فهرست مطالب mohammad reza hatef

The chemical reactivity of concrete is one of the most important factors in long term damage and destruction of concrete structures. In this study, the chemical reactivity of some large concrete structures in the south of Iran has been investigated. For this purpose, the concrete sections of six large dams have been studied during field visits and taking more than 16 concrete samples and sediment of concrete surface. The investigated structures include Dez, Balaroud, Godarlandar (Masjed-Soleyman), Gotvand Uleya, Karkheh, and Jarreh (Ramhormoz) dams. Using field investigations, determination of Damage Rating Index (DRI), and chemical composition of the surface sediments and leachate of the concrete, the chemical reactivity of the concrete and its degradation have been investigated. The method of DRI is the petrographic method to quantify the state of damage of concrete by the alkali-aggregate reaction. The results of DRI and field studies show that except for Dez dam, all concrete structures under study have alkali-aggregate reaction, but it is not yet developed enough to cause serious damage to its concrete. The results of the XRD whit emphasis field evidence indicate the presence of external sulfate attacks in the studied parts of Jarreh and Balaroud dams.

The current study aimed to assess the correlation between lipoproteins, in particular lipoprotein a [Lp (a)], and inflammatory activity in rheumatoid arthritis (RA). This retrospective case control study was conducted over a period of 6 months and studied two groups, RA patients (n=70) and healthy control subjects (n=52), who were matched by age and gender (P value<0.005). The modified Health Assessment Questionnaire (MHAQ) was employed by self-administration. Fasting lipid profiles including LDL, HDL, total cholesterol, triglycerides, and Lp (a) were assayed, and the findings for the two studied groups were compared using the Student t test. Thirty-two patients in the RA group (45.71%) and 27 subjects in the control group (51.92%) had abnormally high Lp (a) levels (P value=0.57). Mean serum Lp (a) values between the RA and control groups were significantly different (P value=0.79). Serum Lp (a) had no significant correlation with ESR (r=0.27, P value=0.028). No significant correlation was found between Lp (a) level and MHAQ (r=0.11, P value=0.37). Serum Lp (a) was also found to have no significant relationship with other laboratory parameters (CRP and RF) or clinical indices of RA activity (functional class and morning stiffness duration). No correlation was observed between serum Lp (a) and clinical/laboratory indices of RA activity other than a weak one with ESR. It is not recommended to use routine serum Lp (a) measurements to assess RA severity.

Juvenile idiopathic arthritis (JIA) is one of the most common chronic rheumatic diseases in children. The complex nature of this immune-mediated disease owes itself to several predisposing genes and environmental factors affecting its pathogenesis. Conducted in Iran, this study was originally intended to investigate every possible association between HLA DRB1 alleles and a susceptibility to JIA.
In this case-control study, 45 patients with a definite diagnosis of JIA based on International League against Rheumatism (ILAR) criteria were compared against 46 healthy controls. DNA samples taken from both groups were analyzed using PCR-sequence specific primers (PCR-SSP) method. Data analysis including parametric and nonparametric test and multivariate analysis was undertaken using the SPSS 11.5 software. A P-value Mean ages in case group and healthy controls were 14.64±6.21 and 13.73±6.39, respectively with no significant difference between the two groups (P=0.515). Sex difference between JIA group and healthy controls was also not significant (P=0.068) .The frequency of HLA-DRB1*01 was found the most frequent HLA-RB1 in our patients (33.3%). No significant statistical correlation between various HLA-DRB1 alleles and clinical subtypes of the disease could be established from the data. HLA-DRB1*11 was shown to raise protection to JIA (P=0.035, OR=2.755, 95% CI=0.963-8.055) in northeastern Iran. In addition, we found that HLA-RB1*09 is nominally associated with an increased risk of JIA (P=0.56, OR=2, 05, 95% CI=0.18-23.63).
HLA-DRB1*11 was shown to raise protection to JIA in northeastern Iran. The disparity of findings in other ethnicities prompts further investigations with larger sample sizes.

Systemic lupus erythematous is an autoimmune disease associated with atherosclerotic manifestations or metabolic disturbance due to inflammation. The aim of this study was to determine frequency of metabolic syndrome (MetS) in SLE compared to healthy controls.
In this cross-sectional study, 150 SLE patients and 220 healthy volunteers were enrolled. MetS was diagnosed according to ATPIII criteria. Patients and controls were compared according to prevalence of MetS. In addition, SLE patients with and without MetS were compared according to laboratory parameters. Each patient also fulfilled a checklist about routine daily activities and diet program. Data were analyzed by SPSS-11 software.
MetS was significantly lower in SLE than healthy controls (18% vs 29.1%, P=0.015). Disease manifestations, major organ involvement, serum values of complements and anti-DNA antibody and pharmacological therapy did not correlate with MetS occurrence in patients. The mean TG, FBS, systolic and diastolic BP were statistically higher in lupus patients compared to healthy volunteers in contrast to waist circumference. HDL-cholesterol serum values did not show any significant difference between two groups.
It seems that despite higher values of blood pressure, serum lipids and glucose in lupus patients, the cumulative metabolic components were in a manner to make MetS more prevalent in healthy volunteers. As far as life habits are concerned, lupus patients in general did not exercise enough and did not go on a healthy diet despite of glucocorticoid therapy and hypertension.

IgG4-positive plasma cell infiltration has been observed in patients with other conditions, including retroperitoneal and mediastinal fibrosis, inflammatory pseudotumor of the lungs and liver, Küttner tumors, and interstitial nephritis, indicating that these diseases and conditions collectively constitute a new disease concept known as "IgG4-related disease". The aim of this study was to present a case of a typical IgG4 syndrome.
Case Report: The case presentation involves a 33-year-old man with a soft tissue mass (3 × 4 cm) on the right side of his frontal area which had enlarged over the space of a year. He had not experienced any allergic disorder, weight loss, night sweating, or anorexia, and did not smoke or use illicit drugs. On examination his vital signs were normal. He had no complains of fever, rash or urticaria. The soft, round mass in the right side of the frontal area had no pain and tenderness, redness, or discharge for the year. Other examinations gave normal results. He was then referred to a rheumatologist.
In further laboratory work, high IgG4 level (119.6; normal range: 5.9-86) was detected and in histopathological studies, chronic inflammation, fibrosis, lymphomononuclear and eosinophilic infiltration with a dilated vascular network were reported.

Due to loss of function and intolerable pain associated with Osteoarthritis (OA), this condition is regarded as one of the major causes of disability, worldwide. Aging and obesity are regarded as two fundamental causes of knee OA. The aim of this study was to review the literature on the efficacy of hyaluronic acid in compression [z1] in patients with knee OA. A systematic web-based search was conducted in Cochrane Library and MEDLINE to identify articles published before December 2014. English articles with available abstracts, relevant to the subject of the study, were retrieved. Moreover, manual search was performed in reference lists of the articles. Two commentators independently reviewed and assessed the inclusion criteria, evaluated the quality of articles and extracted the data. The evaluated articles were published during 2011-2014. All studies were conducted on adult patients with knee OA. Overall, 745 patients were evaluated in five studies. More than 100 participants were enrolled in four studies and 90 patients were included in only one study. Based on the findings, the application of single-dose platelet-rich plasma is safe, useful and cost-effective in patients with knee OA.

Lupus nephritis (LN) is the main cause of mortality and disability in systemic lupus erythematosus (SLE) patients. Therefore, utilizing a reliable and non-invasive method for serial measurements of renal function seems to be necessary. The aim of this study was to evaluate the role of urinary lipocalin-2 as a biomarker of renal involvement in SLE patients. Fifty two lupus patients in this cross sectional study were divided into two groups: patients with and without nephritis. For each group, urinary lipocalin-2, values were measured and reported according to urinary lipocalin-2/creatinine. Urinary lipocalin-2/creatinine sensitivity and specificity for identifying biopsy-proven nephritis were calculated, and a receiver operating characteristic (ROC) curve was constructed. The mean urinary lipocalin-2/creatinine value of patients with biopsy-proven LN was 2.99 ± 4.1 ng/mg, and in non-LN patients was 1.16 ± 1.27 ng/mg. Urinary lipocalin-2/creatinine levels in LN patients were significantly higher than those in non-LN patients (P- Value = 0.03). In LN patients, urinary lipocalin-2/creatinine significantly correlated with proteinuria (r = 0.68; P = 0.0001). Using a cutoff value of 0.896 ng/mg, urinary lipocalin-2/creatinine had a sensitivity of 89.7% and a specificity of 39.1% for identifying SLE patients with biopsy-proven LN. The area under the ROC curve was 0.664 ± 0.076 with a 95% confidence interval of 0.52-0.81 (P=0.04). Analysis of variance showed that urinary lipocalin-2/creatinine is the same in different classes of LN (P-value=0.28). An important clinical conclusion is that measurement of urinary Lipocalin-2 may result in earlier diagnosis of LN.

Apoptosis is a tightly regulated process and plays a crucial role in autoimmune diseases. Because abnormalities in apoptosis are considered to be involved in the pathogenesis of systemic lupus erythematosus (SLE), in present study we studied the apoptosis in T lymphocytes from Iranian SLE patientsat protein and gene expression levels for some molecules which are involved in apoptosis pathways. Thirty five SLE patients (23 female, 12 male), and 20 age matched controls (10 female, 10 male) participated in this study. T lymphocytes were isolated from peripheral blood mononuclear cells (PBMCs) using MACS method. Apoptosis rate was studied at protein level by flow cytometer using Annexin V, and at gene expression level using semi-quantitative RT-PCR method for detection of Fas, FasL, Bcl-2, caspase 8, and caspase 9 genes. The percentage of apoptotic cells in SLE patients was not different in comparison with controls (20.2% ± 1.4 vs 21.1% ± 1.0), but the expression levels of FasL, caspase 8, and caspase 9 genes in all SLE patients and in female patients were significantly lower than controls; 0.45R vs 0.78R for FasL, 0.74R vs 1.0R for caspase 8, and 0.76R vs 1.26R for caspase 9 in all SLE patients and 0.37R vs 0.82R for FasL, 0.45R vs 1.6R for caspase 8, and 0.63R vs 1.56R for caspase 9 in female patients. The expression levels of FasL, caspase 8 and caspase 9 molecules involved in apoptosis decreased in female, but not in male SLE patients.

Systemic lupus erythematosus (SLE) is an autoimmune disease with unknown etiology. Some environmental factors can induce SLE in genetically susceptible individuals; for example, sun exposure and some viral infections may emerge the disease manifestations. Human T lymphotropic virus type 1 (HTLV-I) can dysregulate the human immune system, and the role of this virus in the pathogenesis of autoimmune diseases is under investigation. There are conflicting data about the role of HTLV-I in the pathogenesis of several autoimmune diseases such as SLE. In this study, we have focused on the correlation between HTLV-I infection and SLE in the northeast of Iran, an endemic area for the virus. One hundred and thirty women with SLE and 915 healthy controls were screened for HTLV-I by enzyme linked immunosorbent assay (ELISA). Western blot method was used for confirmation of the positive results done by ELISA in the patients and the control group. Two (1.5%) of the patients and 23 (2.5%) of the healthy controls were HTLV-I seropositive. There was not a statistical difference between patients and controls in the number of HTLV-I seropositive samples (P=0.49). This cross-sectional case-control study did not find any association between HTLV-I and SLE. With regard to the previous studies, these controversies may stem from differences in ethnic background. Geographical and environmental factors should also be taken into account.

BackgroundCeliac disease is an autoimmune disorder which causes malabsorption in genetically susceptible patients who consume gluten. Celiac disease is not limited to the gastrointestinal system, and exhibits different signs and symptoms in other organs. Malabsorption of calcium and vitamin D can cause osteomalacia and secondary hyperparathyroidism. Celiac disease is no longer a rare disease and is more frequent in the Middle East. It is expected that 1% of the in general population has celiac disease. This study aims to determine the prevalence of osteopenia and osteoporosis in Iranian patients with celiac disease.Materials and MethodsIndividuals with intestinal and extra-intestinal problems who had positive serologic tests for anti-tissue transglutaminase or antiendomysial antibody were offered endoscopic duodenal biopsy to confirm their diagnoses of celiac disease. Biopsy-proven celiac disease patients between the ages of 20 to 60 years were enrolled. Exclusion criteria were as follows: 1) the use of drugs such as corticosteroids, anticonvulsants, heparin, cyclosporine, statins, and β-blockers, 2) the presence of any neoplasm, and 3) any metabolic disorder such as diabetes, hyperthyroidism, Cushing''s, and immobility. After obtaining informed consents, we evaluated 76 patients diagnosed with celiac disease. All enrolled patients underwent BMD measurement of the hip, femoral neck, and spine using dual-energy X-ray absorptiometry (bone densitometry with DEXA scan).ResultsA total of 76 patients with celiac disease of ages 20 to 60 years old (mean: 33 years old) underwent bone densitometry. Of these, 66% were female and 33% were male. There were 44 patients (57%) who had normal bone density in the spine, 17 (22.4%) who had osteopenia, and 15 patients (20%) had osteoporosis. In the femoral neck, 38 patients (50%) had normal bone densitometry, 25 (32.9%) had osteopenia, and 12 (15.8%) had osteoporosis. Low bone mineral density (osteoporosis or osteopenia) was seen in 48% of our patients in the femoral neck and 43% in the spine.ConclusionThe prevalence of osteoporosis among celiac disease is much higher than the general population. Of the study patients, 55% had osteopenia in the femoral neck or spine and 36% had osteoporosis in the femoral neck or spine. The prevalence of osteoporosis is elevated enough to justify a recommendation for osteoporosis screening of all patients with celiac disease.

Vitamin D has immunomodulatory function. Polymorphisms of the gene encoding the vitamin D receptor detected by BsmI may be source of diversity in its action. An association between vitamin D receptor gene BsmI polymorphisms and lupus nephritis has been reported. This study was performed to evaluate vitamin D receptor gene BsmI polymorphisms in lupus nephritis.

Twenty nine patients with lupus nephritis enrolled in this study. Vitamin D receptor gene typing was performed based on polymerase chain reaction-restriction fragment length polymorphism.

Vitamin D receptor genotyping of BsmI polymorphisms was 20.6% for BB, 51.7% for Bb, and 27.5% for bb without statistically significant difference (P = 0.090). In 21 patients that renal biopsy was done, the Bb genotype was the most (42.8%). There was not any correlation between renal histology and vitamin D receptor gene BsmI polymorphisms (P = 0.068).

There was no relationship between vitamin D receptor gene BsmI polymorphisms and lupus nephritis.

Soluble Fas (sFas) is a marker of apoptosis that appears to increase in the serum of systemic lupus erythematosus patients and may have a correlation with disease activity. The exact role of sFas in apoptosis is not clear. The purpose of this study is to assess the correlation between serum levels of soluble Fas (Apo/1-CD95) and the activity of systemic lupus erythematosus. Patients and Our study was performed on 114 systemic lupus erythematosus patients who were compared with 50 randomly selected sex، age and race-matched healthy controls. Disease activity was defined according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K). All physical exams and laboratory parameters were collected to determine the SLEDAI. sFas levels were determined using a commercially available ELISA kit. There was a significant difference between serum levels of sFas in the case and control groups (P=0. 001). A significant correlation coefficient existed between the sFas and SLEDAI2K variables (P=0. 001، r=0. 494). Significant statistical difference was found between serum levels of sFas in the active and inactive phases of disease according to SLEDAI≤ 9 or ≥10، (P=0. 002). The sFas levels were 270 – 300 pg/mL for SLEDAI≤9 and 355-502 pg/mL for SLEDAI≥10، with a confidence interval of 95%. This study shows a significant elevation of sFas levels in the sera of systemic lupus erythematosus patients with active disease; therefore it can be used as an appropriate marker for evaluation of disease activity

Systemic Lupus Eyrythematosus (SLE) is an autoimmune disease characterized by antibodies to nuclear antigens, particularly anti-dsDNA. Imbalance between production and destruction of immune cells causes cytopenia. Sex hormones have immunomodulatory effects; estrogen increases the production of autoantibodies in SLE prone NZB/NZW mice. To investigate the relationship between sex hormones, anti-dsDNA, and lymphocyte subsets in Iranian patients with SLE. 38 SLE patients (28 females and 10 males) meeting 4 of 11 ACR revised criteria for SLE classification, and 20 age and sex matched healthy individuals (10 females and 10 males) participated in this study. Lymphocyte subsets were analyzed using flow cytometric analysis. Serum anti-dsDNA levels and sex hormones concentrations were determined using commercial ELISA and RIA kits, respectively. The absolute count of white blood cells, lymphocytes, T lymphocytes(CD3+), T helper cells (CD3+CD4+), B cells (CD19+) and Nk cells (CD3- CD16+CD56+) in SLE patients diminished significantly in comparison to control group (p<0.05). IgG anti-dsDNA antibody levels were significantly higher in patients compared to controls as expected (p<0.05). Prolactin increased significantly, while DHEAS showed a significant decrease in SLE patients compared with the controls (p<0.05), however the level of estrogen did not have any significant difference in SLE patients in comparison to controls. Increased concentration of prolactin together with a simultaneous decrease in serum DHEAS in SLE patients are associated with anti-dsDNA elevation and a decrease in almost all lymphocyte subsets.