مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران
سال شصت و نهم شماره 12 (پیاپی 132، اسفند 1390)

Hypercholesterolemia is considered a major risk factor for pancreatitis, atherosclerosis and coronary heart disease. Cholesteryl ester transfer protein gene polymorphisms are known to be associated with changes in lipid levels. We investigated the association between a polymorphism in the CETP gene (D442G) with plasma lipid levels and CETP activity in patients with hypercholesterolemia. This case/control study that be done in Hamadan university of medical sciences (from October 2008 to September 2009), included 102 patients with hypercholesterolemia and 200 healthy individuals. Polymerase chain reaction and restriction fragment length polymorphisms were used to determine genotypic distribution and allelic frequencies of polymorphisms. The plasma CETP activity was measured by a kit in a fluorescence spectrometer. Lipid concentrations were measured by routine biochemical and enzymatic assays. Plasma cholesteryl ester transfer protein activity was significantly higher in the cases than the controls (P<0.05). The genotypic and allelic frequencies for this polymorphism were not statistically different between the patients with hypercholesterolemia and the controls (in controls: DD 96%, DG 4%, GG 0% and in cases: DD 86%, DG 10%, GG 4%), (P>0.05). Plasma HDL-C, LDL-C and TC were higher in both groups with GG and DG genotypes than with DD genotype, whereas serum CETP activity was lower in GG genotype compared with other genotypes (GD or DD), (P<0.05). The results showed that D442G polymorphism of CETP gene was associated with changes in lipid profile and plasma CETP activity in the selected population and it might have a role in contributing to a genetic risk for developing coronary artery disease.

Fumonisins, a family of mycotoxins, are mainly found in wheat, corn and their products. Previous studies have shown that fumonisin B1 (FB1), the most abundant and toxic of known fumonisins, has been associated with many animal and human diseases including cancer. In the present study, the effects of FB1 were examined on the production of inflammatory cytokines in intestine and stomach cell lines. This study was performed in the Cancer Research Center of Tehran University of Medical Sciences in 2010. The cell lines of colon adenocarcinoma (SW742) and gastric epithelium (AGS) were purchased from the Pasteur Institute of Iran. The cells were pretreated with different concentrations of FB1 (0 to 100 µM) for 3 days. The cells were later stimulated by lipopolysaccharides. Twenty-four hours after cell induction, the cytokines including tumor necrosis factor-alpha (TNF-α), interlukin-1 beta (IL-1β) and interlukin-8 (IL-8) were measured by ELISA. Treatment with FB1 induced a dose-dependent decrease in IL-8 production (P<0.05). This decrease was seen in both SW742 and AGS cell lines. Moreover, FB1 induced a dose-dependent increase in the production of TNF-α and IL-1β in both cell lines (P<0.05). The results of this study indicated that FB1 could increase the inflammatory cytokines including TNF-α and IL-1β in gastric and intestinal celllines. These effects might result in the development of inflammatory responses and subsequent mucosal atrophy in in-vivo conditions.

Uterine environment and fetal period can profoundly affect health of the neonat. Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor that regulates cellular stress responses and its activity is essential in both embryogenesis and postnatal life. The aim of the present study was to investigate the effects of maternal swimming on rat pup's HIF-1α levels as a key regulator of oxygen in lungs. Sixteen female Wistar rats weighing 180- 200 grams were acclimated to a new environment consisting of equal light-darkness cycle and ad lib access to chow and adapted to the stress caused by water for two weeks. The rats were divided into two swimming and control groups. Swimming training began on the first day of pregnancy in a pool and continued for 3 weeks (1 h/day, 5 days/wk). Pup's lungs were removed two days after birth and their HIF-1α concentration was determined with enzyme-linked immunosorbent assay (ELISA). Statistical analysis of the data was done using independent t-test. A p-value smaller than 0.05 was considered statistically significant. Swimming lead to a significant (P<0.001) increase in the pup's lung HIF-1α levels compared with the control group. Although 3-wk period of swimming training, showed no significant increase in weight and also lung weight of newborns. Thus it can be concluded that swimming endurance training in pregnancy, can be considered as appropriate alternative in order to embryos development. Our research suggests that HIF-1α level is an essential element for the development of the lungs of embryos. Moreover, further studies on the lung HIF-1α levels at post-natal period with different modes of exercise will provide more clear insight into the mechanisms of the findings resulting from this study.

Cystic fibrosis (CF) is a multiorgan autosomal recessive disorder. As CF is highly heterogeneous in Iran and many mutations have a low frequency, routine molecular diagnostic methods are not very efficient. The use of highly polymorphic intragenic markers not only can facilitate phenotype prediction in prenatal diagnosis by gene tracking, but also can lead to the demonstration of possible associations between haplotypes and specific mutations. We determined IVS8 polyT and M470V polymorphisms in exon 10 of CFTR gene in this case-control study.

Polymorphisms of IVS8 polyT in 53 patients with CF were referred to Amirkola children's Hospital of Babol University of Medical Sciences, 2007 to 2011 and 49 fertile healthy individuals were determined by reverse dot blot method. M470V polymorphism was analyzed by PCR-RFLP.

In IVS8 polyT study, T7 was the most frequent allele in healthy individuals than patients with CF (respectively, 82.8% Vs. 77.2%). T9 was more abundant in patients with CF than normal individuals (respectively, 21.7% Vs. 7.4%, P=0.005). T9/T9 genotype was more frequent in patients than healthy individuals (respectively, 15.1% and 2%, P=0.032). Study for M470V polymorphism showed that M/V was the most common genotype in normal individuals and patients with CF (respectively, 49% and 40.4%). M-T9 haplotype was highly associated with the disease in both patients with CF and normal individuals (respectively, 19.1% and 2.4%, (P<0.001)

The allelic distribution and heterozygosity results suggest that both M470V and IVS8 polyT can be helpful in the prenatal diagnosis of CF in Northern Iranians with a positive family history of the disease.

Nowadays, cancer is one of the main causes of mortality in the world and many mutagens are the cause of death in millions of patients. Due to the side effects of anticancer drugs, scientists are in search of natural drugs with fewer side effects and more therapeutic efficacy. This study aims to, firstly, investigate the antimutgenic effects of different Aloe vera gel and latex extracts on mutated Salmonella typhimurium bacterium by using Ames test and to, secondly, study the probable effects of the habitat conditions on the antimutagenic effects of the plant. After preparing different Aloe vera gel and latex extracts, the antimutagenic effects of the extracts were evaluated by Ames test. In this test, a mutated strain of S. typhimurium was grown on culture media containing a minimum of salt and glucose in the presence of a mutagen substance (NaN3). Subsequently, only those bacteria that had turned HIS+ by reverse mutation formed colonies. As different alcoholic and aqueous extracts of Aloe vera reduced reversed mutations, the difference between the means of revertant mutants per plate was calculated by one-way ANOVA using SPSS software (version 18). The ethanol extracts of latex from Karaj had a maximum (91%) and aqueous extract from Dezfoul had a minimum (42%) percentage of inhibition. Maximum percentage of inhibition was observed in the extracts of the plant cultivated in Karaj reflecting the impact of environmental conditions on the construction of antioxidant compounds in plants.

Atherosclerotic vascular disease is a major cause of morbidity and mortality in patients with end-stage renal diseases on maintenance hemodialysis. Early atherosclerotic changes of the arterial wall can be evaluated by measuring intima-media thickness (IMT), and looking for the presence and structure of plaques and parameters of vascular resistance. In this study we investigated the relationship between carotid IMT and pulsatility index (PI) or resistive index (RI) values in hemodialysis patients.

Sixty hemodialysis patients (27 females and 33 males; median age 41.7 years) and 60 healthy volunteers (32 females and 28 males, median age 37.8 years) underwent ultrasonography of common carotid artery for the determination of IMT, PI and RI.

Bilateral IMT was significantly higher in hemodialysis patients than in control group (P<0.001). Left carotid artery RI and PI were found to be significantly higher in hemodialysis patients than in the controls (P<0.001). Right carotid artery RI and PI had no significant statistical differences between the two groups (P=0.18 and P=0.78, respectively). There was a moderately significant negative correlation between the left carotid IMT and left RI and PI in the controls (r= -0.42, P=0.001 and r=- 0.43, P<0.001, respectively).

PI and RI values of the left coronary artery increased as did IMT in hemodialysis patients. Therefore, measurement of RI and PI values together with IMT are recommended for early diagnosis of atherosclerosis in hemodialysis patient.

Migraine is the most common cause of headache which affects 15% of female and 6% of male populations. Patients with migraine may have psychological problems, thus, association of migraine with depression, anxiety and other psychological disorders should be considered for choosing the best management approach.

In this case-control analytical study, one hundred and twenty patients with migraine were recruited among patients who attended the Psychiatry Clinic of Farshchian Hospital in Hamedan, Iran during 2008- 2009. The patients met the IHS criteria for migraine and none had disorders, such as Huntington disease, that are associated with obsessive-compulsive disorder (OCD). The people who accompanied patients attending the Internal Medicine Clinic of the Hospital and had no history of migraine headaches were recruited as the controls. Maudsley's inventory was used for the diagnosis of OCD. Finally, the data were analyzed by SPSS software.

In the control group, 3 (2.5%) and in the case group 11 (9.17%) people had OCD (P=0.024). All of those with OCD in the control group and 9 out of 11 in the case group were female. There were no cases of OCD among patients with mild migraine. Among 36 patients with moderate headache 5 (13.89%) people had OCD and among 62 people with severe migraine 6 (9.68%) had OCD (P=0.510).

The prevalence of OCD in patients with migraine was significantly higher than the normal population. Special attention to comorbid conditions such as OCD is necessary in the management of migraine headaches.

Cognitive problems in patients with post-traumatic stress disorder (PTSD) include poor concentration and impaired memory. Prevalence of PTSD in all aspects of life is 8% in USA. Regarding the importance of memory in functional levels, this study was performed to review memory status in these patients. Fifty male war veterans with PTSD and major depression and 50 male non-veterans with depression participated in this study performed at psychiatric outpatient ward in Baqiyatallah hospital during 2008-2009. The patients met the DSM-IV diagnostic criteria. Depression severity, sex, age, educational level, and marital status were matched in both groups. A psychologist completed demographic and Mississippi questionnaires, PTSD checklist (PCL), beck depression Inventory and wechsler memory scale. The collected data were analyzed using SPSS software (version 11.0). A P-value smaller than 0.05 was considered significant. The mean age of the veterans and non-veterans was 43.9±4.7 and 42±9.4 years, respectively. Memory status did not differ between the two groups (P>0.05). There was no statistically significant correlation between duration and severity of PTSD with memory impairment (P>0.05). A negative correlation was found between personal and general information with re-experiencing in the veterans (P<0.05). Impaired memory was correlated with age greater than 45, educational level lower than high school diploma, severity of depression and longer participation in war. Although both PTSD and major depression affected memory, but memory status did not differ between patients with PTSD and depression and patients with chronic depression.

Epidemiological studies have reported positive, negative, U-shaped or J-shaped association between high blood pressure and cognitive function as well as dementia whereas other studies have not reported any significant association. The aim of this study was to examine the association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation (KCF). This cross sectional study was done in Kahrizak Charity Foundation in suburban areas of Tehran, Iran during 2008. The data were collected over one week. Among the 850 elderly residents of the Foundation who were ≥ 65 years old, 185 individuals were chosen randomly. The Mini-Mental State Examination (MMSE) was completed for all. Mean of all blood pressure readings were recorded while anthropometric and biochemical measurements were performed. The findings indicated that in participants with cognitive impairment, systolic blood pressure, diastolic and mean blood pressures were higher than people with normal cognitive function but the differences were not significant statistically. The odds ratio of cognitive impairment in patients with and without hypertension was 1.52 and 1.58, respectively (P>0.05). This study did not show any significant association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation.

Pneumothorax is a potential life-threatening condition especially in patients with underlying disorders. In this study we compared the diagnostic accuracy of general practitioners and emergency medicine specialists in interpreting chest x-rays (CXR) suspected of having iatrogenic pneumothorax in emergency departments. This cross-sectional study was conducted in Shahid Chamran Hospital in Tehran, Iran during 2008- 2010. The study was designed to compare the ability of general practitioners and emergency medicine specialists in diagnosing iatrogenic pneumothorax regarding 500 CXRs of one-hundred patients admitted for upper central venous catheterization. General practitioners and emergency medicine specialists could accurately (P<0.001) diagnose pneumothorax in 484 (96.8%) and 497 (99.4%) CXRs, respectively. None of the underlying causes of the condition affected the diagnostic accuracy of both physician groups (P>0.05). These findings indicate that the diagnostic accuracy of emergency medicine specialists is significantly higher than those of general physicians. The diagnostic accuracy of both physician groups was higher than the values in similar studies that signifies the role of relevant training given in the emergency departments of the Hospital.