• Title/Summary/Keyword: Urinary catheter

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Spinal Epidural Hematoma Occuring after Bloody Tap during Epidural Catheter for Cancer Pain Control -A case report- (암성통증치료를 위한 경막외카테테르 거치술중 혈성천자로 발생한 경막외혈종 -증례 보고-)

  • Woo, Sung-Chang;Cha, Dong-Suk;Kang, Keon;Kim, Young-Ki
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.160-164
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    • 1998
  • We report a case of epidural hematoma occuring after bloody tap during epi-dural catheter for cancer pain control in thrombocytopenic patient. Two hours after epidurl puncture, patient experienced severe back pain and numbness of both legs. Following day, patient complained of motor paralysis and urinary difficulty. Diagnosis utilizing magnetic reasonance imaging, showed epidural hematoma extending from $T_{11}$ to $T_{12}$. Thrombocytopenia prevented surgical intervention. Therefore we restored conservative therapy with packed red cell, platelet concentration, steroid and hemostatic, which provided complete neurologic recovery, spontaneously over several days without surgical intervention.

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Intrapelvic Urethral Anastomosis in a Dog with Complete Obstruction of Proximal Membranous Urethra (막성요도 근위부 완전폐쇄를 지닌 개에서 골반내 요도문합술)

  • Yoon Hun-Young;Kim Jun-Young;Han Hyun-Jung;Jang Ha-Young;Lee Bo-Ra;NamKung Hyo-Sun;Jeong Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.23 no.1
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    • pp.61-64
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    • 2006
  • A 4.65 kg 13-month-old male Pekingese dog was referred to veterinary teaching hospital of Konkuk University for evaluation of dysuria. On physical examination, severe distention of urinary bladder was found in abdominal palpation. Urinary catheter could not be guided into urinary bladder. On serum biochemistry, blood urea nitrogen (35.6 mg/dl) and creatinine (1.9 mg/dl) were increased. Obstruction part of proximal membranous urethra was founded on urethrogram. The length (13 mm) of obstruction part was callipered by cystourethrogram and urethrogram on operation. Surgical resection of obstruction part of urethra was performed without pubic osteotomy, and anastomosis was performed with 5-0 polyglycolic acid. Omentum was placed around the urethral anastomosis. On first day after surgery, appetite was good. On day 5, complete blood count and serum biochemistry showed normal range but mild urinary incontinence was showed after removing catheter. On day 7, urinalysis showed normal condition. On day 14, no leakage of surgical site was observed in excretory urogram. On day 21, no more urinary incontinence and good micturition were found. On 1 year later, the patient showed healthy condition without recurrence.

The Analysis of Expression of Autoinducer Synthesis Genes Involved in Quorum Sensing among Catheter Associated Bacteria (요로감염에 관여하는 카테터 내 박테리아의 Quorum Sensing 관련 autoinducer 합성 유전자의 발현분석)

  • Lee, Mi-Hye;Seo, Pil-Soo;Lee, Ji-Youl;Peck, Kyong-Ran;Lee, Sang-Seob
    • Korean Journal of Microbiology
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    • v.42 no.4
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    • pp.277-285
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    • 2006
  • The most biofilm forming bacteria in catheter, Esctherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were isolated and identified from a patient's catheter occuring catheter-associated urinary tract infection (CA-UTI). We examined mRNA expression and its quantification of AIs synthetic genes encoding signal substance of quorum sensing from each bacterial species in order to elucidated quorum sensing mechanism. Both pure cultures for each bacterial strains and a mixed cultures with three were grown for 24 hr and 30 days. Initial densities to be able to detect mRNA expression oil single strains culture were shown at $2.4{\times}10^5$ CFU/ml, $5.4{\times}10^6$ CFU/ml of E. coli for ygaG and S. aureus for luxS, and at $6.9{\times}10^4$ CFU/ml of P. aeruginosa for rhlI and lasI. Also, in mixed culture of three, initial cell densities of mRNA expression were appear to at $7.3{\times}10^5$ CFU/ml, $1.6{\times}10^7$ CFU/ml of E. coli for ygaG and S. aureus for luxS, and at $2.1{\times}10^5$ CFU/ml of P. aeruginosa for rhlI and lasI. Each AIs synthetic gene was expressed in initial cell density and the mRNA expression of the genes were detected continously during 30 days. And then, the quantification of mRNA expression level of ygaG, rhlI, last, and luxS which were related AIs synthesis was done each time point by real-time RT-PCR. Interestingly, the mRNA levels of ygaG, rhlI, lasI, and luxS from the mixed culture was higher than those from each single strain culture. In the case of E. coli ygaG, the amount of transcript from the mixed culture was at least 30 times for that from single culture. In the case of P. aeruginosa rhlI and lasI, the amount of transcript from the mixed culture was at least 40 times and 250 times for that from single strain culture. In the case of S. aureus luxS, the amount of transcript from the mixed culture was at least 5 times for that from single strain culture. And specially, the mRNA expression of rhlI and lasI of P. aeruginosa showed the highest efficency among four AIs synthetic genes.

Antimicrobial Activity of Vaccinium macrocarpon (Cranberry) Produced Proanthocyanidin (PAC) on the Growth and Adhesion Properties of Staphylococcus aureus

  • Hui, Jonathan;Choy, John;Suwandaratne, Sid P.;Shervill, Jenna;Gan, Bing S.;Howard, Jeffrey C.;Reid, Gregor
    • Preventive Nutrition and Food Science
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    • v.9 no.1
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    • pp.29-33
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    • 2004
  • Cranberries have long been used by lay people to relieve the symptoms of urinary tract infections. Recent research has determined that the component of cranberry called proanthocyanidin (PAC) is the primary mechanism for inhibiting P-fimbriated E.coli adhesion to uroepithelial cells in vitro. A series of experiments were performed to determine the effects of PAC on growth and adhesion of uropathogenic E. coli and Staphylococcus aureus to urinary catheter material. The results showed that PAC-inhibited binding of Gram positive S. aureus to collagen coated surfaces and significantly decreased the growth of these bacteria. P-fimbriated E.coli did not bind well to the biomaterial and their growth was unaffected by the cranberry extract with the exception of some loss in viability at 1000 $\mu\textrm{g}$/mL after 5 to 18 hours of exposure. This is the first report of the potential for cranberries to interfere with the adhesion and growth of S. aureus, a multi-drug resistant organisms responsible for morbidity and mortality especially in hospitalized patients.

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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Reduction of the Isolated Anterior Wall of the Maxillary Sinus Fracture with Double Urinary Balloon Catheters and Fibrin Glue

  • Kim, Jaehee;Yang, Ho Jik;Kim, Jong Hwan;Kim, Su Jin
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.238-242
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    • 2017
  • Background: Conservative treatment is performed for isolated anterior wall of the maxillary sinus fractures, in many cases when the fracture is clinically not severe and asymptomatic. Despite the absence of symptoms, complications such as sinusitis, rhinitis, and chronic purulent secretion may develop; therefore, successful reduction is required. We attempted to reduce the risk of complications using an alternative technique: reduction of the fracture with two urinary balloon catheters inserted through the maxillary ostium and fixation using fibrin glue, which minimizes the damage to the bony fragments and sinus mucosa. Methods: In this study, 38 patients who were diagnosed with an isolated anterior wall of the maxillary sinus fracture at our hospital between January 2014 and January 2017 were enrolled. The fracture site was exposed via the Caldwell-Luc approach followed by reduction through the insertion of two urinary balloon catheters using a nasal endoscope and fixation with fibrin glue. The sex, cause of fracture, physical examination, and presence of complications were examined and patient's medical records and facial bone computed tomography scans were analyzed. Results: Radiological evaluation showed that there was no evidence of collapsed reduction fragments. Although some patients had remaining symptoms of hypoesthesia (15%; 3 patients), there were no complications such as infection, rhinitis, sinusitis, and chronic purulent secretion at the surgical site. Conclusion: In this study, we present an alternative surgical technique using two urinary balloon catheters and fibrin glue for the successful reconstruction of an isolated anterior wall of the maxillary sinus fracture. This technique enables precise restoration with a reduced risk of complications.

Determination of Carnitine Renal Threshold and Effect of Medium-Chain Triglycerides on Carnitine Profiles in Newborn Pigs

  • Heo, K.N.;Odle, J.;Lin, X.;van Kempen, T.A.T.G.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.14 no.2
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    • pp.237-242
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    • 2001
  • Colostrum deprived, newborn pigs (N=12, $1.64{\pm}0.05kg$) were used to study the renal threshold of carnitine, and effects of emulsified medium-chain triglyceride (MCT, tri-8:0) feeding on kinetics of plasma carnitine and urinary carnitine excretion. An arterial catheter was inserted through an umbilical artery, and a bladder catheter was inserted via the urachus. Piglets were oro-gastrically gavaged with one of six carnitine levels (0, 60, 120, 180, 240, $480{\mu}mol/kg\;W^{0.75}$) with (+MCT) or without medium-chain triglycerides (-MCT) in 0.9% NaCl solution. Blood was sampled into heparinized tubes at 0, 1, 2, 4, 6, 8, 14, and 20 h after gavage, and urine was collected and pooled into 1 h or 2 h composite samples to determine free- and short-chain carnitine concentrations. Plasma from the 12 newborn piglets before gavage contained $10.6{\pm}1.2{\mu}mol/L$ free carnitine and $7.2{\pm}0.6{\mu}mol/L$ acid-soluble acyl carnitine. The renal threshold for carnitine was similar between the MCT and the +MCT group (42.6 13.1 and $46.4{\pm}2.0{\mu}mol/L$, respectively), but the correlation between plasma free carnitine and urinary excretion was altered. Plasma free carnitine linearly increased with increasing carnitine dosage (-MCT group, $R^2=0.95$, p<0.001; +MCT group, $R^2=0.91$, p<0.001), but was decreased by 50% when medium-chain triglycerides were fed. The peak in plasma free carnitine concentration was depressed by medium-chain triglycerides feeding also. Therefore, the plasma and urinary short-chain/free carnitine ratio of the +MCT group was increased by 100% and 40%, respectively (p<0.01). Feeding of medium-chain triglycerides may delay plasma carnitine elevation via altering the kinetics of absorption. Similarly, the plasma and urinary short-chain/free carnitine ratio were affected by interaction between medium-chain triglycerides and time (p<0.01). The present study suggests that an oral carnitine dose over $480{\mu}mol/kg\;W^{0.75}$ may be needed to reach the free carnitine renal threshold within a short period, especially when provided together with medium-chain triglyceride.

Spontaneous Perinephric Urinoma after the Removal of a Foley Catheter in a Girl with Acute Kidney Injury (급성 신부전 환아에서 유치 도뇨관 제거 후 발생한 신 주위 요낭종 1례)

  • Yang, Tae Hwan;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.127-131
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    • 2013
  • Urinomas can occur after renal trauma or perforation of the collecting system during an endosurgical procedure. However, spontaneous urinomas are very rare. Here we report a case of a spontaneous perinephric urinoma following the removal of a Foley catheter in an 18-year-old girl with acute kidney injury caused by septic shock. The patient had been treated for septic shock, acute kidney injury, and acute respiratory distress syndrome, and had a Foley catheter in place for seven days. After Foley catheter removal, the patient complained of consistent voiding difficulty. An abdominal computed tomography scan showed a large amount of left perinephric fluid, and the aspirated fluid included urothelial cells, confirming the diagnosis of a urinoma. The urinoma was successfully treated by insertion of a double-J stent into the left ureter. This report discusses the available literature on urinomas, and their clinical features, diagnosis, and treatment.

Nursing Activities and Outcomes Related to Indwelling Urinary Catheterization from a Review of Medical Records and Interviews (의무기록지 분석과 간호사 면담을 통한유치도뇨관 관리에 관한 간호활동 및 환자결과)

  • Jang, Keum-Seong;Chung, Kyung-Hee;Choi, Ja-Yun;Yang, Jin-Ju;Park, Soon-Joo;Ryu, Se-An;Kim, Nam-Young;Sim, Jae-Youn
    • 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.

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Continuous Caudal Analgesia for Post Perianal Surgery (지속적 미추 차단을 이용한 항문 부위 수술 후 통증 치료)

  • Lee, Won-Gi;An, Dong-Ai
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.81-85
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    • 1998
  • Background: Continuous caudal epidural block is a useful method in postoperative pain control after perianal surgery. But caudal epidural block has the potential of developing adverse effects such as urinary retention. The goal of this study is to evaluate the analgesic and adverse effect of bupivacaine with fentanyl through continuous caudal epidural block in relation to the concentration of bupivacaine. Methods: We divided the patients randomly into two groups. For group I(n=25) postoperative pain was controlled by continuous caudal epidural infusion at the rate of 4 ml/hr of 0.0625% bupivacaine with 3 ${\mu}g$/ml fentanyl: group II(n=14), 0.125% bupivacaine with 3 ${\mu}g$/ml fentanyl, respectively, for duration of 48 hours via epidural catheter. We evaluated pain scores with visual analogue scales at 30 mins, 6 hrs, 12 hrs, 24 hrs and 48 hrs after the operation and the incidence of adverse effect, especially urinary retention, for each group. Results: There were no significant differences in the pain score between group I and II. Urinary retention developed in 9 patients(36%) of group I, and 11 patients (78.6%) of group II. Other adverse effects such as pruritus, nausea, vomiting and respiratory depression developed in few patients. Conclusions: While performing continuous caudal epidural block with mixture of bupivacaine and fentanyl after the perianal surgery, we conclude 0.0625% bupivacaine solution is preferable to 0.125% bupivacaine solution because 0.0625% solution resulted in satisfactory analgesia with minimal incidence of adverse effect.

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