Listeria monocytogenes is a gram-positive rod which can be isolated from soil, vegetation, and many animal reservoirs. Human disease due to Listeria monocytogenes is uncommon but occurs most frequently in the neonatal period, during pregnancy and in elderly or immuno-suppressed patients. Listeriosis in pregnant women may cause spontaneous abortion, fetal distress, preterm labor, fetal death, or neonatal septicemia/meningitis. Maternal infection alone may occur without infection of the infant, especially at the end of pregnancy. One case of septicemia with Listeria monocytogenes in pregnant women at the 35th weeks of pregnancy with fetal distress is presented.
Abortion, Spontaneous ; Aged ; Animals ; Female ; Fetal Death ; Fetal Distress* ; Humans ; Infant ; Listeria monocytogenes ; Listeriosis ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnant Women ; Sepsis ; Soil

BACKGROUND: The multifactorial hypothesis is proposed as a working hypothesis which encompass both the genetic and environmental factors known to participate in the etiology of congenital heart anomalies. So, at the moment, it is believed that avoidance of suspected environmental factors in early pregenancy is most certain preventive measure of congenital heart anomalies. This study has been undertaken in order to find the possible environmental risk factors for congenital heart anomalies in Korea. METHOD: A total of 320 mothers of infants with congenital heart anomalies diagnosed at Seoul National University Hospital were included in this study as case group. And 413 mothers of healthy infants, who visited well baby clinic at the hospital during the same period of 2 years from 1987, comprised the control group. Data related to environmental risk factors including drug use during the first trimester of pregnancy, any other confounders were collected by direct interview using questionmaires. RESULT: There were positive associations for lower educational level of mother, indoor smoking habit of father, number of pregnancy, and of experience of previous abortion of mother, and multiple(or twin) birth. Relative risk estimates for the first trimester exposure to anti-emetics and herb medicine were 2.1(p<0.006) and 1.4(p<0.044), respectively. Data showed a positive association between anti-inflammatory drug exposure and congenital anomalies of pulmonary valve(OR=22.7, p<0.01), and between anti-histamine exposure and coarctation of aorata(OR=12.7, p<0.017). CONCLUSION: Environmental factors such as smoking habit of father, certain drugs used in early pregnancy, plays a role in the etiology of congenital heart anomlaies. Further studies, designed to focus on specific drug and to differentiate the effect of the suspected drug and to differentiate the effect of the suspected drug form that of the underlying conditions prompting its use, should be called upon.
Abortion, Induced ; Antiemetics ; Case-Control Studies* ; Fathers ; Female ; Heart* ; Humans ; Infant ; Korea* ; Mothers ; Parturition ; Pregnancy ; Pregnancy Trimester, First ; Risk Factors ; Seoul ; Smoke ; Smoking

Adult ; Connective Tissue ; Extremities ; Head ; Histiocytoma, Malignant Fibrous ; Humans ; Maxilla ; Neck ; Radiotherapy ; Sarcoma

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus oral dinoprostone for labor induction at term. METHODS: One hundred of patients at term were randomized to receive either 50microgram of misoprostol vaginally every 4 hours or dinoprostone 0.5mg orally every 1 hour for the maximum of six doses. Intravenous infusion of oxytocin was administered under such circumferences as the patient did not go into active labor after maximum dose, SROM was developed without an adequate contraction pattern, or the patient had arrest of dilatation(no change in cervical dilatation for 2 hours). We compared the frequency of oxytocin augmentation, administration to delivery interval, vaginal delivery rate within 12 hours and 24 hours, intrapartum complications, induction failure, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: The average interval from administration to delivery was shorter in the misoprostol group(739.4+/-372.4min vs 1087.7+/-765.1min, p<0.05), but the interval from administration to vaginal delivery of each group was similar(724.3+/-375.4min vs 800.3+/-697.0min). Regarding the frequency of vaginal delivery within 24 hours, however, misoprostol group was higher than dinoprostone group(88% vs 56%, p<0.001). And oxytocin augmentation of labor occurred less commonly in misoprostol group than in dinoprostone group(20% vs 76%, p<0.05). Any statistically significant difference in intrapartum complications, mode of delivery, and neonatal or maternal adverse outcome was not appeared between these two group. CONCLUSION: Vaginal misoprostol is as effective and safe as oral dinoprostone for cervical ripening and induction of labor at term. In addition, vaginal misoprostol contributes the curtailment of labor induction expenditure due to its moderate price; misoprostol costs 100 won per 50microgram.
Cervical Ripening ; Dinoprostone* ; Female ; Health Expenditures ; Humans ; Infusions, Intravenous ; Labor Stage, First ; Misoprostol* ; Oxytocin ; Pregnancy

As the effect of the families on the individual's health and disease is profound, it is very important to care patients based on the understanding of their families. The family function assessment tool to evaluate the families objectively and easily is necessary for this purpose. Many instruments have been developed in other countries and we have used these instruments without verification. Therefore, there is a question whether they are appropriate to the Korean families. The family function is especially important to the family with adolescents because adolescents are characterized by psychological instability. My purpose of this research is to develop an instrument to assess the function of the Korean families and this research is made on the Korean families with adolescents. 1,600 middle and high school students and 1,600 of their parents were selected for this study. They were asked to describe 5 kinds of each good and bad family relationship to collect primary basic data. These data were arranged to items based on the established scales and subscales. Secondary basic data were collected from another 200 students and their 200 parents to compliment the items. Preliminary instrument items were selected by the frequency of the responses and the judgement of the author. Through discussions with experts, the preliminary instrument was established. Accessibility was tested and factor analysis was done for the preliminary instrument. After this process, the main instrument was formulated. For the primary basic data, 2,382 people answered (response rate 74.4%) and 10,267 responses and 298 kinds of items were collected. There was no additional item from the secondary data collection. The preliminary instrument was made of 58 items selected from 298 items. It takes 8 minutes to complete this instrument in average and 97% of the subjects had no difficulty in completing it. The main test instrument, developed after factor analysis, was made of 7 scales with 40 items.
Adolescent ; Data Collection ; Family Relations ; Humans ; Parents ; Weights and Measures ; Surveys and Questionnaires

BACKGROUND: We developed Korean Family Function Assessment Tool(KFFAT). In order to confide in the results of the KFFAT, it was necessary to verify the psychometric properties(validity and reliability). METHODS: To evaluate the reliability of the KFFAT, internal consistency and scale-item correlation was carried out with 800 middle and high school students and their 800 parents. A three-week interval test-retest was also carried out with 50 high school students and their 50 parents. In addition, the KFFAT was compared to the family APGAR and the FACES III to evaluate the validity with 800 middle and high school students and their 800 parents. RESULTS: Cronbach alpha of each scale was 0.55-0.88 and overall scale-item correlation coefficient was believed to be appropriate. Pearson's correlation coefficient of test-retest was 0.49-0.79 in each scale. There is little correlation between the Family APGAR and the FACES III with the KFFAT. However, the KFFAT shows similar results in the function of family with the Family APGAR and the FACES III. CONCLUSION: From this reliability and validity test results, the Korean Family Function Assessment Tool(KFFAT) could be used as a assessment tool of Korean family function.
Humans ; Parents ; Psychometrics ; Reproducibility of Results*

Aorto-cutaneous fistula is a rare complication after performing open heart surgery, but if this develops, it is a fatal condition. So, prompt diagnosis and aggressive surgical treatment is needed. We report here on a patient who had two mechanical double valves placed during heart surgery and she was treated for repeated sternal wound infections for about 5 years. She visited the ER due to abrupt bleeding at the sternal wound. She was diagnosed as having an aorto-cutaneous fistula by performing an aortogram and we then performed cardio-pulmonary bypass surgery. The patient is currently doing well and is under follow up 24 months after the repair.
Aorta ; Fistula ; Follow-Up Studies ; Heart ; Hemorrhage ; Humans ; Mediastinitis ; Sternotomy ; Thoracic Surgery ; Wound Infection

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin

OBJECTIVES: As automobile part manufacturing is characterized by high speed and high repetition, observation methods which are usually utilized for static posture are inappropriate to evaluate musculoskeleatal risk factors. This study quantified the risk factors of musculoskeletal disorders on the forearm and suggested exposure limits by estimating the risk factors using surface electromyography (EMG) and electrogoniometer. METHODS: Ten percent of the total workers at 3 automobile part manufacturing factories were randomly selected, and 99 male workers were recruited as study subjects. The study was conducted during May 2003 to September 2004. The workers were equipped with electrogoniometers on the wrist and the elbow, surface EMGs on the skin of the flexor digitorum superficialis (FDS) and extensor carpi radialis (ECR) muscles, and the heart beat recorder during work as indicators of joint movement, local muscle tension and physical work load, respectively. RESULTS: After controlling for age, body mass index and job stress, wrist flexion maximum angle, FDS relative activity (RA) and ECR RA were significantly associated with forearm musculoskeletal symptoms. The odds ratios of the forearm were 5.0(95% CI: 1.1-22.7), 14.0(95% CI: 1.5-128.8) and 7.3(95% CI: 1.1-49.4) for wrist flexion maximum angle more than 76 degrees, FDS RA more than 2.8%, and ECR RA more than 3.5%, respectively. CONCLUSIONS: Joint angle and focal muscle activity were associated with forearm musculoskeletal symptoms. To reduce forearm musculoskeletal symptoms among automobile part manufacturers, the wrist flexion angle, and FDS and ECR activity need to be reduced below the guidelines recommended in this study.
Automobiles* ; Body Mass Index ; Elbow ; Electromyography* ; Forearm ; Heart ; Humans ; Joints ; Male ; Muscle Tonus ; Muscles ; Odds Ratio ; Posture ; Risk Factors* ; Skin ; Wrist

BACKGROUND: Growth factor treatment in combination with microneedling in androgenetic alopecia (AGA) patients is safe and effective. However, there is a lack of studies examining the effect of treatment according to the depth of the microneedle. OBJECTIVE: The aim was to evaluate differences in efficacy according to the depth of microneedle. METHODS: This study was performed on 6 male and 5 female AGA patients who were treated with topical growth factor cocktail (GFC) with microneedling every 2 weeks for 3 months. The scalp was divided into right and left sides and treated with microneedle depths of 0.5 and 0.3 mm, respectively. GFC was topically applied using a microneedle medical device. Treatment efficacy was evaluated by phototrichogram and digital photograph analysis on 6 repeated treatments for 3 months. RESULTS: Phototrichogram of the 0.5- and 0.3-mm-treated sides of the scalp showed 19 and 12 cm2 increase in hair density and 2.6- and 1.8-µm increase in hair diameter, respectively. These results were statistically significant (p<0.05). In terms of density, the 0.5-mm depth was significantly more effective than the 0.3-mm depth (p<0.05). With regard to diameter, the effect according to microneedle depth was not significantly different (p>0.05). CONCLUSION: GFC treatment with microneedling is effective and safe and a microneedle depth of 0.5 mm appears to be more effective than that of 0.3 mm. More research is necessary to confirm these results and determine the most effective depth for microneedling by investigating various depths.
Alopecia* ; Female ; Hair ; Humans ; Male ; Scalp ; Treatment Outcome