Tehran University Medical Journal

---

Background and Aim: Auditory and visual stimuli are the most important factors in communication. It seems during the brain maturation, decrease of visual inputs causes enhancement of somatosensory and auditory cortical responses. In this research latency and amplitude of auditory middle latency responses (AMLR) are studied in blinds and normally sighted subjects.

Materials and Methods: This descriptive-analytical study was performed on 40 congenitally blinds and 40 normally sighted subjects in the range of 14-20 years. All of cases had normal hearing sensitivity and acoustic reflexes without any middle ear disorders. The reason of this age range is the maturation of auditory middle latency responses. Sampling was randomized.

Results: There was significant difference between amplitude of Na, Pa & Nb waves and latency of Na while no significant difference between latency of Pa & Nb in blinds and normally sighted subjects.

Conclusion: Increase of amplitude and decrease of latency of AMLR in blind subjects were due to sensory compensation phenomenon, probably. It seems rate of processing and auditory perception in blinds is better than normally sighted subjects.

---

Background: 4-Aryl-4H-chromenes are novel anticancer agents which induce apoptosis in cancer cells. These compounds were found to induce apoptosis by targeting the tubulin/microtubule system in cell proliferation process. The aim of this study was to report cyototoxic and apoptosis inducing activities of a new series of synthesized 4-aryl-4H-chromenes compounds. Methods: The in vitro cytotoxic activity of the synthesized 4-aryl-4H-chromenes was investigated against a paned of human cancer cell lines including MCF-7 (breast carcinoma), A549 (lung carcinoma), HEPG-2 (liver carcinoma), SW-480 (colon adenocarcinoma), U87-MG (glioblastoma), 1321N1 (astrocytoma), and DAOY (medulloblastoma). The percentage of growth inhibitory activity was evaluated using MTT colorimetric assay versus controls not treated with test derivatives. The data for etoposide, a well known anticancer drug, was included for comparison. For each compound, the 50% inhibitory concentration (IC50) were determined. Apoptosis inducing activity were assessed by DAPI staining. Results: Preliminary screening showed that those chromenes analogs bearing phenyl-isoxazole-3-yl substitution or the derivatives containing methoxyphenyl in chromene ring exhibited cytotoxic and apoptotic inducing activity comparable with or even superior than the reference drug, etoposide. The compounds without this type of substitution have lower activity. Conclusions: Replacement of 3, 4, 5-trimethoxyphenyl group with thiazol ring in the synthesized derivatives reduced the cytotoxic activity. However, the derivatives with phenyl-isoxazole analogue showed potent cytotoxic and apoptotic inducing activity.

---

Background: Several studies have investigated the variations in the anatomy of each segment of circle of Willis whereas a few have addressed the variations of this arterial circle as a whole. In this study the entire circle of Willis and its variations were studied in a cohort of Iranian people and compared with previous reports.
Methods: Anatomical variations of the circle of Willis in 132 brains of Iranian cadavers (102 male adults and 30 fetuses and infants) were studied. The dissection process was digitally filmed for further studies. Using computer software the external diameters of the vessels were measured and the circle variations were classified. The variations of the circle as a whole and segmental variations were compared with previous studies.
Results: Uni-and bilateral hypoplasia of posterior communicating arteries (PcoAs) constituted the most common variation in our study which was similar to previous works. Aplasia of the anterior cerebral artery (A1) and the posterior cerebral artery (P1) were not observed. In 3.3% of fetuses and infants and 3% of adult instances both right and left posterior communicating arteries were absent. There was one case of anterior communicating artery (AcoA) aplasia in adult group.
Conclusions: The anatomical variations discovered in Iranian circle of Willis in this study were not significantly different to those of more diverse populations reported in the literature. The main differences between the fetal and adult disposition are the diameter of the PcoA and the circular part of the P1.

---

---

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Post-intubation tracheal stenosis is a serious problem and surgical resection is the method of choice in long segment tracheal stenosis treatment. The aim of this study was to review the results of surgical treatment of long segment post intubation tracheal stenosis and the role of bilateral hyoid bone cutting in supra- hyoid release technique.
Methods: Between 2004 to 2008, 14 patients with proximal long segment tracheal stenosis with resection of more than 40% of trachea length were evaluated regarding surgical technique and post-operative results.
Results: The mean age of patients was 22.2±0.4 years. Etiology in all patients were head trauma and prolonged intubation and all patients had tracheostomy at the time of trearment. Average time between surgery and first admission was 4.5±0.5 months. Average length of stenosis and resected segment were 3.6±0.5 and 4.3±0.5cm respectively. Average increased length of trachea after bilateral hyoid bone cutting was 1.1±0.3cm. Postoperative complications occurred in one patient with wound infection, and 4 patients had stenosis recurrence which was treated in 3 patients using multiple dilation. Quality of life 2 years after surgery in 71% of patients were classified in good and excellent group. We didn't have any mortality.
Conclusion: Based on the fact that surgery is the best method of treatment in long and multi segment tracheal stenosis and tension in suture line is a serious problem, we recommend extended releasing technique including bilateral hyoid cutting in surgical treatment of these patients.

---

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Recent studies present a high prevalence of multiple sclerosis (MS) in Iran. Treatment with interferon is now the first choice in management of MS. CinnoVex^TM (an interferon beta 1-a) is available in Iran, with achievement of the technology of producing beta interferon. The aim of the present study is to evaluate the efficacy and safety of CinnoVex^TM in a national study named CINA study.

Methods: This study was conducted from 2007 to 2008 in cities of Tehran, Isfahan, Mashhad, Tabriz, and Shiraz. Patients with relapsing/remitting MS with 16-50 years of age and EDSS of <4 received CinnoVex^TM (30µg/week, IM) after diagnosis by a neurologist. EDSS, drug side effects, and frequency of relapse were evaluated for one year in four 3-month visits.

Results: A total of 1050 patients entered the study. Complete data were collected from 627 (60%) patients. Mean age was 30.7±8.6 year and 514 (82%) were female. The most common onset presentations were sensory symptoms (44%). Changes of EDSS through the study showed a significant decrease in the last 3-month of evaluation (p<0.05). Drug side effects were observed in 47%, 50%, 61%, and 61.4% (p>0.05) and relapse was occurred in 13.4%, 15.7%, 16.9%, and 2.4% of the patients in the first, second, third, and forth evaluation visits (p=0.001), respectively.

Conclusion: CinnoVex^TM prevents progression and improves clinical course of MS. The conventional side effects of beta interferon therapy, however, are observed with CinnoVex^TM.

---

Background: Based on the reports, high frequency of special alleles of HLA class II genes might be associated with susceptibility to or protective from a particular cancer. These alleles might vary depending on the geographical region. Here we investigate the association between alleles of HLA class II genes and breast cancer in Iranian women.
Methods: 100 patients with pathologically proved breast cancer who referred to Cancer Institute, Tehran University of Medical Sciences in Tehran, Iran, were divided to two groups based on ages (40 years old and less/ or more than 40 years old) and were randomly selected and compared with a group of 80 healthy blood donor subjects. HLA class II alleles were determined by amplification of DNA with polymerase chain reaction (PCR) method followed by HLA-typing using sequence-specific primer (SSP) for each allele.
Results: The most frequent alleles in the DR and DQ regions in group 1 (40 years old and less) in comparison with control group were HLA-DQA1*0301 (p=0.002) and HLA-DQB1*0302 (p>0.05). In contrast HLA-DQA1*0505 (p=0.004) had significantly lower frequency in this group compared with control group. Patients of group two (more than 40 years old) had a higher frequencies of HLA-DQA1*0301 (p=0.001) and HLA-DRB1*1303 (p=0.02) and a lower frequency of HLA-DQA1*0101 (p=0.002) compared to healthy control.
Conclusion: These findings provide information of a positive and negative association between certain alleles of HLA class II and breast cancer in our population and also might support that the pattern of inheritance in the early and late onset of breast cancer differ substantially.

---

Background: Recombinant tissue plasminogen activator (rt-PA) is one of the most important thrombolytic agentsused in patients with vascular occlusions such as acute ischemic stroke or myocardial infarction. A variety of recombinant protein expression systems have been developed for heterologous gene expression in prokaryotic and eukaryotic hosts. In recent years, Leishmania tarentolae (L. tarentolae), a non-pathogenic trypanosomatid protozoa, has come under consideration because of its safety and immunogenicity as a vaccine vector and special attributes in the expression of complex proteins. This study was done to improve rt-PA expression in this protozoon and create the opportunity for the replacement of rt-PA gene with other genes for the production of other complex proteins.
Methods: Two expression cassettes were used for the integration of two copies of t-PA cDNA, one copy in each cassette, into the parasite genome by electroporation. The transformed clones were selected by antibiotic resistancy. The expression of active secreted rt-PA was confirmed by Western blot analysis and Chromolize assay.
Results: Appearance of a 64 kD band in nitrocellulose membrane in the Western blot analysis confirmed the presence of full-length rt-PA in the culture media. Chromolize assay showed the expression levels of active recombinant t-PA in single and double transfected L. tarentolae clones- 375 IU/ml and 480 IU/ml of the culture media,respectively.
Conclusion: The produced rt-PA in the culture media containing the transfected cells was at least seven times higher than what has been reported in previous studies on L. tarentolae or on some other eukaryotic systems.

---

Background: Fumonisins, a family of mycotoxins, are mainly found in wheat, corn and their products. Previous studies have shown that fumonisin B1 (FB1), the most abundant and toxic of known fumonisins, has been associated with many animal and human diseases including cancer. In the present study, the effects of FB1 were examined on the production of inflammatory cytokines in intestine and stomach cell lines.

Methods: This study was performed in the Cancer Research Center of Tehran University of Medical Sciences in 2010. The cell lines of colon adenocarcinoma (SW742) and gastric epithelium (AGS) were purchased from the Pasteur Institute of Iran. The cells were pretreated with different concentrations of FB1 (0 to 100 µM) for 3 days. The cells were later stimulated by lipopolysaccharides. Twenty-four hours after cell induction, the cytokines including tumor necrosis factor-alpha (TNF-α), interlukin-1 beta (IL-1β) and interlukin-8 (IL-8) were measured by ELISA.

Results: Treatment with FB1 induced a dose-dependent decrease in IL-8 production (P<0.05). This decrease was seen in both SW742 and AGS cell lines. Moreover, FB1 induced a dose-dependent increase in the production of TNF-α and IL-1β in both cell lines (P<0.05).

Conclusion: The results of this study indicated that FB1 could increase the inflammatory cytokines including TNF-α and IL-1β in gastric and intestinal celllines. These effects might result in the development of inflammatory responses and subsequent mucosal atrophy in in-vivo conditions.

---

Background: The prevalence of obesity has risen enormously over the past few decad-es. Both food intake (Appetite) and energy expenditure can influence body weight. Acylated ghrelin enhances appetite, and its plasma level is suppressed by growth horm-one. The present study, examines the effects of an intermittent exercise with progress-ive intensities on acylated ghrelin, appetite, and growth hormone in inactive male students with two levels of obesity.
Methods: Eleven inactive males were allocated into two groups on the basis of their body mass index (BMI). Six subjects in group one, BMI= 31.18±0.92 kg/m2, and five subjects in group two, BMI= 36.94±2.25 kg/m2, ran on the treadmill with progressive intensities of 50, 60, 70 and 80% of VO2max for 10, 10, 5, and 2 min respectively. Blood samples were collected before the exercise (as the resting values), after each workload (during the exercise), and at 30, 60, and 120 min (during recovery).
Results: Plasma acylated ghrelin concentrations and hunger ratings in two groups were decreased and remained significantly lower than resting values (P=0.008 and P=0.002 respectively) at the end of the trial and there was no significant differences between groups. Growth hormone levels in two groups were increased and remained significant-ly higher than resting values (groups one P=0.012, group two P=0.005) at the end of the trial and there was no significant differences between groups. In addition, there were no significant differences between area under the curves (AUC) values over total periods for acylated ghrelin, hunger ratings, and growth hormone in two groups.
Conclusion: These findings indicate that individuals with two levels of obesity have the same response to the different intensities of treadmill running and two hours thereafter during recovery period, which can be considered for designing a more effective weighting loss training program.

---

Background: The incidence and clinical presentation of congenital toxoplasmosis in our newborns was not studied until yet. Goal of study is to evaluates the newborns for congenital Toxoplasma.Gondii infection and describe the clinical presentation from birth and follow up them. 
Methods: We conducted a prospective study upon 270 newborns were born in two university hospitals in Tehran (Rasoul akram & Akbar Abadi) during 2011-2012. Cord blood sample obtained from the newborns during labour. The samples centrifuged, transported and restored in -80 centigrade freezer in our Research Laboratory. Specific T.Gondii- antibodies (IGG, IGM) evaluated by ELISA methods. Neonates with positive T.Gondii- IGM diagnosed and studied as infected cases. The infected cases treated and followed for progression of disease.
Results: Gestational age of newborns was between 28-41 weeks. Positive T.Gondii -IGM and T.Gondii -IGG determined in 1.5%, 44.1% of cases respectively. The most common clinical presentation in seropositive cases was eye involvement (50%), and brain disorders (50%). Positive PCR had not found in cerebrospinal fluids of seropositive (IgM) cases.
Conclusion: One and a half percent of newborns were seropositive for T.Gondii. Wide variation of clinical presentation and early diagnosis of infected newborns in our country is so important. Adding the serologic tests (IGM) to neonatal screening test is recommended strongly.

---

Background: Currently, autologous and allogeneic adipose tissues represent a ubiqui-tous source of material for fat reconstructive therapies. However, these approaches are limited, and often accompanied by a 40-60% reduction in graft volume following transplantation, limited proliferative capacity of mature adipocytes for ex vivo expansion, and extensive adipocyte damage encountered when harvested with conventional liposuction techniques. Recently, cell-based approaches utilizing adipogenic progenitor cells for fat tissue engineering have been developed and were reported to promote both short-term in vivo adipogenesis and to repair defect sites. The aim of this study was to isolate stem cells from fat tissue than examine the growth of stem cells by invitro tests. Methods: For human adipose stem cell isolation (hASC), subcutaneous adipose tissue sites were obtained from female subjects undergoing elective procedures. Tissues were washed 3-4 times in phosphate buffered saline (PBS) and suspended in an equal volume of PBS supplemented with 1% FCS and 0.1% collagenase type I. The tissue was placed in an agitated water bath at 37 1C. The supernatant containing mature adipocytes, was aspirated. Portions of the SVF were suspended in DMEM medium. hASCs were selected based on their ability to adhere to tissue culture plastic and subsequently expanded to 75-90% confluence. Adipose stem cells were isolated and cultured on DMEM. To assess mesenchymal origin of stem cells we used flow-cytomery technique as well as differentiation to osteocyte and chondrocyte lines. Results: The nature of the mesenchymal cells was confirmed by flow -cytometry tech-niques, based on the expression of CD90, CD105, CD166, and lack of expression of hematopoietic markers of CD34, CD31, and CD45. The successful differentiation of our stem cells to osteocyte, chondrocyte had been showed by specific Alizarin-Red and Toluidine-blue staining of cells. Conclusion: Although we have not the results of in vivo tests to support in vivo adipo-genesis either alone or in combination with natural or synthetic matrix, the results showed that stem cells isolation from adipose tissue was successful, and we provided an environment for differentiation of stem cells.

---

Background: This study was done to determine presenting features and treatment out-come of Rhino-Orbital-Cerebral Mucormycosis (ROCM). Methods: This cross sectional study was conducted during 14 years (from 1998-2012) in two educational hospitals of Mashhad University of Medical Sciences in patients with rhino-orbital-cerebral mucormycosis. Clinical symptoms, predisposing factors, demografic parameter and treatment outcome were collected by SPSS and analyzed by cox regression model. Results: A total of 123 cases were (92 proven, 1 probable, 30 possible). From 92 cases of proven rhino-orbital-cerebral mucormycosis, 52% men and 48% women were rec-orded. The most risk factor were diabet 42.4% and immune deficiency 38%. From which 32 patients have hematologic malignancy (50% ALL, 37.5% AML, 6.3% aplas-tic anemia, 6.3% other). Mean time of admission in hospital were 30.1±29.3 days (1-230 days). The sign and symptoms were fever 41.3%, nasal ulceration or necrosis of palate 54.3%, orbital sign 59.7%, Headache 55.4%, central nervous system sign 28.2% and facial sign 53.2%. Median time between first symptoms and start of amphotricin B was 8.2±8.6 days. Treatment consist of both surgery and amphotricin B was done in 70.5% of patients. Mean number of surgery were 1.8±1.5. The mean time of mortality was 60.3±83 day. Thirty seven percent of patients survived with a 6 months follow up. Conclusion: Initial symptoms of sinus invasion by mucormycosis are indistinguishable from other more common causes of sinusitis. We must consider these diseases if there is nasal ulceration or necrosis of palate with fever and orbital sign. Diabet and immune deficiency are the most risk factor for rhino-orbito-cerebral mucormycosis. There is no relationship between age, predisposing factors and adverse effect of drugs with surviv-al. Progression to central nervous system in imaging pattern are related with hospital mortality. Treatment modality and number of surgery affect to mortality P= 0.001, P= 0.033. Survival was affected with the total dose of amphotericin B (P= 0.026).

---

Background: Primary cardiac tumors are rare tumors which should be operated urgently. In this study, cardiac myxoma have been evaluated from diagnosis until dis-charge in a 10 years period and then results including presenting symptoms, approach to the patients were compared with similar study in this center a decade ago. Methods: Patients who underwent operation for myxoma from year 2003 until 2013 in the Shahid Modarres Hospital were included in this study. Results: Eighteen patients included in the study, 11 female and seven male. Patients’ ages were in the range of 13 to 76 years (mean 53 years). Mean time from diagnosis to operation was 5.8 days and mean time from surgery to discharge was 8.6±6.1 days. Most common presenting symptoms were first clinical presentation in four patients. In all patents echocardiography was the main diagnostic modality. In addition to trans thoracic echocardiography (TTE), in five patients TEE was used and in 13 patients coronary angiography was used to rule out concomitant coronary artery disease. 94.4% of all tumors (17 cases) were primary cardiac tumors and only one tumor (5.6%) was recurrent. In 16 patients (88.9%) tumor were found in the Left Atrium (L.A) and in one case, tumor was found in both atria and in another case, tumor was in the ventricle. After tumor excision, atrial septum was repaired primarily in seven cases (38.9%) and with pericardial patch in 9 cases. One patient underwent concomitant coronary artery bypass graft (CABG) and another patient underwent concomitant pulmonary valve repair. 14 patients (77.8%) discharged from hospital without any post operative complication. Heart block occurred in one patient and cerebral emboli with secondary cerebrovascular accident (CVA) developed in two patients. One patient died (5.6%). Conclusion: Comparing results from two similar studies in two consecutive decades revealed that mean time from diagnosis to operation obviously was reduced but ad-vances in diagnostic modalities were unable to change clinical presentation or reduce age of tumor diagnosis or complications or size.

---

Background: Stem cells are applied in the treatment of wide range of diseases and can be separated from different tissues of the body. These cells can treat diseases by cytokine and growth factor secretion and also cell differentiation. Burn wound is a challenging problem of reconstructive surgery and stem cells may help wound healing process. We designed this study to evaluate the beneficial effect of fat derived stem cells for coverage of 3rd degree burn wound. Methods: This study was experimental and has been done in Burn Research Center of Iran University of Medical Sciences during January 2012 to April 2013. Thirty rats randomly divided to three equal groups. Inguinal fat of 10 rats (one group) were used for preparation of autologous adipose-derived mesenchymal stem cells. Acellular amnion was used as a scaffold for stem cell transfer. Each of the thirty rats had been exposed to a cm deep 3rd degree burn on back area. 24 hours after surgery, the wound was excised and it had been covered by three methods: conventional dressing in the first group, acellular amnion in the second group and acellular amnion seeded with adipose-derived stem cell in the third group. The rate of wound healing and pathologic characteristics was compared in all three groups. Results: Healing rate and decrease in wounds size was significantly better in acellular amnion seeded with adipose-derived stem cells compared with other two groups at 3rd and 15th days after surgery P<0.01. Also in histopathology examination, fibroplasia and neovascularization of wounds were significantly better in stem cells group than the other two groups P<0.001. Conclusion: Acellular amnion seeded with adipose-derived stem cell can result in faster wound healing and better histopathology characteristic. The amnion as a scaffold and the fat derived stem cells as healing accelerator are recommended for coverage of the 3rd degree burn wounds after excision and it may reduce the need for skin graft.

---

Background: Gestational diabetes is associated with increased risk of congenital heart disease in neonates. The study was performed to evaluate the cardiac parameters in neonates of mothers with abnormal glucose tolerance test (GTT) and compare them with data of normal newborn. Methods: In a cross-sectional study in Amiralmomenin Hospital, Semnan City, Iran from April to October 2013, two groups of infants were eligible for the study. Sampling was performed in succession for the infants who were eligible. Echocardiography was performed for the babies on the second day, and cardiac parameters including interventricular septal diameter, left ventricular shortening fraction and mass, left ventricular posterior wall thickness, aortic and left atrial diameter were measured. Maternal glycemic control and HbA1c were measured indicators. Analysis with the SPSS software version 16, the Student’s t-test, Mann-Whitney and Chi-square test were performed. Results: Thirty five newborn infants of mothers with impaired GTT and newborn of 33 healthy women were studied. Birth weight, maternal age and HbA1c among infants of mothers with impaired GTT were greater than the control group (P=0.003 and P=0.000 and P=0.000 respectively). Diastolic and systolic ventricular septal thickness, ratio of diastolic ventricular septal thickness to diastolic diameter of the left ventricular posterior wall, the aortic diameter and left ventricular outflow tract diameter in infants of mothers with impaired GTT were significantly increased in comparison to data of the normal group (P=0.008, P=0.034, P=0.016, P=0.017 and P=0.020 respectively). No significant difference was reported in other diameters. Conclusion: Gestational diabetes mellitus results in changes of echocardiographic findings particularly relevant in diastolic ventricular septal thickness. The increase in wall thickness especially during diastole, is associated with pathological cardiac hypertrophy. Based on the results of the present study, cardiac hypertrophy can be related to gestational diabetes. Poor control of disease may cause or aggravate the process.

---

Background: Helicobacter pylori vacA (vacuolating toxin A) gene is comprised of mid- (m), intermediate- (i) and signal-regions. Recently, the vacA-i region genotype has been suggested to be a better predictor of disease severity than either the s- or m-region. The main aim of the present study was to determine the associations of i region poly-morphisms of vacA gene with gastric cancer (GC) and peptic ulcer disease (PUD) in Azerbaijan Province patients. Methods: A number of 89 patients were enrolled. The biopsy samples were taken from patients referring to the endoscopy units of Imam Reza and Shahid Madani Hospitals, Tabriz, Iran from August 2012 to May 2013. The genotype frequencies of vacA-i1 and i2 in were studied using polymerase chain reaction (PCR). Results: The frequency of vacA-i1 and i2 was 51.68% and 48.31%, respectively. The genotypic frequency of vacA-i1 in patients with GC (21/24, 87.5%) was significantly higher than in those with non-atrophic gastritis, NAG (19/48, 39.58%). In contrast, the genotypic frequency of vacA-i2 in patients with NAG, PUD, and GC was 60.42%, 64.70%, and 14.28%, respectively. The results of multiple linear and logistic regression analyses confirmed the intensity of correlation of vacA-i1 allele with GC compared with control group (NAG). No significant correlation was found between the vacA-i-region alleles and PUD risk. Conclusion: We have proposed that the H. pylori vacA-i1 genotype could be an im-portant biomarker for predicting the gastric cancer risk in Azerbaijan Province in Iran. However, due to the difference in the allelic frequency of this gene in H. pylori strains from different parts of the world, the vacA-i1 genotype usefulness in predicting the gas-trointestinal diseases is dependent to the geographic origin of the strains.

---

Background: Nausea and vomiting is one of the most important complications in chemotherapy. Serotonin and dopamine are important neurotransmitters in nausea and vomiting. It seems that oxygen therapy and increase oxygen saturation can cause decrease these neurotransmitters. The aim of this study was to investigate the relationship between arterial oxygen saturation (SaO2) of patients and chemotherapy-induced nausea and vomiting. Methods: A descriptive-analytical study was performed in Koosar Hospital in Semnan, Iran, from 19 September 2013 to 25 April. At first, SaO2 of 30 patients in three periods (pre, during and post chemotherapy) were measured. Severity of nausea and vomiting in three days after chemotherapy was measured with an index of nausea, vomiting and retching (Rhodes Index). Also during chemotherapy, anxiety and depression of patients was measured with Hospital Anxiety and Depression Scale (HADS). Results: In this study thirty patients were evaluated. Most of them were women (66%) with mean age of 55.07±11.9 years old. The most common cancer in patients was breast cancer (46.7%). Mean of SaO2 was 92.1%±3.4 that was not significant difference during the chemotherapy. Mean of nausea and vomiting severity in first day of chemotherapy was (3.27±5.5), in second day was (4.5±6.2) and in third day was (7.2±8.7). The Pearson correlation coefficient did not show the relationship between oxygen saturation with severity of nausea and vomiting (P>0.05). Although severity of anxiety of patients was significant relationship with nausea and vomiting in third day (P=0.03). Conclusion: In this study there was no significant relationship between oxygen saturation and severity of nausea and vomiting, but anxiety of patients was related to nausea and vomiting in third day. Chemotherapy-induced nausea and vomiting was more common in third day and it seems that further research is needed for relationship between oxygen saturation and nausea and vomiting in third day of treatment.

---

Background: Graft survival has been considered the major problem in reconstructive surgery. Clinical studies have helped us to understand the role of PRP in increasing skin survival. Our goal in this study was to examine the treatment effects of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) on autologous full thickness skin graft survival in male rats.

Methods: This experimental study was performed on 36 rats of Sprague-Dawley race with weighing approximately 250 to 300 gr on May 2015 in animal laboratory of Hazrat Fatima Hospital. After anesthesia, rats were divided into 3 groups. We injected platelet-rich plasma (PRP) in the first group, platelet-rich fibrin (PRF) in the second and saline in the third group after removing the skin. Microscopic analysis was performed with camera (Canon powershot SX200, Tokyo, Japan) on days 7, 14, 21 and 28 after surgery. We used image analysis system (ImageJ, ver. 1.45) to examine necrosis and survival rate. Samples were studied with H&E staining on day 28 microscopically for histological analysis of vascular density and angiogenesis.

Results: Our findings showed the area of necrosis in animals injected with PRP on days 7 and 14, was meaningfully less than control group (P= 0.0001). There was no meaningful difference between control and PRP groups (P> 0.05). The area of necrosis in animals injected with PRF did not have any significant difference with control group from beginning to 21st day (P< 0.0001). there was no meaningful difference in vascular density between control and PRP group, whereas in animals injected with PRF the vascular density was significantly less than control group (P= 0.002).

Conclusion: According to our results in this study, we can conclude that using autologous PRP can enhance the process of healing soft tissue injury and be affective at increasing graft survival. This method is suggested to be conducted for patients highly at risk of graft loss and also for those who are in need of early treatments.

---

Background: It is reported that high frequency of chromosomal aberrations in peripheral blood lymphocytes of individuals is a marker of cancer predisposition. The aim of this study was to investigate the in vitro frequency of chromosomal damage in lymphocytes of patients with head and neck cancer against gamma irradiation compared with those in healthy individuals.

Methods: In a case and control study, peripheral blood lymphocytes of 101 patients with head and neck cancer were collected before the onset of radiotherapy. Lymphocytes of 40 healthy individuals were also collected as controls. Head and neck cancer patients and the control group were consecutively recruited between April 2012 and February 2015 from Clinics of Cancer Institute, Imam Khomeini Hospital, Tehran, Iran. Lymphocytes of patients or control group were cultured and exposed to gamma radiation in G2- and G0- phase of the cell cycle. The induced chromosomal aberrations such as chromosome and chromatid breakages, chromosome and chromatid gaps, chromatid exchanges and micronuclei were scored in one-hundred metaphase cells of each individual. The mean of each chromosomal aberration was compared in patient and control groups. Early and late tissue reactions were scored during radiotherapy treatment or thereafter.

Results: There was no significant difference in demographic characterization between the two study groups. The frequency of radiation- induced G2 aberrations in lymphocytes of patients was significantly higher than in those of healthy donors (P= 0.001 for chromosomal breaks). The frequency of radiation-induced micronuclei in G0 assay was also higher in patients than in those in controls (P= 0.05). The results also indicate that there is no correlation between the two assays. No significant correlation was also observed between aberration frequencies in lymphocytes and the degree of both early and late normal tissue reactions.

Conclusion: The results indicate that the in vitro chromosomal radiosensitivity of peripheral blood lymphocytes of patients with head and neck cancer against gamma irradiation was significantly higher than that in healthy individuals.