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Introduction: Recently, we showed that the length of cardiac mucosa in healthy volunteers correlated with age and obesity. We have now examined the immunohistological characteristics of this expanded cardia to determine whether it may be due to columnar metaplasia of the distal oesophagus. Methods: We used the squamocolumnar junction (SCJ), antral and body biopsies from the 52 Helicobacter pylori-negative healthy volunteers who had participated in our earlier physiological study and did not have hiatus hernia, transsphincteric acid reflux, Barrett's oesophagus or intestinal metaplasia (IM) at cardia. The densities of inflammatory cells and reactive atypia were scored at squamous, cardiac and oxyntocardiac mucosa of SCJ, antrum and body. Slides were stained for caudal type homeobox 2 (CDX-2), villin, trefoil factor family 3 (TFF-3) and liver-intestine (LI)-cadherin, mucin MUC1, Muc-2 and Muc-5ac. In addition, biopsies from 15 Barrett's patients with/ without IM were stained and scored as comparison. Immunohistological characteristics were correlated with parameters of obesity and high-resolution pH metry recording. Results: Cardiac mucosa had a similar intensity of inflammatory infiltrate to non-IM Barrett's and greater than any of the other upper GI mucosae. The immunostaining pattern of cardiac mucosa most closely resembled non-IM Barrett's showing only slightly weaker CDX-2 immunostaining. In distal oesophageal squamous mucosa, expression of markers of columnar differentiation (TFF-3 and LI-cadherin) was apparent and these correlated with central obesity (correlation coefficient (CC)=0.604, p=0.001 and CC=0.462, p=0.002, respectively). In addition, expression of TFF-3 in distal oesophageal squamous mucosa correlated with proximal extension of gastric acidity within the region of the lower oesophageal sphincter (CC=-0.538, p=0.001). Conclusions: These findings are consistent with expansion of cardia in healthy volunteers occurring by squamo columnar metaplasia of distal oesophagus and aggravated by central obesity. This metaplastic origin of expanded cardia may be relevant to the substantial proportion of cardia adenocarcinomas unattributable to H. pylori or transsphincteric acid reflux. [ABSTRACT FROM AUTHOR]

Fluid properties, pressure drop and friction factor of MWCNT (multi-walled carbon nanotube)–oil nanofluid for laminar assisting mixed convection was investigated experimentally. Smooth and microfin tubes were used as the test tubes under constant heat flux boundary conditions. Pure heat transfer oil and nanofluids with particle weight concentrations of 0.05%, 0.1% and 0.2% were utilized as the working fluids. Experiments were performed at θ = 0, 45 and 90° for the upward flow and Richardson number ranging from 0.1 to 10. Results showed that pressure drop increased as inclination was increased from 0 to 90°, 58, 2014, 176-183, but it decreased by increasing Grashof number, 58, 2014, 176-183. Moreover, experimental results indicate that effect of addition of nanoparticles to the base fluid doesn't have a notable effect on both pressure drop and friction factor. Also, pressure drop is more pronounced in microfin tube than the smooth one, thus, considering the penalty of pressure drop, utilizing the nanofluid in smooth tube at higher Richardson numbers is an efficient way in thermal applications. Finally, a new correlation was developed to calculate the skin friction coefficient in different inclinations and nanoparticle weight fractions. [ABSTRACT FROM AUTHOR]

Objective There is a high incidence of inflammation and metaplasia at the gastro-oesophageal junction (GOJ) in asymptomatic volunteers. Additionally, the majority of patients with GOJ adenocarcinomas have no history of reflux symptoms. We report the effects of waist belt and increased waist circumference (WC) on the physiology of the GOJ in asymptomatic volunteers. Design 12 subjects with normal and 12 with increased WC, matched for age and gender were examined fasted and following a meal and with waist belts on and off. A magnet was clipped to the squamo-columnar junction (SCJ). Combined assembly of magnet-locator probe, 12-channel pH catheter and 36-channel manometer was passed. Results The waist belt and increased WC were each associated with proximal displacement of SCJ within the diaphragmatic hiatus (relative to upper border of lower oesophageal sphincter (LOS), peak LOS pressure point and pressure inversion point, and PIP (all p<0.05). The magnitude of proximal migration of SCJ during transient LOS relaxations was reduced by 1.6-2.6 cm with belt on versus off (p=0.01) and in obese versus non-obese ( p=0.04), consistent with its resting position being already proximally displaced. The waist belt, but not increased WC, was associated with increased LOS pressure (vs intragastric pressure) and movement of pH transition point closer to SCJ. At 5 cm above upper border LOS, the mean % time pH <4 was <4% in all studied groups. Acid exposure 0.5-1.5 cm above SCJ was increased, with versus without, belt ( p=0.02) and was most marked in obese subjects with belt. Conclusions Our findings indicate that in asymptomatic volunteers, waist belt and central obesity cause partial hiatus herniation and short-segment acid reflux. This provides a plausible explanation for the high incidence of inflammation and metaplasia and occurrence of neoplasia at the GOJ in subjects without a history of reflux symptoms. [ABSTRACT FROM AUTHOR]

A recent study showed an association between hookah/opium use and gastric cancer but no study has investigated the relationship with gastric precancerous lesions. We examined the association between hookah/opium and gastric precancerous lesions and subsequent gastric cancer. In a population-based cohort study, 928 randomly selected, healthy, Helicobacter pylori-infected subjects in Ardabil Province, Iran, were followed for 10 years. The association between baseline precancerous lesions and lifestyle risk factors (including hookah/opium) was analyzed using logistic regression and presented as odds ratios (ORs) and 95% confidence intervals (CIs). We also calculated hazard ratios (HRs) and 95% CIs for the associations of lifestyle risk factors and endoscopic and histological parameters with incident gastric cancers using Cox regression models. Additionally, the proportion of cancers attributable to modifiable risk factors was calculated. During 9,096 person-years of follow-up, 36 new cases of gastric cancer were observed (incidence rate: 3.96/1,000 persons-years). Opium consumption was strongly associated with baseline antral (OR: 3.2; 95% CI: 1.2-9.1) and body intestinal metaplasia (OR: 7.3; 95% CI: 2.5-21.5). Opium (HR: 3.2; 95% CI: 1.4-7.7), hookah (HR: 3.4; 95% CI: 1.7-7.1) and cigarette use (HR: 3.2; 95% CI: 1.4-7.5), as well as high salt intake, family history of gastric cancer, gastric ulcer and histological atrophic gastritis and intestinal metaplasia of body were associated with higher risk of gastric cancer. The fraction of cancers attributable jointly to high salt, low fruit intake, smoking (including hookah) and opium was 93% (95% CI: 83-98). Hookah and opium use are risk factors for gastric cancer as well as for precancerous lesions. Hookah, opium, cigarette and high salt intake are important modifiable risk factors in this high-incidence gastric cancer area. [ABSTRACT FROM AUTHOR]

Understanding the physiology of gastroesophageal junction (GEJ) is important as failure of its function is associated with reflux disease, hiatus hernia, and cancer. In recent years, there have been impressive developments in high resolution technologies allowing measurement of luminal pressure, pH, and impedance. One obvious deficiency is the lack of technique to monitor the movement and location of the GEJ over a prolonged period of time. Proximal movement of the GEJ during peristalsis and transient lower esophageal sphincter relaxations (TLESRs) is due to shortening of the longitudinal muscle of the esophagus. Techniques for measuring shortening include fluoroscopic imaging of mucosal clip, high-frequency intraluminal ultrasound, and high resolution manometry, but these techniques have limitations. Short segment reflux is recently found to be more common than traditional reflux and may account for the high prevalence of intestinal metaplasia and cancer seen at GEJ. While high resolution pHmetry is available, there is no technique that can reliably and continuously measure the position of the squamocolumnar junction. A new technique is recently reported allowing a precise and continuous measurement of the GEJ based on the principle of Hall effect. Reported studies have validated its accuracy both on the bench and against the gold standard, fluoroscopy. It has been used alongside high resolution manometry in studying the behavior of the GEJ during TLESRs and swallows. While there are challenges associated with this new technique, there are promising ongoing developments. There is exciting time ahead in research and clinical applications for this new technique. [ABSTRACT FROM AUTHOR]

Background: Medical education should be considered as a dynamic process. If necessary, the program should be changed. Considering rapid advantages in the field of virology, it seems to be necessary to review and change the virology course of medical students. Therefore we decided to analyze the view of Iranian medical students of the quantity and quality of virology course. Methods: Medical students at basic science of Mashhad University of Medical Sciences attended in this research in the spring semester of 2011. A researcher-made questionnaire was used to analyze the view of students of the importance, quality, and revision of the program. And students' viewpoints about each variable were presented as percentages. Results: 82.5% of students evaluated the importance of virology as high to very high levels. To most of student, the relationship between virology and their future career was high. Most of the students agreed with the increase of duration of the course and revision of the curriculum. The destitution of the courses in basic science was not appropriate according to 86 .25% of students. Conclusion: Considering the results of the study, we suggest increasing of virology credit point for medical students. The present study showed that the importance of the course and its professional application was evaluated as high level by most of the students. The revising of the course and adding the new topics to current curriculum was agreed by most of them. [ABSTRACT FROM AUTHOR]

BACKGROUND Peptic ulcer disease is a multifactorial health problem affecting almost all populations worldwide. Large scale population-based studies are crucial to understanding its scope and specifications in various nations. We aimed to explore environmental risk factors of peptic ulcer disease in the first population based study in Ardabil, Northwest Iran. METHODS This study was a part of a larger survey on upper gastrointestinal tract health conducted in Ardabil and Meshkinshahr with a total catchment area population of 600,000 persons during 2000-01. Using a random sampling proportional to place of residence, 1122 persons aged 40 or elder were selected. 1011 (90.1%) accepted participation and underwent a comprehensive medical examination and a systematic upper gastrointestinal endoscopy. Point prevalence of peptic ulcers was correlated to various life style risk factors. RESULTS Gastric and duodenal ulcers were identified in 33 (3.26%) and 50 (4.94%) participants, making an overall prevalence of 8.20%. Based on multivariable logistic regression analyses, H.pylori infection (OR 3.1, 95% CI: 2.1-4.7), Smoking (OR 1.8, 95% CI: 1.1-6.8), and chronic intake of NSAIDs (OR 2.8, 95% CI: 1.3-4.4) were main risk factors of gastric ulcer. For duodenal ulcer, in addition to H.pylori infection (OR 5.6, 95% CI: 1.9-8.8) and Smoking (OR 2.3, 95% CI: 1.4-6.5), male gender (OR 3.6, 95% CI: 1.2-5.8) and living in an urban area (OR 1.9, 95% CI: 1.1-5.2) were among significant risk factors. CONCLUSION This is the first population-based endoscopic study in North West of Iran reporting accurate point prevalence of peptic ulcer disease. The rate of 3.3% for gastric ulcer and 4.9% for duodenal ulcers are substantially lower than the estimates reported in Asian population-based endoscopic studies but higher than European reports. [ABSTRACT FROM AUTHOR]

Introduction The association between body mass index (BMI) and gastro-oesophageal pressure gradient (GOPG) is incompletely understood. We examined the association between BMI and gastro-oesophageal (GO) barrier function and the effect of mechanically increasing intra-abdominal pressure on GO physiology. Methods (A) 103 dyspeptic patients with normal endoscopy underwent 24 h pH-metry and upper gastrointestinal manometry. Relationships between BMI and acid reflux, intragastric pressure (IGP), GOPG and lower oesophageal sphincter (LOS) pressure were calculated using bivariate correlations. (B) In 18 healthy volunteers, the effects of increasing IGP by abdominal belt on GO manometry were studied. Results (A) There was a linear correlation between BMI and oesophageal acid exposure in erect (R&equals;0.35, p<0.001) and supine (R&equals;0.40, p<0.001) positions. BMI was strongly associated with IGP (inspiration: R¼0.66, p<0.001; expiration: R&equals;0.78, p<0.001) and inspiratory GOPG (R&equals;0.50, p<0.001). There were a positive correlation between BMI and inspiratory LOS pressure relative to atmospheric pressure (R&equals;0.29, p&equals;0.016) and a negative correlation with LOS pressure relative to IGP on expiration (R&equals;0.25, p&equals;0.018). Logistic regression models using all significant manometric variables and relevant interactions revealed marked decline in the magnitude and significance of relationship between BMI and oesophageal acid exposure in supine (from OR 1.12 (95% CI 1.03 to 1.22), p&equals;0.009, to 1.00 (0.86 to 1.17), p&equals;0.999) and upright positions (from 1.11 (1.02 to 1.20), p&equals;0.020, to 1.03 (0.89 to 1.18), p&equals;0.717). (B) Application of the constricting abdominal belt produced similar manometric changes to those associated with increased BMI. However, the belt did not reproduce the reduced LOS pressure relative to IGP. Conclusion The association between reflux and BMI may be largely explained by effects of increased intraabdominal pressure. However, the reduced LOS pressure associated with BMI may be mediated by another mechanism or effects of chronic rather than acute elevation of intra-abdominal pressure. INSET: Significance of this study. [ABSTRACT FROM AUTHOR]

Background and Aim: The prevalence of Helicobacter pylori infection is exceptionally low among the Malays in the north-eastern region of Peninsular Malaysia. The reasons are unknown. Our aim was to compare environmental factors that differed in relation to H. pylori prevalence among Malays born and residing in Kelantan. Methods: A case-control study was conducted among Malays in Kelantan who underwent upper endoscopy between 2000 and 2008. Helicobacter pylori status was determined by gastric histology. Sociocultural and dietary factors were assessed using a validated investigator-directed questionnaire administered after 2008, and the data were analyzed using logistic regression analysis. Results: The study group consisted of 161 subjects (79 H. pylori positive and 82 controls). Univariable analysis identified five poor sanitary practices associated with an increased prevalence of H. pylori infection: use of well water, use of pit latrine, less frequent boiling of drinking water, and infrequent hand wash practice after toilet use and before meals. Multivariable logistic regression analysis identified three variables inversely associated with H. pylori infection: frequent consumption of tea (OR: 0.023, 95% CI: 0.01-0.07), frequent use of 'budu' or local anchovy sauce (OR: 0.09, 95% CI: 0.1-0.7), and frequent use of 'pegaga' or centenella asiatica (OR: 0.25, 95% CI: 0.1-0.65). Conclusions: Under the assumption that sanitary, sociocultural, and dietary habits have not changed over the years, we can conclude that an increased risk of H. pylori was associated with unsanitary practices whereas protection was associated with consumption of tea and locally produced foods, 'pegaga' and 'budu.' These dietary factors are candidates for future study on the effects on H. pylori transmission. [ABSTRACT FROM AUTHOR]

Objective(s) Tuberculosis (TB) is the leading cause of mortality among the infectious diseases, especially in developing countries. One of the main goals in tuberculosis research is to identify antigens which have the ability of inducing cellular and/or humoral immunity in order to use them in diagnostic reagents or vaccine design. The aim of this study was to clone and express the TB10.4 protein in Escherichia coli expression system. Materials and Methods DNA was extracted from Mycobacterium tuberculosis H37Rv. Gene specific primers were designed using Gene Runner software according to sanger sequence database. Gene tb10.4 fragment was amplified by PCR method and purified tb10.4 gene was cloned into pET 102/D vector. Plasmid containing pET102/D-10.4 was transformed into competence E. coli TOP10. A positive transformant was chosen and plasmids DNA was isolated and subsequently transformed into competence E. coli BL21(DE3). The bacterium was induced by IPTG and its lysates were loaded directly onto SDS-PAGE. Purified recombinant protein was achieved using metal affinity chromatography (Ni-nitrilotriacetic acid). Results TB10.4 molecule was successfully cloned, expressed, and purified. An approximately 26.4 kDa exogenous protein was observed on the SDS-PAGE. The recombinant protein was confirmed by DNA sequencing of correct insert. Conclusion The success of expressing the TB10.4 protein could serve as a basis for further studies on the usefulness of the gene and its expression product in the development of subunit vaccine and diagnostic method. [ABSTRACT FROM AUTHOR]

Objective(s) Ziziphora clinopodioides Lam. is a plant widely used in Iranian traditional medicine for gastrointestinal disorders. Several reports have demonstrated antibacterial (Helicobacteria pylori), antioxidant and antiinflammatory properties of Z. clinopodioides. The aim of this study was to investigate the effects of aqueousethanol extract of Z. clinopodioides on rat's gastric acid output in basal, vagotomized (VX) and vagal stimulated conditions. Materials and Methods A total of 24 male Wistar rats weighed 200-250 g were randomly divided into two groups: control and test. Tracheostomy and gastroduodenostomy procedures were performed for each rat. In the vagotomized condition the vagus nerve in the cervical region was dissected and in the vagal stimulation condition the distal portion of the vogues nerve stimulated. Gastric content was collected for 15 min by wash out technique. A volume of 1 ml of three doses (0.5, 1 and 2 mg/kg) was introduced into the stomach (i.g.) of each rat in the test group and the same volume of saline was used in the control group. Total titratable acid was measured by a titrator. Results The extract inhibited acid secretion significantly at basal condition. At VX condition not only this inhibitory effect on acid secretion disappeared but also a stimulatory effect at the dose of 2 mg/kg was shown. In vagal stimulation condition the extract showed a significant inhibitory effect at 1 mg/kg dose. Conclusion Taking together our data resulted from comparison of three conditions showed that the extract exerted an inhibitory effect on acid secretion in basal and vagal stimulation. Also, according to our results this inhibitory effect of the extract could be exerted via gastric vagal parasympathetic nerve. [ABSTRACT FROM AUTHOR]

Background & objectives: Studies of interaction between viruses and mitochondria have shown that viruses can affect the mitochondria. Also linkage between human diseases and mitochondrial dysfunction has been revealed. We studied the effect of measles virus (MV) on cell respiration in MV infected Hela cells to see any possible changes in mitochondria respiration. Methods: Total cell respiration (TCR) of MV infected (10 pfu/cell) HeLa cells was measured using oxygen electrode (OE). Cell lines were grown in growth medium. Virus titration was done in VERO cell line using plaque assay method. Results: TCR of HeLa cells was not significantly changed post MV infection and was similar to most infected cells. Interpretation & conclusion: Infection with measles virus did not reveal any significant effect on mitochondrial respiration in HeLa cells. Further studies need to be done using advanced techniques to throw more light on this aspect. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to elucidate the association between body mass index (BMI) and both Helicobacter pylori and atrophic gastritis.Methods: The study involved 10,197 subjects participating in a Japanese mass endoscopic gastric cancer screening program. Atrophic gastritis was assessed by pepsinogen I to II ratio.Results: In logistic regression models, BMI had an inverse association with atrophic gastritis, with the odds ratios (OR) decreasing progressively to 0.67 (95% confidence interval [CI] 0.57-0.79, P<0.0001) in the highest BMI quintiles (BMI >or=25.66) group compared with the lowest BMI quintiles (BMI <20.97) group. In linear regression models, atrophic gastritis predicted BMI (regression coefficient -0.326, 95% CI -0.469, -0.184, P<0.0001), whereas H. pylori antibody was not a predictor (regression coefficient 0.072, 95% CI -0.053, 0.198, P=0.3).Conclusions: A small, inverse association between BMI and atrophic gastritis was found in the general population. In contrast, no association was observed between H. pylori seropositivity and BMI. [ABSTRACT FROM AUTHOR]

Objective It has been reported that selegiline, a Selective Monoamine Oxidase Inhibitor B (MAOI-B), at low doses would be helpful for treating negative symptoms in schizophrenia. Nevertheless, the results are contradictory so far. This study was designed to investigate the effect of selegiline added to risperidone as augmentation therapy in patients with chronic schizophrenia and prominent negative symptoms in an 8 week, double blind and randomized clinical trial. Methods Eligible participants in this study were 40 patients with chronic schizophrenia. All patients were inpatients and were in the active phase of the illness, and met DSM-IV-TR criteria for schizophrenia. Patients were allocated in a random fashion, 20 to risperidone 6 mg/day plus selegiline 10 mg/day (5 mg bid) and 20 to risperidone 6 mg/day plus placebo. The principal measure of the outcome was Positive and Negative Syndrome Scale (PANSS). Results Although both protocols significantly decreased the score of the positive, negative, and general psychopathological symptoms over the trial period, the combination of risperidone and selegiline showed a significant superiority over risperidone alone in decreasing negative symptoms and PANSS total scores. Conclusion The present study indicates selegiline as a potential adjunctive treatment strategy for the negative symptoms of schizophrenia. Nevertheless, results of larger controlled trials are needed before recommendation for a broad clinical application can be made. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Many studies have indicated that viruses can interact with mitochondria and affect their function. Further, emerging data now show that many more viruses may influence the mitochondrial pathway of apoptosis and thus there is widespread potential for interaction with the respiratory chain in this organelle. Such interactions could have consequences for the clinical outcome of persistent viral infections when energy generation is disturbed; and eventually will be a possible cause for chronic fatigue syndrome (CFS). Therefore, it is hypothesized that viral infections maybe the main aetiology for this syndrome. [ABSTRACT FROM AUTHOR]

Background: Non-cardia gastric adenocarcinoma is positively associated with Helicobacter pylori infection and atrophic gastritis. The role of H pylori infection and atrophic gastritis in cardia cancer is unclear. Aim: To compare cardia versus non-cardia cancer with respect to the premorbid state of the stomach. Methods: Nested case-control study. To each of 129 non-cardia and 44 cardia cancers, three controls were matched. Serum collected a median of 11.9 years before the diagnosis of cancer was tested for anti-H pylori antibodies, pepsinogen 1:11 and gastrin. Results: Non-cardia cancer was positively associated with H pylori (OR 4.75, 95% CI 2.56 to 8.81) and gastric atrophy (pepsinogen 1:11 <2.5; OR 4.47, 95% CI 2.71 to 7.37). The diffuse and intestinal histological subtypes of non-cardia cancer were of similar proportions and both showed a positive association with H pylori and atrophy. Cardia cancer was negatively associated with H pylori (OR 0.27, 95% CI O. 12 to 0.59), but H pylori-positive cardia cancer showed an association with gastric atrophy (OR 3.33, 95% CI 1.06 to 10.5). The predominant histological subtype of cardia cancer was intestinal and was not associated with gastric atrophy compared with the diffuse subtype ((OR 0.72, 95% CI 0.19 to 2.79) vs (OR 3.46, 95% CI 0.32 to 37.5)). Cardia cancer in patients with atrophy had an intestinal: diffuse ratio (1:1) similar to non-cardia cancer (1.9:1), whereas cardia cancers in patients without atrophy were predominantly intestinal (7:1). Conclusion: These findings indicate two aetiologies of cardia cancer, one associated with H pylori atrophic gastritis, resembling non-cardia cancer, and the other associated with non-atrophic gastric mucosa, resembling oesophageal adenocarcinoma. Serological markers of gastric atrophy may provide the key to determining gastric versus oesophageal origin of cardia cancer. [ABSTRACT FROM AUTHOR]

Abstract Background: In Iran, there is insufficient information on the efficacy of Helicobacter pylori eradication regimens shorter than 10 days. This study aims at assessing the efficacy of 4- and 7-day H. pylori eradication regimens in a high-incidence area of gastric cancer in Iran. Methods: Subjects with an endoscopic diagnosis of gastritis, positive urease test, and a histological diagnosis of chronic gastritis were enrolled. Patients were randomly assigned to one of three groups: AOC7 (1000 mg amoxicillin, 20 mg omeprazole, and 500 mg clarithromycin twice daily for 7 days), FOT4 (200 mg furazolidone, 20 mg omeprazole, and 500 mg tetracycline twice daily for 4 days) and FOT7 (the same treatment as the FOT4 group but for 7 days). Sensitivity to these antibiotics was determined in all isolates recovered from culture. The efficacy of eradication was assessed 8 weeks after the end-of-treatment by the 14 C-urea breath test. Results: One hundred and twenty-eight patients were enrolled in the study. Culture was positive for 84 patients and none of these were resistant to amoxicillin, tetracycline or furazolidone, 1.2% were resistant to clarithromycin and 32.1% to metronidazole. Forty-five, 41 and 42 patients were randomly allocated to the AOC7, FOT4, and FOT7 groups, respectively. The intention-to-treat eradication rates were 35.5, 17.1, and 23.8% for the AOC7, FOT4, and FOT7 groups, respectively. Conclusion: Treatment regimens of 4 or 7 days are unacceptable for H. pylori infection in Iran, even in the presence of a favorable sensitivity profile. © 2003 Blackwell Publishing Asia Pty Ltd. [ABSTRACT FROM AUTHOR]

Fasting, that is usually described as abstinence from all food and drink for a period of time, has been experienced for ages. Health, protest, religious expressions of devotion and purification are the most important reasons for fasting. Many changes occur in the body during fasting including metabolic, mineral, hormonal, immunological and psychological. Its use as one of the oldest therapies among human populations has been recognized. Also its effects on many abnormalities for medical and therapeutic purposes have been investigated in animals and human. Recently studies have considered its role in apoptosis (or programmed cell death), and subsequently its outcome on the cell processes. Apoptosis is a dynamic process that occurs in multicellular organisms and is described by changes in many cellular processes, and biochemical alterations that lead to morphological cell changes, self-destruction and cell death. It also limits the accumulation of tumor cells. In this mini-review article the relationship between fasting and apoptosis has been summarized. [ABSTRACT FROM AUTHOR]

In this manuscript, we survey a numerical algorithm based on the combination of the homotopy perturbation method and the Sadik transform for solving the time-fractional nonlinear modified shallow water waves (called Kawahara equation) within the frame of the Caputo–Prabhakar (CP) operator. The nonlinear terms are handled with the assistance of the homotopy polynomials. The stability analysis of the implemented method is studied by using S-stable mapping and the Banach contraction principle. Also, we use the fixed-point method to determine the existence and uniqueness of solutions in the given suggested model. Finally, some numerical simulations are illustrated to display the accuracy and efficiency of the present numerical method. Moreover, numerical behaviors are captured to validate the reliability and efficiency of the scheme. [ABSTRACT FROM AUTHOR]

Potent antiviral agents effectively reduce liver-related events in patients with chronic hepatitis B. This study aimed to determine whether alanine aminotransferase normalization using potent antiviral agents was related to hepatocellular carcinoma development. From 2007 to 2017, we included 610 patients with chronic hepatitis B who received entecavir or tenofovir disoproxil fumarate. The patients were divided into the alanine aminotransferase normalization group (Gr.1) and non-normalization group (Gr.2) within a year of potent antiviral treatment. Liver-related events included hepatic encephalopathy, variceal bleeding, and ascites. The mortality rate and hepatocellular carcinoma incidence were investigated for each group. The patients who showed ALT normalization at 1 year of treatment were 397 (65.1%) of 610. During a median follow-up period of 86 months, 65 (10.7%) patients developed hepatocellular carcinoma. The cumulative incidence of hepatocellular carcinoma was significantly lower in Gr.1 than in Gr.2 (p < 0.001). Risk factors for alanine aminotransferase non-normalization were body mass index, cholesterol, and liver cirrhosis at baseline. Male sex, age, platelet level, alcohol use, presence of cirrhosis at baseline, and non-normalization after 1 year of treatment were independent risk factors for hepatocellular carcinoma. Alanine aminotransferase normalization within 1 year of initiating antiviral agents reduces the risk of hepatocellular carcinoma development. [ABSTRACT FROM AUTHOR]

The induction of heme oxygenase-1 (HO-1) has been shown to have therapeutic potential in experimental models of hepatitis and liver fibrosis, which are closely related to liver cancer. In humans, HO-1 induction is transcriptionally modulated by the length of a GT-repeat [(GT)n] in the promoter region. We aimed to investigate the effect of HO-1 (GT)n variants on liver cancer in a human population. We determined the HO-1 genotype in 1153 study subjects and examined their association with liver cancer risk during a 15.9-year follow-up. Allelic polymorphisms were classified as short [S, <27 (GT)n] or long [L, ≥27 (GT)n]. Newly developed cancer cases were identified through linkage to the National Cancer Registry of Taiwan. Multivariate Cox regression analysis was used to evaluate the effect of the HO-1 (GT)n variants. Alpha-fetoprotein (AFP) and cirrhosis history were also examined. The S/S genotype was found to be significantly associated with liver cancer risk, compared to the L/S and L/L genotypes. The S/S genotype group also had a higher percentage of subjects with abnormal AFP levels than other groups. There were significant percentages of cirrhosis among groups who carried S-alleles. Our findings indicate that short (GT)n variants in the HO-1 gene may confer susceptibility to rather than protection from liver cirrhosis/cancer. [ABSTRACT FROM AUTHOR]

The author comments on the role of gastric atrophy in the negative association between Barrett's esophagus and esophageal adenocarcinoma, and Helicobacter pylori infection and reflux esophagitis. An assumption that the protective effect is due to the infection inducing gastric atrophy and is being associated with increased risk of gastric adenocarcinoma. Meanwhile, Helicobacter pylori infection does not produce detectable atrophy and protects against esophageal adenocarcinoma.