RESUMO
Familial Mediterranean fever (FMF) is known to be a genetic disorder that prevalent among populations surrounding the Mediterranean Sea. Since Mediterranean fever gene (MEFV) was discovered at 1997, some cases have been reported in countries not related or close to this area like Japan. In addition it has been generally accepted that the clinical onset of FMF begins before 20 yr of age in most patients. Onset of the disease at an older age may occur but is rare. Adult-onset FMF may be a form of disease with distinct clinical, demographic and molecular characteristics. We describe a case of adult-onset FMF confirmed by DNA analysis of the MEFV gene in a Korean patient. A 32-yr-old man, who has no family history of FMF, presented with periodic fever, abdominal pain and vomiting. Though several various tests were thoroughly performed to evaluate the cause of his symptoms, there was no evidence of infectious, autoimmune or neoplastic diseases. Several gene analysis of periodic fever syndrome was finally performed and two point mutations (p.Leu110Pro, p.Glu148Gln) were identified. We confirmed the first adult case of FMF through detection of MEFV gene mutations in Korea and describe his clinical characteristics.
Assuntos
Adulto , Humanos , Masculino , Dor Abdominal/etiologia , Proteínas do Citoesqueleto/genética , Análise Mutacional de DNA , Febre Familiar do Mediterrâneo/diagnóstico , Febre/etiologia , Polimorfismo de Nucleotídeo Único , República da Coreia , Tomografia Computadorizada por Raios X , Vômito/etiologiaRESUMO
Familial Mediterranean fever (FMF) is known to be a genetic disorder that prevalent among populations surrounding the Mediterranean Sea. Since Mediterranean fever gene (MEFV) was discovered at 1997, some cases have been reported in countries not related or close to this area like Japan. In addition it has been generally accepted that the clinical onset of FMF begins before 20 yr of age in most patients. Onset of the disease at an older age may occur but is rare. Adult-onset FMF may be a form of disease with distinct clinical, demographic and molecular characteristics. We describe a case of adult-onset FMF confirmed by DNA analysis of the MEFV gene in a Korean patient. A 32-yr-old man, who has no family history of FMF, presented with periodic fever, abdominal pain and vomiting. Though several various tests were thoroughly performed to evaluate the cause of his symptoms, there was no evidence of infectious, autoimmune or neoplastic diseases. Several gene analysis of periodic fever syndrome was finally performed and two point mutations (p.Leu110Pro, p.Glu148Gln) were identified. We confirmed the first adult case of FMF through detection of MEFV gene mutations in Korea and describe his clinical characteristics.
Assuntos
Adulto , Humanos , Masculino , Dor Abdominal/etiologia , Proteínas do Citoesqueleto/genética , Análise Mutacional de DNA , Febre Familiar do Mediterrâneo/diagnóstico , Febre/etiologia , Polimorfismo de Nucleotídeo Único , República da Coreia , Tomografia Computadorizada por Raios X , Vômito/etiologiaRESUMO
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the important nosocomial pathogens and establishs the endemicity within many large hospitals in Korea. The identification and eradication of infection source is essential to prevent and control the spread of MRSA infection. So it is necessary to know how many MRSA clones have existed and how these clones have changed. The aim of this study is to determine the molecular epidemiology of MRSA over a 8-years period from 1991 to 1998 by using pulsed-field gel electrophoresis (PFGE) typing method in a university hospital. METHODS: MRSA isolates from various clinical specimens were collected during 8 years from 1991 to 1998 in Korea University Guro Hospital. The identification of S. aureus was done by catalase and coagulase test. Methicillin resistance was tested by oxacillin disk diffusion method. Pulsed field gel electrophoresis (PFGE) using SmaI was performed for molecular typing. We determined the clonality of MRSA strains by dendrogam analysis. RESULTS: One hundred four MRSA isolates were collected from clinical specimens. PFGE typing showed 8 types and 13 subtypes totally. Type A and type B were the major clonal strains, which comprized of 41.3% (43 strains) and 37.5% (39 strains), respectively, and other types were isolated in small numbers. In 1991, type A and type B were encountered in 36.8% (7/19) each, respectively. In 1994, type A was 65.2% (15/23) and type B was 21.7% (5/23). In 1998, type A was 75.0%(18/24) and type B was 4.2%(1/24). Total types and subtypes according to years were 4 types and 6 subtypes in 1991, 5 types and 6 subtypes in 1992, 4 types and 4 subtypes in 1993, 4 types and 6 subtypes in 1994 and 4 types and 7 subtypes in 1998, respectively. CONCLUSION: The diversity of MRSA strains were observed over 8 years. Type A and type B have been isolated as dominant clones in a university hospital during 8 years. It is presumed that they have isolated from clinical specimens continuously and established the endemicity in this hospital. So it is necessary to prevent the spread of dominant clones intensively, to study the difference of virulence between the dominant and minor clones, and to determine the introduction and spread of MRSA from the community and other hospitals. The PFGE technique was a useful epidemiologic tool for tracking and typing the MRSA isolates.
Assuntos
Catalase , Células Clonais , Coagulase , Difusão , Eletroforese em Gel de Campo Pulsado , Estudos Epidemiológicos , Coreia (Geográfico) , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina , Epidemiologia Molecular , Tipagem Molecular , Oxacilina , Staphylococcus aureus , VirulênciaRESUMO
BACKGROUND: In-line intravenous filters have been used in intravenous administration sets of fluid to retain bacteria and bacterial endotoxin. We evaluated the effects of intravenous filters on Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida and bacterial endotoxin retention. METHODS: S. epidermidis, C. albicans, P. aeruginosa and endotoxin were injected into each 10 bags of amino acid solution. After incubation for 24 and 72 hours, aspirates of 0.1 mL from 30 bags, with filtration and without filtration, were inoculated into culture media. The effluent from bags containing endotoxin was tested by limulus amebocyte lysate test. RESULTS: When effluents were filtered before culture, those from each 10 bags containing P. aeruginosa, C. albicans and endotoxin were sterile; also there was only one positive bacterial culture among 10 effluents from bags containing S. epidermidis. But by contrast all effluents without filtration showed positive cultures and endotoxin detection. CONCLUSION: This result showed that inline intravenous filters were useful device to remove bacteria, Candida, and bacterial endotoxin.
Assuntos
Administração Intravenosa , Bactérias , Candida , Meios de Cultura , Filtração , Caranguejos Ferradura , Pseudomonas aeruginosa , Staphylococcus epidermidisRESUMO
No abstract available.