A Case of Idiopathic Thrombocytopenic Purpura in Patient with Human Immunodeficiency Virus Infection / 감염과화학요법

Thrombocytopenia is a common event in the course of human immunodef-iciency virus (HIV) infection. The maior cause of HIV virus related thrombocytopenia is idiopathic thrombocytopenic purpura (ITP). Treatment options for HIV related ITP are steroids, immunoglobulin, other immunosuppressive agents, and splenectomy. In addition, Antiretroviral agents are reported as effective treatment options in the setting of HIV-associated ITP, by enhancing CD4+ T cell counts, and reducing HIV viral loads. We report a case of HIV related ITP treated with prednisone, immunoglobulin, and highly active antiretroviral therapy (HAART).

A Case of Idiopathic Thrombocytopenic Purpura in Patient with Human Immunodeficiency Virus Infection / 감염과화학요법

Thrombocytopenia is a common event in the course of human immunodef-iciency virus (HIV) infection. The maior cause of HIV virus related thrombocytopenia is idiopathic thrombocytopenic purpura (ITP). Treatment options for HIV related ITP are steroids, immunoglobulin, other immunosuppressive agents, and splenectomy. In addition, Antiretroviral agents are reported as effective treatment options in the setting of HIV-associated ITP, by enhancing CD4+ T cell counts, and reducing HIV viral loads. We report a case of HIV related ITP treated with prednisone, immunoglobulin, and highly active antiretroviral therapy (HAART).

A case of benign metastasizing leiomyoma in the lung of woman with a history of myomectomy / 대한내과학회지

Benign metastasizing leiomyoma is usually detected years after hysterectomy or myomectomy and characterized by well-circumscribed, singular or, often, multiple nodules. The patient was a 33-year-old woman who presented with cough. She underwent a myomectomy for a large uterine leiomyoma 9 years ago. And now she has recurrent uterine myoma. Multiple nodular lesions in both whole lung fields were incidentally found on a routine chest radiograph. Video-assisted thoracoscopy (VATs) was performed. The resected small nodular lesions composed of extremely well- defferentiated smooth muscle cells with collagen. On immunohistochemical stain, they are positive for smooth muscle markers (desmin and actin). There is no definite evidence of malignancy. Therefore, these multiple nodules are considered as benign metastasizing leiomyoma from a uterine leiomyoma. We report this case with review of literatures.

A Case of Early Gastric Cancer with IgA Nephropathy in the Elderly Patient

IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.

Comparison of Left Ventricular Diastolic dysfunctions in Chronic Renal Failure(CRF) Patients and in Elderly Patients

BACKGROUND: We consider that heart failure in elderly and Chronic renal failure patients is closely related to LV diastolic dysfunction. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in Chronic renal failure patients by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography on elderly patients with pulmonary congestion and Chronic Renal Failure patients from Nov; 2000 to June; 2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), F/A ratio, Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd), PVs/PVd ratio. RESULTS: In elderly patients groups with pulmonary congestion, there was significant decreased in E/A ratio compared with CRF patients(0.693+/-0.18 vs 0.905+/-0.116, p<0.01). There was significant increase in deceleration time and isovolumic relaxation time in elderly patients with pulmonary congestion compared with CRF patients(DT 255.83+/-54.41 vs 210.80+/-48.53 p<0.05, IVRT; 123.06+/-26.07 vs 98.75+/-15.12, p<0.01). Although there was no significant difference, increased PVs/PVd ratio was noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially F/A ratio was significant decreased elderly patient group with pulmonary congestion and DT, IVRT were significant increase in elderly patient group with pulmonary congestion. Therefore Left ventricular relaxation is progressively impaired in old age and impaired LV relaxation results in in LV diastolic dysfunction But LV hypertrophy in ESRD patients results in LV diastolic dysfunction.