Tehran University Medical Journal

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Background: Pulmonary TB is still the most common form of the tuberculosis in HIV infected patients with different presentations according to the degree of immunosuppression. The aim of this study was to investigate the impact of HIV infection on the clinical, laboratory and radiological presentation of tuberculosis.

Methods: We compared 80 HIV negative pulmonary TB patients with 40 HIV positive pulmonary TB patients during 1999-2005 in a teaching hospital of Tehran University of Medical Sciences, Iran.

Results: Tuberculosis was more common in men in both groups. The mean age of HIV positive patients was lower than HIV negatives (35.95+/-10.4 versus 46.95+/-20.39, P =0.002). Weight loss and chronic cough were significantly more frequent in HIV negative patients (76.3% vs. 45% p<0.001 and 93.8% vs. 80%, P<0.05 respectively), whereas fatigue were more prominent in HIV positives (45% vs. 21.3%, P< 0.001). Cavitations and infiltrations were reported in the CXR of HIV/TB patients less than HIV negative patients (OR=0.21, 95% CI: 0.05-0.97, P= 0.01 and OR=0.27%, 95% CI: 0.09-0.75%, P =0.02 respectively). Primary involvement pattern was observed more than secondary involvement in HIV/TB group (OR=3.95, 95% CI: 1.73-9.03, P =0.001). The laboratory findings in HIV/TB patients were as follows: more negative PPD skin (75% vs. 50%) tests, higher ESR (86.5% vs. 63.7%), lower mean Hb (10.6 vs. 12.4) and lower mean leukocyte (6545 vs. 9195) and lymphocyte count (1281 vs. 1838). In all of the above mentioned findings the differences between two groups were significant. Fourthy Seven% of patients had Lymphocyte count less than 1200 which means they were in AIDS stage.

Conclusion: Immune system suppression in HIV can alter the clinical, laboratory and radiological features of tuberculosis. It is crucial to consider tuberculosis in differential diagnosis of every HIV patients with respiratory symptoms.

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Background: Vitiligo is a common acquired disorder characterized by depigmented cutaneous patches devoid of melanocytes. The disease carries a risk for ocular abnormalities. Few reports are available about the ocular findings and their possible association with the disease in patients with vitiligo in the literature.

Methods: A total of 72 patients with previously documented cutaneous vitiligo were examined for ocular findings and 50 healthy individuals were enrolled as the control group in Razi Hospital in Tehran, Iran during years 2007-2008. Demographic features including age, gender, duration of the disease, presence of any accompanying autoimmune diseases, type of vitiligo and its anatomical distribution were recorded to investigate a possible association between the disease and the ocular findings.

Results: Amongst 72 patients with vitiligo, 11 (15.3%) had ocular findings including retinal pigment epithelium hypopigmentation, posterior pole pigment changes, peripheral iris atrophy, atrophy of retinal pigment epithelium and iris hyperpigmentation. Amongst the controls, only two cases (4%) had ocular findings which consisted of iris hyperpigmentation. The relationship between ocular findings and vitiligo was statistically significant (p= 0.04). No other remarkable features, such as age, gender, age at the onset of the disease, type of vitiligo, presence of priorbital lesions or body surface area involvement by the disease, were suggestive of an association or presenting a risk factor for vitiligo.

Conclusion: Although the sample size and prevalence of ocular findings were not satisfactory enough to make a definite conclusion, we found a higher occurrence of ocular findings in patients with vitiligo than the control group.

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Background: Breast cancer is the second most common cancer in the world after lung cancer also is the fifth cause of cancer mortality. About 90 percent of cancer mortality is because of metastasis and devastating between cell attachments, especially tight cell junctions. Epithelial mesenchymal transition is a phenomena involved in metastasis and starts with cell detachment. Occludin is the integral membrane protein which is located in tight junctions. Obviously distressing tight junction, which facilitates the stages of metastasis in cancer cells are very critical step. The aim of this study was to demonstrate the importance of occludin expression and its relationship with invasiveness in human breast cancer. Methods: In a cross sectional study we evaluated 30 patients who were referred to Caner Institute of Imam Khomeini Hospital Complex, Tehran, Iran, from March 2013 to April 2013. Samples were derived from fresh frozen tumor of patients suffering from breast cancer after inform consent assignment in the Tumor Bank of Iran (TBI). RNA was extracted from tumor tissue followed by reverse transcription, polymerase chain reaction (PCR), conventional Real-time PCR and data analysis for the occludin gene expression. Data were analyzed based on clinical staging of breast cancer patients which were cited in data bank of TBI. Results: Results of this study have demonstrated that the occludin gene expression was increased with the advanced stage. In 22 of patients the expression of gene was elevated compared with normal samples. On the other hand, the expression was significantly increased in stage II in comparison with stage I. Conclusion: The expression of occludin has increased by elevation of stage compared with normal tissue. It is suggested that alteration in the expression of this gene might be a possible factor which could affect on patient’s prognosis the same as other factors which are belonging to the same family. Increasing in expression of this gene might be considered as one of the possible markers which predict the possibility of invasion and metastasis.