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Volume 56, Issue 6 (7-1998)
Calcium channel blockers are used worldwide in CAD, hypertension and arrhythemia. As recent international studies show these drugs in addition to cardiovascular effects have immunosuppressive effects and can prolong graft life in transplanted patients. In a single blind prospective trial we studied 30 patients on 120 mg/d Verapamil for at least 3 months compared with 15 patients on placebo. Changes of cell immunity markers were impressive as T suppressor lymphocytes increased and CD4/CD8 ratio decreased significantly compared with placebo (P<0.05). This study confirms that Verapamil reduce cell immunity that may prone human beings to infections and on the other side we can use it in hypertensive patients with organ graft.
Volume 65, Issue 13 (3-2008)
Background: This study attempts to examine the relationship between several dismension of organization climate and medical facutly's job satisfaction in Tehran University of Medical Sciences.
Methods: A survey composed of demographic items and job satisfaction indexes were mailed to a stratified random samples of medical faculties (n= 405).
Results: The overall response rate was 45.1%.
Conclusion: The study indicates that score of job satisfaction was 56.5 with SD= 16.96. In general 47.4% of the medical faculties were highly satisfied. A significant statistical correlation have been found between sex (p= 0.008), administrative position (p= 0.044), faculty rank (p= 0.007), marital status (p= 0.001), employment status (p= 0.003) and job satisfaction. The findings of this survey have implications for university administrative.
Volume 66, Issue 8 (11-2008)
Background: Multislice computed tomography (MSCT) is a noninvasive method of detecting coronary artery disease (CAD). The purpose of the present study was to investigate the accuracy of 64-slice MSCT (64-MSCT) in daily practice, without patient selection.
Methods: Sixty-four consecutive suspected CAD patients underwent both 64-MSCT and quantitative coronary angiography (QCA). The CT system The mean time span between MSCT and QCA was 7.2±3.9 days. For the 64-MSCT, detection or exclusion of CAD, defined as one or more areas of >50% stenosis within major epicardial coronary arteries, the sensitivity, specificity, diagnostic accuracy, positive predictive value (PPV), and negative predictive value (NPV) were evaluated both per patient and per segment.
Results: Sixty-one of the 64 coronary CT angiograms (95%) were of diagnostic image quality. QCA showed significant CAD in 64% (39/61) of the patients, with the other 36% (22/61) showing nonsignificant disease or no disease. Sensitivity, specificity, accuracy, PPV, and NPV of 64-MSCT per patient were 92%, 86%, 90%, 92% and 96%, respectively. By the per-segment analysis, 695 of 791 coronary artery segments were assessable (88%). Of these, 64-MSCT showed a sensitivity of 80%, specificity of 92%, accuracy of 90%, PPV of 65%, and NPV of 96%, respectively, in detecting CAD.
Conclusions: Both per patient and per segment analyses for coronary 64-MSCT showed a higher diagnostic accuracy than QCA. This suggests 64-MSCT should primarily be used for risk stratification on a per patient basis as a noninvasive gate-keeper diagnostic method.
Volume 67, Issue 2 (5-2009)
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Background: Coronary
Artery Disease (CAD) is a major cause of death worldwide including Iran. The risk of developing disease in patients
without symptoms is assessed in part by factors that are associated with disease.
Among these factors family history points to the significance of genetic
component in the risk of CAD. The identification of the genetic variants that
confer risk for CAD is essential for detecting high-risk individuals, so
preventative life style and therapeutic action can be taken before overt
disease develops. So far more than 100 genes have been reported with possible
role in developing risk for CAD. Matrix- Gla Protein (MGP) is one of these
genes that association of its single nucleotide polymorphism (SNP) with CAD has
been reported. Among the polymorphisms,
there are two promoter SNPs at position -7 & -138 that their association
with CAD has been reported before. Here we investigated the association of
these SNPs with CAD in Iranian population.
Methods: 150 cases and 150 controls were selected on the basis of their
clinical assessments and angiographic reports. DNA was extracted from blood
samples. The genotypes for both SNPs were determined using Polymerase Chain
Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method with size
fractionation on Polyacrylamide gel.
Results: The
comparison of allele & genotype frequencies between patients and controls
showed that there is an excess of A allele at position -7 and T allele at
position -138 among patients, although these differences were not significant (p<0.2, and p<0.5 respectively).
Conclusions: This study
suggests no association of these SNPs with CAD in Iranian population.
Confirmation of this finding needs independent repeat of similar studies.
Keywords: Coronary
Artery Disease (CAD), Matrix Gla Protein (MGP), Single Nucleotide Polymorphism (SNP).
Volume 67, Issue 7 (10-2009)
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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.
Volume 68, Issue 12 (3-2011)
Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent pulmonary diseases. Use of an automatic system for the detection and diagnosis of the disease will be beneficial to the patients' treatment decision-making process. In this paper, we propose a new approach for the Computer Aided Diagnosis (CAD) of the disease and determination of its severity axial CT scan images.
Methods: In this study, 24 lung CT scans in full inspiratory and expiratory states were performed. Variations in the normalized pattern of the lungs' external parenchyma were exploited as a feature for COPD diagnosis.Subsequently, a Bayesian classifier was used to classify variations into two normal and abnormal patterns for the discrimination of patients and healthy individuals. Finally, the accuracy of the classification was assessed statistically.
Results: With the proposed method, the lungs parenchymal elasticity and air-trapping were determined quantitatively. The more this feature tended to zero, the more severe air-trapping and obstructive pulmonary disease is. By analyzing CT images in the healthy and patient groups, we calculated the hard threshold for the diagnosis of the disease. Clinical results tested by the mentioned method, suggested the effectiveness of this approach.
Conclusion: In regard to the challenges of COPD diagnosis, we propose a new computer-aided design which may be helpful to physicians for a more accurate diagnosis of the disease. Moreover, this severity scoring algorithm may be useful for targeted disease management and risk-adjustment.
Volume 70, Issue 4 (7-2012)
Background: Lung diseases and lung cancer are among the most dangerous diseases with high mortality in both men and women. Lung nodules are abnormal pulmonary masses and are among major lung symptoms. A Computer Aided Diagnosis (CAD) system may play an important role in accurate and early detection of lung nodules. This article presents a new CAD system for lung nodule detection from chest computed tomography (CT) images.
Methods: Twenty-five adult patients with lung nodules in their CT scan images presented to the National Research Institute of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Tehran, Iran in 2011-2012 were enrolled in the study. The patients were randomly assigned into two experimental (9 female, 6 male, mean age 43±5.63 yrs) and control (6 female, 4 male, mean age 39±4.91 yrs) groups. A fully-automatic method was developed for detecting lung nodules by employing medical image processing and analysis and statistical pattern recognition algorithms.
Results: Using segmentation methods, the lung parenchyma was extracted from 2-D CT images. Then, candidate regions were labeled in pseudo-color images. In the next step, some features of lung nodules were extracted. Finally, an artificial feed forward neural network was used for classification of nodules.
Conclusion: Considering the complexity and different shapes of lung nodules and large number of CT images to evaluate, finding lung nodules are difficult and time consuming for physicians and include human error. Experimental results showed the accuracy of the proposed method to be appropriate (P<0.05) for lung nodule detection.
Volume 71, Issue 2 (5-2013)
Background: It has been shown that coronary artery calcium scoring (CACS) can be used as a diagnostic method in coronary artery disease (CAD). The relationship between CACS and calcium metabolism in the body has been shown. The arterial calcification is an organized process similar to bone formation which is controled by parathormone (PTH). The relationship between PTH as an osteoregulatory factor and CACS has been also indicated. In this study, we tried to assess the value of serum PTH and CACS in patients planned to undergo coronary angiography (CAG) in order to find a simple, cost -benefit, noninvasive way, for ruling in/out obstructive CAD.
Methods: In a cross sectional study in Imam Khomeini hospital in 1390, CACS by using non-enhanced multi detector computed tomography (MDCT) and measurement of serum level of PTH, Calcium and Phosphate were done in 178 patients suspected to CAD which were scheduled to undergo coronary angiography serum PTH was measured by immuno-radiometric assay (IRMA) and serum Ca and Phosphate were measured by spectrophotometry methods.
Results: Of 178 Patients, 50 patients were females and 126 patients were male. Mean age of them was 56.2±11.6. The correlation coefficient between CACS and Gensini score (0.507, P<0.001), PTH (0.037, P=0.693), Ca (0.062, P=0.499) and Phosphate (0.061, P=0.506) were obtained. The level of serum PTH in the patients with and without coronary artery disease were 21.8±11.6 pg/dl, 23.2±11.5 pg/dl (P=0.427) respectively.
Conclusion: Our study showed association between CACS and CAD that was statistically significant while no relationship was found between PTH, CACS and CAD.
Volume 72, Issue 1 (4-2014)
Background: The intestinal absorption of fatty acids may take place through simple diffusion as well as through protein carrier mediated transport, although the relative importance of each pathway is dependent on the ambient condition of entrocytes. Cad-mium ion influences the absorption of fatty acids in entrocytes. However, the effect of cadmium ion on the absorption of fatty acids in different pH values has not been evalu-ated yet. Especially, the luminal pH of small intestine has an essential role in the ab-sorption of fatty acids. In the present study we aimed to evaluate reciprocal effects of cadmium ion and pH of intestine lumen on the absorption of fatty acids in rat model. Methods: In this experimental research, 3 months old Wistar rats (45 rats) were used for experiments. After killing the rats, their intestine was removed and the duodenum and jejunum segments were dissected. Everted Gut Sacs (EGS) were prepared from these duodenum and jejunum segments. The sacs were filled with buffer solution and incubated in a medium containing an appropriate concentration of oleic acid. Then the amounts of oleic acid that had been absorbed into the EGSs in the presence and absence of cadmium ions under different conditions of pH, was measured. Results: Findings of the study demonstrated that the luminal pH of small intestine was effective on the oleic acid uptake and the inhibitory effect of cadmium ions on the up-take of the acid was influenced by pH condition, so that this inhibitory effect was 32% and 36% at the alkaline pHs 7.5 and 9.2, respectively (P< 0.05). At the acidic pHs, 2.5 and 4.5, the inhibitory effect reduced to 11% and 5%, respectively (P< 0.05). Conclusion: Cadmium ion decreased fatty acid uptake by small intestine in rats, and the acidic pH of intestine lumen could attenuate the inhibitory effect of cadmium ion.
Volume 72, Issue 12 (3-2015)
Background: Polymorphisms of the upstream transcription factor 1 (USF1) have been associated with familial combined hyperlipidemia (FCHL), type 2 diabetes and coronary heart diseases (CHD). In the current investigation, the association of USF1s2 variant of human USF1 gene with premature coronary artery disease (PCAD) was evaluated in a population from southern Iran. USF1s2 has the best potential as a functional variant .in the USF1 gene. Methods: In a case-control study USF1s2 variant of human USF1 gene was determined by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) technique using BsiHKA I restriction enzyme for 186 women under 55 years of age and 135 men less than 50 years of age who underwent diagnostic coronary angiography in Saadi, Nemazee and Kowsar Hospitals of Shiraz, between July 2009 and March 2012. Data on the history of familial myocardial infarction or other heart diseases, hypertension, and smoking habit were collected by a simple questionnaire. Blood sugar level and serum lipid profile of all participants were also obtained by measuring the levels of fasting blood sugar (FBS), total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high-density lipoprotein cholesterol (HDL). Results: Frequencies of the major (G) and minor (A) alleles of usf1s2 gene variant were 0.74 and 0.26 in the whole population, respectively. Meanwhile, the prevalence of the minor allele was significantly higher in PCAD patients compared with control subjects. This difference remained significant even after adjustment for confounding parameters. Indeed, subjects with mutant homozygous genotype (AA) were about 5 times more likely to suffer from early-onset CAD than those with wild-type homozygous genotype (GG). Moreover, the baseline characteristics of the control subjects and patients were statistically similar for almost all parameters except for the number of male individuals there was no significant difference among various genotypes in the patient group for any of these investigated variables. Conclusion: It appears that the usf1s2 variant in upstream transcription factor 1 gene is an independent predictor of premature coronary artery disease in our population and applies its effects without affecting blood sugar and lipid levels.
Volume 75, Issue 10 (1-2018)
Methods: This cross-section study was done in April 2016. The study population was 95 patients, more than 30 year old with hypertension and chronic renal failure. Patients were selected from clinics of two private and university hospitals affiliated to Qom University of Medical Sciences Shahid Beheshti Hospital and Vali-e-Asr Hospital, Iran. Checklist containing data such as age, sex, duration of renal failure and cause of renal failure were filled. Serum creatinine and serum urea levels were measured and entered in the checklist. The circadian rhythm of blood pressure in all patients was assessed by Holter monitoring. patients who had less than 10% decrease in blood pressure overnight were considered non-dipper and those who had 10% or more decrease in blood pressure overnight were considered dipper.
Results: Average (SD) 24-hour ambulatory systolic and diastolic of blood pressure was 136.56 (16.66) and 84.84 (10.86) mmHg, respectively. 70 patients (73.7%) had non-dipper blood pressure pattern and 25 patients (26.3%) had dipper blood pressure pattern. There was no significant difference between two groups (dipper and non-dipper) based on distribution of gender (P=0.744), age (P=0.407), serum creatinine (P=0.569), serum urea (P=0.689) and renal failure duration (P=0.812). Mean of glomerular filtration rate in dipper group was 68.64±4.13 and in non-dipper group was 65.09±16.27 (P=0.337).
Conclusion: The results of this study did not show a significant relationship between circadian rhythm of blood pressure and renal failure severity. In addition, patients with chronic renal failure showed higher rates of non-dipping pattern of blood pressure.
Volume 76, Issue 2 (5-2018)
Methods: In the present case series study, 70 samples were chosen from the tumor Bank of Cancer Institute taken from patients at Imam Khomeini Hospital, Tehran, Iran. The amount of expression of two genes, E-cadherin and vimentin, was investigated by real-time PCR method from February 2016 to September 2017. The RNA extraction was done manually, and then cDNA synthesis was performed; In each sample the expression level of vimentin and E-cadherin was measured with real-time PCR method. The patient’s clinical information with other data were analyzed with nonparametric statistical methods in SPSS software, version 19 (SPSS Inc., Chicago, IL, USA).
Results: There was a significant relationship between expression of vimentin gene and the stage (P=0.026) of the disease and metastasis (P=0.009), There was no significant relationship between vimentin gene expression and tumor grade (P=0.207), age (P=0.11), tumor size (P=0.71) and family history (P=0.6). There was a significant correlation between E-cadherin gene expression and metastasis (P=0.027), no significant correlation was found between E-cadherin gene expression with tumor grade (P=0.690), stage (P=0.753), age (P=0.09), tumor size (P=0.537) and family history (P=0.56).
Conclusion: According to the changes in expression of vimentin and E-cadherin genes in ovarian tumor cells, and association between these two genes with clinical and morphological findings and the role of these genes in the migration and invasion, we can use the both genes, vimentin and E-cadherin, as genes involved in the EMT process to assess disease progression and incidence of cell invasion in ovarian cancer.
Volume 77, Issue 2 (5-2019)
Methods: In this case-control study, 30 samples including 15 samples of malignant prostate cancer and 15 samples of benign tumor were collected from the patients. RNA was extracted from the tissues, followed by cDNA preparation. In the last step, expression of GPRC6A, E.cadherin and ZEB1 genes was measured using the Real-time polymerase chain reaction (PCR) technique and the Relative expression software tool (REST), Version 2009 (http://rest.gene-quantification.info/).
Results: In this study, the expression of GPRC6A genes compared to its benign tumor increased 3-fold, ZEB1 expression in prostate cancer, compared to its benign tumor, increased 2-fold, and expression of E.cadherin gene in cancerous samples compared to benign tumor declines 10 was equal. In this study, there was no significant relationship between the expression of genes in benign and malignant samples with common diagnostic factors in this type of disease such as age, Prostate-specific antigen (PSA), pathologic stage and Gleason score.
Conclusion: According to this study and similar studies, increased expression of GPRC6A in prostate cancer cells can stimulate the progression of cancer cells by regulating cell proliferation and invasive response to various ligands. Increasing the expression of ZEB1 and decreasing the expression of E.cadherin is also due to the lack of binding of cells and spread of metastasis. As a result, tumors express ZEB1 with absence of E.cadherin is associated with advanced disease or metastases, which indicates that ZEB1 induces EMT and tumor progression in clinical cancers. Therefore examined genes have potential for screening prostate cancer and they can be used as a diagnostic marker for prostate cancer with further investigation.
Volume 78, Issue 4 (7-2020)
Methods: This qualitative and applied research was conducted in two comparative and analytical stages from May 2016 to February 2017 in Iran. The location of the study includes a university, research institute, health center, or research center known as a center of excellence. In the analytical stage, 10 experts and managers of the top centers were selected through a targeted sampling method as a study sample. In the comparative section, all 50 centers of excellence and similar specimens in the world were selected. The data collection tool was a semi-structured interview in the analytical section and the ministry of health's documents. In comparative section data, bases and official sites of the centers were analyzed.
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Results: The term "center of excellence" for units that play a role in one or two of the three dimensions of education, research, and treatment, and the term "comprehensive center of excellence" for a unit that plays a role in all three dimensions, in addition to knowledge management have been agreed upon. Seven missions (national and international) for the comprehensive center of excellence and five different missions for center of excellence were formulated. The role of the ministry of health in the guidance of these centers was agreed in the seven items. Ultimately, the macro model of organizing "comprehensive centers of excellence" and "centers of excellence" at the university level and ministry of health level was designed and presented.
Conclusion: Correcting the governance structure of these centers in ministry, unit command at the highest level of management by reorganizing of duties, the authority of High Council for the Center of Excellences and the establishment of a systematic relationship between ministry and vices are the part of the requirements for fulfilling the roles and mission of center of excellence. |
Volume 79, Issue 5 (8-2021)
Breast cancer is one of the most common types of cancer in women. Screening mammography is a low‑dose X‑ray examination of breasts, which is conducted to detect breast cancer at early stages when the cancerous tumor is too small to be felt as a lump. Screening mammography is conducted for women with no symptoms of breast cancer, for early detection of cancer when the cancer is most treatable and consequently greatly reduce the death rate from the breast cancer. Screening mammography should be performed every year for women age 45-54, and every two years for women age 55 and older who are in good health. A mammogram is read by a radiologist to diagnose cancer.
To assist radiologists in reading mammograms, computer-aided detection (CAD) systems have been developed which can identify suspicious lesions on mammograms. CADs can improve the accuracy and confidence level of radiologists in decision making and have been approved by FDA for clinical use. Traditional CAD systems work based on conventional machine learning (ML) and image processing algorithms. With recent advances in software and hardware resources, a great breakthrough in deep learning (DL) algorithms was followed, which revolutionized various engineering areas including medical technologies. Recently, DL models have been applied in CAD systems in mammograms and achieved outstanding performance. In contrast to conventional ML, DL algorithms eliminate the need for the tedious task of human-designed feature engineering, as they are capable of learning useful features automatically from the raw data (mammogram). One of the most common DL frameworks is the convolutional neural network (CNN). To localize lesions in a mammogram, a CNN should be applied in region‑based algorithms such as R‑CNN, Fast R‑CNN, Faster R‑CNN, and YOLO.
| Proper training of a DL‑based CAD requires a large amount of annotated mammogram data, where cancerous lesions have been marked by an experienced radiologist. This highlights the importance of establishing a large, annotated mammogram dataset for the development of a reliable CAD system. This article provides a brief review of the state‑of‑the‑art techniques for DL‑based CAD in mammography. |
Volume 79, Issue 7 (10-2021)
Methods: The Research performance of the faculty at all universities and institutes of medical sciences in Iran was assessed using the Iranian Scientometric Information Database (ISID) on June 12, 2021. Selected variables in our study were name, gender, university, degree, academic rank, type of faculty, the total number of articles, the total number of citations, self-citation percentage, h-index, citation per article, international cooperation percentage, and the number of research collaborators. The Kruskal-Wallis test was used. The extracted data were analyzed using R v4.0.1 statistical software.
Results: A total of 21064 faculty members in 77 universities and institutes of medical sciences were registered in the ISID database, of which 12093 (57.4%) were men. Men faculty members outnumbered women in all academic ranks, except for the “instructor” rank (1134 female instructors against 835 male). In both sexes, most faculty members were assistant professors. There were more articles (346837 vs. 146024) and citations (5177060 vs. 1639246) by men than women. Among the 1789 faculty members with zero articles, 902 (50.4%) were men. One-hundred-and-fifty-four people were among ESI's top researchers' list, with a majority of men (124 people equal to 80.5%). The medians of all the scientometric indicators were higher in men than women. Men had a higher number of articles, the number of citations, h-index, citation per article, percentage of international articles, and co-authors, however, women had lower self-citations (1.56% vs. 2.51%). In all academic ranks, men had higher scientometric indicators. The only exception was the associate professors’ self-citation, in which women’s citations were higher than that of men (3.5 vs. 3.3). The highest mean h-index was in men with a Ph.D. in Pharmacy (13), men with a Ph.D. by Research (12) and women with a Ph.D. by Research (8.5), respectively.
Conclusion: Gender differences were evident in research performance in Iran. Women faculty members of medical sciences in Iran generally had lower scientometric indicators.
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