Résumé
Mycobacterium genavense, first identified in 1990, is known as a pathogen that mimics disseminated Myocobacterium avium-intracellulare complex (MAC) infection with particular propensity for the gastrointestinal tract. In Korea, no case with the organism has been reported. Herein we report a case of Mycobacterium genavense infection that manifested with erosive lesion of duodenum in a patient with acquired immune deficiency syndrome. The patient presented with epigastric pain and fever, diarrhea. Duodenal biopsy showed histiocytic infiltration with numerous acid-fast bacilli. Identification of the mycobacterial isolate by the polymerase chain reaction restriction analysis of 16S rRNA gene revealed Mycobacterium genavense.
Sujets)
Humains , Syndrome d'immunodéficience acquise , Biopsie , Diarrhée , Duodénum , Fièvre , Tube digestif , Gènes d'ARN ribosomique , Infections à VIH , VIH (Virus de l'Immunodéficience Humaine) , Corée , Mycobacterium , Réaction de polymérisation en chaîneRésumé
Mycobacterium genavense, first identified in 1990, is known as a pathogen that mimics disseminated Myocobacterium avium-intracellulare complex (MAC) infection with particular propensity for the gastrointestinal tract. In Korea, no case with the organism has been reported. Herein we report a case of Mycobacterium genavense infection that manifested with erosive lesion of duodenum in a patient with acquired immune deficiency syndrome. The patient presented with epigastric pain and fever, diarrhea. Duodenal biopsy showed histiocytic infiltration with numerous acid-fast bacilli. Identification of the mycobacterial isolate by the polymerase chain reaction restriction analysis of 16S rRNA gene revealed Mycobacterium genavense.
Sujets)
Humains , Syndrome d'immunodéficience acquise , Biopsie , Diarrhée , Duodénum , Fièvre , Tube digestif , Gènes d'ARN ribosomique , Infections à VIH , VIH (Virus de l'Immunodéficience Humaine) , Corée , Mycobacterium , Réaction de polymérisation en chaîneRésumé
No Abstract available.
Résumé
B cell lymphoma and Kaposi's sarcoma are the most common tumors in AIDS patients. They show more aggressive behavior and poor prognosis in AIDS patients than in the general population. Lymphoma and Kaposi's sarcoma in AIDS patients are associated with Epstein-Barr virus and human herpesvirus 8, respectively. We reported herein a case of lymphoma and Kaposi's sarcoma in an AIDS patient. He presented with a mass on the tongue base and a red papule on the posterior wall of the oropharynx. On the basis of his- tologic findings, immunohistochemical study, and PCR, his illnesses were diagnosed as B cell lymphoma, combined with early Kaposi's sarcoma. Unfortunately, he did not receive any treatment and died of malnutrition 1 month later. To the best of our knowledge, this is the first report of coexisting lymphoma and Kaposi's sarcoma from an AIDS patient in Korea.
Sujets)
Humains , Lymphocytes B , Herpèsvirus humain de type 4 , Herpèsvirus humain de type 8 , Corée , Lymphomes , Lymphome B , Malnutrition , Partie orale du pharynx , Réaction de polymérisation en chaîne , Pronostic , Sarcome de Kaposi , LangueRésumé
We report a case of cytomegalovirus(CMV) pneumonitis in a 21-year-old woman with systemic lupus erythematosus(SLE). She was diagnosed 3 years ago with lupus nephropathy and was on immunosuppressive therapy with prednisolone and cyclophosphamide. She developed dyspnea with fever and hypoxemia. Chest X-ray, and HRCT showed interstitial pneumonitis. We performed open lung biopsy. The diagnosis of CMV pneumonitis was made by the virus culture and immunohistochemical staining for CMV in lung tissue. Despite the admini stration of ganciclovir and high dose immunoglobulin therapy and assistance of mechanical ventilator, the patient died.
Sujets)
Femelle , Humains , Jeune adulte , Hypoxie , Biopsie , Cyclophosphamide , Cytomegalovirus , Diagnostic , Dyspnée , Fièvre , Ganciclovir , Immunisation passive , Poumon , Pneumopathies interstitielles , Lupus érythémateux disséminé , Pneumopathie infectieuse , Prednisolone , Thorax , Respirateurs artificielsRésumé
OBJECTIVES: The renin-angiotensin system(RAS) had an important role in the pathogenesis of ischemic heart disease(IHD). Angiotensinogen(ATG), angiotensin-converting enzyme(ACE), and angiotensin II receptor are key components of RAS and reported to have polymorphisms. We studied to investigate the separate and interactive effects of ACE (I/D) and ATG (M235T) gene polymorphisms on the pathogenesis of IHD, and to compare the genetic influences between on the chronic stable angina(CSA) and on the acute coronary syndrome(ACS). METHODS: We studied total 468 patients who underwent CAG. Control group comprised 159 patients who did not have a significant coronary lesion. IHD group was subgrouped according to clinical manifestation into CSA group(n=90) and ACS group(n=219). To determine the frequency of ACE and ATG genotype, polymerase chain reaction (PCR) and enzyme digestion was done. RESULTS: 1) In ACS group, genotype frequency of ACE(II:ID:DD) was 0.27:0.48:0.25 and ATG (MM:MT:TT) was 0.31:0.59:0.10, which was significantly different from control group (ACE II:ID:DD =0.38:0.45:0.17 and ATG MM:MT:TT =0.51:0.40:0.09) (p<0.05). 2) There was no significant difference in genotype frequency of ACE, ATG gene between CSA group and control. 3) In multiple logistic regression analysis, sex, age, ATG and ACE genotype were independent risk factors for ACS. The relative risk for ACS in ACE DD compared to II genotype was 3.52 (95% CI: 1.52-8.13) and that in ACE ID compared to ACE II genotype was 1.55 (95% CI: 0.82-2.94), which showed that the risk increased with the number of ACE D-allele. In contrast, sex, age, and DM were independent risk factors for CSA, whereas ATG and ACE genotype were not. 4) In combined analysis including both ACE and ATG gene polymorphism, the relative risk for ACS associated with ATG genotype increased with the number of ACE D-allele. CONCLUSION: ACE and ATG gene polymorphism are associated with the development of ACS but not CSA, which suggests that ACE and ATG genes may be involved in the plaque unstabilization or thrombosis rather than the chronic progression of coronary atherosclerosis.
Sujets)
Humains , Syndrome coronarien aigu , Angor stable , Angiotensinogène , Angiotensines , Maladie des artères coronaires , Digestion , Génotype , Coeur , Modèles logistiques , Ischémie myocardique , Réaction de polymérisation en chaîne , Récepteurs aux angiotensines , Système rénine-angiotensine , Facteurs de risque , ThromboseRésumé
BACKGROUND: Systemic sclerosis (scleroderma) is a connective tissue disorder of unknown etiology characterized by fibrosis of the skin and internal organs. It is remarkably heterogeneous in initial presentations and internal organ involvement. Limited and diffuse cutaneous subsets of systemic sclerosis (SSc) are known to be different in clinical and laboratory features. The aim of the present study was to determine the clinical characteristics of systemic sclerosis in Koreans. METHODS: Fifty-six patients with systemic sclerosis at the Rheumatology Clinic of Seoul National University Hospital were studied for age, sex, symptoms, signs, and laboratory results. The differences in clinical and laboratory features between limited and diffuse cutaneous subsets were investigated. RESULTS: The mean age at diagnosis of 56 patients (male:female=1:4.6) was 42.4 years (range 11-72 years). The patients consisted of 30 limited and 26 diffuse cutaneous SSc. Cutaneous involvement was as follows: sclerodactyly (100%), Raynaud's phenomenon (94.6%), digital pitting scar (66.1%), subcutaneous calcinosis (1.8%). In musculoskeletal system, 25 cases (46.3%) developed arthralgia/arthritis, 14 cases (25.9%) myalgia. In gastrointestinal system, esophagus was affected in 11 cases (20.7%). Respiratory involvement consisted of interstitial lung disease (24 cases, 43.7%) and pulmonary hypertension (2 cases, 3.6%). Total skin score and functional vital capacity showed significant negative correlation (p<0.05). Cardiovascular involvement consisted of congestive heart failure (3 cases, 5.5%) and pericardial effusion (1 case, 1.8%). Azotemia was found in one patient (1.8%). Antinuclear antibody was positive in 53 cases (94.6%) and anticentromere antibody 2 cases (3.6%). Anti-Scl 70 antibody was positive in 46.4% of all patients, 40.0% of limited scleroderma and 53.8% of diffuse scleroderma. When comparing clinical features between limited and diffuse cutaneous subsets, musculoskeletal involvement was more common in limited scleroderma. CONCLUSION: Systemic sclerosis in Koreans showed various systemic and organ involvement, musculoskeletal system, lung and esophagus being commonly affected. There was no significant difference between limited and diffuse scleroderma in clinical features except musculoskeletal involvement. Investigation of major internal organs, especially lung and esophagus, is needed, regardless of cutaneous subsets in systemic sclerosis.
Sujets)
Humains , Anticorps antinucléaires , Azotémie , Calcinose , Cicatrice , Tissu conjonctif , Diagnostic , Oesophage , Fibrose , Défaillance cardiaque , Hypertension pulmonaire , Poumon , Pneumopathies interstitielles , Appareil locomoteur , Myalgie , Épanchement péricardique , Rhumatologie , Sclérodermie diffuse , Sclérodermie limitée , Sclérodermie systémique , Séoul , Peau , Capacité vitaleRésumé
No abstract available.
Sujets)
Coagulation intravasculaire disséminée , Plasma sanguin , Fièvre fluviale du JaponRésumé
In a small island community with a population of less than 100 residents, nine persons died and five experienced severe illness during the period from November 1986 to May 1988. Their initial symptoms were sore throat and fever. Renal failure and hepatitis developed which one week after the onset. Oral mucosal ulcer developed in some cases. After one week, progressive respiratory failure and dyspnea developed evidently and severe respiratory distress and hypoxia preceded those fatal cases. Chest X-ray findings revealed bilateral diffuse multiple cystic lesion with occasional multiple large emphysematous bullae. Based on these features paraquat poisoning was diagnosed and route of poisoning was investigated. In three sources of drinking water, trace amount of paraquat was detected in November 1988, six months after the incidence of recent fatal case. In November 1988, soybean sauces and soybean pastes from 12 households were found contaminated with high concentration of paraquat, the cause of this mass poisoning has been suggested.