Chronic/cyclic neutropenia, leukocyte adhesion deficiency syndrome, Papillon-Lefèvre syndrome, and Chédiak-Higashi syndrome are associated with severe periodontitis, suggesting the importance of neutrophils in the maintenance of periodontal health. Various Toll-like receptor (TLR) ligands are known to stimulate neutrophil function, including FcR-mediated phagocytosis. In the present study, the effect of TLR2 activation on the non-opsonic phagocytosis of oral bacteria and concomitant production of reactive oxygen species (ROS) by human neutrophils was evaluated. Neutrophils isolated from peripheral blood were incubated with Streptococcus sanguinis or Porphyromonas gingivalis in the presence of various concentrations of Pam3CSK4, a synthetic TLR2 ligand, and analyzed for phagocytosis and ROS production by flow cytometry and chemiluminescence, respectively. Pam3CSK4 significantly increased the phagocytosis of both bacterial species in a dose-dependent manner. However, the enhancing effect was greater for S. sanguinis than for P. gingivalis. Pam3CSK4 alone induced ROS production in neutrophils and also increased concomitant ROS production induced by bacteria. Interestingly, incubation with P. gingivalis and Pam3CSK4 decreased the amounts of ROS, as compared to Pam3CSK4 alone, indicating the possibility that P. gingivalis survives within neutrophils. However, neutrophils efficiently killed phagocytosed bacteria of both species despite the absence of Pam3CSK4. Although P. gingivalis is poorly phagocytosed even by the TLR2-activated neutrophils, TLR2 activation of neutrophils may help to reduce the colonization of P. gingivalis by efficiently eliminating S. sanguinis , an early colonizer, in subgingival biofilm.
Bacteria* ; Biofilms ; Colon ; Flow Cytometry ; Humans* ; Leukocyte-Adhesion Deficiency Syndrome ; Ligands ; Luminescence ; Neutropenia ; Neutrophils* ; Periodontitis ; Phagocytosis* ; Porphyromonas gingivalis ; Reactive Oxygen Species* ; Streptococcus ; Toll-Like Receptor 2* ; Toll-Like Receptors*

Neurilemmoma is a neoplasing from Schwann cells. It is usually solitary and may be benign or malignant solid or cystic, encapsulated or diffuse. We report a rare case of neurilemmoma developed in the penis and the perineum in a 19 years old male and the relevant literature has been reviewed.
Humans ; Male ; Neurilemmoma* ; Penis* ; Perineum* ; Schwann Cells ; Young Adult

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

BACKGROUND: The frequency of nosocomial bloodstream infections by Candida species has risen dramatically in the past two decades, and a noticeable shift in the species of Candida causing bloodstream infection toward non-albicans species has occurred. Also, the isolation frequency of Candida species are influenced by patient type, nation and region, study period, and investigators. The aim of this study is to investigate the isolation rates and antifungal susceptibility of Candida species isolated from blood cultures at Wonju Christian Hospital during the recent four years (1997~2000). METHODS: For one-hundred twenty-seven isolates of Candida species from blood cultures, we analyzed the isolation frequency by year, age/sex, and department. Identification of yeasts was done by germ tube test and ATB ID 32 C kit. Antifungal susceptibilities to flucytosine, amphotericin B, nystatin, miconazole, econazole, and ketoconazole were determined by ATB FUNGUS. RESULTS: The isolation rates of Candida species in decreasing order were C. albicans (44.9%), C. parapsilosis (21.3%), C. glabrata (14.2%), and C. tropicalis (9.5%). The isolation rates of Candida species by year were as follows; C. albicans decreased from 61.5% in 1997 to 33.3% in 2000; C. tropicalis decreased from 23.1% in 1997 to 5.0% in 2000; C. parapsilosis increased from 0% in 1997 to 30.8% in 2000; and C. glabrata increased from 7.7% in 1997 to 18.0% in 2000. Of 127 Candida species, all but one isolates were susceptible to amphotericin B. CONCLUSION: This data showed that the candidemia by C. albicans and C. tropicalis are decreasing trend, and candidemia by C. parapsilosis and C. glabrata are increasing trend in recent four years.
Amphotericin B ; Candida* ; Candidemia ; Econazole ; Flucytosine ; Fungi ; Gangwon-do ; Humans ; Ketoconazole ; Miconazole ; Nystatin ; Research Personnel ; Yeasts

BACKGROUND: Beta-hemolytic streptococci (BHS) are frequently isolated pathogens in the clinical microbiology laboratory, and the isolation frequency of each serogroup of BHS are influenced by patient type, nation and region, study period, and investigators. The aim of this study is to investigate the isolation rates and distribution of BHS by serogroup at Wonju area during the recent periods. METHODS: Isolation rates of BHS isolated from 1997 to 2000 at Wonju Christian Hospital were investigated. The distribution of each serogroup of BHS according to the types of clinical specimens was also studied. Serogroups A, B, C, F, and G were determined by latex agglutination test (Murex Streptex kit). RESULTS: Of 627 BHS isolated during the study periods, 16.3% were group A, 49.3% were group B, 5.1% were group C, 4.3% were group F, 21.0% were group G, and 4.0% were nongroupable. Isolation rates of BHS by specimen type were as follows:wound/pus was 44.4%; cervix, urine, and respiratory specimen ranged from 10% to 20%; blood was 4.0%; body fluid was 2.9%; and cerebrospinal fluid was 0.5%. The prevalent isolation sites by serogroup were:group A, wound/ pus (78.4%); group B, cervix (32.7%), urine (28.5%), and wound/pus (26.2%); group C and G, wound/pus and respiratory specimen; and group F, wound/pus and urine. From blood, group B streptococci (44.0%) were the most frequent isolate. CONCLUSIONS: Half of BHS isolated from clinical specimens were group B streptococci in this study, which reflects the increasing trend of group B streptococcal infections during the recent years at Wonju area.
Body Fluids ; Cerebrospinal Fluid ; Cervix Uteri ; Female ; Gangwon-do* ; Humans ; Latex Fixation Tests ; Research Personnel ; Streptococcal Infections ; Suppuration ; Tertiary Healthcare*

Massive intravascular hemolysis secondary to Clostridium perfringens septicemia is rare but often fatal. We report a case of a fatal clostridial hemolytic complication in a 71-year-old woman with probable refractory anemia. The patient was admitted to the emergency room due to a comatose mental state and a high fever. Laboratory analysis showed massive hemolysis. She died from severe anemia two hours after admission. The next day, blood cultures grew gram positive cocci and boxcarshaped gram positive rods, which were identified as coagulase-negative staphylococci and C. perfringens, respectively.
Aged ; Anemia ; Anemia, Refractory ; Clostridium perfringens* ; Clostridium* ; Coma ; Emergency Service, Hospital ; Female ; Fever ; Gram-Positive Cocci ; Gram-Positive Rods ; Hemolysis ; Humans ; Sepsis*

Ulcerative colitis is increasing now in Korea, and the diagnosis has become relatively easy because sigmoidoscopy and colonoscopy are frequently used. However, the result of treatment is not satisfactory because the relapse rate is very high. Hence, the aim of treatment is to put this disease into remission as soon as possible and to keep it in remission. The authors reviewed 80 confirmed ulcerative colitis cases which were treated from Feb. 1997 to Sep. 1997 at Song Do Colorectal Hospital. The results are as follows: 1) The male to female ratio for these 80 cases was 41:39, and the most prevalent age group was the 4th decade. 2) The most common clinical symptoms were anal bleeding in 77 cases(96%), diarrhea in 68 cases(85%), and abdominal pain in 21 cases(26%). 3) The extension of the disease were the proctitis in 47 cases(59%), the left - side colitis in 28 cases(35%), the total colitis in 4 cases(5%), and the atypical colitis in 1 case(1.3%). 4) The duration of the disease was below 6 month in 30 cases, 6 months to 1 year in 35 cases, and 1~5 years in 11 cases, and over 5 years in 4 cases. 5) Clinical types were the one-attack-only type(18 cases), the relapsing-remitting type(60 cases), the chronic continuous type(1 case), and the acute fulminating type(1 case). 6) In the 28 cases of left side colitis, the average time to remission depended on the medication was 18 days for a 5-ASA 5-ASA suppository, 14.5 days for a 5-ASA oral steroid, and 8.3 days for a 5-ASA budesonide enema. Thus, a budesonide enema is the most effective medication for obtaining remission. 7) The most commonly suspected predisposing factors for relapse were cessation of medication(58 cases), mental stress(18 cases), physical stress(15 cases), and inadequate diet(8 cases). As indicated above, ulcerative colitis is increasing now in Korea, and the rectum is the most commonly involved site for this disease. Relapsing-remitting ulcerative colitis is the most frequently occurring type. Almost all cases were easily put into remission within 4 weeks, but relapse frequently occurred. Suspected predisposing factors, such as mental stress, physical stress, and inadequate diet, should be avoided in order to prevent relapse, and medication, such as 5-aminosalicylic acid, should be continued to maintain remission.
Abdominal Pain ; Budesonide ; Causality ; Colitis ; Colitis, Ulcerative* ; Colonoscopy ; Diagnosis ; Diarrhea ; Diet ; Enema ; Female ; Hemorrhage ; Humans ; Korea ; Male ; Mesalamine ; Music ; Proctitis ; Rectum ; Recurrence ; Sigmoidoscopy ; Ulcer*

BACKGROUND: Vibrio species may be classified as halophilic or nonhalophilic on the basis of their requirement of NaCl for optimal growth. Recently, attention has been focused on the halophilic vibrios and Vibrio cholerae non-O1/O139 causing extraintestinal infections such as septicemia. The aim of this study is to elucidate the isolation rate and clinical manifestations of Vibrio species isolated from clinical specimens between 1996 and 2000 at Wonju Christian Hospital. METHODS: Stool specimens were inoculated onto the thiosulfate-citrate-bile salt-sucrose media, blood cultures were performed by automated blood culture systems with commercial bottles, and the others were cultured according to the routine procedures. RESULTS: The isolation rate of Vibrio in decreasing order were: V. parahaemolyticus; 87%(62/71), V. alginolyticus; 6%(4/71), V. cholerae non-O1; 4%(3/71), and V. vulnificus; 3%(2/71). The proportions of gastroenteritis and septicemia by Vibrio species were 89% and 7%, respectively. Patients with gastroenteritis recovered without special problem, but the mortality of septicemia was 80%. CONCLUSIONS: Ninety-seven percentage of clinical isolates of Vibrio species were halophilic vibrios, and the mortality of Vibrio septicemia was as high as 80%.
Cholera ; Gangwon-do* ; Gastroenteritis ; Humans ; Mortality ; Sepsis ; Tertiary Healthcare* ; Vibrio cholerae ; Vibrio Infections* ; Vibrio*

Although Leuconostoc species have rarely been isolated from clinical specimens, this organism may cause invasive infections such as bacteremia and meningitis in immunocompromised patients. We report a case of Leuconostoc garlicum bacteremia in an 84-year-old male with hemovac catheter placement, vancomycin therapy, and inflammatory enterocolitis as underlying risk factors.
Aged, 80 and over ; Bacteremia ; Catheters ; Enterocolitis ; Humans ; Immunocompromised Host ; Leuconostoc ; Male ; Meningitis ; Risk Factors ; Vancomycin