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In the field of cancer therapy, magnetic nanoparticles modified with biocompatible copolymers are promising vehicles for the delivery of hydrophobic drugs such as Cisplatin. The major aim of this effort was to evaluate whether Cisplatin-Encapsulated magnetic nanoparticles improved the anti-tumour effect of free Cisplatin in lung cancer cells. The PLGA-PEG triblock copolymer was synthesised by ring-opening polymerisation of d,l-lactide and glycolide with polyethylene glycol (PEG6000) as an initiator. The bulk properties of these copolymers were characterised using Fourier transform infrared spectroscopy. Cisplatin-loaded nanoparticles (NPs) were prepared by double emulsion solvent evaporation technique and were characterised for size, drug entrapment efficiency (%), drug content (% w/w), and surface morphology. In vitro release profile of cisplatin-loaded NP formulations was determined. Cytotoxic assays were evaluated in lung carcinoma (A549)-treated cells by the MTT assay technique. In addition, the particles were characterised by X-ray powder diffraction, scanning electron microscopy, Fourier transform infrared spectroscopy, and vibrating sample magnetometry. The anti-proliferative effect of Cisplatin appeared much earlier when the drug was encapsulated in magnetic nanoparticles than when it was free. Cisplatin-Encapsulated magnetic nanoparticles significantly enhanced the decrease in IC50 rate. The in vitro cytotoxicity test showed that the Fe3O4-PLGA-PEG6000 magnetic nanoparticles had no cytotoxicity and were biocompatible. The chemotherapeutic effect of free Cisplatin on lung cancer cells is improved by its encapsulation in modified magnetic nanoparticles. This approach has the prospective to overcome some major limitations of conventional chemotherapy and may be a promising strategy for future applications in lung cancer therapy.

Altogether, 98 Pseudomonas aeruginosa isolates from a 5-bed intensive care unit were fingerprinted with pulsed-field gel electrophoresis and tested for aminoglycoside resistance genes aac(6')-Ib, aac(3″)-IIa, ant(2″)-Ia, armA, rmtA, and rmtB and integrons and virulence genes/operons phzI, phzII, phzM, phzS, apr, lasB, plcH, plcN, pilA, algD, toxA, exoS, exoT, exoY, and exoU. Two major clusters were identified (49 and 19 isolates), harbouring aac(6')-Ib, blaPSE-1, and ant(3″)-Ia genes or ant(2″)-Ia gene, respectively, on a class I integron. Most virulence genes except for exoU and pilA were found. Only 1 isolate of the minor cluster (8 isolates) and 1 of the 22 sporadic isolates carried integrons (without gene cassettes); virulence profile was highly variable. Comparing the resistance and virulence patterns of endemic and sporadic isolates suggests that integron-borne aminoglycoside resistance is more closely associated with the frequency than virulence. Consequently, aminoglycoside usage may have played a role in maintenance of the endemic clones., (© 2013.)

Background and Objectives: It is suggested that activation of the transverse abdominis muscle has a stabilizing effect on the lumbar spine by raising intra-abdominal pressure without added disc compression. However, its feedforward activity has remained a controversial issue. In addition, research regarding bilateral activation of trunk muscles during a unilateral arm movement is limited. The aim of this study was to evaluate bilateral anticipatory activity of trunk muscles during unilateral arm flexion., Materials and Methods: Eighteen healthy subjects (aged 25 ± 3.96 years) participated in this study and performed 10 trials of rapid arm flexion in response to a visual stimulus. The electromyographic activity of the right anterior deltoid (AD) and bilateral trunk muscles including the transverse abdominis/internal oblique (TA/IO), superficial lumbar multifidus (SLM) and lumbar erector spine (LES) was recorded. The onset latency and anticipatory activity of the recorded trunk muscles were calculated., Results: The first muscle activated in anticipation of the right arm flexion was the left TA/IO. The right TA/IO activated significantly later than all other trunk muscles (P < 0.0005). In addition, anticipatory activity of the right TA/IO was significantly lower than all other trunk muscles (P < 0.0005). There was no significant difference in either onset latency or anticipatory activity among other trunk muscles (P > 0.05)., Conclusion: Healthy subjects showed no bilateral anticipatory co-activation of TA/IO in unilateral arm elevation. Further investigations are required to delineate normal muscle activation pattern in healthy subjects prior to prescribing bilateral activation training of transverse abdominis for subjects with chronic low back pain.

This study evaluated the suitability of flaxseed oil as a source of supplemental dietary lipid for fingerlings of rainbow trout (Oncorhynchus mykiss). Triplicate groups of the 30 fingerlings held under identical culture conditions were fed twice daily by iso-nitrogenous, iso-calorific and iso-lipidic diets for 8 weeks. Experimental diets consisted of 30.2% protein, 18.6 kJ g(-1) energy and 16.5% lipid from fish oil (FO), flaxseed oil (FxO) and 1:1 blends of the oils (FFxO). Moisture, ash, protein, final body weight, specific growth rate, weight gain, feed conversion ratio, survival and hepatosomatic index were not affected by treatments but the percent of lipids was significantly highest in fish fed the flaxseed oil diet (FxOD). The condition factors of fingerlings reared on FxOD and fish and flaxseed oils diet (FFxOD) were significantly lower than those fed the fish oil diet (FOD). Protein efficiency ratio (PER) was significantly higher than those fed the FOD and FFxOD. Whole body fatty acid compositions mirrored those of diet treatments. The highest amounts of highly unsaturated fatty acids (HUFAs) were detected in fish fed 100% FO, which was significantly different from other treatments. In all treatments polyunsaturated fatty acids/saturated fatty acids (PUFAs/SFAs) and n-6/n-3 ratios were higher than 0.45 and lower than 4, respectively. Present results indicate the fingerlings can be reared on diets in which FO has been replaced with FxO, with no significant effects on fish performance.

Objective: To determine the relationship between preterm birth and domestic violence against pregnant women in Iran., Materials and Methods: This cross-sectional study was carried out on 600 women who were hospitalized for giving birth in one of hospitals affiliated to Tehran Medical Science University in Iran, between September 9, 2010 and December 30, 2010. This study was approved by the Research Ethics Committee affiliated with Tehran University, Iran. We applied Abuse Assessment Screen (AAS) Questionnaire., Results: A total of 338 participants (56.3%) declared to experience domestic violence during pregnancy. Psychological violence was the most common form of violence against these women in postpartum (51.3%), and followed by physical violence (5%). Prevalence rate of premature labor was 37.7% among all women in this study which 63.3% of this rate belongs to abuse women., Conclusion: It is noted that healthcare providers with screening violence during pregnancy and assessing the prevalence, consequences, and possible interventions may help to reduce domestic violence against pregnant women.

Background. Lymphedema secondary to breast cancer treatment is a common and serious problem for disease survivors. The objective of the current study was to identify the risk factors of secondary lymphedema after breast carcinoma treatment. Materials & Methods. The breast cancer patients who were followed up in three centers in Tehran and Mashhad in 2010 were recruited in the study. The circumference measurement was used for defining lymphedema. Results. Among 410 breast cancer patients, 123 cases (30%) developed lymphedema. Variables such as low educational level, body mass index (BMI), higher stage of disease, number of involved lymph nodes, comorbid diseases, trauma, infection, and the time after surgery showed significant correlation with the development of lymphedema. In logistic regression analysis, increase of 1 kg/m(2) in BMI (OR = 1.09; 95%  CI 1.05-1.15), each number increase in lymph node involvement (OR = 1.15; 95%  CI 1.08-1.21) and the increase of every 1 month after surgery (OR = 1.01; 95%  CI 1.01-1.02) significantly increased the risk of lymphedema. Conclusion. The results of this study demonstrated that preserving a fitted BMI, emphasis on self-care, and educating preventive activities may have important roles in decreasing the lymphedema incidence and improving the patients' quality of life.

Introduction: The importance of resolving the problem of premenstrual syndrome for patients has been emphasized due to its direct and indirect economical effects on the society. The aim of the current study was to evaluate the effects of magnesium and vitamin B6 on the severity of premenstrual syndrome in patients referring to health centers affiliated to Isfahan University of Medical Sciences, Iran, during 2009-10., Methods: This two-stage double-blind clinical trial was conducted on 126 women who were randomly allocated into 3 groups to receive magnesium, vitamin B6, or placebo. The study was performed in 10 selected health centers in Isfahan and lasted for 4 months. To confirm premenstrual syndrome, the participants were asked to complete a menstrual diary for 2 months at home. Drug interventions were continued for two cycles and the results of before and after the intervention were compared., Results: The findings of this study showed that the mean scores of premenstrual syndrome significantly decreased after the intervention in all groups (p < 0.05)., Conclusion: According to our findings, vitamin B6 and placebo had the most and least efficiency in improving the mean premenstrual syndrome score.

Introduction: There are numerous studies addressing associations of polymorphisms in DNA repair genes and cancer risks because accurate and efficient DNA repair is crucial to genomic integrity and fidelity. ERCC1 is important in DNA nucleotide excision repair., Material and Methods: We genotyped constitutive variants of ERCC1 in approximately 300 adults with breast adenocarcinoma and 126 controls of Iranian women. In total, 426 Iranian sporadic breast cancer affected women compared to the control group were studied by PCR-RFLP for ERCC1 variant., Results: The genotype ERCC1 TT has the highest frequency in both groups (36.6 in patients and 8.5 in controls). The genotype ERCC1 was the most important risk factor in our population [GG/AA odds ratio: 0.692, 95% confidence interval (CI): 0.4-1.199, p = 0.188; GG/AG odds ratio: 3.333, 95% CI: 1.917-5.795, p = 0.001; AA/AG odds ratio: 0.208, 95% CI: 0.124-0.348, p = 0.342]., Conclusions: Our patients was associated with breast cancer risk.

Background: The prevalence of irritable bowel syndrome (IBS) in the community is 10%-20% and have symptom based diagnostic criteria. Many symptoms of celiac disease (CD) with 1% prevalence in some communities can mimic IBS. Sensitive and specific serologic tests of CD can detect asymptomatic cases. The purpose of this study was to compare the level of anti-tissue-transglutaminase (tTG) IgA in IBS patients and controls group., Materials and Methods: This case-control study was performed at a University hospital in which 107 patients with IBS who met the Rome II criteria for their diagnosis were compared with 126 healthy age and sex-matched controls. Both groups were investigated for CD by analysis of their serum tTG IgA antibody with human recombinant antigen. Titers were positive containing over 10u/ml and borderline if they were between 4 and 10 u/ml., Result: 86 percent of IBS patients were female. The mean antibody level was 0.837 u/ml in IBS group and 0.933 u/ml in control group without any significant difference., Discussion and Conclusion: Results of this study may intensify disagreement on the situation of CD in IBS patients.

Background: Electroconvulsive therapy (ECT) is one of the most efficacious treatment for major depressive disorder (MDD), it is also used as a rapid and efficacious treatment for other psychiatric disorders, especially treatment resistant ones. The cognitive impairment is one of the most important side effects of ECT. This study examined the Memoral herbal efficacy in prevention of ECT-induced memory impairment., Methods: In a randomized clinical trial, 70 patients with mood disorders who were candidates for ECT enrolled in either Memoral or Control group, and received either Memoral or placebo. The memory was assessed by Addenbrook Cognitive Examination (ACE), and the findings were analyzed by ANOVA under SPSS18., Results: The Memoral group patients showed significantly higher total ACE scores than placebo group (P < 0.001). The scores of attention and orientation, verbal fluency and memory subscales not only never decreased during the study in Memoral group, but also increased. There was no significant difference between these scores of Memoral and placebo groups for the subscales of language and visuospacial ability., Conclusion: The Memoral herbal is an efficacious and safe choice in prevention of ECT- induced cognitive impairment.

Background: Esophageal replacement is major procedure with high risk for perioperative allogeneic blood transfusion (ABT), especially in pediatric patients due to nutritive deficiency, anemia, small body weight and blood volume. Autologous blood policy is particularly important in female children., Methods: We present treatment strategy with the aim of avoiding ABT, that have been applied in two female pediatric patients with caustic stricture of thoracic esophagus. The patients were 7 and 8 years old, with body weight 34 and 23.5 kg, respectively. Protocol was based on the stimulation of haematopoetic system with erythropoietin, iron therapy and preoperative autologous blood donation (PABD). In the first patient, with a history of previous retrosternal bypass esophagocoloplasty and extraction of necrotic colonic graft, delayed reconstruction--transhiatal subtotal esophagectomy and gastric pull-up with cervical anastomosis were performed. In the second patient, repeated ineffective dilatations of esophageal stricture were reason for retrosternal left colon interposiotion and exclusion of native esophagus., Results: No adverse events were attributed to preoperative blood donation period. No allogenic blood products were used during perioperative period. Both patients had uneventful postoperative course., Conclusion: In specialized institutions for esophageal surgery, PABD with administration of erythropoietin and iron therapy, enable bloodless esophageal replacement, even in children.

Unlike benign pathology, progress of laparoscopy in performing cancer surgery has been slow because of fear of safety and oncological adequacy. However, the initial fear has been replaced by optimism as the results from a numerous studies have shown equivalent if not superior results to open surgery. Laparoscopic gastrectomy is safe and oncologic adequate, but time consuming and technically demanding procedure. Laparoscopic surgery has gained wide acceptance in the treatment of early gastric cancer, especially of the distal stomach. The use of laparoscopic surgery for the treatment of advanced gastric cancer remains controversial. Another open question that need complete evaluation is cost-effectiveness analysis of minimally invasive and open approach.

Background: Since premenstrual syndrome (PMS) can cause suicide, dissociation of familial relationships, abnormalities in the daily work and inter-personal relationships in the patients, and bring about direct and indirect economic burden for the society, it is important to resolve the problems of the patients. The objective of the current study is to determine the effect of magnesium (Mg), combination of vitamin B6 and Mg, and the placebo on the severity of PMS in the patients affected by the disease referred to the health centers of Isfahan University of Medical Sciences during 2009-2010., Methods: The participants were randomly assigned to two intervention groups and one control group. The study was carried out for four months in ten selected health centers in Isfahan. To confirm the PMS diagnosis in patients, they were asked to fill out the PMS daily symptom record form for two months and then, when the diagnosis was confirmed, the participants were randomly assigned to one of the three groups of the study (Mg, Mg plus vitamin B6, and placebo). Medical intervention was carried out in two menstrual cycles and the results of pre- and post-test were compared., Results: After the intervention, the mean score of PMS significantly decreased in all the three groups (p < 0.05). The decrease was the greatest in the Mg plus vitamin B6 group, and was the least in the placebo group., Conclusions: The findings indicated that Mg plus vitamin B6 and placebo has the greatest and the least effect on the mean score of PMS, respectively.

Purpose: Transcription factors act as molecular switches to activate or repress specific genes, which in turn control cellular phenotype. Transcription factor OCT4 is critical for self-renewal and maintenance of embryonic stem cells. OCT4 expression is down-regulated in all differentiated somatic cell types in vitro and in vivo. Our aim is to investigate whether the human corneal epithelium expresses OCT4., Materials and Methods: OCT4 protein was examined in nine human cornea specimens and in human testicular seminoma positive control samples by fluorescence immunohistochemistry. OCT4 mRNA was studied in human corneal epithelial as well as human embryonic stem cells (ESC). The RT-PCR products were further analyzed by DNA sequencing., Results: All of the corneas displayed nuclear staining patterns, limited to the corneal epithelial basal layer. The OCT4 positive staining cells resided mainly in the limbal epithelial basal layer, but some were also found in the peri-limbal and central corneal epithelial basal layers. OCT4 mRNA was detected in the epithelium of all human corneas and human ESC cells. Neither OCT4 mRNA nor protein was detected from negative controls. The sequencing analysis showed that the base sequences of PCR products were 99.17% similar to the human OCT4 gene., Conclusion: The basal layer of corneal epithelium expresses OCT4.

Some new mono-and bis-polycyclic aromatic spiro-beta-lactams and bis-non spiro-polycyclic aromatic beta-lactams have been synthesized from imines derived from anthracene-9-carbaldehyde, 2-naphtaldehyde and a ketene derived from 9H-xanthene-9-carboxylic acid and phenoxyacetic acid by a [2+2] cycloaddition reaction. The cycloadducts were characterized by spectral data, including 1H-NMR, 13C-NMR, IR and elemental analyses. The configurations of some of these mono-spiro-beta-lactams were established by X-ray crystal analysis.

In the title mol-ecule, C(35)H(22)BrNO(2), the four-membered ring of the β-lactam unit is nearly planar [maximum deviation = 0.003 (3) Å] and makes dihedral angles of 87.07 (15), 59.80 (16) and 20.81 (19)°, respectively, with the xanthene system, the anthracene system and the bromo-substituted benzene ring. The mol-ecular conformation is stabilized by weak intra-molecular C-H⋯O and C-H⋯N hydrogen bonds. The crystal structure features weak C-H⋯π inter-actions.

The title compound, C(37)H(27)NO(4), crystallizes with two mol-ecules in the asymmetric unit. The β-lactam ring of each mol-ecule is very nearly planar, with maximum deviations of 0.001 (2) and 0.017 (2) Å in the two mol-ecules. The crystal structure is stabilized by inter-molecular C-H⋯O and C-H⋯N contacts, as well as by weak C-H⋯π inter-actions.

The stabilized conformation of the title compound, C(36)H(25)NO(3), 4-(9-anthryl)-1-(2-methoxyphenyl)-spiro[azetid-in-3,9'-xanthen]-2-one, may be compared with that of the isomeric compound 4-(9-anthr-yl)-1-(4-methoxy-phen-yl)spiro-[azetidin-3,9'-xanthen]-2-one. In the title isomer, the meth-oxy group is slightly twisted out of the plane of the attached benzene ring, with a C-O-C-C torsion angle of 31.5 (2)°. Its β-lactam ring is essentially planar, with a maximum deviation of -0.021 (1) Å. The β-lactam ring makes dihedral angles of 18.815 (9), 83.33 (7) and 53.62 (8)° with the mean planes of the benzene, xanthene and anthracene ring systems, respectively. The structure is stabilized by C-H⋯π, C-H⋯N and C-H⋯O inter-actions.

The β-lactam ring of the title compound, C(35)H(23)NO(2), is nearly planar with a maximum deviation of 0.003 (3) Å from the mean plane. It makes dihedral angles of 17.4 (2), 85.22 (17) and 65.39 (16)°, respectively, with the phenyl, xanthene and anthracene ring systems. In the crystal structure, there are intra-molecular C-H⋯O and C-H⋯N contacts and mol-ecules are also linked by C-H⋯π inter-actions.

Water quality of the Zayandehrud River, located in an arid region of central part of Iran, was assessed using National Sanitation Foundation Water Quality Index (NSF WQI) calculated by four aggregation methods. Water samples were collected monthly (July 2006 to June 2007) from eight stations in the middle of the river. The parameters required for the NSF WQI calculations including saturation percent of dissolved oxygen, biochemical oxygen demand, fecal coliforms, pH, nitrate, total phosphate, temperature deviation, total dissolved solids and turbidity were measured. According to WQI(m) which appeared to be more adapted to environmental conditions of the Zayandehrud River, the studied section of the river was considered as "reasonable" to "polluted" water quality. All of the calculated water quality indices showed the lowest values in August. In addition to BOD(5) and fecal coliform amounts which were generally high, nitrate and total phosphate concentrations were also considerably increased due to agriculture practices in August. Generally, BOD(5) and fecal coliforms are the main water quality subindices that reflect the effect of anthropogenic activities on the water quality of this river.

In the title compound, C(39)H(25)NO(2)·0.5C(6)H(14), the β-lactam ring is nearly planar [maximum deviation of 0.012 (2) Å from the mean plane] and makes dihedral angles of 36.41 (13), 88.87 (13) and 54.16 (12)°, respectively, with the naphthalene, xanthene and anthracene ring systems. The mol-ecular conformation is stabilized by intra-molecular C-H⋯O and C-H⋯N contacts. The complete solvent mol-ecule is generated by inversion. In the crystal structure, mol-ecules are linked to each other by C-H⋯π inter-actions.

Introduction: Gastrointestinal bleeding is the most important complication associated with acetylsalicylic acid therapy. Patients with preexisting haemostatic disorders are at the higher risk and may experience life-threatening hemorrhagic syndrome. Platelet transfusions and desmopressin administration commonly successfully arrest bleeding. However, in clinical situations with profound bleeding and haemorrhagic shock, these therapeutic approaches may fail., Case Outline: We report a 24-year old female patient with previously undetected acquired platelet dysfunction, who underwent reconstructive surgical intervention. On the 20th postoperative day, acetylsalicylic acid was introduced due to reactive thrombocytosis (platelet count 1480x10(9)/L) with daily dose of 100 mg tablets. On the 12th day of the acetylsalicylic acid treatment, massive gastrointestinal bleeding with haemorrhagic shock suddenly occurred. Attempts to control massive haemorrhage by resuscitation, blood products and haemostatics (desmopressin, tranexamic acid) failed. Two bolus doses of recombinant activated factor VII (rFVIIa) (100 microg/kg and 60 microg/kg respectively) in 90 minutes interval were given. Bleeding was successfully controlled with no requirements for further haemoproducts and haemostatic remedies treatment., Conclusion: This case demonstrates that the use of rFVIIa may be a specific treatment option in patients suffering from severe gastrointestinal bleeding associated with acetylsalicylic acid treatment.

In the title mol-ecule, C(36)H(25)NO(3), the β-lactam ring is essentially planar, with a dihedral angle of 3.3 (2)° between the two separate three-atom N/C/C planes. The β-lactam ring makes dihedral angles of 28.45 (14), 87.4 (1) and 51.8 (1)° with the mean planes of the benzene, xanthene and anthracene ring systems, respectively. In addition to a weak intra-molecular C-H⋯N hydrogen bond, the crystal structure is stabilized by two weak inter-molecular C-H⋯O hydrogen bonds.

Introduction: Low level laser therapy (LLLT) has been shown to enhance collagen production and wound healing but its effect on cartilage repair from biomechanical point of view is not known yet. The aim of present study was to evaluate the biomechanical behaviour of repairing osteochondral defect in rabbits which received a pulsed low-level gallium-arsenide (Ga-As) laser irradiation., Materials and Methods: Osteochondral defects with 5mm diameter and 4mm in depth induced by drilling in right femoral patellar grooves of 41 adolescent male rabbits. They were divided into experimental and control groups. Experimental group received pulsed Ga-As (890nm) laser irradiation with energy density of 4.8J/cm(2). The rabbits in control group received placebo LLLT with shut-down equipment. The control defects were allowed to heal spontaneously. Each group were divided into three subgroups: A, B and C. Subgroups A, B and C were sacrificed on 4, 8, and 16 weeks after surgery. The knee joint were removed, and the defects were examined biomechanically by in situ-indentation method. The thickness, instantaneous and equilibrium indentation stiffness was measured during the test. Data were analysed using ANOVA and independent sample t-test., Result: While no difference was observed in the repaired cartilage biomechanical properties among 4th, 8th, 16th weeks in study groups. The equilibrium indentation stiffness of experimental group was significantly higher in 8th week in comparison with control group., Conclusion: LLLT significantly enhances the stiffness of repairing tissue in the 8th week post injury in osteochondral defects in rabbits.

The regeneration structure and biodiversity of trees and shrub species in under story of pure and mixed Oak plantations were investigated in Chamestan Forest and Rangeland Research Station of Iran. Planted species including Oak (as main species) and Hornbeam (as associated species). This species were planted in five proportions (100Q, 70Q:30C, 60Q:40C, 50Q:50C, 40Q:60Z) in Northern of Iran in 11 years ago. All of regenerating seedlings and saplings of woody plants were divided into two height classes of 15-200 cm and more than 200 cm. In biodiversity study dominance index of Berger-Parker, diversity index of Fisher alpha, richness index of Margalef and evenness index of Equitability J were used. The results showed that abundance and diversity of regenerated species in under story of all plantations of oak were more than unplanted control plots and also under 50Q:50C were more than pure stand of oak. The presence of primary forest species in under stories of mixed plantation showed the usage of these plantations in development of succession in natural

Aim: To demonstrate the necessity of intraoperative endoscopy in the diagnosis of secondary primary tumors of the upper digestive tract in patients with obstructive hypopharyngeal carcinoma., Methods: Thirty-one patients with hypopharyngeal squamous cell carcinoma had been operated, with radical intent, at our Institution in the period between 1978 and 2004. Due to obstructive tumor mass, in 7 (22.6%) patients, preoperative endoscopic evaluation of the esophagus and stomach could not be performed. In those patients, intraoperative endoscopy, made through an incision in the cervical esophagus, was standard diagnostic method for examination of the esophagus and stomach., Results: We found synchronous foregut carcinomas in 3 patients (9.7%). In two patients, synchronous carcinomas had been detected during preoperative endoscopic evaluation, and in one (with obstructive carcinoma) using intraoperative endoscopy. In this case, preoperative barium swallow and CT scan did not reveal the existence of second primary tumor within esophagus, despite the fact that small, but T2 carcinoma, was present., Conclusion: It is reasonable to use intraoperative endoscopy as a selective screening test in patients with obstructive hypopharyngeal carcinoma.

A 10-year-old boy with systemic lupus erythematosus (SLE) developed abrupt right upper quadrant pain and vomiting during the course of his active disease. Antiphospholipid antibody was negative and the C3 level was low. Abdominal sonography showed cholecystitis with sludge balls in the gallbladder. He was treated by high-dose prednisolone with ceftriaxone and metronidazole IV for 3 days but due to poor response, cholecystectomy was performed and no stone was identified. Histopathologic examination showed vasculitis in the medium-sized arteries of the gallbladder wall. He was doing well at the 9-month follow-up after the operation. This report describes the first pediatric case of SLE with acalculous cholecystitis caused by vasculitis of the gallbladder.