No abstract available.
Aged* ; Humans

Since human listeriosis was firstly described by Nyfeldt in 1929, Listeria monocytogenes as a cause of septic abortion has been well known. It primarily affects pregnant woman and neonates, the elderly, and persons with immune-system dysfunction due to immunosuppressive drugs, malignant tumors or AIDS. Although several large epidemic listeriosis have been reported in the English literatures, it is still an underdiagnosed and underreported cause of congenital sepsis and septic abortion, because it is not always easy to isolate the organism in culture. There are 17 cases reports of Listeria monocytogenes infection in Korea, however, most of which were described about the bascteriologically proven cases. We describe placental findings of a septic abortion caused by Listeria monocytogenes at 15 weeks gestation in a 23-year-old primigravida woman. Placental examination showed characteristic and relatively specific patterns of granulomatous microabscesses composed of necrotic nuclear debris in the center and surrounding epithelioid histocytes enmeshed in fibrin between the acutely inflamed villi. There were numerous gram positive bacilli on Brown-Brenn stain.
Pregnancy ; Female ; Infant, Newborn ; Humans

We report a rare case of primary glomerular disease with both features of IgA nephropathy and membranous glomerulonephritis in a 27 year-old woman with nephrotic syndrome. Histologically, glomeruli showed slight mesangial expansion, proliferation of mesangial cells, and short subepithelial spikes on capillary wall. Direct immunofluorescence demonstrated granular IgG and C3 deposits along the capillary walls, and IgA with C3 deposits in mesangium. Granular subepithelial and rnesangial deposits were observed by electron microscopy. The patient showed complete remission after 6 months therapy with steroid and ACE inhibitor.
Adult ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerulonephritis, IGA* ; Glomerulonephritis, Membranous* ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Mesangial Cells ; Microscopy, Electron ; Nephrotic Syndrome

BACKGROUND: The influenza is a contagious respiratory illness caused by influenza viruses. The primary target groups recommended for annual vaccination are healthcare workers and households which have frequent contact with persons at high risk and can transmit influenza to those persons at high risk. Members of these groups should be vaccinated against the flu so that they can avoid getting infected with continuously mutating influenza viruses. We assessed healthcare workers' knowledge and attitudes regarding influenza vaccination in order to help promote the vaccination rate. METHODS: This survey was carried out in two hospitals affiliated with the Catholic University School of Medicine, from December 2004 to January 2005. Of the 3,023 questionnaires distributed, 2,023 could be evaluated. RESULTS: The most frequently cited reason for receiving influenza vaccine was self-protection against influenza (55.4%). The most common reasons for not receiving influenza vaccine are personal health problems such as concurrent flu, pregnancy or breast-feeding (29.2%). There is no significant difference in the frequency of side effect between two groups receiving and not receiving vaccine. The most frequent side effect of influenza vaccination is flu-like syndrome; People receiving vaccine have more significant knowledge than those people not receiving vaccine about efficacy of flu vaccination, risk of influenza infection of healthcare workers and their need of flu vaccination. CONCLUSION: In order to promote the vaccination rate, education targeting people at high risk need to keep continuous and facilitate access to vaccination.
Delivery of Health Care* ; Education ; Family Characteristics ; Humans ; Influenza Vaccines ; Influenza, Human* ; Orthomyxoviridae ; Pregnancy ; Vaccination* ; Surveys and Questionnaires

BACKGROUND: It is important to avoid the direct contact with water of detergents as possible for the treatment and prevention of hand eczema. OBJECTIVE: The purpose of this study is to evaluate the protective effect of skin protector, Marly skin on housewifes eczema, METHODS: The patients with hand eczema apply skin protector, Maly skin, four times a day on their both hands. They are evaluated with the scores of subjective symptor is(itch, dryness, smarting) and objective signs(erythema, scaling, fissures), and skin replica which are taken from the specified site are analysed by using an image analyser and, scanning electron micrascipe. RESULTS: 4 weeks after application of skin protector, there are statstically significant decrease of total clinical symptom scores. Scanning electron microscopic findings of the skin replicas show marked changes between the beginning and the end of the study. On quantive image analysis of the skin replicas, the length of fissure is a little decreased and the depth of rrows is slightly increased than before application of skin protector, but these are not statistically significant. CONCLUSION: Skin protector, Marly skin, has a protective effect on the development of hand eczema.
Detergents ; Eczema* ; Hand ; Humans ; Mali ; Skin

Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A 2-month-old boy presented with fever lasting 3 days, conjunctival injection, strawberry tongue, erythematous edema of the hands, and macular rash, symptoms and signs suggestive of incomplete Kawasaki disease. His fever resolved 8 days after treatment with aspirin and high dose infusion of intravenous immunoglobulin. The hemoglobin and hematocrit decreased from 9.7 g/dL and 27.1% to 7.4 g/dL and 21.3%, respectively. The patient had normocytic hypochromic anemia with anisocytosis, poikilocytosis, immature neutrophils, and nucleated red blood cells. The direct antiglobulin test result was positive, and the reticulocyte count was 1.39%. The patient had an uneventful recovery. However, reticulocytopenia persisted 1 month after discharge.
Anemia ; Anemia, Hemolytic* ; Anemia, Hypochromic ; Aspirin ; Coombs Test ; Edema ; Erythrocytes ; Exanthema ; Fever ; Fragaria ; Hand ; Hematocrit ; Hemolysis ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Infant* ; Male* ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils ; Reticulocyte Count ; Reticulocytes ; Tongue

Background: To investigate the association between free fatty acid (FFA) level at mid-pregnancy and large-for-gestational-age (LGA) newborns in women with gestational diabetes mellitus (GDM). Methods: We enrolled 710 pregnant women diagnosed with GDM from February 2009 to October 2016. GDM was diagnosed by a ‘two-step’ approach with Carpenter and Coustan criteria. We measured plasma lipid profiles including fasting and 2-hour postprandial FFA (2h-FFA) levels at mid-pregnancy. LGA was defined if birthweights of newborns were above the 90th percentile for their gestational age. Results: Mean age of pregnant women in this study was 33.1 years. Mean pre-pregnancy body mass index (BMI) was 22.4 kg/m2. The prevalence of LGA was 8.3% (n=59). Levels of 2h-FFA were higher in women who delivered LGA newborns than in those who delivered non-LGA newborns (416.7 μEq/L vs. 352.5 μEq/L, P=0.006). However, fasting FFA was not significantly different between the two groups. The prevalence of delivering LGA newborns was increased with increasing tertile of 2h-FFA (T1, 4.3%; T2, 9.8%; T3, 10.7%; P for trend <0.05). After adjustment for maternal age, pre-pregnancy BMI, and fasting plasma glucose, the highest tertile of 2h-FFA was 2.38 times (95% confidence interval, 1.11 to 5.13) more likely to have LGA newborns than the lowest tertile. However, there was no significant difference between groups according to fasting FFA tertiles. Conclusion In women with GDM, a high 2h-FFA level (but not fasting FFA) at mid-pregnancy is associated with an increasing risk of delivering LGA newborns.

Purpose: The objective of this study was to analyze the results of several noninvasive prenatal tests (NIPTs) from a single center and confirm their efficacy and reliability. In addition, we aimed to confirm the changes in the number of invasive tests performed after introducing NIPT. Materials and Methods: NIPT data from a large single center from March 2014 to November 2018 were analyzed. Karyotyping was confirmed based on chorionic villus sampling, amniocentesis, or postnatal cord/peripheral blood sampling. Data on maternal age, gestational age, fetal fraction, and ultrasonographic results were analyzed. As the secondary outcome, the number of amniocentesis cases before and after the introduction of NIPT was compared. Results: Overall, 1,591 single pregnancy cases that underwent NIPT were enrolled. The mean maternal age was 36.05 (22-45) years. The average gestational age and fetal fraction were 12+1 (9+3 to 27+1) weeks and 10.95% (3.6% to 31.3%), respectively. A total of 1,544 cases (97.0%) were reported to have negative NIPT results and 40 (2.5%) had positive NIPT results. The sensitivity and specificity of the overall abnormalities in NIPT were 96.29% and 99.36%, respectively. The positive predictive value (PPV) and negative predictive value were 72.22% and 99.93% respectively. The mean number of amniocentesis cases were 21.7 per month (21.7±3.9), which significantly decreased from 31.5 per month (31.5±4.8) before conducting NIPT as a screening test. Conclusion NIPT is currently a useful, powerful, and safe screening test. In particular, trisomy 21 is highly specific due to its high PPV. NIPT can reduce the potential risks of procedure-related miscarriages during invasive testing.

Achalasia is a motility disorder of the esophagus characterized by aperistalsis, incomplete lower esophageal sphincter (LES) relaxation, and increased LES tension. Obstruction at the esophageal hiatus results in dilatation of the thoracic esophagus, which can cause coughing and dyspnea by compression of the trachea and main-stem bronchi, and predisposes the patient to regurgitation and pulmonary aspiration of stagnant esophageal contents. We report a case of slight aspiration pneumonia during anesthesia in a pregnant woman who had achalasia of the esophagus. Epidural anesthesia was performed for a cesarian section uneventfully. She had a regurgitation of the gastroesophageal contents after a thiopental 225 mg IV because she wanted to sleep due to anxiety. We performed endotracheal intubation with Sellick's maneuver immediately followed by suction. We regret not to have recognized that she had achalasia of the esophagus. Therefore, we did not remove the esophageal contents with a nasogastric tube. The result was that she had slight aspiration pneumonia.
Anesthesia* ; Anesthesia, Epidural ; Anxiety ; Bronchi ; Cough ; Dilatation ; Dyspnea ; Esophageal Achalasia* ; Esophageal Sphincter, Lower ; Esophagus ; Female ; Humans ; Intubation, Intratracheal ; Pneumonia, Aspiration* ; Pregnant Women ; Relaxation ; Suction ; Thiopental ; Trachea