Clinical characteristics of papular-purpuric gloves and socks syndrome consist of a purpuric erythema affecting the hands and feet in a gloves and stocking distribution. It is sometimes associated with fever and oral lesions. The disease is self-limiting and resolves within 1 to 2 weeks. Serological studies have shown that there is an association with parvovirus B19 infection in most patients affected by this syndrome. We report a case of gloves and socks syndrome in a 21-year-old female. She had a 4-day history of papular-purpuric eruptions of the hands and feet in a gloves-and-socks distribution. She also complained of fever(up to 39C) during the first 2 or 3 days of clinical onset. The oral mucosa was normal and there were no palpable lymph nodes. Laboratory and histopathological findings were non-specific. However, human parvovirus B19 DNA was detected in the serum by a polymerase chain reaction. Systemic manifestations were transient and disappeared within a few days, whereas the skin lesions resolved gradually over a period of 2 weeks.
DNA ; Erythema ; Female ; Fever ; Foot ; Hand ; Humans ; Lymph Nodes ; Mouth Mucosa ; Parvovirus ; Parvovirus B19, Human ; Polymerase Chain Reaction ; Skin ; Young Adult

BACKGROUND: To access the accuracy and clinical usefulness of microplate identification (ID) system for the identification of Enterobacteriaceae, we compared microplate ID system with API 20E(bioMerieux, Etoile, France). METHODS: Ninety-two cultures of Enterobacteriaceae and one isolate of Aeromonas species were simultaneously identified by microplate ID system and the API 20E. Twenty biochemical tests used in microplate ID system were lactose, sucrose, and H2S in Kligler's iron agar media; indole, sucrose, raffinose, arabinose, trehalose, adonitol, dulcitol, sorbitol, cellibiose, methy-red, phenylalanine deaminase, ornithine decarboxylase, lysine decarboxylase, arginine dihydrolase, urease, and citrate in microplate; and oxidase test. The identification was obtained by considering percent likelihood(% ID), modal frequency and ID score method. RESULTS: Among the 92 cultures of Enterobacteriaceae and one isolate of Aeromonas species, agreement rate of identification according to the % ID between microplate ID system and API 20E were 90.3% to the species level and 97.8% to the genus level. CONCLUSIONS: For the identification of clinical Enterobacteriaceae isolates, the microplate ID system compares favorably with API 20E in identification accuracy and have the advantage of costsaving and easy to use.
Aeromonas ; Agar ; Arabinose ; Arginine ; Citric Acid ; Enterobacteriaceae* ; Galactitol ; Iron ; Lactose ; Lysine ; Ornithine Decarboxylase ; Oxidoreductases ; Phenylalanine ; Raffinose ; Ribitol ; Sorbitol ; Sucrose ; Trehalose ; Urease

We present two cases of focal fatty sparing caused by a nontumorous arterioportal shunt. Two patients underwent ultrasonography (US) as a part of routine medical screening, which revealed a hypoechoic lesion in the diffuse fatty liver. Each lesion appeared to be an arterioportal shunt on triphasic mutidetector computed tomography (CT) and was seen as being slightly hyperdense on noncontrast CT. No tumors were delineated around or within the arterioportal shunt. Both lesions remained unchanged on six-month follow-up US.
Fatty Liver* ; Follow-Up Studies ; Humans ; Mass Screening ; Ultrasonography

Transcatheter arterial chemoembolization (TACE) is widely used in the treatment of hepatocellular carcinomas. We report a case of mult iple liver abscess with bile duct necrosis following gallbladder infarction after TACE in a patient with hepatocellular carcinoma. A 62-year old man, wit h four cm sized hepatocellular carcinoma in right lobe, was treat ed by TACE for six times during 18 months. Two days after the last TACE, acute cholecystitis occurred and antibiotics were used until the recovery of cholecystitis. After two months, abdominal CT scan revealed a gas containing liver abscess and percutaneous transhepatic drainage was performed. Cholangiography via drainage cathet er showed findings of bile duct necrosis. Ant ibiotics sensit ive to the causative organism were administered intravenously. However, the abscess persisted despite of treatment for three mont hs.
Abscess ; Anti-Bacterial Agents ; Ants ; Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular ; Cholangiography ; Cholecystitis ; Cholecystitis, Acute ; Drainage ; Fendiline ; Gallbladder ; Humans ; Infarction ; Liver Abscess* ; Liver* ; Middle Aged ; Necrosis* ; Tomography, X-Ray Computed

OBJECTIVE: Our previous study demonstrated that the placental GnRH and GnRH mRNA did not parallel the time course of hCG secretion, though it is thought to be one of the potential paracrine regulators of hCG secretion from the trophoblasts. The present study was designed to examine the potential variation in GnRH-receptor mRNA expression in the placenta, which may account for the GnRH-mediated action of hCG secretion during pregnancy. METHODS: Human placentas in firt, second, and third trimester of normal pregnancy were obtained. These placentas were fixed with 4% paraformaldehyde and embedded in OCT compound, and sectioned by cryostat. For in situ hybridization, S labeled RNA probes were used and followed by autoradiography. RESULTS: The GnRH-receptor mRNA signals were present in both cytotrophoblast and syncytiotrophoblast cell layers. Signal intensities varied with gestational ages and were abundant at 6-7 weeks, peaked at 9-12weeks, declined at 14 and 24 weeks, and were barely detectable at term. The present study demonstrates that GnRH-receptor mRNA exhibits changes paralleling the time course of hCG secretion during pregnancy CONCLUSION: These data provide mechanistic understanding that the paracrine/autocrine regulation of hCG secretion by placental GnRH is mediated through an increase followed by a decline in GnRH-receptor mRNA expression from the first trimester to term placenta.
Autoradiography ; Female ; Gestational Age ; Gonadotropin-Releasing Hormone ; Humans ; In Situ Hybridization ; Placenta* ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Pregnancy* ; RNA Probes ; RNA, Messenger* ; Trophoblasts

BACKGROUND: The selection of identification (ID) system of Enterobacteriaceae depends mainly on accuracy of identification system, cost of operation and convenience of testing. Commercial ID kits are easy to use but too expensive. Therefore, we designed a computerized ID system based on 10 tubes which were composed of 14 conventional biochemical tests to identify the Enterobacteriaceae and Vibrionaceae. The purpose of this present study was to assess the clinical usefulness of 10 tube system as an identification system for Enterobacteriaceae in clinical microbiology laboratories. METHODS: During the period of January 1998, 189 Enterobacteriaceae and 2 Aeromonas spp. consecutively isolated from clinical specimens were simultaneously identified by 10 tube system and the API rapid ID 32 E. Fourteen conventional biochemical tests used in 10 tube system were lactose, sucrose, and H2S in Kligler's iron agar media; motility, indole, and ornithine decarboxylase in motility-indole-ornithine decarboxylase agar media; citrate, urease, lysine decarboxylase, phenylalanine deaminase, arginine dihydrolase, arabinose, trehalose, and adonitol. Identification program used in 10 tube system were % ID method and ID score method. RESULTS: Among the 191 isolates, agreement rate of identification between 10 tube system and API rapid ID 32 E were 96.0% to the species level and 99.4% to the genus level. And identification accuracy of 10 tube system was 90.6% to the species level and 93.2% to the genus level. CONCLUSIONS: 10 tube system has been shown to be an accurate, cost-effective alternative to the use of commercial kit systems for identification of Enterobacteriaceae.
Aeromonas ; Agar ; Arabinose ; Arginine ; Citric Acid ; Enterobacteriaceae* ; Iron ; Lactose ; Lysine ; Ornithine Decarboxylase ; Phenylalanine ; Ribitol ; Sucrose ; Trehalose ; Urease ; Vibrionaceae

Isolated fetal ascites may be different from general category of nonimmune hydrops in both prenatal course and prognosis. We experienced one case of isolated fetal ascites of unknown origin treated by in utero ultrasound-directed paracentesis and so present it with brief review of literature.
Ascites* ; Edema ; Paracentesis* ; Prognosis

BACKGROUND: One of major consideration of any identification (ID) system is the cost. Commercial kits, however, are too expensive. The aim of this study was to evaluate the clinical usefulness of the computerized ID system based on the conventional minimal biochemical tests for the identification of clinical isolates of Enterobacteriaceae. METHODS: During June 1996 to April 1997, Enterobacteriaceae were tested by triple sugar iron, motility, indole, ornithine decarboxylase, and citrate, and 2-4 biochemical tests were tested additionally according to the characteristics of colony on MacConkey agar. We also compared the conventional ID system with API Rapid 32E (ATB system, bioMrieux, France) to determine the accuracy of conventional ID system. RESULTS: Among the 3,652 strains of Enterobacteriaceae, 84.4% were identified by conventional tests. The identification rate of Enterobacteriaceae by conventional tests; K. pneumoniae, E. coli, P. stuartii, M. morganii, and P. mirabilis were more than 80%; K. oxytoca, Enterobacter, and S. marcescens were ranged from 70% to 80%; P. vulgaris, P. rettgeri, and C. freundii were less than 70%. Among the 133 isolates tested simultaneously by two ID systems, each of one strain of M. morganii, E. cloacae, and S. marcescens on conventional minimal biochemical tests were identified as E. coli, E. sakazakii, and S. liquefaciens by commercial kit. CONCLUSIONS: Our computerized ID system based on the minimal biochemical tests was found to offer simple, reliable and economic in the identification of clinical isolates of Enterobacteriaceae. And further studies are needed for the improvement of accuracy and identification rate.
Agar ; Citric Acid ; Cloaca ; Enterobacter ; Enterobacteriaceae* ; Iron ; Mirabilis ; Ornithine Decarboxylase ; Pneumonia

BACKGROUND: In clinical microbiology the accurate and rapid identification of members of the family Enterobacteriaceae is essential for diagnostic and therapeutic purposes and for epidemiologic studies. Accuracy of identification system depends mainly on data base such as positive rate of biochemical reactions, relative frequency of occurrence of biotype, and isolation frequency of microorganisms. The purpose of this study was to analyze the isolation rate and biotype frequency of the family Enterobacteriaceae isolated from tertiary care hospital in Korea. METHODS: Isolation frequency of the family Enterobacteriaceae isolated from clinical specimens during the period of January 1998 to June 1998 were analyzed. And biochemical phenotypes of 2,022 isolates tested by 10 tube system consisting of 14 conventional biochemical tests were also analyzed. RESULTS: Isolation rate of the family Enterobacteriaceae to the genus level in order of decreasing frequency were Escherichia (37.0%), Serratia (15.9%), Klebsiella (14.9%), Enterobacter (11.1%), Providencia (8.1%), Citrobacter (2.8%), Proteus (2.5%), Morganella (2.4%), Salmonella (2.4%), and Cedecea (0.7%). Among the genus of the family Enterobacteriaceae, Budvicia, Edwardsiella, Ewingella, Hafnia, Kluyvera, Leminorella, Moellerella, Shigella, Tatumella, Xenorhabdus, Yersinia, and Yokenella were not isolated. The number of species and genus of the family Enterobacteriaceae by this study were 48 and 12, respectively. Over 95% of all clinical isolates belonged to only 25 species. CONCLUSIONS: Although these data about frequency of relative isolation rate and biotype patterns of the family Enterobacteriaceae is inadequate according to species and genus, yet these data will be utilized for the application and development of identification method of the family Enterobacteriaceae.
Citrobacter ; Edwardsiella ; Enterobacter ; Enterobacteriaceae* ; Escherichia ; Hafnia ; Humans ; Klebsiella ; Kluyvera ; Korea ; Morganella ; Phenotype ; Proteus ; Providencia ; Salmonella ; Serratia ; Shigella ; Tertiary Healthcare ; Xenorhabdus ; Yersinia

Breast is a typical female sexual physiologic organ that is influenced by steroid hormone from menarche until menopause. Therefore various diseases can be developed by continuous action of estrogen and progesterone. Breast diseases are mainly categorized as benign and malignant. It is very important to distinguish the malignancy from breast diseases. However, it is very difficult to diagnose malignancy in pregnant and lactating women even though the same breast diseases took place. Therefore, we will review breast diseases such as breast carcinoma during pregnancy and lactation.
Breast ; Breast Diseases ; Estrogens ; Female ; Humans ; Hypogonadism ; Lactation ; Menarche ; Menopause ; Mitochondrial Diseases ; Ophthalmoplegia ; Pregnancy ; Progesterone