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To compare the characteristics and risk factors for surgical site infections (SSIs) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in a nationwide survey, using shared case detection and recording systems.
Retrospective cohort study.
Twenty-six hospitals participating in the Korean Nosocomial Infections Surveillance System (KONIS).
From 2006 to 2009, all patients undergoing THA and TKA in KONIS were enrolled.
SSI occurred in 161 (2.35%) of 6,848 cases (3,422 THAs and 3,426 TKAs). Pooled mean SSI rates were 1.69% and 2.82% for THA and TKA, respectively. Of the cases we examined, 42 (26%) were superficial-incisional SSIs and 119 (74%) were “severe” SSIs; of the latter, 24 (15%) were deep-incisional SSIs and 95 (59%) were organ/space SSIs. In multivariate analysis, a duration of preoperative hospital stay of greater than 3 days was a risk factor for total SSI after both THA and TKA. Diabetes mellitus, revision surgery, prolonged duration of surgery (above the 75th percentile), and the need for surgery due to trauma were independent risk factors for total and severe SSI after THA, while male sex and an operating room without artificial ventilation were independent risk factors for total and severe SSI after TKA. A large volume of surgeries (more than 10 procedures per month) protected against total and severe SSI, but only in patients who underwent TKA.
Risk factors for SSI after arthroplasty differ according to the site of the arthroplasty. Therefore, clinicians should take into account the site of arthroplasty in the analysis of SSI and the development of strategies for reducing SSI.
To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.
A nationwide prospective multicenter study.
Twenty university-affiliated hospitals in Korea.
The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.
Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 (±12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09–2.58]), increased operation time (1.20 [1.07–1.34] per 1-hour increase), reoperation (7.27 [3.68–14.38]), combined multiple procedures (1.79 [1.13–2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09–8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26–5.64]) were independently associated with increased risk of SSI.
Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.
A method allowing for the stable growth of carbon nanotubes (CNTs) on the surface of a fibrous metal mesh substrate (SUS304) was developed with the assistance of the microwave plasma-enhanced chemical vapor deposition process. The controlled addition of up to ∼13% of O2 to the CH4 plasma reacting gas flow was found to promote the growth of the CNTs by oxidizing the amorphous carbon and removing the active H2 radicals. However, excessive amounts of O2 (i.e., fraction of O2 > ∼13%) and H2 were found to play a negative role in the growth of the CNTs. The control of the density and length of the CNTs was also achieved by varying the H2 plasma reduction time and CH4 plasma reacting time, respectively. Longer H2 reduction pretreatment of the catalytic metal islands resulted in the formation of a less dense CNT forest with craters. When the growth time of the CNTs was increased to ∼20 min, their length was increased to ∼10 μm. However, when the growth time of the CNTs exceeded 20 min, their length was significantly decreased, indicating that the continuous presence of O2 in the CH4 plasma destroys the preformed CNTs due to the oxidation reaction.
Solid solutions in the Ag(NbxTa1−x)O3 (where 0 ≤ × ≤ 1) system exhibit excellent dielectric properties at microwave frequency including high dielectric constant (200<k<400), low loss (tanΔ ∼ 0.004) and a composition controlled temperature coefficient of capacitance (TCC). For Ta-rich and Nb-rich solid solutions, the TCC values are negative and positive, respectively, and two-phase mixtures provided an average TCC close to zero. Series, parallel, and logarithmic mixing rules were applied to predict dielectric constant and TCC of polyphase assemblages (45wt%Ag(Nb0.65Ta0.35)O3+55wt% Ag(Nb0.35Ta0.65)O3) yielded an average dielectric constant of 450 and a TCC of 180ppm/°C. Microstructure analysis revealed that a CuO-rich liquid remains at the grain boundary and transmission electron microscopy shows that the CuO resides at triple points. Ag(NbxTa1−x)O3 ceramics were successfully integrated into LTCC for embedded capacitors. The addition of CuO lowered the sintering temperature to below 900°C and a low TCC was maintained for fine grained microstructures.
In this study, Adhesion force and Nanotribological Characteristics of fluorocarbon (FC) films on Al deposited by Plasma Enhanced Chemical Vapor Deposition (PECVD) were evaluated. The contact angle of FC thin films on Al was measured to be around 110°. The surface energy was calculated to be 15 dynes/cm from the measurements of contact angles of polar and nonpolar solutions on surfaces. The contact angle hysteresis, which is an indicator for the surface heterogeneity, was lower than 30°. The friction force of FC films coated surfaces was three times lower than bare Al. The adhesion force of bare Al was measured to be around 9.6nN. The presence of FC films on Al reduced it to below 4nN. Fourier transform infra-red (FTIR) spectra showed the presence of fluorocarbon groups such as –CFn- and =CF=CF2.
Thin film electrodes of the perovskite oxide (Ba,Sr)RuO3 (BSR) were deposited on 4 inch ptype Si wafers by metal organic chemical vapor deposition (MOCVD) for the practical (Ba,Sr)TiO3 (BST) capacitor application using a new single cocktail source. The source materials used for the MOCVD BSR process were Ba(METHD)2, Sr(METHD)2 and Ru(METHD)3 and these were dissolved in n-butyl acetate. The source-feeding rate was precisely controlled by liquid mass flow controllers (LMFC). As-deposited BSR films possessed a (110)-oriented structure, with good uniformity and adherence on bare Si wafer. The phase formation was strongly affected by the oxygen flow rate and the input source rate. As the oxygen flow rate increased, the Ru/(Ba+Sr) composition ratio in the film decreased, while the Ba/(Ba+Sr) ratio was almost independent of the oxygen flow rate. The dielectric constants of BST capacitors fabricated using these electrodes was greater than 500.
MgxZn1-xSi: Ho3+, MgxZn1-xSe: Er3+, and MgxZn1-xSe: Tm3+ single crystals were grown by the closed-tube sublimation method. The single crystals crystallized into a zincblende structure at the composition x = 0.11 and a wurtzite structure at the composition x = 0.25, 0.32, and 0.41. The trivalent ions (Ho3+, Er3+, and Tm3+) of the rare-earth elements Ho, Er, and Tm site in Td and C3v symmetries in the single crystals with zincblende and wurtzite structures, respectively. Sharp emission peaks appeared in the photoluminescence spectra of the single crystals. These emission peaks are identified to originate from the radiation recombination between the energy levels of the trivalent ions sited in Td and C3v symmetries.
We studied the layer by layer deposition technique of a-Si:H film, where the hydrogen radicals are exposed between the deposition of each layer. The effects of each layer thickness and hydrogen radical exposure time on the electrical and optical properties were studied. With the decrease of the each layer thickness, more hydrogen is involved in the network if the structure is still amorphous, but the hydrogen content is very small for microcrystal Si formed by long exposure to hydrogen radicals in between the depositions of thin layers.
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