No abstract

Background: Mycobacterium tuberculosis (TB) infection of the liver, known as hepatic TB, is an extrapulmonary manifestation of TB. Hepatic TB has become more prevalent, likely as a result of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. We sought to review case series to characterize the epidemiology, pathophysiology, clinical features, diagnosis, and treatment of hepatic TB and to comment on the impact of HIV co-infection on these characteristics. Methods: We conducted a systematic literature search in PubMed and ScienceDirect for articles pertaining to hepatic TB with human subjects from 1960 to July 2013.

The collagens were studied in 13 normal and 19 myxomatous human mitral valves. The collagens of the valve were completely solubilized by using a method consisting of guanidinium chloride extraction, limited pepsin digestions and CNBr cleavage of the residue. The normal valves contained 74% type I, 24% type III and 2% type V collagen. The type I and type III collagens had similar solubility patterns, although only type I collagen was detected in the guanidinium chloride extract. Type V collagen was only detected in the first pepsin extract. The type I and III collagens had higher contents of hydroxylysine than did the same collagens from age-matched dermis. The two-dimensional electrophoretic 'maps' of CNBr-cleavage peptides showed low recoveries of the C-terminal alpha 1(I) CB6 and alpha 1(III) CB9 peptides, which are involved in forming intermolecular cross-linkages. Most of the reducible cross-linkages were present in large-Mr peptide complexes, and these complexes were shown by labelling with 125I to include the tyrosine-containing alpha 1(I) CB6 peptide. The myxomatous valves contained 67% type I, 31% type III and 2% type V collagens. There was a significant increase in the concentration of each type of collagen, which consisted of a 9% increase of type I collagen, a 53% increase of type III collagen and a 25% increase of type V collagen. The contents of hydroxylysine in type I and III collagens and the electrophoretic 'maps' of the CNBr-cleavage peptides involved in cross-linkages did not differ significantly from the results obtained from the normal valves. The biochemical findings suggest that there is an increased production of collagen, in particular type III collagen, and glycosaminoglycan as well as a proliferation of cells as part of a repair process in the myxomatous valves.

stead of the calculated one [21]. This is due to the fact that, at the self-consistent field level, the excitation energy is overestimated by a factor of 2±3 (this is brought about by the neglect of coulomb and exchange integrals).

Severe mitral regurgitation requiring surgery is the most common life-threatening complication of mitral valve prolapse (MVP) , and 1:28 (22-41), respectively. In women, the risk was less than half that in men (p<0.001). We conclude that the risk of developing severe mitral regurgitation is age and sex related, is minimal before the age of 50, and rises sharply after the age of 50, particularly in men, and that the current minimum number of patients requiring myxomatous mitral valve surgery in Australia is between 150 and 200 per year, a caseload that will increase with the advancing age of the population. The findings are consistent with the predictions of a response-to-injury hypothesis that explains the pathogenesis of progressive changes in the prolapsing mitral valve. (Circulation 1988;78:10-14) P rimary mitral valve prolapse, as opposed to that secondary to a systemic disorder of connective tissue or to a reduction in left ventricular cavity size, occurs with a prevalence of 2.5-5% in the adult population, according to recent surveys using careful clinical and echocardiographic diagnostic criteria. [1][2][3][4] It is relatively uncommon before the growth spurt of adolescence,5,6 but thereafter, the prevalence in men remains relatively constant. Most studies have found a greater prevalence in women than in men, and among women, there are data suggesting a greater prevalence in adolescence and young adulthood. 1,4 (However,