JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2011 | Volume:21 | Issue:82|Papers Count:12

Background and purpose: Gastric carcinoma is one of the most common malignancies and its early diagnosis can be effective in the treatment method and the rate of the patients’ survival. In the past recent years, many genes have been identified which may have relationship with the prognosis of this disease and the patient’s survival. This study is going to investigate the rate and pattern of p53 and HER2 expression in gastric carcinoma by immunohistochemistry (IHC).Materials and methods: 114 paraffin wax-embedded gastric carcinoma specimens were selected and the results obtained from IHC stains were compared with histopathologic findings. The data were analyzed using Chi Square test in SPSS.Results: In this study, male to female ratio was 1.92 with the average age of 65.44±10.92. The most common tumor locations were antrum or pylorus (54 cases) and the average size of tumor was 5.32±2.62 cm. According to Lauren classification, intestinal tumor (101 cases) and in Ming classification, infiltrative tumor (74 cases) were the most prevailing. The most dominant cases were grade 2 (58 cases) and T3 staging (76 cases). Lymph nodes metastasis was also observed in 70 cases. The amount of p53 and HER2 expression were 52.6% and 24.6% of gastric carcinomas, respectively, showing a significant correlation between these two (P<0.05). Also a significant correlation (P<0.05) was found between the rate of p53 expression and tumor size, location of tumor and lymph node metastasis (P=0.05) in gastric cancers. Besides, HER2 protein had significant correlation with age of patient, tumor size, and Lauren’s classification intestinal type carcinoma (P<0.05).Conclusion: The results of the study indicated that the incidence of p53 protein is associated with larger tumor size and lymph node metastasis. HER2 protein and its expression in gastric cancer are similar to ductal adenocarcinoma in breast cancer.

Background and purpose: Gastric carcinoma is the second leading cause of cancer death worldwide and its incidence varies considerably according to geographical location. There are multiple etiologic factors such as infection with EBV that play a role in carcinogenesis of gastric cancer, yet there is not enough evidence about pathogenesis of EBV and its relationship with gastric cancer. Thus, recognizing pathogenic genes can help improve the prognosis of the patients. The purpose of this study is to explore the relationship between EBV and EBV-encoded BARF-1 oncogene in gastric adenocarcinoma pathogenesis.Materials and methods: In this analytical case-control study, 200 paraffin-embedded blocks of biopsies of patients with gastric cancer and those of healthy people were selected. After DNA extraction, polymerase chain reaction (PCR) was used to determine EBV genome and BARF-1 oncogene by specific primers of BARF-1. Grade and stage of the gastric cancer biopsies were also examined.Results: The results of PCR indicated that EBV genome was detected in three cases in the case group, whereas all samples in the control group were negative for EBV. Thus, no significant relationship was observed between the two groups (P>0.05). The EBV positive gastric cancers were negative for BARF-1 oncogene. It was also found that 41% of the cancers were grade I, 52% grade II, and 7% grade III.Conclusion: The findings suggest that gastric cancer has a high prevalence in the geographical region under study; however, EBV plays a minor role in the carcinogenesis of gastric adenocarcinoma.

Background and purpose: Considerable attention has recently been paid to the role of ghrelin hormone in the metabolism of carbohydrate. Beta-cell dysfunction is also considered to be an important factor in the prevalence of diabetes. This study aimed at investigating the relationship between serum ghrelin with beta-cell function and insulin resistance in type 2 diabetic patients.Materials and methods: Forty six male adults with type 2 diabetes and a body mass index of greater than 29 were recruited in this study through convenience sampling. To measure the participants’ serum insulin, ghrelin, and glucose level, their blood samples were obtained after an overnight fast. The relationship between serum ghrelin with beta-cell function index, insulin resistance, insulin, and glucose were determined through multiple regression analyses.Results: Multiple regression analyses revealed that beta-cell function (P=0.003) and fasting glucose level (P=0.005) were positively correlated with serum ghrelin level, while serum insulin level was negatively correlated with ghrelin level (P=0.011). Moreover, no significant correlation was observed between serum ghrelin levels and insulin resistance (P=0.083).Conclusion: The findings support the role of ghrelin in blood glucose level in type 2 diabetic patients which is mostly due to the effect of ghrelin on beta-cell function.

Background and purpose: To analyze the data in which the correlation between observations are to be considered, a general method is using marginal model with repeated measures, yet there is another method called conditional model with random clusters. According to the binary responses, the aim of the present study is to compare the efficiency of these two models in studying the risk factors affecting hypertension in Mazandaran province.Materials and methods: This cross-sectional study is part of research studying the risk factors of the non-infectious diseases in Mazandaran province in 2007 with a sample size of 1000 cases. First, stratified sampling was employed and then random cluster sampling was used in each stratum. In all cases, blood pressure was measured three times through standard methods. The obtained data were analyzed using c2 test and fitting marginal and conditional logistic models.Results: Of the total of 1000 (500 male and 500 female) cases, 38 percent had high blood pressure. In both models four variables of age, physical activity, body-mass-index, and the consumption of fruits and vegetables were identified as factors affecting hypertension. In addition, gender and fasting blood sugar were statistically significant only in marginal logistic model. Using goodness-of-fit criteria, values of all the statistics for conditional logistic model with random effects of individuals were lower in comparison with the marginal logistic model with repeated measures.Conclusion: It can be concluded that although one cannot decisively select a model as the most appropriate one, conditional logistic model fits were somewhat better than the marginal logistic model with repeated measures, so it can be used to analyze such data.

Background and purpose: Due to the beneficial physiological effects of conjugated linoleic acid (CLA), there has been a growing tendency to produce it as a functional lipid in recent years. Different CLA isomers have different physiological effects; hence, production of certain CLA isomers with high purity is of great importance. CLA can be produced through both chemical and enzymatic methods; however, unlike chemical catalysts, enzymes make it possible to produce pure CLA isomers. In this study, linoleic acid isomerase from Propionibacterium acnes was expressed in E. coli and the possibility of the production of CLA was studied.Materials and methods: The vector containing linoleic acid isomerase, pGEX-6P-PAI, was transformed inE. coli. Transformants were selected based on their resistance to ampicillin and restriction digestion analysis. To express the recombinant linoleic acid isomerase, transformants were induced using isopropyl-beta-thiogalactopyranoside (IPTG). The expression of recombinant protein was confirmed by SDS-polyacrylamide gel electrophoresis and Western blotting using anti-linoleic acid isomerase antibody. Then, the possibility of the production of CLA from Linoleic acid by usingE-coli transformant was investigated.Results: Recombinant linoleic acid isomerase was intracellularly produced as a glutathione Stransferase (GST) tagged protein by transformedE-coli. The fusion of GST to the N-terminus of linoleic acid isomerase increased its molecular weight from 49 to 75 kDa. GST-tagged enzyme acted like linoleic acid isomerase and the transformed bacterium could convert considerable amounts of linoleic acid to CLA.Conclusion: The findings indicated that transformed E. coli can be used for CLA production in biocatalytic processes.

Background and purpose: Due to the advantages of laparoscopic donor nephroctomy, such as maintaining cosmetic appearance, less post-operative pain, rapid rehabilitation, and less surgical scar, it has become a good alternative to open donor nephroctomy. No study has yet been done to compare the clinical consequences of open and laparoscopic donor nephroctomy in Iran.Materials and methods: This was a cross-sectional study conducted in Hashemi Nejad Hospical in Tehran. One hundred and twenty one kidney donors operated in this hospital were studied. Among them, 67 had experienced open and 54 had undergone laparoscopic donor nephroctomy. The amount of creatinine, GFR, and urine volume of the two groups were compared.Results: Warm ischemic time and hospitalization were significantly longer in the group with laparoscopy operation (P<0.05). Also the urine volume was significantly more in those undergone open donor nephroctomy (P<0.05). Moreover, the GFR index was significantly higher in the open donor nephroctomy group during the first two weeks after transplant (P<0.05).Conclusion: According to the findings of this study, it can be concluded that laparoscopic donor nephroctomy is a practical and safe method; therefore, it is recommended to apply this method for such cases.

Background and purpose: The role of head nurses in delivering health care is important and training and making them physically and mentally (attitude and belief) ready to accept the role is also important, so the researchers aimed at identifying and explaining the factors influencing the formation and the maintenance of the nurses’ commitment to clinical nursing identity.Materials and methods: The participants in this cross-sectional study were 123 male and female head nurses (based on Morgan Table) working in Mazandaran hospitals. The participants were randomly selected and were asked to fill in a questionnaire. For data analysis, Spearman correlation coefficient was used to measure the amount of correlation among variables and multiple regression analysis was employed to determine the variables related to commitment to clinical nursing identity.Results: There was a significant positive relationship between “self-efficacy” and “attitudes toward the nurse to head nurse role transition” (r=0.438), the same relationship was found between “social norms” and “attitudes toward the nurse to head nurse role transition” (r=0.627). On the other hand, there was no meaningful relationship between “attitudes toward the nurse to head nurse role transition” and “behavioral beliefs” (r=0.437). Contrary to the expectations, there was a positive relationship between “attitudes toward the nurse to head nurse role transition” and “commitment to clinical nursing identity” (r=0.369).Conclusion: According to the aforementioned findings, nurses should be informed of the effectiveness of the managerial roles in the hospitals and in the clinical improvement of the patients so that the head nurses are provided with their colleagues’ support.

Background and purpose: Diabetes mellitus is one of the most common endocrine diseases. Nowadays, there is a growing interest in the study of the antidiabetic effects of herbal plants. Previous studies have confirmed the antidiabetic effects of Citrullus colocynthis. However, this study aimed at investigating the effect of the different concentrations of Citrullus colocynthis fruit on the histological alterations in normal and diabetic male rats.Materials and methods: In this experimental study, diabetes mellitus was induced by subcutaneous injection of streptozotocin (50 mg/kg). Normal and diabetic rats were daily fed by the 1%, 2% and 5% Citrullus colocynthis fruit powder concentrations in their basic and usual diet for 4 weeks. Then, the rats were anesthetized and the kidney, liver, stomach, and pancreas tissues were obtained by slash surgical and stained by H& E method for histological studies.Results: Considerable positive effects were observed in the slides of kidney, stomach, pancreas and liver tissues in the diabetic rats fed with 5% concentration of Citrullus colocynthis fruit powder. In kidney cortex, abnormal width in the Bowman's capsular space, segregation of parietal cells and cellular infiltration were improved. Sinusoidal wide spaces between hepatocyts in the liver were also disappeared and epithelium naps staved in segments of stomach mucus recovered, too. Moreover, in pancreas, the bright corona at lobule centre indicating the evacuation of acinocyts changed to normal state.Conclusion: The results of the present study indicated that the consumption of 5% concentration of Citrullus colocynthis fruit in diabetic rats had beneficial therapeutic effects on improving the signs of diabetes.

Background and purpose: The monitoring of the patients’ hemodynamic status and vital signs is a routine practice in ICU and the use of a low-cost and soothing method to maintain stable physiological parameters is necessary. This study aimed at investigating the effect of music on the vital signs and SpO2 of patients after open heart surgery.Materials and methods: This study was a randomized clinical trial (RCT) conducted on 60 patients hospitalized in the open heart surgery ICU of Mazandaran Heart Center. Patients were randomly assigned into case and control groups. In the case group, the patients listened to the music, which they selected before, through headphones for 30 minutes, while headphones without playing any music were used for patients in the control group. Vital signs and SpO2 of the patients were assessed before the intervention, immediately, 30 and 60 minutes after the intervention. The data were analyzed using Chi-square; T-test and repeated measure statistical tests.Results: Findings showed that music led to a significant decrease in the rate of heartbeat, systolic blood pressure, and mean arterial pressure and a significant increase in SpO2 rate (P<0.05) was also observed. But music had no significant effect on the respiratory rate and diastolic blood pressure (P>0.05).Conclusion: As a non-pharmacologic, inexpensive, non-invasive method and without any side effects, music can improve the vital signs of the patients after open heart surgery.

Background and purpose: Identifying the students’ attributional style and helping them to be responsible and have a proper view is of critical importance which can lead them to achieve greater success and creativity. Considering its significant role in being an active or a passive, and demotivated person, the present study was conducted in order to determine the attributional style of the students studying in Mazandaran University of Medical Sciences.Materials and methods: This is a descriptive study conducted in Mazandaran University of Medical Sciences in 2008-2009 with the population of 2582 students on 343 male and 428 female randomly selected students. The data were collected using the Attributional Style Questionnaire. This is a descriptive study conducted in Mazandaran University of Medical Sciences in 2008-2009 on 343 male and 428 female randomly selected students among a population of 2582 students.Results: The obtained data showed that 43.9% of the participants had internal, while 56.1% of them demonstrated external attributional style. Among the female participants, 42.3% used internal and the rest (57.7%) employed external attributional style, similarly, 45.8% of the male participants preferred internal and 54.2% of them tend to use external attributional style.Conclusion: According to the results, the dominant attributional style of the participants is the external style which has a negative impact on their motivation, effort, and academic achievement which then, may negatively influence their success. Thus, it seems necessary to train them the coping strategies in order to reduce their external attributional style.

Colon lipoma is a rare benign tumor which is usually detected incidentally and is mostly asymptomatic. The author describes a case of obstruction due to lipoma. A 46-year-old man with a twomonth history of abdominal pain, and intermittent nausea, vomiting and melena for 3 weeks is reported. During colonoscopy, it was found that there was a colon mass and the pathological report showed chronic inflammation and a complete obstruction with barium was observed. Due to his constipation, severe abdominal pain and transverse, colectomy was performed. Pathological report showed submucosal lipoma. Finally, he felt well and was discharged from hospital.