Bacteremia caused by Salmonella enterica serotype Choleraesuis in Taiwan.

Since 1995, there has been a steady increase in the number of reported cases of Salmonella enterica serotype Choleraesuis (S. Choleraesuis) sepsis in Taiwan. Representative Taiwanese survey data from 1996 to 2004 revealed that these adult patients with S. Choleraesuis bacteremia presented with primary bacteremia (57%, especially immunocompromised hosts), mycotic aneurysm (16%), and fever (86%) predominantly. S. Choleraesuis septicemia demonstrated a higher invasion index (with secondary involved sites) than other Salmonella spp. In swine experiments, the inoculation dose of 10(3) colony forming units S. Choleraesuis was cleared without apparent sequelae. Transmission of specific strains (with mutations of GyrA and parC, subsequently resistance to fluoroquinolones) from swine, and the acquisition of genes (CMY-2, AmpC complex) encoding beta-lactamases (with resistance to extended-spectrum cephalosporins) have been implicated in the evolution of multiresistant phenotypes of S. Choleraesuis. The virulence plasmid of S. Choleraesuis (pSCV), and other genes mediating adhesion to the epithelial cell membrane of the gastrointestinal tract, were considered important pathogenic factors for S. Choleraesuis. Vaccines for domestic animals combined with effective controls on antibiotic use offer the greatest potential to control the increasing impact of S. Choleraesuis on humans.     

The role of response domain and scale label in the quantitative interpretation of patient-reported outcome measure response options

Quality of Life Research - Uncertainties exist in how respondents interpret response options in patient-reported outcome measures (PROMs), particularly across different domains and for different...     

Hypoxic Lung-Cancer-Derived Extracellular Vesicle MicroRNA-103a Increases the Oncogenic Effects of Macrophages by Targeting PTEN

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Extreme thrombocytosis under the treatment by amoxicillin/clavulanate

Amoxicillin/Clavulanate related extreme thrombocytosis during the treatment of pneumonia has never been reported. We present a 54-year-old patient who was admitted due to pneumonia, and was treated with amoxicillin/clavulanate IV and 3-day course of 500 mg azithromycin. Despite clinical and radiological evidence showing that pneumonia improved, thrombocytes increased rapidly. After stopping the antibiotic, the thrombocytes returned gradually to normal. Considering the clinical course, we propose that this extreme thrombocytosis was caused by the administration of amoxicillin/clavulanate. We describe this rare and unique patient and review the literature.     

Comparison of laparoscopy and laparotomy in managing hemodynamically stable patients with ruptured corpus luteum with hemoperitoneum

STUDY OBJECTIVE: To compare differences between laparoscopy and laparotomy in managing women ruptured corpus luteum with hemoperitoneum. DESIGN: Three-year, prospective, nonrandomized study (Canadian Task Force classification II-2). SETTING: University-affiliated regional hospital. PATIENTS: Sixty hemodynamically stable women. INTERVENTION: Laparoscopic surgery (30 women) and laparotomy (30). MEASUREMENTS AND MAIN RESULTS: Laparoscopic surgery had significant advantages over laparotomy, including shorter hospital stay (55.33 +/- 7.67 vs 97.77 +/- 14.45 hrs, p < 0.001) without increased adverse events. Laparoscopic surgery also showed trends of shorter operating time, improved wound care, and less postoperative pain. CONCLUSION: Laparoscopy surgery for diagnosis and treatment of women with ruptured hemorrhagic corpus luteum appears superior to laparotomy. We suggest that surgeons try laparoscopy first as a diagnostic and probably therapeutic procedure.     

Uterus didelphys with cervical agenesis associated with adenomyosis,a leiomyoma and ovarian endometriosis. A case report

BACKGROUND: Elevated level of serum CA-125 was detected in a 48-year-old woman who was diagnosed with a lateral fusion defect in association with congenital agenesis of the uterine cervix. This unusual case combined two developmental anomalies of the müllerian duct. CASE REPORT: A 48-year-old woman consulted our outpatient department due to persistent abdominal pain for six months. Bimanual pelvic examination showed absence of the cervix, an anteverted uterus and a 6-cm, left adnexal mass. Ultrasound and computed tomography revealed a uterus didelphys with a 3-cm cystic mass over the right ovary. Serum level of CA-125 was 641.4 U/mL. The patient underwent exploratory laparotomy, and total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathology confirmed adenomyosis and a leiomyoma of the uterus with functional endometrium in conjunction with endometriosis of the right ovary. CONCLUSION: Multiple müllerian anomalies associated with adenomyosis and endometriosis should be considered in patients presenting with primary amenorrhea. Thorough evaluation, careful planning, fertility preservation and postoperative outcomes should be reviewed.     

Management of postvitrectomy diabetic vitreous hemorrhage with volume homeostatic fluid-fluid exchanger

Background  To evaluate the clinical outcome of patients with postvitrectomy diabetic vitreous hemorrhage (PDVH) who underwent vitreous cavity lavage (VL) by volume homeostatic fluid–fluid exchange. Methods  We performed a retrospective chart review for 88 eyes of 80 consecutive patients who underwent VL for PDVH. Final best-corrected visual acuity after VL was compared to those before VL. Anatomic outcome, including rate of fundus clear-up, recurrent vitreous hemorrhage, increased intraocular pressure, iris neovacularization and anterior hyaloid fibrovascular proliferation were considered. Results  Between July 1999 and January 2006, 88 eyes of 80 patients underwent this procedure. Significant visual improvement was observed after VL (2.86 ± 0.40 logMAR at baseline vs 1.71 ± 0.97 logMAR at last visit, p < 0.0001). The fundus clear-up rate after VL was achieved in 84 out of 109 times (77.1%). Recurrent vitreous hemorrhage was found in 17 of 88 eyes (19.3%) with the mean interval of 92.6 ± 126.7 days after VL. Conclusions  For patients suffering from postvitrectomy diabetic vitreous hemorrhage, volume homeostatic vitreous cavity lavage can be an alternative method for removing the bloody content in the vitreous cavity efficiently and permitting rapid visual recovery.     

Evidence for Uptake of Vital Dye by Activated Rat Peritoneal Mast Cells: An in Vitro Imaging Study

Uptake of material from surrounding medium by activated rat peritoneal mast cells (PMCs) was studied using in vitro peritoneal eluate cells, the vital fluorescent dye sulforhodamine B (SFRM-B), secretagogue compound 48/80, and an imaging technique. PMCs, which undergo different states of degranulation, are shown to possess the ability to take up (by endocytosis) SFRM-B in an activity-dependent manner. The endo-cytosed dye is incorporated in the granules and can be discharged into the medium when the cells are reactivated. Both the uptake and the discharge processes are calcium-dependent. The reactivity of mast cells to secretagogue is not altered by the application of the dye. SFRM-B, a negatively charged, nonspecific protein stain, displays greater photostability and less leakage than the positively charged acridine orange, and its fluorescence persists for hours, whereas acridine orange fluorescence fades within 1 min when exposed to ultraviolet illumination. The fluorescent image of the dye-loaded mast cells can be preserved overnight in a container at room temperature. SFRM-B elicits no detectable damaging influence on the activated afferent discharge of splanchnic afferent nerve fibers with mesenteric terminals. This enables the use of SFRM-B for studying the interactions between mesenteric afferent terminals and their surrounding mast cells.