Assessment of changes in expression and presentation of NKG2D under influence of MICA serum factor in different stages of breast cancer.

Breast cancer is the most common cancer in women worldwide. In this study, we correlated the serum level of major histocompatibility complex class I-related chain A (sMICA) with expression and presentation of NKG2D receptors on NK cells among patients with breast cancer. Peripheral blood (PB) samples were collected from 49 healthy and 49 breast cancer patients before surgery and chemotherapy. The expression and presentation of NKG2D were assessed using qRT-PCR and flow cytometry, respectively. Furthermore, sMICA levels were determined using ELISA. In flow cytometry, whole blood samples were stained with anti-CD56/NKG2D/CD3 and the obtained results were analyzed using WinMDI software. In addition, SPSS software was used for statistical analysis of data. Significantly higher levels sMICA were detected in the sera of the majority of cancer patients in contrast to healthy volunteers (P < 0.001). The expression and presentation of NKG2D receptor were significantly lower than those in healthy persons, and with an inverse correlation to sMICA and positively correlated with tumor stage. Our study showed that sMICA may have an important role in diminishing the expression and presentation of NKG2D receptor in breast cancer patients and proposes the notion that sMICA can be a target candidate for treatment of breast cancer.

Mortality and Morbidity and Disease Free Survival after D1 and D2 Gastrectomy for Stomach Adenocarcinomas.

BACKGROUND: A number of randomized trials addressing alternative operative and multimodality approaches to gastric cancer have characterized early postoperative morbidity and mortality rates. The aim of this study was to compare mortality and morbidity and disease free survival after D1 and D2 gastrectomy for adenocarcinomas of the stomach MATERIALS AND METHODS: From June 2006 to January 2012, patients were selected according to information of the cancer administrator center of Ahvaz Jundishapur Medical University. The inclusion criteria were age between 20-85 years and histologically proven adenocarcinoma of the stomach without evidence of distant metastasis. Patients were excluded if they had previous or coexisting cancer or disability disease. In this research, D1 was compared to D2 gastrectomy. RESULTS: 131 patients were randomised, 49 allocated to D1 and 82 to D2 gastrectomy. The two groups were comparable for age, sex, site of tumors, and type of resection performed. The overall post-operative morbidity rate was 17.5%. Complications developed in 14.2% of patients after D1 and in 19.5% of patients after D2 gastrectomy (p=0.07). Postoperative mortality rate was 0.8% (one death); it was 2% after D1 and 0% after D2 gastrectomy. In this research disease free-survival after 3 years was 71.2 % with 63.2% after D1 and 76.8% after D2 gasterctomy. CONCLUSIONS: This study indicates that D2 gastrectomy with pancreas preservation is not followed by significantly higher morbidity and mortality than D1 resection. Based on the results of present study, D2 resection should be recommended as the standard surgical approach for resectable gastric cancer.

Arterio-arterial prosthetic duct (AAD) as a vascular access in hemodialysis.

Vascular access (VA) is mainly a problem confronting patients undergoing hemodialysis (HD). In some cases, peripheral veins are damaged or thrombosed because of repeated vein punctures and subsequent thrombophlebitis or accompanying ailments like diabetes or other kinds of vasculitis, making the use of conventional VA methods unsuitable. In this study, we present our experience using a synthetic vascular graft as an arterio-arterial duct (AAD) in the upper arm of patients undergoing HD, in whom other procedures had failed. In this procedure, we used a synthetic vascular prosthesis of polytetrafluoroethylene(ePTFE) (Gore-Tex) or Vasculink as an AAD, subcutaneous in the media aspect of the upper arm. HD was performed for this duct. Twenty patients were selected in whom all other VA means had failed. Patient age ranged from 33-83 yrs. In two patients (12%), early graft thrombosis was the cause of failure. In the remaining 14 patients (87%), a suitable flow was established. In another two patients, after several dialysis sessions the duct stopped functioning. We believe the reason for this malfunction was too much pressure on the graft to control bleeding due to the inadequate training of the HD personnel. The remaining 12 patients (75%) used the duct for >6 months. With this method, because we used only the artery for placing the conduit, complications relating to the vein such as limb ischemia, edema and venous hypertension did not prevail. On the other hand, because the conduit is an accessory duct, should it have become thrombosed, arterial flow to the limb would be unhindered. Therefore, we believe when all other conventional VA methods have failed, AAD is a suitable technique.