Risk factors for de novo hepatitis B during solid cancer treatment

BACKGROUNDReactivation of hepatitis B virus (HBV) during anticancer treatment is a critical issue. When treating patients with solid tumors, it is unclear whether specific cancer types or treatments affect HBV reactivation in hepatitis B surface antigen (HBsAg)-negative and hepatitis B core antibody (HBcAb)-positive patients, so-called de novo hepatitis B patients. The risk of de novo hepatitis B may vary based on different background factors.AIMTo determine the frequency and risk factors for de novo hepatitis B during solid tumor treatment.METHODSThis retrospective cohort study comprised 1040 patients without HBsAgs and with HBcAbs and/or hepatitis B surface antibodies (HBsAbs). The patients were treated for solid cancer from 2008 to 2018 at the National Kyushu Cancer Center and underwent HBV DNA measurements. Patient characteristics and disease and treatment information were investigated. HBV DNA measurements were performed using TaqMan polymerase chain reaction (PCR). To identify the risk factors associated with HBV DNA expression, the age, sex, original disease, pathology, treatment method, presence or absence of hepatitis C virus (HCV), and HBsAb and/or HBcAb titers of all subjects were investigated. In patients with HBV DNA, the time of appearance, presence of HBsAgs and HBsAbs at the time of appearance, and course of the subsequent fluctuations in virus levels were also investigated.RESULTSAmong the 1040 patients, 938 were HBcAb positive, and 102 were HBcAb negative and HBsAb positive. HBV DNA expression was observed before the onset of treatment in nine patients (0.9%) and after treatment in 35 patients (3.7%), all of whom were HBcAb positive. The HBV reactivation group showed significantly higher median HBcAb values [9.00 (8.12-9.89) vs 7.22 (7.02-7.43), P = 0.0001] and significantly lower HBsAb values (14 vs 46, P = 0.0342) than the group without reactivation. Notably, the reactivated group showed a significantly higher proportion of cancers in organs related to digestion and absorption (79.0% vs 58.7%, P = 0.0051). A high HBcAb titer and cancers in organs involved in digestion and absorption were identified as independent factors for HBV reactivation (multivariate analysis, P = 0.0002 and P = 0.0095). The group without HBsAbs tended to have a shorter time to reactivation (day 43 vs day 193), and the frequency of reactivation within 6 mo was significantly higher in this group (P = 0.0459) than in the other group.CONCLUSIONA high HBcAb titer and cancers in organs involved in digestion and absorption are independent factors that contribute to HBV reactivation during solid tumor treatment.     

Comparison between a traditional single still image and a multiframe video image along the z‐axis of the same microscopic field of interest in cytology: Which does contribute to telecytology?

The limitation of cytologic still images is one of the reasons why telecytology has not met with widespread acceptance by the cytology community. Cytologic still image only displays a single depth of field, and this is a particularly acute problem in cytology where the specimen is often much thicker than a single microscopic depth of focus. In this article, we examine the validity of a “z‐axis” video of a microscopic field of interest. After observing videos of fields of interest from 10 cases, five cytotechnologists reached suitable cytologic findings and diagnosed the fields correctly in great majority of cases. Five other cytotechnologists, who looked only at a single representative still image, could not always make a correct diagnosis. The difference between two observer groups was statistically significant by Wilcoxon's matched pairs signed‐rank test. The results indicate that “z‐axis” video of microscopic field of interest provides a similar experience to “focusing through” observation of the specimen under a microscope and may improve an accuracy of primary telecytodiagnosis. And we expect that video image telecytology will strongly influence cytology, especially in education and training. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

Effects of a fluoride etchant and a phosphate primer on bonding of veneering composite to Ti–6Al–4V alloy for CAD/CAM restorations

PurposeTitanium abutments and superstructures are commonly veneered or covered with esthetic materials. The present investigation was carried out to evaluate the effects of an experimental surface treatment using etchant and primer on bond strength between a resin composite and Ti–6Al–4V alloy.MethodsDisk-shaped Ti–6Al–4V alloy was machine milled, the surface was air abraded with alumina, and the alloy was chemically etched with 5wt% ammonium hydrogen fluoride (F-etch) for 30 s. A phosphate primer (MDP-primer) was applied to the bonding area, and then a resin composite, with or without milled-fiber resin composite (FRC), was veneered on the specimen. Shear bond strengths were determined after thermocycling for 20,000 cycles. Bond strength data were analyzed by means of ANOVA and a multiple comparison test (α = 0.05). The surface of Ti–6Al–4V alloy was observed using a scanning electron microscope before and after the etching procedure.ResultsNo-FRC/F-etch/MDP-primer exhibited the highest bond strength (28.2 MPa), followed by No-FRC/No-etching/MDP-primer (24.2 MPa), FRC/F-etch/MDP-primer (19.9 MPa), FRC/No-etching/MDP-primer (17.8 MPa), No-FRC/No-etching/No-primer (13.6 MPa), while FRC/No-etching/No-primer (2.5 MPa) resulted in the lowest value. Microphotographs showed that numerous micro and nano pits were created on the Ti–6Al–4V alloy surface modified with F-etch.ConclusionsThe bond strength between Ti–6Al–4V alloy and the veneering resin composite was the highest when the alloy surface was modified with alumina blasting, fluoride etchant, and phosphate primer successively.