Association of genetic polymorphism of BCL-2 (rs2279115) with susceptibility to HCV-related hepatocellular carcinoma.

Hepatitis C virus (HCV) infection is the main risk factor for chronic hepatitis (CHC), liver cirrhosis, and hepatocellular carcinoma (HCC). B cell lymphoma-2 (BCL-2) prevents apoptosis, and its overexpression could promote cancer cell survival. The purpose of this study is to evaluate the association of Bcl-2 gene polymorphism (rs2279115) and HCV-related HCC susceptibility. Two hundred and seventy individuals included in this case-control were divided into three groups. Group I: It included 90 apparently healthy subjects as control. Group II: It includes 90 patients with chronic HCV hepatitis. Group III: It includes 90 patients with HCC with positive HCV. Bcl-2 gene polymorphism (rs2279115) C > A genotypes by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). There are significantly higher incidence of CA and AA genotypes in HCV patients with HCC compared with those without HCC (OR 2.3, %CI (1.2-4.6), P = 0.01 and OR 5.7, %CI (2.4-13.8), respectively) and compared with control group (OR 2.9, %CI (1.5-5.8), P = 0.002 and OR 7.1, %CI (2.9-17.4), P < 0.001, respectively), while no significant difference between the control and HCV patients without HCC groups (OR 1.2, %CI (0. 7-2.4), P = 0.48, for CA, and OR 1.2, %CI (0.4-3.3), P = 0.67, for AA).The frequency of A allele was highly significantly overrepresented in the HCC group in comparison to HCV group (53.3% versus 30.6%, P < 0.001) and control group (53.3% versus 27.2%, P < 0.001) but no significant difference (p = 0.49) between control group and HCV patients. This study demonstrated that Bcl-2 gene polymorphism (rs2279115) was associated with increased susceptibility to HCV-related HCC.

Impact of non-selective beta blockers on portal hypertension and hepatic elasticity in hepatitis C virus-related liver cirrhosis.

Portal hypertension and its complications are the leading causes of morbidity and mortality in patients with liver cirrhosis. Noninvasive assessment of liver stiffness had been an effective tool for assessment of fibrosis progression in chronic liver disease. It was intended to assess liver stiffness measurement (LSM), portal vein diameter (PVD), splenic bipolar diameter (SD), and the platelet count/spleen diameter (PC/SD) ratio in patients who test positive for the hepatitis C virus (HCV) and to study the impact of non-selective beta blockers (NSBB) on the grade of esophageal varices (EVs) and liver elasticity. Subjects were 80 patients with Child-Pugh grade A or B compensated cirrhosis who tested positive for HCV. All of the patients underwent a laboratory workup including AFP, HCV antibodies, HCV RNA, HBsAg, LSM according to real-time elastography, upper gastrointestinal endoscopy (UGIE) to detect and grade EVs, calculation of the PC/SD ratio, and measurement of the PVD and SD according to real-time abdominal ultrasonography. All patients were given the maximum tolerated dose of NSBB for three months, and UGIE, LSM, PC/SD, PVD, and SD were subsequently reassessed and reported. LSM and the PC/SD ratio were exceptional noninvasive tools for prediction of significant EVs (grade ≥ II, p < 0.001) with a sensitivity 82.4% and a specificity 82.6% at a cutoff point 18 kPa for LSM, and a sensitivity 94.1% and specificity 69.6% at a cutoff point 880 for the PC/SD ratio. LSM is highly correlated with PVD, the PC/SD ratio, SD, and the Child-Pugh score. NSBB significantly decreased PVD. The percent change in PVD significantly correlated with LSM, the grade of EVs, and SD. Findings indicated that LSM is a noninvasive, rapid, and reproducible tool with which to detect portal hypertension and EVs. NSBB therapy can effectively decrease PVD and may consequently improve the EV grade with no significant impact on LSM in patients with liver cirrhosis.

Conscious sedation using propofol versus midazolam in cirrhotic patients during upper GI endoscopy: A comparative study.

AIM: We aimed to assess the safety and efficacy of propofol versus midazolam in cirrhotic patients undergoing upper GI endoscopy. METHODS: Ninety compensated cirrhotic patients (all met class I-III criteria according to the American Society of Anesthesia) were enrolled in this comparative study. They were classified into three groups according to scheduled pre-endoscopy sedation drugs; the midazolam group, which included 30 patients who received IV weight-dependent midazolam (0.05 mg/kg with additional doses of 1 mg every 2 min when necessary, up to a maximum dose of 0.1 mg/kg or 10 mg); the propofol group, which included 30 patients who received a propofol bolus dose according to age and weight (0.25 mg/kg with additional doses of 20-30 mg every 30-60 s when necessary, up to a maximum dose of 400 mg); and the combined group, which included 30 patients who received half a dose of midazolam and of propofol. RESULTS: Prolonged postendoscopy recovery times were reported in the midazolam group, while shorter recovery times were reported in the propofol and combined groups. All patients in the propofol and combined groups gained consciousness shortly postendoscopy; however, only half of the midazolam group's patients gained consciousness after the standard recovery time (10-30 min). Highly significant differences were found among the three groups regarding consciousness level according to the Glasgow coma scale, as well as regarding the occurrence of hypoxia during endoscopy. CONCLUSION: Considering safety and efficacy issues, propofol is better than midazolam in gastrointestinal endoscopy, especially in patients with liver cirrhosis.

Genetic polymorphism of IL-23R influences susceptibility to HCV-related hepatocellular carcinoma.

BACKGROUND: Genetic variations may play an important role in the development of HCC in HCV patients. Variants of IL23R gene were investigated for association with many diseases like chronic inflammatory disorders, RA, inflammatory bowel diseases and the susceptibility to the development of gastric cancer but no data are available concerning the association of IL23R gene (rs11209026) polymorphism with HCC development in HCV patients. Therefore the current study aimed to analyze this polymorphism within the gene to evaluate its contribution to chronic HCV susceptibility and/or HCC development in Egyptian patients. SUBJECTS AND METHODS: One hundred and ninety-two patients with chronic HCV infection were included in this study (92 of them without HCC and 100 of them with HCC). One hundred healthy control subjects with no history of previous liver disease (HBV and HCV infection were negative) were included in the study. The IL23R polymorphism (rs11209026 G>A) were genotyped by real time PCR. RESULTS: We found a significant lower incidence of GA and AA genotype in HCV patients with HCC compared to those without HCC (p=0.026 and 0.040 respectively) and compared to control group (p=0.008 and 0.007 respectively). While, no significant difference between control and HCV patients without HCC groups was found. CONCLUSIONS: Our study suggests that wild type IL-23R GG serves as a risk factor for HCC and supports for the protective role of the rare variant rs11209026 (Arg381Gln) against HCV-related HCC in Egyptian patients.

Irradiation of silver and agar/silver nanoparticles with argon, oxygen glow discharge plasma, and mercury lamp.

The irradiation effect of argon, oxygen glow discharge plasma, and mercury lamp on silver and agar/silver nanoparticle samples is studied. The irradiation time dependence of the synthesized silver and agar/silver nanoparticle absorption spectra and their antibacterial effect are studied and compared. In the agar/silver nanoparticle sample, as the irradiation time of argon glow discharge plasma or mercury lamp increases, the peak intensity and the full width at half maximum, FWHM, of the surface plasmon resonance absorption band is increased, however a decrease of the peak intensity with oxygen glow plasma has been observed. In the silver nanoparticle sample, as the irradiation time of argon, oxygen glow discharge plasma or mercury lamp increases, the peak intensity of the surface plasmon resonance absorption band is increased, however, there is no significant change in the FWHM of the surface plasmon resonance absorption band. The SEM results for both samples showed nanoparticle formation with mean size about 50 nm and 40 nm respectively. Throughout the irradiation time with the argon, oxygen glow discharge plasma or mercury lamp, the antibacterial activity of several kinds of Gram-positive and Gram-negative bacteria has been examined.