Journal of Gorgan University of Medical Sciences
Year:2011 | Volume:13 | Issue:3 (39)|Papers Count:19

L-glutamate is the major excitatory neurotransmitter in the central nervous system (CNS). It contribute in various physiological conditions such as brain development, synaptic plasticity, memory and learning. However, increasing of the extracellular glutamate concentration and overactivation of glutamate receptors in particular ionotropic subtypes leads to excitotoxicity which is the fundamental pathological pathway of neuronal injury. Due to lack of extracellular enzymatic destruction, the removal of released glutamate is achieved through the excitatory amino acid transporters (EAATs) which are distributed in glia that tightly surround the synaptic clefts, as well as in neurons. EAATs which known as Na+-dependent high-affinity glutamate transporters are the main responsible for maintaining extracellular glutamate concentration below excitotoxic levels. Moreover another membrane transporters regulating the flux of glutamate in different areas of the CNS. This system is cystine-glutamate exchanger (XCG-) that is Na+-independent system. Dysfunction of EAATs has been implicated in both acute insults e.g. stroke, trauma and chronic neurological and neuropsychiatric disorders e.g. amyotrophic lateral sclerosis, epilepsy, schizophrenia and Alzheimer's disease. Therefore, the purpose of this review article is to explain the pathway of glutamate biosynthesis, its release into CNS, discribing and elaborating Glutamate transporters, activites and their role in excitoxcity in CNS.

Background and Objective: Alzheimer’s disease is caractrized by brain degenerative alterations with subsequent learning and memory loss. Learning and memory is closely associated with brain colinergic system. Colinergic fibers originated from minent basal nucleus which is extended to cortex and hippocampus. This study was conducted to investigate sensory processing in the barrel cortex neurons of Rat model of Alzheimer’s disease.Materials and Methods: In this experimental study, 14 male Wistar Rats weighing 250-350g randomly divided into control and experimental groups. Alzheimer’s disease in Rats induceted, by infusion of ibotenic acid (5 mg/ml in each site) into nucleus basalis of Meynert (NBM) using Hamilton syringe and stereotaxic apparatus. The control group was non-lesion Rats with vehicle treatment. Two weeks after NBM-lesion, each animal was tested by passive avoidance learning (PAL), then neural response assessed by extracellular recording.Results: In cases, ibotenic acid infusion into NBM, significantly reduced memory (P<0.05). The results evoked by multiple whisker stimulation in extracellular single unit recording showed that in Alzheimer’s disease model of animals excitatory receptive field (RF) of neurons were extended but inhibitory RF was decreased (P<0.05). In addition the magnitude of neural response following principal whisker deflection decreased in cases (P<0.05).Conclusion: This study indicated that in animal model of Alzheimer’s disease possibly reduce sensory processing and contact discrimination.

Background and Objective: The neurohypophysis originates from the floor of diencephalon. Its development controles by several cellular interactions that mediated by some molecules such as cell surface and extra cellular matrix Glycoconjugates terminal sugars. In this study we used lectin histochemichal technique to evaluate distribution of the Glycoconjugates and their changes during development of neurohypophysis.Materials and Methods: This experimental study carried on 40 female and 20 male adult Rats. After mating and appointment day zero of pregnancy, pregnant Rats were sacrificed from days 10-20 of gestation and their embryos were collected for histochemical study. The serial section of head specimens were fixed and incubated with different HRP-lectins from Orange fungus (OFA) Vicica villosa (VVA), Glycine max (SBA), Wistaria floribunda (WFA), peanut (PNA), Griffonia simplicfolia (GSA1-B4), Lotus tetragonolobus (LTA) and Ulex Europeus (UEA-1). OFA, LTA and UEA-1 lectins are specific for terminal sugars a-L-Fucose and WFA, SBA, VVA and PNA are specific for D-GalNAc, a, b-D-GalNAc and GalNAc, D-Gal- (b-1-3) - DGalNAc of complex glycoconjugates respectively.Results: Our findings demonstrated that the reaction of neurohypophysis cells with OFA initiated from gestational GD10 and increased to GD15 (P<0.05) and then increased to GD17 (P<0.05). A few cells of neurohypophysis reacted with PNA from GD13 to GD16 and decreased afterward (P<0.05). Some cells of neurohypophysis reacted with SBA from GD14 to GD18 and decreased afterward (P<0.05). Reacting of many cells of neurohypophysis with WFA started on GD13 and increased to GD15 (P<0.05) and then decreased afterward (P<0.05). Neurohypophysis cells showed no reaction with the UEA-1, LTA, VVA and GSA1-B4 lectins.Conclusion: The expression of Glycoconjugates with terminal sugars a-L-Fucose, a, b-D-GalNAc and D- Gal– (b-1-3) - D-GalNAc have importanct role and special spatiotemporal situation in neurohypophysis development.

Background and Objective: The painful menstruation is one of the common disorders of female sexual organ which is experienced by almost fifty percent of the women affected by regular menstrual periods. The primary dysmenorrhea is referred to as the menstrual pain in absence of undetectable pelvic disease which occurs usually during 2 years after first menstruation when ovulation is established. This study was done to investigate the effect of heat and vibration on primary dysmenorrhea.Materials and Methods: This clinical trial study carried out on 75 female students, aged 18-22 years old from Islamic Azad University. Each subject evaluated for two menstrual cycles. At first cycle the participants received the routine pain-relief method. During the second cycle each of them applied combined heat-vibration device for ten minutes during menstrual pain. Data collected using questionnaire and pain visual analog scale and analyzed using SPSS-14, t student and Wilcoxon tests.Results: In contols, pain score was 5.34 and 4.09 prior and after routine intervertion, respectively (P<0.001). Also, in cases pain score significantly reduced from 5.34 to 3.44 after intervention by heat and vibration. In 8% of cases a slight redness was observed.Conclusion: This study showed that heat and vibration is more effective than routine intervention in pain during menstrual cycles.

Background and Objective: Carpal tunnel syndrome (CTS) is one of the most common disease among the entrapment neuropathies. The purposes of this study was to compare the efficacy of a new dorsal wrist splinting versus common palmar splinting for CTS based on sensory nerve conduction measurements.Materials and Methods: This single blind randomized control trial study was carried out on 22 idiopathic CTS patients. Subjects were randomly divided in two groups: Dorsal splint group (n=12) and palmar splint group (n=10). Both groups used splints for 4 weeks. Sensory conduction study of median nerve were done initially for having baseline and after 4 weeks follow up. SPSS-16 and Kolmogorov–Smirnov, independent T, and paired T tests were used for analysis of DataResults: After four weeks median nerve sensory distal latency and conduction velocity improved significantly in both groups (P<0.05). There was significant difference between both groups due to electro-diagnostic improvement.Conclusion: This study showed that based on electro-diagnostic method, dorsal wrist splint is more effective than cockup splint in carpal tunnel syndrome.

Background and Objective: Anterior cruciate ligament (ACL) tear is one of the most common injuries at knee joint. This study was done to evalute the effect of reconstruction surgery on hamstring reflex in patients with ACL tear.Materials and Methods: In this Quasi- experimental study, 30 patients (16 males, 14 females) with ACL tear, with mean age of 26.52±8.72 years old were recruited during 2007. Patients were selected in a non probability sampling manner. The Kinsiological Electromyography and trauma mechanism were used for testing the hamstring reflex. Muscle activity were measured as a dependent variable. Data were analyzed with Paired T-Test, ICC, SEM and K-S tests.Results: Hamstring reflex in affected knee and after reconstruction surgery was 73.25±3.22 and 47.35±3.85, respectively. This difference was significant (P<0.05).Conclusion: Reconstruction surgery in patients with ACL tear at acute phase is effective in improvement of hamstring reflex.

Background and Objective: The reactive oxygen species (ROS) continuously are neutralized by antioxidant. Biological molecules become protected from oxidative stress under normal conditions. The production of ROS during hypoxia is reported In Vitro which is also known as reductive stress. In order to study this phenomenon at physiologic scales which occurs in routine activities, this study was conducted to evalute, the effect of voluntary apnea on serum ROS level.Materials and Methods: In this semi-experimental study, the participants were 12 healthy non-athlete men aged 21±3 years. At the end of normal depth inspiration the voluntary apnea had been started till 40 seconds. The respiratory rate and depth, heart rate and arterial oxyhemoglobine saturation percent were continuously monitored. Venous blood samples were collected at two times: (1) immediately after the apnea and (2) at the end of it and before rebreathing. The serum ROS level was measured using the standard D-ROM test.Results: The mean and the range of breath holding time were 52.5±7.9 and 40±61.7 seconds respectively. The heart rate and the arterial oxyhemoglobine saturation percent decrease 12.75% (P<0.003) and 2.05% (P<0.001) respectively. The mean and the range of basal vs. apnea of these parameters were as follow: 93.3±3.03 and 87-107 bpm vs.81.43±3.7 and 71-93 bmp; 97.6±.16 and 97-98 percent vs.95.6±.33 and 94-97%. The serum ROS level after 40 seconds of apnea did not show significant differences.Conclusion: In non-athletes the voluntary apnea had no effect on serum reactive oxygen species level.

Background and Objective: Hirschsprung’s disease is a congenital disorder, characterized by the absence of ganglion cells in the intramural and submucosal plexus in distal parts of large bowel. Diagnosis is based on the histopathologic examination of hematoxilin and eosin stained sections. Due to diagnosis limitation by Hematoxylin and Eosin staining (H&E), this study was done to identify the ganglion cells by BCL-2 immunoreactivity and compared it with H & E staining.Materials and Methods: In this laboratory study, paraffin blocks of 36 specimens demonstrating ganglion cells on original H&E stained sections and 35 specimens lacking ganglion cells on H&E staining, were selected. Recuts were stained by H&E and BCL-2 methods.Results: Ganglion cells were observed in 36 cases by H&E staining but in BCL-2 staining ganglion cells were detected in 29 cases. In 35 cases reported negative for ganglion cells on H&E staining, ganglion cells were detected in 5 cases by BCL-2 method. Sensitivity, spesificity, positive and negative predictive values for BCL-2 method for diagnosis of hirshsprung’s disease were 81%, 86%, 85% and 86% respectively. discordancy (positive BCL-2, negative H&E) was 14%.Conclusion: Immunohistochemistry method using BCL-2 improve the accuracy of diagnosis in hirschsprung’s disease, when accompanied with H&E staining, particulary for negative slides.

Background and Objective: Breast cancer is one of the most important malignant tumors world -wide and the second common cancer in the females. Breast cancer is associated with a number of environmental factors and genetic damages. Ki67 is a proto-oncogene which is activated in cell proliferation process. Ki67 is important in prognosis and response to chemotherapy. The aim of this study was to investigate the Ki67 gene expression in patients with breast cancer by immunohistochemistry method.Materials and Methods: This descriptive laboratory study was conducted on 80 breast cancer specimens from patients admitted to the hospitals in Sabzevar, Iran during 2005-09. Samples were fixed in formalin, the tissue processing was done and sections were stained by Hematoxilin and Eosin method. The malignancy was diagnosed by two pathologists blindly. Over expression of ki67 was determined with the immunohistochemistry method. Slides were scored into negative, weak, average and strong based on percentage of cells which were stained. The Data were analyzed by SPSS-11.5, Chi-Square and Fisher’s exact tests.Results: Ki67 proliferative marker was observed in 37 (46.3%) specimens with breast cancer. Sensivity of staining was one positive (+) in 15 cases, two positive (++) in 14 cases and three positive (+++) in 8 cases. There was a significant relationship between Ki67 gene expression and tumor type and tumor staging (P<0.05), but there was no significant relationship between Ki67 gene expression and tumor grade.Conclusion: It is concluded that, ki67 is expressed mostly in invasive and developed breast cancer.

Background and Objective: Neisseria meningitidis is an obligate pathogen of human and temporary colonizes the mucosa of upper respiratory tract. This study was done to determine the frequency of pharyngeal Neisseria Carriage among 10-12 years old pupiles.Materials and Methods: This cross sectional study was carried out on 364 pupiles at four primary schools in Tehran during spring 2008 and winter 2009. The samples were collected from pharyngeal region and were cultured on Thayer-Martin Agar.Results: Among 364 collected samples from pharynx of pupiles, Neisseria meningitidis not found on the selective media, but three of pupiles were carrier of Neisseria lactamica.Conclusion: This study showed that Neisseria meningitides colonization was not observed in the pharynx of 10-12 years old pupiles.

Background and Objective: The characterization of any disease have important role for the evaluation and control strategy and programming of diseases. This study was done to determine the epidemiology of Tuberculosis in Iran during 2001-08.Materials and Methods: In this descriptive cross sectional study, Annual percentage change (APC), average annual percentage change (AAPC) of Tuberculosis incidence rate, mortality of Tuberculosis, case detection rate, success percentage in Tuberculosis treatment and relapses cases during 2001-08 have been studied in Iran. Linear segmented regression model was used for analysis trend of Tuberculosis and estimate parameters.Results: The trend of Tuberculosis smear positive (SP) incidence rate was reduced in Iran during 2001-08. Anually, 4.1% and 3.6% reduction took place in incidence rate and relapses cases, respectively. Tuberculosis mortality decreased annually by 6.8% and success in case detection increased by 2.5%. The Tuberculosis treatment though AAPC is decreasing by 0.5%. The trend of Tuberculosis are higher among women and in both sexes over 65 years of age.Conclusion: This study showed that trend of SP pulmonary tuberculosis and treatment success rate is decreased, but case detection was increased.

Background and Objective: Normal psychological behaviour is one of the general concept of health. This study was carried out to evalute psychological disorders among inhabint residing in poor social district of Gorgan, Iran.Materials and Methods: This cross-sectional study was done on 376 subjects (188 males and 188 females) with simple random sampling method. Data were gathered using the general health questionnaire (GHQ-28). Data was analyzed by SPSS-16, Kruskal-Wallis and Pearson tests.Results: The prevalence of psychological disorders was 37% (33.5% in men, 40.4% in women), depression was 24.45% (22.5% in men and 26.4% in women) and anxiety was 31.6% (31.2% in men, 32% in women). Social affairs disorder 21% (19.2% in men, 22.7% in women) and psychosomatic disorders in 28.5% (22% of men, 35% of women). The relationship between psychological disorder with economic level and family size was significant (P<0.05).Conclusion: This study showed that 37% of inhabint residing in poor social district of Gorgan, Northern Iran had psychological disorders.

Background and Objective: In term of health and economic, Hospitals is the most important sector in the healthcare providers. Therefore it is necessary to use economic analysis to achieve optimum performance. This study was done to determine the revenue sources of 150 Iranian educational hospitals during 2007.Materials and Methods: In this descriptive analytical study, data was collected by using of web based software in 150 educational hospitals affiliated to medical universities in Iran. We used the questionnaire for gathering the hospital profile which was filled by experts of budget personel in Ministry of Health and Medical Education.Results: 23674 active beds were in 150 selected hospitals. The total revenue was 4116 billion Iranian rial. The two major sources of total revenue were insurance organizations reimbursement (75.97%) and out of packet payment (24.03%). Per bed revenue was 174 million rial. The composition insurance organizations reimbursement are medical services insurance organization (46.7%), social security organization (32%), army force insurance organization (5.8%), Emdad committee insurance (2.9%), traffic injuries (business insurance) (9.7%), donors funds (0.1%) and the other insurance program (2.7%).Conclusion: The revenue of hospitals in Iran, highly depended on insurance reimbursement. Therefore, the hospitals confront serious problem if insurance organizations delay the reimbursement.

Background and Objective: Urinary tract infection is the most common bacterial infection during pregnancy. The pregnant women seems to be at risk for pyelonephritis and untreated infection. Timely recognition and on-time appropriate treatment of urinary tract infection particularly in pregnant women reduce the related complications. This study was done to assesse Sensitivity of isolated E.coli from pregnant women urine to antibiotics.Materials and Methods: In this descriptive study E.coli isolated from 360 urine samples from pregnant women, were examined, using Eosin Methylene Blue, blood sugar method. Antibiogram diffusion disk Kirby-Bauer was performed to assess the antibiotic response.Results: The persent of sensitivity of Escherichia coli to antibiotics were Co-amoxiclav (5.72%), Ampicillin (8.86%), Amoxicillin (11.87%), Cefazolin (32.12), Cephalexin (36.1%), Gentamicin (40.28%), Co-trimoxazole (48.15%), Nalidixic acid (55.3%), Nitrofurantoin (72.48%) and Ceftriaxone (80.78%).Conclusion: This study showed that there is a high level of E.coli antibiotics resistance toward Amoxicillin and Ampicillin high sensevity is related to Ceftriaxone and Nitrofurantoin in this region.

Background and Objective: Patients consent for medical care is a legal requirement. Consent is a document that patient must be necessary aware about all risks of surgery, treatment strategy, Substitution and the risks involved by physician. This study was done to evaluate status of filled consent form of hospitalized patients in Ardabil - Northwest of Iran.Materials and Methods: This descriptive cross sectional study was done by interview with patients and accompained patients in hospitals of Ardabil - Northwest of Iran during 2010. Patient demographics and other variables gathered by a questionnaire. Data was analyzed by Chi-Square test.Results: 86 (57%) of patients were female and 64 (43%) male.35 (23%) were illiterate and 92 (61%) under diploma.45% of patients get information about their illness from doctors. According to patient ideas, 13% of reception personals did not complete consent form. 65 (43.3%) of patients stated that the context of consent form was unreadable and long. Rate of completing form for patients were 87%.40% of completed forms was not signed by witnesses. The patients and relatives were not satisfied with the form itself, and this observation statistically was significant (P<0.001).Conclusion: This study showed that validity of completed consent forms are low and it is necessary to design programs for improvement the quality of filling the consent forms.