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

PURPOSE: The purpose of this study was to analyze any effectiveness, advantages, and the procedure of an ultrasound-guided suprascapular nerve block via the proximal approach in patients suffering from shoulder pain. MATERIALS AND METHODS: A total of 51 patients treated with nerve block between November 2015 and November 2016 were analyzed. We identified the suprascapular nerve that branches off the superior trunk of the brachial plexus, and found the suprascapular nerve, which is located in the fascial layer between the inferior belly of the omohyoid muscle and the serratus anterior muscle. We then performed a nerve block. We evaluated the visual analogue scale (VAS) of pre- and post-nerve block, and the visualization of the nerve, depth from the skin to the nerve, angle of needle entry, as well as complications. Moreover, we measured the visualization of the nerve, depth from the skin to the nerve in a classic approach, and compared it with the proximal approach. RESULTS: There was significant improvement (p < 0.05) in the mean VAS, from 7.1 to 3.4, without any major complications. Compared with the classic approach, we were able to identify the suprascapular nerve much better (classic 25.5%/proximal 96.1%), and the mean distance from the skin to the nerve (classic 38 mm/proximal 12 mm) was significantly short (p < 0.05), and the mean angle of needle entry was 19 degrees in the proximal approach. CONCLUSION: In an ultrasound-guided suprascapular nerve block by proximal approach, the nerve and needle tip can be more easily identified, which increases accuracy; with a small amount of local anesthetic, more effective pain control can be achieved. Hence, this approach is an effective alternative pain control method for patients suffering from shoulder pain.
Brachial Plexus ; Humans ; Methods ; Needles ; Nerve Block* ; Shoulder ; Shoulder Pain ; Skin ; Ultrasonography

No abstract available.
Lung Neoplasms* ; Lung*

BACKGROUND AND OBJECTIVES: Ramipril and candesartan have decreased the incidence of new onset diabetes in large scale randomized clinical studies. Because ramipril and candesartan have distinct mechanisms of action in the renin angiotensin aldosterone system, we hypothesized that combination therapy would have additive beneficial metabolic effects in patients with hypertension. SUBJECTS AND METHODS: Thirty-four patients were given ramipril 10 mg and placebo, ramipril 10 mg and candesartan 16 mg, or candesartan 16 mg and placebo daily in a randomized, double-blind, placebo-controlled cross-over trial with three treatment arms and two washout periods (each being 2 months). RESULTS: Ramipril, combination therapy or candesartan significantly increased the plasma adiponectin levels relative to the baseline measurements by 17+/-6% (p=0.038), 25+/-5% (p<0.001), and 14+/-6% (p=0.016), respectively. Combination therapy significantly increased the plasma adiponectin levels more than either ramipril or candesartan alone (p=0.020 by ANOVA). Only combination therapy significantly increased the QUICKI level relative to the baseline measurements (p=0.002). There were no significant correlations between these changes of the metabolic parameters and reduction of the systolic blood pressure (-0.288< or =r< or =0.284) and reduction of the diastolic blood pressure (-0.282< or =r< or =0.190). On multivariate analysis, only the change of adiponectin levels was an independent predictor of the changes in the QUICKI levels (beta=1.549, p=0.040) following combination therapy. CONCLUSION: Ramipril in combination with candesartan increases the plasma adiponectin levels to a greater extent than monotherapy with either drug alone. Only combination therapy significantly improves insulin sensitivity relative to the baseline measurements. The only predictor for the improvement of insulin sensitivity is the increase of plasma adiponectin levels by combination therapy.
Adiponectin* ; Angiotensin-Converting Enzyme Inhibitors ; Arm ; Blood Pressure ; Humans ; Hypertension ; Incidence ; Insulin Resistance* ; Insulin* ; Multivariate Analysis ; Plasma* ; Ramipril* ; Renin-Angiotensin System

BACKGROUND: Laminoplasty is a surgical procedure frequently performed for cervical myelopathy. We investigated correlations between changes in the anteroposterior diameter (APD) of the spinal canal, spinal canal area (SCA), and laminar angle (LA) and clinical outcomes of laminoplasty. METHODS: Of the 204 cervical myelopathy patients who underwent laminoplasty from July 2010 to May 2015, 49 patients who were evaluated with pre- and postoperative computed tomography of the cervical vertebrae were included. The average age of the patients was 60.4 years (range, 31 to 82 years), and the average duration of follow-up was 31.6 months (range, 9 to 68 months). Changes in the APD and SCA were measured at the middle of the vertebral body. Changes in LA were measured where both pedicles were clearly visible. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) score and visual analog scale score for pain preoperatively (1 day before surgery) and postoperatively (last outpatient visit) and examining postoperative complications. RESULTS: The APD showed an average of 54.7% increase from 11.5 to 17.8 mm. The SCA showed an average of 57.7% increase from 225.9 to 356.3 mm². The LA increased from 34.2° preoperatively to 71.9° postoperatively. The JOA score increased from an average of 9.1 preoperatively to 13.4 postoperatively. Three patients were found to have hinge fractures during surgery. Postoperative complications, including two cases of C5 palsy, were recorded. The correlation coefficient between the LA change and JOA score improvement was −0.449 (p < 0.05). Patients with a < 33° (25%) increase in the LA showed the most significant clinical improvement. CONCLUSIONS: Patients with a < 33° (25%) change in the LA after laminoplasty with a titanium miniplate showed the most significant clinical improvement. Thus, LA changes can be useful in predicting the clinical outcome of laminoplasty.
Asian Continental Ancestry Group ; Cervical Vertebrae ; Female ; Follow-Up Studies ; Humans ; Laminoplasty* ; Outpatients ; Paralysis ; Postoperative Complications ; Spinal Canal ; Spinal Cord Diseases* ; Titanium* ; Visual Analog Scale

PURPOSE: The purpose of this study is to compare and analyze the clinical results according to the complications occurring after laminoplasty for cervical myelopathy patients. MATERIALS AND METHODS: Among patients diagnosed as cervical myelopathy, 152 cases in which patients underwent cervical laminoplasty from March 2006 to March 2011 from Chungnam National University Hospital and had follow-up for at least two years were selected for the study, and the mean follow-up period was 39.7 months. The cases were divided into two groups; cases that underwent plate fixation for hinge fracture during cervical laminoplasty or showed postoperative spontaneous interlamina fusion were included in group A and cases that did not show such complications were included in group B. Clinical results were measured using visual analogue scale (VAS) score and Neck Disability Index (NDI) preoperatively, postoperatively, and on the final follow-up. RESULTS: Among 152 cases, 31 cases were included in group A and 121 cases in group B. Group A consisted of 11 cases of fixation due to intraoperative hinge fracture and 20 cases of postoperative spontaneous interlamina fusion. Mean preoperative VAS score was 7.52 in group A and 7.26 in group B, and mean postoperative VAS score was 2.87 in group A and 3.03 in group B. Mean NDI improved from 74.32% preoperatively to 43.84% postoperatively in group A and 75.74% preoperatively to 45.36% postoperatively in group B. In both groups, on postoperative follow-up, no significant difference of VAS score and NDI was found and both showed improvement compared to before surgery. CONCLUSION: The clinical results of cases that underwent plate fixation for hinge fracture that occurred during cervical laminoplasty and postoperative spontaneous interlamina fusion showed no significant difference compared to cases that did not show any complications.
Follow-Up Studies ; Humans ; Neck ; Spinal Cord Diseases*

PURPOSE: This study was undertaken to evaluate retrospectively the clinical results of surgery for the rectal villous adenoma. METHODS: The study took place from the period of Mar. of 1988 to Feb. 1998 at the Dept. of Surgery, Sungkyunkwan Univ., Medical college. The study consisted of : Among the 97 cases diagnosed with colon & rectal villous adenoma, and 59 were rectal villous adenoma, and 42 cases underwent resection. We focused on these 42 cases, especially on the position of tumor, its size, surgical technique, histologic results & keeping close follow up post-surgically. RESULTS: The sex ratio was 2:1 with male predominence, 18 cases were in their fifties with the average age of 55. In 30 cases, the lesion was situated within the 8 cm of anal verge. The average size of tumor was 3.64 cm. The applied methods were; rectotomy 19 cases, anterior resection 13 cases (including low anterior resection), endoscopic excision and transanal excision were 7 cases, and 2 cases, respectively. And in one case where the tumor size was 14.5 cm and which was situated within 3 cm of anal verge, Miles' operation was conducted. Death due to post-operative complication was not observed. 2 cases of wound infection in postoperation, one case of transient urinary incontinence & hematoma were found. And in the case of explo-laparotomy, anastomosis site leakage, in one case, anastomosis site stricture in 2 cases were noted. malignant cells were observed in total of 73.8%, among these, 80% were from villous adenoma, 70% from tubullovillous adenoma. In the case of tumor size less 1 cm, and tumor size greater than 1 cm, the probability of finding malignant lesion were 33.3% and 76.9%, respectively. CONCLUSIONS: We suggest that wideexcision through York-Mason approach is a safe and effective technique for huge villous adenomas of the rectum.
Adenoma ; Adenoma, Villous* ; Colon ; Constriction, Pathologic ; Follow-Up Studies ; Hematoma ; Histological Techniques ; Humans ; Male ; Rectum ; Retrospective Studies ; Sex Ratio ; Urinary Incontinence ; Wound Infection

PURPOSE: Conventional laparoscopic appendectomy is performed using three ports, and single-port appendectomy is an attractive alternative in order to improve cosmesis. The aim of this study was to compare pain after transumbilical single-port laparoscopic appendectomy (SA) with pain after conventional three-port laparoscopic appendectomy (TA). METHODS: From April to September 2011, 50 consecutive patients underwent laparoscopic appendectomy for simple appendicitis without gangrene or perforation. Patients who had undergone appendectomy with a drainage procedure were excluded. The type of surgery was chosen based on patient preference after written informed consent was obtained. The primary endpoint was postoperative pain evaluated by the visual analogue scale score and postoperative analgesic use. Operative time, recovery of bowel function, and length of hospital stay were secondary outcome measures. RESULTS: SA using a SILS port (Covidien) was performed in 17 patients. The other 33 patients underwent TA. Pain scores in the 24 hours after surgery were higher in patients who underwent SA (P = 0.009). The change in postoperative pain score over time was significantly different between the two groups (P = 0.021). SA patients received more total doses of analgesics (nonsteroidal anti-inflammatory drugs) in the 24 hours following surgery, but the difference was not statistically significant. The median operative time was longer for SA (P < 0.001). CONCLUSION: Laparoscopic surgeons should be concerned about longer operation times and higher immediate postoperative pain scores in patients who undergo SA.
Analgesics ; Appendectomy ; Appendicitis ; Drainage ; Gangrene ; Humans ; Informed Consent ; Laparoscopy ; Length of Stay ; Operative Time ; Pain, Postoperative ; Patient Preference

PURPOSE: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. MATERIALS AND METHODS: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. RESULTS: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. CONCLUSION: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.
Achilles Tendon* ; Ankle ; Foot ; Heel ; Humans ; Leg ; Nerve Block ; Range of Motion, Articular ; Retrospective Studies ; Rupture* ; Suture Techniques ; Sutures*

PURPOSE: Laparoscopic surgery has became or is being tried as a standard procedure in most of abdominal surgeries due to the advantages of little postoperative pain, shortened of hospital stay, early return to daily life, the cosmetic effect etc. In this article, we examine the availability of laparoscopic herniorrhaphy through a clinical review of patients who had undergone by laparoscopic or conventional herniorrhaphy. METHODS: The records and data of 137 inguinal hernia patients who underwent laparoscopic herniorrhaphy (n=57) or conventional herniorrhaphy (n=80), with similar sex and age distribution, were retrospectively analyzed. Laparoscopic herniorrhaphy equated to transabdominal preperitoneal repair and conventional herniorrhaphy to Bassini's or Ferguson's repair. As statistical method, the Chi-square and T-test was used. RESULTS: There was no significant difference noted between the groups in relation to sex, age, site and type of hernia, complication rate, or recurrence rate in both group. The laparoscopic group had a longer mean operative time (87.3 vs 68.6 min) and less frequent postoperative analgesic use (49.1 vs 72.6%) as compared to the conventional group. However there was no statistical significance. The laparoscopic group had a significantly shorter mean postoperative hospital day (3.6 vs 7.8 days) and the mean period of return to work (6.2 vs 15.2 days) as compared to the conventional group. CONCLUSION: Laparoscopic herniorrhaphy is thought to be becoming the preferred operative procedure for young patients with a flourishing social activity particularly due to its shortening of the postoperative hospital stay and facilitating the early return to work. There is a need for the complication and recurrence rate to be reestimated following a sufficient and strict follow up. After studying more cases, a reevaluation must be done concerning the advantage of laparoscopic herniorrhaphy.
Age Distribution ; Follow-Up Studies ; Hernia ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Pain, Postoperative ; Recurrence ; Retrospective Studies ; Return to Work ; Surgical Procedures, Operative