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ABSTRACT The aim of this study was to alert the ophthalmic community to an atypical manifestation of ocular surface squamous neoplasia, which may delay diagnosis and treatment and result in a guarded visual prognosis and significant sequelae. A 61-year-old immunocompetent man presented with an initial diagnosis of necrotizing scleritis in the right eye for 3 months. He was treated with systemic prednisone but experienced persistent pain and low visual acuity. Conjunctival biopsy of the affected region confirmed the diagnosis of invasive ocular surface squamous neoplasia, which progressed with intraocular and orbital invasion; thus, exenteration was performed. Masquerade syndrome should be suspected in patients with nodulo-ulcerative lesions of the conjunctiva and sclera. This clinical can be more aggressive, with a greater likelihood of intraocular and orbital involvement. The earlier the diagnosis and treatment, the better the patient prognosis.
RESUMO O objetivo é alertar a comunidade oftalmológica sobre uma manifestação atípica de neoplasia escamosa da superfície ocular (OSSN) que pode levar a um atraso no diagnóstico e tratamento, evoluindo com prognóstico reservado e significativas sequelas. Homem, imunocompetente, 61 anos com diagnóstico inicial de esclerite necrosante em olho direito há 3 meses, em tratamento com prednisona sistêmica porém com persistência da dor e baixa acuidade visual. Realizado biópsia conjuntival em região acometida e diagnosticado como neoplasia escamosa da superfície ocular invasiva. Evolui com invasão intraocular e orbital sendo submetido a exenteração. Assim sendo, deve-se suspeitar de síndrome mascarada frente a um paciente com lesões nódulo-ulcerativas da conjuntiva e esclera. Essa forma clínica pode ser mais agressiva, com maior chance de comprometimento intraocular e orbital. Quanto mais precoces o diagnóstico e o tratamento, melhor o prognóstico para o paciente.
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RESUMEN Introducción: en la literatura biomédica son escasos los reportes sobre el uso de los interferones como tratamiento en el carcinoma epidermoide. En una unidad de atención primaria, en Colón, Matanzas, se implementó el HeberFERON® en este tipo de tumor, con experiencias favorables. Objetivo: describir la efectividad del HeberFERON® en el carcinoma epidermoide. Materiales y métodos: se realizó un estudio observacional, descriptivo en 33 lesiones de carcinoma epidermoide en 29 pacientes. La dosis fue de 7,0 y 10,5 MUI de actividad antiviral, infiltrada de forma perilesional tres veces por semana durante tres semanas. Se realizó el seguimiento clínico de los pacientes antes del tratamiento y a las 16 semanas del inicio del mismo. Las variables fueron: edad, sexo, fototipo de piel, procedencia, localización, tipo clínico, estadio y respuesta clínica al tratamiento. Se consideraron cuatro categorías de respuesta: completa, parcial, enfermedad estable y progresiva. Se incluyó la respuesta objetiva (completa más parcial). Se recogieron los datos en una historia clínica. Se utilizaron los programas Microsoft Excel y SPSS para el procesamiento estadístico. Resultados: el 65,5 % de los pacientes correspondió al sexo masculino. Un 58,6 % son fototipo II y de procedencia urbana. Predominaron las edades entre 61 y 80 años (55,2 %). Hubo respuesta objetiva en 57,6 % (cinco completas y 14 parciales). Las mejores respuestas la mostraron el carcinoma epidermoide queratósico superficial y el noduloulceroso. Conclusiones: la mezcla de interferones fue efectiva en el carcinoma epidermoide en todos los subtipos clínicos, aunque los autores sugieren un segundo ciclo de HeberFERON® o asociarlo con quimioterapia cuando la respuesta no sea completa.
ABSTRACT Introduction: there are few reports in the literature on the use of interferon in the treatment of the squamous cell carcinoma. In a primary care unit in Colon, Matanzas, HeberFERON® was implemented in this type of tumor with favorable experiences. Objective: to describe the effectiveness of HeberFERON® in epidermoid carcinoma. Materials and methods: an observational, descriptive study was conducted in 33 epidermoid carcinoma lesions in 29 patients. The doses were 7.0 and 10.5 MUI of antiviral activity, perilesionally infiltrated three times a week for three weeks. Clinical follow-up of patients was performed before the treatment and at 16 weeks from the beginning of the treatment. The variables were: age, sex, skin phototype, origin; location, clinical type, stage and clinical response to treatment. Four categories of response were considered: complete, partial, stable and progressive disease. The objective response (complete plus partial) was included. Data were collected in a clinical record. The Microsoft Excel and SPSS programs were used for statistical processing. Results: 65.5 % of patients were male. 58.6 % are phototype II and of urban origin. Ages ranging from 61 to 80 years (55.2 %) predominated. There was objective response in 57.6 % (five complete and 14 partials). The superficial keratotic squamous cell carcinoma and the nodular ulcerative one showed the best responses. Conclusions: interferon mixing was effective in all clinical subtypes of epidermoid carcinoma, although the authors suggest a second cycle of HeberFERON® or to associate it with chemotherapy when the response is not complete.
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RESUMEN Fundamento: el carcinoma basocelular es el cáncer cutáneo más frecuente. El tratamiento de elección es quirúrgico, existen otras terapéuticas. El HeberFERON es una formulación farmacéutica que contiene una mezcla de interferones alfa2b y Y en proporciones sinérgicas de actividad anti-tumoral. Objetivo: caracterizar los pacientes con carcinoma basocelular tratados con HeberFERON. Métodos: se realizó un estudio observacional descriptivo transversal. El universo lo constituyeron 22 pacientes con diagnóstico clínico e histológico de carcinoma basocelular, que asistieron a consulta de Dermatología del Hospital Universitario Manuel Ascunce Domenech de la provincia Camagüey, durante el periodo de estudio se administró 3,5 millones UI de HeberFERON, perilesional, tres veces por semana en días alternos, durante tres semanas, seguidos cada 15 días durante 13 semanas, con evaluación final a la semana 16. Las variables estudiadas fueron: sexo, foto tipo cutáneo, localización, tamaño de las lesiones, subtipo clínico, ocupación laboral, respuesta clínica, efecto cosmético y reacciones adversas. La información obtenida fue procesada mediante el paquete estadístico SPSS v21.Los métodos empleados fueron estadística descriptiva con distribución de frecuencias absolutas y relativas. Los resultados se expusieron en tablas y gráficos. Resultados: predominó el sexo masculino, foto tipo cutáneo III en más de la mitad de los enfermos. Las lesiones en cara predominaron en más de las cuatro quintas partes de ellos, casi las dos terceras medían menos de dos centímetros. Prevaleció el subtipo clínico nodular en la mitad de estos, igual que los trabajadores expuestos al sol. Todos tuvieron respuesta clínica favorable, con respuesta completa en los dos tercios, y parcial en un tercio, igual que el efecto cosmético aceptable. La mayoría presentó escalofríos como reacción adversa, seguida de fiebre. Conclusiones: el HeberFERON resultó un medicamento eficaz y seguro para tratar el carcinoma basocelular; ofrece una alternativa en enfermos que no pueden ser sometidos a cirugía.
ABSTRACT Background: basal cell carcinoma is the most frequent skin cancer. The treatment of choice is surgical, but there are other therapies. HeberFERON is a pharmaceutical formulation containing a mixture of interpheron alpha2b and IFN-Y in synergistic proportions of anti-tumor activity. Objective: to characterize patients with basal cell carcinoma treated with HeberFeron. Methods: a transversal, observational, descriptive study was carried out in which 22 patients were clinically and histologically diagnosed with basal cell carcinoma, who attended a Dermatology consultation at the University Hospital Manuel Ascunce Domenech, Camagüey, Cuba. 3.5 million IU of HeberFeron, was administered, near the lesion, three times a week on alternate days for three weeks, followed biweekly for 13 weeks, with final evaluation at week 16. The variables studied were: sex, skin photo-type, tumor site, size of lesions, clinical subtype, occupation, clinical response, cosmetic effect and adverse reactions. The information obtained was processed using the statistical package SPSS v21. The methods used were descriptive statistics with distribution of absolute and relative frequencies. The results were presented in tables and graphs. Results: male sex, cutaneous photo-type III, predominated in more than half of the patients. Face lesions predominated in more than four fifths of them, and almost two thirds measured less than two centimeters. The nodular clinical subtype prevailed in half of these, just like workers exposed to the sun. All had a favorable clinical response, with a complete response in two thirds, and partial in a third, as well as an acceptable cosmetic effect. Most presented chills as an adverse reaction, followed by fever. Conclusions: the HeberFERON was an effective and safe medicine to treat basal cell carcinoma, and offer an alternative in patients who cannot be operated on.
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Objective To analyze the efficacy of entecavir (ETV) combined with Peg IFNα-2b in chronic hepatitis B ( CHB) patients with low levels HBsAg following initial ETV treatment.Methods Sixty-nine CHB outpatients achieving serum HBsAg ＜2 000 IU/mL and HBV DNA＜100 IU/mL following initial ETV treatment in Pujiang People's Hospital and the First Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to January 2016 were enrolled.Patients were randomly assigned in two groups: 39 patients in combination group received ETV (0.5 mg/d ) and Peg IFNα-2b (1.5 μg· kg－1· week －1, hypodermic injection), and 30 patients in ETV group received ETV (0.5 mg/d) alone.Serum HBsAg quantification, negative conversion rate of HBsAg and HBeAg , and levels of aminotransferase (ALT) were measured at baseline , 12th, 24th, 48th, 72th and 96th week after treatment.Results The levels of HBsAg in the combination group decreased gradually with the prolongation of therapy , which were lower than those in ETV group 24 week after treatment (Z＝－2.566,P＜0.05),and at 48th, 72th and 96th week (Z＝－3.499,－3.825 and －3.864,P＜0.01).Clearance of HBsAg appeared in the combination group at 24th week,the clearance rates were 7.70%(3/39) and 28.20%(11/39) at 24th and 96th week, respectively;while the clearance of HBsAg occurred in ETV group at 96th week, the clearance rate was only 3.30%(1/30).The negative conversion rates of HBsAg in combination group were higher than those in ETV group at 48th,72th and 96th week (P＜0.05 or＜0.01).In the combination group, there were 11 cases of clinical cure , 11 cases of clinical efficacy and 17 cases of clinical effectiveness , while there were 1, 1 and 28 cases in ETV group,respectively.The treatment effect of the combination group was better than that of ETV group(χ2＝18.496,P＜0.01).Serological conversion rates of HBeAg were 30.00%(6/20) and 65.00%(13/20) in combination group at 12th and 96th week, while those were 11.11%(2/18) and 22.22%(4/18) in ETV group at 48th and 96th week.There were significant differences in the HBeAg serological conversion rates at 12th, 24th, 72th and 96th week between two groups (P＜0.05 or ＜0.01). The levels of ALT in combination group increased at 12th and 24th week, which had significant difference compared with ETV group (Z＝－1.236 and －2.658,P＜0.05), and the ALT levels gradually declined 48 week after treatment in combination group and there were no statistical differences between two groups at other time points.The ETV combined with Peg IFNα-2b and low baseline HBeAg levels were associated with the clearance rate of HBsAg (both P＜0.01).Conclusions CHB patients with low HBsAg levels following initial ETV monotherapy can achieve high negative conversion rate of HBeAg and HBsAg with the combination treatment of ETV and Peg IFN α-2b.
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Objective To investigate the clinical value of oxymatrine combined with interferon alpha -2b in the treatment of chronic hepatitis B.Methods From January 2014 to January 2017,Ninety patients with chronic hepatitis B in the Third People's Hospital of Linfen were divided into observation group and control group according to the random number table method ,with 45 cases in each group.The control group was treated with recombinant human interferon alpha-2b,intramuscular injection of 5 million IU,1 time/d,and on the basis of the control group,the observation group was treated with oxymatrine injection 500 mg+0.9%sodium chloride injection 250mL,intravenous infusion of normal saline,1 time/d,the treatment cycle was 6 months.The changes of liver function ,HBV-DNA negative rate and liver fibrosis indicators were compared between the two groups before and after treatment .Results After treatment,the liver function indicators of the observation group and the control group [ALT(45.2 ±8.3)IU/L, (68.4 ±9.5)IU/L;AST(42.6 ±7.2)IU/L,(63.7 ±9.3)IU/L]were significantly decreased,which of the observation group were significantly lower than those of the control group , the differences were statistically significant ( t ＝11.678,10.186,all P＜0.05).The negative rate of HBV -DNA in the observation group (82.2%) was significantly higher than that in the control group(60.0%),the difference was statistically significant(χ2＝5.409,P＜0.05).After treatment,the levels of Ⅳ-C[(57.7 ±10.6)ng/L,(132.2 ±47.6)ng/L],LN[(103.1 ±33.1)ng/L,(162.5 ± 57.9)ng/L]and HA[(158.7 ±59.2)ng/L,(263.4 ±97.9)ng/L]of the observation group and the control group were significantly decreased ,which of the observation group were significantly lower than those of the control group , the differences were statistically significant (t ＝9.899,5.971,5.856,all P ＜0.05).Conclusion Oxymatrine injection combined with interferon alpha -2b in the treatment of chronic hepatitis B can significantly improve liver function,improve the negative rate of virus and liver fibrosis.
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Objective To investigate the correlation between serum ferritin (SF) level and antiviral effect of pegylated interferon-α-2a (Peg-IFNα-2a) in chronic hepatitis C (CHC) patients.Methods A total of 85 CHC patients who were admitted to The First People's Hospital of Zigong from November 2013 to July 2014 were enrolled and treated with subcutaneous injection of Peg-IFNc-2a 180 μμg once a week combined with oral ribavirin 10-15 mg · kg-1 · d-1.The course of treatment was 48 weeks and the patients were followed up for 24 weeks after the treatment ended.SF was measured at week 0,and HCV RNA was measured at weeks 0,4,12,24,48,and 72 to evaluate therapeutic outcome.According to the therapeutic outcome,the patients were divided into rapid virologic response (RVR) group,early virologic response (EVR) group,sustained virologic response (SVR) group,no response group (NR group),and recurrence group;according to the SF level,the patients were divided into high-SF group (≥400 ng/ml) and low-SF group (＜400 ng/ml).An analysis of variance was used for comparison of continuous data between groups,and SNK-q test was used for comparison between any two groups;the chi-square test was used for comparison of categorical data between groups,and Spearman rank correlation was used for correlation analysis.Results Of all patients,36 (42.35％) achieved RVR,70(82.35％) achieved EVR,68 (80.00％) achieved SVR,15 (17.65％) had no response,and 2 (2.35％) experienced recurrence.The NR group and recurrence group had a significant increase in SF level,and the NR group had a significantly higher SF level than RVR group (1489.15 ± 278.21 ng/ml vs 398.12 ±-252.45 ng/ml,q =10.826,P ＜0.01),EVR group (1489.15 ± 278.21 ng/ml vs 514.85-± 275.64 ng/ml,q =10.151,P ＜ 0.01),and SVR group (1489.15 ± 278.21 ng/ml vs 486.45 ± 251.60 ng/ml,q =10.614,P ＜0.01).SF level was negatively correlated with the therapeutic effect of PEG-IFN (rs =-0.688,P ＜0.001).Compared with the high-SF group,the low-SF group had a significantly higher proportion of patients who achieved RVR (85.29％ vs 13.73％,P ＜0.001),EVR (100％ vs 70.59％,P ＜ 0.001),or SVR (100％ vs 66.67％,P ＜ 0.001) and a significantly lower proportion of patients who had no response (0 vs 29.41％,P ＜ 0.001).Conclusion In CHC patients,SF level before treatment is correlated with the antiviral effect of PEG-IFN,suggesting that SF level can predict the antiviral effect of PEG-IFN in CHC patients.
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Objective To investigate the correlation between serum ferritin (SF) level and antiviral effect of pegylated interferon-α-2a (Peg-IFNα-2a) in chronic hepatitis C (CHC) patients.Methods A total of 85 CHC patients who were admitted to The First People's Hospital of Zigong from November 2013 to July 2014 were enrolled and treated with subcutaneous injection of Peg-IFNc-2a 180 μμg once a week combined with oral ribavirin 10-15 mg · kg-1 · d-1.The course of treatment was 48 weeks and the patients were followed up for 24 weeks after the treatment ended.SF was measured at week 0,and HCV RNA was measured at weeks 0,4,12,24,48,and 72 to evaluate therapeutic outcome.According to the therapeutic outcome,the patients were divided into rapid virologic response (RVR) group,early virologic response (EVR) group,sustained virologic response (SVR) group,no response group (NR group),and recurrence group;according to the SF level,the patients were divided into high-SF group (≥400 ng/ml) and low-SF group (＜400 ng/ml).An analysis of variance was used for comparison of continuous data between groups,and SNK-q test was used for comparison between any two groups;the chi-square test was used for comparison of categorical data between groups,and Spearman rank correlation was used for correlation analysis.Results Of all patients,36 (42.35％) achieved RVR,70(82.35％) achieved EVR,68 (80.00％) achieved SVR,15 (17.65％) had no response,and 2 (2.35％) experienced recurrence.The NR group and recurrence group had a significant increase in SF level,and the NR group had a significantly higher SF level than RVR group (1489.15 ± 278.21 ng/ml vs 398.12 ±-252.45 ng/ml,q =10.826,P ＜0.01),EVR group (1489.15 ± 278.21 ng/ml vs 514.85-± 275.64 ng/ml,q =10.151,P ＜ 0.01),and SVR group (1489.15 ± 278.21 ng/ml vs 486.45 ± 251.60 ng/ml,q =10.614,P ＜0.01).SF level was negatively correlated with the therapeutic effect of PEG-IFN (rs =-0.688,P ＜0.001).Compared with the high-SF group,the low-SF group had a significantly higher proportion of patients who achieved RVR (85.29％ vs 13.73％,P ＜0.001),EVR (100％ vs 70.59％,P ＜ 0.001),or SVR (100％ vs 66.67％,P ＜ 0.001) and a significantly lower proportion of patients who had no response (0 vs 29.41％,P ＜ 0.001).Conclusion In CHC patients,SF level before treatment is correlated with the antiviral effect of PEG-IFN,suggesting that SF level can predict the antiviral effect of PEG-IFN in CHC patients.
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A 2‑year‑old boy presented with a recurrent strawberry‑like reddish mass arising from the left caruncular region for 8 months. An incisional biopsy was performed elsewhere 2 months earlier, followed by an increase in size of mass, significant epiphora, and intermittent bleeding. On examination, exuberant exophytic gelatinous mass with multifocal origin was observed arising from inferior forniceal conjunctiva and caruncle. Clinical differential of multifocal conjunctival papilloma was kept, and topical interferon alfa‑2b (INFα‑2b) was started. No clinical reduction in mass or symptomatology was observed over 6 weeks. Excision biopsy with cryotherapy and subconjunctival injection of INFα‑2b was performed over all foci. Conjunctival papilloma was confirmed on histopathology, and topical INFα‑2b was continued in postoperative period for 3 months. At 14 months of follow‑up, no recurrence, epiphora, or bleeding was noticed. We advocate a possible role of local INF therapy in managing and preventing recurrences of conjunctival papillomatosis.
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Objective To explore the nutritional risk factors in patients with chronic hepatitis C (CHC), who have been accepted pegylated interferon (IFN) and ribavirin (RVB) therapy (PR). Methods A total of 175 CHC patients treated with PR were included in this study. Data of heights, body weights, and calculated body mass index (BMI) were recorded in patients. At the same time, patients were evaluated nutritional risk with Nutritional Risk Screen 2002 (NRS 2002), and divided into risk group (n=35) and non-risk group (n=140). Results There were significant differences in age, HCV genotype (1b type and not 1b), clinical type (CHC/cirrhosis), the length of treatment time and the tolerance degree for PR therapy between two groups (P<0.05). Logistic regression analysis showed that age (OR=16.068,β=2.777), IFN dosage (OR=3.096, β=1.130), RVB dosage (OR=3.382, β=1.219) and clinical type (OR=5.092, β=1.628) were nutritional risk factors. The HCV genotype (OR=0.384; β=-0.957) was protective factors for nutritional risk. Conclusion There is higher occurrence rate of nutritional risk for CHC patients accepted PR therapy. The dependant nutritional risk factors are advanced age, intolerance for PR therapy and cirrhosis associated CHC. HCV without genotypes 1b is not a nutritional risk factor.
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Conjunctival malignant melanoma (CMM) is rare and can be life threatening. Management of CMM is by surgical excision of the tumor. Non-surgical treatment consists of topical eye drops especially in diffuse and multifocal malignant melanoma. Interferon is reported as an effective agent of CMM treatment. The purpose of this study is to evaluate the effect of Interferon alfa 2a in diffuse recurrent conjunctival melanoma and follow up of primary conjunctival melanoma after treatment with Interferon alfa 2a. In this paper we are going to present a case of CMM in bulbar conjunctiva and 12 years of follow-up. Once the CMM was suspected, surgical removal of the affected area was performed and the subsequent biopsy resulted positive. Ten years later CMM reappeared in the same place and second surgery was performed. Two years later a second recurrence of the melanoma occurred at the same place as before. In order to avoid another surgery a treatment with topical interferon alpha 2 a 1 MIU/mL, 4 drops/day for 3 months was performed instead. Following 15 months of this treatment no sign of conjunctival melanoma came into sight.
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Objective To investigate clinical efficacy of adefovir dipivoxil (ADV) combined with interferon α-2b in treatment of chronic hepatitis B.Methods During Jan 2008 to Dec 2014,ninety patients with chronic hepatitis B were divided into adefovir dipivoxil group (33 cases),interferon group (28 cases),and adefovir dipivoxil combined with interferon α-2b group (29 cases).Alanine aminotransferase (ALT) normalization rate,negative rate of HBV-DNA,and HBeAg/anti-HBe seroconversion rates were evaluated among three groups.Results After 48 weeks of treatment,HBeAg negative rate,HBV-DNA negative rate,and ALT normalization rate of combination group were significantly higher than that of interferons αt-2b group and adefovir dipivoxil group (P ＜ 0.05).Conclusions Adefovir dipivoxil combined with interferon α-2b treatment can inhibit the hepatitis B virus,increase the negative rate of HBV-DNA and HBeAg,and reduce liver cell damage.
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ObjectiveTo investigate the efficacy of peginterferon alfa-2a (PEG-IFN α-2a) in the treatment of HBeAg-positive chronic hepatitis B (CHB) resistant to multiple nucleos(t)ide analogues (NAs). MethodsA total of 120 patients with HBeAg-positive CHB resistant to multiple nucleos(t)ide analogues who were hospitalized or treated in the outpatient department in our hospital from August 2009 to February 2014 were randomly divided into two groups, with 60 patients in each group. The patients in the treatment group stopped NAs and were given PEG-IFNα-2a for 48 weeks, and those in the control group received PEG-IFNα-2a for 48 weeks in addition to the original therapeutic regimen with NAs. The changes in the serological markers of hepatitis B and HBV DNA were observed at weeks 24 and 48 of treatment and at 24 weeks after drug discontinuation. The chi-square test was used for comparison of categorical data between groups, while comporison of continuous data was mode by t test. ResultsThe patients in both groups achieved a satisfactory outcome. The serum HBeAg clearance rate, HBeAg seroconversion rate, HBV DNA clearance rate, and HBsAg clearance rate showed no significant differences between the two groups at weeks 24 and 48 of treatment and at 24 weeks after treatment (all P＞0.05). The adverse events that occurred during PEG-IFNα-2a treatment were pyrexia, headache, inflammation at the injection site, diarrhea, neutropenia, anemia, and depression, and the disease is not serious. ConclusionPEG-IFNα-2a is safe and effective in the treatment of CHB resistant to multiple NAs, and the patients can convert to PEG-IFNα-2a directly as their antiviral therapy.
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PURPOSE: To investigate the clinical features, surgical treatments, and their outcomes in conjunctival squamous papilloma. METHODS: A retrospective chart review was conducted on 31 patients with 32 eyes that were treated for conjunctival papilloma from October 2000 to February 2015 in Seoul National University Hospital and Seoul National University Bundang Hospital. RESULTS: Among the 31 patients, 9 patients had papilloma which recurred after previous surgical excision at another hospital. Twenty-five eyes had one papilloma lesion, 2 eyes had 2 lesions, and 5 eyes had more than 3 lesions. The most affected location of papilloma was the tarsal conjunctiva. The recurrent group displayed a tendency to have multiple lesions. Surgical excision without any adjuvant therapy was performed in 13 eyes; surgical excision and cryotherapy in 15 eyes; surgical excision, cryotherapy, and topical interferon alfa-2b in 3 eyes; and surgical excision and amniotic membrane transplantation in 1 eye. The mean postoperative follow up period was 11.1 months. There were 5 cases of recurrence and the mean time of recurrence after surgical excision was 4.22 months (range, 3 days to 9 months). Among 5 cases of recurrence, 3 cases were after surgical excision only, 1 case was after surgical excision and cryotherapy, and 1 case was after surgical excision, cryotherapy, and topical interferon alfa-2b. These 5 recurred cases were retreated with surgical excision and cryotherapy, surgical excision and topical interferon alfa-2b, or surgical excision, cryotherapy, and topical interferon alfa-2b. CONCLUSIONS: Conjunctival squamous papilloma is likely to recur even though the tumor is completely removed. Therefore, long-term postoperative follow up may be necessary for recurrence.
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Humains , Amnios , Conjonctive , Cryothérapie , Études de suivi , Interférons , Papillome , Récidive , Études rétrospectives , SéoulRésumé
Behcet's disease (BD) involves multisystem vasculitis of unknown origin. Ocular manifestations of BD mostly include bilateral panuveitis and retinal vasculitis, which are very challenging to treat. Interferon alfa-2a (IFN) has been recently introduced for treating refractory Behcet uveitis, mainly in Germany and Turkey. Nonetheless, there is so far no consensus about the ideal treatment regimen of IFN for Behcet uveitis. We report our experience of IFN treatment in five Korean BD patients with refractory uveitis. All patients complained of oral ulcers; one patient had a positive pathergy test and 2 showed the presence of HLA-B51. Immunosuppressive agents used prior to IFN treatment included cyclosporine and methotrexate. The IFN treatment was commenced with a dose of 6-9 MIU/day for 7 days, adjusted according to individual ocular manifestations, tapered down to 3 MIU three times in a week, and then discontinued. All patients showed positive response to IFN treatment; 50% of them showed complete response without additional major ocular inflammation during the follow-up period. Other BD symptoms also improved after IFN treatment in most cases. After treatment, the relapse rate and the required dose of oral corticosteroid were decreased in most cases, showing a significant steroid-sparing effect. However, the visual acuity was not improved in most cases due to irreversible macular sequelae. Despite the small sample size of this study, we suggest that, in Korean patients, IFN is an effective treatment modality for BD uveitis as was observed in German and Turkish patients.
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Adulte , Femelle , Humains , Mâle , Maladie de Behçet/complications , Maladie chronique , Ciclosporine/usage thérapeutique , Immunosuppresseurs/administration et posologie , Interféron alpha/usage thérapeutique , Protéines recombinantes/usage thérapeutique , Récidive , Induction de rémission , Résultat thérapeutique , Turquie , Uvéite/diagnostic , Acuité visuelleRésumé
Objective To investigate the efficacy and safety of different optimal therapy strategies for hepatits B e antigen (HBeAg) positive chronic hepatitis B (CHB) patients with suboptimal response to peginterferon-α-2a (peg-IFN-α-2a) at 24 weeks.Methods This open-label,single-center and prospective clinical observational study was conducted in Department of Infectious Diseases at Shanghai Changhai Hospital between January 2009 and December 2011.The cases of HBeAg-positive CHB with suboptimal response to peg-IFN-α-2a at week 24 were enrolled.Based on virological markers and patient preference,patients were treated with either peg-IFN-α-2a add-on adefovir dipivoxil (ADV) or switch-to telbivudine (LdT).Hepatitis B virus (HBV) virological and serological data were collected at week 12,24 and 48 after the initiation of optimal therapy.Adverse reactions were also monitored.Therapeutic efficacy was compared between two groups of patients before and after treatment by x2 test.Kruskall Wallis test and Mann-Whitney test were used for analysis of continuous variables.Results Among 193 HBeAg positive CHB patients treated with interferon,67 had suboptimal response and were enrolled.Forty five cases received peg IFN-α-2a add-on ADV treatment and 22 cases received switch-to LdT treatment.After 48 weeks of optimized therapy,the total tBeAg seroconversion rate was 25.3 ％.The rates of HBeAg loss,HBV DNA negative and alanine aminotransferase normalization were 26.8％,73.1％ and 83.5％,respectively.The peg-IFN-α-2a switch-to LdT strategy had better HBV DNA inhibition efficiency compared with the peg-IFN-α-2a add-on ADV strategy at week 12,24 and 48 (P=0.00,0.00 and 0.01,respectively).However,there was no significant difference of HBV DNA negative rate between two groups at week 48 (x2 =0.01,P=0.89).The obviously intolerable adverse reaction was not reported in two optimized strategy groups.Conclusions The 48-week optimized treatment for HBeAg positive CHB with suboptimal response to peg-IFN-α-2a at week 24 could achieve a higher HBeAg seroconversion rate.The switch-to LdT strategy may have better HBV DNA inhibition efficiency.Both strategies show satisfactory safety and tolerance.
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Objective To explore the clinical effect of IFN combined with adefovir dipivoxil in the treatment of patients with the hepatitis B and hepatitis C overlapping infection.Methods 90 cases of hepatitis B overlapping infection of hepatitis C were divided into control group(n =43) and treatment group(n =47).The control group was treated with IFN,the treatment group was treated with IFN and adefovir dipivoxil.Results The treatment group was better than the control group in the liver function,HBV DNA,HCV RNA.At the 24th weeks,the negative rates of HBV DNA and HCV RNA in the control group were 14 (32.6%) and 18 (41.9%),while there were were 38 (80.9%) and 34(72.3%) in the treatment group.There was significant differences between the two groups(x2 =6.43,5.28,all P ＜ 0.05).Conclusion The clinical efficacy of IFN combined with adefovir dipivoxil for the hepatitis B and hepatitis C overlapping infection patients was significant better than IFN,which is worthy of clinical application.
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Objective To investigate the antiviral efficacy of standard treatment with interferon (IFN)-α 2b and ribavirin (RBV) in patients with chronic hepatitis C (CHC) originating from a same blood donor.Methods The test group consisted of 65 CHC patients originating from a same blood donor,and was treated with IFN-α 2b 3-5 MU every other day in combination with RBV 0.6-1.0 g/d.Meantime,the control group consisted of 32 CHC patients who visited the Department of Infectious Diseases in Qiannan People's Hospital,and was treated with Peg-interferon (PEG-IFN)-α 2a 180 μg every week in combination with RBV 0.6-1.0 g/d.All the patients in the two groups were treated for 48 weeks and followed up for 96 weeks.Assessment indictors included sustained virological response (SVR),early virological response (EVR),end of treatment virological response (ETVR),biochemical response after withdrawal of treatment.Side effects during treatment were also evaluated.Measurement data were analyzed by x2 test.Results In test group,SVR rate was 83.1％ (54/65),EVR rate was 93.8％ (61/65),ETVR rate was 86.2％ (56/65) and biochemical response rate after withdrawal of treatment was 100.0％.In control group,SVR rate was 87.5％ (28/32),EVR rate was 96.9 ％ (31/32),ETVR rate was 90.6 ％ (29/32) and biochemical response rate after withdrawal of treatment was 100.0 ％.SVR rates of the two groups were not significantly different (x2 =0.072,P=0.086).Patients of the two groups were divided into two subgroups according to viral load:hepatitis C virus (HCV) RNA＜1.0 × 106 copy/mL and HCV RNA≥1.0 × 106 copy/mL.SVR rates of patients with low and high viral load in test group were 88.9％ and 54.5％,respectively (x2=7.67,P=0.008),those in control group were 96.0％ and 57.1％,respectively (x2 =4.41,P=0.038).SVR rates were higher in the subgroup of patients with low viral load.Leukopenia and thrombocytopenia were more common in control group than in test group (x2 =9.805,P =0.003 ; x2 =6.643,P=0.009).Conclusion IFN-α 2b and RBV combination therapy has similar antiviral efficacy to that of PEG-IFN-α 2a and RBV combination therapy,and has a lower rate of side effects as well.
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Objective To investigate the efficacy of sequential add-on of pegylated interferon α-2a (PEGIFN-α-2a) for 48 weeks in chronic hepatitis B (CHB) patients with low serum hepatitis B e antigen (HBeAg) titer after long term adefovir dipivoxil (ADV) monotherapy.Methods This was a randomized,open and prospective clinical trial.Patients who had been treated with ADV for 72 to 144 weeks,with undetectable serum hepatitis B virus (HBV) DNA level,low HBeAg titer (5 S/CO＜ HBeAg＜50 S/CO) and serum hepatitis B surface antigen (HBsAg) ＜5000 IU/mL were included.The patients were categorized into ADV monotherapy group and ADV plus PEGIFN-a-2a combination therapy group by random number table.Patients in ADV group continued ADV monotherapy and patients in combination therapy group added PEGIFN-α-2a to ADV for 48 weeks.After the treatment,efficacy of the two therapies were assessed by comparing the reduction of serum HBeAg reduction,HBeAg loss rate,HBeAg seroconversion rate,and reduction of intrahepatic HBV DNA and HBV covalently closed circular DNA (cccDNA).Pre-and post-treatment results were compared by paired samples t test.Comparison between groups was performed using indepedent samples t test.Comparison of rates between groups was performed using x2 test.Results The trial enrolled 55 CHB patients,and there were 27 patients in ADV monotherapy group,28 patients in combination therapy group.Baseline characteristics including age distribution,sex ratio,alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBil),serum HBeAg and HBsAg,hepatic HBV DNA and HBV cccDNA were all comparable (all P＞0.05).Twenty-five patients in ADV monotherapy group and 26 patients in combination therapy group completed 48 weeks treatment.HBeAg loss rates and seroconversion rates of combination therapy group were higher than those of ADV monotherapy group (x2 =5.38 and 4.69,respectively,both P＜0.05).HBeAg titers of both groups were significantly lower than those of baseline (t=8.43 and 8.50,respectively,both P＜0.05).The HBeAg titer of combination therapy group was lower than that of monotherapy group (t=5.60,P＜ 0.01).HBV DNA and HBV cccDNA in liver tissue of combination therapy group was (6.934±0.52) lg IU/mg and (5.63±0.54) lg IU/mg post-treatment,respectively,which were both lower than baseline (t＝7.12.6.67,respectively,both P＜0.01).HBV DNA in liver tissue of monotherapy group was (7.09＝0.43) lg IU/mg post-treatment,which was lower than baseline (t=2.67,P=0.02).After treatment,HBV cccDNA in liver tissue of combination therapy group was lower than that of monotherapy group (t =2.87,P=0.00).Conclusions Compared with ADV monotherapy,sequential add-on of PEGIFN-a-2a in combination with ADV can achieve higher serum HBeAg loss rate and seroconversion rate and facilitate the clearance of hepatic HBV DNA and HBV cccDNA in CHB patients with low HBeAg titer after long-term ADV monotherapy.
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Objective To study the effect of combining loop electrosurgical excision procedure (LEEP) and recombinant human interferon α2b (rhIFNα-2b) suppository in treatment of cervical intraepithelial neoplasia (CIN).Methods Prospective,random and control study was conducted in 82 patients with CINⅠ-CINⅢ.Before canting out LEEP to these patients,all women were performed HPV DNA detection by the method of Hybri Max.Among these patients,41 patients were assigned to the studying group,in which the patients were given rhIFNα-2b suppository for three courses of treatment after LEEP.The other 41 patients who carried out LEEP simply were assigned to the control group.Liquid-based ThinPrep cytology test (TCT) and HPV DNA were examined in the sixth and twelfth month after treatment.Results In the studying group,the cure rate was 90.2％ when LEEP ended six months,and the cure rate was 100.0％ when LEEP ended twelve months.In the control group,the cure rate was 43.9％ when LEEP ended six months,and the cure rate was 61.0％ when LEEP ended twelve months.In the sixth and twelfth month after LEEP,the difference was significant when we compared the cure rate between the two groups (x2 =19.93,19.89,all P ＜ 0.05).Conclusion The clinical effect of combining LEEP and rhIFNα-2b suppository is better than LEEP in treatment of CIN.The method can remove or destroy the cervical lesions effectively and inhibit HPV replication and spread of HPV infection.