Stable versus progressive hepatitis unique to pregnancy.

BACKGROUND: Urgent delivery of the fetus is often considered as the treatment of choice for mothers in their second or third trimester with hepatitis unique to pregnancy (HUP). OBJECTIVE: To determine whether standard liver function tests (serum bilirubin and international normalized ratio levels) help to identify mothers and their newborns who might benefit from early delivery. METHODS: A total of 149 patients with HUP were retrospectively classified as those with normal (stable-HUP, n=118) or abnormal (progressive-HUP, n=31) liver function tests. Clinical outcomes consisted of maternal lengths of hospital stay after delivery and neonatal appearance, pulse, grimace, activity, respiration score ratings at 0 and 5 min. RESULTS: Patients with stable-HUP had similar lengths of hospital stay after delivery whether delivered early (4.8±3.4 days) or at term (4.8±3.6 days). Appearance, pulse, grimace, activity, respiration score ratings at birth were similar in neonates from patients with stable-HUP delivered prematurely (5.8±2.7) and at term (7.8±1.7, P=0.48) but significantly higher at 5 min in those delivered at term (7.5±2.0 vs. 8.9±0.3, P=0.003). Too few patients with progressive-HUP were delivered at term (N=4) to allow similar comparisons in this cohort. CONCLUSION: The results of this study indicate that mothers with HUP and normal liver function tests (bilirubin and international normalized ratio) can be safely followed to term without jeopardizing the health of either mother or neonates. Additional studies are required to determine whether abnormal liver function tests represent an indication for immediate delivery of the fetus in mothers with HUP.

[Inhibitory effects of ODC and AdoMetDC bi-antisense virus on the growth and invasion of lung cancer cell A-549].

OBJECTIVE: To study the inhibitory effects of antisense bicistronic recombinant adenovirus vector of ornithine decarboxylase (ODC) and S-adenosylmethionine decarboxylase (Ad-ODC-AdoMetDCas) on polyamine biosynthesis,proliferation and invasion of lung cancer cells. METHODS: Adenovirus-mediated gene transduction efficiency was assessed with counting GFP-positive cells using trypan blue. Western Blot and HPLC were used to detect ODC and S-AdoMetDC expression and polyamine content in A-549 cells respectively. Viable cell counting and cell cycle analysis were adopted to evaluate cell growth and cell cycle distribution, and A-549 cell invasion in vitro was detected with Matrigel invasion assay. RESULTS: Approximate 75% of A-549 cells were infected with Ad-ODC-AdoMetDCas when multiplicity of infection reached 50. Our study demonstrated that Ad-ODC-AdoMetDCas vector-mediated gene transfer inhibited tumor cell growth through the blockade of polyamine synthesis pathway. The tumor cells were arrested at cell cycle G1 phase after gene transfer. Gene transferred tumor cells were shown to possess markedly decreased invasiveness. CONCLUSION: Ad-ODC-AdoMetDCas has significant inhibitory effects on lung cancer cell proliferation and invasion and bears therapeutic potential for the treatment of lung cancer.

Occult hepatitis B virus infection in a North American community-based population.

BACKGROUND/AIMS: Occult hepatitis B virus (HBV) infection [HBV-DNA detection in hepatitis B surface antigen (HBsAg)-negative individuals] may cause acute and/or chronic liver disease. The objective of this study was to document the prevalence of occult HBV in an isolated, North American Inuit community. METHODS: Four hundred and eighty seven HBsAg negative sera (61% of the community population) were available for HBV-DNA testing by real time PCR. Of these, 80 (Group 1) had serologic evidence of resolved HBV infection and 407 (Group 2) were HBV-seronegative. RESULTS: HBV-DNA was detected in 14/80 (18%) and S-variants in 12/14 (86%) samples from Group 1. In Group 2, HBV-DNA was detected in 33/407 (8.1%) and S-variants in 17/33 (52%). In all cases (Groups 1 and 2) viral loads were low (<10(5) viral copies/ml) and clinical or biochemical features did not distinguish HBV-DNA positive from negative individuals. However, S-variants were more common (P<0.0001) in older age groups. CONCLUSIONS: The results of this study indicate that in this community-based population; (1) the prevalence of occult HBV infection is 18% in those with serologic evidence of previous HBV infection and 8.1% in HBV seronegative individuals, (2) age, gender and liver biochemistry findings do not identify those with occult HBV and (3) S-variants are present in the majority of individuals with occult HBV.

Occult hepatitis B virus infection in a North American adult hemodialysis patient population.

Hepatitis B virus (HBV) infections continue to occur in adult hemodialysis units. A possible contributing factor is the presence of occult HBV (serum hepatitis B surface antigen [HBsAg] negative but HBV DNA positive). Two hundred forty-one adult hemodialysis patients were screened for occult HBV. HBV DNA testing was performed by real-time polymerase chain reaction (PCR) with 2 independent primer sets (core promoter and surface). Two (0.8%) of the 241 patients were HBsAg positive. Of the remaining 239 HBsAg-negative patients, 9 (3.8%) were HBV DNA positive. Viral loads in these individuals were low (10(2)-10(4) viral copies/mL). Seven of the 9 (78%) were nt 587 mutation (sG145R mutant) positive. Demographic, biochemical, and HBV serological testing did not help to identify those with occult HBV. In conclusion, the prevalence of occult HBV in adult hemodialysis patients in this North American urban center is approximately 4 to 5 times higher than standard HBsAg testing would suggest. The majority of these infections are associated with low viral loads and a high prevalence of the sG145R mutant. Finally, the demographic, biochemical, and/or serological features of HBV DNA-positive subjects do not distinguish these individuals from the remainder of the dialysis patient population.