Clinical Utility of Adenosine Deaminase Isoenzyme Determinations in Leukemia / 대한임상병리학회지

BACKGROUND: Adenosine deaminase (ADA), an enzyme involved in purine metabolism, catalyzes the hydrolytic deamination of adenosine or 2-deoxyadenosine to inosine or 2-deoxyinosine. Human ADA consists of three molecular forms: ADA1, ADA1+CP, and ADA2. The two ADA isoenzymes represent two different gene products and have different tissue distributions, and their concentrations in serum appear to reflect different pathological conditions or physiological responses. Elevation of serum ADA activity has been described especially in leukemia and lymphoma. The purpose of this study was to evaluate the clinical utility of ADA isoenzyme determination in the diagnosis of leukemia. METHODS: We studied the activity of serum ADA and its isoenzyme in 44 leukemic patients. The study population consisted of 17 patients with acute lymphoblastic leukemia (ALL), 23 with acute myeloid leukemia (AML), and 4 with chronic myelogenous leukemia (CML). ADA isoenzyme was measured by erythro-9- (2-hydroxy-3-nonyl) adenine [EHNA] inhibitory assay using the Hitachi 7170 autoanalyzer. RESULTS: The rates of abnormally high total ADA activity were 100% for ALL, 60.8% for AML, and 50% for CML. In isoenzyme pattern, there was a clear difference between ALL and AML. High level of ADA1 activity was found in patients with ALL (P <0.01). The ADA1/ADA2 ratio was significantly higher (P <0.001) in ALL than AML. There was a correlation between ADA1 and absolute number of peripheral blasts in AML (r=0.840). CONCLUSIONS: It is concluded that the measurement of ADA isoenzyme may be a useful biochemical marker for leukemic diagnosis.

Diagnosis of Bacteremia by Universal Primer of Eubacteria / 대한임상병리학회지

BACKGROUND: The prompt detection of bacteremia continues to be one of the most important responsibilities of clinical microbiology. But clinical diagnosis of bacteremia remains difficult, particularly in the neonates and young children. And fastidious bacteria with specific growth requirements or bacteria requiring longer incubation period are apt to be negative results in blood cultures. Therefore, polymerase chain reaction (PCR) amplification which targets the highly conserved DNA sequences found in all eubacteria would permit fast and sensitive determination of the presence of bacteria in blood. METHODS: A primer pair (DG74, RW01) for highly conserved regions of bacterial DNA encoding 16S ribosomal RNA (rRNA) was utilized for PCR amplification. PCR results were compaired with blood cultures and PCR products were digested with SmaI restriction enzyme for cutting of recognition site. RESULTS: Among 44 blood specimens which organisms were isolated by blood culture, 41 samples were positive for PCR, and 3 samples which C. albicans, P. aeruginosa, and gram- positive bacillus isolated were negative. No signal was observed when blood obtained from person without clinical sign and or symptoms of bacteremia. All 41 PCR products (371 bp) were cutted in two DNA fragments (161 bp, 210 bp) by SmaI enzyme. CONCLUSIONS: We concluded that a single primer pair designed to anneal to a highly conserved region of bacterial DNA can amplify DNA specimens from different bacteria, while not amplifying human DNA. Because of early detection, molecular trial of patients with signs and symptoms of possible bacterial infection will decrease morbidity and mortality with bacteremia, this approach may make it possible to identify new, nonculturable bacterial pathogens. Furthermore, if we use the specific primers for gram positive or negative bacteria in PCR method, it would be a more useful diagnostic tool for the clinicians.

A Case of Bacteremia Caused by Vibrio parahaemolyticus / 대한임상병리학회지

Vibrio parahaemolyticus is a gram-negative halophilic organism commonly associated with outbreaks of acute gastroenteritis which also sometimes causes serious wound infection. It is an uncommon cause of bacteremia. We have experienced a case of bacteremia due to Vibrio parahaemolyticus in a 59-year old man who initially presented with edema and dyspnea. He was diagnosed as liver cirrhosis, gastric cancer, and hepatoma. On hospital day 13, Vibrio parahaemolyticus was isolated from blood culture. The isolate showed typical cultural and biochemical characteristics such as salt tolerance and did not ferment lactose. The isolate was intermediate to ampicillin but susceptible to other agents.

A Family Case of A3B and A3 / 대한수혈학회지

Authors experienced a case of A3B in a 46-year-old patient with liver cirrhosis and two cases of A3 in her children by family study. A3 subgroups were confirmed by delayed and weak positive with anti-A and anti-A,B, negative in anti-A1 lectin, adsorption-elution test, and family study. We report a family case of A3B and A3 with brief review of literatures.