Tehran University Medical Journal

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Cystic Fibrosis (CF) is an inherited disease that affects multiple organ systems. It is the most common cause of severe progressive lung disease and exocrine panceratic insufficiency. In our investigation 67 patients had CF. Of these, 79% had panceratic insufficiency and 92% had lung disease under 2 years age. Also 67% of patients were < 2 percentile and 28% between 3-10 percentile weight for age. Unfortunately 27% of them died because of respiratory problems

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Migraine as one of the most common types of headaches with high intensity and prevalence, affects life significantly. This study was devised to determine the effects of migraine on economic status and life quality of Iranian surffcres.
"Pain database questionnaire", prepared by the International Association for the Study of Pain (IASP) in the year 1995, was translated to Farsi. Then we modified it regaiding cultural, geographical and social characteristics of Iran. 65 patients (55 women and 10 men) were recruited form neurology clinic consultants. Those patients who met the International Headache Society. (IHS) criteria for migraine, were interviewed using IASP questionnaire. Pain effects on sleep, marital life, social, recreational and sexual activities, quality and quantity of drug consumption as well as using paraclinic procedures were considered.
Significant decrease in sleep duration was seen during pain (7.4 ± 1.9 h) compared to pain-free conditions (6 ± 3.7 h) (P < 0.001). The effects of pain on marital life, social, recrealtional and sexual activities during pain were compared with pain-free conditions based on a zero to ten ranking schedule,. Wilcoxone test showed statistically significant (P < 0.02) differences.
We concluded that the economic effect of migraine and its impact on patients' quality of life are significant and should be considered in health planning and disease management

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Systemic sclerosis is a generalized disorder of connective tissue, in which the pattern of disease extent, progression and outcome is heterogenous. To determine clinical features, disease extent and progression, we studied our patients in two phases of disease early (the first 3 years) and late phases (after 6 years of disease). 19 patients had diffuse cutaneous and 34 patients had limited cutaneous scleroderma. In patients with diffuse cutaneous scleroderma, disease progression has occurred mostly in the early phase of disease, but in patients with limited cutaneous scleroderma, disease progression was slow and incidious, so disease progression has occurred mostly in the late phase of the disease, thus raynaud's phenomenon, telangiectasia, hyperpigmentation and esophagitis were observed more in the late phase of the disease (statistically significant). In comparison of two groups, early and extensive organ involvement was observed in patients with diffuse cutaneous sclerodema.

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Squamous cell carcinoma, a cancer of keratinocytes origin, mostly involves sun-exposed areas of the skin. To study the pathologic and demographic features of this disease, records of 395 patients of squamous cell carcinoma of skin and lip were reviewed. Most of the patients (83%) aged 40 years or more at the time of diagnosis. Respectively, 74.4% and 75.8% of cases with skin and lower lip carcinoma were men, but in upper lip cases frequencies of both sexes were equal. The number of patients referred from western and north-western provinces were much more than those of other provinces of the country. The most frequent histologic stage was grade I (53% and 58.8% in skin and lip carcinoma, respectively), showing that most patients visit physicians early enough, and are diagnosed in early stages of the disease.

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The use of Antiepileptic drugs (AEDs) in children may be associated with adverse effects especially behavioral and cognitive and teratogenic potential effects. The main propose of this study was to find an answer to the question of which factors in EEG of patients before AED withdrawal could have prognostic role in our decision. We studied 106 children whom their medication had been withdrawn 2 years after their last seizure. Before starting of this, an EEG was recorded and interpreted by an expert neurologist. Many variables such as background activity, focal spike, generalized sharp and spik waves, focal slowing, in comparison with the EEG of patient at the time of diagnosis, and also final result of the trace interpret also examined. Follow-up visits were scheduled every 3 months at least for one year. If seizure relapsed, AEDs was resumed and follow up terminated. The overall probability of remaining seizure free was analyzed as a function of time by Kaplan-Meier survical analysis. Prognostic factors affecting seizure relapse were evaluated by using the log-rank test. The overall probability of seizure recurrences was 24.8 percent (95 percent C.I, 22.5 to 28.5) at 12 months. EEG comparisons with previous times were a significant factor for prediction of relapses. Relative risk of this factor was about 1.98 (95 percent C.I, 1.01 to 3.91) (P<0.05). We found that EEG interpretation at the time of diagnosis was not a significant factor but if it divided by sex, there is a significant difference in gender (P=0.06). According to our study the rate of AED withdrawal in children is small. The benefits of continuing AED therapy must be weighted against the risk of potential adverse effects. EEG comparison with previous traces could be evaluated as a prognostic factor before AED withdrawal in children.

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Background: Mechanical low back pain (L.B.P) is most common in middle-aged people especially in developing countries and the symptom compromises routine life activities of the patients. Disk herniation is the most frequent cause of LBP. The less costly way for diagnosing the cause of LBP is performing a careful physical examinations. This study aimed to evaluate the sensitivity and specificity of clinical diagnosis of the cause of Discal Sciatic Neuralgia at Construction Labors in comparison to MRI as the gold standard.

Methods: In a descriptive- analytic study 60 middle-aged professional construction workers were evaluated. Their age range was 25-45 years old and all of them had the complaint of mechanical LBP. Medical history was taken and all cases under went a cautious physical examination. The presence of disk herniation between L4-L5 orL5-S1 was recorded according to clinical signs and symptoms. Lumbosacral MRI was performed for all cases and the results were compared to clinical data.

Results: The clinical diagnosis of presence and severity of pathology was confirmed by MRI in all stages of discopathy in L5-S1 and L4-L5 vertebrae (sensitivity= 100%).

Conclusion: This study showed that careful physical examinations will be sufficient for the sciatic neuralgia diagnosis and even the staging of disk herniation can be performed clinically. Requesting MRI as an expensive procedure is not recommended for diagnosis of Discal sciatic neuralgia because of feasibility of the cost effective way of precise physical examination.

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Background: Rheumatoid arthritis (RA) is a chronic inflammatory condition. The condition can affected many tissues throught out the body, but the joints are usually most severely affected. The high incidence of RA, the conventional treatments and the experimental observation have shown by combination therapy, the disease symptoms of the patients reduce. To compare the efficacy and tolerability of single-agent Hydroxychloroquin (HCQ) with combination therapies composed of (HCQ) and Methotrexate (MTX) and (HCQ), (MTX) and Sulfasalazin (SSZ) in active rheumatoid arthritis patients with additive arthritis.
Methods: One hundred and twenty RA patients with active arthritis (male/female: 30/90) who were treated in rheumatology clinic between 2003 and 2005 were enrolled in this trial. Patients treated with (HCQ) alone(200 mg/day)were include in group (I), patients treated with combination of (HCQ) (200 mg/day)and (MTX) (7.5mg/week)in group (II),and patents treated with combination of (HCQ) (200mg/day),(MTX) (7.5mg/week)and (SSZ)(1 gr/day)in group (III), Forty patients (male/female:10/30) in group (I),(II) and (III)were eligible for statistical analysis at the end of study. Changes in variable were compared by the T-test.
Results: The combination of (MTX), (HCQ)and (SSZ) and the combination of (MTX) and (HCQ) were more effective regarding the clinical and laboratory parameters than (HCQ) alone (P<0.05). Moreover the combination of (MTX), (HCQ) and (SSZ) was more effective than the combination of (MTX) and (HCQ) (P<0.05). Combination therapies seem to be more effective and no more toxic than monotherapy in RA patients with additive arthritis.
Conclusion: Combination therapy with methotrexate, hydroxychloroquin and sulfasalazin is more effective than hydroxychloroquin alone or a combination of methotrexate and hydroxychloroquin in RA. We suggest starting combination therapy for the patients with early RA, when the diagnosis has been established.

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Background: Atrial and ventricular arrhythmias are among the most common complications after coronary artery bypass graft (CABG) surgery. Previous studies demonstrated that cardiopulmonary bypass itself results in reduced serum magnesium levels. In this study, we evaluated the effect of total blood magnesium level (TMG) on the prevention of perioperative arrhythmias with routine regimens of 2-4 grams supplemental magnesium (SMG). Methods: TMG was measured in patients who were scheduled for CABG on three occasions: just before anesthesia, just after entering the intensive care unit (ICU) after completion of the sugery, and on the first morning after the operation. Patients were evaluated for primary cardiac rhythm and other variables that could have an influence on the magnesium level, including serum creatinine, urine output in the operating room and diuretic therapy. The SMG dosage was also recorded in the operating room and ICU. Patients were then evaluated for the rate and type of arrhythmia for the next three days. Results: The mean TMG levels in 174 cases were 2.2 (0.5), 2.6 (0.6) and 2.4 (0.6) mg/dl for the three occasions, respectively. The mean SMG was 2.5 (1.2) grams. Of 164 patients, 51 (31%) developed the following post-operative arrhythmias: AF (7.3%), non-AF SVA (15.2%) and ventricular (16.5%). The mean serum creatinine level and urine output were 1.2 mg/dl and 1800 ml, respectively. Although there was a significant difference between the TMG levels on the three different occasions (P<0.001), all values were within normal range. When we stratified the TMG levels of the patients based on administered SMG, the Mentel-Haenszel test revealed no significant difference between the first and third TMG (P=0.6). Although the TMG levels were higher in arrhythmic patients compared to those without arrhythmia (2.25 vs. 2.14 mg/dl), both values were within the normal range and there was no significant difference between the two groups. Serum creatinine levels and urine volume were not related to TMG levels. Conclusion: This study indicates that routine magnesium administration has no significant effect on SMG levels. Also, serum creatinine and urine output are not determinant factors for SMG administration. There was no correlation between TMG levels and perioperative arrhythmia. We conclude that the routine regimen of magnesium administration has no effect on the incidence of perioperative arrhythmia, though it is necessary for maintaining normal magnesium levels.

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Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease with several factors that contribute to its manifestation and continuation. One of the factors that initiate RA is emotional stress, which is in direct relationship with the sufficiency or insufficiency of the neuro-endocrine axis. Therefore, any stress that is not resolved in the neuro-endocrine axis might lead to RA and, as the stress continues, it causes the continuation of the disease. The aim of this study is to determine the effect of stress on continuation of RA and to find curative methods and, ultimately, the best method for treatment.

Methods: One hundred rheumatoid arthritic patients (80 females and 20 males), having a final diagnosis of RA based on the guidelines of the American College of Rheumatology and onset of disease within the last 12-36 months, were studied as case and control subjects. Data was collected using interviews and questionnaires that reflected their life events with stress as a serious factor in their disease. The patients were divided into two groups: group A with stable stress and group B with unstable stress. The same treatment method was given to both groups. The results of the treatment were evaluated and compared after two years of follow up. Results: There was significant improvement in the patients in group B with unstable stress over that of the patients in group A with stable stress (P<0.0001). Conclusion: The present study shows that a considerable number of RA patients suffer from serious stress that affects their clinical path and improvement, and is quite visible in the health indexes and continuity of the disease. The results further showed that stress can play an important role in the initiation and continuation of RA. Therefore, by identifying and making efforts to remove the stress factors using anti-anxiety drugs, the disease can be better controlled.

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Background: Rheumatoid factor (RF) is an IgM antibody against the Fc portion of IgG, which together form an immune complex. RF is an important criterion in the diagnosis of early-stage rheumatoid arthritis (RA) and prognosis of RA pathogenesis, as higher levels of RF indicate a higher possibility of more damage. Although 2/3 to 3/4 of patients that undergo ordinary standard tests and have final clinical diagnosis are also positive for RF, a 70-90% prevalence of RF among RA patients can be achieved, depending on the method of detection and the target antibody, IgG or IgM. In this study, we measured the frequency of IgG and IgM RF isotypes using the ELISA and latex agglutination methods and compare these results with those of a hospital control group, tested using standard methods, in order to determine the best method for the measurement of RF.

Methods: Of the patients referred to the Rheumatology Clinic of Imam Khomeini Hospital during 2005-2006, one hundred randomly selected rheumatoid arthritis patients, 75 females and 25 males, with classical or definite rheumatoid arthritis (defined by the criteria of the American College of Rheumatology), with a short disease duration of 12-24 months, underwent testing for RF using the latex method for IgM and ELISA for IgM-IgG. The healthy control group (75 females and 25 males) were tested for RF using the ELISA method for IgM-IgG. The variables were compared using the Pearson's chi-square test.

Results: We found that the measurement of RF among RA patients using did not differ significantly between the two methods. The immune complex in RA is mainly IgM. The positive IgM results in RF patients using two similar methods showed a significant relationship by Pearson's correlation co-efficient (r=0.60, p<0.001). In addition, comparison of the IgM and IgG RF by ELISA showed a weak correlation with low significance (r=0.10, p<0.001). In sum, this study showed a significant difference (r=0.24, p<0.001) between the IgM in RA patients and that in healthy people, who had no IgM or IgG RF.

Conclusion: Approximately 75% of confirmed RA cases had the IgM RF however, we found little advantage in using the one method over the other, nor was the measurement of IgG more useful than IgM as a diagnostic criteria.

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Background: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system with multifocal areas of demyelination. Despite an increased understanding of the mechanisms causing MS, immunological factors that indicate disease activity are only starting to be discovered. Chronic brain inflammation is often associated with an increase in production of IgG in the CSF as determined by the IgG index (normal ≤0.77) and oligoclonal bands (OCBs). Different studies have found variable correlations between these two factors and disease progression. We herein evaluate the correlation of IgG index and OCB with disease progression in Iranian MS patients.

Methods: The IgG index was measured in 54 patients with multiple sclerosis. The progression index (PI), type of disease course and the presence of OCBs were compared in patients with normal, high and very high IgG index.

Results: PI was higher in patients with very high IgG indexes (0.10±0.13) vs. patients with high (0.06±0.05) and normal IgG indexes (0.05±0.07 p>0.05). Secondary progressive (SP) patients had higher IgG indexes than those with relapsing-remitting (RR) courses (2.04±1.24 for SP vs. 1.78±1.45 for RR p>0.05). The PI was higher in OCB-positive MS patients (0.08±0.10) vs. OCB-negative patients (0.05±0.04) (p>0.05).

Conclusion: Although the findings of this study need to be treated with some caution since this is not a prospective evaluation, the results indicate a trend toward better prognosis of the disease in patients with lower IgG index values. We think that the IgG index is a useful marker of disease activity in MS. Patients with IgG indexes above 1.1 could have an increased risk of progression and they would benefit from early treatment with immunomodulator agents. Our results did not reveal statistically significant prognostic value for IgG index in patients with multiple sclerosis. Thus the results warrant prospective studies to verify the prognostic value of intrathecal IgG synthesis in multiple sclerosis.

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Background: To evaluate the possibility that prolactin is involved in the pathogenesis and flare-up of systemic lupus erythematosus (SLE).

Methods: In this cross-sectional study we determined serum prolactin levels in sixty (60) serum samples from sixty patients diagnosed with SLE by the criteria of the American College of Rheumatology (ACR). All patients were females between 13-64 years of age. Disease activity was defined according to lupus activity criteria count and scored by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Serum prolactin concentrations were determined by immunoradiometric assay (IRMA) [125I]. Patient blood samples were taken between 10 a.m. and 12 p.m. Serum was separated and kept frozen at -20 ^°C.

Results: Hyperprolactinemia (>21 ng/mL) was found in 7 (11.7%) patients. SLEDAI scores of <4 were considered inactive disease, >15 active disease and 4-15 moderate activity. Accordingly, 6.7% of our patients had active disease.

Normal serum prolactin levels range from 2 to 21ng/mL. Among those with active disease, prolactin levels were higher, with mean prolactin levels of 18.15, 15.11 and 11.5 ng/mL for active, moderate and nonactive groups, respectively. Increased prolactin levels correlated with activity of SLE disease (p=0.019, r=0.305). No correlation was found between tissue involvement and prolactin level (p=0.24) and no significant correlation was found between prolactin level and age (p=0.19).

Conclusion: Hyperprolactinemia, detected in patients with SLE by IRMA, was associated with disease activity. Our findings suggest that prolactin may play a role in the pathogenesis of SLE.

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Background: Acute lung injury (ALI) is a pulmonary pathology occuring in context of infection, trauma, burn, and sepsis. Tissue injury and release of chemical mediators result in tissue damage and organ failure especially respiratory failure. Many therapeutic modalities including vitamin E, allopurinol, and N-acetylcystein (NAC) have been used to decrease levels of inflammatory factors and to control and improve signs and symptoms. The antioxidant feature of NAC induces synthesis of glutathione- the scavenger of free radicals- and increase respiratory drive and PaO₂. In time diagnosis of ALI, prompt institution of treatment will reduce mortality and morbidity in critical illness.
Methods: This open label analytical clinical trial included a total of 50 patients admitted in the ICU ward of Sina University Hospital. They were randomly divided into two groups of 25, the case group received NAC 150mg/kg in 100ml Normal saline within 20 minutes then 50mg/kg in 100ml Normal saline within 4 hr after that 50mg/kg daily for three days. The controls received only normal saline. Oxygenation and ventilation parameters were studied In both groups.
Results: There were no significant difference between the groups in terms of demographic indices, mean SpO₂, ABG values, mortality rates, and clearing of chest x-rays. The best outcome was seen in young traumatic patients.

Conclusion: In this relatively small group of patients presenting with an established ALI/ ARDS subsequent to a variety of underlying disease, intravenous NAC treatment during first four days neither significantly improved systemic oxygenation nor reduced the need for ventilatory support.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Chronic peritoneal dialysis is a safe method for the treatment of end-stage renal failure. Worldwide, patients on chronic peritoneal dialysis constititute approximately 15% of the total number of patients on dialysis. In Iran, very few people have access to chronic peritoneal dialysis, which is targeted by the Ministry of Health. This lack of access is primarily due to the high occurrence of mechanical complications. Improving catheterization procedures is an important way to extend the use of peritoneal dialysis in Iran. Thus, a prospective study was implemented to evaluate the outcome of a new laparoscopic technique for the insertion of peritoneal dialysis catheters under local anesthesia.
Methods: A total of 115 catheters (two-cuff, swan-necked, coiled) were inserted into the peritoneal cavity of 109 patients with end-stage chronic renal failure during a 16-month period. The method of insertion was a two-port laparoscopic technique with local anesthesia and sedation. All patients were followed for 12 to 28 months. We prospectively evaluated mechanical and infectious complications and survival rates of the catheters.
Results: The average age of the patients was 51.5 years (range: 15-84 years) 54.8% of these patients were female. The overall one-year and two-year catheter survival rates using this approach were 88% and 73%, respectively. Event-free catheter survival was 35%. The most common infectious and mechanical complications were peritonitis in 52 cases (45.2%) and temporary dialysate leakage in 10 cases (8.7%) respectively.
Conclusion: Laparoscopic insertion of peritoneal dialysis catheter with local anesthesia is a safe and simple procedure, giving reasonable rates of catheter survival and complications.

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Background: Obstructive gastrointestinal (GI) malformations are one of the most important congenital problems and have different clinical manifestations, which depend on the severity and location. Although, complete obstructive lesions cause classic intestinal obstructive symptoms in infants, incomplete obstruction might be asymptomatic until adulthood and sometimes cause unusual symptoms, which need extensive work up. Moreover, this delay could produce significant complications. Near all of these lesions are surgically correctable therefore awareness of this possibility is important in order to prompt appropriate management and referral plan.

Case report: In this report, we introduce five infants who had congenital GI malformations with different presentations such as vomiting, hematemesis, growth failure and steatorrhea. Appropriate time of diagnosis caused surgical correction of lesions except in one patient with very unusual presentation who was diagnosed late. As a result, in this case, severe growth and developmental delay appeared.

Conclusion: Congenital gastrointestinal obstruction has different manifestations. Awareness can help to survive patients.

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Background: Axillary block is used for inducing anesthesia in outpatient hand and forearm surgeries. Few researches have studied hemodynamic and blockade effects of low doses of Epinephrine. The aim of the present study was to compare the duration of analgesia and hemodynamic changes following the injection of high/low epinephrine doses in such surgeries.

Methods: The present randomized clinical trial study was conducted on healthy individuals (ASA I-II) who were candidates for hand and forearm surgeries. The patients were randomly divided into three groups. The first two groups were allocated to receive lidocaine with low (0.6µg/cc) and high (5µg/cc) doses of epinephrine whereas lidocaine plus normal saline was injected in the third group. The hemodynamic changes (Mean arterial blood pressure and heart rate) and the occurance of any side-effects along with the duration of analgesia and motor block were recorded.

Results: From among the total of 75 patients, 15 cases were excluded due to incomplete blockade or failure needing general anesthesia. The duration of analgesia and the motor block were longer in the high dose epinephrine group, the difference, however, was not statistically significant. Heart rate changes within the groups was significant in the 4^th-7^th and 10^th minutes. Mean arterial blood pressure changes was only significant in the 4^th minute, within the groups.

Conclusions: Administering low doses of epinephrine plus lidocaine as a local anesthetic not only provides acceptable analgesia compared to higher doses of the medication, but also is associated with fewer side effects.

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Background: High Resolution sonography of common carotid artery is a safe method for rapid diagnosis of atherosclerosis in Rheumatoid Arthritis (RA). The purpose of this study was to compare sonographic findings of subclinical atherosclerosis in rheumatoid arthritis patients and control group and comparing the prevalence of atheromatous plaques and Intima- media thickness in arteries of the groups.

Methods: Fifty RA patients and fifty non-RA persons were evaluated in a cross- sectional, Descriptive study. The sonographic findings of common carotid artery of these two groups were compared.

Results: After analysis of the sonographic findings of common carotid arteries of 100 females in our study (50 patients with the mean age of 48.1y/o [23-61] and 50 control group with the mean age of 47y/o [23-61]), the prevalence of RA patients with atheromatous plaques was 32% and in control group was 6%. [OR=7.4, 95%CI=2-27.3, p=0.001]. The mean (SD) of the Intima- Media Thickness (IMT) in RA patients was 7.76 mm (1, 04) while in control group was 6.10 mm (0.95). From 38 RA patients with less or equal 5 joints involvement in hand radiography, 13.2% had atheromatous plaques and the mean (SD) of the IMT was 7.6 (±1.1) mm. From 12 patients with more than 5 joints involvement in radiography, 91.7% had atheromatous plaques and the mean (SD) of the IMT was 8.4 (±0.7) mm. [p=0.012].

Conclusions: Regarding higher prevalence of vascular problems in RA patients, screening and early diagnosis of vascular pathologies could be of value in reducing morbidity and mortality of these patients.

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Background: Diagnosis of multiple sclerosis (MS), as a major cause of neurological disability in young adults, is difficult to establish, especially at the onset of the disease process, due to lack of reliable molecular markers.The goal of the present study was to evaluate serum and urinary concentrations of cystatin C and to find their relationship with patients' expanded disability status scale (EDSS).
Methods: Based on McDonald's criteria, 54 adult patients with M.S.(11 males and 43 females, with a mean age of 32.18±8.37 years) were enrolled as the case group and 24 age and sex-matched healthy, non-M.S. individuals (7 males and 17 females, with a mean age of 34.31±10.07 years) were recruited as the controls. Serum and urinary concentrations of cystatin C were measured in all the participants.
Results: The means of serum cystatin C concentrations (mg/Lit) in the case and control groups respectively were 0.90±0.01 and 0.89±0.02, (p=0.84) and the means for its urinary concentrations were 25.37±1.91 and 21.11±2.54 (p=0.18).The means of serum and urinary cystatin C concentrations were 0.90±0.01 and 25.11±2.33 in patients whose EDSS was ≤2.5 and 0.90±0.03 and 26.30±2.84 in patients whose EDSS was ≥2.5,respectively, although, the differences between the two groups of patients were not statistically significant (p=0.80 and 0.74,respectively for serum and urinary concentrations of cystatin C).
Conclusions: This study showed that serum and urinary cystatin C concentrations cannot be used for multiple sclerosis diagnosis or even as a marker in its treatment follow ups or for the determination of disease severity.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Gastric cancer is one of the most common diseases of digestive system with a low 5-year survival rate and metastasis is the main cause of death. Multi-factors, such as changes in molecular pathways and deregulation of cells are involved in the disease development. Epidermal growth factor receptor pathway (EGFR) which is associated with cell proliferation and survival can influence cancer development. EGFR function is governed by its genetic polymorphism thus, we aimed to study the tyrosine kinase domain gene mutations of the receptor in patients with gastric cancer.
Methods : In this experimental study, 123 subjects (83 patients with gastric cancer and 40 normal subjects) were investigated in north of Iran for EGFR gene polymorphisms during 1 year. Genomic DNA was extracted by DNA extraction kit according to the manufacture's protocol. Polymerase chain reaction single-stranded conformation polymorphism (PCR-SSCP) and silver staining were performed for investigating EGFR gene polymorphisms.
Results : The participants included 72 men and 44 women. Gene polymorphism in exon 18 was present in 10% of the study population but SSCP pattern in exon 19 did not show different migrate bands neither in patients nor in normal subjects.
Conclusion: It seems that screening for tyrosine kinas gene polymorphism of epidermal growth factor receptor in patients with gastric cancer and use of tyrosine kinas inhibitors could be useful in the prevention of disease progress and improvement of treatment process for a better quality of life in these patients.

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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.