No abstract available.

Two strains of vancomycin-resistant Leuconostoc species were isolated from blood cultures in two compromised patients. The isolates produced gas from Lactobacillus MRS booth, hydrolysed esculin, and produced no ammonia from arginine, thus fulfilling the major criteria as Leucorostoc spp. We recommend that clinical laboratories should perform susceptibility test to vancomycin for clinical isolates (especially from cerebrospinal fluid and blood) which resemble streptococci so as not to confuse Leuconostoc spp. with more commonly isolated pathogens such as streptococci.
Ammonia ; Arginine ; Bacteremia* ; Cerebrospinal Fluid ; Esculin ; Humans ; Lactobacillus ; Leuconostoc* ; Vancomycin

BACKGROUND: An accurate and rapid method for specise identification of coagulase negative staphylococci(CNS) has been increasingly necessary for the clinical significance and planning the management of patients with staphylococcal infections. Recently, it has been reported that there is a highly conserved area on their 60KDa heat shock protein(HSP60) gene sequences between the interspecies of CNS and it can be amplified by a set of universal degenerate primer. This led us our attention to focus on whether the PCR-based RFLP method using Mse / restriction enzyme could be a useful tool for the species identification of CNS. METHODS: In the present study, we performed PCR-based RFLP analysis using a set of degenerate primers covering HSP60 and Mse / restriction enzyme on the reference strains and 25 clinical isolates(10 of S. epidermidis, 10 of S. haemolyticus, 4 of S. lugdunensis and 1 of S. warneri) which were previously identified by the API-STAPH, Vitek GPI card and/or with conventional biochemical test. RESULT: All the seven reference strains revealed that each strain has a distinct electrophoresed band patterns with combination of different number (up to 8) and size of fragments. And these distinct band patterns showed remarkable concordance with the seven reference strains and 25 clinical isolates. CONCLUSION: These result strongly suggest that the PCR-RFLP method using degenerate primers covering the HSP60 gene and Mse / digestion enzyme offer a convenient and accurate tool for species-specific identification of CNS.
Chaperonin 60* ; Coagulase* ; Digestion ; Heat-Shock Proteins* ; Hot Temperature* ; Humans ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Shock ; Staphylococcal Infections

The Fracture of the os calcis is quite common in relation to fracture in other tarsal bone, and fractures involving the subtalar joint may cause serious and persistant disabilities. The treatment of these calcaneal fractures remains controversial So there is no universal agreement in the treatment of these fractures, especially involving the subtalar joint. Twenty displaced intraarticular fractures of calcaneus in 15 patients were treated by open reduction and internal fixation with a plate and screws and bone graft through a lateral approach to elevate the depressed lateral portion of the posterior facet at the Inchon Chritian Hospital from Jan., 1990 to Dec, 1991. Twenty feet in 15 patients of calcaneal fractures involving the subtalal joint were treated and were clinically analysed and following result were obtained. 1. The 20 cases were classified according to the Sanders classification, 9 in type II, 9 in type III and 2 in type IV. 2. The 20 cases were treated by open reduction andinteranl fixation with plate and screws and iliac bone graft through an Sanders lateral approach. The bone graft is packed under the elevated posterior to prevent late collapse of the central fragment and to supply structral stability. 3. The preoperative average Böhler's angle was 0.4°. The post operative average Böhler's angle was 23.4° which was increased significantly. 4. Based on assessment of result of Salama, excellenwas 6, good was 7, fair was 4 and poor was 3. 5. The most common complication after treatment was persistant pain, especially beneath the lateral malleolus.
Calcaneus ; Classification ; Foot ; Humans ; Incheon ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tarsal Bones ; Transplants

PURPOSE: To investigate the surgical outcome of both lateral rectus resection in the treatment of residual esotropia with previous both medial rectus recession METHODS: The medical record of 30 patients who had underwent both lateral rectus resection from 1996 to 2001 for residual esotropia occurred after bilateral medial rectus recession and who had followed up for more than one year, were analysed retrospectively. Successful outcome was defined as esotropia 0.05), but it was not significant statistically. Postoperative angle of deviation in group II was increased from 8.1+/-4.6PD at postoperative 1 day to 13.8+/-7.9PD at postoperative 1 year (p<0.001). CONCLUSIONS: Both lateral rectus resection is an effective method in the treatment of residual esotropia less than 40 PD.
Esotropia* ; Exotropia ; Female ; Humans ; Male ; Medical Records ; Reoperation ; Retrospective Studies

BACKGROUND: Teicoplanin is a glycopeptide antimicrobial agent effective against methicillin-resistant staphylococci. Decreased susceptibility of staphylococci to glycopeptides has been increasing. Teicoplanin diffuses poorly in agar and therefore the correlation between the inhibition zone diameter and the minimal inhibitory concentration(MIC) is rather poor. The purpose of this study was to evaluate the prevalence of teicoplanin-resistant staphylococci and to assess the reliability of inhibition zone diameters for determining the susceptibility of staphylococci to teicoplanin by comparing the results of the agar dilution MICs. METHODS: From June to August 1997, 290 clinical isolates of staphylococci(77 coagulase negative staphylococci(CNS), 213 Staphylococcus aureus) were collected. The antimicrobial susceptibilities to teicoplanin were determined by inhibition zone diameter and the results were compared with the MICs determined by the agar dilution method. RESULTS: Among 77 CNS strains, 75(97.4%) were susceptible and 2(2.6%) were intermediate by agar dilution method and all 213 strains of S. aureus were susceptible to teicoplanin. There was a poor correlation(r=0.50) between the zone diameters of inhibition and agar dilution MICs. In comparison with the results of disk diffusion test and agar dilution MIC, eight (2.8%) out of 290 isolates showed discrepancies (major error rates : 0.3%, minor error rates: 2.4%). CONCLUSIONS: Two(2.6%) out of 77 strains of CNS and none of 213 S. aureus strains revealed decreased susceptibility to teicoplanin. And the inhibition zone diameter was less reliable in determining the susceptibility of staphylococci than MICs. Therefore, the more effective and convenient method is needed.
Agar ; Coagulase ; Diffusion* ; Glycopeptides ; Methicillin Resistance ; Prevalence* ; Staphylococcus ; Teicoplanin*

BACKGROUND: Emerging drug resistance and increasing incidence of enterococci infection necessitates an accurate species identification. METHOD: We compared the identification of twelve strains of American Type Culture Coliection(ATCC) (E. faecalis, E. avium, E. faecium, E. raffinosus, E. durans, E. casseliflavus, E. hirae, E. flavescens, E. malodoratus, E. gallnarum, E. mundtii, and E. sulfureus) and 73 clinical isolates of enterococci(E. faecalis 8, E. faecium 8, E. avium 13, E. durans 5, and unidentified strains 39) by Vitek Gram-positive Identification card (version R08.1, bio- Merieux Vitek, Hazelwood, Mo., U.S.A.), ribotyping and conventional scheme of Facklam and Sahm. RESULTS: All ATCC strains could be identified on the basis of characteristic 16S-23S rDNA fingerprint patterns by using Eel I and Hind III. Of 39 strains unidentified by Vitek GPI card, 25 strains were identified as E. faecium, 5 strains were E. gallinarum, 5 strains were E. casseliflavus, 3 strains were E. avium and 1 strain was E. hirae. CONCLUSION: By ribotyping with Eel I and Hind m digestion, all twelve ATCC strains and 73 clinical strains were identified and it seems to be a reliable method for identification of Enterococcus species.
Dermatoglyphics ; Digestion ; DNA, Ribosomal ; Drug Resistance ; Eels ; Enterococcus* ; Incidence ; Ribotyping*

With increased infection by methicillin-resistant staphylococci, the use of glycopeptides has been increasing. Recently, staphylococci with decreased susceptibility to glycopeptides, especially teicoplanin, are increasingly reported. We isolated a Staphylococcus aureus strain isolated repeatedly from a wound culture, which showed susceptibility to teicoplanin by the disk diffusion method but showed growth on the Mueller-Hinton agar containing 6 g/mL of teicoplanin. This strain was clinically resistant to treatment at 200 mg/day of teicoplanin. By changing the treatment into combining rifampin (600 mg/day) and increasing the dose of teicoplanin (400 mg/day), the S. aureus was not isolated any more.
Agar ; Diffusion ; Glycopeptides ; Methicillin Resistance ; Rifampin ; Staphylococcus aureus* ; Staphylococcus* ; Teicoplanin* ; Wound Infection* ; Wounds and Injuries*

Hereditary non-polyposis colorectal cancer (HNPCC) is an autosomal dominant disease characterized by early manifestation of colorectal cancer (CRC), occurrence of multiple colorectal tumors and high frequencies of extracolonic malignancies. Evaluation of clinical findings in concert with a well-documented and extended pedigree and genetic studies of colorectal cancer can identify person who are at high risk and who thereby might benefit from targeted early detection and primary prevention programs. Here we report 4 cases of HNPCC including 2 cases with synchronous gastric cancers.
Colorectal Neoplasms ; Humans ; Pedigree ; Primary Prevention ; Stomach Neoplasms* ; Stomach*

Although malignant melanoma involving the stomach is commonly mentioned in association with autopsies, endoscopic experience in this gastric malignancy is still limited, and few cases have been illustrated in the literature. This clinical condition is even rarer in Asians who are much less vulnerable to malignant melanoma than Caucasians. We experienced two cases of gastric metastases of malignant melanoma which presented as indigestion and epigastric pain. In the first case, a 75-year-old man visited because of indigestion persisting for 2 months. He had a history of multiple gastric ulcer and was treated at a local medical center, but symptoms did not improved. Endoscopic finding revealed multiple and elevated lesions with central black pigmented bases. In the second case, a 47-year-old man visited because of epigastric soreness and intermittent pain for 1 month. Metastatic melanoma in the stomach was noticed by endoscopic examination. Both patients had multiple metastatic lesions in the liver, thyroid, and brain. These two cases were diagnosed as having metastatic malignant melanoma in the stomach of unknown origin. Therefore, we report these cases with a brief review of the related literature.
Aged ; Asian Continental Ancestry Group ; Autopsy ; Brain ; Dyspepsia ; Humans ; Liver ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Stomach ; Stomach Ulcer ; Thyroid Gland