OBJECTIVE: Human immunodeficiency virus (HIV) infection has been known to damage the microstructural integrity of white matter (WM). However, only a few studies have assessed the brain regions in HIV-associated neurocognitive disorders (HAND) with diffusion tensor imaging (DTI). Therefore, we sought to compare the DTI data between HIV patients with and without HAND using tract-based spatial statistics (TBSS). MATERIALS AND METHODS: Twenty-two HIV-infected patients (10 with HAND and 12 without HAND) and 11 healthy controls (HC) were enrolled in this study. A whole-brain analysis of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity was performed with TBSS and a subsequent 20 tract-specific region-of-interest (ROI)-based analysis to localize and compare altered WM integrity in all group contrasts. RESULTS: Compared with HC, patients with HAND showed decreased FA in the right frontoparietal WM including the upper corticospinal tract (CST) and increased MD and RD in the bilateral frontoparietal WM, corpus callosum, bilateral CSTs and bilateral cerebellar peduncles. The DTI values did not significantly differ between HIV patients with and without HAND or between HIV patients without HAND and HC. In the ROI-based analysis, decreased FA was observed in the right superior longitudinal fasciculus and was significantly correlated with decreased information processing speed, memory, executive function, and fine motor function in HIV patients. CONCLUSION: These results suggest that altered integrity of the frontoparietal WM contributes to cognitive dysfunction in HIV patients.
Anisotropy ; Automatic Data Processing ; Brain ; Corpus Callosum ; Diffusion Tensor Imaging ; Executive Function ; Hand ; HIV ; Humans* ; Memory ; Neurocognitive Disorders* ; Pyramidal Tracts ; White Matter*

Urinary tract infection is one of the causes of acute renal failure. But it has been reported rarely, so we must consider another etiologies before diagnosis. Abdominal ultrasonogram is a good non-invasive technique for radiologic diagnosis or for differential diagnosis, but it's possible that tiny abscesses and small lesions of focal bacterial nephritis might be missed. CT is the best radiologic method to diagnose renal lesion, especially acute bacterial nephritis. Nevertheless, CT has several problems, including contrast-induced nephropathy, exposure to radiation. We experienced a severe form of anuric acute renal failure secondary to acute bacterial nephritis due to E. coli infection. The patient's renal lesion was not visualized on the ultrasonogram and his uremic symptom was severe. So we decided to do a kidney biopsy to find another possible cause of acute renal failure. The renal biopsy finding showed acute bacterial nephritis, and abdominal CT reconfirmed it. His serum creatinine increased to a maximum 8.5 mg/dL, but decreased to 1.24 mg/dL through continuous antibiotic therapy. We emphasize that urinary tract infection is not a rare cause of acute renal failure any more, and that positive diagnositic approaches, including kidney biopsy, are important for accurate and early diagnosis.
Abscess ; Acute Kidney Injury ; Biopsy* ; Creatinine ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Kidney ; Nephritis* ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Tract Infections