frequency of Helicobacter pylori infection in gastric biopsies of patients with gallbladder stones

There were few studies reporting simultaneous presence of Helicobacterpylori [H.pylori] in stomach and gallbladder stones, most of which have been conducted on bile specimens or gallbladder tissues. Presence of a chronic inflammatory disease may contribute to gallstone formation through production of inflammatory cytokines. Chronic active gastritis due to H.pylori may contribute to lithogenesis in gallbladder. In this regard, the present study aimed to investigate the frequency and association of gastric H.pylori infection and gallstones in patients who were undergoing upper endoscopy in a teaching hospital. In this case-control study patients presenting with dyspeptic symptoms who underwent upper endoscopy during 2008-2012 in Shahid Beheshti Hospital of Babol, northern Iran were enrolled, 72 patients with and 136 patients without gallstones were assigned as the case and control groups, respectively. Patients with history of gastric surgery PPI, and antibiotic consumption four weeks before endoscopy were excluded from the study. Two biopsies were obtained from gastric antrum and body of each patient in both groups and examined histologically for gastritis and the presence of H.pylori. Then, endoscopic, histological and demographic features [age, gender, BMI, smoking, NSAID] in these two groups were compared. The SPSS software [version 18] was used for analysis. P-value of 0.05 was considered as statistically significant. Fifty-two [72.2%] and 98 [72.1%] of all patients with and without gallstone were female, respectively [p=0.7]. The mean age of patients with gallstone was 51.8 +/- 14 years, while it was 51.1 +/- 15 years in patients without gallstone [p= 0.9]. H.pylori was detected in gastric mucosa of 31 [43.1%] and 45 [33.8%] cases with and without gallstone, respectively. Although H.pylori infection was higher in patients with gallstones, the difference was not statistically significant [p =0.19]. In the group with gallstones, 21 [29.2%] patients revealed severe gastritis, and in those without gallstones, 17 [12.5%] patients were found with severe gastritis. This difference was statistically significant [p=0.003, OR=2.88, CI: 1.41-5.91]. This study demonstrates that patients with severe H.pylori induced gastritis are likely to have gallstone in comparison with mild gastritis. The frequency of H.pylori infection in patients with gallstones is more than those without gallstones

Immunohistochemical expression of estrogen and progesterone receptors in epulis fissuratum

Epulis Fissuratum [Epulis Fissuratum [EF] or Denture Epulis or inflammatory fibrous hyperplasia] is a common hyperplastic tumor-like lesion with reactive nature, related to loose and ill-fitting, full or partial removable dentures and it is more common in women than men. For this reason, hormonal influences may also play role in its creation. The effect of steroid hormones especially sex hormones [Estrogen and progesterone] on oral mucosa is identified in some studies. In the present study, the distribution pattern and presence of estrogen and progesterone receptors in epithelial, stromal, endothelial and inflammatory cells in Epulis Fissuratum was investigated. This cross-sectional study was carried out on 30 samples of paraffin blocks with Epulis Fissuratum diagnosis and 30 samples of normal mucosal tissues as a control group who have had surgery as a margin beside the above lesions and had been obtained from the oral and maxillofacial pathology departement of Babol Dental School since 2003 up to 2010. Intensity of staining and immunoreactivity were evaluated using subjective index and considering the positive control group [breast carcinoma]. Epithelial, stromal, endothelial and inflammatory cells didn't show reaction with monoclonal antibodies against estrogen and progesterone in none of the samples. It seems that the hypothesis of the existence of estrogen and progesterone receptors in epulis fissuratum and normal oral mucosa is ruled out. The possibility of direct effect of estrogen and progesterone in occurring of epulis fissuratum is rejected

Comparison of stool antigen test with gastric biopsy for the detection of helicobacter pylori infection

Helicobacter Pylori [H.pylori] is one of the most important causes of dyspepsia and diagnosis can be made by invasive or non-invasive methods. One of the non-invasive methods, H.pylori stool antigen test [HpSA] is simple, fast and relatively inexpensive. According to this view with regard to gastric biopsy as a gold standard the sensitivity, specificity, positive and negative predictive values of this method were calculated. Stool samples of 61 patients who underwent upper endoscopy and gastric biopsy due to dyspepsia were evaluated for H. Pylori stool antigen using sandwich ELISA method. From the 61 patients who participated in this study, H.pylori was diagnosed in 38 [62.3%] gastric biopsies, 25[66%] of these had positive HpSA test. Also, of 27 [37.7%] positive HpSA cases, H.pylori was seen in 25 gastric biopsies. For this method, sensitivity of 66% with 93% positive predictive value was calculated. Also, 91% specificity with 62% negative predictive value was estimated. High positive HpSA indicates high risk of H.pylori infection and high specificity shows that the likelihood of false positive is low. Therefore, physicians can trust on this method and start patient`s treatment

Study of the Murine Double Minute 2 status in patients with gastric and colorectal carcinomas and its correlation with prognostic factors.

Background: Gastric and colorectal cancers are the second and the fourth most common cancers in Iran, respectively. The presence of Murine Double Minute 2 (MDM2) has been identified in many cancers and its relationship with prognosis is under investigation. This study aimed to assess the status of MDM2 and its relationship with prognostic factors in gastric and colorectal carcinoma. Materials and Methods: This study was performed on 99 paraffin blocks of gastric and colorectal cancers, during the years 2001 to 2007 from Mostafa Khomeini Hospital, Tehran, Iran. Tissue sections were prepared, stained with Hematoxylin and Eosin and immunohistochemistry to evaluate for MDM2 expression. The type of tumor, lymph node involvement and tumor grade was determined. Results: Of the 99 cases, 34.3% and 65.7% cases were diagnosed with gastric and colorectal adenocarcinoma, respectively. The average tumor size was 5.5 cm. MDM2 expression level was 82.4% and 90.8% in gastric and colorectal adenocarcinoma, respectively. No statistical difference was found between MDM2 expression and various prognostic factors; however, significant correlation was observed between gastric (P = 0.03) and colorectal (P = 0.03) tumor size and the percentage of MDM2 immunoreactivity. Conclusion: Considering the role of MDM2 in cell growth and its positive correlation with tumor size (an established prognostic factor), it can be indirectly concluded that MDM2 is also important in prognosis. However, additional investigation is needed.

McCune-albright syndrome: a case report

Fibrous dysplasia is a benign bone lesion of unknown etiology. Bone involvement usually is solitary [monostotic]. Multiple forms [polyostotic] associated with extra skeletal symptoms, particularly cutaneous pigmentation, endocrine dysfunction and precocious puberty is called McCune-Albright syndrome [MAS]. We report the case of a 40-year-old man who presented with left mandibular body expansion and intermittent suppuration from the skin sinus tract formation since he was 18 years old. He had skeletal deformities, limping, and multiple skin pigmentation. X-ray revealed multiple fractures and radiolucent lesions in numerous bones. Laboratory analysis showed an increased serum alkaline phosphatase. Precocious puberty was determined upon taking the patient's history. The patient's height was 148 cm. Microscopic findings of the mandibular lesion, clinical presentation and X-ray findings were strongly diagnostic for MAS