• 제목/요약/키워드: Intravenous Therapy

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Seroprevalence of Toxoplasma gondii Infection among HIV/AIDS Patients in Eastern China

  • Shen, Guoqiang;Wang, Xiaoming;Sun, Hui;Gao, Yaying
    • Parasites, Hosts and Diseases
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    • v.54 no.1
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    • pp.93-96
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    • 2016
  • Toxoplasmosis, a neglected tropical disease caused by the protozoan parasite Toxoplasma gondii, occurs throughout the world. Human T. gondii infection is asymptomatic in 80% of the population; however, the infection is life-threatening and causes substantial neurologic damage in immunocompromised patients such as HIV-infected persons. The major purpose of this study was to investigate the seroprevalence of T. gondii infection in subjects infected with HIV/AIDS in eastern China. Our findings showed 9.7% prevalence of anti-T. gondii IgG antibody in HIV/AIDS patients, which was higher than in intravenous drug users (2.2%) and healthy controls (4.7%), while no significant difference was observed in the seroprevalence of anti-Toxoplasma IgM antibody among all participants (P>0.05). Among all HIV/AIDS patients, 15 men (7.7%) and 10 women (15.9%) were positive for anti-T. gondii IgG antibody; however, no significant difference was detected in the seroprevalence of anti-Toxoplasma IgG antibody between males and females. The frequency of anti-Toxoplasma IgG antibody was 8.0%, 13.2%, 5.5%, and 0% in patients with normal immune function ($CD4^+$ T-lymphocyte count ${\geq}500cells/ml$), immunocompromised patients (cell count ${\geq}200$ and <500 cells/ml), severely immunocompromised patients (cell count ${\geq}50$ and <200 cells/ml), and advanced AIDS patients, respectively (cell count <50 cells/ml), while only 3 immunocompromised patients were positive for anti-T. gondii IgM antibody. The results indicate a high seroprevalence of T. gondii infection in HIV/AIDS patients in eastern China, and a preventive therapy for toxoplasmosis may be given to HIV/AIDS patients based on $CD4^+$ T lymphocyte count.

Oxidative and Anti-oxidative Status in Blood of Streptozotocin-induced Diabetic Piglets

  • Inoue, H.;Murakami, H.;Matsumoto, M.;Kaji, Y.
    • Asian-Australasian Journal of Animal Sciences
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    • v.24 no.6
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    • pp.818-824
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    • 2011
  • Eight LW${\times}$D crossbred, castrated weanling piglets were used to examine the effect of hyperglycemia by streptozotocin (STZ)-injection on oxidative and anti-oxidative status in circulating fluid. Every two of the eight piglets were intravenously administrated STZ at a dose of 0 (control), 100, 125 or 150 mg/kg BW, respectively, and on 15th day after the STZ-injection, some markers of the oxidative stress in circulating fluid were measured to evaluate oxidative and anti-oxidative status in the piglets. First, piglets with hyperglycemia were selected from the STZ-injected piglets as measured by the levels of fasting plasma glucose (FPG) during 2 weeks after the STZ-injection. Additionally, data obtained from the intravenous glucose tolerance test (IVGTT) on 14th day were analyzed. Secondly, the data obtained in this experiment were divided into the control group and the hyperglycemic (STZ) group, and compared. The FPG level or area under curve (AUC) for plasma glucose during the IVGTT in the STZ-induced diabetic piglets was slightly significantly (FPG, p = 0.070; AUC, p = 0.072) higher compared with the control. On the other hand, the plasma level of lipid peroxidation in the STZ-induced diabetic piglets was significantly (p<0.05) higher compared with the control. These results raise the possibility that STZ-induced diabetic piglets produced in this study can be used as a diabetic animal model to research the pathogenic mechanisms or therapy of complications in diabetic mellitus.

Severe Anemia Due to Parvovirus Infection Following Treatment with Rituximab in a Pediatric Kidney Transplant Recipient : Anemia after Treatment of Rituximab in Kidney Recipient Patient

  • Kim, Seung Yun;Lee, Hyoung Jin;Park, Eujin;Ahn, Yo Han;Ha, Il-Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.176-179
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    • 2015
  • Rituximab (RTX), a monoclonal antibody against the B-cell marker CD20, is commonly used as a treatment for antibody-mediated diseases or B-lymphocyte-mediated diseases. Destruction of B cells may reverse the disease course in many conditions; however, patients who are treated with RTX cannot respond appropriately to de novo infection due to lack of B lymphocytes. Here, we report one such case. A 7-year-old renal allograft recipient presented with severe anemia due to parvovirus infection after RTX treatment. The patient had focal segmental glomerulosclerosis and had received cadaveric kidney transplantation 6 months previously. She was treated with high-dose steroid for acute rejection and RTX for Epstein Barr Virus infection 3 months previously. At presentation, her hemoglobin level was 5.4 g/dL and leukocyte and platelet counts were normal. She had microcytic normochromic anemia and high viral load of parvovirus B19(70,578 copies/mL). Intravenous immunoglobulin ($200mg/kg{\cdot}d$) treatment controlled the progression of anemia and parvovirus infection. De novo parvovirus infection during the B lymphocyte-depletion period may have precipitated the severe anemia in this case. Close monitoring of infection is required after RTX therapy.

Activation of Innate Immunity by Lepiota procera Enhances Antitumor Activity (큰갓버섯(Lepiota procera) 추출물의 면역자극 활성에 의한 항암 증진 효과)

  • Kim, Doh-Hee;Han, Kyung-Hoon;Song, Kwan-Yong;Lee, Kye-Heui;Jo, Sun-Young;Lee, Seog-Won;Yoon, Taek-Joon
    • Korean Journal of Pharmacognosy
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    • v.41 no.2
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    • pp.115-121
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    • 2010
  • The present study was designed to explore an immunostimulating activity of crude extracts of Macrolepiota procera, and a combination therapy of cisplatin and Macrolepiota procera extracts which can potentiate the anti-cancer activity of cisplatin. For these, water extraction of Macrolepiota procera were performed at $4^{\circ}C$(MPE-4) and $100^{\circ}C$(MPE-100). In experimental metastasis of colon26-M3.1 cells, prophylactic intravenous administration of MPE ($80-2,000{\mu}g$/mouse) inhibited tumor metastasis compared with tumor control. Peritoneal macrophages stimulated with MPE produced IL-12 as well as induced tumoricidal activity. In an analysis of NK-cell activity, i.v. administration of MPE ($200{\mu}g$/mouse) significantly augmented NK cytotoxicity to YAC-1 tumor cells. The combination treatments of cisplatin ($20{\mu}g$) and MPE ($100{\mu}g$) exhibited prolongation of lifespan in colon26-M3.1 tumor bearing mouse. These results suggested that MPE stimulate immune system non-specifically and application as adjuvant in cancer treatment.

Efficacy and Safety of Aerosolized Colistin in the Treatment of Ventilator-Associated Pneumonia: A Systematic Review and Meta-analysis (기계환기관련 폐렴치료 시 Aerosolized Colistin의 효과 및 안전성에 대한 체계적 문헌 고찰 및 메타분석)

  • Paik, Minwoo;Jeung, Kyeonghye;Kim, Eun Young
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.207-213
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    • 2017
  • Background: It is recommended to use aerosolized (AS) colistin in patients undergoing mechanical ventilation therapy as an adjunctive in the latest guidelines, in spite of high nephrotoxicity and limited studies. In this study, systematic reviews and meta-analyzes were conducted to evaluate the safety and efficacy of AS colistin in patients with ventilator-associated pneumonia Methods: Two authors independently searched related literature published from Pubmed and EMBASE until July 2016 and included a study comparing adjunctive AS colistin with intravenous (IV) colistin monotherapy. The primary outcome was the clinical response rate, the secondary outcome was the overall mortality, and nephrotoxicity. The publication bias was evaluated using the Egger's test. Results: Of the total 279 articles, nine were finally included in the final analysis. There was a significant difference between the adjunctive AS colistin group and the IV colistin monotherapy group for the treatment-response rate (odds ratio (OR), 1.56; 95% CI, 1.14-2.14; p = 0.005; $I^2=36%$), although there was no significant difference in overall mortality (OR, 0.77; 95% CI, 0.57-1.04; p = 0.09; $I^2=20%$). However, there was no significant difference between the two groups in nephrotoxicity (OR, 1.13; 95% CI, 0.74-1.74; p = 0.57; $I^2=4%$). Conclusion: The addition of aerosolized colistin to IV colistin monotherapy showed better results in terms of efficacy than IV colistin monotherapy and did not show any significant difference in terms of total mortality and nephrotoxicity. Additional large-scale studies of this need to be verified.

Deep Cerebral Venous Thrombosis : Successful Treatment by Systemic Urokinase Followed by Heparin - Case Report - (뇌 심부 정맥 혈전증 : 전신적 유로키나제 혈전용해술 후 헤파린 투여 치료법의 성공 증례 - 증 례 보 고 -)

  • Park, Jae Hyo;Yang, Ji Ho;Yoo, Do Sung;Cho, Kyoung Suok;Huh, Pil Woo;Kwon, Seong Hh;Kim, Dal Soo;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.99-104
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    • 2001
  • We present two cases of deep cerebral venous thrombosis(DCVT) with the totally occluded straight sinus. A 42-year-old female received with altered mentality . She has taken antihistamine for six years to treat the paranasal sinusitis. Another 34-year-old female who used the oral contraceptive for 11 months presented with acute behavior change . Both of these patients were diagnosed by computed tomography(CT), magnetic resonance(MR) imaging, and cerebral angiography. They were fully recovered with systemic urokinase thrombolysis followed by heparin therapy. We report that the intravenous thrombolysis was potentially effective management strategy in our cases of DCVT with the totally occluded straight sinus.

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Recent Advancements of Treatment for Leptomeningeal Carcinomatosis

  • Gwak, Ho-Shin;Lee, Sang Hyun;Park, Weon Seo;Shin, Sang Hoon;Yoo, Heon;Lee, Seung Hoon
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.1-8
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    • 2015
  • Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.

Neonatal invasive Streptococcus gallolyticus subsp. pasteurianus infection with delayed central nervous system complications

  • Park, Jung-Weon;Eun, So-Hee;Kim, Eui-Chong;Seong, Moon-Woo;Kim, Yun-Kyung
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.33-36
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    • 2015
  • Group D streptococci are known to cause newborn septicemia and meningitis, but the Streptococcus bovis group strains rarely cause serious neonatal infections in Korea. Central nervous system (CNS) complications of neonatal S. bovis group infection have rarely been reported. In adults, S. bovis group strains cause bacteremia and endocarditis, and are associated with gastrointestinal malignancy. However, only a few studies have reported meningitis and septicemia in infants. Here, we describe a case of bacteremia and meningitis due to Streptococcus gallolyticus subsp. pasteurianus with a delayed CNS complication in an infant. A 28-day-old male infant was admitted to the hospital with a 1-day history of fever. Cultures of blood, cerebrospinal fluid, and urine showed the presence of S. bovis group strain-S. gallolyticus subsp. pasteurianus. He was discharged after 21 days of intravenous ampicillin and cefotaxime administration. Two weeks later, he was readmitted with a fever and short episodes of tonic-clonic movements. Brain magnetic resonance imaging showed marked bilateral frontal subdural effusion. He was discharged after 31 days of antibiotic therapy, and no neurological sequelae were observed at the 9-month follow-up. In conclusion, we present a rare case of neonatal S. gallolyticus subsp. pasteurianus infection causing urinary tract infection, septicemia, meningitis, and delayed CNS complications. This case emphasizes the need for physicians to be aware of S. bovis infection in infants.

A Case of Acute Disseminated Encephalomyelitis by Enterovirus 71 (Enterovirus 71에 의한 급성 파종성 뇌척수염 1례)

  • Hwang, Hui Sung;Cho, Sung Hee;Kim, Sun Mi;Jung, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.114-122
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    • 2003
  • Acute transverse myelitis is a focal inflammatory disorder of the spinal cord, resulting in motor, sensory, and autonomic dysfunction which would be the initial manifestation of acute disseminated encephalomyelitis. A 7-year-old boy developed weakness of lower extremities associated with dizziness and urinary dysfunction after upper respiratory infection. He showed gradual decreased mental status with respiratory difficulty. Spinal MRI showed diffuse spinal cord swelling from C3 to C7 levels with high signal intensity lesion on T2-weighted image, which is involved central gray matter of spinal cord from C3 to C7, proximal portion to cervicomedullary junction, and distal portion to the cornus medullaris. After the supplement of high dose intravenous methylprednisolone therapy with ventilator care, he showed gradual improvement. The brain MRI after extubation showed multifocal high signal intensity lesions in bilateral cerebral white matter on axial T2-weighted image. Immunoserologic test(neutral antibody test) for enterovirus 71 was positive. Dysfunction of the bladder lasted for 33 days. We report a case of transverse myelitis which progressed to acute disseminated encephalomyelitis by enterovirus 71 in a 7-year-old boy with related literatures.

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A Case of Acute Idiopathic Thrombocytopenic Purpura Following Influenza B Virus Infection (B형 인플루엔자 감염에서 나타난 특발성 혈소판 감소성 자색반증)

  • Jung, Seungwon;Kang, Sunghee;Kang, Jin Han;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.117-120
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    • 2015
  • Virus-associated immune thrombocytopenic purpura (ITP) can occur following common viruses, but cases of ITP associated with influenza infection has seldom been reported. In this report we describe a previously healthy 5-year-old boy who admitted with fever, flu-like symptoms and a few bruises on both legs. Severe thrombocytopenia were found. Bone marrow aspirates and biopsy showed no abnormalities and results of coagulation tests were all in normal limit. Real-time polymerase chain reaction was positive for influenza B infection. The patient fully recovered with intravenous immunoglobulins and steroid therapy.