Fatal septicaemia from Chromobacterium violaceum: case reports and review of the literature.

Chromobacterium violaceum rarely causes infection in humans and its mechanism of pathogenicity is not well understood. Human infection carries a high mortality rate with a fulminating clinical progression. A high index of suspicion is required for diagnosis, and is based on recovering the organisms from blood cultures or other appropriate specimens. We present three cases of human infection managed in a tertiary referral hospital in Hong Kong with a review of the literature.

Diabetes and mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS): radiolabeled polymerase chain reaction is necessary for accurate detection of low percentages of mutation.

A 6-yr-old boy presented with muscle weakness, lactic acidemia, and insulin-dependent diabetes mellitus (IDDM). Using PCR and restriction enzyme analysis, he was found to have the classical A3248G mitochondrial DNA (mtDNA) mutation frequently associated with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS). The mutation was confirmed by sequencing muscle mtDNA. The mutation in mtDNA from muscle, lymphoblasts, and blood was clearly demonstrable by standard methods using ethidium bromide staining. His mother also had IDDM, but no A3243G mutation could be detected in her blood or transformed lymphoblasts using the same PCR technique. When PCR was carried out in the presence of [32P]deoxycytidine triphosphate, subsequent autoradiography detected the presence of the mutation at low levels in mtDNA from the mother's lymphoblasts and blood. Study of the mother's muscle showed a mitochondrial myopathy, despite the fact that she was asymptomatic. We emphasize that the increased sensitivity of radiolabeled PCR may be necessary to detect small percentages of heteroplasmic A3243G mtDNA mutation in blood from diabetic subjects. Otherwise the incidence of mtDNA mutations in both IDDM and non-insulin dependent diabetes may be underestimated.

Cultural and psychosocial considerations in screening for thalassemia in the Southeast Asian refugee population.

The combination of a high incidence of thalassemia and a high fertility rate in the Southeast Asian refugee population mandates effective screening programs, but unique cultural and psychosocial factors often impede optimal screening and genetic counseling. This paper identifies cultural and psychosocial barriers often associated with refugee thalassemia screening, and offers practical guidelines for remediation.

[Strategies for detecting restriction polymorphisms of Y chromosome sequences]. / Stratégies de recherche des polymorphismes de restriction des séquences du chromosome Y.

Six cloned genomic sequences from the human Y chromosome were used for the detection of restriction polymorphisms in a panel of unrelated DNAs. Three sorts of strategies for the detection of polymorphisms were used: (a) mixing individual DNAs restricted by several endonucleases, (b) separated restrictions of the DNA library members with six different restriction enzymes, (c) individual DNA digestion with TaqI and MsqI. Results show that restriction polymorphisms are detected only rarely; this result can be explained by exemption of most of the Y chromosome from meiotic pairing and exchange.

A DNA probe detecting multiple haplotypes of the human Y chromosome.

We have characterized a DNA probe (49f) that detects about 15 Y-specific TaqI bands corresponding to a low-copy number sequence. Five of these bands, each representing a single DNA fragment, can either be present, absent, or variable in length. Familial segregation studies have shown that the variations of these fragments are inherited in a Mendelian fashion and strictly Y-linked. A survey of 44 male individuals indicated that the five variable TaqI fragments detected by probe 49f can be considered as five independent allelic series. Each series represents the different and mutually exclusive allelic forms observed for a single DNA fragment. A total of 16 haplotypes, each defined by a different combination of the various forms of each of these five restriction fragment length polymorphisms, were observed among the 44 scored individuals. These TaqI restriction polymorphisms are not observed with other restriction digests and have therefore been attributed to point mutations. The five polymorphic fragments map to Yq11, a region that does not recombine with the X chromosome and are therefore not redistributed. This implies that an apparently independent reassortment of one of these series with respect to the others can be explained only on the basis of mutations that occurred several times (or reverted) during evolution of the Y chromosome. However, an examination of the different combinations of two or more allelic series suggests that some alleles are not randomly distributed and raises the possibility of establishing a genealogy of the human Y chromosome.

Klebsiella plasmid K21 is not involved in the aetiology of ankylosing spondylitis.

The possibility that a plasmid carried by Klebsiella pneumoniae plays a role in the pathogenesis of ankylosing spondylitis was explored. K. pneumoniae K21 contains a congruent to 25-kb plasmid, but this plasmid is not present in lymphocyte DNAs of ankylosing spondylitis HLA-B27 patients, as demonstrated by molecular hybridization experiments.

Polymorphism of HLA class I genes after restriction by endonucleases Eco RI, Eco RV and Hind III.

After electrophoresis and transfer onto a hybridization membrane, the restriction endonuclease fragments obtained were probed with a cDNA carrying the nucleotide sequence encoding a class I HLA gene. Polymorphism for presence or absence of various Eco RI and Eco RV and Hind III fragments was noted in a panel of unrelated Parisian people: frequent polymorphism was described for 2 Eco RI restriction fragments of sizes 16.5 and 7.7 kb, for 5 Eco RV restriction fragments of sizes 25, 20, 11.5, 7.8 and 4 kb, and for 3 Hind III restriction fragments of sizes 27.5, 23.5 and 4.7 kb. The French population studied is in Hardy-Weinberg equilibrium for the different variants described.

DNA polymorphism of the RC8 sequence on the short arm of the X chromosome in a French population.

Restriction fragment length polymorphism of the RC8 probe, which is loosely linked to the Duchenne muscular dystrophy locus, was studied in a French population. Among 22 females, 18.1% were found to be heterozygous for the two frequent B1 and B2 alleles, and a rare allele was found in 1 woman with a corresponding variant band at 3 kb. Among 18 males, 6 were found to have the B2 allele. The B2 gene frequencies were 0.09 and 0.33 in males and females, respectively. This difference was statistically significant (p less than 0.05), but may nevertheless be fortuitous. There was no significant gene frequency difference between the English and French populations.

Resolution of DNA linkage discrepancies through analysis of a VNTR locus in a family study of cystic fibrosis.

First-trimester prenatal diagnosis of a fetus at 25 per cent risk for cystic fibrosis (CF) was performed by indirect linkage analysis of polymorphic markers using Southern blotting and polymerase chain reaction (PCR) amplification. The results revealed discrepancies in the allelic patterns between the father and the affected child, thereby complicating the prediction of fetal outcome. Analysis of a highly polymorphic VNTR locus within the human retinoblastoma (RB) gene on chromosome 13 showed that the affected child and the fetus did not have the same biological father, and therefore the affected child could not be used to determine linkage of markers in the father of the fetus. The analysis of VNTR loci can be an effective method of resolving conflicting data during prenatal diagnosis of monogenic diseases.

Homozygous and heterozygous deletions of the von Willebrand factor gene in patients and carriers of severe von Willebrand disease.

Severe von Willebrand disease is characterized by undetectable or trace quantities of von Willebrand factor in plasma and tissue stores. We have studied the genomic DNA of 10 affected individuals from six families with this disorder using probes from the 5' and 3' ends of the vWF cDNA and with a probe extending from the 5' end into the central region. Southern blots of restriction endonuclease digests and gene dosage analysis measurements carried out with quantitative slot blots of undigested genomic DNA separated these patients into three groups. The first group consisted of a family with complete homozygous deletions of the vWF gene in the four probands. Gene dosage analysis was consistent with heterozygous deletions in both of the asymptomatic parents and four asymptomatic siblings of this kindred (P less than 0.01). The second group was comprised of a family in which there was a complete heterozygous deletion of the vWF gene in the proband and one asymptomatic parent, suggesting that a different type of genetic abnormality was inherited from the other parent. Thus, the patient appeared to be doubly heterozygous for interacting genetic abnormalities affecting vWF expression. In the third group, no gene deletions could be detected. Alloantibodies developed only in the kindred with homozygous deletions. These techniques should prove useful in identifying carriers of severe von Willebrand disease and also in defining patients predictably at risk of developing alloantibodies to vWF.

Pseudoautosomal DNA sequences in the pairing region of the human sex chromosomes.

A DNA probe from a human Y chromosome-derived cosmid detects a single-copy genomic DNA fragment which can appear in different allelic forms shared by both sex chromosomes. Variants at this DNA locus show an autosomal pattern of inheritance, undergo recombination with sexual phenotype and can therefore be described as 'pseudoautosomal'. Another probe from the same cosmid detects a sequence repeated 15-20 times per haploid genome. These repeats also appear pseudoautosomal and map exclusively to the short-arm terminal region of each sex chromosome.