Background. Melanoma antigen genes (MAGE)and GAGE genes are encoded by genes t hat are silent in virtually all normal adult tissues but are expressed in tumors from various tissues. These gene products are targets for...Background. Melanoma antigen genes (MAGE)and GAGE genes are encoded by genes t hat are silent in virtually all normal adult tissues but are expressed in tumors from various tissues. These gene products are targets for specific immunotherap y as they are presented by HLA I molecules and recognized by autologous cytotoxi c T-lymphocytes. However, the characteristics of these genes, especially in ute rine cervical cancer are relatively unknown. Purpose. This study evaluated the p revalence of MAGE and GAGE by reverse transcription-poly-merase chain reaction (RT-PCR) with common primers and discusses clinical implications in cervical c arcinoma. Materials and methods. Fresh tissue from 37 cases of primary squamous cell carcinoma and normal cervical mucosa were evaluated for clinicopathologic p arameters including Human Papilloma Virus (HPV)-16,18 infection by PCR, tumor s tage by FIGO classification and lymph node involvement. RT-nested PCR for the M AGE and GAGE genes was performed with common primers and DNA sequencing after su bcloning was used for identification of PCR products of MAGE. Formalin-fixed pa raffin embedded material from the same specimen was analyzed by in situ RT-PCR for MAGE. Results. Expression of MAGE and GAGE was not observed in normal tissue s. Eleven out of 37 cases expressed MAGE mRNA (29.7%): analysis of subtypes ide ntified one case of MAGE-1, two cases of MAGE-4b, six cases of MAGE-3, and tw o unknown subtypes. Thirteen out of 37 cases (35.1%) expressed GAGE mRNA. No si gnificant relationships between expression of these genes and FIGO staging, lymp h node metastasis or HPV infection were found. Conclusion. Expression of MAGE an d GAGE may be involved in the development of uterine cervical carcinoma from int raepithelial neoplasia, although without distinct prognostic significance. MAGE and GAGE genes have the potential to be used as targets for the treatment of ute rine cervical carcinoma.展开更多
Hepatitis A virus (HAV) superinfection is associated with a high risk of liver failure and death in patients with underlying chronic liver disease. Although HAV vaccination is recommended for all patients with chronic...Hepatitis A virus (HAV) superinfection is associated with a high risk of liver failure and death in patients with underlying chronic liver disease. Although HAV vaccination is recommended for all patients with chronic hepatitis C virus (HCV) infection, little is known about adherence to these recommendations in clinical practice. The aims of this study were to determine the frequency of HAV testing and vaccination among patients with chronic HCV infection. We conducted a retrospective cohort study of 1,193 patients diagnosed with chronic HCV infection over a 1-year period. During 1,646 person-years of follow-up, patients were seen by their primary care provider a median of 10.0 times (interquartile range, 4.0- 20.0). HAV antibody testing was performed in 640 subjects (53.6% ), and 317 (49.5% ) of those tested were susceptible (HAV antibody negative). Only 94 of the 1,193 patients (7.9% ) received the HAV vaccine, including 26.8% of the 317 susceptible patients, 0.9% of the 323 patients who were already immune to HAV, and 1.1% of the 553 subjects who were never tested. Among the 94 vaccinated patients, 45 received only one dose of the vaccine. Three of the unvaccinated patients developed acute HAV infection during follow-up, and 1 of them died of acute liver failure. In conclusion, despite published recommendations to vaccinate against HAV in patients with chronic HCV infection, we found that HAV testing and vaccination rates were low in clinical practice. Public health programs to increase awareness about HAV vaccination in patients with chronic liver disease are needed.展开更多
Acute pancreatitis is a rare complication of interferon (IFN) and ribavirin (RBV) therapy. The aim of this study was to determine the incidence, clinical presentation, and outcome of acute pancreatitis in patients wit...Acute pancreatitis is a rare complication of interferon (IFN) and ribavirin (RBV) therapy. The aim of this study was to determine the incidence, clinical presentation, and outcome of acute pancreatitis in patients with chronic hepatitis C virus (HCV)-infection treated with IFN and RBV combination therapy. We conducted a retrospective review of 1706 HCV-infected patients treated with IFN α-2b and RBV. The diagnosis of drug-induced acute pancreatitis was made based on the presence of epigastric pain, elevated amylase and lipase levels, and the absence of other identifiable causes of pancreatitis. Acute pancreatitis was diagnosed in 7 of 1706 HCV-infected patients (0.4% ; 95% CI,0.2 to 0.8% ) who were treated with IFN α-2b and RBV. The mean age of the patients (four males and three females) was 51.4 ± 4.7 years and the median duration of therapy prior to development of pancreatitis was 12.0 weeks (range, 4.0-21.0 weeks). All patients presented with epigastric pain associated with nausea, vomiting, and/or fever. The median amylase and lipase values at the time of diagnosis of pancreatitis were 330.0U/L (range, 182.0-1813.0 U/L) and 500.0 U/L (range, 171.0-2778.0 U/L), respectively. IFN and RBV were discontinued in all patients at the time of diagnosis and six of the seven patients were hospitalized; one patient refused hospital admission.Pancreatitis resolved in all seven patients and none of these individuals had recurrent pancreatitis during a median follow-up of 18.0 months (range, 3.0-27.0 months). In conclusion,IFN and RBV combination therapy is a potential cause of drug-induced pancreatitis in patients with chronic HCV. In these individuals, pancreatitis is often severe enough to warrant hospital admission, although symptoms resolve promptly after discontinuation of antiviral therapy.展开更多
文摘Background. Melanoma antigen genes (MAGE)and GAGE genes are encoded by genes t hat are silent in virtually all normal adult tissues but are expressed in tumors from various tissues. These gene products are targets for specific immunotherap y as they are presented by HLA I molecules and recognized by autologous cytotoxi c T-lymphocytes. However, the characteristics of these genes, especially in ute rine cervical cancer are relatively unknown. Purpose. This study evaluated the p revalence of MAGE and GAGE by reverse transcription-poly-merase chain reaction (RT-PCR) with common primers and discusses clinical implications in cervical c arcinoma. Materials and methods. Fresh tissue from 37 cases of primary squamous cell carcinoma and normal cervical mucosa were evaluated for clinicopathologic p arameters including Human Papilloma Virus (HPV)-16,18 infection by PCR, tumor s tage by FIGO classification and lymph node involvement. RT-nested PCR for the M AGE and GAGE genes was performed with common primers and DNA sequencing after su bcloning was used for identification of PCR products of MAGE. Formalin-fixed pa raffin embedded material from the same specimen was analyzed by in situ RT-PCR for MAGE. Results. Expression of MAGE and GAGE was not observed in normal tissue s. Eleven out of 37 cases expressed MAGE mRNA (29.7%): analysis of subtypes ide ntified one case of MAGE-1, two cases of MAGE-4b, six cases of MAGE-3, and tw o unknown subtypes. Thirteen out of 37 cases (35.1%) expressed GAGE mRNA. No si gnificant relationships between expression of these genes and FIGO staging, lymp h node metastasis or HPV infection were found. Conclusion. Expression of MAGE an d GAGE may be involved in the development of uterine cervical carcinoma from int raepithelial neoplasia, although without distinct prognostic significance. MAGE and GAGE genes have the potential to be used as targets for the treatment of ute rine cervical carcinoma.
文摘Hepatitis A virus (HAV) superinfection is associated with a high risk of liver failure and death in patients with underlying chronic liver disease. Although HAV vaccination is recommended for all patients with chronic hepatitis C virus (HCV) infection, little is known about adherence to these recommendations in clinical practice. The aims of this study were to determine the frequency of HAV testing and vaccination among patients with chronic HCV infection. We conducted a retrospective cohort study of 1,193 patients diagnosed with chronic HCV infection over a 1-year period. During 1,646 person-years of follow-up, patients were seen by their primary care provider a median of 10.0 times (interquartile range, 4.0- 20.0). HAV antibody testing was performed in 640 subjects (53.6% ), and 317 (49.5% ) of those tested were susceptible (HAV antibody negative). Only 94 of the 1,193 patients (7.9% ) received the HAV vaccine, including 26.8% of the 317 susceptible patients, 0.9% of the 323 patients who were already immune to HAV, and 1.1% of the 553 subjects who were never tested. Among the 94 vaccinated patients, 45 received only one dose of the vaccine. Three of the unvaccinated patients developed acute HAV infection during follow-up, and 1 of them died of acute liver failure. In conclusion, despite published recommendations to vaccinate against HAV in patients with chronic HCV infection, we found that HAV testing and vaccination rates were low in clinical practice. Public health programs to increase awareness about HAV vaccination in patients with chronic liver disease are needed.
文摘Acute pancreatitis is a rare complication of interferon (IFN) and ribavirin (RBV) therapy. The aim of this study was to determine the incidence, clinical presentation, and outcome of acute pancreatitis in patients with chronic hepatitis C virus (HCV)-infection treated with IFN and RBV combination therapy. We conducted a retrospective review of 1706 HCV-infected patients treated with IFN α-2b and RBV. The diagnosis of drug-induced acute pancreatitis was made based on the presence of epigastric pain, elevated amylase and lipase levels, and the absence of other identifiable causes of pancreatitis. Acute pancreatitis was diagnosed in 7 of 1706 HCV-infected patients (0.4% ; 95% CI,0.2 to 0.8% ) who were treated with IFN α-2b and RBV. The mean age of the patients (four males and three females) was 51.4 ± 4.7 years and the median duration of therapy prior to development of pancreatitis was 12.0 weeks (range, 4.0-21.0 weeks). All patients presented with epigastric pain associated with nausea, vomiting, and/or fever. The median amylase and lipase values at the time of diagnosis of pancreatitis were 330.0U/L (range, 182.0-1813.0 U/L) and 500.0 U/L (range, 171.0-2778.0 U/L), respectively. IFN and RBV were discontinued in all patients at the time of diagnosis and six of the seven patients were hospitalized; one patient refused hospital admission.Pancreatitis resolved in all seven patients and none of these individuals had recurrent pancreatitis during a median follow-up of 18.0 months (range, 3.0-27.0 months). In conclusion,IFN and RBV combination therapy is a potential cause of drug-induced pancreatitis in patients with chronic HCV. In these individuals, pancreatitis is often severe enough to warrant hospital admission, although symptoms resolve promptly after discontinuation of antiviral therapy.
