ABSTRACT
Background: Colorectal carcinoma is the third most common cause of death in Iran. This study was performed in order to determine the appropriate distal clearance margin [DCM] for resection of rectal cancer in patients who undergo neoadjuvant chemoradiotherapy for sphincter preserving procedure. Materials and Methods: This was a cross-sectional study conducted in Shahid Faghihi Hospital of Shiraz University of Medical Sciences from 2006 to 2011. We included all patients with low rectal cancer who underwent neoadjuvant chemoradiotherapy. The medical charts of patientsand disease characteristics were recorded. The local recurrence, recurrence-free survival and mortality rates were compared between those with DCM >/=2cm and DCM <2cm. Results: Overall, 82 patients with a mean age of 56.7 +/- 16.4 years were included. The DCM was found to be >/=2cm in 45 [54.9%] patients and <2cm in 37 [45.1%]. The two study groups were comparable in terms of age [p=0.573], sex [p=0.505], histopathological tumor grade [p=0.165], and distance of tumor to anal verge [p=0.125]. Patients with DCM >/=2cm had a lower local recurrence rate [35.6% vs. 97.3%; p<0.001], a higher recurrence-free survival rate [88.9% vs. 67.6%; p=0.032] and a lower mortality rate [11.1% vs. 32.4%; p=0.027]. Conclusion: Although some studies have showed that DCM<2cm leads to similar results compared to DCM>/= 2cm, our findings revealed that obtaining a distal clearance margin of 2cm for resection of rectal cancer in patients who have undergone neo-adjuvant chemoradiotherapy is associated with a lower local recurrence rate, higher recurrence-free survival rate and lower mortality rate
ABSTRACT
In patients with ulcerative colitis [UC], the repeated cycle of injury and repair of intestinal mucosa has been reported to increase the risk of colon cancer. So, a safe and efficient therapy is required for the treatment and prophylaxis for the disease. This study aims to investigate the efficacy of Calendula officinalis extract in treatment of experimentally induced ulcerative colitis in dog animal model. During fall 2010, 10 out-bred female German dogs [1-2 years old; weighs of 20-25 kg] were enrolled. Ulcerative colitis was induced with 6% acetic acid as enema and method of treatment was retrograde [via enema] too by C. officinalis. Loose stools, diarrhea, gross bleeding and loss of body weight happened after administration of acetic acid and crypt damage, loss of epithelium, infiltration of inflammatory cells and depletion of goblet cells were noticed histologically. C. officinalis could successfully resolve the damages of UC. Treatment with C. officinalis can broaden the current therapy options for UC
ABSTRACT
In a 2 year period, 64 children with caustic ingestion were prospectively studied. The ingested agents were: bleach in 41 patients, caustic soda in 13, strong acids in 8 and Savlon in 2. The injury was assessed within 48 hours of ingestion by fiberoptic endoscopy of the whole esophagus, stomach and duodenum in all patients. Grade 0 [normal] was seen in 43 patients, grade 1 in one, grade 2a in 11, grade 2b in 5 and grade 3 in 4 patients. No significant burn was found after ingestion of bleach. Signs and symptoms were unreliable in predicting the severity of injury. Those with grade 2 or 3 burn received corticosteroid, antibiotic and antacid. Only 3 cases [16.6%] developed esophageal stricture; one improved with esophageal dilation, the other two needed colonic interposition. It is concluded that: a] Endoscopy is safe and indicated after caustic ingestion but could be withheld in asymptomatic patients after ingestion of bleach. b] Corticosteroids when used with antibiotics are safe and may have a role in prevention of stricture formation. c] Early prophylactic esophageal replacement is not indicated even in severe burn without perforated viscus, since most cases recover without sequelae