ABSTRACT
Adverse reactions to drugs are more common in HIV infected patients. Hypersensitivity to trimethoprim-sulfamethoxazole (TMP/SMZ) during treatment or prophylaxis of Pneumocystis carinii pneumonia (PCP) is the most frequent drug reaction of HIV infection. Although less extensively documented than sulphonamides, other drugs also seem to induce drug reactions in HIV-seropositive patients more than in other groups. Rifampin is an essential anti-tuberculosis medication; thus, desensitization of rifampin is especially necessary in our country in which mycobacterial infection is common. We report two cases of AIDS patients with pulmonary tuberculosis who have rifampin hypersensitivity whose rifampin treatment will end successfully through rifampin desensitization.
Subject(s)
Humans , HIV , HIV Infections , Hypersensitivity , Pneumonia, Pneumocystis , Rifampin , Trimethoprim, Sulfamethoxazole Drug Combination , Tuberculosis, PulmonaryABSTRACT
PURPOSE: Activation of telomerase is proposed to be an essential step in cancer cell immortalization and cancer progression. 3'-azido-2',3'-dideoxythymidine (AZT), a reverse transcriptase inhibitor, was reported to be incorporated in telomeric sequences of immortalized cells in culture and to suppress the activity of telomerase and the cell proliferation. In this study, after induction of cancer cell senescence with long-term treatment of AZT, we investigated the dynamics of telomerase subunits (hTERT, hTR, TEP), transcription factors (c-Myc, Mad1), telomerase activity, and finally, telomere length in a human breast cancer cell line. MATERIALS AND METGODS: Human breast cancer cell (MDA-MB-231) was treated with AZT. Senescence was measured by senescence-associated beta-gal staining and apoptosis was counted by dTd enzyme assay. Telomerase activity (by TRAP assay), expression of telomerase subunit genes (by RT-PCR and real-time PCR) and telomere length (by Southern blot analysis) were measured after the AZT treatment. RESULTS: We found evidences of senescence, apoptosis and growth delay after AZT treatment. In addition, AZT- treated cancer cells showed inhibition of telomerase activity and shortening of telomere length in a dose- and duration-dependent way. Among the telomerase subunits, hTERT and c-Myc were the first factors to change after AZT treatment, subsequently, followed by the changes of hTR, Mad1 and TEP. CONCLUSION: The suppression of hTERT and c-Myc by AZT treatment was the initial genetic phenomenon, subsequently followed by the changes of hTR, Mad1 and TEP.
Subject(s)
Humans , Aging , Apoptosis , Blotting, Southern , Breast Neoplasms , Cellular Senescence , Cell Line , Cell Proliferation , Enzyme Assays , Genetic Phenomena , RNA-Directed DNA Polymerase , Telomerase , Telomere , Transcription Factors , ZidovudineABSTRACT
No Abstract Available.
Subject(s)
Brucella abortus , Brucella , Immunity, Humoral , Recombinant ProteinsABSTRACT
BACKGROUND: Human immunodeficiency virus(HIV) is the causative agent of acquired immune deficiency syndrome(AIDS). Current diagnosis of HIV infection relies on the detection of anti-HIV antibodies by ELISA. Recently, simultaneous detection kit of p24 antigenemia and anti-HIV1/anti-HIV2 antibodies were developed. The aim of this study was to evaluate the diagnostic kit of simultaneous detection with p24 antigen and anti-HIV1/2 in diagnostic aspect. METHODS: Eight hundred and four sera which were obtained between July 1999 and August 1999 and 110 sera from 54 patients diagnosed as HIV infection were included. One lot of panels composed of consecutive sera obtained from known HIV-infected patients was included. The detection of anti-HIV1/2 antibodies was done by Genedia HIV1/2 ELISA 3.0 kit(Greencross, Seoul, Korea) and Enzygnost anti-HIV1/2 Plus(Behringwerke, Marburg, Germany). The simultaneous detection of p24 antigenemia and anti-HIV1/2 antibodies was done with VIDAS DUO kit(bioMerieux, Lyon, France). The Vironostika HIV-1 antigen kit was used for detection of p24 antigen. The HIV RNA PCR and anti-HIV western blot assay were also performed to confirm the test results in discrepant cases. RESULTS: The simultaneous detection kit showed 100% sensitivity and 99.6% specificity. The possibility of earlier diagnosis than conventional anti-HIV1/2 EIA was also suggested by the results obtained with a group of consecutive panel sera infected with HIV. CONCLUSION: The simultaneous p24 antigen and anti-HIV1/2 detectin kit can be applied as a clinical screening test as a substitution of conventional anti-HIV1/2 EIA, and there is a probable gain especially in early diagnosis.
Subject(s)
Humans , Antibodies , Blotting, Western , Diagnosis , Early Diagnosis , Enzyme-Linked Immunosorbent Assay , HIV , HIV Infections , HIV-1 , Mass Screening , Polymerase Chain Reaction , RNA , Sensitivity and Specificity , SeoulABSTRACT
OBJECTIVES: Developments in endoscopic technique and equipments have improved duct clearance rate in patients with extrahepatic bile duct(EHBD) stone. In this study, we reviewed our experience in extracting EHBD stones with standard and more advanced technique and equipments such as mechanical lithotripsy and extra corporeal shock wave lithotripsy. Aims of this study were to determine the overall success rate of endoscopic ex tracting for EHBD stone, to identify risk factors for failed duct clearance at initial and final therapeutic ERCP. METHODS: We retrospectively reviewed 214 consec utive patients who underwent Endoscopic Retrograde Cholangiopancreatography(ERCP) for EHBD stone over 45 months period. Factors evaluated for failed duct clearance included stone size, stone number, stone shape, concomitant stone of gallbladder and intrahepatic duct, presence of distal bile duct stricture, periampullary diverticula(PAD), Billroth-II gastrojejunostomy, and sepsis at admission. RESULTS: The overall success rate of endoscopic treatment for EHBD stone was 93.5% (200/214). The causes of failed duct clearance were failed endoscopic sphincterotomy in 5/214 (2.3%), technical failure of extracting stone in 5/214(2.3%), and aggravation of acute cholecystitis between therapeutic endoscopic sessions in 4/214(1.9%). Risk factors for failed duct clearance with endoscopic extraction of EHBD stone were size and shape of the stone, concomitant stone of gallbladder and intra hepatic duct, and stricture of distal common bile duct. The duct clearance rate with initial therapeutic ERCP was 56.5%(121/200). Risk factors for failed duct clearance with initial therapeutic ERCP were size, shape and number of stone, and sepsis at admission. The com plications of endoscopic treatment for EHBD stone were major bleeding in 5/200 (2.5%), pancreatitis in 18/200 (9.0%), but there was no perforation. CONCLUSION: Eventhough risk for failure of endo scopic treatment for EHBD stone were giant or piston shaped stone, concomitant stone of gallbladder and intra hepatic duct, and stricture of distal common bile duct, we conclude that endoscopic treatment for EHBD stone is safe and effective treatment modality, and choice of treatment.
Subject(s)
Humans , Bile , Bile Ducts , Cholangiopancreatography, Endoscopic Retrograde , Cholecystitis, Acute , Common Bile Duct , Constriction, Pathologic , Gallbladder , Gastric Bypass , Hemorrhage , Hepatic Duct, Common , Lithotripsy , Pancreatitis , Retrospective Studies , Risk Factors , Sepsis , Shock , Sphincterotomy, EndoscopicABSTRACT
A 21-year-old woman found to be hypertensive was referred for hypertension. On examination, blood pressure was 170/110mmHg in the right arm, 160/100mmHg in left arm,and 120/70mmHg in legs. A grade 2/6 systolic ejection murmur was present at the left upper sternal border, and a chest x-ray revealed a rib notching on the inferior margin of 4th rib. Two-dimensional echocardiogram showed the coarctation of aorta beyound the origin of the left subclavian artery. Biplane TEE demonstrated a discrete narrowing of the descending aorta at the site of coarctation. The blood pressure was 169/86mmHg in ascending aorta and 118/84mmHg in descending aorta. Aortogram showed a localized coarcted aortic segment of 7mm in diameter and 5mm long just distal to the left subclavian artery. Balloon coarctation angioplasty was performed with 7F 30x15mm pediatric balloon dilatation catheter. Balloon position was confirmed on fluoroscopy by the hourglass appearance of the balloon inflation and thereafter, the balloon was inflated until the waist of the balloon disappeared. After procedure, a pull back pressure tracing across the coarctation of aorta revealed no pressure gradient between ascending and descending aorta with 141/90mmHg. Aortogram showed an increase in diameter of the coarctation of aorta to 18mm with aneurysmal formation. 3 months later, follow up aortogram showed no significant change in diameter of coarctation of aorts or aneurysmal formation. Nonsurgical balloon coarctation angioplasty appears to be an alternative therapy for the coarctation of aorta in adults.