Pulmonary tuberculosis misdiagnosed as extensively drug-resistant tuberculosis due to selection of a nontuberculous mycobacterial colony from a preculture dish used for a drug-susceptibility test.

Drug-susceptibility test (DST) is important for tuberculosis care; however, there are several pitfalls with the procedure. A 70-year-old woman was diagnosed with extensively drug-resistant tuberculosis based on the result of a DST using microdilution method. Because she had no history of medication for tuberculosis and the sputum acid-fast bacillus smear test turned negative during standard treatment, identification of the strain used for DST was performed. Consequently, the strain was found to be M. intracellulare. It was assumed that a colony of M. intracellulare that had existed in the preculture solid medium was selected and used for the DST.

Stone clearance after extracorporeal shockwave lithotripsy in patients with solitary pure calcium oxalate stones smaller than 1.0 cm in the proximal ureter, with special reference to monohydrate and dihydrate content.

OBJECTIVE: The aim of this study was to assess stone-free rates following extracorporeal shockwave lithotripsy (ESWL) of pure calcium oxalate (CaOx) stones in the proximal ureter. MATERIAL AND METHODS: The investigators retrospectively examined 53 patients with 5-10 mm pure CaOx stones in the proximal ureter from the medical archives of 593 consecutive patients treated with ESWL. The compositions of calcium oxalate monohydrate (COM) and dihydrate (COD) in a given stone were determined by infrared spectrometry. Stone size, attenuation number and stone-to-skin distance (SSD) were measured using plain radiography and computed tomography (CT). ESWL success was evaluated by stone-free status after the first single session. RESULTS: On average, calculi were 8.0 × 5.3 mm in size, with an SSD of 11.0 cm. The mean CT attenuation value was 740.1 HU. Attenuation numbers correlated significantly with stone diameter (r = 0.49), but had no correlation with the stone content of COM or COD. A negative correlation was observed between COM and COD content (r = -0.925). With regard to patients' physical characteristics and COM and COD content, no differences were found between study subgroups with stone-free and residual status (n = 38 and 15, respectively). There were also no differences in clinical features between patient subgroups with COM- or COD-predominant stones (n = 22 and 31, respectively). CONCLUSION: The findings indicated that the differences in COM and COD content of CaOx stones had no impact on stone clearance after ESWL and that a favorable stone-free rate of the stones treated with ESWL may be achieved independently of CaOx hydration.

p53 antibodies in the serum of patients with prostate cancer.

UNLABELLED: We assessed the potential clinical utility of levels of p53-specific antibodies as a novel serum biomarker of prostate cancer that could be used in conjunction with level of PSA. MATERIAL AND METHODS: Serum levels of p53-specific antibodies in patients with relapsed, newly diagnosed prostate cancer and in patients with benign prostate hyperplasia were quantified by an enzyme-linked immunoabsorbent assay. RESULT: There was no significant difference (P=0.96) between the serum levels of p53-specific antibodies in patients with newly diagnosed prostate cancer and with benign prostatic hyperplasia. In the newly diagnosed prostate cancer group, stage T1c (n=8) showed the lowest p53-specific antibody level. However, the difference between T1c group and benign prostatic hyperplasia group was not significant (P=0.686). The relapsed cancer group tended to have low levels of the antibodies, and, there was no significant difference between the relapsed prostate cancer group and the benign prostatic hyperplasia group (P=0.14). The serum levels of p53-specific antibodies in patients with metastatic and with localized prostate cancer showed no significant difference (P=0.68). CONCLUSION: The use of titers of p53-specific antibodies to make differential diagnosis between prostate cancer and benign prostatic hyperplasia might have no role, and the antibodies should not be used as a marker of prostate cancer by itself. Because our study is based on small number of patients, further studies are necessary before its absolute validity can be determined.