Gastroenterology and Hepatology From Bed to Bench Journal
Volume:8 Issue: 3, Summer 2015

Inflammation can lead to malabsorption of important micronutrients such as iron. Malabsorption and nutritional deficiency can be caused by a variety of pathological and environmental factors causing a range of other symptoms commonly caused by both H. pylori infection and coeliac disease (CD). National guidelines suggest the routine taking of duodenal biopsies to exclude CD when investigating patients for iron deficiency anemia (IDA). Studies suggest that in absence of positive antibodies, IDA is rarely caused by CD. Recent British Society of Gastroenterology guidelines discourage the routine duodenal biopsies in low risk cases but despite this guidance, taking duodenal biopsies for IDA is a common practice. Many studies have reported that H. pylori infection is associated with IDA even in patients with CD. In countries with low H. pylori prevalence we still detect more H. pylori than CD standing behind IDA. Despite the strong association between IDA and H. pylori, taking biopsies to diagnose H. pylori infection is not usually a routine part of the diagnostic workup to identify the etiology of IDA. In this review we will discuss the impact of H. pylori in IDA and highlight the possible gaps in identifying the IDA etiology.

Survival models are statistical technique to estimate or predict the overall time up to specific events. Prediction is important in medical science and the accuracy of prediction is determined by a measurement, generally based on loss functions, called prediction error. The aim of this study is using parametric models to determine the factors influencing predicted survival time for patients with colorectal cancer (CRC) and select the best model by predicting error’s technique. 600 colorectal cancer patients whom admitted to the Cancer Registry Center of Gastroenterology and Liver Disease Research Center, Taleghani Hospital, Tehran, who were followed at least for 5 years and have completed information selected for this study. Body Mass Index (BMI), Sex, family history of CRC, tumor site, stage of disease and histology of tumor included in the analysis. The survival time was compared by the Log-rank test and multivariate analysis was carried out using parametric. For selecting the best model, the prediction error by apparent loss was used. Log rank test showed better survival for females, BMI more than 25, patients with early stage at diagnosis and patients with colon tumor site. Prediction error by apparent loss was estimated indicated that Weibull model was the best one for multivariate analysis. BMI and Stage were independent prognostic factors according to Weibull model. In this study, Weibull regression showed a better fit according to prediction error. Prediction error would be a criterion to select the best model with ability to make prediction of prognostic factors in survival analysis.

The present study investigated the differentiation potential of human Umbilical Cord Mesenchymal Stem Cells (UCMSCs) into hepatic lineage through embryonic body-like aggregate formation in the presence of IGF-1. Cells derived from Wharton’s jelly have been reported to display a wide multilineage differentiation potential, showing some similarities to both embryonic (ESC) and mesenchymal stem cells (MSCs).Patients and Human MSCs isolated from the umbilical cord were plated in 20 μL micro drops. A two-step differentiation protocol was used and the cell aggregates were exposed to the media supplemented with IGF, HGF, oncostatin M, and dexamethasone for 21 days. Immunoperoxidase and immuno fluorescence were performed for cyrokeratins 18, 19 and albumin. Functional assays were done by periodic acid Schiff (PAS) and indocyanine green. The expression of cytokeratin 19 was shown to be higher in the cells derived from 3D spheroids compared to those cultured in conventional protocol. They showed a polygonal shape after being exposed to hepatogenic media. Immunostaining demonstrated the expression of cytokeratin-18, 19 and albumin by the differentiated cells. Besides, PAS staining revealed glycogen storage in differentiated cells. Also, a greater number of large size differentiated cells were found at the periphery of the expanded cell aggregates. We established a protocol for UCMSC differentiation into hepatocytes and these cells were morphologically and functionally similar to hepatocytes. Thus, hepatocyte differentiation may be facilitated by the UCMSCs aggregate formation before administration of the differentiation protocols.

To identify primary sclerosing cholangitis (PSC) predisposing factors in order to prevent inflammatory bowel disease (IBD) progression to PSC. IBD is commonly associated with PSC and there is no effective therapy for PSC except for liver transplantation. Patients and This retrospective study was conducted on 447 IBD patients from IBD Clinics of Ghaem and Emam Reza Hospitals. Data were collected by interview and through a review of the patient's medical records. Patients were divided into two groups: those with IBD and PSC (IBD-PSC) and those without PSC. Variables were compared between two groups and those with statistically significant differences in IBD-PSC group were considered as predictive factors for the development of PSC. The frequency of PSC in IBDs was 4.3% and all were ulcerative colitis. The mean age of patients with PSC was 39.1±11.33 years. The male to female proportion in PSCs was 3.8:1 and in IBDs was 0.9:1. There were statistically significant associations between PSC and gender, IBD duration and UC extension, mucocutaneous involvement, oral contraceptive pills (OCP) consumption, history of surgery and history of PSC in the first- degree relatives. PSC frequency among IBD patients in North-East of Iran was 4.3%. It is recommended to limit OCP consumption in IBD patients. Identification and modification of probable predisposing risk factors, as well as early diagnosis of PSC are necessary.

The aims of this study were to investigate the phenotypic and genotypic of extended-spectrum β-lactamase (ESBL) and metallo-β-lactamases (MBLs) and determine phylogenetic background E. coli isolates from fecal samples of patients with diarrhea in Kerman, southeast of Iran The emergence of ESBLs and MBLs-producing E. coli caused problems in antibiotic treatments. E. coli strains can be assigned to four main phylog-groups, including: A, B1, B2 and D.Patients and E. coli isolates (n=216) were obtained from fecal samples of patients with diarrhea between June and December 2013. ESBLs and MBLs were confirmed by disk-diffusion and broth micro dilution methods. Using PCR, the ESBL-positive isolates were screened to determine the phylo-groups and the presence of blaCTX-M-15, blaOXA-1, blaPER-1, blaVIM and blaIMP genes. ESBL-positive isolates (n= 56) were detected. Among ESBL-positive isolates, 51 isolates were positive for blaCTX-M15 and one isolate was positive for both blaCTX-M-15 and blaOXA-1 genes. None of the isolates were positive for blaPER-1, blaVIM and blaIMP genes. PCR assay for phylotyping of isolates indicated that the isolates were belonged to groups A (54.16%), B1 (11.11%), B2 (12.96%) and D (21.75%). The isolates possessed blaCTX-M-15 gene were belonged to A (35 isolates), B1 (5), B2 (3) and D (8) phylo-groups. Our results indicate that blaCTX-M-15 gene is widespread among diarrheagenic E. coli isolates. ESBLproducing E. coli isolates were disseminated among a diversity of phylo-groups. Further studies are necessary to identify the ESBL genes in relation to phylogenetic groups.

This study is aimed to elicit the possible correlation between breast and colon cancer from molecular prospectiveby analyzing and comparing pathway-based biomarkers. Breast and colon cancer are known to be frequent causes of morbidity and mortality in men and womenaround the world. There is some evidence that while the incident of breast cancer in young women is high, it is reportedlower in the aged women. In fact, aged women are more prone to colorectal cancer than older men. In addition, manystudies showed that several biomarkers are common among these malignancies.Patients and The genes were retrieved and compared from KEGG database and WikiPathway, and subsequently,protein-protein interaction (PPI) network was constructed and analyzed using Cytoscape v:3.2.1 software and related algorithms. More than forty common genes were identified among these malignancies; however, by pathways comparison,twenty genes are related to both breast and colon cancer. Centrality and cluster screening identified hub genes, includingSMAD2, SMAD3, (SMAD4, MYC), JUN, BAD, TP53. These seven genes are enriched in regulation of transforminggrowth factor beta receptor signaling pathway, positive regulation of Rac protein signal transduction, positive regulationof mitochondrial outer membrane permeabilization involved in apoptotic signaling pathway, and positive regulation ofmitotic metaphase/anaphase transition respectively. As there are numerous genes frequent between colorectal cancer and breast cancer, there may be a commonmolecular origin for these malignancies occurrences. It seems that breast cancer in females interferes with the rate ofcolorectal cancer incidence.

Chronic Granulomatous Disease (CGD) is an inherited primary immunodeficiency disease which increases the body’s susceptibility to infections caused by certain bacteria and fungi. CGD is a rare disease, caused by four genes, one type is 1X linked and the other three are “autosomal recessive”. Although clinical presentation is variable, but characteristic features are recurrent pneumonia, lymphadenitis, hepatic or other abscesses. Gastrointestinal tract symptoms are common in xlinked recessive form of CGD. These include gastric and esophageal obstruction and inflammatory bowel disease. GI involvement including small and large intestines, the findings of luminal narrowing and the presence of granuloma can make it difficult to distinguish from Crohn’s disease. On the other hands according to the literature ulcerative colitis is rarely reported in patients with CGD. Our case presented with ulcerative colitis with CGD.

Original Article Evaluation of parametric models by the prediction error in colorectal cancer survival analysis Ahmad Reza Baghestani, Mahmood Reza Gohari, Arezoo Orooji, Mohammad Amin Pourhoseingholi PDF An in vitro model for hepatocyte-like cell differentiation from Wharton’s jelly derived-mesenchymal stem cells by cell-base aggregates Tahereh Talaei-Khozani, Maryam Borhani-Haghighi, Maryam Ayatollahi, Zahra Vojdani PDF Frequency and Risk Factors of Primary Sclerosing Cholangitis among Patients with inflammatory bowel disease in north-east of Iran Ahmad Khosravi Khorashad, Mohammad Khajedaluee, Elham Mokhtari Amirmajdi, Ali Bahari, Mohammad Reza Farzanehfar, Mitra Ahadi, Siavash Abedini, Mohammad Reza Abdollahi, Rosita Vakili, Hassan Vossoughi Nia PDF Phylogenetic groups, extended-spectrum B-lactamases and metallo-?-lactamase in Escherichia coli isolated from fecal samples of patients with diarrhea in Iran Hesam Alizade, Fatemeh Fallah, Reza Ghanbarpour, Mohammad Reza Aflatoonian, Hossein Goudarzi, Hamid Sharifi PDF Protein-Protein Interaction Network could reveal the relationship between the breast and colon cancer Mona Zamanian Azodi, Mostafa Rezaei Tavirani, Sara Rahmatirad, Hadi Hasanzadeh, Majid Rezaei-Tavirani, Samaneh Sadat Seyyedi PDF Multilocus variable-number tandem-repeat analysis for genotyping of Shigella sonnei strains isolated from pediatric patients Mojtaba Memariani, Reza Ranjbr PDF Case Report Ulcerative colitis associated with chronic granulomatous disease: case report Imanzade Farid, Sayarri Aliakbar, Pantea Tajik PDF