Molecular Epidemiological Typing of Clinical Strains of Methicillin-Resistant Staphylococcus aureus / 대한임상미생물학회지

BACKGROUND: Meicillin-resistant Staphylococcus aureus(MRSA) is a common cause of nosocomial infections worldwide. Identification of strains by molecular typing facilitates epidemiological studies and improves disease control This study was performed to determine the usefulness of mecA-associated hypervariable region(HVR) polymerase chain reaction (PCR) and random amplified polymorphic DNA(RAPD) analysis in the investigation of a nosocomial MRSA infections. METHODS: Methicillin-resistance was identified by NCCLS disk diffusion method using the oxacillin disk. And PCR was done for detection of mecA gene. Antimicrobial susceptibility test, HVR-PCR and RAPD using 3 primers were performed for epidemiological analysis on isolates of MRSA. RESULTS: During the period from 1997 Dec. to 1998 May, 120 strains of S. aureus were isolated from clinical specimens. Among them, 78 strains were MRSA, and 72 strains were mecA positive. The strains of mecA positive MRSA were classified into four types by antibiogram, six genotypes by HVR-PCR, and 29 groups by RAPD using three primers. The combination of HVR genotypes and RAPD analysis showed 43 different types in 72 mecA positive MRSA isolates The five strains which were repeatedly isolated from the same patients showed the same HVR genotypes and RAPD analysis. CONCLUSIONS: Antibiogram, HVR-PCR, and RAPD could classify MRSA isolates into only 4-6 types, respectively, but combination of these methods could improve the typability. And combination of results of RAPD analysis using three primers were better than that using one primer in epidemiological studies of MRSA because of same reasons. It can be concluded that molecular typing of MRSA using HVR-PCR and RAPD assay is useful in epidemiolgical investigation of nosocomial infections caused by MRSA, because of its simplicity and reproducibility.

Liver ; Comparative Study between Laparoscopic and Histologic Findings in Patients with Viral Hepatitis / 대한소화기내시경학회지

BACKGROUND/AIMS: The authors compared laparoscopic changes of the diseased liver surface according to Shimadas classification with laparoscopic needle biopsy in order to clarify whether the two diagnostic criteria have consistency or discrepancy in each other. By serologicai tests the patients with chronic hepatitis B were 179 cases, chronic hepatitis C 22 cases and NBNC hepatitis 54 cases. Histologically the patients with non-specific reactive hepatitis were 35 cases, chronic lobular hepatitis 20 cases, chronic persistent hepatitis 18 cases, chronic active hepatitis 8~5 cases, subacute hepatic necrosis 32 cases, circumscribed hepatic necrosis 9 cases and liver cirrhosis 56 cases. METHODS: We performed laparoscopy on 255 patients with chronic hepatitis and laparoscopic guided liver needle biopsy was done in all cases. RESULTS: 1) Age incidence of chronic viral hepatitis was peak in chronic hepatitis C, and then that in chronic hepatitis B and NBNC heatitis in decreasing order. 2) Code numbers of liver surfaces were mainly numbers between 200 and 300 in chronic hepatitis B and NBNC hepatitis, but those of chronic hepatitis C were numbers between 300 and 400 which meant advanced patterns. 3) Comparing macroscopic fmdings of liver surfaces with histologic diagnosis by guided liver biopsy, the consistency of two criteria was 83.9% in all cases and the discrepancy was 16.1%. 4) Among the cases with diagnostic discrepancy, the patients showing macroscopically chronic hepatitis but histologically liver cirrhosis were predominant in chronic hepatitis B under the age of 40. In contrast to this, the cases showing surface changes of liver cirrhosis but histologically chronic hepatitis was mainly in chronic hepatitis C over the age of 40. CONCLUSIONS: The above results suggest that laparoscopy and guided liver biopsy may be very useful diagnostic tools to determine correct diagnosis, adequate treatment and prognosis.

A Case of Primary Cutaneous Aspergillosis / 대한의진균학회지

We report a case of primary cutaneous infection by Aspergillus fumigatus in a 19-year-old immunocompetent woman. She developed pruritic erythematous papules on the frontal and temporal scalp area and pubic area. The lesions rapidly progressed to ulcers with central black eschars and pus drainage. The diagnosis of Aspergillus fumigatus infection was established by the mycologic study of cultures from wound exudate and histopatholosic examination of the skin lesion. The skin lesions were improved after 5 weeks of antifungal therapy with oral itraconazole (200mg/day). Five months later, the skin lesions had healed, leaving some scar.

Pseudohypoparathyroidism type Ia and type II / 대한내분비학회지

No abstract available.

A Case Report of Peutz - Jeghers' Syndrome Associated Anemia and Intussusception / 대한소화기내시경학회지

The Peutz-Jeghers syndrome has three cardinal features: gastrointestinal polypasis, mucocutaneous piginentation and autosomal dominant heredity. This syndrome is ciinically important because of the complication caused by the gastrointestinal ployp, leading to abdominal pain, gastrointestinal bleeding and intussusception. We experienced a case of Peutz-Jeghers syndrome who complained of dizziness, vague abdominal pain, melanin pigmentations of the lips, oral mucosa and digits and reported with the review of the literature.

The Mega Cisterna Magna: Report of 4 Cases

The size of the cisterna magna is still detatable. Robertson13) stated that the cisterna magna varies greatly in capacity and described the large cisterna magna as a separate entity. He also found that in most cases the cisterna magna extended approximately 2.5cm above the foramen magnum and was usually 5mm deep with a variable width. Liliequist8) proposed a mean heigh of 28mm for the normal cisterna magna with a wide variation of 15 to 60mm, and a depth of 6mm at the foramen magnum with a variation of 2 to 10mm:however, he did not quote measurements for the width. Gonsette, et al.5) reported 28 cases of enlarged cisterna magna diagnosed by ventriculography and coined the phrase "mega grande citerne" or mega cisterna magna. All of these cases, however, had symptoms of posterior fossa disease. Our study of the syndrome of the mega cisterna magna without specific syndrome is presented nystagmus, transient syncope in the first & third cases were operated under suboccipital craniectomy and was confimed the large cisterna magna. This paper presents the clinical diagnosis with vertebral angiogrraphy, pneumoencephalography and computed tomography.