Tehran University Medical Journal

Effect of oral administration of lactobacillus acidophilus on the immune responses and survival of BALB/c mice bearing human breast cancer

Soltan Dallal MM

Background: In according to immunomodulatory effect of probiotics and effect of these bacteria on the effectiveness of immune responses, at the present work we proposed the evaluation of oral administration of L.acidophilus on the immune statues in BALB/c mice bearing breast cancer.
Methods: A total of 30 In-bred BALB/c mices aged from six to eight weeks weighting 25-30g were randomly enrolled in our study, in two groups each consist of 15 mices. The L.acidophilus ATCC4356 strain used in this study was inoculated in MRS broth and cultivated for a day at 37°^C under anaerobic conditions, collected by centrifugation and resuspend in Phosphate Buffer Saline (PBS). After preparation of proper amount of these suspensions it was orally administered to the mice with a gastric feeding, Control mices received an equal volume of PBS in duration of study.
Results: Results showed the increase in production of IFnγ (p<0.005), and decrease in production of Th2 cytokines such as IL4 (p=0.347) in the L.acidophilus administered mice in comparison to control group of mice. In addition the proliferation of immune cells in probiotic group was significantly higher than controls, and most importantly probiotic administered mice showed an increase in survival rate of this group compared to control mice (p<0.001).
Conclusion: Results of our study suggested that daily consumption of Lactobacillus acidophilus can regulate immune responses skewed Th1 balance that is needed against tumor, further studies is needed to investigate the other mechanisms of this effect.

The impact of combined paraoxonase1 Q/R 192 and 5A6A matrix metalloproteinase-3 polymorphisms on coronary artery disease

Ghasemi A

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: It has been suggested that Q/R 192 polymorphism of paraoxonase1 (PON1) and 5A/6A polymorphism of matrix metalloproteinase-3 (MMP-3) might be associated with the predisposition to coronary artery disease (CAD). Therefore to investigate the significance of these polymorphisms in the pathogenesis of CAD we performed an association study of the polymorphisms with CAD and the number of diseased vessels in patients with CAD.
Methods: We studied the human PON1 and MMP3 gene polymorphisms in patients with CAD by polymerase chain reaction/ restriction fragment length polymorphism (PCR/RFLP). These polymorphisms were determined in 129 CAD patients and 115 control subjects who underwent coronary angiography. CAD was defined as the presence of one or more stenoses>50% in at least one major coronary artery and subjects with <10% stenosis served as controls.
Results: The frequencies of the PON1 192 RR genotype and MMP-3 6A6A genotype were increased among CAD patients compared with controls (p<0.05 and p<0.001 respectively). The combined genotypes of RR/6A6A had significantly higher frequency in the CAD patients compared with subjects who possess neither the MMP-3 6A6A nor the PON1 RR genotype (p<0.001) and finally in the study of relationship between genotypes and severity of disease, distribution of PON1 192 and MMP-3 5A6A genotypes were not associated with the number of diseased vessels (p>0.05).
Conclusion: The combined PON1 192 and MMP-3 5A6A polymorphisms are associated with CAD but don't have any effect on the number of diseased vessels.

Correlation of HER2 overexpression with histopathologic features in breast cancer: a two- year study

Khazaeian K

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Breast cancer is the most common cancer and the second most common cause of death from cancer in women. HER2 is an epidermal growth factor receptor which plays a substantial role in pathogenesis of breast cancer and also a target for new antineoplastic drug Herceptin. This study was conducted for determining the correlation between HER2 overexpression and histopathologic characteristics of breast cancer and also degree of intraobserver and interobserver agreement in scoring of Immnohistochemistry (IHC) slides between pathologists in samples referred to pathology ward.
Methods: This study was conducted as a descriptive cross sectional study. Among the breast cancer samples referred to pathology ward in Shariati Hospital in Tehran, Iran. 140 samples have been selected sequentially using simple non-random sampling method. All the information has been extracted using medical records and pathology reports.
Results: This study showed significant difference between diagnosis and HER2 status (p<0.05). Significant difference observed between lymph node invasion and HER2 status (p<0.05). Positive significant association between the size and tumor grade with HER2 status (r=0.188, p=0.026), Significant difference between histopathologic types with scoring of HER2 (p=0.001). Significant difference between histopathologic types with lymph node invasion (p=0.001). Agreement level of HER-2 scoring was shown to be nearly perfect between two observers (kappa statistic= 0.715) and the same observer (Kappa statistic= 0.78).
Conclusion: We do not recommend IHC and FISH test in invasive lobular carcinoma of breast and uncommon subgroups of breast cancer except in invasive ductal carcinoma and its subgroups.

Thoracoscopy Vs conventional methods in the management of empyema: a prospective study

Vejdan SAK

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Empyema is one of the most common and important thoracic diseases which can lead to some sort of debilitating consequences if does not managed properly. Surgery usually is indicated in the third stage of the disease which contains more and devastating complications that do not respond to the other treatment options. This investigation evaluates the role of thoracoscopy (minimal invasive surgical intervention) in the management of second stage of empyema.
Methods: In a prospective investigation, 54 patients with stage II of empyema were selected and divided in two groups. In control group, patients were treated with chest tube thoracic drainage plus antibiotics administration, on the other side, Thoracoscopic diagnosis and drainage was added to the modalities of the control group. Thoracoscopy is aimed to explore the total thoracic cavity for releasing the fibrous bands and adhesions and draining of the loculated abscess. At the end of procedure plural cavity wash out and chest tube insertion were done.
Results: The rate of complication was 35% and 8% (p<0.05) in control group and investigated group, respectively. The average admission days were significantly greater in control group (the investigated group got better faster) (p<0.05). The need for thoracotomy was 7 time greater in control group (p<0.05).
Conclusion: Application of Thoracoscopy for stage 2 of empyema is a safe modality which can be advised for all of the patients. This minimally invasive technique can decrease complications rate, need for thoracotomy and hospital admission time.

Glucose intolerance as a risk factor for cardiovascular outcomes: Tehran Lipid and Glucose Study (TLGS)

Hadaegh F

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Diabetes and dysglycemia have a high prevalence in Iranian population but the information about their impact on the cardiovascular disease (CVD) risk is scarce in this population. This study aimed to determine the risk of CVD according to glucose tolerance status.
Methods: We ascertained cases with incident CVD in a population of 1752 men and 2273 women, 40 years old and over and free of CVD at the beginning of study, during a follow up with a median of 7.6 years. To calculate hazard ratio (HR) for CVD, we controlled traditional risk factors, including age, body mass index, waist, total cholesterol, HDL-cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, education, smoking, hypertension medication, lipid lowering medication and family history of premature CVD and diabetes.
Results: Cardiovascular events occurred in 197 men and 143 women. Its incidence density was 11.8 per 1000 person-years (95% confidence interval: 10.6 to 13.1) totally. Multiple adjusted HR in women with known diabetes was 3.88 (95%CI: 2.40 to 6.27) and with newly diagnosed was 2.34 (95%CI: 1.39 to 3.95) and the corresponding values for men were 1.72 (95%CI: 1.00- 2.95) and 1.52 (95%CI: 1.01- 2.31) respectively. Impaired fasting glucose and impaired glucose tolerance increased 56% the risk of CVD in women (HR: 1.56 with 95% CI, 1.00 to 2.45), just in the age adjusted model.
Conclusion: All diabetic patients should receive primary prevention for CVD intensively, regardless of whether they are newly diagnosed or are known cases specially, females who have abnormal glucose metabolism.

Detection of Epstein- Barr virus infection in lymphoma: ELISA and PCR method

Mamishi S

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Latent Epstein- Barr virus (EBV) genomes are found in the malignant cells of approximately one-third of Hodgkin's lymphoma (HL) cases. Detection of EBV viral DNA could potentially be used as a biomarker of disease activity. Our goal was to compare of EBV DNA detection in samples obtained from lymphoma patients versus controls.
Methods: One milliliter uncoagulated and 1ml coagulated blood sample for DNA extraction and serum analysis using ELISA for IgG anti EBNA-1 were obtained from 44 lymphoma patients and from 44 normal controls, respectively. EBV genome, EBNA-2, was examined from DNA extracts of paraffin embedded and blood samples using Nested PCR with type specific inner primers.
Results: Positive results for ELISA, Blood and biopsy PCR in study group were, 84.1%, 27.3% and 13.6%, respectively. However, these results in control group were 47.7% and 16% for ELISA and Blood PCR assays, respectively. Positive results in ELISA, Blood PCR and Biopsy PCR in Hodgkin and non-Hodgkin patients were found in 21(84%), 6(24%), 4(16%) and 16(84.2%), 6(31.6%), 2(10.5%) of specimens, respectively. No significant differences in EBV detection were found between these two patient groups (p values for ELISA, Blood PCR and Biopsy PCR were 0.26, 0.73 and 0.68, respectively).
Conclusion: Comparison of ELISA and Blood PCR results in children and adult patients with the same age of controls have showed difference in ELISA results of children, only. None of the test results have showed statistically significant difference between Hodgkin and non-Hodgkin patients. However, the mean of ELISA results in Hodgkin patients was higher as compared with controls. Blood PCR assay cannot be recommended as a biomarker of disease activity in EBV positive Hodgkin's lymphoma patients.

Antifungal susceptibility testing of vaginal candida isolates: the broth microdilution method

Mahmoudi Rad M

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Vulvovaginal candidiasis is a common mucosal infection among immunocompetent, healthy women, and is caused by opportunistic yeasts that belong to genus Candida. In this study, we isolated and identified the Candida species in the vagina of patients who admitted in Gynecology Department of Mahdieh Hospital in Tehran, Iran to evaluate the in vitro activities of fluconazole, miconazole, itraconazole and flucytosine against 191 clinical Candida isolates by the NCCLS microdilution method.
Methods: 191 Candida were isolated from vaginal secretions and identified with conventional mycological methods in the diagnosis of Candida species. The identity of all strains was confirmed genotypically by multiplex PCR. In vitro susceptibility testing of vaginal Candida isolates was performed by the NCCLS broth microdilution method. The results were read at 48 h.
Results: Most C. albicans isolates (>90%) were sensitive in vitro to the antifungal agents tested. Most C. glabrata isolates showed sensitivity to miconazole and then flucytosine while they were more resistant to Itraconazole and fluconazole. Many isolates of C. tropicalis were susceptible to miconazole and then fluconazole. They showed a little resistance to all antifungals tested and flucytosine-resistance was the most frequent in the C. tropicalis isolates. High susceptibility to miconazole was observed in isolates of C. krusei and their susceptibility to the rest of the antifungals tested was dose-dependent. fluconazole -resistance was the most frequent in the C. krusei isolates.
Conclusion: Most isolates tested were susceptible to miconazole. A trend toward increased resistance among C. glabrata and C. krusei strains to antifungals tested was noted. Our findings suggest that, miconazole should be the agent of choice for the treatment of resistant vaginal candidiasis.

Transvaginal sonography of cervix in high risk pregnant women for predicting preterm delivery: a prospective study

Marsosi V

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Preterm delivery is a relevant public health problem since it is an important factor determinant of morbidity and the main reason for neonatal mortality. Many publications have pointed at clinical methods, biological, biochemical and ultrasonographic markers, which applied in combination or on their own, aim at predicting spontaneous preterm delivery. Transvaginal sonography is an effective method for the study of uterine cervix during pregnancy since it permits to assess the cervical morphology and biometry in detail with a high degree of reliability. The aim of this study was to evaluate the association between spontaneous preterm delivery (SPTD) before 35 and 37 weeks of gestational age, in high risk population and the measurement of the cervix length and cervical funneling.

Methods: A prospective cohort of 200 women carrying high risk pregnancies were evaluated by transvaginal sonography between 14th and 28th weeks of gestation.
Results: Cervical length less than 18mm before 35th and 37th weeks of gestational age and the presence of cervical funneling presented a satistically significant association with spontaneous preterm delivery before 35 weeks. The cervical length with less 18 mm demonstrated a strong association with SPTD before 37 weeks (p<0.005 OR=92.15) and before 35 weeks' gestation (p<0.001 OR=32.33). The logistic regression analysis suggested the cervical length with less than 18mm as the only variable that revealed satistically significance association with SPTD.
Conclusion: The results seem to indicate that the assessment of cervical length is an important ultrasound marker for predicting spontaneous preterm delivery.

Cleft lip and cleft palate relationship with familial marriage: a study in 136 cases

Azimi C

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Clefts of the lip and palate are one of the most common congenital birth anomalies. Genetic factors play a great role in the etiology of them and the high percentage of the consanguineous marriage of the parents of the affected persons is one of the reasons. These defects not only make abnormal changes on appearance of the neonate, but also make a lot of stress and psychological problems for the patients and their families. Study on the prevalence of clefts, their risk factors and also genetic counseling for affected persons and their families can be a guideline for general population and probably reduce these anomalies over the generations.
Methods: Patients referred to the Department of Genetics, Imam Khomeini Hospital, Tehran, Iran were studied. A total of 7374 pedigrees of all the patients admitted to the Department, were studied during 2002-2005 and 99 pedigrees with the patients with cleft lip± palate or isolated cleft palate were separated. The total number of cases among these 99 pedigrees was 136. The effects of consanguineous marriage, positive family history and sex were investigated among cases.
Results: 70.8% of patients with syndromic clefts and 58.7% of patients with nonsyndromic CL±P had parents with consanguineous marriage. In addition 44.4% of patients with nonsyndromic CL±P had positive family history.
Conclusion: In our population prevalence of nonsyndromic CL±P was estimated to be 7 in 1000 (with 95% Confidence Interval was between 5 & 9) and prevalence of nonsyndromic CP was about 3.1 in 1000 (with 95% Confidence Interval was between 1.8 & 4.4). Consanguineous marriage of parents seems to have a significant role (p=0.02) on prevalence of the clefts.

Seroprevalence of Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) infection among street children in Isfahan, Iran

Babak A

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: There are millions of children around the world living on the street. They are at higher risk of physical, sexual and drug abuse, and have no access to health care facilities. Therefore they are at risk of viral infections such as HCV and HIV. The aim of this study was determining the prevalence of HCV and HIV infection in Isfahan street children (2005-2007).
Methods: The cross-sectional study was taken place on 386 street children through a nonprobable-convenience sampling method. They were requested to answer a questionnaire (demographic and behavioral data), and then they were tested for anti HCV and anti HIV antibodies.
Results: Among 386 street children, 270 (70%) were boys and the mean age was 12.62±3.23 years. The majority of them, 267 cases (69%), were on the street for financial reasons. 353 (91.7%), 366 (94.8%) and 375 (97.2%) of them had no history of smoking, using alcohol or substance addiction, respectively. 40 (34.5%) of girls and 12 (4.4%) of boys (p<0.0001) were engaged in sex and 79 (68%) of girls and 46 (17%) of boys (p<0.0001) were involved in physical fighting. All of the children had negative serology for HIV infection. Nevertheless, four of them (1%) were positive for HCV Ab.
Conclusion: The knowledge of street children about high risk behaviors and the infectious diseases should be improved through educational programs. They need also legal, social and health support.

Electroconvulsive therapy in drug resistant neuroleptic malignant syndrome: a case report

Yousefi A

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Neuroleptic malignant syndrome is an idiosyncratic and potentially fatal reaction to neuroleptic drugs and is characterized by fever, muscular rigidity, altered mental status, autonomic dysfunction, elevated serum CPK and leucocytosis Neuroleptic malignant syndrome is treated with dantrolene, bromocriptin, amantadin and electroconvulsive therapy.
Case: A 22 years old, schizophrenic female was refered to the Emergency ward of Roozbeh hospital in Tehran, Iran in December 2008 with aggression, impulsivity, and reduced sleep. After injection of haloperidol, the patient developed a high grade fever, diaphoresis and muscular stiffness. She was diagnosed as neuroleptic malignant syndrome and the treatment with dantrolen, bromocriptin and amantadin initiated. Although fever subsided, other signs continued, therefore we applied electroconvulsive therapy to this case.
Conclusion: Due to excellent response of the patient to electroconvulsive therapy and the rare reports of electroconvulsive therapy in neuroleptic malignant syndrome in the Iranian population, this case may lead to develop studies for further investigations of this issue.