Staphylococcus epidermidis is a normal inhabitant of skin, throat, mouth, vagina, and urethra. It is not usually pathogenic, particularly in immunocompetent hosts. This report describes a case of a pyogenic liver abscess caused by Staphylococcus epidermidis in a healthy 12-year-old boy. He was admitted to Seoul St. Mary's Hospital with intermittent fever for 6 days. Findings on abdominal computed tomography (CT) showed a mass measuring 7.0x6.5 cm in the right hepatic lobe. Culture of the abscess resulted in growth of Staphylococcus epidermidis as a causative organism. The patient was successfully treated with intravenous administration of antibiotics and percutaneous drainage of the abscess.
Abscess ; Administration, Intravenous ; Anti-Bacterial Agents ; Child ; Drainage ; Fever ; Humans ; Liver Abscess ; Liver Abscess, Pyogenic ; Mouth ; Pharynx ; Skin ; Staphylococcus ; Staphylococcus epidermidis ; Urethra ; Vagina

PURPOSE: The aim of this study is to investigate the colonization rate of Methicillin-resistant Staphylococcus aureus (MRSA) in neonates by different clinical characteristics, to presume the origin of MRSA acquisition, and to identify the risk factors associated with MRSA colonization. METHODS: We retrospectively reviewed the medical records of 1,733 neonates admitted to Seoul Eulji hospital Neonatal Intensive Care Unit between January 2008 and December 2011. Nasal, inguinal and rectal swab specimens were obtained upon admission and each week until discharge. We classified the route of MRSA acquisition as; hospital associated (HA-MRSA) and community associated (CA-MRSA) according to the case definition. RESULTS: Among 1,733 neonates, 415 (23.9%) were colonized with MRSA. Gestational age, birth weight, delivery type, maternal antibiotics usage before delivery, birth place and care place before admission were influencing factors in colonization of MRSA. The colonization rate was significantly high in neonates without maternal prophylactic antibiotics use before delivery than in the other group (relative risk 2.77, 95% CI 1.88-4.07; P<0.01), and outborns showed higher MRSA colonization rate compared to inborns (relative risk 2.28, 95% CI 1.17-4.42; P=0.015). CONCLUSION: We identified the neonatal MRSA colonization rate to be 23.9%. We estimated HA-MRSA colonization rate to be 10% (51/511) and CA-MRSA colonization rate to be 36% (309/858). We ascertained that risk factors in MRSA colonization in neonates were prophylactic use of antibiotics in mothers and the birth place.
Anti-Bacterial Agents ; Birth Weight ; Colon ; Gestational Age ; Humans ; Hypogonadism ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mitochondrial Diseases ; Mothers ; Ophthalmoplegia ; Residence Characteristics ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus

Hypersensitivity myocarditis is an inflammatory disease of the myocardium usually related to drug allergy. The clinical manifestation may be nonspecific, and the diagnosis is seldom suspected or established during the life. So in most of the reported patients, the diagnosis was made at autopsy. Although, retrospectively, more than 90% of the patients described have had clinically recognizable cardiac involvement before death, tole clinical suspicion of hypersensitivity myocarditis is rare. The presence of nonspecific cardiac finding in a patient receiving any drug associated with hypersensitivity should alert the clinician to the possibility of drug related myocarditis. We experienced a case of hypersensitivity myocarditis accompanying allergic skin lesion in a 58 years old man with a history of taking cefadroxil. Fortunately, the outcome was favorable, therefore we do not have histologic confirmation of the diagnosis.
Autopsy ; Cefadroxil ; Diagnosis ; Drug Hypersensitivity ; Humans ; Hypersensitivity* ; Middle Aged ; Myocarditis ; Myocardium ; Retrospective Studies ; Skin

No abstract available.
Dwarfism*

Pseudohypoparathyroidism is a medical disorder characterized by a complex disorder of renal resistance to parathyroid hormone and the mechanism underlying the disease is still unclear. The authors described two cases of pseudohypoparathyroidism in sibling,who had metabolic anomalies(hypocalcemia and hyperphosphatemia, high circulatin immunoreactive PTH)and basal ganglia calcification. Bilateral basal ganglia calcifications, which was not visible on plain skull film, was detected by CT scan of brain MRI. We report these cases with a review of related literatures.
Basal Ganglia ; Brain ; Humans ; Hyperphosphatemia ; Magnetic Resonance Imaging ; Parathyroid Hormone ; Pseudohypoparathyroidism* ; Siblings* ; Skull ; Tomography, X-Ray Computed

No abstract available.
Beckwith-Wiedemann Syndrome*

BACKGROUND: Cardiac troponin T (cTnT) is a new serological marker for use as a diagnostic toots for acute myocardial infarction (AMI). This study was designed to evaluate tee diagnostic efficiency of troponin T in AMI. METHODS: We determined the reference range of troponin T in 20 healthy adults without previous cardiovascular diseases and chest pain. We evaluated troponin-T, CK, LD, AST and CK-MB in serum of 13 AMI and 5 angina pectoris patients. The patients were arrived at the hospital within 3 hours after onset of (most recent) acute symptoms. Samples were drawn individually at the times of 0, 1, 3, 7, 18 and 24 hours after admission and continued at 6-h intervals for 2 days and 24-h intervals fort 2 weeks. Troponin T was determined by an enzyme-linked immuno-sorbent assay (one step sandwich assay) on an ES-300 analyzer. RESULTS: We found that serum troponin-T concentrations in healthy control adults were below 0.07microgram/L. The peak level of troponin-T concentration of patients with AMI was 22.0microgram/L, mean value, at 7 hours after admission and showed 110 times its discrimination limit value (0.2microgram/L). CK-MB value was normalized within 3 days after admission, but cTnT value remained high above its discrimination limit value until 2 weeks after admission during this study. CONCLUSIONS: The data indicate that the measurement of serum cTnT improves efficiency of serological testings of AMI as compared with conventionally used cardiac enzymes.
Adult ; Angina Pectoris ; Cardiovascular Diseases ; Chest Pain ; Discrimination (Psychology) ; Humans ; Myocardial Infarction* ; Reference Values ; Serologic Tests ; Troponin T* ; Troponin*

Insulinoma is a rare tumor, occurring more often in women and in the older age range. Eighty percent of patients have a single benign tumor, usually 2 cm in diameter, located with about equal frequency in body, head or tail of pancreas and amenable to surgical cure. About 10% have multiple tumors. The remaining 10% of patients have metastatic malignant insulinoma. The symptom of insulinoma is characterized by the periodic attack of hypoglycemia of blood sugar level below 50mg%, by fasting or exertion, and rapid relief of symptom by oral or intravenous administration of glucose. Symptom often lead to misdiagnosis as a neurologic or psychiatric disorder. A case described by authors was 44-year old female with the chief complaints of the loss of consciousness, epileptic seizure although she has been treated by anticonvulsants. Serum blood sugar and insulin level during fasting suggested insulinoma but abdominal computed tomography shows no definitive mass in pancreas. Celiac angiography revealed insulinoma. She transferred to the department of General Surgery and was performed enucleation. Microscopic findings shows the islet cell tumor of pancreas. A brief review of the literature was made.
Adenoma, Islet Cell ; Administration, Intravenous ; Angiography ; Anticonvulsants ; Blood Glucose ; Diagnostic Errors ; Epilepsy ; Fasting ; Female ; Glucose ; Head ; Humans ; Hypoglycemia ; Insulin ; Insulinoma* ; Pancreas ; Tail ; Unconsciousness

PURPOSE: To correlate signal intensities of hepatocellular carcinomas on MR images with applied field strength, tumor vascularity, history of transarterial chemoembolization, and their histopathologic findings. MATERIALS & METHODS: Twenty-two tumors in 18 patients with histologically proved hepatocellular carciomas were examined by MRI at 0.5T(14), 1.5T(5), or 2.0T(3). Tumor size ranged from 1 cm to 10 cm. We analyzed the signal intensities, presence of pseudocapsule and mosaic pattern of hepatocellular carcinomas on TI-, T2- and heavily T2-weighted images, and correlated them with histologic type and grade, as well as tumor vascularity on hepatic arteriography. RESULTS: Signal intensities of the tumors were hyperintense(6), isointense(11), or hypointense(5) on Tl-weighted images, hyperintense(21) or isointense(1) on T2-weighted images, and hyperintense(15) or isointense(3) on heavily T2-weighted images. There were hypointense tumors(3/13) on Tl-weighted MR images at 0.5 T, whereas they were absent at 2.0 T(0/4). Only one tumor was avascular which was hyperintense on Tl-weighted images. Capsules were present in 13 cases and Tl-weighted images depicted them in 10 cases, while T2-weighted images depicted them in 8 cases. Mosaic patterns with inhomogeneous signal intensity were present in 15 cases, and were seen in 7 cases on Tl-weighted images whereas 11 cases on T2-weighted images. Mixed trabecular and pseudoglandular patterns of histologic growth were seen in 5 tumors. On MR images, trabecular portion was seen as hypointense area on Tl-weighted images and hyperintense on T2-weighted images. Pseudoglandular portion was seen as isointense or hyperintense area on Tl-weighted images and as marked hyperintense and on T2-weighted images. Mixed cytologic feature of classic and clear cell was found in 4 tumors and three of these 4 cases were hyperintense on Tl-weighted images. Four of the six tumors with grades I-II were hyperintense on Tl-weighted images. Tumors with grades II-Ill, Ill-IV were 14 cases, and only two of these cases showed hyperintensity on Tl-weighted images. Peliotic change was present in one case, and was seen as hyperintense foci on T2, & heavily T2-weighted images. CONCLUSION: Pathologic correlation suggest that hyperintensity on Tl-weighted images might be due to pseudoglandular pattern, low grade of malignancy or clear cell portion of hepatocellular carcinoma. Marked hyperintensity on T2-weighted images may be due to pseudoglandular pattern or peliotic change.
Angiography ; Capsules ; Carcinoma, Hepatocellular* ; Humans ; Magnetic Resonance Imaging*

Levator ani syndrome (LAS) is a functional disorder of the pelvic floor muscles in which recurrent and persistent distressing pain is felt in the anus without detectable organic pathology. Eighty one percent of coccygodynia was alleviated by the levator massage when the massage motion was repeated 10 to 15 times on each side of the pelvis daily for 5 or 6 days. The authors encountered the LAS patient for whom successive visit to pain clinic was economic burden. Therefore, the authors managed the patient by intermittent levator massage with caudal block, once a week for 3 times, resulting in two years of pain free status. Intermittent levator massage with caudal block may be as effective as successive levator massage and induce longer painless period in the management of LAS.
Anal Canal ; Anus Diseases ; Humans ; Massage ; Muscles ; Pain ; Pain Clinics ; Pelvic Floor ; Pelvis