A case of cytomegalovirus colitis in immunocompetent patient / 대한내과학회지

Cytomegalovirus (CMV) infection is more frequent in immunocompromised patients those with acquired immunodeficiency syndrome (AIDS), malignant disease, steroid therapy. However, CMV can infect a healthy person who has normal immunity. Most cases of CMV infections are due to reactivation of latent virus. We report a case of cytomegalovirus colitis in a 73 years old woman who has congestive heart failure with normal immunity. Sigmidoscopy reveals cobble stone like mucosa and deep ulceration. CMV infection produces a cytomegalic cell containing a intranuclear inclusion, which is surrounded by clear halo in Hematoxylin-Eosin stain. Immunohistochemical stain for CMV reveals focal positive in cytoplasm and in nuclei of large cells. We diagnosed CMV colitis with histopathologic finding and immunohistochemistry through sigmoidoscopic mucosal biopsy.

Prevalence of Hepatitis G Virus Infection in Patients with Chronic Renal Failure / 대한간학회지

BACKGROUNDS/AIMS: To investigate the prevalence and clinical implications of hepatitis G virus (HGV) infection in patients with chronic renal failure, a cross-sectional study of 131 hemodialysis patients and 33 kidney transplantation recipients was conducted. METHODS: HGV RNA was amplified by reverse-transcription (RT) polymerase chain reaction (PCR) assay with primers from the 5'-untranslated region of the viral genome. RESULTS: The prevalence of HGV infection in patients with chronic renal failure was 25%(41/164). The following factors were taken into consideration: the mean age(43.15+/-11.97 years vs 46.46+/-13.08 years), the male to female ratio(2.15:1 vs 1.86:1), the mean of the dialysis duration(4.58+/-3.18 years vs 3.90+/-3.31 years), transfusion history (75.6% vs 62.6%), the mean of the ALT level during the prior 6 months(25.78+/-21.50 IU/L vs 23.00+/-59.49 IU/L), and the amount of transfusion(6.22+/-8.03 units vs 5.74+/-9.44 units). The anti-HCV(4.88% vs 8.94%) showed no difference between HGV RNA positive and negative group. The HBsAg positive ratio was 19.5% and 5.81% in HGV RNA positive group and negative group, respectively. CONCLUSION: The prevalence of HGV infection in patients with chronic renal failure was 25%. There was a higher rate of HBsAg positivity in the HGV RNA positive group rather than in the negative group. HGV infection did not seem to be associated with clinically significant hepatitis.

Aneurysm of Sinus of Valsalva Dissecting into Interventricular Septum: A Possible Cause of Complete Atrioventricular Block

Dissection of the interventricular septum by aneurysm of sinus of Valsalva is a rare lesion and has poor prognosis. However, it can be diagnosed noninvasively with echocardiography and managed well by surgical repair. A 55 year old female was readmitted due to aggravated exertional dyspnea. She was implanted with permanent pace-maker due to complete atrioventricular (AV) block of recent onset at a community hospital. Previous diastolic murmur near aortic area was changed to a new continuous murmur. The diagnosis of an aneurysm of sinus of Valsalva dissected into the interventricular septum was confirmed by routine two-dimensional echocardiography. The neck of the aneurysm was closed primarily with patch and aortic valve replacement was done. The pro-gnosis was good. The finding of AV block of recent onset and obscure origin in a young patient should alert the physician to the possibility of an aneurysm of sinus of Valsalva and warrants systematic echocardiography.