Cervical lymph node involvement by medullary carcinoma of unknown origin; a rare presentation

Medullary thyroid carcinoma [MTC], comprising 5-10% of all cancers, is a rare malignancy which frequently spreads to cervical lymph nodes. Occurring in both the sporadic and familial forms, the latter accounts for 20-25% of cases, while the former is considered the most frequent type. We report a case of metastatic MTC presented with cervical lymphadenopathy in a patient without evidences of MTC in thyroid gland

Surgical management of localized Crohn's disease of the fourth part of the duodenum

Upper gastrointestinal tract [gastroduodenal] Crohn's disease [CD] is an uncommon condition, occurring in about 1-5% of all CD cases. Our case was an extremely rare manifestation of CD, who presented with distal duodenal obstruction. As preoperative diagnosis was not established he underwent segmental resection and end-to-end anastomosis. Postoperative small bowel fistulae were not observed, and there was no morbidity during the follow up period. There were no disturbances in digestive function

Trans-thoracic versus trans-hiatal esophagectomy complications and outcomes in patients with esophageal cancer in Shohada-E-Tajrish Hospital, Tehran, Iran; 2000-2008

Esophageal cancer is a poor-prognosis cancer which is common in Iran. The main treatment for this cancer is surgery which may be performed with either trans-thoracic [TTE] or trans-hiatal esophagectomy [THE]. Each of these methods has some specific complications, morbidity and mortality rate, leading to controversies in method selection. Therefore, in this study we evaluated the outcomes of these two approaches in Iranian patients. In this retrospective survey, we evaluated 100 patients with esophageal cancer who underwent either TTE or THE in Shohada-e-Tajrish Hospital, Tehran, from 2000 to 2008 and categorized them into two groups. The patients in the two groups were compared according to age, sex, tumor location and histopathologic characteristics, surgery results and complications, morbidity, mortality and death results. Sixty nine percent [69%] of patients had squamous cell carcinoma [SCC] and 59% had undergone THE. The mean age of the patients was 61.18 years. There was no difference in age, sex distribution, tumor pathology and location in the two groups. Although neck leakage of anastomoses was more frequent in THE [7.31% vs 10.16%], there was no statistically significant difference between the two groups in complications and mortality. Duration of the surgery was longer in TTE. Trans-hiatal and trans-thoracic esophagectomy are the same in outcomes. Both methods can be considered as therapeutic surgical approach regarding to physician's opinion and patient's situations

[Study passengers' view about travelers norouz guidance national plan of red crescent youth organization]

Background: guiding the travelers in Norouz is one of the important activities which are done by Youth Organization of Red Crescent society. This plan follows some goals as, to help travelers to have a safe trip [by making relief and safety recommendations]; to provide tranquility for them [by giving precise information about roads]; to develop the culture of humanism and kindness among young people [by increasing youth contribution in charities]; and also to improve various leisure facilities in Norouz. The present paper aims to study the mentioned plan, its weak and strength points and how people know about it

Methods: by using of questionnaires in this survey research, there were selected and completed about 3500 samples in 30 provinces

Findings: according to the findings, about 76% of responders had a positive view about the necessity of education. Also, they declared that for having a safe trip it is useful to cooperate with the Youth Organization of Red Crescent society. Over 80% of responders were satisfied with the plan and the given services in all provinces

Conclusion: relief services are important for Norouz travelers; therefore, it should be the main important priority for Youth Organization of Red Crescent society

Anastomotic leakage following low anterior resection of rectal cancer considering the role of protective stoma

Probable risk factors of clinical anastomotic leakage and the role of defunctioning stoma in patients undergoing low anterior resection [LAR] for rectal cancer, is still controversial. The goal of our study was to find out possible risk factors of anastomotic leakage and to locate the influence of protective stoma in the rate of anastomotic leakage. In this retrospective study, 44 patients underwent LAR with total mesorectal excision [TME] during the period from 2001 to 2006 were analyzed. From these 44 patients 24 were treated with protective stoma while 20 were not. Overall anastomotic leakage rate was similar among patients with and without protective stoma [odds ratio=0.51, P=0.2357]. Male gender, Low anastomosis, Coronery Artery Disease, preoperative radiotherapy, and smoking were great risk factors for developing anastomotic leakage. We did not find any differences between handsewn and stapled anastomosis [odds ratio = 0.6]. protective stoma will be helpful depending on surgeon experiences and is not recommended for all the patients routinely. Beside this, male gender, low anastomosis, coronary artery disease, preoperative radiotherapy, and smoking are the major risk factors of anastomotic leakage

Prevalence of helicobacter pylori infection in subjects with gastric cancer surgery

To determine the prevalence of helicobacter pylori [H. Pylori] infection in patients with gastrectomy for gastric cancer. Samples from 95 [69 males, 26 females] consecutive patients who had undergone surgery for gastric cancer were included in this study. Histologic examination of tumor obtained at the time of surgery yielded the diagnosis and then the specimens were stained with haematoxylin and eosin and Giemsa for the assessment of tumor and H.pylori infection. All patients did H.pylori immunologic and urease test. From 95 patients with gastric cancer, 83 patients [87.36%] were positive for H. pylori infection. Histologic type of tumors was intestinal in 61 patients and diffuses in 7 patients. The prevalence of H. pylori was 93.2% in intestinal type carcinoma and 28.5% in diffuse type [P- value=0.0002]. No significant difference was found in sex, smoking and staging between H.pylori positive gastric cancer and H.pylori negative cases. This study reconfirmed a high prevalence of H. pylori infection in patients suffering from gastric cancer and provided that evaluation for H. pylori infection might confer additional benefit in identifying the population that is at greater risk for this tumor

[Surveying the success of infra-inguinal revascularization in the treatment of lower limb ischemia in patients hospitalized with trauma]

The purpose of this clinical study was to assess the success of infra-inguinal revascularization in the treatment of lower limb ischemia in patients hospitalized with trauma. Fifty seven consecutive patients admitted with trauma, during April 2000- March 2005, underwent bypass operations in the Shohada Hospital. Records of all patients were reviewed. Late control visits including clinical and color Doppler ultrasound examinations of arteries distal to the bypass were programmed for 41 patients. Primary, and secondary patency rates, and survival were determined. Patients included 54 men [94.7%] and 3 women [5.3%] who underwent infrainguinal bypass with autologous saphenous vein. Primary patency rate was 89.5% and secondary patency rate was 97.3% with 44.5 months offollow up. Complication rate was 3.5% and amputation 10.5%. Mean transportation time was 22.7 +/- 17 h8ours. Limb salvage was done in 26.8% of patients with no mortality. Infra-inguinal revascularization can be performed in damaged limbs due to trauma with high primary and secondary patency rates and low complication rate

Assessment of notaras posterior meshrectopexy in treatment of rectalprolapse: a ten year experience

The aim of this study is to evaluate the long and short term postoperative results after the Notaras procedure as a surgical treatment of rectal prolapse in adults.Thirty-one patients suffering from rectal prolapse who were operated with Notaras posterior mesh rectopexy in Shohada-e-Tajrish hospital between 1991-2000 were followed up for results and complications and the results were compared with other surgical techniques for this disease.The mortality rate was zero which was ideal in comparison with other studies; short term complications were seen in 20% of cases which had the same prevalence as other abdominal surgeries.Sexual impotence and retrograde ejaculation as long term complications were seen in only one patient [3.22%].The recurrence rate was zero which stands above nearly all other procedures, also we had recuperation of fecal incontinence in all of our cases and gas incontinence in 92% of them. The constipation rate has not increased significantly postoperatively [p= 0.8]The Notaras procedure can be used in the management of rectal prolapse with low mortality and recurrence rate but although not contraindicated, may not be appropriate for young and sexually active male patients