A Case of Systemic Lupus Erythromatosus Presenting with Periorbital Edema / 대한류마티스학회지

Periorbital edema is a rare manifestation of systemic lupus erythematosus (SLE). We describe here a patient with bilateral periorbital edema as a presenting symptom of SLE. A 23-year-old woman was admitted for a sudden onset of severe periorbital edema that developed 7 days previously. On the basis of the malar rash, arthritis of the right hand and left wrist, leukopenia, proteinuria and the positive anti-nuclear and anti-dsDNA antibodies, she was diagnosed with SLE. Kidney biopsy revealed lupus nephritis (WHO class IV). After treatment with high dose of steroids, intravenous cyclophosphamide and daily hydroxychloroquine, her symptoms resolved, including the periorbital edema. She was discharged with prescriptions for prednisolone and hydroxychloroquine and she remains well.

Bacteriologic Analysis of Expectorated Sputum in Patient with Bronchiectasis / 결핵및호흡기질환

BACKGROUND: Bronchiectasis (BE) remains a rare respiratory disease in Korea. This retrospective study was done to investigate the potential pathogenic microorganisms (PPMs) that cause in patients with BE, through the use of sputum specimens. METHODS: One hundred eleven adult patients, who had undergone chest computed tomography (CT), sputum gram stain/culture, and BE detected by chest CT, were included in this study. Sputum adequacy was determined by using Murray-Washington classification. RESULTS: The mean (+/-SD) age of patients was 60.9 (+/-14.0). The number of PPMs was 167 (67%) in the total 248 isolated organisms. The most frequent PPMs were P. aeruginosa (23.4%), K. pneumoniae (10.5%), and S. aureus (8.4%). The proportion of adequate sputum (AS) was 25.8% in the total sputum specimens. The patients with AS were 41 (37%) and the patients with inadequate sputum (IS) were 70 (63%). The proportion of P. aeruginosa was higher in AS compared to that of IS (44% vs. 19%, p=0.004). The BE score was also higher in P. aeruginosa (+) patients compared to that of P. aeruginosa (-) patients (10.8 vs. 7.6, p=0.001). CONCLUSION: Although the proportion of AS in the total sputum was low, PPMs were isolated in most patients with BE. It is likely that P. aeruginosa was isolated in AS and AS patients had higher BE scores.

A Newly Designed Nitinol Stent: Early Clinical Experience in the Treatment of Iliac Artery Stenoses and Occlusions

OBJECTIVE: To investigate the effectiveness of the newly designed Niti-S stent in the management of iliac arterial stenoses and occlusions. MATERIALS AND METHODS: Stenoses (n=25) or occlusions (n=5) in the iliac arteries of 25 patients (30 limbs) were treated. The site of the lesions was the common (n=15) or external (n=11) iliac artery, or both (n=4). Eight limbs were treated for diffuse disease, six for highly eccentric lesion, five for occlusive lesion, and 11 for failed angioplasty. RESULTS: In all patients, technical success was achieved without major complications. One death, not procedure-related, occurred within 30 days. Ankle-brachial indexes improved from 0.63 +/- 0.30 to 0.99 +/- 0.21, and ischemic symptoms showed improvement in 22 patients (88%). Fontaine classifications before stenting, namely IIa(n=3), IIb(n=16), III(n=2), and IV(n=4) improved to I(n=17), IIa(n=5), and IV(n=3). Follow-up over a 27 (mean, 19.8 +/- 8)-month period showed that cumulative patency rates were 95.8% at 1 year and 86.2% at 2 and 3 years. No significant decrease in the mean ankle-brachial index was observed. CONCLUSION: The Niti-S stent appears to be a safe and effective device for the treatment of iliac stenoses and occlusions. These preliminary results require confirmation with a larger series.