Diagnosis and Treatment of Bizarre Parosteal Osteochondromatous Proliferation / 대한정형외과학회잡지

PURPOSE: There have been a few reports of bizarre parosteal osteochondromatous proliferation (BPOP) in Korea to date. The purpose of this study was to investigate the etiology, diagnosis, treatment, and prognosis of BPOP and to report the clinical outcomes from a single institution. MATERIALS AND METHODS: Between 1999 and 2016, six patients who were diagnosed and treated operatively at Yeungnam University Medical Center were reviewed retrospectively. The analysis was performed using medical records, simple radiographs, magnetic resonance imaging (MRI), and pathology results, based on clinical and oncological results. All patients underwent surgical treatment for complete resection. We also analyzed one patient who was initially diagnosed with BPOP, showing different clinical features during the follow-up period. RESULTS: The age of patients ranged from 17 to 60 years. All patients did not show a history of trauma. All patients showed localized edema on the tumor lesion, and three patients also showed tenderness. The tumor lesions were distributed to the femur, tibia, and humerus. All patients underwent marginal resection or wide resection. The mean follow-up period was 50.3 months. There was a malignant change in one patient, but no recurrence or metastasis. CONCLUSION: In this study, there was no difference in the incidence of BPOP in accordance with sex. Moreover, there was no significant relationship between trauma and onset of BPOP. Unlike previous reports, no recurrence occurred after complete resection. If BPOP is diagnosed, it is necessary to consider the possibility of malignant change and distinguish it from other malignant tumors.

Antibacterial activity of different types of snake venom from the Viperidae family against Staphylococcus aureus / Atividade antibacteriana de diferentes tipos de veneno de serpentes da família Viperidae contra Staphylococcus aureus

Toxins and venoms produced by living organisms have exhibited a variety of biological activities against microorganisms. In this study, we tested seven snake venoms from the family Viperidae for antibacterial activity and the activities of reversal of antibiotic resistance and inhibition of biofilm formation against 22 clinical isolates of Staphylococcus aureus. Bothrops moojeni venom exhibited anti staphylococcal activity with the lowest mean value of minimum inhibitory concentration (MIC). Moreover, reversal of antibiotic resistance was observed for combinations of B. moojeni venom (½ x MIC) and norfloxacin or ampicillin (both ½ x MIC) for 86.4% and 50% of the isolates, respectively. B. moojeni venom alone at ½ MIC inhibited 90% of biofilm formation, whereas in combination with ciprofloxacin, both at ½ MIC, a reduction on the NorA efflux pump activity was observed. The detection of in vitro mutants colonies of S. aureus resistant to B. moojeni venom was low and they did not survive. A phospholipase A2 was purified from the venom of B. moojeni and displayed anti-staphylococcal activity when tested alone or in combination with ciprofloxacin. The results presented here will contribute to the search for new antimicrobial agents against resistant S. aureus.

Toxinas e venenos exibem uma variedade de atividades biológicas contra micro-organismos. Neste estudo, investigou-se a atividade de sete venenos de serpentes, da família Viperidae, sobre o crescimento de Staphylococcus aureus, na reversão fenotípica da resistência a antibióticos e inibição de formação de biofilme contra 22 isolados clínicos de S. aureus. O veneno de Bothrops moojeni apresentou a menor média de concentração inibitória mínima (CIM). Além disso, observou-se reversão da resistência a antibióticos para combinações do veneno de B. moojeni (½ x CIM) e norfloxacina ou ampicilina (ambos ½ x CIM) para 86,4% e 50% dos isolados, respectivamente. O veneno de B. moojeni na concentração de ½ CIM inibiu 90% de formação de biofilme, enquanto ele em combinação com ciprofloxacina, ambos na concentração de ½ CIM, diminuiu a atividade da bomba de efluxo NorA. A detecção in vitro de colônias mutantes de S. aureus resistente ao veneno de B. moojeni foi baixa e eles não sobreviveram. Uma fosfolipase A2 purificada a partir do veneno de B. moojeni exibiu atividade antibacteriana quando testada sozinha ou em combinação com ciprofloxacina. Os dados obtidos poderão contribuir para a pesquisa de novos agentes antimicrobianos contra S. aureus.

Bizarre parosteal osteochondromatous proliferation and other similar lesions on humerus: a comparative analysis of clinicopathologic and imageologic characteristics / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic and imageologic characteristics of bizarre parosteal osteochondromatous proliferation (BPOP),osteochondroma and chondrosarcoma.Methods One case of BPOP on right humerus,one case of osteochondroma on left humerus,and one case of chondrosarcoma on right humerus were analyzed and compared on their clinical,pathologic and imaging manifestations and followup.Results The patients of BPOP and osteochondroma did not feel pain,but patient with chondrosarcoma felt severe pain.Microscopically,it was composed of different amounts cartilage,bone,and spindle cells with a poorly organized distribution.It appeared bizarre chondrocyte and characterized " blue bone".The mass was arising from the surface of the bone and the lesion was not cortical erosion and continuity with medullary cavity in the imaging findings.BPOP,osteochondroma and chondrosarcoma could be distinguished by the above characteristics.Conclusion BPOP is a rare and benign osteochondroma-like lesion,which may be confused with osteochondroma and chondrosarcoma.BPOP can be diagnosed definitely by combining histology with medical imageology.

Inhibitory effects of andrographis paniculata and silybum marianum on the efflux pump of MRSA 41577 / 中国生化药物杂志

Objective To study the inhibitory effects of andrographis paniculata and silybum marianum on the efflux system of MRSA 41577. Methods Inhibitory effects of andrographis paniculata and silybum marianum on efflux system of MRSA 41577 was evaluated using fluorescence spectrophotometry.PCR was applied to detect the norA efflux gene.By RT-PCR method for detection of andrographis paniculata and silybum marianum influence of the expression of norA efflux gene.Results Andrographis paniculata and silybum marianum significantly increased the accumulation of ciprofloxacin in MRSA 41577 in a time-dependent manner.At 12 minute, andrographis paniculata and silybum marianum respectively increased ciprofloxacin in MRSA41577 by 49% and 76%( P <0.05 ) , which is superior to that of reserpine. Further mechanism studies indicated that andrographis paniculata and silybum marianumcould reduce the expression of norA in MRSA 41577.After incubated with andrographis paniculata and silybum marianum for 16 h, the relative expression of norA of MRSA41577 was respectively reduced by 35% and 42% ( P <0.05 ). Conclusion Andrographis paniculata and silybum marianumcould inhibit MRSA efflux system through reducing pathogen ’s expression of norA and NorA protein.

Study of the anti-MRSA activity of Rhizoma coptidis by chemical fingerprinting and broth microdilution methods / 中国天然药物

AIM@#Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogenic bacterium that causes both hospital- and community-acquired infections, and for which single-drug treatments are becoming less efficient. Rhizoma coptidis has been used for more than two thousand years in China to treat diarrhea, fever, and jaundice. In this study, the anti-MRSA activity of Rhizoma coptidis is examined and its effective components sought.@*METHODS@#The mecA and norA genes were determined by PCR amplification and sequencing. Drug susceptibility of Staphylococcus aureus ATCC43300 was performed using the VITEK2 compact system. The chemical fingerprint of Rhizoma coptidis was investigated using HPLC and preparative liquid chromatography, and the anti-MRSA activity was determined using an improved broth microdilution method.@*RESULTS@#The drug susceptibility test revealed that the penicillin-binding protein phenotype of the strain changed in comparison to penicillin-sensitive Staphylococcus aureus. Ten batches of Rhizoma coptidis showed anti-MRSA activity on the norA-negative Staphylococcus aureus strain, as well as the strain that contained a norA gene. The spectrum-effect relationship revealed that the berberine alkaloids were the effective components, within which berberine, coptisine, palmatine, epiberberine, and jatrorrhizine were the major components.@*CONCLUSION@#This study lays a foundation for in vivo studies of Rhizoma coptidis and for the development of multi-component drugs.

Bizarre Parosteal Osteochondromatous Proliferation in the First Metatarsal Bone: A Case Report / 대한골관절종양학회지

Bizarre parosteal osteochondromatous proliferation (Nora's lesion) is a rare benign tumor and known to be primarily occur in the small tubular bone of the hands and feet. However, it is very unusual to be reported that it occurs in metatarsal bone in Korea. Thus, we report this tumor of metatarsal bone including the literature review because we have experienced this example.

Bizarre Parosteal Osteochondromatous Proliferation (Nora's lesion) of the Big Toe. (A Report of Two Cases and Review) / 대한족부족관절학회지

Bizarre parosteal osteochondromatous proliferation (BPOP) is an rare benign tumor which involve mostly tubular bones of feet and hand. BPOP has clinical, radiographic, and histologic similarities with osteochondroma.Radiologically, BPOP has not central continuity with underlying osseous medulla. Histologically, the lesion has marked proliferative activity, and enlarged, bizzare, and binucleated chondrocytes.Despite the high risk of recurrence, treatment of choice is surgical resection. This report presents two cases of BPOP of the big toe with reviews of clinical, radiographic, and histological characteristics.

Isolation of the drug-resistant Staphylococcus aureus strains from burn wound flora and analysis of norA genetic mutation / 中华创伤杂志

Objective To investigate the genetic mutation of the norA gene and its promotor from the wild-type drug-resistance Staphylococeus aureus(S.aureus)strains. Methods A total of 10 antibiotic-resistant S.aureus strains were isolated and screened from the burn wound for the sequencing and analysis of the nora gene and its promoter. Results There isolated 87 S.aureus strains from the burn wound flora,which were completely sensitive to vacomycin,highly sensitive to Quinupristin and Nitrofurantoin,but highly resistant to the other antibiotics,even up to91.7% of MRSA.There found the same point mutation(G→A) located at 1 349 sites of the norA gene coding region in all the S.aureus strains,saying that the amino acid was changed from Gly(glycin)to Asp(agpartic acid) in 291 sites.The resetpine reverse test showed that the MICs value of three antibiotics was lowered at various degrees in all 10strains.Conclusion NorA gene mutation is one of the mechanisms for antibiotic-resistance of S.aureus.

A Case of Subungual Bizarre Parosteal Osteochondromatous Proliferation of the Toe / 대한피부과학회지

Bizarre parosteal osteochondromatous proliferation (Nora's lesion) is a rare lesion with a tendency to recur. It is usually a solitary lesion that most often develops on the hands and feet. We now present a case of bizarre parosteal osteochondromatous proliferation initially misdiagnosed as subungual exostosis on the left great toe of a 13-year-old boy. The diagnosis was confirmed by radiologic and histopathologic features, followed by complete excision of the lesion. He had a relapse after two months and was treated with re-excision. We suggest that bizarre parosteal osteochondromatous proliferation should be considered in the differential diagnosis of any digital mass.

Effect of Fluoroquinolones on Transcription Level of norA Gene in Staphylococcus aureus / 中华医院感染学杂志

OBJECTIVE To study the effect of fluoroquinolones on the level of transcription of norA gene in Staphylococcus aureus(SAU).METHODS The accumulation of fluoroquinolones in SAUz and its induced resistant strain(SAUz-16) and the effect of carbonyl cyanide m-chlorophenylhydrazone(CCCP) on accumulation were studied by fluorescence measured method.The level of transcription of norA gene was studied by slot blot hybridization.RESULTS The steady-state accumulation of SAUz-16 was lower than that of its parent(SAUz).The accumulation of hydrophilic fluoroquinolones in SAUz-16 increased obviously when CCCP was added,but it is lower than that of SAUz.The level of transcription of norA gene in SAUz-16 was higher than that of SAUz.CONCLUSIONS Fluoroquinolones can increase the level of transcription of norA gene.The increase in efflux of hydrophilic fluoroquinolones resulted from the increase in transcription of norA gene is one of causes of decrease in the accumulation of drugs in S.aureus.