ABSTRACT
Pneumocystis jirovecii pneumonia (PJP) in patients with HIV infection can, in rare cases, present with pulmonary nodules that histologically involve granulomatous inflammation. This report describes an intriguing case of granulomatous PJP with pulmonary nodules after commencing antiretroviral therapy (ART) in an HIV-infected patient without respiratory signs or symptoms. Diagnosis of granulomatous PJP was only achieved through thoracoscopic lung biopsy. This case suggests that granulomatous PJP should be considered in the differential diagnosis of pulmonary nodules in HIV-infected patients for unmasking immune reconstitution inflammatory syndrome manifestation after initiation of ART.
ABSTRACT
Antioxidants oppose the toxic actions of lipid peroxides and oxygen radicals, and they limit the amount of lipid peroxides formed. Women with normal pregnancies have an increase in oxidative stress and lipid peroxidation when compared with nonpregnant women. The antioxidants also increase progressively with advancing gestation, and the antioxidants in the fetus also increase with advancing gestation, especially during late gestation. The purpose of this study is to investigate the diefference of antioxidant status in maternal and neonatal plasma according to the delivery type. So, we investigated the status of antioxidant in the maternal and neonatal plasma when compared normal vaginal delivery with Cesarian section without labor. This study was done under the hypothesis that labor pain is originated from the hypoxic state of myometrium during uterine contraction. The number of women who were studied was total 56, 24 women were delivered by normal vaginal delivery and 32 women were done by Cesarean section without labor. The blood was sampled during active labor and postpartum 24 hour in the case of normal vaginal delivery, the women who were done Cesarean section being sampled before operation and 24 hours after operation. The neonatal blood was sampled from cord, birth 1 day and 3 day. The antioxidant levels were measured by Total Antioxidant Status (Randox Laboratory Ltd., UK) kit. The results were as follows. 1. The mean maternal plasma antioxidant status was not significantly different according to delivery types and not significantly different when compared antepartum with postpartum (vaginal delivery; antepartum: 1.54+/-0.31 mM/L, postpartum: 1.58+/-0.32 mM/L, Cesarean section; antepartum: 1.55+/-0.29 mM/L, postpartum: 1.56+/-0.33 mM/L). 2. The neonatal antioxidant status was not significantly different between the neonates who were born by vaginal delivery and the neonates who were born by Cesarean section. The neonatal plasma antioxidant status was increased progressively after birth (cord: birth 1 day: birth 3 day=1.46+/-0.25 mM/L: 1.59+/-0.25 mM/L: 1.79+/-0.37 mM/L). Therefore, labor pain was not seems to be significantly affect the maternal and neonatal plasma antioxidant status. And the neonatal antioxidant status was increased for adaptation to the external environment after birth.