Infectious endocarditis following cardiac surgery, particularly that caused by methicillin-resistant Staphylococcus, aureus is a rare and highly lethal complication. We report a case of a 2-year-old girl who developed methicillin-resistant S. aureus endocarditis and mediastinitis following the intracardiac repair of tetralogy of Fallot using Dacron patches. The patient enveloped severe bacteremia accompanied by disseminated intravascular coagulation and progressive enlargement of vegetation. Despite this condition, the patient was successfully treated by repair using double autogenous pericardial patches. Aggressive removal of foreign material and replacement with autogenous tissue resulted in a favorable outcome.

Child, Preschool↗

PubMedDate not supplied

Fine needle aspiration cytology of glycogen-rich clear cell carcinoma of the breast. A case report.

BACKGROUND: Glycogen-rich clear cell carcinoma (GRCC) is a rare variant of breast carcinoma that was first described by Hull et al in 1981. The histologic findings have been described; however, the cytologic characteristics have not been well described. CASE: A 44-year-old female exhibited a palpable mass in her right breast. The fine needle aspirate contained cell clusters in a necrotic background. In addition to carcinoma cells with increased degrees of nuclear atypia, carcinoma cells with less atypia were identified. The tumor cells contained small round or ovoid nuclei and abundant, clear cytoplasm. The tumor, resected by modified radical mastectomy, was diagnosed as GRCC with detection of glycogen accumulation in the cytoplasm. CONCLUSION: Although rare, glycogen-rich clear cell carcinoma should be considered in the differential diagnosis of breast cancer in fine needle aspiration cytology to prevent misdiagnosis because of its varied morphologic patterns and less atypical cytologic features.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Copper deficiency in an infant on prolonged total parenteral nutrition.

An infant with the megacystis microcolon intestinal hypoperistalsis syndrome, required total parenteral nutrition due to ineffective gastrointestinal function, and developed copper deficiency after a prolonged course in total parenteral nutrition in conjunction with a chronic draining jejunostomy. She responded promptly to copper supplementation.

Calcinosis↗

PubMedDate not supplied

In vivo chemosensitivity of human malignant cystosarcoma phyllodes xenografts.

Malignant cystosarcoma phyllodes (MCSP) is a rare breast tumor. Chemotherapeutic regimens for treatment of MCSP have not been established. We previously established an MCSP xenograft line MC-3-JCK. In this study, we established a new MCSP xenograft line, MC-10-JCK, by serial transplantation in nude mice. We studied the chemosensitivity of these two MCSP tumor xenografts to anticancer drugs in vivo. We also examined the expression of multidrug resistance-related proteins such as p-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) by immunohistochemical analysis. These two xenografts were sensitive to doxorubicin, vincristine and cyclophosphamide in vivo. Immunohistochemically, clinical specimens and xenografts were negative for Pgp and MRP expression. These results are consistent with the chemosensitivity of human MCSP to lipophilic anticancer compounds.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMedDate not supplied

Risk factors for acute myocardial infarction among Okinawans.

PURPOSE: Okinawa is well known as the leading area for longevity and people in Okinawan islands are known to have the lowest risk of ischemic heart disease (IHD). Reasons for this particularly low IHD risk among Okinawans are unclear. Since most studies about IHD risk factors have been based on population in Western nations and their findings may not apply to Okinawans, a hospital-based case-control study was conducted at a community hospital in Okinawa. METHODS: To assess the relative importance of risk factors for IHD among the people in Okinawa, 205 Okinawan patients who had acute myocardial infarction (AMI) and 205 age-and-gender matched control were analyzed. RESULTS: The most important risk factor of AMI was current cigarette smoking. History of diabetes mellitus and hypertension were also independent risk factors. Of lipid profile, lower concentrations of serum high density lipoprotein (HDL) cholesterol and higher serum triglyceride (TG) were independent risk factors while, in contrary, serum low density lipoprotein cholesterol and uric acid were not associated with AMI. CONCLUSIONS: To effectively prevent IHD among Okinawans, smoking cessation and treatment of hypertension, diabetes, and dyslipidemia (high TG and low HDL) are important. However, lowering LDL cholesterol may be not.

Acute Disease↗

PubMedDate not supplied

Successful nutrition management of megacystis-microcolon-intestinal hypoperistalsis syndrome--a case report.

Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS), a visceral myopathy causing intestinal obstruction in the newborn, is a generally fatal condition, with death being secondary either to sepsis or to malnutrition if long-term intravenous feeding is not provided. A patient with MMIHS is described who has been raised by total parenteral nutrition (TPN) for seven years since her birth. Severe hepatic dysfunction was encountered in early infancy, which gradually cleared after the initiation of milk feeding by mouth, although the milk could not be absorbed because of the high-output jejunostomy. The patient also experienced a bone disease similar to scurvy but caused by copper deficiency at the age of 9 months. The central venous catheter now in situ is the 25th one for the patient. When these catheters were evaluated, the Broviac proved more efficacious than the traditional Silastic for use in long-term TPN. The patient does not yet have normal bowel function and still requires TPN.

Catheterization, Central Venous↗

PubMedDate not supplied

Effects of oral lentinan on T-cell subsets in peripheral venous blood.

The effect of oral lentinan, a biological response modifier, on the control of systemic immune function was studied in six-week-old male Wistar-Imamichi specific-pathogen free rats. In the lentinan-treated group, 1 mg of lentinan dissolved in 1 ml of physiological saline was administered forcibly into the stomach twice weekly for four or eight weeks. Physiological saline alone was administered in a similar fashion to the control group. Leukocyte and lymphocyte counts were made and lymphocyte subsets measured using monoclonal antibodies W3/13, W3/25, and OX8, and a laser flow cytometry system. The T-cell level, the helper/inducer T-cell level, and the suppressor/cytotoxic T-cell level were measured. The peripheral leukocyte and lymphocyte counts did not change significantly in either group during treatment. After four weeks of treatment, however, the lentinan group had a significantly higher T-cell level, helper-cell level, and helper-suppressor ratio, and a significantly lower suppressor-cell level than did the control group. No significant between-group differences in the lymphocyte subsets or the helper-suppressor ratio were noted after eight weeks of treatment. Oral administration of lentinan appears to modulate the systemic immune function through stimulation of T cells, especially helper cells. Continued administration produced less effect, possibly due to a tolerance to the effect of lentinan.

Animals↗