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Nguyen MT, Dang CT, Song Nguyen TB, Pham NC, Le DD, Pham MD, Nguyen HT, Dung Phan DT, Phu Nguyen DV, Nguyen TP, Doan PV, Nguyen DS, Pham AV. Lymph node harvesting after laparoscopic complete mesocolic excision colectomy in colon cancer with practical application of glacial acid, absolute ethanol, water, and formaldehyde solution: A prospective cohort study. SAGE Open Med 2024; 12:20503121241233238. [PMID: 38456163 PMCID: PMC10919137 DOI: 10.1177/20503121241233238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/23/2024] [Indexed: 03/09/2024] Open
Abstract
Objectives Quality of surgery has recently become an essential topic in the prognosis of colon cancer. Complete mesocolic excision for colon cancer has recently gained popularity with high-quality surgery. Patient specimens after complete mesocolic excision with central vessel ligation procedures have an integrity of the mesocolon and the yield of three fields of lymph node harvest. We apply the glacial acid, absolute ethanol, water, and formaldehyde solution to each specimen based on the Japanese classification of lymph node groups and station numbers. We aim to identify the distribution and status of lymph node metastasis according to each tumor site and some pathological characteristics related to this disease. Methods A prospective cohort study was performed on 45 laparoscopic complete mesocolic excision surgery patients. Results 2791 lymph nodes were harvested after complete mesocolic excision surgery. The average number was 62.0 ± 22.3 nodes. The mean tumor size (in the largest dimension) was 4.2 ± 1.8 cm. The average length of the resected bowel segments was 29.1 ± 7.7 cm. There are 63 (2.3%) node metastases in 2791 lymph nodes, in which 17/45 (37.8%) patients had pN(+). The minimum positive node size was 1 mm. The positive pericolic lymph nodes (station 1) accounted for the highest rate, with 53 nodes (1.9%). The number of lymph nodes in young age ⩽60 is more significant than in older. The results were similar, with a more significant node retrieval in the group with a tumor size >4.5 cm and specimen length >25 cm. The number of lymph nodes in lower tumor invasive (pT1,3) was smaller than pT4. Our research shows that the cecum, ascending, and descending colon had greater nodes than others, with a mean number of 78.6, 74.2, and 71.3, respectively. Conclusions The metastasis and harvested lymph nodes accounted for the highest rate of colon cancer in station 1 and the lowest rate in station 3. The number of retrieved lymph nodes was significantly associated with tumor location, size, specimen length, and patient age.
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Affiliation(s)
- Minh Thao Nguyen
- Anatomy and Surgical Training Department, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Cong Thuan Dang
- Pathology Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Histology, Embryology, Pathology and Forensic Medicine, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Tran Bao Song Nguyen
- Pathology Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Histology, Embryology, Pathology and Forensic Medicine, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | | | - Dinh Duong Le
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Minh Duc Pham
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Huu Tri Nguyen
- Anatomy and Surgical Training Department, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Dinh Tuan Dung Phan
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Doan Van Phu Nguyen
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Thanh Phuc Nguyen
- Anatomy and Surgical Training Department, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Phuoc Vung Doan
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Dinh Son Nguyen
- Anatomy and Surgical Training Department, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Anh Vu Pham
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
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Nguyen MT, Dang CT, Nguyen THT, Ngo QT, Pham AV. Synchronous tumors of gastric carcinoma combined gallbladder cancer and pseudotumor chronic pancreatitis. Int J Surg Case Rep 2024; 116:109344. [PMID: 38340624 PMCID: PMC10943665 DOI: 10.1016/j.ijscr.2024.109344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Synchronous primary cancers in the stomach and gallbladder were not previously reported in the medical literature. Pseudotumor pancreatitis was also described many years ago. It was misdiagnosed and required surgery for pancreatic head neoplasms. PRESENTATION OF CASE A 57-year-old male patient went to our hospital for abdominal pain. He was indicated for gastroduodenal endoscopy, and the result was adenocarcinoma. Abdominal ultrasound and Ctscan detected the gallbladder fundus's localized thickening structure and the pancreatic head's hyperechoic structure. The endoscopic ultrasound and MRI showed a gallbladder + pancreatic head tumor with chronic pancreatitis with pancreatic stones. The patient underwent distal gastrectomy, cholecystectomy, and pancreaticoduodenectomy. CLINICAL DISCUSSION The detection of gastric cancer is often based on upper gastrointestinal endoscopy and biopsy results. Gallbladder cancer is often diagnosed at an advanced stage, and only very few patients are diagnosed early. Pancreatic cancer often occurs in the head of the pancreas. Symptoms may include obstruction of the common bile and Wirsung duct, often in advanced stages. Surgery for the gallbladder, distal stomach, and head of pancreatic tumors are related to each other located in a neighboring location in the anatomy, so surgery to remove all three tumors is relatively similar to a pancreaticoduodenectomy procedure. CONCLUSION Synchronous tumors of gastric carcinoma combined with gallbladder cancer and pseudotumor chronic pancreatitis are rare. The attitude of treating these three diseases at the same time requires a tumor board. Simultaneous surgery for gallbladder, stomach, and pancreatic head tumors can be performed if the tumors are still in the resectable stage.
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Affiliation(s)
- Minh Thao Nguyen
- Anatomy and Surgical Training Department, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Department of Digestive Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam.
| | - Cong Thuan Dang
- Pathology Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam.
| | - Thi Huyen Thuong Nguyen
- Department of Gastrointestinal Endoscopy, Hue University of Medicine and Pharmacy Hospital, Hue University, Hue City, Viet Nam.
| | - Quy Tran Ngo
- Pathology Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam.
| | - Anh Vu Pham
- Department of Digestive Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam..
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Nguyen MT, Pham AV. Early small bowel obstruction as a complication of abdominal drain in colon cancer surgery: a case report and literature review. Ann Med Surg (Lond) 2023; 85:5804-5808. [PMID: 37915704 PMCID: PMC10617939 DOI: 10.1097/ms9.0000000000001369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/21/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Early postoperative small bowel obstruction (EPSBO) is an obstruction that occurs within 4 weeks after the initial surgery. Routine prophylactic abdominal drainage does not provide any benefit in colon cancer surgery. The cause of EPSBO due to the abdominal drainage tube is infrequent. Case presentation A 72-year-old male patient was diagnosed with sigmoid carcinoma and underwent laparoscopic left colectomy. A surgical drain was placed in the pouch of Douglas through the incision of the right iliac fossa trocar site. On the fourth day, he began to flatus, and the abdominal pain decreased. However, on the ninth day after surgery, the patient had more abdominal pain, could not pass gas and defecate, and the abdomen was more distended. An abdominal computed tomography (CT) scan showed a dilated loop of the small intestine above the transition site with a drainage sonde and no dilation of the loop below the sonde. The patient was indicated to remove the sonde. He could pass gas and defecate the next day again and was relieved of the abdominal distention. Discussion Once an EPSBO is considered, it is essential to think of the bowel obstruction caused by the drainage tube in the case of abdominal drainage. It is necessary to have a contrast CT scan to examine. Conclusion EPSBO due to intra-abdominal drainage is a rare condition that presents a challenge in diagnosis and treatment. Diagnosis usually begins on the fourth postoperative day, mainly in operations in the lower transverse mesentery, including drainage placement after laparoscopic surgery.
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Affiliation(s)
- Minh Thao Nguyen
- Anatomy and Surgical Training Department, Hue University of Medicine and Pharmacy
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy
| | - Anh Vu Pham
- Department of Gastrointestinal Surgery, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy
- Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
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Nguyen MT, Pham AV. Bilateral incarcerated Morgagni hernia with bowel obstruction: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231207210. [PMID: 37869584 PMCID: PMC10585985 DOI: 10.1177/2050313x231207210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023] Open
Abstract
Morgagni hernia is a rare congenital diaphragmatic hernia associated with the minor retro-xiphoid region between the sternal and costal attachments. The bilateral and complicated Morgagni hernia occurred exceptionally rarely, at a rate of 4% and 6.5%. An 81-year-old woman with occasional constipation went to the emergency department for epigastric pain and vomiting 3 days before. She could no longer pass gas that caused abdominal distention. Clinical examination and ultrasound showed partial bowel obstruction, an unspecified cause. She received nil per os, nasogastric decompression. The abdominal and chest computed tomography Scan showed the bilateral diaphragmatic hernia, and the dilated loops of the cecum and ascending colon were 7 cm. She required an emergency operation to resolve the etiology of bowel obstruction. The midline incision was chosen to release the hernia contents and repair the posterior sternal defects with Polypropylene mesh. An abdominal approach can solve a bilateral incarcerated Morgagni hernia.
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Affiliation(s)
- Minh Thao Nguyen
- Digestive Surgery Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam
| | - Anh Vu Pham
- Digestive Surgery Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam
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Le HDT, Nguyen TTMH, Pham AV, Dang CT, Nguyen TT. Pheochromocytoma of the organ of Zuckerkandl. Radiol Case Rep 2021; 16:268-272. [PMID: 33299507 PMCID: PMC7708655 DOI: 10.1016/j.radcr.2020.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/03/2022] Open
Abstract
Paragangliomas are uncommon neuroendocrine neoplasms that occur in characteristic locations. While parasympathetic paragangliomas are mainly located at the head and neck, sympathetic paragangliomas are mostly located below the neck. Among parasympathetic paragangliomas, pheochromocytomas are the most common. Ninety percent of cases of pheochromocytomas arise within the adrenal gland. We report a case of a 63-year-old woman with an extra-adrenal pheochromocytoma of the organ of Zuckerkandl detected by CT and MRI and subsequently confirmed by postoperative histology and immunohistochemistry.
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Affiliation(s)
- Hoang Di Thu Le
- Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen t., Hue, Vietnam
| | - Thai Thi My Hanh Nguyen
- Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen t., Hue, Vietnam
| | - Anh Vu Pham
- Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Cong Thuan Dang
- Department of Histology, Embryology, Pathology & Forensic Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thanh Thao Nguyen
- Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen t., Hue, Vietnam
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Nguyen MT, Nguyen VM, Tran VH, Pham AV. A case report of anorectal malignant melanoma in the transitional zone. Int J Surg Case Rep 2020; 75:264-268. [PMID: 32979823 PMCID: PMC7519280 DOI: 10.1016/j.ijscr.2020.09.091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/12/2020] [Accepted: 09/12/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Anorectal malignant melanoma is an uncommon and highly malignant disease with a greater incidence in females. Many patients were misdiagnosed as hemorrhoids, benign polyps, and rectal cancer. They were often diagnosed in an advanced stage. Wide local excision and abdominoperineal resection are the main treatments of rectal melanoma. PRESENTATION OF CASE A case report is a 77-year-old man who has blood in the stool for 4 months without clinical examination. He admitted to the emergency room with sudden syndromes that related to bowel perforation. Rectal examination detected a large anorectal polyp. Computer tomography showed free air and fluid in the peritoneal cavity. He was received laparoscopic surgery and found the fishbone penetrated the sigmoid colon without polyp resection. The polyp was treated by local excision a few days later. The histology examination was a primary malignant melanoma. Due to the pigmented lesion that remained from the resected polyp's root, the abdominoperineal resection was performed as a radical treatment. DISCUSSION Diagnosis of anorectal malignant melanoma is difficult because of atypical signs, that are confused with bleeding hemorrhoids especially an amelanotic melanoma. Treatment is controversial, including surgery, radiotherapy, chemotherapy, and target therapy. A present case is an option in radical surgery. CONCLUSION Anorectal melanoma is a rare disease with poor results and prognosis. A lack of large-data leads to a missing evidence-based guideline in this disease. Early-staging diagnosis and surgical treatment help patients improve their overall survival.
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Affiliation(s)
- Minh Thao Nguyen
- Digestive Surgery Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, 49126, Hue City, Viet Nam.
| | - Van Mao Nguyen
- Pathology Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, 49126, Hue City, Viet Nam.
| | - Van Huy Tran
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, 49126, Hue City, Viet Nam.
| | - Anh Vu Pham
- Digestive Surgery Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, 49126, Hue City, Viet Nam.
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Nguyen TTMH, Dang CT, Pham AV, Nguyen TT. Retroperitoneal gastrointestinal stromal tumor: A case report and literature review. Radiol Case Rep 2020; 15:1823-1828. [PMID: 32793324 PMCID: PMC7415774 DOI: 10.1016/j.radcr.2020.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 07/15/2020] [Indexed: 11/16/2022] Open
Abstract
Retroperitoneal gastrointestinal tumor is the rarest subtype among 3 subtypes of extragastrointestinal tumors, which are uncommon stromal tumors. We herein report a case of a 55-year-old man with retroperitoneal gastrointestinal tumor detected by magnetic resonance imaging and confirmed by postoperative histology and immunohistochemistry.
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Affiliation(s)
- Thai Thi My Hanh Nguyen
- Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, Hue, Viet Nam
| | - Cong Thuan Dang
- Department of Histology, Embryology, Pathology and Forensic Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Viet Nam
| | - Anh Vu Pham
- Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, Hue, Viet Nam
| | - Thanh Thao Nguyen
- Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, Hue, Viet Nam
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Yu JH, Chang YT, Lin KY, Chang CC, Chang SF, Ye Y, Pham AV, Tobias BJ, Zhu Y, Domier CW, Luhmann NC. Millimeter-wave system-on-chip advancement for fusion plasma diagnostics. Rev Sci Instrum 2018; 89:10H108. [PMID: 30399905 DOI: 10.1063/1.5035559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/08/2018] [Indexed: 06/08/2023]
Abstract
Recent advances in radio-frequency system-on-chip technology have provided mm-wave fusion plasma diagnostics with the capability to overcome major challenges such as space inefficiency, inflexible installation, sensitivity, susceptibility to EMI, and prohibitively high cost of conventional discrete component assemblies as higher imaging resolution and data accuracy are achieved by increasing the number of channels. Nowadays, shrinking transistor gate lengths on fabrication techniques have enabled hundreds of GHz operation, which is suitable for millimeter-wave diagnostics on current and future tokamaks. The Davis Millimeter Wave Research Center (DMRC) has successfully developed V-band (55-75 GHz) transmitter and receiver chips for Microwave Imaging Reflectometer (MIR) instruments. The transmitter can illuminate 8 different frequencies simultaneously within 55-75 GHz. Moreover, the receiver has the capability to amplify the reflected signal (>30 dB) while offering 10-30× reduction in noise temperature compared to current MIR instruments. Plasma diagnostics requires ultra-wideband (more than 20 GHz) operation which is approximately nine times wider bandwidth than the recent commercial impetus for communication systems. Current efforts are underway for gallium-arsenide monolithic microwave integrated circuit receiver chips at W-band (75-110 GHz) and F-band (90-140 GHz) permitting measurements at higher toroidal magnetic fields.
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Affiliation(s)
- J-H Yu
- University of California, Davis, California 95616, USA
| | - Y-T Chang
- University of California, Davis, California 95616, USA
| | - K-Y Lin
- Department of Electrical Engineering, National Taiwan University, Taipei 10617, Taiwan
| | - C-C Chang
- Department of Electrical Engineering, National Chung-Cheng University, Chiayi 62102, Taiwan
| | - S-F Chang
- Department of Electrical Engineering, National Chung-Cheng University, Chiayi 62102, Taiwan
| | - Y Ye
- University of California, Davis, California 95616, USA
| | - A V Pham
- University of California, Davis, California 95616, USA
| | - B J Tobias
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - Y Zhu
- University of California, Davis, California 95616, USA
| | - C W Domier
- University of California, Davis, California 95616, USA
| | - N C Luhmann
- University of California, Davis, California 95616, USA
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Davis GH, Pham AV, Triscott MX. Polysaccharase activity in Streptococcus agalactiae (group B streptococci). J Gen Microbiol 1982; 128:1381-4. [PMID: 6750033 DOI: 10.1099/00221287-128-6-1381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Of 300 recently isolated strains of Streptococcus agalactiae from human sources, 97% degraded starch. Representative strains also degraded glycogen, pullulan, amylopectin and amylose. The polysaccharase activity is easily detected by clearing around growth on Columbia agar base medium. The activity is weaker than that of some S. pyogenes strains, and it does not appear to produce fermentable products but is inhibited by the presence of easily used sugars.
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