Microdissection testicular sperm extraction outcomes in azoospermic patients with bilateral orchidopexy.

BACKGROUND: Cryptorchidism is considered to be one of the most common causes of non-obstructive azoospermia. There are several surgical techniques to retrieve sperm in these patients. Microdissection testicular sperm extraction (m-TESE) is a recent sperm retrieval technique which is considered to be a safe, non-blind, and feasible method. OBJECTIVES: This study aimed to investigate sperm retrieval rate (SRR) by the mTESE method in patients who have undergone orchidopexy due to bilateral cryptorchidism. MATERIALS AND METHODS: In this retrospective study, 56 ex-cryptorchid patients, who underwent mTESE due to post orchidopexy azoospermia, were included. Patients with hypogonadotropic hypogonadism, Klinefelter syndrome, azoospermia factors (AZF) microdeletion, or chromosomal translocation were excluded from the study. Data were obtained from medical files. RESULTS: SRR in this study was 46%. Patients were divided into two groups of negative (n = 30) and positive (n = 26) based on the sperm extraction outcomes. There was no statistically significant difference between two groups regarding the mean age at mTESE, mean age at orchidopexy, testicular size, and serum testosterone concentration. However, testicular location, histological patterns, FSH, and LH level showed to have statistically significant relation with sperm retrieval results. But, according to our logistic regression, none of the included variable in the model including FSH, LH, histopathology, and testis location have a significant effect on the presence of the sperm. DISCUSSION: In the present study, SRR was significantly higher in patients with scrotal testis and low level of FSH and LH. CONCLUSIONS: Performing mTESE could be recommended in ex-cryptorchid patients with post orchidopexy NOA. Preoperative testicular biopsy seems to be unnecessary while clinical criteria can perfectly define NOA.

Topography of gastritis and its severity in 864 first degree relatives of gastric cancer patients.

OBJECTIVES: Studies on gastric mucosal histological findings among first degree relatives (FDR) of gastric cancer (GC) patients are scarce. The aim is to evaluate the topography and the severity of gastritis among FDR of GC patients. DESIGN: A total of 989 subjects who were FDR of GC patients, ages 40-65 years underwent gastroscopies. When no gross lesion was found, five specimens were evaluated according to the Sydney Classification and one for urease testing in order to determine the type of gastritis and its severity. RESULTS: Of the 989 subjects, 107 had significant lesions, including two with GC and one with esophageal cancer. The 864 subjects who had complete morphological data taken from five gastric areas (two from the antrum and three from the corpus) comprised 419 males (mean age 48.5±7 years) and 445 females (mean age 47±6.4 years). The H. pylori rate was 76.6%. Normal mucosa was seen in 6.9%, antrum-restricted gastritis in 7.4%, antrum-predominant gastritis in 63.5% and corpus-predominant gastritis in 20% (both had >80% H. pylori infection) and corpus-restricted gastritis in 2%. More atrophy was seen in the antrum and corpus of FDR females than males. The severity did not differ between those with one or more GC patients' relatives. Forty-nine percent of FDR had atrophy and 9.4% intestinal metaplasia (IM) in the corpus. After the age of 40, there was progression of intestinal metaplasia from 12.2 to 27.3% in the antrum and from 6.7% to 26.2% in the corpus during two decades. No high grade dysplasia was found in this mid-age population. CONCLUSION: Only one-fifth of FDR have H. pylori-induced corpus-predominant gastritis who are at risk for cancer and suitable for eradication. Corpus-restricted gastritis is a rare disease in this area.

Cancer occurrence in old age: Results of a population-based cancer registry in Semnan, Iran.

INTRODUCTION: The proportion of elderly persons has increased in most countries during the last few decades, and will increase further in the coming years. A population-based study was here carried out to clarify the site-specific cancer-incidence rates in old age in Iran. AIMS AND METHODS: A comprehensive search was undertaken to survey and register all new cancer cases during a 5-year (1998-2002) period among the indigenous population of Semnan Province aged 65 years or over. Diagnosis of cancer was based on histopathology, clinical or radiological findings, and death certificates. RESULTS: A total of 791 patients were registered with cancers. Of these, 492 (62.1%) were males. Crude rates were 1,310 and 962 per 100,000 persons per year for males and females respectively, and age-standardized ratios (ASRs) were 1350 and 973. Gastric cancer was the most common tumor with incidence rates of 340 and 153 per 100,000 persons per year for elderly males and females respectively. In women breast cancer was the second most common cancer (ASR= 108). In men prostate cancer was the second most common cancer with ASR= 150. CONCLUSIONS: Based on the present standardized rates, cancer is almost 9 times and 7 times more frequent among the elderly compared with younger men and women (30-64). The highest incidence of cancers was in group 75-79 years in both sex and then decrease was noted with increasing age.

Prospective evaluation of a new "paper urease test" for ultra-rapid detection of Helicobacter pylori.

BACKGROUND: The purpose of this study was to determine the sensitivity, specificity, and positive and negative predictive values of a newly developed paper urease test (PUT) for ultra-rapid detection of helicobacter pylori (HP) in gastric mucosa. MATERIAL/METHODS: 100 patients (43 men) with a mean age of 57+/-6.8 years participated. Patients presenting for upper endoscopy with no recent exposure to HP-altering drugs were enrolled. Gastric biopsy specimens were tested by the PUT and histology methods, and then the patients underwent [13C] urea breath tests (UBT). HP was considered positive when either UBT or histology demonstrated it, and negative if HP was not detected in either UBT or histology. The PUT was reported at 15 minutes. RESULTS: 87 of 100 patients tested positive for HP. The PUT correctly identified 74 of 87 HP-positive and 13 of 13 HP-negative patients, yielding sensitivity, specificity, and positive and negative predictive values of 87%, 100%, 100% and 53.5%, respectively, in this population. CONCLUSIONS: Rapidly available and reliable results from the PUT can facilitate clinical decision prior to patient discharge from the endoscopy suite. We recommend PUT for screening of HP in endoscopy candidates, due to high specificity, rapid reaction, simplicity and low cost. A positive result shows a definite diagnosis, although a negative result needs further diagnostic methods.

Cancer occurrence in Semnan Province, Iran: results of a population-based cancer registry.

INTRODUCTION: suitable information of different cancers in special geographic areas can help define medical programs for treatment and screening of high-risk groups. AIMS AND METHODS: The provincial health authority reported a high mortality rate from upper GI cancer in the center of Iran. A comprehensive search was undertaken to survey and register all cases of cancer during a 5-year (1998-2002) period among the indigenous population of Semnan Province. Diagnosis of cancer was based on histopathology, clinical or radiological findings, and death certificates. RESULTS: A total of 1732 patients with cancers (mean age 59.41% +/-19.08% years) were found during the study. Of these, 936(54.86%) were in males. Crude rates were 124.8/100,000 and 112.1/100,000 for males and females, respectively. Age-standardized ratios (ASRs) for all cancers in males and females were 156/100,000 and 136/100,000 person-year, respectively. Gastric cancer was the most common tumor with an incidence rate of 19.7 per 100,000 people (ASR=27.5). In upper gastrointestinal cancers, gastric cancer was the most common (47.17%), followed by colon malignancies (8.1%, 9.5 per 100,000 populations), esophagus (6.8%, 7.9 per 100,000 populations), liver (2.4%, and 2.8 per 100,000 populations). In women, breast, uterine and ovary, stomach and skin were the most common cancers. In the child population the most common tumors were of the brain, acute lymphocytic leukemia, and bone. CONCLUSION: Gastric cancer alone constitutes one-sixth of all cancers in Semnan, with the highest ASR incidence rate reported from Iran up to now.