Tehran University Medical Journal

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Background: Epidural injection of the drugs such as opioids has rather been a successful method in controlling post operative pain.

Materials and Methods: In a clinical trial study, 50 Female patients, in a range of 20-40 years old and ASA class I, who were scheduled for gynecologic operation were investigated. They were randomly divided in two groups. Before induction of general anesthesia, an epidural catheter was placed for each patient. Sixty minutes after the end of operation, a 15-ml solution containing 50-microgram clonidine was injected through the epidural catheter in the first group. In the second group, a similar volume solution containing 50- microgram fentanyl was injected. The catheter was removed after all the patients were followed for 4 hours and their pain was assessed by VAS (Visual Analogue Scale) method.

Results: Our findings revealed that the clonidine group had more intense pain however they had fewer complications than the opioid group.

Conclusion: We concluded that although clonidine might act as an analgesic drug, but epidural injection of a single dose of 50 microgram of the drug could not be effective enough for postoperative analgesia.

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Background: This research was conducted for the purpose of determining the effect of hormonal and non-hormonal contraception on the mother milk and infants growth among lactating women received by south Tehran’s Health Centers. In this regard a broad spectrum study from December 2000 until February 2001 was done by Tehran university.

Materials and Methods: By sampling method, 200 lactating women were chosen randomly. They were divided into two groups according to their preferred method of contraception: 67 women chose hormonal method and 133 women chose non –hormonal method.

Results&Conclusion: During the time of the study on infants growth (increase in head circumstances, increase in height, increase in weight), There was no significant difference between the two groups. If we take the effect of contraceptive methods into consideration, the Triglyceride levels in non-hormonal group were increased considerably compared to the other group. Other ingredients were almost the same.

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Background: Heroin is one of the opiates which is used, as the most addictive drugs, in Iran. Considering the damaging effects of these drugs on the health of opiate addicts, investigation on the effects of heroin used in Iran, on male genital indicators including daily sperm production and its development, which has an essential role in fertility, seems to be necessary.

Materials and Methods: A total of 70 Bulb/c mature male mice, were divided into 5 groups of control, [intact (n=10), sham I (n=10) sham II (n=10)] and experimental groups [I (n=20), II (n=20], and 50 days after addiction to heroin (50 mg/kg) via intra peritoneal injection (IP), 6 mice from each groups were selected and after euthenizing, the testes and epididymes were removed. The rate of daily sperm production (DSP), epididymic sperm preservation (ESP) and the rate of sperm motility were measured accurately.

Results: In the study of the effect of heroin on daily sperm production and sperm preservation between the control and experimental groups, no significant differences were observed. The effect of heroin on sperm motility between control and experimental groups, the difference were significant (P<0/05).

Conclusions: In this survey, it was indicated that, the heroin used in Iran, causes a decrease in healthy sperms of mice their motility, and consequently can affect on genital indicators.

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Background: It was believed that Inhabitant of Islamshahr avoid referring to their health centers and health posts to receive bargain medical services. In search for the rate and causes of such neglect, this study was formed.

Materials and Methods: In a cross-sectional study from all urban centers and health posts under the supervision of Islamshahr health network, 712 files were selected randomly.

Results: Investigating the selected files it revealed that 25% were complete, 51% were defective and 24% were blank. In other words, only 25% of the files were complete and 75% of the files showed lack of full participation in primary care services. In the process of evaluation of each separate service unit, more defective files were found in family planning and oral health programs. But in the prenatal care and growth observation units, the number of complete files was a little higher than the number of defective ones. This is probably justifiable de to free vaccination of children and pregnant women, which causes the customer to refer to the mentioned units. In search for the causes of this lack of participation, 533 defective files were selected and those families were interviewed through some questionnaires.

Conclusion: In family planning and growth observation and prenatal care, the interviewees believed that there was no need for them to seek such services. This in turn shows their lack of knowledge about the necessity of these cares. In case of oral health, lack of such unite in the health center was mentioned as the reason. More details are discussed in the article.

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Background and Aim: Auditory and visual stimuli are the most important factors in communication. It seems during the brain maturation, decrease of visual inputs causes enhancement of somatosensory and auditory cortical responses. In this research latency and amplitude of auditory middle latency responses (AMLR) are studied in blinds and normally sighted subjects.

Materials and Methods: This descriptive-analytical study was performed on 40 congenitally blinds and 40 normally sighted subjects in the range of 14-20 years. All of cases had normal hearing sensitivity and acoustic reflexes without any middle ear disorders. The reason of this age range is the maturation of auditory middle latency responses. Sampling was randomized.

Results: There was significant difference between amplitude of Na, Pa & Nb waves and latency of Na while no significant difference between latency of Pa & Nb in blinds and normally sighted subjects.

Conclusion: Increase of amplitude and decrease of latency of AMLR in blind subjects were due to sensory compensation phenomenon, probably. It seems rate of processing and auditory perception in blinds is better than normally sighted subjects.

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Background: The male antifertility activity of Gossypol, the active ingredient of cotton seed, inspired the idea for development of an agent with male contraceptive activity. The result of subsequent studies lead to the discovery of several class of compounds with antifertility activity. In this study the antifertility activity of iso-Propyl and iso-Butyl derivatives of dihydropridine were evaluated.
Methods: The two aforementioned compounds were administered subcutaneously in (10 mg/kg/day) dose to male rats. The animals were treated and kept according to the TUMS committee recommendations on ethical and animal maintenance considerations. Sixty days after the first injection the following fertility and histological indices were evaluated, animal’s body weight difference (B.W.D), sperms motility, sperm viability, ESR (epididymal sperm reserve), DSP (daily sperm production), serum testosterone concentration, fertility index, GSI (gonado somatic index). Histological indices are respectively the area and circumference of seminiferous tubules, each testis and their crosswise dissections, the diameter of seminiferous tubules and the number of seminiferous tubules per square millimeter, that were determined.
Results: The values of the two test groups were determined and compared with the results of normal group that were using normal saline only and the blank that were receiving propyllenglycol only.
Conclusion: The significant inhibitive activity of candidate compounds on animal's physiologic indices were in accordance of our pervious estimation of compounds activity as (lead compound) for synthesis and preparation of new compounds with male contraceptive activity

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Background: Rheumatoid arthritis (RA) is an autoimmune disorder with unknown etiology. In recent years, a great number of studies have investigated the possible role of reactive oxygen species in the etiology and pathogenesis of Rheumatoid Arthritis. The aim of this study was to analyze the level of activities of catalase, glutathione peroxidas (GSH-Px), Super oxide dismotase (SOD) in patients with RA compared with the healthy subjects.
Methods: In a case-control study sixty rheumatoid arthritis patients 18-75 years old and 60 healthy sex and age-matched controls were selected, Catalase activity was measured by determining the constant rate (k) of hydrogen peroxide decomposition. GSH-Px activity of plasma was measured with spectrophotometer by Glutathione oxide generation due to GSH-Px. SOD activity is measured by degree of inhibition effect of SOD in generating super oxide radicals by xanthine and xanthine oxidase. C-reactive protein and rheumatoid factor values were determined by agglutination and latex tests.
Results: The plasma activity of catalase (p<0.001), GSH-Px (p<0.01), plasma level of hemoglobin and hematocrit (p<0.05) were significantly lower in patients with RA comparing with controls. The reduction in SOD activity was not significant (p>0.05). There was a negative significant relation between C reactive protein and Rheumatoid factor values with the erythrocyte activity of catalase and GSH-Px (p<0.01).
Conclusion: These results suggested that oxidative stress plays a very important role in the inflammation and pathogenesis of RA.

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Background: The cause of osteoporosis is multifactorial and many dietary factors are important in the prevention of this disease. Antioxidants as free radical scavengers may influence osteoporosis by reducing the effects of oxidative stress that may be associated with bone loss. Vitamin E is an important antioxidant that protects polyunsaturated fatty acids (PUFA) in cell membranes from oxidation. There are only two studies regarding vitamin E plasma levels in subjects suffering from osteoporosis. The purpose of this study was to investigate the association between plasma vitamin E levels and bone mineral density (BMD) in Iranian patients.
Methods: Subjects were consecutively recruited between May and September 2005 from among a total of approximately 1000 people referred for instrumental screening for osteoporosis to the Jami Clinic in Tehran. Inclusion criteria for the study group were: a femoral neck T-score of -1 or less, osteopenia, severe osteopenia and osteoporosis. A total of 137 subjects were enrolled. According to their femoral and spinal BMD scores, 54 persons were selected as a control group. The control group consisted of subjects with a femoral neck T-score and spine T-score of -1 or more. In selecting the case group, only the femoral BMD score was used. Plasma vitamin E was measured, after extraction with methanol, by HPLC with UV detection at 280 nm. Methanol, deionized water and butanol (90:4:6) was used as a mobile phase with a C8 column. The flow rate was 1.0 ml. min-1 and the acetate ester of vitamin E was used as an internal standard.
Results: The results show no significant difference in plasma vitamin E between the control and case groups, however linear regression analysis does reveal a significant difference between the T-score and plasma vitamin E.
Conclusion: Deceleration Femoral bone Density during osteoporosis will be Accelerated with Decrease of Vitamin E Antioxidant level.

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Background: Thyroid cancer is a rare disease which includes less than 1% percent of all human cancers. The aim of this study is to evaluate the demographic characteristics and risk factors among patients with thyroid malignancy at the Cancer institute and Imam Khomeini hospital in Tehran Iran.
Methods: This is a retrospective descriptive study of the charts of 320 patients admitted with the diagnosis of thyroid malignancy based on pathologic reports in the above- mentioned hospitals from 1992 to 2002.
Results: From the 320 patients diagnosed with thyroid malignancy 68.1% were papillary cancer, 10.9% were follicular cancer, 10.6% were anaplastic cancer, 9.06% were medullary cancer and 1.2% were lymphoma. The average of the patients was 50.2 years, ranging from 12 to 98 years 60.6% were female and 39.4 %were male 22.8% of the patients had histories of thyroid nodule and 5% had received radiation therapy. From the anatomic point of view 57.5% of the cancers were in the right lobe of thyroid, 38.1% were in left lobe and 4.4% in the isthmus. None of the patients had positive family history of thyroid malignancy.
Conclusion: Thyroid malignancy is more prevalent in the fifth decade of life and more common among females. Therefore, among patients in this group, alarming symptoms, such as anterior neck mass, thyroid nodule and voice change, should be evaluated more seriously.

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Background: Magnesium Sulfate (MgSO4) has been used as a pharmacologic agent in different situations for many years in the treatment of tachyarrhythmias, myocardial ischemia, preeclampsia, and tocolysis among others. The analgesic effect of MgSO4 for postoperative pain has been used since the 1990s. Postoperative pain is one of the most common complications in the perioperative period and can result in serious consequences in different organs if left untreated. Inguinal herniorrhaphy is among the most common surgeries and is almost always accompanied by severe pain. The object of this study is to determine the effect of a pre-induction infusion of MgSO4 on the reduction of postsurgical pain after herniorrhaphy.
Methods: This double-blind, randomized clinical trial included 105 ASA class I and class II herniorrhaphy patients at Shariati Hospital in years 2004 and 2005. For statistical analysis, the 2 and T tests were used. The patients were divided into three groups based on block randomization. Patients in the following groups received: Group A, 200 ml of normal saline infusion (placebo) Group B, 25 mg/kg MgSO4 in 200 ml of normal saline Group C, 50 mg/kg MgSO4 in 200 ml of normal saline. All groups were infused twenty minutes before induction of anesthesia using identical methods and dosage in all three groups. Heart rate and mean arterial pressure (MAP) at pre- and postintubation and so at skin incision time were charted. Visual analog scale (VAS) pain score, nausea, vomiting and the amount of morphine used before recovery room discharge and in six, twelve and twenty-four hours after recovery discharge was recorded.
Results: The average age for the different groups was as follows: Group A: 33.6, Group B: 37.37, Group C: 32.74. Nausea and vomiting between the case and control groups were not statistically different (60% vs. 71.4%, p=0.0499), nor was the amount of Morphine used. On recovery room discharge, the VAS scores were 8.1, 7.2, and 5.5 for the first, second and third groups, respectively (P<0.001). However, no statistical significance was found for the VAS scores six hours after recovery room discharge.
Conclusion: The results in this study show that pre-induction with MgSO4 has no remarkable effect on decreasing postoperative pain or morphine use for inguinal herniorrhaphy.

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Background: People vary greatly in their response to painful stimuli, from those with a low pain threshold to those with indifference to pain. However, insensitivity to pain is a rare disorder, characterized by the lack of usual subjective and objective responses to noxious stimuli. Patients who have congenital indifference to pain sustain painless injuries beginning in infancy, but have sensory responses that are otherwise normal on examination. Perception of passive movement, joint position, and vibration is normal in these patients, as are tactile thresholds and light touch perception.
Case report: A twelve-year-old boy was admitted to the hospital for a painless deformity, degeneration in both knees and a neglected femoral neck fracture that was inappropriately painless. Further examination revealed normal sensory responses, perception of passive movement, joint position, vibration tactile thresholds and light touch perception. Spinal cord and brain MRI were normal as was the electromyography and nerve conduction velocity (EMG/NCV) examination. There was no positive family history for this disorder.
Conclusion: The deficits present in the different pain insensitivity syndromes provide insight into the complex anatomical and physiological nature of pain perception. Reports on pain asymbolia, in which pain is perceived but does not cause suffering, and related cortical conditions illustrate that there can be losses that independently involve either the sensory-discriminative component or the affective-motivational component of pain perception, thus highlighting their different anatomical localization. The paucity of experience with this entity and the resultant diagnostic problems, the severity of the associated disabling arthropathy and underscore the importance of this case report of indifference to pain.

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Background: Invasive procedures such as bone marrow aspiration in children with oncologic malignancies are painful and may produce anxiety for both patients and their parents. Various pharmacologic treatments have been used to sedate children undergoing bone marrow aspiration. This prospective randomized study was designed to compare the effectiveness of these combinations, as well as their associated hemodynamic and respiratory side-effects and recovery in pediatric patients undergoing bone marrow aspiration.
Methods: Fifty children with oncologic malignancies whose ages ranged between 2-12 years were enrolled in this study. Patients were randomly assigned either to the Propofol- Alfentanyl group or the Midazolam- Ketamine group for analgesia and sedation during bone marrow aspiration in the operating room. Time to induce sedation, sedation score and recovery time were recorded.
Results: There were no statistical differences between groups in weight, age, sex and duration of procedures. Procedures were completed with satisfactory sedation levels in all patients in the study groups according to the modified Ramsay score. Induction and recovery times in the Propofol- Alfentanyl group were significantly shorter than in the Midazolam- Ketamine group (p<0.001). After Midazolam- Ketamine sedation, a statistically significant increase in systolic blood pressure and heart rate were seen, however the opposite was observed after Propofol- Alfentanyl sedation. Other side effects, such as nausea and vomiting, agitation myoclonus and aspiration, were not seen in our patients.
Conclusion: Both Propofol- Alfentanyl and Midazalam-Ketamine combinations can be used safely and effectively for sedation and analgesia during bone marrow aspiration in the pediatric patient group.

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Background: Health care workers (HCWs) are at substantial risk of acquiring bloodborne pathogen infections through contact with blood and other potentially infectious materials. The main objectives of this study were to determine the epidemiological characteristics of occupational exposure to blood/body fluids, related risk factors of such exposure, and hepatitis B vaccination status among HCWs.
Methods: This cross-sectional study was conducted from December 2004 to June 2005 at three university hospitals in Tehran, Iran. Using a structured interview, we questioned HCWs who had the potential for high-risk exposure during the year preceding the study.

Results: With a total number of 467 exposures (52.9%) and an annual rate of 0.5 exposures per HCW, 391 (43%) of the 900 HCWs had at least one occupational exposure to blood and other infected fluids during the previous year. The highest rate of occupational exposure was found among nurses (26%) and the housekeeping staff (20%). These exposures most commonly occurred in the medical and emergency wards (23% and 21%, respectively). The rate of exposure in HCWs with less than five years of experience was 54%. Percutaneous injury was reported in 280 participants (59%). The history of hepatitis B vaccination was positive in 85.93% of the exposed HCWs. Sixty-one percent had used gloves at the time of exposure. Hand washing was reported in 91.4% and consultation with an infectious disease specialist in 29.4%. There were 72 exposures to HIV, HBV and HCV exposure to HBV was the most common. In 237 of the enrolled cases, the source was unknown. Job type, years of experience and hospital ward were the risk factors for exposure.
Conclusion: Education, protective barriers and vaccination are important in the prevention of viral transmission among HCWs.

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Background: Relaxation of the corpus cavernosum plays a major role in penile erection. Nitric oxide (NO) is known to be the most important factor mediating relaxation of corpus cavernosum, which is mainly derived from nonadrenergic noncholinergic (NANC) nerves. The aim of the present study was to investigate the effect of biliary cirrhosis on nonadrenergic noncholinergic (NANC)-mediated relaxation of rat corpus cavernosum as well as the possible relevant roles of endocannabinoid and nitric oxide systems.

Methods: Corporal strips from sham-operated and biliary cirrhotic rats were mounted under tension in a standard oxygenated organ bath with guanethidine sulfate (5 µM) and atropine (1 µM) to induce adrenergic and cholinergic blockade. The strips were precontracted with phenylephrine hydrochloride (7.5 µM) and electrical field stimulation was applied at different frequencies (2, 5, 10, 15 Hz) to obtain NANC-mediated relaxation. In separate precontracted strips of the sham and cirrhotic groups, the concentration-dependent relaxant responses to sodium nitroprusside (10 nM-1mM), as an NO donor, were assessed.  

Results: The NANC-mediated relaxation was significantly enhanced in cirrhotic animals (P<0.01). Anandamide potentiated the relaxations in both groups (P<0.05). The cannabinoid CB1 receptor antagonist AM251 (10 µM) and the vanilloid receptor antagonist capsazepine (10 µM) each significantly prevented the enhanced relaxations in cirrhotic rats (P<0.01). The CB2 receptor antagonist AM630 had no effect on relaxations in the cirrhotic group. In a concentration-dependent manner, L-NAME (30-1000 nM) inhibited relaxations in both the sham and cirrhotic groups, although cirrhotic groups were more resistant to the inhibitory effects of L-NAME. The degree of relaxation induced by sodium nitroprusside (10 nM-1 mM) was similar in the two groups.

Conclusions: Biliary cirrhosis enhances the neurogenic relaxation in rat corpus cavernosum probably via the NO pathway and cannabinoid CB1 and vanilloid VR1 receptors.

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Background: The most common methods for screening of patients with probable ischemic heart disease are stress test and in special conditions are perfusion scan, so that their positive results was important indication of coronary angiography. Although, predictive value of perfusion scan has been considered, with regard to the impact of technical and specialized factors and according to the spread of this technique that has wrongly replaced the stress test, it is necessary to compare predictive value of this method with stress test in our country.

Methods: In a cross-sectional study, patients referred to Tehran Heart Center from all centers of country between January 2004 and January 2005 for coronary angiography was included. Demographic characteristics of patients were collected by interview and clinical tests and analyzed in two genders. Then, positive predictive value (PPV) of both techniques was calculated and compared.

Results: The total number of positive perfusion scan and stress test were 2178 and 2581, respectively. It was not significant difference between PPV of perfusion scan and stress test in men (86.9% vs 86.6%, P=0.814). PPV of perfusion scan was higher than stress test only in women more than 60 years old (P=0.0002).

Conclusions: According to the results of this study and with regard to high cost of perfusion scan, it seems that in case the possibility of stress test, the use of perfusion scan had no advantages with the condition of our scan centers and especially in women, predictive value of these techniques were similar. However, it is necessary to consider the causes of this unusual finding according to the role of drugs, instruments, and specialists in the future.

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Background: Relaxation of the corpus cavernosum plays an important role in penile erection. Previous studies have suggested that nitric oxide (NO) appears to be the most important relaxant involved in the erection process. The aim of the present study was to evaluate the effect of cholestasis in nNOS and eNOS activity of corpus cavernosum.
Methods: forty-two adult male Sprague-Dawley rats were divided equally into seven groups: control, sham operated, 2-, 7-, and 14-day bile duct-ligated animals, 7-day bile duct-ligated chronically treated with L-NAME (3mg/kg/day, i.p.) and 7-day bile duct-ligated animals chronically treated with Naltrexone (20 mg/kg/day, i.p.). The animals in each group were killed and the cavernosal tissues analyzed histologically by light and transmission electron microscopy, with NOS activity detected on NANC nerves and endothelium using an NADPH-diaphorase staining technique.
Results: our results showed that NADPH diaphorase staining in corporal NANC nerves and endothelium of sham-operated and control group had equal intensity. The staining was more intense in 2-day cholestatic rats than in control group, the staining intensity increased in 7-, and 14-day groups too. There were no significant differences between control group and 7-day cholestatic rats that had been treated chronically with L-NAME or Naltrexone.
Conclusions: These results state that in corpus cavernosum of cholestatic rats there is a time-dependent increase in NOS activity of the corporal NANC nerves and endothelium. inhibition of nitric oxide and endogenous opioids by L-NAME or Naltrexone during cholestasis may play a key role in preventing the adverse effects of cholestasis.

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Background: Various imaging tests as well as different scoring systems based on symptoms, signs and laboratory findings are commonly used to improve diagnostic accuracy in acute appendicitis. The aim of this study was to compare the diagnostic accuracy of MANTRELS scoring system (designed by Alfredo Alvarado), which is based on symptoms, signs and laboratory results, with sonographic findings.

Methods: In this prospective observational study, 106 patients with acute abdomen suspicious of acute appendicitis at Sina Hospital, Isfahan, Iran, were studied from March 2004 to February 2006.

Results: The disease was most common in patients aged 20-29 years, with male predominance. All patients had appendectomies. One hundred patients had acute appendicitis and six had negative appendectomy. Among the patients with acute appendicitis, 88% had an Alvarado score of ≥6 and 12% had a score of ≤5. Among the six patients with negative appendectomy, 66.7% had Alvarado scores of ≤5 and 33.3% had scores of ≥6, which was significantly different (p=0.005). The sonographic results were abnormal in 71.9% of patients with acute appendicitis and in 25% of patients with negative appendectomy, which was not significantly different (p=0.08). In our study, the diagnostic accuracy of an Alvarado score ≥6 was 88% and that of the sonographic results was 71.9% for acute appendicitis. If the Alvarado score ≥6 and abnormal sonographic findings are considered together, the diagnostic accuracy improves to 97.2%.

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Background: The relationship between coping styles and psychological adaptation during the recovery process was investigated in a sample of coronary heart disease (CHD) patients.

Methods: One hundred and fifty patients from Shahid Rajaee Heart Center, Tehran, Iran, were included in this study at intake and forty five patients (27 men, 18 women) participated in the follow-up study. All participants were asked to complete the Tehran Coping Styles Scale (TCSS) and Mental Health Inventory (MHI). The Recovery Process Questionnaire (RPQ) was completed using each patient's medical file and clinical examinations by cardiologists. Styles of coping with stress were categorized as problem-focused, positive emotional-focused and negative emotional-focused. Psychological adaptation included psychological well-being and psychological distress.

Results: Objective recovery status showed no significant correlation with either coping styles or psychological adaptation. Perceived recovery revealed a significant positive association with negative emotional-focused coping (p<0.05), but no significant correlation with other coping and psychological adaptation variables. Perceived recovery revealed a significant negative association with psychological distress (p<0.05), but showed no significant correlation with psychological well-being.

Conclusions: Perceived recovery in CHD patients is positively influenced by negative emotional-focused coping styles. Results and implications are discussed specifically in terms of the possible reasons for the positive relationship between perceived recovery and negative emotional-focused coping.

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Background: Tumor cells need food and oxygen supply for growth and division. Therefore one of the most promising areas of cancer therapy focuses on using agents that inhibit tumor angiogenesis. Inhibition of angiogenesis prevents cell growth, division and metastasis. Previous studies showed that plasminogen related Protein-B has an anti-tumor activity in mice. This protein has a high level of homology with preactivation Peptide (PAP) of human plasminogen. According to this high homology, antiangiogeneic activity of PAP was investigated in an in vitro angiogenesis model.

Methods: PAP encoding region of human plasminogen gene was isolated by Polymerase Chain Reaction and ‎cloned in pGEX-2T vector. This plasmid was expressed in Escherichia coli as a fusion protein (GST-PAP). ‎GST-PAP was expressed as inclusion body and purified by affinity chromatography on GSH-sepharose ‎resin after refolding. antiangiogenic effects of purified protein were surveyed with Matrigel assay‏.‏‎ ‎

Results: The GST-PAP was expressed and purified and its accuracy was confirmed by SDS-PAGE analysis ‎and immunoblotting. Microscopic studies showed that GST-PAP inhibited angiogenesis in Matrigel system ‎which is shown by shrinking the length of capillary like structures and a decrease in the number of tubule. ‎While applying concentarations of 25μg/ml of GST-PAP and concentrations above that, antiangiogenic ‎activity of GST-PAP was significant comparing to the controls. ‎

Conclusion: Finding shows that GST-PAP can inhibit network formation in Matrigel system. This findings ‎support the theory that PAP is a potent angiogenesis inhibitor.‎

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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.