Iranian Journal of Medical Sciences
Year:2006 | Volume:31 | Issue:1|Papers Count:16

Background: Stimulation of collateral artery growth (arteriogenesis) and/or capillary network growth (angiogenesis) would be beneficial to the patients with myocardial infarction. To understand the central role of vascular endothelial growth factor (VEGF) in biological angiogenesis, we performed molecular analysis of the VEGF gene in patients afflicted with acute myocardial infarction (AMI).Method: Forty patients with AMI were divided into two groups according to the presence or absence of created collateral blood vessels in ischemic myocardial region. In these patients we also evaluated the possible relationship of plasma levels of VEGF and its growing ability of new blood vessels. The molecular characterization of VEGF gene may highlight the presence of natural genomic variants which could facilitate the formation of new vessels in the ischemic area.Results: The genomic analysis of VEGF gene did not reveal any mutations in the coding region, but showed the presence of four and one single nucleotide substitutions in the intronic region and 5'UTR respectively. The C to T nucleotide transition at position –7 of 5'UTR is located in a potential binding site for Sp-1 transcription factor, which could probably affect the VEGF gene transcription.Conclusion: The molecular study of VEGF gene showed that its coding region is highly conserved. Therefore, variations of angiogenesis could be due to the regulatory elements participating in this mechanism.

Background: Noise pollution is considered as a stressful factor in every day’s life of the industrial world. The present study was designed to investigate the probable effects of different time exposure of noise stress on histomorphometric changes of adrenal gland, plasma cortisol and body weight of the rat. Methods: Sixty adult male Wistar rats were divided into two series of short time noise or STNE exposure (n=20) for one day and long time noise exposure or LTNE (n=40) for 30 days with a sound intensity of 100 dBA. LTNE series were further divided into five groups of control, sham, 4, 8 and 12-hrs noise exposure and STNE series were divided into four groups of the same as LTNE except sham group. The cortisol assay was performed on blood samples of pre and post treatment with noise in two series and Cavalieri methods in a stereological study for determination of adrenal volume changes only in LTNE series. Results: The results showed that the mean plasma cortisol level (5.4±3.2  mg/dl in LNTE-8hrs and 4.9±1.8 mg/dl in LNTE- 12hrs), the volumes of cortex (7.08±1.31 mm3 in LNTE-8h and 7.12±1.31 mm3 in LNTE-12h), medulla (0.68±0.19 mm3 in LNTE-8h) of adrenal gland increased. The mean animal weight did not show any significant changes. Conclusion: Sound pollutions can increase the stress hormone level and cause increasing the volume of adrenal gland that may be related to the effect of noise on the hypothalamuspituitary- adrenal axis. These results may be important to increasing of many disorders such as cardiovascular diseases in industrial societies.

Background: Macrophages have important role in defense against Herpes Simplex Virus type-1 (HSV-1). The present study was performed to determine the viability and nitric oxide (NO) production by HSV-1 infected mouse peritoneal macrophages (HIM). Method: The viability of macrophages was evaluated using MTT reduction assay and the production of nitrite using Griess method. Results: The ability of infected macrophages to reduce Tetrazolium (MTT) was diminished at virus to cell ratios of multiplicity of infection (MOI) of one, three and 10; but not at 0.01and 0.1. Induction and inhibition of NO production by HIM were MOI dependent. The basal NO production by these cells was inhibited at MOI of three and ten. In contrast virus to cell ratios of 0.01 and 0.1 induced low but significant enhancement in NO production. The inability of HIM to reduce MTT at MOI of three was significant after 12-hrs and inhibition of NO production was initiated between 12-20 hours after infection. Conclusion: High doses of HSV-1 seem to decrease the normal activity of macrophages by inhibiting the production of nitric oxide.

Background: Gastrointestinal stromal tumors (GISTs) constitute the majority of gastrointestinal mesenchymal tumors. They usually express a proto-oncogen protein called CD117 detected by immunohistochemistry. This study investigated the differentiation of GISTs as well as the risk of aggressive behaviors in GISTs from surgically-treated patients in university affiliated hospitals. Methods: The clinicopathologic, histomorphologic and immunohistochemical features of 36 GISTs of patients referring to two large general hospitals in the last 13 years were examined. Results: The GISTs occurred in 36 patients (41.6% male and 58.4% female) aging 15 to 89 years. 50% of the cases were in the stomach, 30% in the small intestine and the remainder in the colon and mesenter. The diameters of tumors were 0.7 to 30 cm and mostly (60.6%) more than 5. 85% of tumor cells were spindle, 14% epithelioid, and the remainders were mixed. 36.1% of tumors showed mitotic counts > 5/50 HPF and 11.1% less than 5/50HPF. 33.3% of the tumors showed necrosis. 8 tumors had malignant behavior during 13-yrs follow up. Immunoreactivity for c-kit, SMA, chromogranin, synaptophysin, desmin and S100 were 83.3%, 69.4%, 44.4%, 41.6%, 50% and 0%, respectively. The decreasing rank order of differentiation forms were neural, smooth muscle, dual and null. Most of our tumors were in high risk group and most of the high risks were intestinal with neurogenic differentiation. Conclusion: Immunostaining including c-kit is necessary to study the differentiation of gastrointestinal stromal tumors.

Background: Certain marker studies have practical importance in the biology of prostate cancer. The purpose of this study was to determine whether the quantification of certain neuroendocrine and proliferative markers obtained during transurethral resection or prostatectomy, would help in the prognostic evaluation of prostatic adenocarcinomas. Methods: The present study was performed on samples obtained from two groups of patients with acinar type prostatic adenocarcinoma. Each group comprised 21 patients with Gleason scores  ³7 (high-grade) and Gleason scores£6 (low-grade). Tumors with their surrounding benign tissues were stained with Ki67 and chromogranin A (ChA), and their cell proliferation and neuroendocrine differentiation were examined. Results: The mean number of neuroendocrine cells (ChA positive cells) in high grade tumors was 21% and that of low grade was less than one percent (P<0.001). Whereas, the mean proliferative index determined by Ki67 positive cells was 49% in high grade tumors as compared to less than 4% in low grade tumors (P<0.001). No significant difference was found between the mean percentages of chA cells in the non-tumoral tissues of high grade (2.7%) and low grade (1.9%). The mean proliferative index in the non-tumoral tissues of high grade (2.8%) was significantly higher (P<0.001) than of low grade tumors (1.4%). Conclusion: The usage of proliferative index seems to be an acceptable diagnostic index for the determination of tumor grading.

Background: Coriandrum sativum L. has been recommended for relief of insomnia in Iranian traditional medicine. However, no pharmacological studies have yet evaluated its sedative effects. The aim of this study was to determine if extracts and essential oil of coriander seeds have sedative-hypnotic activity. Methods: The aqueous or hydro-alcoholic extracts or essential oil of coriander seeds (100, 200, 400 and 600 mg/kg) were intraperitoneally administered to male albino mice, 30 minutes before pentobarbital injection (40 mg/kg). Latency to sleep and sleep duration were recorded. Results: Aqueous extract prolonged pentobarbital-induced sleeping time at 200, 400 and 600 mg/kg. Hydro-alcoholic extract at doses of 400 and 600 mg/kg increased pentobarbital-induced sleeping time compared to saline-treated group. The essential oil increased pentobarbital-induced sleeping time only at 600 mg/kg. Conclusion: The extracts and essential oil of coriander seeds possess sedative-hypnotic activity. However, it is strongly suggested that the major active component(s) responsible for the hypnotic effect is mainly present in the aqueous extract.

Background: Sodium valproate, an anticonvulsant drug, is reported to stimulate Human Immunodeficiency Virus type 1 and Human cytomegalovirus replication. Since epileptic patients undergoing sodium valproate therapy may suffer from various virus infections, the effect of this drug on replication of viruses especially those affecting neuronal tissues such as Herpes simplex virus type 1 is worthy of investigation. Methods: Viral replication was studied by quantal response method. Electron microscopy was also performed on cell monolayers treated with the drug and infected with the virus. Results: Significant reduction in viral infectivity was observed in cell cultures exposed to 0.5-2 mM of sodium valproate either one hr before or after infection. The corresponding electron microscopic examination revealed a very few intracytoplasmic enveloped virions and a marked reduction in the number of intracytoplasmic nucleocapsids in drug-treated virus infected cells compared with those of infected control. However, significant stimulation of virus replication was found upon treatment of cells with 1 mM (p<0.01) and 2 mM (p<0.001) of the drug 24 hours prior to infection. No remarkable change was seen in corresponding electron micrographs.Conclusion: Although the ultimate outcome of this study awaits in vivo assessments, possible stimulation of Herpes simplex virus type 1 replication by sodium valproate should be considered by clinicians prescribing this drug.

Background: Association between body mass indexes (BMI) and blood pressure have been observed, but remains poorly understood. BMI is shown to be a measure of overweight status and is applicable to all populations. In this cross-sectional study we have examined the relationship between the BMI and blood pressure in school age children. Methods: This study comprised of 486 boys and 463 girls at aged from 7 to 14-yrs. We examined the age-adjusted relationship between systolic (SBP) and diastolic (DBP) blood pressures and BMI in three age groups of 7, 11 and 14-yrs. BMI was calculated by dividing the body weight in kg by the square of height in meters (m2). At first multiple regression analyses were separately used for SBP and DBP to establish their association with BMI, age, gender and height. The analyses test was then repeated by replacing BMI by adjusted BMI. Result: SBP and DBP were positively and significantly related to BMI (P<0.01). According to multivariate regression analysis, SBP and DPB showed significant associations with age and weight with respective relation coefficient of 0.569 and 0.469 for BMI, SBP and DBP.Conclusion: The results of this study showed that BMI was highly associated and linearly related with both systolic and diastolic blood pressures in Iranian school-age children.

Background: During last decades, many otologists attempted to make a long standing dry ear, resulting in better hearing after cholesteatoma surgery. This study evaluated the prognosis of two common methods of cholesteatoma ear surgery considering ten years follow-up. Methods: This retrospective analysis was done using medical records of 108 adult patients with cholesteatoma. After ten years of operation, in these patients we compared the results of the two major trends of canal wall up (CWU) and canal wall down (CWD). Results: Among these patients, 72 (67%) and 36 (33%) underwent the CWD and CWU method respectively. During follow- up, 8% of patients with CWD and 21% of those with CWU had undergone at least one revision operations. Ten yrs after primary surgery, 93% of the ears were dry, 90% with intact tympanic membrane, with 42% of CWD and 52% of CWU groups having fair hearing. One deaf individual was found in each group. The recurrence rate was reported in 6% of CWD and 17% CWU patients, and independent of the size of cholesteatoma, mastoid status or foot plate erosion. The major predisposing factors for recurrence were retraction and discharge, especially in combination. Intact tympanic membrane was more frequent in CWD group, although there was no significant difference between the recurrence rates of these two groups. Conclusion: The result of this study indicated a need for improving surgical techniques in order to lower the recurrence rate and improvement of hearing, especially with the help of endoscopes.

Peritoneal adhesions are challenging in abdominal surgery. In spite of different kinds of treatments still no definitive and effective treatment is suggested. To determine the prevention effects of intraperitoneal (ip) methylene blue in post surgical adhesion formation 44 rabbits were randomly divided in two groups of equal number. Group I received an intra peritoneal injection of a 1% suspension of methylene blue diluted with Talc powder, and group II received ip injection of diluted Talc powder. Five months later both rabbits of groups were evaluated for severity of adhesion. The mean scores for adhesions for groups I was 0.9±0.88 which was significantly lower than 3.72±1.32 for group II (p<0.05). It is therefore, concluded that intraperitoneal administration of methylene blue decreases the rate of post surgical adhesion formation in the rabbit.

Systemic lupus erythematous (SLE) is an autoimmune process in which cutaneous lesions occur in majority of patients. This study was conducted to determine the pattern and prevalence of such lesions in SLE in Iranian children infected with SLE. Forty-eight patients, age between 3-16 yrs and male to female ratio of 7/1 were examined for the presence of cutaneous manifestations of SLE. The most common skin changes noted were malar rash, discoid eruptions, alopecia, and  photosensitivity.Vascular lesions including peripheral gangrene, chronic ulcers, Raynauds phenomenon, urticaria, palmar erythema, and erythema multiform were rare. Anti nuclear antibodies and anti-ds-DNA were positive. The prominent part of SLE is skin change which may be used as helpful diagnostic means. The result of the present study indicated that cutaneous involvements were more common in Iranian children and these changes would provide helpful information in early diagnosis of juvenile systemic lupus erythematous.

Antiphospholipid antibodies (APLA) may be detected in normal pregnancies and also may cause thrombosis, recurrent fetal loss, placental infarction and preeclampsia. In the present study the possible differences in APLA titer between healthy pregnant women and preeclampsia cases without history of thrombosis was examined. The APLA titer in 50 healthy pregnant women with 50 preeclampsia cases without the history of thrombosis and autoimmune disease was compared. Preeclampcia is defined as hypertension ³140/90 mmHg after 20 weeks of gestation and proteinuria > 300mg/24h. IgG and IgM anticardiolipin antibodies were measured by immunoassay methods and Teclot kits for lupus-like anticoagulant antibodies were used. In normal pregnant women, 6% had lupus-like anticoagulant antibody, 12% had IgG anticardiolipin antibody, and 26% had IgM anticardiolipid antibodies. In preeclapsia, 8% lupus-like anticoagulant antibody, 4% had IgG anticardiolipin antibody, and 30% had IgM anticardiolipid antibodies. Despite the evidence of prothrombotic state during preeclampsia, it is unlikely that antiphospholipid antibodies represent as a risk factor for preeclampsia among women without the history of thrombosis or autoimmune diseases.

We report five cases of duplicated external ear canal with especial attention to its histology and surgical care of facial nerve for their complete resection. These five patients were selected from 50 cases of first bronchial cleft anomalies including atretic external ear canals, preauricular fistula, cyst and sinuses. The characteristic histopathology and clinical features such as external opening around the auricle and upper neck above the level of the hyoid bone were not observed in other patients. There were no other abnormalities in the real external ear canal (EEC) and auricle. Three of them were connected to the natural EEC with an opening, hence producing ear discharges. Histologic appearances of well formed canal included a circumferential epithelial lined up and canal consisting of stratified squamous epithelium with skin adnexes. A remarkable cartilaginous skeleton (type 2 of first branchial cleft anomaly according to Work's classifications) was also observed. All of them were treated surgically, with preservation of the facial nerve and excising the superficial parotid gland along with the ductal opening and the tract.

Although tuberculosis involves every organ and has a wide range of clinical manifestation, however involvement of the thyroid gland is rare. We report a case of a 25-yr-old female with supraclavicular lymphadenitis that developed nodular swelling of the thyroid and had symptoms and sonographic features mimicking a nodule with a cystic component. The diagnosis was made by using fine needle aspiration (FNA). We conclude that thyroid tuberculosis should be considered in the differential diagnosis of thyroid nodules and that FNA can be the main diagnostic procedure.

An asymptomatic fungal cyst of a conjunctival infection was found and removed by biopsy in a young shepherdess. Histopathologic evaluations of the excised tissue specimen from the lesion of the conjunctiva demonstrated an epithelium lined cavity containing a tangled mycelial mass that was surrounded by inflammatory cells and the fungus was identified as Bipolaris spicifera. It is concluded that asymptomatic conjunctival infections by fungi may occur without a having previous history of trauma or having any signs of inflammation.

A 76-yr-old man with unipolar ventricular pacemaker, previously implanted in the right ventricular apex, presented with syncopal attack and twitching of the right pectoralis muscle. He finally was diagnosed as having Twiddler's syndrome. The patient had a pulse rate of 36/min and cannon waves in the neck veins. Chest radiography showed a dislodged pacing lead completely wrapped around the pulse generator. After uncoiling the lead it was positioned in the right ventricular apex and the pulse generator implanted and sewed tightly in a smaller pocket. After six months follow-up there was no further twiddling or pacemaker dysfunction.