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Abstract Colorectal cancer (CRC) is currently ranked as the third most common type of cancer, contributing significantly to mortality and morbidity worldwide. Epigenetic and genetic changes occurred during CRC progression resulted in the cell proliferation, cancer progression, angiogenesis, and invasion. Angiogenesis is one of the crucial steps during cancer progression required for the delivery of essential nutrients to cancer cells and removes metabolic waste. During angiogenesis, different molecules are secreted from tumoral cells to trigger vascular formation including epidermal growth factor and the vascular endothelial growth factor (VEGF). The production and regulation of the secretion of these molecules are modulated by different subcellular pathways such as NF-κB. NF-κB is involved in regulation of different homeostatic pathways including apoptosis, cell proliferation, inflammation, differentiation, tumor migration, and angiogenesis. Investigation of different aspects of this pathway and its role in angiogenesis could provide a comprehensive overview about the underlying mechanisms and could be used for development of further therapeutic targets. In this review of literature, we comprehensively reviewed the current understanding and potential of NF-κB-related angiogenesis in CRC. Moreover, we explored the treatments that are based on the NF-κB pathway.

Background: The objective is to assess lung compliance and identify the optimal positive end-expiratory pressure (PEEP) levels in patients with tuberculosis-associated Acute Respiratory Distress Syndrome (TB-ARDS) compared to non-TB-ARDS patients. Methods: This observational case–control study utilized electrical impedance tomography to evaluate lung mechanics in 20 TB-ARDS and 20 non-TB-ARDS patients. Participants underwent PEEP titration from 23 to 5 cm H2O in 2 cm H2O decrements. Lung compliance and the rates of hyperdistention and collapse were assessed at each PEEP level. Results: Delta impedance values showed higher amounts in a PEEP range of 11–17 cm H2O and in patients with TB-ARDS (P > 0.05). In addition, both hyperdistention and collapse rates were nonsignificantly higher in TB-ARDS patients (P > 0.05), and the compromised levels of hyperdistention and collapse rates were at 15–17 cm H2O, indicating the most favorable PEEP level. Conclusions: The observed patterns of hyperdistention and collapse rates across various PEEP levels provide valuable insights into the susceptibility of TB-ARDS patients to barotrauma. Notably, the identified optimal PEEP range between 15 and 17 cm H2O may guide ventilator management strategies in mitigating both hyperdistention and collapse; nonetheless, due to the high variability of lung compliances within groups, we strongly recommend individualized consideration for tailored respiratory support and evaluation.

Abstract Background Various surrogate markers of insulin resistance have been developed, capable of predicting coronary artery disease (CAD) without the need to detect serum insulin. For accurate prediction, they depend only on glucose and lipid profiles, as well as anthropometric features. However, there is still no agreement on the most suitable one for predicting CAD. Methods We followed a cohort of 2,000 individuals, ranging in age from 20 to 74, for a duration of 9.9 years. We utilized multivariate Cox proportional hazard models to investigate the association between TyG-index, TyG-BMI, TyG-WC, TG/HDL, plus METS-IR and the occurrence of CAD. The receiver operating curve (ROC) was employed to compare the predictive efficacy of these indices and their corresponding cutoff values for predicting CAD. We also used three distinct embedded feature selection methods: LASSO, Random Forest feature selection, and the Boruta algorithm, to evaluate and compare surrogate markers of insulin resistance in predicting CAD. In addition, we utilized the ceteris paribus profile on the Random Forest model to illustrate how the model’s predictive performance is affected by variations in individual surrogate markers, while keeping all other factors consistent in a diagram. Results The TyG-index was the only surrogate marker of insulin resistance that demonstrated an association with CAD in fully adjusted model (HR: 2.54, CI: 1.34–4.81). The association was more prominent in females. Moreover, it demonstrated the highest area under the ROC curve (0.67 [0.63–0.7]) in comparison to other surrogate indices for insulin resistance. All feature selection approaches concur that the TyG-index is the most reliable surrogate insulin resistance marker for predicting CAD. Based on the Ceteris paribus profile of Random Forest the predictive ability of the TyG-index increased steadily after 9 with a positive slope, without any decline or leveling off. Conclusion Due to the simplicity of assessing the TyG-index with routine biochemical assays and given that the TyG-index was the most effective surrogate insulin resistance index for predicting CAD based on our results, it seems suitable for inclusion in future CAD prevention strategies.

Abstract Background Sexual dysfunction may lead to sexual distress in women with infertility, while polycystic ovarian syndrome (PCOS) may escalate this distress. This study aimed to investigate the role of PCOS in the relationship between sexual dysfunction and sexual distress in Iranian women with infertility. Methods The Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and Depression and Anxiety modules of the DASS-21 were cross-sectionally investigated in 190 women with infertility (103 women with PCOS and 87 women without PCOS). Results There were negative correlations between sexual function domains and sexual distress (P

Background: The COVID-19 pandemic has affected millions globally, and still continues to do so. Regarding the cardiovascular influences of COVID-19, this study aimed to investigate the relationship between cardiac indices, particularly cardiac output (CO), and severity of disease. Methods: This retrospective cohort study was conducted on intubated COVID-19 patients admitted to the intensive care unit (ICU). The study involved analyzing data from mechanically ventilated patients, excluding those with preexisting cardiovascular or pulmonary comorbidities. Hemodynamic parameters were evaluated by ultrasonic cardiac output monitoring (USCOM), and the severity of disease was evaluated by acute physiology and chronic health evaluation (APACHE II) and sequential organ failure assessment (SOFA) scoring systems. Results: The study included 41 patients, predominantly male with an average age of 63.1 years. Hemodynamic parameters and scores were reported for 6 days. This showed significant changes in CO, SOFA, and APACHE II over time (with P = 0.02, 0.04, 0.03, respectively). A negative correlation was found between CO and both SOFA and APACHE II scores (P < 0.05), indicating that as CO increased, the severity scores decreased. Conclusion: This study emphasizes the importance of continuous hemodynamic monitoring in ICU settings for COVID-19 patients. The correlation between CO and severity scores suggests that USCOM, along with APACHE II and SOFA, can be crucial in assessing the dynamic clinical state of patients, contributing to better management and potentially improving outcomes.

Background: Diffusion-weighted imaging with background body signal suppression (DWIBS) is a new imaging tool for the diagnosis of breast lesions. This study aims to compare DWIBS with contrast-enhanced magnetic resonance imaging (CE-MRI) sequences. Materials and Methods: Eighty consecutive patients underwent both CE-MRI and DWIBS images. DWIBS was assessed qualitatively and quantitatively using the apparent diffusion coefficient mapping. A threshold of 1.44 × 10-3 mm2/s was considered as a cutoff value between malignant and benign lesions. CE-MRI images were evaluated based on a combination of kinetic and morphological information and reported using Breast Imaging Reporting and Data System lexicon. Statistical analysis was performed for both sequences based on pathologic findings as a gold standard. Results: Fifty-five out of 80 lesions (69%) were benign, and 25 malignant lesions (31%) have been reported. The sensitivity, specificity, positive predictive value, and negative predictive value for CE-MRI were 100, 38, 42, and 100%, respectively, and those for DWIBS were 77, 70, 53, and 87%, respectively. By comparing DWIBS and CE-MRI data, no statistically significant difference was reported. Conclusion: DWIBS can be used as an effective alternative for breast CE-MRI in cases of contradictions of IV contrast injection.

Myocardial infarction (MI) stands at top global causes of death in developed countries, owing mostly to atherosclerotic plaque growth and endothelial injury-induced reduction in coronary blood flow. While early reperfusion techniques have improved outcomes, long-term treatment continues to be difficult. The function of lncRNAs extends to regulating gene expression in various conditions, both physiological and pathological, such as cardiovascular diseases. The objective of this research is to extensively evaluate the significance of the lncRNA called Metastasis associated lung adenocarcinoma transcript 1 (MALAT1) in the development and management of MI. According to research, MALAT1 is implicated in processes such as autophagy, apoptosis, cell proliferation, and inflammation in the cardiovascular system. This investigation examines recent research examining the effects of MALAT1 on heart function and its potential as a mean of diagnosis and treatment for post- MI complications and ischemic reperfusion injury.

Abstract Background It has been reported that long non‐coding RNAs (lncRNAs) can play important roles in a variety of biological processes and cancer regulatory networks, including breast cancer. Aims This study aimed to identify a novel upregulated lncRNA in breast cancer and its associated gene using bioinformatics analysis, and then evaluate their potential roles in breast cancer. Methods and Results Extensive in silico studies were performed using various bioinformatics databases and tools to identify a potential upregulated breast cancer‐associated lncRNA and its co‐expressed gene, and to predict their potential roles, functions, and interactions. The expression level of MRPS30‐DT lncRNA and MRPS30 was assessed in both BC tissues and cell lines using qRT‐PCR technology. MRPS30‐DT lncRNA and MRPS30 were selected as target genes using bioinformatics analysis. We found that MRPS30‐DT and MRPS30 were significantly overexpressed in BC tissues compared with normal tissues. Also, MRPS30 showed upregulation in all three BC cell lines compared with HDF. On the other hand, MRPS30‐DT significantly increased in MDA‐MB‐231 compared with HDF. While the expression of MRPS30‐DT was significantly dropped in the resistance cell line MCF/MX compared to HDF and MCF7. Moreover, bioinformatics analysis suggested that MRPS30‐DT and MRPS30 may play a potential role in BC through their involvement in some cancer signaling pathways and processes, as well as through their interaction with TFs, genes, miRNAs, and proteins related to carcinogenesis. Conclusions Overall, our findings showed the dysregulation of MRPS30‐DT lncRNA and MRPS30 may provide clues for exploring new therapeutic targets or molecular biomarkers in BC.

Objective: This study aimed to evaluate the outcome and risk factors in operative and non-operativemanagement of splenic injury.Methods: This cross-sectional study was conducted on patients with traumatic splenic injuries who werehospitalized in Kashani Hospital (Isfahan, Iran) from 2017 to 2019. The studied variables were extracted fromthe medical records of the enrolled participants. The outcomes such as mortality complications and risk factorswere compared based on treatment methods.Results: A total of 240 patients were investigated. The mean age of the patients was 29.8±12.2, with 180(77.5%) patients being men. 154 (64.2%) patients underwent operative treatment. The mortality rate was 18.9%and 4.6% among operative and non-operative groups (p

Abstract Background MicroRNAs (miRNAs) are small molecules that have prominent roles in tumor development and metastasis and can be used for diagnostic and therapeutic purposes. This study evaluated the expression of miR‐92a‐3p and miR‐1245b‐5p and their potential target gene, GATA3 in patients with breast cancer (BC). Materials and Methods In the search for BC‐related microRNAs, miR‐124b‐5p and miR‐92a‐3p were selected using Medline through PubMed, miR2disease, miRcancer and miRTarBase. Moreover, target gene GATA3 and their possible interaction in the regulating epithelial‐mesenchymal transition (EMT) and invasion was evaluated using in silico tools including miRTarBase, TargetScan, STRING‐db, and Cytoscape. The expression level of miR‐92a‐3p, miR1245b‐5p, and GATA3 were assessed on extracted RNAs of tumor and nontumor tissues from 36 patients with BC using qPCR. Additionally, clinical‐pathologic characteristics, such as tumor grade, tumor stage, lymph node were taken into consideration and the diagnostic power of these miRNAs and GATA3 was evaluated using the ROC curve analysis. Results In silico evaluation of miR‐92a‐3p and miR‐1245b‐5p supports their potential association with EMT and invasion signaling pathways in BC pathogenesis. Comparing tumor tissues to nontumor tissues, we found a significant downregulation of miR‐1245b‐5p and miR‐92a‐3p and upregulation of GATA3. Patients with BC who had decreased miR‐92a‐3p expression also had higher rates of advanced stage/grade and ER expression, whereas decreased miR‐1245b‐5p expression was only linked to ER expression and was not associated with lymph node metastasis. The AUC of miR‐1245b‐5p, miR‐92a‐3p, and GATA3 using ROC curve was determined 0.6449 (p = .0239), 0.5980 (p = .1526), and 0.7415 (p

Background: Work-related accidents are those events that occur while on duty in the workplace. Due to the lack of accurate information about the epidemiological status of occupational injuries in Isfahan, the present study was conducted to investigate the epidemiology of workplace accidents. Methods: This was a retrospective cross-sectional study assessing the medical records of all patients injured in the workplace in 2018. The list of all work accident patients was collected from the Hospital archives that accounted for 836 cases. The information about age, sex, the season in which the accident has occurred; type of insurance, nationality, marital status, occupation, and the type of injury were extracted. Afterward, they were statistically analyzed using qualitative variables as well as Chi-square or independent t-test. A P-value of less than 0.05 was considered significant. Results: Based on the findings, the 836 assessed cases had the mean age of 34.43±12.73 years old and were predominantly males (n=812, 97.2%). They were mostly bachelor (n=462, 55.26%) and aged less than 40 years old (57.4%). Soft tissue injuries (53.94%), amputation (13.63%), upper (13.27%) and lower (7.77%) extremities fractures ranked the highest types of injuries. 342 (40.9%) of the cases did not have any insurance, while Social security insurance (48.3%) was the most common one among the supported workers with insurances. Conclusion: According to the present study, the highest number of hospitalizations due to workplace injuries were related to less than 40 years old young adults who were mostly bachelor, experienced soft tissue injuries. Most of the patients were under Social security insurance coverage, while the significant rate of 40% without any insurance surprised us. The results are consistent with the previous studies. Further investigations with more precise assessments are strongly recommended.

Polyphenols are abundant in regular diets and possess antioxidant, anti-inflammatory, anti-cancer, neuroprotective, and cardioprotective effects. Regarding the inadequacy of the current treatments in preventing cardiac remodeling following cardiovascular diseases, attention has been focused on improving cardiac function with potential alternatives such as polyphenols. The following online databases were searched for relevant orginial published from 2000 to 2023: EMBASE, MEDLINE, and Web of Science databases. The search strategy aimed to assess the effects of polyphenols on heart failure and keywords were “heart failure” and “polyphenols” and “cardiac hypertrophy” and “molecular mechanisms”. Our results indicated polyphenols are repeatedly indicated to regulate various heart failure-related vital molecules and signaling pathways, such as inactivating fibrotic and hypertrophic factors, preventing mitochondrial dysfunction and free radical production, the underlying causes of apoptosis, and also improving lipid profile and cellular metabolism. In the current study, we aimed to review the most recent literature and investigations on the underlying mechanism of actions of different polyphenols subclasses in cardiac hypertrophy and heart failure to provide deep insight into novel mechanistic treatments and direct future studies in this context. Moreover, due to polyphenols' low bioavailability from conventional oral and intravenous administration routes, in this study, we have also investigated the currently accessible nano-drug delivery methods to optimize the treatment outcomes by providing sufficient drug delivery, targeted therapy, and less off-target effects, as desired by precision medicine standards.

Background and Objectives: Traffic accidents are the most important cause of trauma and mortality in communities. Due to the limited information in this field about Isfahan, a metropolitan in the center of Iran, this study investigates and identifies the epidemiological characteristics of fatal traffic accidents in this city. Methods: This is a case–control study conducted on hospitalized patients due to traffic accidents in 2016-2017. Lethal accidents (n = 189) were considered cases, and a group of survivors (n=189) was the control. The demographic and clinical characteristics of the population were gathered, and compared between the cases and controls. Logistic regression assessment was applied to determine the factors associated with death. Results: Logistic regression assessments revealed that facial and head trauma, chest trauma, abdominal trauma, pelvic trauma, lower extremity trauma, surgical procedure requirement within 12 hours after the accident and intubation were the prognostic factors associated with fatality. Conclusions: According to the findings of this study, mortality due to accidents was independently associated with facial and head, chest, abdominal, pelvic and lower extremity traumas, intubation requirement, and surgery within the first 12 h after the accident. Besides, aging was inversely associated with the chance of survival following a road accident.

Background: The roles of Epstein–Barr virus (EBV) in breast cancer and breast lymphoma by transfecting EBV DNA have been indicated in different studies, but few investigations have been conducted on its roles in recurrence of breast cancer. Here, we aimed to evaluate the roles of EBV in recurrent breast cancer tissue. Materials and Methods: This is a cross-sectional retrospective study that was performed in 2020–2021 in Isfahan on patients with breast cancer. The study population consisted of 30 tissue samples from recurrent breast cancer and 30 samples from nonrecurrent breast cancer. We collected demographic data of patients including age using a checklist. Other collected data were type of cancer, stages of cancer, tumor size in greatest dimension, lymph node involvements, and presence of metastasis. Furthermore, we evaluated all of the pathology samples from both groups for the presence of DNA of EBV and compared the data of both groups. Results: The DNA of EBV was positive in 8 patients of the relapsed group (26.6%) and 7 patients in the nonrelapsed patients (23.3%). There was no significant difference between two groups regarding positive DNA of EBV (P = 0.39). There were no significant differences between two groups of positive DNA of EBV with and without recurrent breast cancer regarding type of cancer (P = 0.63), stage of cancer (P = 0.19), tumor size in greatest dimension (P = 0.31), mean lymph node involvement (P = 0.27), number of lymph node involvement (P = 0.43), and metastasis (P = 0.69). Conclusion: EBV might have no significant role in recurrence of breast cancer.

Lipoma is an uncommon mesenchymal tumor of the colon. They are typically symptom free, the large lipomas within the colon are rare, and can cause obstruction, bleeding, or intussusception. Intussusception is comparatively common in pediatrics and in adults, it could be a rare entity. Pathologic lesions are usually found with a major percentage of malignancy. This is a retrospective evaluation of an adult with an intestinal intussusception who underwent oncosurgical treatment. He was diagnosed with surgically proven intussusception. Using ultrasound and colonoscopy as diagnostic studies, colocolic intussusception was discovered. The patient underwent oncosurgical exploration. Intestinal resection with abrupt anastomosis was the procedure of choice for the patient. The etiology was benign lipoma. Adult intussusception should be evaluated in any patient with subacute abdominal discomfort with bearing in mind the high rate of malignancy and a lower rate of benign tumors. intestinal resection without reducing is highly recommended for colonic intussusceptions.

Background: Appendicitis is the most common cause of acute abdomen often hard to be diagnosed that leads to high incidence of negative laparotomy. Therefore, clinical methods for the diagnosis of appendicitis with high sensitivity are necessary. This study aimed to evaluate the diagnostic value of Lanwei acupuncture point for acute appendicitis. Methods: 150 patients admitted to Alzahra and Kashani hospitals, Isfahan, Iran, with suspected appendicitis were entered the study. The patients were examined using the tests Mcburney and Lanwei and then, went to the operating room and the appendix was assessed by pathologist. Finally, the results of pathology were compared with the results of Mcburney and Lanwei tests using t, chi-square test and ANOVA tests. Findings: For Lanwei test, the sensitivity, specificity, false positive and false negative values were 22.6%, 23.5%, 77.4% and 76.5%, respectively, with the accuracy of 22.7%. But Mcburney test, the sensitivity, specificity, false positive and false negative values were 95.5%, zero, 100% and 4.5%, respectively, with the accuracy of 84.7%. Conclusion: The Lanwei test did not have high agreement with the results of pathology other clinical criteria of diagnosiing such as Mcburney test.

Background: Esophageal resection is the standard treatment for resectable esophageal cancer and some of the benign esophageal lesions. The most important cause of mortality and morbidity after Esophageal resection is the development of pulmonary complications. This study was performed to determine respiratory complications after the ER and associated risk factors. Methods: In this descriptive–analytic prospective study all patients who underwent transhiatal esophagectomy for esophageal cancer in AL-Zahra hospital in Isfahan from 2006 to 2007 to were entered to the study. All data were gathered through multiple variables questionnaire. During 12 months of follow–up after orringer procedure, respiratory complications including: pneumonia, pulmonary atalectasia, empyema or plural effusion, pulmonary emboli and chylothorax were determined. The frequency of risk factors in these patients was compared with those patients without any respiratory complications (P < 0.05). Findings: Pulmonary complications occurred in 18 (26.5%) of 61 patients. Serum albumin level less than 3.5 gr/dl, weight loss more than 20%, leak of the anastomosis, FEV1 < 2 lit and the time of mediastinal manipulation, were higher in the patients with pulmonary complications (P < 0.05). Conclusion: It seems the cardiopulmonary rehabilitation, improvement in nutritional status (weight loss, serum albumin) and reducing the time of mediastinal manipulation are the main strategies which reduce the pulmonary complications after ER. Key words: Esophageal cancer, Transhiatal esophagectomy (THE), Respiratory complication.

Background: Head-and-neck squamous cell carcinoma (HNSCC) is the sixth most prevalent type of cancers in the world. Due to its relatively high rate of recurrence, the prognosis of patients is poor and the survival rate is low; therefore, identifying the prognostic factors is considered necessary for better treatment. Materials and Methods: This historical cohort study was conducted on 201 patients diagnosed with aerodigestive SCC who underwent surgery and lymph node dissection. We determined the prognostic value of lymph node ratio (LNR) on overall survival (OS), disease-free survival (DFS), and locoregional failure-free survival (LFFS). We noticed an association between LNR and survival by Kaplan–Meier analysis. Hazard ratio (HR) of LNR was determined by Cox's regression model. Results: Two hundred and one patients entered this study after their medical histories were evaluated. The mean of lymph node count and LNR was 14.30 (±9.50) and 0.12 (±0.23), respectively. Eighty patients (39.80%) experienced recurrence of SCC. Five-year OS, DFS, and LFFS were 32%, 21%, and 64%, respectively. The median of OS was 40.70 months and 30.11 months in patients with LNR of ≤0.06 and >0.06, respectively (P < 0.01). The LNR >0.06 was found to be a significant prognostic factor for lower OS of patients with HNSCC (HR = 2.11 [1.10, 4.40]; P = 0.04). DFS was not significantly different among patients with LNR ≤0.06 and patients with LNR >0.06 (P = 0.9). However, LFFS was slightly different among two groups (HR = 2.04 [0.90–4.80]; P < 0.1). Conclusion: We recommend more intensive adjuvant therapies such as chemotherapy with radiotherapy and short interval follow-up for patients with LNR >0.06. Further investigations with larger sample sizes are recommended.

Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.Keywords: Aneurysm, Aortic dissection, Aortic aneurysm abdominal surgery.

Introduction: A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand’s hernia. Here we present a case with Amyand’s hernia.Case Presentation: A 63-year-old Caucasian man with a perforated vermiform appendix in the hernia sac (acute suppurative appendicitis), presented an incarcerated right groin hernia and underwent simultaneous appendectomy and hernia repair.Conclusions: A surgeon repairing hernia may encounter unexpected intraoperative findings, like Amyand’s hernia. It is important to be always prepared for such conditions and apply the appropriate treatment.

Background: Short bowel syndrome is arbitrarily defined as the presence of less than 200 cm of residual small bowel in adults. Most of the patients are dependent to total parenteral nutrition (TPN), rather than high cost, it has many complications such as sepsis. The surgical procedures are associated with intestinal obstruction and their efficacy needs to be defined. This study was performed to implant small intestinal mucosa in colonic submucosal bed in order to find a new treatment for the patients suffering from short bowel syndrome and dependent to TPN. Methods: This study was experimental and performed in Torabinejad Research Center in Isfahan University of Medical Sciences in 2008. Eight Persian male cats was studied and during laparotomy a 1 × 1 cm mucosal patch of terminal ileum was implanted in submucosa of the colon. After 14 days, second laparotomy was done and the colon was examined hystologically. Findings: In 7 cats, colonic mucosal structure was seen in the site of the patch (87.5%) and in 1 cat, ileal mucosal structure was seen (12.5%). Conclusion: According to the results, implantation of small intestinal mucosa in colonic submucosal bed was unsuccessful but possibly it may be a new alternative treatment for short bowel syndrome.

Introduction: Fusarium species are hyaline saprophytic fungi that are frequently found in the soil, air, and water. They can cause severe systemic infections in immunocompromised patients. Clinical manifestations depend on the way of entry of the mold and host immune system status. The main ways of entrance are the airways, skin, and mucosal membranes. Disseminated fusariosis often occurs in patients with hematological disorders, patients with cancer, and solid organ transplant recipients. Case Presentation: Herein we report a case of Fusariumfungemia in a patient with adrenocortical carcinoma from Isfahan, Iran. The patient was a 41-year-old female with stage III adrenal cortical carcinoma. Despite antifungal therapy with liposomal amphotericin B, the patient passed away 6 days after admission. Internal transcribed spacer region sequencing applied for species identification and its sequence deposited in the GenBank (accession number: MK880379). Conclusions: Since the ideal strategies against invasive fungal infections remain uncertain and the mortality rate ishigh, we recommend primary prophylaxis with a broad-spectrum antifungal agent for vulnerable patients particularly those admitted to high-risk units such as oncology, hematology, and transplant units. [ABSTRACT FROM AUTHOR]

Background: Head-and-neck squamous cell carcinoma (HNSCC) is the sixth most prevalent type of cancers in the world. Due to its relatively high rate of recurrence, the prognosis of patients is poor and the survival rate is low; therefore, identifying the prognostic factors is considered necessary for better treatment. Materials and Methods: This historical cohort study was conducted on 201 patients diagnosed with aerodigestive SCC who underwent surgery and lymph node dissection. We determined the prognostic value of lymph node ratio (LNR) on overall survival (OS), disease-free survival (DFS), and locoregional failure-free survival (LFFS). We noticed an association between LNR and survival by Kaplan-Meier analysis. Hazard ratio (HR) of LNR was determined by Cox's regression model. Results: Two hundred and one patients entered this study after their medical histories were evaluated. The mean of lymph node count and LNR was 14.30 (±9.50) and 0.12 (±0.23), respectively. Eighty patients (39.80%) experienced recurrence of SCC. Five-year OS, DFS, and LFFS were 32%, 21%, and 64%, respectively. The median of OS was 40.70 months and 30.11 months in patients with LNR of ≤0.06 and >0.06, respectively (P < 0.01). The LNR >0.06 was found to be a significant prognostic factor for lower OS of patients with HNSCC (HR = 2.11 [1.10, 4.40]; P = 0.04). DFS was not significantly different among patients with LNR ≤0.06 and patients with LNR >0.06 (P = 0.9). However, LFFS was slightly different among two groups (HR = 2.04 [0.90-4.80]; P < 0.1). Conclusion: We recommend more intensive adjuvant therapies such as chemotherapy with radiotherapy and short interval follow-up for patients with LNR >0.06. Further investigations with larger sample sizes are recommended. [ABSTRACT FROM AUTHOR]

Background: Short bowel syndrome is arbitrarily defined as the presence of less than 200 cm of residual small bowel in adults. Most of the patients are dependent to total parenteral nutrition (TPN), rather than high cost, it has many complications such as sepsis. The surgical procedures are associated with intestinal obstruction and their efficacy needs to be defined. This study was performed to implant small intestinal mucosa in colonic submucosal bed in order to find a new treatment for the patients suffering from short bowel syndrome and dependent to TPN. Methods: This study was experimental and performed in Torabinejad Research Center in Isfahan University of Medical Sciences in 2008. Eight Persian male cats was studied and during laparotomy a 1 x 1 cm mucosal patch of terminal ileum was implanted in submucosa of the colon. After 14 days, second laparotomy was done and the colon was examined hystologically. Findings: In 7 cats, colonic mucosal structure was seen in the site of the patch (87.5%) and in 1 cat, ileal mucosal structure was seen (12.5%). Conclusion: According to the results, implantation of small intestinal mucosa in colonic submucosal bed was unsuccessful but possibly it may be a new alternative treatment for short bowel syndrome. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Objectives: Capparis spinosa has been used in traditional medicine for various applications including treatment of liver disorders and cancer. We studied the effects of this plant on cell proliferation and morphological characteristics of PLC/PRF/5 liver cancer cell line. Methods: After preparing ethanolic extract of the plant, the inhibitory effect of the extract was assessed using MTT assay, and morphological changes were assessed by an inverted microscope. Results: C. spinosa ethanolic extract exhibited anti-cancer effects in a concentration-dependent manner. Half-maximal inhibitory concentration of the extract was 1051±4.21 mg/mL. Morphological changes including cell shrinkage, reduction of cell volume and nuclear condensation confirmed the inhibitory effect of C. spinosa on PLC/PRF/5 cells. Conclusion: According to the results of this study, extract of C. spinosa seems to be suitable for prevention and treatment of liver cancer. Further studies on animal models could verify the efficiency of the extract against cancer cells. KEYWORDS: Plants, Medicinal, Capparis spinosa, Liver Neoplasms.

Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.