Tehran University Medical Journal

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Glycoconjugates are a class of cell surface glycoproteins, the terminal sugars of which are important indicators of neoplasia and the aberrant biological behavior of cancer cells. Lectins are a class of plant or animal glycoproteins that specifically bind to the terminal sugars of glycoconjugates. The aim of the present study is to identify the presence of L-fucose in cell surface glycoconjugates and extracellular matrix glycoconjugates of cancer cells of different grades of colonic adenocarcinoma.
Methods: Paraffin blocks of colonic adenocarcinoma tissue from 30 patients were collected from the Pathology Department of Khatam Al Anbia Hospital in Zahedan, Iran. Sections, 5-7μm thick, were prepared and stained using hematoxylin and eosin. Sections were graded histopathologically and then stained using the lectin Ulex europaeus agglutinin (UEA, 10μm/mL), which binds specifically to L-fucose, and Alcian blue (pH=2.5). Sections were graded blindly according to lectin staining intensity on a scale of 0-3. Collected data were analyzed using Kruskall-Wallis and Mann Whitney nonparametric tests with SPSS.
Results: Our results show that there is a significant difference in the staining intensity for L-fucose between tumoral cells of different grades of colon carcinoma (p<0.001). Results show that the degree of UEA lectin binding to cancer cells is lower in the cytoplasm and nucleus and higher in the extracellular matrix in tumors, with the degree increasing with histopathological grade. Furthermore, staining intensity differs in different portions of cancer cells.
Conclusions: The increased staining intensity of L-fucose in the extracellular matrix of colon carcinoma is a reflection of the aberrant protein glycosylation pathway in neoplasia.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: The ability of a specific test to predict a difficult intubation is decreased by the variability of definitions of difficult intubation/laryngoscopy. The Mallampati classification system is a widely utilized approach for evaluating patients in the preoperative setting. Zero class of Mallampati is a new class of airway view that to add to the four modified Mallampati classes. This study estimates the incidence of class zero airway and determines the ability of Mallampati score, age and sex on the prediction of the larangoscopy grade.
Methods: This is a cross sectional study in which 376 patients aged 7-18 years and A.S.A physical status I or II were enrolled. They were scheduled for surgery under general anesthesia All the airway assessments were done in the sitting position, with the patient's head in neutral position, mouth fully open, tongue fully extended and without phonation. After induction of general anesthesia, laryngoscopy grade was assessed in sniffing position using the Cormak & Lehame grading scale.
Results: Class zero airways occurred in 0.3% of patients, and the patients with class zero airway had a grade I laryngoscopy. 49.5% of patient had class I, 37.2% class II, 13% of patient had class III and there found no patient with class IV airway. Grade II and III laryngoscopy were more frequent in females than in males but this correlation was not statistically significant. 
Conclusions: Assessment of airway by Mallampati scoring system and attention to the age can be an important factor in the prediction of high laryngoscopy grade.

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Background: Recently the use of “two tier" grading system in which ovarian serous carcinoma was classified as low-grade or high-grade in comparing to preceding system has improved authority in prognosis and survival. This approach is simplistic, reproducible, and based on biologic evidence. In this study, we reclassified ovarian serous carcinoma by a new two-tier system for grading and then evaluation of P53 expression in these tumors by immunohistochemistry method. Methods: We retrospectively reviewed 32 cases of ovarian serous carcinoma with previous diagnosis of well differentiated (eight cases) and moderate to poorly differentiated serous carcinoma (24 cases) and according "two tier" grading system in low-grade vs. high-grade serous carcinoma reclassified. Subsequntly all cases immunostained by P53 marker. Also clinical data related to survival of patients (with or without recurrence of tumor and death) and paraclinical findings such as presurgical blood serum level of CA125 are gathered. Results: Out of total eight patients with previously diagnosis well diferentiated serous carcinoma and of 24 patients with moderate to poorly differentiated serous carcinoma reclassified as low-grade and high-grade ovarian serous carcinoma respectively and a statistically significant difference was found between two groups. (P<0.005) Also of total 24 cases with high grade serous carcinoma, in 12 cases (54%) P53 immunostaining was detected but in non of all low grade serous carcinoma was seen. All 8 low grade serous carcinoma were alive without recurrence of tumor. In 10 and 12 out of 24 cases with high grade serous carcinoma recurrence of tumor and death were seen respectively. Conclusion: Since the presence of P53 negative expression in all of low-grade serous carcinoma by immunostaining and low-grade serous carcinoma accounts for small pupulation of all ovarian serous carcinoma and also few cases in our study, we did not find significant differences between P53 expression and survival in two low-grade vs high-grade serous carcinoma groups.

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Background: This study investigated compatibility between post chemoradiation magnetic resonance images and histologic findings after operation and chemoradiation in patients with locally advanced rectal cancer.

Methods: In this prospective study, 63 patients referred to Cancer Institute of Emam Khomeini Hospital, Tehran, Iran, from October 2011 to October 2013 with locally advanced rectal cancer receiving neoadjuvant chemoradiation (50.4 Gy external beam radiation with concomitant capecitabine 825 mg/m2 PO twice a day with or without 60 mg/m2 oxaliplatin weekly). Patients had an MRI before chemoradiation and MRI assessment were used to identify Tumor (T) and lymph node (N) staging by an experienced radiologist. Patients were recommended to repeat MRI after surgery but it was not obligatory. Findings of post chemoradiation MRI and histopathologic reports were compared. Downstaging was defined as at least one stage decrease in T or N in histopathologic report comparing to their first MRI, on condition of no sign of disease progression.

Results: 32 patients (50.79%) had T downstaging and 36 of them (57.14%) showed N downstaging: none had disease progression. In this study MRI had an accuracy of 55.5% for rectal tumor (T) restaging after chemoradiation comparing to pathology. MRI sensitivity for T restaging was 33.3% to 83.3%.  There was a higher possibility to have errors in restaging of T1-2 stages. Specificity of MRI for T restaging was higher than its sensitivity, 66.6%. In this study lymph node involvement (N) was determined according to morphology and size. MRI has an accuracy of 42.8% for detecting lymph node involvement. Its sensitivity and specificity for N restaging were 50% and 66.6% respectively. All patients had MRI before chemoradiation, although 21 of them repeated MRI after chemoradiation since it was not mandatory. 19 of these 21 patients underwent surgery.

Conclusion: Although MRI is a suitable imaging for staging locally advanced rectal cancer its use for restaging after chemoradiation is under question. According to this study, MRI accuracy rates for both T and N restaging were below the rates of previous studies.