• Childhood Kidney Diseases
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• 제24권1호
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• pp.47-52
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• 2020

Pneumocystis pneumonia (PCP) is a rare disease in healthy people but a potentially fatal opportunistic infection by Pneumocystis jirovecii in immunocompromised patients with organ transplantation. We present three cases of PCP after kidney transplantation in pediatric patients. First case was a 4-year-old boy diagnosed with Denys-Drash syndrome and received living-donor kidney transplantation from his mother at age of 1. Second case was a 19-year-old male, with polycystic kidney disease, who received kidney transplantation from his mother at the age of 18. Third case was a 19-year-old female with chronic kidney disease of unknown etiology, who received kidney transplantation from her father at age of 15. These three patients who were on immunosuppressive therapy and completed of routine PCP prophylaxis for 6 months had presented with cough and dyspnea more than 1 year after transplantation. Chest x-ray all showed diffuse haziness of both lung fields, and bronchoalveolar lavage from bronchoscopy revealed Pneumocystisjirovecii infection. All patients showed clinical resolution with intravenous trimethoprim-sulfamethoxazole (TMP-SMX) therapy for at least 3 weeks and had continued secondary prophylaxis for another 6-12 months. This report suggests that clinicians should have suspicion for the possibilities of opportunistic infection such as PCP after kidney transplantation in children.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.93-95
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• 2011

Purpose: Mucormycosis generally occurs in patients with uncontrolled diabetes mellitus and immunocompromised conditions. It is rare, but once a patient is infected with it, it can occur as a rapidly extending, aggressive, and life-threatening rhinocerebral infection with a high mortality rate. Methods: A 70-year-old female patient had a 40 years of history of adult onset diabetes mellitus. She presented herself with severe right hemifacial pain, swelling, and weakness for 3 days and was admitted to ENT. On a facial computed tomography (CT) scan, it was found that her infection extended from her inferior temporal scalp to her submental area and involved her submandibular, masseter, prevertebral, parapharyngeal, retropharyngeal, and pharyngeal mucosal space and pansinusitis. Through endoscopic sinus surgery, mucormycosis was confirmed via histologic examination. Results: Despite empiric antibiotics and amphotericin B administration, the patient was in a septic condition and in a coma. The patient's family wanted to withdraw her life support, and the patient expired. Conclusion: Mucormycosis is very rare, but is one of the disastrous complications of uncontrolled diabetes mellitus. Suspicion of its occurrence, based on identified risk factors, and its rapid diagnosis can enhance the chance of its cure.

• Parasites, Hosts and Diseases
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• 제37권3호
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• pp.149-156
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• 1999

Pneumocystis carinii is pulmonary pathogen of immunocompromised humans or other mammals. Its infection results from activation of organism involves in latent infection or form new infection through the air. Almost all children are known to be infected within 2 to 4 years of birth, though prenatal transplacental transmission has not yet been demonstrated. In this study we observed experimental P.carinii infection in neonatal rats, thus investigating the possibility of transplacental vertical transmission by Diff-Quik staining of the lung impression smears and in-sity hybridization for lung sections. The postive rate of P.carinii infection in immunosuppressed maternal rats was 100%, but that in normal maternal rats was 0%. Cystic forms of P.carinii were observed in three of six 1-week old neonatal rats born of heavily infected mothers, but none of them was positive by in-situ hybridization. Five weeks after birth, cystic forms were detected in four neonatal rats. In the lobes of the lungs, no predilection site of P.carinii was recognized. Counts of cystic forms on smears and the reactivity of in-situ hbridization in the lungs of neonatal rats 0 were signficantly lower than in maternal rats. The present findings suggest that P.carinii is rarely transmitted through the placenta and proliferates less successfully in the lungs of neonatal rats than in mothers.

• 대한미생물학회지
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• 제35권1호
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• pp.1-8
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• 2000

In order to explore the potential of ascorbic acid supplementation for the prevention and treatment of herpes simplex viral diseases, plaque reduction assays were performed. Ascorbic acid as well as copper chloride/ferric chloride were added to wells containing Vero cells infected with herpes simplex virus type 1 (HSV-1), and the infectivity of HSV-1 was determined. Since copper and iron are major transition metals in human plasma, near the normal human plasma concentrations of them were used for experiments. When Cu(II) and Fe(III) were applied, there were no significant differences between virus control and Cu(II)/Fe(III)-treated groups. But, when appropriate concentrations of ascorbic acid were added to wells, meaningful differences between control and ascorbate-treated groups were found. In the presence of Cu(II)/Fe(III) at $5.8/3.7\;{\mu}M$, 72-h treatment with ascorbate at $50\;{\mu}M$ reduced HSV-1 infections to $10.77%{\pm}4.25%$ (P < 0.001) and $500\;{\mu}M$ did to $3.06%{\pm}1.62%$ (P < 0.001). Moreover, the cytotoxicities for Vero cells at those concentrations were insignificant (P > 0.05). Current recommended dietary allowance (RDA) of ascorbic acid is 60 mg/day, and the oral intake of 60 mg/day of ascorbic acid yields plasma ascorbic acid at 45 to $58\;{\mu}M$ in a healthy adult man. Therefore, the results of this study suggest that the maintenance of appropriate level (more than $50\;{\mu}M$) of ascorbic acid in human plasma by appropriate amount (more than the RDA) of ascorbic acid supplementation may be helpful for the prevention and treatment of diseases caused by HSV -1 in an adult man. In addition, this study also suggests that ascorbic acid may be useful for the prophylaxis of fatal HSV-1 infections in neonates and the prevention of HSV-1 reactivation in immunocompromised hosts.

• Tuberculosis and Respiratory Diseases
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• 제57권6호
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• pp.553-556
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• 2004

Bacillus종은 그람양성 간균으로 포자를 형성하며 주변 환경 어디에나 존재하여 임상 가검물에서 분리되는 경우 대부분 오염균으로 생각된다. B. licheniformis에 의한 감염증인 경우 외상, 면역저하, 주사약물남용과 연관성을 가지며, 적절한 항생제 사용과 카테타 제거나 수술적 국소조직 제거에 의해 잘 치유되는 특징이 있다. 그러나 위험인자가 없는 상태에서도 B. licheniformis 균혈증은 생길 수 있으며 본 증례에서도 58세의 위험인자가 없던 여자에서 기관지경 후에 B. licheniformis 균혈증이 발생하였고 다른 증례들처럼 경험적 항생제 치료 후에 합병증 없이 치유되었다.

• Tuberculosis and Respiratory Diseases
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• 제71권5호
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• pp.322-327
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• 2011

Background: Pneumocystis jirovecii is a fungus that has become an important cause of opportunistic infections. We present a summary of the clinical status and findings from bronchoalveolar lavage (BAL) of patients with Pneumocystis jirovecii pneumonia (PJP). Methods: We selected 30 cases of PJP that were proven through a surgical specimen evaluation. BAL fluid cytology was reviewed, and agreement with the initial diagnosis was evaluated. Results: All 30 cases of PJP occurred in immunocompromised patients. Only 15 of the 30 cases were initially diagnosed as PJP. We found PJP in 13 of the 15 cases that were negative at the initial diagnosis. The most characteristic finding of PJP was frothy exudates, and BAL fluid tended to show rare neutrophils. Two of seven patients with PJP and diffuse alveolar damage (DAD) revealed no frothy exudates in BAL fluid. Conclusion: BAL fluid cytology was reconfirmed as a sensitive and rapid method to diagnose PJP. We must be aware of the possibility of PJP to maintain high diagnostic sensitivity. We cannot exclude PJP in cases of PJP with DAD, even if frothy exudates are not observed in the BAL fluid.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.761-766
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• 2012

Objective: Although various human cancer stem cells (CSCs) have been defined, their applications are restricted to immunocompromised models. Developing a novel CSC model which could be used in immunocompetent or transgenic mice is essential for further understanding of the biomolecular characteristics of tumor stem cells. Therefore, in this study, we analyzed murine lung cancer cells for the presence of CSCs. Methods: Side population (SP) cells were isolated by fluorescence activated cell sorting, followed by serum-free medium (SFM) culture, using Lewis lung carcinoma cell (LLC) line. The self-renewal, differentiated progeny, chemosensitivity, and tumorigenic properties in SP and non-SP cells were investigated through in vitro culture and in vivo serial transplantation. Differential expression profiles of stem cell markers were examined by RT-PCR. Results: The SP cell fraction comprised 1.1% of the total LLC population. SP cells were available to grow in SFM, and had significantly enhanced capacity for cell proliferation and colony formation. They were also more resistant to cisplatin in comparison to non-SP cells, and displayed increased tumorigenic ability. Moreover, SP cells showed higher mRNA expression of Oct-4, ABCG2, and CD44. Conclusion: We identified SP cells from a murine lung carcinoma, which possess well-known characteristics of CSCs. Our study established a useful model that should allow investigation of the biological features and pharmacosensitivity of lung CSCs, both in vitro and in syngeneic immunocompetent or transgenic/knockout mice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권3호
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• pp.268-272
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• 2007

Herpes zoster is caused when the varicella zoster virus(VZV) that has remained latent since an earlier varicella infection is reactivated with cutaneous and mucous manifestations. They occur in 20% cases in the trigeminal area and typical manifestations are neuralgias simulating dental pain, also vesicles with an erythematous halo located in the territory of the second and third trigemial branch. They erupt on the skin, the lips, tongue, palate and cheeks. With an ever-increasing number of elderly and immunocompromised patients attending the dentist, the dental profession can expect to encounter an increased number of herpes zoster patients. Furthermore, the oral and maxillofacial surgeons must be familiar with the presenting signs and symptoms of patients experiencing the prodromal manifestations and oral complication of herpes zoster of the trigeminal nerve. As presentation of our patient with ulcer on hard palate caused by herpes zoster, current treatment of herpes zoster and post-herpetic neuralgia are discussed.

• Pediatric Infection and Vaccine
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• 제11권1호
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• pp.121-125
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• 2004

신생아 수두는 모체가 감염된 시기에 따라 그 증상과 예후가 달리 나타날 수 있으며, 출생 후 감염된 경우는 태반을 통해 모체로부터 태아에게 항체가 전달되지 못하기 때문에 합병증의 발생 가능성이 높고, 예후가 좋지 않아 적절한 치료와 추적관찰이 필요하다. 저자는 합병증의 동반없이 acyclovir를 사용하여 치료한 불현성 감염 엄마로부터 감염된 신생아 수두 1례를 경험하였기에 보고하는 바이다.

• 한국임상수의학회지
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• 제32권2호
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• pp.212-214
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• 2015

토끼에서 뇌포자육충증은 Encephalitozoon(E.) cuniculi에 의해 유발되는 전염성 질환이다. E.cuniculi는 숙주영역이 상당히 넓으며, 특히 면역능이 저하된 사람에서 기회 감염을 유발하기도 한다. 본 증례 보고에서 4 마리의 토끼가 사경과 안구진탕 증상으로 내원하였으며, 각 개체의 채혈을 통해 ELISA 검사를 수행하여 E.cuniculi에 양성임을 확인하였다. 토끼들은 fenbendazole로 4 주간 치료를 실시하였고, 치료효과는 신경증상의 발현정도에 따라 평가하였다. 치료한 네 마리 토끼 중 세 마리의 토끼에서 치료 3-5일 후부터 증상이 상당히 개선되었으나, 한 마리는 식욕부진과 사경증상이 개선되지 않고 치료 후 10일째 폐사하였다. 본 증례보고는 뇌포자육충 감염 애완토끼에 대한 fenbendazole의 치료효과를 규명한 최초의 보고이며, 본 증례를 통하여 애완토끼가 사람과 동물에 있어서 잠재적 E. cuniculi 보균동물로 인식되므로 이에 대한 주의를 필요로 한다.