Methicillin-resistant Staphylococcus aureus colony variants (SCVs) are frequently auxotrophic for hemin, menadione, thiamine, and CO2 involved in biosynthesis of the electron transport chain element. This phenotype grows slowly, and forms very small, nonhemolytic colonies in routine culture, so it may be led to the misidentification of this organism. We isolated an organism with catalase-positive, gram-positive cocci in cluster from the urine of a 55-years-old woman with persistent and relapsing bladder stone, who had undergone the antibiotic treatment with cefotaxime, ceftizoxime, amikacin, and/or micronomicin, intermittently for three years. The possibility of SCVs should have been ruled out because this organism didn't grow on Mueller-Hinton agar (MHA) for the susceptibility test. It formed small colonies on blood agar plate overnight, and grew only on MHA with supplement of hemin, or with 5% CO2. This organism was coagulase-positive, DNase-positive, manitol-salt positive, and identified as S. aureus with VITEK GPI card. The susceptibility test could be performed after adding hemin(1mg/mL) into bacterial suspension and showed susceptibility against vancomycin, teicoplanin, and rifampin. Because these phenotypes can be misidentifide as other non-pathogenic organisms due to their atypical characteristics, we should consider SCVs in case of small, nonhemolytic colonies with catalase-positive, gram-positive cocci in cluster, showing no growth on MHA. In addition, infections caused by SCVs are recently recognized in relation to persistent and relapsing infection, so they could be isolated from the patients with long-term antibiotic therapy.
Agar ; Amikacin ; Cefotaxime ; Ceftizoxime ; Electron Transport ; Female ; Gram-Positive Cocci ; Hemin ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Phenotype ; Rifampin ; Teicoplanin ; Thiamine ; Urinary Bladder Calculi* ; Urinary Bladder* ; Vancomycin ; Vitamin K 3

No abstract available.
Resuscitation* ; Shock, Hemorrhagic*

Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.
Brain ; Cerebral Infarction* ; Child ; Child, Preschool ; Decompressive Craniectomy ; Diagnosis ; Enoxaparin ; Humans ; Immunoglobulins ; Inflammation ; Levofloxacin ; Magnetic Resonance Imaging ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Stroke ; Thrombophilia ; Thrombosis ; Vasculitis

Speckled lentiginous nevus is circumscribed patch of hyperpigmentation with smaller, darker pigmented macules or papules within the patch. The background shows histologic features of lentigo simplex. The speckled areas show junctional or compound nevus. Association of speckled lentiginous nevus with multiple spitz nevi was rarely reported. We report a case of multiple spitz nevi arising in a giant speckled lentiginous nevus.
Hyperpigmentation ; Lentigo ; Nevus* ; Nevus, Epithelioid and Spindle Cell*

Eccrine angiomatous hamartoma is a rare condition characterized histologically by increased numbers of eccrine structures and numerous capillary channels. It may be congenital or appear later in childhood. It rarely arises during puberty or adulthood. We report a case of eccrine angiomatous hamartoma on the left shoulder in a 34-year-old man. The patient presented with asymptomatic, dome-shaped, about 3X2.5 cm, reddish telangiectatic nodule on the left shoulder. Histological examination showed an increased numbers of eccrine sweat glands and vascular structures.
Adolescent ; Adult ; Capillaries ; Hamartoma* ; Humans ; Puberty ; Shoulder ; Sweat Glands

No abstract available.
Growth Plate*

We investigated the comparative effects of electroacupuncture (EA) with different frequency on the spinal c-fos and inotropic glutamate receptor expression in carrageenan-injected rats. Bilateral EA stimulation with 2, 15 and 120 Hz were delivered at those acupoints corresponding to Zusanli and Sanyinjiao in man via the needles. The inhibitory effects of the EA on the inflammatory process were investigated in the central nociceptive sites by immunohistochemical analysis. Three hours after carrageenan injection, the number of c-fos-like immunoreactive (LI) neurons was significantly increased in all layers of the ipsilateral spinal cord at L4-5 segment. But these immunoreactive neurons were markedly reduced in the spinal gray matter, especially in the superficial laminae, by all kinds of EA stimulation. The number of NMDA (NR-1 and NR-2A) and AMPA receptors (GluR-1, GluR-2/3) -LI neurons was also increased by carrageenan injection. But NR-2A-LI neuron was significantly reduced in superficial laminae of dorsal horn by 2 Hz EA stimulation. While GluR-1-LI neuron of 15 Hz and 120 Hz EA was increased in the nucleus proprius compared with carrageenan-injected group, GluR-2/3-LI neuron of these EA stimulated groups significantly reduced in superficial laminae of dorsal horn. In conclusion, EA treatment can attenuate spinal c-fos expression in carrageenan injected rats and regulates spinal inotropic glutamate receptor expression.
Acupuncture Points ; alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; Carrageenan ; Electroacupuncture* ; Glutamic Acid* ; Horns ; N-Methylaspartate ; Needles ; Neurons ; Rats* ; Receptors, AMPA ; Receptors, Glutamate* ; Spinal Cord

We investigated the comparative effects of electroacupuncture (EA) with different frequency on the spinal c-fos and inotropic glutamate receptor expression in carrageenan-injected rats. Bilateral EA stimulation with 2, 15 and 120 Hz were delivered at those acupoints corresponding to Zusanli and Sanyinjiao in man via the needles. The inhibitory effects of the EA on the inflammatory process were investigated in the central nociceptive sites by immunohistochemical analysis. Three hours after carrageenan injection, the number of c-fos-like immunoreactive (LI) neurons was significantly increased in all layers of the ipsilateral spinal cord at L4-5 segment. But these immunoreactive neurons were markedly reduced in the spinal gray matter, especially in the superficial laminae, by all kinds of EA stimulation. The number of NMDA (NR-1 and NR-2A) and AMPA receptors (GluR-1, GluR-2/3) -LI neurons was also increased by carrageenan injection. But NR-2A-LI neuron was significantly reduced in superficial laminae of dorsal horn by 2 Hz EA stimulation. While GluR-1-LI neuron of 15 Hz and 120 Hz EA was increased in the nucleus proprius compared with carrageenan-injected group, GluR-2/3-LI neuron of these EA stimulated groups significantly reduced in superficial laminae of dorsal horn. In conclusion, EA treatment can attenuate spinal c-fos expression in carrageenan injected rats and regulates spinal inotropic glutamate receptor expression.
Acupuncture Points ; alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; Carrageenan ; Electroacupuncture* ; Glutamic Acid* ; Horns ; N-Methylaspartate ; Needles ; Neurons ; Rats* ; Receptors, AMPA ; Receptors, Glutamate* ; Spinal Cord

To evaluate the differences between current and past surgical treatment of intussusception, the medical records of 48 intussusception patients who underwent surgical treatment over 4 years (1975-1978, Group A) were reviewed and compared to the medical records of 75 intussusception patients who underwent surgical treatment over 4 years (1995-1998, Group B). Sex ratio is male predominant in both group (2.7:1 vs 1.6:1) and mean age of operation is 6.7+/-5.0 month (Group A) and 8.1+/-7.0 month (Group B). Major symptoms and signs of both groups are vomiting, hematochezia and irritability. White blood cell count of peripheral blood in both groups had no significant difference (12,417+/-4,446/mm3 vs 12,297+/-4,531/mm3). In operation methods, group A had significantly higher bowel resection rate over group B (31.3% vs 14.7%, p<0.05). In group A, 2 patients were died after operation, but group B have no operative mortality. Admission period after operation is significantly short in Group B (7.5+/-2.7 day vs 5.4+/-2.1 day, p<0.01). These results suggest there were no significant difference in characters of patients between Group A and B. But surgical treatment of intussusception in 1990s was more conservative than that in 1970s. We expect that recent surgical treatment lead early recovery from operation and early discharge from hospital.
Gastrointestinal Hemorrhage ; Humans ; Intussusception* ; Leukocyte Count ; Male ; Medical Records ; Mortality ; Sex Ratio ; Vomiting

Cosmetic lateral canthoplasty, in which the size of the eye is increased by extending the palpebral fissure and decreasing the degree of the eye slant, has become a prevalent procedure for East Asians. However, it is not uncommon for there to be complications or unfavorable results after the surgery. With this in mind, the authors have designed a surgical method to reduce complications in cosmetic lateral canthoplasty by preserving the lateral canthal angle. We discuss here the anatomy required for surgery, the surgical methods, and methods for reducing complications during cosmetic lateral canthoplasty.
Asian Continental Ancestry Group ; Humans ; Lacrimal Apparatus ; Methods