No abstract available.
Escherichia ; Hemolytic-Uremic Syndrome

BACKGROUND: Viral myocarditis is considered as a cause of dilated cardiomyopathy. At present, two pathogenic mechanisms may be involved in the pathogenesis of viral myocarditis and subsequent cardiomyopathy. First, the virus infection of myocyte may directly lead to either cell death or persistent metabolic dysfunction. Second, virus-induced immune or autoimmune mechanism may play a role. METHODS: To test the therapeutic efficacy of immunosuppression with cyclophophamide(CYP) on coxsackievirus B3(CB3) myocarditis, 10-14 week-old Balb/c mice were inoculated with 4000 plaque-forming units of CB3. In experiment 1, CYP (100mg/kg/day subcutaneous injection, s.c) was administrated daily on days 1-7(group 2, n=16). In experiment 2, CYP 30mg/kg/day s.c(group 3, n=32) or CYP 100mg/kg/day s.c(group 4, n=32) were administrated on days 8-14. The animals of infected controls(group 1, n=26) and group 2, 3, 4 were dissected at days 4, 7, 15, 22 and spleen, heart, thymus and body weights were measured. RESULTS: In experiment 1. survival rate in group 2 on day 7, 15 were low compared with group 1(85%, 0% vs 100%, p<0.05). and myocardial virus titers in group 2 on day 4 was 50 times, and on day 7, 1000 times higher compared with group 1, Histologically, on day 7, focal cellular infiltrations were prominent findings in group 1, but diffuse myocardial necrosis without cellular infiltration were observed in group 2. In experiment 2, survival rate, cardiac histopathology myocardial virus titer and serum neutralizing antibody titers did not differ among groups 1, 3 and 4. In experiment 1 and 2, the spleen-to-body-weight and thymus-to-body-weight ratios were significantly lower in CYP treated groups than those in controls and marked cellular depletions in spleens and thymus were observed in CYP treated groups. CONCLUSIONS: As the results of above, it can be concluded that the immunosuppression during viremic phase of murine viral myocarditis aggravated the myocardial necrosis, and during aviremic phase, the administration of CYP didnot affect the process of viral myocarditis. Thus, direct viral mechanisms in the production of cardiomyocyte injury in CB3-infected mice appear to bo more important than cell mediated immune mechanism. To understand relevant pathogenic mechanisms of clinical myocarditis and dilated cardiomyopathy resulting from viral infection, the experimental study expanding into nonmurine animals and into various models using other infectious agents may be required.
Animals ; Antibodies, Neutralizing ; Body Weight ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cell Death ; Cyclophosphamide* ; Heart ; Immunosuppression ; Injections, Subcutaneous ; Mice ; Muscle Cells ; Myocarditis* ; Myocytes, Cardiac ; Necrosis ; Spleen ; Survival Rate ; Thymus Gland ; Viral Load

No abstract available.
Small Cell Lung Carcinoma*

A rare case of the tongue is encountered and we report the case with the literature review on osteoma, chondroma, and osteochondroma of the tongue. The most common oral extraskeletal site is the tongue. The occurrence of osteochondroma in soft tissues of the oral cavity is rather uncommon. They are usually seen on the lateral border and foramen cecum of the tongue. It has been suggested that they arise from metaplastic formation or remnants of branchial arch cartilage. Following surgical removal, recurrence has not been reported. The etiology and pathogenesis remain obscure. The possible causes of this unusual neoplasm are discussed.
Branchial Region ; Cartilage ; Cecum ; Chondroma ; Mouth ; Osteochondroma* ; Osteoma ; Recurrence ; Tongue*

A 71-year-old woman with minimal change disease visited our clinic complaining of pleuritic chest pain. Cefepime was given under the impression that she had pneumonia. Three days after cefepime administration, she became unconscious. A brain MRI scan was non-revealing and an EEG showed triphasic waves. As there was no evidence of septic, uremic or hepatic encephalopathy, we suspected cefepime-induced neurotoxicity. Cefepime was stopped and she underwent hemodialysis to decrease the blood levels of the drug. Following hemodialysis, she regained consciousness.
Aged ; Brain ; Cephalosporins ; Chest Pain ; Consciousness ; Electroencephalography ; Female ; Hepatic Encephalopathy ; Humans ; Magnetic Resonance Imaging ; Nephrosis, Lipoid ; Neurotoxicity Syndromes ; Pneumonia ; Renal Dialysis ; Unconscious (Psychology)

Donor-specific anti-human leukocyte antigen antibodies (DSA) following kidney transplantation predict the evolution of humoral rejection and reduced graft survival. Rapid, complete elimination of DSA during antibody-mediated rejection (AMR) is rarely achieved with traditional antihumoral therapies. We report the case of a 39-year-old female who was admitted for increasing azotemia and diagnosed with AMR based on diffusely positive histological changes on C4d immunostaining. In this case, bortezomib reversed the histological changes and induced a reduction in DSA. Proteasome-inhibitor-based combination therapy is a potential means for rapid DSA elimination in antibody-mediated rejection in renal transplant recipients.
Adult ; Antibodies ; Azotemia ; Boronic Acids ; Complement C4b ; Female ; Graft Survival ; HLA Antigens ; Humans ; Kidney Transplantation ; Leukocytes ; Peptide Fragments ; Proteasome Inhibitors ; Pyrazines ; Rejection (Psychology) ; Transplants ; Bortezomib

Donor-specific anti-human leukocyte antigen antibodies (DSA) following kidney transplantation predict the evolution of humoral rejection and reduced graft survival. Rapid, complete elimination of DSA during antibody-mediated rejection (AMR) is rarely achieved with traditional antihumoral therapies. We report the case of a 39-year-old female who was admitted for increasing azotemia and diagnosed with AMR based on diffusely positive histological changes on C4d immunostaining. In this case, bortezomib reversed the histological changes and induced a reduction in DSA. Proteasome-inhibitor-based combination therapy is a potential means for rapid DSA elimination in antibody-mediated rejection in renal transplant recipients.
Adult ; Antibodies ; Azotemia ; Boronic Acids ; Complement C4b ; Female ; Graft Survival ; HLA Antigens ; Humans ; Kidney Transplantation ; Leukocytes ; Peptide Fragments ; Proteasome Inhibitors ; Pyrazines ; Rejection (Psychology) ; Transplants ; Bortezomib

BACKGROUND/AIMS: Kidney transplantation (KT) reportedly provides a significant survival advantage over dialysis in diabetic patients. However, KT outcome in diabetic patients compared with that in non-diabetic patients remains controversial. In addition, owing to recent improvements in the outcomes of KT and management of cardiovascular diseases, it is necessary to analyze outcomes of recently performed KT in diabetic patients. METHODS: We reviewed all diabetic patients who received living donor KT between January 2008 and December 2011. Each patient was age- and sex-matched with two non-diabetic patients who received living donor KT during the same period. The outcomes of living donor KT were compared between diabetic and non-diabetic patients. RESULTS: Among 887 patients, 89 diabetic patients were compared with 178 non-diabetic patients. The incidence of acute rejection was not different between the diabetic and non-diabetic patients. Urinary tract infection and other infections as well as cardiovascular events occurred more frequently in diabetic patients. However, diabetes, cardiovascular disease, and infection were not significant risk factors of graft failure. Late rejection (acute rejection after 1 year of transplantation) was the most important risk factor for graft failure after adjusting for diabetes mellitus (DM), human leukocyte antigen mismatch, rejection and infection (hazard ratio, 56.082; 95% confidence interval, 7.169 to 438.702; p < 0.001). Mortality was not significantly different between diabetic and non-diabetic patients (0 vs. 2, p = 0.344 by log-rank test). CONCLUSIONS: End-stage renal disease patients with DM had favorable outcomes with living donor kidney transplantation.
Cardiovascular Diseases ; Diabetes Mellitus ; Dialysis ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Leukocytes ; Living Donors* ; Mortality ; Risk Factors ; Transplants ; Urinary Tract Infections

HMG-CoA reductase inhibitors (statins) are widely used to treat hypercholesterolemia. Among the adverse effects associated with these drugs are statin-associated myopathies, ranging from asymptomatic elevation of serum creatine kinase to fatal rhabdomyolysis. Fluvastatin-induced fatal rhabdomyolysis has not been previously reported. We describe here a patient with liver cirrhosis who experienced fluvastatin-induced fatal rhabdomyolysis. This patient had been treated with simvastatin (20 mg/day) for coronary artery disease and was switched to fluvastatin (20 mg/day) 10 days before admission. He was also taking aspirin, betaxolol, candesartan, lactulose, and entecavir. Rhabdomyolysis was complicated and continued to progress. He was treated with massive hydration, urine alkalization, intravenous furosemide, and continuous renal replacement therapy for acute renal failure, but eventually died due to rhabdomyolysis complicated by hepatic failure. In conclusion, fluvastatin should be used with caution in patients with liver cirrhosis, especially with other medications metabolized with CYP2C9.
Coronary Artery Disease/complications/*drug therapy ; Fatal Outcome ; Fatty Acids, Monounsaturated/administration & dosage/*adverse effects/therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage/*adverse effects/therapeutic use ; Indoles/administration & dosage/*adverse effects/therapeutic use ; Liver Cirrhosis/*complications ; Male ; Middle Aged ; Rhabdomyolysis/*chemically induced ; Simvastatin/administration & dosage/therapeutic use

Autoimmune pancreatitis is now considered to be a systemic fibroinflammatory disease that can involve multiple organs. As it is associated with IgG4-positive plasma cells by an autoimmune mechanism, extrapancreatic organs as well as the pancreas could be affected with a lymphoplasmacytic infiltrate. The proximal bile duct, the salivary gland, the retroperitoneum and the kidney are well known to be involved with, but less is known about the involvement of hollow viscus which is pathologically associated with autoimmune pancreatitis. We report here on a case of gastric involvement in a 53-year-old man with autoimmune pancreatitis.
Bile Ducts ; Humans ; Immunoglobulin G ; Kidney ; Middle Aged ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic ; Plasma Cells ; Salivary Glands