[Association of intron 3 16 bp duplication polymorphism of p53 with thyroid cancer in northwest of Iran]

Intron 3 16 bp duplication polymorphism of p53 gene has been associated with increased risk of colorectal, breast and lung cancers. Nevertheless there are inconsistent results and we need more studies to understand the importance of this polymorphism in increased risk of cancer predisposition. The aim of this study was to assess the association of 16 bp duplication polymorphism of p53 with thyroid cancer risk. Material and This case-control study included 105 thyroid patients and 170 controls. Cases and controls were matched for age, sex and ethnicity. Genomic DNA was extracted from peripheral blood samples and tumor tissues. P53 PIN3 genotype was determined using PCR products length analysis on polyacrylamide gel. Result: In the control and case groups, 62.9% and 53.3% had no 16 bp insertion, 7.1% and 8.6% had insertion in both p53 alleles and 30% and 38.1% were heterozygous, respectively. There were no significant differences between the case and control groups in regard to genotype frequencies as well as allelic frequencies. According to the results of our study PIN3 16 bp duplication polymorphism of p53 could not be considered as a risk factor for predisposition to thyroid cancer in northwest of Iran

Fatty Acid Composition of Tissue Cultured Breast Carcinoma and the Effect of Stearoyl-CoA Desaturase 1 Inhibition / 한국유방암학회지

PURPOSE: Stearoyl-CoA desaturase 1 (SCD1) is a novel therapeutic target in various malignancies, including breast cancer. The present study was designed to investigate the effect of the pharmacologic inhibition of SCD1 on fatty acid composition in tissue explant cultures of human breast cancer and to compare these effects with those in adjacent nonneoplastic breast tissue. METHODS: Paired samples of tumor and adjacent noncancerous tissue were isolated from 12 patients with infiltrating ductal breast cancer. Samples were explant cultured in vitro, exposed to the highly selective SCD1 inhibitor CAY10566, and examined for fatty acid composition by gas liquid chromatography. The cytotoxic and antigrowth effects were evaluated by quantification of lactate dehydrogenase release and by sulforhodamine B (SRB) measurement, respectively. RESULTS: Breast cancer tissue samples were found to have higher levels of monounsaturated fatty acids (MUFA) (p<0.001) and arachidonic acid (20:4n-6, p<0.001) and a lower level of linoleic acid (18:2n-6, p=0.02) than the normal-appearing breast tissues. While exhibiting no evident cytotoxicity, treatment with the SCD1 inhibitor, CAY10566 (0.1-1 microM), for 48 hours significantly increased 18:2n-6 levels in both the tumor and adjacent normal-appearing tissue (approximately 1.2 fold, p<0.05). However, the breast cancer tissue samples showed significant increases in the levels of MUFA and 20:4n-6 compared to the normal-appearing breast tissues (p<0.05). The SRB growth assay revealed a higher rate of inhibition with the SCD1 inhibitor in breast cancer tissues than in normal-appearing tissues (p<0.01, 41% vs. 29%). The SCD1 inhibitor also elevated saturated fatty acid (1.46-fold, p=0.001) levels only in the tumor tissue explant. CONCLUSION: The fatty acid composition and response to SCD1 inhibition differed between the explant cultures from breast cancer and the adjacent normal-appearing tissue. Altered fatty acid composition induced by SCD1 inhibition may also, in addition to Delta9 desaturation, modulate other reactions in de novo fatty acid synthesis and lipogenesis, and subsequently affect the overall survival and progression of breast cancer.

comprehensive study of mediastinal goiters

Thyroid masses are common, especially in areas of iodine deficiency. Mediastinal goiter is defined by the presence of enlarged thyroid tissue below the level of the thoracic inlet. This study aimed to evaluate the presentation, diagnosis, treatment, histopathological findings and complications of patients with mediastinal goiter or masses. This was a descriptive cross-sectional chart review study of patients with substernal goiter or masses who underwent cervical and mediastinal thyroidectomy from March 2003 to February 2007. From a total of 470 patients admitted for thyroid surgery, 60 cases [12.7%] presented with substernal extension of goiter or masses during the study period; 88% of patients were females with a mean age of 46.77 +/- 10.77 yrs. Cervical masses were the most common preoperative presentation [78%], followed by compressive symptoms [67.8%]; 5.08% of cases were asymptomatic. In 10%, the goiter or masses were located in the posterior mediastinum. Total thyroidectomy was performed in 59% of patients mostly by low collar incision. Sternotomy or thoracotomy was required in three patients [5%] mainly because of mediastinal masses or invasion of carcinoma. Postoperative complications included transient hypocalcaemia [46%] and persistent recurrent nerve paralysis [3.4%]. There was no mortality. Histopathologically, 18.5% of masses were malignant; mostly papillary carcinoma. Presence of substernal goiter or masses is an indication for early surgery, even in asymptomatic or elderly patients. These masses have progressive enlargements and carry a high risk of tracheal compression

Acute nonpenetrating tracheobronchial injuries: what is important in the mortality?

Nonpenetrating tracheobronchial disruption are rare and potentially life threatening and associated with blunt thoracic trauma. Sometimes diagnosis is missed. 2340 traumatic patents were admitted to the trauma center of Tabriz University Hospital, Iran. Only twelve patients of them had ruptured tracheobronchial airways following blunt chest trauma. In this retrospective study of twelve patients, we aim to document and evaluate causes, presentation, and diagnosis and treatment modalities over fourteen years [1993- 2006]. All the cases admitted to our referral hospital from six hours to 72 hours, underwent surgical interventions. There were two deaths; one in the operating room because of massive bleeding of pulmonary vascular disruptions coexisted with tracheobronchial injuries and in other due to severity of disruption of carina, right and left bronchus five days after repair. Diagnosis was missed in one patient and he repaired after six month. Stricture formation of anastomotic site and localized empyema with bronchopleural fistula were the complications of two patients. A high-level of suspicion in blunt thoracic trauma and use of bronchoscopy confirm the diagnosis of tracheobronchial disruption. Early diagnosis of tracheobronchial disruption is important, but severity of disruptions predisposes mortality

Massive life-threatening hemoptysis from pulmonary hydatid cysts: a 13 - year experience from an endemic area

Echinococcosis is a parasitic disease often seen in sheep and cattle raised in countries with unsanitary conditions. The disease is encountered endemically in northwest of Iran. Life-threatening hemoptysis due to a pulmonary hydatid cyst is a rare condition. This study assessed the prevalence and treatment of this condition. Materials and In a retrospective study, between 1993 and 2005, 520 patients with pulmonary hydatid cysts were operated at the Imam Khomeini Hospital in Tabriz, Iran. Ten [1.9%] cysts exhibited life-threatening hemoptysis [Group II]. The remaining 510 patients with pulmonary hydatid cyst were studied [Group I] and compared with group II. Ten patients were included in group II, with a mean follow - up of 2.5 years. Four [40%] cases were males and six [60%] were females. The age ranged between 8 and 46 [mean 27.90 +/- 13.86] years. The most common symptoms were cough [100%], massive hemoptysis [100%], respiratory distress [100%], and chest pain [90%]. The amount of hemoptysis was between 600 and 1400 ml [mean 840 +/- 249.66] a day. The origin of bleeding in six [60%] was from the cyst in the right lung and in four [40%] from the left lung. Bronchoscopy revealed the site of bleeding in all 10 patients, and the lobe in seven [70%]. Chest x-ray and CT scan showed patchy infiltration in one or both lungs and a ruptured hydatid cyst in eight cases. Lobectomy was the most frequent applied procedure [100%]. Two [20%] cases died due to blood aspiration and respiratory distress syndrome, one in the 3rd and the other in the 4th postoperative day. The postoperative hospital stay ranged between 7 and 25 [mean 11.30 +/- 6.56] days. Two and a half years follow-up of patients was good. There was no recurrence. There were significant differences between the two groups In terms of complications and mortality [X2 =102.39, df=1, p<0.0005] and [X2 = 5.82, df=1, p<0.16]. Massive life-threatening hemoptysis due to pulmonary hydatid cysts must be managed as an urgent clinical entity. It has serious symptoms, serious post-operative complications and a high mortality rate.

Severe neonatal hypercalcemia due to primary hyperparathyroidism; a case report

Neonatal primary hyperparathyroidism [NPHP] is a rare disease characterized by marked hypercalcemia, diffuse parathyroid hyperplasia and skeletal demineralization. These patients have symptoms of chronic hypercalcemia such as failure to thrive, irritability, abdominal pain and anorexia. It is often fatal unless parathyroidectomy is performed. Treatment with drugs usually is inadequate and often results in chronic hypercalcemia and death. A 10-day-old, 2.9 kg male newborn was hospitalized for anorexia, poor feeding, cyanosis, hypotonia, lethargy and severe dehydration. Diagnosis of severe hypercalcemia due to primary hyperparathyroidism was established and surgical approach selected because of failure of medical therapy to control hypercalcemia. The baby was successfully treated by total parathyroidectomy with autotransplantation. Although neonatal primary hyperparathyroidism [NPHP] is a rare disease, it must be considered for differential diagnosis in neonates with severe hypercalcemia. Early diagnosis and total parathyroidectomy with autotransplantation can be life-saving

Comparison of pulmonary hydatid disease between children and adults

Hydatid disease is a parasitic infestation which is endemic in many sheep and cattle raising areas and is still an important health hazard in the world. The aim of this study was to compare the clinical features, radiologic accuracy, and the surgical approaches of pulmonary hydatid cysts among children and adults in Northwestern Iran. 445 patients treated for pulmonary hydatid cysts over the last ten years, were retrospectively evaluated. The patients were arranged in two groups. There were 383 adults [86%] and 62 children [14%] and their clinical, radiological and surgical characteristics of the pulmonary hydatid cysts were compared. Unlike adults, in children the frequency of pulmonary hydatid cysts in males was significantly [p=0.0036] higher than in females [65% vs. 36%]. Cough was the most common symptom in both groups. The frequency of hemoptysis was more common [p=0.0042] in adults [38%] than in children [19%]. However, giant pulmonary hydatid cysts were more commonly found in children [p < 0.05]. Cystotomy with or without capitonnage was the most preferred method used in both groups. Postoperative complications [pneumothorax] developed in five adults and one child, and were more frequent in noncapitonnage procedures. Only one recurrence was observed in the adult group. The accuracy of chest x-ray was 84% and 74% in children and adults, respectively. Due to the high accuracy of chest x-ray in diagnosis of hydatid cysts of the lung in both groups, it is recommended as the preferred method of diagnosis in endemic regions

Inflammatory pseudotumor of the lung: report of four adult cases

Inflammatory pseudotumors of the lung are rare and may produce diagnostic and therapeutic dilemma for the clinicians, pathologists, and surgeons. Herein, we reported on four patients with this uncommon disease. They were three men and one woman with a mean age of 37 years [range: 20 - 50]. Three cases were symptomatic, complaining of cough, expectoration of sputum, hemoptysis, and chest pain. Three had solitary pulmonary nodule [SPN] and one had a tumor-like mass in chest X-ray films. Wedge resection was performed for the first three cases. With suspicion of lung cancer, pneumonectomy was carried out for the last patient. The overall survival was 100%. There was no operative or postoperative complications/death or recurrence within 5 - 10 years of follow-up. All of them had benign appearances, which was proven by pathologic examination. Inflammatory pseudotumors of the lung are rare. Most behave in a benign fashion. It may increase slowly in size and sometimes has an aggressive behavior. Frozen section may be used during the operation for the diagnosis. According to pathologic examination, complete resection is safe and leads to excellent survival