Interrelación entre Anatomía Patológica y Dermatología ilustrada mediante un caso clínico de sarcoma de Kaposi / Illustrating the relationship between Pathological Anatomy and Dermatology by means of a clinical case of Kaposi's Sarcoma

Se presenta el caso clínico de un paciente asistido en el servicio de Dermatología por tener lesión tumoral gigante en calcáneo derecho de instauración progresiva. La biopsia incisional muestra sarcoma de Kaposi endémico sin afectación visceral. El estadio tan avanzado de la enfermedad propició la evolución tórpida del paciente. El estudio histopatológico estableció el diagnóstico certero de la lesión tumoral; la biopsia fue el método auxiliar que estableció el vínculo necesario entre el examen macroscópico y microscópico de la piel, y la interrelación básico-clínica entre dos disciplinas: Anatomía Patológica y Dermatología.

We present a clinical case of a patient seen in the Dermatology service due to a progressive giant cell tumour in the right calcaneus. Incisional biopsy shows endemic Kaposi's sarcoma without visceral involvement. The advanced stage of the disease led to the torpid evolution of the patient. The histopathological study established the accurate diagnosis of the tumour lesion, the biopsy was the auxiliary method that established the necessary link between the macroscopic and microscopic examination of the skin and the basic and clinical relationship between two disciplines: Pathological Anatomy and Dermatology.

Seroprevalence of antibodies against herpesvirus type 2 in a female prison population in Mato Grosso / Soroprevalência de anticorpos contra herpesvírus tipo 2 em população prisional feminina mato-grossense

Descrever a soroprevalência de anticorpos contra herpes vírus simples 2 em reeducandas de uma cadeia pública feminina de Mato Grosso no ano de 2016. Trata-se de um estudo transversal com abordagem quantitativa, realizado com 50 reeducandas reclusas de uma cadeia pública feminina de Mato Grosso. A coleta de dados foi realizada por meio de entrevista com 50 mulheres. Para determinar a soroprevalência da infecção por HSV-2, foram analisadas amostras de soro pelo método ELISA em busca de anticorpos do tipo IgG no Laboratório de Imunologia Viral do Instituto Oswaldo Cruz ­ RJ. A soroprevalência de HSV-2 encontrada na população avaliada foi de 80%, valor muito superior ao relatado na população geral brasileira e em outras estudos com populações prisionais em todo o mundo. O perfil das reeducandas predominou entre mulheres jovens, pardas, com baixa escolaridade, solteiras e com renda mensal baixa. O presente estudo encontrou alta soroprevalência de anticorpos contra HSV-2 nesta população. Esses dados fornecem importantes informações que podem auxiliar na implementação de ações efetivas que melhor previnam e controlem a herpes genital, bem como as demais ISTs em populações encarceradas.

Research progress on clustered regularly interspaced short palindromic repeats-associated 9 system for the treatment of HSV / 中华检验医学杂志

Herpes simplex virus (HSV) is a double-stranded DNA enveloped virus that causes severe effects on the human body by infecting the skin and nerve tissues. Because of latency and reactivation, the rapid detection and eradication of HSV are great challenges for clinical treatments. In recent years, clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Cas9) system has developed rapidly in the field of gene editing and detection due to its simple design and high targeting efficiency.

Identificación etiológica de agentes virales de la encefalitis aguda en Guadalajara, México, 2011-2015 / Etiological identification of viral agents in acute encephalitis in Guadalajara, México, 2011-2015

Resumen Introducción. La encefalitis viral aguda se define como un proceso inflamatorio asociado a disfunción neurológica con desenlace fatal o daño grave permanente. En México no se han hecho estudios de identificación directa de los agentes etiológicos causales de la encefalitis viral aguda. Objetivo. Identificar mediante PCR en tiempo real los principales agentes virales causantes de encefalitis viral aguda en México. Materiales y métodos. Se obtuvo el líquido cefalorraquídeo de pacientes con sospecha de encefalitis viral que ingresaron al servicio de urgencias del Hospital Civil Fray Antonio Alcalde. Se extrajeron ácidos nucleicos para identificar los patógenos mediante PCR y PCR con transcripción inversa en tiempo real. Resultados. Se captaron un total de 66 pacientes entre el 2011 y el 2014. En 16 de los casos (24 %) se identificó el agente viral y se encontró que el principal agente causal fue el enterovirus, con ocho casos (50 %), seguido del virus del herpes simple (HSV: 37 %), con seis casos, y el citomegalovirus (CMV: 12,5 %), con dos casos. El promedio de edad fue de 25 años (0-70 años). Los casos positivos predominaron en los varones (63,3 %) y se estableció un predominio estacional en otoño (37,5 %). La mayoría de los pacientes presentó fiebre (48,4 %) o cefalea (36,3 %) y, en menor proporción, convulsiones, confusión y debilidad muscular (30,3 %) seguidas de desorientación (28,75 %) y apatía (25,7 %). En dos de los casos se observó el signo de Kerning (3 %) y en otros dos, el signo de Brudzinski (3 %). Conclusiones. La PCR en líquido cefalorraquídeo es una técnica de diagnóstico adecuada para la identificación de virus causales de encefalitis viral, lo cual permite prescribir los medicamentos específicos.

Abstract Introduction: Viral encephalitis is a well-known inflammatory process associated with neurological dysfunction that might derive into severe brain damage or a fatal outcome. In México there is no epidemiological data that describes the prevalence of viral agents responsible for acute encephalitis. Objective: To identify the main viral agents by real time PCR involved in acute encephalitis in Mexico. Materials and methods: We obtained cerebral spinal fluid (CSF) samples from all patients with suspected viral encephalitis admitted to the emergency service of the Hospital Civil de Guadalajara "Fray Antonio Alcalde". To identify pathogens, we performed nucleic acid extraction using real-time PCR and RT-PCR. Results: Sixty-six patients were diagnosed with acute encephalitis from 2011 to 2014. A definitive viral etiological diagnosis was established in 16 patients (24%); the main causative agents were enteroviruses in 50% of the 16 positive samples, followed by herpes simplex virus (37%) and cytomegaloviruses (12.5%). Patients with encephalitis were predominantly male (63.3%) and a seasonal predominance was observed during autumn (37.5%). The main clinical characteristics in the acute encephalitis phase were fever (48.45) and cephalea (36.3), followed by seizures, disorientation, and muscular weakness (30.3%). Kerning sign was present in two cases (3%) and other two cases presented Brudzinski's sign (3%). Conclusions: CSF PCR is a suitable diagnostic technique for the identification of viral encephalitis caused by viral infections that allows an appropriate antiviral therapeutic treatment.

Mechanism of herpes virus latent infection and its significance / 白血病·淋巴瘤

Human herpes virus (HHV) spreads widely in a latent-infected way. HHV is divided into 3 kinds and 8 types. Herpes simplex caused by HHV-1 and HHV-2, varicella-zoster caused by HHV-3 and Epstein-Barr virus (EBV) known as HHV-4 and recognized firstly as human tumor virus, are well known in the field of virology. With the application of hematopoietic stem cell transplantation , cytomegalovirus (HHV-5) and HHV-6 have gained an increasing attention. The biological characteristic of HHV is latent infection in a long time and HHV can be reactivated in some immunocompromised individuals. Clarification of latent infection mechanism will help provide targets for therapy and lay a foundation for clinical treatment. This paper summarizes the clinical significance of HHV infection. Taking the mechanism of EBV latent infection as an example, the pathway and significance as well as strategy of co-evolution of organism and virus will be discussed in order to provide clues for prevention and therapy.

Clinical Significance of the Levels of IgG Antibodies Against HSV,CMV and EBV in Patients' Serum with Pemphigus Vulgaris / 现代检验医学杂志

Objective To regard the implication of viruses particularly herpes in pemphigus vulgaris,and assess and compare the level of immunoglobulin G (IgG) antibodies against herpes simplex virus types 1 and 2 (HSV1 and HSV2),cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in patients with pemphigus vulgarisand healthy people.Methods In this study,23 patients with pemphigus vulgaris and 26 healthy individuals comprised the experimental and control groups,respectively.Serum samples were taken from both groups;the levels of IgG antibodies against HSV1,HSV2,CMV and EBV were measured using ELISA.Results Immunoglobulin G titer was higher for all four viruses in the patient group in comparison to the control group.This difference was significant for anti-EBV,anti-CMV and anti-HSV2 (t=2.16,P＜0.05;t =4.76,P＜ 0.01;t=3.75,P＜0.01),respectively,but not significant for anti-HSV1 (t=0.52,P＞0.05).Conclusion Viruses including EBV,CMV,and HSV2 probably play a role in the pathogenesis of pemphigus in addition to the effects of genetics,toxins and other predisposing factors.In this study,no statistically significant relationship was observed between HSV1 and pemphigus vulgaris.More studies must be done in this regard.

Descarga de HSV-1, HSV-2, CMV y EBV en la saliva de receptores de trasplante de precursores hematopoyéticos de la Fundación HOMI - Hospital de la Misericordia, Bogotá, DC / Shedding of HSV-1, HSV-2, CMV, and EBV in the saliva of hematopoietic stem cell transplant recipients at Fundación HOMI - Hospital de la Misericordia, Bogotá, DC

Introducción. El trasplante de precursores hematopoyéticos es una alternativa en el tratamiento de diversas condiciones en la población pediátrica. La intensidad del acondicionamiento para el trasplante predispone al desarrollo de complicaciones en los receptores. Las infecciones por el virus herpes simple 1 (HSV-1), el virus herpes simple 2 (HSV-2), el citomegalovirus (CMV) humano y el virus de Epstein-Barr (EBV) son una causa importante de morbimortalidad en estos pacientes. La reactivación de infecciones latentes puede producir descargas virales asintomáticas detectables en la saliva, lo cual ayuda a determinar el comportamiento de dichas infecciones en pacientes con trasplante y a establecer el diagnóstico temprano de la reactivación. Objetivo. Evaluar el comportamiento de la descarga viral de HSV-1, HSV-2, CMV y EBV en la saliva de pacientes hospitalizados en la Unidad de Trasplante de la Fundación HOMI - Hospital de la Misericordia, entre enero y noviembre de 2012. Materiales y métodos. Se evaluaron muestras de saliva de 17 receptores de trasplante. La presencia de ADN de HSV-1, HSV-2, CMV y EBV en las muestras de saliva se detectó mediante reacción en cadena de la polimerasa convencional. Resultados. Se detectó el ADN del HSV-2 en la saliva de cuatro pacientes, del CMV en la de cuatro y del EBV en la de nueve, lo cual se asoció con leucopenia. Cuatro de los 17 pacientes presentaron cargas simultáneas de CMV y EBV. No se detectó el ADN del HSV-1. Conclusiones: Se demostró una descarga asintomática de HSV-2, CMV y EBV asociada a leucopenia en la saliva de los pacientes.

Introduction: Hematopoietic stem cell transplantation in pediatric patients is an alternative treatment for different diseases. The conditioning regimen for transplant predisposes recipients to the development of infections. Viral infections by herpes simplex virus 1 (HSV-1), herpes simplex virus 2 (HSV-2), human cytomegalovirus (CMV), and Epstein-Barr virus (EBV), are the most common, and the leading cause of morbidity and mortality among these patients. These viruses lie dormant in various cell types and the reactivation of latent infections may lead to asymptomatic viral shedding in saliva. The detection of these viruses in secretions may contribute to understand the behavioral dynamics of these viral infections in transplanted patients, and to the early diagnosis of reactivation. Objective: To assess HSV-1, HSV-2, CMV and EBV viral shedding in the saliva of patients admitted for hematopoietic stem cell transplantation at Fundación HOMI - Hospital de la Misericordia between January and November of 2012. Materials and methods: We evaluated stimulated saliva samples of 17 hematopoietic stem cell transplantation recipients weekly. We performed DNA extraction from saliva, and we evaluated the presence of DNA for HSV-1, HSV-2, CMV, and EBV by PCR. Results: While we detected HSV-2 and CMV DNA in the saliva of four patients, EBV DNA was detected in nine patients with leukopenia. In contrast, we did not detect HSV-1 DNA in saliva. Additionally, four out of the 17 patients showed a simultaneous shedding of CMV and EBV. Conclusions: By conventional PCR, we demonstrated asymptomatic HSV-2, CMV, and EBV viral shedding in saliva, associated with leukopenia.

Epidemiological surveillance of herpes viral encephalitis in Cordoba, Colombia / Vigilancia epidemiológica de encefalitis por herpes virus en Córdoba, Colombia

Objective To establish an epidemiological surveillance of viral herpes encephalitis in major hospitals of Monteria, Cordoba. Methods From September 2009 to December 2011, a descriptive study of cases of viral encephalitis was made in three hospitals in the city of Monteria. Cerebrospinal fluid (CSF) samples from 118 patients were included in the study. Clinical aspects, as well as cytochemical and microbiological analysis (Gram stain and culture) of CSF, were used for selecting the patients. Virus detection was performed by using multiplex nested PCR for Herpes simplex virus 1 and 2, Epstein Barr virus, Cytomegalovirus and Varicella zoster virus. Results Viral DNA of herpesvirus was detected in the CSFs of 30 (25.4 %) participants, as follows: 22 (18.6 %) Herpes simplex 1 and 2 viruses, 4 (3.3 %) Cytomegalovirus and 1 (0.8 %) Varicella zoster virus. Co-infections were observed in 3 patients (2.5 %), 1 case by HSV-VZV and 2 cases by CMV/HSV. The clinical manifestations of the patients included: headache (18.6 %), fever (14.4 %), asthenia (10.1 %), seizures (9.3 %), vomiting (8.4 %), and stiff neck (5.9 %). Thirty percent of the patients also had HIV-AIDS. A case fatality rate of 20 % was observed for the patients. Conclusions This paper shows that herpesvirus is a cause of infection of the CNS in patients from Cordoba. This study contributes to the epidemiology of encephalitis, as well as to patient management.(AU)

Objetivo Establecer una vigilancia epidemiológica de la encefalitis viral herpética en los principales hospitales de Montería, Córdoba. Materiales y Métodos Se realizó un estudio descriptivo de los casos de encefalitis viral entre septiembre de 2009 diciembre de 2011 en tres hospitales en la ciudad de Montería. Las muestras líquido cefalorraquídeo (LCR) de 118 pacientes fueron incluidos en el estudio. Los aspectos clínicos como el análisis citoquímico y microbiológico (tinción de Gram y cultivo) de LCR fueron utilizados para la selección de los pacientes. La detección de virus se realizó por PCR anidada multiplex para Herpes simplex virus 1 y 2, virus de Epstein Barr, virus zoster de la varicela y el citomegalovirus. Resultados Se detectó ADN viral del virus del herpes en 30 (25,4 %) muestras de LCR en los pacientes de la siguiente manera: 22 (18,6 %) Herpes simplex virus 1 y 2, 4 (3,3 %) Citomegalovirus y 1 (0,8 %) del virus de la varicela zóster. Se observaron Co-infecciones en 3 pacientes (2,5 %), 1 caso por el VHS-VZV y 2 casos por CMV / HSV. Las manifestaciones clínicas de los pacientes fueron: cefalea (18,6 %), fiebre (14,4 %), astenia (10,1 %), convulsiones (9,3 %), vómitos (8,4 %), y rigidez de nuca (5,9 %). El treinta por ciento de los pacientes también tenía VIH-SIDA. Se observó una tasa de letalidad del 20 % de los pacientes. Conclusiones Se demuestra que el herpesvirus es causa de infección del SNC en pacientes en Córdoba. Este estudio contribuye a la caracterización serológica viral epidemiológica de la encefalitis viral, así como en el manejo del paciente ya que se describen hallazgos clínicos importante en la población adulta estudiada.(AU)

The detection of herpes simplex virus infection rate by jointly using chemiluminescence assay and PCR / 国际检验医学杂志

Objective Detect the infection rate of herpes simplex virus (HSV ) by jointly using chemiluminescence assay and PCR ,and provides reference for clinical diagnosis .Methods The serum samples were collected from the pregnant women who had routine examination records in the hospital .Chemiluminescence assay was used to detect HSV IgM and IgG in those samples .Cervi‐cal secretions were collected from pregnant women with positive results and qualitatively tested for HSV DNA .Results The posi‐tive rate of HSV1 DNA was 0 .5% (7/1 422) ,the positive rate of HSV2 DNA was 1 .1% (16/1 422) .For pregnant women whose HSV IgM and IgG were both positive ,positive rate of HSV1 DNA was 0 .4% (4/1 008) and that of HSV2 DNA was 0 .6%(6/1 008);for those who only had HSV IgM positive ,the positive rate of HSV1 DNA was 0 .8% (1/130) ,and that of HSV2 DNA was 3 .1% (4/130);for those who only had HSV IgG positive ,the positive rate of HSV1 DNA was 0 .7% (2/284) ,that of HSV2 DNA was 2 .1% (6/284) .Among those three HSV antibody positive cases ,the difference in HSV1 DNA positive rate was not sta‐tistically significant(P>0 .05) ,while the difference in HSV2 DNA positive rate was statistically significant(P<0 .05) .Conclusion The test of HSV antibodies during pregnancy can be used as a routine test ,and HSV DNA test can be used as further test for those with HSV antibody positive ,which could improve the accuracy of diagnosis .Early screening ,detection ,and treatment are im‐portant for pregnant women with HSV infection .

TORCH serologic screening in fertile women and infants and its clinical values from 2008 to 2015 / 中华检验医学杂志

Objective To retrospectively study the serum IgG and IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2 in various populations, and analyze the clinical values.Methods From 2008 to 2015, 2 661 pregnant women, 324 infertile women, 2 492 women with abnormal pregnancy history, 623 women with recent abnormal pregnancy, 261 infants with intrauterine growth retardation and other diseases, 170 women for preconceptual examination, and 702 women for physical examination in Beijing were included .Commercial EIA kits were used to detect serum IgG and IgM antibodies to toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2. Positive reactions of IgM antibodies to any pathogens were re-tested with another kind of commercial EIA kit. PEMS3.1 software was used for statistical analysis.Results The prevalence of serum IgG or IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1& 2 were found within 0.7%-1.6%(0-1.2%) , 85.3%-92.0% ( 0.4%-2.7%) , 89.1%-94.9% ( 0.7%-1.7%) , 74.8%-86.0% ( 0 -0.7%) , 8.1% -17.4% ( 0 -4.1%) respectively in the studied population groups.The prevalence of TORCH IgG and IgM antibodies were not found to be higher in both populations with past suspicious exposure ( infertile women and women with abnormal pregnancy history ) and recent suspicious exposure ( women with recent abnormal pregnancy and infants with intrauterine growth retardation and other diseases) than that in pregnant women and women for preconceptual and physical examination. Conclusion No associations between TORCH infections and the suspicious exposure were found in the populations above.

Synthesis and verification of herpes simplex virus envelope glycoprotein gC / 中华皮肤科杂志

Objective To synthesize herpes simplex virus (HSV) envelope glycoprotein gC using gene engineering techniques,and to verify its expression.Methods Two separate parts of the HSV envelope glycoprotein gC,i.e.,GC-F and GC-R,were respectively synthesized.The GC-F and GC-R genes were synthesized,subcloned into the expression vectors pSumo-Mut (containing recognition sequences for endonucleases Stu1 and XhoI) and pCzn1 (containing recognition sequences for endonucleases NdeI and XhoI) respectively to form the recombinant plasmids pSumo-Mut-GC-F and pCzn1-GC-R.E.coli BL21 Arctic Express (DE3) cells were transformed with the two recombinant plasmids separately.Isopropyl thiogalactoside (IPTG) was used to induce the expression of target protein which was subsequently purified by nickel affinity chromatography.Finally,Western blot was performed to verify the reactivity of the synthesized protein with the sera of HSV-1-positive patients.Results Both GC-F and GC-R genes were synthesized by a total gene synthesis method.As sodium dodecyl sulfate polyacrylamide gel electropheresis (SDS-PAGE) showed,the fusion proteins were mainly distributed in the sediment layer.The purity of GC-F and GC-R proteins was over 80％ after purification by affinity chromatography.Western blot showed that both of the proteins were reactive with anti-HSV-1 antibody-positive sera.Conclusions Fusion expression vectors have been constructed for the gC protein,and IPTG successfully induces its expression.Moreover,the resulting proteins could react with anti-HSV-1 antibody-positive sera,and may serve as an ideal experimental material for next functional study.

Bilateral lineal endotheliitis: case report / Endotelite linear bilateral: relato de caso

To report the case of a patient with bilateral herpetic lineal endotheliitis successfully treated with topic steroids and systemic antiviral. 17 year old female with blurred vision, at evaluation localized edema was observed on both corneas associated to Descemet folds and a line of pigmented precipitates. Topic prednisolone and oral acyclovir are initiated with complete resolution of signs and symptoms. Lineal endotheliitis is produced as an answer of endotelial cells to viral infection; maybe due to an immune reaction against some antigens from herpes virus family. It has the potential of relapses even in the absence of viral replication, with secondary untreatable stromal edema. It responds well to antiviral and steroids treatment, although, on those patients who don't improve, is necesary to make additional tests.

Relatar o caso de uma paciente com endotelite linear herpética bilateral tratado com sucesso por meio de corticoides tópicos e antivirais sistêmicos. Paciente do sexo feminino, 17 anos de idade, com a visão turva, na avaliação foi observado edema localizado em ambas as córneas associadas a dobras de Descemet e uma linha de precipitados ceráticos pigmentados. Prednisolona tópica e aciclovir oral foram utilizados com resolução completa dos sinais e sintomas. A endotelite linear é uma resposta das células endoteliais à infecção viral, talvez devido a uma reação imunológica contra alguns antígenos do vírus da família do herpes. Tem o potencial de recidiva, mesmo na ausência de replicação viral, com edema estromal secundário intratável. Ela responde bem ao tratamento antiviral e esteroides, embora, em pacientes que não melhoram, é necessária a realização de testes adicionais.

Comparative Analysis of Polymerase Chain Reaction Assay for Herpes Simplex Virus 1 Detection in Tear

PURPOSE: To comparatively analyze the methodological efficacy of the polymerase chain reaction (PCR) assay for herpes simplex virus 1 (HSV) detection in tears. METHODS: This retrospective study reviewed the medical records of 115 patients who were clinically diagnosed with herpes keratitis, and their tear samples were collected for HSV detection. PCR positive rates were analyzed for their dependence on the PCR primers used (conventional PCR primer vs. nested PCR primer), the tear collecting method used (micropipetting vs. collection with schirmer strip), the disease manifestation and the patient's previous medication history. RESULTS: HSV DNA was detected in 23 out of 115 (20%) tear samples. The PCR positive rate in tear samples did not differ depending on the PCR primer or tear collection method used. Typical epithelial lesions showed a higher positive rate (31.4%) than atypical epithelial lesions (10.9%). The previous history of the antiviral agent seemed to affect the PCR positive rate. CONCLUSIONS: Although the PCR positive rate was not dependent on the tear collection method or primers, HSV detection in tears using PCR was shown to be a supplementary diagnostic test in typical and atypical herpes epithelitis.

Upper Gastrointestinal Hemorrhage from Esophageal Ulcer Caused by Coinfection of Herpes Simplex Virus and Cytomegalovirus in Immunocompromised Patient

Coinfection with herpes simplex virus and cytomegalovirus is a very rare cause of esophageal ulcer and upper gastrointestinal hemorrhage. A 26 year-old male kidney transplant recipient was referred with a complaint of melena. Upper gastrointestinal endoscopy showed a huge esophageal ulcer in the anastomosis site of the esophagogastrostomy. The ulcer occupied about two-thirds of the circumference of the esophageal lumen and an exposed vessel in the ulcer base was noted. Pathologic findings with immunohistochemical stain showed co-infection of herpes simplex virus and cytomegalovirus. He was treated successfully with endoscopic hemostasis and antiviral therapy. We report a case of upper gastrointestinal hemorrhage from esophageal ulcer caused by coinfection of herpes simplex virus and cytomegalovirus.

Upper Gastrointestinal Hemorrhage from Esophageal Ulcer Caused by Coinfection of Herpes Simplex Virus and Cytomegalovirus in Immunocompromised Patient

Coinfection with herpes simplex virus and cytomegalovirus is a very rare cause of esophageal ulcer and upper gastrointestinal hemorrhage. A 26 year-old male kidney transplant recipient was referred with a complaint of melena. Upper gastrointestinal endoscopy showed a huge esophageal ulcer in the anastomosis site of the esophagogastrostomy. The ulcer occupied about two-thirds of the circumference of the esophageal lumen and an exposed vessel in the ulcer base was noted. Pathologic findings with immunohistochemical stain showed co-infection of herpes simplex virus and cytomegalovirus. He was treated successfully with endoscopic hemostasis and antiviral therapy. We report a case of upper gastrointestinal hemorrhage from esophageal ulcer caused by coinfection of herpes simplex virus and cytomegalovirus.

Diagnóstico molecular de las infecciones neurológicas por herpes virus en pacientes de la ciudad de Medellín / Molecular diagnosis of neurological herpes virus infection in patients from Medellin / Diagnóstico molecular das infecções neurológicas por herpes virus em pacientes da cidade de Medellín

Objetivo: describir la frecuencia, y el comportamiento clínico y de laboratorio de las infecciones por citomegalovirus (CMV), virus Epstein-Barr (EBV) y virus herpes simplex 1 y 2 (HSV 1 y HSV 2) en el sistema nervioso central tanto en pacientes inmunocomprometidos como inmunocompetentes. Metodología: se analizaron 204 líquidos cefalorraquídeos con el uso de la reacción en cadena de la polimerasa (PCR, de su sigla en inglés) en tiempo real como herramienta diagnóstica molecular para la detección de infección. Resultados: un 16% de los líquidos cefalorraquídeos es positivo para alguno de los virus estudiados, el EBV se detectó en el 22.8% de los casos positivos y se ubica por encima de las infecciones ocasionadas por HSV y CMV. El 61.9% de los pacientes con resultado positivo tenía algún tipo de inmunocompromiso. onclusiones: la utilización de la PCR en tiempo real permite establecer el agente causal de infección en el sistema nervioso central y es de gran ayuda en los pacientes inmunocomprometidos en los que las variaciones clínicas y de laboratorio no son concluyentes. Esto permitiría la implementación de una terapia específica.

Objective: To describe the frequency and the clinical and laboratory characteristics of infections with cytomegalovirus (CMV), Epstein-Barr (EBV) and herpes simplex virus 1 and 2 (HSV 1 and HSV 2) in central nervous system in both immunocompetent and immunocompromised patients. Methods: A total of 204 cerebrospinal fluid samples were tested for CMV, EBV or HSV 1 and 2 using real time PCR as a molecular diagnostic tool for detection of infection. Results: Sixteen percent of cerebrospinal fluid was positive for at least one of the viruses, and Epstein Barr virus was detected in 22.8% of cases, which is above the infections caused by HSV and CMV. 61.9% of positive patients had some form of immune compromise. Conclusions: The use of real-time PCR identifies the causative agent of infection in the central nervous system and is of great help in immunocompromised patients where clinical and laboratory variations are inconclusive; this will also help to implement a specific therapy.

Objetivo: descrever a frequência, e o comportamento clínico e de laboratório das infecções por citomegalovírus (CMV), vírus Epstein-Barr (EBV) e vírus herpes simplex 1 e 2 (HSV 1 e HSV 2) no sistema nervoso central tanto em pacientes imuno-comprometidos como imuno-competentes. Metodologia: analisaram-se 204 líquidos cefalorraquídianos utilizando a reação em corrente da polimerase (PCR, de sua sigla em virilhas) em tempo real como ferramenta diagnostica molecular para a detecção de infecção. Resultados: um 16% dos líquidos cefalorraquídianos foram positivos para algum dos vírus estudados, o EBV se detectou no 22.8% dos casos positivos localizando-se acima das infecções ocasionadas por HSV e CMV. O 61.9% dos pacientes com resultado positivo tinha algum tipo de imuno-compromisso. Conclusões: a utilização da PCR em tempo real permite estabelecer o agente causal de infecção no sistema nervoso central sendo de grande ajuda nos pacientes inmunocomprometidos onde as variações clínicas e de laboratório não são concludentes e isto permitiria a implementação de uma terapia específica.

Prevalence of toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus infections among 3084 individuals with childbearing-age in Henan province / 中华临床感染病杂志

Objective To investigate the prevalence of toxoplasma gondii (Tox),rubella virus (RV),cytomegalovirus (CMV) and herpes simplex virus (HSV) infections (TORCH infections) among childbearing-age population in Henan province.Methods Enzyme-linked immunosorbent assay (ELISA) was applied to detect plasma TORCH IgM and IgG among 3084 childbearing-age men and women from theFirst Affiliated Hospital of Zhengzhou University during July and September,2011.The positive rates of anti-TORCH antibodies were compared among the various age and gender groups by x2 test.Results The total positive rate of anti-TORCH IgM was 5.5％ (170/3084),in which the positive rate of anti-RV IgM was the highest (2.9％),followed by anti-HSV IgM (1.0％).Within positive rate of anti-TORCH IgG,anti-HSV IgG was the highest (90.4％),followed by anti-CMV IgG (89.7％),RV IgG (48.1％) and Tox IgG (0.7％).The positive rate of anti-TORCH IgM was the lowest in individuals aged ＞ 30-40 year old.With the age increasing,the positive rates of anti-Tox IgG,anti-CMV IgG and anti-HSV IgG increased,but the positive rate of anti-RV IgG decreased.Women had higher positive rates of anti-CMV IgG and antiHSV IgG than men (x2 =83.470 and 7.026,P ＜ 0.O1).Conclusions Current infection of TORCH exists in childbearing-age population of Henan province,and the positive rate of anti-RV IgG is low.It is recommended to screen for TORCH infection in childbearing-age men and women.

Long-term and stable expression of transgene mediated by piggyBac transposon in gynecological malignant tumor cells / 中华妇产科杂志

Objective To investigate the expression of exogenous gene transferred by piggyBac (PB) transposon in various gynecological malignant cell lines and reveal its potential application of gene therapy in gynecological cancer.Methods Amplified herpes simplex virus thymidine kinase (HSV-tk) gene coding region by PCR and integrated it into PB expression vector, PB[Act-RFP]DS, for reconstructing PB[Act-RFP, HSV-tk]DS (pPB/TK).By using different transfection reagents: FuGENE HD, jetPEI, lipofectamine 2000, pPB/TK together with helper plasmid Act-PBase were cotransfected into four mostly common gynecological malignant tumor cell lines HeLa, JEG-3, SKOV3 and HEC-1B.The mRFP1 report gene expressions was observed and detected by fluorescence microscope and flow cytometry to analyze transfection efficiency.The expressions of HSV-tk and mRFP1 gene were detected by reverse transcription PCR (RT-PCR).The cytotoxic effect of various concentration of pro-drug ganciclovir (GCV) for transfected cells was detected by methyl thiazole tetrazolium assay.The transfected cells were positive sorted by flow cytometry and limiting diluted to obtain the stable transfected cell line.The insertion sites of foreign gene tranferred by PB transposon in genome were analyzed by inverse PCR.Results (1) Double digests analysis and sequences test demonstrated that pPB/TK vector was reconstructed successfully.(2) Using three different transfective reagents, PB trausposon transferred HSV-tk gene and mRFP1 gene into HeLa, HEC-1 B, SKOV3 and JEG-3 cell efficiently, and the transfection efficiency of pPB/TK for the same cell was different by using different transfective reagents; in Hela cell, the transfection efficiency of FuGENE HD [(78.7 ± 9.2) %]was higher than that of lipofectamine 2000 [(54.1 ± 11.4) %]and jetPEI [(46.5 ± 7.4) %, all P < 0.05] ; using the same transfective reagent, the transfection efficiency of pPB/TK was also different on various cell lines, using FuGENE HD, the transfeetion efficiency of pPB/TK on HeLa, JEG-3 and SKOV3 cell was (78.7 ± 9.2) %, (74.4 ± 8.9) % and (83.2 ± 9.7) % respectively, which all were higher than that on HEC-1B [(39.5 ± 8.7) %, P < 0.05] .(3) RT-PCR showed that there were the mRNA expression of HSV-tk and mRFP1 in all cell lines.(4) 50% inhibitory concentration of GCV for transfected cells, HeLa, JEG-3, SKOV3 and HEC-1B, was 1.29, 3.35, 0.09 and 13.28 μg/ml respectively.Inhibitory effect of GCV (10 μg/ml) on SKOV3 transfected with pPB/TK was (86 ± 9) %, which was superior to that transfected with pORF-HSVtk alone [(52 ± 12)%, P < 0.05] .(5) The insertion sites of PB transposon in the target cells genome were located at TTAA sites, mRFP1 expression still could be detected in three months after transfected.Conclusions PB transposon could transfer exogenous gene into various gynecological malignant cells, which could integrated into genome and obtain a long-term and stable expression.It is expected that PB transposon may supply a more efficient and safer transgene technology platform for gene therapy in gynecological cancer.

Construction of recombinant adenovirus vector with HSV-TK controlled by hTERT promoter and experimental study of anti-hepatoma / 肿瘤研究与临床

Objective To construct the recombinant adenovirus vector with hTERT-HSV-TK and observe the killing effect of Ad-hTERTp-HSV-TK/GCV system on hepatocellular carcinoma cells. Methods A recombinant replication defective adenoviral vector of Ad-hTERTp-HSV-TK was constructed via homologous recombination which both shuttle plasmid pSU-Tp-TK and adenovirus backbone plasmid pBHGE3 transfected into the HEK293 packaging cells. Then the Ad-hTERTp-HSV-TK was amplified and purified through PCR. The activity of the HepG2 cells and the L-02 cells were tested by methyl thiazolyl terazolium (MTT) after they were transfected by the recombinant adenovirus of different multiplicities of infection (MOI) and then were added GCV of different conc.entration. Results The recombinant replication defective adenoviral vector of Ad-hTERTp-HSV-TK were identified by PCR successfully. The viral titer was 1.5×1010 pfu/ml after amplification and purification. The HepG2 cells were targetedly suppressed by Ad-hTERTp-HSV-TK/GCV system. The survival rate of cells decreased gradually along with the increase of the MOI and the GCV' s concentration. Conclusion The recombinant replication defective adenoviral vector of Ad-hTERTp-HSV-TK can inhibit the HepG2 cells significantly, but has not influence on the L-02 cells.

Viruses: mechanisms of immune evasion and involvement in periodontal diseases: a review article

Periodontite é uma doença multifatorial com diversos padrões clínicos não precisamente explicados pelo papel etiológico de bactérias. Herpesvírus têm sido encontrados em locais afetados por periodontite, pela PCR. Sabe-se que os herpesvírus afetam a regulação imune; assim, variações nas respostas inflamatória e imune atribuídas a eles podem reduzir a resistência do hospedeiro contra colonização subgengival e multiplicação de patógenos periodontais. Mais investigações experimentais para avaliar a real relação dos efeitos observados em estudos descritivos podem trazer provas causativas e conclusivas dos efeitos específicos dos herpesvírus nas doenças periodontais.

Periodontitis is a multilayered factors disease with diverse clinical features not precisely explained by the etiologic role of bacteria. Herpesviruses have been found in periodontally affected sites by PCR. Herpesviruses are known to exertimmune regulation and thus, variations on inflammatory and immune responses attributed to them may reduce host resistance against subgingival colonization and multiplication of periodontal pathogens. More trials to evaluate whether the effects seen in observational studies are truly related to herpes viruses could bring a causative and conclusive proof for their specific effect in periodontal disease.