Journal of Advances in Medical and Biomedical Research
Year:2003 | Volume:11 | Issue:43|Papers Count:10

Background: hK13 is one of the enzymes that encode by hK13 gene from the kallikrein family gene. It has been reported that this enzyme is found in the seminal plasma, ascites fluid of the patients with ovarian cancer and the breast milk. In this study, we aimed to detect the enzymatic activity and the substrate specificity of the hK13, which may be used in the future for the diagnosis and management of the cancer patients.Materials and Methods: The pichia pastoris culture supernatant, with incorporated hK13 recombinant DNA, was collected by FPLC for the purification of the hK13. The fluorescence was measured by Wallace Victor fluorometer and the Km was calculated by non-linear regression analysis using the Enzyme Kinetics Module 1.1 (Sigma plot, SSPS Inc).Results: The Kcat/Km for Val-Pro-Arg-AMC and Phe-Ser-Arg-AMC was higher than that of the other substrates. hK13 was unable to cleave the peptide bonds from carboxyl side of the lysine effectively. The Kcat/Km value for Val-Pro-Arg-AMC hydrolysis by trypsin was 1.5 times more than that of the hydrolysis of the same substrate by hK13.Conclusion: Among the 6 fluorogenic substrates, the tripeptide Val-Pro-Arg-AMC was the best substrate with the highest value of Kcat/Km for hK13. So hK13 may be used as a tumor marker for identification of patients with cancer. The practical application of this suggestion needs to use advanced clinical laboratory techniques, especially substrates for hK13 and to eliminate the interference of the enzyme activity in the circulation.

Background: Information regarding the effects of macronutrients on metabolic and hemodynamic responses in type 2 diabetes mellitus patients is lacking, however, we have information about these responses in healthy subjects. Therefore, this study was designed to explore the effects of macronutrients in diabetics at Shaheed Beheshti University in 2001. Materials and Methods: This clinical trial was carried out on 15 patients with type 2 DM. Insulin and norepinephrine responses were determined before and 15, 30, 60, 90, 120 and 180 minutes after the intake of the wheat starch, sodium caseinat and olive oil while cardiovascular responses such as cardiac output, heart rate, stroke volume and systolic blood pressure measured before and 15, 30, 60, 90 and 120 minutes after these macronutrients. Statistical analyses were done by analysis of variance with repeated measures, independent and dependent t-test. Pearson linear correlations of the responses were used to establish any relationship between cardiovascular and metabolic responses. Results: The mean age of patients (4 women and 11 men) was 38.9 ± 5.2 year and their the mean of body mass index was 24±106 kg/m2. Insulin increased significantly following intake of carbohydrate and protein (p<0.05). Insulin changes were not significant after fat intake. Norepinephrine increased significantly following intake of carbohydrate, protein and fat (P<0.05). Post-prandial cardiac output rose only after protein intake (P=0.004). Systolic blood pressure fell after the ingestion of the macronutrients but, it was significant only after the intake of the fat (P=0.003). Conclusion: There were significant differences between all patients for their cardiovascular and metabolic responses after the intake of carbohydrate, protein and fat. For more conclusive data, we recommend more investigations on a larger group of subjects.

Background: There is a general consensus that the prevalence of gestational diabetes mellitus (GDM) is increasing globally, but there is considerable controversy about the screening method of this entity. So, this study was performed to indicate the relationship between the screening for the gestational diabetes with a 75-gram oral glucose tolerance test and the outcome of the pregnancy.Materials and Methods: In this descriptive study a total of 450 qualified pregnant women who received prenatal cares were selected by convenience method. Collecting data were performed through the interviewing and studying their medical history. A 75 g oral glucose tolerance test was performed for all the pregnant women at 24-28 weeks of gestation. The subjects who had two or more abnormal blood plasma glucose based on ADA criteria were known as gestational diabetic individuals. All subjects were followed until delivery and their pregnancy outcomes were recorded. Fisher Exact test and chi-square test were used for data analysis. Results: In this study, 2.9% of the subjects had positive screening test for GDM. There was a significant relationship between the positive test and the adverse pregnancy outcomes including congenital abnormalities, macrosomia, preeclampsia/eclampsia and preterm labor. However, there was no relationship between the positive test and the still birth. In addition, there was a significant relationship between the positive test and the age, weight, BMI, gravity, glucosuria, fasting blood sugar and also the history of the abortion, preterm labor, still birth, macrosomia, and familial diabetes. There was no relationship between the positive test and the history of abnormal infant and history of the GDM in previous pregnancies. Conclusion: Since there is a significant relationship between the positive results with 75-g oral glucose tolerance test and the adverse pregnancy outcomes we suggest that the screening test with 75-g glucose can be used for screening of GDM at least in high risk women.

Background: It seems that with careful review of the history, physical examination, ECG and standard chest radiography, the left ventricular systolic function can be predicted accurately without need for more complex methods. So this study was performed in patients who referred to Emam Khomani hospital in Tehran in 2001. Materials and Methods: In this descriptive study after taking the past medical history, all patients were examined by one cardiologist and the changes in their ECG and chest x-ray were recorded. Then their left ventricular systolic function were predicted based on the distinct algorithm and classified into three groups: those with normal ejection fraction, probably low or low ejection fraction. Then these results were compared with the results of echocardiography and sensitivity, specificity and positive and negative predictive values of the semi-clinical method were calculated. Results: The estimation of ejection fractions were confirmed by echocardiography in 90% of the first group, 63% of the second group and 13% of the third group. The semi-clinical method (history + physical exam+ ECG + C. R) had 91% sensitivity and 75% specificity for detection of low ejection fraction in left ventricular. The positive predictive value of this method was 63% and it's negative prediction value was 95%. Conclusion: It seems that with careful review of the history, physical examination plus ECG and standard chest radiography, the left ventricular systolic function can be evaluated accurately without need for echocardiography.

Background: Pharmacotherapy of acromegaly has been successful in recent years. The therapeutic efficacy of long-acting sandostatin in the treatment of acromegaly has been established in multiple studies. In this report, we investigated the effectiveness of multiple injections of sandostatin and its acting period in Tehran in 2001. Materials and Methods: In this Quasi-experimental study five diagnosed patients with acromegaly after hypophysectomy were treated with sandostatin LAR and followed up for at least 63 days after injection. After octreotide test, a dose of 30 mg sandostatin was prescribed for 3 injections. Frequency of mean daily growth hormons (GH) less than 5µg/L were compared after the first and the third injections. Then acting time of the drug was assessed. The efficacy of 30 and 40 mg doses were compared in 3 cases. Results: There was no relationship between response rate to octreotide and sandostatin. Frequency of GH<5µg/L after the third injection was higher than that of the first one (P<0.01). Therapeutic effect of the drug continued for 42 days after the treatment in responding patients. Conclusion: Octreotide test (with single dose injection) is not a good method for prediction of patients' response to treatment. Measuring GH after multiple injections is a better method for this purpose. Drug injection interval should be determined separately for each patient.

Background: Urinary tract infection (UTI) is one of the most important bacterial diseases among children and it's early detection has an important role in preventing secondary complications. The gold standard for diagnosis of UTI is urine culture, however, there are some arguments about the value of urine analysis as a screening test. This study was designed to evaluate specificity and sensitivity of urine analysis in patients suspicious to UTI in Shahid Fahmideh and Razi Hospitals during 1999-2000 in Kermanshah.Materials and Methods: This descriptive study was conducted on patients suspicious to UTI Who were not taken any antibiotic during the last 72 hours. Mid-stream urine samples were taken and the existence of leukocyte or bacteria were examined by microscope. Blood, nitrite and protein were checked by Behring (Gremany) dipstick and urine culture were done for all samples. Positive criteria for diagnosis of UTI were positive culture with more than 105 colony count, existence of protein more than 1+, blood more than 1+ and more than 5 leukocytes in one microscopic field, positive nitrite test and any bacteria seen in one high power field of microscope. Results: Two hundred and twenty one patients including 163 girls and 58 boys were studied. Urine cultures were positive in 69.6%. Sensitivity and specificity were 86.3% and 73% for leukocyte, 66% and 84.3% for nitrite, 56.9% and 35.2% for protein, 61% and 44% for blood and 71.9% and 71.8% for bacteriuria, respectively. The existence of leukocyte in urine analysis had a sensitivity of 86.3% and positive nitrite test had a specificity of 84.3% for the diagnosis of UTI. Conclusion: In this study, the existence of leukocyte in urine analysis had the best sensitivity and positive nitrite test had the best specificity for the diagnosis of UTI. Therefore, dipstick is not a reliable screening test for the diagnosis of UTI.

Background: Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of several disorders including adult T-cell leukemia, HTLV-1-associated myelopathy and tropical spastic paralysis. HTLV-1 can be transmitted through different routes such as: blood transfusion, needle sharing, breast-feeding and heterosexual intercourse. This study was carried out to detect HTLV-1 antibody in patients with thalassemia major as a high-risk group versus healthy individuals in the cities of Zahedan and Zaboul in 2001. Materials and Methods: This historical cohort study was conducted on 379 individuals (190 sufferers of B-thalassemia and 189 healthy persons) from cities of Zahedan and Zaboul. 3ml peripheral blood was collected from each person. Sera were separated and ELISA was used to detect anti-HTLV-1 antibody. In positive samples, the virus type was determined by Western blotting. The results were statistically analysed by student's t-test. Results: Antibodies against HTLV-1 were detected in 1.6% of thalassemic patients and 0.5% of control group. None of the positive individuals were received blood from Khorasan province and there were no relationship among age, sex, family relation between father and mother, thalasemic patient in the family and history of travel to Khorasan province with HTLV-1. Conclusion: The results indicated that the main route of HTLV-1 infection in Iran is probably blood transfusion. Therefore, it is recommended that all the blood donors be screened for HTLV-1 in order to prevent viral infection.

Background: Zanjan city with population of about 300,000 is supplied with groundwater resources for drinking water. Now, Zanjan sewage is disposed to cesspools. On the other hand, precipitation has decreased during the past decade. Because of the importance of the safe drinking water, this study was conducted to determine some chemicals and microbial characteristics in drinking water in 1999-2000. Materials and Methods: This descriptive study was performed on total drinking water resources (wells) in Zanjan. During four seasons, 280 samples were collected and nitrate, nitrite and chloride concentrations were measureed by spectrophotometry and argantometric titration. Total coliforms and fecal coliforms were detected according to the approved methods. The data were analysed by Kroscal Wallis method. Results: In this research, 36 drinking water wells were divided into two groups: 22 wells in the city and 14 wells out of the city. Mean concentrations of nitrate, nitrite and chloride in the wells inside the city, in comparison with the ones' outside, were statistically higher (p<0.0003, p<0.003, p<0.0003) respectively. In some wells inside the city, the nitrate was greater than of its standard limit, but the nitrite and chloride levels were less than the standard limits in all the wells. All the wells had desirable microbiological quality. Conclusion: Nitrate and nitrite concentrations in some drinking water wells were undesirable and some of the wells were exposed to the contamination. Thus, it is necessary to determine the nitrate and nitrite concentrations in drinking water distribution system.