PURPOSE: To compare chest radiographic findings of pulmonary tuberculosis in non-AIDS immunocom- promised adult patients with those in immunocompetent patients. MATERIAL AND METHOD: Eighty six patients who had pulmonary tuberculosis were included in the study. Of these, 41 were non-AIDS immunocompromised adult patients and 45 were immunocompetent adult patients. Chest radiographs obtained from 86 patients were retrospectively evaluated with regard to the followings ;the anatomic distribution and extent of tuberculous lesions, typical or atypical patterns of radiographic findings. We then compared the results in non-AIDS immunocompromised adult patients with those in immunocompetent adult patients. RESULTS: The characteristic manifestation of pulmonary tuberculosis was a tendency of pulmonary lesions to localize in the apico-posterior segments of the upper lobe and the superior segment of the lower lobe in both groups but more wide distribution such as the anterior segment and the lingular segment of the upper lobe and the basal segments of the lower lobe was frequently identified in non-AIDS immunocompromised adult patients, and also bilateral, multisegmental and multilobular extents were common findings. in immunocompetent adult patients, more common findings were in local exudative and productive lesions and several cavities in preferential sites. Atypical plain radiographic findings were more common in non-AIDS immunocompromised adult patients, and which were multiple cavitary lesions, wide extent of bronchogenic spread and tuberculous pneumonia, and .miliary disseminations and mass like lesions. CONCLUSIONS: Pulmonary tuberculosis in non-AIDS immunocompromised adult patients is characterized by frequent bilateral distribution, wide pulmonary extent, and atypical radiographic findings.
Adult* ; Humans ; Pneumonia ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis, Pulmonary*

Indocyanine green (ICG) could be applied for multiple functions such as fluorescent tumor localization, fluorescence lymph node mapping (FLNM), and intraoperative angiography in colorectal cancer surgery. With the near-infrared (NIR) systems, colonoscopic ICG tattooing can be used to define the early colorectal cancer that cannot be easily distinguished through the serosal surface. The lymphatic pathways can be visualized under the NIR system when ICG is injected through the submucosal or subserosal layer around the tumor. Intraoperative ICG angiography can be applied to find a favorable perfusion segment before the colon transection. Although all fluorescence functions are considered essential steps in image-guided surgery, it is difficult to perform multifunctional ICG applications in a single surgical procedure at once because complex protocols could interfere with each other. Therefore, we review the multifunctional ICG applications for fluorescent tumor localization, FLNM, and ICG angiography. We also discuss the optimal protocol for fluorescence-guided colorectal surgery.

Indocyanine green (ICG) could be applied for multiple functions such as fluorescent tumor localization, fluorescence lymph node mapping (FLNM), and intraoperative angiography in colorectal cancer surgery. With the near-infrared (NIR) systems, colonoscopic ICG tattooing can be used to define the early colorectal cancer that cannot be easily distinguished through the serosal surface. The lymphatic pathways can be visualized under the NIR system when ICG is injected through the submucosal or subserosal layer around the tumor. Intraoperative ICG angiography can be applied to find a favorable perfusion segment before the colon transection. Although all fluorescence functions are considered essential steps in image-guided surgery, it is difficult to perform multifunctional ICG applications in a single surgical procedure at once because complex protocols could interfere with each other. Therefore, we review the multifunctional ICG applications for fluorescent tumor localization, FLNM, and ICG angiography. We also discuss the optimal protocol for fluorescence-guided colorectal surgery.

Disseminated adenovirus infection can result in high mortality and morbidity in immunocompromised patients. Here, we report the case of a 10-year-old renal allograft recipient who presented with hematuria and dysuria. Adenovirus was isolated from his urine. His urinary symptoms decreased after intravenous hydration and reduction of immunosuppressants. However, 2 weeks later he presented with general weakness and laboratory tests indicated renal failure necessitating emergency hemodialysis. Adenovirus was detected in his sputum; therefore, intravenous ganciclovir and immunoglobulin therapy were initiated. Renal biopsy revealed diffuse necrotizing granulomatous tubulointerstitial nephritis compatible with renal involvement of the viral infection. Adenovirus was detected in his serum. Despite cidofovir administration for 2 weeks, adenovirus was also detected in the cerebrospinal fluid, resulting in generalized tonic-clonic seizure. The patient died 7 weeks after the onset of urinary symptoms. Adenovirus should be considered in screening tests for post-renal transplantation patients who present with hemorrhagic cystitis.
Adenoviridae Infections* ; Adenoviridae* ; Allografts* ; Biopsy ; Cerebrospinal Fluid ; Child* ; Cystitis ; Dysuria ; Emergencies ; Ganciclovir ; Hematuria ; Humans ; Immunization, Passive ; Immunocompromised Host ; Immunosuppressive Agents ; Kidney Transplantation ; Mass Screening ; Mortality ; Nephritis, Interstitial ; Opportunistic Infections ; Pediatrics ; Renal Dialysis ; Renal Insufficiency ; Seizures ; Sputum

OBJECTIVE: Peripheral blood mononuclear cells (PBMC) in culture release a biologically active human chorionic gonadotropin (hCG). This effect is detectable during pregnancy with a maximum between the 16th and 19th week. HCG plays an important role for the corpus luteum rescue during the early gestational age and possibly for the immunotolerance. This study was performed to investigate the relationships between the productivity of cultured PBMC of pregnant women and the ability to maintain early pregnancy, and whether 12-o-tetradecanoyl-phorbol-13-acetate (TPA) increases hCG sectetion by cultured PBMCs. MATERIALS AND METHODS: PBMC were obtained from 20 pregnant women between 16th to 19th week of gestation , and cultured with TPA. Culture cells were harvested and hCG mRNA were extracted and RT-PCR were performed. Culture supernatants were collected and hCG concentration were determined by commercial RIA methods. RESULTS: The mean age was 31.0 years old, 19 of 20 (95%) pregnant women's PBMC secereted hCG and expressed hCG mRNA, but in control group exept male hepatitis B patient, none of them produced hCG. TPA activated expression of hCG in PBMC in linear manner. CONCLUSION: Pregnant women's cultured PBMC secreted hCG, but not in non-pregnant or male. We could confirm the mRNA of hCG in PBMC as well in the placental control. The productivity of hCG in PBMC might be closely related with maintenance of early pregnancy.
Chorionic Gonadotropin ; Corpus Luteum ; Efficiency ; Female ; Gestational Age ; Hepatitis B ; Humans ; Male ; Pregnancy* ; Pregnant Women ; RNA, Messenger

PURPOSE: Food protein-induced enterocolitis syndrome (FPIES) is a symptom complex of vomiting and diarrhea caused by non-IgE mediated allergy to cow's milk and/or soy in young infants. Transforming growth factor (TGF)-beta has been reported to protect the epithelial barrier of the gut from foreign antigens. We studied the expression of type 1 and 2 TGF-beta receptors in the mucosa of small intestine to investigate their roles in the pathogenesis of FPIES. METHODS: Twenty-eight patients, aged 7 to 120 days (mean 49 days) who were diagnosed with FPIES by clinical criteria and challenge tests were included. Immunohistochemical stainings for type 1 and 2 TGF-beta receptors were performed on endoscopic duodenal biopsy specimens. RESULTS: Type 1 and 2 TGF-beta receptors were expressed in the villous and crypt epithelial cells but nearly absent in the lamina propria in both patients and controls. Type 1 TGF-beta receptor expression was significantly lower in the patients who had villous atrophy than in the patients who had not and in controls. The expression of type 1 TGF-beta receptor was negatively correlated with the severity of villous atrophy. Type 2 TGF-beta receptor expression showed no significant difference between the patients and controls. CONCLUSION: Our results suggests that the decreased activity of type 1 TGF-beta receptor is implicated in the pathogenesis of FPIES in young infants.
Atrophy ; Biopsy ; Diarrhea ; Enterocolitis* ; Epithelial Cells ; Humans ; Hypersensitivity ; Infant ; Intestine, Small ; Milk ; Mucous Membrane ; Receptors, Transforming Growth Factor beta ; Transforming Growth Factors ; Vomiting

PURPOSE: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in infants and also responsible for the production of asthma syndrome which can persist after the acute infection. This study evaluated the role of chemokine RANTES in airway inflammation in RSV bronchiolitis. METHODS: RANTES in nasal secretion examined in 20 infants with RSV bronchiolitis (RSV group) and 22 infants with non-RSV bronchiolitis (non-RSV group) and 10 age-matched controls. Eosinophil cationic protein (ECP) was determined to evaluate the RANTES-induced eosinophil activation. The severity of disease in RSV group was investigated by the presence of hypoxemia and the duration of wheezing. RESULTS: RANTES in RSV group (131+/-77 pg/mL) was significantly higher than those in non-RSV group (55+/-41 pg/mL) and controls (16+/-13 pg/mL) (P=0.0002, P= 0.0001, respectively). ECP in RSV group (49+/-57 ng/mL) was significantly higher than in controls (6.4+/-12.3 ng/mL) (P<0.05). RANTES and ECP concentrations showed significant correlation in both RSV and non-RSV groups (r=0.59, P<0.01 and r=0.64, P<0.01, respectively). Concentration of RANTES in RSV group was not significantly higher in infants with severe symptoms than in those with mild symptoms. CONCLUSION: RANTES, an effective eosinophil chemoattractant and activator, may play a role in the pathogenesis of airway inflammation and later airway hyperreactivity induced by RSV bronchiolitis in infants.
Anoxia ; Asthma ; Bronchiolitis* ; Chemokine CCL5* ; Eosinophil Cationic Protein ; Eosinophils* ; Humans ; Infant ; Inflammation ; Respiratory Sounds ; Respiratory Syncytial Viruses*

In order to investigate the role of adenovirus in diarrheal children, we evaluated 907 children with diarrhea and 193 children without diarrhea for a 22-month. Stools were tested for group A rotavirus antigen and for adenovirus types 40/41 (Ad 40/41) by using ELISA, cell technique and indirect immunofluorescent method. Adenovirus was detected in 10.1% of the diarrheal children and 3.1% of the non-diarrheal children. Ad40/41 was detected in 4.85% of the diarrheal children. Other nonenteric adenovirus was detected in 5.29% of the diarrheal children. In addition, 24% of the adenovirusinfected children excreted rotavirus simultaneously. Rotavirus was found in 57.1% of the diarrheal patients. Among the diarrheal children. 88% of those with adenovirus were younger than 24 months. Although peaks of adenovirus infection were detected in July and Autumn in the study, there is no apparent seasonal trend with adenovirus. The average duration of admission caused by adenoviral infection was 4.9 days and 88% of the cases accompanied by fever. Stool occult blood test revealed positive reaction in 66.3% of the cases and serum aminotransferase activities transiently elevated in 5.4% of the cases. Diarrhea with more than 10 stools per day, vomiting, or fever in adenovirusinfected children were similar with ratavirus, where as the first two manifestions were associated with confection of rotavirus and adenovirus. Nine out of 92 cases(9.8%) of the gastroenteritis caused by adenovirus revealed intussusception. We conclude that Ad40/41 is an important cause of diarrhea among infants and children, and non-enteric adenovirus is considered to be a cause of diarrhea, but their role in diarrheal children should be further studied.
Adenoviridae Infections ; Adenoviridae* ; Candy ; Child* ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Fever ; Gastroenteritis ; Humans ; Infant ; Intussusception ; Occult Blood ; Rotavirus ; Seasons ; Vomiting

Rituximab, a chimeric anti-CD20 IgG1 monoclonal antibody, has been used as a rescue therapy for steroid-dependent or refractory nephrotic syndrome. However, the adverse effects of rituximab are yet to be investigated. We report a case of a 9-year-old boy with steroid-dependent nephrotic syndrome who developed Kikuchi-Fujimoto disease after several cycles of rituximab therapy. Kikuchi-Fujimoto disease is a benign, self-limited necrotizing histiocytic lymphadenitis of unknown etiology. In the present case, Kikuchi-Fujimoto disease developed when the peripheral blood B-cell count of the patient was at nadir, and the lesion regressed slowly but spontaneously after recovery of the B-cell count. To our knowledge, although the pathologic diagnosis of Kikuchi-Fujimoto disease was unavailable, this is the first report of Kikuchi-Fujimoto disease with clinical diagnosis as a possible adverse effect of rituximab.
Antibodies, Monoclonal, Murine-Derived ; B-Lymphocytes ; Child ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Immunoglobulin G ; Lymphadenitis ; Nephrotic Syndrome ; Rituximab

Ki-1 positive anaplastic large cell lymphoma is a newly described high-grade lymphoma and is defined by histopathological and immunologic criteria. We experienced a case of systemically involving Ki-1 positive anaplastic large cell lymphoma in a 44 year- old female which initially manifested as pleural effusion. Abdominopelvic CT scan showed the evidence of marked lymphadenopathy in retroperitoneal and both external and inguinal lymph nodes. On cytologic examination of pleural fluid, tumor cells revealed pleomorphic large isolated cells with prominent nucleoli and abundant cytoplasms. The nuclei were large with irregular profiles including some deep invaginations. Also, occasional multilobed/ multinucleated and binucleated nuclei were seen. Immunohistochemical examination was performed to differentiate from the undifferentiated adenocarcinoma, Hodgkin's disease, non-Hodgkin's lymphoma and malignant histiocytosis. The neoplastic cells were positive for leukocyte common antigen, CD3, CD30(Ki-1) but negative for cytokeratin, epithelial membrane antigen, and CD15. A histologic diagnosis of Ki-1 positive anaplastic lymphoma was made by biopsies of the inguinal lymph node, polypoid lesions of the stomach and cecum.
Adenocarcinoma ; Amyloid ; Antigens, CD45 ; Biopsy ; Cecum ; Child* ; Cytoplasm ; Diagnosis ; Female ; Histiocytic Sarcoma ; Hodgkin Disease ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Mucin-1 ; Multiple Myeloma ; Pleural Effusion ; Stomach ; Tomography, X-Ray Computed