RESUMO
Hepatitis C virus core antigen (HCV Ag) is a recently developed marker of hepatitis C virus (HCV) infection. We investigated the clinical utility of the new HCV Ag assay for prediction of treatment response in HCV infection. We analyzed serum from 92 patients with HCV infection who had been treated with pegylated interferon and ribavirin. HCV Ag levels were determined at baseline in all enrolled patients and at week 4 in 15 patients. Baseline HCV Ag levels showed good correlations with HCV RNA (r = 0.79, P < 0.001). Mean HCV Ag levels at baseline were significantly lower in patients with a sustained virologic response (SVR) than in those with a non SVR (relapse plus non responder) based on HCV RNA analysis (2.8 log10fmol/L vs. 3.27 log10fmol/L, P = 0.023). Monitoring of the viral kinetics by determination of HCV RNA and HCV Ag levels resulted in similarly shaped curves. Patients with undetectable HCV Ag levels at week 4 had a 92.3% probability of achieving SVR based on HCV RNA assay results. The HCV Ag assay may be used as a supplement for predicting treatment response in HCV infection, but not as an alternative to the HCV RNA assay.
Assuntos
Antígenos Virais/sangue , Hepacivirus/genética , Hepatite C Crônica/virologia , RNA Viral/sangue , Antivirais/uso terapêutico , Automação , Quimioterapia Combinada , Feminino , Genótipo , Hepacivirus/isolamento & purificação , Hepacivirus/metabolismo , Hepatite C Crônica/tratamento farmacológico , Humanos , Imunoensaio , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/uso terapêutico , Reação em Cadeia da Polimerase , Kit de Reagentes para Diagnóstico , Proteínas Recombinantes/uso terapêutico , Recidiva , Ribavirina/uso terapêutico , Resultado do TratamentoRESUMO
OBJECTIVE: To investigate whether adding rifampicin to vancomycin could cure more patients with nosocomial methicillin-resistant Staphylococcus aureus pneumonia compared with vancomycin-only. DESIGN: Prospective randomized open-label study. SETTING: Medical intensive care unit in Seoul, Korea. PATIENTS: Ninety-three of 183 patients with Gram-positive nosocomial pneumonia. INTERVENTIONS: The enrolled patients with subsequently documented methicillin-resistant Staphylococcus aureus pneumonia (modified intention-to-treat population) were treated with vancomycin (1 g intravenous every 12 hrs) plus rifampicin (300 mg twice daily by mouth) (n = 41) or with vancomycin-only (n = 42). The intended treatment (at least 5 days) was completed in 30 patients in the vancomycin plus rifampicin group and 34 patients in the vancomycin-only group (per protocol population). MEASUREMENTS AND MAIN RESULTS: The primary outcome was the clinical cure rate on day 14 of treatment. The secondary outcomes were intensive care unit mortality on days 28 and 60, and microbiological eradication on day 14. The clinical cure rate in the modified intention-to-treat population was 53.7% (22 of 41) in the vancomycin plus rifampicin group, and 31.0% (13 of 42) in the vancomycin-only group (p = .047), and the respective rates in the per protocol population were 63.3% (19 of 30) and 38.2% (13 of 34) (p = .079). The respective mortality rates were nine (22.0%) of 41 and 16 (38.1%) of 42 on day 28 (p = .151), and 11 (26.8%) of 41 and 21 (50.0%) of 42 on day 60 (p = .042). The microbiological eradication rate did not differ between groups (p = .472). CONCLUSIONS: Vancomycin plus rifampicin seems to be more effective than vancomycin alone in the treatment of nosocomial methicillin-resistant Staphylococcus aureus pneumonia.
Assuntos
Infecção Hospitalar/tratamento farmacológico , Mortalidade Hospitalar , Staphylococcus aureus Resistente à Meticilina , Pneumonia Estafilocócica/tratamento farmacológico , Rifampina/administração & dosagem , Vancomicina/administração & dosagem , Centros Médicos Acadêmicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidados Críticos/métodos , Infecção Hospitalar/microbiologia , Infecção Hospitalar/mortalidade , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Unidades de Terapia Intensiva , Coreia (Geográfico) , Masculino , Pessoa de Meia-Idade , Pneumonia Estafilocócica/diagnóstico , Pneumonia Estafilocócica/mortalidade , Probabilidade , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Análise de Sobrevida , Resultado do TratamentoRESUMO
BACKGROUND/AIMS: The standard therapy for patients with genotype 1 chronic hepatitis C (CHC) is a combination of peginterferon and ribavirin for 48 weeks. However, the most appropriate duration of treatment remains to be established because of treatment-related side effects and cost. The aim of this study was to compare the efficacies of 24- and 48-week treatments, and to assess the efficacy of split 24-week therapy (a further 24 weeks of treatment in patients with relapse after the initial 24 weeks of treatment). METHODS: A total of 130 patients with genotype 1 CHC was treated between June 2004 and December 2006. Patients with undetectable HCV RNA at 24 weeks of treatment (as assessed by qualitative PCR assay; n=101 patients) were allowed to choose either 24 or 48 weeks as the duration of their treatment; 51 patients chose the 24-week treatment regimen and the remainder chose the 48-week regimen. Patients who relapsed after 24 weeks of treatment were treated for further 24 weeks. The sustained virologic response (SVR) of each treatment group was analyzed. RESULTS: The SVR rate was higher in patients treated for 48 weeks than in those treated for 24 weeks (74.0% vs. 52.9%, P=0.028). In the multivariate analysis, age < 50 years, platelets > or = 150,000/mm(3), and treatment duration for 48 weeks remained significant independent predictors of SVR. Fourteen of the 24 patients who relapsed in the 24-week treatment group received split 24-week therapy, and 6 patients (42.9%) achieved SVR. The overall SVR rate did not differ significantly between the 24-week treatment group, including those who underwent 24-week split therapy (64.7%), and the 48-week treatment group (64.7% vs. 74%, P=0.311). CONCLUSIONS: The 24-week plus additional split 24-week therapy following failure is a useful treatment strategy for patients with genotype 1 CHC.
Assuntos
Antivirais/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/administração & dosagem , Polietilenoglicóis/administração & dosagem , Ribavirina/administração & dosagem , Adulto , Fatores Etários , Idoso , Antivirais/uso terapêutico , Esquema de Medicação , Quimioterapia Combinada , Feminino , Genótipo , Hepacivirus/genética , Humanos , Interferon alfa-2 , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Polietilenoglicóis/uso terapêutico , RNA Viral/sangue , Proteínas Recombinantes , Ribavirina/uso terapêuticoRESUMO
We studied 1-dimensional (1-D) photonic crystal (PC) films with three alternating layers to investigate multi-mode photonic band-gaps (PBGs) at red, green, and blue color regions. From simulations, it was shown that PCs with three alternating layered elements of [a/b/c] structure have sharp PBGs at the three color regions with the central wavelengths of 459 nm, 527 nm, and 626 nm, simultaneously. Experimentally, it was proven that red, green, and blue PBGs were generated clearly by the PCs, which were made of multilayers of [SiO(2)/Ta(2)O(5)/TiO(2)], based on the simulation. It was also shown that the measured wavelengths of the PBGs corresponded exactly to those of the simulated results. Moreover, it was demonstrated that a 1-D PC of [a/b/c] structure can be used for making white organic light emitting devices (OLEDs) with improved color rendering index (CRI) for color display or lighting.
Assuntos
Desenho Assistido por Computador , Iluminação/instrumentação , Membranas Artificiais , Modelos Teóricos , Óptica e Fotônica/instrumentação , Compostos Orgânicos/química , Semicondutores , Simulação por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Teste de Materiais , FótonsRESUMO
AIM: To avoid the limitation of the use of cationic polyethlenimine (PEI)-complexed plasmid DNA use for in vitro or in vivo gene delivery due to its cytotoxicity and lower efficiency in the presence of serum. METHODS: A polyplex with decreased positive charge on the complex surface was designed. The PEI/DNA (PD) complexes coated with an anionic biodegradable polymer, alginate were prepared and their gene delivery behavior with PD was compared. RESULTS: The alginate-coated PD polyplex, where alginate : PEI : DNA [alginate : DNA, 0.15 (w/w); PEI : DNA, N : P = 10] showed about 10 - 30 fold-increased transfection efficiency compared to corresponding non-coated complexes to C3 cells in the presence of 50% serum. The surface charge of the alginate-coated complex was approximately half of that of the alginate-lacking complex. The size of alginate-coated complex was slightly smaller than that of the corresponding complex without alginate. The former complex also showed a reduced erythrocyte aggregation activity and decreased cytotoxicities to C3 cells in comparison with PD complex. CONCLUSION: The alginate-coated PD polyplexes as a new gene delivery system can improve transfection efficiency in high serum concentration with low cytotoxicity to C3 cells.
Assuntos
Alginatos/metabolismo , DNA/metabolismo , Técnicas de Transferência de Genes , Polietilenoimina/metabolismo , Alginatos/administração & dosagem , Animais , Linhagem Celular Transformada , Sobrevivência Celular , Meios de Cultura , DNA/administração & dosagem , DNA/genética , Agregação Eritrocítica , Fibroblastos/citologia , Fibroblastos/metabolismo , Vetores Genéticos , Ácido Glucurônico/administração & dosagem , Ácido Glucurônico/metabolismo , Ácidos Hexurônicos/administração & dosagem , Ácidos Hexurônicos/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Plasmídeos , Polietilenoimina/administração & dosagem , Soro , TransfecçãoRESUMO
Due to their intracellular permeability, protein transduction domains (PTDs) have been widely used to deliver proteins and peptides to mammalian cells. However, their performance in gene delivery has been relatively poor. To improve the efficiency of PTD-mediated gene delivery, we synthesized a new peptide, KALA-Antp (K-Antp), which contains the sequences for PTD of the third alpha-helix of Antennapedia (Antp) homeodomain and the fusogenic peptide KALA. In this configuration, Antp is designed to provide the cell permeation capacity and nuclear localization signal, while the KALA moiety to promote cellular entry of the peptide-DNA complex. An optimal K-Antp/DNA formula was nearly 400-600 fold more efficient than Antp or poly-lysine-Antp (L-Antp) in gene delivery, and comparable or superior to a commercial liposome. The K-Antp-mediated plasmid DNA transfection not only exhibited temperature sensitivity, reflecting the involvement of an endocytosis-mediated gene transfer mechanism similar to other known PTDs, but also temperature insensitivity, suggesting the role of an energy-independent mechanism. Incorporation of an endosomolytic polymer polyethylenimine (PEI) into the system or treatment with chloroquine further increased the efficiency of K-Antp-mediated gene delivery. These results demonstrate the potential of the combinatorial use of KALA, Antp and PEI in the development of efficient PTD-derived gene carriers.
Assuntos
Técnicas de Transferência de Genes , Peptídeos/química , Peptídeos/metabolismo , Sequência de Aminoácidos , Animais , Linhagem Celular Tumoral , DNA/genética , Endossomos/metabolismo , Camundongos , Dados de Sequência Molecular , Plasmídeos/genética , Polímeros/metabolismo , Estrutura Terciária de Proteína , Temperatura , TransfecçãoRESUMO
Strain S22(T), a novel cellulolytic bacterium was isolated from the rhizosphere of pine trees. This isolate was Gram-reaction positive, motile and rods, and formed terminal or subterminal ellipsoidal spores. S22(T) represented positive activity for catalase, oxidase, esterase (C4), esterase lipase (C8), beta-galactosidase, leucine arylamidase, and hydrolysis of esculin. It contained meso-diaminopimelic acid as the diagnostic dia-mino acid in the cell-wall. The predominant isoprenoid quinone was menaquinone 7 (MK-7), and the major cellular fatty acids were anteiso-C(15:0) (52.9%), iso-Ci(16:0) (11.3%), and iso-C(15:0) (10.0%). The DNA G+C content was 43.3 mol%. Phylogenetic analysis based on 16S rRNA gene sequences showed that this isolate belonged to the family Paenibacillaceae. S22(T) exhibited less than 97.0% 16S rRNA gene similarity with all relative type strains in the genus Paenibacillus, and the most closely related strains were Paenibacillus anaericanus MH21(T) and Paenibacillus ginsengisoli Gsoil 1638(T), with equal similarities of 95.8%. This polyphasic evidence suggested that strain S22(T) should be considered a novel species in the genus Paenibacillus, for which the name, Paenibacillus pini sp. nov., is proposed. The type strain is S22(T) (=KCTC 13694(T) =KACC 14198(T) =JCM 16418(T)).
Assuntos
Celulose/metabolismo , Paenibacillus/classificação , Paenibacillus/metabolismo , Pinus/microbiologia , Raízes de Plantas/microbiologia , Microbiologia do Solo , Técnicas de Tipagem Bacteriana , Composição de Bases , Parede Celular/química , Análise por Conglomerados , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Ácido Diaminopimélico/análise , Ácidos Graxos/análise , Dados de Sequência Molecular , Paenibacillus/genética , Paenibacillus/isolamento & purificação , Filogenia , Quinonas/análise , RNA Ribossômico 16S/genética , Análise de Sequência de DNARESUMO
Atopobium rimae, previously Lactobacillus rimae, is a strictly anaerobic, non-spore forming grampositive rod which was frequently isolated from odontogenic infection. We report a case of A. rimae bacteremia. A 47-yr-old man with liver cirrhosis was admitted to the hospital via emergency room due to fever and chill. His abdominal and pelvic computed tomography revealed a small abscess near the left adrenal gland. Three sets of blood cultures were taken and non-spore forming, grampositive rods were detected in all anaerobic vials. This isolate grew small nonhemolytic, gray-white translucent colonies on Brucella blood agar and was obligatory anaerobic on air-tolerance test. This organism was negative for catalase, indole, nitrate-reduction and beta-lactamase and failed to identify by Vitek ANI card (bioMerieux, France). 16S rRNA sequences of this showed 99.8% homology of the published sequence of A. rimae (GenBank accession number AF292371). Aspirates of periadrenal abscess grew Escherichia coli and Peptostreptococcus micros. He was treated with metronidazole and imipenem and follow-up cultures of blood were negative at days 4 and 10. To our knowledge, this is the first report of bacteremia of A. rimae.