Toxoplasmosis of the central nervous system occurs in 3 to 40 percent of all patients with the acquired immunodeficiency syndrome (AIDS), and it is the most common opportunistic infection to cause encephalitis or focal intracerebral lesions. We experienced two cases of cerebral toxoplasmosis in AIDS patients presenting as high fever, seizure and general weakness.
Acquired Immunodeficiency Syndrome ; Central Nervous System ; Encephalitis ; Fever ; Humans ; Opportunistic Infections ; Seizures ; Toxoplasmosis ; Toxoplasmosis, Cerebral*

PURPOSE: To identify candidate genes related with urolithiasis, the vitamin D receptor (VDR) gene polymorphisms were searched. MATERIALS AND METHODS: Between July 2002 and June 2003, 212 healthy subjects, used as normal controls, and 155 patients with urolithiasis were examined. The control volunteers had no histories of urolithiasis, familial stone disease or osteoporosis. The patients underwent a stone metabolic study and stone analysis. 49 patients received a stone analysis, of which, 45 had calcium stones. Using a polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) analysis of peripheral blood, the association between the VDR gene BsaM I polymorphism and urolithiasis was evaluated. The polymorphism was divided into three groups: excisable (C/C), unexcisable (T/T) and heterozygote (C/T). RESULTS: For the VDR gene BsaM I polymorphism, there was no statistically difference between the control and the urolithiasis groups. The distribution of VDR genotypes in the 155 patients with urolithiasis was as follows: C/C, 139 (89.7%); C/T, 12 (7.7%) and T/T, 4 (2.6%), which was not significantly different from that in the 212 control subjects: C/C, 195 (92.0%); C/T, 14 (6.6%) and T/T, 3 (1.4%). The frequencies of VDR genotypes in the 45 patients with calcium stone were: C/T (13.3%) and T/T (6.7%), and that of the T allele 13.3%, which were significantly different from those of the controls: C/T (6.6%) and T/T (1.4%) and that of the T allele, 4.7% (p<0.05). CONCLUSIONS: VDR BsaM I polymorphism appears to be a good candidate for a genetic marker in calcium stone disease. The T allele especially may be in charge of the pathogenesis of calcium stones. Further analysis and case accumulation are required to identify the genetic marker of urolithiasis. (Korean J Urol 2004;45:1143-1147)
Alleles ; Calcium* ; Genetic Markers* ; Genotype ; Heterozygote ; Humans ; Osteoporosis ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitriol* ; Urolithiasis ; Vitamin D* ; Vitamins* ; Volunteers

PURPOSE: To identify candidate genes related with urolithiasis, the vitamin D receptor (VDR) gene polymorphisms were searched. MATERIALS AND METHODS: Between July 2002 and June 2003, 212 healthy subjects, used as normal controls, and 155 patients with urolithiasis were examined. The control volunteers had no histories of urolithiasis, familial stone disease or osteoporosis. The patients underwent a stone metabolic study and stone analysis. 49 patients received a stone analysis, of which, 45 had calcium stones. Using a polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) analysis of peripheral blood, the association between the VDR gene BsaM I polymorphism and urolithiasis was evaluated. The polymorphism was divided into three groups: excisable (C/C), unexcisable (T/T) and heterozygote (C/T). RESULTS: For the VDR gene BsaM I polymorphism, there was no statistically difference between the control and the urolithiasis groups. The distribution of VDR genotypes in the 155 patients with urolithiasis was as follows: C/C, 139 (89.7%); C/T, 12 (7.7%) and T/T, 4 (2.6%), which was not significantly different from that in the 212 control subjects: C/C, 195 (92.0%); C/T, 14 (6.6%) and T/T, 3 (1.4%). The frequencies of VDR genotypes in the 45 patients with calcium stone were: C/T (13.3%) and T/T (6.7%), and that of the T allele 13.3%, which were significantly different from those of the controls: C/T (6.6%) and T/T (1.4%) and that of the T allele, 4.7% (p<0.05). CONCLUSIONS: VDR BsaM I polymorphism appears to be a good candidate for a genetic marker in calcium stone disease. The T allele especially may be in charge of the pathogenesis of calcium stones. Further analysis and case accumulation are required to identify the genetic marker of urolithiasis. (Korean J Urol 2004;45:1143-1147)
Alleles ; Calcium* ; Genetic Markers* ; Genotype ; Heterozygote ; Humans ; Osteoporosis ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitriol* ; Urolithiasis ; Vitamin D* ; Vitamins* ; Volunteers

BACKGROUND: Patients with unstable angina or non Q wave myocardial infarction still have an elevated risk for subsequent cardiac events. Therefore early assessment of the risk of future cardiac events is important. In this study, prognostic value of troponin l and myoglobin was evaluated and compared with other known early available risk indicators. METHODS: Serum troponin l and myoglobin were measured at presentation and 8 hours, 16 hours, and 24 hours thereafter in 126 patients with unstable angina (n=70) or non Q myocardial infarction (n=56) from Jan 1998, through Feb 2000. Echocardiography was performed with calculation of wall motion score index. The incidence of cardiac death or myocardial infarction was compared between patients with normal troponin l, myoglobin and abnormal ones, respectively. RESULTS: (1) At 6 months, 1 death (2.2%) and 1 myocardial infarction (2.2%) occured in the 45 unstable angina patients with normal troponin l compared with 3 deaths (12.0%) and 8 myocardial infarctions (32.0%) in the 25 unstable angina patients with elevated troponin l. (2) At 6 months, 1 death (1.7%) and 3 myocardial infarctions (5.2%) occured in the 58 unstable angina patients with normal myoglobin compared with 3 deaths (25.0%) and 6 myocardial infarctions (50.0%) in the 12 unstable angina patients with elevated myoglobin.(3) When the analysis was limited to patients with normal baseline troponin l (< or = 0.4 ng/dl: n=45), increased myoglobin level remained significantly associated with increased incidence of cardiac deaths or myocardial infarction compared with normal myoglobin level (16.7% vs 0%). (4) Together with age, diabetes, wall motion score index, troponin I and myoglobin levels were identified as independent prognostic variables for myocardial infarction or cardiac death in a multivariate logistic regression analysis. (5) The maximal troponin l and myoglobin value obtained during the first 24 hours provides independent and important prognostic information regardless of whether the patient is classified as having unstable angina or non Q wave myocardial infarction. CONCLUSION: The maximum troponin l and myoglobin obtained during the first 24 hours provides independent and important prognostic information in patients with unstable angina or non Q wave myocardial infarction.
Angina, Unstable ; Coronary Artery Disease* ; Coronary Vessels* ; Death ; Echocardiography ; Humans ; Incidence ; Logistic Models ; Myocardial Infarction ; Myoglobin* ; Prognosis ; Troponin I ; Troponin*

Idiopathic myelofibrosis is characterized by replacement of the bone marrow with fibrous tissue and the development of extramedullary hematopoiesis. The latter involves mainly the spleen and liver but also occurs in lymph nodes, kidneys, retroperitoneal fat, and more rarely, the skin. We report a 48-year-old male with idiopathic myelofibrosis who was admitted due to numerous papules and nodules on his trunk. The skin lesions were histologically defined as cutaneous extramedullary hematopoiesis.
Bone Marrow ; Dermis ; Hematopoiesis, Extramedullary* ; Humans ; Intra-Abdominal Fat ; Kidney ; Liver ; Lymph Nodes ; Male ; Middle Aged ; Primary Myelofibrosis* ; Skin ; Spleen

The number of persons with HIV infection in Korea have increased steadily, total number of HIV infection in Korea were 478 on August, 1995. To investigate the clinicoimmunologic manifestation of AIDS in Korea, we reviewed complete blood counts (CBC), CD4 counts, serum beta2-microglobulin level, opportunistic infections and cause of death for 19 AIDS patients who had been admitted or visited at Pusan national university hospital during the period of January, 1990 to August, 1995. 1) The predominant mode of HIV transmission was heterosexual contact(18), other modes of transmission were homosexual contact(1). Clues of diagnosis of HIV infection were routine occupational health examination(14), and opportunistic infection symptoms such as fever, coughing(4). 2) Mean CD4 cell counts(/mm3) were 53 +/- 72 totally, 22 +/- 27 for 8 dead patients at mean 2 month before, 91 +/- 87 for 7 living patients. There were not significant difference(p>0.05). 3) Serum beta2-microglobulin(MG;ug/ml) was measured at 12 patients, mean serum beta2-MG level was4.8 +/- 7.3 totally, 7.1 +/- 10.3 for 6 dead patients at mean 1.3 month before, 2.5 +/- 0.4 for 6 living patients. There were not significant(p>0.05). 4) At CBC examination, WBC(/mm3) was 5,932 +/- 2,899 totally, 5,452 +/- 3,436 for 10 dead patients, 6,500 +/- 2,221 for 9 living patients(p>0.05). Hb(g/dl) was 11,4 +/- 2.8 totally, 9.4 +/- 1.8 for dead patients, 13.6 +/- 1.8 for living patients(p<0.05). Lymphocyte count(/mm) was 1,255 +/- 800 totally, 731 +/- 424 for dead patients, 1,838716 for living patients(p<0.05). ESR(mm/h) was 72 +/- 47 totally, 97 +/- 33 for dead patients, 47 +/- 47 for living patients(p<0.05). 5) Opportunistic infections had developed at 14 patients, candidiasis 7, pneumocystis carinii pneumonia 5, tuberculosis 3, cytomegalovirus infection 2, herpes zoster 3, toxoplasmosis 1, cryptococcal infection 2, bacterial pneumonia 5, and herpes simplex l. Malignant lymphoma had developed in 1 patient. 6) Mean survival interval from diagnosis of HIV infection to death was 32.8 +/- 19.1 months, and the most common cause of death was pneumocystis carinii pneumonia, and other causes of death were meningitis, bacterial pneumonia and AIDS-wasting syndrome. Based on these results, We concluded that CD4 counts, serum beta2-microglobulin level, Hb, total lymphocyte count and ESR in AIDS patients are specific laboratory markers of progression and prognosis of AIDS, the most common opportunistic infection was candidiasis, and the most common cause of death in AIDS patients was pneumocystis carinii pneumonia.
Biomarkers ; Blood Cell Count ; Busan ; Candidiasis ; Cause of Death ; CD4 Lymphocyte Count ; Cytomegalovirus Infections ; Diagnosis ; Fever ; Herpes Simplex ; Herpes Zoster ; Heterosexuality ; HIV ; HIV Infections ; Homosexuality ; Humans ; Korea ; Lymphocyte Count ; Lymphocytes ; Lymphoma ; Meningitis, Bacterial ; Occupational Health ; Opportunistic Infections* ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Pneumocystis ; Prognosis ; Toxoplasmosis ; Tuberculosis