TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)
Year:2011 | Volume:69 | Issue:2|Papers Count:15

Background: Adipose-derived stem cells (ADSCs) have noticeable self-renewal ability and can differentiate into several cell lines such as adipocytes, osteoblasts, chondrocytes, and myocytes. Progesterone plays a significant role in the myelination of peripheral nerves. Regarding the role of progesterone on the myelination of peripheral nervous system, we evaluated its effects on the in-vitro expression of P0, S100 and Krox20 mRNA in adipose-derived stem cells.Methods: In this experimental study, rat adipose-derived stem cells were isolated from the inguinal region of the animals and were evaluated by flow cytometry before culture. In preinduction phase, the cells were sequentially treated with various factors such as b- mercaptoethanol and all-trans-retinoic acid, followed by different induction mixtures. The cells were divided into four groups including two control groups (receiving either fibroblast and platelet derived-growth factors, or fibroblast growth factor, platelet derived-growth factor, forskolin and heregulin) and two experimental groups (receiving either fibroblast growth factor, platelet derived-growth factor, forskolin and progesterone, or fibroblast growth factor, platelet derived-growth factor, heregulin and progesterone). Expression of Schwann cell markers, S-100, P0 and Krox20 mRNA, was determined by semi-quantitative RT-PCR.Results: ADSCs expressed CD90, CD73, and CD31 but showed lack of CD45, and VEGFR2 expression. After the induction stage, S-100, P0 and Krox20 mRNA were expressed in the progesterone receiving experimental groups, but expression of S-100 and Krox20 mRNA were less than the control group which was receiving forskolin and heregulin (P<0.0001).Conclusion: Progesterone can promote the in-vitro expression of S-100, P0, and Krox20 genes in adipose-derived stem cells.

Background: Molecular DNA markers are one of the most important tools in molecular biology labs. The size of DNA molecules is determined by comparing them with known bands of markers during gel electrophoresis. There are many different protocols to produce these kinds of molecular markers. In this study we have suggested an efficient strategy to produce molecular weight markers in industrial proportions.Methods: To achieve the desired sizes of DNA fragments, a combination of two previously known methods, restriction enzyme digestion and polymerase chain reaction (PCR), were used. The enzymatic digestion process was based on designing and constructing plasmids which equaled in size with the desired length of DNA fragments and produced the desired DNA fragment upon linearization. In the PCR method, the desired length of DNA fragments were cloned in multiple cloning sites of pTZ57R plasmid and in a PCR reaction, the new constructed plasmid was used as a template to produce the final fragment.Results: Upon application of this strategy, 2000 and 3000 bp DNA fragments were produced by enzymatic digestion of plasmids of the same size. Moreover, 100 to 1500 bp fragments were produced during PCR using only a set of forward and reverse primers at the flanking region of pTZ57R multiple cloning site.Conclusion: The highest advantage of this cost-benefit approach is to produce different types of molecular weight markers by using an effective and short protocol.

Background: Different studies have shown that despite the expanding number of antifungal agents, death rate caused by Aspergillus species has been increased during the recent decades due to drug-resistance occurrence, increased minimum inhibitory concentration (MIC) and cross-resistance among the isolated species. Regarding the lack of effective response to conventional treatments and antifungal susceptibility patterns of the most common isolated Aspergillus species, this study was undertaken to draw a clearer picture in the Iranian setting.Methods: During 13 months from September 2009 to October 2010, 50 clinically isolated Aspergillus cases were identified based on the method described by Klich (2002) and their morphological features. Subsequently, their susceptibility test was carried out according to NCCLS- M38A broth microdilution method.Results: We found that 7.5% of the isolated A. flavus with an MIC>2 mg/ml to amphotericin B were probably clinically resistant types, and 25% of them with an MIC<8 mg/ml to itraconazole were less sensitive isolated species. The isolates were less sensitive to voriconazole too. The MIC range of 9 strains of A. niger and the MIC of one strain of A. fumigatus had increased to all the three medications in comparison with similar foreign studies.Conclusion: In this study we found that the MICs of most isolates were in the range of the reference strains and the MICs of some isolates were in the range of similar foreign studies. In some significant cases, the MICs were beyond the known ranges showing the lower sensitivity of Iranian isolates and their increased MIC patterns.

Background: An increased risk for invasive infections with encapsulated bacteria suchas Streptococcus pneumoniae has been described in patients with chronic kidneydisease (CKD) or in those on dialysis. The aim of this study was to evaluate the antibodyresponse to pneumococcal capsular polysaccharide vaccine in CKD patients.Methods: Sixty-six patients with CKD and 40 healthy individuals were vaccinated withpneumococcal polysaccharide vaccine. The serum antibody response (IgG and IgG2) tothe Pneumovax antigens was determined by enzyme-linked immunosorbent assay(ELISA) prior to and four weeks after vaccination.Results: Out of 66 vaccinated patients with CKD, 14 were found to be hyporesponsive tothe vaccine (Group 1). Patients with normal specific antibody response were regarded asrespondents and were assigned to Group 2 (n=52). The mean post-vaccination IgG titerto the pneumococcal antigens in Group 1 was significantly lower than those in Group 2(P=0.012 for IgG and P=0.02 for IgG2). The increased anti-pneumococcal IgG titer wassignificantly lower in patients in Group 1 versus Group 2 (P=0.001) or the healthycontrol group (P=0.005). During the follow-up period of patients, patients in Group 1developed higher episodes of pneumococcal infections than those in Group 2 (P=0.007).Conclusion: A substantial proportion of patients with chronic kidney disease fail tomount an adequate antibody response to pneumococcal antigens and remain atsignificant risk for such infections. These patients should be offered other prophylacticmeasures to protect them against invasive pneumococcal diseases.

Background: One of the most common orthopedic complaints is direct or indirect trauma to the knee with torn anterior cruciate ligament(ACL). Reconstruction of the tornACL is emphatically offered in active individuals as by this operation, we prevent osteoarthritis, knee instability and injury to the meniscus. There are numerous methods for graft fixation in the femoral tunnel inACL reconstruction. If the graft proves to be stable after the operation, patients would not complain of giving way knee joints. In this clinical trial, we compared transfemoral pinning with endobutton fixation of hamstring graft in arthroscopicACL reconstruction by examining knee stability and use of other relevant functional tests.Methods: Fourteen Patients who had undergone arthroscopic ACL reconstruction in Shariati Hospital during the years2008-2009 and were being followed up were evaluated at least15 months post-operatively by physical examination and the use of an arthrometer made by the Faculty of Mechanics of Sharif Technical University.Results: The results showed that two out of seven patients in which their ACL had been reconstructed by hamstring graft fixation by endobutton technique, and in one out of seven patients who had undergoneACL reconstruction by hamstring graft fixation through transfemoral pinning, Lachmann test (in 25 position) was greater than 5 mm but there were not any complaints of giving way knee joints.Conclusion: The clinical results of ACL reconstruction by transfemoral pinning technique seems to be superior to the reconstruction by endobutton technique.

Background: Urinary tract infection 0 in children causes renal scarring and permanentdamage to the organ. In this study, we compared the diagnostic value of magneticresonance urogram for urinary tract anomalies with other conventional imagingmethods in children with UTI.Methods: In this case-control study, 190 children (mean age 3.23±3.59 yrs) with UTIwere recruited from the Pediatric Ward of Rasul-e-Akram Hospital during 2007-2009. The patients were divided into two groups based on the applied imaging technique: MRU (cases) and conventional imaging groups (controls).Results: Abnormal imaging detection rates for Ultrasonography were 32%, X-ray ofkidneys, ureters and bladder (KUB) 9%, Intravenous Pyelogram (IVP) 26%, VoidingCystoure therogram (VCUG) 54%, Dimercaptosuccinic Acid scan (DMSA) indicatingnon-obstructive (reflux) uropathy in 76% (mean age 3.5 yrs) and MRU 43% (mean age1.6 yrs), respectively. A meaningful correlation was observed between MRU and DMSAscan with IVP results (Kappa=0.75). KUB and Ultrasonography had similar results incases with abnormal MRU and DMSA scan (P=0.121). MRU had strong agreement withVCUG and IVP for the detection of obstructive uropathy and scar due to congenitalmalformation even during intrauterine life but not with sonography results.Conclusion: Sonography had poor results for the diagnosis of urinary tract anomalies incomparison with MRU. Use of dynamic MRU for the diagnosis of congenital anomalies(hydronephrosis, obstruction, pyelonephritis, renal scar) in children with UTI seems tobe of better help, although higher costs and the need for sedation during MRU still areits disadvantages.

Background: Trauma to the hand is very common and consequently, metacarpal fractures are not rare entities. Some of these fractures need surgery. Considering the diversity of surgical methods available for these kinds of fractures and also the importance of achieving full function and speedy return to work for patients that are mainly young workers or athletes, this study was undertaken to investigate the outcome of treating these fractures by mini-plates.Methods: Eighteen patients with open or comminuted fractures of metacarpal bones who were admitted to the emergency department of Sina Hospital between the years 2007and 2010 underwent fixation surgery using mini-plates. Fourteen patients with 17 metacarpal fractures completed the study.Results: Thirteen out of 14 patients had complete fracture union. The patient with nonunion underwent revision surgery and bone graft. Four individuals developed an extensor lag of 15 degrees without functional impairment. Two patients had joint stiffness that was relieved after a period of physiotherapy and one developed wound dehiscence and discharge that improved with debridement and use of antibiotics without plate removal. Six patients had complaints regarding their hardware prominence and were satisfied after its removal. Overall, there was a79% satisfaction rate upon the treatment.Conclusion: Despite the afore-mentioned complications, use of mini-plates seems to be a suitable treatment option for patients with comminuted metacarpal fractures.However, more studies with larger sample sizes are suggested to reach a firm conclusion.

Background: Obesity is currently a worldwide health epidemic which has incited majorinterest among researchers to look for the underlying mechanisms that regulate bodyweight. In fact, adiponectin and leptin concentrations that are called adipokines arealtered in obesity with a decreased production of adiponectin and an increasedproduction of leptin. Adiponectin has anti-inflammatory, anti-atherosclerotic and antiinsulinresistance properties, but increased levels of leptin are observed in patients withdiabetes and cardiovascular diseases. The aim of the present study was to investigatethe effects of an 8-week aerobic training program on the plasma levels of adiponectinand leptin in healthy middle-aged men.Methods: Thirty healthy middle-aged men were selected based on their body fatpercentage and were assigned to two equal groups. The experimental group took the 8-week training, four days a week on alternate days with an intensity of 60-80% of theirheart rate reserve but the control group lived their sedentary life. Blood samples werecollected before and after the training program from all subjects and plasma adipokinelevels were measured.Results: Plasma adiponectin concentration increased while leptin levels decreasedsignificantly (P<0.001 and P≤0.042 respectively) upon completion of the 8-weekprogram. Moreover, reduction in body fat percentage (P≤0.001) negatively correlatedwith adiponectin (P≤0.001) and positively with leptin changes (P≤0.008).Conclusion: In healthy middle-aged men, 8-week aerobic training programs couldreduce body fat percentage and improve plasma adipokines levels. Therefore, aerobictraining can be considered as a major strategy for preventing obesity and itsaccompanying diseases.

Background: Body weight is regulated by both food intake and energy expenditure. Ghrelin, a hormone produced by the stomach and pancreas, enhances appetite. Thisstudy was undertaken to determine the effects of intermittent treadmill running onacylated ghrelin and appetite in individuals with obesity.Methods: Nine inactive male students, with a mean age of 20.56±0.48 yrs, a body massindex of 32.68±0.84 kg/m2 and a maximum oxygen uptake of 34.21±1.48 ml/kg/min, participated in the study in two trials (control and exercise) in a counterbalanced, randomized design. The protocol included intermittent running with a constant intensityat 65% of VO2 max on a treadmill. Blood samples were collected before, during, and 2hafter cessation of the exercise.Results: Acylated ghrelin concentrations and hunger ratings decreased significantly inthe second phase and remained lower than baseline (P=0.006 and P=0.002, respectively)at the end of the exercise. The total area under the curve values and hunger ratings (allP<0.0005) were significantly lower in the exercise trial compared with the control state. Similarly, growth hormone rose significantly at the second phase and remained higherthan baseline (P=0.033) at the end of the exercise trial.Conclusion: These findings indicate that acylated ghrelin and appetite are reduced byrunning at 65% of VO2 max and remain lower than baseline even two hours afterwardsin individuals with obesity. Growth hormone seems to be more responsible for thissuppression. Further studies are required to investigate whether this protocol couldelicit the same effects in short-term training programs.

Background: Infection with Taenia saginata or taeniasis is an uncommon parasitic infection in Iran with a prevalence rate of 2-3% and it is more seen in the northern parts of the country. Epigastric pain, nervousness, dizziness, nausea and loss of appetite may be the only presenting symptoms but secondary appendicitis, acute intestinal obstruction and necrosis of the pancreas are its serious and rare complications.Case presentation: A 62-year old woman was admitted to Imam Khomeini Hospital with signs of acute abdomen. She had a past history of infection with hydatid cyst and its subsequent surgery, eight years ago. At the time of admission, she suffered from persistent abdominal pain and loss of appetite for two years. Despite having the epidemiological evidence of working along the banks of rivers contaminated with human sewage and working on farms fertilized with human waste and presence of signs hinting at the disease, parasitic infection had not been considered in its diagnosis.Conclusion: Although signs and symptoms of taeniasis are non-specific but a complete history, physical examination and detailed patient notes, especially by considering epidemiological factors, are very important to the early diagnosis of taeniasis.