No abstract available.
Dilatation* ; Urethra*

No abstract available.
Leiomyoma*

No abstract available.
Peritoneum*

No abstract available.
Child* ; Humans ; Rheumatic Heart Disease*

BACKGROUND: Serratia marcescens proliferates well in a humid environment or soil and is recently considered as an important pathogen for the severe nosocomial infections. this organism is spreads easily by hand-to-hand transmission, and contaminates medical equipment used for invasive procedures, working environment, medications, and soap. METHODS: We investigated the source of an outbreak of bloodstream infections by S. marcescens isolated that occurred during the period from July to December, 2004, at a university hospital in Gyeonggi Province and attempted to intervene in the outbreak and control it. RESULTS: From July to December, 2004, S. marcescens grew from 296 blood culture from 283 patients. The medical charts of the patients were reviewed, and surveillance cultures were taken to identify the outbreak of nosocomial infections and risk factors. Only four cases of infection were identified and all remaining positive blood cultures were due to contamination. Nine isolates randomly selected from the 296 S. marcescens showed an identical pulsed-field gel electrophoresis pattern. To identify the source of infection, environmental culture and hand cultures of the related medical workers were carried out, but S. marcescens was not isolated. CONCLUSION: As the result of aggressive infection control activities, such as re-education on environmental management methods, hand washing techniques, and blood culture sampling techniques, no more S. marcescens had been grown in blood culture since January, 2005.
Cross Infection ; Electrophoresis, Gel, Pulsed-Field ; Gyeonggi-do ; Hand ; Hand Disinfection ; Humans ; Infection Control ; Risk Factors ; Serratia marcescens ; Serratia* ; Soaps ; Soil

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.

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

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.

Manipulation of the sensory branches of the trigeminal nerve is known to cause autonomic changes, such as bradycardia or asystole, known as the trigemino-cardiac reflex. In this case, the patient underwent microvascular decompression due to trigeminal neuralgia and developed sudden bradycardia, followed by abrupt asystole with a concurrent fall in the systolic blood pressure. There was spontaneous return of cardiac rhythm and blood pressure, but two more episodes of sinus bradycardia occurred during the surgery.
Blood Pressure ; Bradycardia ; Heart Arrest* ; Humans ; Microvascular Decompression Surgery* ; Reflex, Trigeminocardiac ; Trigeminal Nerve ; Trigeminal Neuralgia*