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2.
Ann Vasc Surg ; 32: 131.e1-5, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26827685

ABSTRACT

A 52-year-old man was admitted in the emergency department for deteriorating mental status and suspicion of discitis. Computed tomography and positron emission tomography scan showed evidence of localized infection of the aortic bifurcation and blood cultures were positive for Staphylococcus aureus. Ten years ago, the patient underwent placement of covered metal stents on each common iliac artery due to arteritic stenosis. The infected material was removed and aortic bifurcation repaired using an autologous femoral vein graft. This case report describes the surgical procedure, patient outcome, and review on prevention of such complications.


Subject(s)
Device Removal , Endovascular Procedures/adverse effects , Femoral Vein/transplantation , Iliac Artery/surgery , Prosthesis-Related Infections/surgery , Staphylococcal Infections/surgery , Staphylococcus aureus/isolation & purification , Stents/adverse effects , Computed Tomography Angiography , Endovascular Procedures/instrumentation , Humans , Iliac Artery/diagnostic imaging , Iliac Artery/microbiology , Male , Metals , Middle Aged , Prosthesis Design , Prosthesis-Related Infections/diagnosis , Prosthesis-Related Infections/microbiology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/microbiology , Time Factors , Transplantation, Autologous , Treatment Outcome
3.
APMIS ; 115(7): 869-74, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17614857

ABSTRACT

Plasmablastic microlymphoma (PML) is defined as the accumulation of monotypic but polyclonal plasmablasts in lymphoid tissues involved in human herpes virus 8 (HHV-8)-positive multicentric Castleman's disease (MCD). So far, the nature of this very rare condition remains poorly determined. In this study, we describe a human immunodeficiency virus (HIV)-seropositive patient who developed a PML in the setting of HHV-8-positive MCD. In contrast to the cases previously reported, most of the plasmablasts in our patient were localized within the germinal center (GC) of lymphoid follicles. These plasmablasts expressed the multiple myeloma-1/interferon regulatory factor-4 (MUM1/IRF4) protein as well as IgMlambda in a monotypic fashion. They did not show any immunoreactivity with antibodies directed against Pax-5, CD20, CD79a, CD10, CD30, CD23, CD138, epithelial membrane antigen (EMA) or BCL-6. These cells exhibited a high proliferation rate, expressed the HHV-8 latent nuclear antigen-1, and secreted the HHV-8 viral homologue of human interleukin-6. Polymerase chain reaction analysis did not demonstrate any clonal rearrangement of the genes coding for the heavy chain of the immunoglobulin. Moreover, no Epstein-Barr virus (EBV) RNA transcript could be found, using in situ hybridization. The present case illustrates that PML may arise within the GC of lymphoid follicles in the absence of EBV coinfection. In our opinion, PML occurring in MCD likely represents a variant of HHV-8-positive MCD in which lytic HHV-8 replication is particularly prominent, due to a local or systemic immune imbalance.


Subject(s)
Castleman Disease/complications , Herpesvirus 8, Human/isolation & purification , Lymphoma, B-Cell/diagnosis , Lymphoma, B-Cell/virology , Adult , Biomarkers, Tumor/analysis , Castleman Disease/virology , Fatal Outcome , HIV Seropositivity/complications , Humans , Lymph Nodes/pathology , Lymphoma, B-Cell/pathology
4.
J Acquir Immune Defic Syndr ; 35(3): 279-85, 2004 Mar 01.
Article in English | MEDLINE | ID: mdl-15076243

ABSTRACT

This study documented the HIV-1 subtype distribution in 2 Belgian hospitals and determined predictive demographics for non-B subtypes. Overall, subtype B was the most prevalent subtype in this population, followed by subtypes A and C. Several recombinants were detected, circulating recombinants as well as new ones. We found a rise in non-B subtypes from 0% in 1983 to 57% in 2001. The Cochran-Armitage trend test (P < 0.001) as well as the correlation analysis (R = 0.71, P = 0.0006) was highly significant. Recombinants were also increasing in this patient population from 0% in 1983 to 10% in 2001, with good support from the statistical analyses (trend test P < 0.001; correlation analysis R = 0.67, P = 0.0016). Heterosexual route of infection, black African race, African origin of the virus, and year of diagnosis were predictors for infection with non-B subtypes in multivariate analysis. This analysis indicates that the prevalence of non-B subtypes and recombinants in this patient population is high and increasing. Gathering demographic and sequence information from newly diagnosed patients could be useful to further follow the spread of non-B subtypes in Belgium and Europe, but subtyping based on sequence information still remains the most reliable method.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , HIV Infections/epidemiology , HIV-1/classification , Acquired Immunodeficiency Syndrome/classification , Adult , Belgium/epidemiology , Female , Geography , HIV Infections/classification , HIV-1/isolation & purification , Humans , Male , Racial Groups , Sexual Behavior
5.
J Cutan Pathol ; 29(2): 72-8, 2002 Feb.
Article in English | MEDLINE | ID: mdl-12150136

ABSTRACT

BACKGROUND: Kaposi's sarcoma (KS) is a tumor whose ontogenic origin remains a matter of contention. KS tissues are characterized by predominant expression of endothelial markers, while KS-derived cell cultures are usually characterized by expression of mesenchymal non-endothelial cell markers. AIMS: In order to clarify the ontogenic origin of KS cells, we investigated the expression of the fibroblast/macrophage marker 1B10 in KS tissues (AIDS-associated KS, n = 9; classic KS, n = 6; iatrogenic KS, n = 6) and in KS-derived cell cultures. RESULTS: 1B10 was expressed by loosely distributed spindle-shaped cells in early 'patch-stage' KS and by a variable proportion of spindle cells in late 'plaque- and nodular-stage' KS. Using immunohistochemistry and immunoblot analysis, we found that, in vitro, reactivity for 1B10 was uniformly evidenced in fibroblasts and in KS-derived spindle cell cultures, irrespective of their histological or epidemiological setting. By contrast, vascular smooth muscle cells and endothelial cells were negative for 1B10. CONCLUSIONS: These results suggest that the KS spindle cells isolated in vitro may represent a particular subpopulation of the KS spindle cell compartment.


Subject(s)
Antigens, Surface/biosynthesis , Biomarkers, Tumor/analysis , Sarcoma, Kaposi/metabolism , Skin Neoplasms/metabolism , Antigens, Surface/analysis , Biopsy , Fibroblasts/metabolism , Immunohistochemistry , Macrophages/metabolism , Sarcoma, Kaposi/pathology , Skin Neoplasms/pathology , Tumor Cells, Cultured
6.
Int J Cancer ; 100(2): 140-3, 2002 Jul 10.
Article in English | MEDLINE | ID: mdl-12115561

ABSTRACT

Iron is suspected to be involved in the induction and/or progression of various human tumors. More particularly, we have previously shown that iron may be involved in the pathogenesis of Kaposi's sarcoma (KS). We have also shown that the iron chelator desferrioxamine (DFO) has a potent anti-KS activity in vitro, suggesting that it may represent a potential therapeutic approach for the treatment of KS. The present study was designed to investigate the effect of DFO on the growth of human KS xenografts in immunodeficient mice. Unexpectedly, we found that mice treated with DFO (400 mg/kg, 3 times weekly) (n = 30) exhibited a marked enhancement of tumor growth compared with control mice (n = 33) (230 +/- 134 mm(2) versus 143 +/- 70 mm p < 0.01). No enhancement of tumor growth was seen in mice treated with iron-saturated DFO. At least 2 findings suggest that this paradoxic pro-KS activity occurred independently of mice iron stores. First, treatment with DFO had only a marginal effect on ferritin and hematocrit levels. Second, induction of effective iron depletion by an iron-poor diet (6.7 mg iron/kg diet) (n = 23) did not have a deleterious effect on the growth of the KS xenografts. The lesions obtained from the DFO-treated animals exhibited a significantly decreased apoptotic index (p < 0.05), indicating that some antiapoptotic mechanism induced by DFO may be operating in vivo to favour tumor growth. In conclusion, our data show that DFO has a stimulatory effect on KS growth in immunodeficient mice, suggesting that this drug is not indicated in patients with KS.


Subject(s)
Acquired Immunodeficiency Syndrome/pathology , Deferoxamine/pharmacology , Iron Chelating Agents/pharmacology , Sarcoma, Kaposi/pathology , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/metabolism , Animals , Apoptosis/drug effects , Body Weight/drug effects , Bromodeoxyuridine , Cell Division/drug effects , Humans , In Situ Nick-End Labeling , Iron/metabolism , Male , Mice , Mice, Inbred BALB C , Mice, Nude , Neoplasm Transplantation , Sarcoma, Kaposi/etiology , Sarcoma, Kaposi/metabolism , Transplantation, Heterologous , Tumor Cells, Cultured
7.
J Infect Dis ; 185(2): 178-87, 2002 Jan 15.
Article in English | MEDLINE | ID: mdl-11807691

ABSTRACT

The risk of clinical progression for human immunodeficiency virus (HIV)-infected persons receiving treatment with highly active antiretroviral therapy (HAART) is poorly defined. From an inception cohort of 8457 HIV-infected persons, 2027 patients who started HAART during prospective follow-up were examined. Results were validated in another 2 groups of patients (n=1946 and n=1442). In total, 200 patients (9.9%) experienced clinical progression during 5177 person-years (incidence, 3.9/100 years). The most recently measured CD4 cell count, virus load, and hemoglobin level all were independently related to the risk of clinical progression, as was a diagnosis of severe AIDS before the start of HAART. On the basis of these findings, a scoring system was derived (range, 0-17). A single unit increase in the score was associated with a 38% increased risk of clinical progression (relative hazard, 1.38; 95% confidence interval, 1.33-1.43; P<.0001). The scoring system was validated with remarkably good agreement in the 2 other cohorts. This system can be used in patient and resource management.


Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/drug therapy , Adult , CD4 Lymphocyte Count , Cohort Studies , Female , HIV Infections/immunology , Humans , Male , Prognosis , Prospective Studies
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