Epidemiologic analysis of Ampicillin Resistance in Shigella sonnei Isolates by blaTEM Hybridization

Forty-seven ampicillin-resistant R plasmids derived from 218 Shigella sonnei isolates from Daegu and Gwangju areas from 1980 to 2000 were epidemiologically compared by fragments of restriction endonuclease patterns by EcoRI and SmaI, and by Southern hybridization with a blaTEM-1 probe. All the ampicillin-resistant strains isolated in the 1980S carried a conjugative R plasmid responsible for multiple resistance other than ampicillin, and an ampicillin-resistance plasmid. Ampicillin-resistant strains isolated in the 1990S harbored single conjugative R plasmid encoding ampicillin resistance along with variable antimicrobial resistances. The restriction endonuclease digestion patterns and Southern hybridiztion analysis of conjugative R plasmids showing identical resistance pattern and a same size showed different fragment and Western blotting patterns according to different isolation years and areas, while identical patterns were observed among the plasmids derived from a same isolation year and area. These findings suggest that ampicillin resistance among S. sonnei isolates was due to introduction of ampicillin-resistant R plasmids originated from different sources.

Lichtenstein's Tension-Free Repair of Groin Hernias: A Single-Surgeon Experience with 321 Cases

PURPOSE: Tension-free hernioplasty has become the most popular procedure for the repair of groin hernias in the United States and United Kingdom. The purpose of this study is to describe a 7-year personal experience with Lichtenstein's tension-free groin hernia repair under local anesthesia. METHODS: We retrospectively studied the clinical outcome of 321 cases of Lichtenstein repairs, performed consecutively by an experienced surgeon between Jan. 1994 and Dec. 2000. RESULTS: Of the 321 cases, 242 (75.4%) were indirect, 34 (10.6%) were direct, 8 (2.5%) were femoral, 7 (2.2%) were pantaloon, and 30 (9.3%) were recurred hernias. The mean age was 55 years; 91% were male. The mean number of injections of analgesics required in the postoperative period was 3.2. The mean hospital stay following repair was 2.7 days. Complications occurred in 23 cases (7.1%). Most of these were minor, consisting of five cases of bruising or hematomas (1.6%), four superficial infections (1.3%), three seromas (0.9%), two hydroceles (0.6%), six patients with persisting groin pain for more than a month (1.8%), one foreign body granuloma, one urinary retention, and one testicular atrophy. There were no recurrences or operative deaths. CONCLUSION: Lichtenstein's tension-free hernioplasty is an easy and simple technique with less pain, minor complications and only rare instances of recurrence. This procedure can be performed on a same-day basis under local anesthesia. Lichtenstein repair may be the most promising technique for the repair of groin hernias.