Association of HLA-DQ polymorphisms with Hepatitis B virus infection in Turkish population

Amaç Konak genetik faktörleri hepatit B virüs (HBV) enfeksiyonunun doğal seyri ve HBV ilişkili karaciğer hastalıklarının gelişme riski ile progresyonu üzerinde etkili olabilmektedir. Bu çalışmada HLA-DQ gen rs9272105, rs2856718 ve rs9275572 polimorfizmlerinin HBV doğal klirensi, viral yük ve HBV ile ilişkili karaciğer hasarı gelişimi ile ilişkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem Çalışmaya 150 kronik hepatit B (KHB) hastası ile kontrol grubu olarak 58’i kronik hepatit C (KHC) ve 82’si farklı klinik endikasyonlar nedeniyle karaciğer biyopsi işlemi gerçekleştirilen 140 hasta dâhil edildi. HLA-DQ rs9272105, rs2856718 ve rs9275572 genotip ve polimorfizmlerinin belirlenmesinde TaqMan SNP genotiplendirme yöntemi kullanıldı. Bulgular KHB’li ve kontrol grubundaki hastaların HLA-DQ gen rs9272105, rs2856718 ve rs9275572 genotip ve allel frekansları arasında farklılık tespit edildi (P<0,05). HLA-DQ rs9272105 AA genotip ve A allel varlığı, hepatit B yüzey antijen (Hepatitis B surface antigen; HBSAg) klirensi ve karaciğer hasarı ile ilişkiliydi (p<0,05). HLA-DQ gen rs2856718 ve rs9275572 ise HBV klirensi ve hastaların histolojik sonuçlarıyla ve ayrıca rs9272105 de dâhil hastaların viral yükleriyle ilişkili değildi. Sonuç HLA-DQ rs9272105 AA genotip ve A allel gerek HBV enfeksiyonunun kronikleşmesi gerekse HBV ilişkili karaciğer hasarının gelişmesi için risk faktördür.Objective Host genetic factors can affect the natural course of hepatitis B virus (HBV) infection and the risk of development and progression of HBV-related liver diseases. The aim of this study is to evaluate the role of the HLA-DQ gene polymorphisms rs9272105, rs2856718 and rs9275572 with HBV natural clearance, viral load and the development of HBV associated liver injury. Materials and Methods The study included 150 patients with chronic hepatitis B (CHB) and 140 patients as the control group, 58 of whom had chronic hepatitis C (CHC) and 82 of whom had undergone a liver biopsy due to different clinical indications. The HLA-DQ gene rs9272105, rs2856718 and rs9275572 polymorphisms were genotypes in liver samples using the hybridization probe assay. Results A difference was found between the HLA-DQ gene rs9272105, rs2856718 and rs9275572 genotype and allele frequencies of the patients with CHB and the control group (P<0,05). The HLA-DQ rs9272105 AA genotype and presence of A allele were associated with hepatitis B surface antigen (HBsAg) clearance and liver injury (p<0,05). In contrast, the HLA-DQ genes rs2856718 and rs9275572 were not associated with HBV clearance and patients’ histological outcomes, nor with patients’ viral load, including rs9272105. Conclusions It has been suggested that the HLA-DQ rs9272105 AA genotype and the A allele are risk factors for both the persistence of HBV infection and the development of HBV-related liver damage

Radiological Signs of Intra-abdominal Gossypiboma

Gossypiboma is a mass lesion at the site of surgery due to a forgotten surgical sponge. Forgotten foreign bodies are mostly retained in the abdominal cavity but there are some cases in the thorax, cranium, breast, and an extremity. Gossypiboma should be considered, especially by radiologists, in patients with a history of surgery, who present with non-specific symptoms and abdominal mass. In this report, we describe the case of a female patient who presented with non-specific abdominal discomfort and fever about six months after open cholecystectomy. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 47-9

Multimodality Imaging Findings of a Renal Aspergilloma

Background: Renal aspergillosis is a rare infection that usually occurs in persons with a predisposition for this condition. Its differential diagnosis includes primary and metastatic renal malignancies, pyelonephritis and secondary abscess formation, granulomatous disorders, and renal infarction. We aim to stress the role of multimodality imaging and percutaneous biopsy in the diagnosis of this condition. Case Report: We present diffusion weighted imaging (DWI) and positron emission tomography-computed tomography (PET-CT) findings in addition to conventional imaging modalities in a 55-year-old man with secondary renal aspergilloma. Conclusion: Radiological imaging methods are an integral part of diagnostic workup for renal aspergillosis. A definitive diagnosis is made by histopathological and/or microbiological examination of the material obtained via percutaneous biopsy under guidance of imaging method

Treatment of atypically-localized cavernous hemangioma in abdomen with atypical pain

Introduction: Hemangiomas are the most common benign lesions of the liver. They usually remain asymptomatic and it is sufficient to follow up with intermittent imaging methods. The case presented herein featured with localization and atypical symptoms. Presentation of case: A man aged 59 years was admitted with a three-month history of continuous and recently increased abdominal pain, and also early satiety. Computed Tomography (CT) showed a 9 × 6-cm mass that compressed the spleen on the left sub-diaphragmatic area, attached to the inferior part of the diaphragm. The mass was removed laparoscopically and pathology was cavernous hemangioma. Discussion: Although surgical treatment of cavernous hemangioma of the liver (CHL) remains in the background, for symptomatic patients who have no clear diagnosis, when complications emerge, surgery can be preferable. Here in minimally invasive surgery was performed in this case suffering from atypical abdominal pain. Conclusion: Cavernous hemangiomas of the liver rarely require treatment. Surgery is one of the options in selected cases and abdominal pain is one of the indications. In patients complaining from persistent abdominal pain, if intraabdominal atypical-localized mass was seen in examinations, hemangioma should be remembered in differential diagnosis

Multimodality Imaging Findings of a Renal Aspergilloma

Background: Renal aspergillosis is a rare infection that usually occurs in persons with a predisposition for this condition. Its differential diagnosis includes primary and metastatic renal malignancies, pyelonephritis and secondary abscess formation, granulomatous disorders, and renal infarction. We aim to stress the role of multimodality imaging and percutaneous biopsy in the diagnosis of this condition. Case Report: We present diffusion weighted imaging (DWI) and positron emission tomography-computed tomography (PET-CT) findings in addition to conventional imaging modalities in a 55-year-old man with secondary renal aspergilloma. Conclusion: Radiological imaging methods are an integral part of diagnostic workup for renal aspergillosis. A definitive diagnosis is made by histopathological and/or microbiological examination of the material obtained via percutaneous biopsy under guidance of imaging methods

Nöroblastomun karaciğer kapsülü ve peritona nadir görülen metastazı

Nöroblastom çocukluk çağında, özellikle de hayatın ilk yılında en sık görülen solid tümörlerdendir. Uzak metastazlar bu hastalığın evrelemesinde önemli rol oynar. Metastatik karaciğer hastalığı nöroblastom vakalarında ilerlemiş hastalığın bir bulgusudur. Biz bu olguda adrenal nöroblastomlu üç yaşında kız çocuğunda karaciğer kapsülü ve periton tutulumunu tanımladık. (Haseki T›p Bülteni 2013; 51: 18-20)Neuroblastoma is one of the most common solid tumors in childhood, particularly in the first year of life. Distant metastases play an important part in the staging of this disorder. Metastatic liver disease in cases of neuroblastoma is considered to be a sign of advanced disease. We describe liver capsule and peritoneal involvement in a 3- year-old female with adrenal gland neuroblastoma. To the best of our knowledge, this involvement is the first reported case in the English literature. (The Medical Bulletin of Haseki 2013; 51: 18-20

Effectiveness of Using Dual-source CT and the Upshot it creates on Both Heart Rate and Image Quality

Background: Early detection of coronary artery disease (CAD) is important because of the high morbidity and mortality rates. As invasive coronary angiography (ICA) is an invasive procedure, an alternative diagnostic method; coronary computed tomography angiography (CTA), has become more widely used by the improvements in detector technology. Aims: In this study, we aimed to examine the accuracy and image quality of high-pitch 128-slice dual-source CTA taking the ICA as reference technique. We also aimed to compare the accuracy and image quality between different heart rate groups of >70 beates per minute (bpm) and ≤70 bpm. Study Design: Retrospective cross-sectional study. Methods: Among 450 patients who underwent coronary CTA with the FLASH spiral technique, performed with a second generation dual-source computed tomography device with a pitch value of 3.2, 102 patients without stent and/or bypass surgery history and clinically suspected coronary artery disease who underwent ICA within 15 days were enrolled. Image quality was assessed by two independent radiologists using a 4-point scale (1=absence of any artifacts- 4=non-evaluable). A stenosis >50% was considered significant on a per-segment, per-vessel, and per-patient basis and ICA was considered the reference method. Radiation doses were determined using dose length product (DLP) values detected by the computed tomography (CT) device. In addition, patients were classified into two groups according to their heart rates as ≤70 bpm (73 patients) and >70 bpm (29 patients). The relation between the diagnostic accuracy and heart rate groups were evaluated. Results: Overall, 1495 (98%) coronary segments were diagnostic in 102 patients (32 male, 70 female, mean heart rate: 65 bpm). There was a significant correlation between image quality and mean heart rate in the right coronary artery (RCA) segments. The effective radiation dose was 0.98±0.09 mili Sievert (mSv). On a per-patient basis, sensitivity, specificity, and positive and negative predictive values were 93.8%, 88.8%, 93.8% and 88.8%, respectively. These values were also similar in per-vessel and per-segment basis. Two different groups categorized by mean heart rate had almost similar results in terms of the diagnostic power of dual-source CTA. Conclusion: CTA with a high pitch value is a reliable, non-invasive diagnostic method that can CAD with low radiation doses not only in patients with a heart rate below 70 bpm, but also in patients with higher heart rates

Prevalence of occult hepatitis B infection in liver biopsy sample of patients with nonviral liver disease

Aim: To determine the prevalence of occult hepatitis B (HBV) infection (OBI) in patients with nonviral liver disease. Materials & methods: This study included 83 HBsAg-negative patients followed up at a gastroenterohepatology clinic. The presence of HBV DNA was investigated by using an in-house nested-PCR method applied to liver parenchymal biopsy samples obtained from patients who underwent due nonviral chronic liver disease. Results: OBI was detected in 19 (22.9%) of the 83 cases, in 11 (44%) of 25 anti-HBc-positive patients, and 15 (31.9%) of 47 anti-HBc and/or anti-HBs antibodies-positive patients. Conclusion: There is a considerable prevalence of OBI among patients with nonviral chronic liver disease. Therefore, it is suggested that closely monitoring HBV can be useful to prevent or more effectively manage possible OBI-related complications among patients with nonviral chronic liver disease, especially those who are HBsAg seronegative or anti-HBV antibody seropositive