Tehran University Medical Journal

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Background: Human Cytomegalovirus (HCMV) infections are a significant challenge in patients with Hematopoietic Cell Transplant (HCT). Acute Graft vs. Host (GVHD) is recognized as a predisposing factor for increased incidence of HCMV reactivation. Availability of rapid and accurate tests for HCMV detection in HCT recipients is of foremost importance in developing countries, such as Iran.
Methods: A total of 201 peripheral blood leukocyte (PBL) and plasma specimens from 26 allogeneic HCT recipients were examined for HCMV DNA by polymerase chain reaction (PCR) assay. Densitometric analysis of 257bp PCR products from clinical samples and 101-106 "cloned plasmid" per µg DNA containing a HCMV specific fragment were analyzed using LabWorks software (v3.0.02). Optical density of amplicons was plotted, and calculated HCMV viral loads were compared with the patients' antigenemia results.
Results: HCMV viral loads ranged between <102 to 1.35×102 copies per µg DNA among 7 HCT patients. In addition, 14 episodes of positive antigenemia assay in 7 patients in which peak HCMV load were compared with GVHD grade II-IV patients. Significant correlation was also detected between HCMV DNA load in PBL and plasma samples, as well as HCMV DNA load in PBL samples and antigenemia results. Receiver–Operating Characteristic analysis determined that 2,200 HCMV copies in PBL samples as the threshold value for initiation of Ganciclovir therapy.
Conclusion: This report shows that rapid and sensitive assays, like quantitative PCR, are extremely valuable for detection of active HCMV infection, and life-threatening HCMV disease in HCT recipients during the post transplant period. Furthermore, high HCMV DNA load among GVHD grade II-IV patients confirms the high risk of HCMV reactivation among these HCT recipients. Tests such as quantitative PCR also helps physicians initiate timely preemptive therapy and for a shorter period, which may lead to better clinical outcome in HCMV-infected transplant patients.

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Background: Germ cell tumor (GCT) account for approximately 2-3% of all malignancies in childhood. About 20% of patients with GCT are still resistant to therapy.
Methods: This study was undertaken on 57 patients with Germ cell tumor who were admitted to Ali Asghar Children’s Hospital during 1990-2004. Through this study, information about sex, age type of pathology, clinical sign, treatment and survival (5-year period) was gathered in order to have better treatment and follow up. This study was carried out as across-sectional survey and the obtained data was analyzed via Spss 10 soft ware.
Results: The findings showed that the mean age of patients was 4/9 ± 0/1 (1mo -14y), male 54%, female 46%, male/female, ratio=1/1. Site of tumor: saccrococcygeal 57/8 %( 33), gonadal 42% (24). Pathological type is yolk sac 61/4% (35), dysgerminoma 12/2% (7), malignant teratoma 14% (8), embryonal carcinoma 10/5% (6). The most common clinical sign were buttock mass 31/5% (18), abdominal pain 10/5% (6), abdominal mass 17/5%(10), testicular mass 28% (16). All of the patients were treated with chemotherapy (bleomycine, vinblastin, cisplatinum) mean of duration follow up were 48/4 months. In all of patients 31/5% (18) of the cases were alive and 70% (40) of patients were relapse and 15/7% (9) no information, 52/6% (30) of cases were expired. Five years survival of patients was 62%.
Conclusion: The analysis of the patients treated shows that extragonadal location of primary tumor (specially sacrococcygeal), level of AFP above 10 ng/ml in patients ,6 or more months of age and metastatic disease were the most unfavorable factors for overall survival.

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Background: Germ cell aplasia (G.C.A) is one of the most important testicular causes of infertility and azospermia.In this condition the seminiferous tubules are only lined by a single layer of sertoli cell. In some cases, there is focal area with spermatogenic activity.
Methods: We studied infertile men with G.C.A referred to Jahade Daneshgahi of Iran during 1381-82, retrospectively. All the cases had more than one biopsy of one testis.
Results: In 11.6٪ of 320 cases, comparison of multiple biopsy sites of a testis revealed: when one site showed G.C.A, another site revealed areas with spermatogenic activity. Considering the cases who showed germ cells in both sites, 15.3٪ of cases multiple biopsy sites appeared to have focal spermatogenesis, better maturation of germ cells or higher scoring area for urologic operation.
Conclusion: According to new techniques in treatment of infertility with ICSI (intra cytoplasmic sperm injection) in which fertility is possible with one spermatozoa or even spermatid (after recovery), biopsy of multiple sites instead of only one site is highly recommended in azospermic patient.

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Background: Job stressors in managers are progressively affecting and destroying their immune systems. The relationship between hardiness, stress and immune system is important for mental health. This study was designed to determine the resources in managers against stress, resources herein designated as “hardiness” and “social support". Also in this research, the correlation between hardiness, defined collectively as feelings of challenge, commitment and control, as a resource against stress and the immune system of high school managers in Khozestan Province were studied.
Methods: The study sample was comprised of 340 managers (male and female), selected by the cluster sampling method. Each subject completed the personal view survey scale and social support questionnaire. Then the individuals were divided into four groups (n= 35 in each group) of high and low hardiness and social support as follows: high hardiness / high social support, high hardiness / low social support, low hardiness / high social support and low hardiness / low social support. Subjects who suffered from disorders that affect the immune system were excluded. The number of T-helper cells (CD4), T-suppressor cytotoxic cells (CD8), natural killer cells (CD56+ CD16), complement system (C3, C4, CH50), immunoglobulin M and G (IgM and IgG), cortisol hormone, eosinophils, neutrophils and lymphocytes were measured for each subject.
Results: The results revealed that, there was a significant positive correlation between hardiness and CD4, CD4/CD8, CD56, CD16, CH50, IgM and neutrophil levels. Also, there was a significant negative correlation between hardiness and CD8, cortisol and eosinophil levels. There was a significant difference between the four groups of in CD4, CD8, CD4/CD8, cortisol, C3, C4, CH50 and lymphocyte levels. Also, there was a significant positive correlation between social support and CD4, CD4/CD8, CD56, CD16, CH50, IgM, C3 and neutrophil levels.
Conclusions: The results revealed that the performance of the immune system in managers with high hardiness and high social support is significantly better than that of managers with low hardiness and low social support. Furthermore, high hardiness and high social support act as resources and moderating factors against stress.

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Background: The aim of this study was to review the frequency, histopathology and outcome in children with tumors of the liver.
Methods: Included in this retrospective/descriptive study were 30 children treated for liver tumors from 1375-1384 (ca. 1996-2005), at Children’s Hospital Medical Center, Tehran, Iran. We included the clinical, radiologic, and pathologic data of our patients, focusing on the frequency, etiology and outcome.
Results: Patient ages ranged from three months to 12 years (median 3.8 years), with 18 males (60%) and 12 females (40%). Of these, 17 patients had hepatoblastoma (55.66%), including 13 males and four females, with an age range of six months to five years. Four cases (13.33%) had neuroblastoma. Hepatocellular carcinoma (HCC) was found in three cases (10%), all of whom were carriers of hepatitis B. Two cases (6.66%) were diagnosed with mesenchymal hamartoma, two cases (6.66%) with hemangioendothelioma and two cases (6.66%) with rhabdomyosarcoma and leiomyosarcoma of the biliary tract. Abdominal swelling and hepatomegaly were seen in all of patients. Jaundice was observed in two cases. Serum alpha-fetoprotein levels greater than 500 ng/ml were seen in 17 cases (56.66%). All patients were receiving specific treatment. The three-year survival rate was 65% for hepatoblastoma and 2% for HCC
Conclusion: With the introduction of specific treatment, the survival rate for children with tumors of the liver has significantly increased. Further improvement can be achieved using diagnostic biopsy for hepatoblastoma, although it may result in complications, and preoperative chemotherapy followed by complete surgical excision (per International Society of Pediatric Oncology guidelines), yielding an outstanding survival rate of 80%.

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Background: The aim of this study was to evaluate the association between atypical glandular cell (AGC) on Pap smear and significant pathologic finding to tailor management protocols.
Methods: Between 2002 and 2005, Among 26893 Pap smears 122 women with AGC Pap smears (prevalence=0.45%) were referred to our colposcopy clinic. Forty one women underwent colposcopy directed biopsy, endocervical curettage, endometrial sampling and cervical conization to determine the cytologic and histologic correlations of AGC on pap smears.
Results: A total of 122 women with AGC Pap smear were found. Only 41 women accepted to participate in the study and followed the workup procedures. The mean age of the patients was 46.92 ±11.48 years (range, 23-80 years). Of these patients 13 patients (31.7%) were post menopause and 28 patients (68.2%) were in reproductive age. We found 13 (31.7%) significant pathologic findings including 4 (9.7%) high grade squamous intraepithelial lesion (HG-SIL), 3(7.3%) low grade squamous intraepithelial lesion (LG-SIL), 2(4.8%) Endometrial hyperplasia, 1(2.4%) Endometrial adenocarci-noma, 1(2.4%) adenocarcinoma of cervix, 1(2.4%) squamous cell carcinoma of cervix and 1(2.4%) papillary serous tumor of ovary. There was not any significant difference in the prevalence of significant pathologic findings and subtype of squamous or adenomatous lesions between pre and postmenopausal group.
Conclusion: AGC on Pap smear was associated with a clinically significant diagnosis in approximately one third of our cases. The women with a diagnosis of AGC on cervicovaginal smear are needed to be evaluated at least with colposcopy, endocervical and endometrial curettage. Clinicians should be careful about the significance of AGC in pap smears.

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Background: Despite major diagnostic and industrial progresses in the technology and use of Ionizing radiations, they have been found to be harmful to the health of the radiology and nuclear medicine staffs. Since Ionizing radiations have the potential to produce free radicals, therefore, it is likely that the total plasma level of anti-oxidant in medical and nuclear medicine staffs could be reduced.

Methods: In this case-control study the relationship of total anti oxidant level of plasma and the function of immune cells such as lymphocyte proliferating response using MTT method, Neutrophil chemotaxi, Intensity of respiratory burst (NBT) and evaluation of IL-2 and IL-4 (ELISA) were investigated. 101 samples were collected for this study and they were assigned as two groups: 61 samples cases from radiology and nuclear medicine staffs of Tehran University Of Medical Science hospitals (Shariaty, Imam Khomeyni, Ghalb-e-Tehran) were assigned as the exposed group, whereas, 40 samples from Pediatric, Orthopedic, Infirmary and Emergencies wards were assigned as control group. Using heparinized syringes, 8 to 10 ml of blood samples were collected from each person with age between 25 to 50, averaging 36.4±7.2, and several assays including Anii Oxidant Capacity of Total Plasma (FRAP Method), T cell proliferative response to PHA mitogen (MTT Method), Chemotaxi of neutrophils and Magnitude of respiratory burst were carried out on these samples. The results were analyzed using spirman correlation analysis.

Results: The results showed that exposure to ionizing radiation chronically with low dosed had no effect on chemotaxis of neutorophils and intensity of respiratory burst, but could have effect on lymphocyte function specially in cytokines secretion like IL-2 which are essential in the immune responses.

Conclusion: This study indicates that long term low dose ionizing radiation may have effect in some parts of the immune function.

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Background: Cervical cancer is the second most common cancer of the women worldwide. It is also an important cause of cancer-related mortality in women, after breast cancer. Nearly half million of new cases are identified yearly. The incidence rate in developing countries is greater than the developed countries. Epidemiologic studies have shown that the association of genital human papilloma virus (HPV) with cervical cancer is strong, independent of other risk factors, and consistent in several countries. The aim of this study was to determine the frequency of HPV in patients with high grade cervical intraepithelial neoplasia (CINIII, CIN II) and squamous cell carcinoma (SCC) of cervix.
Methods: Hundred specimens from patients with SCC and CINIII, CIN II, confirmed by histological review, referring to Mirza Koochak Khan Hospital from 1999-2004 were enrolled in a cross sectional study. Polymerase chain reaction was utilized for identification and typing of HPV DNA. To increase the sensitivity of HPV detection, nested PCRs were performed using MY09/MY11 as outer and GP5/GP6 as inner primers.
Results: It was possible to extract 77 of 100 specimens that HPV DNA was detected in 47 of 77 specimens. Infection with HPV was present in 32 specimens (86.5%) among SCC patients and in 15 specimens (37.5%) among CINIII, CIN II patients. The most frequent HPV types in SCC patients were HPV 16 and 18 (59.38%) and then 33 (34.38%) and in CINIII, CIN II patients was 16 (53.33%) and 18 (40%). the most frequent co-infection in both groups was HPV 16 and 18 which was present in 40.62% and 26.7% of cases respectively.
Conclusions: The most frequent HPV types in patients with SCC and CINIII, CIN II was 16 and 18 that is identical to many other countries infection pattern.

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Background: Juvenile xanthogranuloma is a benign, normolipemic, dendrocytic histiocytosis that usually affects young children. It presents clinically as single or multiple yellow-brown papulonodular lesions in the upper part of the body, especially the head and neck. In adults, xanthogranuloma is not common and usually presents as a single lesion. Multiple xanthogranuloma in adults is rare. For the most part, cutaneous lesions are self-limited and seldom necessitate treatment. Here we report an adult patient with multiple xanthogranuloma.

Case: A 45-year-old woman presented with multiple papulonodular lesions around the eyes and over her breasts and back. Biopsy showed giant cells with a wreath-like arrangement of nuclei (Touton giant cell) and diagnosis of juvenile xanthogranuloma was made.

Conclusion: Although juvenile xanthogranuloma is a disease of children, it can rarely occur in adults. These patients should be evaluated for involvement of other organs to prevent complications. With ocular involvement, the risk of morbidity is high, and complications can include glaucoma, retinal detachment, cataract, vascular occlusion, hyphema, and corneal blood staining.

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Background: MSCs have been isolated from a variety of mammals by the plastic adherence method. However, this method can be problematic due to the unwanted growth of hematopoietic cells and non-MSCs. The potential of MSCs to differentiate along multiple lineages is the key to the identification of stem cell populations in the absence of molecular markers. In the present study, we describe a homogeneous population of MSCs from mouse bone marrow isolated using an improved plastic adherence method that employs frequent medium change (FMC) at the initial hours of harvested bone marrow cell culture.
Methods: Balb/c mice were sacrificed and whole bone marrow cells were aspirated from the femur and tibia and then cultivated in six-well plates. After 3-4 hours of culture, old medium was removed and fresh medium was added. FMC was performed every eight hours over a 72 hour period. When primary cultures became nearly confluent, the first passage was performed. These cells were then used for further examination. To investigate their mesenchymal nature, the cells were allowed to differentiate into mesenchymal lineages and examined at each passage up to the tenth passage for surface antigens by flow cytometry.
Results: We achieved purified populations of fibroblast-like cells in the two weeks after culture initiation. The cells were capable of differentiating into osteocytes and adipocytes. Isolated MSCs were reactive to the CD44, Sca-1, and CD90 cell surface markers. MSCs were negative for hematopoietic surface markers such as CD34, CD11b, CD45, CD31, CD106, CD117 and CD135.
Conclusions: This protocol provides an efficient isolation of homogeneous populations of MSCs from mouse bone marrow.

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Background: Ewing's sarcoma is one of the most malignant tumors in children and young adults. Only a few established cell lines of Ewing's sarcoma have been reported, which makes it difficult to study the biological features of these tumors. We have recently established a new Ewing's sarcoma cell line designated SS-ES-1, originating from a thoracic tumor of a 16-year-old female patient. The SS-ES-1 cells have been grown continuously in culture for over 90 passages. In this report, some characteristics of SS-ES-1 cells are presented.
Methods: The cells were grown in DMEM medium supplemented with 10% fetal bovine serum (FBS), 100 mg/ml streptomycin and 100 U/ml penicillin in a humidified atmosphere with 7% CO2 at 37 ºC. The cells were immunocytochemically characterized using a panel of monoclonal and polyclonal antibodies. Furthermore, the chemo-sensitivity of this cell line to some anticancer drugs was assessed using MTT assay and IC50 values were determined.
Results: Morphologically, the SS-ES-1 cell line is composed of poorly differentiated small round cells growing in a multilayer pattern. The immunocytochemical staining demonstrates strong reactivity to CD99, cytokeratin, neurofilament, p53 and Ki67 proteins, but no reactivity to GFAP. Based on IC50 values, SS-ES-1 cells display considerable sensitivity to vinblastine (2±0.7 pM), followed by vincristine (0.3±0.12 nM), doxorubicin (0.05±0.03 µM), etoposide (0.64±0.28 µM) and cisplatin (0.67±0.45 µM).
Conclusions: In conclusion, the SS-ES-1 cell line demonstrates unique cellular properties, which make it a useful model for studying various aspects of the biology of Ewing's sarcoma.

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Background: Langerhans cell histiocytosis (LCH) is a group of idiopathic disorders characterized by the proliferation of specialized bone marrow-derived Langerhans cells and mature eosinophils. The estimated annual incidence ranges from 0.5-2 cases per 100,000 persons per year. The pathogenesis of LCH is unknown. The prevalence of LCH seems to be higher among whites and males. The most common complaints at presentation are those related to bone lesions. Treatment consists of surgery, chemotherapy and radiotherapy alone or in combination. The age of onset varies according to the variety of LCH. Solitary lesions may occur in bones or skin. Cutaneous lesions present with firm, painless papulonodules or vesicles.

Case report: This six-month-old baby presented with firm papulonodules on her temporal skin, but fortunately her other organs were healthy. She underwent two surgeries, separated by a one-month interval. Due to local recurrence after a short period of time, she underwent a 10-Gy dose of radiation. Her response proved good during follow-up.

Conclusion: Radiotherapy is good for controlling local recurrence in LCH, with few sequelae related to treatment.

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Background: Vascular endothelial growth factor (VEGF) has mitogenic effect for endothelial cells and is an important mediator of tumor expansion, metastasis and angiogenesis in vivo. Isosorbide dinitrate, as a nitric oxide donor, has been widely used in treatment of many cardiovascular diseases such as congestive heart failure and acute coronary syndromes. Furthermore this drug was found to have inhibitory effect on angiogenesis, tumor growth and metastasis in vivo. In the present study we evaluated the isosorbide effect on the VEGF production using some human leukemic cell lines.

Methods: Human leukemic MOLT-4, JURKAT and U937 cells were cultured in complete RPMI medium. The cells at the exponential growth phase were then incubated with different concentrations of Isosorbide (4´10^-7 -4´10^-4 M) in the presence or absence of PMA (25ng/ml) for 24 hours. The VEGF concentrations in the culture supernatants were measured by enzyme immunoassay kits (R&D systems) according to the manufacturer's instructions.

Results: The level of VEGF produced by the human leukemic cell lines which was treated with different concentrations of isosorbide, did not show any significant difference with untreated control cells.

Conclusions: The results of this study showed that isosorbide had no significant effect on VEGF production. Our findings suggest that anti-angiogenesis effect of isosorbide could be mediated through VEGF-independent mechanism(s). Further studies are warranted to determine definite isosorbide effect on VEGF and other angiogenic factors production in patients as well as animal models.

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Background: Leukemia is one of the most common pediatric malignancies. T-cell Acute Lymphoblastic Leukemia (T-ALL) accounts for 15% of hematopoetic cancers. It has been well understood that identification of genetic alterations associated with leukemias is very critical. The molecular genetic techniques have promoted the identification of leukemia-associated genetic changes that may characterize the most accurate predictors of clinical outcome. These considerations reinforce the requirement for rapid identification of the abnormalities.

Methods: Multiplex RT-PCR, a highly sensitive and specific method applied to screen simultaneously three most frequent transcription factors, TLX1/HOX11, TLX3/HOX11L2 and TAL1/SCL which are associated with T-cell Acute Lymphoblastic Leukemia (T-ALL).

Results: We describe here our efforts to establish a multiplex RT-PCR analysis system that facilitates the detection of HPB-ALL and K562 cell lines, respectively.

Conclusion: The multiplex RT-PCR technique is a sensitive, valuable and cost-effective diagnostic tool which could improve our ability to accurately and rapidly risk-stratification of patients with childhood T-ALL. In order to perform multiplex RT-PCR technique researchers do not need bone marrow samples and they can employ this method using peripheral blood samples. Therefore, the status of treatment could be followed by assessment of the level of mRNA expression of oncogenic transcriptional factor using peripheral blood sample. Use of this procedure not only provides the best results in short term for specialist, but also clinicians could have opportunities to choose suitable treatment strategies with decrement of drug side effects.

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Background: Transitional Cell Carcinoma (TCC) of bladder is the second most common urogenital malignancy and because of its high rate of recurrence (two third of tumors recur) vigilant surveillance is necessary. There have been a lot of efforts to find a proper biomarker for detecting urothelial cancers because available methods are expensive and invasive (like cystoscopy) or have a low degree of sensitivity (like urine cytology). Urothelial malignancies, like other cancers tend to express a large amount of telomerase. The aim of this study was to evaluate the possible application of voided urine human telomerase reverse transcriptase (hTERT) mRNA assay in detecting low-grade bladder carcinoma in comparison with urine cytology.

Methods: Voided urine samples were collected from 49 patients who were supposed to go under operation. Samples were examined by both Quantitative Real-time RT-PCR (for measuring hTERT mRNA level) and cytology the results were then compared to the final pathologic studies.

Results: Regardless of clinical stage and or pathological grade of tumor, sensitivity of telomerase test and urine cytology was 74% and 16% respectively. There was a strong correlation between results of urine cytology and stage and/or grade of tumor however, sensitivity of telomerase test was acceptable regardless of stage and or grade of tumor. There was a statistically significant difference between sensitivity of urine cytology and telomerase test (p<0.001).

Conclusion: Detection of hTERT-mRNA can potentially be used as a non-invasive method for diagnosis and follow up of bladder carcinoma instead of urine cytology.

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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: CD4 T-Lymphocyte counts have proven to be a standard laboratory marker of disease progression and severity of immunodeficiency in adults infected with HIV is used to initiate and monitor highly active antiretroviral therapy however, its application may not be feasible for its expensive equipments and reagent in resource-limited setting. There is a need to have another marker of immunodeficiency that is less resource-demanding. In April 2002, the World Health Organization (WHO) recommended that, when CD4 cell count is not available, a TLC of 1200cell/mm3 or less in individuals with stage 2 or 3 of the disease may be used as an indication to initiate ART.
Methods: The aim of this study was to determine the relationship between total lymphocyte count and CD4 count in HIV-infected adults. This was a retrospective cross-sectional study. Subject characteristics were patients who had positive serologic HIV test results, confirmed via western blot. Analysis unit was the results of CBC and CD4 measurements on the same blood sample each time. Data of 100 patients were collected. In this study, TLC accounts for the main predictor of CD4 count. The amounts of TLC which can predict CD4 less than 200cell/mm3 were considered eligible.
Results: Our data revealed high sensitivity and specificity of TLC as a surrogate measure of CD4 count. In this study, TLC cutoff of 1300cell/mm³ indicated the optimal combined sensitivity and specificity altogether.
Conclusion: Total lymphocyte count and its changes can be used as alternative to CD4 count and its changes in the management of HIV-infected individuals.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Neck lymph node metastasis has the prognostic role in SCC of the tongue and the importance of the biologic markers in tumor invasion and metastasis has been stated in the medical literature. The aim of this study was to evaluate the relationship between two biomarkers, p53 and EGFR (which had the main role in cell proliferation) and two other biomarkers, CD44 and E-cadherin, in lymph node metastasis.
Methods: In an analytic descriptive study fifty three patients with SCC (Squamous Cell Carcinoma) of the tongue who underwent the resection of tumor and dissection of neck lymph nodes were assessed during the year of 2002-2009. Histological samples from 53 patients were immunohistochemically stained and the analysis of these markers were performed due to clinicopathological variable and metastasis of the neck lymph nodes.
Results: The result showed that among the clinicopathological factors, the relationship between Age (p=0.01), history of having risk factors (p=0.002), clinical lymphadenopathy (p=0.002), the size of the tumor (p=0.001), decreasing of CD44 (p=0.02) and lymph node metastasis of the neck were statistically significant. No significant relationship were found between sex and other biomarkers including p53, EGFR, E-cadherin.
Conclusion: CD44 is an important indicator of prognostic markers that can also be used as an indicator of clinocopathological markers.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Human bone marrow mesenchymal stem cells (hMSCs) can differentiate into several types of mesenchymal cells, including osteocytes, chondrocytes, and adipocytes, but can also differentiate into non-mesenchymal cells, such as neural cells, under appropriate experimental conditions. Until now, many protocols for inducing neuro-differentiation in MSCs in vitro have been reported. In this study, we induced differentiation into neural phenotype in the hMSCs population by new protocol. In this treatment, hMSCs could express neural markers more than other reports, associating with remarkable morphological modifications. 
Methods: The Bone marrow specimens were aspirated from the iliac crest of normal men. hMSCs were isolated and cultured in DMEM containing 15% FBS. Between 4-8 passages conversion of hMSCs into neurosphere-like structures and induction this cells to nerve precursors in the low-attachment plastic bacterial dishes with bFGF, EGF & RA were initiated. After seven days terminal neural differentiation was initiated by plating the cells on poly-L-ornithin and Laminin coated dishes. Cells were differentiated for 7-14 days. We used flowcytometry and immunocytochemistry analysis for assessment of specific neural stem cell markers in induced cells.
Results: Flowcytometery analysis showed that after induction, 90±2.52 percent of the cells will express neuronal marker Nestin and about 41±1 percent of the cells will express Tuj-1 and about 67±1.05 percent of the cells will express GFAP. Immunocytochemistry and morphologically modifications revealed the same results.
Conclusion: Results showed that hMSCs treatment with bFGF, EGF & RA the number of Tuj1 neurons. These data confirmed that hMSCs can exhibit neuronal differentiation potential in vitro, depending on the protocols of inducement.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Hairy cell leukemia (HCL) is a rare B-cell neoplasm that comprise approximately 2% of all lymphoid leukemias. Over the past 20 years splenectomy was the only effective therapy but with the advent of purine analogues such as cladribine, splenectomy has been limited to certain situations. After cladribine therapy most patients achieve complete and durable remission. The aim of this study was to compare effectiveness of splenectomy and cladribine in Iranian patients with HCL and also to evaluate the clinical and laboratory features of patients at diagnosis.
Methods: 50 patients with the diagnosis of HCL enrolled to our study. The male to female ratio was 3:1, and the median age at diagnosis was 50 years. After diagnosis  20(40%) and 12(24%) of patients had splenectomy and cladribine therapy respectively. The reminder of patients were treated with both splenectomy and cladribine.
Results: The most common clinical findings were splenomegaly (98%) and fatigue (80%) respectively. Leucopenia and anemia was present in 96% and 80% patients in order. 88.6% and 55.5% of patients achieved complete remission after cladribine therapy and splenectomy respectively. After cladribine therapy and splenectomy relapse occurred in 10% and 74% of the patients.
Conclusions: Our finding are comparable with previous studies and show that Cladribine induces complete and durable remission in most hairy cell leukemia patients and should be considered as first line therapy. Splenectomy should be performed in certain cases such as spleen rupture.