RESUMO
The case of a young man with acute type B dissection is reported. Inserting an endovascular stentgraft was the treatment of choice, with a good short-term result. We do believe that this is a promising strategy in the management of this serious pathology in which the classical surgical treatment is still associated with an important mortality and morbidity.
Assuntos
Aneurisma da Aorta Torácica/cirurgia , Ruptura Aórtica/cirurgia , Implante de Prótese Vascular , Endoscopia , Stents , Doença Aguda , Aneurisma da Aorta Torácica/diagnóstico por imagem , Ruptura Aórtica/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , UltrassonografiaAssuntos
Angioplastia Coronária com Balão/métodos , Doença das Coronárias/cirurgia , Revascularização Miocárdica/métodos , Robótica/métodos , Terapia Combinada , Doença das Coronárias/diagnóstico por imagem , Doença das Coronárias/terapia , Ecocardiografia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
The amikacin resistance gene aac(6')-Im [corrected] from Citrobacter freundii Cf155 encoding an aminoglycoside 6'-N-acetyltransferase was characterized. The gene was identified as a coding sequence of 521 bp located down-stream from the 5' conserved segment of an integron. The sequence of this aac(6')-Im [corrected] gene corresponded to a protein of 173 amino acids which possessed 64.2% identity in a 165-amino-acid overlap with the aac(6')-Ia gene product (F.C. Tenover, D. Filpula, K.L. Phillips, and J. J. Plorde, J. Bacteriol. 170:471-473, 1988). By using PCR, the aac(6')-Im [corrected] gene could be detected in 8 of 86 gram-negative clinical isolates from two Belgian hospitals, including isolates of Citrobacter, Klebsiella spp., and Escherichia coli. PCR mapping of the aac(6')-Im [corrected] gene environment in these isolates indicated that the gene was located within a sulI-type integron; the insert region is 1,700 bases long and includes two genes cassettes, the second being ant (3")-Ib.
Assuntos
Acetiltransferases/genética , Amicacina/farmacologia , Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Citrobacter freundii/genética , Proteínas de Escherichia coli , Genes Bacterianos , Sequência de Aminoácidos , Sequência de Bases , Bélgica , Citrobacter freundii/enzimologia , Citrobacter freundii/isolamento & purificação , Clonagem Molecular , Resistência Microbiana a Medicamentos/genética , Resistência a Múltiplos Medicamentos , Escherichia coli/enzimologia , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Humanos , Klebsiella/enzimologia , Klebsiella/genética , Klebsiella/isolamento & purificação , Dados de Sequência Molecular , Plasmídeos , Reação em Cadeia da PolimeraseRESUMO
Genes encoding aminoglycoside 6'-N-acetyltransferases, were identified using the polymerase chain reaction (PCR). Four sets of primers delineating DNA fragments of 209 bp, 250 bp, 260 bp and 347 bp, specific for the four known aacA genes, and probes within these fragments, were constructed based on the nucleotide sequences of the aacA genes. The specificity of the primers was evaluated using reference strains encoding various aminoglycoside-modifying enzymes. The primers reacted with their corresponding aacA genes and did not cross-react with genes coding for other aminoglycoside-modifying enzymes. One hundred and sixty-one aminoglycoside resistant clinical isolates showing AAC(6')I activity were tested using the PCR assays. The gene described by Tran Van Nhieu & Collatz (1987) was the most frequently identified aacA gene. One strain of Citrobacter freundii contained two distinct aacA genes. However, in 46% of the strains, the majority being Serratia spp. and Acinetobacter spp. none of the specific amplified DNA fragments for any of the known aacA genes could be detected.
Assuntos
Acetiltransferases/genética , Genes Bacterianos , Bactérias Gram-Negativas/genética , Infecções por Bactérias Gram-Negativas/microbiologia , Acetiltransferases/análise , Acetiltransferases/normas , Sequência de Bases , Resinas de Troca de Cátion , Celulose/análogos & derivados , Primers do DNA , Sondas de DNA , Bactérias Gram-Negativas/enzimologia , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/enzimologia , Humanos , Dados de Sequência Molecular , Reação em Cadeia da Polimerase/métodos , Padrões de Referência , Contagem de CintilaçãoRESUMO
A patient is reported with hypothalamic-pituitary dysfunction due to multiple cerebral midline tumours of germinoma type. The symptomatology and differential diagnosis are reviewed. The necessity of stereotactic biopsy is discussed. The treatment of these tumours as proposed in recent literature is mentioned, with special reference to radiotherapy (cranial and spinal) and chemotherapy.
