Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24301320131201Cytotoxic/Proliferative Effects of Umbelliprenin on Colon Cancer Cell Lines114545510.17795/acr-12476ENMaryamHamidiniaShiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR IranMohammadRamezaniDepartment of Pharmacognosy, Faculty of pharmacy, Mashhad University of Medical Sciences, Mashhad, IR IranZahraMojtahediColorectal Research Center, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranJournal Article19700101Background Colon carcinoma growth depends on many factors such as, different organisms, and immune cells, which induce and produce inflammatory cytokines. Umbelliprenin is a naturally prenylated coumarin with anti-inflammatory activities. Its ability to induce cancer cell death has shown variation on different cancer cell lines. Objectives 7-Prenyloxycoumarins, including umbelliprenin have been widely investigated because of their pharmacological activities. This paper shows the effect of umbelliprenin on colon cancer cell lines. Material and Methods In the present study, invasive SW48 and noninvasive SW1116 were treated with umbelliprenin (6.25, 12.5, 25, 50, 100, and 200 μM), and the cytotoxicity was determined using a methyl thiazolelydiphenyl-tetrazolium bromide (MTT) assay. Results Umbelliprenin had significant cytotoxic activity against SW48 cells at all study concentrations (except for 6.25 μM), with IC50 values of 117, 77, and 69 μM after 24, 48, and 72 h, respectively. However, it was cytotoxic against SW1116 only at higher concentrations of 100 and 200 μM (34% and 64% cell death). At lower concentrations, umbelliprenin showed a significant proliferative effect on this noninvasive cancer cell line. Our data were validated by eye and microscopic images. Conclusions We found a moderate cytotoxic activity of umbelliprenin against invasive SW48 cells, and both cytotoxic and proliferative effects on noninvasive SW1116 cells. Therefore, using umbelliprenin as an anti-inflammatory or cytotoxic compound for patients with colon cancer should be used with care.Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24301320131201Primary Mucosa-Associated Lymphoid Tissue Lymphoma of the Rectum114545610.17795/acr-13953ENShapourOmidvariDepartment of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranHamidNasrolahi00989173361958LeilaMoaddabShoarDepartment of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranSeyed HasanHamediDepartment of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranMohammadMohammadianpanahColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranYahyaDaneshbodDr Daneshbod pathology laboratory, Shiraz, IR IranMansourAnsariDepartment of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranNiloofarAhmadlooDepartment of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranAhmadMosalaeiShiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, IR IranJournal Article19700101Introduction Mucosa-associated lymphoid tissue (MALT) lymphoma most commonly involves the stomach and its treatment is surgery, antibiotic therapy or radiotherapy. Rectal MALT is not only so rare but treatment is not as clear as gastric MALT. Case Presentation Our patient was a 66 year-old man presenting with 5-6 months abdominal pain and anemia. In colonoscopy, a rectal ulcer was found and biopsy revealed MALT lymphoma. Physical examination and staging evaluations were normal. Radiotherapy was started for him but he did not tolerate radiotherapy and instead received chemotherapy. After 38 months, he is fine. Conclusions The incidence of rectal MALT is rare and treatment is not so clear. The results on H. pylori eradication, radiotherapy and chemotherapy are more controversial.Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24301320131201Epidemiology of Inflammatory Bowel Diseases (IBD) in Iran: A review of 740 patients in Fars province, Southern Iran114545710.17795/acr-15331ENMuratKekilliAnitaBalintFirst Department of Medicine, University of Szeged, Szeged, HungaryAlpaslanTanogluDepartment of Gastroenterology, GATA Haydarpasa Training Hospital, Istanbul, TurkeyKlaudiaFarkasFirst Department of Medicine, University of Szeged, Szeged, HungaryRenataBorFirst Department of Medicine, University of Szeged, Szeged, HungaryTamasMolnarFirst Department of Medicine, University of Szeged, Szeged, HungaryJournal Article19700101Introduction Mucosa-associated lymphoid tissue (MALT) lymphoma most commonly involves the stomach and its treatment is surgery, antibiotic therapy or radiotherapy. Rectal MALT is not only so rare but treatment is not as clear as gastric MALT. Case Presentation Our patient was a 66 year-old man presenting with 5-6 months abdominal pain and anemia. In colonoscopy, a rectal ulcer was found and biopsy revealed MALT lymphoma. Physical examination and staging evaluations were normal. Radiotherapy was started for him but he did not tolerate radiotherapy and instead received chemotherapy. After 38 months, he is fine. Conclusions The incidence of rectal MALT is rare and treatment is not so clear. The results on H. pylori eradication, radiotherapy and chemotherapy are more controversial.Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24301320131201Aspirin for the Primary Prophylaxis of Colorectal Cancer784545810.17795/acr-16264ENKamranB LankaraniHealth Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranJournal Article19700101Context Increasing epidemic of colorectal cancer worldwide and the expenses of the current screening and treatment of this potentially fatal condition have raised the interest of in finding a primary prophylactic measure. Aspirin has been administrated for more than 40 years to achieve this. Evidence Acquisitions In this manuscript, we reviewed the best available evidence on the prophylatic use of aspirin for colorectal cancer prevention. Results The analysis and large cohort studies revealed that although using ASA would probably decrease the risk of colon cancer, this would not occur before 5-8 years after treatment. ASA usage would increase the risk of major gastrointestinal bleeding. Conclusions Aspirin has been proposed as a chemopreventive agent in colorectal cancer (CRC) for many years, but there are still debates on the proper candidates, treatment time and cost benefit analysis of this potentially harmful drug. This brief review would try to answer these questions using the currently available evidence.Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24301320131201The Effect of Oral Psyllium Herbal Laxative Powder in Prevention of Hemorrhoids and Anal Fissure during Pregnancy, a Randomized Double Blind Clinical Trial274544210.17795/acr-11488ENBuddhike Sri HarshaIndrasenaDepartment of Surgery, Teaching Hospital Batticaloa, Batticaloa, Sri LankaLeilaGhahramaniColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran0000-0002-5282-2212Seyed VahidHosseiniColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranSalarRahimikazerooniColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranAli MohammadBananzadehColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranBahiaNamavar JahromiDepartment of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, IR IranAlamtajSamsamDepartment of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, IR IranAbbasRezaeian ZadehDepartment of Epidemiology, Shiraz University of Medical Sciences, Shiraz, IR IranAli RezaSafarpourAliBagherpour JahromiColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranSeyed HesamaddinBanihashemiDepartment of Surgery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.Journal Article19700101Background Pregnancy and delivery make susceptible women to hemorrhoidal disease and fissure during pregnancy because of an increase in abdominal pressure and constipation. Objectives We aimed to determine the preventative effect of psyllium powder (herbal laxative) on constipation, anal fissure and hemorrhoidal diseases during pregnancy. Patients and Methods Regarding the properties of oral psyllium powder, in this study, we aimed to determine the preventative effect of psyllium powder on constipation, anal fissure and hemorrhoidal diseases during pregnancy. This is a randomized clinical trial. All primigravid women, aging 20-30, at the onset of 3rd trimester who referred to OB clinic of Shiraz university of medical sciences were divided into two groups. Treatment group received psyllium powder twice daily while control group received placebo. All cases were evaluated two times before delivery and occurrence of constipation and fissure and hemorrhoid were assessed by a single team. Results The mean and SD of age in group A (psyllium consumption group) was 29.9 ± 2.24 and in group B (placebo group) was 29.5 ± 2.48. Comparison between three outcome variables (hemorrhoid, fissure and constipation) revealed significant difference in group A and group B in compare with group B, p < 0.001). Conclusions According to our study psyllium powder consumption during the third trimester of pregnancy could significantly prevent constipation, hemorrhoid anal fissure.Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24301320131201Prognostic Value of Total Lymph Node Identified and Ratio of Lymph Nodes in Resected Colorectal Cancer894545910.17795/acr-15311ENLeilaGhahramaniColorectal Research Center, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran0000-0002-5282-2212LeilaMoaddabshoarStudent Research Committee, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranSamiraRazzaghiStudent Research Committee, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranSayed HasanHamediStudent Research Committee, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR IranSaeedehPourahmadBiostatistics Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR IranMohammadMohammadianpanah0000-0001-9391-8977Journal Article19700101Background The extent of lymph node involvement is the most significant prognostic indicator in resected locoregional colorectal cancer. Objectives This study aimed to investigate the prognostic value of total lymph nodes identified and ratio of lymph nodes in resected colorectal cancer. Patients and Methods Two hundred seventy five patients with histologically proven resected locoregional invasive colorectal adenocarcinoma from 2003 to 2011 were included. All patients were treated with standard surgical resection for their colorectal cancer. Patients with incomplete data, or unresectable tumors or distant metastases were excluded from the study. All potential prognostic variables were evaluated for their impact on the local control, disease-free, and overall survival rates. Results Of the 275 patients, 162 were men and 113 were women with a median age of 54 (range 23-84) years. The mean total lymph nodes were significantly higher in colon cancer than rectal cancer (11 versus 7.5, P = 0.001). In node positive (stage III) patients, the mean lymph nodes ratio was 0.5 for rectal cancers and 0.37 for colon cancers respectively showing a nonsignificant (P = 0.05) trend toward higher lymph nodes ratio in rectal cancer patients. In univariate analysis, the mean total number of lymph node identified was a prognostic factor for 5-year disease free (P = 0.04) and overall survival (P = 0.02) rates. In node positive patients, lymph nodes ratio was a prognostic factor for 5-year local control (P = 0.04), disease free survival (P = 0.01), and overall survival (P = 0.01) rates. On multivariate analysis, advanced primary tumor stage, rectal primary site and the presence of perineural invasion were independent adverse prognostic factors for overall survival. Conclusions Total lymph nodes identified and ratio of lymph nodes are associated with oncological outcomes outcomes in patients with colorectal cancer.Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24301320131201Periumbilical Multiport Laparoscopic Appendectomy: A Preliminary Experience Using a Novel Technique994546010.17795/acr-14952ENIbrahimAkkoyunDepartment of Pediatric Surgery, Dr. Faruk Sukan Maternity and Children Hospital, Konya, TurkeyJournal Article19700101Background Single incision laparoscopic surgery (SILS) is especially developed to achieve better cosmetic results. Using the umbilicus for ports access is widely accepted in this approach. Objectives The aim of this study was to evaluate our initial experience with a new port access technique applied for laparoscopic appendectomy: Periumbilical Multiport Laparoscopic Appendectomy (PUMLA). Patients and Methods Between January 2011 and March 2013, a total of 14 appendectomies were performed using a new port access technique. Patients were selected randomly. Thirteen of these cases had acute appendicitis, and one patient had familial Mediterranean fever (FMF). During these operations, three separate curvilinear incisions were created in the periumbilical skin folds and ports were placed in these ways. The five mm port was used for a zero degree telescope. The other two were used to manipulate the laparoscopic instruments. The appendectomy was performed intracorporeally in six cases; however, in eight cases, the appendix was taken out via trocar after dissecting the mesoappendix, then the appendectomy was performed extracorporeally. Reconstruction was not needed to the umbilicus as there was no anatomical distortion. Results Five patients were female, and nine were male. Age range was 5 to 15 years (mean 9.7 y). Operation time was between 20 and 82 minutes (mean 43 min). We did not need to convert to standard laparoscopic appendectomy or place an additional port in any of these patients. The average postoperative hospitalization was 14.1 hours (5-33 h). No complications such as wound infection, trocar site hernia, adhesive small-bowel obstruction, or abscess were observed in the early and late postoperative period. Good cosmetic results were obtained after separate periumbilical curvilinear incision technique. Conclusions We found that this new port access technique is feasible, safe, and associated with good cosmetic results.Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24301320131201The Effects of Human Amniotic Membrane on Healing of Colonic Anastomosis in Dogs914546110.17795/acr-16139ENNedaNajibpourDepartment of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR IranMohammad BagherJahantabDepartment of Surgery, Shiraz University of Medical Sciences, Shiraz, IR IranMassoodHosseinzadehColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranRezaRoshanravanColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranSamMoslemiDepartment of Surgery, Shiraz University of Medical Sciences, Shiraz, IR IranSalarRahimikazerooniColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranAli RezaSafarpourGastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranLeilaGhahramaniColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran0000-0002-5282-2212Seyed VahidHosseiniJournal Article19700101Background Anastomotic leakage is claimed to be responsible for about one third of deaths following colon surgeries. Therefore, research on applied materials that may prevent leakage and improve healing requires more attention. Objectives This study was conducted to determine surgical and histological outcomes of applying human amniotic membrane (HAM) in colonic anastomosis in dogs. Materials and Methods Eight cross-breed male dogs were divided into two equal groups. After anesthesia and exploration, 5cm of left colon was resected, and end-to-end anastomosis was performed in a single layer. In the treatment group (B), HAM patch measuring 2×3 cm was wrapped around the anastomotic line. Mann-Whitney U test was used to compare the results in the two groups due to small sample size, and normal distribution of data was examined using the kolmogorov-simirnov test (P = 0.03). Results Modified scoring system for surgical wound healing was used to identify the grade of healing in all samples. The healing score was significantly higher in the HAM group (P = 0.01). Conclusions HAM plays a positive role in healing of colonic anastomosis, and would lead to better histological outcomes compared to simple anastomosis in dogs.