Tehran University Medical Journal

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Background: The components of the classical complement pathway play an important role in the pathogenesis of systemic lupus erythematosus (SLE) and are reportedly useful biomarkers of disease activity. In this study, we evaluate disease activity, complement function (total hemolytic complement, CH50) and complement protein levels (C3, C4, C3d, C4d, SC5b-9), comparing the results of patients with active disease versus those with inactive disease.
Methods: This cross-sectional study included 78 hospitalized women with SLE, 24 of whom were in the active group, with SLE disease activity indexes (SLEDAI.2K) of >6, and 54 in the inactive group, with SLEDAI.2K of ≤6. Serum CH50 was measured using a red blood cell hemolytic assay. C3 and C4 levels were determined by nephlometry and plasma levels of C3d, C4d, SC5b-9 by ELISA. The data were statistically analyzed using SPSS.
Results: The mean (±standard error) C4d levels of the inactive group were significantly higher than those of the active group (23.39±1.1µg/ml and 16.9±1.6µg/ml, respectively p=0.003). There was also a significant correlation between C3 and C4 levels (p=0.807). The mean values of the other proteins (C3, C4, CH50, SC5b-9, and C3d circulating immune complex concentrations) were not significantly different between the inactive group vs. the active group: 89.35±6.8 vs. 85.54±7.6mg/dl, 18.33±2.3 vs. 20.45±2.4mg/dl, 149.03±4.3 vs. 157±4.3U, 1414.4±114.94 vs. 1471.1±216.9ng/ml, 9.43±0.96 vs. 13.31±3.16µgEq/ml, respectively (p>0.05).
Conclusions: According to our results, C4d levels may be used as a biomarker of disease activity. The significant correlation between C3 and C4 may confirm the activity of the classical pathway in SLE patients.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Cyclosporine is one of the main immunosuppressors used for renal transplant recipients, and is given to prevent transplant rejection. Although the drug increases the survival of patients and grafted organs, it has some side effects independent of its effect on the immune system that are usually ignored. In this study, we evaluate the effect of cyclosporine on serum Mg levels and metabolic side effects in renal graft patients.
Methods: In this study, we followed 157 renal transplant recipients (62 females and 95 males) who were being treated with cyclosporine at a private clinic to prevent transplant rejection. The patients were first physically examined and then blood samples were obtained in order to measure levels of cyclosporine, Mg, creatinine, fasting blood sugar, lipids, calcium, phosphorus, and uric acid levels. We then analyzed the data for correlations between serum Mg levels, cyclosporine and other metabolic complications.
Results: The mean levels of Mg and cyclosporine were 196±0.31mg/dl and 371±192 μg/dl, respectively. Hypomagnesemia was detected in 16 patients (10.2%).There was a significant negative correlation (p<0.05) between levels of Mg and cyclosporine levels (r=-0.53), serum creatinine (r=-0.61), plasma LDL (r=-0.3), fasting blood sugar (r=-0.60) and uric acid (r=-0.36), and no correlation (p>0.05) between levels of Mg and calcium (r=0.2), phosphorus (r=-0.01), triglycerides (r=0.06) and HDL (r=-0.08). Mean levels of cyclosporine, creatinine, LDL, fasting blood sugar and uric acid in patients with hypomagnesemia were significantly different from those patients with normal serum Mg levels (p<0.05). There was no significant difference between the two groups with regard to mean total cholesterol, HDL, calcium and phosphorus (p>0.05).
Conclusion: According to the results of this and previous studies, there is a significant correlation between cyclosporine levels and hypomagnesemia as well as other biomedical complications secondary to hypomagnesemia. Therefore, we recommend routine serum Mg determination and greater attention to hypomagnesemic patients to prevent further complications.

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Background: Obstructive nephropathy has been associated with disorders in metabolism state and oxidative balance of kidney. Stress oxidative play a key role in the pathophysiological processes of renal diseases. The objective of this study was to investigate effects of vitamin-E, as a powerful antioxidant, on renal oxidative stress and metabolism defect induced by 24-hr unilateral ureteral obstruction (UUO).

Methods: Anesthetized male Sprague-Dawley rats (n=10 in each group) were sterilely operated to occlude the left ureter. In UUO+NS, we had a single dose normal saline injection and in UUO+VitE and UUO+OO groups, D-α-tocopherol (50 mg/kg), the main component of vitamin-E, and its vehicle (Olive Oil), respectively, were twicely infused I.P. before and after UUO-induction. There were also sham-operated and control groups. 24-hr after of UUO-induction, both kidneys were removed and stored in -70°C. To determine metabolism condition, the levels of ATP and ADP and to evaluate redox state, the levels of malondialdehyde (MDA) and ferric reducing/antioxidant power (FRAP) of kidneys were assessed.

Results: The comparisons between UUO+NS and sham groups indicated that UUO increased MDA (p<0.001) and ADP (p<0.05), but decreased FRAP, and ATP/ADP ratio in obstructed kidney (all p<0.001). In UUO+VitE group, MDA and FRAP were equal to their levels in sham group, while ATP, ADP and ATP/ADP ratio were not different from those of UUO+NS group in obstructed kidney.

Conclusion: Twenty four hour of UUO caused renal reduction in oxidative metabolism and elevations in reactive oxygen species and administration of vitamin-E, although considerably ameliorated the oxidative stress, could not improve the defected metabolism.

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Background: The clinical importance of yeast infections has increased in recent decades. There are 10-15 pathogenic Candida species. The current morphological and physiological methods for identification of Candida species are generally not easy to interpret and may be expensive or time-consuming. In the present study, we introduce and use a new approach for the identification and differentiation of medically important yeast species of Candida. In this method, size polymorphism of the internal transcribed spacer regions, ITS1 and ITS2, of the ribosomal DNA in various Candida species is used as the basis of species recognition.

Methods: The genomic DNA of 31 standard strains and 60 clinical isolates was extracted and PCR-amplified using two primer pairs (ITS1-ITS2 and ITS3-ITS4) separately. Both PCR products were mixed and analyzed after standard agarose gel electrophoresis. The species of the tested yeasts were identified by the electrophoretic patterns of the mixed PCR products of each sample, comparing the data obtained from the sequence analyses of ITS1 and ITS2 molecules.

Results: By this method, with the exception of C. albicans and C. dubliniensis, we were able to clearly differentiate nearly all common pathogenic Candida species, including C. albicans, C. glabrata, C. gulliermondii, C. parapsilosis, C. tropicalis,      C. krusei, C. kefyr, C. lusinaniae and C. rugosa. All standard and clinical strains were identified correctly, without expensive methods such as sequencing and capillary electrophoresis.

Conclusion: It seems that the PCR-FSP method introduced in this study is the easiest molecular approach for the identification of a wide range of pathogenic Candida species and is applicable for diagnostic and epidemiological purposes in reference laboratories.

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Background: Penetrating thoracoabdominal stab wounds may cause diaphragmatic and abdominal organ laceration. However, 15-20% of these cases who are stable and managed by conservative treatment might have hidden diaphragmatic injuries, which could ultimately lead to chronic diaphragmatic hernia. Therefore, a safe and exact diagnostic method for the detection of occult diaphragmatic injuries is very valuable. In this study we have assessed the diagnostic value of thoracoscopy in occult diaphragmatic injuries resulting from penetrating thoracoabdominal stab wounds.

Methods: From March 2005 to October 2007, 30 hemodynamically stable patients with penetrating thoracoabdominal injuries, not requiring emergent exploration, were enrolled in this study. All subjects underwent thoracoscopy to evaluate probable diaphragmatic injury. Diaphragmatic injuries were repaired via thoracoscopy or laparatomy. All patients were evaluated for chronic diaphragmatic hernia by CT-scan six months later.

Results: The mean patient age was 26.2 years, with a male/female ratio of 5:1. Using thoracoscopic exploration, we observed five (16.7%) hidden diaphragmatic injuries, three (9.9%) of which were repaired using the thoracoscopic approach and two (6.6%) by laparatomy. Lung parenchymal laceration was seen in two patients (6.6%), for whom the repair was performed using thoracoscopy. Intra-abdominal injury was seen in one patient (3.3%), which was repaired by laparatomy. After thoracoscopy, there were no complications or evidence of chronic diaphragmatic hernia in the chest and abdominal CT-scans performed six months later. Therefore, the diagnostic accuracy of thoracoscopy in occult diaphragmatic injuries in our study was 100%.

Conclusion: With its high degree of diagnostic accuracy, low degree of invasiveness, as well as its utility in treatment, we recommend thoracoscopy for all clinically stable patients with penetrating thoracoabdominal stab wounds.

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Background: Chronic pancreatitis is a progressive fibrosis of the pancreas that leads to loss of endocrine and exocrine function of pancreas. The most common symptom is intractable pain. Which adversely effects quality of life, remains the most common indication for surgery in patients with chronic pancreatitis.

Case report: Three patients underwent operations for chronic pancreatitis at the Ghaem hospital, Mashhad University of Medical Sciences Mashhad, Iran. Indication for operation in all cases were intractable abdominal pain. In all of the three patients complete relief of symptoms was obtained. There was no morbidity and mortality. In one patient exocrine function of pancreas and malabsorpation resolved after surgery.

Conclusions: Although chronic pancreatitis is uncommon, but in persistent abdominal pain surgery should be considered. Surgery for patients with chronic pancreatitis can be performed safely with minimal morbidity and effective in control of pain and malabsorption.  

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Background: Adenosine receptors play an important role in the treatment of paroxysmal supraventricular tachycardia in cardiovascular system. This effect is through interaction with A1 type of G-protein-coupled adenosine receptors. The effect of N6-cyclopentyladenosine (CPA), an A1-selective adenosine agonist, was studied on ouabain-induced toxicity in spontaneously beating isolated guinea pig atria.

Methods: In the beginning the isolated guinea pig atria were mounted on the organ bath containing modified krebs and contractile responses in the four groups (shame, CPA, ouabain, CPA- ouabain) were measured.

Results: CPA (2-16nM) produced a dose-dependent decrease in the force of contractions (34%-51%) and in the rate of contractions (22%-48%). CPA significantly increased the time of onset of arrhythmia (toxicity) induced by ouabain (1.2µM) when it was administered 10 min before ouabain was added in organ bath. Ouabain (1.2µM) alone produced arrhythmia at 7 min and either asystole or standstill at 22 min. CPA (8nM) increased the time required to produce arrhythmia to 27.5 min and prolonged beating atria to more than 63 min and prevented the occurrence of asystole.

Conclusion: CPA produces direct cardiac action, probably due the inhibition of cardiac Ca²⁺ channel and membrane hyperpolarization of atrium cells in guinea pig atria. Moreover, our results suggest that CPA may reduce the membrane conduction through inhibition of ionic channels, which decrease ouabain- induced toxicity.

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Background: Type I diabetes is an autoimmune disease characterized by T-cell Mediated destruction of pancreatic β-cells. A variety of environmental, genetic and Immunologic factors are involved in the development of the disease. IL₁₈ is a cytokine secreted by macrophage and monocytes and play an important role in the pathogenesis of diabetes Type I through inducing IFN-γ production. It is shown to be strongly associated with the development of diabetes in NOD mice. It is also shown to have increased level in the subclinical stage of diabetes mellitus (type 1). Genetic polymorphisms in the IL-18 gene influence production and secretion of cytokine and are considered as a risk factor in auto-Immune diseases.

Methods: In this case control study, 75 type I diabetic patients and 88 healthy controls studied for polymorphism at positions -137 and -607. DNA extraction from the whole blood was performed according to the standardized method and polymorphism was determines by SSP-PCR. Data were analyzed by SPSS-12 using Chi-Square Test with 95% Confidence interval.

Results: A statistical significant difference in GG genotype (53%) and CC genotype (16%) at the -137 position of IL₁₈ gene was found, as compared to the control subjects (p=0.000) whereas we have not shown any statistical significance at the position -607.

Conclusion: IL₁₈ is a key cytokine secreted by macrophages and monocytes and stimulate the Th₁ lymphocyte. This cytokine can activate cytotoxic T lymphocytes (CTL) and destroy the pancreatic β cell. Our results show that the frequency of GG and CC genotypes at the position -137 may be associated with susceptibility to diabetes.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Malaria is an important parasitic vector-borne disease with considerable infectivity and world-wide distribution. Since prevalence of chloroquine resistance in Plasmodium falciparum at the malarious areas such as Iran and reliable reports from many countries indicating emergence of chloroquine- resistant strains of P.vivax, this study was conducted to monitor the current response of vivax and falciparum plasmodia to chloroquine in Bandar-Abbas district, a malarious area in Iran.
Methods: The study was conducted at the Bandar-Abbas district in Hormozgan province, Iran. 123 patients were enrolled and considered. The patients were treated with a standard 3-day regimen of chloroquine and were followed-up clinically and parasitologically. The results were interpreted as mean parasite clearance time (MPCT) in P. vivax and early treatment failure (ETF), late treatment failure (LTF) and adequate clinical and parasitological response (ACPR) in P. falciparum.
Results: The patients with vivax malaria were responded to the regimen of chloroquine within 24-216 hours. Most cases of the parasite clearance time occurred at 48 hours (50.40%), and less of them at 120, 168, 192 and 216 hours with 0.81% for each of them. MPCT in this study was calculated as 61.07 (±26/47) hours for all of the patients. 33.33% and 66.66% of the patients with falciparum malaria were found at ACPR and LTF groups, respectively.
Conclusion: This study confirms the efficacy of chloroquine on P.vivax. The extended parasite clearance time in a number of patients may be an early sign for reduced susceptibility of P.vivax to chloroquine in the studied areas. Most of the patients with falciparum malaria (66.66%) considered in this study did not respond to the regimen of chloroquine because of chloroquine- resistance in P.falciparum at the area.

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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.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Occult hepatitis B infection (OBI) is a form of hepatitis in which despite absence of detectable HBsAg, HBV-DNA is present in peripheral blood of patients. The responsible mechanisms for progression of OBI yet to be clarified, but some investigators believed that the genetics and immunological parameters are different in resistant individuals and patients. Vitamin D3 and its receptor interaction could be involved in anti-viral immune response. The aim of this study was to investigate the association between polymorphisms in intron 8 of VDR with OBI.
Methods: In this experimental study, the plasma samples of 3700 blood donors were collected and tested for HBsAg and anti-HBs by ELISA. The HBsAg negative and anti-HBc positive samples were selected and screened for HBV-DNA using PCR. HBV-DNA positive samples were assigned as OBI cases and PCR-RFLP was performed to examine the polymorphisms in intron 8 of VDR genes.
Results: Results of current study indicated that 352 (9.5%) of 3700 blood samples were HBsAg^- and anti-HBc⁺. HBV-DNA was detected in 57/352 (16.1%) of HBsAg^- and anti-HBc⁺ samples. Our results showed that no significant difference was observed in Apa-1 polymorphisms of intron 8 of VDR and OBI patients.
Conclusion: Our results demonstrated that there are not any association between Apa-1 detected alleles and OBI, hence, it can be concluded that these alleles are not associated with OBI and other researchers should evaluate relation between other polymorphisms of VDR with OBI.

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Background: Central venous catheter (CVC) related infections are important complications of cathter application. This study assessed the usefulness of mupirocin in prevention and control of these infections.
Methods: In this randomized clinical trial, consecutive surgical patients requiring central venous catheter (for more than 2 days) in Amir-Alam Hospital from 2006-2008 were enrolled. Patients were divided in two groups in “case group” patients received topical mupirocin 2% every 48 hours at the time of insertion of catheter and dressing change and for “control group” mupirocin was not used. All of the patients received chlorhexidine and enoxoparin as complementary treatments. Two groups were comparable in regard of age, sex and risk factors.
Results: One hundred eighteen patients enrolled in the study (57 in case and 61 in control group) completed the study. 84 catheters in case group and 88 catheters in control group were inserted. The catheters in 90% of patients were inserted in jugular vein. At the end of study 29(16.8%) patients (16 in control versus 13 in case group) had catheter colonization (p=NS). Catheter related bloodstream infection was observed in 16(9.3%) patients (6 in case versus 10 in control group) (p=NS).Catheter related local infection was seen in 2(1.1%) patients of control versus none of mupirocin group. (p=NS).
Conclusions: Mupirocin was not effective to control and prevention of bacterial colonization and catheter related infection.

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Background: Cerebral palsy (CP) is a group of nonprogressive motor impairment syndromes with potentially different risk factors and causal pathways which is caused by damage in the very young brain. The etiology of CP is mostly unknown and the prevalence has not decreased in comparison to past decades, although many advances have occurred in obstetric and neonatal care. In fact, it seems that the prevalence might have even increased in term infants. The aim of this study was the evaluation of cerebral palsy risk factors in Iran to compare them with other countries.
Methods: In this case-control study, all one to six years old children who were referred to a rehabilitation center from Shahid Beheshti child-health-care centers during the years 2007–2008, with documented cerebral palsy for evaluation of perinatal and neonatal risk factors were enrolled in the study, with matched controls.
Results: 112 in the case and 113 in the control group were studied. The main factors associated with CP, were: preterm delivery, neonatal and postnatal seizures, Apgar score of zero to three at twentieth minute after birth, low birth weight, and multiple gestations. The majority of infants with CP were born at term and only 37.8% before 37 weeks.
Conclusions: Preterm birth, hypoxic-ischemic encephalopathy and low birth weight were the independent predictors of CP in this population.

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Background: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community.
Methods: Inhabitants (age≥15 yrs) in 22 randomly selected districts (Tehran) participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate). Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extra-articular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden’s/ Bouchard’s nodes, CMC1’s squaring), pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1). Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis.
Results: Symptomatic hand osteoarthritis was present in 2.8%(CI 2.3-3.4) (52.6% female, mean age 37.1±16.3). Prevalence was higher in females (4.3% vs. 1.3%, p=0.000) and increased with age (0.1% in people <30 versus 23% in people >70, p=0.000). The most common signs in the DIP, PIP and CMC1 joints were bony enlargement, followed by tenderness and pain on movement.
Conclusions: our study confirms the evidence of high prevalence of symptomatic hand osteoarthritis in an urban community. The prevalence, pattern of hand joints involvement and relationship with age and sex in this study performed in an Eastern community resemble those in Westerners, which calls for further attention by appropriate services.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Telomere, by which is a terminal structure of eukaryotic chromosomes was discovered at first in 1938 and has a vital role in chromosome protection. Telomere in human and other vertebrates consists of thousands of 5′-TTAGGG-3′ tandem repeats at the end of the chromosome, has a main role in the chromosome stability. Telomere protects the end of the chromosome from degeneration, rearrangement and end to end fusion. There is a telomere loss at every cell division. Progressive loss in telomere length results in disassociation of telomere binding proteins and change in gene expression profiles. Adjacent genes are suppressed by the telomere effect so the telomere loss results in adjacent gene expressions. Apoptosis and replicative senescence are caused by progressive telomere loss. There are three mechanisms for increasing telomere length in eukaryotes and telomerase is the predominant mechanism. Telomerase can synthesize telomere, without the template. Telomerase is overexpressed In 90% of cancers. Therefore cancerous cells compensate the telomere loss in every cell division because of telomerase. In conclusion, telomerase is a proper target for cancer therapy and many methods including direct inhibition of telomerase and immunotherapy have been introduced.

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Background: Measuring end tidal carbon dioxide (ETCo2) is one of the methods used for estimating arterial carbon dioxide (PaCo2) during general anesthesia. ETCo2 measurements maybe obviate the need for repeating arterial puncture for determination of arterial PaCo2. This study performed to determine the accuracy of ETCo2 levels as a measure of PaCo2 levels in patients undergoing coronary artery bypass graft and also to evaluate variation of the gradient between PaCo2 and ETCo2, peri- cardiopulmonary bypass operation. Methods: In a prospective, cross-sectional study, a total of 40 patients with age 57±11 (35-73) years old undergoing coronary artery bypass graft were enrolled. ETCo2 levels (mmHg) were recorded using side stream capnography at the time of arterial blood gas sampling, before (T0) and after (T1) cardiopulmonary bypass. Results: Mean P(a-ET)Co2 at T0 was 4.3±4.4mmHg, with the mean PaCo2, 33±6mmHg and mean ETCo2, 29±5mmHg and these values at T1 were 4.5±4.1mmHg, 33±5mmHg and 29±2mmHg respectively. There was no variation of the mean gradient (PaCo2-PETCo2) during, before and after cardiopulmonary bypass (p>0.870). Significant correlation was found between ETCo2 and PaCo2 at T0 and T1 (r=0.754 and 0.685respectively and p=0.001). Conclusion: Capnography is a non- invasive and a safe technique for determining arterial PCo2 and for measurements of ETCo2 that correlate well with PaCo2 values in healthy patients undergoing coronary artery bypass graft. ETCo2 measurements maybe sufficient measures of PaCo2 in selected patients and obviate the need for repeatingarterial blood gas determination. Further study is warranted.

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Background: Ureteral obstruction has been shown to induce renal oxidative stress, suppressed energy metabolism and defected acid excretion. This study was aimed to examine the improving effects of L-carnitine, a facilitating cofactor for mitochondrial oxidation of fatty-acids as well as a scavenger of free-radicals, and -tocopherol as the most potent antioxidant on these renal disorders at early hours following release of unilateral ureteral obstruction.
Methods: The left ureter was ligated in 60 anaesthetised rats, L-carnitine, -tocopherol, or their vehicles (normal saline and olive oil, respectively) were injected (i.p.) in four groups. Each rat was re-anesthetized and cannulated, and ureteral legation was released at exactly 24h after UUO-induction. A 30-min clearance period performed to separately collect urine from both kidneys. The collected urine and arterial blood samples were given to pH-gas analyzer and autoanalyzer, and malondialdehyde (MDA), ATP and ADP levels were assessed in preserved kidneys. There were also sham and control groups (n=8-10 in each).
Results: In the post-obstructed kidney of vehicle-treated groups with respect to the equivalent kidney of sham group, there were increases in MDA (p<0.001), ADP (p<0.01), urinary pH (p<0.001), absolute (p<0.05) and fractional bicarbonate excretions (p<0.01), but decreases in ATP, ATP/ADP (both p<0.001), and urinary PCO2 (p<0.01). -tocopherol could normalize MDA level but did not affect the altered amounts of energy metabolic indices and acid-base excretions, while L-carnitine improved all of them except of decreased urinary PCO2.
Conclusions: Increased bicarbonate-excretion in post-obstructed kidney is due to defected acid-secretion at collecting duct, which is not related to ureteral obstruction-induced renal oxidative stress and suppressed energy metabolism.

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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.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Defective sperm function is now recognized as one of the most important causes of male infertility. Seminal plasma possesses a rich source of different enzymatic and non-enzymatic antioxidants such as vitamin C (ascorbic acid) that protect spermatozoa against oxidative stress as one of the mediators of infertility causing sperm dysfunction and low sperm quality. The aim of this study was investigation of seminal total antioxidant capacity and determination of vitamin C effects on sperm motility.

Methods: We designed a case-control study with a total subject of 62 males. Sperm parameters were analyzed according to World Health Organization guidelines (WHO, 1999). Total antioxidant capacity and vitamin C level of seminal plasma were measured in the 32 normozoospermic as the control group and 32 asthenospermic men as the case group using FRAP (Ferric Reducing of Antioxidants Powers) and RP-HPLC (Reverse Phase High Performance Liquid Chromatography) methods, respectively.

Results: Our results indicated that total antioxidant capacity levels in the seminal plasma of asthenospermic men were significantly lower than healthy men (p=0.002). In addition, we found a positive correlation between reduced total antioxidant capacity levels and low sperm motility. Vitamin C levels of seminal plasma in asthenospermic men were statistically lower than control men (p=0.01).

Conclusions: It is suggested that asthenospermia could be related to an antioxidant deficiency or it&aposs reduction.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: American pediatric Association proposes to screen all neonates with Oto-Acoustic Emission (OAE). In developing countries, because of several limitations, health policy makers recommend to screen only in high risk patients. This study is performed with the aim to screen hearing loss in 950 high risk newborns hospitalized in hospitals affiliated to Tehran University using the OAE test.
Methods: A total of 950 neonates hospitalized in the Neonatal and NICU wards of Vali-e-Asr, Shariati, Medical Center and Bahrami Hospitals during the years 2004-2006 who showed at least one risk factor using TEOAE hearing test were enrolled into this cross-sectional descriptive analytical study and were diagnosed with mild deafness and total deafness. Blood exchange due to hyperbillirubinemia, septicemia, congenital heart disease, the fifth minute apgar scores below six, PROM more than six hours, epilepsia, need to NICU more than five hours, pneumonia and Oto-Toxic drugs were considered as risk factors. Data was past medical history, current disease, admission cause, sign & symptoms and complications of disease.
Results: Multivariate logistic regression and paired t-test showed that blood exchange, low birth weight and low first minute Apgar scores had the highest independent risk for hearing loss among newborn.
Conclusion: Despite of the low prevalence of neonatal hearing loss, screening of hearing loss at early stages is important.