RESUMEN
The success of human kidney allotransplantation was realized over six decades ago. First described 50 years ago, renal autotransplantation has been utilized sparingly as a salvage procedure for patients at risk of losing renal function, either from a benign or malignant condition. While classically associated with colorectal malignancies, Lynch syndrome also carries a small yet significant risk for the development of ureteral carcinoma. For these patients who develop chronic kidney disease, allotransplantation may not be an option due to the lifelong risk of several malignancies. We report the first known case of renal autotransplantation in a patient with metachronous ureteral cancer due to Lynch syndrome.
Asunto(s)
Neoplasias Colorrectales Hereditarias sin Poliposis/cirugía , Trasplante de Riñón , Neoplasias Primarias Secundarias/cirugía , Neoplasias Ureterales/cirugía , Anciano , Femenino , Humanos , Neoplasias Primarias Secundarias/etiología , Nefrectomía , Pronóstico , Trasplante Autólogo , Neoplasias Ureterales/etiologíaRESUMEN
Pasteurella multocida is composed of three subspecies that are often differentiated by fermentation of sorbitol and dulcitol. We studied 35 dulcitol-negative P. multocida isolates from infected dog and cat bite wounds, 16 of which yielded weak and/or conflicting fermentation reactions in Andrades sorbitol, thus making it difficult to distinguish between the two dulcitol-negative subspecies of P. multocida, i.e., P. multocida subsp. multocida and P. multocida subsp. septica. All isolates and two control strains were further analyzed using a PCR fingerprinting technique with a single primer (M13 core) and assessed for alpha-glucosidase (alpha-Glu) activity. Although the PCR fingerprint patterns and alpha-Glu activity did not correlate well with the sorbitol fermentation reactions, they did correlate well with each other. All strains identified as P. multocida subsp. septica were positive for alpha-Glu activity and exhibited the group I PCR fingerprint profile. All strains categorized as P. multocida subsp. multocida displayed either the group II or group III PCR fingerprint profile; 9 of 11 of these isolates were alpha-Glu negative. These data suggest that both PCR fingerprinting and alpha-Glu activity provide reliable means for differentiating P. multocida subsp. multocida from P. multocida subsp. septica, particularly in strains that produce weak and/or discrepant sorbitol fermentation reactions.
Asunto(s)
Mordeduras y Picaduras/complicaciones , Infecciones por Pasteurella/microbiología , Pasteurella multocida/clasificación , Reacción en Cadena de la Polimerasa/métodos , Infección de Heridas/microbiología , alfa-Glucosidasas/metabolismo , Animales , Técnicas de Tipificación Bacteriana , Gatos , Dermatoglifia del ADN , Perros , Fermentación , Galactitol/metabolismo , Humanos , Pasteurella multocida/enzimología , Pasteurella multocida/genética , Sorbitol/metabolismoRESUMEN
This study was designed to define the bacteriology of infected soft-tissue wounds from human bites, and to compare this with the bacteriology of infected animal bites in humans as determined in previous studies. The specimens were collected from 57 patients presenting to emergency rooms at 12 locations around the country. Three hundred and eighty organisms were isolated (224 aerobes and 156 anaerobes), for an average of 6.6 per specimen. The most prevalent anaerobes recovered were Prevotella spp. (34%), while streptococci comprised 44% of all aerobic organisms, over half of which were in the "Streptococcus milleri" group, particularly S. anginosus. The study demonstrated that the pathogens in human bite infections differ considerably from those present in animal bites.