Leukocyte antigen [HLA] class ii allele frequencies in female patients with breast cancer: a case control study

The study aimed to examine the association between human leukocyte antigen [HLA] class II allele frequencies and breast cancer in Iranian women. A total of 100 patients with pathologically proven breast cancer who referred to Cancer Institute were randomly selected and compared with a group of age matched healthy blood donors [n = 80]. HLA class II alleles were determined by amplification of DNA followed by HLA-typing using sequence-specific primer [SSP] for each allele. The frequency of HLA-DQA1 0301 [P=0.001, OR=3.4] and HLA-DRB11303 [/M].02, OR=2.3] among breast cancer patients was significantly higher than those in control group. HLA-DQA 10505 [/M].003, OR=0.4], HLA-DRB11301 CP=0.002, OR=0.12] and HLA-DQA10101 [P=0.01, OR=0.21] alleles showed negative association with breast cancer. The findings suggest that HLA-DQA10301 allele is mainly associated with increased risk of breast cancer in Iranian female patients. HLA-DQA 10505 and HLA-DRB11301 alleles are suggested as protective genetic factors against breast cancer. The findings confirm that specific alleles of HLA class II influence breast cancer risk

Midgut malrotation in older children

Midgut malrotation is typically presented during the first few months of life but sometimes may encounter later in life, causing difficulties and mistakes in diagnosis. We reviewed records of eleven rare patients with midgut malrotation older than one year of age and extracted their clinical and paraclinical data. The most common presenting symptoms were bilious vomiting, recurrent abdominal pain and constipation. Five of eleven patients had presented from neonatal period. The average interval between first symptoms and surgical correction of malrotation was about 22 months. Some of the patients had been undergone false treatments. Most cases were diagnosed by contrast studies [upper gastrointestinal series and barium enema]. Diagnosing midgut malrotation in older children is often delayed. This anomaly should be suspected in all children with signs and symptoms of small bowel obstruction, chronic abdominal pain and vague abdominal discomfort and in all patients of any age with abdominal discomfort who do not respond to other therapies. Contrast studies may be necessary to rule out malrotation in suspected patients

[Congenital intestinal malrotation as the serious cause of neonatal intestinal obstruction]

Congenital intestinal malrotation as an abnormal embryonic intestinal rotation and fixation leads to various clinical presentations of high complete or incomplete intestinal obstruction, especially midgut volvulus and extensive intestinal loss that may cause short bowel syndrome or death of the patient. we conducted this study to assay clinical presentations, surgical findings, mode of management and outcome of neonates with intestinal malrotation. We studied retrospectively data of 25 neonates with intestinal malrotation in 3 hospitals of the Tehran University of Medical Sciences [1985-2003]. Patients consisted of 17 males and 8 females. 5 [24%] patients had extensive intestinal gangrene that resulted in short bowel syndrome in 2 patients. 7 [20%] patients died, 5 of them due to intestinal volvolus and 2 other due to associated anomalies and sepsis. Most common clinical signs and symptoms were vomitus [96%], bilious vomiting [80%], constipation [24%],], coliky abdominal pain [23%]. Abdominal distention was observed only in patients with volvolus [38%]. Obstipation [31%] and rectorragia were seen only in patients with volvolus and intestinal gangrene. 28% of neonates had associated anomalies. Malrotion was suggested by abdominal X-ray in 3 out of 12 [25%], barium enema in 9 out of 11 [81.8%], and gastrointestinal follow through in 3 out of 4 [75%] examinations. 3 patients were surgically managed according to only one abdominal X-ray. Ladd procedure was performed in all patients and other necessary corrective operations for associated anomalies included intestinal resection with anastomisis in 5 and intestinal resection with entrostomy in 2 cases. To prevent extensive intestinal loss due to intestinal volvolus in neonates with abrupt bilious vomiting, malrotation must be excluded, and if a volvulus is suspected, emergency laparotomy should be undertaken

[ survey of etiology of intestinal obstruction in a pediatric surgery center in Tehran]

Intestinal obstruction is a common cause of abdominal surgery in pediatric age group. A delay in diagnosis and treatment of this disease can lead to serious complications. This study has been conducted to evaluate different causes of intestinal obstruction. 231 children were operated on intestinal obstruction. Prior to surgery all patients underwent a labarotory examination consisting of CBC, abdominal X'ray and, if necessary, gastrointestinal [GI] study with contrast media or CT-Scan and sonography. Final diagnosis was reached by surgical findings. 231 children were operated due to intestinal obstruction. Among these, 128 cases, [55.4%] were male and 103 cases [44.6%] were female. The causes of intestinal obstruction were: Incarcerated hernia in 41 cases [17.7%], GI atresia in 38 cases [16.4%], malrotation in 32 cases [13.8%], anorectal malformation in 29 cases [12.5%] and benign or malignant masses inside or outside GI tract in 28 cases [12.1%]. The most common causes of intestinal obstruction were: incarcerated hernia, GI atresia and malrotation