Upper airway tract and upper gastrointestinal tract involvement in patients with pemphigus vulgaris

Pemphigus vulgaris (PV) is an autoimmune disease involving the skin and mucous membranes. The frequency of upper airway tract (UAT) and upper gastrointestinal tract (UGIT) involvement in PV is not clearly known. Our aim was to determine the incidence of UAT and UGIT involvement in patients with PV. Thirty-seven patients who were diagnosed with PV and treated between March 2008 and April 2009 at the Dermatology Department of the Vakif Gureba Teaching and Research Hospital were included. All patients were evaluated for UAT manifestations by endoscopic examination, and 22 of 37 patients were investigated for UGIT involvement by gastrointestinal endoscopy. Mucosal biopsies were obtained by UGIT endoscopy for direct immunofluorescence (DIF) examination, and a histopathological examination was conducted in patients with active UGIT mucosal lesions. Thirty-five of 37 patients (94.6%) had active pharyngeal, laryngeal, or nasal PV lesions on endoscopic evaluation. Oral symptoms (83.8%) and active oral PV lesions were the most frequent findings (100%). Pharyngeal lesions (64.9%) were the most commonly present lesions on UAT examination. The frequency for laryngeal and nasal lesions was 51.4% and 21.6%, respectively. Five of 22 patients (22.7%) presented with active laryngeal and esophageal lesions. Twenty-one of 22 (95.4%) patients had positive DIF results. We believe that UAT and UGIT endoscopies are useful and necessary diagnostic methods in patients with PV with or without UAT and UGIT symptoms. UAT and UGIT endoscopies should be performed as standard diagnostic procedures in all patients with PV.     

Genital tract papillomavirus infection in children

Genital tract papillomas in five children were examined for the presence of human papillomavirus (HPV) DNA by molecular hybridization. Papillomavirus DNA was detected in each sample and was identified as HPV-6 (three cases), HPV-6 or HPV-11 (one case), or HPV-16 (one case). These viruses are the same as are responsible for genital papillomas (condylomata) of adults. The transmission of adult genital tract viruses to children occurs primarily by a venereal route but may occur by a nonvenereal route.     

性兴奋与尿路感染2例报告

1病例11.1病情介绍患者某某,女,19岁,大专生。主诉尿频,排尿困难。患者曾在某市级医院检查过小便,未发现异常,经治医生按尿路感染给予环丙沙星等治疗,症状未见改善。1.2诊治经过详细询问病史,患者最近两个多月以来,每天刚躺下不久就欲小便,入厕小便,排尿困难,量少,有时只有几滴。但患者觉得无法控制,只有排出来才觉得舒服一些。事后每隔几分钟又想小便,如此反复,每天晚上要持续一个小时左右。学校厕所离宿舍较远,又是冬天,加上同宿舍同学的嘲笑,患者焦虑,自卑,痛苦不堪。患者习惯睡前性幻想,自觉会阴部肿胀难受欲小便,偶尔用手指按压会阴部,…     

Pyoderma gangrenosum and urinary tract infection

A case of pyoderma gangrenosum is reported in a 52-year-old man who had skin lesions without any association. On investigation urinary tract infection was detected. Treatment of UTI led to spontaneous healing of the lesions in short period thus avoiding the need of oral corticosteroids.     

Metabolic syndrome and lower urinary tract symptoms

Recently,clinical and epidemiologic data indicating the involvement of metabolic syndrome(Met S)in the pathogenesis and progression of lower urinary tract symptom(LUTS)/benign prostatic hyperplasia(BPH)are reported.This review evaluates the reports on the influence of MetS in the development and progression of LUTS/BPH,and discusses possible clinical implications for the management and treatment of this disease.Recent studies on the epidemiological relationship between MetS and LUTS hypothesize that MetS may be associated with an overactivity of the autonomic nervous system for which hyperinsulinemia,a key element of the Met S,might be responsible.An alternative explanation is that LUTS are associated with chronic ischemia of pelvis resulting from atherosclerotic changes in blood vessels,which leads the production of reactive oxygen species,which can damage the bladder detrusor.Control of autonomic nervous system overactivity and control of chronic bladder ischemia have potential as new targets for LUTS treatment.Studies suggest an association of Met S with LUTS/BPH,although further research is needed to understand how MetS influences LUTS/BPH.Met S should be considered a new domain in basic and clinical research in patients with LUTS/BPH and as a target for treatment.     

Activity of ciprofloxacin against genital tract pathogens

The in vitro activity of the quinolone carboxylic acid, ciprofloxacin, against a variety of genital tract pathogens was examined. Each of 35 isolates of Neisseria gonorrhoeae, including some beta-lactamase producing strains and strains resistant to tetracycline, was inhibited at a concentration of 0.01 mg/l. Most (13 of 20) strains of Gardnerella vaginalis were inhibited at 1 mg/l but three isolates had minimum inhibitory concentrations (MICs) of 8 mg/l or more. Each of seven strains of Chlamydia trachomatis was completely inhibited at a concentration of 2 mg/l. Prolonged (72 hours) exposure of the chlamydiae to ciprofloxacin was required for inhibition at this concentration.     

Cutaneous facial sinus tract of dental origin

Abstract: Cutaneous sinus tract on the head and neck area in a child may originate from dental disease. A high degree of clinical suspicion and complementary tests are often needed, as the diagnosis is usually not straight forward. Anatomical correlation is also useful in tracing the affected tooth or teeth. We present the case of a boy with a facial sinus tract that originated from periapical abscesses of maxillary molars.     

泌尿道支原体药敏试验的耐药情况分析

目的:了解泌尿道支原体感染及其在体外对药敏试验的耐药情况,指导临床合理用药.方法:采用南京黎明生物制品经营部的解脲支原体(Uu)及人型支原体(Mh)培养加药敏的试剂盒,对泌尿道支原体培养阳性的158例标本进行10种抗生素药敏试验的耐药情况分析.结果:药敏耐药率检测显示,红霉素(95.06%、80.43%、87.10%)、四环素(71.60%、56.62%、93.55%),氧氟沙星(35.80%、32.61%、74.12%)、环丙沙星(29.63%、45.65%、61.29%),强力霉素(14.81%、36.96%、35.48%)、交沙霉素(3.70%、2.17%、25.81%).结论:本研究表明,红霉素、四环素耐药率最高,氧氟沙星、环丙沙星次之,强力霉素、交沙霉素耐药率最低.     

Ejaculatory disorders and lower urinary tract symptoms

A growing body of literature supports the observed association between lower urinary tract symptoms and sexual dysfunction. The causal relationship between these two conditions has not been determined. Ejaculatory function is an important aspect of sexual functioning, and recent studies have shown a high prevalence of this ejaculatory dysfunction in men with lower urinary tract symptoms. Furthermore, the degree of bother associated with ejaculatory dysfunction is quite high, making it an important problem for patients. Thus, health care providers should have a heightened sense of awareness for the presence of ejaculatory dysfunction and appropriate patient counseling should be undertaken before initiation of specific treatments for lower urinary tract symptoms.     

Genital Paget's disease and urinary tract malignancy

Eight cases of Paget's disease of genital mucosa with malignancy of the lower urinary tract are described. In five it was apparent that there was concurrence of two separate malignancies. In one patient with long-standing Paget's disease of the genital mucosa, carcinoma of the urethra and bladder developed subsequently in continuity with the genital lesion; the two lesions were indistinguishable histologically, suggesting extension of the Paget's disease into urothelium. In two patients with bladder malignancy, there was histologic evidence of outward pagetoid extension of this process along urothelium and onto the genital mucosa. The significance of genital Paget's disease is discussed in the light of these findings, and the possible origins of Paget cells within the epidermis are reviewed.     

Ejaculatory disorders and lower urinary tract symptoms

A growing body of literature supports the observed association between lower urinary tract symptoms and sexual dysfunction. The causal relationship between these two conditions has not been determined. Ejaculatory function is an important aspect of sexual functioning, and recent studies have shown a high prevalence of this ejaculatory dysfunction in men with lower urinary tract symptoms. Furthermore, the degree of bother associated with ejaculatory dysfunction is quite high, making it an important problem for patients. Thus, health care providers should have a heightened sense of awareness for the presence of ejaculatory dysfunction and appropriate patient counseling should be undertaken before initiation of specific treatments for lower urinary tract symptoms.     

新生儿包皮环切可预防尿路感染

新生儿期割礼约从公元前1200年古埃及和古希腊太阳崇拜的宗教仪式和部族的风俗习惯沿续而来。以后在一部分信奉宗教的人群中继续流行,从19世纪在使用英语的各国中广泛施行。目前在美国约80％的新生儿施行包皮环切术。美国学者认为:此术对生后一年内的男婴尿路感染(肾盂肾炎)可起到预防作用。乳婴幼期的肾盂肾炎,多为无尿路梗阻的单纯性肾盂肾炎,3岁以下小幼儿发病,形成肾瘢痕的危险性很高,对小儿科及泌尿科医生来说都是重要的疾患。Littiewood研究66例婴儿出生1个月以内的尿路感染,其死亡率为11％,7例死亡6例是男婴,5例为单纯性     

Cutaneous sinus tract of dental origin.

A 47‐year‐old woman presented with a nodular lesion on her face that had been discharging pus intermittently for 7 months. She could not recall any previous trauma to the site. Dermatologic examination revealed a nontender, erythematous, nodular, draining lesion on the patient's chin ( Fig. 1 ). Dental examination showed poor oral hygiene and severe chronic periodontitis, but no acute infection. Radiography demonstrated diffuse periapical radiolucency associated with the right central mandibular incisor ( Fig. 2 ). The patient was diagnosed with chronic apical periodontitis. Because it was too late for her oral condition to be corrected with endodontic treatment, the tooth was extracted and the scar on her chin was revised later.

Figure 1 Open in figure viewer PowerPoint A cutaneous draining sinus of dental origin presenting as an erythematous nodule on the patient's chin