[Antibiotic prophylaxis in the operating room].

BACKGROUND: There are growing interests in perioperative preventation of surgical site infection, since the World Health Organization has published surgical safety checklist with the slogan "safe surgery saves lives" in 2008. According to the surgical safety checklist, the surgical team needs to check whether antibiotic prophylaxis has been given within 60 minutes of skin incision. In this study, we investigated whether anesthesiologists in our institution completed the administration of antibiotics before skin incision. METHODS: Anesthetic records of patients who had undergone elective surgery between April to October 2011 were collected. The records were retrospectively analyzed to examine whether administration of antibiotics had been completed before skin incision or not. RESULTS: Although all the anesthesiologists were aware of the necessity of antibiotic prophylaxis, the administration of antibiotics before skin incision was not completed in 22.8% of 880 patients. The administration of antibiotics tended to delay patients receiving general surgery. CONCLUSIONS: Anesthesiologists should have knowledge on the preventation of surgical site infection especially on antibiotic prophylaxis, because it starts in the operating room.

Development of a novel computer-aided diagnosis system for automatic discrimination of malignant from benign solitary pulmonary nodules on thin-section dynamic computed tomography.

OBJECTIVES: As an application of the computer-aided diagnosis of solitary pulmonary nodules (SPNs), 3-dimensional contrast-enhanced (CE) dynamic helical computed tomography (HCT) was performed to evaluate temporal changes in the internal structure of nodules to differentiate between benign nodules (BNs) and malignant nodules (MNs). METHODS: There were 62 SPNs (35 MNs and 27 BNs) included in this study. Scanning (2-mm collimation) was performed before and 2 and 4 minutes after CE dynamic HCT. The CT data were sent to a computer, and the pixels inside the nodule were characterized in terms of 3 parameters (attenuation, shape index, and curvedness value). RESULTS: Based on the CT data at 4 (MN: 1.81-27.1, BN: -42.8 to -3.29) minutes after CE-dynamic HCT, a score of 0 or higher can be assumed to indicate an MN. CONCLUSIONS: Three-dimensional computer-aided diagnosis of the internal structure of SPNs using CE dynamic HCT was found to be effective for differentiating between BNs and MNs.