter was placed in infraclavicular space(66.7%), about the humeral head(17.9%) and in upper arm in 3 cases as U-shape(7.9%). Catheters were maintained for $6.7{\pm}2.6$(3-12) days. There were no complications such as: perforation of major vessels, needle trauma to nerve, infection, bleeding or hematoma. Conclusion: This study demonstrated continuous axillary brachial plexus block with epidural anesthesia set is safe, easy and convenient modification of technique of Selander.

• Journal of Korean Clinical Nursing Research
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• v.21 no.1
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• pp.31-42
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• 2015

Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

• Journal of Korean Academy of Nursing
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• v.50 no.4
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• pp.541-553
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• 2020

Purpose: In spite of the recent application of a general infection control method, central line-associated infections is still relatively high in Korea. Central line bundle with Chlorhexidine gluconate (CHG) tegaderm dressing was reported to be effective in reducing catheter colonization and central line-associated bloodstream infections (CLABSI). Therefore, this study aimed to examine the incidences of catheter colonization occurrence and CLABSI while using Tegaderm vs. CHG Tegaderm dressings. Methods: We used a descriptive design. 400 patients who had central venous catheters were selected from four hospitals in the Korean National Healthcare-associated Infections Surveillance System. Of all subjects, 200 used Tegaderm™ (Tegaderm group), and the remaining 200 used CHG Tegaderm (CHG Tegaderm group) dressing at the catheter insertion site. Data were analyzed using the χ² test or Fisher's exact test, t-test, and logistic regression analysis using SPSS WIN 21.0. Results: In the Tegaderm and CHG Tegaderm groups, CLABSI incidences were 5.89 and 1.79 per 1,000 catheter-days, catheter colonization incidences were 3.93 and 1.43 per 1,000 catheter-days, and central line bundle compliance rates were 26.0% and 49.0%, respectively. Catheter colonization risk factors were 'reinsertion after failure' and 'Tegaderm dressing' at the central line insertion site. CLABSI risk factors were 'incomplete performance of 7 central line bundle items' and 'Tegaderm dressing' at the central line insertion site. Conclusion: A further prospective study is needed to examine the effects of central line bundle with CHG Tegaderm dressing, avoiding central line reinsertion after failure, and improving the bundle compliance in reducing catheter colonization and CLABSI.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.1
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• pp.64-77
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• 1999

This study was conducted to investigate the use of medical equipment in patients receiving home care service. The subjects of this study were 88 patients cared by seven home care nursed who were registered in the Seoul Nurses Association. Data was collected from Aug. 1, 1998 to Dec. 30, 1998. The findings are as follows. 1. The sample was found to be 55.7% female : 51.7% over 65 years old. 75% with neurologic disease including CVA, brain tumor, ICH, Parkinsonism & Spinal stenosis and 78.4% living in Seoul. The Clinical experience of the home care nurses was greater than five years. 2. Medical equipment which the patients possessed were foley catheters(61.4%), L-tubes(59.1%) and tracheostomy tubes(51.1%). 3. Technical difficulties in use of medical equipment were related to home care ventilators(60.0%), L-tubes(3.8%) and tracheostomy tubes(2.2%). 4. Most of the medical equipment were obtained from the hospital where they had been admitted previously or from medical equipment companies. 5. Complications from the use of this equipment were infection through invasive techniques including wound drainage tubes(50%), and IV injections(22.2%), The complications were resolved through referral to the doctor of the hospital where they were previously admitted or through community health centers. 6. Most of the equipment was disposable, and equipment was disinfected by using various methods including boiling and soaking in antiseptic solutions. These findings suggest that consistant policy on the management of medical equipment is necessary for the safety of home care patients.

• Korean Journal of Materials Research
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• v.21 no.6
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• pp.320-326
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• 2011

Flat rolling of wire is an industrial process used to manufacture electrical flat wire, medical catheters, springs, piston segments and automobile parts, among other products. In a multi-step wire flat rolling process, a wire with a circular crosssection is rolled at room temperature between two flat rolls in several passes to achieve the desired thickness to width ratio. To manufacture a flat wire with a homogeneous microstructure, mechanical and metallurgical properties with an appropriate pass schedule, this study investigated the effect of each pass schedule (1stand ~ 4stand) on the microstructures, mechanical properties and widths of cold rolled high carbon steel wires using four-pass flat rolling process. The evolutions of the microstructures and mechanical properties of the widths of cold rolled wires during three different pass schedules of the flat rolling process of high carbon wires were investigated, and the results were compared with those for a conventional eight-pass schedule. In the width of cold rolled wires, three different pass schedules are clearly distinguished and discussed. The experimental conditions were the same rolling speed, rolling force, roll size, tensile strength of the material and friction coefficient. The experimental results showed that the four-pass flat cold rolling process was feasible for production of designed wire without cracks when appropriate pass schedules were applied.