Biliary brush cytology in the assessment of biliary strictures at a tertiary center in Iran

Background: Confirmation of cholangiocarcinoma and other malignant bile duct stenosis is challenging. The aim of the current study was to assess the accuracy of brush cytology for diagnosis of malignant biliary strictures. Methods: 105 patients with hepatic biliary strictures undergoing ERCP were included in this study. Prospectively collected data included symptoms, results of biochemical testing and imaging procedures, as well as details of ERCP. Exclusion criteria were: 1) strictures that would not permit passage of guidewire and brush accession; and 2) post-operative strictures. Brushings of the bile duct strictures were performed. All patients were followed for at least 6 months. The final diagnosis was confirmed following surgery, histopathological diagnosis of the lesion, radiological infiltration of adjacent organs or metastases, or after at least a 6-month follow-up. Results: 88 brush samples from 88 patients were of appropriate quality. The overall diagnostic sensitivity and specificity for malignant nature of biliary strictures were 40.7% and 100%, respectively. The sensitivity was 66.6 % for ampullary carcinomas, 36.3% for pancreatic cancer and 32.5% for cholangiocarcinomas. Conclusions: Despite the low sensitivity, due to the relative ease and safety, brush cytology should remain the first choice for diagnosis of causes of biliary strictures.     

Depilatory Agents intoxication and factors contributing to its mortality: a 9-year review

Poisoning with depilatory agents is a rather uncommon entity in western countries. In this study, we describe poisoning with a corrosive arsenic-based depilatory agent (CABD) and factors related to its mortality in a poisoning center in Tehran. In a retrospective study, the medical records of all patients with CABD intoxication who attended the emergency ward of Loghman-Hakim hospital, the only poisoning center in Tehran, over a 9-year period between 2000 and 2009 were reviewed. The majority of patients were men (78.7%, n = 122 vs. women: 21.3%, n = 33). The mean age was 35.55 ± 16.68 years. Mean time of arrival to hospital was 3.63 hours (SD = 4.07). The mortality rate was 5.8% and increased significantly with higher amounts of ingestion and delay in arrival to hospital. CABD poisoning may be lethal if not treated promptly and correctly. Restriction or, if not practical, reduction of harmful components of this substance should be considered.     

Melatonin,an inhibitory agent in breast cancer

Background

The heterogeneous nature of breast cancer makes it one of the most challenging cancers to treat. Due to the stimulatory effect of estrogen in mammary cancer progression, anti-estrogenic agents like melatonin have found their way into breast cancer treatment. Further studies confirmed a reverse correlation between nocturnal melatonin levels and the development of mammary cancer. In this study we reviewed the molecular inhibitory effects of melatonin in breast cancer therapy.

Methods

To open access the articles, Google scholar and science direct were used as a motor search. We used from valid external and internal databases. To reach the search formula, we determined mean key words like breast cancer, melatonin, cell proliferation and death. To retrieval the related articles, we continuously search the articles from 1984 to 2015. The relevance and the quality of the 480 articles were screened; at least we selected 80 eligible articles about melatonin molecular mechanism in breast cancer.

Result

The results showed that melatonin not only inhibits breast cancer cell growth, but also is capable of inhibiting angiogenesis, cancer cell invasion, and telomerase activity. Interestingly this hormone is able to induce apoptosis through the suppression or induction of a wide range of signaling pathways. Moreover, it seems that the concomitant administration of melatonin with other conventional chemotherapy agents had beneficial effects for patients with breast cancer, by alleviating unfavorable effects of those agents and enhancing their efficacy.

Conclusion

The broad inhibitory effects of melatonin in breast cancer make it a promising agent and may add it to the list of potential drugs in treatment of this cancer.

     

Association of polycyclic aromatic hydrocarbons of the outdoor air in Ahvaz,southwest Iran during warm-cold season

Polycyclic aromatic hydrocarbons (PAHs) are one of the main components of urban air pollution. The level of concentration PAHs and effects are depended on seasonal variations and amount of exposure to PAHs. Nowadays, PAHs are one of the important pollutants that threat the public health. The purpose of this study was to evaluate the polycyclic aromatic hydrocarbons of the outdoor air in Ahvaz, southwest Iran using active sampling system during the warm and cold seasons of 2016. Data collection was performed daily during the study period in three stations in Ahvaz citizens at industrial, high traffic and residential areas. Omni sampler and equipped with PTFE filters (8*10) were utilized for sampling in this study. Gas chromatography with mass spectrometry (GC/MS) were utilized for detection of PAHs concentration (ngm^?3). Statistical SPSS software (SPSS version 16) was used to determine the effects of PAHs during warm and cold season. According to result this study, the industrial and residential areas had the highest and the lowest PAHs concentrations. Based on result this study, PAHs concentrations in three main areas at industrial, high traffic and residential were 7.021?±?3.45, 5.162?±?2.63 and 4.187?±?1.76 ngm^?3, respectively. The results showed that the average concentration of polycyclic aromatic hydrocarbons in three main areas outdoor air in Ahvaz were more than recommended scales by international organizations. According to this study, the mean of PAHs concentration in different areas was significantly higher than standard. Results showed that the short-term exposure to PAHs during cold season were higher than the levels of exposure during warm season. The levels of exposure to PAHs can increased risk of health endpoint and the oxidative stress.     

MEG Coherence and DTI Connectivity in mTLE

Magnetoencephalography (MEG) is a noninvasive imaging method for localization of focal epileptiform activity in patients with epilepsy. Diffusion tensor imaging (DTI) is a noninvasive imaging method for measuring the diffusion properties of the underlying white matter tracts through which epileptiform activity is propagated. This study investigates the relationship between the cerebral functional abnormalities quantified by MEG coherence and structural abnormalities quantified by DTI in mesial temporal lobe epilepsy (mTLE). Resting state MEG data was analyzed using MEG coherence source imaging (MEG-CSI) method to determine the coherence in 54 anatomical sites in 17 adult mTLE patients with surgical resection and Engel class I outcome, and 17 age- and gender- matched controls. DTI tractography identified the fiber tracts passing through these same anatomical sites of the same subjects. Then, DTI nodal degree and laterality index were calculated and compared with the corresponding MEG coherence and laterality index. MEG coherence laterality, after Bonferroni adjustment, showed significant differences for right versus left mTLE in insular cortex and both lateral orbitofrontal and superior temporal gyri (p < 0.017). Likewise, DTI nodal degree laterality, after Bonferroni adjustment, showed significant differences for right versus left mTLE in gyrus rectus, insular cortex, precuneus and superior temporal gyrus (p < 0.017). In insular cortex, MEG coherence laterality correlated with DTI nodal degree laterality (\(R^{2} = 0.46; p = 0.003)\) in the cases of mTLE. None of these anatomical sites showed statistically significant differences in coherence laterality between right and left sides of the controls. Coherence laterality was in agreement with the declared side of epileptogenicity in insular cortex (in 82 % of patients) and both lateral orbitofrontal (88 %) and superior temporal gyri (88 %). Nodal degree laterality was also in agreement with the declared side of epileptogenicity in gyrus rectus (in 88 % of patients), insular cortex (71 %), precuneus (82 %) and superior temporal gyrus (94 %). Combining all significant laterality indices improved the lateralization accuracy to 94 % and 100 % for the coherence and nodal degree laterality indices, respectively. The associated variations in diffusion properties of fiber tracts quantified by DTI and coherence measures quantified by MEG with respect to epileptogenicity possibly reflect the chronic microstructural cerebral changes associated with functional interictal activity. The proposed methodology for using MEG and DTI to investigate diffusion abnormalities related to focal epileptogenicity and propagation may provide a further means of noninvasive lateralization.     

Hetero-annulated coumarins as new AChE/BuChE inhibitors: synthesis and biological evaluation

A series of chromene-fused coumarins known as 10,11-dihydrochromeno[4,3-b]chromene-6,8(7H,9H)-diones 4a–o were synthesized through one-pot reaction of appropriate benzaldehydes, dimedone, and 4-hydroxycoumarin in the presence of nano-silica sulfuric acid under solvent-free condition in good yields. The in vitro anticholinesterase assay revealed that the 3-hydroxyphenyl analog 4e showed the highest inhibitory activity against both acetylcholinesterase and butyrylcholinesterase, possessing IC₅₀ values of 3.28 and 2.19?µM, respectively. The structure-activity relationships study demonstrated that the selectivity for acetylcholinesterase over butyrylcholinesterase could be modulated by introducing second hydroxyl or methoxy substituent on the para-position of the 3-hydroxyphenyl pendent group. The docking study of compound 4e with acetylcholinesterase confirmed π–π stacking interaction between the coumarin moiety and Trp279 as well as the formation of hydrogen bonding between hydroxyl group and Asn85.