GOVARESH JOURNAL
Year:2004 | Volume:9 | Issue:2|Papers Count:10

Introduction and Aims: H. pylori has been implicated in peptic diseases, some with detrimental consequences such as ulcer or cancer. Since considerable genetic heterogeneity has been observed within H. pylori population worldwide, it appears an ideal achievement to recruit PCR-based methods and design genetic markers which recognize isolates from normal and symptomatic individuals. In this study 61 H. pylori isolates from dyspeptic patients were fingerprinted by REP-PCR.Materials and Methods: REP-PCR was performed on extracted DNAs of 61 H. pylori isolates from 39 normal, 18 ulcer and 4 cancer patients. Synthetic 18-nt primers, specific for interspersed repetitive elements in the bacterial genome, were recruited. PCR conditions were optimized and reproducibility of the reactions were confirmed. The size and number of PCR products were determined and DNA fingerprints of all isolates were analyzed by NTSYSpc programme, and dendrograms were generated.Results: Among 39 H. pylori isolates from normal patients 28 comprised a distinct cluster and 5 clustered along with isolates from ulcer patients. The remaining 6 isolates comprised a separate cluster distinct from other groups. Among 18 isolates from ulcer patients, 17 classified in a specific cluster, only one isolate was clustered along with isolates from normal patients. Isolates from cancer patients consisted a quite distinct cluster.Conclusions: In this study REP-PCR was used to show that majority of isolates from normal, ulcer, and cancer patients have distinct fingerprints which can be recruited for predicting the outcome of the infection with certain H. pylori isolates. It is concluded that REP-PCR is an effective and reproducible technique for fingerprinting H. pylori isolates from different human origins.

Introduction and Aims: The northeastern region of Iran has some of the highest rates of esophageal squamous cell carcinoma (ESCC) in the world.Materials and Methods: To investigate the role of polycyclic aromatic hydrocarbons (PAHs) in the etiology of ESCC in northeastern Iran, we measured urine 1-hydroxypyrene glucuronide (1-OHPG), a stable PAH metabolite, in 99 inhabitants of this area.Results: The median urine 1-OHPG in participants of this study was 4.2 pmol/ml. Forty-two subjects (42%) had levels ranging from 1 to 5 pmol/ml, indicative of moderate PAH exposure, and 41 (41%) had levels above 5 pmol/ml, indicative of very high exposure. Further analysis showed that 1-OHPG levels were high in all subgroups of our study subjects, including both sexes; rural and urban dwellers; and smokers and non-smokers. Only 15% of the variance in 1-OHPG was explained by age, sex, residence, smoking, nass, or opium consumption. This pattern of PAH exposure parallels with the ESCC incidence pattern seen in this area.Conclusions: We conclude that people in northeastern Iran are exposed to widespread and very high levels of PAH, largely from unknown sources, and this may contribute to the high rates of ESCC observed in this area.

Introduction and Aims: Microscopic colitis has been generally recognized as lymphocytic colitis and collagenous colitis: two inflammatory diseases of large intestine without a definite origin. The colon appears normal by colonoscopy. So, biopsy of the colonic mucosa is mandatory for diagnosis.Materials and Methods: As a descriptive design we assessed epidemiological, clinical and laboratory findings of patients diagnosed as microscopic colitis from 2001 to 2003, retrospectively. This study had been conducted in one of the University related clinics in Tehran. Results: In this setting, 12 patients were diagnosed as microscopic colitis (3 collagenous colitis, and 9 lymphocytic colitis). Most of these patients were female (11 patients). The average of the patients age at the time of the diagnosis was: 47.6±18.1 years. The delay of diagnosis was distributed from 2 months to 27 years (average: 8 years). The most prominent complaint was diarrhea (100%). Most of the cases were presented as a chronic intermittent manner (6 patients- 50%).Hyperthyroidism, atrophic gastritis, and type 1 diabetes mellitus, each of them were detected in 3 separate patients. After treatment initiation, recurrence of the disease was not seen during 2 years of follow-up.Conclusions: Most of the time, microscopic colitis is mis-diagnosed as irritable bowel syndrome. Clinical suspicion plays the main role in diagnosis of microscopic colitis cases among patients with watery diarrhea and normal colonoscopy.

Introduction and Aims: Noscapine has been recently known as an antagonist of Bradykinin, and in this study its effect on the animal model of acute pancreatitis has been evaluated.Materials and Methods: 49 male Wistar rats have been evaluated in five experimental and four control groups. Common bile duct has been ligated by means of surgery to induce acute pancreatitis in rats. The resulted inflammation of the pancreas and the effect of Noscapine on it have been documented by measuring serum amylase levels. Amylase was measured in experimental groups after surgery and injection of Noscapine. Amylase was also measured in control groups while they did not undergo similar procedures.Results: The only meaningful effect of Noscapine values on the level of serum amylase was an unexpected increase in the 0.5 mg/kg dose; and in other doses (1, 2, 5, 10 mg/kg) the changes in the level of serum amylase were not meaningful.Conclusions: Noscapine has affected the inflammation of acute pancreatitis via probable mediation of Bradykinin, but the inflammation was not favorably reduced, probably because of short lifetime of Noscapine.

Introduction and Aims: TT virus (TTV) is a DNA virus and is proposed as a potential cause of non-A to E hepatitis. We aimed to investigate, for the first time, the prevalence of TTV in Iranian healthy blood donors.Materials and Methods: Three hundred and twelve healthy Iranian blood donors were randomly selected and tested for TTV DNA by the seminested polymerase chain reaction method.Serum alanine aminotransferase (ALT) levels were determined in those infected and uninfected individuals that adequate serum were available. HBsAg or HCV antibody-positive subjects were excluded.Results: TT virus DNA was detected in 70 (22.4%) of the 312 subjects under study. ALT was elevated in 8 (18.2%) of the 44 TTV positive blood donors and in 8 (10.9%) of the 73 TTV negative blood donors. There was no significant difference between these two groups.Conclusions: TTV viremia is common among Iranian blood donors. Its prevalence in Iran is higher than US (1%) and most West-European countries and is comparable to China (28%) but lower than Thailand (37%) and Italy (42.4%). Our data do not support the correlation between TTV viremia and elevated ALT level.

The term "Non- Alcoholic Steatohepatitis (NASH)" is applied when sonographic and pathologic view of liver shows alcoholic hepatitis changes without history of alcohol consumption. Radiologic findings can easily make the diagnosis and liver biopsy confirms the initial suspicion. It is showed that up to 43.5% of patients with asymptomatic abnormal liver transferases levels have some degrees of NASH, which suggest the importance of being familiar with the issue and how to approach and treat it. NASH is commonly accompanied with diabetes mellitus (especially type II), obesity and hyperlipidemia. These findings support the theory in which insulin resistance is the mainstay of NASH pathophysiology. The natural history of NASH is unclear but surely it is far better than alcoholic related liver disease. It is estimated that up to 8% of patients would meet cirrhosis, considering risk factors such as obesity and features found in biopsy specimen. Steatosis, polymorphonuclear lobular inflammation, ballooning degeneration, hyaline- Mallory bodies and cirrhosis are among different pathologies seen in biopsy. It is important to rule out other chronic liver diseases including drug induced liver disease, chronic viral hepatitis, and metabolic and autoimmune liver diseases to establish the diagnosis of NASH. There is no definite treatment for NASH. Therapeutic measures are categorized as reducing risk factors and using hepatocellular protective agents. The former includes weight reduction, treating hyperinsulinemia and diabetes, control of hypertriglyceridemia and leptin. Protective agents are anti-oxidants like vitamin E and/ or C, probucol, silymarin, ursodeoxycholic acid, reducing iron load, N-acetyl cystein, food supplements and cytokines. Increasing rate of NASH is reported among children and adolescences, which could be due to growing amount of obesity in these age groups.

The case was an 18-year-old female with progressive crampy abdominal pain, nausea and vomiting, initiated from 4 months ago, Who had 4-5 Kg weight loss in this period.In physical examination, an ill-defined mass with mild tenderness in periumblical region palpation was detected.In upper GI endoscopy, bulging folds with a necrotic mass in D2- D3 were detected.In small bowel series study, cut off of barium in D2-D3 portions was seen. For better evaluation spiral CT was performedin which a large mass with extension to small bowel in retroperitoneum was seen. In Pathologic study, caseification granuloma compatible with tuberculosis was reported. This finding was confirmed with Ziel Neelsen staining and PCR.

About 50% of all patients affected by CRC develop liver metastases. Surgery remains the only potentially curative strategy, but is impossible in the majority of patients. For non-resectable patients, two options are available: local treatment strategies (radiofrequency ablation and cryosurgery: alone or in combination with surgery) and chemotherapy. High rates of objective response achieved with Fluoropyrimidines, Oxaliplatin (OHP) and Irinotecan (CPT-11) based chemotherapy, enable initially non-resectable patients to undergo surgery, with a 5-year survival rate comparable to that observed for primary resectable patients. Therefore, chemotherapy has not only a palliative aim, but becomes a strategy with curative purposes. Adjuvant therapies have been investigated to reduce recurrence rates, some testing hepatic arterial infusion (HAI) schedules but definitive data are not yet available. Our experience, based on results from retrospective studies, suggests a possible role of systemic adjuvant chemotherapy in reducing recurrence rates after surgery. New targeted drugs and new loco-regional therapies are expected to further improve prognosis in neoadjuvant, adjuvant and palliative settings