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  Background & Objectives: Esophageal carcinoma has more prevalency in northwest of Iran. Relapsing dysphagea after esophagectomy is one of the common delayed complication. It emerges due to technique of surgery. Reflux and or leakage in anastomotic area. The aim of this study is to evaluate the prevalence and etiologies of dysphagea after esophagectomy and postoperative endoscopic dilation results.

  Methods: This is a retrospective discreptive study, during 2000-2005 at Imam Khomeini hospital, all patients who had esophagectomy because of esophageal carcinomas entered this study. Data collected from medical records, Primary tumoral diagnosis, operation endoscopy, dysphagea, histopathological findings, Postoperative complications, especially dysphagia and it’s etiology, and different methods of therapy, reoperation and or endoscopic dilatation were studied.

  Results: Among 324 patients 81 patients had esophagectomy for esophageal carcinomas. In eighteen patients (22.2%), dysphagea reappered after operation. Rate of dysphagea in patients with carcinoma of lower one third area was 5.3 times greater than middle third of the esophagus. Mean time between first hospitalization and second hospitalization due to relapsing dysphagea was 10.03 months. The main cause of relapsing dysphagia in 88.24%, was benign stricture in anastomotic area. 17 patients with endoscopic dilation and one patient with surgical stricturoplasty, were treated.

Conclusion: Relapsing dysphagea after esophagectomy is common in our patients. This represents mostly benign strictures after esophagectomies for esophageal carcinoma. In benign anastomotic strictures, endoscopic dilation is an effective treatment and it is recommended.

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 Background and objectives: Chemotherapy-induced nausea and vomiting are the most important complications for cancer patients. Ginger is an effective herbal drug for the treatment of nausea and vomiting. It hasn’t any known side effects. In some countries, it is used for making of antiemetic drugs. The aim of this study was to determine the effect of ginger on the intensity of chemotherapy-induced nausea and vomiting in cancer patients .

 Method: This study is a randomized, cross-over, double – blinded, clinical trial that was done on 44 cancer patients undergone chemotherapy. In the first cycle of the study, patients were assigned by four block random allocation to receive one of the antiemetic regimens regimen A (routine and 1gr ginger) and regimen B (routine and 1gr placebo). After 28 days, in the next cycle of chemotherapy, another regimen was administrated A or B plus chemotherapy drugs., the severity of the nausea and vomiting was measured in 4h (1, 2, 3, 4) after second dose and at the end of the 24h after receiving the first dose by using VAS and kortila tools .The data were analyzed by independent student t - test and non-parametric test (Mann-Whitney U test) by using SPSS, version 16 software .

 Results: The results showed that the frequencies of nausea and vomiting in two regimen groups weren’t different, but nausea score was significantly decreased in ginger group, compared to placebo. Independent student t - test and Mann-Whitney U test also revealed a significant difference on nausea scores in 3rd and 24th hour post chemotherapy (p=0.06, p=0.01, respectively).

 Conclusion: In respect to low nausea score in ginger regimen, compared to placebo, it seems ginger using is a safe and simple method and it can be used as antiemetic drugs in patient undergoing chemotherapy

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Background & objectives: According to the new theory of cancer stem cells, interruption in the self-renewal pathway of tissue stem cells can cause cancerous tumors. Current work has evaluated the role of self-renewal Oct-4 gene in thyroid tumors.

Methods: In this case-control study, the expression of Oct-4 gene has comparatively assessed between cancerous specimens, marginal tissues of tumors and non-tumoral nodules of thyroid using RT-PCR technique.

Results: Statistical analysis of data by one-way ANOVA showed that Oct-4 gene is significantly expressed in thyroid papillary carcinomas in comparison with tumor margin and non-tumoral nodules (p<0.05).

Conclusion: In conclusion, the dominant expression of Oct-4 gene in thyroid tumoral cells not only demonstrates the cancer stem cell theory but also shows its role in thyroid cancer appearance that can be used in differentiating thyroid papillary carcinomas from non-tumoral nodules as well as demarcation of tumors.

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Background & objectives:  The use of supplements such as L-carnitine, optimum nutritional support and early feeding after surgery in cancer patients can be important in the prevention of cancer complications. The aim of this study was to determine the effects of early L-carnitine-rich feeding on complications of esophageal cancer surgery and duration of hospitalization.
Methods: In a clinical trial, 50 patients with esophageal cancer under surgery in two equal groups were randomly selected. Nutritional information was obtained using food record questionnaire. Basic blood samples and 24-hour urine samples were taken in order to measure the hematological parameters (like blood cell count, hemoglobin, hematocrit and blood urea) and nitrogen balance, respectively from two groups at the beginning and end of the study. Then, the intervention group received 3 g L-carnitine daily in 3 doses on the first day after the complementary operation, with a routine hospital diet at each meal, and the control group received a routine hospital diet for ten days. Data were analyzed using independent t-test, paired t-test and chi-square test.
Results: The results showed that changes in the mean BUN and nitrogen balance were significantly different after intervention between the study groups (p<0.05). Patients with early L-carnitine-rich feeding had less hospitalization time in hospital wards and were discharged earlier (p<0.05).
Conclusion:  The results of this study showed that early L-carnitine-rich feeding after surgery has probably a positive effect on the duration of hospital stay in patients with esophageal cancer.