Publications by authors named "Taghi Amiriani"

30 Publications

  • Page 1 of 1

Preconditioning and anti-apoptotic effects of Metformin and Cyclosporine-A in an isolated bile duct-ligated rat heart.

Eur J Pharmacol 2021 Feb 5;893:173807. Epub 2021 Jan 5.

Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran. Electronic address:

Despite all previous studies relating to the mechanism of cirrhotic cardiomyopathy (CCM), the role of cirrhosis on Ischemic Preconditioning (IPC) has not yet been explored. The present study strives to assess the cardioprotective role of IPC in bile duct ligated (BDL) rats as well as the cardioprotective role of Cyclosporin-A (CsA) and Metformin (Met) in CCM. Cirrhosis was induced by bile duct ligation (BDL). Rats' hearts were isolated and attached to a Langendorff Apparatus. The pharmacological preconditioning with Met and CsA was done before the main ischemia. Myocardial infarct size, hemodynamic and electrophysiological parameters, biochemical markers, and apoptotic indices were determined at the end of the experiment. Infarct size, apoptotic indices, arrhythmia score, and incidence of VF decreased significantly in the IPC group in comparison with the I/R group. These significant decreases were abolished in the IPC (BDL) group. Met significantly decreased the infarct size and apoptotic indices compared with I/R (BDL) and normal groups, while CsA led to similar decreases except in the level of caspase-3 and -8. Met and CsA decreased and increased the arrhythmia score and incidence of VF in the BDL groups, respectively. Functional recovery indices decreased in the I/R (BDL) and IPC (BDL) groups. Met improved these parameters. Therefore, the current study depicted that the cardioprotective effect of Met and CsA on BDL rats is mediated through the balance between pAMPK and apoptosis in the mitochondria.
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http://dx.doi.org/10.1016/j.ejphar.2020.173807DOI Listing
February 2021

Association Between Helicobacter pylori Colonization and Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.

J Clin Gastroenterol 2020 Aug 21. Epub 2020 Aug 21.

Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Various observational studies have examined a potential relationship between Helicobacter pylori colonization and inflammatory bowel diseases (IBDs); however, results are inconclusive. This systematic review evaluates articles reporting an association between human H. pylori colonization and IBD.

Methods: A systematic search of studies was conducted to evaluate a possible relationship between H. pylori colonization and IBD. Seven databases and different types of gray literature were searched. After screening for relevant articles, selection and data extraction were done. After that, the data were analyzed, and pooled odds ratios (ORs) were calculated, using meta-analysis. Heterogeneity, sensitivity, and subgroups analyses were conducted. Funnel plots followed by Begg and Egger tests were done to assess the publication bias.

Results: Among 58 studies, including 13,549 patients with IBD and 506,554 controls, the prevalence of H. pylori colonization was 22.74% and 36.30%, respectively. A significant negative association was observed between H. pylori colonization and IBD (pooled OR: 0.45, 95% confidence interval 0.39-0.53, P≤0.001). The random-effect model showed significant statistical heterogeneity in the included studies (I=79%). No publication bias was observed. Among subgroups, ORs were notably different when the data were stratified by the age difference between patient and control group, and by study regions and/or continent. Finally, the meta-regression analysis showed significant results, in terms of the age difference and region variables.

Conclusions: In this meta-analysis, all statistical data support the theory that H. pylori has a protective role in IBD. However, more primary studies using proper methodology are needed to confirm this association.
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http://dx.doi.org/10.1097/MCG.0000000000001415DOI Listing
August 2020

A simple risk-based strategy for hepatitis C virus screening among incarcerated people in a low- to middle-income setting.

Harm Reduct J 2020 08 14;17(1):56. Epub 2020 Aug 14.

Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hepatitis C virus (HCV) is among the highest priority diseases in custodial settings; however, the diagnosis remains suboptimal among people in custody. This study aimed to validate a short survey for identifying people with HCV infection in a provincial prison in Iran.

Methods: Between July and December 2018, residents and newly admitted inmates of Gorgan central prison completed a questionnaire, including data on the history of HCV testing, drug use, injecting drug use, sharing injecting equipment, and imprisonment. Participants received rapid HCV antibody testing, followed by venipuncture for RNA testing (antibody-positive only). Each enrollment question (yes/no) was compared with the testing results (positive/negative).

Results: Overall, 1892 people completed the questionnaire, including 621 (34%) who were currently on opioid agonist therapy (OAT); 30% of participants had been tested for HCV previously. About 71% had a history of drug use, of whom 13% had ever injected drugs; 52% had ever shared injecting equipment. The prevalence of HCV antibody and RNA was 6.9% (n = 130) and 4.8% (n = 90), respectively. The antibody prevalence was higher among people on OAT compared to those with no history of OAT (11.4% vs. 4.0%). History of drug use was the most accurate predictor of having a positive HCV antibody (sensitivity: 95.2%, negative predictive value: 98.9%) and RNA testing (sensitivity: 96.7%, negative predictive value: 99.5%). The sensitivity of the drug use question was lowest among people with no OAT history and new inmates (87% and 89%, respectively). Among all participants, sensitivity and negative predictive value of the other questions were low and ranged from 34 to 54% and 94 to 97%, respectively.

Conclusions: In resource-limited settings, HCV screening based on having a history of drug use could replace universal screening in prisons to reduce costs. Developing tailored screening strategies together with further cost studies are crucial to address the current HCV epidemic in low- to middle-income countries.
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http://dx.doi.org/10.1186/s12954-020-00400-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427767PMC
August 2020

The association between leptin and adiponectin, and metabolic syndrome components and serum levels of lipid peroxidation in bipolar disorder patients treated with lithium and valproic acid.

Heliyon 2020 Jul 27;6(7):e04553. Epub 2020 Jul 27.

Metabolic Disorders Research Center, Department of Biochemistry and Biophysics, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Golestan province, Iran.

Background: The aim of study is to assess a relation between the adiponectin and leptin levels, and metabolic syndrome components and lipid peroxidation treated with Li and VPA in bipolar disorder patients and compared with controls.

Materials And Methods: 56 patients and 31 healthy controls were enrolled. The ATP III criteria were used to determine metabolic syndrome components. Leptin, adiponectin, lipid peroxidation and lipid profiles were measured.

Results: Malondialdehyde in Li patients was higher than VPA patients. BMI, waist circumference (WC), triglyceride, malondialdehyde and adiponectin levels were increased, whereas HDL-cholesterol (VPA treated patients) and leptin were decreased in patients compared with controls. Leptin and adiponectin were correlated with WC, triglyceride and malondialdehyde in both groups. Adiponectin was correlated with HDL-cholesterol in VPA patients.

Conclusion: Patients should be checked metabolic syndrome components, serum leptin and adiponectin level occasionally to prevent possible deficiency or pathologic increase of these parameters.
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http://dx.doi.org/10.1016/j.heliyon.2020.e04553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393417PMC
July 2020

The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta-analysis.

Helicobacter 2020 Oct 23;25(5):e12730. Epub 2020 Jul 23.

Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran.

Background: Antimicrobial resistance of Helicobacter pylori can result in eradication failure. Metadata on the antimicrobial resistance of H pylori in Iran could help to formulate H pylori eradication strategies in Iran.

Methods: A systematic review was performed after searching in MEDLINE, Scopus, Embase, Web of Science, and the Cochrane Library. A meta-analysis was performed, and a comparison of the rates between children and adults; time periods (1999-2010, 2011-2016, 2017-2019); and the methods used was carried out.

Results: A total of 66 studies investigating 5936 H pylori isolates were analyzed. The weighted pooled resistance (WPR) rates were as follows: clarithromycin 21% (95% CI 16-26), metronidazole 62% (95% 57-67), clarithromycin in combination with metronidazole 16% (95% CI 10-23), ciprofloxacin 24% (95% CI 15-33), levofloxacin 18% (95% CI 9-30), erythromycin 29% (95% CI 12-50), furazolidone 13% (95% CI 4-27), tetracycline 8% (95% CI 5-13), and amoxicillin 15% (95% CI 9-22). During the three time periods, there was an increased resistance to amoxicillin, clarithromycin, ciprofloxacin, furazolidone, and tetracycline (P ˂ .05). Furazolidone and a clarithromycin/metronidazole combination had the higher resistance rates in children (P ˂ .05).

Conclusion: An increasing rate of resistance to amoxicillin, clarithromycin, ciprofloxacin, furazolidone, and tetracycline in Iranian H pylori isolates was identified. In children, the resistance to furazolidone and a combination of clarithromycin and metronidazole is higher compared to adults. As a stable, high resistance to metronidazole was found in children and adults in all Iranian provinces, we suggest that metronidazole should not be included in the Iranian H pylori eradication scheme.
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http://dx.doi.org/10.1111/hel.12730DOI Listing
October 2020

Genetic polymorphisms -137 (G > C) (rs187238) and -607 (C > A) (rs1946518) and serum level of interleukin 18 in Fars ethnic groups with metabolic syndrome in Northern Iran.

Arch Physiol Biochem 2020 Jul 7:1-7. Epub 2020 Jul 7.

Metabolic Disorders Research Center, Department of Biochemistry and Biophysics, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.

We aimed to determine the genetic polymorphisms and serum level of interleukin 18 in Fars ethnic groups. 226 Fars ethnic groups were participated. The ATP III criteria were used to assess MS components. The SNPs of the IL-18 gene were determined with ARMS-PCR. The GG, GC, and CC genotypes of -137 were 50%, 40%, and 10%. The CC, CA, and AA genotypes of -607 were 45%, 37%, and 18%. The GG, GC, and CC genotypes of -137 were 44.20%, 43.40%, and 12.40%, and were 55.75%, 36.28%, and 7.97% in subjects with and without MS, respectively. The CC, CA, and AA genotypes of -607 were 48.70%, 37.20%, and 14.20% and were 41.60%, 37.20%, and 21.20% in both groups, respectively. IL-18 gene may different in specific populations, different ethnic groups and geographic regions. The IL-18 polymorphisms might not be used as a marker of metabolic syndrome.
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http://dx.doi.org/10.1080/13813455.2020.1784954DOI Listing
July 2020

Recent cancer incidence trends and short-term predictions in Golestan, Iran 2004-2025.

Cancer Epidemiol 2020 08 15;67:101728. Epub 2020 Jun 15.

Section for Cancer Surveillance, International Agency for Research in Cancer, Lyon, France. Electronic address:

Background: We examine recent trends in the major cancers occurring in the Golestan province, a high-risk region for upper gastrointestinal cancers in Northern Iran, and provide short-term cancer predictions of the future cancer burden.

Methods: New cancer cases diagnosed in Golestan 2004-2016 were obtained from the Golestan population-based cancer registry (GPCR) database, and age-standardized rates by cancer site, year and sex calculated per 100,000 person-years. Using IARC's DepPred package we fitted time-linear age-period models to the available GPCR data to predict the cancer incidence burden in the year 2025. We calculated the contribution of demographic changes versus changes in risk to the overall changes in incidence from 2016 to 2025.

Results: The number of new cancer cases (excluding non-melanoma skin cancers) in 2025 is predicted to increase by 61.3% from 2678 cases in 2016 to 4319 cases. While a 17.6% reduction in the number of esophageal cancer cases is predicted by 2025, the number of new cases for each of the remaining major cancers is predicted to increase over the next decade, including cancers of the stomach (a 36.1% increase from 2016 to 2025), colorectum (56.2%), lung (67.8%), female breast (93.2%), prostate (101.8%) and leukemia (96.1%). The changes in the population structure and risk contributed 37.8% and 23.5% respectively, to the overall increase in incidence.

Conclusion: Other than for the major upper gastrointestinal cancer types, the incidence rates of common cancers observed in the province are on the rise, reinforcing the need for continuous surveillance, as well as the design and implementation of effective cancer control programs.
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http://dx.doi.org/10.1016/j.canep.2020.101728DOI Listing
August 2020

Trends in the Incidence of Stomach Cancer in Golestan Province, a High-risk Area in Northern Iran, 2004-2016.

Arch Iran Med 2020 06 1;23(6):362-368. Epub 2020 Jun 1.

Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: We aimed to present the temporal and geographical trends in the incidence of stomach cancer in the Golestan province, a high-risk area in Northern Iran.

Methods: This study was conducted on stomach cancer cases registered in the Golestan Population-based Cancer Registry (GPCR) during 2004-2016. Age-standardized incidence rates (ASRs) per 100000 person-years were calculated. The Joinpoint regression analysis was used to calculate the average annual percent changes (AAPC). We also calculated the contribution of population aging, population size and risk to the overall changes in incidence rates.

Results: Overall, 2964 stomach cancer patients were registered. The ASR of stomach cancer was significantly higher in men (26.9) than women (12.2) (P<0.01). There was a significant decreasing trend in incidence of stomach cancer in men (AAPC=-1.80, 95% CI: -3.30 to-0.28; P=0.02). We found a higher ASR of stomach cancer in the rural (21.4) than urban (18.1) (P=0.04) population, as well as a significant decreasing trend in its rates (AAPC=-2.14, 95% CI: -3.10to-1.17; P<0.01). The number of new cases of stomach cancer increased by 22.33% (from 215 in 2004 to 263 in 2016), of which 18.1%, 25.1% and -20.9% were due to population size, population aging and risk, respectively. Our findings suggest a higher rate for stomach cancer in eastern areas.

Conclusion: We found high incidence rates as well as temporal and geographical diversities in ASR of stomach cancer in Golestan, Iran. Our results showed an increase in the number of new cases, mainly due to population size and aging. Further studies are warranted to determine the risk factors of this cancer in this high-risk population.
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http://dx.doi.org/10.34172/aim.2020.28DOI Listing
June 2020

Vitamin D decreases CD40L gene expression in ulcerative colitis patients: A randomized, double-blinded, placebo-controlled trial.

Turk J Gastroenterol 2020 Feb;31(2):99-104

Department of Clinical Nutrition, Tehran University of Medical Sciences School of Nutritional Sciences and Dietetics, Tehran, Iran.

Background/aims: The interaction of CD40 ligand (CD40L) and CD40 triggers the induction of pro-inflammatory cytokines. It has been proposed that vitamin D deficiency might be an important factor, which causes or aggregates the autoimmune situations. The aim of the present study was to assess the effect of vitamin D on CD40L gene expression in patients with ulcerative colitis (UC).

Materials And Methods: Ninety mild-to-moderate UC patients were randomized to receive a single injection of 7.5 mg cholecalciferol or 1 mL normal saline. At baseline and 90 days following the intervention, RNA samples from whole blood were obtained. Fold changes in CD40L mRNA expression were determined for each patient using the 2-ΔΔCq method. The data were analyzed.

Results: The serum levels of vitamin D and calcium increased only in the vitamin D group (p<0.05). Relative to baseline values, the CD40L gene expression fold change was significantly lower in the vitamin D group compared with the placebo group (median±interquartile range: 0.34±0.30 vs 0.43±1.20, respectively, p=0.016).

Conclusion: The results of this study showed that vitamin D administration in mild-to-moderate UC patients led to the downregulation of the CD40L gene, which is an essential part of inflammatory pathways.
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http://dx.doi.org/10.5152/tjg.2020.181028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062129PMC
February 2020

Effect of Lactocare® Synbiotic on Disease Severity in Ulcerative Colitis: A Randomized Placebo-Controlled Double-Blind Clinical Trial.

Middle East J Dig Dis 2020 Jan;12(1):27-33

Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.

BACKGROUND Inflammatory bowel diseases are managed by different methods, which may not be well tolerated because of their side effects. Recently, pro-prebiotics are considered as a supplementary treatment in gastrointestinal diseases. In this study, the effect of Lactocare® (ZistTakhmir Company) was investigated on the disease severity in mild to moderate ulcerative colitis. METHODS In this randomized, double-blind clinical trial (Iranian Registry of Clinical Trials number: IRCT201407271264N5), 60 patients with mild to moderate ulcerative colitis were included. An 8-week trial was carried out comparing Lactocare® as a supplement with standard therapy against placebo. Simple Clinical Colitis Activity Index (SCCAI) was measured at baseline and after 8 weeks. Statistical analysis was performed using paired ttest to assess the temporal changes (before and after the treatment) in the mean of SCCAI in each group. Chi-square test was used to compare the response rates. Odds ratios (OR) and the 95% confidence intervals (95%CI) were also calculated. p values of less than 0.05 were considered significant. RESULTS A significant decreased mean SCCAI was seen in the intervention group (4.56 ± 2.56) vs. placebo group (6.54 ± 2.47) ( < 0.05). Response to treatment was seen in 64.3% of the treatment group vs. 47% in the placebo group ( = 0.18). Response to treatment was observed in 90.9% of patients with ulcerative colitis for more than 5 years compared with 44.4% of the control group ( = 0.01). CONCLUSION Regarding the effectiveness of pre-probiotics in mitigating symptoms in patients with ulcerative colitis, it could be suggested to try pre-probiotics in the standard treatment particularly in those with more than five years ofthe disease.
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http://dx.doi.org/10.15171/mejdd.2020.160DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023645PMC
January 2020

Minocycline, focus on mechanisms of resistance, antibacterial activity, and clinical effectiveness: Back to the future.

J Glob Antimicrob Resist 2020 09 12;22:161-174. Epub 2020 Feb 12.

Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Objectives: The increasing crisis regarding multidrug-resistant (MDR) and extensively drug-resistant microorganisms leads to appealing therapeutic options.

Methods: During the last 30 years, minocycline, a wide-spectrum antimicrobial agent, has been effective against MDR Gram-positive and Gram-negative bacterial infections. As with other tetracyclines, the mechanism of action of minocycline involves attaching to the bacterial 30S ribosomal subunit and preventing protein synthesis.

Results: This antimicrobial agent has been approved for the treatment of acne vulgaris, some sexually transmitted diseases and rheumatoid arthritis. Although many reports have been published, there remains limited information regarding the prevalence, mechanism of resistance and clinical effectiveness of minocycline.

Conclusion: Thus, we summarize here the currently available data concerning pharmacokinetics and pharmacodynamics, mechanism of action and resistance, antibacterial activity and clinical effectiveness of minocycline.
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http://dx.doi.org/10.1016/j.jgar.2020.01.022DOI Listing
September 2020

The combination of sofosbuvir and daclatasvir is effective and safe in treating patients with hepatitis C and severe renal impairment.

J Gastroenterol Hepatol 2020 Sep 5;35(9):1590-1594. Epub 2020 Feb 5.

Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background And Aim: Many of the treatment regimens available for hepatitis C include sofosbuvir. Unfortunately, sofosbuvir has not been recommended for use in patients with severe renal impairment leaving these group of patients with very few options. Nevertheless, there are many reports in which these patients have been treated with sofosbuvir-containing regiments without important adverse events. This study aims at determining the safety and effectiveness of a sofosbuvir-based treatment in patients with severe renal impairment, including those on hemodialysis.

Method: We enrolled subjects with hepatitis C and estimated glomerular filtration rate under ml/min/1.73m from 13 centers in Iran. Patients were treated for 12 weeks with a single daily pill containing 400-mg sofosbuvir and 60-mg daclatasvir. Patients with cirrhosis were treated for 24 weeks. Response to treatment was evaluated 12 weeks after end of treatment (sustained viral response [SVR]). ClinicalTrials.gov identifier: NCT03063879.

Results: A total of 103 patients were enrolled from 13 centers. Seventy-five patients were on hemodialysis. Thirty-nine had cirrhosis and eight were decompensated. Fifty-three were Genotype 1, and 27 Genotype 3. Twenty-seven patients had history of previous failed interferon-based treatment. Three patients died in which cause of death was not related to treatment. Six patients were lost to follow-up. The remaining 94 patients all achieved SVR. No adverse events leading to discontinuation of medicine was observed.

Conclusions: The combination of sofosbuvir and daclatasvir is an effective and safe treatment for patients infected with all genotypes of hepatitis C who have severe renal impairment, including patients on hemodialysis.
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http://dx.doi.org/10.1111/jgh.14994DOI Listing
September 2020

Increased Expression of MiR-27a and MiR-24-2 in Esophageal Squamous Cell Carcinoma.

J Gastrointest Cancer 2020 Mar;51(1):227-233

Sayad Shirazi Hospital, Golestan Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.

Purpose: Esophageal squamous cell carcinoma (ESCC) is one of the predominant types of esophageal cancer with poor prognosis which shows high prevalence in eastern countries. Studying microRNAs that were considered for their capabilities such as tissue-specific expression and involvement in different cell features may be informative in the field of diagnostic and prognostic tumor markers. The expression levels of miR-27a and miR-24-2 have been reported to be dysregulated in various cancers and contribute in tumorigenesis and progression; thus, evaluating their expressional behavior and its association with tumor states alteration in ESCC could potentially be helpful.

Methods: The study was conducted on 30 fresh specimens including tumor and normal counterparts' tissues of ESCC. After the extraction of total RNA, complementary DNA synthesis was performed by the use of linear specific primers. Eventually, real-time polymerase chain reaction was carried out for the measurement of microRNAs expression level.

Results: According to the obtained data, miR 27a and miR-24-2 were significantly upregulated (~2.5 fold, p < 0.05) in tumor specimens compared with their normal adjacent tissue; Moreover, upregulation of miR-27a and 24-2 showed cooperative relationship while analyzed. However, there was no correlation between clinicopathological features and microRNAs upregulation.

Conclusions: The results of this study show that miR-27a and miR-24-2 cooperatively upregulate in ESCC and suggest that these microRNAs can be introduced as a candidate for further study in the field of screening and prognostic biomarkers.
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http://dx.doi.org/10.1007/s12029-019-00232-xDOI Listing
March 2020

Therapeutic bacteria to combat cancer; current advances, challenges, and opportunities.

Cancer Med 2019 06 5;8(6):3167-3181. Epub 2019 Apr 5.

Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Successful treatment of cancer remains a challenge, due to the unique pathophysiology of solid tumors, and the predictable emergence of resistance. Traditional methods for cancer therapy including radiotherapy, chemotherapy, and immunotherapy all have their own limitations. A novel approach is bacteriotherapy, either used alone, or in combination with conventional methods, has shown a positive effect on regression of tumors and inhibition of metastasis. Bacteria-assisted tumor-targeted therapy used as therapeutic/gene/drug delivery vehicles has great promise in the treatment of tumors. The use of bacteria only, or in combination with conventional methods was found to be effective in some experimental models of cancer (tumor regression and increased survival rate). In this article, we reviewed the major advantages, challenges, and prospective directions for combinations of bacteria with conventional methods for tumor therapy.
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http://dx.doi.org/10.1002/cam4.2148DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558487PMC
June 2019

Temporal and geographical variations in colorectal cancer incidence in Northern Iran 2004-2013.

Cancer Epidemiol 2019 04 13;59:143-147. Epub 2019 Feb 13.

Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Faculty of Medicine, Helsinki University, Helsinki, Finland; Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.

Introduction: Colorectal cancer (CRC) is one of the most common cancers in the Golestan province, Northern Iran. The purpose of this study is to describe colorectal cancer incidence patterns and trends in the province 2004-2013.

Methods: Data on CRC cases were obtained from the Golestan Population-based Cancer Registry (GPCR). The GPCR is a high-quality cancer registry that collects data on primary cancers according to internationally accepted standard protocols. Age-standardized Incidence rates (ASR) were calculated and the 10-year trend quantified using the average annual percentage change (AAPC) from Joinpoint regressions.

Results: The overall ASR of CRC were higher in men (14.8 per 100,000 person-years) and the urban populations (35.4), relative to women (11.5) and the rural populations (17.1), respectively. The overall incidence rate was observed to significantly increase 2004-2013 in men (AAPC = 7.3; 95%CI: 2.9-11.8) and women (AAPC = 6.6; 95%CI: 2.7-10.6). The analysis also showed that urban areas (AAPC = 8.1; 95%CI: 2.4-14.1) had a relatively more rapid increase in rates compared to rural areas (AAPC = 6.9; 95%CI: 2.2-11.7).

Conclusions: CRC incidence rates in Golestan have been rising during the most recent decade, with a higher incidence and more rapid increases among men and the urban populations. The underlying risk factors should be assessed in the context of developing CRC prevention interventions in Golestan.
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http://dx.doi.org/10.1016/j.canep.2019.02.003DOI Listing
April 2019

Assessing the Correlation of Fecal Calprotectin and the Clinical Disease Activity Index in Patients With Ulcerative Colitis.

Gastroenterol Nurs 2018 May/Jun;41(3):201-205

Taghi Amiriani, MD, Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. Sima Besharat, PhD, MD, Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. Mohammad Dadjou, MD, Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. Gholamreza Roshandel, PhD, MD, MPH, Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. HoneySadat Mirkarimi, MSc, Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. Faezeh Salamat, MSc, Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. Hamidreza Joshaghani, PhD, Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.

It has been shown that fecal calprotectin can be used to evaluate mucosal inflammation better than using clinical indices and serum markers. The aim of this study was to assess the use of fecal calprotectin for evaluating the disease activity in 2 groups of patients with ulcerative colitis and a control group. The study population consisted of 30 patients with active-phase ulcerative colitis, 30 remission-phase patients, and 30 healthy control patients. After obtaining informed consent, we took blood and fecal samples. Fecal calprotectin was assessed by the enzyme-linked immunosorbent assay method; levels of more than 200 μg/g were considered abnormal. The Simple Clinical Colitis Activity Index was used to evaluate disease activity. A one-way analysis of variance test and a Pearson correlation test were used to analyze the results. The means ±SD of the disease activity index were 4 ± 2.8, 6 ± 1.9, and 2.7 ± 2.5 in patients with active-phase and remission-phase ulcerative colitis, respectively (p < .001). Fecal calprotectin (μg/g) values (mean ±SD) for active-phase patients, remission-phase patients, and the control group patients were significantly different: 711.7 ± 228, 517 ± 328.2, and 304 ± 297.5, respectively. There was a significant correlation between fecal calprotectin and the disease activity index values (r = .41; p = .004). Fecal calprotectin could be a useful tool in assessing the bowel disease activity in patients with ulcerative colitis.
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http://dx.doi.org/10.1097/SGA.0000000000000314DOI Listing
December 2018

Assessment of Gastric Accommodation in Patients with Functional Dyspepsia by 99mTc-Pertechtenate Single Photon Emission Computed Tomography Imaging: Practical but not Widely Accepted.

Mol Imaging Radionucl Ther 2015 Oct;24(3):105-9

Bushehr University of Medical Sciences, The Persian Gulf Nuclear Medicine Research Center, Bushehr, Iran Phone: +90 0098-771-2580169 E-mail:

Objective: Impaired gastric accommodation is one of the main symptoms in patients with functional dyspepsia. The aim of the present study was to assess gastric accommodation in patients with functional dyspepsia using single photon emission computed tomography (SPECT) imaging.

Methods: Twenty-four patients with functional dyspepsia and 50 healthy volunteers as control group were enrolled in this study. All participants were given 5 mCi 99mTc-pertechtenate intravenously, served with a low fat meal, and underwent SPECT scanning 20 minutes after the meal.

Results: Based on the scintigraphic data, gastric volumes were found to be significantly increased after food ingestion in both patient and control groups. We also found that while there was no significant difference between patient and control groups in terms of fasting gastric volumes, postprandial gastric volume was significantly lower in patients as compared to healthy individuals (p<0.05).

Conclusion: Measuring gastric volume by using SPECT can be a valuable method in the detection of functional dyspepsia and in differentiation of this entity from other organic disorders.
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http://dx.doi.org/10.4274/mirt.36854DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745402PMC
October 2015

Emerging Epidemic of Inflammatory Bowel Disease in a Middle Income Country: A Nation-wide Study from Iran.

Arch Iran Med 2016 Jan;19(1):2-15

Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: The burden of inflammatory bowel disease (IBD) hasn't been reported in Iran. We aimed to estimate the prevalence and incidence of IBD and its trend in Iran at national and subnational level from 1990 to 2012.

Methods: We conducted a systematic review of English and Persian databases about the epidemiology of IBD. We also collected outpatient data from 17 provinces of Iran using almost all public and private referral gastroenterology clinics. Prevalence and incidence rate was calculated at national and subnational levels. The Kriging method was used to extrapolate provinces with missing data and GPR model to calculate time trends of rates at subnational level.

Results: We found 16 case series, two population-based studies, and two review articles. We collected 11,000 IBD cases from outpatient databases. Among them, 9,269 (84.26%) had ulcerative colitis (UC), 1,646 (14.96%) had Crohn's disease (CD), and 85 had intermediate colitis (IC). A total of 5,452 (49.56%) patients were male. Mean age at diagnosis was 32.80 years (CI: 13 - 61) for UC and 29.98 years (CI: 11 - 58) for CD. Annual incidences of IBD, UC, and CD in 2012 were 3.11, 2.70, and 0.41 per 100,000 subjects respectively. Prevalence of IBD, UC, and CD in 2012 were 40.67, 35.52, and 5.03 per 100,000 subjects respectively. The incidence of UC and CD showed a significant increase during the study period (P for trend < 0.05).

Conclusions: The incidence and prevalence of IBD are increasing in Iran. Establishing a national IBD registry seems necessary for comprehensive care of IBD patients in Iran.
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http://dx.doi.org/0161901/AIM.003DOI Listing
January 2016

Correlation between low bone density and disease activity in patients with ulcerative colitis.

Middle East J Dig Dis 2015 Jan;7(1):25-30

3. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.

BACKGROUND Different clinical and epidemiological studies using dual-energy X-ray absorptiometry have shown an increased prevalence of low bone mineral density in patients with inflammatory bowel diseases. The aim of this study was to assess the correlation between bone density and the disease activity in patients with ulcerative colitis. METHODS In this cross-sectional study, 52 patients with ulcerative colitis (duration of the disease less than 5 years) were invited to our research center, Golestan province, northeast of Iran, during February 2012 up to August 2012. A demographic checklist and Simple Clinical Colitis Activity Index was completed for each patients and 5 cc of blood sample was taken after obtaining the informed consent. We used colorimetry method for measuring serum calcium, UV method for serum phosphorus and ELISA for serum vitamin D. Dual-energy X-ray absorptiometry was done to evaluate the bone density. Data analysis was done using SPSS software version 16. Normality of data was assessed using Kolmogorov- Smirnov test. T and ANOVA tests were used if data had normal distribution. Mann-Whitney U or Kruskal-Wallis tests were used for the remaining data. Correlation between qualitative variables was evaluated by Chi-square test. RESULTS The mean (±SD) age and disease activity of the patients were 37.72 (±12.18) years and 4.78 (±1.98), respectively. There were no correlation between disease activity and mean age. Low bone density was seen in 30.8%, 11.5%, and 15.4% in spine, femur neck, and hip, respectively. There was no relationship between Z-score of total hip, spine, and femur neck with disease activity, age, and duration of disease (p>0.05). CONCLUSION Our results showed an acceptable rate of low bone density in patients with ulcerative colitis without any correlation with the disease activity index.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293797PMC
January 2015

Diagnostic values of serum levels of pepsinogens and gastrin-17 for screening gastritis and gastric cancer in a high risk area in northern Iran.

Asian Pac J Cancer Prev 2014 ;15(17):7433-6

Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran E-mail :

Background: Gastric cancer (GC) is the second cause of cancer related death in the world. It may develop by progression from its precancerous condition, called gastric atrophy (GA) due to gastritis. The aim of this study was to evaluate the accuracy of serum levels of pepsinogens (Pg) and gastrin-17 (G17) as non-invasive methods to discriminate GA or GC (GA/GC) patients.

Materials And Methods: Subjects referred to gastrointestinal clinics of Golestan province of Iran during 2010 and 2011 were invited to participate. Serum levels of PgI, PgII and G17 were measured using a GastroPanel kit. Based on the pathological examination of endoscopic biopsy samples, subjects were classified into four groups: normal, non-atrophic gastritis, GA, and GC. Receiver operating curve (ROC) analysis was used to determine cut-off values. Indices of validity were calculated for serum markers.

Results: Study groups were normal individuals (n=74), non-atrophic gastritis (n=90), GA (n=31) and GC patients (n=30). The best cut-off points for PgI, PgI/II ratio, G17 and HP were 80 μg/L, 10, 6 pmol/L, and 20 EIU, respectively. PgI could differentiate GA/GC with high accuracy (AUC=0.83; 95%CI: 0.76-0.89). The accuracy of a combination of PgI and PgI/II ratio for detecting GA/GC was also relatively high (AUC=0.78; 95%CI: 0.70-0.86).

Conclusions: Our findings suggested PgI alone as well as a combination of PgI and PgI/II ratio are valid markers to differentiate GA/GC. Therefore, Pgs may be considered in conducting GC screening programs in high-risk areas.
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http://dx.doi.org/10.7314/apjcp.2014.15.17.7433DOI Listing
June 2015

Gastroesophageal Reflux Disease and overall and Cause-specific Mortality: A Prospective Study of 50000 Individuals.

Middle East J Dig Dis 2014 Apr;6(2):65-80

Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

BACKGROUND Only a few studies in Western countries have investigated the association between gastroesophageal reflux disease (GERD) and mortality at the general population level and they have shown mixed results. This study investigated the association between GERD symptoms and overall and cause-specific mortality in a large prospective population-based study in Golestan Province, Iran. METHODS Baseline data on frequency, onset time, and patient-perceived severity of GERD symptoms were available for 50001 participants in the Golestan Cohort Study (GCS). We identified 3107 deaths (including 1146 circulatory and 470 cancer-related) with an average follow-up of 6.4 years and calculated hazard ratios (HR) and 95% confidence intervals (CI) adjusted for multiple potential confounders. RESULTS Severe daily symptoms (defined as symptoms interfering with daily work or causing nighttime awakenings on a daily bases, reported by 4.3% of participants) were associated with cancer mortality (HR 1.48, 95% CI: 1.04-2.05). This increase was too small to noticeably affect overall mortality. Mortality was not associated with onset time or frequency of GERD and was not increased with mild to moderate symptoms. CONCLUSION We have observed an association with GERD and increased cancer mortality in a small group of individuals that had severe symptoms. Most patients with mild to moderate GERD can be re-assured that their symptoms are not associated with increased mortality.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034667PMC
April 2014

Scintigraphy with 99mTc(V)-DMSA in monitoring patients with inflammatory bowel disease.

Hell J Nucl Med 2013 Sep-Dec;16(3):209-12

The Persian Gulf Nuclear Medicine Research Center, The Persian Gulf Biomedical Sciences Institute, Boostan 19 Alley, Sangi Street, Bushehr, Iran.

The clinical significance of pentavalent technetium-99m dimercaptosuccinic acid (99mTc(V)-DMSA) scintigraphy in diagnosing inflammatory bowel disease (IBD) has not yet been fully elucidated. The aim of this prospective paper was to study the above. This study included 54 patients, 22 females and 32 males (mean age: 36.68±11.49; range: 18-63 years) with IBD who came to our clinics for follow-up and were examined clinically by colonoscopy and 99mTc(V)-DMSA scintigraphy. On the follow-up studies, five patients (9.25%) relapsed, and 49 (90.74%) remained at a steady condition. There was a good correlation between the scintigraphic results and the clinical and colonoscopy data of the patients (P<0.05). In conclusion, our results indicated that 99mTc(V)DMSA scintigraphy can be complementary to colonoscopy for the diagnostic evaluation of IBD.
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April 2014

Serum vitamins A and E deficiencies in patients with inflammatory bowel disease.

Saudi Med J 2013 Apr;34(4):432-4

Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Tehran, Iran.

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April 2013

Depressive mood and disease activity in inflammatory bowel disease.

Arab J Gastroenterol 2012 Sep 3;13(3):136-8. Epub 2012 Sep 3.

Golestan University of Medical Sciences, Golestan Research Center of Gastroenterology and Hepatology, Gorgan City, Golestan Province, Iran.

Background And Study Aim: Some mood disorders are more prevalent in chronic medical conditions compared with the general population. The relationship between inflammatory bowel disease (IBD) and psychiatric disorders has been raised as an area of interest for investigation. In this study, we aimed to assess the probable relationship between depression and disease activity in IBD patients in Golestan province, northeast of Iran.

Patients And Methods: During February 2008 to February 2010, 50 patients recently diagnosed as IBD cases attended the Golestan Research Center of Gastroenterology and Hepatology (GRCGH), northeast of Iran. The Simple Clinical Colitis Activity Index (SCCAI) was used to evaluate the disease activity. The Beck Depression Inventory (BDI) was used to assess the severity of depressive symptoms. Depression was assumed when the BDI score was 13 points or higher.

Results: Sixteen cases (32%) had depressive characteristics. SCCAI and the Beck score were not significantly different between the two sexes. There was a non-significant correlation between SCCAI, Beck score, age and body mass index (BMI).

Conclusions: We reported a relatively high percent of depression in IBD patients, although no significant relationship was seen.
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http://dx.doi.org/10.1016/j.ajg.2012.03.007DOI Listing
September 2012

Effects of omeprazole consumption on serum levels of trace elements.

J Trace Elem Med Biol 2012 Oct 6;26(4):234-7. Epub 2012 Jun 6.

Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.

Project: Omeprazole is one of the most frequently prescribed drugs in patients with gastroesophageal reflux disease (GERD). It increases the gastric pH and this in turn may change the intestinal absorption of trace elements. This study was conducted to assess the effects of omeprazole consumption on the serum level of trace elements.

Procedures: The studied subjects were selected from the list of patients referred to the gastroenterology department of 5 Azar hospital in Golestan province of Iran for whom omeprazole was prescribed by a gastroenterologist. Blood samples were obtained before (phase I) and after an eight-week period (phase II) of omeprazole consumption. Serum levels of trace elements were assessed by the photometric method.

Results: Sixty seven patients were recruited of whom, 35.82% were males. There was no significant difference in serum levels of Fe, P, Ca and Cu between phases I and II. Serum concentration of Zn was significantly lower in phase II than I (P=0.02). The proportion of male patients with low Zn levels was significantly higher in phase II (50%) than I (16.7%) (P=0.01). We found no significant difference in the proportion of female patients with low Zn levels between phase I (37.2%) and phase II (27.9%).

Conclusions: We found no significant reduction in serum levels of Fe, P, Ca and Cu in phase II. However, our results showed that serum level of Zn was significantly lower after omeprazole consumption in males. So, nutritional supplement of Zn should be considered in male patients treated with omeprazole.
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http://dx.doi.org/10.1016/j.jtemb.2012.02.002DOI Listing
October 2012

Should we look for celiac disease in irritable bowel syndrome?

Oman Med J 2011 Jan;26(1):59-60

Golestan University of Medical Sciences, Golestan Research Center of Gastroenterology and Hepatology, Gorgan, Iran.

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http://dx.doi.org/10.5001/omj.2011.16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191611PMC
January 2011

Heartburn in Staff of Golestan Medical University, Northeast of Iran.

Gastroenterology Res 2009 Jun 20;2(3):157-161. Epub 2009 May 20.

Golestan University of Medical Sciences, Golestan Research center of Gastroenterology and Hepatology, Iran.

Background: Gastro-esophageal reflux disease (GERD) is the most common gastrointestinal disease in the west that has shown increasing incidence in Iran and Asian countries. The main presentations, described for GERD, are heartburn and acid regurgitation.

Methods: In this cross-sectional study in 2006, all personnel of Golestan Medical University (Northeast of Iran) were enrolled. A questionnaire consisting of demographic data, symptoms and risk factors was completed for all volunteers. Height and weight were measured. Chi-square and Non-parametric tests were used for analysis.

Results: Symptoms of heartburn were seen in 60% of all 155 studied subjects. No significant relationship was seen between symptoms and variables like age, gender, BMI and tribes. Symptoms were more common in married ones (P < 0.05).

Conclusions: Heartburn prevalence was high in this study. Heartburn was seen more in women and in married. The probable underlying etiology and explanation for these results should be studied more.
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http://dx.doi.org/10.4021/gr2009.06.1296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139707PMC
June 2009

Serum leptin levels and irritable bowel syndrome: a new hypothesis.

J Clin Gastroenterol 2009 Oct;43(9):826-30

Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.

Goals: This study was undertaken to investigate the relationship between serum leptin levels and the development irritable bowel syndrome (IBS).

Background: Stress has been known as an important causative factor in IBS. Various studies have indicated the relationship between serum leptin levels and stress levels. So searching the relationship between the production and level of this hormone and development of IBS may help to understand the pathophysiology of the disease.

Study: This was a case-control study. Eighty IBS patient and 80 controls were recruited. All participants were asked to fill in a questionnaire included demographic information and medical history and also a stress questionnaire. Serum leptin level was measured by enzyme-linked immunosorbent assay method. Chi-square, Student t test, Pearson correlation and logistic regression were used for investigating the relationships between variables.

Results: Mean serum leptin levels were 7.41 and 19.33 ng/mL in IBS and control groups, respectively (P<0.001). Participants in IBS group had significantly higher stress levels than controls (P<0.001). Multivariate logistic regression analysis showed that adjusted odds ratios (ORs) for serum leptin level (OR: 0.9; 95% confidence interval: 0.85-0.94) and stress level (OR: 1.15; 95% confidence interval: 1.09-1.23) were nearly the same as crude ones.

Conclusions: This study indicated the relationship between leptin and IBS for the first time. Our results show that serum leptin level is significantly lower in IBS group than controls and this relationship is independent of other variables such as stress levels, body mass index, etc. This may help in better understanding of the pathogenesis of IBS and consequently lead to the development of more effective treatments.
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http://dx.doi.org/10.1097/MCG.0b013e3181986900DOI Listing
October 2009

Relationship between p53 expression and gastric cancers in cardia and antrum.

Arch Iran Med 2008 Sep;11(5):502-6

Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran.

Background: The mutations in p53 gene and accumulation of p53 protein are the most common genetic events in gastric carcinomas. The present study was conducted to compare the frequency of p53 gene overexpression in a consecutive series of adenocarcinomas arising from the cardia and the antrum. This study also evaluates the associations of this gene expression with demographic and clinicopathologic findings (age, sex, histology, and grade of tumor).

Methods: Retrospective analysis was performed on 111 patients with gastric cancer who had undergone upper gastrointestinal endoscopies in 5th Azar Medical Center (northeastern, Iran), during 1998-2005. The series comprised of 25 patients with cardia adenocarcinoma and 86 patients with antral adenocarcinoma. p53 alteration (nuclear p53 overexpression) was detected by immunohistochemistry.

Results: Nuclear p53 overexpression was found in 14 (56%) out of the 25 and 27 (31.3%) out of the 86 patients with cardia and antral adenocarcinomas, respectively. p53 gene overexpression was significantly more frequent in adenocarcinomas of the cardia than the antrum. There were no differences in the clinicopathologic characteristics of the tumors between p53-positive and p53-negative cases in both types of the cancer.

Conclusion: This study shows that p53 alterations correlate well with gastric location, and they are more frequent in adenocarcinoma of the cardia than the antrum. This result reinforce the hypothesis that the cancers of the lower esophagus and upper stomach have distinct epidemiologic, pathogenesis, and molecular characteristics from that observed in cancers of the lower part of the stomach.
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September 2008