ABSTRACT
Resistance to wide range of structurally and functionally different chemotherapy drugs acts as a major obstacle in the cancer therapy. There are different mechanisms that cause multi drug resistance [MDR] but the most important one is ATP Binding Cassette [ABC] transporters super-family that increases the ability of tumor cells to transport drugs out of the cells by using ATP molecule, over expression of these proteins such as MDR1 and MRP1 is responsible for MDR phenotype in cancerous cells. We analyzed the expression level of MDR1/MRP1genes by using Real time RT-PCR in 60 colorectal cancer patients also we investigate their relationship with clinical, Para-clinical characterizes of colorectal cancer patients and their responses to treatment. The expression of the MDR1 gene showed a significant increase in cancerous regions compared to adjacent normal tissue. In addition the expression of MDR1 gene showed association with histological grade of tumors but expression level of MRP1 was not significantly important. Our study once more emphasizes the effects of MDR1 over expression which impact on response to drugs in Iranian colorectal cancer patients
ABSTRACT
Hemorrhoidectomy is the treatment of choice for patients with third or fourth-degree hemorrhoids. Although the majority of surgeons believe that surgical hemorrhoidectomy is the most effective approach with excellent results in the management of hemorrhoid disease, but hemorrhoidectomy is not a simple procedure. One of the complications of this surgery is an injury to anal sphincters that can lead to incontinency in some patients. In this study, we aimed to reveal the percentage of external and internal anal sphincter injuries in surgical hemorrhoidectomy. We prospectively enrolled 128 patients from April 2006 to February 2007. They underwent hemorrhoidectomy in three general hospitals in Tehran. All patients were in grade III or IV and underwent open hemorrhoidectomy [Milligan-Morgan]. After surgery, all resected material was histopathologically examined by two expert pathologists and the results confirmed by other one if there is any discrepancy. From all specimens which sent to the pathology department 15.8% [21 Pts.] had muscle fibers that Smooth muscle fibers were seen in 80.5% [17 Pts.] of them and striated muscle fibers were found in 19.5% [4 Pts.]. Although hemorrhoidectomy is a safe and effective method for treatment of hemorrhoid, but the inadvertent removal of smooth and striated muscle during open hemorrhoidectomy had raised concerns about its effects on postoperative anorectal function.