Tehran University Medical Journal

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Background: Over the past 50 years, subtotal or supracervical hysterectomy has come to be viewed as a suboptimal procedure reserved for those rare instances in which when concern over blood loss or anatomic distortion dictates limiting the extent of dissection, the aim of this study was to compare total and subtotal laparoscopic hysterectomy.
Methods: The patients who were candidates for hysterectomy with benign disease, with no contraindication for laparoscopic surgery entered the study in Arash Hospital, from March 2007 to April 2009. By simple randomization 45 patients (25 for TLH and 20 for SLH) were selected. Demographic Details and intra and post operative complications, were recorded by the staff and were compared between two groups.
Results: The average time for TLH operations look significantly longer than SLH operation (148.6±29.7 minutes 128.5±25.64 minutes, p=0.03). Although, the hemoglobin (gr/dl) drop in TLH was significantly higher than SLH (1.54 Versus 0.9, p<0.05) Blood transfusion were common in SLH (1 case Versus 3 Cases). The total length of hospital stay, was significantly shorter after SLH than TLH (3.6±1.47 day and 2.85±0.59, p=0.04). The drug requirements to control pain during hospitalization after both surgeries with analgesic injection were not significantly different, but with suppositories analgesic in SLH more than TLH. The time of return to normal activity was reported (p<0.0001) significantly shorter after SLH than TLH (13.12±18.1 and 5.04±1.79, p=0.0001). Sexual function had no significant difference between two groups but dysparunia in SLH was significantly lower than TLH (p=0.02). Cyclic bleeding and cervical prolaps, was not reported in two groups. Finally intra and post operative complications were more frequent in TLH.
Conclusions: SLH is a safe and effective surgery. Our data suggest that SLH can replace TLH in selected cases.

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Background: Finding a reliable diagnostic method for brucellosis is the most challengeable problem. In this study we determined the optimal diagnostic cut-off point for ELISA test.
Methods: We gathered 56 confirmed cases of brucellosis. Furthermore blood samples from 126 controls including 73 healthy controls and 53 without brucellosis febrile patients were collected. In all of the cases and controls ELISA Ig G and ELISA Ig M levels were measured and compared with each other by Box plot graph and the Receiver Operating Characteristic (ROC) curve. The sensitivity and specificity of ELISA Ig G and Ig M were fixed in different cut-off values and Ig G and Ig M levels yielding maximal sensitivity plus specificity were selected for determination of optimal cut-off point.
Results: The nineteen patients had positive blood cultures for Brucella melitensis. The standard agglutination test results were 1/160 or more in 54 patients. The Box plot graph indicated a high degree of dispersion for Ig G and Ig M data in patients with brucellosis compared with febrile patients without brucellosis and healthy controls. We observed partial overlap for Ig M data (not for Ig G) between cases and controls. The area under ROC curve for discrimination of cases and healthy controls was more for Ig G than Ig M.
Conclusions: The ELISA Ig G is more reliable test than ELISA Ig M in diagnosis of brucellosis. Using cut-off of 10 IU/ml and 50 IU/ml have the most sensitivity (92.9%) and specificity (100%) for ELISA Ig G test, respectively.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: One of the clinical manifestations of Human Immunodeficiency Virus (HIV) infected patients is cardiovascular disorder. The aim of this study was to evaluate the prevalence of cardiovascular disorders in HIV infected patients for the beginning treatment of these patients and reducing mortality and morbidity in these patients.
Methods: This cross-sectional study was performed on 134 HIV infected patients who referred to Imam Khomeini hospital, Tehran University of Medical sciences, Tehran Iran during years 2007-2008. Demographic characteristics, history of smoking and opium addiction, antiretroviral therapy, class of drugs and duration of consumption were recorded. After completion of physical examination, electrocardiography and echocardiography studies were done.
Results: In this study 98(73.1%) patients were male. The mean age of the patients was 36.5±10.3 years. The mean of the CD4 number were 296±181. Injection drug users were 54.4% of the study patients. Cardiovascular disorders were found in 84(62.7%) patients. Among patients with heart diseases, 75% were male. The most Electrocardiographic change was the axis deviation of the heart found in 32(23.7%) patients. Pericardial effusion and LVEF<50% were noted in 7(5.2%) and 23(17.2%) patients respectively. The involvement of the mitral valve in 59(44%), tricuspid valve in 21(15.7%) and aortic valve in 6(4.5%) patients were noted. Myocardial dysfunctions existed in 10(7.4%) patients.
Conclusions: Our results showed a high prevalence of cardiovascular disorder in HIV infected patients. We recommend the evaluation of the cardiovascular system in all HIV infected patients even if they are symptom free.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Asthma prevalence has increased in developed and developing countries in several last decades. Although cigarette smoking is an identified risk factor for many diseases such as coronary Heart disease and chronic obstructive lung disease, its effect on asthma is controversial. The aim of this study was to determine the odds ratio and its confidence interval for asthma morbidity among children referred to the Immunology and Allergy department of children medical center according to their parents' smoking and daily cigarette consumption.
Methods: A case-control study was conducted during two years period on the asthmatic patients who referred to Immunology and Allergy department of children medical center. Demographic information and parents' smoking and daily cigarette consumption assessed by a questionnaire. Healthy children with same age and sex were entered to the study as the control group. Statistical analysis was performed to calculate odds ratio.
Results: Among 215 patients who entered the study 63 patients were exposed the cigarette smoke. Odds ratio for asthma morbidity among children whose parents smoke more than five cigarettes per day in comparison with whose smoke less than five or do not smoke was 2.38 (p<0.01).
Conclusion: Parent's cigarette smoking is a risk factor for childhood asthma and could increase the risk of asthma to 2.38 folds in children whose parents smoke more than five cigarettes. Increasing in parents' knowledge level that probably relate to their education results in cigarette consumption decline.

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Background: Cough is one of the most common symptoms for which outpatient care is sought. Since, a few research evaluated efficacy and therapeutic effect of baclofen in remedy of cough (especially chronic cough), In this study we compared the efficacy of oral Baclofen 20 mg with Dextromethorphan to improvement of cough in two groups.
Methods: In this double blind randomized clinical trial, 120 patients with chronic cough (up to three weeks) that were referred to respiratory diseases clinic of Ali Ebn-e Abitaleb (AS) hospital in Zahedan, Iran at 2007 were randomly devided to two groups. 60 peoples in each, (baclofen recipient group with mean age 32.32±6.51 and dextromethorphan recipient group with mean age 31.54±5.06 year) were evaluated for qualitative decline of severity, period and duration of cough for 14 days.
Results: In baclofen recipient group 73.3% and in dextromethorphan recipient group 65% all patients had decline of severity, period and duration of the cough. Statistically, there were no significant differences between two groups in regard to qualitative decline of severity, period and duration of cough (p>0.05). Also, there were no drug related side effects in the patients.
Conclusions: Baclofen decreased severity, period and duration of cough more than dextromethorphan. Because there were no significant differences between two groups, we needed to do more quantitative researches to compare them.

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Background : Septic Arthritis is an acute infection of intra-arthicular space. Delay in diagnosis and in appropriate treatment may lead to prolongation of treatment duration and poor outcome. We decided to evaluate clinical aspects of this disease in our department pediatric department, Imam Khomeini Hospital complex, Tehran, Iran during a 10 years period.

Methods : In a retrospective cross-sectional study, 60 patients with age from 1 month to 14 year-old during 1996-2005 were evaluated. The demographics characteristics, clinical observations (signs & symptoms) and paraclinic values were gathered from medical records and analyzed with statistical tests.

Results : Pain and Swelling was seen in all, joint limited motion in 80% ( 50 cases) claudicating in 64% ( 38 cases), fever in 80% ( 48 cases), monoarticular disease in 80% ( 48 cases) and polyarticular one in 20% ( 12 cases) of them. Hip was most Common involved joint 62% ( 37 cases), elevated ESR was seen in all patients. CRP was positive in 85% ( 51 cases). Leuckocytosis was found in 65/8% ( 17 cases) of cases. In infectious cases, Staphylococcus aurous was responsible organism in 65.6% ( 16 cases), klebsiella in 12.4% ( 3 cases), Streptococcus pneumonia in 12.3% ( 3 cases), group b streptococcus in 4.1% ( 1 case), Hemophilus Influenza type b in 4.1% ( 1 case) of study patients. With therapy ESR was normalized in 64% ( 39 cases) and CRP was normalized in all patients.

Conclusions: In general, all children with complaint of fever, pain, and limited joint motion or claudicating should be suspected for septic arthritis.

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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.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Salmonellosis is a bacterial gasteroenteritis caused by different serovars of Salmonella. In the recent years, Salmonella enterica subspecies. Enterica serovar enteritidis is a major cause of gastroenteritis and food poisoning in the worldwide.  Different genus of salmonella is increasingly being resistant to common antibiotics. The aim of this study was to determine the frequency and the antibiotic resistance patterns of Salmonella enterica isolated from medical health centers in Tehran.

Methods: In this descriptive cross- sectional study from April to December 2008, 1950 fecal specimens from children with diarrhea were cultivated to identify Salmonella enteritidis. We used Clinical and Laboratory Standard Institute (CLSI) protocol to determine resistance patern of the isolates to 16 different antibiotics.

Results: In this study, out of 26 isolates 14(54%) were S. enteritidis, 2(8%) S. para B, 6(23%) S. para C, 3(11%) S. arizonea and 1(4%) S. para A. all of them were sensitive to ceftazidime, cephalexin, cefotaxime, ceftiraxone, ciprofloxacin, imipenem, meropenem, gentamicin and colistin sulfate. All of the isolates were resistant to nitrofurantoin whereas 71.4% of them were resistant to nalidixic acid.

Conclusions: The most prevalent isolated salmonella was S.enteritidis. According to high sensivity of these isolates to cephalosporin and flourqouinolon family, they can used as infective treatment for salmonellosis infections.

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Background: Sepsis is one of the most important causes of mortality in severely ill ICU patients. At least, a part of high mortality rate in sepsis patients is due to less specific clinical symptoms for prompt diagnosis. Recently some studies report that serum levels of procalcitonin will increase in these patients but changes of serum levels following treatments is not known. This study was designed to determin procalcitonin levels in patients with bacterial infectious disease in ICU, initially and during therapy and compare the levels during response to treatment.

Methods: This prospective cross-sectional study was conducted on ICU patients with infectious diseases, blood specimen collected on day 1 and then in days 3 and 7 of ICU admission. The semi-quantitative PCT-Q test was performed.

Results: Thirty five patients, 22(62.9 %) men and 13(37.1%) women, were enrolled in this study. 18(51.4%) patients died. Procalcitonin level in most patients in admission day was more than 10 ng/ml [16 (45.7%)] but in patients that react to treatment, decline to lower than 0.5 ng/ml [14(77.8%)]. Mean rank of procalcitonin level from 1.14 ng/ml in first day reached to 2.72 ng/ml in seventh day (p<0.0001).

Conclusions: This study showed that serum procalcitonin levels in ICU patients with bacterial sepsis significantly decrease following response to treatment. The measurement of serum procalcitonin in ICU patients with bacterial infectious diseases at first arrival day and following treatment is recommended.

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Background: Proteolytic enzymes, especially collagenases, are used for digestion of extracellular matrix, cell isolation and primary culture. Because of the problems in purification and low amount of collagenases in bacterial or animal sources, it is important to find new sources of the enzymes. So, in the present study actinidin, a plentiful protein in kiwifruit was purified and a mixture of actinidin and trypsin was applied to isolate rat aortic endothelial cells. Methods: Aortic endothelial cells were isolated using digestion solution containing different concentrations of actinidin (from 2 to 16 mg/ml) and trypsin (0.3, 0.6, 1.2 and 2.4 mg/ml) in different times (from 15 to 90 minute). Isolated cells were cultured in DMEM culture medium. Isolated cells were identified by morphological characteristics and immunocytochemical staining viability of separated cells was estimated by trypan blue exclusion test. Results: Actinidin in concentration of 10 mg/ml with trypsin in concentration of 1.2 mg/ml for one hour could isolate rat aortic endothelial cells. In this condition the viability of cells was estimated 90%. Morphological and immunocytochemical charac- teristics confirmed the isolated cells as endothelial cells. Conclusion: The results showed that the mentioned mixture of actinidin and trypsin has not considerable toxic effects on separated cells and is a novel and suitable option for isolation of rat aortic endothelial cells

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Background: Meningiomas are among the most common tumors of the brain. Skull base meningiomas comprise s major part of brain meningiomas. They are difficult to treat because of proximity to major vital neuro-vascular structures which makes their surgical resection hazardous and fraught with a high rate of complications. Radiosurgery is considered as an alternative efficient way to treat them, which targets the tumor and its supplying vasculature. The standard treatment consists of tumor eradication and its supplying vessels through homogeneous dose of 201 rays of cobalt 60 source. Methods: In a case-series study, we report 230 meningiomas referred to Iraninan Gamma Knife Center, treated by radiosurgery with type C Gamma Knife. Radio-surgery was performed at a mean dose of 15 Gy and 50% isodose. Results: Two hundred and thirty of all meningioma cases refered to our institute were skull base lesions. Eighty (35%) were new case and the rest were previously treated microsurgically one or more times. None of the patients died after treatment and the most common post-operative complications were headache (30 patients) and peri- tumoral edema (12 patients). Conclusion: Tumoral control is defined as reduced tumor volume or as no change in tumor volume. Tumor control was achieved in 218 (95%) patients. In those who were not treated microsurgically, clinical improvement was more pronounced. Thus when suitable (favorable tumor size and absence of progressive mass effect signs) the patients could be primarily treated with Gamma knife. Other patients could be managed complementarily with radiosurgery after they are treated surgically.

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Background: The inguinal hernia is a common disorder in general surgery. Different methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP) is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia. Methods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared. Results: The operation duration, the rate of complications and frequency of recurrence were similar in two groups but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the Lichtenstein technique (p<0.001, p<0.001, p=0.012, p<0.001, respectively). Conclusion: The TEP surgical technique can be recognized as a safe method with acceptable results for patients and has significant effects on improvement of patients’ quality of life after hernia repair. Suitable results of this surgical method are achieved when the surgeon goes through the learning curve.

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Background: Coronary Artery Disease (CAD) is one of the leading causes of mortality and morbidity all over the world. One of the most important predictors of outcome of patients with coronary aterey disease is the site of stenosis i.e. Proximal versus nonproximal stenosis. This study designed to evaluate the relationship between CAD risk factors and site of stenosis. Methods: In this case- control study in the patients undergone coronary angiography (CAG) in Imam Khomeini Hospital, Tehran, Iran a total of 125 CAD patients with proximal lesion in CAG enrolled the study as case group and equal sex and age matched number of patients with non proximal lesion selected as control group. Two groups were compared based on presence or absence of DM, hypertension, hyper cholestrolemia, hypertriglyceridemia and cigarette smoking. Results: Relative frequency of DM was 33.6% and 10.4% in case and control group respectively (p< 0.0001). Relative frequency in two groups were 33.6 vs 28.8% For HTN (p= 0.41), 30.4% vs 29.6% for hyper cholestrolemia (p= 0.89), 19.2% vs 16.8% for hypertriglyceridemia (p= 0.062) and 28.8 vs 39.2 for C/S (p= 0.08). Multivessle disease was significantly more prevalent in diabetics compared with non diabetic patients 89.1% vs 61% (p< 0.0001), no relationship was seen with HTN (p= 0.41), Hyper cholest- rolemia (p= 0.052) hypertriglyceridemia (p= 0.38) and cigarette smoking (p= 0.375). Conclusion: Proximal involvement of coronary arteries and multivessle disease in CAD patients is related to the history of DM but not to the history of hypertension, hypercholestrolemia, hypertriglyceridemia and cigarette smoking.

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Background: Human respiratory syncytial virus (HRSV) is the most important viral agent of acute lower respiratory tract disease in infants and young children worldwide. This virus is responsible for 50% brochiolitis and 25% pneumonia in infants. There are limited data of molecular epidemiology of HRSV from developing countries. This is the report on the molecular epidemiology of human respiratory syncytial virus in Iran. Methods: In this study, RT-PCR for second hypervariable region of the HRSV G glycoprotein was performed on 72 throat swabs collected from children less than 5 years of age with acute respiratory symptoms in 1386. Results: Of the 72 throat swabs collected from children with acute respiratory symptoms, 14 (19.44%) were positive for HRSV. Phylogenetic analysis revealed that all HRSV-positive samples clustered in three genotypes of subgroup A: 12 strains (85/71%) in genotype GA2, 1 strain (7/1%) in genotype GA1, and 1 strain (7/1%) in genotype GA5. In this study we couldn’t identify any genotype of subgroup B. Conclusion: Our results revealed that multiple genotypes of subgroup A were co- circulated during 1386 in children less than 5 years of age in Iran. Also this study revealed that genotype GA2 was predominant genotype in isolates were obtained from several cities (Tehran, Isfahan, Karaj, Qazvin, Bandar Abbas, Shahreza), so we speculate that this genotype may be predominant during 1386 in Iran. This study supported that RT-PCR for second variable region of G protein is an effective method for further studies of HRSV genotype designation in Iran.

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Background: A correlation between coronary artery disease (CAD) and atherosclerosis of peripheral arteries and the determination of noninvasive indexes for its existence and extent have been sought by many researchers. Some studies report that the intima-media thickness (IMT) of peripheral arteries could play this role. This study evaluated the correlation between the IMTs of common carotid and common femoral arteries and the degree of atherosclerosis in aortic arch and to evaluate the severity of CAD in candidates of coronary artery bypass grafting (CABG).

Methods: In a cross-sectional analytic-descriptive study, The severity of CAD, the grade of atherosclerosis of the aortic arch, and the IMTs of the common carotid and common femoral arteries were determined.

Results: There was a significant weak positive correlation between the IMT of common carotid artery (ρ = 0.193, p = 0.039) and common femoral artery (ρ = 0.206, p = 0.028) with the number of involved carotid vessels the mean of these two parameters was not significantly different between the three CAD groups. There was not any significant relation between the IMTs of common carotid and common femoral arteries with the severity of atherosclerosis in the aortic arch too. There was not any significant relation between the presences of atherosclerotic plaque in the common carotid or the common femoral arteries with the severity of CAD. The severe atherosclerosis of the aortic arch was significantly higher in patients with three vessel disease.

Conclusion: According to our results, the IMTs of common carotid and/or common femoral arteries may increase with the severity of CAD however, these parameters are not a surrogate for predicting the CAD severity.

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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.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Skin-derived precursors (SKPs) are a type of progenitor cells extracted from mammalian dermal tissue and can be differentiate to neural and mesodermal lineage in vitro. These cells can introduce an accessible autologos source of neural precursor cells for treatment of different neurodegenerative diseases. This research was done in order to set up isolation, culture, proliferation and differentiation of human skin derived precursors (hSKPs).
Methods: Human foreskin samples were cut into smaller pieces and cultured in proliferation medium after enzymatic digestion. To induce neural differentiation, cells were cultured in neural differentiation medium after fifth passage. We used immunocytochemistry and RT-PCR for characterization of the cells. Neuron and glial cell differentiation potential was assessed by immunofloresence using specific antibodies. The experiments were carried out in triplicate.
Results: After differentiation, βΙΙΙ- tubulin and neurofilament-M positive cells were observed that are specific markers for neurons. Moreover, glial fibrillary acid protein (GFAP) and S100 positive cells were identified that are markers specifically express in glial cells. Detected neurons and glials were also confirmed by their morphologic characterizations.
Conclusion: Our results demonstrated that skin-derived precursors obtained from human foreskin can exhibit neuronal and glial differentiation potential in vitro, depending on the protocols of induction.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Uterine smooth muscle tumors classified as leiomyoma, leiomyosarcoma and tumors with uncertain malignant potential. The leiomyoma and leiomyosarcoma are separated tumors biologically. Uterine smooth muscle tumors with uncertain malignant potential include a group of tumors which are not specifically placed into two others groups which result in a serious problem in a way of their treatment. In the present study expression of marker "p16" in smooth muscle tumors of uterine and normal myometrium has been investigated.
Methods: The entire paraffin blocks related to hysterectomy cases with diagnosis of normal myometrium, leiomyoma and leiomyosarcoma (3768 cases) available in pathology lab. in Shariati Hospital in Tehran, Iran from 1372 to 1387 were investigated. Among them 62 normal myometrium, 62 leiomyoma and 12 leiomyosarcoma had been chosen and after staining for marker "p16" were investigated separately.
Results: There were a statistically significant difference in both intensity and percentage of staining for this marker between leiomyoma and leiomiosarcoma (p< 0.001) and between leiomyosarcoma and normal myometrium (p< 0.001) but not between leiomyoma and normal myometrium (p= 3.6).
Conclusion: Based on this study if strong and more than focal immunoreactivity for marker "p16" suppose as positive then leiomyosarcoma will be positive for this marker but leiomyoma and normal myometrium will not be and this could be considered as a good guide for categorizing the uterine smooth muscle tumors.

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Background: Infections caused by opportunistic yeasts such as Candida species, Trichosporon, Rhodotorula and Saccharomyces have increased in immunocompromis- ed patients and their identification is crucial as intrinsic and acquired resistance of some yeast species to antifungal agents are on the rise. The aim of this study was to identify the organisms to the species level in order to suggest accurate and effective antifungal therapies. Methods: In this study that carried out in Tehran, Iran in 2009, 200 patients with yeast infection were medically examined and clinical specimens were prepared for direct examination and culture on Sabouraud dextrose agar. Subsequently, the isolated yeast colonies were identified using various tests including culture on Corn Meal agar with Tween 80, CHROMagar Candida and casein agar. For the definite identification of organisms some biochemical tests were done based on carbohydrate assimilation by RapID Yeast Plus System kit, and, finally, a molecular method, PCR-RFLP, using Hpa II enzyme, was performed for the remaining unknown yeast species. Results: A total of 211 yeast isolates were identified in 200 patients with yeast infections. The most frequent isolated yeasts were Candida albicans, 124 (58.77%), followed by Candida parapsilosis, 36 (17.06%), Candida tropicalis, 17 (8.06%), Candida glabrata, 13 (6.16%), Candida krusei, 8 (3.79%), Candida guilliermondii, 2 (0.96%), Trichosporon, 3 (1.14%), Rhodotorula, 1 (0.47%), Saccaromyces cerevisiae, 1 (0.47%) and other yeast species, 6 (2.84%). Conclusion: Nail candidiasis was the most prevalent type of yeast infection in the patients and Candida albicans was the most frequent isolated species from all clinical specimens.

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Background: Molecular DNA markers are one of the most important tools in molecular biology labs. The size of DNA molecules is determined by comparing them with known bands of markers during gel electrophoresis. There are many different protocols to produce these kinds of molecular markers. In this study we have suggested an efficient strategy to produce molecular weight markers in industrial proportions. Methods: To achieve the desired sizes of DNA fragments, a combination of two previously known methods, restriction enzyme digestion and polymerase chain reaction (PCR), were used. The enzymatic digestion process was based on designing and constructing plasmids which equaled in size with the desired length of DNA fragments and produced the desired DNA fragment upon linearization. In the PCR method, the desired length of DNA fragments were cloned in multiple cloning sites of pTZ57R plasmid and in a PCR reaction, the new constructed plasmid was used as a template to produce the final fragment. Results: Upon application of this strategy, 2000 and 3000 bp DNA fragments were produced by enzymatic digestion of plasmids of the same size. Moreover, 100 to 1500 bp fragments were produced during PCR using only a set of forward and reverse primers at the flanking region of pTZ57R multiple cloning site. Conclusion: The highest advantage of this cost-benefit approach is to produce different types of molecular weight markers by using an effective and short protocol