PURPOSE: To evaluate lung parenchymal change as seen on chest radiographs and high-resolution CT (HRCT) afterthe resolution of adenovirus pneumonia (a common cause of lower respiratory infection in infants and children),and the usefulness of HRCT during follow-up. MATERIAL AND METHODS: Four to 13(mean, 8) months after recovery, tenpatients infected with adenovirus pneumonia underwent HRCT and chest radiographs. Eight were boys and two weregirls, and their mean age was 26(range, 14-45) monthes. Adenovirus pneumonia had been confirmed by viral isolationin culture or serologic test. CT scanning was performed during quiet breathing ; collimation was 2mm and theinterval from apex to diaphragm was 5-10mm. Lung settings were 1600 HU (window width) and -700 HU(level). CTfindings were assessed and compared with chest radiographs by two chest radiologists, who reached a consensus. Thepatients were clinically followed up for one year. RESULT: On chest radiographs, hyperlucent lung was seen in 8of 10 patients (80%) ; in one other there was partial collapse, and in one, findings were normal. The most commonHRCT finding was a mosaic pattern of lung attenuation with decreased pulmonary vascularity in the area of lowerattenuation ; this was seen in 8 of 10 patients (80%). Other findingss were partial collapse, bronchiectasis, andbronchial wall thickening, each seen in two patients, and reticulonodular density, seen in one. In two patientsHRCT findings were normal ; in one of these, chest findings were noraml but a mosaic pattern of lung attenuationwas found in all lobes. During follow-up, three patients wheezed continously. CONCLUSION: In cases of adenoviruspneumonia, HRCT demonstrated more specific parenchymal change than did chest radiographs ; a mosaic pattern oflung attenuation was seen, with decreased pulmonary vascularity in areas of lower attenuation ; bronchiectasis,bronchial wall thickening, and reticulo-odular density were also noted. These findings were presumably due tobronchiolitis obliterans, a well known complication of adenovirus pneumonia, and are prognostically helpful.
Adenoviridae* ; Bronchiectasis ; Bronchiolitis Obliterans ; Consensus ; Diaphragm ; Follow-Up Studies ; Humans ; Infant ; Lung* ; Lung, Hyperlucent ; Pneumonia* ; Radiography, Thoracic* ; Respiration ; Serologic Tests ; Thorax* ; Tomography, X-Ray Computed

BACKGROUND: Recently, CD34 antigen expressed on hematopoietic stem cells which is not detected on non-Hodgkin lymphoma (NHL), multiple myeloma and most solid tumors, is identified. In autologous bone marrow transplantation (BMT), positive selection of CD34+ cells may be used to provide hematopoietic stem cells capable of engraftment but depleted of tumor cells. And it can be used to depletion of T lymphocytes to prevent the graft versus host disease (GVHD) in allogeneic BMT. So we performed this study to evaluate the efficacy of purification of CD34+ stem cells with CEPRATE SC Stem Cell Concentration System (CellPro Inc.) and to assess the influence of CD34+ stem cells on engraftment. METHODS: Peripheral blood stem cells were mobilized with cyclophosphamide (except one patient with malignant lymphoma) and G-CSF and harvested using CS-3000 (Fenwall). CD34+ stem cells counted by FACScan (Becton-Dickinson). The conditioning regimens were ICE (Ifosphamide/Carboplatin/Etoposide) in breast cancer, high dose melphalan in multiple myeloma, BEAC (BCNU/Etoposide/Ara-C/Cyclophosphamide) in NHL, TBI (total body irradiation) with cyclophosphamide in acute lymphocytic leukemia (ALL) and busulfan with cyclophosphamide in myelodysplastic syndrome (MDS). We used G-CSF (10 microgram/kg) after transplantation in all patients. RESULTS: Eleven patients, six with high risk or metastatic breast cancer, one with refractory multiple myeloma, one with acute lymphocytic leukemia (transformed from lymphoblasticlymphoma), two with relapsed malignant lymphoma, one with myelodysplastic syndrome (HLA one-locus mismatched allogeneic BMT case, for T lymphocyte depletion) were treated. Hematopoietic stem cells were harvested from autologous peripheral blood in all patients except one patient with MDS whose stem cells were harvested from allogeneic bone marrow. Median duration and number of peripheral blood stem cell (PBSC) harvest were 15 days (13~22) and 3 times (2~8), respectively. The mean number of total stem cells and CD34+ stem cells harvested per pheresis were 204.8 (17.4~797.9)x106/kg and 3.0 (0.3~11.9)x106/kg, respectively. The mean efficacy of CD34+ hematopoietic stem cell selection by CEPRATE SC Stem Cell Concentration System was 47.7% (1.4~99.0%). The number of infused CD34+ stem cells per patient ranged from 0.34 to 4.8x106/kg (mean 2.3x106/kg). After transplantation, the median day of achieving granulocyte counts of >0.5x109/L was 10.5 days and platelet counts of >50x109/L was 14 days. CONCLUSION: CD34+ stem cells separated with CEPRATE SC Stem Cell Concentration System provided reliable and timely hematopoietic reconstitution.
Antigens, CD34 ; Blood Component Removal ; Bone Marrow ; Bone Marrow Transplantation ; Breast Neoplasms ; Busulfan ; Cyclophosphamide ; Drug Therapy* ; Graft vs Host Disease ; Granulocyte Colony-Stimulating Factor ; Granulocytes ; Hematopoietic Stem Cells* ; Humans ; Ice ; Lymphocytes ; Lymphoma ; Lymphoma, Non-Hodgkin ; Melphalan ; Multiple Myeloma ; Myelodysplastic Syndromes ; Platelet Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stem Cells ; T-Lymphocytes

Leptospirosis is a zoonotic disease of worldwide distribution that is caused by spirochetes known as Leptospira; more than 20 serogroups and more than 200 serovars are known. The disease has seasonal incidence occurring in the late summer or early fall. The typical severe case of leptospirosis is known as Weil's disease; it is characterized by hepatic and renal involvement and is common in Korea. Elevated amylase can be seen when ARF is associated but true acute pancreatitis is an uncomon complication of leptospirosis and only seven cases of well documented pancreatitis have been described abroad, with there was no case report in Korea yet. We experienced a 55-year old male patient who had Weil's disease associated with acute pancreatitis which was confirmed by elevated amylase and lipase with pancreatic swelling and peripancreatic fat infiltration on abdomen CT.
Abdomen ; Amylases ; Humans ; Incidence ; Korea ; Leptospira ; Leptospirosis ; Lipase ; Male ; Middle Aged ; Pancreatitis* ; Seasons ; Spirochaetales ; Weil Disease* ; Zoonoses

Leptospirosis is a zoonotic disease of worldwide distribution that is caused by spirochetes known as Leptospira; more than 20 serogroups and more than 200 serovars are known. The disease has seasonal incidence occurring in the late summer or early fall. The typical severe case of leptospirosis is known as Weil's disease; it is characterized by hepatic and renal involvement and is common in Korea. Elevated amylase can be seen when ARF is associated but true acute pancreatitis is an uncomon complication of leptospirosis and only seven cases of well documented pancreatitis have been described abroad, with there was no case report in Korea yet. We experienced a 55-year old male patient who had Weil's disease associated with acute pancreatitis which was confirmed by elevated amylase and lipase with pancreatic swelling and peripancreatic fat infiltration on abdomen CT.
Abdomen ; Amylases ; Humans ; Incidence ; Korea ; Leptospira ; Leptospirosis ; Lipase ; Male ; Middle Aged ; Pancreatitis* ; Seasons ; Spirochaetales ; Weil Disease* ; Zoonoses