Tehran University Medical Journal

---

Amount of environmental lead pollution is increased with progression of industry. This pollution is able to damage the living beings in many ways. Blood and Immune systems are more sensitive to toxic effects of lead. 30 female and 6 male rats from Sprague dawley race are chosen by simple random sampling. After copulation and vaginal plug observation, expectant rats are calssified in test and control groups. Since the first day of pregnancy, test group is given a drink containing lead acetate 0.13% in distilled water and control group is given distilled water. After delivery, for ultrastrectural studies, spleen specimens of newborn rats are fixed in glutaraldehyde solution 2% and after processing are studied by T.E.M. Sinusoidal endothelial cell show: morphological changes in mitochondria, appearance of primary & secondary lysosomes and multivesicular bodies and swelling in ER. It seems that these changes are caused by interaction of lead with enzymathic functions or lead accumulation in these cellular organels.

---

Between 270 patients complaining of symptoms of vaginitis, bacterial vaginosis was diagnosed in 68 women (%25) based on at least three of four criteria: 1. Homogenous vaginal discharge 2. Positive amine test 3. pH more than 4.5 4. Clue cell in wet smear. The results were compared to 55 normal controls.
Clue cell with more than %20 of epithelial cells was seen in %87 of cases and %5.5 of controls. A pH more than 4.5 showed the greatest sensitivity (%100) and the smallest specificity (%47). The most frequent complaints included increased discharge, bad odor, and sensing bad odor after coitus.

---

Mycosis Fungoides (MF) is a cutaneous T-cell lymphoma (2,5). Alopecia is rarely seen in this disease, and the reported cases are in the form of follicular mucinosis (1,2,4). In this case report a patient is presented whose lesions all showed alopecia without mucinosis. Furthermore there was a patch of alopecia without any epidermal changes, which was clinicaly identical with alopecia areata, and histologically identical with MF. After six months of treatment there is regrowth of almost normal hair on all of the lesions

---

Our purpose was demographic clinical and pathological aspect of BCE in patients seen in Razi Hospital, during a six-month period (75.8.12 to 76.2.12). Results: From the total 20000 patients, 103 cases of BCE were detected. (0.5%). The male female ratio was 1.71 BCE was more frequent in sixth decade. 40.8% of patients were fair skin (Type II), 54.4% tawny (Type III) and 4.9% brown (Type IV, V). 15.5% of patients had a past history of freckles and history of radiotherapy in childhood was present in 41.7% 89.3% had no history of acne and seborrhea. The scalp was the most common site of BCE. The most common clinical type was nodular BCE and solid BCE was the dominant histological feature. Conclusion: BCE was more common in male and fair skin patients with dry skin. In those having history of radiotherapy of the scalp, lesions were seen mostly on the scalp, forehead and neck: pigmented BCE was predominant in this group.

---

Brucellosis is a multisystem disease with diverse clinical presentations and involvement of the nervous system is considered to 5 to be 10% in adult patients and 1% in children. The presentations of neurobrucellosis includes meningoencephalitis, subarachnoid haemorrhage, myelitis, radiculoneuritis, intracerebral and epidural abscess, psychosis and vascular syndrome. Twenty-two patients with neurobrucellosis are described. Ten patients had meningoencephalitis, seven patients had meningitis, three patients had polyradiculopathy and one patient presented with spinal epidural abscess and one patient had brain abscess. Results of an agglutination test for Brucella in serum were positive for all patients (>1:160) eight of 15 patients had positive agglutination test in CSF. Five patients had positive blood cultures, 3 patients had positive bone marrow cultures and 2 of 15 patients had positive CSF cultures. All of cultures were Brucella Mellitensis. Antimicrobial treatment included concurrent administration of Doxycycline, Rifampin and Trimethoprim-Sulfametoxazole. Four patients received Dexamethason concurrently. In conclusion, nervous system involvement is a serious manifestation of brucellosis. As brucellosis is an endemic disease in Iran we suggest that brucellosis be investigated with neurological symptoms and signs.

---

Squamous cell carcinoma, a cancer of keratinocytes origin, mostly involves sun-exposed areas of the skin. To study the pathologic and demographic features of this disease, records of 395 patients of squamous cell carcinoma of skin and lip were reviewed. Most of the patients (83%) aged 40 years or more at the time of diagnosis. Respectively, 74.4% and 75.8% of cases with skin and lower lip carcinoma were men, but in upper lip cases frequencies of both sexes were equal. The number of patients referred from western and north-western provinces were much more than those of other provinces of the country. The most frequent histologic stage was grade I (53% and 58.8% in skin and lip carcinoma, respectively), showing that most patients visit physicians early enough, and are diagnosed in early stages of the disease.

---

?2 microglobulin (?2M) fibril has been recognized as the major factor of dialysis-related amyloidosis. Elevated serum levels are thought to be the basis for tissue deposition. In order to evaluate the effect of cellulosis membrane (FB 110) and treatment duration on S?2M levels, we determined serum levels in 23 hemodialyzed patients with end-stage renal failure. S?2M levels were markedly elevated in all patients with a mean of 74.71 (SD=21.2 mg/l, range: 46 mg/l after 2 years hemodialysis-123.8 mg/l after 10 years treatment) that statistically is higher than healthy subjects (P<0.0001). Serum ?2M in 19 healthy subjects was 2.36 (SD=0.4 mg/l, rang: 1.58-3.3 mg/l). Although in hemodialysis group, no significant correlation was found between S?2M and age or sex but increased serum levels of ?2M had significant correlation with duration of hemodialysis treatment (r=0.53, P<0.01). Since the dialysis membrane has a very effective role in clearance of S?2M, we suggest that the particular effort should be made towards improvement of dialysis membranes.

---

Zinc has an important role in skin health and its deficiency reduces immunity. To evaluate levels of Zinc in squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) of skin, we studied 44 BCC and 38 SCC cases together with 33 controls. Blood samples were taken and after separation of serum, levels of Zinc, albumin and total protein were measured by atomic absorption, albumin kit and reflectometer consecutively. Serum globulin levels were stimated by substracting albumin from total protein levels. Zinc levels were significantly lower in cancer cases than control (P<0.001). Mean serum albumin of BCC cases was significantly more than controls (P<0.01), but in BCC cases was not significantly different. Significant correlations were seen between levels of serum Zinc and albumin of SCC (R=0.507, P<0.01) and BCC (R=0.43, P<0.01) patients and controls (R=0.35, P<0.01). Mean globulin levels in cancer cases were significantly lower than control group (P<0.01). We concluded that serum Zinc and globulin levels decrease in BCC and SCC of skin.

---

Non-Hodgkin's lymphoma is the 3rd most common cancers in children. In the present study, to determine pathological and clinical features of this cancer, we reviewed records of 84 cases of non-Hodgkin's lymphoma who were admitted to Ali Asghar and Bahrami children hospitals from 1989 to 1996. 59% of cases had small non-cleaved cell (SNCC) subtype of disease. 15% were lymphoblastic and 5% diffuse large cell subtype. The most prevalent primary sites were abdomen and lymph nodes. The most prevalent symptoms were abdominal mass (34%), abdominal pain (37%) and cervcal lymphadenopathy (26%). Over half of our patients were small non-cleaved cell subtype, and further studies should be done to find out reasons for this unusual finding.

 

 

---

Although cellular immunity involving activated macrophage is important in resistance to Brucella infections, serum factors and polymorphonuclears (PMNs) play some role in the initial responses to Brucella infections. In this research, we studied respiratory burst of PMNs against opsonized yeast and opsonized inactivated Brucella melitensis in chronic Brucellosis patients and controls with no previous history of Brucellosis. A group of 41 patients and another group of 20 blood donors as control, were included. The other 2 groups included 10 cases and 6 controls. Mean responses of PMNs of patients and controls to opsonized yeast were 110.3 and 129.3 milivolt respectively and the difference was not statistically significant. No statistically significant difference was observed between respiratory burst of PMNs exposed to inactivated Brucella in 10 patients with chronic Brucellosis (Mean 67.2) and 6 control blood donors (Mean 112.5), so we concluded that inactivated Brucella melitensis can't inhibit activity of myeloproxidase enzyme.

 

---

Considering the incidence of meconium-stained amniotic fluid (MSAF) in newborns and its complications, and also based on indirect reports pointing out relationship between nucleated red blood cell (nRBC), as a marker of chronic hypoxia, and MSAF in term newborns, and in order to determine this relationship more accurately, this study was done on women with uncomplicated singleton term pregnancy that admitted for delivery at Shariati hospital in year 2000. After excluding confounding factors on nRBC, case group who includes infants with MSAF, and control group who have clear amniotic fluid were determined. Maternal age and parity, gestational age, birth weight, apgar score, neonatal out come, and FHR pattern as well as newborn hemoglobin values were evaluated. Venous cord blood was analyzed for nRBC counts per 100 WBC. Case and control groups were divided according to nRBC counts with cutoff point of 10 and then compared statistically. From the samples, 117 cases and 67 controls were evaluated. Maternal and neonatal factors were similar in two situations. Number of nRBC was 3.75±4.8 in control group and 12.04±11.7 in case group (P<0.01) and it was abnormal (>10) in 9 percent of newborns with clear fluid and 32 percent of MSAF (P<0.01). Cord blood nRBC count increased when meconium is passed intrauterine. This suggests that cases with MSAF may be at risk of chronic hypoxia. Cohort research is recommended to study the affect of delivery mode on the neonatal outcome in cases with MSAF and to evaluate the cause of fetal hypoxia in uncomplicated pregnancy with MSAF.

---

Testicular germ-cell tumors are the most common malignancy among men aged 20-40 years, and 60 percent of them are seminomas. These tumors are now an important socio-economic problem, considering their growing incidence. Thus we undertook to evaluate the results of curative irradiation in our testicular seminoma patients and compare them to literature results considering the use of cobalt-60 systems in our department (in contrast to the use of linear accelerators). All testicular seminoma cases referred after orchiectomy to Radiation-Oncology Department of Tehran Cancer Institute and treated curatively during the 12-years period of 1987-1998 were reviewed. These included 147 patients. The results showed a mean age of 34.5 years. Eighty-six patients (58.5 percent) were in stage I, 57 (38.8 percent) in stage II and 4 (2.7 percent) in stage III. With a mean follow-up time of 53.5 months (range 2-158 months) after radiotherapy, there were 12 (9 percent) local relapses and 8 (6.5 percent) distant metastases among the 122 patients who came back for follow-up. The 10-years overall survival was 97.9 percent and disease-free survival 79.7 percent (life-tables). Mean overall and disease-free survival time was 155 and 133 months respectively, with a median survival time of more than 158 months (Kaplan-Meier). The only significant prognostic factor was stage of the disease (P=0.01), though lactate dehydrogenase (LDH) was significant only in multi-factorial analysis (P=0.02). In conclusion, our survival figures were all favorably comparable to literature results, considering the higher ratio of stage II in our patients. We recommend training of young men for testicular self-examination and a greater attention to LDH measurement, and hope for installation of linear accelerators in our department to further improve the treatment results with less side effects.

---

Ectomesenchimal cells, placed near the embryonal tube, migrate to down and share in facial and cardiac structures. Migration or differentiation disorders of these cell causes cleft lip/ or palate and congenital heart disease (CHD). This item was performed to determine co-appearing of cleft and CHD and to know adjutant factors to that for better management of these patient.
Materials and Methods: Two hundered children with cleft lip and palate were registered. Finding was analyzed by fisher's exact text and chi-square tests.
Results: CHD is ten times of normal population in this research (p< 0.01 and odd ratio 10.39) and incidence of CHD in cleft is high in cleft patient if another congenital animalies were presented (p< 0.001, odd ratio 5.18).
Conclusion: By attention to higher incidence of CHD in cleft patients, it is advised to cardiologist consulting before cleft surgery for better managing.

 

---

Obstructive cholestasis is associated with overproduction of endogenous opioids (EOP), nitric oxide (NO), and cytokins in the blood streams. Therefore we investigated the relationship between obstructive cholestasis and function of germ cells in adult male rats.
Material and Methods: To study this, we used three groups of animals: No-surgery, Sham-surgery, and surgical ligation of the bile duct. After 3 weeks all animal were killed by ether, serum concentrations of FSH, LH and testosterone were determined by Radioimmunoassay, apoptosis was evaluated by DNA fragmentation detected by in situ terminal deoxynucloetidyl Transfrase-mediated dUTP nike end labeling (TUNEL).
Results: The mean of FSH level in cholestatic, control and sham groups were 13.22+ 1.038, 18.14+ 1.276, and 16.92+ 1.072 ng/ml, respectively. The mean of LH level in cholestatic, control and sham groups were 0.83 + 0.21, 2.058 ± 0.26, and 1.84 + 0.17 ng/ml, respectively. In addition, the mean of testosterone level in cholestatic, control and sham groups were 1.52 ± 0.16, 2.41 ± 0.18, and 2.31 + 0.14 ng/ml, respectively. The results of this study were indicated that serum FSH, LH and testosterone were significantly lower in cholestatic than control and sham groups (p=0.0195, P= 0.0029, and P=0.0023, respectively). However there was no significant difference in apoptotic index between all of groups (P=0.195). The apoptotic index in cholestatic, control and sham rats were 9.897± 1.374, 7.086 + 0.91, and 7.729 + 1.101, respectively.
Conclusion: These findings have been shown which as obstructive cholestasis was decreased the levels of serum gonadotropins and testosterone but it has no significant effector testicular germinal cells apoptosis.

 

---

Background: Vitamin C is a major antioxidant in lung airways and also functions against external insulting oxidant sources such as smoke and environmental contaminants. The aim of study was to assess the vitamin C in asthmatic patients, by it’s measurement in plasma and white blood cells (WBC).

Materials and Methods: In a case–control study 50 asthmatic patients and 50 healthy person were randomly selected. The data were obtained by utilizing socioeconomic questionnaire and 24 hour dietary recall. l0 c.c blood samples were drawn. Plasma and WBC vitamin C concentration were measured colorimetrically. The data were analyzed by FPI and SPSS software.

Results: The results indicate that 38 percent and 92 percent of patients had deficient plasma and WBC vitamin C concentrations respectively. There was a significant difference in plasma and WBC vitamin C concentrations among patients and control group (P<0.0001) Analysis of regression showed that a significant dependence was observed between the duration of asthma and plasma vitamin C status (P=0.03), though a positive significant correlation was obtained between plasma vitamin C status and dietary vitamin C intake (P=0.0001, r =0.56), The interaction of socioeconomic parameters and vitamin C concentration in asthmatic patients in this study was not significant .

Conclusion: Present study indicates that while there is an association between vitamin C status and asthma but WBC vitamin C status is more sensitive in this regard and deserves further study and consideration.

---

Background: Hematopoietic stem cell (HSC) transplantation has brought the possibility of the use of high dose chemotherapy in the treatment of malignant hematopoietic diseases. Short-term HSC preservation at 4˚C is the most common method for autologous peripheral blood stem cell transplantation (PBSCT).

Materials and Methods: Thirty-seven mobilized PBSC samples from thirteen hematological patients (4 AML, 4 MM and 5 Lymphoma cases) who were selected for autologous PBSCT and 24 normal candidates for allogenic PBSCT were preserved in five separate sterile 2 ml tubes in 4˚C. Each sample was evaluated for total nucleated cell (TNC) count, dye exclusion cell viability and Granulocyte-Macrophage colony forming unit (GM-CFU in semisolid medium after 16 days) in days 0, 2, 4, 6 and 8. The results were converted to percentages of day 0 measures. The data were analyzed by SPSS 10.0 using Paired Samples T test, Independent Samples T test and Regression.

Results: The mean percentages (and standard deviations) of TNC count, cell viability and GM-CFU for days 0, 2, 4, 6 and 8 are shown below: No significant correlation was found between age, sex, weight and the kind of donor with TNC, viability and GM-CFU.

Conclusion: In this study, we have found that during storage of mobilized PBSC in 4˚C, TNC count and cell viability still remains higher than 70% after eight days, while GM-CFU decreases more rapidly and falls to less than 50% after day 4.Therefore, TNC count and cell viability do not decrease as fast as GM-CFU.

---

Background: Role of cytokines in regulation of immune system has been the subject of studies and clinical investigations. One of these cytokines, IL-2 has been well initially introduced as T cell Growth factor (TCGF), but subsequently it appeared that IL-2 is one of the important mediators affecting growth, development and activity of T, B, NK and LAK cells. Nowadays this cytokines has extensive use in clinical and research fields of immunotherapy of cancer and infectious disease.

Materials and Methods: In this study, we used Jurcat cell line for production and partial purification of IL-2 106 cell/ml were stimulated by PHA (1 µg/ml) and PMA (10 µg/ml) at the third day of the culture and then supernatant were collected after 22 hrs.

 Results & Conclusion: In order to obtain sufficient amount of IL-2 and eliminate interfacing materials, supernatants were concentrated using Amicon 10 and 30 PM filters. After concentrating, bioassay and Elisa were performed to detect the biological activity and amount of produced IL-2. Reversed phase-HPLC was used to confirm the IL-2 identity and purification.

---

Background: This study was performed to investigate the rate of inner cell mass of blastocyst which obtain from culture of mouse two cell embryos in presence and absence of recombinant of human leukemia inhibitory factor.
Materials and Methods: ICR female mice that were between 6-8 weeks old received intra peritoneal injection of 7.5 IU of pregnant mare serum gonadotropine for super ovulation, this was followed by intra peritoneal administration of 7.5 of hCG 46-48 hours later. The mice were then mated to mature ICR male mice and were checked for vaginal plug 20 hours later. Female mice were killed by cervical dislocation 48-50 hours after hCG administration and after washing and flushing of the oviduct from the proximal end of the oviduct, two cell embryos were selected and collected by 100 microscopy. All two cell embryos were randomly divided in 4 groups (Groups A, B C and D) and culture in special media. Groups A: KSOM+AA, Groups B: KSOM+AA 500 IU/ml LIF. Groups C: KSOM+AA 1000 IU/ml LIF. Groups D: KSOM+AA 1500 IU/ml LIF media until 120 hours in Co2 incubator .After that time all blastocysts collected and the number of ICM was assessed by differential staining technology.
Results: The rates of ICM of blastocysts which obtain from groups A, B, C and D were 19 2.6, 28 4.4, 24 2.1, 26 2.2 respectively. This data indicated that the rate of ICM in groups B, C and D was statistically higher than group A (P=0.02) and also there was not statistically different between three groups of B, C and D.
Conclusion: Briefly leukemia inhibitory factor can improve the rate of ICM of blastocyst and we suggest that this factor is better added to blastocyst culture medium.

---

Background: In this study we evaluated the treatment of giant cell tumor (GCT) of long bones using cryosurgery combined with curettage and polymethylmetacrylate (PMMA) cementing.
Material and methods: From January 1999 to December 2004, twenty patients (mean age at the time of surgery 29.2 years) 13 females and 7 males were included in the study. Cortical disruption were presented in 7 patients 4 with soft tissue extension, but none of them had intra-articular extension of tumor, 3 patients presented with pathologic fracture of distal femoral lesions. These tumors were located in distal femur in 6 patients, proximal tibia in 7, distal radius in 3, proximal femur in 2, and each of proximal humerus and distal ulna in one patient. In each case diagnostic biopsy was done and surgical procedure performed including curettage, power burr of the wall, cryosurgery with liquid nitrogen and finally filling the space with PMMA cementing. The mean follow-up was 34 months (7 to 61 ).
Results: During follow-up, we observed one recurrence of GCT of proximal tibia. Secondary Aneurysmal bone cyst was reported at the site of one primary distal femoral lesion, without any finding in favor of a recurrence. Neurapraxia of the proneal nerve was occurred in one patient with proximal tibia tumor improved after 8 months.
Conclusion: Cryosurgery combined with power burr and PMMA cementing in the treatment of GCT could be an effective approach in tumor eradication. This method obviates the need for extensive resections and reconstructive procedure.

---

MicroRNAs form a class of small non-coding RNA molecules. With only 21-23 nucleutide in length, they have an important role in gene expression. These molecules bind to their target mRNA molecules and repress the protein expression via mRNA degradation or blocking the translation machine of the cell. From the advent of molecular biology microRNA molecules were out of focus, however huge amount of studies in the past few years revealed a lot of facts about their nature. Nowadays around 1600 different microRNA are discovered in human, animals, plant and even viruses. In this review article the most recent data in the history, genes, expression and process of these molecules are introduced. Furthermore, the findings about diverse roles of these molecules in normal and abnormal conditions, cancer in particular, are shown. Finally, the differences to siRNA molecules and the prospect of microRNA have been explained.