608例早孕绒毛宫内感染巨细胞病毒的免疫组织化学诊断

目的建立简便、快速的巨细胞病毒（ＣＭＶ）胚胎感染的诊断方法,早期诊断胚胎ＣＭＶ感染。方法应用免疫组化过氧化物酶抗过氧化物酶（ＰＡＰ）方法,检测与观察早孕绒毛组织的ＣＭＶ感染病灶。结果早孕绒毛６０８例,感染ＣＭＶ２２２例（３６．５％）。感染灶可分为三类,点状感染占７１％（１５８／２２２）,巢状感染占１７％（３７／２２２）,弥散状态感染占１２％（２７／２２２）。发现随胎龄增加巢状及弥散状感染增多,ＣＭＶ往往先侵入绒毛霍夫保尔细胞。经电镜观察验证了ＰＡＰ法。结论免疫组化ＰＡＰ法简便、灵敏、有效,可用于大量筛查宫内ＣＭＶ感染     

Actinomyces odontolyticus isolation during prosthetic aortic graft infection with paraprosthetic duodenal fistula

INTRODUCTION: Prosthetic vascular graft infection is a rare complication of vascular surgery. We report a case with graft enteric fistula and Actinomyces odontolyticus bacteremia. EXEGESIS: A 73 year-old man with a prosthetic aortic graft and who had a parodontal disease, has been hospitalised for fever of unknown origin. Blood cultures grew with Escherichia coli and Actinomyces odontolyticus. The imaging studies indicated graft infection. Laparotomy has confirmed the diagnosis and highlighted a polymicrobial infection and a paraprosthetic duodenal fistula. A review of the literature's data concerning prosthetic vascular graft infections is made. The role of Actinomyces odontolyticus in that case is discussed. CONCLUSION: Prosthetic aortic graft infection due to graft enteric fistula is usually a polymicrobial infection and is a late complication of aortic surgery. Imaging is essential for the diagnosis of prosthetic aortic graft infection. It is possible that Actinomyces odontolyticus has contributed to prosthesis infection in this case.     

Autoimmune hepatitis--sequel of a relapsing hepatitis A in a 75-year-old woman

Acute hepatitis A virus (HAV) infection is a global cause of acute hepatitis. However, chronic HAV infection is unlikely. Nevertheless, there is some evidence that acute infection with HAV may trigger chronic active hepatitis which fulfils the criteria of autoimmune hepatitis (AIH). Whether AIH following HAV infection is virus specific remains unclear. Despite evidence that inherited factors may play a role in the development of autoimmunity after viral infection, the pathomechanism remains unclear. We describe a 75-year-old woman with a history of pulmonary sarcoidosis who developed AIH after acute HAV infection.     

Antibiotic agents in the elderly

Changes that occur in the pharmacology of drugs in the elderly must be considered in the use of antimicrobial agents. Although absorption of orally administered drugs is not affected in a significant way, renal function decreases, drug-drug interactions increase, compliance with regimens may be decreased, and drug toxicity is increased. The most frequent infections occurring in the elderly are pneumonia, urinary tract infection, and soft-tissue infection. CDAD is usually a complication of antibiotic therapy. Pneumonia can be categorized as community-acquired, LTCF, and hospital-acquired. Therapeutic approaches vary according to which of these sites is involved. Urinary tract infection is divided into upper tract infection, lower tract infection, and asymptomatic bacteriuria. Upper tract infection is treated for a longer period than lower tract infection; with few exceptions, asymptomatic bacteriuria is usually not treated. Soft-tissue infection is usually caused by an infected pressure ulcer or cellulitis (which may be a complication of a diabetic foot ulcer or an ulcer due to peripheral vascular disease). These infections have different microbial causes and require different therapeutic approaches.     

Relapsing polychondritis associated with hepatitis C virus infection

This article is aimed to review of relapsing polychondritis (RP) and its association to hepatitis C virus (HCV) infection. A case of RP associated with HCV infection in a 59-year-old male is reported. The English medical literature was reviewed for RP and its association with HCV infection. RP is a rare autoimmune and multisystem disorder of unknown etiology in which the cartilaginous and related tissues are the primary targets of inflammation. HCV infection is a more common systemic illness with known hepatic and extra-hepatic manifestations. Although RP is associated with other diseases in about 35% of cases, only one case of RP, HCV, and mixed cryoglobulinemia has been reported. We report a case of RP associated with HCV infection. Treatment with pegylated interferon and ribavirin resulted in sustained virologic response and remission of treatment-resistant RP with azathioprine. We report a case of RP and associated HCV infection. Although treatment of HCV infection resulted in remission of RP, it is unknown if there is a causal relationship between HCV infection and RP.     

Is malarial placental infection related to peripheral infection at any time of pregnancy?

Placental infection measured by placental smear at delivery is a standard indicator, widely used to characterize malaria infection in pregnant women. However, a single measure can hardly reflect the entire history of infection during pregnancy. To investigate the relation between this indicator and peripheral infection during pregnancy, we used data collected in a randomized trial of malaria prophylaxis in 928 pregnant women in Burkina Faso, 1987-1988, during which repeated measures of peripheral infection were taken. We analyzed placental infection using a logistic model, with two methods for handling missing data. Peripheral infection during two periods of pregnancy was significantly related to placental infection at delivery, before the fifth month: OR = 2.9 [1.3; 6.3]; after 7 months: OR = 4.9 [2.7; 8.8]). Therefore, an early peripheral infection may persist throughout gestation, and placental infection is a good indicator of the women's parasitological status during pregnancy.     

胃幽门螺杆菌与胃癌发病机制关系的分子生物学研究

近期流行病学研究已发现胃幽门螺杆菌(HP)是胃癌发生的重要始发因素。本文应用敏感特异的聚合酶链反应(PCR)方法检测胃粘膜组织HP,分析其与C—Ha—ras第12位密码子点突变,ras基因产物P~(21)蛋白表达及DNA倍体的关系。发现C—Ha—ras点突变率于HP阳性组高于阴性组,并且HP阳性组较HP阴性组出现rasP~(21)表达增强,说明HP感染与C—Ha—ras基因活化有关,HP感染后DNA含量及S％期细胞明显增高,提示核苷酸代谢旺盛,DNA损伤及非整倍体的危险性也增高。本研究为HP致胃癌的可能机制从分子水平及细胞代谢水平作了初步研究。     

疱疹病毒治疗性疫苗研究进展

疱疹病毒感染极为普遍,可表现为原发性、潜伏性或复发性感染,几乎能在所有的动物中建立潜伏感染,且潜伏感染期间病毒保持休眠状态,宿主不表现出任何临床症状,机体在受到一些应激后,潜伏的病毒被重新激活,使机体引起复发性感染.目前预防性疫苗免疫接种仍是预防疱疹病毒感染和控制其相应疾病流行的有效手段,然而免疫接种后机体免疫系统虽能...     

The SEN virus--will there be another letter in the alphabet of viral hepatitis?]

The SEN virus (SENV) is a small nonenveloped single-stranded DNA virus which is probably a circovirus. By phylogenetic analysis it is possible to differentiate genotypes SENV A-H. The pathway of transmission of infection is not known so far but the infection by this virus is frequent in recipients of blood transfusions and liver grafts and in intravenous drug addicts. This suggests possible parenteral transmission of infection. Other routes of transmission of the infection are also possible as the virus can be detected also in a significant proportion of young subjects without the risk of parenteral infection in the case-history. Whether SENV causes hepatitis has not been proved unequivocally so far. The prevalence of this infection does not differ significantly in patients with different liver diseases, acute or chronic viral or non-viral. SENV infection very probably does not influence the course of chronic hepatitis C.     

Healthcare-associated infections in rheumatology in Japan

Prospective observational study was performed to elucidate the incidence and characteristics of healthcare-associated infections in a university hospital for rheumatology care. In this study, a total of 1,226 patients were prospectively enrolled between March 2004 and February 2006 and between April 2008 and December 2008. Healthcare-associated infection was defined as an infection developing after the third day of admission to the rheumatology ward. We detected the following 54 healthcare-associated infections in 49 patients: respiratory tract infection, 14 cases; Clostridium difficile infection, 2 cases; urinary tract infection, 4 cases; bloodstream infection, 9 cases; skin infection, 2 cases; reactivation of latent cytomegalovirus infection, 6 cases; herpes zoster infection, 5 cases; Candida infection, 7 cases; others, 4 cases. The incidence rate of respiratory tract infection was the highest. Methicillin-resistant Staphylococcus aureus was the causative bacterium in 21% of respiratory tract infections cases. Bloodstream infection due to the insertion of a catheter and opportunistic infection by a latent virus were also occurred commonly. Respiratory tract infection, bloodstream infection and opportunistic infection by a latent virus were the most common causes of healthcare-associated infection in rheumatology. It is important to pay more attention to healthcare-associated infection.     

Disseminated Ochroconis gallopavum infection in a chronic lymphocytic leukemia: a case report and review of the literature on hematological malignancies

Disseminated fungal infection is an important cause of morbidity and mortality among patients with hematological malignancies. Ochroconis gallopavum is a dematiaceous and thermotolerant fungus that causes opportunistic infections in immunocompromised hosts. About only 30 cases of this organism infection have been reported worldwide. We report a disseminated Ochroconis gallopavum infection in a B-cell chronic lymphocytic leukemia patient. In spite of intensive anti-fungal treatment, no improvement in the clinical condition was observed and the patient died 4 months after diagnosis of the infection. Ochroconis gallopavum infection is a potentially fatal disease in hematological malignancies.     

Acupuncture-associated arthritis in a joint with an orthopaedic implant

Viral infection is a well-recognized complication of acupuncture therapy. Bacterial infection however is rare. We report a rare case of intra-articular bacterial knee infection due to inadvertent acupuncture needle penetration.     

Toxic shock syndrome associated with Staphylococcus aureus sinusitis in children

Toxic shock syndrome (TSS) is a severe, acute, multisystem illness associated with rash and shock. It is usually associated with a focal infection (e.g., during menstruation associated with tampon use, abscess, surgical wound infection) caused by certain Staphylococcus aureus strains. Identification and drainage of the focus of infection may be important in therapy. Occasionally, a focus of infection is not obvious, requiring additional diagnostic procedures. Three cases of children with TSS associated with sinusitis and no other focus of S. aureus infection are presented, demonstrating the important consideration of the perinasal sinuses as a cryptic focus of S. aureus infection causing TSS.     

Pressure sores and underlying bone infection

Pressure sores are a serious complication of hospitalized and chronically ill patients. Evaluation for underlying bone infection can be made difficult by radiographic, nuclear imaging, and soft-tissue culture studies that are abnormal and suggest the presence of bone infection, when no infection is present. Evaluation by bone biopsy with histologic and microbiological studies can accurately and promptly diagnose whether bone infection is present. This allows appropriate treatment when infection is present, and prevents unneeded and potentially toxic antibiotic therapy when preliminary studies incorrectly suggest that infection is present.     

Pathogenesis and pathophysiology of anemia in HIV infection

Anemia is common in human immunodeficiency virus infection, particularly in patients with acquired immunodeficiency syndrome. Anemia is multifactorial. HIV infection itself causes anemia, probably as a consequence of HIV infection of stromal cells rather than HIV infection of hematopoietic stem cells. Other common causes of anemia in AIDS are anemia of chronic disease consequent on opportunistic infections, bone marrow suppression by antiretroviral therapy, and hemolytic anemia induced by oxidant drugs. Thrombotic microangiopathy is a significant complication of HIV infection and may respond to plasmapheresis.     

Acquisition of anal human papillomavirus (HPV) infection in women: the Hawaii HPV Cohort study

BACKGROUND: The majority of anal cancer is associated with human papillomavirus (HPV) infection, yet little is known about women's risk of acquisition of anal HPV infection. METHODS: Risk factors for the acquisition of anal HPV infection were examined in a longitudinal cohort study of 431 women, via repeated measurement of HPV DNA. RESULTS: Seventy percent of women were positive for anal HPV infection at one or more clinic visits from baseline through a follow-up period that averaged 1.3 years. The incidence of a high-risk (HR) infection was 19.5 (95% confidence interval [CI], 16.0-23.6) per 1000 woman-months. The most common incident HR HPV types were HPV-53, -52 and -16. The presence of an HR anal HPV infection at baseline increased the risk of an incident anal infection by 65%. Baseline HR cervical HPV infection also predicted the acquisition of an HR anal HPV infection (odds ratio, 1.81 [95% CI, 1.09-3.02]). Nonviral risk factors for acquisition of HR HPV infection included younger age, lower socioeconomic status, greater lifetime number of sexual partners, past use of hormones, and condom use. CONCLUSIONS: The results of this study suggest that women's risk of anal HPV infection is as common as their risk of cervical HPV infection.     

Duration of HCV infection as a predictor of nonresponse to interferon

Duration of hepatitis C virus (HCV) infection is a key feature in determining responsiveness to interferon (IFN). Studies assessing its value as a predictive factor in chronic HCV infection show that a long duration of infection reduces the likelihood of a sustained response to IFN (defined as ALT normalization and clearance of serum HCV-RNA). The effect of HCV infection duration is independent of the presence of cirrhosis and level of HCV viremia. Meta-analysis of IFN trials in acute HCV infection shows an obvious effect of the drug on long-term ALT normalization and HCV-RNA clearance. Treatment of HCV infection during the acute or early chronic phase could therefore maximize therapeutic effectiveness.     

A view of dynamics of immune responses against tuberculosis infection through QFT

QFT has been approved as a diagnostic test of TB infection in April 2005 in Japan, and further adopted to health insurance in January 2006. QFT is now a necessary tool to diagnose TB infection, especially in contact investigation. Since QFT uses M. tuberculosis-specific antigens, which are absent from BCG and most of non-tuberculous mycobacteria, to stimulate blood samples, and Interferon-gamma (IFN-gamma) produced with antigen-specific T cells is measured to diagnose TB infection, QFT can specifically diagnose TB infection without influence of BCG vaccination or infection of most of non-tuberculous mycobacteria. There is another diagnostic test, T-SPOT.TB, which uses similar antigens to QFT, and these two tests are called as IGRAs (Interferon-Gamma Release Assays). However, as production of IFN-gamma is a small part of protective immune responses against TB infection, it is difficult from this point of view to understand the dynamics of protective immune responses against TB infection through IGRAs results. Especially, it is impossible to distinguish between active TB and latent TB infection, to identify time of TB infection, or to detect dormancy TB infection using current IGRAs. Using biomarkers other than IFN-gamma or antigens other than antigens used in current IGRAs, development of newer diagnostic tests which have these performances would be awaited.     

Pneumocystis jirovecii pneumonia 13 years post renal transplant following a recurrent cytomegalovirus infection

Pneumocystis jirovecii (formerly Pneumocystis carinii) pneumonia (PCP) is a rare but serious infection that usually occurs within a year after solid organ transplantation. PCP may occur after 1 year post transplantation, but the rate is reported to be very low. Studies have shown an association between cytomegalovirus (CMV) infection in solid organ transplant patients and an increased risk of opportunistic infection. This increased risk is thought to be a result of the immunomodulatory effects of the CMV infection. We present a case of PCP infection occurring 13 years after a renal transplantation. This occurred following a recurrent CMV infection while the patient was on low‐dose immunosuppressants.