• Journal of Sensor Science and Technology
• /
• v.15 no.2
• /
• pp.139-147
• /
• 2006

Lower urinary tract symptoms (LUTS) affect self-assessed quality of life. The prevalence of LUTS is commonly high in the elderly. The purpose of urodynamic investigation is to obtain information on the function of the urinary system. One of the most frequently used measurement procedures in urodynamics is filling and voiding cystometry. But in this system transurethral catheter is used and it makes patients uncomfortable. The aim of this study is to implement the system that could evaluate noninvasively the function of urinary tract. A new system has been developed to analyze urine flow rate and vesical pressure during voiding. These signals were recorded simultaneously and transmitted to a PC. For system evaluation, a model for the lower urinary system of men was constructed. From the evaluation of the model, vesical pressure was correlated with the occlusion degree. In a pilot study with five male subjects, maximum of standard deviation was 1.26, error rate was 3.49 and coefficient of variation was 3.48.

• Journal of Korean Academy of Nursing
• /
• v.36 no.7
• /
• pp.1204-1214
• /
• 2006

Purpose: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology. Method: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. Result: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. Conclusion: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

• Archives of Plastic Surgery
• /
• v.38 no.1
• /
• pp.35-42
• /
• 2011

Purpose: Blow-out fractures can be reduced using various methods. The orbital reconstruction technique using a balloon under endoscopic control has advantages over other methods. However, this method has some problems too, such as postoperative follow-up, management of the balloon catheter, and reduction of the posterior orbital floor. Thus, we developed a simple, effective method for orbital floor reduction that involves molding and shaping the antral balloon catheter. Methods: A 0, 30, or $70^{\circ}$, 4-mm endoscope was placed though a two-point, 5-mm maxillary antrostomy. The balloon catheter is placed directly at the orbital apex to reconstruct the anterior shelf (spherical shape), while it is turned in a U-shape towards the anterior maxilla for the posterior shelf (elliptical shape). Orbital floor defects, compound or comminuted fractures are reconstructed with alloplastic materials through an open lid incision under the endoscopic control. Results: This technique was applied to ten patients with orbital floor fractures: five anterior shelf and five posterior shelf fracture, respectively. Four of the patients had zygomatico-orbital fractures, while the rest had isolated orbital floor fractures. Two patients were given porous polyethylene implants Synpor$^{(R)}$) and three underwent reconstruction with a resorbable mesh plate. No complication associated with this technique was identified. Conclusion: The freestyle placement and selection of a urinary balloon catheter under endoscopic control and the preoperative estimation of the volume enhanced the stabilization of the orbital contour. This method improves the adaptation of the orbital floor without the risk of injuring the surrounding orbital contents, dissecting blindly, or using sharp traction. One drawback of this method is the patient's discomfort from the catheter during treatment.

• Childhood Kidney Diseases
• /
• v.19 no.2
• /
• pp.143-147
• /
• 2015

Purpose: Burkholderia cepacia is an aerobic, glucose-non-fermenting, gram-negative bacillus that mainly affects immunocompromised and hospitalized patients. Burkholderia cepacia has high levels of resistance to many antimicrobial agents, and therapeutic options are limited. The authors sought to analyze the incidence, clinical manifestation, risk factors, antimicrobial sensitivity and outcomes of B. cepacia urinary tract infection (UTI) in pediatric patients. Methods: Pediatric patients with urine culture-proven B. cepacia UTI between January 2000 and December 2014 at Samsung Medical Center, a tertiary referral hospital in Seoul, Republic of Korea, were included in a retrospective analysis of medical records. Results: Over 14 years, 14 patients (male-to-female ratio of 1:1) were diagnosed with B. cepacia UTI. Of 14 patients with UTI, 11 patients were admitted to the intensive care unit, and a bladder catheter was present in 9 patients when urine culture was positive for B. cepacia. Patients had multiple predisposing factors for UTI, including double-J catheter insertion (14.2%), vesico-ureteral reflux (28.6%), congenital heart disease (28.6%), or malignancy (21.4%). Burkholderia cepacia isolates were sensitive to piperacillin-tazobactam and sulfamethoxazole-trimethoprim, and resistant to amikacin and colistin. Treatment with parenteral or oral antimicrobial agents including piperacillin-tazobactam, ceftazidime, meropenem, and sulfamethoxazole-trimethoprim resulted in complete recovery from UTI. Conclusion: Burkholderia cepacia may be a causative pathogen for nosocomial UTI in pediatric patients with predisposing factors, and appropriate selection of antimicrobial therapy is necessary because of high levels of resistance to empirical therapy, including aminoglycosides.

• Clinical and Experimental Pediatrics
• /
• v.45 no.8
• /
• pp.1038-1042
• /
• 2002

We present a case of in-utero vesicoamniotic shunting and postnatal vesicostomy in a very low birth weight baby with posterior urethral valve syndrome. He was diagnosed as posterior urethral valve at $24^{+5$ weeks' gestation. Because of severe hydronephrosis and oligohydroamnios, the shunt was established by basket-shaped catheter at $27^{+0}$ weeks' gestation. After shunt, hydronephrosis improved. At $29^{+4}$ weeks' gestation, the shunt catheter escaped from its position and severe urinary ascites and hydronephrosis developed. At 30 weeks' gestation, the baby was born and showed elevated BUN and creatinine. On the 10th day of birth, vesicostomy was done for urinary drainage. Thereafter, the baby has been followed up for 10 months and has had recurrent episodes of urinary infection. We report the case with a brief review of literature.

• Clinical and Experimental Pediatrics
• /
• v.58 no.5
• /
• pp.183-189
• /
• 2015

Purpose: Catheter urine (CATH-U) and suprapubic aspiration (SPA) are reliable urine collection methods for confirming urinary tract infections (UTI) in infants. However, noninvasive and easily accessible collecting bag urine (CBU) is widely used, despite its high contamination rate. This study investigated the validity of CBU cultures for diagnosing UTIs, using CATH-U culture results as the gold standard. Methods: We retrospectively analyzed 210 infants, 2- to 24-month-old, who presented to a tertiary care hospital's pediatrics department between September 2008 and August 2013. We reviewed the results of CBU and CATH-U cultures from the same infants. Results: CBU results, relative to CATH-U culture results (${\geq}10^4$ colony-forming units [CFU]/mL) were widely variable, ranging from no growth to ${\geq}10^5CFU/mL$. A CBU cutoff value of ${\geq}10^5CFU/mL$ resulted in false-positive and false-negative rates of 18% and 24%, respectively. The probability of a UTI increased when the CBU bacterial count was ${\geq}10^5/mL$ for all infants, both uncircumcised male infants and female infants (likelihood ratios [LRs], 4.16, 4.11, and 4.11, respectively). UTIs could not be excluded for female infants with a CBU bacterial density of $10^4-10^5$ (LR, 1.40). The LRs for predicting UTIs based on a positive dipstick test and a positive urinalysis were 4.19 and 3.11, respectively. Conclusion: The validity of obtaining urine sample from a sterile bag remains questionable. Inconclusive culture results from CBU should be confirmed with a more reliable method.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.6
• /
• pp.113-120
• /
• 2016

The purpose of this study is to identify the knowledge of and adherence to the infection control guidelines for indwelling urinary catheters, central venous catheters and ventilators among intensive care nurses. The subjects were 175 intensive care nurses working in 2 upper general hospitals and 3 general hospitals. Data were collected from July 1 to July 31, 2013. The collected data were analyzed by descriptive statistics, t-test and ANOVA using SPSS 18.0 for Windows. The mean scores of the knowledge of the infection control guidelines on indwelling urinary catheters, central venous catheters and ventilators were 0.87, 0.82 and 0.82 points, respectively. The average scores for the adherence to the infection control guidelines for indwelling urinary catheters, central venous catheters and ventilators were 4.18, 4.04 and 4.07 points, respectively. Statistically significant correlations were found between the knowledge of and adherence to the infection control guidelines for indwelling urinary catheters (r=.72, p<.00), central venous catheters (r=.54, p<.001) and ventilators (r=.30, p<.001). The knowledge of and adherence to the infection control guidelines for indwelling urinary catheters differed significantly according to gender, educational status, total career, number of patients, type of hospital, and attendance of seminar. The knowledge of and adherence to the infection control guidelines for central venous catheters differed significantly according to educational status, total career, number of patients, type of hospital, and attendance of seminar. The knowledge level of the infection control guidelines for the ventilator differed significantly according to the total career. The results of this study indicate that education and training programs for improving the knowledge of adherence to the infection control guidelines should be developed.

• Clinical and Experimental Pediatrics
• /
• v.55 no.5
• /
• pp.181-184
• /
• 2012

Voiding cystourethrography (VCUG) is a commonly performed diagnostic procedure for the evaluation of vesicoureteral reflux with urinary tract infection or congenital renal diseases in children. The procedure is relatively simple and cost-effective, and complications are very rare. The iatrogenic complication of VCUG range from discomfort, urinary tract infection to bacteremia, as well as bladder rupture. Bladder rupture is a rare complication of VCUG, and only a few cases were reported. Bladder rupture among healthy children during VCUG is an especially uncommon event. Bladder rupture associated with VCUG is usually more common in chronically unused bladders like chronic renal failure. Presented is a case of bladder rupture that occurred during a VCUG in a healthy 9-month-old infant, due to instilled action of dye by high pressure. This injury completely healed after 7 days of operation, and it was confirmed with a postoperative cystography. The patient's bladder volume, underlying disease, velocity of the contrast media instilled, catheter size, and styles of instillation are important factors to prevent bladder rupture during VCUG. Management of bladder rupture should be individualized, but the majority of infants are treated with the operation. In conclusion, bladder rupture is a rare complication, however, delicate attention is needed in order to prevent more dire situations.

• The Journal of Internal Korean Medicine
• /
• v.23 no.2
• /
• pp.286-291
• /
• 2002

Urinary tract infection(UTI) is one of the common complications in stroke patients. As it has negative effect on the recovery of stroke, it should be cured out immediately. But antibiotics might cause some adverse reactions such as diarrhea, eruption, anorexia, nausea and vomiting. so there have been several reports about treating urinary tract infection with Traditional Korean Medication. We treated a 54-year-old male patient with cerebral hemorrhage, who had had neurogenic bladder after stroke and had been urinated by intermittent catheterization. About 10 days later, he could void by himself without catheter, but showing the symptoms of UTI; Voiding pain, hematuria and yellowish pus. The pus culture grew Staphylococcus spp., which was resistant to most of antibiotics except vancomycin and teicoplanin. Based on accompanying symptoms of intermittent dizziness, headache, insomnia, nocturnal sweating, weak pulse, red tongue and urinary problem, we differentiated him as the deficiency of Yin of the Kidney[腎陰虛] and treated with Gagamyookmijihwang-tang (Jia-Jian-Liu-Wei-De- Huang-Tang), which improved his urinary symptoms and other general conditions without any side effect. In next follow-up culture, there was no pathogen. We conclude that Traditional Korean Medicine based on differentiation is useful in the treatment of urinary tract infection.

• The Korean Journal of Pain
• /
• v.9 no.2
• /
• pp.439-442
• /
• 1996

Continuous epidural analgesia has been used widely for chronic pain control, especially in cancer patients. As one of the complications, paraplegia developed during continuous epidural analgesia may be caused by epidural abscess, epidural hematoma, neural damage, chronic adhesive arachnoiditis, anterior spinal artery syndrome, delayed migration of extradural catheter into subdural space or subarachnoid space and preexisting disease. A 55-years-old male with lung cancer was implanted with continuous thoracic epidural catheter for pain control. Twenty days after catheterization, moderate back pain, weakness of lower extremity and urinary difficulty were developed. We suspected epidural abscess at first and made differential diagnosis with MRI which showed metastatic cancer at T2-4 spine, And compressed spinal cord was the main cause of the lower extremity paralysis.