Genospecies Classification of Acinetobacter calcoaceticus-Acinetobacter baumannii Complex by Restriction Fragment Length Polymorphism

Acinetobacter calcoaceticus-Acinetobacter baumannii (A. calcoaceticus-A. baumannii) complex, which includes A. calcoaceticus (genospecies 1), A. baumannii (genospecies 2), Acinetobacter genospecies 3 and 13, has been identified as A. baumannii by automated bacteria identification system. The purpose of this study is to develop rapid genospecies classification of A. calcoaceticus-A. baumannii complex by molecular techniques. Random amplified polymorphic DNA (RAPD) and restriction fragment length polymorphism (RFLP) were determined for 4 reference strains and 80 isolates of A. calcoaceticus-A. baumannii complex from clinical sources. Four and eleven RAPD patterns were observed among the reference strains and the isolates, respectively. RAPD might be useful for genomic typing but not for genospecies classification of Acinetobacter spp. RFLP of 16S-23S rRNA intergenic spacer gene with three selected restriction enzymes (ApaLI, SwaI, and SalI) showed only four RFLP patterns in the reference and the isolates. Of 80 isolates, 10 of A. calcoaceticus (12.5%), 50 of A. baumannii (62.5%), 11 of A. genospecies 3 (13.75%), and 9 of A. genospecies 13 (11.25%) were classified by RFLP. This result suggests that RFLP of 16S-23S rRNA intergenic spacer gene of A. calcoaceticus-A. baumannii complex might be useful for genospecies classification.

Pediatric Solitary Castleman's Disease Concurrently Arising from Neck & Axilla

Castleman's disease (CD) is an unusual benign lymphoproliferative disorder of unknown etiology and pathogenesis. It most commonly occurs in the mediastinum, but rarely in the axilla or neck. CD has been rarely reported at pediatric age in Korea. Here we report a 17-month-old male patient with histopathologically proven cervical & axillary CD of the hyline vascular type who presented with a painless axillary palpable mass and was treated with a complete excision of the neck & axilla mass without complication.

Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

PURPOSE: To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. MATERIALS and METHODS: We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. RESULTS: The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). CONCLUSION: US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception.

Evaluation of Newly Developed Small (< or = 20 mm) Enhancing Nodules on the Arterial Phase CT after Transcatheter Arterial Cheomoembolization in Patients with Hepatocellular Carcinoma

PURPOSE: We assessed the clinical significance of newly developed small (< or = 20 mm) early-enhancing hepatic nodules on arterial phase CT after performing transcatheter arterial cheomoembolization (TACE) in patients suffering with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: We searched for the radiologic reports that showed small early enhancing nodule (< or = 20 mm) on the arterial phase imaging of follow-up CT after performing TACE. Thirty-seven lesions in 30 patients had round or oval shaped nodules and the numbers of nodule for one patient was less than five. We classified the nodules by size, location and the decreased attenuation seen on the portal venous phase. The latest follow-up CTs were reviewed to assess the nodules for the final diagnosis. All the follow-up CTs were two-phase spiral CT scans. RESULTS: Twenty-five (67%) of the 37 nodules were recurred HCC, as was determined on the basis of their interval growth and lipiodol uptake after TACE. Among the 37 nodules, seven (18%) disappeared on the latest follow-up CT and they were considered as definite pseudolesions. The remaining five (15%) were stable in size or they decreased in size, and they were considered as probable pseudolesions. The mean size of the nodules on initial CT was 11 mm. The mean size of the malignant nodules was 11+/-4.2 mm and that of the benign pseudolesions was 9+/-4.9 mm. The nodules located on the hepatic surface were possible to definite benign pseudolesions (p<0.05). All ten low attenuated nodules seen on the portal phase were HCCs. CONCLUSION: When seen on the follow-up CT scans of HCC patients after performing TACE, the newly developed small early-enhancing nodules were considered to have high potential of being HCC by their locations and enhancing patterns.