Long-term effect of lamivudine treatment on the incidence of hepatocellular carcinoma in patients with hepatitis B virus infection

Background

Nucleotide analogues have recently been approved for the treatment of patients with hepatitis B virus (HBV) infection. However, it is still controversial whether the decrease of HBV-DNA amount induced by treatment with nucleotide analogues can reduce the risk of hepatocellular carcinoma (HCC) development in HBV patients.

Methods

A total of 293 HBV patients without HCC who were treated with lamivudine (LAM) were enrolled in a multicenter trial. The incidence of HCC was examined after the start of LAM therapy, and the risk factors for liver carcinogenesis were analyzed. The mean follow-up period was 67.6?±?27.4?months.

Results

On multivariate analysis for HCC development in all patients, age ≥50?years, platelet count <14.0?×?10⁴/mm³, cirrhosis, and median HBV-DNA levels of ≥4.0?log copies/ml during LAM treatment were significant risk factors. The cumulative carcinogenesis rate at 5?years was 3% in patients with chronic hepatitis and 30% in those with cirrhosis. For the chronic hepatitis patients, the log-rank test showed the significant risk factors related to HCC development to be age ≥50?years, platelet count <14.0?×?10⁴/mm³, and hepatitis B e antigen negativity, but median HBV-DNA levels of <4.0?log copies/ml (maintained viral response, MVR) did not significantly suppress the development of HCC. In cirrhosis patients, however, the attainment of MVR during LAM treatment was revealed to reduce the risk of HCC development.

Conclusions

These results suggest that the incidence of HCC in HBV patients with cirrhosis can be reduced in those with an MVR induced by consecutive LAM treatment.     

Pulpal blood flow: effects of corticotomy and midline osteotomy in surgically assisted rapid palatal expansion.

INTRODUCTION/PURPOSE: Surgically assisted rapid palatal expansion is used for the management of transverse maxillary deficiency in the early permanent dentition. The success depends on the maintenance of an adequate blood supply to the mobilized segments. The aim of this study was to assess the effects of corticotomy and midline osteotomy on the tooth pulpal blood flow. MATERIAL: Laser Doppler flowmetry was applied as a non-invasive and reliable technique for the assessment of pulpal blood flow in the maxillary centrals, canines and first molars. The blood flow was investigated pre- and postoperatively, on the first, third, and seventh postoperative days bilaterally in 13 cases. RESULTS: The results of this study indicate that ischaemia of the pulp can occur following osteotomy at the Le Fort I level. CONCLUSION: Corticotomy 5mm above the dental apices and separating the midpalatal suture did not have any serious effect on pulpal blood flow in this study.     

Long‐term survival and conditional survival of cancer patients in Japan using population‐based cancer registry data

Although we usually report 5‐year cancer survival using population‐based cancer registry data, nowadays many cancer patients survive longer and need to be followed‐up for more than 5 years. Long‐term cancer survival figures are scarce in Japan. Here we report 10‐year cancer survival and conditional survival using an established statistical approach. We received data on 1 387 489 cancer cases from six prefectural population‐based cancer registries in Japan, diagnosed between 1993 and 2009 and followed‐up for at least 5 years. We estimated the 10‐year relative survival of patients who were followed‐up between 2002 and 2006 using period analysis. Using this 10‐year survival, we also calculated the conditional 5‐year survival for cancer survivors who lived for some years after diagnosis. We reported 10‐year survival and conditional survival of 23 types of cancer for 15–99‐year‐old patients and four types of cancer for children (0–14 years old) and adolescent and young adults (15–29 years old) patients by sex. Variation in 10‐year cancer survival by site was wide, from 5% for pancreatic cancer to 95% for female thyroid cancer. Approximately 70–80% of children and adolescent and young adult cancer patients survived for more than 10 years. Conditional 5‐year survival for most cancer sites increased according to years, whereas those for liver cancer and multiple myeloma did not increase. We reported 10‐year cancer survival and conditional survival using population‐based cancer registries in Japan. It is important for patients and clinicians to report these relevant figures using population‐based data.     

Osteoblastoma of the mandible with root resorption: a case report.

This article reviews the clinical behavior, histologic features, differential diagnosis, and treatment of a benign osteoblastoma. Benign osteoblastoma is a rare tumor constituting 1% of all primary bone tumors. Only 15% of osteoblastomas occur in the skull and jaw bones. The most common clinical presentation is a painful or tender swelling. A case is presented of a 21-year-old female who had noted discomfort for approximately 2 years, and the pain was not relieved by any analgesic. The choice of treatment was local excision and curettage. In this case, root resorption of the adjacent tooth, which is not a characteristic behavior of osteoblastoma, is seen.     

Prevalence of refraction errors and color blindness in heavy vehicle drivers

AIM: To investigate the frequency of eye disorders in heavy vehicle drivers. METHODS: A cross-sectional type study was conducted between November 2004 and September 2006 in 200 driver and 200 non-driver persons. A complete ophthalmologic examination was performed, including visual acuity, and dilated examination of the posterior segment. We used the auto refractometer for determining refractive errors. RESULTS: According to eye examination results, the prevalence of the refractive error was 21.5% and 31.3% in study and control groups respectively (P<0.05). The most common type of refraction error in the study group was myopic astigmatism (8.3%) while in the control group simple myopia (12.8%). Prevalence of dyschromatopsia in the rivers, control group and total group was 2.2%, 2.8% and 2.6% respectively. CONCLUSION: A considerably high number of drivers are in lack of optimal visual acuity. Refraction errors in drivers may impair the traffic security.