Cutaneous, pulmonary and hepatic sarcoidosis associated with autoimmune complications during interferon-alpha treatment for hepatitis C virus infection

A patient with hepatitis C virus (HCV) infection was diagnosed with cutaneous, pulmonary and hepatic sarcoidosis following interferon alpha therapy. There are only a few cases of sarcoidosis associated with this treatment. This is the first case who not only developed sarcoidosis, but also autoimmune hypothyroidism and thrombocytopenia during interferon alpha therapy due to the immunomodulatory effects of the drug.     

Inhibition of hepatitis B virus DNA replicative intermediate forms by recombinant interferon-γ

AIM: To evaluate the in vitro anti-HBV activity of recombinant human IFN-γ, alone and in combination with lamivudine. METHODS: A recombinant baculovirus-HBV/HepG2 culture system was developed which could support productive HBV infection in vitro. Expression of HBsAg and HBeAg in infected HepG2 culture medium was detected by commercial enzyme immunoassays. HBV DNA replication intermediates were detected in infected cells by Southern hybridization and viral DNA load was determined by dot hybridization. RESULTS: IFN-γat 0.1 to 5μg/L efficiently down regulated HBsAg expression in transduced HepG2 cells. At 5μg/L, IFN-γalso suppressed HBV DNA replication in these cells. While treatment with a combination of lamivudine and IFN-γshowed no additive effect, sequential treatment first with lamivudine and then IFN-γwas found to be promising. In this culture system the best HBV suppression was observed with a pulse of 2μmol/L lamivudine for two days, followed by 1μg/L IFN-γfor another four days. Compared to treatment with lamivudine alone, the sequential use of 0.2μmol/L lamivudine for two days, followed by 5μg/L IFN-γfor six days showed a 72% reduction in HBV cccDNA pool. CONCLUSION: This in vitro study warrants further evaluation of a combination of IFN-γand lamivudine, especially in IFN-αnon-responder chronic hepatitis B patients. A reduced duration of lamivudine treatment would also restrict the emergence of drug-resistant HBV mutants.     

An Unusual Form of Skin Tuberculosis Following B.C.G. Vaccination

A 25-year-old female has had brown to erythematous telangiectatic patches and grouped papules on her face, neck, arm, and trunk since childhood following B.C.G. vaccination. Histopathologically, the lesions consisted of hyperkeratosis, slight acanthosis, tuberculoid granulomas with some Langerhans type giant cells in the mid-dermis. Although various forms of cutaneous tuberculosis after B.C.G. vaccination have been reported, it was difficult for us to assign the patient's skin lesion to any specific disease entity. Remission of her cutaneous lesions occurred clinically and histopathologically after treatment with isoniazid and rifampin.     

A method combining morphological, immunocytochemical and chromosomal examinations of the same cell in the study of lymphoproliferative diseases

6 cases of different lymphoproliferative diseases were studied with the new MAC (Morphology-Antibody-Chromosome) method in order to find out 1) if the abnormal karyotype is confined to the monoclonal cell population, 2) if there are, within this clone, also cells with a normal karyotype, and 3) if the method can help the pathologist to diagnose malignant lymphoproliferative diseases. The MAC method allows a simultaneous study in the same metaphase cell of the karyotype, surface markers, and some morphological features. In all cases in which a monoclonal cell proliferation was detected immunohistologically, the MAC examination showed a chromosomal abnormality for the same light chain as was detected in immunohistology, but not in other cells. In all but a single case, all mitotic cells belonging to the clonal cell proliferation had an abnormal karyotype. In this case with lambda clonality, 2/8 lambda-positive mitoses had a normal karyotype. However, all the normal mitoses occurred in small lymphocytes whereas the abnormal mitoses were seen in large blastic cells. In 1 case, the MAC method helped in confirming the diagnosis of malignant lymphoma (nodular small cleaved cell type). Especially in lymphomas composed of a mixed cell population, the MAC method makes it possible to find out which cell types have an abnormal karyotype and which have a normal karyotype.     

Abnormalities in immune regulation precede the development of multiple myeloma.

Immunosuppression of immunoglobulin synthesis seen in patients with multiple myeloma is in part due to immunosuppressive CD5 positive B cells. In a 13 year longitudinal study of an IgA-deficient blood donor who developed multiple myeloma, the presence of immunosuppressive CD5 positive B cells and T cells preceded the diagnosis of overt multiple myeloma and the appearance of immunosuppressive monocytes. These data argue that certain immune defects may be involved in the development of myeloma and are not simply a consequence of overt malignancy.     

病毒性肝炎病人血浆VitE水平及其临床意义

观测了急性肝炎和重症肝炎病人血浆ＶｉｔＥ及Ｌｐｏ水平及其动态变化。急性肝炎和重症肝炎病人血浆ＶｉｔＥ低于对照组，Ｌｐｏ高于对照组，均以重症肝炎更明显，且死亡病例血浆ＶｉｔＥ低于存活者。部份病人口服ＶｉｔＥ不能提高其血浆水平，并随病情加重而逐渐降低。讨论了病毒性肝炎病人血浆ＶｉｔＥ降低与Ｌｐｏ升高的关系及其临床意义，认为动态观测血浆ＶｉｔＥ可作为判断重症肝炎病情进展及预后的参考。     

传染病研究40年（1955～1995年）

本文综述本校传染病学教研室１９５５～１９９５年间所取得的科研成果。内容包括１０余种传染病与寄生虫病的临床和基础研究，其中以华支睾吸虫病、恙虫病等有广东特色的传染病以及伤寒、痢疾、病毒性肝炎等影响人民健康最普遍的传染病为重点。反映了建国以来各个时期本教研室对防治这些传染病所作的贡献。所取得的成果，相当一部分通过多年来的验证，已获得广大传染病工作者所认同或列为常规，部分已获得部委级奖励。现在重温这些成果，可能起承前启后的意义。     

甲状腺肿瘤X线造影与超声检查对比分析

本文报告了经手术病理证实的53例甲状腺肿瘤,均作了甲状腺造影和B超检查.通过比较分析,我们认为造影对确定肿瘤的良、恶性以及延伸到胸骨后的异位甲状腺肿瘤有其优越性,是一项有效的检查方法;超声则能准确地判断肿瘤的囊、实性,适合碘过敏患者的检查.两种检查各有特点,配合使用有利于对甲状腺肿瘤的诊断和治疗.     

不同形状界面对界面射流的影响──彩色多普勒与激光荧光染料方法的研究

本文通过应用彩色多普勒及激光荧光染料显示射流方法研究了不同形状界面对射流的影响。结果表明对照组及平坦界面射流时，彩色多普勒与激光荧光染料两种方法无显著差异；在弯曲界面条件下，彩色多普勒射流小于激光荧光染料射流（Ｐ＜０．０１～０．０００１）。彩色多普勒研究表明不同形状界面射流大小分别与每搏容量相关好（ｒ＝０．８３～０．９９），但射流大小明显不同。凹形界面射流面积最小，平坦及凸形界面射流面积也小于对照组。研究提示不同形状界面可以导致界面射流不同程度地减小，并且彩色多普勒也不易对弯曲界面的射流完全成像。在临床上应用彩色多普勒对返流定量时，需考虑上述影响。