Role of interleukin-28B polymorphisms in the treatment of hepatitis C virus genotype 2 infection in Asian patients.

UNLABELLED: Genome-wide association studies have linked single nucleotide polymorphisms (SNPs) near the interleukin-28B gene to the hepatitis C virus genotype 1 (HCV-1) response to peginterferon/ribavirin treatment. We aimed to explore the impact on the treatment outcomes of Asian HCV-2 patients. We determined rs8105790, rs8099917, rs4803219, and rs10853728 to be candidate SNPs in 482 Asian HCV-2 patients treated with the standard of care. Because the first three SNPs were in very strong linkage disequilibrium with one another (r2 = 0.94-0.96), rs8099917 and rs10853728 were selected for an analysis of their influence on the achievement of rapid virological response [RVR; seronegativity for hepatitis C virus (HCV) RNA in treatment week 4] and sustained virological response (SVR; seronegativity for HCV RNA throughout 24 weeks of posttreatment follow-up). The rs10853728 genotype did not predict RVR or SVR in HCV-2 patients. However, patients with the rs8099917 TT genotype, in comparison with patients with GT/GG genotypes, had a significantly higher rate of achieving RVR (85.2% versus 72.0%, P = 0.017) but did have not a significantly higher rate of achieving SVR (89.4% versus 86.0%). Multivariate analysis revealed that a baseline HCV viral load <400,000 IU/mL was the strongest predictor of RVR [odds ratio (OR) = 4.27, 95% confidence interval (CI) = 2.31-7.87, P < 0.001], and this was followed by advanced liver fibrosis (OR = 0.28, 95% CI = 0.15-0.53, P < 0.001), the carriage of the rs8099917 TT genotype (OR = 3.10, 95% CI = 1.34-7.21, P = 0.008), and the pretreatment level of aspartate aminotransferase (OR = 0.996, 95% CI = 0.99-1.00, P = 0.04). Nevertheless, the achievement of RVR was the single predictor of SVR with an OR of 19.37 (95% CI = 8.89-42.23, P < 0.001), whereas the rs8099917 genotypes played no role in achieving SVR with or without RVR. CONCLUSION: The rs8099917 TT genotype is significantly independently predictive of RVR, which is the single best predictor of SVR, in Asian HCV-2 patients.

Effect of periodontitis on susceptibility to atrial fibrillation in an animal model.

BACKGROUND: Inflammation is implicated in the pathophysiology of atrial fibrillation (AF). Periodontitis causes a general inflammatory response. Whether periodontitis is related to AF is unknown. OBJECTIVE: The aim of the study was to test the hypothesis that inflammation facilitates AF. METHODS: Twenty-two adult mongrel canines of either sex were used for this study. Periodontitis was induced in 12 dogs (periodontitis group) by tying 2-0 silk ligatures at the second premolar of mandibula. Ten healthy dogs were used as controls. Before the ligation procedure and on the day 30, 60, and 90 after ligation, an electrophysiologic evaluation was performed to measure atrial refractoriness and AF inducibility by delivering a single atrial extrastimuli in the high right atrium, atrial septum (AS), and coronary sinus (CS), respectively. Before each electrophysiologic study, blood samples were taken for determining the levels of C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-alpha). Animals were killed after 90 days. The hearts and mandibulae were harvested for morphological study, and the periodontal disease severity was quanti fi ed. RESULTS: Atrial effective refractory period (AERP) shortened, and AF inducibility increased progressively in the periodontitis group. At a drive length of 300 milliseconds, AERP in the CS was 126.7 +/- 13.0 milliseconds and 107.5 +/- 9.7 milliseconds after 60 and 90 days of ligation, respectively (vs 165.8 +/- 10.8 milliseconds at baseline; P < .001). By CS pacing, AF was induced in 5 and 10 of 12 dogs on day 60 and 90 after ligation, respectively (vs 1/12 at baseline; P < .05 and P < .01, respectively). Elevation of CRP and TNF-alpha occurred after 60 days of ligation (CRP, 13.42 +/- 2.21 mg/L vs control, 1.92 +/- 0.38 mg/L; P < .001; TNF-alpha, 9.85 +/- 1.72 mg/L vs control, 3.36 +/- 0.75 mg/L; P < .001) and reached the peak at the end of the study (CRP, 31.38 +/- 2.69 mg/L vs control, 1.99 +/- 0.40 mg/L; P < .001; TNF-alpha, 12.32 +/- 1.07 mg/L vs control, 3.24 +/- 0.53 mg/L; P < .001). There was a negative correlation between the levels of serum inflammatory factors and AERP values (P < .05). Alveolar bone level decreased in the periodontitis group (P < .001). The long axis (P < .001) of atrial cardiomyocytes including the right atrial appendage (25.50 +/- 3.58 microm vs 18.14 +/- 3.32 microm), AS (24.78 +/- 3.45 microm vs 17.47 +/- 2.57 microm), and left atrial appendage (31.90 +/- 4.80 microm vs 18.78 +/- 2.42 microm) from the periodontitis group was larger than the control group. The short axis of atrial cardiomyocytes was larger than the control group, too (P < .001). Inflammatory cells were more generally found in the atria of the periodontitis group (P < .001). Myolysis affected some atrial cardiomyocytes of the dogs with periodontitis. CONCLUSION: Periodontitis led to inflammatory responses in the atrial myocardium, which disturbed the structural and electrophysiologic properties of the atrium and facilitated AF.

Tensile force produced by a lipoma in the masseteric space possibly causing hyperostosis of the angle of the mandible.

BACKGROUND: A lipoma is a benign tumor which may occur in the adipose tissue of any part of the body. The tumor is most commonly found on the trunk and extremities. Although it is the most common tumor of mesenchymal origin in the head and neck, its incidence is relatively rare. Lipoma of the head and neck is usually located in subcutaneous tissue. It is rarely deep seated with osseous involvement and rarely occurs in children, especially below the age of 10. CASE REPORT: The case of a painless mass of one-year history in the right parotidomasseteric region of an eight-year-old boy is presented. The mass was revealed to be a classical lipoma in the masseteric space, possibly causing hyperostosis of the angle of the mandible. After removal of the mass and a spherical protuberance in the angle of the mandible, the boy recovered and no recurrence was noted after one-year follow-up. CONCLUSIONS: Hyperostosis is a rare phenomenon with lipoma. In this case, the hypothesis was posed that the tensile force produced by the lipoma in the masseteric space possibly caused hyperostosis of the angle of the mandible. To the authors' knowledge, a classical lipoma arising from the deep fascial space resulting in osseous change has not been described in the literature before.

[Oral lymphoepithelial cyst: report of 3 cases].

Three cases with oral lymphoepithelial cyst were reported in this paper. The most frequent site of the cyst was mouth floor, and the cyst was often misdiagnosed as mucous cyst and other diseases of cyst. Histopathologically, the central cystic lesion was lined with stratified squamous epithelium. Simultaneously, there were lymphoid cells located at the surrounding of the cystic fibrous connective tissue. Oral lymphoepithelial cyst was regarded to originate from secretory duct of the sublingual gland and the small salivary gland epithelium. With chronic stimuli, the epithelium of secretory duct was squamous metaplasia. The deciduous cells in the inner side of the duct induced the infiltration of the surrounding lymphocytes. The relevant literatures were reviewed regarding to the histological origin and the pathogenesis of the disease to provide some references for diagnosis and treatment of this disease.