Persistence of immune responses to the HPV-16/18 AS04-adjuvanted vaccine in women aged 15-55 years and first-time modelling of antibody responses in mature women: results from an open-label 6-year follow-up study.

OBJECTIVE: Evaluation of the long-term HPV-16/18 AS04-adjuvanted vaccine immunogenicity persistence in women. DESIGN: Multicentre, open-label, long-term follow-up (NCT00947115) of a primary phase-III study (NCT00196937). SETTING: Six centres in Germany and Poland. POPULATION: 488 healthy women (aged 15-55 years, age-stratified into groups: 15-25, 26-45, and 46-55 years) who received three vaccine doses in the primary study. METHODS: Immune responses were evaluated in serum and cervicovaginal secretion (CVS) samples 6 years after dose 1. Anti-HPV-16/18 geometric mean titres (GMTs) were measured by enzyme-linked immunosorbent assay (ELISA), and were used to fit the modified power-law and piecewise models, predicting long-term immunogenicity. Serious adverse events (SAEs) were recorded. MAIN OUTCOME MEASURES: Anti-HPV-16/18 seropositivity rates and GMTs 6 years after dose 1. RESULTS: At 6 years after dose 1, all women were seropositive for anti-HPV-16 and ≥97% were seropositive for anti-HPV-18 antibodies. GMTs ranged from 277.7 to 1344.6 EU/ml, and from 97.6 to 438.2 EU/ml, for anti-HPV-16 and anti-HPV-18, respectively. In all age groups, GMTs were higher (anti-HPV-16, 9.3-45.1-fold; anti-HPV-18, 4.3-19.4-fold) than levels associated with natural infection (29.8 EU/ml). A strong correlation between serum and CVS anti-HPV-16/18 levels was observed, with correlation coefficients of 0.81-0.96 (anti-HPV-16) and 0.69-0.84 (anti-HPV-18). Exploratory modelling based on the 6-year data predicted vaccine-induced anti-HPV-16/18 levels above natural infection levels for at least 20 years, except for anti-HPV-18 in the older age group (piecewise model). One vaccine-related and two fatal SAEs were reported. CONCLUSIONS: At 6 years after vaccination, immune responses induced by the HPV-16/18 AS04-adjuvanted vaccine were sustained in all age groups.

Mutations in Pol gene of hepatitis B virus in patients with chronic hepatitis B before and after therapy with nucleoside/nucleotide analogues.

Chronic hepatitis B (CHB) is one of the most common infections worldwide. Currently approved treatments of CHB include nucleoside/nucleotide analogues (NAs). However, long-term NA therapy is associated with accumulation of resistant mutations within the hepatitis B virus (HBV) polymerase gene. The incidence of naturally occurring HBV mutations leading to primary antiviral resistance has not been fully elucidated yet. The objective of present study was to detect the frequency of mutations within the HBV polymerase gene in 263 patients naïve to nucleoside/nucleotide analogues. Prevalence of HBV Pol gene mutations secondary to NA treatment in patients without pre-existing antiviral resistance mutations was also examined. Retrospective analysis showed that HBV Pol gene mutations were present in 7 out of 263 patients prior to the treatment. Mutations observed in NA-naïve CHB patients were associated only with resistance to lamivudine and adefovir. Compensatory mutations were observed as well. In the course of antiviral treatment, HBV Pol gene mutations were identified in 65 out of the remaining 256 CHB patients (25.39%), while no mutations of any type were detected in 160 patients (62.5%). The profiles of detected mutations were comparable to those observed in other studies that focused on the analysis of clinically relevant NA-resistant mutations. In conclusion, we found out that antiviral resistance mutations may pre-exist in the overall viral population present in untreated patients, although the incidence of HBV Pol gene mutations in NA-naïve CHB patients was low and reached only up to 2.66%. However, possible circulation and transmission of NAs-resistant HBV mutants in human population should be taken into account.

A nationwide analysis of risk factors for mortality and time to endoscopy in upper gastrointestinal haemorrhage.

BACKGROUND: We analysed nationwide in-patient data from 2002 to 2007 to determine significant demographic variables when predicting mortality and receipt of prompt oesophagogastroduodenoscopy (OGD) for acute variceal haemorrhage (AVH) and nonvariceal upper gastrointestinal haemorrhage (NVUGIH). AIM: To study the effects of demographic variables in predicting time to endoscopy and mortality in AVH and NVUGIH. METHODS: We analysed the United States' Nationwide Inpatient Sample (NIS), for risk factors for mortality and receipt of OGD within 1 day of admission for upper gastrointestinal haemorrhage. RESULTS: Risk factors for increased mortality in AVH included: age >60, men, African Americans, comorbidities, insurance type and delayed OGD. Risk factors for increased mortality in NVUGIH were similar to AVH, except race which was not significant. After correction for factors such as insurance type, comorbidity, hospital location and time to endoscopy, this increased risk of mortality persisted, suggesting that none of these factors was the primary cause of the observed differences. For AVH, OGD within 1 day of admission was more likely in men, White Americans, patients aged 18-40 years, privately insured and those with no comorbidities. OGD within 1 day of admission in NVUGIH was more likely in men, patients age 40-60, Whites, Hispanics, privately insured and those with a single comorbidity. CONCLUSIONS: In multivariate analysis, in-patient mortality in AVH and NVUGIH increased with age, comorbidity, male gender, and delayed time to endoscopy. Young, healthier men were most likely to receive OGD within 1 day of admission. African Americans were less likely to receive OGD within 1 day of admission and had increased mortality in cases of AVH.

Abdominal radiation exposure elicits inflammatory responses and abscopal effects in the lungs of mice.

An inflammatory reaction is a classical feature of radiation exposure and appears to be a key event in the development of the acute radiation syndrome. We have investigated the radiation-induced inflammatory response in C57BL6/J mice after total abdominal or total-body irradiation at a dose of 15 Gy. Our goal was to determine the radiation-induced inflammatory response of the gut and to study the consequences of abdominal irradiation for the intestine and for the lungs as a distant organ. A comparison with total-body irradiation was used to take into account the hematopoietic response in the inflammatory process. For both irradiation regimens, systemic and intestinal responses were evaluated. A systemic inflammatory reaction was found after abdominal and total-body irradiation, concomitant with increased cytokine and chemokine production in the jejunum of irradiated mice. In the lungs, the radiation-induced changes in the production of cytokines and chemokines and in the expression of adhesion molecules after both abdominal and total-body irradiation indicate a possible abscopal effect of radiation in our model. The effects observed in the lungs after irradiation of the abdomino-pelvic region may be caused by circulating inflammatory mediators consequent to the gut inflammatory response.

Screening of a large panel of gastrointestinal peptide plasma levels is not adapted for the evaluation of digestive damage following irradiation.

The aim of this study was to assess the potential of gastrointestinal peptide plasma levels as biomarkers of radiation-induced digestive tract damage. To this end, plasma levels of substance P, GRP, motilin, PYY, somatostatin-28, gastrin, and neurotensin were followed for up to 5 days in pigs after a 16-Gy whole-body X-irradiation, completed by a histopathological study performed at 5 days. Each peptide gave a specific response to irradiation. The plasma levels of GRP and substance P were not modified by irradiation exposure; neither were those of motilin and PYY. Concerning gastrin, a 2-3-fold increase of plasma concentration was observed in pig, which presented the most important histological alterations of the stomach. The plasma levels of somatostatin, unchanged from 1 to 4 days after irradiation, was also increased by 130% at 5 days. In contrast, a diminution of neurotensin plasma levels was noted, firstly at 1 day (-88%), and from 3 days after exposure (-50%). The present study suggested that changes in gastrin and neurotensin plasma levels were associated with structural alterations of the stomach and ileum, respectively, indicating that they may be relevant biological indicators of radiation-induced digestive damage to these segments.

Transmission of HCV infection among long-term hospitalized onco-haematological patients.

Hepatitis C virus (HCV) infection is becoming a substantial problem in long-term hospitalized patients. Onco-haematological patients undergoing chemotherapy are especially prone to HCV infection. These patients are usually immunosuppressed and therefore antibodies to HCV are not produced despite the presence of HCV RNA in peripheral blood. The aim of the study was to see how often long-term hospitalized patients acquired HCV infection, and what were the possible sources and routes of virus transmission. The study involved 129 children with lymphoproliferative diseases, 36 patients with solid tumours, and 61 healthcare workers from onco-haematological wards. All were HCV RNA and anti-HCV negative at the time of first hospitalization. During a two and a half-year follow-up study among 165 onco-haematological patients, HCV RNA appeared in 87 in subsequent hospitalizations. The majority of infections were (82/87) were 1a genotype, 2 were 1b, 1 was 1a + 1b and 1 was 1a + 3a. In an attempt to establish the origin of HCV infection, healthcare workers were screened for HCV genotyping. All HCV-infected staff working on wards had the same genotype (1a). None of the staff was infected with 1b genotype. As the most prevalent genotype in Polish blood donors is 1b, HCV infection in onco-haematological patients is most likely due to horizontal transmission, probably involving genotype 1a, and potential horizontal transmission of HCV is implied by the presence of 1a genotype of HCV in saliva and urine of selected patients. Spread of hospital HCV infection among children may be facilitated by micro-injury of the skin and mucosa. Early detection of HCV RNA is important in such immunosuppressed patients, as they are not able to produce anti-HCV antibodies. This may enable the introduction of prophylactic steps to prevent the spread of HCV infection by horizontal transmission.

Expression of mRNA for cytokines (TNF-alpha and IL-1alpha) in human cytomegalovirus (HCMV) and hepatitis B virus (HBV) infections.

The study was aimed at detecting cellular sources of transcripts for two cytokines, TNF-alpha and IL-1alpha in infection with human cytomegalovirus (HCMV) or hepatitis B virus (HBV). The studies were performed on paraffin sections of organs (liver, pancreas, spleen, lungs) obtained upon autopsy from a child deceased due to acute inborn HCMV infection, on paraffin sections of liver biopsy, obtained from a child with HCMV-induced chronic hepatitis, and of liver biopsies obtained from children with chronic type B hepatitis (n = 13). The classical in situ hybridization was applied with digoxygenin-labeled probes and amplification by the ImmunoMax technique. In HCMV infection, the most pronounced expression of mRNA for TNF-alpha and Il-1alpha was detected in pancreatic islets (mainly in beta cells) and, then, in a decreasing sequence, in liver (in macrophages and sinusoidal endothelial cells) and in lungs (in alveolar macrophages). No expression of the two cytokines was detected in the spleen. In HBV infection, weak expression of TNF-alpha and more intense expression of IL-1alpha in the liver were observed, mainly in sinusoidal endothelial cells and in macrophages as well as in hepatocytes. These results were confirmed by immunocytochemical experiments.

[Viral hepatitis as a disease with occupational etiology]. / Wirusowe zapalenie watroby, jako choroba o podlozu zawodowym.

This paper reviews the literature and discusses the occupational background and conditions of hepatitis. There are known three hepatitis viruses (HAV, HBV and HCV) with proved transmission through occupational contacts. In addition, occupation-related infections HDV and HGV, are probable or possible. Current diagnostic and epidemiological data as well as suggestions concerning the prevention of occupational hepatitis are also presented. A concept of work ability of health-care workers infected with HBV and HCV is discussed.

[Active infection with Epstein-Barr virus in two children with non-Hodgkin's lymphoma]. / Aktywne zakazenie wirusem Epsteina-Barr u dwojga dzieci z nieziarniczym chloniakiem zlosliwym.

Epstein-Barr virus is common in environment. It has an organothropy to lymphoid tissue and liver tissue and the acute infection causes a mononucleosis. The aim of this study was to present two cases in children. In postmortal examination a non-Hodgkin lymphoma was diagnosed. In the first case the course was acute and in the second was chronic. In both cases the unique ethiologic factor was Epstein-Barr virus.

Studies on tissue expression of HBV in children with chronic hepatitis type B using Immunomax technique.

The study aimed at employing the Immunomax technique to detect the markers of HBV replication (HBcAg and HBV-DNA) in liver biopsy material, obtained from children with chronic hepatitis type B. In line with the currently modified classification of chronic hepatitis and with the increasing potential of antiviral therapy it seemed purposeful to supplement routine staining techniques with studies at the molecular level. Our studies demonstrated the effective detection of both the core antigen and HBV-DNA in liver tissue in children using immunocytochemical techniques and in situ hybridization, amplified with the Immunomax technique. HBcAg was detected in 26 out of 27 liver biopsies from patients with chronic hepatitis type B and with replication of the virus. HBV-DNA was detected in all study children with HBV infection and in 2 out of 5 cases of chronic hepatitis of a distinct etiology. No significant relationships could be found between the detection of tissue HBV markers on the one hand and the intensity of inflammatory lesions or severity of fibrosis on the other.

A substance P receptor antagonist (FK 888) modifies gut alterations induced by ionizing radiation.

PURPOSE: We previously reported disturbances of ileal substance P (SP) levels and of characteristics of specific receptors after ionizing radiation associated with disorders of intestinal motility. The aim of this study was to investigate the effect of a SP receptor blockade by FK 888 on gut SP levels and contractile properties after rat irradiation. MATERIALS AND METHODS: Rats were exposed to 6 Gy whole-body gamma-irradiation and injected 1 h post-irradiation with FK 888 for 3 days (0.1 mg/kg/day). Plasma and ileal SP concentrations, ileal muscle SP receptor binding and SP-induced contractions in isolated ileum were investigated 3 and 14 days post-irradiation and FK 888 treatment. RESULTS: Irradiation induced an increase of total SP binding site number at day 3 (1.3-fold) and day 14 (1.6-fold). FK 888 had no effect on SP receptor characteristics in irradiated animals. In contrast, FK 888 treatment caused a reduction of endogenous ileal SP level in mucosal (-29%) and muscularis (-40%) layers at day 3 and these decreases were greater at day 14, -88% in mucosal and -61% in muscularis layers. FK 888 treatment decreased efficacy of ileal contraction in both the control and irradiated rat but surprisingly it increased potency at day 3 and decreased it at day 14 in the irradiated rat. CONCLUSIONS: The findings demonstrate that a SP receptor antagonist could be effective on intestine contractility alteration induced several days after ionizing radiation exposure but not at 3 days after irradiation.

Distances between the cochlea and adjacent structures related to cochlear implant surgery.

A sound knowledge of the topographic anatomy of the cochlea, especially of the distances between it and the adjacent structures, is essential for otosurgery in general, and in surgical procedures for cochlear implantation in particular. One hundred temporal bones of humans aged from one month to 71 years, of either sex, taken from both body sides (but not bilaterally) were studied by dissection under the operating microscope and exposing the cochlea and its neighbourhood. The minimal distances were measured between the cochlear turns and the internal carotid artery, the bulb of the jugular vein, the facial nerve and the floor of the internal acoustic meatus. It was found that in children aged up to 4 years most of the measured distances were significantly smaller than in older individuals. Only the minimal distance between the basal turn of the cochlea and the floor of the internal acoustic meatus was shorter in small children without statistical significance.

[Levels of tumor necrosis factor alpha in serum of patients with hyperlipoproteinemia IIB before and after micronized fenofibrate therapy]. / Stezenia czynnika martwicy nowotworów alfa w surowicy pacjentów z hiperlipoproteinemia IIb przed i po podjeciu teràpii fenofibratem mikronizowanym.

UNLABELLED: Tumor necrosis factor alpha (TNF alpha) secreted by activated macrophages stimulates proliferation and migration of vascular smooth muscle in atherogenesis. Up to now, the effect of fibrates on concentration of TNF-alpha has not been investigated. The aim of this study was to estimate TNF-alpha plasma concentration in healthy subjects before and after fenofibrate therapy in patients with hyperlipoproteinaemia IIb and to correlate their levels with plasma concentration of total cholesterol (TC), low density lipoproteins (LDL) and apolipoprotein B (ApoB). METHODS: 10 patients with hyperlipoproteinaemia IIb were treated with micronized fenofibrate (Lipanthyl 200 m-Fournier) for 1 month. Cytokines levels before and after therapy was measured by the ELISA method with Genzyme kits. RESULTS: The levels of lipid parameters at the onset study were as follows: TC: 265.4 +/- 9.4 mg%, TG: 344 +/- 53 mg%, LDL: 167.2 +/- 4.7 mg%, and ApoB: 1.62 +/- 0.05 g/l. After 1-month therapy with Lipanthyl 200 m the parameters decreased: TC 206 +/- 16 mg% (p < 0.05), TG: 194 +/- 30 mg% (p < 0.05), ApoB: 1.43 +/- 0.04 g/l (p < 0.01), and LDL: 144.4 +/- 12.9 mg% (ns). The decreased level of TC, TG and LDL correlated with the decreased concentration of TNF alpha. Before treatment the TNF concentration was 19.2 +/- 1.6 pg/ml and was higher than the concentration of control subjects (9.9 +/- 1.1 pg/ml, p < 0.01). After 1-month therapy the level of TNF alpha in blood from patient was 9.2 +/- 1.0 pg/ml (p < 0.01). The results of this study indicate that the concentrations of TNF alpha in plasma from hyperlipidemic patients are higher than concentrations of healthy subjects. Fenofibrate decreased the levels of this cytokine. This effect may be of significance for the treatment of HLPIIb and of atherosclerosis prevention.

[Needle testicular biopsy in the diagnosis of male infertility]. / Iglowa biopsja jader w diagnostyce nieplodnosci meskiej.

OBJECTIVES: Evaluation of testicular tissue is very important diagnostic procedures in cryptozoospermia and azoospermia. It is verified the patient for treatment (stimulation spermatogenesis), for micromanipulation ICSI or for insemination donor semen procedure. Surgical biopsy is very popular between andrologist and urologist, but needle biopsy seems to be easier and safer. DESIGN: The authors present their experience with needle testicular biopsy during the diagnosis patients with azoospermia or cryptozoospermia and the men with paraplegia after trauma and without ejaculation. MATERIAL AND METHODS: The study group included 63 biopsies in 58 men with azoospermia and severe oligoasthenozoospermia (cryptozoospermia) and 2 with paraplegia. The specimens were taken from 125 testes under general anesthesia (i.v-Diprivan, Propofol, Zeneca and Fentanyl) using biopsy needle from Hepafix B. Braun Melsungen, Germany. All procedures were performed as a day case. RESULTS: In 95% specimens were adequate for histopathological investigations and for planning the treatment. Only one complication (0, 8%) -small haematoma testis was observed. CONCLUSIONS: The needle biopsy of testicular tissue is sufficiency in histopathological examination, safe for patients and easy for urologists. The total cost is much more lower than cost of surgical biopsy.

[Percutaneous sperm retrieval for ICSI procedures in men with obstructive azoospermia: ICSI-PESA and ICSI-TESE micromanipulation: our experience]. / Wlasne doswiadczenia w przezskórnym pozyskiwaniu plemników do zaplodnienia pozaustrojowego ICSI-PESA oraz ICSI-TESE u mezczyzn z azoospermia obstrukcyjna.

OBJECTIVES: The sperm retrieval for ICSI procedures is possibly using following procedures: ejaculate sperm, epididymal sperm obtained by microsurgical aspiration or percutaneous puncture and testicular sperm that are obtained by surgical excision or percutaneous biopsy. Percutaneous techniques seem to be rather simple and effective procedures. DESIGN: The authors present their own experiences with percutaneous sperm retrieval for micromanipulation ICSI from the epididymis (ICSI-PESA) and from the testicular tissue (ICSI-TESE) in men with obstructive azoospermia and with reactive impotence. First time in Poland ICSI-PESA was done on April 11, 1996 in Private Infertility Center "Novum", Warsaw. MATERIAL AND METHODS: From April 1996 to the end of January 1998, 10 ICSI-PESA procedures (in 9 couples) and 8 ICSI-TESE (in 6 couples) were performed. In one case ICSI-PESA was performed in man with psychological inability of masturbation during his wife's IVF protocol. All procedures were performed as the day case urology, under general anesthesia. The fine needles No 6 in PESA or biopsy needle from Hepafix Set B. Braun in TESE were used. The therapy of antibiotic and common analgesic drug was used routinely after puncture. RESULTS: The effectiveness of obtaining sperm for micromanipulation were 100% ICSI-PESA and 75% ICSI-TESE. The pregnancy rate in PESA was 50% and 5 healthy children were born. In TESE only 1 woman (17%) was pregnant, but early spontaneous miscarriage was reported. No surgical and anesthesiological complications were noticed. CONCLUSIONS: Obtaining sperm for micromanipulation ICSI using percutaneous epididymal puncture or testicular tissue needle biopsy seems to be effective and safe for patients with obstructive azoospermia or reactive impotence.

Effects of fenofibrate on plasma cytokine concentrations in patients with atherosclerosis and hyperlipoproteinemia IIb.

BACKGROUND AND OBJECTIVE: In recent studies atherosclerosis has often been referred to as immune disease. The atherosclerotic plaque consists of large amounts of inflammatory cells, mainly monocytes/macrophages and T lymphocytes. Macrophages activated by low-density lipoproteins (LDL) secrete tumor necrosis factor alpha (TNF-alpha) and interleukin-1 (IL-1) in vitro, while LDL-stimulated T lymphocytes release interferon gamma (IFN-gamma). The aim of this study was to estimate the plasma levels of TNF-alpha, IL-1, IFN-gamma in patients with hyperlipoproteinemia IIb (HLPIIb) and atherosclerosis. Since the fibrates are drugs of choice in HLPIIb, we additionally evaluated the effect of fibrates on the cytokine levels. METHODS: Ten patients with HLPIIb were treated with micronized fenofibrate for 1 month. Before and after treatment, the cytokine levels were measured by the ELISA method. To accurately evaluate cytokine levels, we excluded atherosclerotic patients and control subjects with any inflammatory disease. RESULTS: The initial lipid parameters were as follows: total cholesterol (TC): 6.9 +/- 0.24 mmol/l, triglycerides (TG): 3.44 +/- 0.53 mmol/l, LDL: 4.35 +/- 0.12 mmol/l, and apolipoprotein B (ApoB): 1.62 +/- 0.05 g/l. After 1 month of fenofibrate treatment the parameters decreased to the following values: TC 5.36 +/- 0.42 mmol/l (p < 0.05), TG 1.94 +/- 0.30 mmol/l (p < 0.05), ApoB 1.43 +/- 0.04 g/l (p < 0.01), and LDL 3.75 +/- 0.34 mmol/l (p > 0.05). Before therapy, TNF-alpha levels in atherosclerotic patients were higher than in control subjects, 19.2 +/- 1.6 and 9.9 +/- 1.1 pg/ml, respectively (p < 0.01). After 1-month therapy, TNF-alpha levels in atherosclerotic patients were 9.2 +/- 1.0 pg/ml (p < 0.01). Similarly, the initial levels of IFN-gamma were higher in atherosclerotic patients compared with healthy subjects, 44.4 +/- 5.3, and 19.4 +/- 2.1 pg/ml, respectively (p < 0.01). After fenofibrate therapy, IFN-gamma levels decreased to 24.8 +/- 2.9 pg/ml (p < 0.01). The decreased levels of TC, TG, and LDL correlated with the decreased levels of TNF-alpha and IFN-gamma. CONCLUSION: The results of this study indicate that plasma TNF-alpha and IFN-gamma levels in hyperlipidemic patients are higher than in healthy subjects, and that fenofibrate is effective in decreasing lipids and cytokines in plasma.

[Cochleostomy during the intracochlear implantation. Anatomical conditions in children and adults]. / Kochleostomia podczas operacji wszczepu wewnatrzslimakowego. Uwarunkowania anatomiczne u dzieci i doroslych.

Cochleostomy is an opening of the perilymphatic spaces of the cochlea. It is the most important moment in intracochlear implant surgery. There are contradictory opinions in the available literature regarding this surgical intervention. Cochleostomy is performed through the round window, the oval window, the promontory or through the apical turn of the cochlea. A microanatomical study was performed to evaluate which kind of cochleostomy would be most effective and safe for the main structures of the temporal bone. The distances between round window and round window niche structures, the jugular bulb, internal acoustic meatus, posterior semicircular canal, internal carotid artery and cochlear canalicule were measured. It was stated that all the dimensions were smaller in children of up to four years of age and the differences were statistically significant. Cochleostomy through the promontory, especially using the "soft" technique of endosteum opening is safe for all the structures, and in children it also protects the cochlear canalicule.

Hepatitis B and C virus infection in Polish children with malignancies.

UNLABELLED: Infections by hepatotropic viruses belong to the most common complications of chemotherapy in children suffering from neoplastic diseases. The rate of hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and the effectiveness of passive immunization against HBV were studied in 285 children; 148/285 with lymphoproliferative diseases and 137/285 with solid tumours. HBV infection was observed in 10.2% children receiving hepatitis B immune globulin as compared to 36.8% without passive immunization against HBV. Anti-HCV antibodies were similar in both groups amounting 38.7% and 32.6% respectively. CONCLUSION: The results show that hepatitis B immune globulin administration is effective and that HCV might become the main cause of hepatitis among immunosuppressed patients in the future.

[Advanced nasopharyngeal tumor]. / Rozlegly guz nosogardla.

Nasopharyngeal cancer is a rare neoplasm in most parts of the world, it is the most common cancer the Chinese. Nasopharyngeal cancer is often misdiagnosed because of the variety of subtle signs and symptoms and the difficulty of examining this region. The most common neoplasms of the nasopharynx are epithelial malignancies originates from epithelial cells in the nasopharynx. The authors has presented a rare case of advanced nasopharyngeal adenocarcinoma.