mohammad reza mohajeri

The jaw plasmacytoma is a very rare condition which its diagnosis is difficult in clinical routine. Up to now, less than 60 cases of jaw plasmacytoma have been reported in the literature. In the present case report, we reported a rare case of jaw plasmacytoma in a 42-year-old female which was misdiagnosed with dental granuloma and abscess. The diagnosis of plasmacytoma was done by immunohistochemistry (IHC) evaluation following a cone beam computed tomography (CBCT) assessment. The patient was treated with radiotherapy and is disease free after 2 years.

Diabetic foot is one of the main complications of diabetes, which is caused by a significant proportion of patients with diabetes and which imposes costs on the family and the health system around the world. This review aims to summarize the latest findings in the field of diabetic foot based on clinical guidelines.

In this review study, in order to achieve the best clinical guide in the field of diabetic foot by determining the search strategy and inclusion criteria, all related clinical guides were searched in the databases and websites of clinical guidelines.  Clinical guidelines related to diabetic foot care were searched and retrieved from January 2000 to early 2019 and screened separately by two researchers to select the selected clinical guideline.

Based on the study criteria, the clinical guide of the International Diabetic Foot Working Group was selected as the most complete guide in the field of diabetic foot. This summary is based on the International Working Group on the Diabetic Foot (IWGDF) Guidance 2015, consist of five documents including prevention of foot ulcers in at‐risk patients, footwear and offloading principles, diagnosis, prognosis and management of peripheral artery disease, foot infections in patients with diabetes and enhance healing of chronic ulcers of the foot in diabetes.

This Summary Guidance for Daily Practice is intended to overview of the main aspects of the prevention and treatment of foot problems in patients with diabetes. This summary guidance is adviced at healthcare providers and specialists in foot care throughout the world.

Peripheral neuropathy is one of the most common problems in diabetic patients. The increased risk of Diabetic Foot Ulceration (DFU) and amputation would be a complication of diabetic neuropathy. The aim of this study was to compare the DFU healing in different severity classification of neuropathy.

This is a retrospective study that was conducted over a two-year period from April 2016 to March 2018 according to the information of patients records with Diabetes Mellitus (DM) referred to clinic of diabetes and metabolic disorders of Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences. Wound healing criteria including area, depth and healing duration were studied. Accordingly, changes in the area and depth of wounds were evaluated and reported during the first, third and sixth months after baseline. Data were analyzed using descriptive and inferential statistics using SPSS software version 16.

The results of the study of patients with neuropathic ulcer showed that males and age group of 56 to 65 years had the highest frequencies. In addition, most of these patients suffered from type 2 DM (79%). The rate of wound healing, which was measured by area and depth of wound in three time periods, differed in different severity classification of neuropathy; at mild level of neuropathy the area and depth of wound decreased faster but in severe neuropathy, duration of wound healing in both mentioned criteria has increased. Regarding to the increase in the duration of DM, the healing time increased too. However the rate of wound healing decreased with increased age (p-value = 0.001).

Evidence suggests that early identification of neuropathy can reduce the incidence of DFU and amputation. Due to the slow healing of the size and depth of the wound in diabetic patients with severe neuropathy, it is necessary to prevent DFU by conducting preventive care and educational interventions.

Acromegaly is a rare disorder resulting from benign growth hormone (GH)-secreting pituitary adenomas in 90% of the cases. In recent years, many researchers have studied the Ki-67 index level of pituitary tumors and its relationship with demographics, biochemical parameters, clinical behavior, and recurrence rate. This study aimed to evaluate the correlation of Ki-67 index level with clinicoradiological and endocrinological parameters in confirmed GH-secreting pituitary adenomas, as well as with the surgical response and medical treatment after surgery. We collected the medical and pathologic records of 49 patients with GH-secreting pituitary adenoma who underwent surgeries from 2008 to 2017 in Shariati hospital affiliated to Tehran University of Medical Sciences. According to MRI reports, 94% of the tumors were macroadenomas. The MRI findings also revealed the median maximal adenoma diameter of 18.5 mm. About 40% of the patients achieved remission three months after the surgery. Younger patients had a significantly higher Ki-67 index level (P = 0.036). We did not observe any significant difference in the Ki-67 index level regarding gender, tumor type, maximal tumor diameter, tumor invasiveness, tumor secretory type, and remission. Interestingly, the Ki-67 index level was negatively correlated with the insulin-like growth factor-1 (IGF-1) level at the last follow-up (P = 0.02). In logistic regression analysis, patients with higher preoperative GH serum levels had a better outcome. Our results indicated a negative correlation between age and Ki-67 index level. However, there was no association between the Ki-67 index level and some tumor behaviors, as well as short- and long-term remission.

The effect of the marker expression high molecular weight cytokeratin ) HMWCK ( in Benign prostatic hyperplasia (BPH) and adenocarcinoma prostate. There were conventional reported about rate expression HMWCK in adenocarcinoma prostate The purpose of this studied was to determine expression of the marker HMWCK with histopathological parameters in BPH and adnocarcinoma in prostatic by immunohistochemistry methods.

This descriptive analytical research was conducted on 79 patients admitted to Hospital in Isfahan Iran. Samples were fixed in formalin and tissue processing and stained by hematoxilin and eosin adenocarcinoma samples were classified with Gleason pattern ( score) method by two pathologist. The effect of over expression in marker expression HMWCK was done after diagnosis by two expert(blind). The obtained data were analyzed using chi-square test.

Out of the 79 specimens 43 samples were BPH and 36 samples were adenocarcinoma . in 40 samples with diagnosis BPH were observed of the marker HMWCK and 3 samples were negative. Out of 36 samples with diagnosis adenocarcinoma 35 them over expression marker of the HMWCK were negative but one samples was positive. . The over specimens malignancy were in higher Gleason score There was significant relationships between type samples (BPH and adenocarcinoma) with over expression of the marker HMWCK P

An ectopically placed parathyroid in the mediastinum is a rare cause of persistent or recurrent primary hyperparathyroidism. They are rarely in a huge size. We report a case of a 70-year-old man with a history of total parathyroidectomy and thymectomy presented with a lack of appetite, nausea, and generalized bone pain, polydipsia and a calcium level of 14.4 mg/dl. 99mTc-sestamibi scintigraphy with single-photon emission computerized tomography (SPECT) showed a focal zone of radiotracer accumulation in the midline of anterior chest wall (xiphoid level). The mass excised from our patient surgically was 75 grams. This weight and location of the tumor is a very rare finding in parathyroid adenomas.

Breast cancer is the most common cancer among women. HER2 gene is a proto-oncogene that encodes the receptor of tyrosine kinase from epidermal growth factor receptor (EFGR) family. It is an important prognostic factor with a determinant role in treatment of breast cancer. There is no globally accepted method for determining the status of this gene and the method of choice is still a matter of debate. We aimed to evaluate the validity of immunohistochemistry (IHC) method in predicting HER2 status using fluorescence in-situ hybridization (FISH) method and also, to investigate some clinicopathological variables associated with HER2 amplification. In this cross-sectional study, 190 formalin-fixed and paraffin-embedded tissue specimens of invasive breast carcinoma with HER2 of ++ and +++ in IHC evaluation were enrolled. FISH method was performed on all these samples and the relationship of HER2 status and clinicopathological variables was evaluated. The studied population included 160 specimens of ++ and 30 specimens of +++ HER2 in IHC evaluation. The estrogen and progesterone receptors (ER and PR) were expressed in 64.2% and 74.2% of the specimens, respectively. HER2 amplification on FISH method was found in 27.5% and 83.3% of specimens of ++ and +++ HER2 in IHC evaluation, respectively. Tumors with HER2 amplification were more likely to be negative for estrogen (52.2% vs. 26.4%, P < 0.001) and progesterone (39.1% vs. 18.2 %, P = 0.013) receptors. This study showed that immunohistochemistry is not a good method for evaluating HER2 status and decision making about trastuzumab therapy even in patients with +++ HER2.

Keratocystic odontogenic tumor (KCOT) is a developmental odontogenic cyst on which various investigations have been focused due to its biological activities, high tendency to recur and different growth mechanisms in comparison with other cystic lesions. Previous studies have shown different biological and proliferative activities for the lining epithelium of KCOT. The aim of this study was immunohistochemical evaluation of Bcl-2 and epidermal growth factor receptor (EGFR) expression in KCOT compared with dentigerous cyst and ameloblastoma. Formalin-fi xed and paraffi n-embedded tissue sections of 16 cases of KCOT, 16 cases of dentigerous cyst and 16 cases of ameloblastoma were immunohistochemically analyzed to determine Bcl-2 and EGFR proteins’ expression. Biotin-Stereotavidin method was used. It was observed by two oral pathologists separately, and the data were analyzed by Mann–Whitney and Kruskul–Wallis. P < 0.05 was considered as signifi cant. Regardless of staining intensity, all cases of ameloblastoma and KCOT except dentigerous cases were positively stained for Bcl-2. Expression of Bcl-2 was higher in the peripheral layer of ameloblastoma and basal layer of KCOT. Furthermore, all cases of ameloblastoma and dentigerous cysts except KCOT samples were positively stained for EGFR. Expression of EGFR was higher in the peripheral layer of ameloblastoma and basal layer of dentigerous cysts. According to the expression of — Bcl-2 in ameloblastoma and KCOT, and no expression of EGFR in KCOT, it can be concluded that the biological activity and growth mechanisms of KCOT are different compared with other cystic lesions. However, the aggressive potential of KCOT is not as severe as that of a neoplasm such as ameloblastoma.

Seeds or plant organs are usually used as the materials for the long-term cryopreservation. The aim of this study is to investigate the possibility of seed cryopreservation of Lilium ledebourii (Baker) Boiss. as an endemic and endangered species because of genetic erosion. To evaluate seed potentials for the cryopreservation, four treatments including vitrification, 30% glycerol, desiccation and encapsulation-dehydration were applied on seeds before immerging in the liquid nitrogen (-196˚C) for a week. Then, seeds were removed from liquid nitrogen and exposed to heat shock (42˚C water bath), washed with the distilled water and eventually, sown in petri-dishes containing tissue papers. Some criteria including seed germination percent, root and shoot length values, root/shoot length ratio and seed vigor index were recorded and statistically analyzed after four weeks. Data of germination was converted to an arc-sine transformation prior to the analysis of variance. Results showed that germination percentages were 97.50, 97.43, 94.86 and 69.47% for 30%-glycerol, vitrification, desiccation, and encapsulation-dehydration treatments, respectively. They were not significantly different from control seeds (89.33%). On the other hand, other germination attributes of seeds almost showed no significant differences in comparison with control treatment in most treatments. In addition, 30%-glycerol, vitrification and desiccation experienced the highest amounts of germination attributes whereas they showed no significant differences with the control treatment in most qualities. In contrast, the encapsulated seeds showed the lowest amounts in germination indices though they had no significant differences with control treatment (except germination rate). Most of germination attributes of encapsulated seeds were significantly lower than the other cryogenic treatments. Both 30% glycerol and desiccation treatments showed some advantages over vitrification method. However, desiccation was the best treatment because it does not need any chemical substances. It was concluded that the cryopreservation technique is an important approach for the long-term preservation of the seeds of this endangered species.

A 16-year-old girl was referred for the evaluation of headache exacerbation and progressive loss of visual field from one month ago. She also suffered from intermittent diarrhea since 12 months ago and secondary amenorrhea, headache, weight loss (4 – 5 kg) and weakness from six months ago. She had a history of transient polydipsia and excessive urine output during this period. Brain Magnetic Resonance Imaging (MRI) reported a 15 x 15 x 9 millimeters mass lesion in the sellar region. It was extended to the suprasellar cistern with mild compression of the optic chiasm and mild thickening of the pituitary stalk with posterior displacement were reported. In an exisional biopsy of pituitary stalk lesion, the pathology result was indicative of Langerhans cell histiocytosis (LCH). The patient underwent four periods of chemotherapy with prednisolone and vinblastin in 28-day intervals followed by one cycle of radiation therapy. In three months follow up after treatment the tumor size was reduced, Levothyroxin and Prednisolone were tapered, and pituitary hormones were improved.

Colorectal tumor is one of the main causes of death in our country. The aim of the present study was to determine the clinicopathological aspects of tumor and the presence of hepatic micrometastasis in patients with colorectal cancer (CRC). Forty two patients with CRC were evaluated in the study surgical treatment was performed and liver biopsy was taken for the evaluation of micrometastasis by immunohistochemistry and polymerase chain reaction. The variables that have been evaluated were: Patient’s gender, patients age at the time of diagnosis, size and location of tumor, tumor-node-metastasis stage and grade of the primary tumor, lymph node involvement, lymphovascular and neural invasion, presence of macrometastasis and carcinoembryonic antigen level prior to surgery. After 1 year patients were called and asked to come back to the clinic for elective colonoscopy to evaluate the surgical site for recurrence of tumor and survival. All variables were compared between patients in whom liver micrometastasis were present in comparison with patients without liver micrometastasis. Of the studied patients (6 with positive micrometatsis and 36 without micrometstasis), 38 were alive after 1 year (6 with positive micrometatsis and 32 without micrometstasis) and the difference was not significant between groups with or without micrometastasis (P = 0.52).In four of survived patients colonoscopy was abnormal, however this difference was not also significant between groups (P = 0.59). Clinicopathologic aspect of tumor was not different in CRC patients with and without hepatic micrometastasis.

Hand ischemia is a rare complication of diabetes and some other chronic vascular diseases. Critical hand ischemia causes painful limbs and disability and requires urgent revascularization. There have been a few reports of successful trans-brachial percutaneous angioplasty in the upper extremity in the radial or ulnar artery. Herein, we report the results of the endovascular treatment of a 68-year-old diabetic patient with an ischemic hand ulcer due to the severe stenotic lesions of the infra-brachial arteries. The patient underwent successful angioplasty via the retrograde trans-femoral technique to avoid the drawbacks. At the first week of post-procedural follow-up, the patient’s finger was warm with a well–healing wound and reduced pain. In the next two months, he had no complaint of pain or active ulceration; the ulcer was well healed, and the hand was warm.The present case shows that history taking and physical examination should be followed by upper-extremity arteriography for the evaluation of hand ischemia. The trans-femoral approach enabled us to perform percutaneous catheterization for both diagnostic and interventional purposes. Not only is this strategy useful even for the severe stenotic disease of the distal parts of below-the-elbow arteries but also it avoids the unpleasant complications of antegrade brachial cannulation.

Urinary tract infection (UTI) is a common bacterial disease which may cause chronic renal failure and hypertension. Many reports suggest that the rate of antibiotic resistance to infectious organisms is increasing.. This study aimed to detect and also compare the frequency and drug resistance pattern of Gram negative bacteria isolated from patients with community-acquired UTIs in Isfahan..Patients and In this cross-sectional descriptive study, 702 samples from 476 females and 226 males referred to medical centers in Isfahan city from June to September 2011 were collected, we investigated the urine cultures and antibiotic sensitivity of the isolated organisms were measured.. Urinary infectious was detected in 203 persons. The most prevalence isolated bacteria were Escherichia coli 138 (68%), followed by Klebsiella spp. (13%). Antibiotic resistance pattern of Gram negative bacteria isolated was investigated. Among E. coli isolates the most antibiotic sensitivity and resistance were related to Nitrofurantoin, Cotrimoxazol and Nalidixic acid, Trimetsulpha respectively. Klebsiella spp. isolates were the most antibiotic sensitive to Cotrimoxazol and Cipropheloxacin and the most antibiotic resistant to Trimetsulpha, Cipropheloxacin and Nalidixic respectively.. With regards to the continuous changing in causative microorganisms isolated from patients with UTI and antibiotic sensitivity patterns, it is recommended that bacterial sensitivity patterns in populations are determined in any region annually.. .

This study was proposed to evaluate a new method for autograft transplantation of liver tissue fragments (LTF) in the lung parenchyma and bronchus of dogs and to compare the results to find out if they are suitable sites for hepatocyte implantation or not. The dogs were randomly assigned into two categories: LTF auto-transplantation to the lung parenchyma and into the bronchus. The suspensions of normal saline and LTF were injected and implanted into the lung parenchyma and the main bronchus of the right accessory lobe in first and second groups, respectively. Two weeks later the right accessory lobe was removed and sent for a histopathological study. All samples were checked under a light microscope with regard to the presence of hepatocytes, with both the Hematoxylin and Eosin (H and E) preparation and immunohistochemistry (IHC) method, using a CK-18 marker. All results were double-checked with a polymerase chain reaction (PCR). The mean weight of all the dogs was 19.87 ± 0.93 kg and mean age was 3.58 ± 0.31 years. After 15 days, the H and E, IHC, and PCR studies revealed that in the first group, all the dogs (n = 4) had living liver tissue, which survived in the lung parenchyma successfully. In contrast, none of the dogs (n = 0) in the second group showed surviving hepatocytes in the bronchus (P < 0.001). Implantation of the LTFs into the lung parenchyma could be a source of hepatic cell production.

Multiple sclerosis (MS) is a demyelinating disease which can cause many disabilities for the patient. Recent data suggests that MS patients have higher risk for osteoporosis. This study was performed to investigate if the osteoporosis prevalence is higher in MS patients and to determine the possible factors affecting bone mineral density (BMD). 51 definite relapsing-remitting MS patients according to McDonald's criteria (45 females, 6 males aged between 20 and 50 years) participated in this study. The control group included 407 females aged from 20 to 49 years; they were healthy and had no history of the diseases affecting bone metabolism. Femoral and lumbar BMD were measured by Dual Energy X-ray Absorptiometry (DXA). The disability of MS patients was evaluated by Expanded Disability Status Scale (EDSS). The patient’s quality of life was evaluated by the validated Persian version of multiple sclerosis impact scale (MSIS-29). Patients’ mean age was 36 ± 3.3 years and their mean disease duration was 8.7 ± 1.7 years. The mean EDSS score and the mean body mass index (BMI) of the patients were 3 ± 0.9 and 23.5 ± 2.3 kg/m2, respectively. 29% of the patients had never been treated by ß-interferon and 6% of them had not received glucocorticoids (GCs) pulses since their MS had been diagnosed. 26% of the patients had a history of fracture.18% of our patients were osteoporotic and 43% of them were osteopenic. Femoral BMD was significantly lower among MS patients than age matched controls (P < 0.001), but lumbar BMD showed no difference. There was no correlation between administration of GCs pulses, interferon and BMD; however, we found a significant correlation between EDSS score, quality of life (QoL), disease duration and BMD of both site. As a result of this study, bone loss inevitably occurs in MS patients. The major factor of BMD loss is immobility. Osteoporosis should be managed as part of MS patients’ treatment protocols.

This prospective study aimed to evaluate the detailed outcomes of diabetic patients with critical limb ischemia, six months after percutaneous transluminal angioplasty and appropriate multidisciplinary wound care. Totally, 45 consecutive patients (50 limbs) were enrolled and then divided into two groups according to the healing of ulcers. The endpoints were ulcer healing and major adverse events including amputation, mortality, and cardiac or cerebral morbidities, during a six- month follow-up period. During six months follow-up, major amputation was performed for four of 50 limbs (8.0%). A total of nine (20%) patients died and the leading cause was cardiac death (13.3 %). Also, stroke and non-fatal myocardial infarction occurred in three (6.7 %) and one (2.2 %) of the patients, respectively. Among the 29 (59.2 %) healed wounds, 22 (44.9 %) were completely closed. The patients with nonhealing wounds had a higher rate of dialysis (40% vs. 0 %, P-value < 0.001) and more ulcers with stage of D3 according to the Texas Wound Classification (60% vs. 31 %, P-value = 0.016). Other demographic, clinical, ulcer characteristics and procedural characteristics such as number and level of the treated lesions did not differ significantly between the two groups. Based on our findings, it seems that along with current usual therapeutic routines which focus on wound healing and limb salvage, more attention should be paid to simultaneous diagnostic assessments and treatment of cardiovascular disease in this group of patients during short-term follow- up.

Thalassemia major and its treatment by stem cell transplantation can have deleterious effects on bone integrity. This study assesses the adverse effects of transplantation on growing bones of pediatric thalassemic patients. Bone mineral density (BMD) of 20 patients from three thalassemia classes whose mean (SD) age was 7.4 (3.8) years were tested with a Norland XR-46 device at baseline (before transplantation), 6 and 12 months after transplantation. At 6 and 12 months after transplantation we observed no significant changes in mean BMD. There were no Z-scores less than -2 among patients. Class 3 thalassemia did not negatively impact BMD. Calcium (Ca), phosphorous (P) and ferritin levels were not significantly related to patient's BMD scores. Transfusion duration and chelation therapy showed positive significant relationships to BMD (g/cm2), but no significant relation with the BMD Z-score. The deleterious relation between corticosteroid use and changes in BMD was not significant. In contrast, patients who developed acute graft versus host disease (aGVHD) after transplantation showed significant adverse effects on BMD of their femur (P = 0.020) and spine (P = 0.027). Stem cell transplantation in pediatric thalassemic patients who do not develop aGVHD does not appear to have any significant positive or negative effects on BMD.

Neuropathy is the mostly prevalent of complications and the major cause of amputation, pain and disability in patients with diabetes. The purpose of this study was to investigate the role of individual, psycho-social, and disease-related risk factors in neuropathy of type 2 diabetes patients. In this retrospective cross-sectional study, 271 patients with type 2 diabetes were selected by convenience sampling in diabetic outpatient clinics of Tehran University of Medical Sciences and the Iranian Diabetic Association. The data were collected by demographical and disease characteristics questionnaires and DASS-42, QOLS, DSMS, and DKS scales. Then, the data were analyzed by r binary logistic regression along with PASW software. Socio-economic status, glycosylated hemoglobin, body mass index, diabetes self-management, depression, quality of life, diabetes knowledge, and diabetes duration were significantly able to differentiate diabetic patients with neuropathy from diabetic patients without neuropathy (p<0.001). Gender, treatment type and patient age were not significantly able to differentiate two groups (p>0.05). The total regression model explained that 95.2% of cases were classified correctly. Inappropriate socio-economic status, glycosylated hemoglobin over 9%, being overweight and obesity, poor diabetes self-management, clinical depression, low quality of life, poor diabetes knowledge, and longer diabetes duration contribute to the incidence of neuropathy in patients with type 2 diabetes and attention must be paid to them for neuropathy prevention.

Breast cancer is the most common cancer and the second cause of mortality in women. It is also the main cause of death among 45-55 year-old women. Several predictive and prognostic factors have been detected until now. Some of these factors, such as steroid hormone receptors and human epidermal growth factor receptor 2 (HER2) and P53, have been proved. The aim of this study was to investigate these factors in women with breast cancer in Isfahan, Iran. During 1999-2009, this descriptive study was conducted on patients with pathologically confirmed breast cancer who referred to Seyed-Al-Shohada Cancer Clinic and doctor's offices in Isfahan. Data was extracted from patient files. The collected data was then entered into SPSS16 and analyzed using descriptive statistics like frequencies and mean values, and chi-square and non-parametric tests. In this study, 685 patients with breast cancer were investigated during 10 years. The mean age of patients was 47.39 ± 11.07 years. While 22 patients were in stage 1, 327, 60, and 38 subjects were in stages 2-4, respectively. In this study, the frequency of estrogen receptor, progesterone receptors, P53 protein, and HER2 was 39.4%, 36.9%, 49.9%, and 23.3%, respectively. Significant differences were detected between positive and negative estrogen receptor in stage 4, progesterone receptor in stages 2 and 4, P53 in all stages, and HER2 in stage 2. Stages of cancer were not significantly different in terms of frequency of these factors. A relation was found between estrogen and progesterone receptors and patient's age. However, such a relation could not be established in case of HER2 and P53. Assessments of hormone receptors and HER2 and P53 after the diagnosis of breast cancer seem necessary in identifying the best treatment choice. However, population differences should not be ignored in this process.

According to recent studies, 1 in every 9 women is at risk for breast cancer. Moreover, 30% of total cancers in women are related to the breast. Although the 5-year survival rate in patients who are in stage I is 84%, in stage IV patients it decreases to 18%. As a result, survival after detection depends on the stage of the disease. Early detection would lead to decreased mortality rate. The triple test (ultrasound, mammography and fine needle aspiration (FNA)) is a main step in detecting breast cancer. FNA is the most important procedure in the triple test. This study was conducted to determine the sensitivity, specificity, and negative and positive predictive values of FNA. In a descriptive study conducted in Jam Imaging Center, Isfahan, Iran, 82 patients with breast tumor and referred to the center for core needle biopsy (CNB) under ultrasound were examined by both FNA and CNB. Sensitivity, specificity, and positive and negative predictive values of the two methods were analyzed. SPSS18 was used for data analysis. In comparison to CNB, sensitivity, specificity, and positive and negative predictive values of FNA were 84.8%, 94.4%, 95.1% and 82.9%, respectively. According to the results of this study, FNA under ultrasound guide has a reliable sensitivity and specificity for detection of breast cancer. However, this test cannot be applied as a final test for breast tumor because it may show false negative and false positive results. For final diagnosis CNB may be needed.

Choriocarcinoma is an extremely rare pathology among breast malignancies. It is introduced by two distinct terms in the literatures: breast cancer with choriocarcinomatous features and metastatic choriocarcinoma to the breast. In this case report, the history, physical examination, laboratory findings, imaging studies, and pathological findings of breast choriocarcinoma in a 41-year-old woman are described and previous literatures about choriocarcinoma in the breast are reviewed.

Diabetes Mellitus is a common metabolic disorder around the world. Chronic foot ulcers are one of the debilitating complications in patients with diabetes. Several studies have shown that bacterial colonization and bacterial load can affect healing process in these patients. In this study, the effect of low level laser therapy on bacterial load of diabetic foot ulcers was evaluated.

In this pilot study, patients with stage I and II Wagner chronic diabetic foot ulcer (more than 3 months) were enrolled. Patients were randomly assigned in two laser and placebo groups. Laser parameters used in laser group were wavelength 670 nm, output power 30 mW, fluence 10 J/cm2. Bacterial load assessment was done through post debridement wound fluid collection. Three samples from 3 different sites of each wound were collected on day 0, 7, 14 after beginning of treatment.

Single and average intraclass correlation coefficients (ICC) for 32 samples were 0.7 and 0.873, respectively. There was no statistically significant difference between laser and placebo groups before and aftertwo week-treatment according to bacterial count.

Our findings showed that post-debridement wound fluid could be used asa reproducible and noninvasive method for detecting bacterial load accurately. Further studies are needed to evaluate the effect of low level laser therapy on growth of bacteria in clinical conditions.

A common polymorphism at codon 72 of TP53 gene has been associated with increased risk for many human cancers. We studied this TP53 polymorphism in colorectal adenocarcinomas in small population selected from Isfahan city. Samples: We undertook a case-control study on 180 controls and 180 paraffin block specimens of sporadic colorectal adenocarcinomas. PCR amplification of TP53 codon 72 polymorphism: TP53 codon 72 genotypes were detected by PCR using specific primer pairs for amplifying the Proline or the Arginine alleles. STATISTICAL ANALYSES: The 42-test was used to assess the significance of any difference in the prevalence of TP53 codon 72 polymorphism between colorectal cancer patients and controls. In control samples, the genotype distribution for TP53 polymorphism showed 28.3%, 48.9% and 22.8% for the Arginine/Arginine, Arginine/Proline and Proline/Proline genotypes, respectively. In the cancer group 40% of the cases were Arginine/Arginine, 42.2% were Arginine/Proline and 17.8% were Proline/Proline. A significant difference between cases and controls was found for the Arginine/Arginine genotype compared with (grouped) Arginine/Proline and Proline/Proline genotypes (Odds Ratio = 1.686 (1.085-2.620), P = 0.02). TP53 codon 72 polymorphism may be a genetic predisposing factor for colorectal adenocarcinomas in Isfahan city.

Due to the absence of frozen section in the majority of hospitals, malignant breast masses are being operated in two admissions first for biopsy and second for mastectomy. With simple and rapid technique of touch imprint (intraoperative cytology) both operations can be done in the same time. In this study the diagnostic accuracy of intraoperative cytology (touch imprint) in malignancy of breast masses is evaluated. During 2003 to 2006, reports of touch imprints of 70 patients with breast masses were compared to reports of their permanent section. Based on gathered data, positive and negative predictive value, sensitivity and specificity, and positive and negative likelihood ratio of the test were determined. In 70 patients, 39 cases had malignant and 31 cases had benign masses. In 39 patients with malignant masses, 36 patients had malignant and 3 patients had benign cytologic reports. In 31 patients with benign masses 2 patients had malignant reports in cytology. Therefore sensitivity, specificity and accuracy of touch imprint in diagnosis of malignant breast masses were 92.3%, 93.5% and 92.9% respectively. Because of high specificity of touch imprint, it seems that this test can be done in centers that do not have frozen section for intraoperative diagnosis of malignant breast masses.

Apoptosis and cell cycle regulation play an important role in pathogenesis and tumor progression in patients with Diffuse Large B-Cell Lymphoma (DLBCL). Bcl-2 associated athanogene-1 (BAG-1) is an antiapoptotic protein as well as a regulator of cell growth. There is no conclusive evidence about BAG-1 protein expression in this disease. To investigate the expression level of BAG-1 protein in DLBCL. Thirty patients diagnosed from 1997-2004, as having DLBCL, were selected. Also 30 normal lymph nodes were included as normal counterparts in this study. BAG-1 expression was determined by immunohistochemical staining in both DLBCL and normal lymph node samples. Of the 30 DLBCLs examined, 100% were positive for nuclear and 83% were positive for cytoplasmic BAG-1 staining. Of the 30 normal lymph nodes investigated, 20% were positive for nuclear and 0% were positive for cytoplasmic BAG-1 staining. Nuclear staining in DLBCL samples was significantly higher than those of normal lymph nodes (100% versus 20%, p <0.001). Besides, cytoplasmic staining in DLBCL samples was significantly higher than those of normal lymph nodes (83% versus 0%, p <0.001). There was no association between BAG-1 staining and patients’ overall survival. Our data indicated that BAG-1 protein was deregulated in this disease similar to some other malignancies such as breast and colon cancer. Overexpression of BAG-1 in DLBCL suggests that this protein probably plays an important role in the pathogenesis of DLBCL. Besides, higher nuclear BAG-1 staining might be correlated with poor prognosis.