Avicenna Journal of Clinical Medicine
Year:2006 | Volume:12 | Issue:4 (SN 38)|Papers Count:14

Introduction & Objective: Telomerase is a reverse transcriptase enzyme that is required in immortalized cancer cells. Early detection of telomerase activity in tumors particularly in bladder cancer is promising. The aim of this study was to compare specificity and sensitivity between cytology and telomerase activity in diagnosis of bladder cancer.Materials & Methods: This study was a case-control study and carried out on 33 patients with bladder cancer as case group and 33 patients without bladder cancer as control group who referred to urology clinic in Imam Teaching Hospital of Uremia University of Medical Science From all of the patients two consecutive fresh urine samples were obtained before any interventional treatment for purpose of urine cytology and measurement of telomerase activity. The activity of telomerase enzyme was measured using telomeric repeat amplification protocol (Trap Assay) based on polymerase chain reaction and Elisa systems. Results: Sensitivity of urine cytology was 30% in grade I tumors, 83% in grade n and 52% in grade three tumors. Sensitivity of telomerase enzyme activity was 80% in grade I and 100% in grade n and III tumors. Total Sensitivity of urine cytology was 51.5% and telomerase sensitivity was measured 93%. Also Total specificity of Telomerase enzyme activity was 87.5%. Telomerase enzyme activity and urine cytology weren't positive in any of the patients without bladder cancer.Conclusion: It is speculated that telomerase activity significantly increase in bladder cancer patients and it is more sensitive than conventional urine cytology method. Measurement of telomerase activity could be a favorable biomarker in bladder cancer diagnosis.

Introduction & Objective: Stroke is the third most common cause of death in the world, and it is also a major cause of longterm disability. The most promising strategy to reduce the stroke is prevention and the success of this prevention strategy depends, however, on identifying and controlling all important causal and modifiable. risk factors. A previously emerging risk factor for stroke, which is prevalent and modifiable and may be causal, is elevated plasma homocysteine. The author of this study hypothesized that elevated homocysteine (Hcys) is a risk factor for all of stroke subtypes in which atherosclerosis plays a primary role.Materials & Methods: This case-controlled study included 58 patients (33 men and 25 women) with stroke who were admitted to a university teaching hospital in Hamadan. The control group consisted of 103 randomly selected subjects (60 men and 53 women) with a mean age of 50 years who did not have a stroke. Both groups of patients provided a history of their vascular modifiable risk factors, effectiveness factor in plasma Hcys level Then analyzed fasting blood samples, for plasma Hcys levels.Results: Compared with control subjects, ischemic (n=44), and hemorrhagic (n=14) strokes had higher geometric mean values of total Hcys and higher proportions of Hcys³11.0 µmol/L that was significant.Conclusion: There is a significant association between elevated Hcys and all of stroke subtypes.

Introduction & Objective: Leptin is considered to play an important role in the regulation of body weight and metabolism. Many studies have shown an association between BMI and leptin concentration. Our study compares the relationship between plasma leptin levels and risk factors for CHD in patients with type 2 diabetes and non-diabetic controls. Materials & Methods: A total of 88 patients without diabetes (group A) were compared with 17 diabetic subjects (group B). Patients with CHD; according to myocardial perfusion scan results, renal, thyroid and hepatic disorders were excluded from the study. After a 12-hours overnight fast, blood samples were obtained. Plasma was immediately separated for laboratory measurements: Plasma leptin levels were measured with radioimmunoassay (RIA) kit.Results: The mean age for 88 non-diabetic subjects and 17 diabetic patients didn't have differences. Frequency of smoking and BMI mean score were significantly higher in diabetic patients. There were no differences in leptin levels in two groups. A close relationship between BMI and leptin levels was observed.Conclusion: Leptin concentration didn't show correlation with CHD risk factors except for BMI in diabetic and nondiabetic subjects.

Introduction & Objective: Hearing loss is the most prevalent form of sensory impingent in humans, affecting approximately one in 1000 infants. In more than half of the cases, the deafness is inherited, and about 80% of hereditary deafness transmitted by autosomal recessive pattern. In hereditary congenital deafness, numerous mutations in GJB2 make the largest fractional contribution in many world populations. The GJB2 gene locus was identified in long arm of chromosome 13 (13q 11-12).Materials & Methods: In this study, we investigated 76 probands (152 chromosomes) of 76 families from Hamadan Province, suffering from severe to profound non-syndromic deafness, to determine the frequencies of GJB2 mutations. All samples were screened for 35delG mutation in GJB2 gene by allele-specific PCR (ARMS-PCR). Study was terminated for those who were homozygote for 35delG mutation. DHPLC analysis had been done on others to find abnormal elution profiles, followed by direct sequencing on samples with abnormal elution profiles.Results: We identified allelic variants and mutations in exons 1 & 2 of CX26 (35 delG, R127H, V27I, V153I, E114G, -3170G>A). Interestingly we found a novel frame-shift mutation (507insAACG), that was not reported before in related medical literature. Also we detected a previously reported complex allelic variant "V27I; EI14G/wt. 11 persons carried the 35delG allele (8 homozygote, 3 heterozygote), 2 cases were compound heterozygote for 35delG/wt and 3170G>A/wt and I proband showed the V27I;EI14G/wt mutation. Conclusion: Based on these data, GJB2 mutations account for approximately 18.1% of severeto-profound congenital deafness in the Hamadan population, and the most common of this mutation is 35delG.

Introduction & Objective: Both CD4+ type 1 helper (Th1) cells and CD8+T cells play effective roles in protection against Mycobacterium tuberculosis infection. DNA vaccine encoding MPB51 can induce Th1-type immune responses and protective immunity upon challenge with M.tuberculosis. This study address to identify T-cell immunodominant epitopes on MPB51 in C57BL/6mice.Materials & Methods: We cloned DNA encoding MPB51 molecule in pCI plasmid. After constructing MPB51 DNA-covered gold cartridge, C57BL/6 mice were immunized by using a gene gun system. Two weeks after the last immunization, the immune spleen cells were cultured in the presence of a synthetic overlapping library peptides covering the mature MPB51 sequence or medium alone. Intracellular and cell culture supernatant gamma interferon (IFN-γ) production was analyzed using flow cytometry and ELISA, respectively. Results: Mapping of T-cell epitopes on MPB51 molecule was performed in the spleen lymphocytes restimulated by 20-mer overlapping synthetic peptides of mature MPB51 sequence. Flow cytometric analysis with intracellular IFN-g and the T-cell phenotype revealed that P171-190 and P191-210 peptides contain immunodominant CD4+T-cell epitopes. Further analysis by using T-cell subset depletion and serial peptide dilution revealed that P171 and p191 are H2-Ab-restricteddominantand subdominant CD4+T cell epitopes, respectively.Conclusion: This study proved that vaccination with plasmid DNA encoding M. tuberculosis-secreted MPB51 protein not only induce CD4+T cells immune response but also is an appropriate method for identifying immunogenic peptides.

Introduction & Objective: Melanocytic nevi are very frequent and there is a relationship between these nevi and malignant melanoma. So we need to know the prevalence and kinds of these nevi in our country. The aim of this study was to clarify the prevalence and kinds of melanocytic nevi in rural areas of Hamadan in the west of Iran.Materials & Methods: A cluster random sampling was followed. The survey included 9450 rural inhabitant of all ages and both sexes from representative of 33 villages of Hamadan. The data were collected through personal interview and examination at homes in 2002.Results: This study showed melanocytic nevi in 88% of population, lentigo in 50%, freckling in 12.7% and cafe-au-lait spots in 6.7% of studied subjects. The range of age in the patients was 1-75 years with the mean of 35.7 year.Conclusion: Due to relation of melanocytic nevi with malignant melanoma avoiding sun exposure and health education are important, especially for high risk people.

Introduction & Objective: Abuse of anabolic steroids in body builders and competitive sports (doping) is common and prevalent in our country. Due to disagreement about cardiovascular side effects of these drugs and existing controversy in published articles, this study was designed to evaluate the echocardiographic finding in athletics who are current user of these drugs.Materials & Methods: Body builders with continues sport for preceding year and at least twice weekly selected and divided into steroid abuser and not abuser and compared with age and BMI matched non athletic healthy volunteers.Results: There was not significant difference in age, body mass index, ejection fraction, ventricular compliance and valve function between three groups. But diastolic size of septum and free wall is significantly thicker in both of athletics in comparison with non athletic volunteer but observed differences were only significant (P value=0.05) between first and third group. The difference between the above mentioned index was not significant between two groups of athletic.Conclusion: Observed differences in diastolic size of septum and free wall between first and third group and also absence of difference between two athletic groups is in favor of that long term abuse of anabolic steroid (more than one year) results in augmentation of physiologic hypertrophy due to isometric exercise. Furthermore long term abuse and supra pharmacologic dose does not have significant effect in size and left ventricular function.

Introduction & Objective: Post operative nausea and vomiting are more common in females and pregnant patients. Pregnancy induced changes increases the risk of nausea and vomiting and aspiration after general anesthesia. Promethazine a HI-receptor antagonist is a phenothiazine with prominent antiemetic property. This study was done to determine the effectiveness and side effects of promethazine for prevention of post operative nausea and vomiting in women after general anesthesia for cesarean section.Materials & Methods: The 101 ASA status I or II women undergoing cesarean section , were prospectively and randomly allocated to receive either 1 cc promethazine (25 mg) (n=51) or 1 cc placebo (n=50) at the induction of anesthesia. Techniques of anesthesia and administered drugs were similar and doses were in the base of body weight in both groups. The occurrence of post operative nausea and vomiting and use of drug for treatment and probable side effects of promethazine were recorded blindly in the recovery room and 12-24 hrs post operative period. Demographic data did not have differences between two groups.Results: The incidence of post operative nausea and vomiting was identical in two groups and had not meaningful difference. The score of sedation was increased considerably in promethazine group (P=0.029).Conclusion: Promethazine did not significantly decreased post operative nausea and vomiting versus placebo (P=1, P=0.67).

Introduction & Objective: Hydatidosis, a disease caused by the cestod helminth echinococcus granulosus, is one of the most important parasitic zoonosis in man and a variety of animals. Sensitive and reliable serologic methods are necessary to confirm the diagnosis. In this study, Ag B and Psc Ag were purified as two specific parasitic antigens and evaluated by Dot blotting used on the serum of hydatidosis patients and control group in order to identify the most sensitive and specific subunits.Materials and Methods: In an analytic and comparative study, serum samples collected from 22 patients under operation of hydatid cyst. As a control group, 4 patients with acute toxoplasmosis, 4 patients with leishmaniasis, 4 patients infected by non-hydatid cestods (Tenia saginata and H.nana) and 4 normal subjects were included in this investigation. Infected sheep's liver and lung were used for the preparation of antigen. Cyst fluid containing protoscoleces was extracted and then partially purified with a protein A column. AgB and Psc Ags were interacted with hydatid and control sera, with Dot blot method and sensitivity and specificity of these antigenswere evaluated.Results: Sensitivity and specificity were estimated 95.9% and 81% respectively, for AgB and 100% and 63% respectively, for Psc Ag in Dot blot Method. Conclusion: Evaluation of sensitivity and specificity of AgB and Psc Ag using Dot blotting revealed that AgB has high value for diagnosis of hydatidosis and presumably can help Physicians to diagnose hydatid cyst easier than other routine tests.

Introduction & Objective: During the most dental procedures, contamination of devices with blood, saliva and other body fluids, which is the most important factor for transmission of infectious diseases, is inevitable. Therefore principles of infection control should be carefully considered in the dentistry. The purpose of this study was the evaluation of bacterial contamination of active radiographic apparatus in dental centers of Hamadan city in year 2003.Materials & Methods: In this cross-sectional study 37 radiographic apparatus in dental centers of Hamadan were evaluated. Samples were collected from four area (25 cm2 each) that are frequently touched by dentists, personnel, etc. using a swab. The swab was inserted into the carrier media containing thioglycolate, a smear was obtained from then solution and remaining solution was cultured in blood agar. Smear and blood agar cultures were transferred to microbiology lab to determine bacterial contamination level as well as bacterial typing.According to WHO criteria the area which has more than 10 microorganism/cm2 is considered as contaminated.Results: It was found that 13 of radiographic apparatus (35%) were contaminated, the most frequent bacterial type detected in this study was micrococcus (75.7%) and the least were enterobacter and nocardia (2.7% each). Antiseptic materials used for decontamination of the devices were as follow: Alcohol (43.2%), Deconex (32.4%), Micro10 (18.9%), Savlon (10.8%), Hypochlorid (5.4%), Glutaraldehyde (2.7%).Conclusion: Based on the results (35% bacterial contamination) it can be concluded that careful performance of infection control principles, daily decontamination of devices and offering periodic instructions for dental personnel are essential.

Introduction: A mucocele is an epithelial lined mucus-containing sac, completely filling paranasal sinus and capable of expansion. Sinus orifice obstruction produces aggregation of mucosal discharge from respiratory epithelium inside them that is called sinus mucocele. Case Report: Present case-report is related to a case of concha bullosa mucocele in a 18-year old girl presenting to the clinic due to partial obstruction of left-side nasal cavity over 8 months ago and then completed obstruction within the recent two months. The patient underwent surgical operation with a likely diagnosis of concha bullosa mucocele.Conclusion: Pathologic study on the specimen taken during the surgery supported the mucocele. Post-operatively, no complication was detected. In a second examination within two months after the operation, the nasal cavity was open and no complication was found.

Introduction: To prevent spinal lesions during surgery we can use somatosensory evoked potentials (SSEP) to monitor the patients who are under surgery particularly the ones under the spinal cord surgery.Case Report: The following case refers to the monitoring of a 23 year-old youth with the use of Intraoperative SSEP who has been under the operation of tumor removal with the diagnosis of space occupying mass in the conous region of spine in Tabriz Shohada Hospital.Conclusion: SSEP study for left tibial nerve after surgery was the same as before surgery.Pathology diagnosis was epandymom. Patient gave recovery process in few days.