紫色毛癣菌所致老年头癣继发头面部带状疱疹1例

患者女,62岁,头皮红斑、丘疹、鳞屑1个月,加重伴脓疱3周,结痂1周。取痂壳直接镜检发现真菌菌丝,将痂壳接种沙堡弱培养基25℃培养25d见紫色菌落生长,周围有红色色素。提取菌落DNA做PCR扩增后测序为紫色毛癣菌,诊断为老年头癣。经牛奶送服伊曲康唑联合2%酮康唑洗剂洗头后外用萘替芬酮康唑治疗3周后患者头皮痂壳消退,但于右侧头面部出现带状分布簇集张力性水疱,诊断为带状疱疹。服用溴夫定片125mg/d治疗9d后水疱消退。     

长期误诊的颈部难辨认癣1例

患者男,35岁,颈部皮疹伴瘙痒2年,曾多次误诊为皮炎、湿疹、玫瑰糠疹等,给予外用糖皮质激素等治疗效果不佳,皮损面积扩大。查体:颈部见鳞屑性丘疹、斑块和脓疱。刮取鳞屑镜检见大量真菌菌丝,培养后镜下检查见纺锤形大分生孢子,符合犬小孢子菌,诊断为难辨认癣,给予抗真菌治疗后痊愈。     

5-氨基酮戊酸光动力联合伊曲康唑治疗着色芽生菌病1例

患者男,68岁。右前臂和手背丘疹、红斑块、鳞屑伴瘙痒6 a,疼痛、部分指功能障碍1 a。真菌直接镜检发现菌丝及厚壁孢子,皮肤病理组织检查真皮内见棕黄色厚壁孢子。诊断为着色芽生菌病。经2次5-氨基酮戊酸光动力联合伊曲康唑治疗,随访半年,疗效满意。     

紫色毛癣菌致成人迁延性黑点癣1例

患者女,36岁,头皮黑点10余年。体检:头部散在多个毛囊性黑点。皮肤镜下表现为黑点征、逗号发和螺旋发。头屑真菌荧光染色可见大量孢子。真菌培养可见紫红色菌落,小培养镜下可见短粗、分隔菌丝和厚壁孢子。临床分离菌株进行nrDNA ITS扩增测序,所得序列与GenBank中紫色毛癣菌序列同源性99%。诊断为紫色毛癣菌所致黑点癣。治疗:伊曲康唑0.2g/d口服,酮康唑洗剂洗头,特比萘芬喷剂外用,4周后患者痊愈,目前仍在随访中。     

须癣毛癣菌所致面部体癣继发癣菌疹1例

报道1例由须癣毛癣菌引起面部体癣后继发的癣菌疹。患者女,10岁,因右眶周红斑、鳞屑10 d就诊。鳞屑直接镜检查见菌丝,培养生长的菌落鉴定为须癣毛癣菌。内服特比萘芬、外用萘替芬酮康唑乳膏治疗8 d后面部及颈胸部出现片状红斑,考虑为癣菌疹,加服抗过敏、抗炎药物(左西替利嗪、复方甘草酸苷片)、外用卤米松/三氯生软膏14 d后皮损消退。     

紫色秃马勃的生物学特性

为研究不同培养条件对紫色秃马勃(Calvatia lilacina)菌丝生长的影响,优选出最适合其菌丝生长的条件。通过单因素试验,以菌丝的生长状态和生长速率为指标,筛选出最佳碳源、氮源、微量元素、培养温度和初始pH;再通过正交试验L_9(3~4),进一步确定最优的培养基配比组成。结果表明:最佳碳源为葡萄糖、最佳氮源为酵母粉、最佳微量元素为MgSO_4,最适合紫色秃马勃菌丝生长的培养基配方为葡萄糖浓度2%、酵母粉浓度1%、MgSO_4浓度0.1%,最适初始pH值6.5,最适培养温度30℃。通过对紫色秃马勃生物学特性的研究,得到了最适合其菌丝生长的培养条件,为紫色秃马勃的进一步研究和开发利用提供依据。     

从足癣患者趾间皮损处分离出黏膜毛孢子菌1例

报道由黏膜毛孢子菌感染所致的足癣1例。患者因"双足趾间及足底脱屑伴瘙痒6个月"就诊,查体见双足趾间及足底白色鳞屑,双趾间潮湿,右足大拇趾有数个跖疣。取趾间皮屑直接镜检见大量分隔菌丝;真菌培养及分子鉴定为黏膜毛孢子菌。临床诊断为足癣、跖疣。分别予抗真菌及冷冻等治疗后治愈。     

密切接触宠物兔后幼儿鼻孔周围体癣1例

报道1例密切接触宠物兔后发生在幼儿双侧鼻孔周围及上唇部的体癣。患儿4岁,因“鼻唇部红斑、鳞屑、伴瘙痒10余日”就诊。取皮屑镜检见真菌菌丝及毳毛内孢子,培养见棒形分隔大分生孢子、葡萄串状小分生孢子及螺旋菌丝。尿素酶试验阳性、毛发穿孔试验阳性,鉴定为须癣毛癣菌。经内服伊曲康唑胶囊和外用萘替芬酮康唑乳膏治疗6d后红斑瘙痒明显减轻,34d后皮损消退。复查真菌阴性。     

多变根毛霉致面部皮肤毛霉病1例

报道1例由多变根毛霉引起的面部皮肤毛霉病.患者男,65岁,面部结节斑块伴痒半年余.皮损组织病理检查示真皮中下层有炎细胞及多核巨细胞浸润,并见粗大较短的无隔菌丝.经真菌培养和分子生物学鉴定,菌种鉴定为多变根毛霉.皮损经短时两性霉素B治疗后好转.     

3例不同临床表现的石膏样小孢子菌感染

报道3例由石膏样小孢子菌感染引起的、临床表现不同的皮肤癣病.例1表现为阴囊红色斑片,上覆白色斑点状痂屑,刮去痂屑后见湿润的基底面,患者父亲有同样病变,父子穿用同一件内裤,其父与家猫有密切接触.例2患儿左面部擦伤后局部出现钱币大小红斑,中央为白色痂皮,边缘有渗出伴痒.例3患儿右面部出现钱币大小、边界清楚的红斑,表面有散在的丘疹及少许鳞屑伴痒,偶有家猫接触.3例患者均平素体健.取皮损表面组织直接镜检均发现大量菌丝;真菌培养及鉴定为石膏样小孢子菌.诊断为石膏样小孢子菌所致皮肤感染.3例患者经抗真菌治疗1～2周后痊愈,取得很好疗效.     

Speech in same- and different-sex twins 4 and 5 years old.

The purpose of this study was to examine the impact of the sex makeup of pairs of twins on language acquisition. Past research indicated that this variable plays a role in speech problems of twin children. The questions raised were whether being a boy or a girl and having a boy or girl co-twin affected linguistic performance. A language test was given to 30 pairs of boy-girl twins, 16 pairs of boy twins, and 16 pairs of girl twins whose average age was 4 years 8 months. Their test scores confirmed our hypotheses. The poorest performance was obtained by the boy twin pairs and the best performance, by either the girl twin pairs or the different-sex pairs. The results were interpreted in the light of findings on language learning differences between girls and boys, and also in terms of Vygotsky's zone of proximal development.     

Long term follow-up of two sibs with an autosomal recessive form of chrondrodysplasia punctata and epilepsy

Long term follow-up of two sibs with an autosomal recessive form of chrondrodysplasia punctata and epilepsy: A variety of osteodysplasias are referred to with the term chondrodysplasia punctata (CDP). Here we report on two sibs, a boy and a girl, with probable autosomal recessive form of CDP and epilepsy followed-up for 30 and 19 years, respectively. Family history was unremarkable but for consanguinity. Pregnancies and deliveries were uneventful. At birth, length was 46 (-3SD) and 45 (-4SD) cm, respectively. Craniofacial dysmorphism was noted: severe nasal hypoplasia, flat face, hypertelorism, a low nasal bridge, short stature. Skeletal abnormalities included epiphyseal stippling in the thoracic spine, bilateral proximal and distal humeri, femur, tibia and bilateral carpal and tarsal bones. The boy had a hemivertebrae T12, with absence of a rib. After the age of 6 years facial dysmorphism had improved. Final height was 154 cm (-3SD) in the boy and 158 cm (-0,5SD) in the girl. The boy was operated on for scoliosis. Both sibs had club feet, the girl had also genu valgum. IQ was evaluated to be 55 in the girl and 83 in the boy. The first non febrile generalized seizure appeared in the boy when he was 11 months of age, and in the girl when she was 25 months of age. Both had many other seizures and were taking antiepileptics. EEG were abnormal. Karyotypes were normal. Extensive screening for metabolic disorders was normal. Acquired in utero CDP were excluded. We suggest the sibs described in this report have yet another provisionally unique possibly autosomal recessive syndrome, with CDP and epilepsy as phenotypic traits.     

Biofeedback and Cognitive Coping in the Treatment of Pediatric Habit Cough

Habit cough is a persistent ‘barking’ cough that does not have a medical basis. The current study evaluated a biofeedback approach using skin temperature feedback with a family focus in the treatment of an 11-year-old girl diagnosed with habit cough. Treatment consisted of six, one hour sessions with the family for part of the session and then individually with the girl. Individual treatment involved skin-temperature biofeedback to teach relaxation during the coughing episodes. The girl was cough free at the end of the sixth session and remained cough free at the end of a one and two year follow-ups. The use of a single case baseline design demonstrated the reduction of coughing and increase in extracurricular activity. It is, noteworthy that the girl demonstrated a significant ability to increase skin temperature during treatment and when asked to try to control her cough.     

Q fever in a 5-year-old girl

The first case of Q fever in Poland in a 5-year girl is presented. A girl is inhabitant of the Lublin region where this disease is of endemic character. Q fever was diagnosed on the base of the clinical examinations and serological tests. The course of the disease was acute. Doxycycline and lincomycin were given. A short time lapse between the treatment and eradication of Coxiella burnetii antigen indicates rather spontaneous recovery.     

10 years of successful treatment with dextrothyroxine in a girl with TSH-induced hyperthyroidism.

14 years ago, a 5.7-year-old healthy girl was treated with desiccated thyroid for a goiter and elevated TSH levels. The goiter disappeared and TSH levels were normalized. However, hyperthyroidism appeared. Without therapy, the goiter reappeared and hyperthyroidism aggravated. Based on hormone values, TSH-induced hyperthyroidism was diagnosed. After exclusion of neoplastic TSH secretion, treatment with dextrothyroxine (DT4) was initiated at age of 10 years and continued during the last 10 years (except for short periods). The girl became euthyroid, has no goiter and normal TSH values. Since thyrotrophs and peripheral tissues are probably normally sensitive to T4, we postulate that her hypothalamopituitary-thyroid control is operating on a higher set point level for T4.     

Congenital diverticulum of the left atrium

Two cases of congenital diverticulum of the left atrial appendage are described. The first patient was a 3-year-old girl who had a cerebral embolism. The second patient was a 3(1/2)-year-old girl with signs of pericarditis. Treatment consisted of excising the diverticula. The limited literature on diverticulum of the left atrium as a congenital abnormality is also briefly reviewed.     

须癣毛癣菌致儿童脓癣1例

报道由须癣毛癣菌引起的儿童头部脓癣1例.患儿为4岁幼女,因头皮部丘疹1个月,脓肿4d就诊.内服青霉素V钾无效.取断发镜检查见发外真菌孢子,培养鉴定为须癣毛癣菌,细菌培养为棒状杆菌.经内服和外用特比萘芬抗真菌,静脉输入头孢噻肟钠联合克林霉素及万古霉素抗细菌治疗,12d后脓肿减轻,细菌培养阴转,但真菌培养仍阳性,继续抗真菌治疗2个月后皮损消退,真菌检查阴性.     

Preference for a first-born boy in Western societies

Many studies in the last 45 years have shown that women prefer a boy to a girl for their first-born child, suggesting that this preference is universal in Western societies. A careful examination of these studies reveals, however, that the subjects were often women who were not pregnant and/or students. A review of sixteen studies with first-time-pregnant women showed that in most cases the opposite was true, namely, that a girl was desired more often than a boy, especially during the last two decades (from 1981 to 1996). Data concerning expectant fathers, however, indicate that they prefer a boy rather than a girl. A preference for a boy first was also observe for both non-expectant males and females. Women's preference for a male child decreased and men's preference increased slightly when the two sub-periods (before 1980vs after 1981) were compared. A difference between men and women is, however, evident whatever the sub-period: men more often prefer a boy than women. These findings suggest that something specific about being pregnant is related to the preference for a girl first.     

Co-occurrence of mutations in both dystrophin- and androgen-receptor genes is a novel cause of female Duchenne muscular dystrophy

Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder. Here, we report a novel mechanism for the occurrence of DMD in females. In a Vietnamese DMD girl, conventional PCR amplification analysis disclosed a deletion of exons 12–19 of the dystrophin gene on Xp21.2, with a karyotype of 46, XY. Furthermore, a novel mutation in the androgen-receptor gene on Xq11.2-q12 was identified in this girl, which led to male pseudohermaphroditism. Co-occurrence of mutations of these two genes constitutes a novel mechanism underlying female DMD.     

Tiny interstitial duplication of proximal 7q in association with a maternal paracentric inversion

Summary Paracentric inversion of chromosome 7 was found in a female infant with multiple malformations and in her phenotypically normal mother. Examination of prometaphase chromosomes revealed an additional small dark band on the inverted chromosome 7 of the girl. It was assumed that an unequal crossing over at the base of a meiotic loop of chromosome 7 had occurred in the mother and resulted in a tiny interstitial duplication in the girl.