Germ cell tumor's survival rate in young patients

Background: Germ cell tumors are neoplasms that originate from multi potential germ cells and can be intra or extra gonadal. According to pathologic classification, they have different subtypes. They account for 3% of pediatric malignancies and most commonly happen in children before the age of 15 years old. Epidemiologic evidence about pediatric germ cell tumors is scant in our region

Objectives: The aim of current study was to determine demographic characteristics, recurrence and survival rate of germ cell tumor patients under the age of 21 years

Patients and Methods: During a 10-year period [1996 - 2006], 106 patients under the age of 21 years suffering from germ cell tumor were admitted to our centers. We extracted the data needed for our study from patients' medical records in the hospitals

Results: Thirty seven boys and 69 girls with a mean age of 8.4 +/- 7.8 years were included. Most tumors were diagnosed before the age of one year [37%]. The most common pathologic subtype was mature teratoma [44%]. Ovary [35%] was the most common primary site. Surgery plus chemotherapy were used to treat 54 patients and BEP was the most common chemotherapy regimen. Metastasis and recurrent tumor were seen in 22% and 8% of cases, respectively. Four-year overall survival was 89%

Conclusions: Our study showed that demographic characteristics of GCT patients in our population are similar to patients of other geographic regions in the world. Primary tumor site, histologic subtype and metastasis were significant prognostic factors for survival

Preventive effect of three pomegranate [punica granatum l.] seeds fractions on cerulein-induced acute pancreatitis in mice

Acute pancreatitis [AP] refers to afflicted inflammation of pancreas with unfavorable adverse effects and developed multiple organ failures. Unfortunately, there is not a certain therapeutic method for this disease. Oxidative stress has a serious role in the pathogenesis of AP. Thus, decreasing of oxidative stress may prevent induction and progression of AP. Punica granatum L. has been extensively used in traditional medicine and possesses various active biological elements. Due to antioxidant and anti-inflammatory properties of pomegranate, it could be considered as a good candidate alternative medicine with beneficial effects on AP. In this study, we decided to study the protective effect of three fractions of pomegranate seeds on cerulein-induced AP. AP was induced in male Syrian mice by five intraperitoneal [i.p.] injection of cerulein [50 Mg/kg] with 1 h intervals. Treatments with pomegranate freeze-dried powder [PFDP] and hydroalcoholic pomegranate seeds extract [PSE] at doses of 125, 250, 500 mg/kg [i.p.] were started 30 min before pancreatitis induction. Pomegranate seed oil fraction [PSOF] was orally administered [50, 100, 200 ML/kg] and continued for 10 days. Pancreatic tissue was evaluated for histopathological parameters and pancreatic myeloperoxidase [MPO] activity as well as lipase and amylase levels were measured in plasma. The higher doses of three fractions [250 and 500 mg/kg for PFDP and PSE and doses of 100, 200 microL/kg for PSOF] significantly reduced amylase and lipase activity in serum [at least P < 0.01], pancreatic MPO activity [P < 0.001], edema, leukocyte infiltration and vacuolization in comparison to the control group [P< 0.05]. These results propose that pomegranate seeds fractions can prevent and/or treat the AP

direct medical costs of colorectal cancer in Iran; analyzing the patient's level data from a cancer specific hospital in Isfahan

The Immense cost of cancer treatment is one of the main challenges of health care systems all over the world including Iran. The aim of this study was to analyze the direct treatment costs of colorectal cancer patients in Isfahan, Iran. In this cross sectional study, the medical records of colorectal cancer [CRC] patients admitted to the Seyyed-al-Shohada Hospital "SSH" from 2005-2010 were reviewed. The profiles of 452 patients were examined. However based on inclusion, exclusion criteria a total number of 432 profiles were analyzed. All records including age, sex, treatment processes and treatment costs were extracted from the patients' profiles and analyzed using Kruskal-Wallis test. The results showed that 56.1% of CRC patients were male. The mean age of patients suffering from CRC was 56 +/- 13.4. More than Thirty-six percent of the patients were in stages 1-3 of CRC and more than half of them [64.4%] were in the 4[th] stage. The higher the stage of the cancer the higher the percentage of treatments used. 5-Fluorouracil and Leucovorin [5FU/LV] was the most common used chemical treatment protocol. The mean treatment cost for stage one was 10715 [ +/- 4927], for stage two 15920 [ +/- 3440], stage three 16452 [ +/- 2828] and for stage four was 16723 [ +/- 2555] US Dollars. The cost of drug treatment was the first cost driven between the medical services. CRC in Iranian population starts in younger age than people in western countries. This imposed considerable direct and indirect economic cost to the society. The direct medical cost of colorectal cancer in Iran is very higher than 38 million [dollar sign]. Screening programs could reduce the economic cost of CRC significantly

40 years old woman with monolobar Caroli's syndrome treated by left hepatic lobectomy

Caroli's disease [CD] is a rare congenital abnormality characterized by dilatation of intra hepatic bile ducts, which causes stone formation, recurrent cholangitis and higher risk for biliary malignancy. Association of this anomaly with congenital hepatic fibrosis is named Caroli's syndrome [CS]. The monolobar involvement of CS is a very rare condition, curable by partial hepatectomy. We report a 40-year-old woman with recurrent epigastric pain without icterus with normal AST, ALT and alkaline phosphates for 5 years due to left lobe Caroli syndrome which was diagnosed by CT scan and MRCP. Then, the patient underwent successful operation [left hepatic resection]. After 8 months follow up, she was symptom free. Because the presentation of unilobar CS may be as late as middle age, this congenital anomaly should be considered in differential diagnosis of patients with recurrent epigastric pain without icterus in this age group and MRCP is a useful diagnostic tool

[P53 antigen expression in cutaneous Melanoma and its relation to tumor thickness]

P53 tumor suppressor gene mutation is one of the most common genetic alterations in human malignancies. The mutated from of the gene is stable and can be detected with immunohistochemistry methods. There is much controversy about the expression rate of this gene in malignant melanoma. To determine the frequency of the P53 antigen expression by sex, age, type and thickness of melanoma, and site of the antigen expression. Paraffin embedded blocks of 50 patients [45 primary and 5 metastatic] with documented diagnosis of melanoma were deparaffinized and immunostained with D0-7 monoclonal antibody. The lesions were divided depending on the degree of the staining as follows: 1][No staining], 2] Mild [Less than 10%], 3] Moderate [10%-50%], 4] Severe [More than 50%]. Of 50 cases, 27 [54%] evaluated skin biopsy specimens belonged to female patients and 23 [46%] skin biopsies were related to male patients. 40% of lesions were graded as no staining. 36% of lesions showed mild staining, 14% moderate and 10% severe staining. Site of expression was exclusively in the cytoplasm. There was no meaningful statistical relationship between severity of staining and the age group, and sex of the patients, type and thickness of melanoma [P > 0.05]. Mutation in P53 tumor suppressor gene probably occurs in the early stages of melanoma