GOVARESH Quarterly gltpHdayooenotafniacsAanr h oaro cifitneicS folanruoJ eht ygoloretneortsaGfonoitaicossAnainarI dna ygolotapeH

pISSN: 1560-7186, oISSN: 2008-756x, eISSN: 2008-7578 Vol. 16, Supplement, Autumn 2011, No. 76-1

Concessioner: Founder and Director: Iranian Association of Gastroenterology and Hepatology Mirmadjlessi SH, M.D.

Publisher: Editor-in-Chief: Iranian Association of Gastroenterology and Hepatology Daryani NE, M.D.

Editorial Board (In Alphabetic order) Associate Editors Aghazadeh R, M.D. Masjedizadeh AR, M.D. Allahverdi B,M.D. Montazeri GH, M.D. Darvish Moghaddam S, M.D. Massarat S, M.D. Bagheri M, M.D. Pourshams A, M.D. MPH Daryani NE, M.D. Mikaeli J, M.D. Falahi GH, M.D. Setoodehmanesh R, M.D. Emami NajafiDehkordi SMH M.D. Minakari M, M.D. Farahvash M, M.D. Zamani F, M.D. Hashemi SJ, M.D. NasiriToosi M, M.D. Merat S, M.D. Zaremehrjerdi A, M.D. Malekzadeh R, M.D. Sima HR, M.D. Mir-Nasseri MM, M.D.,MPH Zendehdel N, M.D. Mansour-Ghanaei F, M.D. Somi MH, M.D. Mohammadnejad M, M.D.

International Members of Editorial Board

Adler G M.D. (Germany) Sobhani I M.D. (France)

Keshavarzian A M.D. (USA) Schuppan D M.D. (USA)

Executive Editor Scientific Editor

Mir-Nasseri MM, M.D., MPH Mohammadnejad M, M.D.

Persian Text Editors English Text Editor Sadjadieh AH, M.D., Namazi HR, M.D. Kim Vagharfard, M.S. Ansari E, M. D.

Office Staff Page designing Sayyad M, Valizadeh A, Etehad F Etehad F

Address of Editorial Office Publisher's Address Iranian Association of Gastroenterology and Iranian Association of Gastroenterology and Hepatology, Hepatology, Unit 1, No. 13, Shahrivar Alley, Unit 1, No. 13, Shahrivar Alley, Kargar-e-Shomali Ave., Kargar-e-Shomali Ave., Tehran, Iran. Tehran, Iran. Dr. Massarat S Dr. Mirmadjlessi SH P. O. Box: 14395-163 Tehran, Iran. Telefax: +98 21 88 33 50 61-3 Telefax: +98 21 88 33 50 61-3 E-mail: [email protected]

This journal is sponsored by Iranian Association of Gastroenterology and Hepatology. Any reproduction or use of contents of articles of this journal is permitted only if the source is cited precisely. Web Site: www.iagh.org E-mail: [email protected] In The name of God

Abstract Submitted for Iranian Congress of Gastroenterology and Hepatology - ICGH 2011 October 5-7, 2011

Contents

ICGH 2011 Committees • Executive Committee ...... 3 • Scientific Committee ...... 4

• Sponsor Societies ...... 5 • Abstracts Categories ...... 6

Abstracts of the ICGH 2011 ...... 7-90

• Author Index ...... 91 ICGH 2011 Committees

Organizing committees:

President, ICGH 2011 President, Iranian Society of Gastroenterology Reza Malekzadeh, MD and Hepatology Professor of Medicine and Gastroenterology Seyed Hossein Mir-Madjlessi, MD Director, Digestive Disease Research Center, Internist Gastroenterologist, Tehran University of Medical Sciences Iranian Institute of Medicine

Scientific Secretary, ICGH 2011 Executive secretary, ICGH 2011 Mohammad Hossein Somi, MD Seyed Mohammad Mehdi Mir- Nasseri,MD, MPH Professor of Medicine and Gastroenterology Research Fellow, Liver and Gastrointestinal Diseae Research Center Digestive Disease Research Center, Tabriz University of Medical Sciences Theran University of Medical Sciences

Executive Committee (Alphabetical):

• Abdollahi MR., MD • Faramarzi E., MD • Pouri AA., MD • Alkhacht Y. • Farhang S., MD • Rashidi MR., MD • Ansari E., MD • Ghargazlou A. • Rezazadeh R., MD • Ashayeri R. • Golbahar Ghadimi A. • Sepehri B., MD • Bagheri M. • Khodaei A. • Shakeri R., MD • Bargi E. • Khoshbaten M., MD • Soleimanpour M., MD • Dabbagh P. • Mirinezhad SK., MD • Somi MH., MD • Dabiri Oskui SH, MD • Mir-Nasseri MM., MD • Valizadeh H., MD • Dorosti F. • Naghashi S., MD • Valizadeh A. • Etehad F. • Nikniaz Z. • Yghobi AR., MD • Faghih Dinevari M., MD • Paknejhad P.

Govaresh\ Vol.16\ Supplement\ Autumn 2011 3 ICGH 2011 Committees Scientific Committee (Alphabetical): Agah Shahram MD (Tehran-Iran) Malekzadeh Reza MD (Tehran-Iran) Aghazadeh Rahim MD (RCGLD, Tehran-Iran) Mansour-Ghanaei Fariborz MD (Gilan-Iran) Alavian Seyed-Moayed MD (Baghyatallah, Tehran-Iran) Mansouri Siavosh MD (Tehran-Iran) Alizadeh Mohammad PhD (Tabriz-Iran) Masjedizadeh Abdolrahim MD(Ahvaz-Iran) Ansari Reza MD (Tehran-Iran) Masnadi Koorosh MD (Tabriz-Iran) Antikchi Mohammad-Hossein MD (Yazd-Iran) Masoudi Mohsen MD (Tehran-Iran) Ashktorab Hassan MD (Howard University, Washington D.C-USA) Masoumi Hatef MD (New York-USA) Asvadi Iradj MD (Tabriz-Iran) Massarrat Sadegh MD (Tehran-Iran) Bafandeh Yousef MD (Tabriz-Iran) Merat Shahin MD (Tehran-Iran) Baghaee – Oskui Mohammad MD (Tabriz-Iran) Mikaeli Javad MD (Tehran-Iran) Bagheri Mohammad MD (Tehran-Iran) Mirbagheri Amir MD (Tehran-Iran) Bagheri-Lankarani Kamran MD (Shiraz-Iran) Mirmadjlessi Hossein MD (Tehran-Iran) Bahari Ali MD (Mashhad-Iran) Moaddab Seyed-Yaghob MD (Tabriz-Iran) Baiat Amrollah MD (Tabriz-Iran) Mohamad-AlizadehAmir-Houshang MD (RCGLD. Tehran-Iran) Behroouzian Ramin MD (Uremia-Iran) Mohammadnejad Mehdi MD (Tehran-Iran) Borhanmanesh Fathali MD (Shiraz-Iran) Mosaddeghi Samad MD (Tabriz-Iran) Darvish-Mogaddam Sodaif MD (Kerman-Iran) Mousavi Seyed Mohsen MD (Mazandaran-Iran) Delavari Ali-Reza MD (Tehran-Iran) Nasiri-Tousi Mohssen MD (Tehran-Iran) Derakhshan Faramarz MD (Tehran-Iran) Nasseri-Moghaddam Siavosh MD (Tehran-Iran) Ebrahimi-Daryani Nasser MD (Tehran-Iran) Nobakht Hossein MD (Semnan-Iran) Eftekharsadat Amir-Taher MD (Tabriz-Iran) Nourbakhsh Khosro MD (Mashhad-Iran) Eghtesad Bijan MD (Cleveland-USA) Nouri-Nayyer Babak MD (Tehran-Iran) Ehsani Ardakani Mohammad-Javad MD (Tehran-Iran) Ostadrahimi Alireza MD-PhD (Tabriz-Iran) Eloubeidi Mohamad-Ali MD (Beirut-Lebanon) Peyrin-Biroulet Laurent MD (Nancy-France) Emami Bahman MD (Chicago-USA) Pierre Hainaut MD (IARC, Lyon- France) Emami Mohammad-Hassan MD (Isfahan-Iran) Pourshams Akram MD (Tehran-Iran) Esfandiari Tuba MD (Kansas-USA) Pourzand Ali MD (Tabriz-Iran) Esmaeilzadeh Abbas MD (Mashhad-Iran) Rad Saeid MD (Tabriz-Iran) Faghihi Amir-Hossein MD (Tehran-Iran) Rafeey Mandana MD (Tabriz-Iran) Fallah Soltanali MD (Tehran-Iran) Saadatnia Hassan MD (Mashhad-Iran) Farahvash Mohammad-Jafar MD (Tehran-Iran) Saberi-Firouzi Mehdi MD (Tehran-Iran) Farasati Farris PhD (Kansas University-USA) Salmanroghani Hassan MD (Yazd-Iran) Fattahi Ebrahim MD (Tabriz-Iran) Samalavicius Narimantas Evaldas MD (Vilnius-Lithuania) Fattahi Mohammad-Reza MD (Shiraz-Iran) Semnani Shahryar MD (Golestan-Iran) Forootan Hossein MD (Tehran-Iran) Shahbazkhani Bijan MD (Tehran-Iran) Forootan Mojgan MD (RCGLD, Tehran-Iran) Shateri Kamran MD (Uremia-Iran) Ganji Azita MD (Mashhad-Iran) Shavakhi Ahmad MD (Isfahan-Iran) Ghadir Mohammad-Reza MD (Qom-Iran) Sima Hamid reza MD (Mashhad-Iran) Ghavidel Ali MD (Tabriz-Iran) Sobhani Iradj MD (Paris-France) Hajiani Eskandar MD (Ahvaz-Iran) Somi Mohammad-Hossien MD (Tabriz-Iran) Hashemi Hasan MD (Tabriz-Iran) Sotoudehmanesh Rasoul MD (Tehran-Iran) Hashemi Seyed Jalal MD (Ahvaz-Iran) Taghavi Alireza MD (Shiraz-Iran) Hashemzadeh Shahryar MD (Tabriz-Iran) Tarzamani Mohammad-Kazem MD (Tabriz-Iran) Hosseini Kazem MD (Shiraz-Iran) Tavakkoli Hamid MD (Isfahan-Iran) Houshyar Afshin MD (Ardebil-Iran) Vaez Jalil MD (Tabriz-Iran) Jabbarpour Bonyadi Morteza PhD (Tabriz-Iran) Vahedi Homayoon MD(Tehran-Iran) Jodeiri Behzad MD (Tehran-Iran) Vosooghinia Hassan MD (Mashhad-Iran) Kakaie Farzad MD (Tabriz-Iran) Yazdanbod Abbas MD (Ardebil-Iran) Khatibian Morteza MD (Tehran-Iran) Zahedi Mohammadjavad MD (Kerman-Iran) Khoshbaten Manouchehr MD (Tabriz-Iran) Zali Mohammad-Reza MD (RCGLD, Tehran-Iran) Mahdavi Reza PhD (Tabriz-Iran) Zamani Farhad MD (Tehran-Iran) Malekhosseini Seyed-Ali MD (Shiraz-Iran) Ziad- Alizadeh Behrooz MD PhD (Groningen, Netherlands) Maleki Iraj MD (Sari-Iran) 4 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Sponsor Scoieties

►Bakhtar Bioshimi ► Roche Pharmaceutica ► Aburaihan Pharmaceutica

► Pooyesh Darou Pharmaceutica ► Arya Sun Co. (Fujinon) ► Rossendarman Pharmaceutica (Tillotts)

►Arman Idehgostar Pars (AIP) ►Teb Dakheli Pishro Co. (Pentax) ►Jahan Behbood Co. (Janssen-Cilag)

►Mavaraye Fonoon Asr (Boston Scientific) ►Nikan Teb Sasan Co. ►Peyk Darou Nikan Co. (Nycomed)

► Bayer Pharmaceutica ►Zahravi Pharmaceutica ►Behestan Darou Co.

Govaresh\ Vol.16\ Supplement\ Autumn 2011 5 Abstract Categories

Schedule of Abstracts Peresentation - ICGH 2011

Day 1: Wednesday, October 5/Mehr 13 W-F-001 to W-F-051...... 7-34 Day 2: Thursday, October 6/Mehr 14 T-S-052 to T-S-102...... 34-61 Day 3: Firday,October 7/Mehr 15 F-T-103 to F-T-153...... 62-90

Abstract Categories

1- CLINICAL PRACTICE 7.5 Cirrhosis and complications: basic aspect...... 56 1.1 Epidemiology...... 7-12 7.6 Cirrhosis and complications: clinical aspects...... 56-59 1.2 Management strategies...... 13 7.7 Viral hepatitis: basic aspects...... 60-61 1.3 Evidence-based clinical practice...... 14 7.8 Viral hepatitis B: clinical aspects...... 61-63 1.4 Outcome studies...... 14-15 7.9 Viral hepatitis C: clinical aspects...... 63-66 1.5 Pharmacoeconomics...... 15-16 7.10 Immunology - autoimmune liver disease...... 67 2- ESOPHAGEAL-GASTRIC AND DUODENAL DISORDERS 7.11 Acute liver failure - transplantation/surgery...... 68 2.1 Cell/molecular biology/pathology...... 16 7.12 Imaging - radiology (incl. interventional radiology)...... 68-69 2.2 Dyspepsia...... 17-19 7-13 Miscellaneous...... 70 2.4 Reflux disease - pathogenesis...... 20 8- BILIARY 2.5 Reflux disease - diagnosis...... 20 8.1 Bile acids - transport - cholestasis...... 71 2.7 Reflux disease - complications...... 21 8.2 Gallstones...... 71-72 2.8 Esophageal malignant disease...... 21-23 8.3 Malignant hepato-biliary diseases...... 72 2.9 Other esophageal disorders...... 24 9- PANCREAS 2.10 Acid peptic disease (includes NSAIDS - but NOT H.pylori)- 9.2 Pancreatitis - experimental...... 73 epidemiology...... 24 9.4 Pancreatitis - chronic (including hereditary pancreatitis)....74 2.12 Acid peptic disease (includes NSAIDS - but NOT H.pylori)- 9.5 Malignant disease and endocrine tumors of the pancreas... 74 diagnosis and treatment...... 25 10- NUTRITION 2.13 Gastroduodenal malignancies...... 25-30 10.2 Nutrients and gut function...... 75-77 3- H.PYLORI 13- ONCOLOGY-BASIC 3.2 Pathogenesis: microbial factors...... 31 13.2 Molecular biology/genetics/pathology...... 77-79 3.4 Diagnosis...... 32-33 14- ONCOLOGY-CLINICAL 3.5 Management strategies...... 33-36 14.1 Malignant disease - epidemiology - screening and 4- INTESTINAL prevention...... 80-81 4.1 Enterocyte biology/pathology and nutrient/water transport/ 14.2 Diagnosis of malignant disease...... 81 electrolyte transport...... 37 14.4ÎõAoÅGÏlAqWpAcþ ...... 82 4.2 Coeliac disease/malabsorption syndromes and food en- 15- NERVE GUT AND MOTILITY teropathies...... 37-40 15.2 Brain-gut and gut-brain axes - neuro-hormonal - neural-im- 5- IBD mune and visceral sensitivity...... 82 5.1 Basic/pathogenesis/pathology/...... 40-41 15.5 Functional gastrointestinal disorders (clinical - management)..83 5.2 Etiology/epidemiology...... 42-43 16- IMMUNOLOGY/MICROBIOLOGY 5.3 Genetics...... 44 16.1 Host defence mechanisms - immune reactions...... 84 5.5 Treatment...... 45 19- ENDOSCOPY AND IMAGING 5.7 Management...... 46-48 19.1 Endoscopy - Upper GI...... 85-86 6- COLONIC AND ANORECTAL DISORDERS 19.4 Endosonography...... 86-87 6.1 Malignant disease - pathogenesis...... 48 19.5 Enteroscopy...... 88 6.2 Malignant disease - diagnosis/histopathology...... 49 20- THERAPEUTIC ENDOSCOPY/INTERVENTIONAL RA- 6.3 Malignant disease - management...... 50 DIOLOGY 6.4 Other colonic and anorectal disorders...... 50-52 20.1 Biliary and pancreatic stenting...... 89 7- LIVER 20.2 Enteral dilatation and stenting (esophagus - stomach - duo- 7.3 Metabolic/genetic disorders...... 52-55 denum - colon)...... 89 7.4 Hepatotoxicity/alcohol - regeneration - apoptosis...... 56

6 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Category: 1 CLINICAL PRACTICE information about epidemiologic aspects of oral 1.1 Epidemiology mucosal lesions that can be valuable in organized W-F-001 national program targeting on oral health and hygiene Prevalence of oral mucosal in the society. lesions in an adult Iranian population Send Date: 2011/06/27 Fariborz Mansour-Ghanaei1*, Farahnaz Joukar1, Maryam Rabiei1, Alireza Dadashzadeh1, Ali Kord Valeshabad1 1Gastrointestinal & Liver Diseases Research Center Category: 1 CLINICAL PRACTICE (GLDRC), Guilan University of Medical Sciences 1.1 Epidemiology Introduction: There is no other study about the W-F-002 epidemiology of all oral lesions in Iran and most of the Epidemiology of Inflammatory conducted studies included only tumors and ulcers or bowel diseases (IBD) in Iran: biopsy specimens or just some of the oral lesions in A review article and comparative study with Asia dental patients. A great need is sensed in Iran for Alireza Safarpour1*, Seyed Vahid Hosseini2, establishment of baseline data toward the prevalence Davood Mehrabani3 of oral lesions in general population.To assess the 1Gastroenterohepatology Research Center, Shiraz University prevalence and types of oral lesions in a general of Med Sciences. population in Rasht, Northern Province of Iran. 2 Colorectal Surgery Research Center, Shiraz University of Method:In this cross-sectional study, 1581 persons Med Sciences. with the age>30 years who were resident in Rasht, Iran 3 Stem Cell and Transgenic Technology Research Center, were enrolled the study. A detailed questionnaire based Shiraz University of Med Sciences. Introduction: on the world health organization (WHO) guidelines The prevalence of inflammatory bowel was filled for each individual that contained all diseases (IBD) is going to be stabilized in Western required data in order to diagnosis of the lesions. Europe and North America but has an increasing trend Participants were divided into two groups with and in developing countries in Asia. The epidemiology of without oral mucosal lesions. Demographic IBD in the areas in which, incidence and prevalence characteristics and clinical information were collected are relatively low provides an opportunity for and compared between these two groups. researchers to determine the unknown aspects of them. Method: Results: The prevalence of mucosal lesions in our In this review article, data bases such as study was 19.4%. Our data demonstrated higher Pubmed, Science Direct, Scopus and Medline were prevalence of oral mucosal lesions in males (55.8%) searched from 1970 to 2010.The epidemiological and young adults (30-40 years) (53.9%). The most aspects which assessed in Iranian articles compared common mucosal lesion among our participants was with the same subjects in other Asian countries. The fissured tongue (3.4%), followed by Fordyce granules total documented articles on IBD epidemiology were (2.2%), geographic tongue (2.1%), pigmentation 21 and 52 in Iran and Asia, respectively. Results: (2.0%), Candida (1.6%), Recurrent aphthous (1.2%), According to present review, CTLA- Keratosis (1.2%),Traumatic ulcer (1.1%),Infected gene polymorphism and male/female ratio in tooth-related Cyst (1.1%),Varices (1.1%), Herpes ulcerative colitis, the incidence of extra intestinal labial (1.1%), White plaque (0.4%),Lichen planus manifestations, extent of intestinal involvement and (0.4%),Effusion (0.3%),Leukoplakia (0.1%) and family history in both ulcerative colitis and Crohn’s hemorrhage (0.1%). No case of malignant lesions was disease in Asia and Iran seems to be different. detected. No statistically significant difference was In contrast, the incidence of primary sclerosing confirmed between two groups regarding smoking cholangitis in IBD patients, association of (cigarette and tobacco), opium consumption, NO2/CARD15 mutation and Crohn’s disease as medication and oral and dental hygiene (use of C3435-T allele and ulcerative colitis are nearly the same. Conclusion: toothbrush, toothpick, dental floss, mouthwashes, The rate of IBD has increased number of filled or decayed tooth) (p>0.05). significantly in Iran as other Asian countries during Conclusion: Our data has provided baseline the last decade, and an exact, well designed,

Govaresh\ Vol.16\ Supplement\ Autumn 2011 7 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 population based, multi regional epidemiologic study history of surgery on the GI and age under 18. From is mandatory due to substantial demographic and total number of 1634 (56% female, mean age 51.3 characteristic variability in IBD patients in our years, range 18 to 90) 420 participants had criteria for region. patient group and the rest formed control group. The Send Date: 2011/07/18 calculated prevalence of GERD is 25.7% in our samples. The risk factors with significant effects are smoking, NASIDs (p<0.001), excessive eating Category: 1 CLINICAL PRACTICE (p<0.001), chronic disease (p<0.001), tea drinking, 1.1 Epidemiology GERD in the spouse (p<0.001), Weekly Fast food W-F-003 eating (p<0.001) and asthma (p<0.001). Prevalence Prevalence and Risk Factors of in the past 2 month was similar to that in the 12 Gastro-esophageal Reflux Disease month.(p<0.001) in Urban Population of Mashhad Conclusion: GERD prevalence in the residents of Hassan Vossoughinia1, Alireza Shariati1*, Mashhad is above the average in other cities of Iran. Siavash Abedini1, Mohammad-Taghi Shakeri1, However risk factors are similar to those reported in Mohammad-Javad Shariati1, Reza Bakhtiyari1, other studies 1 1 Reza Etemad Eslami , Ali Aminizadeh , Send Date: 2011/07/20 Ashkan Pooyan1, Ashkan Hatami1, Arash Aryan1, Ali Ghannadzadeh1 1 Medicine Faculty, Mashhad University of Medical Sciences Category: 1 CLINICAL PRACTICE Introduction: Gastro-esophageal Reflux Disease 1.1 Epidemiology (GERD) is a chronic and common disease which W-F-004 characterize with heartburn and regurgitation. In last Gender Role in Irritable Bowel Syndrome: couple of decades lots of attention has been paid to A comparison of IBS module (ROME III) GERD and studies have shown that its prevalence is between male & female patients 1 2* increasing. In Iran a few studies conducted to Sanam Javid Anbardan , Nasser Ebrahimi Daryani MD , 3 evaluate GERD prevalence in the population but Seyed-Mohammad Fereshtehnejad , Sahar Taba Taba Vakili 4, Mohammad Reza Keramati5, Hossein Ajdarkosh6 neither of them has been done on the north east of Iran. 1Research Fellow, Gastroenterology & Hepatology Department, The aim of our study is to evaluate prevalence rate of Tehran University of Medical Sciences, Tehran, Iran GERD and its risk factors in Mashhad population. 2 Professor, Gastroenterology & Hepatology Department, Method: This is a cross sectional case control study Tehran University of Medical Sciences, Tehran, Iran using a questionnaire. The modified Mayo Clinic 3 Research Fellow, Gastrointestinal & Liver Disease questionnaire distributed between 2500 randomly Research Center (GILDRC), Firoozgar Clinical Research selected people (50 cluster of 50 participants each, Development Center, Tehran University of Medical randomly selected based on power bill code). The Sciences, Tehran, Iran 4 questionnaire include questions about patient Resident of Internal Medicine, Shahid Beheshti characteristics (age, gender, marital status and University of Medical Sciences, Tehran, Iran 5 Resident of Surgery, Tehran University of Medical education) , and history of regurgitation and Sciences, Tehran, Iran heartburn in last year. Based on the collected data 6 Gastroenterologist, Gastrointestinal & Liver Disease participants divided into two groups, patient and control. Research Center (GILDRC),Tehran University of Medical Participants with the history of GERD in last year and Sciences, Tehran, Iran having symptoms at least once a week were put in the Introduction: Irritable bowel syndrome (IBS) is a Patient group and the rest in the Control group. The widespread chronic health condition, characterized rate of risk factors was evaluated in two groups. by a defined symptom complex in the absence of any Results: Of 2500 distributed questionnaires 1685 biochemical or pathological structural abnormalities. successfully recalled. 51 participants were excluded We conducted a gender difference analysis by from the study for the following reasons: pregnancy, comparing findings for men and women to determine

8 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 whether or not significant differences exist. cause of cancer death worldwide. To treat patiens Method: This single-center study was conducted in with unresectable gastric cancer by neoadjuvant Tehran, Iran during 2009-2010. IBS was diagnosed chemotherapy we can downstage and resect the on the basis of Rome III criteria. Finally 144 patients tumors.The end-points are the evaluation of were confirmed to have IBS and recruited to the Neoadjuvant Chemotherapy on R0 resection rate of study. A simple 10 point objective questionnaire was the tumors and 3-year survival rate of patients. used. Method:All published trials of Neoadjuvant Results: A total number of 144 IBS patients including chemotherapy for locally advanced gastric cancer 44 (33.5%) males and 100 (69.5%) females with the were searched. Only Ovid database and only English mean age of 37.50 (SD=11.50) years, were assessed. written language articles from 2008 to 2011 were The only differently observed symptom was nausea included in our search strategy. which was significantly more prevalent in females Results: In our study 5 trials were included. A total of (49% vs. 18.2%, p<0.001). The commonest subtype 131 patients with locally advanced gastric cancer of IBS in male patients was diarrhea predominant IBS were enrolled. The 3-year survival rate with (IBS-D) (38.6%); while, constipation predominant IBS neoadjuvant chemotherapy was 53% (95%CI: (IBS-C) was the most frequent type among females 43.4-62.2) (38%). Moreover, the frequency of loose, mushy or And R0 resection rate was 61% (95%CI:54.06-68.5). watery stools within last 3 months was also signifi- Conclusion: According to the results it seems that cantly more common in males [2.11 (SD=1.67) vs. neoadjuvant chemotherapy can improve survival rate 1.37 (SD=1.50), p=0.009]. and R0 resection rate of locally advanced gastric Conclusion: Gender differences can be defined as cancer. male–female differences in the incidence, prevalence, Send Date: 2011/07/21 mortality, and burden of diseases and other adverse health conditions and the responses to those diseases and conditions. Hereby, we report that gender is Category: 1 CLINICAL PRACTICE important in IBS. Although the debated finding of 1.1 Epidemiology more women with IBS-C was confirmed, more men W-F-006 than women appeared to have IBS-D, according to ROME III criteria. MEFV mutations in Iranian Azeri Turkish Send Date: 2011/07/21 Patients with familial Mediterranean fever Mortaza Bonyadi1* 1Natural Sciences, University of Tabriz Category: 1 CLINICAL PRACTICE Introduction: Familial Mediterranean fever (FMF) 1.1 Epidemiology is an autosomal recessiveautoinflammatory disorder W-F-005 with more than 60 disease-associated mutations in the Evaluvation of Neoadjuvant Chemotherapy on responsible gene locally advanced Gastric Cancer: A Meta-alysis Method: Five hundred and twenty-four unrelated Mohammadhossein somi1*, Rizan Ashayeri1, patients were tested for 15 known mutations in the Yahya Alhojjat1, Morteza Ghojazadeh2, MEFV gene using amplification refractory mutation Ardalan Golbahar Haghighi1, Farhad Shokraneh3 system-polymerase chain reaction and polymerase 1Liver and Gastrointestinal Diseases Research Center, chain reaction-restriction fragment length Tabriz University of Medical Sciences polymorphism methods. 2 Physiology Department, Tabriz University of Medical Results: Thirty-five different genotypes were Sciences characterized among the studied patients. Of the 3 Research Center for Pharmaceutical Nanotechnology alleles investigated, the most common mutation was (RCPN), Tabriz University of Medical Sciences Introduction: The incidence of gastric cancer has p.M694V (42.4%), followed by p.V726A (17%), reduced, though; it is the 4th common cancer and 2nd p.E148Q (16.2%), and p.M680I (c.2040G>C)

Govaresh\ Vol.16\ Supplement\ Autumn 2011 9 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

(15.2%). The p.R761H mutation (4.7%) was found Results: Totally, 48(1.3%) suffered from hepatitis B and to be the most frequent among the rare mutations. just one HBsAg positive case had HDV infection. The Conclusion: The results show the diversity and the prevalence rate of hepatitis D infection in Qom Province frequency of the mutations in the Iranian Azeri Turk- was 0.03%. The prevalence rate of hepatitis D infection ish FMF patients. The p.R761Hmutation is rather in HBsAg positive cases was 2%. Our anti-HDV Ab prevalent in Azeri Turks; therefore positive case had history of tattooing, surgery history and Send Date: 2011/08/11 dental surgery history. There was no significant relationship between tattooing, surgery history and dental surgery history and hepatitis D infection. Category: 1 CLINICAL PRACTICE Conclusion: The prevalence rate of hepatitis D in 1.1 Epidemiology Qom is low. This research showed that the prevalence W-F-007 of HDV in Qom province is the lowest rate in Iran Prevalence of Hepatitis D Virus like the similar study in Babol (North of Iran). Infection among HBV Infected Send Date: 2011/08/13 Patients in Qom Province, Center of Iran Mohammad-Reza Ghadir1*, Mojtaba Belbasi2, Akram Heidari3, Abolfazl Iranikhah4, Category: 1 CLINICAL PRACTICE Seyed-Saeid Sarkeshikian1, Seyed-Moayed Alavian5 1.1 Epidemiology 1 Shahid Beheshti Hospital, Qom University of Medical W-F-008 Sciences, Qom, Iran Hepatitis C virus infection in HIV 2 Research Center, Iranian Blood Transfusion Organization, positive attendees of Shiraz Behavioral Qom, Iran Diseases Consultation Center in southern Iran 3 Qom University of Medical Sciences, Qom, Iran 1 4 Hazrat Masoumeh Hospital, Qom University of Medical Mohammad Ali Davarpanah , Farnaz 2* 3 Sciences, Qom, Iran Khademolhosseini , Abdolreza Rajaeefard , 4 4 5 Gastroenterology and Liver Research Center, Alireza Tavassoli , Seyed Kamalaldin Yazdanfar , 3 Baghiatallah University of Medical Sciences, Tehran, Iran Abbas Rezaianzadeh 1 Introduction: Hepatitis D virus (HDV) is a defective HIV-AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran RNA virus that depends on the hepatitis B surface 2 Gastroenterology and Hepatology Research Center, antigen (HBsAg) of hepatitis B virus for its replication, Shiraz University of Medical Sciences, Shiraz, Iran developing exclusively in patients with acute or 3 Department of epidemiology,School of public health, chronic hepatitis B. There is little data available Shiraz University of Medical Sciences, Shiraz, Iran regarding the routes of HDV transmission in Iran. 4 Fars Blood Transfusion Organization, Shiraz,Iran The risk factors for acquiring HDV infection in some Introduction: The aim of this study was to determine studies in Iran are blood transfusion, surgery, family the prevalence of HCV co-infection and its correlation history, Hejamat (traditional phlebotomy), tattooing, with demographic and risk factors among HIV-infected war injury, dentistry interventions and endoscopy. We individuals attending Shiraz Behavioral Diseases planned this study to determine the prevalence of Consultation (SBDC) Center in southern Iran. hepatitis D in the general population of Qom province Method: In a cross-sectional study, 226 consecutive and potential risk factors for acquiring HDV. HIV-positive patients who referred to SBDC Center Method: The present study is a cross-sectional study. from April 2006 to March 2007 were interviewed A total of 3,690 samples were collected out of 7 rural face-to-face to record demographic data and risk clusters and 116 urban clusters. HBs-antigen was factors of HIV transmission. A 10 ml sample of measured at the lab and if the test was positive, venous blood was drawn from every subject and anti-HDV Ab would investigate. Ten teams, each tested for HCV-antibodies by third generation consisting of 2 trained members, were assigned to enzyme linked immunosorbant (ELISA) and conduct sampling and filling the questionnaires. The recombinant immunoblot assays (RIBA). All samples data were analyzed using the SPSS software. were also analyzed by qualitative reverse transcriptase

10 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 polymerase chain reaction (RT-PCR) for detection of were evaluated for HCV antibody with HCV-RNA. enzyme-linked immunosorbent assay (ELISA).PCR Results: The study population consisted of 214 men is being done right now. (94.7%) and 12 women (5.3%) with a mean age of Results: Fifteen out of 6095 (2218 men and 3877 35.6±7.9 years. The most prevalent risk factor was women with minimum age of 7 years and maximum imprisonment (88.9%) followed by injecting drug use of 95 years old, mean±SD age of 34.58±17.29) (79.2%). The prevalence of HCV infection was participants were anti-HCV positive (prevalence 88.5% by ELISA and 86.7% by RIBA, while HCV 0.24%). The highest prevalence was seen in age ≤12 viremia was detected in 26.1% of the patients. years old (1%). A statistically significant correlation HCV-antibody positivity was significantly associated was found between blood transfusion and presence with gender, age, marital status, occupation, injecting of anti-HCV antibody (p=0.000). Those with a drug use, and history of imprisonment. It was history of blood transfusion had fifteen fold higher inversely related to “having an infected or high risk risk for anti-HCV positivity (odds ratio 15.54; sexual partner”. In the logistic regression model, the 95%CI= 4.89-49.41). No statistically significant predictors of HCV-positivity were injecting drug use correlation was found among other variants and (OR=24.9, P=0.004) and imprisonment (OR=21.4, positive anti-HCV P<0.001). Conclusion: Due to non-significant correlation Conclusion: Prevalence of HCV infection among between other variants and anti-HCV+ except blood HIV-positive individuals in our region is very high and transfusion, further evaluation for detection of risk there is a need for stricter preventive actions against factors is recommended. Moreover, it is emphasized transmission of HCV among this group of patients. that the donated bloods be evaluated with PCR and Send Date: 2011/08/17 the importance of sterility of instruments in medical and non- medical conditions and education of transmission routes be taken into account. Category: 1 CLINICAL PRACTICE Send Date : 2011/08/18 1.1 Epidemiology W-F-009 The prevalence of hepatitis C infection in general Category: 1 CLINICAL PRACTICE population of two villages of Fars province 1.1 Epidemiology Mohammadreza Fattahi1, Faezeh Mohammad Doust2*, W-F-010 Seyed Mohammad Kazem Hosseini Asl3 Epidemiologic profile and clinical 1 Gastroenterohepatology Research Center (GEHRC), characteristics of inflammatory bowel Shiraz University of Medical Sciences, Shiraz, Iran disease in northeast of Iran: a 7 year review 2 Department of Internal Medicine ,Shiraz University of Hassan Vossoughinia1, Siavash Abedini1, Ahmad Medical Sciences,Shiraz,Iran Khosravi Khorashad1, Hamid Reza Sima2, Ali Bahari2, 3 Gastroenterohepatology Research Center (GEHRC), Mohammad Khajedaluee1, Sahar Abedini1, Shiraz University of Medical Sciences, Shiraz, Iran Maryam Golshahi3*, Fereshteh Hosseini3 Introduction: Hepatitis C virus (HCV) infection is a 1 Internal Medicine Department,Ghaem Hospital, Mashhad major blood-borne infection with silent epidemic and University of Medical Sciences major global public health problem and diverse 2 Internal Medicine Department,Emam Hospital, Mashhad prevalence worldwide. To determine the prevalence University of Medical Sciences of HCV infection in general population of two 3Razavi Hospital, Mashhad University of Medical villages, Farmashkan and Akbarabad, of Kavar city, Sciences, Iran Fars province in Iran, and evaluate the real risk Introduction: Few studies have been done in Iran factors in these areas. about inflammatory bowel disease (IBD). In this Method: A cross-sectional study was performed study, we tried to determine the epidemiologic and during 3 years from July 2007 to April 2010. All of clinical characteristics of IBD in northeast of Iran. Iranian participants aged equal or above 7 years old Method: This was a retrospective study in a 7 year

Govaresh\ Vol.16\ Supplement\ Autumn 2011 11 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 period of time (since 2005 until 2012). This study controversial. included all the patients who had approached to a Method: We evaluated 200 individuals, 100 with and private gastroenterology clinic in Mashhad and were 100 without osteoporosis, from the rheumatology diagnosed as IBD. clinic in Imam Khomeini and Shariati Hospital by Data were collected from the patients’ electronic files, serologic screening for celiac disease. The clinical encoded and then entered in SPSS. These Data findings were evaluated in the both groups and were included age, gender, type of disease (Ulcerative compared together. colitis and Crohn’s disease), extension of intestinal Results: 2 (2%) of 100 patients with osteoporosis and disease and also extra-intestinal manifestation. 1 (1%) of 100 patients without osteoporosis tested Results: A total of 364 patients including 183 females positive by serologic screening for celiac disease. All (50.3%) were evaluated. Mean age of the patients patients with positive serologic test were female and was 34.3 ± 13.04 years. Male to female ratio was 0.58 the mean age was 56.5± 6.4 years. The prevalence of for Crohn’s disease and 1.07 for ulcerative colitis. clinical findings in 2 patients with osteoporosis was 13.5% had Crohn’s disease and 86.5% had ulcerative more than 1 patient without osteoporosis. colitis. The most common sites of involvement were Conclusion: The prevalence of celiac disease in pancolitis, proctitis and then left-sided colitis. For osteoporosis is not high enough to justify a recom- Crohn’s disease, the most common presentation was mendation for serologic screening of all patients with terminal ileitis. Among extra-intestinal manifesta- osteoporosis for celiac disease; but in patients with tions, sclerosing cholangitis had the highest endocrine autoimmune disease and gastrointestinal frequency and was found in 12 (3.4%) patients. finding it is necessary to evaluate celiac disease. Conclusion: This study shows that in northeast of Send Date: 2011/08/20 Iran, the disease is most common in the third decade of life and it almost has the same frequency in males and females.The most common extra-intestinal Category: 1 CLINICAL PRACTICE presentation is primary sclerosing cholangitis. 1.1 Epidemiology Send Date: 2011/08/18 W-F-012 ìýrAóKnüp},OÏlAkðýpôÿAðvBðþôuÇeGñlÿglìBR AqkülâBûKryßBóìpOHÈGBuçìQâõAo}ôÞHl Category: 1 CLINICAL PRACTICE 1 ,oÂBìéàqAkû 1 ,ìùlÿ¾BGpÿÖýpôqÿ 1 ,ìdílìùlÿìýpðB¾pÿ 1& yý×PúÎBGlüBó 1.1 Epidemiology ìpÞrOdÛýÛBRâõAo}ôÞHl,GýíBouPBóypüÏPþ,OùpAó,AüpAó 1 W-F-011 GúìñËõoGpouþkülâBûyBÒéýòKryßþkoqìýñúâõAo}ôÞHlkoìõok ìÛlìú: Prevalence of celiac dusease in osteoporotic OÏlAkðýpôÿAðvBðþôìýrAóKnüp}kuPýBoÿ,uÇeGñlÿglìBRôðõÑ@óAüò patients in comparison to healthy subjects Ahmad Khoncheh1, Ahmad Reza Jamshidi2, OdÛýÜAðXBïyl. Farza Ranjpour1, Atieh Rahmati3, Bijhan koÞñãpûAðXíòìPh¿¿ýòâõAo}ôÞHlAüpAókouBë9831Gú Gpouþ: oô} Shahbazkhani1* AÆçÎBR yl. uõAë ÞññlâBó ypÞQ ðËpAR ÞPHþ, Aÿ KpuzñBìú ôuýéú 1 Digestive Disease Research Center, Tehran University of ÖÏBèýQ ðõÑ ô ÖÏBèýQ ìdê koüBÖQ@ó, uBë ô Od¿ýéþ ìloá kìõâpAÖýà, Medical Sciences 2 Rheumatology Research Center, Tehran University of yÓéþ,ôuõAæOþkoìõokìõÂõÎBRÖõÝâñXBðlûyl.Aq002KpuzñBìúOõqüÐ Medical Sciences ylû,421KpuzñBìúOßíýêôGpâpkAðlûyl. 3 GI and liver Disease Research Center, Tehran University ìPõuÈuòKBuikøñlâBó68/34uBë,5/06%ÖõÝOh¿Àô1/73% üBÖPúøB: of Medical Sciences ÞíPp üB uBë 01 37% ô uBë 11 Aq Gý{ 72% Aðl. kAyPú kAgéþ Oh¿À Introduction: There is an increased prevalence of ÖBoÕAèPd¿ýêylûGõkðl.24%koOùpAóôìBGÛþkogBoZAqOùpAóGúÖÏBèýQ osteoporosis among patients with celiac disease. However, the relative prevalence of celiac disease ìzÓõëGõkûAðl.8/05ko¾lKBuikøñlâBókoAuPhlAïkôèQô85ko¾lAÖpAk among osteoporotic and nonosteoporotic populations GúÎñõAóÒýpøýEQÎéíþÖÏBèýQkAyPúAðl.5/34%OÏlAkÖÏéþðýpôÿAðvBðþ is not known, and the benefit of screening the ìPh¿ÀâõAo}ôÞHl(ðýîGpAÿøp¾lørAoð×p)oAÞBÖþô65%Gý{AqAüòOÏlAk osteoporotic population for celiac disease remains oAÂpôoÿkAðvPúAðl.4/84%ìýrAóKnüp}ÖÏéþkuPýBoÿâõAo}ôÞHloAqüBk

12 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

ô5/53%@ðpAìñBuIAoqüBGþÞpkûAðl.clôk09%GBuÇeGñlÿglìBROh¿¿þ among the four groups regarding heart rate (HR), âõAo}ôÞHlkoÞzõoìõAÖÜGõkûô7/88ko¾lGBÆpfAoAüúAüòglìBRko4 oxygen saturation (O2S), systolic blood pressure uÇeìõAÖÜGõkûAðl. (SBP), diastolic blood pressure (DBP), duration of Gh{ìùíþAqðýpôÿAðvBðþkoGh{øBÿÒýpkôèPþÖÏBèýQìþ ðPýXúâýpÿ: endoscopy (DE), skin color (SC), blood flow (BF) Þññl.OípÞrðýíþAqìPh¿¿ýòkoìpÞrÞzõo,ðýBqGúGpouþWlÿkAok.OñËýî and respiratory state (RS). Conclusion: Based on our findings, on EGD no OÏlAkðýpôÿAðvBðþôìýrAóKnüp}GpAÿAoADúglìBRko^ùBouÇeìþOõAðlAq sedation is needed unless the patient feels anxious øA AHk ü yúkÞõGy.AAúgìRìqþKôz ô Ktôøzþ glìBR@ìõqyþ AoADú koÞzõoGByl. oyPú Aüò oAøHpkÿ AølAÙ and therefore cannot cooperate appropriately. For this koìBðþKýzpÖPúkoìÏlôkÿAqìpAÞrOõAðíñlôâvPp}glìBRuBkûôAôèýúko case, administration of propofol alone is prioritized AÚ¿þðÛBÉÞzõoAqA¾éþOpüòAWrAÿAüòuÇeGñlÿìþGByñl. over midazolam alone and propofol plus midazolam. Send Date: 2011/08/23 Send Date: 2011/06/04

Category: 1 CLINICAL PRACTICE Category: 1 CLINICAL PRACTICE 1.2 Management strategies 1.2 Management strategies W-F-014 W-F-015 Application of Midazolam and Propofol in Effect of Synbiotic in the Treatment of Children Esophagogastroduodenoscopy; a with Functional Constipation Referring to Triple-Blind, Randomized Controlled Trial Alzahra University Hospital in Isfahan, 2010 Narges Soltanpour1, Fatemeh Bayat1, Vahid Mirzaee1* Hossein Saneian1*, Pardis Adhamian2, 1 Department of Gastroenterology, Rafsanjan University of Kamran Tavakol2, Ali Gholamrezaei1 1 Medical Sciences, Rafsanjan, Iran Medical college, Isfahan University of Medical Sciences Introduction: Use of intravenous sedatives became (IUMS) 2 common in gastrointestinal endoscopy. This study is to Medical college, Islamic Azad Najafabad University of Medical Sciences evaluate the safety and efficacy of propofol and/or Introduction: Constipation is one of the most midazolam in induction of proper sedation in common gastrointestinal disorders in children and in esophagogastroduodenoscopy (EGD) compared with a more than 90% of the cases there is no structural control group which does not receive sedation for EGD. cause for which diagnosis of functional constipation Method: Four groups (A, B, C and D) of patients is made. We compared mineral oil plus Symbiotic each of which consisted of 30 patients for whom with mineral oil alone in the treatment of functional esophagogastroduodenoscopy had been indicated constipation in children. were defined. For groups A, B, C and D, no sedative, Method: This controlled clinical trial was conducted midazolam, propofol and midazolam plus propofol in Isfahan in 2010. Children with functional were administered intravenously, respectively. The constipation (Rome III) were included and four groups were compared with each other regarding randomized to receive symbiotic (1 tab Lactol /20 heart rate (HR), O S (oxygen saturation), systolic 2 kg/d) plus mineral oil (1 ml/kg/d) or mineral oil alone blood pressure (SBP), diastolic blood pressure for two months. Symptoms of constipation including (DBP), duration of endoscopy (DE), patient frequency of deification, stool form, urgency, strain, compliance (CM), retrograde amnesia (RA), incomplete evacuation, pain, and leakage of stool antegrade amnesia (AA), patient activity (PA), skin were assessed and compared before and after the color (SC), patient consciousness (CS), blood flow study. After the study, the two groups were also (BF), respiration state (RS) and pain. compared in regards to subjective global Results: Patient compliance (CM), retrograde improvement and adequate relief of symptoms. Data amnesia (RA), antegrade amnesia (AA), patient were analyzed with SPSS using t-Test, Chi-Squae, activity (AC), patient consciousness (CS) and pain Mann-Whitney, and Wilcoxon tests and also were significantly different in our patient groups. On multivariate analyses. the contrary, no significant difference was found Results: During the study, 30 children were included

Govaresh\ Vol.16\ Supplement\ Autumn 2011 13 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 in each group; all of them completed the study. The GýíBoüùBÿÚéHþÎpôÚþìÇpfylûAuQ.øí`ñýòìÇBèÏBRAoOHBÉìPñBÚÃþ two groups were similar in age, sex, and baseline GýòkoüBÖQÖõæRôgÇpGpôqupÆBóÞõèõóðzBókAkûAðl. symptoms except stool frequency. After treatment, GúìñËõoGpouþASpARkoüBÖQðBÞBÖþÖõæRGpGpôqôKýzpôÿ Gpouþ: oô} stool frequency increased in both groups (p<0.001) upÆBóÞõèõó,ìÇBèÏBRAðXBïylûAquBë2002ìõokGpouþÚpAoâpÖQ. with greater increase in symbiotic group (p<0.05). ðPBüYcB¾êAqìÇBèÏBRìhPéØ,AqWíéúìPB@ðBèýrAðXBïylûkouBë øB: üBÖPú Frequency of hard/very hard stool and frequency of 0102KýzñùBkìþÞñlÞúAoOHBÉìÏßõuþGýòkoüBÖQÖõæRôgÇpGpôqupÆBó painful deification decreased in both groups similarly (p<0.001). Urgency was decreased in symbiotic ÞõèõóôWõkkAok;ÞúkooAuPBÿìPB@ðBèýrAðXBïylûkouBë5002AuQ.ðPBüY (p<0.05) but not the mineral oil group. Strain ðzBóìþkølÞúkoüBÖQGBæÿÖõæRgÇpupÆBóÞõèõóoA51-8%ÞBø{ decreased in both groups (p<0.001) but more ìþkøl.AgýpA«^ñlìÇBèÏúÞBo@qìBüþGBèýñþkooAGÇúGBðÛ{ÖõæRkoGpôq decrease was seen in symbiotic group (p<0.05). upÆBóÞõèõóAðXBïylûAuQôðPBüYcB¾êAqüàìÇBèÏúðzBókAkûAuQÞú Mucus in stool was decrease in both groups similarly ìßíêüBoÿ5ìýéþâpïÖõæRkooôqGúìlRuúuBëGBÞBø{ìÏñþkAoGpôq (p<0.001). Incomplete evacuation and leak of stool upÆBókoAoOHBÉAuQ.ko¾õoOþÞúkoüBÖQÖõæRkoìÛBküpKBüýò^ñýòASpÿ decreased in both groups (p<0.05) with greater de- oAðzBóðlAk. crease in symbiotic group (p<0.05). Finally, overall koìXíõÑìþOõAóâ×QÞúkoüBÖQìÛBküpÞBÖþÖõæR^úGú ðPýXúâýpÿ: symptoms in mineral oil group improved moderately in 36.7% and extremely in 40.0% of children. In the ¾õoRìßíêüBoÿô^úkoÚBèIÒnAøBìþOõAðlgÇpupÆBóÞõèõóoAÞBø{ symbiotic group, overall symptoms improved mod- køl;øp^ñlGpAÿOÏýýòìÛlAokÚýÜÖõæRìõokðýBqGpAÿkuPýBGþGúAüòølÙ erately in 13.8% and extremely in 86.2% of children. GúìÇBèÏBRGýzPpÿðýBqAuQ. According to multivariate analyses, among factors in- Send Date: 2011/08/22 cluding age, sex, baseline constipation symptoms and groups, only receiving the symbiotic mineral oil was associated with greater improvement in overall symp- Category: 1 CLINICAL PRACTICE toms (p=0.003, t=3.1). No severe side effects were 1.4 Outcome studies observed in children. W-F-017 Conclusion: These results indicated that adding The prevalence of Hepatitis B virus symbiotic (Lactole) to the routine treatment of infection in kavar - southern of Shiraz, Iran constipation in children (mineral oil) can significantly Mohammadreza Fattahi1, Zahra Zonubi1, 1* 1 increase the global improvement in symptoms, Maryam Ardebili , Abbas Rezaianzadeh 1 without specific side effects. Further studies Gastroenterohepatology Research Center (GEHRC), Shiraz University of Medical Sciences, Shiraz, Iran evaluating and comparing other symbiotic agents Introduction: Hepatitis B virus infection is a either alone or along with other standard treatments common cause of chronic liver disease in Iran and and longer follow-ups of children with constipation is other countries. It is one of the most prevalent public warranted. health problems worldwide, particularly in Send Date: 2011/08/04 developing countries. The prevalence of hepatitis B virus infection in Fars, Southwest province of Iran is Category: 1 CLINICAL PRACTICE estimated to be 1.7% based on previous researches. 1.3 Evidence-based clinical practice Routine neonatal vaccination for hepatitis B virus W-F-016 infection prevention has been started since 1973 in ðÛ{ìdBÖËPþÖõæRkoGpAGpupÆBóÞõèõó Iran. The aim of current population based cross- jla edipeS ijulhaM *1 sectional study was to compare the prevalence of hepatitis B virus infection in vaccinated versus ceslcdmf tseiuzra niitN1 ,noitirtuN zirbaT ytisrevinu fo lacidem ecneis unvaccinated population of this area. ÞõÖBÞPõoìùíþko B ÖõæRGúÎñõAóqüpâpôøþAqôüPBìýñùBÿâpôû ìÛlìú: Method: We randomly selected 10352 subjects out ôìvýpøBÿìPýçuýõóAuQ.ÞíHõkÖõæRÞúìñXpGúAÖrAü{ AND uñPr of normal population of Kavar, a small town located ÇføõýPý ogóìyk úÎõóov BPoìvPÛê ÖBÞPõo oüvà ÎñõAó Gú ìþyõk, gõó ko øíõuývPEýò uÇõf in Southeast of Shiraz. Subjects enrolled in this study were older than 7 years. Serum samples were tested

14 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 for hepatitis B surface Antigen (HBs-Ag) and Aìõq}Aó,kôoûøBÿOßíýéþÖéõyýM,OÏlAkÞñãpûøB,AqypÞQÞññlâBóko antihepatitis B core Antibody(antiHBc-Ab) by ÞñãpûuBë9831uõAëyl.Aq002KpuzñBìúOõqüÐylûOÏlAk421KpuzñBìú Enzyme linked immunoassay (ELIZA). OßíýêôGpâpkAðlûyl(26%). Results: In our study 19.7% of subjects were younger 701ìpkô71qóGBìPõuÈuò68.34uBë(OB57uBë),57ð×pÖõÝ øB: üBÖPú than 18 years which for them routine neonatal ÖÏBèýQ OùpAó ko ð×p 33 kAyPñl. ìzBoÞQ kAgéþ ìPh¿À ô64 Oh¿À vaccination against hepatitis B has been done that is kAuPúAðl.GúOpOýI28,87,86,95,55,82ko¾lAÖpAkAÎíBëôülDõ@ðlôußLþ, almost compatible with the percentage of vaccinated population against hepatitis B in Kavar (24.55%). ôülDõÞõèõðõußLþ,ÞñPpëgõðpürÿôAoüvþ,ÞñPpëgõðpürÿÒýpôAoüvþ,oA The prevalence of hepatitis B surface Antigen GpAÿGýíBoAógõkAðXBïìþkøñl.ko¾õoOýßúAÎíBëìBðõìPpÿôKþAbìPpÿ (HBs-Ag) and antihepatitis B core Antibody ô@yBæqÿ, ìpÿ Oñãþ küçuýõó Kþ, Aüþ@ouþ ìBðõìPpÿ@ðõoÞPBë, ìpÿ, (HBc-Ab) in vaccinated population were 0.88%(18 ,@ðPpôußLþôÞLvõë@ðlôußLþOõuÈÞíPpAq03% GEP KõèýLßPõìþ,OÏHýú subjects) and 1.66%(34 subjects) respectively; and in AÖpAkAðXBïìþyõk.41OB73ko¾lypÞQÞññlâBókogõAuQ@ìõq}ìlAôïko unvaccinated population were 1.14%(95 subjects) üàüB^ñlðõÑAqAÎíBëqüpkAyPúAðl.57,56,ô65ko¾lAÖpAkðýBqGúânoAðló and 6.56%(546 subjects) with p= 0.0001 for HBs-Ag kôoûøBÿÖéõyýMKýzpÖPúAðlôuõðõâpAÖþ,AüþAouþKþôKýõðlÞHloAìõok and p=0.001 for HBc-Ab that were significant. Conclusion: Although exposure rate was OBüýlÚpAokAkûAðl.97%OÏlAkÞñãpûøBoAÞBÖþkAðvPúAðl.1/25%OíBüêGúOzßýê significantly decreased after vaccination(as WévBR@ìõq}ìlAôïcÃõoÿô9/74%GúAoAüúAìõq}øBÿÒýpcÃõoÿOíBüê manifested by significantly lower rate of Anti HBc ðzBókAkðl. Ab positivity,1.66% in vaccinated versus 6.56%in ÆpAcþôOùýúGpðBìúøBÿ@ìõqyþGpAÿAoOÛBÿìùBoRAÖpAkko ðPýXúâýpÿ: unvaccinated population),the rate of hepatitis B virus GB GBüvPþ øBôÞõèõðõußLþ gõðpürÿ yBüÐìBðñl@ðlôußLþ,ÞñPpë AÎíBë infection was not decreased in the same rate(0.88% in AôèõüQGpðBìúoürÿyõk.GBôWõkKBüýòGõkóìýrAóAÎíBëküãpÖõÝOh¿¿þ vaccinated versus 1.14%in unvaccinated population). OÛBÂBÿ@ìõq}GpAÿAðùBÞíPpAq04ko¾lìþGBylÞúìþOõAðlGlèýêÞíHõk This discrepancy may be indicate a significant role AìßBðBR,ørüñúøBÿGBæ,ôÎõAoÅAcPíBèþAüòAÎíBëkoìpAÞrÞõ^àGByl. for vertical transmission of hepatitis B virus infection, which cannot be really affected by routine neonatal oAûAðlAqÿôOÛõüQkôoûøBÿÖéõyýMGBüvPþìõokOõWúWlÿÚpAoâýpk. vaccination; although this theory needs further Send Date: 2011/08/22 studies to be proven (Gastroenterohepatology Research Center at Shiraz University of medical Sciences is testing the families of HBs-Ag positive Category: 1 CLINICAL PRACTICE subjects to verify this theory.) 1.5 Pharmacoeconomics Send Date: 2011/08/19 W-F-019 The effect of Probiotics in Iranian patients with irritable bowel syndrome: Category: 1 CLINICAL PRACTICE a double-blind randomized-controlled study 1.4 Outcome studies Homayoon Vahedi1*, Elham Jafari1, W-F-018 Shabnam Momtahen1, Aina Riahi1, Reza Malekzadeh1 GpouþkülâBûøBôðýBqøBÿ@ìõqyþKryßBóyBÒê 1 Digestive Diseases Research center, Tehran University of koqìýñúuçìQâõAo}ôÞHl Medical Sciences Introduction: Probiotics are Live microorganisms zoiiea idheM, izoorifirebaS 1 , hetfihS naidebA *1 which when administered in adequate amounts confer 1 1 eaklMazeR hedazkelaM dammahoM, idheM iresanriM a health benefit on the host. We aimed to access the ìpÞrOdÛýÛBRâõAo}ôÞHl,GýíBouPBóypüÏPþ,OùpAó 1 efficacy of probiotics for improvement of some IBS GúìñËõoGpouþkülâBøùBôðýBqøBÿ@ìõqyþKryßBóyBÒêkoqìýñú ìÛlìú: symptoms in a double-blind randomized trial. âõAo}ôÞHl,ðËpARypÞQÞññlâBóÞñãpûuBæðúAðXíòâõAo}ôÞHlAüpAó Method: 160 eligible patients with normal lactose GõuýéúKpuzñBìúAÿÞPHþìõokGpouþÚpAoâpÖQ. intolerant breath test were randomly assigned to GúôuýéúüàKpuzñBìúÞPHþAÆçÎBRkìõâpAÖýà,@gpüòìloá oô}Gpouþ: receive Probiotics (n=80) or placebo (n=80), 2 cap Od¿ýéþôuBëkoüBÖQ@ó,ìdêôðõÑÖÏBèýQ,AðõAÑAÎíBë@ðlôußLþôðýBqGú /day during one month. Severity of abdominal pain and bloating compared before and after treatment.

Govaresh\ Vol.16\ Supplement\ Autumn 2011 15 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Results: A total of 99 patients ended the trial, significantly lower than many other countries. While 64patients (80%) of probiotcs group and 35 patients 35.6 % of the patients categorized in stages I-III, (44%) of placebo group, abdominal pain and bloating 64.4% were in stage IV. As the stages of the disease reduced significantly in probiotics group but this were increased, the diversity and frequency of reduction was not significant in placebo group. medical services were also increased considerably. Improving effect of probiotics remained at least for The treatment costs of the patients varied one month in 85% of patients. significantly within and between the disease stages. Conclusion: This is the first trial in Iran showed that 5FU/LV was the most chemotherapy regimen probiotics can reduce the severity of pain and (42/5%) used for the patients. The average costs of bloating in Iranian patients affected by pain and treatment were 86 (22.5) Million Rials in stage I and bloating predominant IBS and this effect will be 141(29.0) Million Rials in stage IV. remained at least for one month. Conclusion: Colorectal cancer treatment attracts Send Date: 2011/08/06 considerable amount of financial resources of the Iranian population each year. This is particularly important when taking into account that the treatment Category: 1 CLINICAL PRACTICE costs considered in this study obtained from a state 1.5 Pharmacoeconomics hospital. Thus, it is reasonable to expect that the W-F-020 market price of colorectal cancer treatment in Iran is The direct medical costs of colorectal cancer in Iran much higher than the figures presented in this study. Mohamad Hasan Emami1, Mohammad Reza Maracy2, Considering the fact that patients' age group in Iran is 3 1 4* Saeid Massah , Diana Taheri , Majid Davari lower than many other countries, the results may 1 School of Medicine, Isfahan University of medical Sciences encourage clinicians and health policy makers to 2School of Health, Isfahan University of medical Sciences consider preventive strategies which may possibly 3School of Pharmacy, Isfahan University of medical Sciences 4School of Management and Medical Information, Isfahan provide better value for money for managing University of medical Sciences colorectal cancer in Iran. Introduction: The treatment cost of cancers is one of Send Date: 2011/08/21 the major issues globally and in Iranian health system. The high cost treatment of colorectal cancer, as one of the important cancers in Iran, has affected Category: 2 ESOPHAGEAL-GASTRIC AND both patients and the government importantly. The DUODENAL DISORDERS aim of this study was to analyze the direct medical 2.1 Cell/molecular biology/pathology costs of colorectal cancer in Iran. W-F-021 Method: This study is a retrospective analysis of all Diagnostic values of pepsinogens to patients with colorectal cancer in Seyed-Alshohada discriminate gastritis, atrophic hospital in Isfahan (a state-owned cancer hospital in gastritis and corpus atrophic gastritis 1 1* Isfahan) between the years 1384 and 1389. The Fatemeh Nejhadi Kelarijani , Taghi Amiriani , Gholamreza Roshandel1, Abbasali Keshtkar2, relevant data including age, sex, disease stage and Behzad Faghani3, Atefeh Akhavan Tabib4, treatment expenditures extracted from patients' Ali Ahmadi3, Masoud Khoshnia1, Yazdan Sadeghi4, profiles. Extracted data were analyzed using Alireza Mojrian4, Sima Besharat1, Shahryar Semnani1 descriptive and inferential statistical methods 1 Golestan University of Medical Sciences, Golestan (Kruskal-wallis) through SPSS software. Research Center of Gastroenterology and Hepatology Results: The profiles of 435 patients were reviewed. 2Endocrinology and Metabolism Research Institute, Tehran But, considering inclusion and exclusion criteria, University of Medical Sciences only 320 patients were included in the study. The 3 Department of pathology, Tehran University of Medical results showed that the numbers of male patients Sciences 4 (56/1%) are higher than the females. The average age Golestan University of Medical Sciences Introduction: Golestan province in northeast of Iran of the patients were 56 years old which is

16 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 has been known as a high risk area for helicobacter DUODENAL DISORDERS pylori (HP) infection as well as upper gastrointestinal 2.2 Dyspepsia (UGI) cancers. Gastritis (G), as an outcome of HP W-F-022 infection, is an important health problem in this area. Comparison of domperidone and Subtypes of G, including atrophic gastritis (AG) and pyridostigmine in treatment of dyspeptic corpus AG (CAG) were considered as risk factors for symptoms in patients with functional UGI cancers. Endoscopy, as the diagnosis of choice dyspepsia: a randomized clinical trial for these conditions, is an invasive procedure with Javad Shokrishirvany1, Esrafil Shad1*, low acceptance rate. So, considering a noninvasive Hassan Taheri1 method such as a serum marker may help for early 1Department of Gastroenterology, Babol University of diagnosis of the conditions and result in prevention Medical Sciences Introduction: and controlling UGI cancers. We conducted this study Various drugs with unsatisfactory to evaluate the accuracy of pepsinogens I (PI) and II result were suggested for functional dyspepsia. This (PII) and the PI/PII ratio to discriminate G, AG and study was designed to evaluate the efficacy of CAG. domperidone and pyridostigminea in patients with Method:In this diagnostic accuracy study, patients functional dyspepsia. Method: with gastritis and its subtypes as well as normal This clinical trial performed on 117 patients individuals were recruited. Endoscopic biopsy and with functional dyspepsia (basis on ROME II criteria) histopathological examination was done as gold for comparing the effect of four weeks of treatment standard for diagnosis of gastritis. Serum levels of PI with domperidone 10 mg TDS, pyridostigmine 60 mg and PII were assessed by quantitative enzyme linked TDS and placebo. VAS score was used for scoring eight immunosorbent assay (ELISA) method. Receiver individual upper GI symptoms (fullness, early satiety, operating characteristic (ROC) curve analysis was gnawing, nausea, vomiting, belching bloating and used to determine the accuracy of pepsinogens for epigastric pain) before and at the end of treatment. Results: identifying G, AG and CAG. The total score decreased from 24 to 13 but Results: A total number of 69 normal individuals in ANOVAtest there was significant differences in 3 with mean age of 43 years and 126 gastritis patients of 8 symptoms score between three groups: bloating, with mean age of 47 years were recruited (P=0.1). 46 early satiety and nausea (p=0.039, p=0.006 & p= 0.016; percent of normal group and 47% of patients were respectively). With post Hoc Test, domperidone were male (p=0.9). The area under ROC curve (AUC) and more effective than pyridostigmine in nausea (p=0.024,) its 95% confidence interval (CI) for PI to discriminate placebo had superiority in controlling of bloating than G, AG and ACG were 69% (61-77), 79% (71-88), pyridostigmine (p=0.042 ) domperidone was more 83% (73-93), respectively. The AUC (95% CI) PI/PII effective than placebo in relieving bloating ratio to distinguish G, AG and ACG were 68% (p=0.023). domperidone was more effective than (60-76), 77% (68-86), 89% (81-98), respectively. pyridostigmine and placebo In improvement of early Conclusion: The accuracy of PI and PI/PII ratio was satiety (p=0.038 , p=0.014; respectively). In total GI acceptable for distinguishing G, AG and CAG with symptoms domperidone had more efficacy than other the highest accuracy for CAG. So, pepsinogens may two treatment (p=0.045). Conclusion: be useful for conducting screening programs in high Dompridone and pyridostigmine would risk areas. The epidemiology and burden of disease in be usefull in improving early satisty and nausea. But the population as well as the main goal of the were similar with placebo in controlling of epigastric program should be considered to make the best pain, fullness, belching and gnowing. decision in the community level. Send Date: 2011/07/20 Send Date: 2011/07/14

Category: 2 ESOPHAGEAL-GASTRIC AND Category: 2 ESOPHAGEAL-GASTRIC AND DUODENAL DISORDERS 2.2 Dyspepsia

Govaresh\ Vol.16\ Supplement\ Autumn 2011 17 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

W-F-023 2.2 Dyspepsia Correlation of dyspepsia with quality of life in W-F-024 Qashqui migrating nomads, Southern Iran Prevalence of dyspepsia in Qashqui Fariba Moradi1, Seyed jalil Masoumi2*, Davood migrating nomads, Southern Iran Mehrabani3, Najaf Zare4, Ahmad Mostaghni5, Seyed jalil Masoumi1*, Fariba Moradi2, Mehdi Saberi-Firouzi5, Ali Montazeri6 Davood Mehrabani3, Najaf Zare4, 1 Vice Chancellor for Health Affairs, Shiraz University of Ahmad Mostaghni5, Mehdi Saberi-Firouzi5 Medical Sciences, Shiraz, Iran 1 Gastroenterohepatology Research Center/ Department of 2 Gastroenterohepatology Research Center/ Department of Nutrition, School of Nutrition and Health,Shiraz Nutrition, School of Nutrition and Health, Shiraz University of Medical Sciences, Shiraz, Iran University of Medical Sciences, Shiraz, Iran 2 Vice Chancellor for Health Affairs, Shiraz University of 3 Gastroenterohepatology Research Center/Stem Cell and Medical Sciences, Shiraz, Iran Transgenic Technology Research Center, Shiraz University 3 Gastroenterohepatology Research Center/Stem Cell and of Medical Sciences, Shiraz, Iran Transgenic Technology Research Center,Shiraz University 4 Department of Biostatistics, School of Medicine, Shiraz of Medical Sciences, Shiraz, Iran University of Medical Sciences, Shiraz, Iran 4 Department of Biostatistics, School of Medicine,Shiraz 5 Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran University of Medical Sciences, Shiraz, Iran 5 Gastroenterohepatology Research Center, Shiraz 6 Iranian Institute for Health Sciences Research, Tehran, Iran University of Medical Sciences, Shiraz, Iran Introduction: Functional dyspepsia is a highly Introduction: Dyspepsia is a common disorder that prevalent gastrointestinal disorder that can present occurs in approximately 25 percent (range 13 to 40 many clinical dilemmas in patient management. percent) of the population each year can present many Although not life-threatening, the symptoms are clinical dilemmas in patient management. Although long-lasting, interfere with daily activities and have a not life-threatening, the symptoms are long-lasting, significant impact upon the quality of life. This study interfere with daily activities and have a significant investigates the correlation of dyspepsia and quality impact upon the quality of life. This study was of life in Qashqai migrating nomads in Fars province, performed to evaluate the prevalence and risk Factors southern Iran. of dyspepsia and its relation to life style in Qashqai Method: In summer 2009, 784 Qashqai migrating migrating nomads in Fars province, southern Iran. nomads aged 25 years or older were enrolled using a Method: In summer 2009, 784 Qashqai migrating multiple-stage stratified cluster random sampling nomads aged 25 years or more were enrolled using a method. The questionnaire of Rome II diagnostic multiple-stage stratified cluster random sampling criteria for dyspepsia was used for diagnosis of method. A questionnaire consisting of demographic dyspepsia. For about 50% of them, SF 36 factors, lifestyle data and gastrointestinal symptoms questionnaire was also completed. was completed for each participant. The Results: The prevalence of dyspepsia was 29.9%. questionnaire of Rome II diagnostic criteria for The dyspeptic patients were classified as having dyspepsia was used for diagnosis of the disease. ulcer-like (27.9%), dysmotility-like (26.2%), or Results: Among dyspeptic patients (29.9%), 27.9% unspecified dyspepsia (45.9%). Difference in SF36 had ulcer-like; 26.2%, dysmotility-like and 45.9% questionnaire domains was significant in dyspeptic had unspecified dyspepsia. The prevalence was patients in comparison to non-dyspeptic ones. higher in females, water-pipe smokers, NSAIDs Conclusion: Dyspepsia had a high prevalence in users, and in those with psychological distress, Shiraz, southern Iran and its relation to quality of life recurrent headache, anxiety, nightmare and past was very high. history of gastrointestinal disease. Dyspepsia had an Send Date: 2011/08/12 inverse relationship with consumption of pickles, fruits and vegetables and with duration of meals. Subjects with dyspepsia symptoms were more likely Category: 2 ESOPHAGEAL-GASTRIC AND to restrict their diet, take herbal medicine, use DUODENAL DISORDERS

18 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 over-the-counter drugs, consult with physicians, and minutes after breakfast was significantly higher in consume medication advised by their friends. patients compared to controls (751 vs. 576.9 Conclusion: Dyspepsia had a high prevalence in p=0.033).Although compared to controls, patients Shiraz, southern Iran and was associated with several had a higher mean of ghrelin at other times, only 30 demographic factors, life style, and health-seeking minutes after breakfast the difference was significant. behavior. Also patients had a higher level of ghrelin at all times Send Date: 2011/08/12 compared to controls, except 90 minutes after breakfast and shape of the curve was different in the patients and controls after 60 minutes of study. Category: 2 ESOPHAGEAL-GASTRIC AND Figure1: Serum Ghrelin level in functional dyspeptic DUODENAL DISORDERS patients and control group 2.2 Dyspepsia W-F-025 Pattern of serum ghrelin level related to meal-time: A comparison between functional dyspeptic patients and normal population Mohammadhassan Kazemi1*, Seyed Alireza Taghavi1, Abbas Rezaianzadeh1, Laleh Hamidpour1 1 Gastroenterohepatology Research Center (GEHRC), Shiraz university of Medical Sciences, Shiraz , Iran Introduction: Functional dyspepsia (FD) is the most common type of dyspepsia that implies when a complete diagnostic evaluation has been performed and obvious structural gastrointestinal disease has been excluded. Ghrelin which is a ligand of growth factor receptor is synthesized mostly in gastric Group 1:Control mucosa. It has a wide range of function in Group 2:patients gastrointestinal tract including motor activity, control Conclusion: Highest level of serum ghrelin in both of appetite and healing of mucosa. The level of group was 30 minutes pre-meal time. Then serum ghrelin is increased pre-prandial and decreased level of ghrelin decreased just before meal time until postprandially. The aim of this study was to compare 30 minutes after meal time.after that the level of the change of serum ghrelin level at different times serum ghrelin increased. Although statistically between patients with functional dyspepsia and significant differences of serum ghrelin level between control group and investigate if any differences two groups was only at 30 minutes after meal ,but observed between those two groups, maybe this after 30 minutes till 90 minutes of serving breakfast, hormone possibly has a role in inducing FD. pattern of the curve which showed changing of serum Method: 18 subjects with functional dyspepsia and 8 ghrelin level in different times related to meal time normal subjects as a control group were enrolled in was different between two groups as showed in figure this study. Blood samples were collected 5 times , 30 1.This time(30 till 90 minutes after meal) was the minutes before special breakfast, exactly be- time that dyspeptic group became symptomatic . fore,30,60 and 90 minutes after breakfast. Radioim- Different pattern of changes in serum ghrelin level in munoassay was done for determination of total functional dyspeptic patients compared to normal ghrelin in serum. control group in the time which dyspeptic group Results: The mean age of patients and control group became symptomatic, open a new window of were 33.3 ±9.8 and 24.7±1.2 respectively. This possibilities that Ghrelin as a hormone may have an difference was statistically significant. (p=0.022). important role in inducing symptoms in patients with Serum level of ghrelin in the two groups under study, functional dyspepsia. Send Date: 2011/08/18 control and patients was checked. Ghrelin level 30

Govaresh\ Vol.16\ Supplement\ Autumn 2011 19 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Category: 2 ESOPHAGEAL-GASTRIC AND impaired was role-physical (40.9 vs 77.3) followed DUODENAL DISORDERS by role-emotional (44.7 vs 77.5), physical functioning 2.4 Reflux disease - pathogenesis (66.9 vs 84.6), and general health (46.8 vs 63.8). W-F-026 Quality of life impairment was associated with the Correlation of quality of life with frequency (p<0.05) but not the severity of GERD. gastroesophageal reflux disease in Qashqai Conclusion: Health-related quality of life, as migrating nomads in Southern Iran measured by SF-36, was significantly associated with Seyed Jalil Masoumi 1*, Farnaz Khademolhosseini2, presence of GERD in Qashqai migrating nomads of Davood Mehrabani 3, Fariba Moradi 4, Fars province in southern Iran. All dimensions of Amir Ahmad Mostaghni 2, Najaf Zare 5, SF-36 were meaningfully impaired in GERD patients 6 2 Ali Montazeri , Mehdi Saberi-Firoozi in comparison with the non-GERD group. 1 Gastroenterohepatology Research Center/ Department of Send Date: 2011/08/15 Nutrition, School of Nutrition and Health, Shiraz University of Medical Sciences, Shiraz, Iran 2 Gastroenterohepatology Research Center, Shiraz Category: 2 ESOPHAGEAL-GASTRIC AND University of Medical Sciences, Shiraz, Iran DUODENAL DISORDERS 3 Gastroenterohepatology Research Center/ Stem Cell and Transgenic Technology Research Center, Shiraz University 2.5 Reflux disease-diagnosis of Medical Sciences, Shiraz, Iran W-F-027 4 Vice Chancellor for Health Affairs, Shiraz University of Status of GERD in Iran Medical Sciences, Shiraz, Iran Fathali Borhanmanesh1*, Bita Geramizadeh2 5 Department of Biostatistics, School of Medicine, Shiraz 1 Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran University of Medical Sciences,Shiraz,Iran 6 Iranian Institute for Health Sciences Research, Tehran, 2 Transplantation Research Center, Shiraz University of Iran Medical Sciences,Shiraz,Iran Introduction: Gastroesophageal reflux disease )Þú DREG KlülûGBqâzQìdPõüBR@ÒzPúGúAuýlAqìÏlûGúìpÿ( ìÛlìú: (GERD) is one of the most common gastrointestinal koAÖpAkuBèîOñùBKwAqKpgõoÿylülôüBgõokóÒnAøBÿðBuBqâBo¾õoR diseases encountered in daily practice. GERD AüòKlülû ) SEL ìþâýpkkoGÏÃþGúÎéQyêGõkókoü`úìýBóìpÿôìÏlû( symptoms are troublesome and disrupt physical, GúÆõoìßpo¾õoRâpÖPúôGBÎUuõgPãþôqgîylóìpÿìþyõkÞúko social and emotional well-being of many patients. This cross-sectional study was carried out on Qashqai ¾õoROlAôïGýzPp,AüòKlülûìñXpGúAüXBkqgîÎíýÜôOñãþìpÿôÂBüÏBR migrating nomads of Fars Province in southern Iran koÞzõoøBÿ DREG ôðùBüPB«upÆBóìpÿìþyõk.ðzBðúøBÿGBèýñþ s'tterraB to determine how GERD affects their quality of life. ÒpGþ(@ìpüßBôyíBëAoôKB)OBclôk02%ôkoWñõJAoôKB01OB51%ôkoÞzõoøBÿ Method: 748 subjects older than 25 years were @uýBüþclôk5%ârAo}ylûAuQ.ko^ñlìÇBèÏúAÿÞúkoAüpAóAðXBïylû interviewed to complete two questionnaires. One AuQ(AqÆpüÜì¿BcHúOé×ñþôüBoôkooôOõuÈAÖpAkÒýpKryà)yýõÑGBèýñþAüò consisted of questions on gastroesophageal reflux ðBoAcPþìõokOõWúGõkûAuQô@ìBoÿkoclôk04%WíÏýQârAo}ylûAuQ.Aq symptoms. The second questionnaire was the Short koclôk06%ìþGByl,OÏýýò DREG @ðXBÞúcvBuýQOzhý¿þÎçDîGBèýñþ Form Health Survey (SF-36). This generic health- yýõÑÎçDîGBèýñþkoìpkïðíþOõAðlðzBðãpôAÚÏþ@ð`úÞúkoìpÿìþânokGByl. related quality of life instrument consists of 36 items divided into eight dimensions. It has a 0- to 100-point GlôóìÇBèÏúAðlôußõKþðBÚÀôâípAûÞññlûAuQ.GBOõWú DREG GñBGpAüòìÇBèÏú scale where higher scores show better functioning ô DREG GúAüòAìpGúìñËõoìÇBèÏúÞBìêGBèýñþôAðlôußõKþGýíBoAóìHPçGú and well-being. WéõâýpÿAqGpôqôSHQAgPçÙðËpkoìzBølARGBèýñþôAðlôußõKýàGúOñùBüþ Results: Of 748 Qashgai migrating nomads who ìvEõèýQAðXBïKtôø{oAGÏùlûâpÖQ. participated in the study, 717 subjects completed the âõAoyþ GýíBoüùBÿ ôAcl ÞBko@ìõqyþ OõuÈ Þú oA GýíBoAðþ Gpouþ: oô} GERD questionnaire, while 371 subjects completed kokoìBðãBû ÖÛýùþ) yùýl ô ðíBqÿ yýpAq(GýíBouPBó Kryßþ Îéõï kAðzãBû the SF-36 questionnaire. For all dimensions of @ìBkûylûGõkðlìõokGpouþ DGE GýíBoüùBÿâõAoyþkülûylûGõkðlôGpAÿ SF-36, the mean score was consistently lower in patients with GERD when compared to non-GERD ÚpAokAk.ÆþìlR9ìBû(gpkAkOBAu×ñlìBû8831),376GýíBoupKBüþ(61OB48 subjects (p<0.001). The dimension most frequently uBèú)ÞúGpAÿðBoAcPþøBÿâõAoyþGúkoìBðãBûâõAo}ìpAWÏúÞpkûGõkðl,

20 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

ìõokìÇBèÏúAüòOdÛýÜÚpAoâpÖPñl.AqAüòOÏlAk563GýíBoqóGBuòìPõuÈ34 instrument (JAEGER – Germany) and total respiratory uBëô803GýíBoìpkGBuòìPõuÈ64uBëGõkðl. resistance (R5), proximal respiratory resistance (R20), )koâpôû traeH nrub dna noitatigruger ( SREG ôWõkÎçDîGBèýñþ üBÖPúøB: resonant frequency (Fres), and distal capacitive qðBóôìpkAóüßvBóôGpAGp03%GõkôèþôWõkqgíùBÿuÇdþkoqðBóÞúÎçDî reactance (X5) of each patient were recorded. Results: GBèýñþOp}ÞpkókAyPñl4/6%ôkoqðBðþÞúÖBÚlÎçDîGBèýñþGõkðl8/0%Gõk. All parents had a normal spirometric results , while; 50% of them had an increased resistant of air ÆHÛúGñlÿèõx@ðXéw ô @uýIøBÿìpÿkoqðBóøíúg×ýØôAqWíéú B A wayes according to oscillometric finding , 60% of qgîô@uýIøBÎíýÜOpôGúÆõoôAÂe DREG Gõkðl.koìpkAóGBÎçDîGBèýñþ patients with abnormal aiway resistance had class B yBüÐOpGõk,02%koìpkAóGBÎçDîGBèýñþô4%koìpkAóGlôóÎçDîGBèýñþ. or C of esophagitis and 40% had class A. kAyPñl ) SREG GñBGpAüòOÏlAkÚBGêOõWùþAqqðBóÞúÎçDîGBèýñþ( ðPýXúâýpÿ: After treatment only 16.3% of patients had abnormal koâpôûqðBó lataiH ainreH ÚpAoìþâýpðl.yýõÑGvýBoÞíPp DREN koâpôû oscillometry (P=0.004) Inspite of normal value of ðýrAqüBÖPúøBÿGvýBoWBèIAüòOdÛýÜAuQÞúìõokGdUÚpAogõAølâpÖQ pulmonary function tests (including FEV1, FVC , FEV1/FVC ) and mean FEEF (25- 75%) befor Send Date: 2011/08/20 therapy . the results significantly increased after treatment.(p=0.001) . There was no differences in Category: 2 ESOPHAGEAL-GASTRIC AND respiratory responces between patient with mild or DUODENAL DISORDERS sever classes of esophagitis . Conclusion: 2.7 Reflux disease - complications Abnormal airway resistance may be W-F-028 present in GERD pateints even when there is no Comparison of spirometric and oscilometric obvious respiratory symptoms. Anti reflux therapy indices befor and after treatment of may improve pulmonary function tests, and oscillometry Gastroesophageal reflux disease in a group of can be shown abnormality of baseline parameters better patients with no respiratory symptoms than spirometry Seyed Jalal Hashemi1*, Esmaeil Eidani2, Send Date: 2011/07/22 Masoomeh Hosaini askarabadi1 1 GI ward, Ahvaz - Jondishapoor University 2 pulmonology ward, Ahvaz - Jondishapoor University Category: 2 ESOPHAGEAL-GASTRIC AND Introduction: Gastroesophageal reflux disese DUODENAL DISORDERS (GERD) is a common chronic condition that carries 2.8 Esophageal malignant disease a risk of respiratory disorders including asthma . Anti W-F-029 reflux therapy appears to be useful is improvement Demographic, Clinical Features and Treatment of asthma symptoms and pulmonary functional Outcomes in 700 Patients with Achalasia in Iran tests.whoever the significant of respiratory abnormalities Javad Mikaeli1*, Abbas Hassanzadeh1, Elham Elahi1, 1 1 1 in patients without symptomatic asthma is a matter Narges Mehrabi , Arash Etemadi , Reza Malekzadeh 1 of debate .Oscilometry is an objective and sensitive Digestive Disease Research Center, Tehran university of Medical Sciences tools for evaluation of airway resistance and may be Introduction: Achalasia is the most recognized abnormal in patients with normal spirometry . The motor disorder of the esophagus. Because it is not a main purpose of this study is comparison between common disease, there is little information about it. spirometry and oscillometry results in GERD after Here, we report demographic, clinical features and and before treatment . treatment outcomes in 700 patients with achalasia Method: This study performed on thirty patients with that were referred and managed in our center from reflux esophagitis (16 person grad B and 14 person in 1994-2009. grad A) Without any pulmonary symptoms . patients Method: Diagnosis of achalasia was made according receive omeprazol 40 mg twice a day for 12 weeks . to patient's clinical, radiographic, endoscopic and pulmonary function tests and oscillometry were manometric features. A questionnaire was filed for performed before and after treatment . impulse each patient, that included patients age, sex, first oscillometry (IOS) performed by force oscillation symptoms, frequency of different symptoms,

Govaresh\ Vol.16\ Supplement\ Autumn 2011 21 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 presence of familial cases of achalasia, other percent) and 47 women ( 43/9 percent).The mean accompanying diseases and treatment outcomes. survival time in patients 15 / 2 ± 34/28 (95% CI: Results: In our study men were affected more than 57/32-12/24) months, respectively. Kaplan- Meier women. (54.3% vs. 45.7% ). Mean age was about 38 method showed survival rates at 1, 2, 3 and 4 years years. Most frequent symptoms were : dyphagia to old respectively 70, 53, 39 and 39 percent. In solids , dysphagia to liquids , active regurgitation , multivariate analysis using Cox regression model, passive regurgitation , and weight loss. tumor stage, chemoradiotherapy status and place of Conclusion: Major clinical and demographic features residence independent variables associated the of achalasia in Iran are almost the same as in reports survival of patients were identified. from other parts of the world , but contrary to some Conclusion: These variables as the most important reports ,we found it more prevalent in men and also prognostic factors in esophageal cancer patients. chest pain was more frequent in women Therefore, early detection of cancer using screening Send Date: 2011/07/13 programs can improve survival in such patients. Send Date: 2011/07/20

Category: 2 ESOPHAGEAL-GASTRIC AND DUODENAL DISORDERS Category: 2 ESOPHAGEAL-GASTRIC AND 2.8 Esophageal malignant disease DUODENAL DISORDERS W-F-030 2.8 Esophageal malignant disease 4-year survival rate of esophageal W-F-031 cancer radiation therapy center Molecular insights of esophageal Seyed Kazem mirinezhad1*, Mohammed Hossein squamous cell carcinoma in Iran Somi1, Saeed Dastgiri2 , Amir Ghasemi Jangjo3, Behnoush Abedi-Ardekani1*, Farin Kamangar2, Farshad Sydnzhad3, Mohammed Mohammedzadeh3, Masoud Sotoudeh3, Stephanie Villar4, Ali Reza naseri 3, Behnam Nasiri3 Sanford Dawsey5, Christian Abnet5, 1 Liver and Gastrointestinal Diseases Research Centre, of Reza Malekzadeh6, Pierre Hainaut4 Medical Sciences,Tabriz 1Digestive Disease Research Center, Shariati Hospital, 2 School of Medicine and liver and Gastrointestinal Tehran University of Medical Sciences, Tehran, Iran; Diseases Research Centre, of Medical Sciences,Tabriz International Agency for Research on Cancer, Lyon, 3 Radiation Oncology Therapy of IMAM REZA Hospital, France; Social security Organization, Tehran, Iran of Medical Sciences,Tabriz 2 Department of Public Health Analysis, School of Introduction: Esophageal cancer in Iran as the sixth Community Health and Policy, Baltimore, Maryland, most common cancer and third most common cancer USA, Morgan State University is one in east Azerbaijan. The aim of this study was 3 Digestive Disease Research Center, Shariati Hospital, to define the prognostic factors in esophageal cancer Tehran University of Medical Sciences 4 patients using univariate and multivariate methods. International Agency for Research on Cancer, Lyon, France, IARC Method: In this study, all patients with esophageal 5 Division of Cancer Epidemiology and Genetics, National cancer registered in the Radiation Therapy Center Cancer Institute, Bethesda, Maryland, USA, Imam Reza (AS), of Tabriz university of medical National institute of Health sciences; during March 21, 2006 to March 21, 2010 6 Digestive Disease Research Center, Shariati Hospital, were analyzed.All patients were followed up and vital Tehran University of Medical Sciences status. The probability curves for survival were Introduction: Golestan Province in Northeastern Iran calculated according to the Kaplan–Meier Method, has one of the highest incidence of Esophageal then compared by the Log-rank test. Multivariate Squamous Cell Carcinoma (ESCC) in the world with analysis was carried out using the Cox proportional rates over 50/100,000 person-years in both sexes. hazard model. While the etiological role for some carcinogens such Results: Out of 114 patients, survival data was as polycyclic aromatic hydrocarbons (PAHs) has obtained on 107 patients including 60 males ( 56/ 1 been already shown (Abedi-Ardekani et al, 2010), the

22 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 main carcinogen(s) have not been fully identified yet. tern of mutations in ESCC from Golestan was not sta- This study was aimed to assess the molecular profile tistically different from Henan Province (China). of ESCC in Golestan. Mutation types showed differences according to the Method: 160 histopathologically confirmed mucosal temperature of tea consumption, with G:C to A:T mu- biopsies of ESCC cases from Golestan Case-Control tations at CpG sites and Wild-type TP53 being sig- Study (GCCS) as part of group of collaborative nificantly more common among hot tea drinkers studies so called GastroEsophageal Malignancies in (adjusted OR: 6.40, 95% CI, 1.16-35.16 and OR: Northern Iran (GEMINI)( methods: Nasrollahzadeh 6.27, 95% CI, 1.04-37.69; respectively), suggesting et al, 2008). with at least 70% of tumor cells were an association between the temperature (and/or com- selected for TP53 mutation analysis of exons 2 position) of tea consumption and the presence and through 11. The analysis was performed by direct types of TP53 mutation. sequencing of PCR products. The mutation results Conclusion: ESCC tumors in people from Golestan from Golestan were compared with other geographic Province show the highest rate of TP53 mutations areas using the IARC TP53 mutation database ever reported in any cancer anywhere with a (http://www.iarc.fr/p53). All statistical analyses were significantly different pattern from Tehran and closer conducted by Stata Version 11. Two-sided P < 0.05 to China. The heterogeneous mutation pattern is was considered as statistically significant. highly suggestive of a causative rolefor multiple Results: DNA was successfully amplified for all environmental carcinogens, including PAHs. The TP53 coding exons in 119/160. The mean age of the temperature and composition of tea may also recruited patients was 65.5±11 with an equal sex influence mutagenesis. distribution (F=50.4%). 54.6% were Turkmen. 43.4% Send Date: 2011/08/01 reported drinking tea 4 minutes or more and 16% in less than one minute after pouring tea (hot drinkers). Only 4.2% of patients reported ever using alcohol. Category: 2 ESOPHAGEAL-GASTRIC AND The use of tobacco or opium products in various DUODENAL DISORDERS forms was reported by 43.7%, among whom 17.6% ìõÂõÑ:2.8GýíBoüùBÿGlgýîìpÿ reported using both substances. The majority of the 230-F-W subjects (71.4%) were from rural areas. ârAo}ÖBqAôëÞõøõoR000,05ð×pÿâévPBó TP53 mutations were confirmed in 107 patients , 2& ,ÎéýpÂBuXBkÿ 2 ,øõìògBkìþ 1 AèùBïWÏ×pÿ,AÞpïKõoyíw (89.9%) including nine patients with two and two pa- 4 ,oÂBìéàqAkû 3 ,âõøpyBkâõâçðþ 3 AÞHpÖBÂêOHBoìéßzBû tients with three different mutations (total: 120 muta- kAðzýBo,ìpÞrOdÛýÛBRâõAo}ôÞHl,kAðzãBûÎéõïKryßþOùpAó,AüpAó 1 tions). The most common mutation type was G:C to Ktôøzãp,ìpÞrOdÛýÛBRâõAo}ôÞHl,kAðzãBûÎéõïKryßþOùpAó,AüpAó 2 A:T transitions (38.3%), one third of them at CpG Ktôøzãp,ìpÞrOdÛýÛBRâõAo}ôÞHl,kAðzãBûÎéõïKryßþOùpAó,AüpAó 3 dinucleotides, followed by G:C to T:A transversions AuPBk,ìpÞrOdÛýÛBRâõAo}ôÞHl,kAðzãBûÎéõïKryßþOùpAó,AüpAó 4 (16.7%). The majority of the mutations (84.2%) were pB éëuãpþìÿkyÝâvB ß qGBæOpüò Aq üßþ âévPBó koypÝ ìpÿ uñã×pyþ uéõë upÆBó : ìÛlìú detected in exons 5-8. Less than 10% of the mutations (7.5%) occurred at ìýrAóøBÿGpôqoAkoWùBókAoAìþGByl.GpAÿyñBuBüþÎéê@óìÇBèÏBRìÛÇÏþ “hotspot” TP53 codons (codons 175, 245, 273 and ôìõok-yBølÿìPÏlkÿAðXBïylûAuQ.GBOõWúGúGpOpÿìÇBèÏBRÞõøõoR 282 where 20% of known TP53 mutations occur in (øíãpôøþ)GpAÿyñBuBüþÎõAìêgÇpuBqGýíBoÿøB,AWpAÿüàìÇBèÏú all cancers). Among the G:C to T:A mutations, 40% ÞõøõoR@üñlûðãpGBKýãýpÿkûuBèúìõokOõWúÚpAoâpÖQ. occurred at codons previously described as sites of 42086ð×pAquBÞñBóypÝAuPBóâévPBókoìdlôkûuñþ57-04uBë oô}ÞBo: PAH adduct formation which are commonly mutated GúìÇBèÏúkÎõRylðl.kooôuPBøBOíBïAÖpAkôkoyùpâñHlGúÆõoO¿BkÖþ,Gú in lung cancer of smokers. oô}gõyúAÿuývPíBOýàGpAuBxyíBoûgBðõAo,AðPhBJylðl. A significant difference between the proportion of transition mutations at CpG dinucleotides (P=00.2). WíÏB«54005ð×pìpAWÏúÞpkðlÞú14212ð×pìpk(24%)ô40882ð×pqó üBÖPúøB: was found between Tehran (Sepeher et al, 2001; Bi- (85%)Gõkðl.ìýBðãýòuñþAÖpAkìpAWÏúÞññlû1/9±21/25uBëô9/32%@ðBó ramijamal et al, 2001) and Golestan The overall pat- yùpÿô1/67%oôuPBüþGõkðl.

Govaresh\ Vol.16\ Supplement\ Autumn 2011 23 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

p uB éPóøõ qìBÜGô BÿuÆóuéõë upÆBó GBæÿ Gpôq ìñBÆÜ Aq øñõq âévPBó AuPBó ypÝ âýpÿ: ðPýXú height and volume of barium > 50%) response uñã×pyþìpÿkoWùBóGúyíBoìþoôk.AðXBïìÇBèÏúÞõøõoRGéñlìlRkû rate.Mean ASS decreased from 11.38 (± 1.5) to 3.23 uBèúGúÞBø{GpôqAüòGýíBoÿAqÆpüÜyñBgQôÞñPpëÎõAìêgÇpuBq@óÞíà (±1.96) at 1.5 months after last injection (p=0.001). ìþðíBül. Mean volume of barium in TBE decreased from OBoüiAouBë:0931/40/21 81.38 (±51.11) ml to 40.69 (±61.22) ml at 1.5 months after last injection (P=0.016).The mean duration of follow up was 17.83 (±1.12) months. Relapse was occurred in 6 patients, all successfully was treated by Category: 2 ESOPHAGEAL-GASTRIC AND one re-injection. DUODENAL DISORDERS Conclusion: This study indicates that EO is well 2.9 Other esophageal disorders tolerated and potentially effective in patients with IA W-F-033 that might be explained by the local inflammatory Ethanolamine oleate in resistant idiopathic properties of EO. Since presented data are too achalasia: A novel therapy preliminary to support the routine use of EO in the Javad Mikaeli1*, Ramin Niknam1, Narges treatment of all patients with IA, its use in selected Mehrabi1, Laleh Mahmoudi2, Elham Elahi1, Shapoor cases can be considered. Shirani3, Reza Malekzadeh1 Send Date: 2011/07/13 1Digestive Disease Research Center, Tehran University of Medical Sciences 2 Department of Clinical Pharmacy, Faculty of pharmacy, Category: 2 ESOPHAGEAL-GASTRIC AND Shiraz University of Medical Sciences DUODENAL DISORDERS 3 Departmet of Radiology, Tehran Heart Center, Tehran 2.10 Acid peptic disease (includes NSAIDS - but University of Medical Sciences Introduction: Idiopathic achalasia (IA) is a chronic NOT H.pylori)-epid emiology disease without definite therapy. Ethanolamine oleate W-F-034 (EO) has multiple biological effects, including Comparison of continuous infusion of inflammatory activities. We investigated the efficacy Pantoprazole versus oral Omprazole for of EO injection in selected patients with IA. prevention of ulcer rebleeding 1* 1 Method: 136 patients with IA evaluated prospectively. Eskandar Hajiani , Seyed Jalal Hashemi , Nima Aghamohamadi1 We evaluated the efficacy of EO injection in 13 patients 1 GI ward, Ahvaz - Jondishapoor University with IA that are resistant to or poor candidate of Introduction: PPIs have a prolonged and significant pneumatic balloon dilation and/or cardiomyotomy at effect on gastric acidity therefore; represent a rational the Digestive Disease Research Center, Shariati choice for prevention of ulcer rebleeding. After Hospital, Tehran, as the major referral center for endoscopic homeostasis in patients with peptic ulcer achalasia in Iran in an interventional study. Diluted bleeding, rebleeding occurs in 20% of patients. EO was injected in divided dose into each of four Rebleeding remains the most important determinant quadrants of lower esophageal sphincter, using a of clinical outcomes and prognosis. We designed a trial standard sclerotherapy needle. Injection was repeated comparing of continuous infusion of Pantoprazole versus at two and four weeks after first injection. The oral Omprazole for prevention of ulcer rebleeding. patients were evaluated with achalasia symptom Method: 94 cases with GI bleeding due to duodenal or score (ASS) and timed barium esophagogram (TBE) gastric ulcer with major sign of recent bleeding were before and after injections. Good response was treated with epinephrine injection and electroquagulation. defined as decrease in ASS ≥ 50% of baseline and Inclusion criteria were patients with active bleeding decrease in height and volume of barium ≥ 50% of ulcer, visible vessel ulcer, adhesion clot ulcer. After baseline in TBE, at 1.5 months after last injection. homeostasis was achieved, they were randomly Any side effects were recorded. assigned to receive intravenous Pantaperazole (80 mg Results: All patients (13 cases) had good ASS intravenous bolus followed by an infusion at a rate of (decreased > 50%) and good TBE (decreased in

24 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

8 mg per hour) or oral Omeprazole (80mg Po initially 98%, 96%, 91%, 0.897; ; UBT: 89%, 73%, 92%, 90%, and followed by 80mg BID) for 72 h.The primary 82%, 0.892; RUT: 93%, 75%, 95%, 94%, 86%, 0.831; end-point was the rate of rebleeding and outcomes. Histology: 89%, 78%, 93%, 91%, 85%, 0.881; Serology: Results: There were no statistically significant 50%, 54%, 46%, 61%, 52%, 0.563. differences between the groups in rebleeding rate Conclusion: Stool antigen test is the most accurate (p=0.21) transfusion requirement (p=0.26), Hospital days test for helicobacter pylori infection diagnosis before (p=0.24), mortality (p=1), but there were significant eradication of this bacteria. differences between the groups with regard to the need Send Date: 2011/08/05 for emergency surgery (p=0.04). Conclusion: Infusion Pantoperazol is not superior to oral Omeprazol as an adjunct treatment to endoscopic Category: 2.13 Gastroduodenal malignancies injection therapy in high-risk bleeding ulcers. W-F-036 Send Date: 2011/07/21 GÛBFGýíBoAóìHPçGúupÆBóìÏlû 2 ,kÞPpÎéþA¾ÓpKõoÿ 2 ,kÞPpìdílcvýò¾õìþ 1& kÞPpìpOÃþÚõWBqAkû âpôûÖýrüõèõsÿkAðzßlûKryßþ,kAðzãBûÎéõïKryßþOHpür 1 Category: 2 ESOPHAGEAL-GASTRIC AND ìpÞrOdÛýÛBRGýíBoüùBÿâõAo}ôÞHl,kAðzãBûÎéõïKryßþOHpür 2 DUODENAL DISORDERS upÆBóìÏlûGÏéQôÂÏýQgBÁ@ðBOõìý¼gõkøîküpÎçìQìþkøl ìÛlìú: 2.12 Acid peptic disease (includes NSAIDS - but ôøîqôkGúAoâBðùBÿìXBôokôoôðrkü¼gõkkuQAðlAqÿìþÞñlôAüòkôAìp NOT H.pylori)- diagnosis and treatment ìùîìõWIâpkülûÞúGýíBoAókoìpAcêKýzpÖPúgõkìpAWÏúÞññl.GBOõWú W-F-035 GúyýõÑðvHPB«GBæÿupÆBóìÏlûôGÛBÿÞî,ølÙAqìÇBèÏúcBÂpGpouþìýrAó The Value of Stool Antigen Test, Urea Breath Test, Rapid Urease Test, Serology, and Histology GÛBkoGýíBoAóìHPçGúupÆBóìÏlûìþGByl. in Diagnosis of Helicobacter Pylori Infection koAüòKtôø{ÞéýúGýíBoAóìHPçGúupÆBóìÏlûSHQylûkoìpÞr oô}Gpouþ: Shadi Kazemi1*, Hamid Tavakoli2, Mohamad Reza SHQOõìõoAuPBó@moGBüXBóypÚþkoÖB¾éúuBèùBÿ98-78GpouþôAÆçÎBR Habizadeh3, Mohammad Hasan Emami2 ìpGõÆúAuPhpAZâpkül.@gpüòôÂÏýQuçìQGýíBoAóAqÆpüÜGBqgõAðþ 1 Department of Internal Medicine, Isfahan University of KpôðlûGýíBoAóôüBKýãýpÿOé×ñþAðXBïâpÖQ.GpAÿOdéýêkAkûøBAqoô} Medical Sciences 2 Poursina Hakim Research Institute, Department of Gas- ÞBKçóìBüpôìlëôAüHêAuP×Bkûâpkül. troenterology, Isfahan University of Medical Sciences ìýBðãýòuñþAÖpAkìHPç35/11±28/66uBëGõk.clôk27%GýíBoAó üBÖPúøB: 3 Amin Hospital ìpkGõkðl.AqGýòÎçDî(yßBüQ)GýíBoAókokAKþâBuPpGB26%,ÞBø{ôqóGB Introduction: The purpose of this study was to 96%ôGþAyPùBDþGB15%yBüÐOpüòÎçDîGýíBoAóô@uýQGB9%ôèñ×BkðõKBOþGB compare the validity of five diagnostic tests of 5%ðBkoOpüòÎçDîGýíBoAóGõkðl.AqðËpìdêOõìõo@ðPp52%ÞBoküB54%ôAðdñBÿ helicobacter pylori including stool antigen test (SAT), GB acitsalpsitiniL Þõ^¼GB02%GýzPpüòìdêkoâýpÿôAðdñBÿGroåGB9%ô urea breath test (UBT), rapid urease test (RUT), serology, and histology. 5/6%ÞíPpüòkoâýpÿoAðzBóìþkAkðl.AqðËpøývPõèõsÿ63%ìõAokAqðõÑ Method: A total of 94 patients who had indication of oôkûAÿô92%ìõAokAqðõÑìñPzpGõkðl.GÛBüßvBèú24%,uúuBèúôKñYuBèúGú endoscopy were entered into the study and the five OpOýI71ô01%Gõk.ìýBðúÆõëÎípGýíBoAó5/81ìBûGõk tests performed for each patient. When the results of GÛBGýíBoAóGvýBoKBüýòGõkûôAoADú@ìõqyùBÿæqïWùQìpAWÏú ðPýXúâýpÿ: at least two tests (except serology) were positive, upüÐGýíBoAóKýzñùBkìþâpkk helicobacter pylori infection was considered to be Send Date: 2011/07/22 positive. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under Receiver Operating Characteristic Category: 2 ESOPHAGEAL-GASTRIC AND Curve of these five tests was determined. DUODENAL DISORDERS Results: The sensitivity, specificity, positive 2.13 Gastroduodenal malignancies predictive value, negative predictive value, accuracy, and W-F-037 area under Receiver Operating Characteristic Curve of Peer review of gastric cancer in Iran the tests were as below respectively: SAT: 96%, 83%,

Govaresh\ Vol.16\ Supplement\ Autumn 2011 25 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Mortaza Gojazadeh1*, Mohammad Hossein gõkuñXþAÂÇpAJqôðäAuP×Bkûyl.kAkûøBGBAuP×BkûAq@qìõóoAGÇúìXnôoÞBÿ Somi2, Aliasghar Pouri2 ìõokGpouþÚpAoâpÖQ. 71.SSPS ôGBAuP×BkûAqðpïAÖrAo 1 Departement Physiology Faculty of Medicine, Tabriz ÖpAôAðþAÂÇpAJôAÖvpkâþkoAüòGýíBoAóGúOpOýI7.62ko¾lô74ko¾l øB: üBÖPú University of Medical Sciences 2 Liver and gastrointestinal Disease Research Center, Gõk.AÂÇpAJôAÖvpkâþkoqðBóôkoâpôûuñþ54OB55uBèúÖpAôAðþGBæOpÿkAyQ. Tabriz University of Medical Sciences ÖpAôAðþAÂÇpAJôAÖvpkâþkoGýíBoAóìHPçGúupÆBóìÏlûGBæ ðPýXúâýpÿ: Introduction: In Iran gastric cancer is the most GõkènAæqïAuQkoÞñBokoìBóøBÿoôOýò,ìlAgçRgBÁoôAðþWùQGùHõk common cancer in male and it is reported to be the ôÂÏýQoôAðþðýrGpAüòGýíBoAóAðXBïGãýpk. third cancer after Breast and Colorectal cancers in female .The incidence of gastric cancer in Iran is 14.5 Send Date: 2011/07/30 cases/100,000 population in men and 8.2/100,000 in women. Mean age at diagnosis is 52.5 years. Category: 2 ESOPHAGEAL-GASTRIC AND Method: Gastric cancer is the second leading cause of DUODENAL DISORDERS cancer deaths in men and the third in women. The 2.13 Gastroduodenal malignancies relatively high rate of gastric cancer in Iran appears to W-F-039 be mainly due to dietary factors, and there are Establishment of a Population-Based etiologic and epidemiologic differences among Registry of Premalignant Gastric Lesions regions of the country. in Shiraz University of Medical Sciences Results: Although type of surgical resection may vary from 2006 to 2011 from center to center, D2 dissection is increasingly Maryam Moini1*, Kamran Bagheri Lankarani2, preferred in experienced clinics, with an associated Seyed Alireza Taghavi3, Mohammadreza Fattahi3, mortality of about 5.2%. Bita Geramizadeh4, Laleh Hamidpour1, Maryam Conclusion: Adjuvant chemoradiotherapy is widely Ardebili1, Zahra Tollabzadeh1, Zahra Mansoorabadi1 used. Few chemotherapy regimens are used in 1 Gastroenterohepatology Research Center, Shiraz advanced disease. Gastric cancer remains an University of Medical Sciences,Shiraz,Iran important public health problem in Iran. With the 2 Health Policy Research Center, Shiraz University of adoption of healthier dietary practices and screening Medical Sciences,Shiraz,Iran programs in endemic areas, the mortality from gastric 3 Gastroenterohepatology Research Center, Shiraz cancer is expected to decrease. University of Medical Sciences,Shiraz,Iran 4 Send Date: 2011/07/22 Shiraz Transplant Research Center, Shiraz University of Medical Sciences,Shiraz,Iran Introduction: A Population–Based Registry covers Category: 2 ESOPHAGEAL-GASTRIC AND all residents in a given geographic area within a given DUODENAL DISORDERS time period. It intends to include all with the disease 2.13 Gastroduodenal malignancies in the population. Even if it fails to include “all” W-F-038 cases, intention rather than performance defines the GpouþôÂÏýQAÖvpkâþôAÂÇpAJkoGýíBoAóìHPçGúupÆBóìÏlû term. Gastric cancer is usually diagnosed in an 2 ,ÎéþA¾ÓpKõoÿ 2 ,ìdílcvýò¾õìþ 1& ìpOÃþÚõWBqAkû incurable stage and premalignant changes are âpôûÖýrüõèõsÿkAðzßlûKryßþ,kAðzãBûÎéõïKryßþOHpür 1 well-known risk factors for it, though the aim of ìpÞrOdÛýÛBRGýíBoüùBÿâõAo}ôÞHl,kAðzãBûÎéõïKryßþOHpür 2 establishing a population-based registry is to build a AÖvpkâþôAÂÇpAJGpôÂÏýQÎíéßpk,Þý×ýQqðlâþ,ìlRGvPpÿô ìÛlìú: reliable data source which will be of considerable help cPþKýBìløBÿkoìBðþGýíBoAóìHPçGúupÆBóìÏlûOBSýpìñ×þkAokôAoqüBGþô to find a way for early diagnosis, better management koìBóAüòkôAgPçëkoAüòGýíBoAócBürAøíýQAuQ.AüòKtôø{GBølÙ and follow-up of premalignant lesions that hopefully AoqüBGþAÖvpkâþôAÂÇpAJkoGýíBoAóìHPçGúupÆBóìÏlûAðXBïyl. decrease progression to gastric cancer. Method: Registry is managed by Gastroenterohepatology koüàìÇBèÏúìÛÇÏþGúìñËõoAoqüBGþAÂÇpAJôAÖvpkâþko78GýíBo Gpouþ: oô} Research Center (GEHRC) at Shiraz University of GvPpÿìHPçGúupÆBóìÏlûkoìpÞr@ìõqyþ–koìBðþAìBïoÂBOHpürkouBë9831AðXBï Medical Sciences. A governing committee consists of l pÿAqBþAvkþôAÇA úOOIA@ìóAvkþG ô@qìõó Gà AÖvpkâþ Aq@qìõó OpOýI Gú AÂÇpAJ ô AÖvpkâþ AoqüBGþ GpAÿ yl. a head, 2 other faculty members and an appointed

26 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 manager who are responsible for decisions regarding The correlation between tissue expression budget allocations and other purposes. The of vascular endothelial growth factor geographic area is all pathologic lab and clinics (VEGF) and angiogenic marker affiliated to Shiraz University of Medical Sciences. CD34 in Gastric Adenocarcinoma The designed questionnaire includes a consent form, Ezzat Haj Mola Rezaee1*, Kamran Ghaffarzadehgan2, basic history data, nutritional history data, risk Hanieh Hosseinnezhad3, Hamid Reza Sima4, Sepideh factors, related procedures, medical therapy, and Ghadri5, Mohammd Naser Forghani6, Tahoora 7 8 3 follow-up data. Establishment process has two Abdolahi , Mostafa Jafarzadeh , Reihaneh Zoghian , 1 parallel setting phases. In the first phase all recorded Mahboubeh Parsa , Samaneh Boroumand Noghabi9, Hamid Reza Raziee10 pathology data as any of gastric premalignant lesions 1 Gastric Cancer Research Group, Student Research in defined pathologic laboratories is collected from Committee, School of Medicine, Mashhad University of 2006 to 2011. Then the collectors contact patients and Medical Sciences, Mashhad, Iran ask for an appointment. In the interview the 2 Gastric Cancer Research Group, Department of Research questionnaire is completed and blood samples are Affairs, Razavi Hospital, Mashhad, Iran taken. The gathered data are entered in the designed 3 Gastric Cancer Research Group, Young Researchers' and computerized data base. Two blood samples Club, Islamic Azad University, Mashhad Branch, which is extracted DNA are kept in -70 while four Mashhad, Iran 4 others is kept in -20°. In the second phase, all patients Gastric Cancer Research Group, Department of Internal with gastric premalignant lesions who referred to Medicine, Surgical Oncology, Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of defined clinics are referred to the registry office to fill Medical Sciences, Mashhad, Iran the questionnaire and ask to do another endosopy as 5Gastric Cancer Research Group,Young Researchers' Club, follow-up next year. Islamic Azad University, Mashhad Branch, Mashhad, Iran Results: The premalignant gastric lesion registry of 6 Department of Surgery, Mashhad University Cancer Shiraz University of Medical Sciences has started to Research Center, Omid Hospital, Mashhad University of register patients with premalignant gastric lesions.Till Medical Sciences, Mashhad, Iran now approximately 95 patients have been registered. 7 Gastric Cancer Research Group, Young Researchers' Conclusion: It is hoped that establishment of Club, Islamic Azad University, Mashhad Branch, population–based registry of premalignant gastric Mashhad, Iran 8 lesions help to determine the incidence, prevalence, Gastric Cancer Research Group, Department of Forensic Medicine and Toxicology, School of Medicine, Tehran demographic characters and causes of morbidity and University of Medical Sciences, Tehran, Iran mortality ,to facilitate future researches aimed to 9 Gastric Cancer Research Group, Department of identify etiology , new management and treatment Pathology, Imam Reza Hospital, School of Medicine, options, to monitor the time trends and the course of Mashhad University of Medical Sciences, Mashhad, Iran premalignant gastric lesions until developing cancer, 10 Gastric Cancer Research Group, Department of to evaluate whether the surveillance practice of Radiation Oncology, Mashhad University Cancer Research patients with these premalignant lesions matches their Center, Omid Hospital, Mashhad University of Medical cancer risk and to investigate the progression and Sciences, Mashhad, Iran Introduction: regression of these premalignant lesions that all can As a major worldwide cause of be used to devise a definite follow-up model for these morbidity and cancer-related deaths, gastric cancer patients. needs molecular-based approaches for predicting Send Date: 2011/08/16 clinical outcome and guiding treatment strategies. CD34 is a glycoprotein which present in the vascular endothelium is a new biomarker for the evaluation of Category: 2 ESOPHAGEAL-GASTRIC AND angiogenesis quantification and tumor development. DUODENAL DISORDERS CD34 were supposed to have relationship with the 2.13 Gastroduodenal malignancies others angiogenic markers like vascular endothelial W-F-040 growth factor (VEGF).We aimed to investigate the

Govaresh\ Vol.16\ Supplement\ Autumn 2011 27 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 correlation of CD34 and VEGF tissue expression in Medical Sciences, Mashhad, Iran gastric adenocarcinoma and their relationship with 3 Gastric Cancer Research Group, Department of clinicopathological features. Immunology, Immunology Research Center, School of Method: Thirty-two patients with gastric adenocarcinoma Medicine, Mashhad University of Medical Sciences, who had undergone gastrectomy at Mashhad university Mashhad, Iran 4 Gastric Cancer Research Group, Department of Forensic hospitals were enrolled. Clinicopathological and Medicine and Toxicology, School of Medicine, Tehran epidemiological characteristics were reviewed. CD34 University of Medical Sciences, Tehran, Iran and VEGF were assessed using immunohistochemical 5 Gastric Cancer Research Group, Department of Research staining. Data were analyzed by SPSS software. Affairs, Razavi Hospital, Mashhad, Iran Results: VEGF and CD34 were positive in all and 26 6 Department of Internal Medicine, Imam Reza Hospital, (81.2%) of patients, respectively., With regard to School of Medicine, Mashhad University of Medical tumor subtypes classification, the tissue expression Sciences, Mashhad, IRAN. of VEGF and CD34 were reported in 72% and 77% 7 Gastric Cancer Research Group, Student Research Com- of intestinal type and 28% and 23% of diffuse type mittee, School of Medicine, Mashhad University of Med- tumors, respectively. No significant relationship was ical Sciences, Mashhad, Iran 8 Gastric Cancer Research Group, Student Research Com- shown between age, gender, stage and location of mittee, School of Medicine, Mashhad University of Med- tumor with expression of CD34 and VEGF, although ical Sciences, Mashhad, Iran there was a significant correlation between Introduction: As a pro-inflammatory cytokine, expression of VEGF and grade (p=0.008). We failed IL-18 is an important mediator in chronic gastritis. to find a significant correlation between tissue ex- The role of IL-18 in gastric cancer is controversial pression of CD34 and VEGF in Gastric Adenocarci- and dual; anti-cancer effects by immune cell noma. stimulation and pro-cancerous effects by induction of Conclusion: Tissue expression of VEGF may be invasion, migration and metastasis of tumor cells and helpful in predicting the malignant behavior of gastric also angiogenesis. IL-18 may cause cancer cells to adenocarcinoma. Further studies are needed to con- escape from immune system by regulating the firm any relationship between CD-34 and VEGF in expression of some markers such as vascular this area. endothelial growth factor (VEGF). This study was Send Date: 2011/08/19 aimed to investigate the correlation of serum level of IL-18 and VEGF in patients with normal mucosa, pre- cancerous lesions and intestinal type adenocarcinoma. Category: 2 ESOPHAGEAL-GASTRIC AND Method: Fifty-eight non-tumoral patients with DUODENAL DISORDERS normal gastric mucosa (n=10), chronic H.pylori- 2.13 Gastroduodenal malignancies associated gastritis (n=33), atrophic gastritis and W-F-041 metaplasia (n=12) and low dysplasia (n=3) plus 41 Serum IL-18 correlates with serum VEGF in patients with intestinal-type were included. gastric carcinogenesis and they may be utilized Clinicopathological and epidemiological characteristics in early diagnosis of gastric adenocarcinoma were reviewed. The serum level of IL-18 and VEGF Anahita Masoom1*, Hamid Reza Sima2, Mohsen were assessed using ELISA. Data were analyzed by Tadayon1, Jalil Tavakol Afshari3, Mostafa Jafarzadeh4, Kamran Ghaffarzadehgan5, Hanieh Hosseinnezhad1, SPSS (Version 16) at the significant level of p<0.05. Results: Abbas Esmaeilzadeh6, Sepideh Ghadri1, Tahoora Serum level of IL-18 and VEGF were Abdolahi1, Mostafa Abrishami7, Mostafa Parizadeh8 significantly higher in adenocarcinoma in comparison 1 Gastric Cancer Research Group, Young Researchers' with non-tumoral (p =0.04 and p =0.02, respectively). Club, Islamic Azad University, Mashhad Branch, An overall increasing pattern was seen in the serum Mashhad, Iran level of both IL-18 and VEGF from mild gastritis to 2 Gastric Cancer Research Group, Department of Internal adenocarcinoma. (p =0.03 and p =0.05, respectively). Medicine, Surgical Oncology Research Center, Imam Reza A significant correlation was observed between Hospital, School of Medicine, Mashhad University of increasing level of serum IL-18 and VEGF in

28 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 different steps from normal mucosa to adenocarci- common gastrointestinal cancer in Iran. IL-18 plays noma (p =0.01, Pearson correlation=0.23). an important role in chronic gastritis; however its role Conclusion: Serum level of IL-18 correlates with in gastric cancer is controversial and dual; anti-cancer serum VEGF in gastric carcinogenesis and they may effects by immune cell stimulation and pro-cancerous be utilized in early diagnosis of gastric adenocarcinoma. effects by induction of invasion, migration and Further studies may assess diagnostic value of IL-18 metastasis of tumor cells and also angiogenesis. We and VEGF gene expression in this area. aimed to assess the IL18 607C/A and IL18 137G/C Send Date: 2011/08/19 gene polymorphism in patients with gastric adenocarcinoma and non-tumoral individuals as well as its relation with histological grade and tumor stage. Category: 2 ESOPHAGEAL-GASTRIC AND Method: One hundred and sixty-seven cases DUODENAL DISORDERS including 71 patients with gastric adenocarcinoma 2.13 Gastroduodenal malignancies that had undergone gastrectomy and 97 non-tumoral W-F-042 individuals in which gastric cancer was ruled out by IL-18 607C/A gene polymorphism might gastroscopy and biopsy were enrolled. Demographic be utilized as a useful biomarker in and epidemiological characteristics and patient diagnosis of gastric adenocarcinoma survival data were reviewed. Histological type and Mohsen Tadayon1*, Jalil Tavakol Afshari2, Mahdi grade and tumor stage (TNM) were determined by 3 4 Afzalaghaee , Hamid Reza Sima , Hanieh single expert GI pathologist. H pylori infection status 1 5 Hosseinnezhad , Ghodratollah Maddah , IL18 607C/A and IL18 137G/C gene polymorphism Mostafa Jafarzadeh6, Rashin Ganjali7, were assessed by ELISA and Arms-PCR, Sepideh Ghadri1, Monavar Afzalaghaee8, Anahita Masoom1, Tahoora Abdolahi1 respectively. Data were analyzed using SPSS 1 Gastric Cancer Research Group, Young Researchers' software version 16. Club, Islamic Azad University, Mashhad Branch, Results: Patient with gastric adenocarcinoma Mashhad, Iran expressed significantly more IL18 607C/A gene 2 Gastric Cancer Research Group, Department of comparing with non-tumoral group (p =0.002). No Immunology, Immunology Research Center, School of significant difference was found in IL18 137G/C Medicine, Mashhad University of Medical Sciences, gene expression between patient with gastric Mashhad, Iran. adenocarcinoma and control group (p=0.6). There 3 Department of Internal Medicine, Imam Reza Hospital, were no significant relationship between IL18 School of Medicine, Mashhad University of Medical Sci- 607C/A and IL18 137G/C gene expression and ences, Mashhad, Iran 4 Gastric Cancer Research Group, Department of Internal histological grade and T and N stage of tumor. Conclusion: Medicine, Surgical Oncology, Research Center, Imam IL18 607C/A gene polymorphism might Reza Hospital, School of Medicine, Mashhad University of be utilized as a useful biomarker in diagnosis of Medical Sciences, Mashhad, Iran gastric adenocarcinoma. Further studies are needed 5 Department of Surgery, Ghaem Hospital, School of to show any potential role of these biomarkers in Medicine, Mashhad University of Medical Sciences, prediction of tumor behavior and patients prognosis. Mashhad, Iran Send Date: 2011/08/19 6 Gastric Cancer Research Group, Department of Forensic Medicine and Toxicology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Category: 2 ESOPHAGEAL-GASTRIC AND 7 Department of Immunology, Immunology Research DUODENAL DISORDERS Center, School of Medicine, Mashhad University of 2.13 Gastroduodenal malignancies Medical Sciences, Mashhad, Iran 8 Department of Research Affair, Mashhad University of W-F-043 Medical Sciences, Mashhad Tissue expression of Fas (Apo1/CD95) Introduction: Gastric cancer is the second leading might be utilized as a predictor of cause of cancer-related death worldwide and the most tumor behavior in gastric adenocarcinoma

Govaresh\ Vol.16\ Supplement\ Autumn 2011 29 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Samaneh Boroumand Noghabi1*,Kamran Results: Nineteen patients (63%) were male with Ghaffarzadehgan2, Reyhaneh Zoghian3, mean age of 62.5. 19 patients (63%) did not express Hamid Reza Sima4, Hanieh Hosseinnezhad3, Fas while 23 patients (79.3%) expressed FasL. 5 6 Jalil Tavakol Afshari , Vahideh Hosseinzadeh , Diffuse type gastric cancers expressed Fas less than 7 8 Hamid Reza Raziee , Mostafa Jafarzadeh , intestinal type (p=0.049). Fas expression was lower in Elahe Andakhshideh6,MasoudSajjadi6 high-stage tumors (p =0.038) and tumors with lymph 1 Gastric Cancer Research Group, Department of Pathology, Imam Reza Hospital, School of Medicine, node metastasis (p =0.004). There were no significant Mashhad University of Medical Sciences, Iran relation between Fas expression and tumor grade, 2 Gastric Cancer Research Group, Department of Research location (cardia/non cardia) and history of H.pylori Affairs, Razavi Hospital, Mashhad, Iran infection. FasL expression had no relation with any of 3 Gastric Cancer Research Group, Young Researchers' Club, the studied variables. Islamic Azad University, Mashhad branch, Mshhad, Iran Conclusion: Tissue expression of Fas might be 4 Gastric Cancer Research Group, Department of Internal utilized as a predictor of tumor behavior in gastric Medicine, Surgical Oncology Research Center, Imam Reza adenocarcinoma. Further studies with larger sample Hospital, School of Medicine, Mashhad University of size are needed to confirm this idea. Medical Sciences, Iran Send Date: 2011/08/19 5 Gastric Cancer Research Group, Department of Immunology, Immunology Research Center, School of Medicinee, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Iran Category: 2 ESOPHAGEAL-GASTRIC AND 6 Gastric Cancer Research Group, Student Research DUODENAL DISORDERS Committee, School of Medicine, Mashhad University of 2.13 Gastroduodenal malignancies Medical Sciences, Iran W-F-044 7 Gastric Cancer Research Group, Department of Radiation Serum CCL5/RANTES level might be Oncology, Mashhad University Cancer Research Center, utilized as a predictive marker of tumor Omid Oncology Hospital, Mashhad University of Medical behavior and prognosis in patients Sciences, Iran with gastric adenocarcinoma 8 Gastric Cancer Research Group, Department of Forensic Ali Reza Sima1*, Houshang Rafatpanah2, Medicine and Toxicology, School of Medicine, Tehran Hanieh Hosseinnezhad3, Hamid Reza Sima4, University of Medical Sciences, Iran 5 6 Introduction: Hamid Reza Hakimi , Kamran Ghaffarzadehgan , As a member of TNF-family receptors, Anahita Masoum7, Mostafa Mehrabi Bahar 8, Fas (Apo1/CD95) and its ligand (FasL) play critical Narges Valizadeh9, Mina Erfani5, Hamid Reza Raziee10 roles in apoptosis as well as immune system-tumor 1 Department of Internal Medicine, Imam Reza Hospital, counter attack. Although, Fas/FasL tissue expression School of Medicine, Mashhad University of Medical has been shown to have a prognostic impact in some Sciences, Iran malignancies, there are conflicting reports about the 2 Gastric Cancer Research Group, Department of correlation of their expression and gastric cancer Immunology, Immunology Research Center, School of behavior. We aimed to evaluate the relations between Medicine, Mashhad University of Medical Sciences, Iran 3 tissue expressions of these molecules and Gastric Cancer Research Group, Young Researchers' Club, Islamic Azad University, Mashhad branch, Mshhad, clinicopathological characteristics of patients with Iran gastric adenocarcinoma. 4 Gastric Cancer Research Group, Department of Internal Method: Thirty newly diagnosed cases of gastric Medicine, Surgical Oncology Research Center, Imam Reza adenocarcinoma who had undergone gasterectomy at Hospital, School of Medicine, Mashhad University of Mashhad University of Medical sciences hospitals were Medical Sciences, Iran enrolled. Clinical and pathological characteristics were 5 Gastric Cancer Research Group, Student Research Com- reviewed. Fas and FasL tissue expression in mittee, School of Medicine, Mashhad University of paraffin-embedded tumor specimens were measured Medical Sciences, Iran 6 by Immunohistochemical staining. Data was Gastric Cancer Research Group, Department of Research analyzed using SPSS version 17. Affairs, Razavi Hospital, Mashhad, Iran

30 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

7 Gastric Cancer Research Group, Young Researchers' Category: 3 H.PYLORI Club, Islamic Azad University, Mashhad branch, Mashhad, 3.2 Pathogenesis: microbial factors Iran W-F-045 8 Department of Surgery, Surgical Oncology Research Relation between serum leptin and helicobacter Center, Imam Reza Hospital, School of Medicine, pylori infection in patients with dyspepsia Mashhad University of Medical Sciences, Iran Farhad Zamani1, Nafiseh Abdolahi1, 9 Department of Immunology, Immunology Research Gholamreza Roshandel2, Hossein Ajdarkosh1, Center,SchoolofMedicine,MashhadUniversityof Mahmoud reza Khansari1, Mehrdokht Najafi1* Medical Sciences, Iran 1 Gastrointestinal and Liver Disease Research 10 Department of Radiation Oncology, Mashhad University Center(GILDRC), Tehran University Of Medical Cancer Research Center, Omid Hospital, Mashhad Science,pardis hemmat, Tehran, Iran University of Medical Sciences, Iran 2 Golestan Research Center of Gastroenterology and Introduction: Gastric cancer is the second leading Hepatology, Golestan University Of Medical Sciences, cause of cancer-related death worldwide and the most pardis hemmat, Tehran, Iran common gastrointestinal cancer in Iran. Introduction: Relationship between leptin and some CCL5/RANTES is one of the most potent angiogenic gastrointestinal (GI) diseases have been proved factors, and plays an important role in tumor growth, during recent years. This study was conducted to invasion, and metastasis. We aimed to assesstheCCL5 assess the relationship between serum leptin level and serum level in patients with gastric adenocarcinoma Helicobacter pylori (HP) infection in patients with and its relation with histological grade and tumor stage as dyspepsia. well as the disease prognosis. Method: The study population included patients with Method: Seventy-four patients with gastric dyspepsia that fulfilled the ROM II criteria and did adenocarcinoma that had undergone gastrectomy and not have any abnormal finding on endoscopic 96 non-tumoral individuals in which gastric cancer evaluation. After recording demographic data, a was ruled out by gastroscopy and biopsy were biopsy was taken from the stomach for assessing HP enrolled. Demographic and epidemiological infection and blood samples were taken for characteristics and patient survival data were measuring leptin serum level via ELISA method. reviewed. Histological type and grade and tumor Results: Totally, 153 patiens were recruited. Mean stage (TNM) were determined by single expert GI age of participants was 43.12 (24-96) years. There pathologist. H pylori infection status and CCL5 was a significant positive relationship between age serum level were assessed by ELISA. Data were and serum leptin level (p=0.03). The mean level of analyzed using SPSS software version 16. serum leptin was higher in females comparing to Results: Patient with gastric adenocarcinoma had males (p=0.03). The results of univariate and significantly higher serum CCL5 level comparing multivariate analysis showed that serum leptin level with control group (p<0.001). Higher CCL5 serum was significantly lower in HP positive patients than levels were associated with lower histological HP negative ones (p<0.001). differentiation (p<0.001), higher depth of tumor Conclusion: Our findings confirm the result of some invasion (p=0.022), more frequent nodes previous studies suggesting HP infection may reduce involvement (p=0.028). Overall survival of patients serum leptin level. Reducing body fat mass due to with CCL5 levels above 70671 pg/ml was worsening of symptoms by eating which compels the significantly lower than those with lover values than patient not to eat and releasing cytokines from the this cut-off (p=0.043). injured gastric epithelium are possible explanations Conclusion: Serum CCL5 levels might be utilized as of this effect. Determination of the exact relationship a predictive marker of tumor behavior and patient between these variables in future studies may reveal prognosis. Further studies are suggested to assess tis- newer aspects of their roles in physiology and sue expression of CCL5 receptors and its gene pathogenesis of GI diseases. polymorphisms. Send Date: 2011/07/28 Send Date: 2011/08/19

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Category: 3 H.PYLORI was H. pylori positive. There was no significant 3.4 Diagnosis difference between the rate of H. pylori prevalence W-F-046 among the persons who had and did not have a Does Helicobacter pylori eradication in patients history of NSAID/ASA use. with duodenal ulcer need a diagnostic test? Conclusion: Given the high prevalence of Mohammad-Reza Ghadir1*, Jamshid Vafaeimaneh 1, Helicobacter pylori in patients with DU in Ghom Seyed-Saeed Sarkeshikian1, Abolfazl Iranikhah1, Province, Iran, whether such patients had a history of Ali Amiri2, Maryam Bolandmartebeh3 NSAID/ASA use or not, this study showed that DU 1 Gastroenterology Section, Department of Internal patients can receive empirical therapy for H. pylori. Medicine, Faculty of Medicine,Qom University of Medical Send Date: 2011/07/17 Sciences, Qom, Iran 2 Department of Internal Medicine, Qom Azad University, Qom, Iran Category: 3 H.PYLORI 3 Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran 3.4 Diagnosis Introduction: The damage caused by Helicobacter W-F-047 pylori infection and NSAIDs accounts for most cases Accuracy of diagnostic tests for of duodenal ulcers (DU). Treatment of Helicobacter Helicobacter Pylori infection 1* 2 pylori infection reduces the recurrence of DU cases to Siamak Khaleghi , Mahshid Talebi-Taher , Elnaz Salimi3, Hoda taghipour3, Shabaz nekozadeh3 a large extent, and if the infection is left untreated, 1 Gastrointestinal & Liver Disease Research Center the natural trend of DU occurs in the form of (GILDRC), Firoozgar Hospital, Tehran University of recurrences. During the past recent years, the Medical Sciences (TUMS) (pardis, hemmat), Tehran, Iran prevalence of H. pylori in the community and its 2 The Department of Infectious disease, Tehran University consequent role in causing DU has reduced. The of Medical Sciences (TUMS) (pardis, hemmat) , Tehran, purpose of the present study is to investigate the role Iran of this factor in causing DU, and determine, on 3 Medical student, Tehran University of Medical Sciences prevalence basis, whether H. pylori can be treated in (TUMS) (pardis, hemmat) , Tehran, Iran Introduction: DU cases without any diagnostic test. The diagnosis of Helicobacter pylori Method: The present study was conducted in infection has been made through invasive and 2008-2009 and the subjects who underwent non-invasive methods. The present study was carried endoscopies for DU diagnosis were studied for H. out to evaluate and compare the accuracy of three pylori by means both RUT and histopathology non-invasive and one invasive methods of H.pylori procedures, and if the results of both were positive, infection diagnosis. Method: the patients were considered as infected with A total of 108 dyspeptic patients older than Helicobacter pylori. The patients were asked about 12 years old who were not previously treated for NSAID/ASA use, whereby taking one dose of H.pylori infection, were selected to undergo upper NSAID/ASA during the month preceding the study GI- endoscopy. Histology was considered as a gold was considered as intake. standard diagnostic test. Urea breath test and Results: 127 subjects were investigated in this study Biopsy-based tests included histologic examination of which 53 (41.7%) were female and 74 (58.3% and rapid urease test were done in endoscopic unit. were male). The mean age of the subjects was Serology and stool antigen detection test were done 41.39±15.359. Of the 127 patients, there were 80 elsewhere using ELISA method. Sensitivity, (62.99%) in whom only H. pylori was the cause of specificity, positive and negative predictive value DU, 4 (3.15%) who only had a history of were calculated. The tests' results were assessed by NSAID/ASA use, 37 (29.1%) in whom both factors McNemar test. Results: played a role, and 6 (4.72%) in whom both factors According to histologic method 56 patients were negative. had H.pylori infection. Sensitivitiy and specificity Altogether, in 117 (92.1%) of the patients the result was 89% and 71% for the rapid urease test, 94% and

32 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

52% for serology, 90% and 82% for the urea breath Category: 3 H.PYLORI test, and 46% and 80%, respectively, for the stool 3.5 Management strategies antigen test. Rapid urease test and urea breath test, if W-F-049 done in combination together had the most diagnostic Detection of A2142C, A2142G, and A2143G accuracy. Mutations in 23s rRNA Gene Conferring Conclusion: Rapid urease test and urea breath test in Hamid Abdollahi1, Mohammad Savari2, combination together showed acceptable diagnostic Mohammad Javad Zahedi3,Sodaif reliability. Darvish Moghadam3*, Mehdi Hayatbakhsh Abasi3 1 Send Date: 2011/08/01 Department of Medical Microbiology, Virology & Immunology,Kerman University of Medical Sciences, Kerman, Iran 2 Category: 3 H.PYLORI Department of Medical Microbiology, School of Medicine,Kerman University of Medical Sciences,Ker- 3.4 Diagnosis man, Iran W-F-048 3 Department of Gastroentrology, Kerman University of survey on results of helicobacter stool Medical Sciences,Kerman, Iran antigen test with pathologic achievements Introduction: Clarithromycin resistance in in children with peptic disease Helicbacter pylori has been found to be associated Shohreh Maleknejad1*,MarjanBordbar1 with point mutations in 23s rRNA gene leads to 1 17 shahrivar hospital, guilan reduced affinity of the antibiotic to its ribosomal Introduction: Helicobacter pylori had been proposed target or changing the site of methylation. The aim of as an effective factor in peptic diseases in past this study was to determine the most important point decades.This agent has a strong role in pathogenesis mutations in 23s rRNA gene in H. pylori that are of chronic gastritis and peptic ulcer;therefore closely related to clarithromycin resistance among introducing simple and cost effective tests are such isolates. important for diagnosis of H.pylori infection .We Method: Sixty three H. pylori isolates, obtained from measure the sensivity,specifity,positive and negative gastric biopsy speciemens in Kerman, Iran, were used predictive value of stool antigen test in children to evaluate their susceptibility to clarithromycin by infected with H.pylori. disk diffusion test, and to detect the most common Method: In a cross sectional survey during 1 year,96 point mutations in 23s rRNA gene associated with patients with abdominal pain referred to gastrointstinal clarithromycin resistance by Polymerase chain clinic in 17- shahrivar hospital in Rasht from April reaction-amplification and restriction fragment length 2009 to march 2009.l had been studied . Stool antigen polymorphism (PCR-RFLP) and 3'-mismatch PCR. test and endoscopy was performed for all patients in Results: 31.7% of the H. pylori isolates were resistant same laboratories .Other data had been collected and to clarithromycin, and each of the resistant isolate had entered in SPSS software for analysis. at least one of the most common point mutations in Results: Among 96 patients ,52.1%(50 cases)were 23s rRNA gene associated with calrithromycin boys and 47.9%(46 cases) Were girls.Stool antigen resistance. test result was positive in 34 subjects(35.4%)was Conclusion: According to our results three common negative in 62 subjects(64.6%).On the other hand point mutation in 23s rRNA gene in H. pylori are only 33 children (34.4% )had positive pathology closely related to clarithromycin resistance. There results according to H.pylori infection .Sensivity, was an absolute relation between 23s rRNA gene specifity,positive and negative predictive value of point mutations and clarithromycin resistance in this stool antigen test were 72.72%, 84.12%, 70.5%, study. Helicbacter pylori resistance to clarithromycin 85.4% respectively. can cause failure in the eradications of the bacteria. Conclusion: According to negative predictive value The resistance of the bacteria is expanding in most of this test ;we can make this decision that if the test parts of the world including Iran. result become negative , in 85.4%of cases the Send Date: 2011/05/25 infection will be rules out. Send Date: 2011/08/05

Govaresh\ Vol.16\ Supplement\ Autumn 2011 33 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Category: 3 H.PYLORI respectively; significantly higher in group B 3.5 Management strategies (p=0.001). Abdominal pain was significantly more W-F-050 frequent in group B comparing with the other groups. Comparison of helicobacter pylori Vomiting was reported significantly more frequent in eradication rate with four different group C comparing with the other groups. The other quadruple regimens in dyspeptic patients. complications were comparable between the four Ebrahim Fattahi1*, MohammadHossein Somi1, groups. Ali Gavidel1, Alireza Ghamghar1,Asraf Conclusion: The rate of compliance and HP Faghrjo2, Shahnaz Naghashi1 eradication was similar in four quadruple regimens; 1 Liver and Gastrointestinal Diseases Research Centre, however due to difference in rate of complications, Tabriz University of Medical Sciences A or D regimens are recommended. 2 Department of Patology of ImamReza Hospital, Tabriz Send Date: 2011/07/20 University of Medical Sciences Introduction: Helicobacter pylori (HP) was discovered long time ago, but it has only been in the Category: 3 H.PYLORI past several years that the diagnosis and treatment of 3.5 Management strategies this organism has gained wide acceptance. The T-S-051 optimal regimen should have high efficacy, tolerable The study of two sequential therapies for side effects, simple dosage and should be economical. patients with gastric and duodenal ulcer Intensive efforts are being made to identify such an infected helicobacter pylori optimal regimen, but there are many obstacles hin- Ebrahim Fattahi1*, MohammadHossein Somi1, dering the achievement of this goal. This study aimed Manuchehr Khaoshbaten1, Turaj Rosta1 at comparing the rate of HP eradication with 4 1 Liver and Gastrointestinal Diseases Research Centre, quadruple regimens in dyspeptic patients. Tabriz University of Medical Sciences Method: In this open-label randomized clinical trial, Introduction: Prevalence of Helicobacter pylori (Hp) 270 patients with positive rapid urease test result infection in adults varies in different parts of the were randomized in these four groups: the group “A” world depending on the social and economic who received omeprazole+amoxicillin+bismuth standards of the population. While the prevalence subcitrate+clarithromycin for 2 weeks (73 patients); among the middle-aged population in developing the group ‘B” who received omeprazole+tetracy- countries is about 80%, it is only 20-50% in cline+bismuth subcitrate+metronidazole for 2 weeks developed countries. The sequential regimen is a (46 patients); the group “C” who received om novel, promising therapeutic approach for Hp eprazole+amoxicillin+bismuth subcitrate+furazoli- eradication. We aimed to compare two sequential done for 2 weeks (64 patients); and the group “D” quadruple regimens based on Azithromycin and who received omeprazole+amoxicillin+bismuth Ofloxacin. subcitrate+furazolidone/metronidazole interchange- Method: In this open-label randomized clinical trial, ably each one for one week (87 patients). Six-week 150 patients with H.pylori positive peptic ulcer after treatment halt, the compliance, eradication and disease were randomized in tow groups of 75 cases complication rates were evaluated in each group. each. Group A treated with quadruple regimens based Results: The compliance was “complete”, ‘good” or on Azithromycin and other group (B) treated with “poor” in 83.6%, 11% and 5.5% in group A, 87%, regimens based on Ofloxacin. The eradication, 6.5% and 6.5% in group B, 90.6%, 4.7% and 4.7% compliance and complication rates were compared in in group C, and 86.2%, 11.5% and 2.3% in group D, two groups. respectively (p=0.683). HP was eradicated in96.3%, Results: Mean patients’ age was 39.3± 1.2 within the 87%, 79.7% and 79.3% of the patients in groups A, B, age range 18 to 85 yrs. There were 47(62.7%) male C and D, respectively (p=0.506). Overall and 28(37.3%) female patients in group A while complications were present in 37%, 63%, 32.8% and 50(66.7%) male and 25(33.3%) female patients in 28.7% of patients in groups A, B, C and D, group B. There was no significant difference

34 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 considering type of peptic ulcer in the two groups. assay. Infection was considered eradicated if patients The compliance was “complete”, ‘good” or “poor” in tested negative. 94.7%, 1.3% and 4% in group A and 96%, 1.3% and Results: The rate of H. pylori eradication in groups A 2.7% in group B respectively (p=0.91). HP was and B was 66.7% and 66.7% respectively (p=1). The eradicated in 89.3% in group A and 85.3% in group B rate of H. pylori eradication in groups A and C was (P=0.31). There was no significant difference in 66.7% and 82.3% respectively (P= 0.053). The rate H.pylori eradication and compliance rates in the two of H. pylori eradication in groups B and C was 66.7% groups. and 82.3% respectively (P= 0.053). The cure rates in Conclusion: According to our study, we could the 7days+ N-Acetylcysteine treatment was not conclude that there’s no superiority using four drug significantly different with standard 7 and 14 treatment. regimen based on Ofloxacin compared to Conclusion: N-Acetylcysteine is mucolytic agent. It Azithromycine based regimens but the eradication can to decrease stomach's mucose barrier and was higher than 85% in each group. Each regimen viscosity and increases efficacy of antibiotics. But could be prescribed considering drug complication according to this study, this treatment method don’t rates in different patients. have significant different with others methods. Send Date: 2011/07/20 Send Date: 2011/07/31

Category: 3 H.PYLORI Category: 3 H.PYLORI 3.5 Management strategies 3.5 Management strategies T-S-052 T-S-053 Comparative of standard anti Helicobacter The efficacy of NSAIDs in shortening the pylori therapy with and without N-Acetylcysteine H Pylori eradication period Akbar Arjmandpoor1*, Fariba Arjmandi2, Akbar Arjmandpoor1*, Hamed Daghaghzade2, Hajar Amiri1, Peyman Adibi3 Hojat Alah Rahimi3, Fariba Arjmandi4, 1 Gastroenterology Department, Faculty of Islamic Azad Mohammad Hassan Emami3 University Najafabad Branch, Isfahan, Iran. 1 Gastroenterology Department, Faculty of Islamic Azad 2 Community medicine specialist, Faculty of Islamic Azad University Najafabad Branch, Isfahan, Iran. University Najafabad Branch, Isfahan, Iran. 2 Gastroenterology Department, Faculty of Isfahan 3 Gastroenterology Department. Faculty of Isfahan University of Medical Sciences, Isfahan, Iran. University of Medical Sciences, Isfahan, Iran 3 Gastroenterology Department, Poursina Hakim Research Introduction: For eradication of helicobacter pylori Institute (H. pylori), many regimens is offered. H. pylori is 4 Community medicine specialist, Faculty of Islamic Azad resistance to Metronidazole and duration of treatment University Najafabad Branch, Isfahan, Iran is long. N-Acetylcysteine is sulfidrile component and Introduction: Helicobacter pylori (H. pylori) mucolytic effect. It decreases stomach's mucous colonizes not only on the surface of mucous barrier and viscosity and increases efficacy of membrane but also beneath the surface mucous gel antibiotics. layer (SMGL). Since Na-Diclofenac decreases the Method: 173 patients were randomly assigned to secretion of SMGL, we examined this drug as an three treatment groups. 54 patients received adjuvant therapy to a quadruple therapy for H Pylori quadruple therapy (azithromycine 250 mg , eradication. amoxicillin 500 mg, bismuth subcitrate 250 mg and Method: One hundred and seventy-two patients were omeprazole 20 mg) bid for 1 weeks (A group), 57 randomly assigned to three groups. 54 patients patients received the same dosage of those agents received azithromycine 250 mg , amoxicillin 500 mg, plus N-Acetylcysteine tab 600 mg for 1 week (B bismuth subcitrate 250 mg and omeprazole 20 mg) group) and 62 patients received the same dosage of BID for 1 week (A group) and 65 patients received those agents for 1 week (A group). Eradication was the same dosage of those agents plus Na Diclofenac assessed 4 weeks after treatment by stool antigen tab, 100 mg daily for 1 week (B group). 62 patients

Govaresh\ Vol.16\ Supplement\ Autumn 2011 35 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 received the same quadruple therapy (for 2 weeks C Results: The rate of H. pylori eradication in groups group), Eradication was assessed 4-6 weeks after A(14- day) and B(7- day) was 82.3% and 66.7% completion of treatment by H pylori stool antigen respectively (p=0.053). The cure rates in the standard assay. 14 days treatment was better than standard 7 days Results: The rate of H. pylori eradication in groups A treatment. and B was 66.7% and 82.1% respectively (p = Conclusion: A 7-day quadruple therapy with 0.062).The rate of H. pylori eradication in groups B Azithromycine, Amoxicillin, Bismuth subcitrate, and and C were similar; 82.1% and 82.3% respectively (p Omeprazole is not effective for eradication of = 0.987). H. pylori compared with the standard 14-day Conclusion: Na Diclofenac seem to be effective in quadruple therapy. shortening two weeks anti H Pylori regimens. More Send Date: 2011/07/31 investigations must be done to better clarify the efficacy of NSAIDs for this purpose. Send Date: 2011/07/31 Category: 3 H.PYLORI 3.5 Management strategies T-S-055 Category: 3 H.PYLORI Comparison between different regimen 3.5 Management strategies for H pylori eradication in Iran-shiraz T-S-054 Maryam Hasanzarrini1*, Maryam ardabili1 Comparative of standard 14-day and 7- day 1 Gasteroenterohepatology research center, shiraz for eradication of Helicobacter pylori Introduction: Helicobacter pylori is a gram-negative Akbar Arjmandpoor1*, Fariba Arjmandi2, organism that induces gastric infection. The infection Leila Adhami1, Mohammad Minakari3 causes chronic gastritis and may lead to peptic ulcer 1 Gastroenterology Department, Faculty of Islamic Azad disease (PUD). H pylori is also associated with University Najafabad Branch, Isfahan, Iran. gastric adenocarcinoma and low-grade gastric 2 Community medicine specialist, Faculty of Islamic Azad lymphoma, referred to as mucosa-associated University Najafabad Branch, Isfahan, Iran. lymphoid tissue (MALT) lymphoma. Eradication of 3 Gastroenterology Department, Faculty of Isfahan Uni- the infection will prevent the recurrence of the versity of Medical Sciences, Isfahan, Iran. majority of such disease. Multiple regimens have Introduction: Although quadruple combination been evaluated for Helicobacter pylori therapy but therapy containing a proton pump inhibitor (PPI) and the optimal therapeutic regimen has not yet been three antibiotics is considered as a standard regimen defined. We evaluated different combined treatment for the first-line anti-Helicobacter pylori treatment, in Iran – from 1388 to1390 in the patients who was there are still debates on the ideal duration of referred to Namazi Hospital. treatment. Shorter treatment duration should improve Method: 952 patients who as APD (NUD, DU, GU) compliance to therapy and keep an acceptable H. were treated with different regimen(single .double pylori eradication rate. The aim of this study was to ,triple, quadruple drug) for H pylori and then referred compare the efficacies of 7-day and 14-day quadruple to Namazi hospital for confirmation of eradication therapy. with UBT were evaluated. Method: 116 patients were randomly assigned to two Results: 952 patients who were enrolled in H pylori treatment groups. 62 patients received quadruple eradication test (UBT), most of them were in BAMO therapy (Azithromycine 250 mg ,Amoxicillin 500 group (108 pts.) with response rate about 75.5% . mg, Bismuth subcitrate 250 mg and Omeprazole 20 [p- value=0/003] Other groups contain BTMO mg) bid for 2 weeks (A group), 54 patients received (31pts.) BACO (25 pts.) BAFO (10 pts.) with the same dosage of those agents for 1 week (B group) response rate about 80%, 88%, 90% respectively. Eradication was assessed 4-6 weeks after treatment by [p-value=0/003]. From the patients who received stool antigen assay. Infection was considered eradicated triple therapy, most of them were in BMO (34 pts.) if patients tested negative.

36 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

BAO (33pts.) AMO (32 pts.) with response rate about medicated by vitamin E was lower than the burned 67%, 87%, 81%, respectively. [p-value =0/003] {Chi ones without medication (p<0.01). There were no square test}. significant differences between study groups in Conclusion: The intention-to-treat H pylori intestinal diameter and muscular layer thickness. eradication with routine regimen BTMO is less than Conclusion: The results show that vitamin E is other quadruple therapy in this local study. So further effective on intestinal villuses height and lumen investigation need for best regimen with the most diameter and its consumption at the time of burning response rate in Shiraz city. can protect intestine mucosa from injuries. A=Amoxicillin B=Bismuth M=Metronidazole Send Date: 2011/06/04 T=Tetracycline C=Clarithromycin O=Omeprazole Send Date: 2011/08/22 Category: 4 INTESTINAL 4.2 Coeliac disease/malabsorption syndromes and Category: 4 INTESTINAL food enteropathies 4.1 Enterocyte biology/pathology and nutrient/water T-S-057 transport/electrolyte transport The prevalence of celiac T-S-056 disease in patients with IBS The effects of vitamin E on small Aliakbar Shayesteh1*, Seyed Jalal Hashemi1, Eskandar intestine mucosal injuries in burned rats Hajiani1, Abdolrahim Masjedizadeh1, Mehdi Shayesteh1 Shahsanam Gheibi1*, Mojtaba 1 GI ward, Ahvaz - Jondishapoor university Karimipour2, Ali Soleymany2 Introduction: The prototype of diffuse small 1 Motahhary Hospital, Urmia University of Medical Sciences intestinal disease which presents with malabsorption 2 Medical College, Urmia University of Medical Sciences is Celiac disease (Celiac disease). Typical form Introduction: Vitamin E is a fat soluble agent that presents in childhood, but atypical forms are more protects cells from damage of free radicals by common in adults & may presents with intestinal & neutralizing them. The aim of this study was the extra intestinal manifestations. One of the intestinal evaluation of vitamin E effects on small intestine presentations, common in general population, is s mucosal changes in burned rats. imulation of Irritable bowel syndrome (IBS). The aim Method: Mature male rats (n=32) with weight range of this study was to determine the value of of 260 ± 10 gram were used. After induction of Antiendomysial Ab IgA in predicting celiac disease in general anesthesia, a determined area of the skin of patients with IBS. the back region was exposed to 95ºC water for 8 Method: Patients full fill the Rome 3 Criteria from seconds in order to producing wet burns. The April 2007 -2009 in subspecialty clinics of Ahvaz evaluated four groups in our study were: rats without Jundisapur University of medical sciences enter the burning, rats without burning treated with vitamin E study. After exclusion of differential diagnosis of IBS 300 mg/kg/day till 15 days, burned rat without med- screening for CD were done by Anti tTG IgA & Anti ication and burned ones treated with vitamin E 300 gliadine Ab IgA. CD was confirmed by duodenal mg/kg/day till 15 days. All of the rats were biopsy according to the modified Marsh classification euthanized at the fifteenth day by ether inhalation. in patients with positive test results. The data was The samples were prepared from the beginning of collected & analyzed by x2 & t- test by SPSS version 19. small intestine and were smeared by Hematoxylin Results: 465 patients entered the study, 40 & 31 of and Eosin staining. them had positive test for Anti gliadine Ab IgA & Results: Statistical analysis revealed that in the Anti tTG IgA respectively .Biopsy of 2nd portion of burned rats received vitamin E, intestinal villuses duodenum showed marsh 1 or greater in 11 patients were higher than the burned ones without vitamin E .All of them responded to gluten free diet. treatment, and this was near to results of unburned Conclusion: Celiac disease is a common condition rats and this was statically significant (p<0.05). Also in patients with IBS. All patients should be screaned the intestinal lumen diameter in burned rats

Govaresh\ Vol.16\ Supplement\ Autumn 2011 37 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 for celiac disease befor marked as IBS. Normal total Duodenal Intraepithelial Send Date: 2011/07/21 Lymphocytes, CD3+ and CD8+ T-Cells in Celiac Patients of Isfahan, Iran Mohammad Hassan Emami1*, Morad Masjedi2, Category: 4 INTESTINAL Hadi Hossein Nattajarab3,Fereshteh 4.2 Coeliac disease/malabsorption syndromes and Sahebfosoul2, Mojgan Mokhtari4 food enteropathies 1 Poursina Hakim Research Institute, Department of T-S-058 Gastroenterology, Isfahan University of Medical Sciences 2 The Efficacy of Herbal Medicine Department of Immunology, Isfahan University of " Lax-asab" in Treating Constipation-a Medical Sciences 3 Iranian Celiac association Randomized Controlled Clinical Trial 4 Poursina Hakim Research Institute, Department of 1 1* Mohammad-Hossein Somi , Masood Bagheri , Pathology, Isfahan University of Medical Sciences 1 2 Zahra Rashe , Morteza Ghojazadeh Introduction: Although increased numbers of 1 Liver and Gasteroenterology Diseases Research, Tabriz duodenal intraepithelial lymphocytes (IEL) is a key University of Medical Sciences 2 Physiology Department of Medical Faculty, Tabriz histological finding in celiac disease (CD), this may University of Medical Sciences vary by the geographic area and type. There are some Introduction: Chronic constipation is a common borderline histology and sero-negative CD cases disorder and its treatment is unsatisfactory in many which might be differentiated with other causes of patients.We designed this study to introduce a new duodenal immunological reactions by measuring the herbal protocol (Lax-asab) for treatment of chronic mean percentages of IEL expressing abTCR, gdTCR, constipation which has higher efficacy and lower side CD3, CD4, and CD8. This study was conducted to effects and price in comparison with other currently measure and compare total and CD3 + and CD8+ IEL available chemical and herbal protocols. in celiac patients and healthy controls in Isfahan, Iran. Method: 40 patients with chronic constipation from Method: Definite CD patients (17 cases) and Emam Reza academic hospital in Tabriz-Iran were age- and sex-matched healthy controls (22 cases) randomly enrolled.Data was collected by check lists were included and duodenal biopsies were taken. and the efficacy of "lax-asab" was compared with H&E staining was done and monoclonal antibodies placebo and determined by a symptom scale during were used by immunoperoxidase staining method. and after stopping the study.We use Descriptive Results: The immunoperoxidase staining showed statistics,Chi-square and Fisher's Exact test by higher mean of total IEL in CD cases compared with SPSS.16. controls (40 vs. 19, P = 0.001). The upper normal Results: Mean of weekly defecation times in limit of CD3+ intraepithelial T-cells was 20% while intervention group was 5.33±0.7 and in placebo was it was 14% for CD8+ T-cells. In addition, The H&E 2.14±0/69 (p=0.012).Diarrhea side effect was 0.66 in staining method showed cut-off of 34% for IELs in intervention group (p=0.09).Other side effects was CD cases. not seen in both of them. Conclusion: This study suggests that total IEL of > Conclusion: Our study show we can use this 34% and CD3+ IEL > 20% by immunoperoxidase experimental herbal drug in treating patients with staining technique, might be considered as MARSH chronic constipation with high efficacy, low side I among general population in Isfahan, Iran. Since effects and price. this cut-off level may differ according to the subtype Send Date: 2011/07/21 of IEL, genetic backgrounds, and by changing socioeconomical status, it is logical to determine nor- mal values in each area and to use immunoperoxidase Category: 4 INTESTINAL staining technique to measure subtypes of IEL in 4.2 Coeliac disease/malabsorption syndromes and suspicious cases of CD. food enteropathies Send Date: 2011/08/05 T-S-059

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Category: 4 INTESTINAL Esmaeilzadeh1, Seyedezahra Mirfeizi1, Gobad 4.2 Coeliac disease/malabsorption syndromes and Abangah1, Ali Mokhtarifar1, Hassan Saadatniya2, food enteropathies Hassan Vosoghiniya3, Ahmad khosravi3, 4 T-S-060 Abdolrasol Hayatbakhsh 1 Prevalence of Celiac Disease in Type 1 Diabetic Imam Reza Hospital, Mashhad University of Medical Sciences children and adolescents in Eeast Azarbaijan 2 Ghaem Hospital, Mashhad University of Medical 1* 1 Robabeh Ghergherehchi , Mandana Rafeey Sciences 1 Liver and Gstrointestinl Research Center, Tabriz 3 Ghaem Hospital, Mashhad University of Medical University of Medical Sciences Introduction: Sciences Celiac disease (CD) is a chronic 4 Imam Hossein Hospital, Mashhad University of Medical enteropathy caused by hypersensitivity to gluten. Sciences Most studies have shown more prevalence of CD in Introduction: Celoac disease is an autoimmune the patients with Diabetes Mellitus type 1. The disorder which cause malabsorption in genetically prevalence of CD among DM1 patients is unknown susceptible patients with ingestion of gluten. Celiac is in Iranian children. The aim of this study is the not limited to gastrointestinal system and can make prevalence survey of celiac disease in type 1 diabetic different sign and symptom in other organs. children in East Azarbaijan. Malabsorption of calcium and vitamin D can cause Method:In a cross-sectional descriptive study, based osteomalacia and secondary hyperparathyroidism . on entrance and exit criteria 135 children with Celiac is not a rare disease anymore and are more Diabetes Mellitus type 1 referring to Tabriz children frequent in middle east. We expect to have 1% of hospital endocrine department and clinic from celiac in general population. The aim of this study 2006 to 2008 were selected. The serumic level of was to determine Prevalence of osteopenia and os- A-tTG-A-IgA and AEA-IgA were measured. In the teoporosis in patients with celiac disease in Iranian case that A-tTG-A either AEA was high, distal duo- population. denal biopsy was preformed. The data was analysed Method: Individuals with intestinal and extara using SPSS, ver 16 software. intestinal problem who had positive serologic testing Results: 28 of 135 patients with diabetes mellitus for antitissue transglutaminase or antiendomysial type 1, were serologically positive for celiac. Four of antibody were offered endoscopic duodenal biopsy 28 (%14.28) seropositive paitients were A-tTG-A to confirm the diagnosis of celiac disease .Biopsy positive, Ten (%35.71) of them were AEA positive proven celiac patients between 20 to 70 y/o of any and Fourteen (%50) were A-tTG-A and AEA sex were enrolled. Exclusion criteria was :1) Using positive. Confirmed celiac prevalence based on drugs such as corticosteroid, anticonvulsant ,heparin, biopsy was %6.8. cyclosporine, statins , B blocker, 2) Neoplasms 3) Conclusion: Celiac Disease in diabetic patients Metabolic disorder such as diabetis , hyperthyroidism (DM1) is common. Screening of celiac disease with , cushings and immobility. After taking informed serologic tests in diabetic patients is necessary for the consent ,we evaluated 71 patients with celiac disease purpose of early diagnosis and prevention from . All enrolled patients had undergone BMD severe complications of celiac disease. measurement of the hip, femoral neck, and spine Send Date: 2011/08/05 using dual-energy x-ray absorptiometry using a QDR-4500W densitometer (osteocore 2,) with bone densitometry with DEXA scan . Routine laboratory Category: 4 INTESTINAL tests, including a complete blood cell count, serum 4.2 Celiac disease/malabsorption syndromes and food 25-hydroxyvitamin D, parathyroid hormone (PTH), enteropathies and alkaline phosphatase, were performed. T-S-061 Results: 72 patients with celiac disease between 20 to Prevalence of osteopenia and osteoporosis 70 years old with mean age of 33 years old had bone in Patients with celiac disease densitometry. 66 % were female and 33% were male. Azita Ganji1*, Mohammad Reza Hatef1, Abbas

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41 (54%) out of them had normal bone density in to the Marsh classification in cases that were positive spine and 17(23.6%) had osteopenia and 14 patients for tTG antibody. (19.4%) had osteoprosis. In femoral neck 36 patients Results: A total of 301 children (138 male, 163 (50%) had normal bone densitometry and 25 (33.3%) female) with (FAP) were studied. Endoscopic patients had osteopenia and 11(15.3%) patients had duodenal biopsy was taken for patients with positive osteoporosis. and borderline tTG test. Two out of 301 cases were Conclusion: The prevalence of osteoporosis among IgA deficient and celiac disease was suspected for celiac disease is much higher than general population one of them based on histological findings. Fourteen (48%) .The prevalence of osteoporosis is high enough out of 299 patients with normal IgA had abnormal to justify a recommendation for screening of all tTG titer; intermediate ranges (16-23 U/ml) and patients with celiac disease for osteoporosis. positive ranges (=or>24 U/ml) were detected in 6 and Send Date: 2011/08/15 8 cases, respectively. CD was suggested in 2 out of 6 patients with intermediate and 2 out of 8 patients with positive ranges of tTG (1.33% based on histological Category: 4 INTESTINAL findings). 4-2 Coeliac disease/malabsorption syndromes and Conclusion: The prevalence of celiac disease in food enteropathies children with FAP is estimated 1.3% (nearly 2 times T-S-062 higher than normal population in Iran). It can be The prevalence of Celiac Disease in Iranian recommended that all children with FAP should be children with Functional abdominal pain screened for celiac disease particularly in those with Vajiheh Modaresi1*, Fatemeh Farahmand2, lower growth curve. 3 Seyedeh Zalfa Modarresi Send Date: 2011/07/27 1 Yazd Shohada-e-kargar hospital, Yazd Medical Islamic Azad University 2 Division of Pediatric Gastroenterology and Hepatology., Children Medical Center,Tehran University of Medical Category: 5 IBD Sciences 5.1 Basic/pathogenesis/pathology/ 3 Immunology, Asthma and Allergy Research Institute, T-S-063 Tehran University of Medical Sciences Introduction: Celiac disease (CD) is a chronic The association between serum 25 (OH) inflammatory disorder of the small intestine induced vitamin D concentrations and in genetically susceptible people by the irritant gluten inflammatory bowel diseases (IBD) activity 1 1* and possibly other environmental cofactors. It is Hassan Vossoughinia , Siavash Abedini , Ahmad Khosravi-Khorashad1, Maryam Sahebari1,Farid characterized by a diverse clinical heterogeneity that Farrokhi2, Keyvan Haghighi2, Asieh Hatefi1, Javad ranges from asymptomatic to severely symptomatic. Pournaghi1, Hamid-Reza Sima1, Abbass Esmaeizadeh1, However, clinical features of Iranian children with Hassan Saadatnia1, Faraneh Abdolhosseinpour3 CD are still unknown and there is scant information 1 Medicine Faculty, Mashhad University of Medical Sciences about atypical presentation of celiac disease (CD) 2 Pathology Department, Razavi Hospital from Iran. The aim of this study was to determine 3 Dentistary Faculty, Mashhad University of Medical Sciences prevalence of CD in Iranian children with chronic Introduction: Inflammatory bowel diseases (IBD) recurrent abdominal pain (RAP) or functional are probably immune mediated diseases of unknown abdominal pain (FAP). etiology affecting the gastrointestinal tract. In Method: In this cross-sectional study, 301 children addition to genetic susceptibilities, one of the affected by functional abdominal pain (FAP) were important environmental factors contributes to screened for CD by antitransglutaminase antibody autoimmune diseases like IBD is vitamin D. (tTG IgA). These antibodies were measured by enzyme Furthermore, the evidence points to vitamin D linked immunosorbent assay. Diagnosis of CD was deficiency and its receptor dysfunction cause confirmed by duodenal biopsy that was scored according exacerbation of experimental IBD .Our aim was to

40 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 evaluate the correlation between serum 25(OH)D ical distress. So, we designed a study to determine the concentration of IBD patients with IBD activity. association between 2 immuno-biological markers Method: Sixty patients who had confirmed diagnoses (p-ANCA and c- ANCA) and depressive symptoms, of IBD were recruited for a cross sectional study. healthy anxiety and personality traits. Most of the identified factors that can interfere serum Method: One hundred and eight patients with UC 25 (OH) D concentrations were considered and entered the study. P-ANCA and c-ANCA were excluded. Disease activity assessed using validated determined by Enzyme-Linked Immunosorbent questionnaires, Including Truelove for Ulcerative Assay (ELISA). Depressive and anxiety symptom Colitis and crohn disease activity index (CDAI) for and personality traits were measured by Center for Crohn’s. Serum 25 (OH) D concentrations were Epidemiologic Studies-Depression (CES-D) scale, determined by chemiluminescent assay. Hospital Anxiety Depression (HAD) scale and Results: Mean serum 25(OH) D was 13.1 ± Revised Eysenck Personality Questionnaire, 11.1(ng/ml) in IBD patients in our study. Almost 95% respectively. Pearson correlation was used to assess of patient were vitamin D insufficient or deficient the relationship between p-ANCA/c-ANCA and (<30 ng/ml). Forty one percent of IBD patients had psychological distress. active disease. Vitamin D deficiency was not Results: Our results showed that 81.5% of the patients associated with IBD activity. )p=0.238 with suffered from anxiety, 43.5% suffered from depression chi-square test).However, vitamin D deficiency was and 75% suffered from introvert personality. significantly associated with having IBD related No patient was positive for p-ANCA. Sixteen patients surgeries. (p=0.001 with T test). (14.8%) had positive c-ANCA test, but the correlation Conclusion: Although most of our patients had inad- between positive c-ANCA and anxiety, depression or equate vitamin D, serum vitamin D concentration was introvert personality was not statistically significant not associated with disease activity. However, vita- and did not statistically differ between those with or min D deficiency was associated with surgical treat- without positive c-ANCA test. ment in these patients. Conclusion: According to our results, the presence Send Date: 2011/07/20 of c-ANCA could not distinguish a special psychological subtype of the patients. Since no patient was positive for p-ANCA, the correlation Category: 5 IBD between positive p-ANCA and psychological distress 5.1 Basic/pathogenesis/pathology/ could not be assessed. However, the high prevalence T-S-064 of anxiety, depression and introversion and their role Correlation between immunologic markers in the clinical course and outcomes of the disease of ulcerative colitis and psychological distress shows the need for early psychological intervention Hafez Fakheri1, Mehran Zarghami1* in those with UC. 1 Zare Hospital, Mazandaran University of Medical Sciences Send Date: 2011/08/17 Introduction: Many studies have investigated the effects of psychological factors on disease activity in patients with ulcerative colitis (UC). On the other Category: 5 IBD hand, some studies have shown a correlation between 5.1 Basic/pathogenesis/pathology/ some immuno-biological markers such as perinuclear T-S-065 antineutrophilic cytoplasmic antibody (P-ANCA) and Serum retinol in ulcerative colitis : correlation some distinct psychobiologic subtypes in UC, but the with disease activity and inflammatory cells results are inconsistent. If this correlation exists, the Mohammad hossein Somi1, nasim abedi manesh1*, presence of these biomarkers can help in selecting alireza ostadrahimi2, Beitollah Alipour3 those patients who need more psychological care and 1 Liver and Gastrointestinal Disease Research Center, also may explain why some studies failed to show the Tabriz University of Medical Sciences relationship between disease activity and psycholog- 2 Nutritional Sciences Research Center, Tabriz University of Medical Sciences

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3 Health and Nutrition Faculty, Tabriz University of 1 Medical Sciences, University of Tehran Medical Sciences Introduction: Ulcerative colitis (UC) and Crohn’s Introduction: vitamin A deficiency in patients with disease (CD) are chronic inflammatory bowel diseases inflammatory bowel disease (IBD) is contributing to (IBD) with uncertain etiology thought to be triggered by defective intestinal homeostasis. To assess serum interactions between various environmental, genetic and retinol and its correlation with disease activity. immunologic factors. Role of different risk factors in Furthermore to determine the correlation of serum IBD are controversial. retinol and systemic inflammatory cells numbers with Method: The aim of this study is to determine the clinical disease activity. possible risk factors in a group of Iranian patients Method:A total of 48 patients with ulcerative colitis with IBD. One hundred and sixty-three consecutive (UC) were enrolled in to the cross-sectional pilot cases of UC and 95 cases of CD were included. Age study.Patients were in remission according to the and sex matched controls were randomly selected. A Truelove-Witts scale. Serum retinol was assessed by total of 489 controls for UC and 285 controls for CD HPLC. Heparinized blood samples were collected for were enrolled. A standard record concerning complete blood count and lymphocyte phenotyping demographic and characteristic features, BMI, infantile by flow-cytochemistry and flow-cytometric analysis nutrition, smoking habit, measles in childhood, measles respectively. vaccination, history of appendectomy and tonsillectomy, Results: Approximately 55% of our patients were VA OCP, and drugs use was completed. Logistic deficient (serum retinol < 30 µg/dL).Serum retinol regression analysis was used to evaluate potential levels were negatively correlated with clinical disease confounding variables. activity (p=0.033 , r=- 0.329).There was a positive Results: A statistically significant protective effect correlation between serum retinol and peripheral for smoking in UC was found (OR=0.18 CD4+ and CD8+ numbers (r=0.355, r=0.335) 95%CI=0.064-0.504, p<0.05). The risk of UC respectively. Neutrophil to lymphocyte (N/L) ratio increases with prolonged exposure to OCP (OR=0.99, and percentage of neutrophil were directly associated 95%CI=0.98-0.99, p<0.05). In patients with CD, 15 with disease activity while there was a significant cases (15.8%) reported a previous history of negative correlation between systemic CD4+ T cell appendectomy compared with 19 controls (6.7%) numbers and disease activity. (OR=2.6, 95% CI= 1.2-5.4, p<0.05). Tonsillectomy Conclusion: Mild vitamin A deficiency is common was reported by 16 patients (16.8%) with CD com- in ulcerative colitis in remission and there is an pared with 25 controls (8.8%) (OR= 2.1, 95% CI= association between serum retinol and clinical disease 1.07-4.1, p<0.05). The logistic regression analysis activity; likewise, the correlation between systemic showed that both appendectomy and tonsillectomy inflammatory cells numbers and disease activity is are risk factors in CD. No association with other noticeable. variables was found for either disease. Send Date: 2011/08/18 Conclusion: Current smoking was a significant protective factor in UC. We observed a relationship between duration of OCP use and UC. Duration of using OCP in UC cases was significantly more than Category: 5 IBD controls. Both appendectomy and tonsillectomy were 5.2 Etiology /epidemiology risk factors in CD in this study. T-S-066 Send Date: 2011/08/02 A Case-Control study on the risk factors of IBD in Iranian patients Homayoon Vahedi1*, Meghedi Chaharmahali1, Category: 5 IBD Shabnam Momtahen1, Shadi Kolahdouzan1, Golrokh 5.2 Etiology /epidemiology 1 1 1 Olfati , Tahmineh Tabrizian , Shadi Rashtak , T-S-067 1 1 Reza Khaleghnejad , Siavash Naserimoghadam , Osteoporosis: frequency and risk factors Fatemeh Malekzadeh1, Reza Malekzadeh1

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in a group of patients with ulcerative find significant correlation between low B.M.I as a colitis refering to gastroentrology clinic predictor of low B.M.D in U.C patients. B.M.D is Khadijeh Hatami1, Mitra Ameli2*, Fatemeh higher in patients taking Azathioprine probably by Kia-kojuri2, Mahmoud reza Khansari1, increasing duration of remission.When planning Mehrdokht Najafi1, Neda Rabiei1 managing programs, evaluation of femoral neck 1 Gastrointestinal & Liver Disease Research Center B.M.D is recommended in patients with U.C, this is (GILDRC),Firoozgar hospital, Tehran University of more important in patients who are not taking Medical Sciences (TUMS) Azathioprine. 2 Department of Gastroenterology, Tonekabon Azad Send Date: 2011/08/07 University of Medical Sciences Introduction: Osteoporosis have been reported but underestimated in patients with Ulcerative Colitis Category: 5 IBD (U.C). The aim of this study was to evaluate 5.2 Etiology/epidemiology frequency of low Bone Mineral Density (B.M.D) in T-S-068 patients with U.C and healthy subjects, and to Establishment of a Population-Based estimate possible risk factors for low B.M.D, that Registry of Inflammatory Bowel deserves attention in planning treatment programs for diseases in Fars, Kohgilooye and these patients. BoyrAhmad, South Provinces of Iran Method: This is a descriptive cross-sectional study. Seyed Alireza Taghavi1*, Kamran Bagheri Lankarani2, Two groups, 33 patients (mean age and SD: Mohammadreza Fattahi3, Maryam Moini1, Laleh 42.9±15.8), Male/Female ratio: 1/3 and 33 age, sex Hamidpour1, Maryam Ardebili3, Zahra Mansoorabadi3 matched healthy subjects were studied. B.M.D, 1 Gastroenterohepatology Research Center, Shiraz relative to age standardized mean (z-score) was University of Medical Sciences measured by dual energy X-ray absorptiometry at the 2 Health Policy Research Center, Shiraz University of lumbar spine and left femoral neck, in patients and Medical Sciences, Shiraz, Iran controls and results of B.M.D were compared. 3 Gastroenterohepatology Research Center, Shiraz Patients were divided in the following groups: University of Medical Sciences, Shiraz, Iran Introduction: patients with osteoporosis (Z<=-2), osteopenia Inflammatory bowel diseases (IBD) (-2-1). Assessment of CRP, are debilitating diseases that lead to a variety of Hemoglobin, Body Mass Index (B.M.I), duration and problems in patient’s everyday life as well as a huge extension of disease, crypt distortion in microscopic burden for the health care system. Since this group of exam and the effect of taking Azathioprine and diseases are multifactorial and complex, long-term, corticosteroid was performed in all 3 groups and longitudinal studies are clearly needed for their better results were compared. Data were analyzed by SPSS understanding. A Population–Based Registry covers software using non parametric method. all residents in a given geographic area within a given Results: The rate of Osteopenia and osteoporosis was time period. It intends to include all with the disease 36.6% and 24.24% respectively in U.C. group versus in the population. Even if it fails to include “all” 27.27% and 3.03% in controls (p=0.005). In U.C. cases, intention rather than performance defines the group femoral neck B.M.D was significantly lower term. The aim of establishing this registry is to build than healthy subjects (p=0.04). Patients taking a reliable data source which will be of considerable Azathioprine had significantly higher B.M.D than help in future planning of the health care resources patients who were not.None of other possible risk needed to deal with IBD and to enable the factors which were assessed showed significant investigators to test their theories on origin and/or difference between B.M.D of osteoporotic, treatment of the diseases. Method: osteopenic and normal cases. Registry is managed by gastroenterohepatology Conclusion: Patients with U.C have reduced B.M.D research center (GEHRC) at Shiraz University of in femoral neck. We found lower B.M.I in U.C Medical Sciences. The geographic area is two patients compared to healthy subjects, but we didn’t provinces of Iran, Fars, Kohkilooye and BoyrAhmad,

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The governing committee which consists of a head T-S-069 and 2 other faculty members and an appointed MEFV Common Mutations in Iranian manager who will be responsible for decisions Azeri Turkish Patients with ulcerative colitis regarding budget allocations and use of data. The Mohammad Hossein Somi1*, Morteza Jabbar pour designed questionnaire includes a consent form, basic Bonyadi2, Seyyed Kazem Mirinejhad1, history data, risk factors, related procedures, medical Mohsen Ismayeeli2, Negar Leghayeeyan2, 1 therapy, and follow-up data. Establishment process Maryam Soleimanpour 1 has two parallel phases: In the first phase, the data is Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences collected from many sources including annual 2 Department of Medical Genetic, Tabriz University of hospital discharge data, referral from university Medical Sciences affiliated physicians and private practices, pathologic Introduction: Ulcerative colitis (UC) and Crohn reports, death certificates, self referral and insurance disease (CD) constitute the two major forms of system data. Then registry office contacts patients to chronic inflammatory bowel disease (IBD) with book an appointment. In the interview, the unknown etiology. It is suggested that environmental questionnaire is completed and blood samples are factors and genetic background are important factors taken. The gathered data is reviewed for confirming in disease susceptibility and patient's response to ther- the diagnosis of IBD and data are entered in the apy. Since there are similarities between FMF and designed and computerized data base. Blood samples IBD, the responsible gene for FMF (MEFV), has are taken, DNA is extracted and will be kept at -70, been introduced as a modifier gene for IBD. another serum sample will be kept at -20°. In the Method: In the present study, 139 unrelated patients second phase, follow up interviews will be done by referred with UC compatible symptoms and also 200 phone or in person yearly .The new IBD patients are matched controls were screened for the five most also being registered. This phase will continue common MEFV mutations (E148Q, V726A, M680I, indefinitely to include the new incident cases. M694I, and M694V) by applying PCR-RFLP and Recruitment of the new cases is being done by regular ARMS-PCR techniques. reminders to all referral sources. Results: Thirty one (22.3%) patients and 52 (26%) Results: The Inflammatory bowel disease registry of control individuals had one of the studied mutations. Shiraz University of medical sciences has started to All studied types of MEFV mutations except M694I register patients whose diagnosis were confirmed to and V726A could be detected in the patients. E148Q be Inflammatory bowel diseases. and V726A mutations were only observed in the Till now approximately 300 patients have been regis- control group. E148Q was the most frequent mutation tered from Fars province. observed in this cohort. There was a significant Conclusion: By retrospective and prospective data difference between the two groups regarding M694V collection methods, this central database of IBD cases mutation (p=0.002). will determine incidence, prevalence and demo- Conclusion: Although the role of M694V mutation graphic characters of IBD in a defined population, in UC susceptibility seems to be significant among facilitate future researches to identify etiology, the Iranian Azeri Turkish patients, studies in a large disease process, new treatment options, factors number of UC and control series and also studies on affecting prognosis, recurrences, optimal health care, further MEFV mutations are needed to determine the morbidity and mortality of IBD, and at last but not least definite relationship between MEFV mutations and UC. provide educational and social support for patients by Send Date: 2011/07/20 educational materials and organizing NGOs. Send Date: 2011/08/16 Category: 5 IBD 5.5 Treatment Category: 5 IBD T-S-070 5.3 Genetics Alexithymia in patients with irritable bowel

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syndrome and therapeutic effect of emotional Meghedi Chaharmahali1, Homayoon Vahedi1*, awareness on the symptoms and severity Mohammad Bagheri1, Mohammad Reza Ghadir1, Alireza Farnam1*, Mohammad Hossein Somi2, Shadi Kolahdouzan1, Naser Ebrahimi Sara Farhang 1, Nafise Mahdavy2 Daryani1, Reza Malekzadeh1 1 Department of Psychiatry, Tabriz University of Medical 1 Medical Sciences, University of Tehran Sciences Introduction: Nonadherence with medication in 2 Liver and Gastrointestinal Diseases Research Center, inflammatory bowel diseases (IBDs) increases the Tabriz University of Medical Sciences risk of colorectal cancer and clinical relapses. The Introduction: The strong evidences for the role of purpose of this study was to find probable reasons of psychological factors in Irritable bowel syndrome nonadherence to treatment among IBDs patients in a (IBS) are supporting the categorization of this group of Iranian patients. syndrome as a psychosomatic disorder. Somatization Method: In 9 months a total of 500 patients were may be a key point in its manifestation. We examined enrolled in the study (225males, 275females; the role of emotional awareness on the symptoms and 150Crohn’s disease (CD), 341Ulcerative colitis (UC), the severity in these patients. 9Intermittent).Patients were interviewed about their Method: Patients were selected according to ROME nonadherence behaviors. After collecting answers, IV criteria for IBS and randomly divided to two we analyzed answers using factor analysis. groups. Both groups received standard medical care Results: The overall rate of nonadherence was for the syndrome, while the intervention groups were reported 33.3 % (27.6%intentional nonadherence, educated to increase conscious awareness about their 5.7% unintentional nonadherence). (33.6%) had at emotions and level of arousal after two sessions least one relapse after discontinuing treatment. The focusing on eight basic emotions. Patients then most reason of intentional nonadherence reported by recorded their emotional amalgam, three times a day patients was: discontinuing the treatment after for one month. Severity of pain (measured by visual recovering symptoms (42.7%).The most frequent analogue scale) and the frequency were recorded unintentional nonadherence reason was forgetfulness before and after the intervention. (5.2%). There were patients who didnt visit their Results: Two groups were matched by gender and gastroenterologist on time and they just refilled drugs age. Patients with IBS scored significantly higher in from drugstore, which the most reason reported was; all aspects of Alexithymia comparing to healthy these clinics were too far and hard for them to access. controls (Difficulty identifying feelings, difficulty We didn’t find any significant relationship between describing feelings and externally oriented thinking). nonadherence and demographic factors. The mean frequency of symptoms significantly Conclusion: We expected to find pregnancy as a decreased from 5.4±1.9 to 3.7±2.6 episodes per week factor of increasing women’s nonadherence. But in the intervention group and from 4.9±2.4 to 1.9±2.5 there was no difference between males and females in the controls, with a significant effect for the inter- and nonadherence. The reasons for nonadherence are vention. The severity for pain was also decreased multiple and widespread. They could be different significantly in both groups, significantly affected by form one population to another. If we could the intervention. determine the reasons of nonadherence then it will be Conclusion: Emotional awareness may promote the possible to find the strategies for reducing or effects of pharmacological treatment in patients with IBS. preventing them. Send Date: 2011/07/20 Send Date: 2011/08/02

Category: 5 IBD Category: 5 IBD 5.5 Treatment 5.7 Management T-S-071 T-S-072 Nonadherence to treatment in 500 inflammatory Depressive mood and disease activity bowel diseases patients; prevalence and reasons in inflammatory bowel disease

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Taghi Amiriani1*, Sima Besharat1, Gholamreza 1 Golestan University of Medical Sciences, Golestan Roshandel1, Mahsa Besharat1, Shahryar Semnani1, Research Center of Gastroenterology and Hepatology Mohammadzaman Kamkar1 Introduction: Anemia is a common complication of 1 Golestan University of Medical Sciences, Golestan inflammatory bowel disease (IBD). One third of IBD Research Center of Gastroenterology and Hepatology patients suffer from recurrent anemia. Both iron Introduction: Some mood disorders are more deficiency (ID) and anemia of chronic disease prevalent in chronic medical conditions compared to contribute most to the development of anemia in IBD. the general population. The relationship between The prevalence of anemia in IBD is high (30%) and inflammatory bowel disease (IBD) and psychiatric prevalence of ID is even higher (45%).Anemia in disorders has been raised an area of interest for patients with IBD results primarily from iron investigation. In this study, we aimed to assess the deficiency because of chronic intestinal blood loss probable relationship between depression and disease from inflamed mucosa, although in active disease activity in patients suffered from inflammatory bowel more complex mechanisms involving absorption are disease (IBD) in Golestan province, Northeast of Iran. also important. In this study, we aimed to assess the Method: During February 2008 to February 2010, fifty prevalence of anemia in patients suffered from in- patients recently diagnosed as IBD cases attended to flammatory bowel disease (IBD) in Golestan Golestan Research Center of Gastroenterology and province, Northeast of Iran. Hepatology (GRCGH), Northeast of Iran. Simple Method: During February 2008 to February 2010, Clinical Colitis Activity Index (SCCAI) was used to 131 ulcerative colitis patients were registered in the evaluate the disease activity. Beck Depression IBD data bank, Golestan Research Center of Inventory (BDI) was used to assess the severity of Gastroenterology and Hepatology (GRCGH), depressive symptoms. Depression was assumed when Northeast of Iran; from whom 50 were new cases the BDI score was 13 points or higher. Data were (less than 2 years past from the diagnosis). Simple analyzed using SPSS-16 software. Chi-square and Clinical Colitis Activity Index was used to assess the Pearson correlation test were used to assess the severity of bowel disease. All 50 cases were relationship between variables. P-value less than 0.05 requested to give blood samples. Data were analyzed considered significant. using SPSS-16 software. Chi-square and Pearson Results: Sixteen cases (32%) had depressive correlation test were used to assess the relationship characteristics. Simple Clinical Colitis Activity Index between variables. and Beck score were not significantly different Results: Mean age (±SD) of the studied subjects was between the two sexes. There was a non-significant 38.74 (±15.4) years (range=17-86 years) and they had correlation between Simple Clinical Colitis Activity mean (±SD) hemoglobin of 12.64± 2.92 gram/dl. There Index, Beck score and age. was no significant relationship between hemoglobin Conclusion: We reported a relatively high percent of level and the activity index of the disease. depression in IBD patients, although no significant Conclusion: There was an acceptable level of relationship was seen. Mental health should be hemoglobin in our IBD patients with no correlation to considered more in the routine evaluation of IBD cases. the activity of disease, but further studies with larger Send Date: 2011/07/14 sample size are needed to evaluate this condition. Send Date: 2011/07/14

Category: 5 IBD Category: 5 IBD 5.7 Management 5.7 Management T-S-073 T-S-074 Anemia in Inflammatory Serum level of 25-hydroxy Bowel Disease cases, Northeast of Iran vitamin D in Ulcerative colitis 1* 1 Taghi Amiriani , Reza Mohammadi ,Sima Taghi Amiriani1*, Somayeh Barzanooni1,Sima 1 1 Besharat , Gholamreza Roshandel , Sedighy2, Sima Besharat1, Afsaneh Borghei2, 1 1 Mahsa Besharat , Honey Sadat Mirkarimi Sasan Seyyedein2, Fatemeh Nejhadi Kelarijani1,

46 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Shahryar Semnani1, Hamidreza Joshaghani1, Medical Sciences Gholamreza Roshandel1, Mahsa Besharat1 Introduction: Ulcerative colitis (UC) is a disease of 1 Golestan University of Medical Sciences, Golestan unknown etiology caused by an inappropriate Research Center of Gastroenterology and Hepatology mucosal immune response to antigens from the 2 Golestan University of Medical Sciences intestinal flora. Its etiology has not yet been resolved, Introduction: Vitamin D deficiency is common among but immunological and genetic factors are known to patients with inflammatory bowel disease, even when play a very important role. Active UC is often the disease is in remission. This study was designed to associated with elevated peripheral blood evaluate the serum level of 25-hydroxy vitamin D in granulocytes and imbalanced inflammatory cells patients suffered from ulcerative colitis and the control (CD4,CD8 Th cells). As these cells are major sources group in Golestan province, Northeast of Iran. of inflammatory cytokines, selective changes of these Method: In this case-control study, serum samples of cells in patients with UC should alleviate inflammation. 60 patients with definite histopathologic diagnosis of According to the anti inflammatory role’s of vitamin Ulcerative Colitis were recruited. Control group was A,we decided to evaluate the effect of vitamin A selected among healthy blood donor. 25(OH)-D3 supplementation on circulatory white blood cell performed by ELISA method (ids- UK). Data were (WBC) subtypes and inflammatory cells in this study. entered into SPSS-16 software and analyzed by t-test Method: Fourty three patients with ulcerative colitis and Chi-square. were included in a before and after, interventional Results: The mean serum levels of vitamin D in survey in a university health clinic of Tabriz. All patients was significantly lower compared to control participants were at clinical remission stages. The group (P-value <0.01). Differences of 25-OH-D3 severity of disease activity was assessed by colitis were statistically significant between the two sexes, activity index (CAI).Vitamin A supplement was in both groups. All cases in proctitis group had injected twice (50000 IU) with two weeks interval. normal vitamin D levels, while only 20% of Study period was considered 45 days. Total WBC rectosigmoiditis group had normal levels of vitamin count was performed by using an automatic blood D and in pan-colitis group, this figure had reached to cell counter. The serum levels of hs-CRP were zero. The difference was statistically significant evaluated by immunoturbidimetry.CD4 and CD8 T (P-value <0.01). cells were analysed by flow cytometry. Conclusion: It can be concluded that serum levels of Results: In UC, neutrophil lymphocyte ratio (NLR) vitamin D in patients with ulcerative colitis is low and and hs-CRP levels positively correlated with CAI (p< inflammatory bowel disease can be a target for 0.05).There was a negative correlation between CD4 specific vitamin D therapy. T-cell and CAI (p=0.01).We found no significant ef- Send Date: 2011/07/14 fect of vitamin A supplementation on CD4 and CD8 T-cell subsets, neutrophil and monocyte count after supplementation.NLR and hs-CRP levels decreased Category: 5 IBD not considerably,while platelet count decreased 5.7 Management significantly (p= 0.004). T-S-075 Conclusion: Vitamin A supplementation seems to Effect of vitamin A supplementation on have a slight effect on peripheral inflammatory cells. white blood cell subtypes in patients Send Date: 2011/08/18 with ulcerative colitis Mohammad hossein Somi1, Nasim Abedi Manesh1*, alireza ostadrahimi2, Beitollah Alipour3 Category: 5 IBD 1 Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences 5.7 Management 2 T-S-076 Nutritional Sciences Research Center, Tabriz University GpouþÞý×ýQqðlâþôuÇeAuPpxoôcþkoGýíBoAó of Medical Sciences 3 Health and Nutrition Faculty, Tabriz University of ÞõèýQAèvpôqôAoOHBÉ@óGBÎõAìêkìõâpAÖýàôGBèýñþ

Govaresh\ Vol.16\ Supplement\ Autumn 2011 47 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

, 1 ,ìdílcvýò¾õìþ &1 ðvýîÎBGlÿìñ{ 2 Department of Immunology, Isfahan University of Med- 3 ,uÏýlÎBGlÿìñ{ 2 ÎéþoÂBAuPBkocýíþ ical Sciences ìpÞrOdÛýÛBRGýíBoüùBÿâõAo}ôÞHl,kAðzãBûÎéõïKryßþOHpür 1 3 Department of Cellular and Molecular Biology, Islamic ìpÞrOdÛýÛBRÎéõïOÓnüú,kAðzãBûÎéõïKryßþOHpür 2 Azad University, Olum Tahgigat, Tehran 4 âpôûGýõyýíþGBèýñþ,kAðzãBûÎéõïKryßþAøõAq 3 Department of Biostatistics and Epidemiology, Isfahan University of Medical Sciences ÞõèýQAèvpôqüàGýíBoÿAèPùBGþìrìòoôkûAuQ.AüòGýíBoAók^Bo ìÛlìú: Introduction: Patients with metastatic colon cancer zç vþ ôð APBþqBÿì õlÞ íòAQAüò AuQ ìíßò Þú yõðl ìþ qüBkÿ ôAWPíBÎþ oôAðþ Wvíþ, ìzßçR often have defects in the percentage and function of ìzßçRGBÎUAgPçëkooôðlÞý×ýQqðlâþ@ðBóâpkk.GúøíýòìñËõoKtôø{ peripheral blood NK cells, and T cells. The aim of cBÂpGBølÙOÏýýòôÂÏýQAuPpxoôcþôÞý×ýQqðlâþkoGýíBoAóÞõèýQ this study was to investigate in more detail not only AèvpôqkoìÛBüvúGBAÖpAkuBèîôAoOHBÉ@óGBÎõAìêkìõâpAÖýàôGBèýñþ¾õoR the percentage but also the activation status and âpÖPúAuQ. function of NK and T cells in patients with metastatic AüòKtôø{ü¼ìÇBèÏúOõ¾ý×þ-øíHvPãþìýHByl.koAüò Gpouþ: oô} colon cancer(n=15) in comparison to control group(n=15). OdÛýÜ35GýíBoìHPçGúÞõèýQAèvpôqìpAWÏúÞññlûGúÞéýñýàOh¿¿þyýi Method: The percentage of peripheral blood AèpDýwkouBë9831Gúoô}ðíõðúâýpÿkokuPpxôâpôûÞñPpëAqGýòAÖpAk CD3-CD56+ NK cells, and CD3+CD56- T cells as uBèîkoWBìÏúGúyßêWõoylûAqðËpuòôWñwGBâpôûGýíBoAðPhBJylðl. well as the expression of the perforin within these AÆçÎBRGBAuP×BkûAqKpuzñBìúuçìQÎíõìþôÞý×ýQqðlâþ63uEõAèþ(Öpï cells were analyzed by flow cytometry. The õB âkôÿy.ueAPxG u×k qpzBúAuPpxÞõøò AqKpuzñBìú AuP×Bkû GB AuPpx uÇe yl. )âpk@ôoÿ ÞõOBû functional capacity of NK cells was evaluated by the AoqüBGþâpkül.ìzh¿BRkìõâpAÖýàôGBèýñþGýíBoAóðýrWíÐ@ôoÿâpkül.GB flowcytometric cytotoxicity assay, while the AuP×BkûAqìdBuHúÂpüIøíHvPãþAuLýpìò,@qìõóOþô@ðBèýrôAoüBðwìõok proliferative activity of T cells was measured by the OXrüúôOdéýêÚpAoâpÖQ. lymphocyte proliferation assay (LPA) to mitogen phytohemagglutinin (PHA). üBÖPúøBðzBókAkÞý×ýQqðlâþkoGýíBoAóÞõèýQAèvpôqkoìÛBüvúGB üBÖPúøB: Results: The results obtained in this study have ).GvýBoÿAqcýÇúøBÿÞý×ýQqðlâþGBuÇe P AÖpAkuBèîKBüýòìþGByl(600.0= revealed a new aspect of NK and T cell dysfunction AuPpxøíHvPãþìÏñþkAokAok.uÇeAuPpxkoGýòGýíBoAóqóGBæOpAq that is not, as commonly reported about colon cancer. ìpkAóGõk.ylRGBèýñþGýíBoÿ,ÆõëkôoûôkÖÏBRÎõkGýíBoÿôuÇeAuPpx Interestingly, a significant number of the investigated ).

48 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 agents in order to overcome the immunosuppression patients over 50 years. (p value=0.03)(orderly were associated with advanced malignancy. 100% and 73.1%). This rate, also, in patients over 50 Send Date: 2011/08/19 years in both male and female were significantly higher than patient below 50 year. Conclusion: The results of our study were as near as Category: 6 COLONIC AND ANORECTAL DIS- the other previous studies; (among the higer rate ORDERS being in the older patients). According to this study, 6.2 Malignant disease - diagnosis/histopathology between two sexes, from pointview of P53 positive T-S-078 rate, there was not any significant difference. Evaluation of P53 gene mutation and (however, in over 50 years age group, this rate was abnormal P53 protein accumulation more in female). More studies are suggested in future in colon adenocarcinoma by with more and newer specimens and also applying Immunohistochemistry method additional parameters like feeding diets and women's 1* Ashraf Fakhrjoo , Seyed Kazem hormone situation. Mirinezhad2, Kyhan Saefari 1 Send Date: 2011/08/08 1 Pathology of Imam Reza Hospital, Tabriz University of Medical Science 2 liver and Gasrointestinal Diseases Research Centre, Tabriz University of Medical Science Category: 6 COLONIC AND ANORECTAL DIS- Introduction: Colorectal cancers and at the head of it, ORDERS adenocarcinoma is one most frequent causes of 6.2 Malignant disease - diagnosis/histopathology mortality due to cancers in the world. Colorectal T-S-079 adenocarcinoma is accompanied with different Synchronous Polyps in patients alterations at the genetic level of the cell. among with colorectal cancer 1 1 them, are mutations of P53 gene. The occurrence of Siamak Khaleghi , Farhad Zamani , 1* 1 this mutation is the introduction of irreversible Mehrnaz Rezghi , Mehrdokht Najafi 1 Gastrointestinal & Liver Disease Research Center malignant changes of the cells and are diagnostic by (GILDRC),Firoozgar Hospital, Tehran University of different procedures namely immunohistochemistry Medical Sciences one. The purpose of this study is the survey on Introduction: The frequency of synchronous positive cases of colorectal adenocancinoma, for P53 adenomatous polyps in patients with colorectal cancer protein by the immunohistochemistry procedure. has been appraised to be 15%-50%. This study was Method: 100 paraffin blocks with diagnosed as performed to estimate the accompaniment of colorectal adenocarcinoma were collected; and from synchronous polyps in patients with colorectal cancer. all blocks, the 4 micron sections were prepared, and Method: In this retrospective study, previously after deparaffining immunohistochemistry staining prepared questionnaires were used to collect the with the help of antibody single specific anti P53, essential information from the medical records of avidin biotin steroptovidin procedure performed on patients with colorectal cancer admitted during all specimens. In every specimens nucleus and 1999-2009 for whom total colonoscopy has been cytoplasma staining in more than 10% of cells of the done. The information required including age, specimens, it was regarded as positive results. In all gender, presence or absence of synchronous polyps, positive cases, with segregation the sexes, and in two location of polyps, location of cancer, size of polyps groups patients over and under 50 years defined and and number of polyps were extracted. compared with the statistic method (chi square). Results: Totally 173 patients with colorectal cancer Results: The positive staining was 60% in all enrolled in this study and total colonoscopy revealed patients, for protein P53. Between two sexes, in all 52(30.1%) synchronous polyps. The mean age of the rates, there were not any significant statistic patients was 57±13 years and 53% (92) of them were difference. The P53 positive rate in female patients male. Rectum with 71(41%) cases was the most over 50 years were clearly more than the male common involved area of colorectal cancers,

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following by sigmoid colon (37 cases,21.4%) and 2009 were studied. Information such as demographic ascending colon (30 cases,17.3%). Sigmoid colon data, tumor location, histologic grade and stage of with 14 cases (26.9%) was the most common disease and MLR were analyzed. Patients with other involved area for synchronous polyps, following by pathologic reports (other than adenocarcinoma), descending colon(10 cases,19.2%) and ascending gastrectomy with positive R1 and R2 margins and colon (10 cases,19.2%).Most of the synchronous also patients who did not undergo lymph node polyps (38.5%) were <5 mm in size and 19 cases dissection, were excluded. (36.5%)5-10 mm in size.67.3% of the synchronous Results: Of 70 patients with mean age of 60.93 years polyps were found to be single ,11(21.2%) patients old, 84% were male. There was a significant had two polyps and multiple polyps was reported in relationship between MLR and age of the patients 6(11.5%) patients .Most of the polyps were found (p=0.01) , metastatic lymph node number (p<0.001) before performing surgery 30(57.7%) and the rest of and stage of the disease (p<0.001) .It means that in reported polyps were revealed after operation. younger patients with high lymph node metastasis Conclusion: In conclusion, considering the high and higher stages of the disease, the MLR is higher. incidence of synchronous polyps in patients with However, we did not find any relationship between colorectal cancer in our region, it is ideal to perform MLR and sex, grade, and location of the tumor. a preoperative total colonoscopy in each patient with Conclusion: MLR is a valuable prognostic factor in colorectal cancer. If not possible, a postoperative predicting the patients and the disease natural history. colonoscopy should be carried out to find Send Date: 2011/07/23 synchronous lesions in order to help improving surveillance of these patients. Send Date: 2011/08/10 Category: 6 COLONIC AND ANORECTAL DIS- ORDERS 6.4 Other colonic and anorectal disorders Category: 6 COLONIC AND ANORECTAL DIS- T-S-081 ORDERS Study of relationship between colorectal polyps 6.3 Malignant disease - management and body mass index in Qom center of Iran T-S-080 Mohammad-Reza Ghadir1*, Ali Akbar Riahin2, Evaluation of metastatic to resected Amir-Hosein Ghanooni3, Habibollah Hajian4, Maryam lymph nodes ratio and factors that Bolandmartabeh5, Ali Azarian5, Masoumeh Abbasi5 1 affect it in gastric cancer patients Gastroenterology Section, Department of Internal Hamidreza Saedi1, Farahnaz Joukar1, Reyhane Medicine, Faculty of Medicine, Qom University of Jafarshad1, Shima Ghasemi1, Afshin Shafaghi1* Medical Sciences, Qom, Iran 2 1 Gastrointestinal & Liver Diseases Research Center Department of Infectious Medicine, Faculty of Medicine, (GLDRC), Guilan University of Medical Sciences Qom Azad University, Qom, Iran 3 Introduction: Gastric carcinomais as the first leading Department of Internal Medicine, Qom University of Medical Sciences, Qom, Iran cause of gastrointestinal cancer-related mortality. 4 Department of Internal Medicine, Qom Azad University, Lymph node status has been considered as the major Qom, Iran determinant of gastric cancer recurrence for patients 5 Shahid Beheshti Hospital, Qom University of Medical undergoing a curative gastrectomy. Metastatic lymph Sciences, Qom, Iran node ratio (MLR), namely the number of metastatic Introduction: It seems that the most of colorectal lymph nodes to the total number of resected lymph cancer are origin of a neoplasm called adenomatous nodes, has also been found to be an important polyp. Different factors are involved in creating prognostic factor. Therefore, we decided to survey the adenomatous polyps. Epidemiologic studies have relationship between MLR and clinicipathologic shown that a significant number of risk factors exist for features of the patients. colorectal adenomas Such as red meat and alcohol, Method: Medical records of patients with gastric smoking and obesity. In this study we decided that cancer undergoing gastrectomy from years 2004 to investigate the prevalence of colorectal polyps in

50 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 people with high body mass index and the relationship infection (UTI) and enuresis. Constipation may cause between body mass index and colorectal polyps. UTI and enuresis due to the uninhibited bladder Method: This descriptive analytical study was contraction. The aim of this study was to investigate performed. In this study subjects about their age, the frequency of UTI and nocturnal enuresis in weight, medical history, family medical history, children with chronic functional constipation. gastrointestinal symptoms, and colonoscopy findings Method: We included 120 children (73, 60.8% were recorded and assessed. Population was patients female) with chronic functional constipation were admitted to Hazrat-e-Masumeh hospital with according to Rom III criteria in the study. Detailed gastrointestinal symptoms and have been undergoing past and present history of UTI or symptoms pointing colonoscopy in Qom while November 2008 to to this diagnosis and enuresis was obtained. January 2009. Urinalysis, urine culture and abdominal ultrasonogra- Results: In this study, among 511 patients, 69 patients phy were performed for all patients. (14 percent) have polyp and 442 patients (86 percent) Results: The mean age of the patients was 7.4±3.2 were in the control group. In patients with polyps, 2 year (range, 1-15 year). 75% of the patients had percent underweight, 33 percent of normal weight, constipation for more than one year. The most 38 percent overweight and 26 percent were obese and common urinary symptoms were dysuria (15%), in control group, 5 percent underweight, 39 percent urinary frequency (12.5%), and dribbling (4.1%). The normal weight, 35 percent overweight, and 21 frequency of nocturnal enuresis and daytime enuresis percent were obese. In the study of relationships be- were 22.5% and 3.3%, respectively. Pyurias were tween obtained data and according to square test and seen in 11 (9.2%) patients that all of them were the coefficients can be claimed that between body female. Of these patients urine culture were positive mass index and colorectal polyps, there is no signif- in 7 (5.8%) cases; E.coli in 5 (71.4%), S.aureus and icant relationship. Enterobacter each in one (14.3%). All organisms Conclusion: Analysis of data for this study didn’t were sensitive to ciprofloxacin. Urinary tract find a significant relationship between colorectal ultrasonography was normal in these patients. polyps and body mass index. Conclusion: Urinary symptoms especially nocturnal Send Date: 2011/07/17 enuresis was found in a significant number of chil- dren who had chronic functional constipation but UTI is not more common than general population. There- Category: 6 COLONIC AND ANORECTAL DIS- fore, we suggest that nocturnal enuresis should be ORDERS questioned in children with chronic functional con- 6.4 Other colonic and anorectal disorders stipation, but screening for UTI is not recommended T-S-082 in these patients. Frequency of Urinary Tract Infection Send Date: 2011/08/17 and Nocturnal Enuresis in Children with Chronic Functional Constipation Seyed Mohsen Dehghani1*, Mitra Basiratnia1,Ali Category: 6 COLONIC AND ANORECTAL DIS- Derakhshan1, Mahmood Haghighat1, Mohammad ORDERS Hadi Imanieh1, Mohammad Hossein 6.4 Other colonic and anorectal disorders 1 1 2 Fallahzadeh , Marzieh Matin , Laleh Hamidpour T-S-083 1 Gastroenterohepatology Research Center, Departments The normal range and related factors of Pediatric Nephrology, Shiraz University of Medical Sci- of the intraepithelial lymphocyte in the ences Shiraz, Iran 2 Gastroenterohepatology Research Center, Shiraz colon mucosa of healthy individuals in University of Medical Sciences Shiraz, Iran Kurdistan province of Iran Introduction: There are controversial results about Amir Taheri1*, Farshad Sheykhesmaili1, Banafsheh 1 1 2 the role of chronic functional constipation in Amin daneshpoor , Bahram Nikkhoo , Elham Farhangi 1 disorders of the urinary tract like urinary tract Kurdistan Digestive Research Center, Kurdistan University of Medical Science

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2 Private Clinic, Kurdistan University of Medical Science 1 Department of Internal Medicine, Mashhad University of Introduction: Increased number of intraepithelial Medical Sciences, Mashhad, Iran. lymphocytes (IEL) in the colon mucosa is an 2 Department of Clinical Biochemistry, Zahedan important criterion for the histological diagnosis of University of Medical Sciences, Zahedan, Iran. 3 lymphocytic colitis. Department of Internal Medicine, Kerman University of As we had found a very high percentage of Medical Sciences,Kerman, Iran. 4 Department of Internal Medicine, Zahedan University of lymphocytic colitis (but not collagenous colitis) Medical Sciences, Zahedan, Iran. diagnosis in patients with chronic non bloody diar- Introduction: Nonalcoholic steatohepatitis is a rhea in our previous investigation in Kurdistan common liver disease that can progress to cirrhosis. providence(39.13%), we decided to determine the Currently, there is no established treatment for this average range of IEL in the different parts of colon disease. in patients without chronic diarrhea in order to Method: We randomly assigned 55 adults with clarifying if this high percentage of diagnosis refers nonalcoholic steatohepatitis(NASH) to receive to a real high prevalence of lymphocytic colitis in this CoQ10 60mg daily (30subjects) or vit E 800 unit area or comes from a higher count of IEL between daily (25 subjects) for 3 months to assessment the normal people of this area without any relation to effect of CoQ 10 versus vit E on BMI, ALT, AST, lymphocytic colitis. ALK-P, PT, Bilirubine, ALB, Ferritin, TG, Total Method: In this cross sectional study 150 patients with Cholestrol, FBS, Serum Insuline, LDL, HDL, total an indication for colonoscopy other than chronic Anti Oxidant Capacity before and after intervention. diarrhea were enrolled. We took biopsies from different Results: In CoQ10 group there was a significant im- parts of colon (ascending, transverse and descending provement in weight and BMI (P value=0.001), AST, colon). These biopsies were stained with Hematoxylin ALT, TAC (p-value<0.0001), Ferritin, Total bilirubin, and Eosin Staining; and the number of IEL in all GGT (p value<0.01), HDL (p value<0.05). In vit E patients was counted by a singular pathologist. group there was a significant improvement in AST, Results: The mean of IEL in each 100 epithelial cells ALT, TAC, Ferritin, GGT, HDL(p value<0.01) but no was (15/5 ± 2/8), (12/8 ± 2/5) and (11 ± 2/6) in significant difference in between the other ascending, transverse and descending colon parameters. There was seen no significant difference respectively. There was no significant difference in in CoQ10 and vit E in improvement any demographic IEL count between different age, sex, and educational and biochemical parameters. groups. Also people in rural and urban areas had Conclusion: Our study assigned that 60 mg CoQ10 is similar count of IEL in this study. effective on improvement of noninvasive liver pa- Conclusion: This study revealed that the mean rameters in NASH, but not superior than 800iu vit E. number of IEL in Kurdistan providence of Iran was Neither CoQ10 and nor vit E ara effective in insulin similar to word and there was not any significant resistance but we suggest longer duration treatment relation between IEL count and socioeconomic status and with larger dosage. We also suggest a larg study of people. Also more proximal parts of colon had with biopy control for the assessment the effect of higher IEL count than distal parts. CoQ10 in NASH. Send Date: 2011/08/22 Send Date: 2011/07/21

Category: 7 LIVER Category: 7 LIVER 7.3 Metabolic/genetic disorders 7.3 Metabolic/genetic disorders T-S-084 T-S-085 Effects of Coenzyme Q10 on biochemical Effect of aerobic exercise on changing in seromic markers of hepatic necroinflammation in level of liver enzymes and liver echogenicity in patients with non alcoholic steatohepatitis patients with non alcoholic fatty liver disease 1* 2 Ali Bahari , Mohammad Hashemi , Manouchehr khoshbaten1, Nasrin Gholami 2*, Sara Shafieipour3, Noralla Hashemzehi4

52 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Yagoub Salek Zamani3, Javad Rashid3, Relation of alanine aminotransferase level Yusof Hoshyar3, Afag Garjani3 with severity of atherosclerosis and 1 Liver and Gastrointestinal Diseases Research Center, metabolic syndrome in patients with Tabriz University of Medical Sciences, Tabriz, Iran non-alcoholic fatty liver disease 2 Liver and Gastrointestinal Diseases Research Center, Manouchehr khoshbaten1, Lili Abbaszadeh1*, Maryam Tabriz University of Medical Sciences, Tabriz, Iran Zaareh1, Faranak Dordaei1, Javad Rashid1, Elham 3 Liver and Gastrointestinal Diseases Research Center, Ramazanzadeh1, Nasrin Gholami1, Koorosh masnadi1 Tabriz University of Medical Sciences, Tabriz, Iran 1 Introduction: Liver and Gastrointestinal Diseases Research Center, NAFLD has various prevalence in Tabriz University of Medical Sciences, Tabriz, Iran different parts of the world, though 20-30% Introduction: The prevalence of non-alcoholic fatty prevalence has been reported in epidemiologic liver disease (NAFLD) is increasing worldwide studies in western countries. Since obesity and low because of the rise of obesity and diabetes mellitus physical activity are main risk factors for the prevalence. This condition is closely related to insulin development of NAFLD, life style modification resistance and markers of oxidative stress and considering weight loss and physical activity is endothelial dysfunction. There have been evidences thought to be as important alternative for treatment indicating that elevated level of serum alanine of this disease and to prevention of cirrhosis that will aminotransferase (ALT) may reflect metabolic manifest consequently if it is not treated. syndrome and general atherosclerosis in NAFLD Method: 90 patients diagnosed by ultrasound as patients; however, the data are not conclusive. This NAFLD was evaluated in a clinical trial, they were study aimed at evaluating possible association evaluated in case (A) and control groups (B). The between serum ALT level with severity of effect of aerobic exercise on changing in liver atherosclerosis and metabolic syndrome in patients enzymes and liver echogenicity was assessed in case with NAFLD. group and compared with control group which were Method: In this analytic-descriptive cross-sectional only on medical therapy. setting, 309 patients with sonographically diagnosed Results: The mean age in the sample group was NAFLD were recruited in Tabriz Imam Reza 37.6±8.3 in the 17-56 yrs age range. 29 patients Teaching centre during a 2-year period of time. (64.4%) were male and 16 patients (35.6%) were Serum level of alanine aminotransferase (ALT) was female in group A, while 28 (62.2%) male and 17 measured in all patients and accordingly, they were (37.8%) female patients were in group B. In group A, allocated in two groups: with normal level of serum fatty liver was in stage I in 26 (57.8%) cases, stage II ALT (<40U/L); or with elevated level of serum ALT in 17 (37.8%), and stage III in 2 (4.4%). In group B, (>40U/L). The right and left carotid IMTs were fatty liver was in stage I in 30 (66.7%) patients, in measured and the maximum reading in both sides stage II in 14 (31.1%), stage III in 1 (2.2%). There was reported as the final result. The sonographic was no significant difference between the two groups grading of NAFLD was also performed. Data were evaluating fatty liver changes (p=0.23).But there was compared between the two groups with normal and significant difference in liver enzymes changes in elevated levels of serum ALT. group A (ALT p=0.0001 AST (p=0.01) Results: There were 166 cases with normal and 143 Conclusion: Considering the present study, we can cases with elevated levels of serum ALT. There was suggest that a controlled aerobic exercise schedule not a significant association between the elevation of can be helpful in the association of medical therapy in serum ALT level and the carotid IMT. Frequency of the treatment of NAFLD. cases with abnormal fasting blood sugar, increased Send Date: 2011/07/21 serum triglyceride and abnormally low serum high density lipoprotein was significantly lower in the group with elevated level of serum ALT. Frequency Category: 7 LIVER of patients with central obesity and hypertension was 7.3 Metabolic/genetic disorders not significantly different between the two groups. T-S-086 Percentage of cases with metabolic syndrome was

Govaresh\ Vol.16\ Supplement\ Autumn 2011 53 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 significantly and independently higher in the group ìPíBürGõkðl. DLFAN gõó(96%)ÖBÞPõoøBüþGõkðlÞúkoGýíBoAóìHPçGú with elevated level of serum ALT (39.2% vs. 22.3%; ,5/03%ôkoìpkAó71/32%Gõk. DLFAN yýõÑøýLõOýpôDýl,koqðBóìHPçGú p=0.001). Association between elevated level of DLFAN øí`ñýòkoGýíBoAóìõokìÇBèÏúìB,yýõÑküBGQkoqðBóìHPçGú serum ALT and grade of NAFLD was not independ- ðvHQGúìpkAóGúÆõoGBoqÿGýzPpGõkôAgPçëÎíéßpkÞHlÿkoìpkAóìHPç ently significant. ðvHQGúqðBóyýõÑÞBìç«GBæOpÿkAyQÞúAüñùBAqküãpðPBüYìùîAüòìÇBèÏú Conclusion: Elevated level of serum ALT is associated with metabolic syndrome and majority of ô DLFAN øvPñl.GpouþøBÿ@ìBoÿcBÞþAqAøíýQAüòÖBÞPõoøBkoAGPçGú its components in NAFLD patients; however, this AüXBkqìýñúuBqÿWùQAGPçìþGByñl. association was not apparent with sonographic grade AgPçæRìPBGõèýàAqÚHýê^BÚþ,küBGQôAgPçæR^pGþgõó ðPýXúâýpÿ: of NAFLD or carotid IMT. GýíBoAó ko gÇp ÖBÞPõoøBÿ ÎñõAó Gú øýLõOýpôDýlÿ ô øî GB ìpOHÈ Æõo Gú Send Date: 2011/07/21 ôkoqðBóyýõÑGýzPpÿkAyPñl. DLFAN Send Date: 2011/07/21 Category: 7 LIVER 7.3 Metabolic/genetic disorders Category: 7 LIVER T-S-087 7.3 Metabolic/genetic disorders GpouþÖpAôAðþðvHþøýLõOýpôDýlüvîko T-S-088 GýíBoAóìHPçGúÞHl^pJÒýpAèßéþ Sampling Error in Histopathology Findings of Nonalcoholic Fatty Liver Eskandar Hajiani1*, Seyed Jalal Hashemi1, Shahin Merat1*, Rasoul Sotoudehmanesh1, Mehdi Hajieh shahbazian2, mohamad Salehvand1 Nouraie2, Masoumeh Peikan-Heirati1, Sadaf Ghajarieh 1 GI ward, Ahvaz-Jondishapoor University Sepanlou1, Reza Malekzadeh1, Masoud Sotoudeh1 2 Diabetes Investigation Center, Ahvaz-Jondishapoor University 1 Digestive Diseases Research Center, Tehran University ÞHl^pJÒýpAèßéþüàGýíBoÿìrìòÞHlÿAuQÞúkoAÖpAkÿÞúuBGÛú ìÛlìú: of Medical Sciences ì¿pÙAèßêðlAoðlôèþüBÖPúøBÿøývPõèõsüàÞHl@ðùBìzBGúAÖpAkÿAuQÞú 2 Department of Internal Medicine and Center for Sickle Aèßêì¿pÙÞpkûAðlkülûìþyõkôGú¾õoRouõGBRìBÞpôôürüßõæo^pGþ, Cell Disease, Howard University ßô pÞl,APB,ìèo BÿôÖHô oGÖ Hÿgko ðzBó oA gõk ÞHlÿ GBÖQ ko ÖýHpôq ô GBkÿ ìBèõoÿ AèPùBJ, KpAÞñlû, ðßpôq Introduction: Many clinical trials and natural history ìþkøl.oAGÇúGýòÞHl^pJÒýpAèßéþôGýíBoüùBüþìTêküBGQ,øýLpèýLýlìþ studies on nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) rely heavily on ô^BÚþyñBgPúylûAuQ.AgPçæROvQøBÿÞHlÿkoAgPçæRôGýíBoüùBÿ liver histology to define their endpoints. There are many OýpôDýlAqküpGBqìõokOõWúGõkûAuQôèþøñõqìÏéõïðzlûAuQÞú@üBGýò indications that the liver is not uniformly involved in AgPçæRÞBoOýpôDýlìTêøýLõOýpôDýlÿôÞHl^pJÒýpAèßéþAoOHBÆþôWõk NAFLD thus sampling error is a major concern. kAoküBgýp?ølÙAqìÇBèÏúAgýpGpouþüBÖPúøBÿGBèýñþôÖBÞPõoøBÿgÇp Method: Samples from a forensic autopsy series were ôAGvPúGúGýíBoAóìHPçGúÞHl^pJÒýpAèßéþôGúÆõoAgP¿B¾þGpouþÖpAôAðþ studied. Subjects with NAFLD were identified. ðvHþøýLõOýpôDýlüvîkoGýíBoAóGBÞHl^pJÒýpAèßéþkoAuPBógõquPBóìþGByl. Specimens were taken from three different parts of WùQAðXBïìÇBèÏúÞéýúGýíBoAðþoAÞúkogçëuBèùBÿ4831OB Gpouþ: oô} each liver. Degree of steatosis, hepatocyte ballooning, 81øp íþG zý H p ýAßþkÞýý Oh¿¿þ koÞéýñýà ÒýpAèßéþ ^pJ ÞHl OzhýÀ GB yívþ øXpÿ 5831 lobular inflammation, portal inflammation, and fibrosis was recorded. A NASH activity index (NAI) âõAo}OdQkoìBóÚpAoâpÖPúGõkðlìõokGpouþÚpAoâpÖPñl.OíBìþGýíBoAó which is the sum of scores of histologic features was kAoAÿuõðõâpAÖþkAëGpÞHl^pJkoÒýBJuBüpÎéêyñBgPúylûGýíBoÿÞHlÿ also calculated. The agreement between the three ôüBì¿pÙAèßêkAyPñl.ÖBÞPõoøBüþìBðñluò, C ,øLBOýQ B ìBðñløLBOýQ samples from each liver was studied. Wñw,^BÚþ,AgPçëÞBoÞpkÞHlÿôAgP¿B¾B«AgPçëOýpôDýlÿôAgPçë^pGþ Results: Nine-hundred and forty-five autopsies were gõókoAüòGýíBoAóìõokGpouþÚpAoâpÖQ. performed, 896 were suitable for histologic Aq002GýíBoGpouþylû28ð×pìnÞpô811ð×pìõðUGõkðl.ìýBðãýòuñþ üBÖPúøB: evaluation and 283 had NAFLD. Of these, 146 livers 2 ÆØuþA4-3uëyBìê uBë Aq45-03 uñþ ôÆýØ ±21 DS ìÏýBo AðdpAÙ GB uBë 24 GýíBoAó were available to our study of which 438 samples were taken. Fibrosis (intra-class correlation=0.87), (09%),AgPçë 52>IMB ìþylðl.GúÆõoÞéþìýBðãýòuñþ(GpcvIuBë), lobular inflammation (kappa=0.83), and portal ÞBoÞpkÞHlÿ(08%),küBGQ(5/43%),øýLõOýpôDýlÿ(5/72%)ôAgPçæR^pGþ inflammation (kappa=0.83) were fairly uniformly

54 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 distributed in the damaged liver. Steatosis was less imaging modalities, histopathologic assessment, uniform (kappa=0.64), and hepatocyte ballooning atomic absorption spectrophotometry and gene was least uniformly distributed (kappa=0.57). The mutation study were performed. The genetic study for ICC for NAI was 0.86 indicating good agreement. HFE gene mutation was examined for all of the Conclusion: The individual histologic features of patients since 2006 while non-HFE mutation was NAFLD and NASH are not uniformly distributed in conducted since December 2010 (only for two of them). the liver. Hepatocyte ballooning is especially Results: Twelve patients were evaluated consisting non-uniform. Such non-uniformity should be taken of 11 men and 1 woman with the mean age of into account when interpreting results of studies 39.58+12.68 yr. The average of atomic iron loads was relying on paired biopsies. A summary score such as 13.25±4.83 fold higher than normal standards. Four NAI is less affected by sampling error. patients had heterozygotic mutation of H63D Send Date: 2011/07/25 (33.3%), while, out of two evaluated patients for Non-HFE mutation, only one was homozygote mutant for TFR2 gene. There was not any significant Category: 7 LIVER difference either in the iron load of liver (P=0.730) 7.3 Metabolic/genetic disorders and heart (P=0.730) or serum concentration of ferritin T-S-089 (P=0.755) and TIBC (P=0.530) between the mutant A Report of Iranian Hereditary and non-mutant HH cases. Hemochromatosis Patients: Baseline Conclusion: In contrast to other studies, C282Y Characteristics, Laboratory mutation was not detected in any of our Iranian HH Data and Gene Mutations patients. While, heterozygotic mutations of H63D Farhad Zamani1, Zohreh Bagheri2*, Maryam Bayat3, (HFE) and TFR2 (non-HFE) genes were found to be 4 1 Seyed-Mohammad Fereshtehnejad , Hossein Ajdarkosh more common in these patients. Similar to previous 1 Gastroenterologist, Gastrointestinal & Liver Disease reports, these mutations were not found to be Research Center (GILDRC), Tehran University of Medical significantly associated with severity of presentation Sciences (TUMS)(pardis-hemmat), Iran 2 Medical Student, Student Research Committee, in HH patients. Gastrointestinal & Liver Disease Research Center Send Date: 2011/07/31 (GILDRC), Tehran University of Medical Sciences (TUMS)(pardis-hemmat) , Iran 3 General Physician,Gastrointestinal & Liver Disease Category: 7 LIVER Research Center (GILDRC), Tehran University of Medical 7.3 Metabolic/genetic disorders Sciences (TUMS)(pardis-hemmat), Iran T-S-090 4 Research Fellow, Gastrointestinal & Liver Disease Adding aerobic exercise to low-caloric Research Center (GILDRC), Tehran University of Medical diet increases the effect of therapy in Sciences (TUMS)(pardis-hemmat), Iran patients with nonalcoholic steatohepatitis Introduction: Hereditary hemochromatosis (HH) is Hossein Nikroo1*, Seyed Reza Attarzade Hosseini 2, the most common autosomal recessive disorder Hamid Reza Sima3, Mohsen Nematy4 between white people which is characterized with 1 MSc student of Sport and Exercise Physiology, Ferdowsi excessive abnormal uptake of iron from the University of Mashhad, Iran gastrointestinal tracts. Recently, mutation studies 2 Faculty of Physical Education and Sport Sciences, have focused to detect the responsible genes for HH. Ferdowsi University of Mashhad, Iran According to rare prevalence of HH and lack of 3 Department of Internal Medicine, Surgical Oncology appropriate mutation studies in Iran, we aimed to Research Center, Imam Reza Hospital, School of assess 12 Iranian HH patients. Medicine, Mashhad University of Medical Sciences, Iran 4 Department of Nutrition, School of Medicine , Mashhad Method: In this cross-sectional study, 12 HH patients University of Medical Sciences, Iran were recruited who were referred to Firoozgar Introduction: Nonalcoholic Steatohepatitis (NASH) Hospital, Tehran, Iran. In addition to the clinical is part of a broad spectrum of nonalcoholic fatty liver assessments, a complete laboratory evaluation,

Govaresh\ Vol.16\ Supplement\ Autumn 2011 55 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 disease. To date, no medical treatment has been of Medical Sciences proven. We aimed to compare the effect of aerobic Introduction: Hepatotoxicity is a major concern exercise along with diet and diet alone on serum during treatment of tuberculosis. Its prevalence range aminotransferases levels, anthropometric indices, and from 1- 4% in developed countries to 11.5% in cardio respiratory fitness in patients with NASH. developing countries and more in some countries Method: Twenty-three NASH patients with the age such as India. Mortality appears to 5%, but can be of range of 25 to 50 years old were randomly divided prevented by early detection. This study was in two groups and underwent aerobic exercise along conducted to reveal prevalence and outcome of with diet (n=12) or diet alone (n=11). In this study, drug-induced hepatitis in smear positive tuberculosis low-caloric diet in both groups included 500 patients taking anti-TB drug therapy in Qazvin, kilocalories of energy less than estimated daily central of Iran. energy requirement. In addition to diet, the first group Method: This observational descriptive retrospective were participated in aerobic exercises consisted of cross-sectional study was done on 324 patients(newly walking, jogging and running, for a period of 8 diagnosed cases) with smear positive TB taking weeks, 3 days a week with 55–60% heart rate reserve. anti-TB drugs as 6 months classic regimen, DOTS Serum aminotransferase levels, anthropometric method (isoniazide+ rifampin+ pyrazinamide+ indices, and peak oxygen consumption were ethambutol or streptomycin for 2 months and then measured before and after eight weeks of the isoniazide +rifampin for 4 months) during 2004-2010. intervention. Data were analyzed by Paired Samples Results: Mean age of the cases was 42±12.1 y/o and Independent-Samples T Test, at a significance (mean± SD). 194 cases (60%) were female and the level of P<0/05. remaining were male. drug-induced hepatitis were Results: Although, no significant difference was seen in 16 cases (4.9%). mean age of affected cases noted in patients on diet alone, serum ALT and AST was 52 y/o. liver enzyme had begun to rise 13-45 levels were significantly decreased in patients days after drug therapy (mean=25.25), the altitude of underwent diet and exercise. Anthropometric enzyme rise were 287-605 i.u. the enzyme level measurements were decreased and peak oxygen returned to normal after 14-43 days (mean=23.45) consumption was increased significantly in both after drugs discontinuation. There was no mortality. groups; however, there were significant difference Conclusion: the prevalence of drug-induced hepatitis between two groups in variables WC, WHpR, WHtR in our study was 4.9%. Although it was seen more in and VO2 peak. females and, age over 50 years but no statistically Conclusion: Aerobic exercise along with low-caloric significant relations were found between diet may be more effective than low-caloric diet drug-induced hepatitis and sex or age of the patients. alone-in treatment of patients with nonalcoholic With base line and 2 week periods Liver enzyme steatohepatitis. check and rapid drugs discontinuation in raised cases Send Date: 2011/08/19 in this study, was not observed any mortality. Send Date: 2011/05/19

Category: 7 LIVER 7.4 Hepatotoxicity/alcohol - regeneration - apoptosis Category: 7 LIVER T-S-091 7.5 Cirrhosis and complications: basic aspects TB Drugs hepatotoxisity, Abundance and out- T-S-092 come (7 years study on 324 patients with Etiology of chronic liver disease in smears positive TB in Qazvin) patients admitted in the Shariati Reza Ghasemi Barghi1, Ali Akbar Haj Agha Hospital Tehran during 2000-2009 Mohammadi2*, Rasoul Samimi2, Ali Zargar2 Shifteh Abedian1*, Mehdi Saberifiroozi1, 1 Infectious Disease Unit, Qazvin University of Medical Reza Malekzadeh1 Sciences 1 Digestive Disease Research Center, Shariati Hospital, 2 Gastroenterology & Hepatology Unit, Qazvin University Tehran, University of Medical Sciences, Tehran, Iran

56 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Introduction: Chronic Liver diseases (CLD) liver disease (NAFLD) is increasing worldwide especially liver cirrhosis (LC) is one of the most secondary to the rise of obesity and diabetes mellitus important causes of death in Iran. 39 percent of (DM) incidence. There are various non-invasive patients admitted in Shariati hospital during methods for determining the atherosclerosis, of 2000-2004, have had chronic liver diseases, cirrhosis which, non-invasive assessment of carotid and hepatic failure. We decided to compare the intima-media thickness (CIMT) by high-resolution etiologic causes of CLD and LC admitted in this large carotid Bmode ultrasonography is widely used in this referral hospital during two time periods of regard.This study aimed at evaluating the effect of 2000-2004 and 2004-2009. NAFLD on CIMT as a risk factor for atherosclerosis. Method: The discharge sheets of 5880 patients had Method: In this case-control setting, 151 subjects been admitted in Shariati hospital GI ward during two divided to three groups: Group 1 including 49 5 years periods of 2000-2004 and 2004-2009 were patients with NAFLD and DM; Group 2,including 50 reviewed. The final diagnosis and etiology of chronic nondiabetic NAFLD patients; and the controls liver disease and /or chronic liver failure on the basis including 52 normal subjects. The right and left of ICD-10 extracted and evaluated statistically. CIMTs and its maximum reading (CIMTmax) were Results: Among the 956 patients in the 1st group measured by a skilled sonographist blind to the during 2000-2004 period, the rate of the most grouping. Demographic and other atherosclerosis risk common etiologic agents were hepatitis B virus factors were compared between groups, as well.The (41.1%),cryptogenic cirrhosis(21.96%), Autoimmune sonographic grading of the NAFLD was determined Hepatitis (12.97%), HCV (11.71%),and primary in group 1. biliary cirrhosis(PBC)(5.12%). While among 861 Results: Median CIMTmax was significantly higher patients in the 2nd period, during 2005-2009, the in the case 1 group comparing with that in the case 2 rates of the most common agents were HBV (29.5%), and control groups (0.6mm, 0.5mm and 0.4mm, cryptogenic cirrhosis (27.75%), HCV (15.91%), AIH respectively, p<0.001). This difference between the (15.79%), and PBC (4.64%). case 1 and case 2 groups was not significant after Conclusion: The rate of HBV has decreased and adjusting for age and previous history of hypertension cryptogenic and HCV have increased in this group of and hyperlipidemia (p=0.089). Between the case 1 patients. These changes may be due to improvements and control groups, the difference was again in the sanitation status and the rising rate of obesity significant after controlling the confounders and metabolic syndrome in our community. We sug- (p=0.018). Similar result was attained in comparison gest more study in other referral centers. between the case 2 and control groups (p=0.043). Send Date: 2011/08/22 Comparing the median CIMTmax between the patients in case 1 group with and without elevated liver function tests, there was no significant Category: 7 LIVER difference (0.6 mm in both groups, p=0.402). 7.6 Cirrhosis and complications: clinical aspects Comparing the median CIMTmax between the T-S-093 patients in case 1 group according the sonographic Effect of non-alcoholic fatty liver disease grading of NAFLD, there was no significant on carotid artery intima-media thickness difference (0.5mm, 0.6 mm and 0.6 mm in grade 1, 2 as a risk factor for atherosclerosis and 3, respectively; p=0.438). Manouchehr Khoshbaten1*, Maryam Zaare1, Reza Conclusion: Based on our findings, there is a signif- 2 1 Javadrashid , Koorosh Masnadi Shirazi , icant association between the presence of NAFLD 1 Neda Sattarnezhad and atherosclerosis. This association was independent 1 Liver and Gastrointestinal Disease Research Center, from the DM presence. The grade of NAFLD and Tabriz University of Medical Sciences 2 Department of Radiology, Tabriz University of Medical elevated lever function tests had no effect on severity Sciences of atherosclerosis. Introduction: The prevalence of non-alcoholic fatty Send Date: 2011/07/15

Govaresh\ Vol.16\ Supplement\ Autumn 2011 57 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Category: 7 LIVER is correlate between the higher bilirubin , severity of 7.6 Cirrhosis and complications: clinical aspects ascites , encephalopathy and rebleeding rate. In these T-S-094 patients intensive care is recommended. Predicting Factors of Rebleeding and Send Date: 2011/07/20 Mortality in Variceal Bleeding in Patients Hospitalized in Gastroenterology Ward of Emam Khomeini Hospital 2007-2008 Category: 7 LIVER Ebrahim Fattahi1*, MohammadHosseian Somi1, 7.6 Cirrhosis and complications: clinical aspects Raha Pishdad1, Parisa Rezaeifar1, Golnar T-S-095 Majidi1, Shahnaz Naghashi1 Evaluation of frequency of Etiology and 1 Liver and Gastrointestinal Diseases Research Centre, clinical profile of liver Cirrhosis in GI Tabriz,University of Medical Sciences clinics of Ahvaz city in 1377-1386 Introduction: Esophageal variceal bleeding is Eskandar Hajiani1*, Seyed Jalal Hashemi1, associated with high mortality rate and hospitalization A Ahmadzadeh1 costs. By diagnosing predicting factors of rebleeding 1 GI ward, Ahvaz - Jondishapoor University at admission, with sufficient actions, we can Introduction: Liver cirrhosis is the end-stage of minimize the mortality and rate of rebleeding. The many different chronic liver diseases. Limited data aim of this study is to determine predicting factors of exists on the epidemiology, natural history and rebleeding and death in patients hospitalized because complications of liver cirrhosis in Ahvaz city. In a of variceal hemorrhage. Cross-sectional study we retrospectively evaluated Method: In a case control study, 100 patients with 165 patients in our set up from 1377 to 1386. variceal bleeding were studied whom were admitted Method: Patients having an evidence of cirrhosis of at Emam Khomeini Hospital from June 2007 to May liver on ultrasound examination of abdomen were 2008. There demographic characteristics were age, enrolled. The diagnosis was based on clinical, gender, etiology, CTP classification and various functional and morphological data, and the clinical, laboratory and endoscopic criteria of patients etiological profile was established by determining were recorded. Patients were divided into case and viral markers, autoimmune markers and by metabolic control groups (with and without variceal bleeding). screening. All those patients who were not confirmed Predictive values of all criteria were surveyed. to be cirrhotic excluded from this study. All cases Results: 32 patients with age (mean±SD) were studied to determine the etiological factors, 54.22±19.81 and 68 with age (mean±SD) complications and prognosis of disease. All data were 49.88±16.42 were in case and control group, recorded on a questioner. respectively. There was no relation between age, Results: Total 165patients were studied, 114(67%) gender, treatment (p=0.30), etiology (p=0.68), males and 51(33%) females. Their mean age was 47 concomitant disease and portal hypertension with years. Majority of patients (63.6%) had HBV rebleeding. Size of varices (p=0.046), encephalopathy infection, (29.9%) had Autoimune Hepatitis, (13.6%) (p<0.05), ascites (p<0.005), bilirubin seric level and HCV infection,(1/8%) had Wilson’s disease and no CTP classification (p<0.0005) had predictive effect etiological factors were recorded in (23%) patients. on rebleeding. Of patients, 12 were CTP class A, 59 Ascites was present in (32%) cases, splenomegaly in CTP class B and 29 CTP class C. CTP and bilirubin (29%), esophageal varices in (38%), acute variceal sensitivity with the aid of ROC evaluation was found hemorrhage in (8%), hepatic encephalopathy in >85% and >62%, respectively. No deaths were seen different grades in (1%), fundal varices in (2%), in the period oh hospitalization. peptic ulcer in (8%) and hepatocellular carcinoma in Conclusion: Determining the class and grade of the (6%) patients. All patients with acute variceal CTP at admission in patients with variceal bleeding, episode(s) were adequately and timely treated in GI will afford useful prognostic information. In this department. When cirrhotic patients were grouped study, patients with CTP class B were strongly into child-Pugh’s classification, (19 %) were in class susceptible for rebleeding. Also, we found that there ‘A’category, ( 30 %) in class ‘B’ category, and (51%)

58 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 in class ‘C’ category. although MELD score was the primary predictor of Conclusion: HBV infection was the major risk factor overall survival in multivariate analysis,the for cirrhosis in our study. Ascites was the commonest relationship between these scoring systems shows we complication. Patients with child-Pugh’s class ‘C’ can use both of them to predict patients' prognosis cirrhosis were more frequent than patients with with equal accuracy. child-Pugh’s class ‘B’ and ‘A’. A multidisciplinary Send Date: 2011/07/21 approach for prevention and control of ever increasing HBV infection must be adopted and to make the public awareness through the mass media Category: 7 LIVER about its drastic complications, and possible modes 7.6 Cirrhosis and complications: clinical aspects of its transmission. T-S-097 Send Date: 2011/07/21 ìÛBüvúASpÞéýñýßþìPõOpôÞvBRôÞézþuýò kokoìBóuýpôq¾×pAôÿAôèýú:ü¼ìÇBèÏúìPB@ðBèýr , 2 ,ìpOÃþÚõWBqAkû 1& ìdílcvýò¾õìþ Category: 7 LIVER 3 ,ìdílAìýòìdílqAkûÚpûGBÒþ 1 ÎéþA¾ÓpKõoÿ 7.6 Cirrhosis and complications: clinical aspects ìpÞrOdÛýÛBRGýíBoüùBÿâõAo}ôÞHl,kAðzãBûÎéõïKryßþOHpür 1 T-S-096 âpôûÖýrüõèõsÿkAðzßlûKryßþ,kAðzãBûÎéõïKryßþOHpür 2 Correlation between MELD Score and kAðzXõÿKryßþÎÃõAðXíòÎéíþkAðzßlûKryßþ,kAðzãBû@qAkAuçìþOHpür 3 Child-Pugh-Turcott Score in Patients GýíBoÿuýpôq¾×pAôÿAôèýúüßþAqGýíBoüùBÿâpôûgõkAüíñþÞHlô ìÛlìú: with End Stage Liver Disease )OdQ ACDU ìXBoÿ¾×pAôÿAuQÞúAÒéIGBAôouõkqôÞvþÞõèý¼Auýl( Mohammad-Hossein Somi1*, Masood Bagheri1, Zahra Rashe1, Morteza Ghojazadeh2 koìBóÚpAoìþâýpkGBOõWúGúÎlïKBuiìñBuIkoOÏlAkÿAqìõAokkAoôøBÿ 1 Liver and Gasteroenterology Diseases Research, Tabriz ìhPé×þðËýpÞézþuýòôìPõOpôÞvBRkoÞñPpëÎçDî@óìõokAuP×BkûÚpAo University of Medical Sciences ASpAR ìÛBüvú WùQ ÖpAOdéýéþ ìÇBèÏú ü¼ cBÂpG¿õoR ìÇBèÏú Aðl âpÖPú 2 Physiology Department of Medical Faculty, Tabriz ÞéýñýßþìPõOpôÞvBRôÞézþuýòÆpAcþylûAuQ. University of Medical Sciences koAüòìÇBèÏúGBWvPXõkoìñBGÐìhPéØKryßþ05ìÛBèúìpOHÈ Gpouþ: oô} Introduction: MELD Score and Child-Turcotte-Pugh score are used to assess the prognosis of chronic liver GBìõÂõÑGúkuQ@ìlOñùBìÇBèÏBOþôAokìPB@ðBèýrylðlÞúGú¾õoRÞBo@qìBüþ disease, mainly cirrhosis.Although the Child-Turcotte GBèýñþkoGýíBoAóìHPçGúuýpôq¾×pAôÿAôèýúGBypAüÈÞéýñýßþìõokðËpGõkðl scoring system was the first of scoring in stratifying GýíBoAóGú¾õoRO¿BkÖþGúkôâpôûOXpGþôyBølOÛvýîylûôAqkAoôøBÿ the seriousness of end-stage liver disease,MELD AÖrAo Aqðpï AuP×Bkû GB ðPBüY Gõkðl Þpkû AuP×Bkû ìPõOpôÞvBR ô uýò Þézþ score is used increasingly to assess patients for liver ìõokGpouþôOXrüúôOdéýê@ìBoÿÚpAoâpÖPñl. 2.AMC transplantation.We wanted to find a relationship ìPõOpôÞvBRôÞézþuýòøpkô@èßBèòÖv×BOBqoAÞBø{kAkûGõkðl üBÖPúøB: between these scoring systems to examine patients ôèþOÓýýpARìPõOpôÞvBRðvHQGúÞézþuýòAqèdBÍ@ìBoÿìÏñþkAoGõk. survival more precisely. Method: In a cross sectional study we collect the data )ôkoìõok@æðýòOpAðv×pAqøpkôÞBø{kAkûGõkðlÞúAüòO×BôRAq P (30/0= from 105 cases of end stage liver disease caused by ). P èdBÍ@ìBoÿìÏñþkAoðHõk(32/0= viral hepatitis,autoimmune hepatitis and other causes )KBui ACDU koGýíBoAðþÞúGúkAoôÿAôouõkqôÞvþÞõèý¼Auýl( ðPýXúâýpÿ: from Emam Reza academic hospital-Tabriz-Iran from ðlAkûGõkðlìPõOpôÞvBRôÞézþuýòìþOõAðñluÇe@ðrüíùBÿÞHlÿoAGùHõk January 2007 to February 2011 .Relationship GhzñlôèþOÓýýpAR@èßBèòÖv×BOBqkoìPõOpôÞvBRGùPpAqÞézþuýòGõk. between two scoring systems was appreciated by calculating the correlation coefficient by SPSS.16. Send Date: 2011/08/18 Results: Strong correlation between MELD score and Child-Turcotte-Pugh score shows in this study (P<0.001),so that according to the results of regression Category: 7 LIVER test in 70 percent Child-Turcotte-Pugh score variations 7.7 Viral hepatitis: basic aspects related to the MELD score variations. T-S-098 Conclusion: The present study demonstrates that Prevalence of HIV coinfection with HCV

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and HBV in Kerman city during 2010 1 Digestive Disease Research Institute, Tehran University Mohammad Javad Zahedi, Sodaif Darvish Moghaddam1, of Medical Sciences Mohammad Mehdi Hayatbakhsh Abasi1, Maryam 2 Department of Biology, Lorestan University Parniyan2, Mohammad Javad Zahedi1* 3 Department of Virology, Tarbiat Modares University 1 Physiology Research Center, Afzalipour Hospital, Introduction: HCVandGBV-Cbelongtothe Kerman University of Medical Sciences, Kerman, Iran Flaviviridae family of viruses and GBV-C is the 2 Afzalipour Hospital, Kerman University of Medical closest virus to HCV genetically. Accumulative Sciences, Kerman, Iran research is in progress all over the world to clarify Introduction: Infection with HIV, HCV and HBV is clinical aspects of GBV-C. Possibility of interaction common worldwide. These viruses have similar routs between HCV and GBV-C and also its consequence of transmission; through blood products, sharing of with other liver diseases are the most important needles for drug injections and sexual activity. clinical aspects which encourage researchers to Therefore, confection with these viruses is common. develop a technique for simultaneous detection of Coinfection with HCV and HBV in HIV positive these viruses. In this study a SYBR Green Real time patients may lead to hepatic complications and multiplex RT-PCR technique as a new economical consequently decreased life expectancy. This study and sensitive method was optimized for simultaneous was designed to assess the prevalence of HCV and detection of HCV/ GBV-C in HCV positive plasma HBV coinfection in HIV positive patients in Kerman, samples. Iran during 2010. Method: After designing and selection of two pairs of Method: In this cross sectional study, 165 HIV specific primers for HCV and GBV-C, SYBR Green positive patients were evaluated for demographic Real time RT-PCR technique optimization was features and history of high risk behaviors. The performed separately for each virus. Establishment patients were tested for HBS Ag, and HCV Ab by of mulitiplex PCR was the next step. Finally our using EIA method. Statistical analysis were technique was performed on positive and negative performed by SPSS 18 software. plasma samples. Results: Out of total 165 HIV positive patients Results: 56 non cirrhotic HCV positive plasma 82.4%were men and 17.6% were women with a mean samples (29 of genotype 3a and 27 of genotype 1a) age of 40.4 ± 9 years. The prevalence of HCV and were collected from patients before receiving HBVcoinfection were 73.8% and 3.7% respectively. treatment. 20.6% of genotype 3a and 18.7% of A simultaneous coinfection of three viruses was genotype 1a showed HCV/ GBV-C coinfection. As a 1.8%. The main risk factors for HCV coinfection result, 19.6% of 56 samples had HCV/ GBV-C were history of being in jail and drug injections. coinfection that was compatible with other results Conclusion: Prevalence of HIV- HCV coinfection in from all over the world. Kerman city is much more common than other Conclusion: SYBR Green Real time multiplex studies, due to high prevalence of injecting drug users RT-PCR technique can be used to detect HCV/ in this study. GBV-C co-infection in plasma sample. Furthermore, Send Date: 2011/07/02 with application of this method more time and cost could be saved in clinical-research settings. Send Date: 2011/07/21 Category: 7 LIVER Category: 7 LIVER 7.7 Viral hepatitis: basic aspects 7.7 Viral hepatitis: basic aspects T-S-099 Development of a SYBR Green Real time multiplex RT-PCR technique for T-S-100 simultaneous detection of HCV and A Population-based Seroepidemiological GBV-C Co-infection in plasma samples Study on Hepatitis E Virus in Iran 1 2* Seied Hossein Mosavi fard , Kiana Shahzamani , Sadaf Ghajarieh Sepanlou1, Hoori Rezvan2, 1 3 Shahin Merat , Farzaneh Sabahi Sedigheh Amini-Kafiabad2, Mohammad-Reza

60 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Deyhim2, Shahin Merat1* with HCV or HIV and patients who diseased was 1 Digestive Diseases Research Center, Tehran University progressed were excluded. Seventy patents divided of Medical Sciences, Tehran, Iran in two groups one group received lamivudine 100 mg 2 Research Center, Iran Blood Transfusion Organization, daily and other group received convention interferon Tehran, Iran five million unit every day. Introduction: Little is known about HEV seroprevalence Results: 70 patients were included. Negative result and its determinants in Iran. Considering the fact that of HBV DNA was negative in 61.9% with interferon Iran is among the countries in which HEV infection and 61.1% with lamivudine in wild type subgroup of is endemic, a large-scale population based study in Hepatitis b and negative HBV-DNA result was 64.3% this regard is justified. in interferon treatment and 68.8% in patient that Method: This survey was conducted in 2006 in received lamivudine in precoer-mutant subgroup of Tehran and Golestan Provinces, Iran. Stored sera of hepatitis B. subjects were tested for serological markers of Conclusion: Virological response was better in pre- anti-HEV. The baseline data were recorded in core muton groups to lamivudine than interferon. structured questionnaires. Weighted seroprevalence Send Date: 2011/07/20 and weighted logistic regression coefficients were calculated. Results: A total of 1423 samples were included. The Category: 7 LIVER overall seroprevalence in two provinces was 7.4%. 7-8 Viral hepatitis B: clinical aspects Age with an odds ratio equal to 1.59 (95% CI: T-S-102 1.26-2.02) and history of traditional phlebotomy with Frequency of YMDD mutations in an odds ratio equal to 2.28 (95% CI: 1.13-4.60) were patients with chronic hepatitis B independent predictors of HEV seropositivity. untreated with antiviral Medicines Conclusion: Considering the high rate of HEV Seyed Hamid Moosavy1*, Hussein Froutan2, seroprevalence in Iran, further studies on the cost- Mohsen Nasiri Toosi2, Yasir Andrabi2,Hadi effectiveness of vaccination among vulnerable groups Ghofrani2, Hamid Vahedi2, Mehrnoosh Rezaee1 are mandatory. 1 Departement of Gastroenterology, Bandar Abbass, Iran Send Date: 2011/07/25 2 Departement of Gastroenterology, Tehran University of Medical Sciences, Iran Introduction: Investigators were suspicious YMDD Category: 7 LIVER mutations occurred only in patients who were treated 7.8 Viral hepatitis B: clinical aspects by lamivudine. But YMDD mutations of hepatitis B T-S-101 virus gene (HBV DNA) in patients with chronic Comparison between efficacy of ,lamivudine ver. hepatitis B (CHB) untreated with antiviral medicines Interferon in treatment of Hepatitis B was reported in some studies. The aim of this study Mohsen Akhondi-Meybodi1*, Azar Rabei1 was to evaluate YMDD mutations in Iranian Patients 1 Shahid Sadoughi University of Medical Sciences-Yazd, Iran with chronic hepatitis B (CHB) untreated with Introduction: Hepatitis B is a global health problem antiviral medicines. that caucuses cirrhosis and hepatocellular cancer Method: In a cross sectional study,151 adult patients through the world .Because of great health problem with positive Hepatitis B surface antigen (HBs Ag) treatment of hepatitis B is important. We evaluated (78 asymptomatic hepatitis B virus carriers, 73 active the effect of lamivudine and interferon in the chronic hepatitis B patients or cirrhosis patients) were treatment of hepatitis B wild type and precormutant evaluated for YMDD mutants. The patients who were variant in Yazd 2007-2010. treated with interferon in recent one year and Method: Patient with chronic hepatitis B who has Lamivudine or Adfovier before the study were elevated liver enzyme two times than normal ,who excluded. YMDD mutations of HBV DNA were last from six month and elevated HBV DNA included detected by PCR-RFLP (PCR Restriction Fragment .Patients who treated previously or have co-infected

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Length Polymorphism) in single laboratory. AüòÆpfG¿õoR@üñlûâpôGílRüàuBëGpoôÿOíBìþGýíBoAó Gpouþ: oô} Results: The mean (±SD) of age of patients was 37±4 ìpAWÏúÞññlûGúÞéýñý¼âõAo}GýíBouPBðùBÿkAðzãBøþÚBDî(ÎY)ôAìBïoÂB years. Eighty one (54%) were male and 70(46%) ìñ×þGõkðl,AðXBïKnüpÖQ.uÇõf gAeBH ìrìòGB B (Ñ)ÞúìHPçGúøLBOýQ were female. Eight cases (5.3%) out of 151 had ôGúoô}Oßíò¾õoRKnüpÖQ.AoOHBÉ TR-RCP upìþGBoôüpôuþVBHOõuÈ YMDD mutations. The type of mutation in all of GýòGBoôüpôuþ,øývPõKBOõèõsÿÞHlô@ðrüíùBÿÞHlÿìõokGpouþÚpAoâpÖQ. these patients was YSDD. There was no significant 051GýíBoyBìê011ìpkô04qóGBìýBðãýòuñþôAðdpAÙìÏýBo44/83ô ðPBüY: relationship between YMDD mutation and viral load and HDV Ab (p>0.05). ðúOñùBGBkoWúGBÖQyñBuþøíHvPãþìÏñþ TSA 43/11ôAokìÇBèÏúylðl. Conclusion: The mutant strains of the YMDD motif ôÂpüIøíHvPãþKýpuõó=4/0),GéßúGBìpcéú

p (1000 F-T-103 GBOÏlAkÞLþôüpôxkoìýéþèýPpAoOHBÉìÏñþkAoÿoAðzBóðlAk. TSA ô TLA üBÖPúøBÿøývPõKBOõèõsüà,ôüpôèõsüàôGýõyýíýBDþ GBèãBoüPîOÏlAkÞLþøBÿôüpôx TSA ô TLA )AìB p ô214/0= p (GúOpOýI80/0= ìñ×þ E ìrìòGB@ðPþsó B koìHPçüBóGúøLBOýQ ueO¿íýî )uÇe

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1 Digestive Disease Research Centre, Tehran University of of Medical Sciences Medical Science Introduction: Acute hepatitis C infection usually 2 Biochemistry Department, Tabriz University of Medical ends in chronic infection, while in a minority of Science patients it is spontaneously cleared. The current 3 Epidemiology and social medicine department, Ilam Uni- population-based study is performed on a large cohort versity of Medical Science in Golestan province of Iran to examine the 4 Gastroenterology Department, Tabriz University of Med- ical Science demographic correlates of Spontaneous Hepatitis C Introduction: B cells represent as much as half of the Clearance. Method: intrahepatic lymphocyte population. IgD is expresses Serum samples used in this study had been on mature B cells and it is not well understood stored in biorepository of Golestan Cohort Study. whether IgD-positive B cells are phenotypically These samples were evaluated for anti hepatitis C different with the stage of chronic hepatitis B. APRIL Virus by third generation Enzyme-linked (a proliferation-inducing ligand, TNFSF 13a) is a immunosorbent assay (ELISA). Subjects who tested member of the TNF superfamily that has positive were then invited and tested by Recombinant co-stimulatory activity on B cells. Immunoblot Assay (RIBA) and Ribonucleic Acid Method: IgD expression in liver biopsy has been Polymerase Chain Reaction test (PCR). If tested carried out by immunohistochemisty and serum positive for RIBA, subjects were recalled and the two APRIL was performed with ELISA on 57 patients tests were re-done after 6 months. Those subjects who with chronic hepatitis B. again tested positive for RIBA but negative for PCR were Results: The intensity and extended of IgD marked as cases of spontaneous clearance (SC). Results: expression was scored and there was no difference in 49,338 serum samples were evaluated. The phenotypic expression of IgD receptor on B cells prevalence of Chronic Hepatitis C Virus (CHCV) in- between all patients. We found a positive correlation fection based on PCR results was 0.31%. Among between serum ALT, liver fibrosis stage and liver IgD those who had acquired hepatitis C, the rate of SC expression with HBV DNA level (r= 0.4, p=0.001; r= was 38%. In multivariate analysis, illicit drug use 0.4, p=0.002 and r= 0.3, p=0.01). Liver IgD expres- both Injecting Use (OR=3.271, 95% CI: 1.784-6.000, sion revealed negative relationship with serum p-value<0.001) and Non-Injecting Use (OR=1.901, APRIL but positive with liver fibrosis stage (r= 95% CI: 1.068-3.386, p-value=0.029) were −0.26, p=0.04 and r= 0.27, p=0.03). significant correlates of CHCV infection versus SC. Conclusion: Conclusion: Our preliminary results suggest Illicit drug use whether intravenous or decreased serum APRIL levels in chronic hepatitis non-intravenous is the only significant correlate of patients in accompany with increased intrahepatic CHCV, for which several underlying mechanisms can IgD-positive B cells associated with higher stage of be postulated including repeated contacts with liver fibrosis. hepatitis C antigen. Send Date: 2011/07/23 Send Date: 2011/08/01

Category: 7 LIVER Category: 7 LIVER 7.9 Viral hepatitis C: clinical aspects 7.9 Viral hepatitis C: clinical aspects F-T-105 F-T-106 The Impact of Illicit Drug Use on Prevalence of Hepatitis C in Multi transfused Spontaneous Hepatitis C Clearance: Experience Thalassemia major patients in Thalassemia from a Large Cohort Population Study clinic of Amol in 1363- 1383 1 Hossein Poustchi1*, Saeed Esmaili1, Ashraf Mohamad- Farhad Zamani1*, Masoumeh Eslami ,Hossein 1 1 khani1, Aghbibi Nikmahzar1, Akram Pourshams1, Sadaf Ajdarkosh , Mahmoud reza Khansari 1 Ghajarieh Sepanlou1, Shahin Merat1, Reza Malekzadeh1 Gastrointestinal,Liver and Digestive Diseases Research 1 Digestive Diseases Research Center, Tehran University Center (GILDRC), Tehran University Of Medical Sci- ence,pardis hemmat, Tehran, Iran

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Introduction: This study attempts to evaluate sero- virological response (SVR) to pegylated interferon prevalence of Hepatitis C(HCV) , Hepatitis B(HBV) (PEG-IFN) and ribavirin therapy. The objective of and Human immunodeficiency Virus (HIV) among this study was to evaluate the durability of the patients with β-Thalassemia major receiving multiple virological response in these patients after 5 years of transfusions in Amol thalassemia center. follow up. Method: This is a cross-sectional study in which 371 Method: Thirty five patients (34 male) with mean age Talassemia major patients were assessed for HCV Ab of 26.20±8.48 (13-48y) were treated with PEG-INF (by ELISA 3rd generation ), HBs Ag and HIV Ab . alfa 2a and ribavirin for 48 weeks from 2002 to 2003 Patients with positive HCV Ab were checked for in Iranian Hemophilic Center. HCV genotype HCV –RNA and positive cases were considered as determination was done in 20 patients of whom 12 true infection .Patients were divided into 2 groups were 1a (60%), 4 were 1b (20%) and 4 were 3a (before and after 1375) and the seropositivity of (20%). 33 patients accomplished the treatment and Hepatitis C was checked separately in order to SVR was achieved in 27 patients (81.8%). Patients evaluate the efficacy of donor blood screening with SVR were followed for the next 5 years. program which started in 1375. Results: Twenty five of 27 patients were available for Results: HCV Ab and HCV – RNA were positive in 5 year follow up. HCV PCR was negative in all of 168 (45.3%) and 118 (31.8%) cases respectively . these patients and no evidence of clinical or Before 1375,HCV- Ab was positive in 53.4% and biochemical relapse was detected.None of the HCV-RNA in 37.5% of cases in contrast with , 16% patients developes hepatocellular carcinoma. and 11.1% respectively after 1375. There were 2 Conclusion: This study reveals that combination positive HBs-Ag (0.53%) cases.None of the patients therapy with PEG-INF and ribavirin in hemophilic had positive HIV Ab .In spite of significant chronic hepatitis C patients has been associated with decrement of HCV infection after the screening a high rate of SVR (81%) and 100% durability of program( P-V <0.005) , it is still high in comparison virological response with no clinical relapse. These with other countries (16% versus 0.1%). data provoke the hypothesis that SVR is probably Conclusion: The sensitivity of HCV Ab ElISA must associated with HCV infection cure in this group. be improved or more sensitive and specific pre-trans- Send Date: 2011/08/05 fusion screening tests (HCV-RNA) should be intro- duced in blood banks. Send Date: 2011/08/03 Category: 7 LIVER 7.9 Viral hepatitis C: clinical aspects F-T-108 Category: 7 LIVER Peginterferon alfa-2a plus ribavirin for 7.9 Viral hepatitis C: clinical aspects treatment of hepatitis C infection in hemophilia F-T-107 and thalassemia patients (preliminary report) Long term outcome of sustained viral response Mohammad Reza Fattahi1*, Faezeh Sadeghian2, in hemophilic patients with chronic Hepatitis C Farzan Abdolahi3, Samaneh Mahmoodi3, Sara Japoni1 Siamak Khaleghi1*, Salma Ahi1, Shahin Merat2, 1 Gastroenterology and Hepatology Research Center, Mahshid Talebi-Taher1 Shiraz University of Medical Sciences, Shiraz, Iran 2 1 Gastrointestinal & Liver Disease Research Center Department of Internal Medicine, Shiraz University of (GILDRC), Firoozgar Hospital, Tehran University of Medical Sciences, Shiraz, Iran 3 Medical Science,pardis hemmat, Tehran, Iran Medical School, Shiraz University of Medical Sciences, 2 Shiraz, Iran Digestive Disease Research Center(DDRC), Tehran Uni- Introduction: versity of Medical Science, Tehran, Iran Hemophilia and major thalassemia Introduction: There are few published data regarding patients who receive regular blood transfusions are long-term outcome of hemophilic patients with highly susceptible to chronic hepatitis C virus (HCV) chronic hepatitis C(HCV) who obtain sustained infection, which results in great morbidity and increased mortality. Peginterferon alfa-2a plus

64 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 ribavirin is the standard regimen for treatment of Abbas Arj1*, Mohsen Razavizadeh1, Kamal individuals with chronic HCV infection, but there is Esalatmanesh1, Alireza Moravveji2,ShahrzadKarimi1 limited evidence of its effectiveness in hemophilia 1 Department of Internal Medicine, Kashan University of and major thalassemia patients. Medical Sciences 2 Method: A single center prospective cohort study was Department of Community Medicine, Kashan University of Medical Sciences done from 2009 through 2011. A total of 51 patients, Introduction: Chronic hepatitis is a variety of liver aged 16-53 years, chronically infected with HCV, dysfunctions with different causes and severities in anti-HCV treatment naive or previously treated, and which inflammation and necrosis last for at least 6 seronegative for human immunodeficiency virus months. Choice treatment for all chronic viral (HIV) and hepatitis B virus (HBV) were included. hepatitis is interferon Alpha (IFN-α). Decreasing The subjects had absolute neutrophilic counts of at bone mass density (BMD) may lead to some least 1500/mm3, hemoglobin ≥12g/dL and platelet complications such as non-traumatic spontaneous counts of ≥100,000/mm3. They did not have liver cir- fractures. Regarding the decreased bone mass rhosis, hepatocellular carcinoma, and were not complications and existed dilemma, we have done the affected by any other liver diseases. HCV genotype 1 current study to compare the BMD in chronic and genotype non-1 infected subjects received hepatitis patients before and after the IFN-α treatment. weekly subcutaneous peginterferon alpha-2a and Method: In a cohort study 22 patients with chronic weight adjusted daily oral ribavirin for 48 and 24 hepatitis need to treat with IFN-α were evaluated by weeks, respectively. Negative HCV RNA at the end BMD in a 6 months period. All the patients were ex- of treatment was considered to be the end of amined by BMD before the treatment. The BMD re- treatment response (ETR). Negative HCV RNA at 48 sult was recorded in information sheet. Six months weeks (genotype 1) and 24 weeks (genotype non-1) after the treatment patients were evaluated again by post-treatment was considered as sustained BMD. All the necessary information such as age, sex, virological response (SVR). co-morbidity and another medication history were Results: 26 hemophila and 25 thalassemia patients asked and recorded. IFN-α dosage was 3 million IU were enrolled. Eight subjects were lost at follow-up 3 times a week. The gathered data were entered in each group. ETR was achieved in 12 of 18 (67%) SPSS14 and analyzed through Chi-Square and of hemophilia and 14 of 17 (82%) of thalassemia Wilcoxon to compare the means. patients. SVR was achieved in 12 of 18 (67%) and Results: Among 22 patients 21 subjects (95.5%) were 14 of 17 (82%) of hemophilia and thalassemia male and 1 subject (4.5%) was female. Mean age was patients, respectively. No Relapse after ETR was 34.04±7.83 years and half of the subjects were in 30 seen. ETR and SVR were not significantly higher in to 35 years age group. The subjects had not thalassemia patients. Genotype, previous treatment, significant difference in bone mass density indices and age were not statistically significant independent (Z-score and T-score) before and after treatment with predictive factors for ETR or SVR. IFN-α (P-value>0.05). The bone mass density indices Conclusion: Efficacy of treatment of hemophilia and had not significant difference between different age thalassemia patients with peginterferon alfa-2a plus groups of hepatitis C patients before and after ribavirin is similar to that in the general population treatment with IFN-α (P-value>0.05). with chronic HCV infection. Conclusion: In the current, as mentioned above, Send Date: 2011/08/17 IFN-α used in the treatment of Hepatitis C patients, had no significant effect on the BMD in them. To Category: 7 LIVER evaluate the long term effect of IFN-α its suggested to 7.9 Viral hepatitis C: clinical aspects do more studies with longer duration, however, the F-T-109 BMD may improve when the inflammation been Relationship between interferon Apha alleviated long term. and bone mass density in hepatitis C patients Send Date: 2011/08/21

Govaresh\ Vol.16\ Supplement\ Autumn 2011 65 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Category: 7 LIVER Abdolrahim masjedizadeh1, Aliakbar shayesteh1, 7.9 Viral hepatitis C: clinical aspects Maryam Belladi behbehani1 F-T-110 1 GI ward, Ahvaz Jondishapoor university Introduction: Is statin effective in treatment Autoimmune hepatitis (AIH) is defined of hepatitis c patients with genotype 1 as a kind of recurrent and unresolving hepatocellular Ahmad Shavakhi1, Mohammad Minakari1, inflammatory process with unknown etiology. It is a Naser Khamisi1* growing diagnosis in the setting of liver diseases in 1 Alzahra Hospital, Isfahan University of Medical Sciences Iran. there is limited data on the epidemiology and Introduction: Statins my be helpful in treatment of clinical course of AIH in our region . so we studied non alcoholic steatohepatitis.we assessed the effect clinical and epidemiologic characteristics of patients of Statins in combination with standard antiviral who diagnosed in GI and hepatology ward and clinics treatment on Hyperlipidemic genotype I HCV of Ahwaz jondishapoor university during 2005 to patients who had been referred to educational and 2009 . Therapeutic Centers of Isfahan University of Medical Method: In this study the demographic and clinical Sciences from 2009-2010. and histological characteristics of patient with AIH Method: Our study was a prospective clinical trial. were studied .The lag time between first presentation All samples (n=40) were tested to confirm HCV to diagnosis and its relation to the severity of disease viremia( Cobas Amplicor HCV Monitor test, version evaluated also .The diagnosis of AIH made according 2 Roche Diagnostics). patients weekly received 180 to the scoring system of International autoimmune µg PEG-INFa2a(Pegasys, roche Company) and hepatitis group. ribaverin. 20 Hyperlipidemic hepatitis c Patients Results: A total of 106 patients (77 women and 29 received 20 mg Atorvastatin (Farabi co,Tehran Iran) men) was eligible for inclusion. the mean age was nightly for three months and placebo was prescribed 34.8 y (9-62 y) . the most common presenting for 20 control patients. Liver enzymes, CBC were symptom was fatigue (66.9 %) fallowed by loss of checked monthly and TSH checked every three appetite (55.6 %), Icter (50.9%) and abdominal pain. months. We also did quantitive HCV-RNA test in 4th, 17.9 % of our patients presented with evidences of 12th week of therapy, at the end of treatment and 6 liver cirrhosis. 15 patients (14.1%) had overlap months after therapy for all samples. syndrome the most and common one overlap disease Results: We didn’t find any significant differences in was PBC. 17 patients (16%) shows other the mean of HCV-RNA numbers in case and control autoimmune disorders among them lupus disease was groups in 4 th, 12th week of treatment, in the end of the most common one. According to the duration of treatment and 6 months after treatment. In this study diagnosis after first presentation The patients divided early response to treatment (EVR) in case and control into two groups: 1- early diagnosed (less than 6 mo) were 80 and 70 % and end of treatment response were and 2- late diagnosed (after 6 mo). The degree of 90 and 95%. Sustain response to treatment (SVR) in fibrosis was compared in the two groups. in early case and control were 95 and 95% respectively. diagnose group 45% had stage ≤ 2 , 45% had stages Conclusion: There was no effect of statins on the 3 0r 4 and 9,1 % had stages > 4 of fibrosis scores . in mean of HCV virus number in this analysis. Further the late diagnosis group 28% had stages ≤ 2 , 17 % studies are necessary to examine the possible antiviral had stages 3 or 4 and 53, 6% had stages > 4 properties of statins and their potential role as (p=0.001). Inflammatory indices in biopsy samples adjuncts to standard HCV therapy. (grading) was not different between two group Send Date: 2011/08/22 (p=0.97). After starting therapy normalization of Category: 7 LIVER transaminases was achieved after 3.3 mo in early and 7.10 Immunology - autoimmune liver disease after 3.1 mo in late diagnosed group (p=0.82). F-T-111 Conclusion: Autoimmune hepatitis is not an Epidemiologic features of uncommon disease in our region .The manner of autoimmune hepatitis in Ahwaz presentation is the same as other regions. Early Seyed Jalal Hashemi1*, Eskandar Hajiani1,

66 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 diagnosis is very important to prevent complications. group was 21.18±16 months. In MMF group we had Treatment is effective even in cases with advance 207 patients that 140 were responded to the drug. The fibrosis. efficacy of MMF was 71.6%.The mean follow up Send Date: 2011/07/16 period in this group was 34.24±8.31 months. Conclusion: Tacrolimus and Mycophenolate Mofetil is effective and well tolerated by patients with Category: 7 LIVER autoimmune hepatitis who do not respond to, or are 7.10 Immunology - autoimmune liver disease intolerant of, conventional immunosuppressive F-T-112 agents, and can be alternative choices for The Efficacy of Tacrolimus and Mycophenolate conventional therapy. Mofetil in Refractory Autoimmune Hepatitis: Send Date: 2011/07/21 Systematic Review and Meta-Analysis Mohammadhossein Somi1*, Mohammadreza Abdollahi1, Samaneh Esfahanian1,Aysan Category: 7 LIVER Gasemi Oskouyi1, Morteza Ghojazadeh2 7.10 Immunology - autoimmune liver disease 1 Liver and Gastrointestinal Diseases Research Center, F-T-113 Tabriz University of Medical Sciences 3 years Survival of Autoimmune hepatitis 2 Physiology Department, Tabriz University of Medical patients referring to Rasool Akram hospital Sciences Introduction: Conventional treatment of and Tehran Hepatitis Center 2004-2010 1 2 autoimmune hepatitis consists of either prednisone Amir-hossein Faghihi , Seyed-Moayed Alavian , Seyedeh-Hoda Alavian2* alone or in combination with azathioprine. Ten to 1 Gastrointestinal & Liver Disease Research 20% of patients do not respond to or are intolerant of Center(GILDRC),Firoozgar hospital, Tehran University of this treatment. Novel drug treatments include Medical Sciences immunosuppressive drugs such as tacrolimus (TAC), 2 Gastrointestinal & Liver Disease Research Center, mycophenolate mofetil (MMF), methotrexate and Baghiat-allah Hospital, Tehran University of Medical cyclosporine. So we conducted a systematic review Sciences of the literature to determine the efficacy of Introduction: Autoimmune hepatitis (AIH) is rela- tacrolimus and mycophenolate mofetil in the tively common among chronic liver disease patients treatment of steroid refractory autoimmune hepatitis. (11-23%) and is responsible for 6% of all liver trans- Method: All published articles from 1978 up to 2011 plantation worldwide. There are few studies concern- that were related to the topic were searched from the ing factors affecting these patients survival. This resources. We also conducted a manual search of the study aimed to examine AIH patients’ survival and reference lists in the review articles. The censor date its related factors. was up to April 2011. The inclusion criteria used were Method: In this historical cohort study records of all articles on patients with autoimmune hepatitis that patients diagnosed as AIH via serological were resistant to conventional therapy and then had examinations, biopsies and ruling out other our choice therapy. All calculations and statistical differential diagnosis, referring to Rasool Akram tests were performed using CMA ver.2.0 software. hospital and Tehran Hepatitis Center were evaluated. Results: 12 related articles involving 230 patients that Patients with a history of medicine administration fulfilled our inclusion criteria were selected to be before definite diagnosis of AIH as well as those who considered in the Meta-Analysis. There were three were on other treatment regimens than our standard articles about tacrolimus and nine were about treatment regimen for AIH were excluded. mycophenolate mofetil. The mean age in TAC group Information regarding clinical conditions, laboratory was 56.39±4.13 years and in MMF group was data (AMA, ALKM-1, ASMA, ANA) and pathologic 44.16±1.27 years. In TAC group we had 23 patients studies of all patients were assessed before and 3 that 19 were responded to the drug. The efficacy of years after beginning of the treatment.According to TAC was 83%.The mean follow up period in TAC their AST level, patients were divided into 5 groups:

Govaresh\ Vol.16\ Supplement\ Autumn 2011 67 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 remission, responsive, relapse, nonresponsive and and drug hepatotoxicity for allogeneic BMT and drug completely nonresponsive. hepatotoxicity for autologous BMT. Fulminant Results: 87 patients (72 females, 15 males) with the hepatic failure occurred in 5 allogeneic transplant mean age of 33.5 years were enrolled. The mean time recipients who had a pretransplantation HBV carrier interval between start of the symptoms and definite and led to death. Multivariate regression analysis diagnosis was 7.84 months. Coincidence of other showed that the age of patients underwent BMT, autoimmune disease was seen in 18.4% of the fever, immunosuppressive therapy and the use of patients. The 1, 6, 12, and 18 months survival non-absorbable antibiotics were predictive risk probability of AIH patients were 67.4%, 91.1 %, factors for post-BMT liver injury. 94.1% and 95.6% respectively. None of the clinical or Conclusion: Early diagnosis and proper treatment of laboratory variables had a significant relation with sepsis, cautious use of non-absorbable antibiotics and these patients survival. immunosuppressive agents may have an important Conclusion: In summary clinical and laboratory role for the prevention of post-BMT liver injury. characteristics of AIH patients in our study were Send Date: 2011/07/12 similar to those in other countries. We propose more investigations to be done regarding time of relapse of AIH patients and their survival. Category: 7 LIVER Send Date: 2011/08/22 7.12 Imaging - radiology (incl. interventional radiology) F-T-115 Category: 7 LIVER Doppler Parameters in Cirrhotic Patients 7.11 Acute liver failure - transplantation/surgery with and without Esophageal Varices F-T-114 Fariborz Mansour-Ghanaei1*, Ahmad Alizadeh1, Causes and Risk Factors for Liver Injury Afshin Shafaghi1, Kambiz Akhavan Rezayat1, Following Bone Marrow Transplantation Farahnaz Joukar1, Reyhane Jafarshad1 1 Rasoul Sotoudehmanesh1*, SA Moosavi1, Gastrointestinal & Liver Diseases Research Center Ebrahim Sarsar1, Maryam Farsinejadmarj1 (GLDRC) , Guilan University of Medical Sciences Introduction: 1 DDRC, tehran university of medical sciences Portal hypertension is one of cirrhosis Introduction: Liver injury is one of the major causes complications that leads to gastroesophageal varice of morbidity and mortality following bone marrow formation. Bleeding from these varices has a high transplantation (BMT). Determination of the factors mortality rate. Upper gastrointestinal endoscopy is that are likely to lead to liver injury may allow earlier the gold standard procedure for varice diagnosis. diagnosis after BMT and may possibly its prevention There are some efforts to substitute endoscopy with and finally improve the prognosis. noninvasive procedures including splenoportal Method: In this retrospective study, the risk factors doppler. The aim of this study was to compare predisposing to liver injury following bone marrow doppler findings in cirrhotic patients with and without transplantation was evaluated. Medical records of esophageal varices. Method: BMT patients were reviewed, and results of serial 66 patients with documented cirrhosis were liver function tests and HBV/HCV serology during enrolled in our cross sectional study. All patients the pre- and post-transplantation with 1-year follow underwent endoscopy and an informational form was up period were noted. Presence of liver injury was completed. Subsequently all of them referred to one assessed and analyzed in 167allogeneic and 50 radiologist to undergo splenoportal doppler. autologous BMTs, performed during 3 years. Laboratory information including platelet count was Results: One-year survival was 85.7% (222 of 259 taken. Results: patients) for allogeneic BMT and 98.1% (104of 106 Of 66 patients, 44 were men. 46 patients had patients) for autologous BMT. The most frequent esophageal varice. There was no significant relation causes of liver injury were graft-versus-host disease between esophageal varices and any of doppler parameters. A negative correlation was found

68 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 between platelet count and spleen diameter and 8.5±2.8, P value of Mann-Whitney U test<0.05). In splenic vein diameter. A significant relation between HCV PCR positive patients, those patients with varice formation and portal vein velocity (pvv) to moderate to severe iron load had higher TE scores, splenic vein diameter also noted (P=0.05). but this difference did not reach statistical Conclusion: Endoscopy is still a gold standard significance (p-value of Mann-Whitney U test=0.09). procedure for detection of gastroesophageal varices Stage and HAI (histologic activity index) did not in cirrhotic patients. Some splenoportal doppler differ significantly between patients with different parameters (eg: portal vein to splenic vein diameter) iron load degrees while inflammatory grade was seems promising further investigation warranted. significantly higher in patients with moderate to Send Date: 2011/07/23 severe iron load compared to patients with normal or mild hepatic iron load (7.1±3.0 vs. 8.7±3.5, P<0.05).Best model for prediction of ascending Category: 7 LIVER scores of TE in those who had liver biopsy is as 7.12 Imaging - radiology (incl. interventional follow: hepatic iron load, ALT, stage, gender, and radiology) bilirubin (adjusted R squared=.510). ROC curve F-T-116 analysis showed that TE is more accurate for the FibroScan in patients with beta-thalassemia diagnosis of patients with cirrhosis (stage six) than with and without hepatitis C: relation to patients with other stages of liver fibrosis T2*magnetic resonance imaging and liver biopsy (AUC=82%). A cut-off score of 10.55 had a sensitiv- Farhad Zamani1, Hossein Poustchi2*, Masoumeh ity of 80%, specificity of 88.5%, and PLR of 6.95 for 2 3 1 Eslami , Amirhossein Modabbernia , Mehrdokht Najafi diagnosing cirrhosis in HCV PCR positive patients 1 Gastrointestinal & Liver Disease Research Center with beta thalassemia. (GILDRC),Firoozgar Hospital, Tehran University Of Med- Conclusion: Although iron deposition may affect the ical Sciences, pardis hemmat 2 Gastrointestinal & Liver Disease Research Center results of TE in these patients irrespective of other (GILDRC), Tehran University Of Medical Sciences,pardis factors,these changes in TE can be explained via hemmat biopsy parameters, and TE can serves as a promising 3 Digestive Disease Research Center(DDRC), Tehran Uni- noninvasive tool in evaluation of liver fibrosis in versity Of Medical Sciences these patients. Introduction: The primary aim of this study was to Send Date: 2011/08/02 evaluate the effect of iron overload, measured by T2* Magnetic Resonance Imaging (T2*MRI) and liver biopsy in thalassemic patients on the Transient Category: 7 LIVER Elastography(TE) and to determine whether this ef- 7-3 Metabolic/genetic disorders fect is mediated through fibrosis. F-T-117 Method: 81 HCV-RNA positive thalassemic patients Hepatitis C Virus Genotyping among drug and 89 HCV-RNA negative thalassemic patients addicted Patients,Urima, West-Azerbaijan underwent T2*MRI within three months of transient 2 ,ìdílAðõyú 2 ,ðýíBcvýñþWrðþ 2 ,ìpOÃþìPnÞp 1& ìÏ¿õìúyõÞQðÛlû elastography (TE). In addition78 patients from the kAðzãBû,kAðzãBû@qAkAuçìþqðXBó 1 HCV-positive group underwent liver biopsy within kAðzãBû,kAðzãBûÎéõïKryßþAoôìýú 2 three months of TE. All of the patients had laboratory measurement at the time of TE, including blood Introduction: More than 170 million people are count, liver enzymes and liver function tests, ferritin, currently infected by the hepatitis C virus (HCV), lipid profile, and blood sugar. which represents a serious cause of chronic liver Results: In HCV PCR(polymerase chain reaction) disease that may progress to cirrhosis liver and negative patients, TE values were significantly higher hepatocarcinoma. The aim of this study was to in patients with severe iron load than in those with determine the prevalence of HCV among drug users iron loads less than severe (mean± SD, 6.6±4.0 vs. referring to treatment center in Urmia, northwest of

Govaresh\ Vol.16\ Supplement\ Autumn 2011 69 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Iran. Information about genotypes of hepatitis C virus 1 Gastroenterology, Bandar Abbass (HCV) may have important to therapeutic implications. 2 Gastroenterology, Tums Method: A cross sectional study was conducted among 3 Gastroenterology, Sbums Introduction: 384 of drug addicted patients. ELISA testing for HCV Patients with obstructive sleep apnea antibody (HCV- Ab) was carried out. Positive (OSA) are at risk of developing the fatty liver as a anti-HCV samples were tested by RT-PCR. HCV geno- result of being overweight. Several studies suggest types were determined by restriction fragment length that OSA per se could be a risk factor for liver injury; polymorphism of the 5'-untranslated region. and ischemic hepatitis with OSA. The OSA is an Results: Thirty-nine (60.9%) out of 64 independent risk factor for Insulin resistance. anti-HCV-positive were HCV RNA positive. HCV Therefore, we investigated liver enzymes and insulin genotyping by RFLP test showed that genotype 3 was resistance in patients with OSA, and compared with the predominant genotype with 25 cases (64 percent) controls. Method: fallowed by 12 (30.8%) for type 1, and one for type Eighty-one consecutive patients with 2. There was also a case with genotypes 1 and 3. The clinical suspicion of OSA were referred to the Sleep highest percentage of genotype 3 was among Unit of Masih Daneshvary hospital. On the basis of illiterates with 6 (75%). There was no statistical Polysomnography results patients were divided into significant association between residency place and two groups: The OSA and non-OSA cases, and also genotype. The highest proportion of genotype 3 patients without OSA were used as internal controls. belongs to Urmia with 18 cases (58.1%). 28 of HCV The Serum levels of liver enzymes were measured in positive people stated heroin as the most used drug. all patients and abdominal ultrasound examination Opium, Crack and Crystal were the other used drugs. performed for screening the fatty liver and its Genotype 3 was observed among (%60.7) 17 cases grading. Insulin resistance was calculated via home- of heroin users that were the highest percentage. ostasis model assessment (HOMA). Results: However this was not statistically significant. The OSA was present in 41 and absent in 40 Genotype 3 was more prevalent in intra-venous drug patients. Age, sex and body mass indices were not abusers with %68 (among 25 injection drug users significantly different in two groups. The mean of HCV positive. There was no statistically significant alanine aminotransferase (ALT) was 31.24±14.05 IU/L relationship between being injection drug user and in OSA and 29.97±8.9 IU/L in non-OSA (p=0.349) and genotype (P=0.882) aspartate aminotransferase (AST) was 29.07±9.6 IU/L Conclusion: The results show a high prevalence of in OSA and 26.85±6.7 IU/L in non-OSA (p=0.389). HCV infection and predominance of genotype 3 The mean of HOMA was 2.05±18.2 in OSA and followed by genotype 1 among drug users in west 1.5±0.54 in non-OSA (p< 0.001). Conclusion: Azarbaijan. These findings highlight the need for This study shows that OSA, independent harm-reduction strategies to reduce HCV transmission. of overweight conditions, is not a risk factor for OBoüiAouBë:0931/40/72 abnormal liver enzymes. However, the OSA per se seems to be associated with increase in insulin resistance and severity of fatty liver. Send Date: 2011/05/03 Category: 7 LIVER 7-13 Miscellaneous Category: 8 BILIARY F-T-118 8.1 Bile acids-transport-cholestasis Effects of obstructive sleep apnea syndrome on F-T-119 serum aminotransferase levels Study of lipoic acid role in prevention and insulin resistance of liver and intestinal damage due Seyed Hamid Moosavy1*, Hossein Froutan2, Nader Faiazi1, Parisa Adimi3, Yasir Andrabi2, to bile duct obstruction in rat 1* 1 Mohsen Nasiri Toosi2 Mohammad Hossein Somi , Hassan Kalagheichi azar , Ghafour Mousavi2, Nser Ahmadi asl2, Mohammad

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Tghyzadyah3, Ali Khodadady2, Babak Hajypour1 effective against hepatic and intestinal injuries after 1 Liver and Gastrointestinal Diseases Research Center, bile duct obstruction in the rats. Tabriz University of Medical Sciences Send Date: 2011/07/20 2 Department of Veterinary Medicin, Islamic Azad University Tabriz Branch 3 Department of Pathology, Islamic Azad University Tabriz Category: 8 BILIARY Branch 8.2 Gallstones Introduction: There are many ongoing researches F-T-120 emphasizing on the role of free radicals in pathogenesis Concomitant Laparoscopic Common Bile of cholestasis and associated liver damage. This is Duct Exploration as a new Treatment Modality believed to be due to concentrated biliary acids which of CBD Stones in the New Millennium in turn, increase the rate of lipid peroxidation. Shahram Nazari1* Likewise, it is previously shown that the aggregation 1 Erfan Hospital, Tehran of biliary acids may induce lesions in hepatic and Introduction: CBD stones are found in intestinal tissues. So it makes sense that antioxidants approximately 16% of LC. In the beginning of might have a preventive role in this regard. The lipoic laparoscopic era, because of an obvious lack of acid is one the most potent known antioxidants which expertise in laparoscopic surgery, if the diagnosis of has received enthusiasm from the scientist. This study choledocholithiasis was established during IOC, the aimed at evaluating the effect of oral lipoic acid in surgeons preferred postoperative ERCP instead of prevention of bile duct obstruction induced liver and conversion to open surgery. With increasing intestinal damage in a rat model. experience of laparoscopic surgeons, it seemed Method: In this experimental study, 45 Wistar male logical to develop a mini-invasive one-stage rats were randomized in three 15-rat groups: group A laparoscopic approach. (sham) consisted of rats underwent only laparotomy; Method: This study evaluates our results of laparoscopic group B (controls) consisted of rats underwent common bile duct exploration (LCBDE) in a series of laparotomy plus induced-cholestasis; and group C 803 patients treated over 68 months and we evaluate the (intervention) consisted of rats underwent laparotomy feasibility and safety LCBDE during LCs. plus induced-cholestasis and received oral lipoic acid. Results: CBD stones were demonstrated in 98 Lesions of liver and intestine were assessed patients by routine IOC. For 7 patients, ERCP/ES histopathologically as well as the hepatic and was performed, with successful stone clearance after intestinal superoxide dismutase (SOD), glutathione completion of LC. LCBDE was done in 91; all peroxidase (GPX) and malondialdehyde (MDA) 2 LCBDEs were completed laparoscopic. In 21 weeks later. patients, CBD closed on a C-Tube and in 14 com- Results: All the studied variables were significantly pleted with T-tube insertion. In 31 cases no CBD better in group A comparing with groups B and C. drainage was performed. The median hepatic score was significantly lower In 84 cases flexible choledochoscopy was done. (better) in group C comparing with that in group B Laparoscopic choledochoduodenostomy and chole- (5 vs. 11; p=0.001). The median intestinal score was dochojejunostomy was done in 24 and 1 cases comparable between the two groups (2 in group B vs. respectively. The mean operative time was 90-130 1 in group C; p=0.029). The median hepatic SOD (1.7 minutes (mean 95), which is significantly greater than vs. 2.6; p=0.001) and GPX (2.8 vs. 3.6; p=0.009) and conventional LC (range 20-40 minutes, mean 30). the median intestinal SOD (1.2 vs. 2.5; p=0.004) and LCBDE was performed without immediate or late GPX (2.6 vs. 3.3; p=0.014) were significantly higher complications. (better) in group C than those in group B. The median Conclusion: There are no debates in the detection hepatic (2.4 vs. 1.3; p<0.001) and intestinal (2.7 vs. and the management of CBD stones in the era of LC. 1.9; p=0.014) MDA were significantly lower (better) Concomitant LCBDE is a cost-effective, efficient, in group C than those in group B. and minimally invasive modality in the management Conclusion: Based on our findings, oral lipoic acid is

Govaresh\ Vol.16\ Supplement\ Autumn 2011 71 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 of CBD stones. Recommendation: We believe that for Thyroid Stimulating Hormone and T4 were checked surgeons familiar with open common bile duct in both groups. Blood samples from patients were exploration and laparoscopic cholecystectomy, the taken before ERCP was done.Results of tests were next logical step is laparoscopic exploration of the assessed by an expert endocrinologist who was blind common bile duct at the time of cholecystectomy, to both groups. Participants were divided into 5 which is safe and readily mastered. It is hoped that groups according to their thyroid function: Normal, LCBDE will be adopted so that patients can undergo Subclinical hypothyroidism, hypothyroidism, a single procedure to remove their gallstones and subclinical hypothyroidism and hyperthyroidism. common bile duct stones in one approach. If the Results: There were 51 and 38 males and 49 and 62 surgeon is not familiar with this approach of the females in patients and control groups respectively. appropriate instruments are not available, ERCP/ES The mean age and BMI of controls were 43± 13.34 is the treatment of choice. years and 25± 3.67 kg/m2, and 59± 17.44 years and Send Date: 2011/05/15 25± 3.58 kg/m2 for patients. There was a significant relationship between thyroid dysfunction generally and CBD stones prevalence with a p.value of 0.012 Category: 8 BILIARY and OR: 2.4 (CI: 1.25-4.7). Cochoran’s test results of 8.2 Gallstones Gender and DM show that this relation is significant F-T-121 only in men (p =0.002) (30% VS 4%) and non Association between common bile diabetic participants (p=0.027) (17% VS 6.5%). duct stones and Thyroid dysfunctions Although univariate analysis showed a significant Hossein Ajdarkosh1, Mahmoud-reza Khansari1, relation between CBD stone and thyroid dysfunction 1 1 Siamak Khaleghi , Mitra Ameli , but after multivariate logestic regressions the best 1* 1 Farhad Zamani , Mehrdokht Najafi model for predicting CBD stone incidence were gender 1 Gastrointestinal & Liver Disease Research Center (p =0.022), DM (p =0.015) , thyroid dysfunction (GILDRC), Firoozgar Hospital, Tehran University of Medical Sciences,pardis hemmat, Tehran, Iran (p =0.005) and age>50 years old (p<0.001). Conclusion: Introduction: It has been previously shown that T4 To be concluded, CBD stone patients reduces prorelaxation of sphincter of oddi. Besides have a 2.4 fold higher risk of thyroid dysfunction and thyroid dysfunction specialy hypothyroidism affects this risk is much higher in non diabetic men. lipid metabolism and changes bile duct excretion rate. Send Date: 2011/08/16 Recent studies revealed that the prevalence of diagnosed hypothyroidism is significantly higher in Category: 8 BILIARY Common Bile Duct (CBD) stone patients compared 8.3 Malignant hepato-biliary diseases with gall bladder stone patients. This study compares F-T-122 the prevalence of thyroid dysfunction among CBD Biochemical profile and tumor marker stone patients with healthy controls considering in bile fluid of patients with obstructive confounding factors. jaundice for differentiation between Method: 100 patients with CBD stones diagnosed by benign and malignant cholestasis Endoscopic Retrograde Cholangio Pancreatography Javad Shokry-Shirvany1, Yasser Taghavi1*,Hssan (ERCP) at Firoozgar hospital 2010-2011 and 100 Taheri1, Mehrdad Kashifard1, Shahriar Savadkoohi1 controls among the same hospital staff and patients 1 Gastroenterology, Babol University of Medical Sciences admitted for other reasons than CBD stone with Introduction: Diagnostic accuracy of conventional normal Liver Functiom Tests (LFT) were enrolled. method such as CT scan, cholangiography and Pregnancy, carbamazepine and phenytoin cytology is low in diagnosing of cholangiocarcinoma. consumption and having a history of previously We aimed to evaluate the diagnostic value of diagnosed thyroid disease were considered as biochemical profile and tumor marker of bile fluid in exclusion criteria for both groups. Fasting Blood patients with malignant cholestasis in comparison Sugar, Trigelyceride, Cholesterol, LDL, HDL, LFT,

72 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 with cholestasis due to billiary stone. Many different antioxidants have been introduced. Method: Forty six patients with extra hepatic The black grape seed extract is one of these novel cholestasis (26 patients with choledocholithiasis and potent antioxidants. This study aimed to evaluate the 20 patients with malignant cholestasis) were studied prophylactic effect of this substance against PEP in prospectively. Bile fluid was obtained by aspiration candidates of ERCP. through ERCP catheter or percutaneus derainage in Method: In this triple-blind controlled clinical trial, patients with choledocholithiasis and colangiocarcinoma 100 candidates of ERCP were recruited during a 11- respectively. Then concentration of biochemical month period in Tabriz Imam Reza Hospital. These profile: TG, cholesterol, Billirubin, LDH, and CA19- patients were divided randomly into two groups: the 9 of bile fluid was measured in these two groups. intervention group consisted of 53 patients who Results: Bile concentration of TG, cholesterol, HDL, received prophylactic black grape seed extract (six direct bilirubin and CA19-9 were significantly higher 200-mg capsules every 8 hours before ERCP) and 47 in patients with benign cholestasis in comparison controls receiving placebo in the same manner.Then with malignant cholestasis: p=0.001, p=0.001, both groups underwent ERCP.The rate of PEP was p=0.001, p=0.012, and p=0.03 respectively. Serum compared between these two groups. levels of AST, ALT, were nonsignificantly higher in Results: The intervention group was comprised of 16 patients with choledocholithiasis but serum total males and 37 females with a mean age of 63.6±15.2 bilirubine and ALP were nonsignificalty higher in years vs. the controls including 19 males and 28 malignant cholestasis than choledocholithiasis. females with a mean age of 61.4±15.5 years (p=0.284 Conclusion: Our study showed that measurement of and 0.475, respectively). After ERCP, pain or bile fluid level of lipid profile speciallyTG, HDL and exacerbation of epigastric pain was reported in 26.4% direct billirubin may be a useful complementary test and 14.9% of patients in the intervention and control in differentiation between malignant and being groups (p=0.158). Similar rates were 1.9% and 2.1% cholestasis. for the PEP (p=0.722); 22.6% and 21.3% for the Send Date: 2011/07/20 hyperamylasemia (p=0.869); 94.3% and 100% for the “discharge in good condition” (p=0.245); and 3.8% and 0% for expiration (p=0.278), respectively. The Category: 9 PANCREAS mean serum amylase level increased significantly 9.2 Pancreatitis - experimental after ERCP in the control group (p=0.035) with F-T-123 borderline nonsignificant increase in the intervention Black grape seed extract effect in group (p=0.053). prevention of post Endoscopic Retrograde Conclusion: This study showed no benefit for the Cholangiopancreatography pancreatitis pre-ERCP administration of black grape seed extract Seyed-Mohsen Mousavi1, Manouchehr in prevention of PEP; however, it seems that this Khoshbaten2, Mehrdokht Najafi1* 1Gastrointestinal & Liver Disease Research Center (GILDRC), approach may ameliorate the increase of serum Firoozgar Hospital, Tehran University of Medical Sciences, amylase in receiving patients. Tehran, Iran Send Date: 2011/08/10 2 Department of Gastroenterology, Imam Reza Hospital, Tabriz University of Medical Sciences, Tehran, Iran Introduction: Acute pancreatitis is one of the major Category: 9 PANCREAS complications of endoscopic retrograde 9.4 Pancreatitis-chronic (including hereditary pancre- cholangiopancreatography (ERCP), which is known atitis) as post-ERCP pancreatitis (PEP). Although the exact F-T-124 underlying cause of this entity is yet to be determined, Autoimmune pancreatitis mimicking the role of oxidative stress has been emphasized in cancer of the head of pancreas several studies. Accordingly, using an antioxidant Farshad Sheikhesmaili1, Mohammad-Reza substance as a preventive mean seems reasonable. Ghadir2*, Seyed-Saeed Sarkeshikian2,

Govaresh\ Vol.16\ Supplement\ Autumn 2011 73 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Abolfazl Iranikhah2, Fatemeh Attari3 Hadi Ghofrani1, Hossein Forutan1, Nasser 1 Gastroenterology Section, Department of Internal Ebrahimi-Dariani1, Mohammad Jafar Medicine, Faculty of Medicine, Kordestan University of Farahvash1, Mohammad Kalani1, Najmeh Aletaha1 Medical Sciences, Sanandaj, Iran 1Digestive Disease Research Center, Shariati Hospital, 2 Gastroenterology Section, Department of Internal Tehran University of Medical Sciences, Tehran, Iran Medicine, Faculty of Medicine, Qom University of Introduction: Endosonography is a distinct method Medical Sciences, Qom, Iran in evaluating GI structural lesions, particularly 3 Digestive Disease Research Center, Tehran University of Pancreatobiliary system. This procedure has made a Medical Sciences, Tehran, Iran fundamental change in the diagnosis of pancreatic Introduction: The primary presentation of mass lesion through providing fine needle aspiration. autoimmune pancreatitis (AIP) as the cancer of the This study aims at evaluating the results and efficacy head of pancreas is rare in Iran and has not been of EUS-FNA in patients with pancreatic solid mass. reported previously in PUBMED site. Method: The present study which is of a descriptive, Case Reports: The patient was a seventy-year-old prospective and case series nature has been studing man with recurrent abdominal pain and jaundice, patients with pancreatic solid mass referred to Imam elevated Bilirubin and elevated Alkaline Phosphatase Khomeini educational hospital in Tehran for duration (ALKP) in association with the presence of of one year since November 2010. In order to heterogeneity of the head of pancreas and dilated determine the false negative cases, the patients have intra and extra hepatic bile ducts in the abdominal CT been fallowed form 6 to 12 months. scan. The common bile duct stent had been placed for Results: EUS-FNA was carried on all 53 patients him with the diagnosis of the head of pancreas cancer. without any complication .The majority of whom was The patient came back with continuation of recurrent male (68%) and 81% had mass in the head of abdominal pain and normal Bilirubin, ALKP and pancreas. The result of cytopathology revealed 36 tumor markers, but remarkable elevated IgG4 and (68%) Adenocarcinoma, 7 (13%) other malignancy anti nuclear antibody. A biopsy was taken from like N.E.T., 3 (6%) benign lesion like autoimmune heterogeneity of the head of pancreas under the guide pancreatitis and 7 (13%) non-diagnostic cases. The of Endoscopic Ultra Sonography (EUS). Pathologic frequency of non-diagnostic results was significantly samples showed fibrosis associated with high in masses smaller than 3cm (6 vs. 1: p<0.002). lymphoplasmacitic infiltration without the evidence Patients with non-diagnostic result were younger than of malignancy. those with malignant cytopathology (52±7.5 vs. Finally, the patient was placed on the treatment of 66±7.5 years: p<0.001). Sensitivity, specificity, PPV, autoimmune Pancreatitis and the bile duct stent was NPV and accuracy of this procedure concerning taken out. Adenocarcinoma were 88%, 100%, 100%, 70% and Discussion : AIP should be considered in suspected 90%, respectively. cases of cancer of pancreas. So the biopsy of pancreas Conclusion: Overall EUS-FNA was diagnostic in helps us to differentiate these and prevents 87% of cases. EUS-FNA is an effective and safe complications of the disease progression and procedure in histopathologic diagnosis of pancreas unnecessary surgery. tumors. This procedure is recommended in all Send Date: 2011/07/17 pancreatic mass cases including resectable and non resectable ones. Category: 9 PANCREAS Send Date: 2011/08/09 9.5 Malignant disease and endocrine tumors of the pancreas Category: 10 NUTRITION F-T-125 10.2 Nutrients and gut function Diagnostic Yield of EUS- FNA for F-T-126 Patients with Solid Pancreatic Neoplasm The effect of different dietary oils Bijan Shahbazkhani1*, Mahmoud Baghbanian1, on C.rodentium induced Colitis

74 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Ghazaleh Eslamian1*, Azita Hekmatdoost2, expression was very low in all infected groups. Kevan Jacobson3 Conclusion: Our results indicate that in Citrobacter 1 Department of Clinical Nutrition; Student Research rodentium induced colitis model, the lower intake of Committee, School of Nutrition and Food Technology, n-6 to n-3 fatty acids ratio results in the less Shahid Beheshti University of Medical Sciences, Tehran, inflammatory response, whereas the Citrobacter Iran rodentium count is not affected by dietary fatty acid 2Department of Clinical Nutrition, School of Nutrition and Food Technology, Shahid Beheshti University of Medical intake. Future studies are recommended to evaluate Sciences, Tehran, Iran the effect of these dietary oils on transgenic mice to 3Divisions of Gastroenterology, Department of Pediatrics, be able to address the exact mechanism of action of British Columbia Institute for Children's and Women's these oils. Health, University of British Columbia, Vancouver, British Send Date: 2011/07/22 Columbia, Canada Introduction: Increasing evidence suggests that high dietary intake of n-3 fatty acids attenuate the Category: 10 NUTRITION inflammation in chemically induced colitis, but there 10.2 Nutrients and gut function is no study to evaluate the effect of different dietary F-T-127 oils on Citrobacter rodentium induced colitis. The Efficacy of probiotics in lactose aim of this study was to determine the effect of fish intolerance patients in Shiraz, Southern Iran oil, canola oil, and safflower oil on Citrobacter Seyed Jalil Masoumi1*, Davood Mehrabani2, rodentium induced colitis. Abdolamir Barootkoob3, Mohammad Amin Hanifpoor3, Method: Thirty-six mice were fed isocaloric diets Mohammad Sadegh Khosravi3, Fariba Moradi4, 5 6 varying only in fat composition for three weeks Najaf Zare , Mehdi Saberi-Firouzi 1 before and 10 days after Citrobacter rodentium Gastroenterohepatology Research Center/ Department of Nutrition, School of Nutrition and Health, Shiraz inoculation. Mice were randomized into the University of Medical Sciences, Shiraz, Iran following diet groups: a) standard chow diet, or b) a 2 Gastroenterohepatology Research Center/ Stem Cell and semi-synthetic diet, with 20% energy from the Transgenic Technology Research Center, Shiraz University following lipid diets: safflower oil high in 18:2n-6, of Medical Sciences, Shiraz, Iran canola oil high in 18:1n-9 and 18:3n-3, and fish oil 3 Iran Dairy Industries co, Iran Dairy Industries co, Iran high in 20:5n-3, 22:6n-3. Mice were orally inoculated 4 Vice Chancellor for Health Affairs, Shiraz University of with 100µl of wild-type C. rodentium (formerly C. Medical Sciences, Shiraz, Iran freundii biotype 4280), strain DBS100 (n=9/group). 5 Department of Biostatistics,School of Medicine, Shiraz Control mice received 100µl of Luria broth University of Medical Sciences, Shiraz, Iran 6 (n=9/group). The distal colon was assessed for Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran histopathology score, bacterial count, and some host Introduction: The prevalence of lactose intolerance immune response factors. Statistical significance was was reported 3-90 percent in different parts of the calculated using ANOVA followed by post hoc. world. Unabsorbed lactose in large intestine causes P-value of <0.05 was considered significant. digestive problems including bloating, flatulence, Results: Fish oil prolonged the mice survival mildly nausea, diarrhea and abdominal pain. In the recent followed by canola, and safflower oil. While the years, many studies have been done to find a way to bacterial count was similar in all groups, the decrease the symptoms such as prescription of histopathology score was at minimum level in fish oil probiotics. They are live microorganism that have group followed by canola oil, safflower oil, and chow beneficial effects in reduction of symptoms, some diet group (p<0.01). Also, fish oil reduced the diseases and improve the microbial balance of the inflammatory cell recruitment and the epithelial cell host. The aim of this study is to determine the proliferation significantly (p<0.01). IL-10 was efficacy of probiotics in patients with lactose expressed at similarly low levels in colon tissues intolerance in Shiraz, Southern Iran. taken from uninfected mice, and IL-6 gene Method: 54 Referral patients from Motahari Clinic

Govaresh\ Vol.16\ Supplement\ Autumn 2011 75 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 or Gastroenterology Research Center of Shiraz developed lethargy, floppiness and mechanical University of Medical Sciences were enrolled. The ventilation was started due to respiratory distress. patients were asked to eat 20 g lactose and after 30 Treatment with NTBC was introduced again and minutes until 3 hours were examined for lactose abdominal respiration continued. After 72 hours, he intolerance using a breath hydrogen test. The clinical received liver transplantation but developed and demographic information of all patients were respiratory arrest and expired. Patient B: A 3.5 years recorded. Probiotic yogurt was administered for old healthy boy developed abdominal protrusion patients with lactose intolerance symptoms for 3 since 8 months of age. After 6 months hepatomegaly weeks and again underwent the breath hydrogen test was detected. NTBC medication was started (Group 1). A control group was considered of patients immediately after diagnosis of tyrosinemia type1. with lactose intolerance symptoms but received a After NTBC interruption by the parents, the patient non-probiotic yogurt identically. developed respiratory insufficiency and diaphrag- Results: In patients of control group, the breath matic paralysis, and mechanical ventilation was im- hydrogen test did not show any significant change but mediately started. Treatment with NTBC was started in the other group, the change was statistically again. The patient developed partial improvement significant (p=0.011). and slowly regained normal neurological functions Conclusion: It seems that probiotics may be effective and recovered after 2 months. Patient C: A 2 years in treatment of lactose intolerance based on breath old boy was referred to a pediatric hepatologist at his hydrogen test. A longer time of follow up may 1st month of age due to nausea, vomiting, fever, di- provide the opportunity to follow the symptoms too. arrhea, abdominal protrusion and Cholestasis. After Send Date: 2011/08/12 receiving paraclinical results tyrosinemia was diag- nosed. NTBC treatment was introduced at 6 months of age. Before admission NTBC treatment was inter- Category: 10 NUTRITION rupted by his parents. Subsequently after 3 weeks, he 10.2 Nutrients and gut function developed abdominal pain, irritability, muscle weak- F-T-128 ness, diaphragmatic paralysis and two episodes of case report: Severe Neurological Crises after tonic generalized convulsion. After admission due to Interruption of NTBC Treatment in 3 respiratory failure, intubation and mechanical Patients with Hereditary Tyrosinemia Type 1 ventilation was started and NTBC medication was Naser Honar1*, Mohsen Dehghani1, Mahmood introduced again. After 2 weeks mechanical 1 1 1 Haghighat , Mohammad-Hadi Imanieh , Sara Japoni ventilation was stopped but NTBC treatment 1 Gastroenterology and Hepatology Research Center, continued. The patient finally regained normal Shiraz University of Medical Sciences, Shiraz, Iran neurological functions and recovered. Introduction: Tyrosinemia type 1 is a hereditary Discussion: Before the NTBC era, 42% of children disorder that results from deficiency of the enzyme with tyrosinemia type 1 developed neurologic crises. Fumaryl acetoacetate hydroxylase. This disorder NTBC abolishes hepatic and neurologic involves multiple organs including liver, kidney and complications and protects against the development peripheral nerves. Studies indicate that the outcome of hepatocellular carcinoma with treatment within the and prognosis of tyrosinemia type 1 significantly first months of life. A report demonstrated that improves after introduction of NTBC [2-(2-nitro- interruption of NTBC treatment in one patient 4-trifluoro-methyl-benzoyl)-1,3 cyclohexanedione]. developed acute neurologic crises and concluded that Case Reports: Patient A: A 2.5 years old boy was discontinuity of medication in tyrosinemia type 1 presented with hepatomegaly since 8 months of age. patients can be life threatening. The current report NTBC was started at the age of 8 months. The patient indicates interruption of NTBC can induce severe was referred to Pediatric Gastroentrology and neurologic crises, diaphragmatic paralysis and even Hepatology ward at Nemazee hospital, Shiraz for pre death. In conclusion, due to the side effects caused transplant evaluation. During this time, his parents by the interruption of NTBC, parents and family mistakenly discontinued NTBC treatment. Finally he

76 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 members should be informed to consult their physician before discontinuing the medication. Send Date: 2011/08/17 Category: 13 ONCOLOGY-BASIC 13.2 Molecular biology/genetics/pathology F-T-130 Category: 10 NUTRITION Modeling genetic determinants of nucleotide 10.2 Nutrients and gut function excision repair and PAH-DNA adduct level F-T-129 among non-smokers in a high risk area for Vit B12 deficiency, a real esophageal squamous cell carcinoma problem in elderly in Shiraz Arash Etemadi1*, Farhad Islami1, Frederik-Jan van Mohammadhassan Kazemi1*, Kamran Bagheri Schooten2, David Phillips3, Akbar Fazel-Tabar Lankarani1, Seyed Alireza Taghavi1, Malekshah1, Akram Pourshams1, Paolo Boffetta4, Laleh Hamidpour1 Christian Abnet5, Reza Malekzadeh1, Sanford Dawsey5 1Gastroenterohepatology Research Center (GEHRC), Shi- 1Digestive Disease Research Institute, Tehran University raz University of Medical Sciences, Shiraz, Iran of Medical Sciences, Iran Introduction: Vit B12 deficiency is common in 2Department of Health Risk Analysis and Toxicology, elderly population. That is due to malabsorption of Maastricht University cobalamine in food. This deficiency can induce some 3Section of Molecular Carcinogenesis, Institute of Cancer problem such as hematologic and neuropsychiatric Research 4 disorder, with non-specific signs and symptoms. The Tisch Cancer Institute, Mount Sinai School of Med- icine Therefore in elderly population, B12 deficiency is of 5Division of Cancer Epidemiology and Genetics, National the important differential diagnosis that every Cancer Institute physician should pay attention. To see prevalence of Introduction: The aim of this study was to develop a deficiency of cobalamine in subjects over 50 years genetic model to explain inter-individual variability old in our region. in the blood level of polycyclic aromatic hydrocarbon Method: From 340 subjects over 50 years old, that (PAH)-DNA adducts and nucleaotide excision repair chase randomly from all area over the city, Shiraz, (NER) capacity. 5cc whole blood was taken in fasting condition. Then Method: Among participants in the Golestan Cohort serum was separated and stored at minus 20 cc. Study, 111 female non-smokers were randomly Serum folate and cobalamine was measured by selected. Twenty-one SNPs in 14 genes related to radioimmunoassay and homocystein was determined xenobiotic metabolism and 13 SNPs in 9 DNA repair by ELISA. We consider serum cobalamine level genes were studied. NER capacity was evaluated by below 200 pg/ml as deficient and below 100 pg/ml the comet assay, and DNA adduct level was measured as severe deficiency with clinical significance. Serum by 32p-postlabelling. Multivariate regression was homocystein over 21.3µmol/ml is also considered as used to assess the simultaneous effects of the number abnormal. of mutant SNPs in each gene, NER capacity, and Results: Cobalamine level was below 200 pg/ml in environmental exposures on the PAH-DNA adduct 36.2%, and below 100 pg/ml in 12.4%.Cobalamine levels. Models were compared by Akaike’s deficiency plus metabolic evidence (cobalamine information criterion (AIC). below mean and homocystein over 21.3 µmol/ml) Results: The model including environmental were seen in 5.25% of samples. exposures, phase 1 xenobiotic metabolism SNPs and Conclusion: Prevalence of cobalamine deficiency is NER capacity had the lowest AIC. Among all SNPs, 36.2% and severe deficiency of cobalamine with NA2 (b=-0.21; p<0.05), myeloperoxidase (b=-0.17; clinical significance is 12.4% in subjects over 50 p<0.05) and ERCC-5 genes (b=0.15, p<0.05) had years old in city, Shiraz. Therefore prevalence of significant associations with PAH-DNA adduct cobalamine deficiency is high in elderly and should levels. NER capacity itself was affected by a be considered in clinical practice. polymorphism in the methylenetetrahydrofolate Send Date: 2011/08/18

Govaresh\ Vol.16\ Supplement\ Autumn 2011 77 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 reductase gene (b=0.41, p<0.01). and Fluorescence Activated Cell Sorting (FACS) Conclusion: A combination of environmental factors, techniques. number of polymorphisms in phase 1 xenobiotic Results: RT-PCR data show that CXCR4 is highly metabolism genes and DNA repair capacity can best expressed on AGS cells. This was confirmed by IHC explain inter-individual variability in PAH-DNA and FACS as CXCR4 is detected in cell membrane adduct levels. and cytoplasm of AGS cell line. More importantly, Send Date: 2011/07/24 we found that CXCR4 is strongly expressed on primary gastric cancer cells from patients, but not on normal gastric cells from normal individuals (as Category: 13 ONCOLOGY-BASIC detected by IHC staining and RT-PCR). Furthermore, 13.2 Molecular biology/genetics/pathology our data show that CXCR4 is expressed at low level F-T-131 on atrophic lesions and its expression is enhanced CXCR4 is Expressed at Low Level on along with progression to metaplasia and Atrophic Lesions and its Expression is adenocarcinoma. Increased Along With Progression to Conclusion: In conclusion; we present evidence that Metaplasia and Adenocarcinoma CXCR4 is expressed on gastric carcinoma and thus Farshad Sheikhesmaeili1*,Mohammadreza Ghadir2, CXCR4 may be a suitable marker for diagnosis of 3 Mehrnoosh Nikzabn , Bahram Nikkhou 4, Hiresh gastric cancer. In addition, we demonstrate for the 5 5 1 Ayoubian , Mohammad Saeed Hakhamaneshi , Ali Jalili first time that CXCR4 expression is enhanced as 1Liver &Digestive Research Centre , Kurdistan University premalignant lesions progress to malignant tumors, of Medical Sciences 2Qom University of Medical Sciences , Qom University of indicating that targeting CXCR4 could be a new Medical Sciences ,Qom,Iran approach for treatment of gastric cancer. 3Cellular & Molecular Research Center, Department of Send Date: 2011/07/30 Genetic, Tabriz University, Tabriz,Iran 4Kurdistan University of Medical Sciences, Kurdistan University of Medical Sciences, Sanandaj. Iran Category: 13 ONCOLOGY-BASIC 5Kurdistan University of Medical Sciences, 13.2 Molecular biology/genetics/pathology Kurdistan University of Medical Sciences F-T-132 Introduction: Stromal derived factor-1 (SDF-1 or Immunohistochemistric evaluation of CXCL12), a member of the alpha chemokines (CXC) HER-2/neu overexpression in 101 cases of and the ligand for the CXCR4 receptor, has been gastric carcinoma using tissue microarray shown in the past to be an effective chemoattractant Nasser Rakhshani1*,HadiBakhti2, Hossein for various CXCR4-expressing cells. SDF-1 is Ajdarkosh3, Mahmoud reza Khansari1,AliBasi4 secreted by stromal and endothelial cells in bone 1Gastrointestinal & Liver Disease Research Center marrow, lung, skeletal muscle, liver, kidney and (GILDRC), Tehran University of Medical Sciences brain. It is therefore important for metastasis of (TUMS) (pardis, hemmet) 2 cancer cells to these organs. Recent studies have The Department of Pathology, Tehran University of shown that CXCR4 plays an important role in cancer Medical Sciences, (TUMS) (pardis, hemmet) 3Gastroenterologist,Gastrointestinal & Liver Disease development and tumor growth, apoptosis inhibition, Research Center (GILDRC), Tehran University of Medical angiogenesis promotion, cellular proliferation, Sciences (TUMS) (pardis, hemmet) invasion and cancer metastasis in many cancers. 4Medical oncologist,Gastrointestinal & Liver Disease Method: Herein, we studied the expression of Research Center (GILDRC), Tehran University of Medical CXCR4 on gastric samples from patients with Sciences (TUMS) (pardis, hemmet) precancerous lesions (atrophy, metaplasia and Introduction: HER-2/neu overexpression hasproved dysplasia) and gastric adenocarcinoma as well as predictive value in breast cancer patients, responding human gastric carcinoma epithelial cell line (AGS) to Trastuzumab. We wanted to investigate the by employing RT-PCR, immunehistochemistry (IHC) frequency of HER-2/neu overexpression in gastric

78 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 carcinoma and its correlation with clinicopathologic including colorectal cancers. Recent studies have variables. been showed that invasion to blood and lymphatic Method: 101 patients with adenocarcinomas of vessels may predict involvement of lymph nodes but stomach and gastroesophageal junction were the number of involved nodes has been less studied . included in this study.Biopsy specimens were The aim of this study was to determine the assessed by immunohistochemistry (IHC) staining for relationship between the size of colorectal HER-2/neu,using tissue microarray method (TMA). adenocarcinoma and lymph node involvement. Results: Mean age of patients was 60.13±11 (32-82) Method: In this cross-sectional study, 116 patients years. Male to female ratio was 2.4:1. HER2/neu were enrolled with colorectal cancer from overexpression was positive in 13 cases (12.9%).The Rasoul-e-Akram and Mehr Hospitals in 2002-2008. frequency of HER2/neuoverexpression in tumors Data analysis was performed by SPSS-15 software. ≥5cm was significantly higher than tumors< 5cm Results were expressed as frequency, percent, and (20% vs. 2.4%; p=0.01).There was no statistically mean ±SD. We used Chi2, student test and correlation significant correlation between HER2/neu tests for statistical analysis. overexpression and other pathological featurs such as Results: 54.3% of patients were male and 45.7% grade, stage,lymph node involvement, tumor were female. Mean age of them was 59.4± 12.9 years. location,histopathological type,nor with age and sex. Mean size of tumor (longest diameter) was 5.4± 2.2 Conclusion: The prevalence of HER-2/neu (range: 1.5 to 12) cm. Mean number of involved overexpression in our study was slightly lower than lymph nodes was 4.9± 3.5 (range: 1-14). There was the range found in most of the other published no correlation between number of lymph node studies.There was a significant correlation between involvement and tumor size. There was no correlation tumor size and HER-2/neu protein overexpression. between lymph node involvement and type of tumor But it hasn’t any correlation with other pathological or age, sex, location and depth of tumor. Poorly featurs of tumor. differentiated tumors significantly correlated to Send Date: 2011/08/01 lymph node involvement (p=0.001). Conclusion: There is no correlation between tumor size and number of involved lymph node in colorectal Category: 13 ONCOLOGY-BASIC cancer. However, poor histopathologic grade is 13.2 Molecular biology/genetics/pathology associated with lymph node involvement. F-T-133 Send Date: 2011/08/0 The Relationship between Size of colon Adenocarcinoma and Lymph Node Involvement Nasser Rakhshani1*, Roshanak Derakhshandeh2, Category: 13 ONCOLOGY-BASIC Seyed Amir Mirbagheri3, Farhad Zamani1, 13.2 Molecular biology/genetics/pathology Ahad Atef Vahid4, Mitra Mehrazma5 F-T-134 1 Gastrointestinal & Liver Disease Research Center Investigation of plasma vascular endothelial (GILDRC), Tehran University of Medical Sciences growth factor & complement C3a level in (TUMS) patients with colorectal cancer in southern Iran 2Department of Hemathology & Oncology, Tehran Univer- 1* 2 sity of Medical Sciences (TUMS) Seyedeh Azra Shamsdin , Mehdi Saberifiroozi , 1 3 3Department of Gastroenterology, Tehran University of Davood Mehrabani , Seyed Taghi Heydari 1 Medical Sciences (TUMS) Gastroenterohepatology Research Center (GEHRC), Shiraz University of Medical Sciences, Shiraz, Iran 4Department of Surgery, Tehran University of Medical Sci- 2Gastroenterohepatology Research Center (GEHRC), ences (TUMS) Shiraz University of Medical Sciences and Digestive 5Department of Pathology, Tehran University of Medical Disease Research Center, Shariati’s Hospital, Tehran Sciences (TUMS) University of Medical Sciences, Tehran ,Iran Introduction: Involvement of lymph nodes is an 3 Department of Biostatistics, Shiraz University of Med- important prognostic factor in most cancers, ical Sciences, Shiraz, Iran

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Introduction: Colorectal cancer is a major cause of found in increased concentrations in feces from worldwide morbidity & mortality and is the second symptomatic patients with gastrointestinal (GI) most common cause of cancer death. Colorectal cancers (including colorectal and gastric cancer is often diagnosed at a late stage with poor malignancies), inflammatory bowel disease, and prognosis. Vascular endothelial growth factor certain infections. Calprotectin in feces seems to be a (VEGF) is a neo-angiogenesis with great importance more sensitive marker for GI cancers than fecal for tumor growth, which has a direct effect on occult blood, but its specificity may be too low for vascular endothelial cell proliferation and migration. screening of average risk populations. C3a is also diagnostic factor in determining colon This study aims at evaluating the diagnostic value of cancer. The aim of the study was to measure the VEGF fecal calprotectin as a screening biomarker of gas- and C3a level in patients with colorectal cancer. trointestinal malignancies. Method: One hundred and ten patients with Method: In a case-control study, 100 patients with GI colorectal cancer, including 66 Men and 44 women. malignancies (50 patients with colorectal cancer and (At an average age of 54 years) were enrolled into the 50 patients with gastric cancer) and 50 controls were study. VEGF and C3a level of 110 patients with recruited from Imam Reza and Sina hospitals of colorectal cancer were determined using ELISA Tabriz University of Medical Sciences, during a method. Only 55 Patients with elevated serum VEGF 24-month period. and C3a were followed up after 3 months, because of One to two weeks after the last endoscopy/ death of the rest. colonoscopy , 5gr of fecal specimen was collected by Results: our result demonstrate that C3a is a suitable the patient and examined by ELISA method for quan- diagnostic tumor marker in patients with colorectal titative measurement of its cancer. A combination of the serum tumor markers calprotectin content. The results were compared C3a and VEGF can significantly increase the between the three groups. pre-operative diagnostic. VEGF and C3a serum level Results: The mean fecal calprotectin level was slowed significantly difference pre- and post – 109.1±105.3 (2.3-454.3, median:74), 241.1±205.2 treatment (mean 509.1 pg/ml, 480pg/ml; 2.5 ng/ml (3.4-610.0, median:19.3) and 45.9±55.1μg/g 2.3 ng/ml) (p=0.8) (p=0.002). (1.3-257.1, median:19.3) in gastric cancer, colorectal Conclusion: Combination VEGF and C3a are useful cancer and control group,respectively. The mean markers to predict future metastasis, survival, and re- level of fecal calprotectin was the highest in patients sponse to the treatment. with colorectal cancer and the lowest in the controls Send Date: 2011/08/17 (p<0.001). This difference still remained after adjusting for age. The optimal cut-off point for fecal calprotectin was ≥75.8μg/g for distinguishing Category: 14 ONCOLOGY-CLINICAL colorectal cancer from normal cases (sensitivity and 14.1 Malignant disease - epidemiology - screening specificity of 80% and 84%, respectively). This value and prevention was ≥41.9μg/g for diffrentiating gastric cancer from F-T-135 normal cases (sensitivity and specificity of 62%). Diagnostic Value of Fecal Calprotectin Conclusion: Our results revealed that fecal as a Screening Biomarker for calprotectin might be a useful and noninvasive Gastrointestinal Malignancy biomarker for discriminating colorectal cancer from Manouchehr Khoshbaten1*, Mohammad Nouri1, non-malignant GI conditions. 1 1 Parinaz Pishahang , Alireza Lashkari , However, due to low sensitivity and specificity, this 1 Neda Sattarnezhad biomarker may not help physicians distinguishing 1 Liver and Gastrointestinal Disease Research Center, gastric cancer cases from healthy subjects. Tabriz University of Medical Sciences Send Date: 2011/07/15 Introduction: The protein calprotectin constitutes approximately 60% of the soluble cytoplasmic proteins in neutrophilic granulocytes and has been

80 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

Category: 14 ONCOLOGY-CLINICAL Gastroenterology, Isfahan University of Medical Sciences 14.1 Malignant disease - epidemiology - screening 3Isfahan University of Medical Sciences and prevention Introduction: The incidence and mortality rates for F-T-136 colorectal cancer (CRC) are among the highest of all A Meta-analysis of Epidemiology malignancies worldwide. The possible association of of gastric cancer in Iran physical activity with reduced risk of various types Mohammadhosein Somi1*, Pooya Paknejad1, of cancer has generated much interest recently. The Morteza Ghojazadeh2, Ardalan goal of this research was, examining the relationship Golbahar Haghighi1, Masood Bagheri1 between physical activity and CRC in Isfahan, Iran. 1Liver and Gastrointestinal Diseases Research Center, Method: We designed a double-blind, population- Tabriz University of Medical Sciences based case-control study with 100 cases and 100 2 Physiology Department, Tabriz University of Medical controls. Newly diagnosed male and female cases of Sciences CRC, aged 30 to 82 were included into the study, Introduction: Gastric cancer is still an important which were referred to Poursina Hakim Institute in health problem in Iran. The aim of this meta-analysis Isfahan, Iran, between the years 2006 to 2008. Data is studying the incidence of gastric cancer, its sub on recreational, occupational and household physical types and male to female ratio in Iranian population. activities was obtained based on a Modified version Method: After an extensive search in almost all of Kriska Standard Physical Activity Questionnaire. English and Persian medical databases for epidemiology Samples were matched based on age and sex. of gastric cancer in Iranian population, we find 173 Multivariable logistic regression was used to estimate articles. These articles were appraised by three the Odds Ratio. individuals independently. The articles that have our Results: After adjustment for marital status, body factors to be concerned in the meta-analysis have mass index (BMI), cigarette smoking, hormone been selected. The data was analyzed by CMA.2 replacement therapy (HRT), educational status, past software. history of cancer and family history of cancer, we Results: The incidence of gastric cancer in Iranian found odds ratio of 0.83 for the relationship between population was 23.9 per 100000 in males and 10 per recreational activity & colorectal cancer in the two 100000 in females by ASR. Adenocarcinoma has the groups (p=0.03, 0.95% CI=0.692, 0.985), but there most incidence and followed by lymphoma. The male was no significant association between CRC and to female ratio was 2.4:1. occupational (p =0.232) and household activities (p Conclusion: According to its high incidence, =0.226). developing a gastric cancer early detection program Conclusion: Recreational physical activity is associated is seriously recommended. with reduced risk of colorectal cancer but occupational Send Date: 2011/07/21 and household physical activities are not. Send Date: 2011/08/05 Category: 14 ONCOLOGY-CLINICAL 14.1 Malignant disease - epidemiology - screening Category: 14 ONCOLOGY-CLINICAL and prevention 14.2 Diagnosis of malignant disease F-T-137 F-T-138 Physical Activity and Reduction in Gastric carcinoid tumor the Risk of Colorectal Cancer: a with normal (gastritis) endoscopy Population-Based Case-Control Study Rahim Mehdioghli1, Jila Hazrati1* 1 2* Parastoo Golshiri , Mohammad Hassan Emami , 1Imam Khomeini Hospital, Urmia University of Medical Reyhaneh Rasooli3, Mehdi Rowshandel3 Siences 1Department of Community Medicine, Isfahan University Introduction: Carcinoid tumors arise from of Medical Sciences 2Poursina Hakim Research Institute, Department of gastrointestinal neuroendocrine cells and can be subdivided into well differentiated &poorly

Govaresh\ Vol.16\ Supplement\ Autumn 2011 81 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 differentiated tumors.They can involve stomach, ),ÎBoÂúìùîôgÇýpWBüãnAoÿ noisorEdnaB AoôqüõóìÏlûðByþAqGBðl( intestine, appendix, colorectal and lung. In former dnaBcirtsaGelbatsujdAcipocsorapaL GBðlÚBGêOñËýîìÏlû they accounted for 2% of all gastrointestinal ),GpAÿkoìBó^BÚþ.ârAo}ìõAokôkoìBó@ðlôußõKýà@ó BGAL ( carcinoids, but in more recent studies, 10% to 30% & AcvBóAÞHpÿ1 of all carcinoids are reported in the stomach. They ÎéõïKryßþ,ÎéõïKryßþìzùl 1 can be sub classified into 3 distinct groups: those ):ÎBoÂúAÿìùîôgÇýpAq noisorEdnaB AoôqüõóìÏlûðByþAqGBðl( ìÛlìú: associated with chronic atrophic gastritis/pernicious )AuQÞúGpAÿ BGAL WBüãnAoÿcéÛúÚBGêOñËýîìÏlûGBoô}æKBoAußõKýà( anemia (type 1)70%-80%, those associated with Zollinger-Ellison syndrome (ZES) with multiple koìBó^BÚþAðXBïìþyõk.AüòÎBoÂúðBkoGõkûôGBkokAKþâBuPp,OùõÑô endocrine neoplasia type I (MEN I) (type 2) 5%, and AuP×pAÕøípAûAuQôGBüvPþOõuÈÎíêWpAcþGpkAyPúyõk.koAüòKtôø{ sporadic NETs of the stomach (type 3)15-20%. GúGpouþÖpAôAðþAüòÎBoÂúGBAðXBï@ðlôußõKþKpkAgPúylûAuQôA¾õë Case Report: Patient is a 53-years old woman with koìBó@ðlôußõKýà@óìõokGdUÚpAoìþâýpk. epigastric pain, bloating and sometims night pain GpAÿOÏlAk036GýíBoÞúAuPBðlAokøBÿÚBGêÚHõëìXBìÐÎéíþ ìõok: ârAo} from 5-6 months ago. Physical examination is N.l. In OÏHýúyl.Þéýú BGAL GpAÿkoìBóWpAcþ^BÚþoAkAyPñl,OõuÈøíßBoWpAf her F.H her father had gastric cancer and died at his GýíBoAóAqðËpôWõkÎçDîâõAoyþKýãýpÿylðl.OÏlAk35GýíBoGÏéQÎçDîô 62 years old. Lab data (CBC, LFT, Biochemistry) are ÎõAoÅÖõÚBðþâõAo}ÞBðlül@ðlôußõKþylðl.ko12GýíBo(uúko¾lÞê N.L. In endoscopy, moderate gastritis in antrum was seen and B.X was taken.pathological report in two AÚlAìBR OõuÈ ìõok ko81 ylÞú külû ìÏlû AqGBðl ðByþ Aoôqüõó GýíBoAó) different centers with expert pathologists after IHC @ðlôußõKýà,GñlAqìÏlûgBoZâpkülôGýíBoAóGBcBëÎíõìþgõJìpgÀ revealed carcinoid tumor. CT scan, reported thickness ylðl.kokôGýíBokoìBó@ðlôußõKýàðBìõÖÜGõkÞúGBðlOõuÈWpAfGBÎíê of lesser curvature of the stomach without WpAcþgBoZyl. metastasis. AuQô BGAL AoôqüõóìÏlûðByþAqGBðlAqÎõAoÅìùîôgÇýp ðPýXúâýpÿ: Discusion: Increased use of endoscopy and advances koìBó@ðlôußõKýàüàoô}ìõÖÜÒýpOùBWíþAuQÞúìþOõAðlWBüãrüò in imaging have led to a relative increase in detection koìBóWpAcþâpkk. of gastric carcinoid tumors. Based on upper OBoüiAouBë:0931/50/20 gastrointestinal studies using single contrast technique Balthazar et al had reported four different radiographic patterns of carcinoid tumors, Single intramural defect, large gastric ulcer, multiple gastric Category: 15 NERVE GUT AND MOTILITY polyps and polypoidal intraluminal lesions . 15.2 Brain-gut and gut-brain axes - neuro-hormonal Endoscopic finding were studied and evaluated in - neural-immune and visceral sensitivity patients with gastric carcinoid tumors.patients had a F-T-140 single or multiple mass(nodule) in stomach. Overall The Incidence of Irritable Bowel Syndrome in in endoscopy results, mass or nodule had reported in Women Undergoing Hysterectomy 1* 2 stomach in over world study, but in presented case Manouchehr Khoshbaten , Manijeh Sayyah Melli , 1 1 repo rt, endoscopy detected only gastritis in antrum Monireh Jabar Fattahi , Neda Sattarnezhad 1Liver and Gastrointestinal Disease Research Center, and abdominal CT scan reported thickness of lesser Tabriz University of Medical Sciences curvature. Therefore we suggest that in patients with 2Obstetrics and Gynecology Department, Tabriz University risk factor and positive family history although of Medical Sciences endoscopy was near normal or gastritis without mass, Introduction: Many studies confirm the high B.X is mandatory and probably CT scan or prevalence of IBS and its impact on the working life, endosonography is complementary. social activities and well-being of sufferers.The Send Date: 2011/08/17 results of previous investigations have shown an increased incidence of IBS after gynecological Category: 14 ONCOLOGY-CLINICAL surgeries such as hysterectomy. However, most of ìõÂõÑ:41.4ÎõAoÅGÏlAqWpAcþ these studies did not use validated symptom-based 931-T-F criteria like Rome II. The aim of this study was to

82 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 assess the incidence of IBS in women undergoing of Medical Sciences hysterectomy and tubular ligation (TL). 3Department of Clinical Psychiatry, Kashan University of Method: Participants were patients of Alzahra and Medical Sciences 4 Taleghani hospitals of Tabriz University of Digestive Disease Research Center, Tehran University of MedicalSciences.Three hundred thirty six healthy Medical Sciences Introduction: Irritable Bowel Syndrome (IBS) is a women were included in the study.One hundred common gastrointestinal disorder that affects Quality seventy two of cases underwent TL and 164 of them of life (QOL). IBS subtypes may have different had hysterectomy.Patients were assessed every 3 expression of the symptoms of depression and months after having aforementioned surgeries, during anxiety with different outcomes on QOL indices. The a 12-month period. IBS was evaluated using a aims of study are: 1) to compare anxiety and questionnaire based on Rome II criteria. Individuals depression symptoms and QOL between IBS diagnosed with Irritible Bowel Syndrome, based on subtypes, 2) to determine the factors independently this criteria, underwent complementary evaluations associated with QOL in IBS patients, 3) to access the by gasteroenterologist for IBS confirmation. correlation between generic QOL (WHOQOL- Results: The mean age of patients underwent TL was BREF) with disease specific QOL tests (QOL-IBS). 37.85± 5 years; and 47.14 ± 6.57 years in Method: Two hundred and fifty IBS patients (121 hysterectomy group. During 12 months after males) referred to gastroenterology clinic and 250 surgeries, 19 (11%) patients in TL group and 19 controls were included. IBS and its subtypes were (11%) in hysterectomy group had abdominal pain defined according to ROME 3 criteria. “WHOQOL- (> 12 weeks) with at least two symptoms of IBS; BREF”, “QOL specific for IBS”, “Stait-Trait Anxiety However, IBS was confirmed in 9 (5%) patients of Inventory,” and “Beck Depression Inventory-2” TL and 13 (8%) patients of hysterectomy groups (p > questionnaires were used for evaluation of QOL, 0.05). In both groups of study, the most prevalent Anxiety, and Depression symptoms. symptoms along with abdominal pain were chronic Results: The mean depression scores were higher in constipation and abnormal stool passage.The least mixed subtype than constipation subtype however, prevalents were diarrhea and passage of mucus. QOL, psychological and social relationships scores There were no significant differences in prevalence were lower in mixed subtype than constipation of symptoms among IBS positive patients of two subtype. (All P values<0.05) Factors associated with groups. QOL-BREF scores were symptom severity, anxiety, Conclusion: Our results suggest that gynecological and depression symptoms. (Regression coefficients surgeries (TL and Hysterectomy) could predispose = -0.2, -0.31, and -0.28 respectively; All P values < patient to IBS. Therefore awareness of physicians and 0.001). There was correlation between WHOQOL- gynecologists about this issue may prevent BREF and QOL-IBS scores. (R2 = 0.79; P value < unnecessary surgeries. Send Date: 2011/07/15 0.001) Conclusion: QOL was not affected by IBS subtype. Proper management of disease, anxiety, and Category: 15 NERVE GUT AND MOTILITY depression symptoms in IBS patients may affect their 15.5 Functional gastrointestinal disorders (clinical - QOL. WHOQOL-BREF and QOL-IBS management) questionnaires were correlated and either test might F-T-141 be applied for evaluation of QOL in IBS patients. Anxiety, depression, and quality of Send Date: 2011/05/30 Life in Irritable Bowel Syndrome Subtypes Raika Jamali1*, Arsia Jamali2, Abdollah Omidi3, Reza Ansari4 Category: 15 NERVE GUT AND MOTILITY 1Anatomical Sciences Research Center, Students Scientific 15.5 Functional gastrointestinal disorders (clinical - Research Center, Kashan University of Medical Sciences, management) 2Students′ Scientific Research Center, Tehran University F-T-142

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Comparison the effects of doxepin, nortriptyline Category: 16 IMMUNOLOGY/MICROBIOLOGY and placebo on diarrhea-predominant irritable 16.1 Host defence mechanisms - immune reactions bowel syndrome: a triple-blind, randomized, F-T-143 placebo-controlled trial Single nucleotide polymorphisms in IFN-α Mohammad-Reza Ghadir1*, Hosein-Ali Habibinejad2, receptor1 gene and its association Akram Heidari1, Maryam Vaez-Javadi3, Farshad with outcome of combination therapy Sheikhesmaeli4, Naser Khanahmadi5 in Iranian HCV infected patients 1 Shahid Beheshti Hospital, Qom University of Medical Kiana Shahzamani1*, Zohreh Heidari1, Arghavan Hj Sciences, Qom, Iran Sheykholeslami1, Shadi Kolahdoozan1, Shahin Merat1 2 Shahid Beheshti Hospital, Qom Azad University of Med- 1Digestive Disease Research Institute, Tehran University ical Sciences, Qom, Iran of Medical Sciences 3 Immunology Department, Qom University of Medical Introduction: Hepatitis C virus (HCV) is one of the Sciences, Qom, Iran main reasons for chronic liver disease and 4Sanandaj University of Medical Sciences, Sanandaj hepatocellular carcinoma. Combination therapy with University of Medical Sciences, Sanandaj, Iran 5Ayatollah Golpayegani Hospital, Qom, Iran Pegylated interferon-α (IFN-α) and ribavirin has Introduction: Irritable bowel syndrome is important become the gold standard for treatment of HCV because of its high prevalence, substantial morbidity, infection, although the achievement of sustained and enormous costs. Several trials have demonstrated virological response (SVR) has not been very benefits of tricyclic antidepressants for irritable satisfactory. The treatment outcome depends on viral bowel syndrome, especially when pain is a prominent genotypes and host genetic polymorphisms in the symptom but the efficacy of antidepressants in genes involved in the IFN-α signaling pathway. The irritable bowel syndrome is controversial. The aim of aim of this study was to identify host genetic this study was to compare the effects of doxepin, polymorphisms of IFN-α receptor 1(IFNAR1) gene nortriptyline and placebo on diarrhea-predominant associated with the efficacy of IFN-based irritable bowel syndrome. combination therapy. Method: Method: Seventy-five patients with IBS according to Participants were treated with pegylated Rome III criteria were treated for 2 months. The interferon-α and ribavirin during therapy. Subjects patients were randomly assigned to one of three with undetectable HCV RNA at week 72 were groups treated with doxepin, nortriptyline or considered to achieve SVR. Subjects with detectable placebo.Subjects were assessed clinically one month HCV RNA at week 24 were considered as non- and two months after treatment. The symptoms and responders. DNA was extracted from collected adverse effects of the drugs were recorded in the peripheral blood mononuclear cells (PBMCs). Four questionnaire. single nucleotide polymorphisms (SNPs) belong to Results: Improvement in abdominal pain and IFNAR1 gene were detected in 30 Iranian healthy bloating in doxepin group was significantly higher volunteers and 270 chronic hepatitis C patients. than nortriptyline and placebo groups (p=0.001 and Genotypes were assessed by TaqMan assays and p=0.012, respectively). Improvement in diarrhea in analyzed with related software. This analysis nortriptyline group was significantly higher than compares genotypes for participants with an SVR to other groups (p=0.018). The mean of improvement non-responder. Results: degree of the patients after 2 months of treatment in Logistic analysis revealed that low viral doxepin group, nortriptyline group and placebo group load, viral genotype 3 and a lower degree of liver were 2.56, 2 and 0.6, respectively(p<0.05). fibrosis but none of studied SNPs were significantly Conclusion: Doxepin or nortriptyline is effective for associated with SVR. treatment of diarrhea-predominant irritable bowel Conclusion: Genetic polymorphisms in IFNAR1 syndrome in a period of two months. Doxepin is more gene were not associated with SVR. In contrast the effective than nortriptyline for treatment of efficacy of recombinant therapy was largely diarrhea-predominant irritable bowel syndrome. dependent on viral factors and liver fibrosis. Send Date: 2011/07/22 Send Date: 2011/07/21

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Category: 19 ENDOSCOPY AND IMAGING Furthermore, it seems that congenital duplications 19.1 Endoscopy - Upper GI usually are located in the greater curvature rather than F-T-144 lesser curvature. Double pylorus in a cirrhotic patient: Discussion: Our case had a deep peptic ulcer at A case report and review of the literature anterior wall of the bulb, which makes the possibility Mohammadreza Fattahi1, Katayoon of a peptic etiology for the additional opening to the Homayoon1, Laleh Hamidpour1* duodenum more likely. On the other hand the round 1 Gastroenterohepatology Research Centre, Shiraz or regular shape of the rim of the two openings may University of Medical Sciences,Shiraz,Iran be in favor of a congenital etiology .In either case Introduction: Double pylorus is an uncommon double pylorus itself and particularly in combination condition that is characterized by two communicating with cirrhosis is a rare finding. To our knowledge channels between gastric antrum and the first part of only one other case of double pylorus and cirrhosis is duodenum. Endoscopically, two separate openings of reported in the literature. the pylorus can be seen leading to the duodenum, most Send Date: 2011/08/16 of them were complication of peptic ulcer disease, although it may also be a congenital condition. Case Report: A 66 year old cirrhotic gentleman was Category: 19 ENDOSCOPY AND IMAGING referred to the endoscopy ward for evaluation of 19.1 Endoscopy - Upper GI cirrhosis and possibility of esophageal varices.The F-T-145 patient was asymptomatic and looked healthy; he had Simethicone for the Preparation before no history of epigastric pain, previous gastrointestinal Esophagogastroduodenoscopy- bleeding or peptic ulcers. In endoscopy double Updated Data on Patient’s Satisfaction orifices in pylorus lead to duodenal bulb with and Duration of the Procedure multiple erosions and deep anterior ulceration was Majid Ahsan1*, Leila Babaei1, Ali Gholamrezaei2, found. Double pylorus is a rare finding which most of Mohammad Hassan Emami3 the times is an incidental finding during endoscopy 1 Medical Student Research Center, Isfahan University of or radiology. The male: female ratio is about 2:1 and Medical Sciences 2 the mean age of the patients was 59.6 years. It may be Poursina Hakim Research Institute, Medical Student acquired or congenital .Acquired form is more Research Center, Isfahan University of Medical Sciences 3 Poursina Hakim Research Institute, Department of common than congenital form that is usually results Gastroenterology, Isfahan University of Medical Sciences from a gastric ulcer eroding through and creating a Introduction: The presence of air bubbles and foam fistula between the lesser curve of the gastric antrum in stomach and duodenum during esophagogastro- and duodenal bulb near the anatomic pylorus .Rarely duodenoscopy (EGD) is a common problem which it has been described in patients with malignant can lead to decreased diagnostic accuracy, prolonged ulcers. The reasons for development of the fistula endoscopy time, and decreased patient’s tolerance. remain unclear, but many systemic diseases, long We evaluated the effectiveness of simethicone in history using corticosteroids, NSAIDs, and alcohol reducing the amount of gastric and duodenal foam/air consumption may be associated with it. The true bubbles, duration of endoscopy procedure, and incidence of congenital double pylorus may be patients’ satisfaction during EGD. underestimated, because great majority of them may Method: Patients who were candidates of elective remain undetected for decades of life. It’s etiology EGD received 40 mg chewable tablet of simethicone probably is the failure of the pyloric lumen to (n = 90) or placebo (n = 83), with 30mL water, 15–30 recanalize during the early stage of embryonic life .A min before the EGD. Foam/air bubbles during congenital origin depends on normal histology in endoscopy were assessed and graded on a 4-point both channels that shows the presence of mucosa, scale by a single endoscopist, and the duration of lamina propria, and muscularis mucosa, with no signs endoscopy procedure was recorded. Patients’ of chronic penetrating ulcer or chronic gastritis. satisfaction with the endoscopy was scored from 0 to 10.

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Results: The amount of gastric foam/air bubbles was Results: Exellent Patients satisfaction for spray and significantly lower in the simethicone group gel was 21.5% and 20% respectively. relative patients compared with the placebo group (P = 0.002). No satisfaction for lidocaine spray and gel was 41.5% difference was found between the two groups with and 52.3% and there is no statistically difference regard to duodenal foam/air bubbles (P > 0.05). between two form of lidocaine (P=0.46),also anxiety Duration of endoscopy was, on average, one minute in gel group was less than spray group (p<0.05). shorter in the simethicone group compared with the Conclusion: According to idea of patients and placebo group (P < 0.001). Patients’ satisfaction with endoscopist no difference between spray and gel and the procedure was the same in the two groups. No physicians can apply any form of lidocaine for local adverse effect was observed with simethicone. anesthesia according to patients preference. lidocain Conclusion: Administration of simethicone prior to gel may be better for anxious patient. EGD reduces the amount of gastric foam and bubbles Send Date: 2011/08/22 significantly and provides better visibility for evaluating the mucosa. It also decreases the duration of endoscopy. Further trials are required to find the Category: 19 ENDOSCOPY AND IMAGING optimal dosage and timing, as well as the final effect 19.4 Endosonography of the drug on diagnosis of pathological lesions. F-T-147 Send Date: 2011/08/05 Endoscopic Ultrasonography Findings in Patients with Achalasia Rasoul Sotoudehmanesh1*, Javad Mikaeli1, Category: 19 ENDOSCOPY AND IMAGING D Mohamad1, A Modirzadeh1, 19.1 Endoscopy - Upper GI Narges Mehrabi1, Maryam Farsinejadmarj1 F-T-146 1 DDRC, Tehran University of Medical Sciences Introduction: Comparison of viscose and spray lidocain Patients with achalasia may have a efficacy for through anesthesia in endoscopy thicker muscularis propria layer than normal subjects. Ahmad Shavakhi Shavakhi1, The aim of our study was to determine the prevalence Mohamad Minakari1, Fatima Asaf1* of increased muscle thickness in patients with 1 Alzahra Hospital, Isfahan University of Medical Sciences achalasia measured by endoscopic ultrasonography Introduction: lidocaine should be used for diagnostic (EUS) and evaluation of its relationship with disease upper gastrointestinal (GI) endoscopy in deeply characteristics. sedated patients, investigators recommend.Many Method: During one year period we studied 16 endoscopists prefer of lidocain gel and othee preffer nonachalsia patients and 16 consecutive achalasia lidocaine spray. Probably The efficacy of local patients before pneumatic dilation. Esophageal anesthesia is very important for an easy endoscopy muscle thickness was measured at EGJ, 5th, and 10th not only for patients butalso for endoscopist . This Cm far from EGJ. Patients’ symptom scores and their study was down to comparison of two form of relieves were evaluated 1, 3 and 6 months after lidocaine (Gel and spray) that used befor endoscopy treatment. Method: This is a clinical trial study that conducted Results: Nearly all patients with well-defined in Alzahra Isfahan hospital in 2009. With use of spe- achalasia, revealed an increase in the muscle cial sample size formula we selected 135 patients that thickness relative to controls. There was a correlation candidate fro endoscopy. This patients were between the thickness at 5, 10th Cm above the EGJ randomly selected in two groups . In the first group and the age of patients with achalasia. None of we use spray and in second group we use lidocain gel symptom scores, mean lower esophageal pressure, for local anesthesia. After 30 minutes we evaluated disease duration and response to treatment were of deep anesthesia for two groups. The data collected correlated with rate of increase in muscle thickness. with special check list and entered to computer and Conclusion: Increased esophageal muscle thickness by analyzed By spss soft ware. EUS is likely to be an important marker of achalasia. Send Date: 2011/07/12

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Category: 19 ENDOSCOPY AND IMAGING computed tomography (CT). However 19.4 Endosonography Method: All patients referred for endoscopic F-T-148 ultrasound because of thickened gastric folds on CT Incidental findings on upper were included. UGIE followed by EUS performed in gastrointestinal endoscopic ultrasonography all patients. Data were recorded prospectively. Rasoul Sotoudehmanesh1*, Payman Arab1, Results: Twenty-eight patients enrolled the study. Ali Ali-Asgari1, Maryam Farsinejadmarj1 The mean ± SD age was 50.8±15.9. The prevalence 1 Digestive Disease Research Center, Tehran University of was higher in men (60.7% were male). Most of the Medical Sciences patients (78.6%) had symptoms. Ten patients (35.7%) Introduction: The issue of incidental findings in finally diagnosed as gastric neoplasm. The presence medicine gains attention due to rapid progress in of dyspepsia or constitutional symptoms is correlated accurate diagnostic technologies and the aging with the presence of gastric abnormality. Eleven population. The aim of this prospective study was to patients (39.3%) had normal UGIE, and 17 patients assess the frequency and clinical significance of (60.7%) had normal EUS. If UGIE was abnormal (17 incidental findings on upper gastrointestinal patients), EUS was abnormal in 10 (58.8%) cases. In endoscopic ultrasonography (EUS). all patients with normal UGIE (11 patients), the EUS Method: Patients who referred for upper was normal. Accuracy, specificity, sensitivity, gastrointestinal EUS, were consecutively enrolled to positive predictive value and negative predictive take part in this prospective study. Any coincidental value of EUS for detecting a lesion in thickened wall abnormality found during the standard EUS was stomach on CT were: 89.3%, 88.8%, 90.0%, 81.8% considered an incidental finding. Significant and 94.1% respectively. incidental findings were defined as abnormalities that Conclusion: In all patients with normal EUS, UGIE required further medical, surgical or endoscopic is normal. The presence of symptoms predicts or intervention including surveillance. increases the likelihood of abnormal EUS. In patients Results: In 552 patients who underwent EUS, 44 IF with thickened gastric wall in CT, UGIE should be were detected in 41 patients (7.4%). Twenty four ab- done before EUS. normalities had high clinical significance. The fre- Send Date: 2011/07/12 quency of IF increased significantly with increasing age (p=0.001). The most frequent If were gallstones, subepithelial lesions and pancreatic lesions. Category: 19 ENDOSCOPY AND IMAGING Conclusion: Incidental findings on EUS are not 19.4 Endosonography uncommon in clinical practice and might be a clue to F-T-150 a significant pathology. The appropriate extent of Endoscopic Ultrasonography in Patients with evaluation in a standard EUS procedure warrants Chronic Liver Disease: A Case-Control Study further research to be defined. Rasoul Sotoudehmanesh1*, S Ainechi1, Ali Ali Asgari1, Send Date: 2011/07/12 Shadi Kolahdoozan1, Maryam Farsinejadmarj1 1 Digestive Disease Research Center, Tehran University Category: 19 ENDOSCOPY AND IMAGING of Medical Sciences 19.4 Endosonography Introduction: The portal system and azygos vein are F-T-149 the main drainage systems during portal Impact of EUS in Patients hypertension. We aimed to compare the diameter of with Thickened Wall Stomach in CT scan these veins by EUS in patients with and without Rasoul Sotoudehmanesh1*,FMirzaAgha1, chronic liver disease. 1 1 Shadi Kolahdoozan , Maryam Farsinejadmarj Method: During one year, patients with chronic liver 1 Digestive Disease Research Center, Tehran University of disease were enrolled as study group. Patients Medical Sciences undergoing endoscopic ultrasonography (EUS) for Introduction: Endoscopic ultrasound (EUS) is often other reasons in the same period served as controls. In used in patients who have gastric wall thickening in

Govaresh\ Vol.16\ Supplement\ Autumn 2011 87 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 cases with chronic liver disease, the relationship report a case that developed acute pancreatitis after between the degrees of hepatic dysfunction DBE. This was the first case of acute pancreatitis in (Child-Pugh class), history of variceal bleeding, our hospital. presence of hyponatremia, thrombocytopenia and Case Report: A 26-year-old’s man was referred to our endoscopic grading of varices with the size of the hospital for evaluation of obscure GI bleeding. He portal, splenic and azygos veins on EUS were had melana seven times from 2.5 y ago. For this assessed. reason, three times had been hospitalized. He Results: In the study period, 63 patients (20 female received red blood cell transfusion in 2 times of the and 43 male) with chronic liver disease and 85 previous hospitalization due to severe bleeding and control subjects (42 female and 43 male) were decreased hemoglobin level (7.5 g/dl). In the first enrolled. Mean age of cases and control were 45.60 ± endoscopy one clean base linear ulcer was reported in 14 and 48.5 ± 15 respectively. The most common greater curvature of antrum. Biopsy from ulcer was cause of chronic liver disease was post-necrotic performed and injection with epinephrine was done. cirrhosis due to hepatitis B virus. Patients with Despite medical management, bleeding was repeated chronic liver disease had significantly higher mean several times later. Then, to identify the cause of portal, splenic and azygos vein diameters than the bleeding five times endoscopy and three times control group (p<0.001). With azygos, portal and colonoscopy performed. In first rectosigmoidoscopy, splenic vein diameters of 10, 11 and 9 mm, sensitivity upper to sigmoid was full of tarry stool and therefore for the diagnosis of portal hypertension was 66%, colonoscopy was not continued. After this period, in 71%, 66% while specificity was 94%, 99% and 99% 2 sessions colonoscopy was done that one of them up respectively. Splenic and portal vein dilation and to hepatic flexure and other up to cecum were normal. thrombocytopenia were significantly correlated with But in all these studies the origin of bleeding was not variceal bleeding (p<0.05). found. Barium follow through of the small intestine Conclusion: EUS allows the collection of valuable also failed to show any lesions. RBC scan & meckel’s quantitative data from the portal system for the diag- scan was normal too. Therefore, the source of nosis of portal hypertension and in the follow up of gastrointestinal bleeding was suspected to be small patients with chronic liver disease. intestine and thus he was referred to our hospital. Send Date: 2011/07/12 Forty days had passed from the last gastrointestinal bleeding. In new admission in our hospital his hemoglobin was 10.5 g/dl. On the next day of his Category: 19 ENDOSCOPY AND IMAGING admission, written informed consent was obtained 19.5 Enteroscopy from him and he underwent per oral double balloon F-T-151 endoscopy. DBE under anesthesiologist supervised Acute pancreatitis as a complication of peroral was done. The total time of the procedure was 130 double-balloon enteroscopy: A case report min. the source of GI bleeding was not found. At the Najmeh Aletaha1* most distal site, the small intestinal mucosa was 1 Imam Khomeini Hospital, Tehran University of Medical marked with a tattoo by a submucosal injection of Sciences sterilized ink through an injection catheter. A few Introduction: Double-balloon enteroscopy (DBE) is hours later the procedure, the patient complained a new technique for evaluation small intestine. DBE from severe abdominal pain. The pain was was initially developed by Yamamoto et al, in Japan. generalized that was most intense in the left upper Potential complications include perforation, quadrant. An abdominal examination revealed pancreatitis, and gastrointestinal bleeding. The moderate LUQ tenderness. His laboratory findings overall complication rate is stated as being about were as follows: white blood cells, 16,100/μL; serum 1.7%. Hyperamylasemia after per oral DBE was amylase, 550 U/L (normal up to 100 U/L). reported in approximately half of the patients, and Abdominal CT revealed an inflammation of the body with 1–8% developing pancreatitis. In this paper, we of pancreas. There was amount fluid around the

88 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011 spleen. Surgery consult was done. The next day, effective in reducing cholangitis in in-vitro studies Laparoscopic surgery was recommended to be done but results of clinical trials are conflicting. We studied to exclude bowel perforation and the probability of the effect of intracontrast gentamicin in reducing the finding the source of bleeding. Diagnostic rate of post-ERCP cholangitis in patients with laparoscopy was done. All the small intestine was obstructive jaundice. investigated. No perforation was seen. Small amount Method: All patients with obstructive jaundice un- of reactive fluid in the abdomen was seen. In distal of derwent endoscopic biliary stenting at the Shariati ileum there was a Meckel's diverticulum about 1.5 Hospital, Tehran between December 2009 and cm. Mini laparatomy was done and Meckel’s October 2010 were enrolled. 10 mg gentamicin or diverticuli resected and anastomosis was done. distilled water, added to each 10cc contrast medium Pathology confirmed ectopic gastric tissue. during ERCP. Intravenous antibiotics were given Discussion: Post-DBE pancreatitis has been before and after the procedure in all patients. After recognized as a complication. In diagnostic ERCP and stent deployment, patients were followed procedures, pancreatitis is the most common and for 72hrs for symptoms and signs of cholangitis. most severe complication. The first post-DBE acute Results: A total of 114 patients were eligible for the pancreatitis was reported by Honda et al in 2006. study. Fifty seven patients were included in each Acute pancreatitis is a feared complication of oral group. Cholangiocarcinoma was the most prevalent DBE (51 cases of acute pancreatitis have been diagnosis. The obstruction was relieved in all patents described in the literature to date, one of them fatal). by stenting. Five patients in each group (8.8%) The underlying mechanism of pancreatitis in these developed cholangitis. There was no significant cases is unclear. Pancreatic duct obstruction by direct difference in the incidence of cholangitis between the pressure of the papilla with the inflated balloon, an two groups (p=1.000). increase in duodenal intraluminal pressure caused by Conclusion: With adequate drainage of obstructed the overtube and gastrointestinal shortening biliary tract by proper stenting, adding gentamicin to technique, the reflux of duodenal contents into the contrast media has no significant effect in reduction pancreatic duct due to intraluminal hypertension of post-ERCP cholangitis. caused by the inflated balloon, or traumatic injury or Send Date: 2011/08/05 ischemia due stretching and shortening of the proximal small bowel have been discussed as possible mechanisms. Category: 20 THERAPEUTIC ENDOSCOPY/IN- Send Date: 2011/05/18 TERVENTIONAL PADIOLOGY 20.2 Enteral dilatation and stenting (esophagus - stomach - duodenum - colon) Category: 20 THERAPEUTIC ENDOSCOPY/IN- F-T-153 TERVENTIONAL PADIOLOGY Achalasia Endoscopic Visual Scale (Achalasia 20.1 Biliary and pancreatic stenting EVS): A Grading Method Predicting Long-term F-T-152 Outcome of Pneumatic Dilation in Patients with The effect of adding gentamicin to contrast Achalasia media for prevention of cholangitis after biliary Mohammad Hassan Emami1*, Mohsen Sharifi2, stenting; a randomized controlled trial Ghasem Mohammad Sharifi2, Ziba Farajzadegan3, Alireza Norouzi1*, Morteza Khatibian1, Parisa Golmohammadi4, Mehran Haghighi5, Razieh Afroogh1, Meghedi Amirhosein Sarrami5 Chaharmahali1, Rasoul Sotoudehmanesh1 1Poursina Hakim Research Institute, Department of 1Digestive Disease Research Center, Tehran University of Gastroenterology, Isfahan University of Medical Sciences 2 Medical University Department of Gastroenterology, Isfahan University of Introduction: Cholangitis is the most common Medical Sciences, 3 infectious complication of ERCP. Prophylactic Poursina Hakim Research Institute, Department of Com- munity Medicine, Isfahan University of Medical Sciences addition of aminoglycosides to contrast medium was

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4Poursina Hakim Research Institute. recurrence and need for re-intervention. 5Isfahan University of Medical Sciences Results: Sixty patients (58.3% female) with mean age Introduction: Pneumatic dilation (PD) is a of 39.9 ±18.9 years completed the study. The mean of reasonable nonsurgical option for management of symptom free survival of PD was 58.9±6.2 months achalasia. Few methods have been used to predict (95% CI: 46.6-71.1) in all patients. Mean (95% CI) long-term efficacy of PD but, with some limitations, symptom free survival with MT grade 1 to 4 were hazards, and expenses. This study was designed to 36.5±6.3 (24.1-49.0), 68.8±10.3 (48.5-89.1), evaluate the potential of a new grading method, 79.8±10.1 (59.8-99.8), and 30.0±0.0 months, Achalasia Endoscopic Visual Scale (EVS), for respectively; P = 0.014. Mean symptom free survival predicting long-term outcome of PD in patients with based on LES opening grading of A to D were achalasia. 30±4.2, 52.0±7.9, 53.6±8.2, and 51.4±7.0 months, Method: In a prospective study, 65 patients with respectively; p= 0.256. definite achalasia underwent PD, consecutively. Conclusion: Achalasia EVS based on new MT Based on the amount of Mucosal Tearing (MT) after classification is a strong independent predictor of PD, patients were graded from 1to 4 and for lower long-term symptom free survival of PD. Multi-centric esophageal sphincter opening (LES opening) from A studies are required to find intra- and inter-observer to D (LES doesn’t open by air insufflations to LES is variations of this grading system and to incorporate open spontaneously without air insufflations with a LES opening and clinical factors in formula for more diameter of 11 mm or more). A validated symptom precise prediction of the PD prognosis. score questionnaire were used before PD and one, six Send Date: 2011/08/05 and twelve months after PD. Annual visits were performed thereafter in order to detect any symptom

90 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Index

Author Index (English Abstracts) A Amini-Kafiabad Sedigheh Boroumand-Noghabi Farhangi Elham...... 51 Abangah Gobad...... 39 ...... 61 Samaneh...... 27,30 Farhoodi Mahmood ...... 62 Abbasi Masoumeh...... 50 Aminizadeh Ali...... 8 C Farnam Alireza ...... 45 Abbaszadeh Lili ...... 53 Amiri Ali ...... 32 Chaharmahali Meghedi Farrokhi Farid ...... 40 Abdolahi Tahoora Amiri Hajar ...... 35 ...... 42,45,89 Farsinejadmarj Maryam ...... 27,28,29 Amiriani Taghi ...... 16,46,47 D ...... 68,86,87 Abdolahi Nafiseh ...... 31 Andakhshideh Elahe ...... 30 Dadashzadeh Alireza ...... 7 Fattahi Mohammadreza Abdolahi Farzan...... 64 Andrabi Yasir...... 61,70 Daghaghzade Hamed...... 35 ...... 11,14,26,43,64,85 Abdolhosseinpour Faraneh Ansari Reza...... 83 Darabi Masoud ...... 62 Fattahi Ebrahim ...... 34,58 ...... 40 Arab Payman ...... 87 Darvish-Moghadam Sodaif Fazel-Tabar-Malekshah Abdollahi Hamid ...... 33 Ardebili Maryam ...... 33,60 Akbar ...... 77 Abdollahi Mohammadreza ...... 14,26,36,43 Dastgiri Saeed ...... 22 Fereshtehnejad Seyed- ...... 67 Arj Abbas ...... 65 Davari Majid ...... 16 Mohammad ...... 8,55 Abedian Shifteh ...... 15,56 Arjmandi Fariba ...... 35,36 Davarpanah Mohammad-Ali Forghani Mohammd-Naser Abedi-Ardekani Behnoush Arjmandpoor Akbar ...... 36 ...... 10 ...... 27 ...... 22 Aryan Arash...... 8 Dawsey Sanford ...... 22,77 Forutan Hossein Abedi-Manesh Nasim Asaf Fatima ...... 86 Dehghani Seyed-Mohsen ...... 61,70,74 ...... 41,47 Ashayeri Rizan ...... 9 ...... 51,76 G Abedini Siavash...... 8, 11,40 Atef- VahidAhad ...... 79 Derakhshan Ali...... 51 Ganjali Rashin...... 29 Abedini Sahar...... 11 Attari Fatemeh ...... 73 Derakhshandeh Roshanak Ganji Azita ...... 39,62 Abnet Christian...... 22,77 Attarzade-Hosseini Seyed- ...... 79 Garjani Afag...... 53 Abrishami Mostafa ...... 28 Reza ...... 55 Deyhim Mohammad-Reza Gasemi-Oskouyi Aysan..... 67 Adhami Leila ...... 36 Ayoubian Hiresh...... 78 ...... 61 Gavidel Ali ...... 34 Adhamian Pardis ...... 13 Azarian Ali ...... 50 Dordaei Faranak ...... 53 Geramizadeh Bita...... 20,26 Adibi Peyman...... 35 B E Ghadir Mohammad-Reza...... Adimi Parisa ...... 70 Babaei Leila...... 85 Ebrahimi-Dariani Nasser 10,27,28,29,32,45,50,73,78,84 Afroogh Razieh...... 89 Baghbanian Mahmoud ...... 74 ...... 8,45,74 Ghaffarzadegan Kamran Afzalaghaee Mahdi ...... 29 Bagheri Masood ...... 38 Eidani Esmaeil...... 21 ...... 27,28,30,62 Afzalaghaee Monavar ...... 29 Bagheri Mohammad...... 45 Elahi Elham ...... 21,24 Ghajarieh-Sepanlou Sadaf Aghamohamadi Nima...... 24 Bagheri Zohreh ...... 55 Emami Mohamad-Hasan ...... 54,61,63 Ahadi Mitra...... 62 Bagheri Masood...... 59,81 ...... 16,25,35,38,81,85,90 Ghamghar Alireza...... 34 Ahi Salma...... 64 Bagheri-Lankarani Kamran Erfani Mina ...... 30 Ghannadzadeh Ali...... 8 Ahmadi Ali ...... 16 ...... 26,43,77 Esalatmanesh Kamal ...... 65 Ghanooni Amir-Hosein .....50 Ahmadi-asl Nser ...... 70 Bahari Ali ...... 11,52,62 Esfahanian Samaneh ...... 67 Gharagozloo Marjan ...... 48 Ahmadzadeh A ...... 58 Bakhti Hadi ...... 78 Eslami Masoumeh ...... 63,69 Ghasemi Shima ...... 50 Ahsan Majid ...... 85 Bakhtiyari Reza ...... 8 Eslamian Ghazaleh...... 75 Ghasemi-Barghi Reza ...... 56 Ainechi S...... 87 Barootkoob Abdolamir .....75 Esmaeelzade Abbas Ghasemi-Jangjo Amir ...... 22 Ajdarkosh Hossein Barzanooni Somayeh ...... 47 ...... 28,39,40,62 Ghazanfari Hadi...... 48 ...... 8,31,55,63,72,78 Basi Ali...... 78 Esmaili Saeed ...... 63 Gheibi Shahsanam ...... 37 Akhavan-Rezayat Kambiz Basiratnia Mitra...... 51 Etemad-Eslami Reza ...... 8 Ghergherehchi Robabeh ...39 ...... 68 Bastani Faegh ...... 62 Etemadi Arash ...... 21,77 Ghofrani Hadi ...... 61,74 Akhavan-Tabib Atefeh...... 16 Bayat Fatemeh...... 13 F Ghojazadeh Morteza Akhondi-Meybodi Mohsen Bayat Maryam ...... 55 Faghani Behzad ...... 16 ...... 9,26,38,59,67,81 ...... 61 Belbasi Mojtaba ...... 10 Faghihi Amir-hossein...... 67 Gholami Nasrin...... 53 Alavian Seyed-Moayed Belladi-behbehani Maryam Faghrjo Asraf ...... 34 Gholamrezaei Ali...... 13,85 ...... 10,67 ...... 66 Faiazi Nader...... 70 Golbahar-Haghighi Ardalan Alavian Seyedeh-Hoda .....67 Besharat Sima...... 16,46,47 Fakheri Hafez...... 41 ...... 9,81 Aletaha Najmeh ...... 74,88 Besharat Mahsa...... 46,47 Fakhrjoo Ashraf...... 49 Golmohammadi Parisa ...... 90 Alhojjat Yahya ...... 9 Boffetta Paolo...... 77 Fallahzadeh Mohammad- Golshahi Maryam...... 11 Ali- Asgari Ali ...... 87,87 Bolandmartabeh Maryam Hossein...... 51 Golshiri Parastoo ...... 81 Alipour Beitollah ...... 41,47 ...... 50,32 Farahmand Fatemeh ...... 40 H Alizadeh Ahmad ...... 68 Bonyadi Mortaza...... 9 Farahvash Mohammad-Jafar Habibinejad Hosein-Ali ....84 Ameli Mitra ...... 43,72 Bordbar Marjan ...... 33 ...... 74 Habizadeh Mohamad-Reza Amin-daneshpoor Banafsheh Borghei Afsaneh ...... 47 Farajzadegan Ziba ...... 90 ...... 25 ...... 51 Borhanmanesh Fathali ...... 20 Farhang Sara ...... 45 Haghighat Mahmood ...51,76

Govaresh\ Vol.16\ Supplement\ Autumn 2011 91 Index

Haghighi Keyvan...... 40 Ismayeeli Mohsen ...... 44 Kord-ValeshabadAli ...... 7 Mohammad-Doust Faezeh Haghighi Mehran...... 90 J L ...... 11 Hainaut Pierre ...... 22 Jabar-Fattahi Monireh...... 82 Lashkari Alireza ...... 80 Mohammadi Reza ...... 46 HajAgha-Mohammadi Ali- Jabbarpour-Bonyadi Morteza Leghayeeyan Negar...... 44 Mohammedzadeh Mo- Akbar ...... 56 ...... 44 M hammed...... 22 Hajian Habibollah ...... 50 Jacobson Kevan ...... 75 Maddah Ghodratollah ...... 29 Moini Maryam ...... 26,43 Hajiani Eskandar Jafari Elham ...... 15 Mahdavy Nafise...... 45 Mojrian Alireza ...... 16 ...... 24,37,54,58,66 Jafarshad Reyhane ...... 50,68 Mahluji Sepide ...... 14 Mokhtari Mojgan ...... 38 HajMola-Rezaee Ezzat...... 27 Jafarzadeh Mostafa Mahmoodi Samaneh ...... 64 Mokhtarifar Ali...... 39,62 Hajypour Babak ...... 70 ...... 27,28,29,30 Mahmoudi Laleh...... 24 Momtahen Shabnam ....15,42 Hakhamaneshi Mohammad- Jalili Ali ...... 78 Majidi Golnar ...... 58 Montazeri Ali ...... 18,20 Saeed ...... 78 Jamali Raika...... 83 Maleknejad Shohreh ...... 33 Moosavi SA...... 68 Hakimi Hamid-Reza...... 30 Jamali Arsia ...... 83 Malekzadeh Reza Moosavy Seyed-Hamid Hamidpour Laleh Jamshidi Ahmad-Reza ...... 12 ...... 15,21,22,24,42,45,54,56,63,77 ...... 61,70 ...... 19,26,43,51,77,85 Japoni Sara...... 64,76 Malekzadeh Fatemeh ...... 42 Moradi Fariba...... 18,20,75 Hanifpoor Mohammad-Amin Javadrashid Reza...... 57 Mansoorabadi Zahra ....26,43 Moradimoghaddam Faride ...... 75 Javid-Anbardan Sanam...... 8 Mansour-Ghanaei Fariborz ...... 62 Hasanzarrini Maryam...... 36 Joshaghani Hamidreza ...... 47 ...... 7,68 Moravveji Alireza...... 65 Hashemi Seyed-Jalal Joukar Farahnaz...... 7,50,68 Maracy Mohammad-Reza....16 Mosavi-fard Seied-Hossein ...... 21,24,37,54,58,66 K Marasi Mohammad-reza... 48 ...... 60 Hashemi Mohammad...... 52 Kalagheichi-azar Hassan... 70 Masjedi Morad...... 38 Mostaghni Ahmad ...... 18 Hashemzehi Noralla ...... 52 Kalani Mohammad ...... 74 Masjedizadeh Abdolrahim Mostaghni Amir-Ahmad ...20 Hassannejad Niloofar ...... 48 Kalantari Hamid ...... 48 ...... 37,66 Mousavi Ghafour ...... 70 Hassanzadeh Abbas ...... 21 Kamangar Farin...... 22 Masnadi-Shirazi Koorosh Mousavi Seyed-Mohsen... 73 Hatami Ashkan...... 8 Kamkar Mohammadzaman ...... 53,57 N Hatami Khadijeh...... 43 ...... 46 Masoom Anahita..... 28,29,30 Naghashi Shahnaz ...... 34,58 Hatef Mohammad-Reza ....39 Karimi Shahrzad ...... 65 Masoumi Seyed-Jalil.....8,20,75 Najafi Mehrdokht Hatefi Asieh ...... 40 Karimipour Mojtaba...... 37 Massah Saeid...... 16 ...... 31,43,49,69,72,73 Hayatbakhsh Abdolrasol ...39 Kashifard Mehrdad ...... 72 Matin Marzieh...... 51 naseri Ali- Reza ...... 22 Hayatbakhsh-Abasi Moham- Kazemi Mohammadhassan Mehdioghli Rahim ...... 81 Naserimoghadam Siavash mad-Mehdi...... 33,60 ...... 19,77 Mehrabani Davood ...... 42 Hazrati Jila ...... 81 Kazemi Shadi ...... 25 ...... 7,18,20,75,79 Nasiri Behnam ...... 22 Heidari Akram...... 10,84 Keramati Mohammad-Reza Mehrabi Narges ...... 21,24,86 Nasiri- Toosi Mohsen... 61,70 Heidari Zohreh...... 84 ...... 8 Mehrabi-Bahar Mostafa.....30 Nazari Shahram ...... 71 Hekmatdoost Azita ...... 75 Keshtkar Abbasali ...... 16 Mehrazma Mitra ...... 79 Nejhadi-Kelarijani Fatemeh Heydari Seyed- Taghi...... 79 Khademolhosseini Farnaz Memar Bahram...... 62 ...... 16,47 Hj-Sheykholeslami Arghavan ...... 10,20 Merat Shahin nekozadeh Shabaz...... 32 ...... 84 Khajedaluee Mohammad ..11 ...... 54,60,61,63,64,84 Nematy Mohsen ...... 55 Homayoon Katayoon...... 85 Khaleghi Siamak..32,49,64,72 Mikaeli Javad...... 21,24,86 Nikkhoo Bahram ...... 51,78 Honar Naser ...... 76 Khaleghnejad Reza...... 42 Minakari Mohammad Nikmahzar Aghbibi ...... 63 Hosaini-askarabadi Ma- Khamisi Naser ...... 66 ...... 36,66,86 Niknam Ramin ...... 24 soomeh ...... 21 Khanahmadi Naser ...... 84 Mirbagheri Seyed-Amir ....79 Nikroo Hossein...... 55 Hoseini Moosarreza...... 62 Khansari Mahmoud-reza Mirfeizi Seyedezahra...... 39 Nikzabn Mehrnoosh ...... 78 Hoshyar Yusof ...... 53 ...... 31,43,63,72,78 Mirinejhad Seyyed-Kazem Norouzi Alireza ...... 89 Hosseini Seyed-Vahid ...... 7 Khatibian Morteza...... 89 ...... 22,44,49 Nouraie Mehdi ...... 54 Hosseini Fereshteh ...... 11 Khodadady Ali ...... 70 Mir-nasseri Mohammad- Nouri Mohammad ...... 80 Hosseini-Asl Seyed-Moham- Khoncheh Ahmad ...... 12 Mehdi...... 15 O mad-Kazem...... 11 khoshbaten Manouchehr Mirza-Agha F ...... 87 Olfati Golrokh ...... 42 Hossein-Nattajarab Hadi... 38 ...... 34,53,53,57,73,80,82 Mirzaee Vahid...... 13 Omidi Abdollah ...... 83 Hosseinnezhad Hanieh ...... 27 Khoshnia Masoud...... 16 Modabbernia Amirhossein ostadrahimi alireza ...... 41,47 Hosseinnezhad Hanieh khosravi Ahmad..11,39,40,62 ...... 69 P ...... 28,29,30 Khosravi Mohammad- Modaresi Vajiheh...... 40 Paknejad Pooya ...... 81 I Sadegh...... 75 Modarresi Seyedeh-Zalfa ..40 Parizadeh Mostafa ...... 28 Imanieh Mohammad-Hadi Kia-kojuri Fatemeh ...... 43 Modirzadeh A ...... 86 Parniyan Maryam ...... 60 ...... 51,76 kiana Shahzamani...... 60 Mohamad D ...... 86 Parsa Mahboubeh ...... 27 Iranikhah Abolfazl ..10,32,73 Kolahdoozan Shadi mohamadkhani Ashraf Peikan-Heirati Masoumeh Islami Farhad...... 77 ...... 84,87,42,45 ...... 62,63 ...... 54

92 Govaresh\ Vol.16\ Supplement\ Autumn 2011 Index

Phillips David ...... 77 Sadeghi Yazdan...... 16 Shokraneh Farhad ...... 9 ...... 10 Pishahang Parinaz ...... 80 Sadeghian Faezeh ...... 64 Shokrishirvany Javad ...17,72 Z Pishdad Raha ...... 58 Saefari Kyhan ...... 49 Sima Hamid-Reza Zaare Maryam...... 57,53 Pooyan Ashkan...... 8 Saeidi Hamidreza ...... 50 ...... 11,27,28,29,30,40,55,62 Zahedi Mohammad-Javad Pouri Aliasghar ...... 26 Safarpour Alireza...... 7 Soleimanpour Maryam .....44 ...... 33,60 Pournaghi Javad...... 40 Sahebari Maryam ...... 40 Soleymany Ali...... 37 Zamani Farhad Pourshams Akram ...... 63,77 Sahebfosoul Fereshteh ...... 38 Soltanpour Narges...... 13 ...... 31,49,55,63,69,72,79 Poustchi Hossein...... 62,63,69 Sajjadi Masoud ...... 30 Somi Mohammadhossein Zare Najaf ...... 18,20,75 R Salehvand mohamad ...... 54 ...... 9,22,26,34,38,41,44,45, Zargar Ali...... 56 Rabei Azar ...... 61 Salek- Zamani Yagoub...... 53 47,58,59,67,70,81,62 Zarghami Mehran ...... 41 Rabiei Maryam...... 7 Salimi Elnaz...... 32 Sotoudeh Masoud... 22,54,62 Zoghian Reihaneh...... 27,30 Rabiei Neda...... 43 Samimi Rasoul ...... 56 Sotoudehmanesh Rasoul Zonubi Zahra...... 14 Rafatpanah Houshang ...... 30 Saneian Hossein ...... 13 ...... 54,68,86,87,89 Rafeey Mandana ...... 39 Sarkeshikian Seyed-Saeid Sydnzhad Farshad...... 22 Rahbani Mohammad...... 62 ...... 10,32,73 T Rahimi Hojatalah ...... 35 Sarrami Amirhosein ...... 90 Taba-Taba-Vakili Sahar...... 8 Rahmati Atieh ...... 12 Sarsar Ebrahim ...... 68 Tabrizian Tahmineh ...... 42 Rajaeefard Abdolreza ...... 10 Sattarnezhad Neda ..57,80,82 Tadayon Mohsen ...... 28,29 Author Index Rakhshani Nasser...... 78 Savadkoohi Shahriar...... 72 Taghavi Seyed-Alireza Rakhshani Nasser ...... 79 Savari Mohammad ...... 33 ...... 19,26,43,77 (Persian Abstracts) Ramazanzadeh Elham...... 53 Sayehmiri Kourosh ...... 62 Taghavi Yasser...... 72 Ranjpour Farza ...... 12 Sayyah-Melli Manijeh ...... 82 taghipour Hoda ...... 32 AuPBkocýíþÎéþoÂB...... 84 Rashe Zahra...... 38,59 Sedighy Sima ...... 47 Taheri Diana...... 16 AÞHpÿAcvBó...... 28 Rashid Javad ...... 53 Semnani Shahryar ...16,46,47 Taheri Hassan...... 17,72 Aðõyúìdíl...... 96 Rashtak Shadi...... 42 Seyyedein Sasan ...... 47 Taheri Amir...... 51 KõoyíwAÞpï...... 32 Rasooli Reyhaneh ...... 81 Shad Esrafil ...... 17 Talebi-Taher Mahshid KõoÿÎéþA¾Óp...... 52,62,95 Razavizadeh Mohsen ...... 65 Shafaghi Afshin ...... 50,68 ...... 32,64 WÏ×pÿAèùBï...... 32 Raziee Hamid-Reza .....27,30 Shafieipour Sara ...... 52 Tavakol Kamran...... 13 cvýñþWrðþðýíB...... 96 rezaee mehrnoosh...... 61 shahbazian Hajieh ...... 54 Tavakol-Afshari Jalil Rezaei Abbas ...... 48 Shahbazkhani Bijhan ...12,74 ...... 28,29,30 gBkìþøõìò...... 32 Rezaeifar Parisa ...... 58 Shahzamani Kiana ...... 60,84 Tavakoli Hamid...... 25 uXBkÿÎéýpÂB...... 32 Rezaianzadeh Abbas Shakeri Mohammad-Taghi Tavassoli Alireza ...... 10 yõÞQðÛlûìÏ¿õìú...... 96 ...... 10,14,19 ...... 8 Tghyzadyah Mohammad ..70 ¾BGpÿÖýpôqÿìùlÿ...... 21 Rezghi Mehrnaz ...... 49 Shamsdin Seyedeh-Azra ...79 Tollabzadeh Zahra...... 26 ¾õìþìdílcvýò...... 52,62,84,95 Rezvan Hoori ...... 61 Shariati Alireza ...... 8 V ÎBGlüBóyý×Pú...... 21 Riahi Aina ...... 15 Shariati Mohammad-Javad Vaez-Javadi Maryam...... 84 ÎBGlÿìñ{ðvýî...... 84 Riahin Ali-Akbar ...... 50 ...... 8 Vafaeimaneh Jamshid ...... 32 ÎBGlÿìñ{uÏýl...... 84 Roshandel Gholamreza Sharifi Davood ...... 62 Vahedi Homayoon ..15,42,45 ...... 16,31,46,47 Sharifi Mohsen ...... 90 Vahedi Hamid ...... 61 ÖBÂêOHBoìéßzBûAÞHp...... 32 Rosta Turaj ...... 34 Sharifi Ghasem-Mohammad Valizadeh Narges ...... 30 ÚõWBqAkûìpOÃþ...... 52,62,95 Rowshandel Mehdi ...... 81 ...... 90 van-Schooten Frederik-Jan âõâçðþâõøpyBk...... 32 S Shavakhi Ahmad ...... 66,86 ...... 77 ìPnÞpìpOÃþ...... 96 Saadatnia Hassan ....39,40,62 Shayesteh Aliakbar ...... 37,66 Villar Stephanie ...... 22 ìdílqAkûÚpûGBÒþìdílAìýò...... 95 Sabahi Farzaneh ...... 60 Shayesteh Mehdi ...... 37 Vosoghiniya Hassan ìéàqAkûoÂB...... 32,21 Saberifiroozi Mehdi Sheikhesmaeili Farshad ...... 39,62,8,11,40 ìýpðB¾pÿìdílìùlÿ...... 21 ...... 15,18,2056,75,79 ...... 51,7378,84 Y sadat-Mirkarimi Honey .....46 Shirani Shapoor...... 24 Yazdanfar Seyed-Kamalaldin

Govaresh\ Vol.16\ Supplement\ Autumn 2011 93 ìXéú âõAo} ko ðíBüú øBÿ qüp AüñlÞw ìþ GByl: ìþ AüñlÞw qüp øBÿ ðíBüú ko âõAo} ìXéú

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ðzBðþ ô Oé×ò ìÇI : : ìÇI Oé×ò ô ðzBðþ

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657-8002 (@ðçüò), 8757-8002 (AèßPpôðýà) 8757-8002 (@ðçüò), 657-8002 x (^BKþ), 6817-0651 yBKB: 1-67 KýBKþ: yíBoû 0931 KBüýr , ðBìú ôütû 61, kôoû ðByp: AìPýBq: ¾BcI AðXíò ìPh¿¿ýò âõAo} ô ÞHl AüpAó AüpAó ÞHl ô âõAo} ìPh¿¿ýò AðXíò AüpAó ÞHl ô âõAo} ìPh¿¿ýò AðXíò upkGýp: : ìvEõë ìlüp ô ìõuw kÞPp ðB¾p AGpAøýíþ koüBðþ AGpAøýíþ ðB¾p kÞPp ìýpìXévþ uýlcvýò kÞPp yõoAÿ upkGýpÿ (Gú OpOýI Aè×HB): OpOýI (Gú upkGýpÿ yõoAÿ Aè×HB): OpOýI (Gú Odpüpüú øýEQ kÞPp ìdílWÏ×p Öpû ô} Öpû ìdílWÏ×p kÞPp ôokÿ Aèú GùBo kÞPp ìvpR ¾BkÝ kÞPp @ÚBqAkû kÞPpocýî kÞPp Òçìdvýò Öçcþ Òçìdvýò kÞPp GBÚpÿ ìdíl kÞPp qAkû ìéà oÂB kÞPp koüBðþ AGpAøýíþ ðB¾p kÞPp kÞPp yBøýò ìp@R yBøýò kÞPp Kõoyíw AÞpï kÞPp ìñ¿õoÚñBÎþ ÖpüHpq kÞPp køßpkÿ ðX×þ AìBìþ uýlìdílcvò kÞPp kÞPp ÚloR Aèú ìñPËpÿ Aèú ÚloR kÞPp ìùpWpkÿ qAoÑ Îéþ kÞPp ìýßBDýéþ WõAk kÞPp ìÛlï koôü{ ¾lüØ kÞPp kÞPp uýlìdílìùlÿ ìýpðB¾pÿ uýlìdílìùlÿ kÞPp qìBðþ ÖpøBk kÞPp ìýñBÞBoÿ ìdíl kÞPp uýíB cíýloÂB kÞPp kÞPp ðvpüò qðlû kë qðlû ðvpüò kÞPp Æõuþ ð¿ýpÿ ìdvò kÞPp ¾õìþ ìdílcvýò kÞPp kÞPp ouõë uPõkû ìñ{ uPõkû ouõë kÞPp øByíþ uýlWçë kÞPp qAkû ìvXlÿ ÎHlAèpcýî kÞPp

AÎÃBÿ Gýò Aèíééþ øýEQ Odpüpüú: øýEQ Aèíééþ Gýò AÎÃBÿ kÞPp âõülô@kèp (@èíBó) kÞPp Îéþ ÞzBôoqüBó (AüBæR ìPdlû @ìpüßB) ìPdlû (AüBæR ÞzBôoqüBó Îéþ kÞPp (@èíBó) âõülô@kèp kÞPp kÞPp AüpZ uHdBðþ (ÖpAðvú) kÞPp kOéØ yõKBó (AüBæR ìPdlû @ìpüßB) ìPdlû (AüBæR yõKBó kOéØ kÞPp (ÖpAðvú) uHdBðþ AüpZ kÞPp

ìlüp AWpAüþ: ìlüp : Îéíþ ôüpAü{ kÞPp uýl ìdílìùlÿ ìýpðB¾pÿ ìdílìùlÿ uýl kÞPp ìdílðtAk ìùlÿ kÞPp

ôüpAü{ AkGþ ìPò Aðãéývþ: ìPò AkGþ ôüpAü{ ÖBouþ: ìPò AkGþ ôüpAü{ kÞPp Aìýpcvýò uXBküú, kÞPp cíýloÂB ðíBqÿ, kÞPp AuíBÎýê Að¿Boÿ AuíBÎýê kÞPp ðíBqÿ, cíýloÂB kÞPp uXBküú, Aìýpcvýò kÞPp Þýî ôÚBoÖpk Þýî

Aìõo kÖPpÿ: Aìõo : @oAüþ ¾×dú ìBoAë ¾ýBk, @qAkû ôèþ qAkû,ÖpqAðú AOdBk qAkû,ÖpqAðú ôèþ @qAkû ¾ýBk, ìBoAë AOdBk ÖpqAðú

ðzBðþ ðByp: ðzBðþ ìXéú: KvPþ ðzBðþ OùpAó, gýBGBó ÞBoâp yíBèþ, WñI ìpÞr ÚéI OùpAó, Þõ^ú yùpüõo, yùpüõo, Þõ^ú OùpAó, ÚéI ìpÞr WñI yíBèþ, ÞBoâp gýBGBó OùpAó, yùpüõo, Þõ^ú OùpAó, ÚéI ìpÞr WñI yíBèþ, ÞBoâp gýBGBó OùpAó, yíBoû 31, ôAcl 1 1 ôAcl 31, yíBoû 1 ôAcl 31, yíBoû kÞPp uýlcvýò ìýpìXévþ uýlcvýò kÞPp 59341 361- KvPþ ¾ñlôÝ 3- 16 05 33 88 88 33 05 16 3- ðíBGp: ô Oé×ò ìvpR ¾BkÝ kÞPp gro.hgai@ofni AèßPpôðýà: KvQ 88 33 05 16 3- ðíBGp: ô é×ò O Aüò ðzpüú ìõok cíBüQ ìBèþ AðXíò ìPh¿¿ýò âõAo} ôÞHl AüpAó ìþ GByl. GByl. ìþ AüpAó ôÞHl âõAo} ìPh¿¿ýò AðXíò ìBèþ cíBüQ ìõok ðzpüú Aüò øpâõðú AuP×Bkû Aq ìÇBèI ðzpüú GB mÞp ìñHÐ GçìBðÐ AuQ. AuQ. GçìBðÐ ìñHÐ mÞp GB ðzpüú ìÇBèI Aq AuP×Bkû øpâõðú :etiS beW :etiS gro.hgai.www :liam-E gro.hgai@hseravog