Tehran University Medical Journal

Background: Pi-GST and Mu-GST are subclasses of glutathione S-transferase that present on human sperm surface and play an important role against oxidative stress. Therefore, any defects in the enzyme activity may be associated with male infertility.In this study the polymorphisms of GSTM1 and GSTP1 in association with enzyme activity and sperm parameters were studied.

Methods: This case-control study involved 95 men with oligoastenoteratozoospermia and 26 controls with normozoospermia. Semen analyses were carried out according to WHO guidelines. Blood DNA was extracted using salting out procedures. GSTM1 and GSTP1 polymorphisms gene were determined through PCR-RFLP and multiplex PCR, respectively. Finally, Glutathione S-transferase activity was measured.

Results: Frequencies of GSTM1 null genotype in oligoastenoteratospermic and normospermic groups were 52.1% and 53.8% respectively. There were no statistically significant differences in sperm parameters and enzyme activity between GSTM1 null and positive genotypes in two groups. There were no statistically significant differences in glutathione S-transferase activity between oligoastenoteratospermia and normospermic groups (p>0.05). All the 121 men in this study had Ile/Ile genotypes at 105 codon of GSTP1. Frequency of normal homozygote (114Ala/Ala), heterozygote (114Ala/Val) and mutant homozygote (114Val/Val) genotypes in oligoastenoteratospermic group were 81.1%, 17.9% and 1.1% respectively but in the control group they were 88.5%, 11.5% and null.

Conclusions: Total glutathione S-transferase activity and sperm parameters were not affected by deficient Glutathione S-transferase activity in GSTM1 null genotype. Compensate activity of other sperm surface glutathione S-transferase isozymes, like GSTP1, may justify the cause.

Background: Visual, brain stem auditory and somatosensory evoked potentials (EPs) have been traditional paraclinical tests to evaluate the competency of sensory tracts in multiple sclerosis (MS) patients. It seems that only one of these EPs could be sufficient, at least as a screening test. The objective of this paper is to evaluate the frequency of these three evoked potentials in definite MS patients.

Methods: This descriptive cross-sectional study involved was 25 definite relapsing remitting MS patients who referred to our university hospital. Twenty five individuals from normal population without any neurologic, visual, auditory or sensory disorders have been evaluated as well to determine the standard values in our electrophysiology lab. Values more than mean+2.5SD for latencies and less than mean-2.5SD for amplitudes were considered as abnormal.

Results: Fifteen (60%), 13 (52%), and 13 (52%) had abnormal visual, auditory and somatosensory EPs respectively. The latency of P100 in visual EP (VEP) had the most sensitivity among all of the parameters. It was determined that the possibility of abnormality in each of auditory and somatosensory EPs in the presence of normal VEP could be 30.8%. In other words 30.8% of patients with negative VEP could have a positive auditory brain stem or somatosensory EPs.

Conclusion: In our study, a VEP abnormality was more frequent than auditory brain stem and somatosensory EPs. Thus it is not logical to perform triple EP tests in all suspected MS patients, but auditory and somatosensory EPs could be considered in patients with normal VEP.

Background: Anterior Cruciate Ligament (ACL) is one of the main knee stabilizing ligaments. Because of high incidence of ACL tearing especially in young athletes its reconstruction is very important. The aim of this study was to evaluate short-term results of anterior cruciate ligament ruptures using four strand hamstring auto graft and Bone patellar tendon autograph.

Methods: The study group included 96 patients (3 female and 93 male) with ACL teared who had been referred to our center in 5 years period (2002-2007). The subject which were Accessed in this study included meniscal injury concomitant chondral injury, determine the most common cause of ACL tearing, comparision of IKDC and lysholm score in all patients before and after surgery, and limitation of rang of motion of knee post operation.

Results: Involvement was in the right knee in 38 patients and in the left knee in 58 patients. Mean age of patients was 27.6 years (19-48). Mean surgical delay was 18 month (1-77). The most common cause of tear was playing soccer. Meniscal injury was in 78 patients. (Medial meniscus in 63 patients, lateral meniscus in 29 patients) Concommitent chondral injury was in 54 patients (56.25%). 68% of patients returned to preoperative functions sport activity. There was no limitation in extension and there was 6 patients limitation in flexion about 20º. In last visit of patients IKDS in class A and B was 96.

Conclusion: It is seem that arthroscopic reconstruction of ACL is a safe and good method in treatment of Knee stability. Use of IKDC and lysholm score for comparision of patients before and after surgery is helpful. The operation should be done early after injury. Reconstruction of ACL in older patients in the abscense of DJD is effective.

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Cancer prevention besides detection and treatment has a very important role in control of cancer disease. Since some chemical compounds that are used in laboratories, especially in pathology laboratory are potentially mutagens, lab assistances that are working with chemicals such as Benzene, Xylazine and Formaldehyde for long period of time may be exposed to overload of these carcinogens. Therefore, it is necessary to use an indicator for detecting these occupational exposures. Ames test has been recommended in biomonitoring of environment that has high risk carcinogenicity characteristic.
Methods: A total of fifty seven urine samples of forensic medicine laboratory personnel's were extracted by C18 column and then tested by TA100 and TA98 standard strains of Ames assay. Each sample was analyzed with and without activator to detect mutagen and promutagen materials.
Results: Levels of mutagenicity were found by TA98 strain without activator in one case as well as with activator in two cases of urine samples of pathology laboratory personnel's. These cases were working in laboratory for long time in all of the workdays.
Conclusion: Personnel's working in pathology laboratories may have greater risk of cancer and should be take care from these occupational exposures.

Background: Clindamycin is a suitable antibiotic for treatment of skin and soft tissue infections. Moreover, it can suppress toxin production in many pathogenic bacteria such as S. aureus. There are two mechanisms of resistance in this antibiotic. Constitutive resistance can be detected by standard disk diffusion method but in the case of inducible resistance, D-test should be carried out. The main aim of this study is to determine prevalence of clindamycin inducible resistance among methicillin resistant and susceptible isolates of S. aureus isolated from different clinical samples.

Methods: A total of 87 clinical isolates from clinical samples were collected. Methicillin resistance was determined using standard disk diffusion method. Subsequently, D-test was carried out according to CLSI guideline. Presence of the sea gene (enterotoxin A) was detected by PCR using specific primers.

Results: Out of 87 isolates, 18(20.7%) were clindamycin inducible resistant while constitutive resistance was detected among 21(24.1%) isolates. The 95% Confidence intervals for the proportion of inducible clindamycin resistance among clinical isolates of S. aureus was 12.2% to 29.2%. The inducible phenotype in MRSA isolates was more common than that of MSSA isolates (33.3% vs 5.1%).Significant differences were found between prevalence of inducible clindamycin resistance and type of infection (p=0.045). Importantly, there was a significant correlation between sea gene and the constitutive/inducible resistance (p<0.0001).

Conclusions: Due to the high prevalence of clindamycin inducible resistance among clinical isolates of S. aureus, we recommend D-test to avoid treatment failure.

Background: Increased rate of oxidative stress have important role in diabetic nephropathy. Oxidative stress induces the synthesis of antioxidant enzymes. One of them, Extracellular- SOD (EC–SOD) is a major anti-oxidative enzyme and the only one that neutralizes superoxide ion, a precursor of reactive oxygen species (ROS). The aim of this study was to evaluate the correlation between diabetes- associated oxidative stress and antioxidative defense in macroalbuminuric type 2 diabetic patients.

Methods: One hundred and thirty three patients (74 women, 59 men) with type 2 diabetes were studied during 1385-86. According to level of urinary protein, two groups of patients normoalbuminuric (urinary protein excertion below 30mg/24h) and macroalbuminuric (urinary protein excretion more than 300mg/24) were recognized. In each group serum level of oxidized- LDL and EC-SOD were measured.

Results: The mean age of patients and the mean duration of diabetes was 59.09±8.26 years and 137.92±65.91 months, respectively. The plasma oxidized-LDL level and extracellular- superoxide dimutase level were significantly higher in macroalbuminuric than normoalbuminuric group (88.57±33.36 versus 78.24±27.59u/l, p=0.039 for oxidized-LDL and 87.60±21.18 versus 76.25±16.25mu/l, p<0.001 for EC-SOD). Oxidized- LDL was significantly correlated to EC-SOD in macroalbuminuric patients (r=0.425, p<0.0001). Oxidized-LDL and EC-SOD does not correlate to Fasting Plasma Glucose and HbA1c in each two groups.
Conclusion: The significantly elevated plasma oxidized-LDL in patients with macroalbuminuria suggests that, oxidized-LDL may play an important role in the progression of diabetic nephropathy. Besides severity of oxidative stress in macroalbuminuic patients, increase level of EC-SOD enzyme could be a compensatory mechanism to prevent tissue damage.

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

Background: Nowadays skin damages caused by ultraviolet (U.V.) radiation from the sun were increased accordingly necessity for safe and inexpensive protective products for reducing the harmful effects of this ray is unassailable. The antiradical, anti irritation and anti-cancer properties of silymarin make it a suitable option for use in cream formulation to investigate its effect on skin disorders caused by U.V. radiation. In this research effect of local application of a cream containing silymarin in prevention of the harmful effects of U.V. radiation on the guinea pig skin were studied and evaluated by using histopathologic and clinical findings.

Methods: 75 albino guinea pigs were randomly divided into five groups of fifteens. 2cm2 of the back hair was shaven. In the first group no treatment was applied, in the second group vaseline, in group 3 base cream without silymarin extract, in group 4 silymarin extract and in group 5 cream containing silymarin extract were used.

Results: In clinical assessment, skin scaling, skin irregularity, erythema, skin hyperpigmentation, and edema were observed and in histopathological observation epidermal hyper keratosis, hyperpigmentation, exocytosis, acanthosis, chromatin discoloration in nucleus of epidermal squamous cells, perifolliculitis, dermal vascular hyperemia, edema and dermal thickness, infiltration of plasma cell lymphocytes and eosinophyls into dermis were detected. The statistical comparison of group 1 and group 5 shows statistically significant difference in most indices (p<0.01).

Conclusions: Clinical and histopathologic examinations showed that local application of a cream containing silymarin is effective in prevention of skin damage caused by U.V. radiation in guinea pig's skin also the results of the clinical and histopathologic observation in this study confirm the enzymatic results in other researches.

Background: Numerous use of Beta Lactame in treatment of bacterial infections resulted in increments of drug resistance of such bacteria. One of difficulties in treatment of hospital infections is Extended Spectrum Beta Lactamase (ESBL) among isolated clinical strains of E.coli. Since some of ESBL strains shows double reaction in drug sensitivity test at in vitro and in vivo condition, therefore it makes difficulties in selection of right treatment. In the last years, CTX-M enzymes have become the most prevalent ESBLs in worldwide. The prevalence of ESBL types largely remains unknown in many parts of the Iran. This study was made to find the prevalence of ESBL-producing E.coli and molecular detection of CTX-M-1 in Tabriz.

Methods: In the present study, 400 urine samples collected between November 2009 and April 2010, from Tabriz Hospitals were studied. Out of the 400 samples, 188 E.coli isolates were detected by standard biochemical tests. Susceptibility to antimicrobial agents was tested to 10 antibiotics by the disk agar diffusion (DAD) method. ESBL production was screened by phenotypic test that included both separate and combined disk agar diffusion techniques. The screened isolates were investigated by PCR assay to detect CTX-M-1 gene.

Results: From the total 188 E.coli isolates, 82 (43.6%) were shown to produce ESBLs by phenotypic test. During the PCR method on the 82 isolates, 69 (84.1%) were confirmed as CTX-M-1 producing group.

Conclusion: The present study showed that CTX-M-producing isolates were increasing among E.coli strains and indicated the need for adequate susceptibility tests in laboratories for choosing the appropriate antibiotics for treatment.

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Anterior knee pain is one of the most common complaints of patients in orthopedic clinics. The first step in the treatment of this problem is conservative treatment which includes administration of anti-inflammatory drugs, exercise and changes in life style. Many patients respond well to these measures in about six months, but a small number of patients may not respond to the conservative treatment therefore, surgical procedures such as Maquet osteotomy or lateral retinacular release may be needed in these cases. The aim of this study was to determine the efficacy of intraosseous drilling and decompression of patella in the treatment of chronic anterior knee pain.
Methods : This study was performed as a case series on ten patients with chronic anterior knee pain attending the Orthopedic Clinic of Imam Khomeini Hospital, in Tehran, Iran in 2009-2010. Eight of the patients were male and the rest were female. The patients met the inclusion criteria and were followed up for at least 12 months after the surgery.
Results : The mean age of the patients was 27.8±4.66 yr and their mean BMI was 22.5±1.71 kg/m². The mean pain severity before the interventions was 8.2±0.78 based on VAS but it decreased to 2.5±1.26 post-surgically. An average reduction of 5.7 scores were noticed in pain severity depicting a significant reduction of pain (P<0.0001).
Conclusion: It may be concluded that intraosseous drilling and decompression of patella is a safe and effective method in the treatment of chronic anterior knee pain not responding to conservative treatment.

Background: Regarding the immunomodulatory effects of lactobacillus bacteria, this study aimed to evaluate the effect of oral administration of Lactobacillus reuteri, as probiotic bacteria, on natural killer cell cytotoxicity and tumor-specific lymphocyte proliferation in Balb/c mice with breast adenocarcinoma.

Methods: A total of 30 female mice, aged 6- 8 weeks and with a weight of approximately 17- 19 g, were randomly divided into two groups of 15 mice. The case group received Lactobacillus reuteri at a dose of 2.7× 108 bacteria in half a milliliter of sterile phosphate buffer saline (PBS) and the control group only received PBS. The probiotic group received the regimen for two weeks prior to tumor transplantation, as they did for 30 days after transplantation with three-day intervals and durations of seven days. For the evaluation of natural killer cell cytotoxicity and also tumor-specific lymphocyte proliferation response, LDH and BrdU assays were performed respectively according to the manufacturers' instructions.

Results: The study showed that the mice in the case group which were receiving Lactobacillus reuteri had statistically significant differences in the replication of tumor -specific lymphocytes, natural killer cell cytotoxicity and delayed hypersensitivity responses Compared to the mice in the control group.

Conclusion: Daily consumption of probiotics seems to regulate the immune system and consequently it can be helpful in people with cancer. Moreover, consumption of probiotics in healthy individuals can also boost the efficiency of the immune system against a variety of abnormalities.

Background: Nitric oxide (NO) is produced in different body organs in mammals and numerous physiological and pathological properties are attributed to this small molecule. The precursor of this substance in the body, L-arginine, is synthesized by the enzyme nitric oxide synthase (NOS), and it is catalyzed, and is inhibited by a substance called L-NG-nitroarginine methyl ester (L-NAME). In this study we investigated the qualitative and quantitative effects of nitric oxide on cerebellar histopathology in vivo environment via increasing and decreasing its production.
Methods: Forty Wister rats, weighing 200- 250 gr with a mean age of 8 weeks, were divided into 5 groups after making sure the rats were pregnant. Except the control group, the other pregnant groups, respectively received: 2 ml/kg normal saline, 200 mg/kg L-arginine, 20 mg/kg L-NAME and a mixture of the same doses of L-arginine and L-NAME on the third, fourth and fifth days of pregnancy. On day 18 of pregnancy, we anesthetized the rats, excised the cerebellum after craniotomy and fixed the organs in 10% formalin. We later prepared 5 to 6-micron in thickness tissue sections and dyed them by the routine Hematoxylin and eosin (HE) and Masson's Trichrom staining methods before studying them by light microscopy.
Results: There was a significant difference between the rats receiving L-arginine and the rats in other groups (P<0.01).
Conclusion: This study showed that L-NAME is capable of significantly decreasing the injury caused by nitric oxides in rat cerebellum.

Background: Several reports indicate that the probiotics can increase body resistance against malignant tumors. The aim of this study is to evaluate the effect of Lactobaci-llus reuteri Persian type culture collection (PTCC) 1655 in preventing tumor growth, improving weight and survival rate in mice with breast cancer.
Methods: Twenty mice, the BALB/c at six weeks age, weighing approximately 17 gram were divided into two groups. Oral administration of 500 micro liters of Lactobacillus reuteri suspension performed for the first group 14 days before tumor transplantation. The second group (control) received the same volume of phosphate buffer saline (PBS). Then the mice had tumor transplantation surgery. Lactobacillus reuteri was prescribed in the first group in seven-day period and three-day interruption pattern. At the same time the second group (control) received PBS. This process was continued until 45 day. The tumor growth, histology and body weight were evaluated in both group and the mortality of mice was recorded.
Results: In the mice transplanted tumors that had received probiotics, tumor growth decreased in comparison with control group. In this group the body weight increased (P>0/05). In addition, the survival of these mice had significantly increased compared to control group (P=0.002). The evaluation of tumor tissue also showed increased immune system function in mice receiving the probiotic (P>0/05).
Conclusion: Lactobacillus reuteri can improve immune system function and have an important role to help treatment of cancer.

Background: Breast cancer is the most common cancer in women. Non-coding RNAs especially miRNAs have important regulatory roles in cancer. MiRNAs are 21-24 nucleotides which have different levels of expression between tumors and normal tissues. In this study, we have analyzed expression level of miR-520d in three different groups of breast cancer.
Methods: Fifty nine samples were divided into different groups according to their immunohistochemistry (IHC) classification: estrogen receptor (ER) positive and/or progesterone receptor (PR) positive group (as group I) human epidermal growth factor receptor 2 (HER2) positive group (as group II) and Triple negative group (as group III). After small RNA extraction from tissues, cDNAs were synthesized and Real time RT-PCR carried out using DNA binding dye. Expression levels were analyzed by LinRegPCR and REST software.
Results: MiR-520d under- expressed in all of three different groups. The expression ratio in groups I ,II, and III were 0.193, 0.167, 0.21, respectively, but only the result from group II was significant (P=0.017). According to the different clinicopathological status of breast cancer, miR-520d underexpressed significantly not only in patients with metastatic lymph node (P=0.019) but also in patients which have cancer at stage III (P=0.036). 
Conclusion: In this study, we found that miR-520d possibly acts as a tumor suppressor. It may be useful for diagnosis of tumor from normal tissue. In addition, miR-520d significantly underexpressed in HER-2 positive group of breast cancers. Therefore, it may be useful as an additional diagnostic test in this group of breast tumors along with other biomarkers.