BACKGROUND: Enterococci exhibit intrinsic resistance or high-level minimum inhibitory concentration (MIC) to beta-lactams than other streptococci. This appears to be due to low affinity of penicillin-binding proteins and rarely production of beta-lactamase, which gives the reason of testing beta-lactamase for blood and cerebrospinal fluid isolates. Ampicillin is more effective than penicillin in vitro, and MIC of ampicillin is generally 1 dilution lower than that of penicillin. The purpose of this study is to detect beta-lactamase producing enterococci an6 to compare MICs of ampicillin and penicillin by Vitek system (bioMerieux, Hazelwood, MO, USA) with those by agar dilution method. METHODS: We collected 110 isolates of Enterococcus faecalis and 51 isolates of E. faecium from clinical specimens in 1998. MICs of antibiotics were determined by agar dilution method and Vitek system. We also performed beta-lactamase test by the Cefinase (Becton Dickinson, USA) for 512 isolates of E. faecalis and 189 isolates of E. faecium collected in 1998. RESULTS: The most common sites of isolates were blood, bile, surgical/traumatic wounds, closed and open pus and urine. MICs of ampicillin were 1 to 2 dilution lower than those of penicillin for E. faecalis (P=0.03). But there were no significant differences in MICs for E. faecium (P=0.19). Five isolates (4 E. faecalis and 1 E. faecium) were susceptible to ampicillin but resistant to penicillin. There were no beta-lactamase producing enterococci among 701 isolates tested. CONCLUSIONS: MIC by Vitek system tends to be 1 to 2 dilution lower than MIC by agar dilution method to beta-lactams, and MIC of ampicillin is 1 to 2 dilution lower than MIC of penicillin, which could result in discrepancy in interpretation of susceptibilty tests. A beta-lactamase test for enterococci is not recommeneded for routine test in Korea.
Agar ; Ampicillin ; Anti-Bacterial Agents* ; beta-Lactamases ; beta-Lactams ; Bile ; Cerebrospinal Fluid ; Enterococcus faecalis ; Enterococcus* ; Korea ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins ; Penicillins ; Suppuration ; Wounds and Injuries

No abstract available.
Humans

BACKGROUND: Early detection and treatment of cytomegalovirus (CMV) infection is very important because CMN infection is a major cause of morbidity and mortality after organ transplantation. CMV antigenemia assay has been reported to be very sensitive and specific for detection of CMV infection among many laboratory methods. However, there is no single method correlated well with the infection state up to now. We compared the results of SHARP Signal System Assay (Digene, USA) using PCR and hybridization with those of CMV antigenemia assay (Clonab CMV-kit; Biotest AG, Germany) to evaluate their clinical usefulness. METHODS: We performed SHARP Signal Assay on whole blood samples of 125 from 56 transplanted patients submitted for CMV antigenemia at Samsung Medical Center. We compared the results with those of CMV antigenemia and evaluated the correlation with CMV disease state. RESULTS: Fifty six patients were classified as three groups; 43 patients with no evidence of CMV infection, four patients with CMV infection and 9 patients with CMV disease. Twenty four cases (19.2%) showed discrepant results between the two methods. Of the 22 cases showing positive only by SHARP Signal Assay, two cases were proved to be CMV disease, 12 cases were on antiviral treatment and remaining cases had no evidence of infection. Two cases showing positive only by CMV antigenemia were confirmed to be CMV disease. For CMV disease, the sensitivity of SHARP Signal Assay and CMV antigenemia were 85.7% and 90.5%, respectively and the specificity of them were 73.1% and 93.3%, respectively. CONCLUSIONS: CMV antigenemia is thought to be useful for early diagnosis and follow-up of antiviral treatment as a quantitative and highly specific method, and SHARP Signal Assay can be used as a complementary method because it correlates well with disease state.
Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis* ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortality ; Organ Transplantation ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Transplants

BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
Area Under Curve ; Heart Arrest* ; Humans ; Hypothermia* ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit* ; Sensitivity and Specificity

No abstract available.
Angina Pectoris* ; Electrocardiography* ; Pheochromocytoma*

No abstract available.
Animals ; Blastocyst* ; Embryonic Structures* ; Glucose* ; Mice*

No abstract available.
Dimethylformamide* ; Liver Diseases* ; Liver*

We report a case of xanthoma disseminatum in a 24 year old male paitient. Multiple yellow-brown papules developed on the flexor aurfaces, such as the neck, axillae, antecubital fossae, groin, and perianal regions. Some papules were detected arouns the eyes and uvulai. biopsy specimen revealed a dense infiltrate of histiocytes, foam cells, Touton giant cells, and other inflammatory cells. No Langerhans granules were seen in the electron microscopic analysis.
Axilla ; Biopsy ; Foam Cells ; Giant Cells ; Groin ; Histiocytes ; Histiocytosis, Non-Langerhans-Cell* ; Humans ; Male ; Neck ; Xanthomatosis* ; Young Adult

No abstract available.

No abstract available.