BACKGROUND: Members of the genus Malassezia, lipophilic yeasts, are considered to be one of the exacerbating factors in atopic dermatitis. When the response of anti-inflammatory treatment of atopic dermatitis to adults was poor, antifungal treatment had a good response to atopic dermatitis. We compared Malassezia species detected in head and neck lesions of atopic dermatitis between children and adults. OBJECTIVE: To compare Malassezia species between children and adults in head and neck lesions of atopic dermatitis and to reveal the correlation levels of P. ovale specific IgE and clinical severity among these groups. METHODS: Malassezia species were incubated in Leeming and Notman media from skin lesions of 28 patients with head and neck lesions of atopic dermatitis (13 children, 15 adults). And ITS1 amplification and sequencing method was done for detection of Malassezia species. We also assayed P. ovale specific IgE and clinical severity grade of the patients. RESULTS: M. globosa was the predominant species in the children group. And M. furfur was the predominant species in the adults group respectively. The levels of P. ovale specific IgE increased more in the adults group than the children group. Clinical severity grade also more increased in the adults group. There was statistically significant correlation between P. ovale specific IgE and clinical severity grade (p<0.001). Conclusion: Malassezia species are aggravating factors in head and neck lesions of atopic dermatitis particularly in adults. We must keep in mind Malassezia species infection when resistance to antiinflammatory therapy in atopic dermatitis of adults.
Adult ; Child ; Dermatitis, Atopic ; Head ; Humans ; Immunoglobulin E ; Malassezia ; Neck ; Skin ; Yeasts

Ochrobactrum anthropi is a ubiquitous gram-negative bacillus and currently thought to be an opportunistic pathogen. We experienced a 66-year-old male patient with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis caused by O. anthropi. Susceptible antibiotic therapy including amikacin and ciprofloxacin improved the patient's clinical status. However, peritoneal effluent showed sustained leukocytosis, thus CAPD catheter was removed. After 2 weeks of temporary hemodialysis, CAPD was successfully restarted with reinsertion of catheter. This is, to our knowledge, the first case of CAPD-related peritonitis caused by O. anthropi in Korea.
Aged ; Amikacin ; Bacillus ; Catheters ; Ciprofloxacin ; Humans ; Korea ; Leukocytosis ; Male ; Ochrobactrum ; Ochrobactrum anthropi ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis

We report a case of Strongyloides stercoralis infection in a 85-year-old male patient who had complained of poor oral intake, diarrhea, and upper abdominal pain for 6 months. At admission, he showed severe eosinophilia in peripheral blood. Rhabditiform larvae were detected in the stool examination on the 15th admission day and developed into filariform larvae with a notched tail after stool culture by the Harada-Mori method. The patient received albendazole therapy for 7 days but no improvement were observed and he fell into pulmonary edema and coma.
Abdominal Pain ; Aged, 80 and over ; Albendazole ; Coma ; Diarrhea ; Eosinophilia* ; Humans ; Larva ; Male ; Pulmonary Edema ; Strongyloides stercoralis* ; Strongyloides*

BACKGROUND: The rising incidence of fungal infections and the increasingly frequent use of antifungal agents have intensified the need for practical and reliable antifungal susceptibility test methods. In the present study, the minimal inhibitory concentration(MIC) distribution of Candida species was investigated and the agar dilution method was compared with the National Committee for Clinical Laboratory Standards(NCCLS) "reference" broth microdilution method for antifungal susceptibility testing. METHODS: A total of 116 clinical isolates of Candida species from patients at Hanyang University Kuri Hospital were studied from October 1997 to July 1999, and the MICs of Candida species were evaluated against amphotericin B and fluconazole by the NCCLS method and the agar dilution method. RESULTS: There were no differences in the MIC50 and MIC90 of Candida albicans and Candida tropicalis against amphotericin B between the two methods, but the MIC50 of C. albicans against fluconazole was higher in the agar dilution method than in the broth microdilution method. The resistant rate of C. albicans against fluconazole was 20.8% in the broth microdilution method and 33.8% in the agar dilution method. For C. tropicalis, 31.3% were resistant to fluconazole in the broth microdilution method and 25.0% in the agar dilution method. The agreement of C. albicans and C. tropicalis between the agar dulution method and the broth microdilution method within one doubling dilution of the microdilution reference were 88.8% for amphotericin B and 34.4% for fluconazole. CONCLUSIONS: The MICs of amphotericin B showed good agreement between the agar dilution and the broth microdilution method. Therefore, resistant strains could easily be detected by screening with agar of 2 g/mL concentrations. However, in the case of fluconazole, the agreement between the two methods was low and the trailing effect could not be ruled out in agar dilution method with some strains, indicating the need for further studies in this area.
Agar* ; Amphotericin B* ; Antifungal Agents ; Candida albicans ; Candida tropicalis ; Candida* ; Fluconazole* ; Humans ; Incidence ; Mass Screening

PURPOSE: The purpose of this study is to compare the effect of antibacterial activities and wound healing effect of silver containing dressings such as Staphylococcus aureus and Pseudomonas aeruginosa with against Betadine. METHODS: One full thickness skin defects in rats(n=72) were developed on the back and were given rise to infection with S. aureus(n=36) and P. aeruginosa(n= 36). The 72 mice were divided into 6 groups:Acticoat(R), Aquacel(R)-Ag, Medifoam silver(R), Polymen silver(R), Ilvadon(R) and Betadine(control group) dressing groups. Five silver containing dressings and Betadine were assesed on infected wound. Measurement of wound size change, bacterial colonies count and histologic findings was applied. Antibacterial activity was analyzed with bacterial restricted zone in Mueller Hinton agar. RESULTS: For S. aureus, wound size was more decreased in all treated groups compared to betadine group, however Ilvadon(R)-treated wound was less decreased on P. aeruginosa. In histologic findings, experimental group showed more effective findings than others on S. aureus, however on P. aeruginosa, which was shown similar. Acticoat(R) was best effective in wound healing against both S. aureus and P. aeruginosa. The bacterial colonies count was increased in all treated groups except Acticoat(R) compared to the control group on S. aureus, which was decreased in Acticoat(R) and Ilvadon(R) group on P. aeruginosa. There were not statistical differences. The restricted zone was shown in Mueller-Hinton agar of all groups except Medifoam silver(R) group on S. aureus, which was shown in all groups on P. aeruginosa. There were statistical differences. CONCLUSION: This study suggests that silver containing dressings may not have better potential than Betadine in assisting management of wounds at risk of infection on S. aureus and P. aeruginosa. However, which have better antibacterial activity on S. aureus and P. aeruginosa.
Agar ; Animals ; Bandages ; Equidae ; Mice ; Povidone-Iodine ; Pseudomonas ; Pseudomonas aeruginosa ; Rats ; Silver ; Skin ; Staphylococcus ; Staphylococcus aureus ; Wound Healing

BACKGROUND: Coagulase-negative staphylococci (CNS) has been considered as a major causative agent of nosocomial infections. A prompt and accurate detection of methicillin resistance (MR) in staphylococci is a current issue of clinical microbiology laboratories. This study was purposed to evaluate various methods for detecting MR from CNS. METHODS: We selected 78 CNS strains obtained from blood cultures from April 1999 through July 2001 including 20 strains of Staphylococcus epidermidis, 20 S. hominis (SHO), 19 S. capitis, 9 S. haemolyticus, 3 S. saccharolyticus, 1 S. saprophyticus (SAP), 2 S. warneri (SWA), 2 S. xylosus, 1 S. lugdunensis, and 1 S. auricularis. In addition, one SAP strain received from World Health Organization for proficiency tests was also studied. The following methods were compared to the mecA gene PCR: MicroScan PosCombo 12, oxacillin salt agar containing 6 microgram/mL (OSA-6) or 0.6 microgram/mL (OSA- 0.6) of oxacillin, oxacillin disk diffusion (ODD), and MRSA-Screen latex agglutination (LA) for detecting penicillin binding protein 2a. RESULTS: One SWA was failed in mecA-PCR and fifty-nine of 78 (75.6%) CNS were positive for mecA gene. The agreement rates, sensitivities, and specificities for each test were as follows: for MicroScan, 97.3%, 98.2%, 88.9%; for OSA-6 and OSA-0.6 at 24-h incubation, 79.5%, 74.6%, 94.7% and 79.5%, 72.9%, 100%, respectively, and at 48-h incubation, 91.0%, 91.5%, 89.5% and 91.0%, 96.6%, 73.7%, respectively; ODD, 84.6%, 84.7%, 84.2%; LA, 80.8%, 76.3%, 94.7%. One SHO and one SAP that were mecA-negative showed resistance in the MicroScan, ODD, and OSA. CONCLUSIONS: MicroScan appears a reliable method to detect MR in all species of CNS except SHO and SAP. ODD and LA were not appropriate in detecting MRCNS due to a low sensitivity. Although OSA-0.6 at 48-h incubation showed a high sensitivity, the low specificity may limit a routine use in clinical laboratory.
Agar ; Agglutination ; Cross Infection ; Diffusion ; Latex ; Methicillin Resistance ; Oxacillin ; Penicillin-Binding Proteins ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Staphylococcus epidermidis ; World Health Organization

BACKGROUND: Microabluminuria is defined as the amount of albumin in urine that is excreted above the normal but cannot be detected by the standard clinical dipstick test, and is used as a predictor for clinical diabetic nephropathy. It is therefore important to diagnose microalbuminuria with a sensitive, rapid and simple method. We developed a home-made ELISA for measuring microalbumin and a home-made latex agglutination method for diagnosing microalbuminuria. The aim of this study is to evaluate these methods and to evaluate the possibility of application for clinical uses. METHODS: We collected 24 hour urine samples from 86 patients at Hanyang University Kuri Hospital from January 1999 to April 1999. The principle of the ELISA is a double antibody sandwich technique. The latex agglutination method used rabbit anti-human albumin and latex bead. RESULTS: Within-run precisions of ELISA were 8.3% in low concentrations and 7.7% in high concentrations. Between-run precisions were 8.7% and 7.8%, respectively. The correlation coefficient between ELISA and RIA in samples from 80 patients was 9.4(P < 0.01). The sensitivity and specificity of the latex method were 90% and 97%, respectively. CONCLUSIONS: The home-made ELISA was a sensitive and relatively simple method for quantitation of microalbumin and correlated highly with the RIA. Therefore, this ELISA may replace RIA and can be used in other clinical uses. The latex agglutination method is simple, rapid, inexpensive and sensitive and correlated highly with the RIA. Clinically, this method may help patients and physicians in screening microalbuminuria.
Agglutination* ; Diabetes Mellitus ; Diabetic Nephropathies ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Latex* ; Mass Screening ; Microspheres ; Sensitivity and Specificity

BACKGROUND: Alterations in blood cell count are well recognized features of bacteremia. The study objective was to determine the hematologic changes predictive of bacteremia. METHODS: We retrospectively studied febrile adult patients with neutrophilia and included patients were either bacteriologically proven cases or those who had clinically suspected bacterial infections. Hematologic findings derived from basic hematologic tests were compared between patients with and those without bacteremia. RESULTS: Of the 624 patients, 143 (22.9%) had significant bacteremia. The following items were significantly different between patients with and those without bacteremia by univariate analysis: absolute neutrophil count, neutrophil differential, absolute lymphocyte count, lymphocyte differential, platelet count and band-associated parameters such as absolute band neutrophil count (ABC). Multivariate analysis revealed platelet count, lymphocyte differential and ABC as independent predictors (P<0.0001, each). Platelet count, the most potent predictor of bacteremia, showed area under the curve (AUC) of 0.685. Analysis according to the primary diagnosis indicated that the most potent predictors of bacteremia in patients with respiratory tract, urinary tract and hepatobiliary system infections were platelet count (P=0.002, AUC=0.697), ABC (P=0.002, AUC=0.681) and neutrophil differential (P=0.0001, AUC=0.822), respectively. CONCLUSIONS: Simple variables obtained from basic hematologic tests were associated with bacteremia even in febrile patients with neutrophilia. In particular, very high neutrophil differential was highly predictive of bacteremia in patients with hepatobiliary system infections and its clinical usefulness needs to be elucidated in a prospective study.
Adult ; Bacteremia ; Bacterial Infections ; Blood Cell Count ; Hematologic Tests ; Humans ; Lymphocyte Count ; Lymphocytes ; Multivariate Analysis ; Neutrophils ; Platelet Count ; Respiratory System ; Retrospective Studies ; Urinary Tract

PURPOSE: Serum alkaline phosphatase (sALP) levels show great variation with age and sex in children and adolescents. We aimed to study pediatric age- and sex-specific reference ranges for sALP and how the pattern changed according to age . METHODS: Cross-sectional results from 1366 healthy Korean children and adolescents (10-19.9 years) from the Korean National Health and Nutrition Examination Survey were analyzed. We constructed age- and sex-specific reference data for sALP with a Hitachi Automatic Analyzer 7600 using Pureauto S ALP. We assessed its peak both in relation to age. RESULTS: Reference values for sALP according to age were constructed. Peak sALP levels were found at 12-13 years in boys (P < 0.001). Total sALP levels decreased to the adult level at the age of 17 in boys and 15 in girls, respectively. CONCLUSION: This study provides reference values for sALP by age for Korean children and adolescents. This normative data that includes upper and lower limits will provide a basis from which to better evaluate sALP levels, especially for bone disorders such as rickets and vitamin D deficiency. However, caution should be made in interpreting sALP levels because different buffers might lead to different values in the same serum.
Adolescent ; Adult ; Alkaline Phosphatase ; Buffers ; Child ; Humans ; Nutrition Surveys ; Reference Values ; Rickets ; Sex Characteristics ; Vitamin D Deficiency

We report on a case of cholesterosis bulbi concurrent with secondary glaucoma. A 36-year-old man, with a history of long-standing retinal detachment in his right eye after the irrigation and aspiration of a congenital cataract, presented with a clinical picture of elevated intraocular pressure and ocular pain. Upon slit-lamp examination, we found a ciliary injection and a pseudohypopyon of polychromatic crystals. Gonioscopic examination revealed a large amount of crystals deposited on the trabecular meshwork and mild rubeosis iridis, but the neovascularization of the angle could not be clearly confirmed due to the presence of so many crystals. Pars plana vitrectomy was performed to remove clusters of crystals and bevacizumab was injected intravitreally to treat iris neovascularization. Aqueous aspirate was examined by light microscopy and the typical highly refringent cholesterol crystals were identified. Intraocular pressure returned to a normal level after the bevacizumab injection, although severe cholesterosis was still evident in the anterior chamber. To our knowledge, this would be the first Korean case of cholesterosis bulbi combined with chronic retinal detachment and presumed neovascular glaucoma, which was treated by pars plana vitrectomy and intravitreal bevacizumab injection.
Adult ; Angiogenesis Inhibitors/therapeutic use ; Anterior Chamber/*metabolism ; Antibodies, Monoclonal, Humanized/*therapeutic use ; *Cholesterol ; Eye Diseases/complications/metabolism ; Follow-Up Studies ; Glaucoma/surgery ; Glaucoma, Neovascular/drug therapy/*etiology/surgery ; Humans ; Intraocular Pressure ; Male ; Vitrectomy/*methods