This case involves a man in his 60s who was undergoing rituximab therapy and developed COVID-19 pneumonia and showed persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Despite treatments with dexamethasone, remdesivir, tocilizumab, and other drugs, the patient remained SARS-CoV-2 positive and ultimately died of respiratory failure. Patients receiving B-cell depletion therapy have an increased risk of persistent viral infections due to immunosuppression, underscoring the importance of early intervention with antiviral drugs and neutralizing antibodies in such cases.

BACKGROUND/AIMS: Sclerotherapy with aluminum potassium sulfate and tannic acid (ALTA) has a potent effect on internal hemorrhoids. In this retrospective study, we compared the effects of endoscopic ALTA therapy and standard ALTA therapy.METHODS: We investigated patients who underwent treatment for internal hemorrhoids at our institution between 2014 and 2016. They were divided into a standard ALTA group (n=33, treated using proctoscopy) and an endoscopic ALTA group (n=48). We compared the clinical findings between the 2 groups.RESULTS: There were no intergroup differences in background factors. The mean ALTA dose was 21.9±7.2 mL and 17.8±3.4 mL in the standard and endoscopic ALTA groups, respectively (p<0.01). Adverse events occurred in 4 patients (12.1%) from the standard ALTA group and 6 patients (12.5%) from the endoscopic ALTA group. In both groups, the patients reported good satisfaction with the therapeutic effect at 1 month after the procedure. Hemorrhoids recurred in 2 patients (6.3%) from the standard ALTA group and 4 patients (8.3%) from the endoscopic ALTA group.CONCLUSIONS: Endoscopic ALTA sclerotherapy is equivalent to standard ALTA therapy in terms of efficacy, adverse events, and recurrence. Therefore, it is a useful non-surgical option for patients with internal hemorrhoids who prefer a less invasive treatment.
Aluminum ; Endoscopy ; Hemorrhoids ; Humans ; Potassium ; Recurrence ; Retrospective Studies ; Sclerotherapy ; Tannins

Using various types of monoclonal antibodies and flow cytometer, whole blood analysis were conducted on subsets of lymphocytes taken from peripheral blood samples of healthy persons and umbilical cord blood samples of mature babies.
The findings were as follows:
(1) Normal values of healthy persons (Mean ± SD) were: T-cell phenotypes-OKT3⁺: 66.2 ± 9.4%, OKT4⁺: 40.9±8.3%, OKT8⁺: 28.2±6.6%, OKT11⁺: 80.1±4.8%, OKT4/OKT8 ratio: 1.57±0.60; B-cell phenotype-SmIg (polyvalent) ⁺: 15.9±6.5%; others-OKTal⁺: 12.9±3.2%, Leu7⁺: 16.2±8.9%.
(2) Of the healthy persons, 17% showed 1.0 or below and 6.5% showed 2.5 or above, in the OKT4/OKT8 ratio.
(3) The OKT4+ OKT8/OKT3 ratio was significantly high (P<0.001) in the babies and persons of 40 years and over.
(4) Physiologic variations were noted in some degree in children and the aged, and between men and women. The individual values of the lymphocyte subsets were almost constant, but the difference between individuals was large. It is suggested that the difference of the immune response of each individual or each family partly depends on the different values of the lymphocyte subsets.