• Journal of Korean society of Dental Hygiene
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• v.15 no.1
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• pp.147-152
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• 2015

Objectives: The purpose of this study was to investigate the oral health and hygiene in the neurosurgical patients in intensive care unit(ICU). Methods: The subjects were 92 neurosurgical patients in intensive care unit(ICU) from March, 2011 to December, 2012. The oral examination consisted of number of residual teeth, DMFT index, clinical attachment loss, gingival index, plague index, and Candida species colony of tongue and saliva. Plaque was inoculated from tongue and saliva and incubated in 36.5C incubator for 48 hours using $Dentocult^{(R)}$ CA(Orion Diagnostica, Espoo, Finland). Glasgow coma scale(GCS) was measured to evaluate the consciousness of the patients on the basis of medical record. Results: Oral health was poor in clinical attachment loss and gingival index. Oral hygiene in neurosurgical patients in ICU was very poor due to high plaque index and Candida colonization of tongue and saliva. Plague index was closely related to Candida colonization of tongue and saliva(p<0.05). Conclusions: Oral health and hygiene of patients in neurosurgical ICU were very poor. More careful oral hygiene care is very important and necessary to enhance the oral health improvement of the neurosurgical patients in ICU.

• Journal of Korean Academy of Nursing
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• v.37 no.6
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• pp.976-985
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• 2007

Purpose: The aim of this study was to identify the present situation of hospital infection and route of infection by clarifying the transmission aspect of methicillin-resistant Staphylococcus aureus(MRSA) in a Neurosurgical Intensive Care Unit by analysing genotype. Methods: MRSA was cultured from twenty five patients with a tracheostomy, twenty five health care workers, and environments in the Neurosurgical Intensive Care Unit of one hospital in D city. Data was collected from December 21, 2004 to November 5, 2005. MRSA isolates representing each genotype were analyzed by spaA typing and a multiplex PCR method capable of identifying the structural type of the staphylococcal cassette chromosome mec(SCCmec) carried by the bacteria. Results: As the same genotype and gene sequence were found among health care workers, patients, and environments, it was assumed that there was cross transmission among them. Conclusion: This study suggests that first, as the hospital infection by MRSA between health care workers and patients in the Neurosurgical Intensive Care Unit was due to result of cross transmission and the relevance of transmission between them was verified, it is necessary to take preventive measures and conduct education. Secondly, development of nursing interventions and study of infection are needed. Thirdly, consistent investment in prevention against hospital infections and environmental renovation is needed.

• Journal of Korean Neurosurgical Society
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• v.55 no.2
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• pp.106-109
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• 2014

A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years. The digital subtraction angiography demonstrated a single-hole fistula, involving the anterior spinal artery and vein. The lesion was occluded by embolization with immediate improvement. The potential mechanism is discussed.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.123-129
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• 2009

Objective: This study was aimed to identify the incidence and risk factors of vancomycin-resistant enterococcus (VRE) colonization in neurosurgical practice of field, with particular attention to intensive care unit (ICU). Methods: This retrospective study was carried out on the Neurosurgical ICU (NICU), during the period from January. 2005 to December. 2007, in 414 consecutive patients who had been admitted to the NICU. Demographics and known risk factors were retrieved and assessed by statistical methods. Results: A total of 52 patients had VRE colonization among 414 patients enrolled, with an overall prevalence rate of 6.1%. E. faecium was the most frequently isolated pathogen, and 92.3% of all VRE were isolated from urine specimen. Active infection was noticed only in 2 patients with bacteremia and meningitis. Relative antibiotic agents were third-generation cephalosporin in 40%, and vancomycin in 23%, and multiple antibiotic usages were also identified in 13% of all cases. Multivariate analyses showed Glasgow coma scale (GCS) score less than 8, placement of Foley catheter longer than 2 weeks, ICU stay over 2 weeks and presence of nearby VRE-positive patients had a significantly independent association with VRE infection. Conclusion: When managing the high-risk patients being prone to be infected VRE in the NICU, extreme caution should be paid upon. Because prevention and outbreak control is of ultimate importance, clinicians should be alert the possibility of impending colonization and infection by all means available. The most crucial interventions are careful hand washing, strict glove handling, meticulous and active screening, and complete segregation.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.12 no.3
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• pp.395-403
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• 2005

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUS). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. Method: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. Result: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. Conclusion: Our findings give support to recent studies that suggest that frequent physical contact maγ increase the nosocomial acquisition of MRSA in a neurosurgical ICU.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.555-557
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• 2012

We report an uncommon case of a 45-year-old woman who presented with spontaneous rhinorrhea. A computed tomography (CT) scan of the head revealed an abnormally large sphenoid sinus associated with a parasellar bony defect (Sternberg's canal) through which magnetic resonance imaging could detect an encephalocele of the right temporal lobe. An endoscope-assisted trans-sphenoidal approach was performed and, with the aid of image guided surgery, reduction of the encephalocele was obtained and followed by surgical repair of the dural and bony defects. The postoperative course was uneventful and the cerebrospinal fluid fistula was closed as confirmed by the postoperative CT scan and by the absence of rhinorrhea. After three years of monitoring the patient remained asymptomatic.

• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.288-297
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• 2009

Purpose: This study was done to evaluate the mean venous velocity (MVV) response with knee and thigh length compression stockings (CS) versus intermittent pneumatic compression (IPC) devices in immobile patients with brain injuries. Methods: We carried out a randomized controlled study. We analyzed both legs of a randomly chosen sample of 43 patients assigned to one of 4 groups (86 legs). The patients were sequentially hospitalized in the intensive care unit (ICU) in "S hospital" from November 2005 to December 2006. The base line and augmented venous velocity was measured at the level of the common femoral vein. We applied leg compression 42 times over 7 days (for 2 hours at a time at 2 hour intervals). Results: There was a statistical difference among the 4 groups. The difference for the "IPC" group was more significant than the "CS" group. Conclusion: These results indicate that the application of IPC can be considered as an effective method to prevent deep vein thrombosis for immobile patients with brain injury.

• Journal of Korean Critical Care Nursing
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• v.8 no.2
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• pp.43-54
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• 2015

Purpose: This study aimed to identify the effects of education, using a relocation information guidebook, on the family caregivers of patients who were scheduled to be transferred from a neurosurgical intensive care unit to a general ward. Methods: They were divided into two groups: an experimental group (n = 21) and a control group (n = 20). A relocation information guidebook was created based on a literature review and an interview with five family caregivers about how to satisfy their needs. The collected data were analyzed with a ${\chi}^2$ test, Fisher's exact test, paired t-test, and t-test. Results: The effect of education, using the relocation information guidebook, on the family caregivers of patients who were relocated to a general ward from the neurosurgical intensive care unit was not significant for relocation stress (t = 0.94p, = .352) or anxiety (t = 1.25, p = .217), but was significant for education satisfaction (t = -2.50, p = .017). Conclusion: There were no differences in relocation stress and anxiety scores between the control and experimental groups. However, several methodological issues were highlighted that must be considered in future research, including the timing and measurement of transfer anxiety, and the intervention itself.

• Journal of Korean Critical Care Nursing
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• v.10 no.2
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• pp.56-70
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• 2017

Purpose: This study was conducted to identify ICU nurses' knowledge of the five moments of hand hygiene and the ambiguity of these moments when demonstrating hand hygiene. Methods: The subjects were 200 intensive care unit nurses at a university hospital. Data was collected using self-report questionnaires, translated according to the instructions of training films developed by WHO, and analyzed using descriptive statistics and ranking tests. Results: The highest number of correct answers was regarding the moment before contact with a patient and the lowest was regarding the moment after contact with a patient. The rate of providing wrong answers regarding required moments of hand hygiene was high. Conclusion: The study identified ICU nurses' knowledge of specific moments of hand hygiene; they had difficulty differentiating between the moments that happened simultaneously, i.e. after touching a patient, and that patient's surroundings, and there was ambiguity concerning patient areas and medical treatment areas. It was concluded that it is necessary to educate nurses regarding both required and unrequired moments of hand hygiene and to ensure that they can distinguish between these moments.

• Journal of Korean Neurosurgical Society
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• v.53 no.5
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• pp.261-268
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• 2013

The Department of Neurosurgery (DNS) of the Seoul National University Hospital (SNUH), belongs to the largest and oldest such institutions in Korea. Because of its growing reputation it is hardly surprising that the DNS draws visitor and scholars for clinical education and academic exchange from far beyond Korea. I myself visited the SNUH in February and March 2013. During this time I composed this evaluation in which I compare the DNS to my home Department at the Johannes Gutenberg-University in Mainz/Germany, as well as the situation of Neurosurgery in Korea and Germany in general. In the first part this evaluation summarizes data concerning equipment, staff and organizational structure, as well as educational and scientific issues of the DNS. In the second part some issues of interest are discussed in special regard to the corresponding practices in Germany.