A comparative study of the clinical features and hematobiochemical indices between the lung-uptake group and the non-lung-uptake group of malarial patients undergoing liver scanning / 대한내과학회지

BACKGROUND: Lung uptake during liver scanning has been considered as a passing phenomenon related to several diseases, and especially infectious diseases and malignancy. Some reports have shown diffuse lung uptake during liver scanning of malarial patients. Therefore, we tried to determine the relationship between the abnormalities of the clinical features, including the hematobiochemical indices and the lung uptake during liver scanning, by analyzing the information of the malarial patients. METHODS: We performed 99mTechnethium(Tc)-sulfur colloid liver scanning on 20 of the 45 malarial patients who were admitted from 1999 to 2004. We divided them into two groups, the Lung-Uptake (LU) group and the Non-Lung-Uptake (NLU) group. We analyzed the hematobiochemical indices and clinical features, including the respiratory symptoms, between the two groups. RESULTS: 10 of the 20 malarial patients showed lung uptake on the liver scan. The mean platelet counts were 74,000/L and 165,000/L, respectively, in the LU group and the NLU group (p=0.012). Also, the mean total cholesterol levels were 80.3 mg/dL and 105.7 mg/dL, respectively, in the LU group and the NLU group (p=0.033). The scores ofthe bone marrow (BM) uptake in the LU group were higher than those in the NLU group (p=0.008). Yet the other values such as Hb, ALT, albumin and total bilirubin were not statistically significant, nor were the peak body temperatureand other features. CONCLUSIONS: Half of the patients had lung uptake on the liver scanning, and this may be considered as a characteristic of vivax malaria. The BM uptake during liver scanning in the LU group was more increased, and this is supposed to be a consequence of hyperstimulated reticuloendothelial system, which was accompanied by thrombocytopenia and a lower level of total cholesterol in malarial patients.

Clinical Characteristics of Tuberculosis in Combat and Auxiliary Police in Korea / 감염과화학요법

BACKGROUND: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. RESULTS: In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (+/-1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/105 and 17.4/105 person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. CONCLUSION: There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea.

Clinical Characteristics of Tuberculosis in Combat and Auxiliary Police in Korea / 감염과화학요법

BACKGROUND: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. RESULTS: In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (+/-1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/105 and 17.4/105 person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. CONCLUSION: There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea.

A Case of Liddle's Syndrome in a Seventy One-year Old Woman / 대한신장학회잡지

Liddle's syndrome is a rare inherited disease with characteristic clinical manifestations of hypertension and hypokalemic metabolic alkalosis. Markedly suppressed serum aldosterone and renin levels are important laboratory findings to differentiate this disorder from primary hyperaldosteronism. When Liddle et al. reported the disorder in 1963, they proposed aggressive Na+ absorption and increased excretion of K+ as the pathogenesis of the syndrome. Since then, specific mutation in the epithelial Na+ channel located in the collecting duct of the kidney has been elucidated as a disease mechanism. Liddle's syndrome is inherited by an autosomal dominant trait and generally the onset of the syndrome is before the age of 20 with increased risk of premature death due to stroke or heart failure. Recently, however, a few cases of late onset and genetically proven nonfamilial cases with de novo mutation of beta or gamma Na+ channel have been reported. We report a case of seventy-one year old woman who had hypertension with hypokalemic metabolic alkalosis and was diagnosed as Liddle's syndrome. Further evaluation revealed low serum renin and aldosterone levels. Primary aldosteronism, Cushing's syndrome, glucocorticoid remediable aldosteronism and deficiency of 11beta-OHase and 17alpha-OHase were ruled out based on her laboratory data and history. Her hypertension and hypokalemia responded to amiloride treatment but not to spironolactone.