Clinical and pathologic findings in the kidneys of 30 consecutive acquired immunodeficiency syndrome (AIDS) autopsies and in 34 consecutive renal biopsies performed on HIV infected patients at our institution between 1983 and 1987 were studied. To determine if the lesions of HIV-associated nephropathy have morphologic specificity, a subgroup of 13 biopsies with a diagnosis of HIV-associated nephropathy (HIVN) were compared to 13 biopsies each of heroin-associated nephropathy (HAN) and of idiopathic focal segmental glomerulosclerosis (IFSGS) matched for patient age, proteinuria and serum creatinine. A diagnosis of HIVN was made in 1 of 30 (3.3%) AIDS autopsies and 26 of 34 (76.5%) renal biopsies. When compared to HAN and IFSGS, HIVN had more globally "collapsed" glomeruli (P less than 0.001), less glomerular hyalinosis (P less than 0.02), more severe visceral epithelial cell swelling (P less than 0.05), more numerous visceral epithelial cell droplets (P less than 0.002), more prevalent and severe tubular microcystic dilatation (P less than 0.02), and tubular cell degenerative changes (P less than 0.001). Focal glomerular electron-dense deposits were present in 14 of 26 cases. Tubuloreticular inclusions were extremely numerous in glomerular and interstitial capillary endothelial cells as well as in interstitial leukocytes (P less than 0.001). Granular degeneration of nuclear chromatin was present in 10 of 26 cases. Nuclear bodies were more numerous in tubular and interstitial cells of HIVN (P less than 0.01), particularly type 3 (P less than 0.001). Reversal of tissue T4/T8 ratio was observed. We conclude that while no single morphologic feature of HIVN is specific, the combination of clinical and pathologic findings is quite distinctive and permits a presumptive diagnosis of HIVN in otherwise asymptomatic carriers.

Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.

The early diagnosis and effective treatment of brain abscess pose a difficult clinical problem.With the advent of computed tomography , however , it appears that motality due to intracranial abscess has significantly diminished.

The basa l vein of Rosenth a l lies on th e surface of th e bra in base, runs around the bra in ste m, drains posteri o rl y into th e ga le nic syste m a nd usu a ll y outlin es importa nt a natomica l stru ctures inciuding a nterior pe rfo rating substa n ce, un c us, cere bra l pe duncle and quadrige minal cistern, eve n though it ma y show ana tomi c va n atlO ns.Th e radi o logic, measure me nt of basa l ce rebra l ve in was pe rform ed in 48 normal ad 비 ts. 1 n lat e ra l proj ectio n, th e lo west po int, roughl y co rres ponding to th e a nte rior border of ce rebra l pe dun cle, was re lated to th e base lin es whi c h pass through th e nasi o n a nd la mbda, a nd tuberculum sellae a nd la mbd a res pective ly. In AP pr o ject io n t he kn ee a nd th e a nkle we re cho se n for th e measure men t.1. NR '/ NL is a pprox ima t ely locat e d at th e mid po int o f th e line whi ch pass throu gh nasion a nd la mbd a in fig ure 1. 2. TR " / TL is near ly lo ca ted at o ne.third o f th e lin e w hich pass thro ugh tub erculum se ll a a nd la mbd a in f igure 2.3. R2M/ NM is usua ll y located within t he range o f 30% an d R 1 appears loca ted at th e me dial aspect of R2 within t he ra nge of 5 m m in f ig ure 3.

No abstract