A Case of Scimiter Syndrome (Adult Form) / 결핵

The scimitar syndrome, a rare complex anomaly, is defined as an anomalous right pulmonary venous drainage, partial or complete, to the inferior versa cava. The shape of the Turkish curved sword (scimitar) huts provided the name of this syndrome. Additional characteristics of this syndrome such as hypoplasia of the right lung and of the right pulmonary arterial tree, anomalous arterial supply of the right lung from the aorta, dextrocardia and bronchial anomalies are common. Recently we experienced a case of scimitar syndrome (adult form) in a 19-year-old woman patient, so we report the case with a brief review of the literature.

Expression of ICAM-1 on the Hantaan virus-infected human umbilical vein endothelial cells

OBJECTIVES: In HFRS, there is a varying degree of disseminated intravascular coagulation which was evident in the early phase of the illness. It is believed also that DIC would be the consequence, at least in part, of functional changes of endothelium resulting in kinin activation and clinical syndrome. This study investigated the role of adhesion molecule in the pathogenesis of Hantaan virus-related disease. METHODS: The expression of ICAM-1 antigen on the cell membrane of human umbilical vein endothelial cells was assessed by immunohistochemistry, and ICAM-1 mRNA in the endothelial cells was assessed by in situ hybridization after Hantaan virus infection (2.6 x 10(4) PFU/mL) with the time course. RESULTS: In immunohistochemistry, the number of ICAM-1 positive cells increased with time during the 12 or 24 hours after infection. 5 to 10% of HUVECs had been positive after 12-24 hours and the number of positive cells decreased abruptly after 24 hours. Hantaan antigen had been noticed after 12 hours focally on the HUVECs but continued to proliferate into day 7 post-infection when most of HUVECs were infected by Hantaan virus. In situ hybridization showed identical patterns of ICAM-1 mRNA expression after Hantaan virus infection. CONCLUSION: It implies that the Hantaan virus infection on HUVECs would express more ICAM-1 on their surface and implicated in the pathogenesis of early clinical syndrome of HFRS.

A Case of Nocardial Peritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis / 대한신장학회잡지

Norcardia is an aerobic, gram-positive, AFB positive filamentous organism which is frequently branching. Nocardial infection is usually opportunistic and is found in immunosuppressed patients during transplantation or anti-cancer chemotherapy. With the increasing number of AIDS, nocardial infection have been increasingly recognized as a serious human infection. Among patients on peritoneal dialysis, Nocardia is a rare cause of peritonitis : only one case has been reported in Korea. It is extremely important to make an early and correct diagnosis and treatment with susceptible antibiotics. We report here a case of nocardial peritonitis associated with Continuous Ambulatory Peritoneal Dialysis(CAPD) which was resistant to trimethoprim/sulfamethoxazole and has treated successfully with imipenem and amikacin.

Clinical Evaluation of Use of Permcath(R) in Patients with Poor Vascular Access / 대한신장학회잡지

Permanent vascular access is a prerequisite for successful treatment of patients with chronic hemodialysis. Although a number of strategies including native and synthetic arterio-venous fistulae are performed to create vascular access, they are often not available due to peripheral vascular diseases which are common in patients with diabetes and elderly patients. So, in spite of technical advance, vascular access for hemodialysis remains a significant problem confronting the nephrologists. Recently, Permcath(R) (double lumen silicone rubber catheter) has been introduced and can provide temporary access in patients whose native fistulas have not yet matured and permanent access in patients who have difficulty in creating a arterio-venous fistula. We investigated the availability and the clinical outcome of use of Permcath(R) as temporary or permanent vascular access. Total 16 catheters were placed in 14 patients who were admitted in Chung-Ang University Hospital between April, 1993 to March, 1996. Clinical course of the patients and outcome of the catheters were observed, retrospectively. The mean age of the 14 patients was 56 9 (39-67) years. The indications were exhausted peripheral access, poor vascular system for conventional access operation, and limited life expectancy. The median survival of the catheters was 80 weeks with a range of one week to 113 weeks. The one-year actuarial catheter survival rate was 67% and 44% at 2 year. The most common complication during use of Permcath(R) was infection, occurred in 5 patients (31.2%). The 5 catheters were removed because of complications of catheter such as infection or malfunction. We suggest that the Permcath(R) is a safe and durable temporary vascular access for patients with poor vascular system anticipating a long duration for arterio-venous fistula maturation and permanent access for patients who have exhausted peripheral access sites.