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

Two cases of an anomalous systemic arterial supply to the basal segments of the left lower lobe without pulmonary wequestration are presented. In the first case, a preoperative diagnosis was made by chest CT, and confirmed by angiograpy, in a 22-year old man who had a recurrent hemoptysis. There was systemic arterial supply that originated from the thoracic descending aorta and no pulmonary arterial supply to the basilar segment of the left lower lobe. However, the pulmonary parenchyma was normal without sequestration. Ligation of the abnormal artery and a left lower lobectomy were performed without complication. In the second case, there were characteristic features of this anomaly on chest CT and the angiogram in a 31-year-old man with symptoms of hemoptysis. The patient refused surgery.
Adult ; Aorta, Thoracic ; Arteries ; Bronchopulmonary Sequestration ; Diagnosis ; Hemoptysis ; Humans ; Ligation ; Tomography, X-Ray Computed

BACKGROUND: A growth factor cocktail (GFC) including fibroblast growth factor 9 (FGF9) in combination with microneedling is an effective and safe treatment for patients with androgenetic alopecia (AGA). However, there is a lack of studies evaluating its effects based on microneedle depth. OBJECTIVE: This study aimed to evaluate the effects of a GFC including FGF9 on hair growth in patients with AGA, and compare the differences in efficacy according to microneedle depth. METHODS: The study was performed on patients with AGA who were treated with topical GFC including FGF9 with microneedling once every 2 weeks for 3 months. The scalp was divided into right and left sides, and treated with GFC including FGF9 (right side) and normal saline (left side). The microneedle depth was 0.8 mm for both sides. A total of 22 patients (11 males and 11 females) were enrolled. GFC including FGF9 was topically applied with a microneedle medical device. Treatment efficacy was evaluated through phototrichogram and digital photograph analyses after 6 repeated treatments for 3 months. RESULTS: The phototrichogram images showed that 3 months of treatment with GFC including FGF9 with microneedling increased hair density (27.4±4.4/cm²) and diameter (2.7±2.7 µm); increases in hair density (5.7±4.4/cm²) and diameter (2.2±2.3 µm) were also seen in the region of the scalp that received normal saline. These results were statistically significant (p < 0.05). The treatment effect was not significantly different between microneedle depths of 0.8 mm (used in this study) and 0.5 mm (used in our previous study) in terms of both hair density and hair diameter. CONCLUSION: GFC including FGF9 with microneedling is an effective and safe treatment for patients with AGA. According to the results of this study and our previous report, we believe that microneedle depths of 0.5∼0.8 mm can sufficiently stimulate the scalp to increase drug-delivery.
Alopecia ; Fibroblast Growth Factor 9* ; Fibroblast Growth Factors* ; Fibroblasts* ; Hair* ; Humans ; Male ; Scalp ; Therapeutic Uses* ; Treatment Outcome

BACKGROUND: The new Multidetector Computed Tomography (MDCT) is useful in visualization of complex coronary artery anatomy. We investigated usefulness comparing of invasive coronary angiography with noninvasive MDCT in judgment of functional degree of coronary arteries grafts after coronary artery bypass graft operation. MATERIAL AND METHOD: We analyzed the patency of 52 conduits from 15 patients whom consented to take both 32 Channel MDCT and coronary angiography from November 2003 to November 2004. Comparisons were performed for sensitivity, specificity, positive prediction value and negative prediction value between coronary angiography and 3 dimensional reconstruction image using MDCT. RESULT: The average graft used was 3.4+/-0.8 per patient. Average heart rate during MDCT was 86/minute (Range, 60~110/minute) without administration ofbeta-blocker. All patients could hold breath as much as necessary. The average graft patency obtained through coronary angiography was 96.2%. In MDCT group, the sensitivity, the specificity, the positive predictive value and the negative predictive value for diagnosis was 100%, 98.0%, 100% and 66.6% respectively. CONCLUSION: The effectiveness of 32 Channel MDCT may be compared to coronary angiography in grasping about patency and bloodstream of graft conduits after coronary artery bypass graft. Also MDCT has the advantage of noninvasiveness and inexpensiveness compared to coronary angiography.
Coronary Angiography* ; Coronary Artery Bypass* ; Coronary Vessels* ; Diagnosis ; Hand Strength ; Heart Rate ; Humans ; Judgment ; Multidetector Computed Tomography* ; Sensitivity and Specificity ; Transplants ; Vascular Patency

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:Epidural anesthesia has been shown to have a direct sedative effect, and to markedly reduce the hypnotic requirement of intravenous anesthetics. The purpose of this study was to investigate whether the level of sensory block by epidural anesthesia is related with the degree of sedation, and to the hypnotic requirement of propofol. In addition, we tested whether bispectral index (BIS) monitoring can quantify the sedative effects of epidural anesthesia. METHODS: Thirty two patients scheduled for elective upper abdominal or lower extremity surgery were allocated into two groups. 2% lidocaine 15 ml was administered through an epidural catheter at the T9 T10 level (group T, n = 16) or at the L3-L4 level (group L, n = 16). Observer's assessment of alertness/sedation (OAA/S) and BIS were evaluated 20 min after the epidural injection. Hypnotic doses of propofol were then determined by evaluating the loss of open eyes in response to a verbal command as an end point while propofol was administered by target controlled infusion (target effect concentration 5microgram/ml, induction time 3 min). At the time of induction of hypnosis, the target effect concentration and BIS were recorded. RESULTS: The average level of sensory block was up to T3 in group T, and up to T11 in group L. Compared with the group L, more decreases were noticed in group T in terms of the hypnotic dose of propofol (1.13+/-0.31 mg/kg vs. 1.67+/-0.36 mg/kg; P = 0.03). A decrease in the OAA/S scale from 5 to 4 was more frequently noticed in group T than in group L (93.7% vs. 12.5%, P < 0.05). BIS recorded at the time of induction of hypnosis was higher in group T than in group L (94.8+/-2.8 vs. 82.6+/-2.2; P < 0.001). CONCLUSIONS: A higher sensory block observed in group T than in group L induced a more profound sedative effect and hypnotic induction with a lesser dose of propofol. These results support the condition that the level of sensory block by epidural anesthesia affects the degree of sedation. Moreover, BIS monitoring could not quantify the sedative effect induced by epidural anesthesia.
Anesthesia ; Anesthesia, Epidural* ; Anesthetics, Intravenous ; Catheters ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Injections, Epidural ; Lidocaine ; Lower Extremity ; Propofol

A rare case of a spontaneous intracerebellar hemorrhage from a solid cerebellar hemangioblastoma is reported with review of articles. The cerebellar hemangioblastoma was strongly suspected in the postoperative brain computerized tomography and vertebral angiography. It was successfully removed by second operation and confirmed histologically.
Angiography ; Brain ; Hemangioblastoma ; Hemorrhage