Evaluation of miR-200c-3p and miR-421-5p levels during immune responses in the admitted and recovered COVID-19 subjects.

Angiotensin-converting enzyme 2 (ACE2) acts as a key receptor for the spike of SARS-CoV-2. Two main microRNAs (miRs), miR-200c-3p and miR-421-5p, are considered to modulate the expression of ACE2 gene and alterations in the expression of these miRNAs may influence the outcomes of COVID-19 infection. Accordingly, we examined whether miRNAs directing ACE2 expression altered in the SARS-CoV-2 infection. 30 patients with COVID-19 included in the study. At the time of admission and discharge, the expression of miR-200c-3p and miR-421-5p, inflammatory cytokine IL-6, and regulatory T cells' expression profiles (CD4, CD25, and Foxp3) were examined using quantitative real-time PCR method. At the time of admission, the expression levels of miR-200c-3p and miR-421-5p as well as CD4, CD25, and Foxp3 significantly decreased while IL-6 expression notably enhanced. However, by the time of discharge, the expression levels of the genes were opposite to the time of admission. Moreover, Pearson correlation analysis indicated that IL-6 expression negatively correlated with Foxp3 and miR-200c-3p expressions despite miR-421-5p and miR-200c-3p positively correlated at admission time. By manipulating miR-200c-3p and miR-421-5p expressions and controlling the ACE2 level, it is plausible to modulate the inflammation by reducing IL-6 and maintenance tolerance hemostasis during COVID-19 infection.

Assessment of prognostic factors in long-term survival of male and female patients with colorectal cancer using non-mixture cure model based on the Weibull distribution.

OBJECTIVE: Colorectal cancer (CRC) is known as one of the malignant form of cells growing in the inner lining of colon and rectum which could seriously affect the cure rate of patients. We aimed to evaluate the effect of prognostic factors on cure fraction of CRC patients. METHODS: A total of 1043 CRC patients were included to the study from December 2001 to January 2007 at the Research Center of Gastroenterology and Liver Disease in Shahid Beheshti University of Medical Sciences, Tehran, Iran. Patients' information was extracted from their medical records, then they were followed to identify their death status via phone-call. Weibull non-mixture cure model was used to evaluate the effect of the risk factors on cure fraction of CRC patients. RESULTS: The five-years survival rate was 0.66 (males: 0.64 and female: 0.69). The median survival time for non-cured CRC patients were 3.45 years (males: 3.46; females = 3.45 years). In the single Weibull model, BMI≥30 (OR = 4.61, p-value = 0.033), poorly differentiated tumor grade (OR = 0.36, p-value = 0.036), tumor size≥25 mm (OR = 0.22, p-value = 0.046), and N1-stage (OR = 0.42, p-value = 0.005) had significant effect on females' cure fraction. Also, cure fraction of male CRC patients significantly affected by BMI (levels:25.0-29.9-OR = 12.13-p-value<0.001; ≥30-OR = 7.00-p-value = 0.017), T1-stage (OR = 0.52, p-value = 0.021), M1-stage (OR = 0.45, p-value = 0.007), IV-staging (OR = 0.36, p-value = 0.041) and IBD (OR = 0.26, p-value = 0.017). In multiple Weibull model, females were associated with tumor size≥25 mm (OR = 0.20, p-value = 0.044) and N1-stage (OR = 0.45, p-value = 0.013) and males were affected by M1-stage (OR = 0.41, p-value = 0.011) and IBD (OR = 0.20, p-value = 0.022).The cure fraction of males and females CRC patients was 64% and 69%, respectively. CONCLUSIONS: The prognostic factors for cure fraction of patients with CRC may be different among males and females. Further multicenter studies are required to assess the effect of common prognostic factors between males and females.

Genetic association of liver X receptor beta rs2695121 polymorphism with obesity-related traits in a northeastern Iranian population.

BACKGROUND: Liver X receptor Beta (LXRß), located in an obesity susceptible region, has been shown to be involved in the metabolism of lipid and carbohydrates. Previous human genetic studies have suggested genetic variability of LXRß could be associated with human obesity. Therefore, we hypothesized that LXRß gene rs2695121 polymorphism may be associated with the risk of obesity in a northeastern Iranian population. METHODS: A TaqMan allelic discrimination assay was used to genotype LXRß rs2695121 polymorphism in this cross-sectional study of 168 obese, 209 overweight and 76 normal-weight subjects recruited from Mashhad city in Iran. Logistic regression analyses were used to analyze alleles and genotypes distribution. Anthropometrics and clinical variables among different genotype carriers were compared by univariate analyses. All statistical analysis was performed using SPSS v.16.0. RESULTS: Allelic and genotypic associations with obesity were not significant for the rs2695121 variant even after adjustment for age and gender (OR=1.17, 95% CI=0.46-2.91), p=0.586). Moreover, haplotype analysis using data from the other variant (rs17373080) of LXRß revealed no significant association (p=0.88). However, among the clinical and metabolic parameters tested, systolic and diastolic blood pressures were found nominally associated with the genotype CT (p=0.031 and p=0.017 respectively). CONCLUSION: This study failed to demonstrate any association between the rs2695121 variant of LXRß and obesity neither alone nor when considered with rs17373080. However, its association with blood pressure may influence one's susceptibility to obesity, supporting further studies in a larger population.

Relationship between histopathological status of the Helicobacter pylori infected patients and proteases of H. pylori in isolates carrying diverse virulence genotypes.

Helicobacter pylori is the main cause of several gastroduodenal diseases in Humans. Among various virulence factors of H. pylori, proteases may also be involved in its pathogenicity. In this study, relationship between proteolytic activity of H. pylori strains and histopathological changes of the stomach was investigated in the patients infected with strains carrying diverse virulence factors. H. pylori strains were isolated from the biopsies of 116 patients who referred to hospital for their gastroduodenal disorders, in Tehran, Iran. Biopsies were sent to microbiology and pathology laboratories for further analysis. All the suspected grown colonies were characterized by both biochemical tests and polymerase chain reaction (PCR). Presence of seven protease genes, htrA, clpP, hp0169, hp1012, hp0382, hp1350 and hp1435, and distinct allelic variants of H. pylori virulence factors, cagA, vacA, iceA, babA2 and sabA, were analyzed in each strain. Protease activity of the strains was assessed using spectrophotometric assay. Furthermore, association between diversity in protease genes and virulence genes, protease activity, as well as pathological changes was estimated statistically. Proteases genes, htrA, clpP, hp0169, hp1012, hp0382, hp1350, hp1435, were detected among 100%, 100%, 98%, 98%, 98%, 98%, and 8% of fifty H. pylori strains isolated from the patients, respectively. Status of cagA, vacA s1, vacA s2, vacA m1, vacA m2, iceA1, iceA2, babA2 and sabA genes in isolates were 64%, 68%, 30%, 26%, 74%, 48%, 52%, 100%, and 96%, respectively. Predominant (84%) combined status for protease genes was: htrA/clpP/hp0169/hp1012/hp0382/hP1350/hp1435, while the prevalent combined status (16%) for virulence genes was: cagA+/vacA s1m2/iceA1+/sabA+/babA2+. Although most of the strains (91.4%) presented moderate protease activity in vitro, lowest activity was measured in strains isolated from the patients with chronic gastritis (4.25%). Present study provide the new data on diversity of protease genes in H. pylori, as well as the proteolytic activity of these genes in H. pylori strains from the sick patients. Presence of significant association between lower protease activity of the strains and mildness of the pathological changes propose involvement of these proteases in the pathogenesis of H. pylori in vivo.

The Early Results of a New Health Care Program Implementation in HBV Screening: an Iranian Experience.

BACKGROUND According to the reports of World Health Organization (WHO) and Centers for Disease Control and Prevention, the prevalence of chronic hepatitis B infection in Iran has decreased from 2-7% in 2001 to 1.3-0.8% in children aged 2-14 years. In 2010 the Institute of Medicine recommended more comprehensive screening by primary care physicians (PCPs) for evaluation, vaccination, and management of infected patients for further decrease in the prevalence of chronic HBV infection. Thus, with contribution of the Health Department, we developed a practical flowchart for PCPs to start active screening of hepatitis B virus (HBV) in all visited patients and refer the positive cases for further evaluation and management to Taleghani Hospital. METHODS With collaboration of Health Department of Shahid Beheshti University of Medical Sciences), physicians of health centers were asked to screen all their patients for HBsAg. Positive cases were referred to Taleghani Hospital. They were first registered and educated about their disease, life style, and prevention methods. Their first degree families were screened for HBV infection too and were referred for vaccination if needed. According to the results of lab tests, appropriate management was done by a hepatologist. RESULTS Since implementation of this program, we have encountered a significant rise in patient detection (even in high risk groups). Many of them were not aware of their disease and most of those who were aware of their disease were not managed appropriately. Family screening and vaccination were inadequate and need more emphasis. CONCLUSION Although health system is active about screening of HBV infection in high risk populations, it is not perfect. It seems that health system needs to upgrade the screening and management programs of HBV infection.

Hepatocellular carcinoma in Asia: Prevention strategy and planning.

AIM: To review all of epidemiological and etiological aspects of hepatocellular carcinoma (HCC) and examined the prevention of this disease in Asia. METHODS: We conducted a systematic review according to the PRISMA guidelines. We were chosen articles that published previously, from PubMed (MEDLINE), the Cochrane database and Scopus. The key words used in this research were as follows: HCC in Asia and the way of prevention of this disease, with no language limitations. We selected those papers published before 2014 that we considered to be most important and appropriate. All relevant articles were accessed in full text and all relevant materials was evaluated and reviewed. RESULTS: More than 70% of all new cases of liver cancer were diagnosed in Asia, a region that 75% of all those chronically infected with hepatitis B virus (HBV) in the world. Chronic HBV infection is the main cause of HCC in Asia, where the virus is endemic and vertical transmission is common. Japan, Saudi Arabia, Egypt and Pakistan are exception because of high prevalence of HCV infection in these regions. The prevalence of this cancer is high in Eastern and South-Eastern Asia, But Middle Eastern countries are characterized as moderate prevalence rate of HCC region and Central Asia and some part of Middle Eastern countries are known as low prevalence rate of HCC. In addition of HBV and HCV the other factors such as aflatoxin, alcohol, obesity, diabetes and non-alcoholic fatty liver disease (NAFLD) might be responsible for a low prevalence of HCC in Asian countries. Currently available HCC therapies, chemotherapy, surgical are inefficient, mainly due to usually late diagnosis and high recurrence rates after surgical resection, and usually end with treatment failure. Liver transplantation also remains as a difficult strategy in patients with HCC. Thus prevention of HCC by treating and prevention HBV and HCV infection, the major causative agents of HCC, and the other risk factors such as aflatoxin, alcohol, obesity, diabetes and NAFLD is of a great medical importance. CONCLUSION: The main challenge which still present in Asia, is the high prevalence of chronic hepatitis. So, prevention of HBV and HCV is the key strategy to reduce the incidence of HCC in Asia.

Non-alcohol fatty liver disease in Asia: Prevention and planning.

AIM: To review all of epidemiological aspects of non-alcoholic fatty liver disease (NAFLD) and also prevent this disease is examined. METHODS: We conducted a systematic review according to the PRISMA guidelines. All searches for writing this review is based on the papers was found in PubMed (MEDLINE), Cochrane database and Scopus in August and September 2014 for topic of NAFLD in Asia and the way of prevention of this disease, with no language limitations. All relevant articles were accessed in full text and all relevant materials was evaluated and reviewed. RESULTS: NAFLD is the most common liver disorder in worldwide, with an estimated with 20%-30% prevalence in Western countries and 2%-4% worldwide. The prevalence of NAFLD in Asia, depending on location (urban vs rural), gender, ethnicity, and age is variable between 15%-20%. According to the many studies in the world, the relationship between NAFLD, obesity, diabetes mellitus, and metabolic syndrome (MS) is quiet obvious. Prevalence of NAFLD in Asian countries seems to be lower than the Western countries but, it has increased recently due to the rise of obesity, type 2 diabetes and MS in this region. One of the main reasons for the increase in obesity, diabetes and MS in Asia is a lifestyle change and industrialization. Today, NAFLD is recognized as a major chronic liver disease in Asia. Therefore, prevention of this disease in Asian countries is very important and the best strategy for prevention and control of NAFLD is lifestyle modifications. Lifestyle modification programs are typically designed to change bad eating habits and increase physical activity that is associated with clinically significant improvements in obesity, type 2 diabetes and MS. CONCLUSION: Prevention of NAFLD is very important in Asian countries particularly in Arab countries because of high prevalence of obesity, diabetes and MS.

In silico experiment with an-antigen-toll like receptor-5 agonist fusion construct for immunogenic application to Helicobacter pylori.

BACKGROUNDS: Helicobacter pylori colonize the gastric mucosa of half of the world's population. Although it is classified as a definitive type I carcinogen by World Health Organization, there is no effective vaccine against this bacterium. H. pylori evade the host immune response by avoiding toll-like detection, such as detection via toll-like receptor-5 (TLR-5). Thus, a chimeric construct consisting of selected epitopes from virulence factors that is incorporated into a TLR-5 ligand (Pseudomonas flagellin) could result in more potent innate and adaptive immune responses. MATERIALS AND METHODS: Based on the histocompatibility antigens of BALB/c mice, in silico techniques were used to select several fragments from H. pylori virulence factors with a high density of B- and T-cell epitopes. RESULTS: These segments consist of cytotoxin-associated geneA (residue 162-283), neutrophil activating protein (residue 30-135) and outer inflammatory protein A (residue 155-268). The secondary and tertiary structure of the chimeric constructs and other bioinformatics analyses such as stability, solubility, and antigenicity were performed. The chimeric construct containing antigenic segments of H. pylori proteins was fused with the D3 domain of Pseudomonas flagellin. This recombinant chimeric gene was optimized for expression in Escherichia coli. The in silico results showed that the conserved C- and N-terminal domains of flagellin and the antigenicity of selected fragments were retained. DISCUSSION: In silico analysis showed that Pseudomonas flagellin is a suitable platform for incorporation of an antigenic construct from H. pylori. This strategy may be an effective tool for the control of H. pylori and other persistent infections.

Correlation between global genome methylation and mutation at CpG codons of p53 gene.

OBJECTIVE: Hypomethylation within the body of the p53 gene, which is normally methylated, has been found in neoplasms. Also, the CG → TA transition was not detected in the CpG codons of the p53 gene in gastritis lesions in Iranian patients. Therefore, an evaluation of the probable correlation between global genome methylation and alteration at CpG codons of p53 gene was needed. METHODS: For defining the genotypes of CpG codons, DNA sequencing was performed on 90 paired samples of gastritis and normal tissues. To measure global genome methylation status, the extracted DNA was digested with HpaII (methylation sensitive) and MspI (insensitive). Then, enzymatic digestion was quantitated using Pyrosequencing as peak height. By calculating the HpaII/ MspI peak ratio it is possible to evaluate the methylation level of normal and gastritis tissues. RESULTS: Codons 9, 245 and 248 underwent a CG → AT transversion but not a CG → TA transition. In addition, the mean methylation level was significantly different between the patients with GG and GT genotypes at codon 245 (P = 0.019). CONCLUSIONS: As CG → AT transversion at codon 245 is associated with global genome methylation, GG hypomethylation may induce different pattern of mutations, for example, C → A instead of C → T at the CpG codons of the p53 gene during gastritis development in Iranian patients.

Detection of p53 common intron polymorphisms in patients with gastritis lesions from Iran.

BACKGROUND: p53 alterations have been implicated in the development of many cancers, such as gastric cancer, but there is no evidence of p53 intron alterations in gastritis lesions. The aim of this study was to investigate the p53 intron alterations in gastritis along with p53 and mismatch repair protein expression and microsatellite status. MATERIALS AND METHODS: PCR-sequencing was conducted for introns 2-7 on DNA extracted from 97 paired samples of gastritis lesions and normal adjacent tissue. Abnormal accumulation of p53 and mismatch repair proteins was investigated using immunohistochemistry. In addition, microsatellite status was evaluated with reference to five mononucleotide markers. RESULTS: Gastritis cases included 41 males and 56 females in the age range of 15-83 years, 87.6% being H.pylori positive. IVS2+38, IVS3ins16 and IVS7+72 were the most polymorphic sites. Their minor allele frequency values were as follows: 0.38, 0.21 and 0.06, respectively. Samples with GG genotype at IVS2+38 and CT at IVS7+72 had no insertion. Moreover, most of the stable samples (91.9 %) had a G allele at IVS2+38. All of the samples were IHC negative for p53 protein, microsatellite stable and expressed mismatch repair proteins. p53 alterations were prominent in the HP+ group, but without statistical significance. CONCLUSIONS: According to our results, some p53 polymorphisms such as IVS2+38, IVS3ins16 and IVS7+72, because of their correlations together or with microsatellite status may contribute to gastritis development. However, so far effects on p53 expression and function remain unclear. Therefore, a comprehensive survey is needed to delineate their biological significance.

Irritable bowel syndrome, gastro-oesophageal reflux disease and dyspepsia: overlap analysis using loglinear models.

BACKGROUND AND STUDY AIMS: Irritable bowel syndrome (IBS), gastro-oesophageal reflux disease (GERD) and dyspepsia are three most important gastrointestinal disorders which occur frequently together in patients. This study aims to assess the association between IBS, GERD and dyspepsia by using loglinear model analysis. PATIENTS AND METHODS: This cross-sectional household survey, the purpose of which was to find the prevalence of gastrointestinal symptoms, disorders and the related factors, has been done from May 2006 to December 2007 in Tehran province, Iran. Subjects were interviewed by trained personnel. GERD was diagnosed as the experience of heartburn and/or acid regurgitation at least once a week for the last 3 months. IBS and dyspepsia were diagnosed according to the Rome III criteria. Loglinear models were applied to investigate the simultaneous association between IBS, GERD and dyspepsia. RESULTS: 77.9% of IBS patients had dyspepsia symptoms and 74.7% had GERD symptoms as well at the same time. As for the other two symptoms, 66% of GERD patients were also suffering from dyspepsia. CONCLUSIONS: These three symptoms frequently overlap; the overlap is systematic and not by chance or random.

Endoscopic electronic record: A new approach for improving management of colorectal cancer prevention.

Digestive endoscopy is currently the main diagnostic procedure for investigation of the digestive tract when a digestive disease is suspected. The use of computers and electronic medical records for the management of endoscopic data are an important key to improving endoscopy unit efficiency and productivity. This technology supports optimal program operation, monitoring and evaluation colorectal cancer screening. This article is a comprehensive survey of endoscopic electronic medical records and information systems. Computerized clinical records have the capability of identifying patients due for screening and to calculate baseline rates of colorectal cancer screening by patient characteristics and by primary care physician and practice group. This paper describes data flow in the endoscopy unit, the minimum data set of colorectal cancer and key features of endoscopic electronic medical record. In addition, the researchers state standards in different aspects, especially terminology standards and interoperability standards for image and text.

Advantage of Applying OSC to (1)H NMR-Based Metabonomic Data of Celiac Disease.

BACKGROUND: Celiac disease (CD) is a disorder associated with body reaction to gluten. After the gluten intake, an immune reaction against the protein occurs and damages villi of small intestine in celiac patients gradually. OBJECTIVES: The OSC, a filtering method for minimization of inter- and intra-spectrometer variations that influence on data acquisition, was applied to biofluid NMR data of CD patients. PATIENTS AND METHODS: In this study, metabolites of total 56 serum samples from 12 CD patients, 15 CD patients taking gluten-free diet (GFD), and 29 healthy cases were analyzed using nuclear magnetic resonance (NMR) and associated theoretical analysis. Employing ProMetab (version ProMetab_v3_3) software, data obtained from NMR spectra were reduced and orthogonal signal correction (OSC) effect on celiac disease metabonomics before and after the separation by principle component analysis (PCA) was investigated. RESULTS: The three groups were separated by OSC and findings were analyzed by partial least squares discriminant analysis (PLS-DA) method. Root mean square error of calibration (RMSEc) and correlation coefficient of calibration (Rc) for PLS-DA referred to an efficient group separation filtered by OSC. CONCLUSIONS: The applied leave-one-out cross-validation to PLS-DA method performed along with OSC confirmed validation of data analysis. Finally four metabolites are introduced as CD biomarkers.

Standard pediatric oncology data and information technology: necessities for cancer care management.

Cancer is the second leading cause of death in children and survivors require life time follow-up. There is a growing recognition of the need to base cancer control policies on accurate, detailed and timely information on cancer management and outcomes. Coordination and central documentation ensure quality of treatment and permit clinical and scientific investigations. The combined data thus obtained create a comprehensive picture of disease, leading to more effective prevention and cure. Medical information can be gathered, processed and analyzed in different ways and the importance of precise language cannot be overestimated. All medical activity arises from the ability to observe and communicate intelligibly and a lack of standardized documentation leads to insufficient integration of clinical work. The Minimal Standard data set is the result of a global effort to establish a common structure and vocabulary for electronic reports. In addition, information technology combines research aspects of decision support and clinical documentation, allowing formal representation of general protocols, calculating of a particular therapy for a patient, data acquisition in the clinics. Our aim in this papers is to stress the need for standard pediatric oncology data and information technology as an approach to cancer care management.

Profile and frequency of p53 gene alterations in gastritis lesions from Iran.

BACKGROUND: It has been frequently shown that p53 alterations have an important role in the development of gastric cancers but there is no data on p53 alteration in gastric cancer and its precancerous lesions from Iran although this country experiences one of the highest gastric cancer incidence and mortality rates in the world. The purpose of this study was to do a comprehensive assessment of p53 alterations in the Iranian population of gastritis patients and to evaluate the association between p53 alterations, microsatellite status and clinicopathological aspects. METHODS: After DNA extraction, PCR sequencing was done for exons 2-7. Also microsatellite status was evaluated using five microsatellite markers: NR-27, NR-21, NR-24, BAT-25 and BAT-26. RESULTS: The highest rate of alteration was seen in codons 72 (85.6%, SNP) and 248 (30.9%, mutation). Also, we found 2 new mutations in codons 9 and 146. In contrast with previous work, transition at the CpG codons was relatively rare. Nucleotide alterations were more prevalent in the Helicobacter pylori-positive group but not significantly. Neither nuclear staining for p53 protein nor microsatellite instability was seen in gastritis lesions. CONCLUSION: p53 alterations might contribute to the pathogenesis of gastritis and perhaps gastric cancer in Iran. However, the different spectrum seen here implies other mechanism(s) in gastritis and gastric cancer development in the Iranian population.

Non-erosive reflux disease compared with erosive esophagitis with regards to acid reflux and symptom patterns.

BACKGROUND/AIMS: Non-erosive reflux disease and erosive esophagitis are the most common phenotypic presentations of gastroesophageal reflux disease. Recent reports suggest that patients with non-erosive reflux disease treated with antireflux medications show lower symptom improvement rates than patients with erosive esophagitis treated with the same medications. The aim was to assess the acid reflux and symptom patterns of patients with non-erosive reflux disease in comparison with those with erosive esophagitis and to identify different non-erosive reflux disease subgroups. MATERIAL AND METHODS: One hundred and twenty consecutive patients (67 male, age: 37.6±12.9 years) seen for classic heartburn symptoms were evaluated for the study. The patients underwent upper endoscopy and 24-hour ambulatory pH monitoring. RESULTS: Erosive esophagitis was identified in 51 patients and nonerosive reflux disease in 69 patients. According to pH metric findings (DeMeester Score >14.72 or Fraction Time >4%), 31.9% of the non-erosive reflux disease group and 47.1% of the erosive gastroesophageal reflux disease group had abnormal acid reflux (p=0.134). Erosive esophagitis patients showed a similar pattern of acid reflux to non-erosive reflux disease patients in the different positions (supine and upright). Non-erosive reflux disease-negative (normal pH test) patients demonstrated a significantly lower degree of esophageal acid exposure when compared with those with erosive esophagitis. About 10.6% of the non-erosive reflux disease-negative patients and 45.5% of the non-erosive reflux disease-positive (abnormal pH test) patients had a positive symptom index (≥50%) during the distal pH metry (p=0.003). CONCLUSIONS: Acid reflux characteristics and symptom patterns suggest that the non-erosive reflux disease group represents a heterogeneous group of patients.

Evaluation of global genome methylation in gastritis lesion and its correlation with clinicopatological findings.

Global genome hypomethylation as an epigenetic phenomenon may induce (pre)neoplastic transformation through inducing chromosomal and genomic instability and activating oncogenes. Global genome hypomethylation has a fundamental role in early stages of tumorigenesis but little is known about this epigenetic event in gastric precancerous lesions such as gastritis. Therefore, we decided to evaluate this issue in gastritis lesion for obtaining new insight toward molecular biology of gastric cancer. Here we used a technique composed of restriction enzyme digestion and pyrosequencing known as luminometric methylation assay to evaluate this issue. DNA obtained from normal and gastritis lesions was digested with HpaII (sensitive to methylation in its cut site) and MspI (insensitive). Overhangs resulting from these enzymes then fill in by polymerase extension assay using pyrosequencing instrument. Nucleotide incorporation during polymerase extension generates light, which expresses as pick in the pyrogram. By comparing the height of picks obtained form both enzymes it can be possible to evaluate and compare global genome methylation level of gastritis and normal tissues. If the target site is fully methylated, the HpaII/MspI (their pick height) will approach zero. If not, this ratio will be around 1. In the other conditions this ratio varies between 0 and 1. Comparing the ratio of normal and gastritis sample, it can be inferred whether or not gastritis is hypomethylated. This study was performed on 83 gastritis and normal adjacent tissues. The patients included 34 male and 49 female and were 15 to 83 years old. According to our study, gastritis tissue was hypomethylated more than the normal tissue (p = 0.028). Global genome methylation has no significant correlation with MSI, pathological findings, age, and gender. We conclude that global genome hypomethylation occurs in the gastritis level. This reduction probably continues in the next steps toward gastric cancer and may induce other epigenetic and/or genetic changes (such as MSI) that promote carcinogenesis.

New perspective for integrated information management in national colorectal cancer screening in Iran.

Colorectal cancer screening management, especially for those with a genetic predisposition, depends on adequate and standard reporting. Standardized reporting systems for diagnostic and screening tests facilitate quality improvement of programs and clear communication among health care providers. This article presents a comprehensive picture of the information content of colorectal cancer screening in the national plan of Iran, consisting of demographic and medical findings and other standard reports (colonoscopy, pathology, genetics and pedigree data). In addition this review presents data flow in screening and data elements in patient perspectives on colorectal cancer screening.

Human epidermal growth factor receptor-2 family in colorectal adenocarcinoma: correlation with survival and clinicopathological findings.

BACKGROUND AND PURPOSE: Erb-B1 (epidermal growth factor receptor, EGFR) and Erb-B2 (HER-2) are two of the best-characterized members in the EGFR pathway. In many tumor types, overexpression of these proteins is associated with enhanced malignant potential. The aim of this study was to determine the prognostic impact of EGFR and HER-2 protein expression on colorectal cancer. METHOD: Immunohistochemistry was carried out in paraffin-embedded specimens of 115 colorectal carcinomas for the assessment of EGFR and HER-2 expression. Immunostaining for EGFR was graded negative, weak or strong according to extension and staining intensity. The results were correlated with traditional clinicopathologic parameters and patients' outcome. RESULTS: The mean survival time was 64 (range 9-78) months in the EGFR-negative group, 166 (range 2-293) months in the group with a low EGFR expression, and 51 (range 4-71) months in the group with a high EGFR expression. The median survival time was 31 (range 2-114) months in the HER-2 negative group, and 30 (range 4-293) months in the HER-2 positive group. None of the clinicopathologic parameters or patient prognoses had statistically significant association with EGFR or HER-2 expression. CONCLUSION: Conventional immunohistochemistry was unable to reveal any association between EGFR or HER-2 expression and outcome predicted by the biologic role of EGFR in tumor behavior and the established prognostic role of HER-2 in breast cancer.

Irritable bowel syndrome: a population based study.

BACKGROUND: The prevalence of irritable bowel syndrome (IBS) is relatively high, but up to now, no population based study in Iran has used the ROME III criteria. The aim of the present study was to determine the prevalence of IBS by using the ROME III criteria in the adult population of Iran. METHODS: A face to face survey was conducted in a large area of the Tehran province. IBS was diagnosed by using a validated questionnaire based on the ROME III criteria. RESULTS: The study population comprised 18,180 participants, with a female to male ratio of 1. 15.3% of participants complained of gastrointestinal (GI) symptoms, while the prevalence of IBS was estimated to be 1.1% (139 women, 59 men, p=0.000). IBS patients were more likely to be married, and older. The most common presenting symptoms of IBS were abdominal pain that was relieved by defecation (94%), change in fecal consistency (78%), and change in bowel frequency (70%). Constipation was predominant in 52% of IBS cases, diarrhea was predominant in 18%, and 8% experienced intermittent diarrhea and constipation. CONCLUSION: The prevalence of IBS is relatively low in the Iranian adult population according to the ROME III criteria. The most probable reasons are the specificity of ROME III criteria and the characteristic low prevalence of GI symptoms in the study population.