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Background: Carbapenemase-resistant Enterobacteriaceae is a major threat to public health. These microorganisms are resistant to all types of beta-lactam antibiotics. Methods: This cross-sectional study was conducted on 51 Enterobacteriaceae isolates from clinical samples in Sina Hospital and Tehran Heart Center in Iran from 2016 to 2018. Antibiotic susceptibility test was performed by disk diffusion method. Carbapenem-resistant isolates were identified by the Modified Hodge Test (MHT) and Polymerase Chain Reaction (PCR) for surveying the presence of VIM, NDM, IMMP, and OXA-48 genes. Results: Out of 51 clinical samples, 38 isolates were positive for both MHT and PCR tests, and 5 isolates were negative in both tests. The results of both tests are similar in 84.3% of the isolates. Conclusion: The MHT is an appropriate and easy method for approving carbapenemase production. Also, a laboratory can detect the carbapenemase production by identification of the KPC genes. [ABSTRACT FROM AUTHOR]

Background: Due to the close association of CD31 marker positivity and tumor microvessel density, the relationship between this marker and the pathophysiological behavior of the tumor, such as the ability to invade the surrounding tissues and organ damage, is also quite probable. Objectives: We aimed at evaluating the association of CD3l expression with the likelihood of microvascular invasion and other abnormal histopathological findings in patients with colorectal cancer. Methods: In our cross-sectional study, the pathology numbers of 50 samples that were diagnosed with colorectal cancer in their pathology report during 202l and 2022 were identified by searching our hospital information system. Immunohistochemical staining (IHC) using CD31 monoclonal antibody was performed for assessing CD31 positivity. Results: CD31 positivity was found in 34.0% of cases, 35.5% in colon masses, and 31.6% in rectal masses. The patients with positive CD31 had significantly higher tumor grades (P< 0.045). The prevalence rate of vascular invasion was significantly higher in patients with positive CD31 compared to those with negative CD31 states (47.1% versus 12.1%, P = 0.006). Also, the rate of lymph node involvement in the groups with positive and negative CD31 was 58.8% and 24.2%, respectively, indicating a significant difference (P = 0.016). In multivariable logistic regression models, CD31 positivity was shown to be associated with the risk for vascular invasion (OR = 6.211, P = 0.020) and lymph node involvement (OR= 6.535, P = 0.011). Conclusions: CD31 positivity in patients with colorectal cancer can effectively predict invasive behavior of the tumor including vascular invasion, lymph node involvement, and high tumor grades. [ABSTRACT FROM AUTHOR]

Background: P21 protein is a cyclin-dependent kinase inhibitor and has a crucial function as a cell cycle regulator in malignant tissues. Thus, its association with aggressive characteristics of malignant lesions is suggested. Objectives: We evaluated the expression level of P21 in gastric cancers and its association with the histopathological findings of cancer. Methods: This cross-sectional study was performed on gastric adenocarcinomas from radical gastrectomy. The histopathological examination was assessed by Hematoxylin & Eosin. The immunohistochemistry technique was then used to assess the expression of the P21 marker. Results: P21 positivity was revealed in 28 specimens of the cancerous lesions with an overall prevalence of 70.0% in our population. There was no association between P21 positivity and tumor-related characteristics, including tumor location, type, grade and stage, as well as the size of the cancerous lesion. P21 positivity could not be related to perineural or lymphovascular invasion of the tumor (P-value > 0.05). Conclusions: In our population, the expression of P21 may not be prognostic or predict tumor biological behavior among patients with gastric adenocarcinomas. [ABSTRACT FROM AUTHOR]

Background: Superficial Venous Aneurysm (SVA) are rare venous diseases that may be asymptomatic or symptomatic. The major etiology of SVA is still unknown. The study presents 17 cases with no underlying disease or risk factors that presented SVA in uncommon and different veins of the body. Methods: 17 patients with SVA were evaluated and treated in our hospital for 11 years. Clinical presentation, treatment, and complications were evaluated. Results: 6 of the aneurysms were located in the great saphenous vein, 2 in the small saphenous vein, 6 in the external jugular vein, 1 in the dorsal foot vein, and also 2 in the forearm veins. Ten patients suffered from acute tenderness, pain, and edema of the limb and others presented with soft tissue mass. All 17 patients underwent surgical excisional therapy. No pulmonary emboli were reported in the patients. Conclusion: The etiology of SVA is unknown. It may cause occlusion in rare superficial veins in patients with no history of the hyper-coagulopathy state or any major risk factor. [ABSTRACT FROM AUTHOR]

Introduction: An exaggerated immune response is considered the most important aspect of COVID-19 pathogenesis. Hypertonic saline (HS) has shown promise in combating inflammation in several respiratory diseases. We investigated the effects of nebulized HS on clinical symptoms and inflammatory status in patients with severe novel coronavirus infection (COVID-19) pneumonia. Materials and Methods: We randomly assigned 60 adults admitted to the intensive care unit (ICU) due to severe COVID-19 pneumonia to the experimental (received nebulized 5% saline) and control (received nebulized distilled water) groups. All interventions were applied 4 times daily for 5 days. The levels of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), and other clinical factors from venous blood were evaluated before and after intervention application. Mortality rate, intubation rate, and durations of ICU and hospital stay were also compared between groups. Results: The levels of TNF-α (MD: −21.35 [−32.29, −10.40], P = 0.000) and IL-6 (−9.94 [−18.86, −1.02], P = 0.003) were lower in the experimental group compared to the control group after applying the interventions. The levels of white blood cell count, PO2, and serum sodium were also statistically significant differences between groups. However, we did not observe significant differences in terms of hospitalization durations and mortality rates. Conclusion: Nebulization of HS in patients with severe COVID-19 pneumonia appears to be effective in reducing inflammation, but does not appear to affect intubation rates, mortality, hospitalization, or length of stay in ICU. [ABSTRACT FROM AUTHOR]

Background & Objective: Antibiotic resistance, especially in the form of multidrugresistant (MDR), is a big problem, especially in intensive care units (ICUs). This study aimed to evaluate antibiotic resistance and MDR patterns among patients hospitalized in the ICUs in one of the large referral centers in Iran. Methods: The present study was conducted at Imam Khomeini Hospital in Tehran (a great referral hospital), which admits critically ill patients requiring ICU services. To determine the rate of positive cultures for resistant strains, the patient's blood specimens were sent to the laboratory of the hospital for inoculation on proper culture media within 2 hours of extraction. Antimicrobial susceptibility tests were done using the Bauer-- Kirby disk diffusion method. Results: A total of 1,755 samples were collected from the patients to assess microbial strains and antibiotic resistance. The most common microbial strains detected in the cultures extracted from peripheral blood samples were Klebsiella pneumonia (22.1%), Staphylococcus epidermidis (7.9%) and another coagulase-negative Staphylococcus (15.0%). The antibiogram test showed antibiotic resistance in 1,509 cases, leading to a resistance prevalence rate of 85.9%. The most common antimicrobial resistance observed was against cotrimoxazole (61.7%), ciprofloxacin (51.3%), imipenem (50.0%), and ampicillin (49.6%). The rate of MDR was found to be 96.3%. Conclusion: In Iran's ICUs, a significantly high level of antibiotic resistance may be seen especially the MDR pattern, which indicates the need to change the pattern of prescribing and managing these drugs in ICU centers. [ABSTRACT FROM AUTHOR]

Background & Objective: Viral infections are associated with the pathogenesis and progression of human malignancies. Several studies have suggested the role of viral infections in papillary thyroid carcinoma (PTC). However, the results are still conflicting, and the potential role of viruses in PTC tumorigenesis remains to be elucidated. In the present study, we aimed to investigate the presence of parvovirus B19, cytomegalovirus (CMV), herpes simplex virus types 1 and 2 (HSV-1/HSV-2), and human papillomavirus (HPV) types 16 and 18 in PTC. Methods: In this cross-sectional study, paraffin-embedded tissue blocks of 40 patients with PTC were used. Tissue blocks were studied for the presence of the virus genome using real-time polymerase chain reaction (PCR). Results: Of the 40 patients with PTC, there was 1 positive case of HPV (2.5%), while 6 cases were positive for parvovirus B19. HSV and CMV DNAs were not detected in any cases. Conclusion: Correlations among HSV, CMV, and PTC are unexpected in our patient population. But parvovirus B19 and, to a lesser extent, HPV DNA genomes were detected in PTC using real-time PCR. [ABSTRACT FROM AUTHOR]

Introduction: Intracranial chondroma and chondrosarcoma are very rare tumors thatmainly originate fromthe base of the skull. Advanced neuroimaging studies, including magnetic resonance spectroscopy (MRS), play a pivotal role in both tumor diagnosis and presurgical planning. Case Presentation: We present two cases of intracranial cartilaginous tumors, including a chondroma and a chondrosarcoma, both of which presented with severe headaches. Due to inconclusive conventional MRI and MRS results, they were both primarily diagnosed as intra-axial brain tumors. However, pathological reports later confirmed the diagnosis of a chondroma and a chondrosarcoma. Conclusion: Based on the present findings, the use of advanced neuroimaging techniques, such as MRS,may improve diagnostic accuracy. We believe that MRS can play a significant role in the surgical planning of similar cases. Also, reporting rare cases worldwide can contribute to the improvement of radiographic diagnosis. [ABSTRACT FROM AUTHOR]

Background & Objective: Lymphovascular tumoral invasion is a typical histopathological feature of gastric carcinomas and supports the recognition of highrisk patients for the recurrence. We aimed to study CD31 expression in diverse subtypes of gastric carcinomas and to show its association with the histopathologic findings of the carcinoma to assess the prognosis. Methods: This cross-sectional study was conducted on 40 established patients with gastric adenocarcinoma from radical gastrectomy. The patients were classified according to the pathology assessments. Tumoral tissues were assessed by immunohistochemical staining for CD31 expression. Malignant behavior was estimated by histopathological evaluations. Results: CD31 positivity was described in 23 (57.5%) of all evaluated patients. In assessment of CD31 expression and tumor features presented, no significant association between the CD31 expression and patients' age, sex, tumor site, size, grade and stage, subtypes of carcinoma, perineural invasion, and also lymphovascular invasion, was found. (P>0.05). Conclusion: Lymphovascular invasion may make valuable additional evidence and may be useful to detect gastric carcinoma patients at high risk for recurrence, who could be candidates for more supplementary therapies. However, in our study, CD31 expression did not show any association with the aggressive histopathologic features of this tumor. [ABSTRACT FROM AUTHOR]

Background: Retroperitoneal schwannoma is a rare tumor rising from Schwann cells in peripheral nerve sheaths. Retroperitoneal schwannoma is really infrequent and has nonspecific symptoms and imperfect radiologic features, and is often identified histologically after surgery. Case Report: We report the case of a 73-year-old man presented with flank mass. Imaging shows a hypoechoic macro lobulated solid cystic mass in retroperitoneum. Intraoperatively, after complete resection of retroperitoneal mass, a suspected lesion in upper pole of right kidney was observed. Histopathology evaluation after surgery shows coexistence of a large retroperitoneal schwannoma and papillary renal cell carcinoma, type 1. Conclusion: Schwannoma should be considered in the differential diagnosis of retroperitoneal spindle cell tumor. Schwannoma coexisted with renal cell carcinoma in a patient is an unusual event. Thus, it can show the importance of appropriate evaluation before any surgery. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer is one of the main causes of mortality due to malignancy. Tumor-associated neutrophil (TAN) has an immunosuppressor role and is related to prognosis. But the mechanism is unknown. The present study investigated the role of CD15 (TAN) in gastric cancer. Methods and Materials: Our study was cross-sectional and made on 40 recognized patients of gastric cancer. Immunohistochemical staining for CD15 was done on gastric cancer tissues. Tumor behaviors were estimated by histopathological assessments. Results: CD15 positivity was revealed in 17 (42.5%) of all evaluated patients. The evaluation of the connection between CD15 expression and demographic data and tumor characteristics revealed no significant relationship between CD15 expression and patients' sex, age, tumor site, and size, subtype of tumor, tumor grade and stage, perineural invasion, and lymphovascular invasion (Pvalue> 0.05). Conclusion: Gastric cancer prognosis is related to diverse immune cells in the tumor microenvironment but in our society, the CD15 expression hasn't any relationship with aggressive histopathologic features of this tumor. [ABSTRACT FROM AUTHOR]

The exact etiology of parathyroid carcinomas (PC) is still unknown. Their associations have with several inherited syndromes or specific genetic lesions have been established. The management of PC is challenging for clinicians. The complexity of molecular phenotypes increases with tumor aggressiveness. Lack of parafibromin on immunohistochemistry staining and HRPT2 mutation would be helpful in differentiation of carcinoma from adenoma. Lack of parafibromin expression, the gene product of HRPT2 is now used as a diagnostic, prognostic, and predictive marker for parathyroid carcinoma. The epigenetic alteration, for example, DNA methylation and modifications in the chromatin structure, are known as significant events involved in the parathyroid tumorigenesis. We suggest that adjuvant genetic and epigenetic target therapy should be considered in treatment of the patients with PC. [ABSTRACT FROM AUTHOR]

It is important to increase the awareness and knowledge of head and neck surgeons about the recent surge of craniofacial mucormycosis in COVID‐19 patients because early diagnosis and appropriate treatment are essential to improve the outcomes. Here, we describe clinical features, treatment protocols, and outcomes of treatment in eight patients with COVID‐19‐associated mucormycosis in the maxilla. Consistent with the findings of previous studies, our experience in the management of these eight patients shows that early administration of amphotericin B and prompt aggressive surgery are essential for optimal control of the disease. [ABSTRACT FROM AUTHOR]

Background: COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has turn into a pandemic and has extended all over the world. Since the virus has the potential ability to severely impair heart and liver, analyzing the biochemical parameters is a suitable approach for clinicians to assess the outcome. Methods: This study was conducted along with 614 recognized COVID-19 patients. All samples were from Emergency department of Sina Hospital in Tehran, Iran, from February to May, 2020. Results: A total of 614 COVID-19 patients with mean age of 57.8 years (16-94 years) consisting of 385 (62.7%) male and 229 (37.2%) female were studied. Patients with COVID-19 had no significant difference between cardiac and liver parameters on the presentation and discharge time (p-value=0.05). Patients with COVID-19 had significant correlation in Lactate dehydrogenase (LDH), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), and Total Bilirubin with recovery and mortality outcome (p-value=0.05). Also, high sensitivity cardiac Troponin-I, LDH, AST, and ALT in patients with COVID-19 were significantly associated with high in-hospital mortality (p-value<0.05). Conclusion: Several laboratory parameters may ease the evaluation of COVID-19 in-hospital mortality. Cardiac and liver parameters are critical in assisting COVID-19 cases. [ABSTRACT FROM AUTHOR]

Chondrosarcoma of the cranium is a rare malignancy. The result of treatment is challenging to assess because the slow-growing rate means that there is a long interval previously discovering the recurrence and last long time to diagnosis of recurrence. This report describes a 38-year-old man who presented with a generalized seizure 2 months before his referral. The patient underwent excisional surgery. The histological examinations revealed a cartilage developing tumor compatible with chondrosarcoma. The radiologic and histologic correlation established the diagnosis. But, the patient had two episodes of recurrence after surgery. We determined that intracranial chondrosarcoma must be comprised in the differential diagnosis of a mass with calcification on cranial imaging. Accurate diagnosis is obligatory for supplementary patient managing, and a recurrence is more common in patients only treated by surgery. [ABSTRACT FROM AUTHOR]

Primary leiomyosarcoma in testis is an uncommon tumor with few cases reported. It generally develops after radiotherapy or long-term taking anabolic steroid medication. We report a 53-year-old male patient with primary testis leiomyosarcoma who presented with painless testicular enlargement without any known predisposing factors. Ultrasound revealed a large heterogeneous left testicular solid lesion. Alpha-fetoprotein (AFP) and beta-human chorionic gonadotrophin (beta-HCG) levels in serum were normal. Left radical orchidectomy following with histology assessment established a diagnosis of primary leiomyosarcoma of testis. No data of cancer metastasis was established. The patient didn't receive any adjuvant therapy. There wasn't any evidence of recurrence after 1 year follow-up. Leiomyosarcoma must be one of the differential diagnoses of seronegative tumors in testis. The motivation for this paper is the extreme infrequency of the situation and the differential diagnosis by all expansive inguinoscrotal tumors. [ABSTRACT FROM AUTHOR]

Background & Objective: Some certain markers, including prostatic specific antigen (PSA), are being used to screen prostate cancer (PC), but none of them have sufficient sensitivity and specificity for evaluation of prognosis. Currently, genetic variants have found their place in the prognosis of PC. ETS-related gene (ERG) expression and its intensity have contradictory evidence regarding ERG expression with PC incidence or associating outcome. Our purpose was to survey the relationship of ERG expression and its intensity with PC and relative clinical outcome. Methods: We studied the immunohistochemichal (IHC) expression of ERG in 101 radical prostatectomy specimens with PC of different histologic grades. All samples were chosen from pathology department of Sina hospital in Tehran-Iran from 2011 to 2018. Positive ERG expression and its association with Gleason score, preoperative PSA, metastasis status, stage and grade of tumors was evaluated. Results: In total, ERG expression was observed in 42 cases (41.58%) and of these, 7 (16.66%) were categorized as weak, 13 (30.95%) moderate and 22(52.38%) as strong. There was no significant correlation between ERG expression and age, preoperative PSA, Gleason score, lymph node involvement, metastatic pattern, stage, and grade of the tumor (P>0.05). ERG expression frequency in the two groups of survived and expired patients was 42.85% and 0%, respectively; despite the noticeable difference, it was not statistically significance (P=0.264). Conclusion: Evaluation of ERG expression and its intensity may have no essential role as an acceptable prognostic factor in Iranian's population for anticipating whether PC itself or the outcomes accompanied. This relation is vigorously under the influence of geographical/ethnical features. [ABSTRACT FROM AUTHOR]

Strongyloides stercoralis is a common cause of gastrointestinal infection. Symptoms are usually mild, but in the setting of impaired host immunity, severe and disseminated illnesses may occur. The present report describes a male patient with a history of asthma and corticosteroid therapy, now presented with dyspnea and abdominal pain. Examinations show Strongyloides stercoralis larvae in Bronchoalveolar lavage fluid specimens. The patients who have undergone immunosuppressive therapy are highly indicated for Strongyloides stercoralis screening which prevents hyperinflation in endemic areas [ABSTRACT FROM AUTHOR]

Background & Objective: Urothelial neoplasm (UN) of bladder is a potentially lethal malignancy, particularly in locally advanced or metastatic cases. Development of molecular markers such as HER2 and Survivin may provide useful information on diagnosis and prognosis in UN of bladder. Methods: We studied the immunohistochemical (IHC) expression of HER2 and Survivin in 84 radical/partial cystectomy and transurethral resection (TUR) specimens with different histologic grades and stages. All samples were obtained from Pathology Department of Sina Hospital in Tehran, Iran from 2014 to 2018. Results: From the total number of 84 UN samples, 10 cases (11.9%) showed papillary neoplasm of low malignant potential, 30 cases (35.7%) presented with lowgrade papillary urothelial neoplasm, and 44 cases (52.4%) diagnosed as high-grade papillary urothelial neoplasm. HER2 and Survivin expressions were seen in 44 (52.4%) (P=0.610) and 9 (10.7%) patients (P=0.046), respectively. Survivin expression showed a mild increase in high grade UN. Conclusion: Our findings suggest that the IHC expression of Survivin and HER2 are not well associated with histological grades of urothelial neoplasms of bladder. This may be partly due to relatively small sample size and other factors such as patient characteristics or antibody specifications. [ABSTRACT FROM AUTHOR]

Introduction: Chondroma is a benign cartilaginous tumor. It is found very rarely in the head and neck. Case presentation: This report describes a 25-year-old woman who presented with generalized headache from 4 months ago. The patient underwent excisional surgery. The histological examinations revealed benign cartilage forming tumor, compatible with chondroma. The radiologic and histologic correlation confirmed the diagnosis. Based on the diagnosis, the patient received no more treatment. Conclusion: We concluded that intracranial chondroma should be included in the differential diagnosis of a calcified mass on skull imaging. Proper diagnosis is necessary Main Subjects: for further patient management. [ABSTRACT FROM AUTHOR]

Background: Certain enzymatic biomarkers such as matrix metalloproteinase (MMPs) are instrumental in the breast cancer. Hence, they are viewed as predictive biomarkers in the primary prognosis of this type of cancer. Furthermore, they enjoy a predictive value in the evaluation of the disease, recurrence of tumor, invasion of tumor cells to other areas as well as therapeutic outcomes. The present study aimed to determine the association between the expression of the three tissue inhibitors of metalloproteinases-1 (TIMP1), MMP2, and MMP9 genes and axillary lymph nodes involvement in patients with breast cancer. Methods: Patients in this study were categorized into two groups, first with axillary lymph nodes involvement (as the case group) and second group without the involvement of axillary lymph nodes (as the control group) referred to Cancer Institute at Imam Khomeini Hospital in Tehran in 2016. The gene expression was assessed using the reverse transcription polymerase-chain reaction technique. Results: There was no significant difference in the mRNA level of MMP2 and MMP9 genes between the cancer tissues with and without axillary lymph node metastasis in comparison with normal samples. However, the mRNA level of TIMP1 gene was considerably higher in the cancer tissue with axillary lymph node metastasis as compared to the samples without metastasis. In other words, the presence of axillary lymph node metastasis induced a 77.8-fold increase in mRNA expression when compared to condition without metastasis. Conclusions: The expression of TIMP1 gene is strongly associated with axillary lymph node metastasis in breast cancer patients. [ABSTRACT FROM AUTHOR]

Transformation of a normal cell to cancerous one is dependent on the accumulation of several genetic and epigenetic alterations. One of the candidate driver genetic alterations can happen in succinate dehydrogenases (SDHx) coding gene include SDHA, SDHB, SDHC, SDHD, and SDHAF2. The most important SDH mutation is in the SDHD gene, which encodes the smallest subunit of mitochondrial complex II (SDH). It has key function both in familial and non-familial hereditary paraganglioma/phaeochromocytoma syndrome (HPGL/PCC). SDHx genes mutations can have resulted in genetic and epigenetic changes like histone hypermethylation. These properties can lead to succinate-mediated inhibition of a-ketoglutarate-dependent dioxygenases. So hypoxic conditions can generate subsequent neoplastic transformation, and in this review, we are presenting the role of SDHx in several malignancies. [ABSTRACT FROM AUTHOR]

In contrast to epidermoid cysts of the dermis, epidermoid cysts of the kidneys are exceptional. This report explains an uncommon patient with renal epidermoid cyst who presented with flank pain and previous history of renal stones. Our patient underwent excisional resection. The histopathological evaluation discovered cyst wall covering by squamous epithelium and containing keratinous materials compatible with the epidermoid cyst. Based on pathology findings, the patient didn't receive any more treatment. Because pathology evaluation is necessary for the diagnosis or rules out the possibility of malignancy, biopsy before surgery is advised. [ABSTRACT FROM AUTHOR]