مجله دانشگاه علوم پزشکی گیلان
پیاپی 77 (بهار 1390)

Dendritic cells are professional antigen presenting cells that obtain necessary regulatory signals for T cells. T regulatory cells are effective cells in reaction with dendritic cells and have an important role in treating of diseases. To evaluated the effect of TGF-β(Trancforming Growth Factor β) Cytokine in dendritic cell generation and capacity of these cells in regulatory T cells development in culture media. In this experimental study blood samples were obtained from 5 volunteers then peripheral blood mononuclear cells were isolated by using Phicole Hypaque dendritic cells of peripheral blood monocyte were produced by GM-CSF IL-4 and TGF-β in comparison with control group. Mixed leukocyte reaction was accesed in allogenic T cell and dendritic cell. The number of CD4+CD25+ T cells CD14+ and their surface markers were evaluated by Flowcytometry. In this study dendritic cells produced in presence and without presence of TGF-β cytokine. The proliferation level of T cells decreased in mixed leukocyte reaction with dendritic cell-treated TGF-β in comparison with control group. In addition the number of T CD25+ cells increased 27 percent in culture media including dendritic cell-treated TGF-β in comparison with control group(p<0.05). The TGF-Beta molecule caused effect on the dendritic cells and producted cells with inhibiting of immune responses in mixed leukocyte reaction. So it concluded that these cells can be have an important role in preventing of unwanted immune reaction invitro.

Marginal seal in class V Cavities and determining the best restorative material to decrease microleakage of them is very important in operative dentistry. To evaluate the microleakage of class V cavity preparations restored with three different types of resin composite and resin modified glass Ionomer. Two class V cavities were prepared in buccal surface of 32 recently extracted premolar teeth. The occlusal margin of each restoration was on enamel and the gingival margin on dentin. Teeth were randomly assigned to four groups of 8 teeth and restored as follows: Group I: microhybrid resin composite (Z250); Group II: nano composite (supreme); Group III: Flowable composite (3M); Group IV: resin modified glass Ionomer (vitremer). In all groups the manufacture instructions were strictly followed. All teeth were immersed in 50% Silver Nitrate during 4 hours and developing solution for 8 hours after thermocycling. The teeth were longitudinally sectioned and observed under a stereomicroscope. The degree of dye penetration was recorded and analyzed with the kruskal-wallis and mann-whitney test. There was no evidence of microleakage on the enamel margins in any groups. When the margins were in dentin vitremer and flowable composite had the less and the most level of microleakage in dentinal margine respectively (p<0.05). There was no significant differents in other groups of dentinal margin. Vitremer has an efficterness role and flawable composite has a weakness role in reducting microleakage of dentinal margin.

Reactivity and negative emotion regulation strategies increased the proboblity substance abuse. Also, those persons who could not control ones arousals probability endangared more risk of substance abuse. Comparison the emotion of regulation strategies between substance abusers with high and low reactivity. In this cross sectional and analytical study, 100 people were selected through census sample method among the substance abusers who were referred to centers of addiction in Ardabil. Data was gathered by emotion cognitive regulation Scale and Interpersonal Reactivity Index. MANOVA were used to analyze the data. The results of this study showed that substance abusers with high reactivity have negative emotion regulation strategies and substance abusers with low reactivity have positive emotion regulation strategies. This Study indicated that high reactivity and use of negative Emotion regulation strategies are the risk factors for substance abuse.

Perfectionism is considered as a characteristic personality for striving performance without deficiency of excessively high standards by tendencies for overly critical evaluations of ones behaviour; in addition job burnout is a variable that could be increased by unhealthy perfectionism and outcomes. Although perfectionism considered appropriate but it may lead to increase some problems like burnout in some vocations like nursing. Investigating the relation between perfectionism and job burnout in 344 nurses in Rasht in 2008. In this descriptive- correlation study, 344 nurses were selected by cluster random sampling of Razi, Dr Heshmat, Velayat, Poorsina and Amir- al- momenin Hospitals in Rasht. Frost multi perfectionism inventory was used for studying perfectionism and Maslach and Jakson’s job burnout inventory was used for studying job burnout. Correlation coefficient and regression and Manova were used for data analysis. Our hypothesis imparted reverse correlation between positive relation and negative dimensions of perfectionism. The results showed that there was a negative relation between job burnout, organization, parental expectance and personal standards (t=-0.227,-0.131,-0.132 respectively, P<0.05). Regression analysis showed that just organization dimension can predicted job burnout in our sample (Beta=-0/197, t=-3/555).In addition age was significant in two younger groups as a prespective variable in relation with profectionism criterion variable. This study showed that job burnout will be decreased by improving positive dimensions of perfectionism such as organization and personal standards. Also perfectionism in younger nurses is more than older ones, so it is better to improve positive dimensions of perfectionism to promotion the quality of their services.

Psychiatric disorders are common in Irritable Bowel Syndrome (IBS) patients. Prevalence of psychiatric disorders is varies in IBS patients in different societies. Objevtive: To determine the prevalence of psychiatric disorders (anxiety-depression) in IBS patients in Rasht. In this cross-sectional study, 256 IBS patients were selected (using criteria of Rome III) and evaluated for psychiatric disorders. In the first phase, subjects were screened by GHQ28. In the second phase, those patients who had scores equal or more than 23 were assessed through semi-structured psychiatric interview. Socio-demographic variables including age, gender, marital status, educational level and occupation, were recorded as well. P-values less than 0.05 were considered statistically significant. Among 256 subjects 30 patients (11.7%) had no significant psychiatric symptoms and 226 subjects (83 male, 143 female) suffered from some degrees of psychiatric problems. After performing semi-structured psychiatric interview; 190 subjects (74.2%) had anxiety-depressive problems [89 patients were suffered from pure anxiety disorders, 41 patients suffered from depressive disorders and 60 patients had co-morbid anxiety-depressive disorders]. In anxiety disorders; generalized anxiety disorder (53.7%) and in depressive disorders; dysthymia (53.5%) had the most frequencies, 53.7% and 53.5% respectively. In comparisone of anxiety-depressive subjects (190 persons) and normal subjects (66 persons), there was a significant statistical differences between the gender (P=0.019), occupation (P=0.002) and intensity of IBS (P<0.001). Although, further studies are needed to determine the relations of demographic variables and types of IBS with psychiatric disorders, it seems to more attention to the psychiatric disorders of some specific patients suffering from IBS is helpful to their treatment.

Irritable Bowel Syndrome (IBS) is the most common gastrointestinal disorder in clinical medicine, since it is not founded biological basis for it, role of psychological causes is investigated in creation of it. To compare the personality characteristics between three groups of patients with Diarrhea dominant, Constipation dominant and dominant of Altering type and investigating the gender, family background of IBS and length of illness. Eighty five patients were selected through temporal classical random method and included of 21 patients with Diarrhea dominant, 30 patients with Constipation dominant and 34 0patient with Altering type). Patients were diagnosed by a gastroenterologist and using the ROME  criteria after clinical evaluation and endoscopy. Personality inventory (NEOPI-R) made by Mc Crue and Kosta containing big five personality factors was used for investigating the sampels personality characteristics. Demographic characteristics and other groups were recognized by question made at the first of main questionnaire. The groups eperated of each other. Analysis of data indicated that there were no significantly differences between the personality characterisrics in three groups of patients. Extraversion was significantly higher in patients with family background of IBS and patients who had IBS more than six mounth and had reported stress gained higher score at neuroticism in comparison with patients who had IBS less than 6 month and had not report stress. Psychological factors participated at quality of illness experience. Neuroticism may be correlated with quality of illness experience (with stress and high length of illness). Thus personality characteristics should be considred as an important factor in improvement of IBS patients by psychiatrics and specialists.

Carotid stenosis is the most common cause of crebrovascular accidents. If we select the patients appropriately, carotid endarterectomy would be acceptable regarding to mortality and morbidity for vascular complications. Since, carotid endarterectomy related complication is dependent on experience, equipment and facilities of surgical team, each surgical ward should be evaluated for complication separetely. Evaluating the postoperative mortality and morbidity and complication of carotid endarterectomy in patients with carotid stenosis in surgical wards of Razi Hospital in Rasht during September 2006 until end of February 2010. In this descriptive study, 51 patients undergoing carotid endarterectomy in surgical wards of Razi Hospital were recruited. Postoprative complications, mortality and morbidity of carotid endarterectomy were recorded during hospitalization and one month follow up period after discharge. The mean age of patients was 66.69±10.33. 35 subjects of patients were male and 16 subjects of patients were female. Mortality was reported in one case (%1.96), complication in asymptomatic patient was (%1.96), in symptomatic patient with Transient Ischemic Attack was (1.96%) and in Cerebro Vascular Accident patients was (0%). Conclusian: Results of this study showed that the rate of mortality and morbidity is acceptable after endarterectomy surgery in Razi hospital in comparison with NASCET. So in order to elevation of quality of surgery in this center, results of surgery should be recorded and analysed every year.

The radial head subluxation is a common cause in less than 7 years old children who refered to emergency center after pulling of their wrist by parents. Compare the method of wrist supination with elbow flexion as classical method with hyperpronation method in reduction of radial head subluxation (pulled elbow) in children less than 7 years old referig to poorsina hospital during 2004-2009. In this randomized clinical trial, children who had referred to Poursina orthopedic emergency center with clinical diagnosis of radial head subluxation were studied consequent. Patients were randomly treated as consequent male and female with one of two methods. The patients were checked in order to diagnosis extremity functions return every 5 minutes. If extremity function had not returned, the primary method was repeated after 15 minutes. Unsuccessful treatment led to treatment with another method 30 minutes after first try. That method repeated if replacing method was not successful after 15 minutes. If both methods were unsuccessful, elbow radiography to roll-out other injury was performed. After collecting data, analysis was performed using chi- square test and T- test with SPSS software version 16. Among 110 patients were included in this study with average age (4.05±1.51 years) 58 patients (3.91±1.41 years) with first method (SF) and 52 patients (4.21±1.62 years) with second method were treated. (P=0.31) %62.7 of patients were male and the remaining were female (%37.3). In 47 patients (%90.4) of 52 patients who were treated by (HP) method. This was 46 patients (%79.3) from 58(P=0.11). Five patients of (HP) group needed second attempt where as this number were 12 about (F) group. Treatment with (HP) method was successful in 100 percent patients, but successful rate was %87.9 for (SP) method. There was significant superiority of (HP) success in comparison to (SF) (P+0/006). In reduction of radial head subluxation(HP) method was more successful upination method in reduction of radial head, it is more successful than supination, when supination was not successful than(SF) method.

Injury with contaminated sharp devices like used needles is the great potential risk factor in nursing staff. Severity of infectious complications of these injuries demonstrated the value of prophylactic activities. To evaluate epidemiologic features of needle stick injuries and coverage of Hepatitis B vaccine among nursing staff in Bualisina hospital in Qazvin from march 2007 to march 2008. In this cross sectional descriptive study, data of needle stick injuries if staff was gathered by direct interview. For statistical analysis were used t student, chi square and Fisher exact test. P value above 0.05 was considered statistically significant. In this period among 172 nurses, 55 subjects experienced needle stick injuries (32%). There was no statiscaly relationship between needle stick injuries with educational level, gender, and related training courses; but there was a statiscaly relationship between the injuries and the number of continous shifts. Reporting the injury to the hospital supervisors was statiscaly significant in nurses who had university education. According to undesirable complications of needle stick injuries, it is considered to organize educational programs in order to decreasing continues shifts in nursing staff and emphasis major priority of prevention methods.

The statistics of HIV/AIDS patients are increasing in the world and Iran. Since previous studies indicated that family structure and communication had an important role in high risk behaviors engagement, Assessing role of family system in high risk behaviors would be help to explore solving problem and prventing high risk behaviors. To determine the effect of family on high risk behaviors. Matarials and This thematic analysis study with qualitative approach was done during 10 months in Behavioral Counseling Clinic of Imam Khomeini Hospital and West Clinic in Tehran. The participated patient were selected by purposeful sampling and data was obtained from in dept and semi-structured interview with open end questions. Total interview was recorded and typed word to word. For analysies the results review of transcripts, themes gained from data and coded categorized were done. Among 61 HIV/AIDS patients 45cases were HIV positive and 16 cases were AIDS patients with range age 21-42 years old with average age of 29.7± 4.86. There were 62.3% males and 37.7 were females. Majority of them was single with secondary and high school educational level. Themes consisted of: 1- defact in family function 2- vulnareble stacture of family 3- risky family norms. This study showed that core variable was inadequate support of family.Then increasing support of family in adolescents and family base intervention can be reduce high risk baheviors and HIV/AIDS incidence.

Despite the easy of detection of cervical cancers in the pre-cancer stage, it is still one of the most common cancers in Iran and the world. The responsibility of womens education about this safe and unexpositive screening test is for nurses and midwives. Survey the knowledge, attitude and practice on Popsmear in nurses and midwifes in Alzahra Maternity Hospital. In this cross-sectonal study, 80 Nurses and midwives of Alzahra maternity Hospital were studied. Data collection tool was a questionnaire designed in 5 section to determined their knowledge, attitude and practice. Chi- square, Maun- Whitney – U, Fishers exact test, Kruskal-wallis and T – student test SPSS ver14 were used for statical analysis. Knowledge of 91.3 % of participations was scored as "Good" and it was significantly different between nurses and midwives. 83.8% of them has "positive" attitude toward the test. There was no significant relationship between attitude, age, duration of occupation and marital status of two groups. Nurses and midwives were matched in terms of age; marital status and duration of occupation.42/9 % were remarked to have (good) practice. With regard to Knowledge role of nurses and midwives in performing papsmear screening test it is necessary to improvement their education and compare their attitude and practice.

The Thyroidea Ima artery (The artery of Neubauer), was recognized and described by Neubauer in 1786. This artery which was described in the all anatomical textbooks may arised from the arch of aorta, brachiocephalic trunk or other arteries in the upper mediastina. It is considered as a compensatory artery when the other thyroidal vessels showed deficiencies. This artery showed greatly variation in size and gave some anastomotic branches to the thymic artery. The thymic artery arised from the anterior mediastinal branch of the internal thoracic artery but, may also arised from the brachiocephalic trunk, arch of aorta, common carotid or the main trunk of the internal thoracic artery. Its origin from the thyroidea ima is rare. Case History: This rare case was seen in a 65 years old male cadaver, the common trunk of the thyroida ima and the thymic arteries originated from the brachiocephalic artery. After a short course it divided into two branches: an ascending (thyroida ima) and descending (thymic) branches. The thyroidea ima artery turned to left and upward to the lower border of the isthmus of thyroid gland. At this point it sent a branch to the lower part of the left lobe of the thyroid which penetrated it deeply and ended in the left inferior parathyroid gland. The main branch continued its course upward to the upper border of the thyroidal isthmus and divided into right and left branches. Each of these branches, after sending a great anastomotic branch to the superior thyroidal artery of their own side, terminated as several small branches in the upper part of the right and left lobes of the thyroid gland. The thymic artery continued its course downward for about three centimeters and ended as two branches in the right and left lobes of thymus. The thyroid gland of this cadaver was larger than the normal ones and the thymus was also clearly noticeable with right and left bobs. According to the embryonic origin and the developmental processes of the inferior parathyroid glands and the Thymus from the neighboring pharyngeal pouches, their blood supply from a common trunk will be acceptable especially when these two glands show some degree of enlargement as shown in this case. In the cases of thyroidectomies, when a surgeon is going to resect an enlarged thyroid gland, the presence of thyroidea ima artery and its branches to the lower part of lobes of thyroid gland would be a useful guidance to identify the inferior parathyroid glands an save them for the prevention of the next hypocalcemia.