Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the first case (to our knowledge) of a primary urethral T-cell lymphoma as the initial manifestation of the acquired immune deficiency syndrome. A 36-year-old white homosexual man with antibodies to human immunodeficiency virus type 1 was evaluated for a hemorrhagic urethral discharge. A 2-cm fleshy, polypoid mass in the bulbous urethra was removed, and the diagnosis of small non-cleaved cell (non-Burkitt's) lymphoma was made. Immunohistochemical analysis confirmed that the tumor was of T-cell lineage. Patients with the acquired immunodeficiency syndrome have an increased incidence of lymphomas, particularly extranodal high-grade non-Hodgkin's lymphomas. Primary urethral lymphomas are extremely rare, with only a handful of cases reported in the literature. This rare form and site of lymphoma should be considered in patients with the acquired immunodeficiency syndrome who have genitourinary symptoms.
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PMID:Urethral T-cell lymphoma as the initial manifestation of the acquired immune deficiency syndrome. 174 38

Supravesical urinary diversion by ureterotransversopyelostomy (UTPS) with unilateral nephrostomy was performed in 57 patients. The age of the 33 women ranged between 42 and 86 (mean 65), of the 24 men between 39 and 77 (mean 62) years. With a single exception, the indication for diversion was palliative: 25 patients had advanced bladder cancer (T3/T4), and 19 had undergone irradiation; 24 patients showed vesico- (recto-) vaginal fistulas due to radiation for gynecological carcinomas. In 2 patients, the indication was urge-incontinence following former radiation therapy for uterine cancer, whereas 5 patients had advanced malignancies originating in the urethra, prostate, rectum or ovaries. The only case without malignant disease exhibited a contracted bladder of uncertain origin, together with an immunodeficiency syndrome. The approach used was an upper abdominal cross incision. In 35 patients, an anastomosis was done between the ureter and contralateral renal pelvis; in 22, a terminoterminal ureteral anastomosis was performed. For placement of the nephrostomy (49 terminal, 8 U-tube nephrostomies) we preferred the right side in 41 of 57 cases. The mean follow-up time in the 22 surviving patients was 36 months (range 2-108); the mean survival time in the 30 deceased patients was 12 months (range 0.5-87). With 4 exceptions, the cause of death was progression of the underlying tumors. Operative lethality was 1.75%, early surgical complication rate 7%, and rate of severe late complications 10.5%. The most frequent problems arose from the nephrostomy and from stenoses of the ureteropelvic or ureteral anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ureterotransversopyelostomy with unilateral nephrostomy]. 409 Jan 30

Human immunodeficiency virus (HIV) is commonly transmitted, during homosexual and heterosexual intercourse, through the rectal and cervicovaginal mucosa, foreskin and urethral epithelia. However, there is uncertainty about HIV transmission through the oral mucosa by oral sex. We have carried out a comparative immunohistological investigation of primate oral, cervicovaginal, foreskin, urethral and rectal epithelia for potential HIV receptors. We investigated epithelial tissues for CD4 glycoprotein, which is the principal receptor for HIV, Fc receptors of IgG for binding HIV-IgG antibody complexes, and HLA class II, which might enable HIV-bound CD4+ cells to gain access to the epithelial cells. CD4 glycoprotein was not found in oral, foreskin, urethral, vaginal or rectal epithelial cells, although CD4+ mononuclear cells were present in the lamina propria of each epithelium. Fc gamma II and Fc gamma III receptors were found in urethral, endocervical and rectal epithelia, and Fc gamma III and Fc gamma I receptors in the foreskin. However, Fc gamma receptors were not found in oral epithelium (buccal, labial, lingual or palatal) and only Fc gamma III receptors were detected in the gingival epithelial cells. HLA class II antigen was also not detected in foreskin, oral or rectal epithelium, but it was expressed by endocervical cells from most human specimens and in male urethral epithelia of non-human male primates. Langerhans' cells were found in all epithelia except those of the urethra and rectum, and they can express CD4 glycoprotein, Fc gamma receptors and HLA class II antigen. The mean number of Langerhans' cells expressing CD4 in the upper third of oral epithelium was significantly lower compared with vaginal epithelium or foreskin. The HIV-binding V1 domain of CD4 was significantly decreased in Langerhans' cells present in oral compared with vaginal epithelium. The results suggest that the foreskin in uncircumcised men and the cervicovaginal epithelium in females might become infected via the CD4+ Langerhans' cells. However, urethral infection might be mediated by HIV-antibody complexes binding to urethral epithelial Fc gamma receptors. The paucity of Langerhans' cells expressing the V1 domain of CD4, the absence of Fc gamma receptors, and a lack of expression of HLA class II antigens in most oral epithelial cells, argue against transmission of HIV through the normal intact oral mucosa.
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PMID:Comparative investigation of Langerhans' cells and potential receptors for HIV in oral, genitourinary and rectal epithelia. 755 38

Human immunodeficiency virus (HIV) can be transmitted through infected seminal fluid or vaginal or rectal secretions during heterosexual or homosexual intercourse. To prevent mucosal transmission and spread to the regional lymph nodes, an effective vaccine may need to stimulate immune responses at the genitourinary mucosa. In this study, we have developed a mucosal model of genital immunization in male rhesus macaques, by topical urethral immunization with recombinant simian immunodeficiency virus p27gag, expressed as a hybrid Ty virus-like particle (Ty-VLP) and covalently linked to cholera toxin B subunit. This treatment was augmented by oral immunization with the same vaccine but with added killed cholera vibrios. Polymeric secretory immunoglobulin A (sIgA) and IgG antibodies to p27 were induced in urethral secretions, urine, and seminal fluid. This raises the possibility that the antibodies may function as a primary mucosal defense barrier against SIV (HIV) infection. The regional lymph nodes which constitute the genital-associated lymphoid tissue contained p27-specific CD4+ proliferative and helper T cells for antibody synthesis by B cells, which may function as a secondary immune barrier to infection. Blood and splenic lymphocytes also showed p27-sensitized CD4+ T cells and B cells in addition to serum IgG and IgA p27-specific antibodies; this constitutes a third level of immunity against dissemination of the virus. A comparison of genito-oral with recto-oral and intramuscular routes of immunization suggests that only genito-oral immunization elicits specific sIgA and IgG antibodies in the urine, urethra, and seminal fluid. Both genito-oral and recto-oral immunizations induced T-cell and B-cell immune responses in regional lymph nodes, with preferential IgA antibody synthesis. The mucosal route of immunization may prevent not only virus transmission through the genital mucosa but also dissemination and latency of the virus in the draining lymph nodes.
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PMID:Mucosal model of genital immunization in male rhesus macaques with a recombinant simian immunodeficiency virus p27 antigen. 810 23

Between 1982 and 1990, 4 males with extensive intraurethral warts presented with marked inflammation of the external genitalia. When sepsis had settled all patients underwent ventral urethrotomy, in which the urethra was divided median as far back as was necessary to expose all of the warts. Surgical and electro-excision were the preferred methods of removal. Of 3 patients who developed recurrences 2 were lost to follow-up. A third remained without treatment for 1 year and when next seen the warts had spontaneously resolved and his urethra was closed. A fourth patient was lost to follow-up for 4 years before returning with destruction of his external genitalia by a verrucous carcinoma. The human immunodeficiency virus (HIV) did not appear to be a factor in the natural history of intraurethral warts in 2 patients who were negative for serum antibodies 2 and 8 years after presentation.
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PMID:Extensive condylomata acuminata of male urethra: management by ventral urethrotomy. 840 46

Sexually transmitted diseases (STD) constitute a frequent presenting complaint. The epidemiology of human immunodeficiency virus (HIV) infection is identical to that of STD and must therefore be systematically investigated in the presence of any STD. Chlamydia trachomatis (CT) is involved in the majority of cases of urethritis and epididymitis in young subjects and is present in the urethra of 10% of subjects with a genital ulcer. Genital ulcers are due to either Treponema Pallidum, Haemophilus ducreyi, or Herpes simplex virus: there is little clinicobacteriological correlation and it is therefore essential to perform laboratory examinations in order to establish the diagnosis. The prevalence of venereal vegetations due to HPV viruses has increased markedly over recent years and require effective treatment and surveillance because of the risk of carcinoma induced by viral oncogenesis. Other viral diseases such as hepatitis B are also classified as STD. The main diagnostic techniques used at the present time for each STD are reviewed and the consensually accepted therapeutic protocols are also proposed.
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PMID:[Sexually transmitted diseases in men]. 876 5

AIDS is a complex illness due to HIV type 1 and 2 infection. It is characterized by an important immunodeficiency mainly caused by depletion of CD4+ T lymphocytes. The reasons for this depletion have not been sufficiently clarified yet. In 1986, Shy Ching Lo astonished the scientific community with reported evidence concerning the direct role played by mycoplasma in the etiopathology of AIDS. Since then, different theories have pointed to mycoplasma as cofactors, commensals or opportunistic agents. Although in vivo and in vitro experiments are controversial they suggest a possible mechanism that would explain the synergism between both agents: the mycoplasma belonging to normal intestinal flora could move to urethra, oropharynx or blood due to high risk sexual practice. There it would proliferate favoured by early immunological disorders related to HIV. It has been speculated that several microorganisms including mycoplasma, acting as superantigens, could induce a chronic CD4+ and CD8+ T lymphocytes activation resulting in apoptosis of the infected lymphocytes. The release of cytokines induced by mycoplasma could influence the progression of the disease.
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PMID:[Mycoplasmas and AIDS]. 941 91

Sexually transmitted diseases (STDs) affect the physiology of male/female reproduction. Chronic bacterial infection of semen is uncommon, but may be a cause of male infertility. Antibacterial treatment results in improvement in sperm quality, once the infection is eradicated. Little is known about how infection with Mycoplasma hominis affects semen quality, but treatment with antibiotics improves motility and decreases the percentage of coiled tails. Chlamydia trachomatis is not frequently isolated from the urethral cultures of normal men, but is a major cause of nongonococcal urethritis and epididymitis. Chlamydia is an important cause of epididymal and oviductal obstruction. Trichomonas vaginalis most frequently colonizes the vagina and cervix of women and the anterior urethra of the male sexual partners. The highest prevalence is in sexually active men and women and Trichomoniasis may well be the most common STD. Syphilis may be an important cofactor in facilitating transmission of the human immunodeficiency virus (HIV). A history of syphilis or a positive serologic test for syphilis is associated with HIV seropositivity in men. In South Africa, the seropositivity in pregnant black women ranges from 11-20%. Ga-Rankuwa Hospital is the referral center for 40 peripheral hospitals and over 4 million people. Since the inception of the Andrology Laboratory in June 1985, more than 5300 semen analyses have been performed on 2000 patients.
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PMID:Sexually transmitted diseases (STD) in infertile males attending the andrology clinic at Ga-Rankuwa Hospital. 1228 85

We evaluated whether or not intraurethral instillation of 5-fluorouracil (5-FU) solution can rapidly, safely, and effectively eradicate intraurethral condyloma acuminata in a human immunodeficiency virus (HIV) carrier. A 43-year-old man presented with the major complaint of difficult micturition and blood dribbling from the urethral meatus for more than 6 months. He was an HIV carrier for more than 10 years and had undergone diathermy for perianal warts. Physical examination showed cauliflower lesions over the orifice of the urethra and frenulum base of the penile prepuce. Urinalysis disclosed pyuria and microscopic hematuria. Cystourethroscopy on the following day showed extensive wart lesions extending from the urethra to the bladder neck. Biopsy of the lesions was compatible with condyloma acuminata. 5-FU solution (500 mg in normal saline 50 mL) urethral instillation with massage at the ventral side of the penile shaft for 20 minutes was given once a week for 7 doses. The urine routine was normal. Management was then prescribed once a month until the lesions became invisible under urethroscopy. After 18 doses of 5-FU solution urethral instillation, no visible wart lesions were noted. He has been asymptomatic with no voiding difficulty for more than 1 year.
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PMID:Pan-urethral wart treated with 5-fluorouracil intraurethral instillation. 1697 Feb 77

Permanent drainage of the urinary tract by catheters or tubes causes bacteriuria. The potential harmful effects of the indwelling catheter's bacteriuria are related to: time since the insertion of the catheter; location of the catheter (urethra, bladder, kidney); catheter composition (latex, silicone, etc.); type of ineffective bacteria and specific pathogenic mechanisms; health status of the urinary tract being drained (prior radiation therapy, tumors, etc.); patient's health status (diabetes, immunodeficiency) and mobility; incidents and manipulations of the catheter, such as obstruction, irrigation, or retrieval. The evaluation of all mentioned factors enables strategies for prevention of septic episodes in relation with indwelling catheters, strategies that can be individualized for greater efficiency. Despite these preventive measures, infections secondary to the indwelling catheter may cause extremely severe septic episodes. Today, the indwelling catheter bacteriuria constitutes the greater source of nosocomial infection and its prevention and treatment a health care action of the highest importance. The study of mechanisms implied in the formation of biofilms, their pathogenic potential and preventive measures have been an attractive field of clinical and experimental research over the last years. The objective of this review is to make a synthesis of the works performed by our group.
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PMID:[Infections of the urinary tract caused by permanent catheterization. Natural history, infective mechanisms and prevention strategies. An overall review based on our clinical experience and research]. 1807 51


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