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Laboratory diagnosis of chancroid using species-specific primers from Haemophilus ducreyi groEL and the polymerase chain reaction.

To enhance laboratory identification of Haemophilus ducreyi, the causative agent of the genital ulcer disease chancroid, a polymerase chain reaction (PCR) assay was developed using target DNA sequences from the essential H. ducreyi gene, groEL. Positive reactions were obtained in this PCR assay with 139 isolates of H. ducreyi from patients in worldwide locations from the 1940s to the 1990s. In contrast, 24 other bacterial species were negative. When genital ulcer specimens from 162 African patients with clinically diagnosed chancroid were evaluated, 66 were culture positive. The sensitivity of PCR as compared with culture was 89% (59 of 66), and specificity was 79% (76 of 96). However, representative samples of the 20 culture-negative, PCR-positive specimens were confirmed as positive by a second PCR assay using different H. ducreyi-specific primers. Thus, combined results of culture and PCR detected H. ducreyi in 86 specimens, with resolved sensitivities of 92% (79 of 86) for PCR, and 77% (66 of 86) for culture. These results suggest that PCR assays for H. ducreyi have great potential for augmenting or replacing problematic cultural techniques.

Bacterial Proteins↗

[Laboratory diagnosis and some remarks concerning mortality and treatment of children with myocardial infarction].

There are presented in the paper laboratory findings, echocardiographic and radioisotope studies results, as well as heart catheterization including coronarography in the pediatric patients suffering from heart infarction. Mortality and malignant arrhythmias due to heart infarct in pediatric age are shortly discussed, too. At last there are some remarks concerning myocardial infarction treatment in children.

Arrhythmias, Cardiac↗

Laboratory diagnosis of defects of creatine biosynthesis and transport.

In recent years, three inherited defects in the biosynthesis and transport of creatine have been described. The biosynthetic defects include deficiencies of L-arginine:glycine amidinotransferase and guanidinoacetate methyltransferase. The third defect is a functional defect in the creatine transporter (SLC6A8). Clinical symptoms of the three defects vary in severity, are aspecific and include mental retardation with severe speech delay, autistiform behaviour, and epilepsy. Some patients with GAMT deficiency exhibit a more complex clinical phenotype with extrapyramidal movement disorder. All three defects can be diagnosed by in vivo proton magnetic resonance spectroscopy of the brain, which shows a severe reduction or absence of creatine. Laboratory investigations for the diagnosis start with the analysis of guanidinoacetate, creatine and creatinine in body fluids (plasma and urine). Based on these findings, enzyme assays for AGAT or GAMT, or a creatine uptake assay for the transporter defect can be performed. DNA mutation analysis of the genes involved can prove the defects at the molecular level. To diagnose female patients with SLC6A8 deficiency, mutation analysis may be the only choice.

Biological Transport↗