A Listeria monocytogenes infection is relatively rare in healthy adults. However, the chance of an infection increases almost 17 times in pregnancy due to changes in the immune function. A Listeria monocytogenes infection results in characteristic gross and microscopic features in the placenta, including multiple yellowish nodules showing microscopic intervillous abscess and intervillositis. We describe the placental findings of a Listeria monocytogenes infection that was complicated by maternal sepsis, myocarditis and congestive heart failure. The infection was discovered in the 34th week of a twin gestation in a 28 year-old woman. This case should emphasize the importance of this condition to pathologists. Antibiotic treatment was started based on the placental histologic findings before a maternal blood culture confirmed growth of Listeria monocytogenes. Both the mother and twin babies were healthy at the time of this report.
Abscess ; Adult ; Female ; Heart Failure ; Humans ; Listeria monocytogenes* ; Listeria* ; Mothers ; Myocarditis ; Placenta ; Pregnancy ; Pregnancy, Twin* ; Sepsis

An experimental study on the effect of the induced dislocation of the femoral head on the femoral anteversion was made in the hips of 55 rabbits, three to four weeks old. The results were as follows; l. In 49 of the 55 operated rabbits, a relative increase of anteversion was observed on the dislocated side, as compared with the nonoperated femur, the differences ranging from 3 to 55 degrees with an average of 20.0 degrees. 2. The anteversion angle of dislocated hip showed steady and gradual increase with the increase of age. 3. The anteversion increase was detected very early after operation; 3 of the 4 rabbits, belonging 4 to 7 days group after operation showed the anteversion increase. 4. The collapse of proximal femoral epiphysis was observed in 42 of the total 55 hips. The incidence of the collapse was higher in postoperative 4 weeks and more groups. 5. The color change, pale discoloration, of the articular cartilage was observed in 32 of the total 55 hips. The icnidence of pale discoloration was higher in the groups within 8 weeks after operation.
Cartilage, Articular ; Congenital Abnormalities ; Dislocations ; Epiphyses ; Femur ; Head ; Hip ; Incidence ; Rabbits

PURPOSE: To measure the size of normal corpus callosum in each portion using objective and reproducible method with MRI and evaluation of morphological change of corpus callosum by grade of hydrocephalus. MATERIALS AND METHODS: Midsagittal Tl-weighted MR imaging of the corpus callosum was investigated in 41 volunteers of normal Korean adults and 19 patients with hydrocephalus. Corpus callosum was measured for the anteroposterior length(A), height(B), and the thickness of genu(C), body (D), splenium(E), and the narrowest portion of body(F). And the analysis of morphology and signal intensity of the corpus callosum were also evaluated. Hydrocephalus was graded as mild, moderate, and severe, and comparision of thickness with normal corpus callosum in each portion was done. RESULTS: The mean length and height were 72.3mm, 28.6mm in male, and 70.7ram, 28.9mm in female. And the mean dimention for C, D, E, and F were 13.1 ram, 8ram, 13.2mm, 5.2ram in male, and 12.8mm, 7.5ram, 12.3 ram, 5mm in female. The morphology of normal corpus callosum was "hook" shaped on midline sagittal Tl-weighted image. Narrowing at posterior third portion of body were present on 30 cases(73.2%) and even in thickness of the body in 11 cases(26.8%). The signal intensity of the corpus callosum on midsagittal Tl-weighted spin echo image of normal cases was homogeneous hyperintense as compared with cerebral gray matter. In hydrocephalus, A and B were increased and other portions were decreased in thickhess. Genu and the narrowest portion of body showed significant difference of thickness according to the grade of hydrocephalus. CONCLUSION: The mean dimention of all portion of corpus callosum were larger in male than female except for callosal height but not significant statistically with the exception of splenium. Hydrocephalus lead to morphological change of the corpus callosum. Among the portion of corpus callosum, genu and the narrowest portion of the body were thought to be the most sensitive indicators of degree in hydrocephalus.
Adult* ; Corpus Callosum* ; Female ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging* ; Male ; Volunteers

According to law the employer who has over 50 workers in his enterprise should employ an occupational physician as industrial health manager. The main role of the occupational physician is emphasized to the prevention of occupational diseases rather than the treatment and he should be the team leader of industrial health personnel. But this ideal system in terms of stipulations has lots of problems in operation. Therefore this study was designed to prove the attitude of reception, real condition and work content of the occupational physician in enterprise. The survey was done in 500 stratified random sampled enterprises over the country from July through September in 1987 by mailing questionnaire. As a result of the response from 145 enterprises, more than 85% of enterprise displaced occupational physicians. Among the occupational physicians 43% of them has no allowance for their working as industrial health managers and are payed less than 100,000 won monthly. And 66% of them visited only once a month or none enterprise, where they were nominated as a occupational physician managers. The major work content of occupational physician was doing outpatient clinic or regular physical examination rather than prevention of occupational disease. And it shows a deep discrepancy with the object of law or the expect of enterprise in which industrial hygiene and health education are more stressed for prevention of occupational diseases. The most of industrial workers showed no interest in work of occupational physician. As a conclusion, the current system of industrial health manager has maintained on paper formally and is apt to fall into making outward show. It is urgent for government and enterprise to find a solution which can be practically used the system of occupational physician. The work content of occupational physician is required high advanced knowledge and experience, and it should be operated dual system by special field and nonspecial field.
Ambulatory Care Facilities ; Health Education ; Jurisprudence ; Korea* ; Occupational Diseases ; Occupational Health ; Physical Examination ; Postal Service ; Questionnaires

BACKGROUND: The aim of this study was to evaluate the sensitivity of a clinicians' self-report method for the detection of nosocomial infections (NIs) in comparison with a total surveillance method in a neonatal intensive care unit (NICU). METHODS: Two surveillance methods were concurrently performed in the NICU of a university hospital during 5 months in 2003. Clinicians' self-report surveillance (CSRS) was based on the retrospective verification of monthly reports of positive bacteriologic results by NICU clinicians. Total surveillance (TS) was done prospectively by an infection control nurse based on chart review and laboratory data. RESULTS: One hundred fifty nine patients accounting to 2759 patient-days were included in the study. Twenty-seven NIs among 26 patients were identified by TS. The sensitivity of CSRS compared to TS was 14.8% (4 of 27 NIs). The specificity was 98.5% (131 of 133 non-NIs). Kappa measures of agreement were -0.309. CONCLUSIONS: Our results confirm that the retrospective review of charts and laboratory data by clinicians lacks sensitivity and agreement for the surveillance of nosocomial infections.
Cross Infection* ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care, Neonatal* ; Prospective Studies ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Pregnancy, Heterotopic*

The continuous emergence of new antimicrobial resistance in major human pathogens is a serious threat to clinical medicine, that increases mortality, morbidity, length of hospitalization, and the cost of healthcare. This review article focuses on the current status of antimicrobial resistance and future strategies to overcome antimicrobial resistance. In the community, multidrugresistant Streptococcus pneumoniae, community-associated methicillin-resistant Staphylococcus aureus (MRSA), and extended-spectrum beta-lactamaseproducing Enterobacteriaceae are major issues. In the hospital, an increasing prevalence of multidrug-resistant or pan-drug resistant gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii are emerging problems, while MRSA still remains the major cause of nosocomial infections. Strategies to control antimicrobial resistance include effective antimicrobial treatment, vaccination, infection control and appropriate policies and regulations. Continuous surveillance activities both in Korea and in an international setting are essential. Control of antimicrobial resistance should be a national priority based on a multisectoral approach, and international collaboration.
Acinetobacter baumannii ; Clinical Medicine ; Cooperative Behavior ; Cross Infection ; Delivery of Health Care ; Drug Resistance, Multiple ; Enterobacteriaceae ; Escherichia coli ; Gram-Negative Bacteria ; Hospitalization ; Humans ; Infection Control ; Klebsiella pneumoniae ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Pseudomonas aeruginosa ; Social Control, Formal ; Streptococcus pneumoniae ; Vaccination

Purpose: To evaluate the relationship between interocular asymmetries of corneal hysteresis (CH) and visual field defects in Korean patients with glaucoma. Methods: A total of 444 eyes from 222 participants with glaucoma in at least one eye were enrolled. CH was measured using an ocular response analyzer (Reichert Technologies Inc). Eyes of each participant were classified into “better eye” and “worse eye” based on the mean deviation (MD) value of visual field test. The correlation between interocular differences in intraocular pressure, axial length, central corneal thickness, CH, and MD values was evaluated using Spearman correlation analysis. To exclude the possible effect of antiglaucoma medication on corneal properties, additional analyses were performed on eyes without any glaucoma treatment at the time of CH measurement (treatment-naive group). Results: Median (interquartile range) MD value was –3.71 dB (–6.87 to –1.30 dB) in the better eye and –10.20 dB (–16.32 to –5.62 dB) in the worse eye. When the correlation between the asymmetry of the MD value and asymmetry of intraocular pressure, axial length, central corneal thickness, and CH were evaluated, only interocular differences in CH were significantly associated with interocular differences in MD values (rho = 0.214, p = 0.001). Among the 222 participants, 60 (27.0%) were treatment-naive group. In these eyes, interocular differences in CH were also significantly associated with interocular differences in the MD values (rho = 0.285, p = 0.029). Conclusions The interocular asymmetry of CH was significantly correlated with the interocular asymmetry of visual field defects in glaucoma.

Background: Psoriasis is a chronic inflammatory skin disease. Despite the current focus on T cells in the pathogenesis of psoriasis, keratinocytes within the psoriatic epidermis are also abnormal in many respects including excessive production of antimicrobial peptides (AMPs). Recently, several studies have used imiquimod (IMQ)- and interleukin (IL)-23-induced mouse models to explore the immunological significance of psoriasis. However, the expression of AMPs in these models remains unclear. Objective: In this study, we evaluated the protein and mRNA expression of AMPs, including cathelicidin-related antimicrobial peptides (CRAMP), mouse β-defensin 3 (mBD3), and psoriasin (S100 calcium-binding protein A7, S100A7) in IMQ- and IL-23-induced psoriasiform mouse models. In addition, we investigated whether ustekinumab, an inhibitor of IL-12 and IL-23, reduces the expression levels of AMPs in these mouse models. Methods: We used IMQ- and IL-23-induced psoriasiform mouse models. Gene and protein expression levels of AMPs were evaluated using quantitative real-time polymerase chain reaction and immunofluorescence staining, respectively. Results: We found that the protein and mRNA expression levels of CRAMP, mBD3, and S100A7 were increased in both mouse models. Ustekinumab decreased AMP expression levels in the two mouse models. Conclusion These data showed that the elevated expression of AMPs in the epidermis decreased following ustekinumab treatment in both psoriasiform mouse models. Therefore, AMP expression levels may be used as an indicator of treatment efficacy.

Background: Few studies evaluate the epidemiology and risk factors of Clostridioides difficile infection (CDI) in Asian patients with inflammatory bowel disease (IBD). We investigated the year-end prevalence, cumulative incidence and risk factors of CDI in Asian patients with IBD using a large-scale population-based cohort in Korea. Methods: Using the National Health Insurance Service database, we identified patients with IBD and sex- and age-matched controls without IBD between 2008 and 2018. The year-end prevalence and cumulative incidence of CDI were compared among patients with Crohn’s disease (CD) and ulcerative colitis (UC) with controls. The risk factors for CDI were evaluated. Results: Among the 54,836 patients with IBD and 109,178 controls, CDI occurred in 293 patients with IBD and 87 controls. The annual year-end prevalence of CDI in patients with IBD increased from 8.6/10,000 persons in 2008 to 22.3/10,000 persons in 2018. The risk of CDI was higher in both patients with CD and UC than that in the matched controls (hazard ratio [HR], 7.285; 95% confidence interval [CI], 5.388–9.851; P < 0.001 and HR, 7.487; 95% CI, 5.796–9.670; P < 0.001, respectively). Among patients with IBD, the risk factors for CDI included older age, female sex, high Charlson comorbidity index score, and IBD-related medications including oral 5-aminosalicylic acid, immunomodulatory agents, biologics, and steroids used for > 90 days. Conclusion The risk of CDI in Korean patients with IBD was approximately seven times higher than that in controls without IBD, and the annual year-end prevalence of CDI continuously increased from 2008 to 2018.