Delayed hemolytic transfusion reaction due to anti-Fyb caused by a primary immune response: a case study and a review of the literature.

Delayed hemolytic transfusion reactions (DHTRs) usually occur between 3 and 14 days posttransfusion as a result of a secondary immune response, with a drop in Hb level, fever, jaundice, or hemoglobinuria. DHTRs caused by a primary immune response are particularly rare events, and only a few reports have been known. In this report, we describe an unusual case of a DHTR caused by anti-Fyb in a 42-year-old man, who had no prior history of transfusion. Although it seems to be a rare phenomenon, we suggest that DHTRs by a primary immune response may be considered even in the case of the patient who had typical evidence of hemolysis but who had no previous transfusion history.

Post-prandial plasma ghrelin levels in people with different breakfast hours.

OBJECTIVES: To investigate the changes in post-meal plasma ghrelin levels in people with different breakfast hours. DESIGN AND INTERVENTIONS: The subjects adhered to strict breakfast times starting 2 weeks before the study. Blood was drawn hourly from 0530 or 0630 until 1130. Plasma ghrelin, leptin, and insulin levels were measured by radioimmunoassay. SETTING: Medical Research Institute, Pusan National University Hospital, Korea. SUBJECTS: A total of 16 healthy volunteers. RESULTS: The mean plasma ghrelin level in subjects consuming breakfast was 548.7 +/- 239.6 fmol/ml before breakfast and 384.8 +/- 168.7 fmol/ml 1 h after breakfast, with leptin levels of 6.8 +/- 2.6 and 6.5 +/- 2.5 ng/ml, respectively. Plasma ghrelin levels were lowest 1 h after the meal, although the breakfast times differed. The plasma ghrelin level was lowest at 0730 in subjects not eating breakfast. CONCLUSIONS: These findings suggest that the plasma ghrelin levels are lowest 1 h after breakfast despite the variance in breakfast times. This timing might best reflect an individual's plasma ghrelin level and enable reasonable comparisons.

False-positive growth of Mycobacterium tuberculosis attributable to laboratory contamination confirmed by restriction fragment length polymorphism analysis.

SETTING: Despite the high prevalence of tuberculosis in Korea, false-positive cultures have not yet been reported. At Pusan National University Hospital, in which positive mycobacterial culture specimens were 2.8 daily on average, 12 specimens from 10 patients requested on the same day were positive for Mycobacterium tuberculosis. OBJECTIVE: To identify an episode of laboratory cross-contamination in a tertiary care hospital. DESIGN: All isolates were analyzed by restriction fragment length polymorphism, and patients' medical records were reviewed. RESULTS: All isolates from 10 patients with supposed cross-contamination were identical. Anti-tuberculosis drugs were administered to two patients unnecessarily, resulting in adverse drug reactions in one patient. In one patient who had known tuberculous empyema, the medication course was probably lengthened unnecessarily. CONCLUSIONS: An episode of laboratory cross-contamination in mycobacterial cultures occurred, possibly due to droplets splashed from a sample in a centrifuge tube. Consequently, the aerosol soiled the tip of the dispenser and contaminated the following specimens sequentially. This episode of laboratory cross-contamination resulted in some modifications in our methods of specimen processing and interpretation of the results.

pncA mutations in clinical Mycobacterium tuberculosis isolates from Korea.

BACKGROUND: Pyrazinamide (PZA) is among the first-line drugs for the treatment of tuberculosis. In vitro, it kills semidormant mycobacteria only at low pH. The purpose of this study was to compare PZA resistance with pyrazinamidase (PZase) activity and the genotype to better understand the molecular basis of PZA resistance and to expand the profile of pncA mutations worldwide. RESULTS: Of the 28 tested strains of Mycobacterium tuberculosis, 6 were susceptible to PZA and positive for PZase activity and had no pncA mutations. Twenty-one strains were resistant to PZA and negative for PZase activity and had mutations in the pncA gene, including 15 point mutations, 5 insertions, and 2 deletions. One strain had no mutation in the pncA gene, even though it was resistant to PZA and negative for PZase activity. Three isolates had adenine to guanine point mutations in the -11 upstream region, making this the most common type of pncA mutations in this study, with at least two different RFLP patterns. CONCLUSION: These data help in the understanding of the molecular basis of PZA resistance. An adenine to guanine point mutation in the -11 upstream region was the most common type of pncA mutation in our isolates. The results of pncA mutation analyses should be carefully interpreted for epidemiologic purposes.

Recurrent self-limited fungemia caused by Yarrowia lipolytica in a patient with acute myelogenous leukemia.

Yarrowia lipolytica is a weakly pathogenic yeast that is rarely isolated from the blood. We observed transient recurrent catheter-related fungemia attributable to this organism in a leukemic patient. The fungemia and accompanying fever subsided spontaneously. The data suggest that it might be possible to withhold specific treatment for Y. lipolytica fungemia even in an immunocompromised patient.

Evaluating the usefulness of the ICT tuberculosis test kit for the diagnosis of tuberculosis.

BACKGROUND: Early diagnosis of tuberculosis is crucial, especially in Korea, where tuberculosis is endemic. AIMS: To evaluate the validity of the ICT tuberculosis test (ICT) in early diagnosis of tuberculosis. METHODS: Sixty eight patients with tuberculosis were tested; 37 had no history of previous tuberculosis (patient group 1), and 31 had reactivated tuberculosis (patient group 2). The control groups comprised 77 subjects: 25 healthy adults, 35 hospital workers, and 17 inpatients with non-tuberculous respiratory diseases. RESULTS: The diagnostic sensitivities of ICT were 73% in patient group 1 and 87.1% in patient group 2. In two patients with extrapulmonary tuberculosis, both tested positive using ICT. The specificities of ICT were 88%, 94%, and 94% in healthy adults, hospital workers, and non-tuberculous patients, respectively. CONCLUSIONS: ICT is a useful tool for the diagnosis of tuberculosis.

Rahnella aquatilis sepsis in an immunocompetent adult.

Rahnella aquatilis, a rare enteric gram-negative rod which is infrequently isolated in immunocompromised patients, was isolated as a causative organism of sepsis in a 26-year-old immunocompetent male patient. The contaminated intravenous fluid was confirmed to be the source of the organism.

Intracellular Ca2+ release mediates ursolic acid-induced apoptosis in human leukemic HL-60 cells.

The effect of ursolic acid (UA) on tumor cell apoptosis was investigated using HL-60 human promyelocytic leukemia cells as a model cellular system. Treatment with UA resulted in a concentration-dependent decreased cell viability assessed by MTT assay. UA also induced genomic DNA fragmentation, a hallmark of apoptosis, indicating that the mechanism by which UA induced cell death was through apoptosis. The intracellular Ca2+ level was increased by treatment with UA. Intracellular Ca2+ inhibitors, such as intracellular Ca2+-release blockers (dantrolene, TMB-8 and ruthenium red) and an intracellular Ca2+ chelator (BAPTA/AM), significantly blocked the UA-induced increased intracellular Ca+ concentration. These inhibitors also blocked the effects of UA on cell viability and apoptosis. These results suggest that enhanced intracellular Ca2+ signals may be involved in UA-induced apoptosis in HL-60 cells.