High frequency of microsatellite instability in sporadic colorectal cancer patients in Iran.

Microsatellite instability in sporadic colorectal cancer patients was assessed, and the clinicopathological associations were evaluated in northeastern Iran, which is a high-risk region for gastrointestinal malignancies. Microsatellite instability (MSI) status of tumoral tissue, compared to normal tissue, was assessed with a standard panel of MSI markers on paraffin-embedded surgically resected tissues from 67 consecutive sporadic colorectal cancer patients. Eleven of the patients were under 40 years old. Female patients were significantly younger than male patients (mean age 54.2 vs 62.1 years, P = 0.020). MSI analysis revealed 18 cases of MSI-H (26.9%), 11 MSI-L (16.4%) and 38 MSS (microsatellite stable tumors; 56.7%). While a greater proportion of patients consisted of males, 56.7 vs 43.3% females, MSI-H was more frequent in females (34.5 vs 21.5%). MSI was associated with proximal location of tumor (P = 0.003) and lower stages of tumor (P = 0.002), while MSS tumors were associated with node metastasis. MSI has a higher frequency in sporadic colorectal cancer patients, suggesting that molecular epidemiology of the genetic alterations involved in colorectal cancer carcinogenesis has a different pattern in the Iranian population, which deserves further epidemiological attention. The high frequency of MSI-H in this population suggests that we should look at microsatellite instability prior to chemotherapy to determine the most appropriate chemotherapeutic strategy in our population.

Bacteriological evaluation of adult dacryocystitis in Iran.

PURPOSE: To examine the microbiology and antibiogram of specimens from patients with dacryocystitis. METHODS: A total of 66 samples from lacrimal sac contents of 61 consecutive patients with acute and chronic dacryocystitis were obtained. These specimens were cultured for bacteria with a routine microbiological technique. Antibiograms were acquired from positive cultures. RESULTS: A total of 61 patients (12 patients with acute and 49 patients with chronic dacryocystitis) were included in this investigation with the average age of 40 (12-85) years (female = 74% and male = 26%). Five patients were culture-negative and five patients had mixed gram-positive cultures (a total of 66 samples were obtained). The total prevalence of gram-positive, gram-negative, and culture-negative samples were 71.2%, 21.2%, and 7.6%, respectively. The prevalence of gram-positive, gram-negative, and culture-negative samples were 77.4%, 18.9%, and 3.8% in the chronic and 46.2%, 30.8%, and 23.1% in the acute groups, respectively. The most prevalent pathogen in both groups was Staphylococcus epidermis. In 38% of patients the culture results were similar to those of the contralateral conjunctival flora. Gram-negative bacteria had a high sensitivity to ciprofloxacin and cephalexin while the gram-positive ones were highly sensitive to ceftriaxone and ampicillin. CONCLUSION: The responsible pathogens in acute and chronic dacryocystitis are significantly different. Because of the high prevalence of gram-negative bacteria and also culture-negative samples and considering the necessity of treatment in acute dacryocystitis, selecting an appropriate antibiotic with a good coverage of gram-negative and gram-positive bacteria seems essential.