مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران
سال هفتاد و یکم شماره 2 (پیاپی 146، اردیبهشت 1392)

Previous reports showed that nucleus accumbens involved in the etiology and pathophysiology of major depression، anxiety and addiction. It is not clear that how these mechanisms occur in the brain. In the present study، the influence of direct nicotine injection in the nucleus accumbens in rats’ anxiety-related behavior was investigated. Wistar rats were used in this study. Male Wistar rats bred in an animal house، in a temperature-controlled (22±2 ◦C) room with a 12 hour light/darkcycle. Rats were anesthetized using intraperitoneal injection of ketamine hydrochloride and xylazine، then placed in an stereotactic instrument for microinjection cannula implantation The stainless steel guide cannula was implanted bilaterally in the right and left dorsal the nucleus accumbens shell according to Paxinos and Watson atlas. After recovery، anxiety behavior and locomotor activity were tested. We used the elevated plus maze to test anxiety. This apparatus has widely been employed to test parameters of anxiety-related behaviors including the open armtime percentage (%OAT)، open arm entries percentage (%OAE)، locomotor activity and we record effect of drugs after injection directly in the nucleus accumbens on anxiety-related behavior. Experiments showed that bilateral injections into the nucleus accumbens Nicotine، acetylcholine receptor agonist، dose 0. 1 of the dose (0. 05 and 0. 1، 0. 25، 0. 5) microgram per rat caused a significant increase in the percentage of time spent in the open arms (%OAT)، compared to the control group. We did not record any significant change locomotor activity and open arm entries percentage (%OAE) in rats. Nicotinic receptors in the nucleus accumbens shell involved to anxiety-like behavior in male rats.

Widespread of telecommunication systems in recent years، have raised the concerns on the possible danger of cell phone radiations on human body. Thus، the study of the electromagnetic fields on proteins، particularly the membrane nano channel forming proteins is of great importance. These proteins are responsible for keeping certain physic-chemical condition within cells and managing cell communication. Here، the effects of cell phones radiation on the activity of a single nanopore ion channel forming protein، OmpF، have been studied biophysically. Planar lipid bilayers were made based on Montal and Muller technique، and the activity of single OmpF channel reconstituted by electrical shock was recorded and analyzed by means of voltage-clamp technique at 20 ˚C. The planar lipid bilayers were formed from the monolayers made on a 60 μm diameter aperture in the 20 μm thick Teflon film that separated two (cis and trans) compartments of the glass chamber. In this practical approach we were able to analyze characteristics of an individual channel at different chemical and physical experimental conditions. The voltage clamp was used to measure the channel’s conductance، voltage sensitivity، gating patterns in time scales as low as microseconds in real time. Our results showed that exposure of single voltage dependent channel، OmpF، to EMF of cell phone at high-frequency has a significant influence on the voltage sensitivity، gating properties and substate numbers of the single channel but has no effect on single-channel conductance. Regarding to the relaxation time، the channel also recovers in the millisecond time range when the field is removed. We observed an increase in the voltage sensitivity of the OmpF single channel while it had no effect on the single-channel conductance، which is remained to be further elucidated.

Breast cancer is the most common cancer in women. Non-coding RNAs especially miRNAs have important regulatory roles in cancer. MiRNAs are 21-24 nucleotides which have different levels of expression between tumors and normal tissues. In this study، we have analyzed expression level of miR-520d in three different groups of breast cancer.

Fifty nine samples were divided into different groups according to their immunohistochemistry (IHC) classification: estrogen receptor (ER) positive and/or progesterone receptor (PR) positive group (as group I); human epidermal growth factor receptor 2 (HER2) positive group (as group II); and Triple negative group (as group III). After small RNA extraction from tissues، cDNAs were synthesized and Real time RT-PCR carried out using DNA binding dye. Expression levels were analyzed by LinRegPCR and REST software.

MiR-520d under- expressed in all of three different groups. The expression ratio in groups I، II، and III were 0. 193، 0. 167، 0. 21، respectively، but only the result from group II was significant (P=0. 017). According to the different clinicopathological status of breast cancer، miR-520d underexpressed significantly not only in patients with metastatic lymph node (P=0. 019) but also in patients which have cancer at stage III (P=0. 036).

In this study، we found that miR-520d possibly acts as a tumor suppressor. It may be useful for diagnosis of tumor from normal tissue. In addition، miR-520d significantly underexpressed in HER-2 positive group of breast cancers. Therefore، it may be useful as an additional diagnostic test in this group of breast tumors along with other biomarkers.

Serum estradiol level is a controversial prognostic factor in the outcome of labial adhesion. The aim of this study was to evaluate serum estradiol levels and topical estrogen response in patients with labial adhesion. A prospective interventional study was conducted among girls with labial adhesion that referred to Pediatrics clinic in Taleghani University Hospital، Gorgan city، Iran in 2011. One hundred patients entered the study. The diagnosis was conducted by clinical examination of vestibule area. Inclusion criteria were، three months to eight years old prepuberty girls، no ambiguous genitalia، lack of vulvovaginitis symptoms، labial adhesion more than twenty five percent، no history of previous topical estrogen treatment since two weeks ago and previous incomplete treatment. The patients who did not use proper amount and duration of drug and also with adverse drug reactions during treatment period were excluded from the study. The maximum frequency of labial adhesion was in the group of less than one year old. The minimum frequency of labial adhesion was in the 7-8 years old group. Eighty six patients had complete or partial remission. No evidence of an improvement was observed in fourteen children. Severity of adhesions did not worsen in our patients. Serum estradiol levels were lower in patients who had a positive response to treatment. There were significant differences in serum estradiol levels between full or relative improvement with no improvement groups (P=0. 044). Findings of this study showed that the labial adhesion patients with low serum estradiol level had better treatment response after using topical estrogen.

Recurrent aphthous stomatitis (RAS) is a common disease with unknown etiology. There is no curative treatment. Purslane is considered as a rich source of antioxidants with anti-inflammatory effects. The purpose of this study is to evaluate the effect of Purslane in the treatment of RAS. A total of 50 patients were selected for this randomized triple-blind placebo-controlled clinical trial from School of Dentistry of Tehran University of Medical Sciences in 2011. All subjects were randomly divided into two groups. Groups A and B received placebo and Purslane، respectively، for three months. Pain intensity based on the visual analogue scale (VAS)، the mean intervals of lesions occurrence، number of lesions and the mean duration of complete healing at baseline and at months 1، 2 and 3 were recorded. While no patient complained from increased severity of pain، decreased severity of pain for 4، 3، 2، and 1 grades were recorded in %16، %20، 20%، and 40%، respectively، which were much higher than 4%، 8%، 8%، and 28%، respectively، in the control group. A significant decrease in pain intensity in VAS scores were seen after treatment in group B (P<0. 001). The mean duration of complete healing showed significant differences (P<0. 001) between groups A (-1. 52±4. 07 days) and group B (-6. 56±4. 50 days). The mean intervals between lesions also showed significant differences (P<0. 001) between group A (17. 88 days) and group B (33. 12 days). No significant differences were found between group A and group B regarding to number of lesions. No serious side-effects occurred in either group. According to our study، Purslane is clinically effective in treatment of RAS and considering the lack of side-effects during the study period، this medicine may be a favorable alternative treatment for recurrent aphthous stomatitis.

It has been shown that coronary artery calcium scoring (CACS) can be used as a diagnostic method in coronary artery disease (CAD). The relationship between CACS and calcium metabolism in the body has been shown. The arterial calcification is an organized process similar to bone formation which is controled by parathormone (PTH). The relationship between PTH as an osteoregulatory factor and CACS has been also indicated. In this study، we tried to assess the value of serum PTH and CACS in patients planned to undergo coronary angiography (CAG) in order to find a simple، cost -benefit، noninvasive way، for ruling in/out obstructive CAD.

In a cross sectional study in Imam Khomeini hospital in 1390، CACS by using non-enhanced multi detector computed tomography (MDCT) and measurement of serum level of PTH، Calcium and Phosphate were done in 178 patients suspected to CAD which were scheduled to undergo coronary angiography serum PTH was measured by immuno-radiometric assay (IRMA) and serum Ca and Phosphate were measured by spectrophotometry methods.

Of 178 Patients، 50 patients were females and 126 patients were male. Mean age of them was 56. 2±11. 6. The correlation coefficient between CACS and Gensini score (0. 507، P<0. 001)، PTH (0. 037، P=0. 693)، Ca (0. 062، P=0. 499) and Phosphate (0. 061، P=0. 506) were obtained. The level of serum PTH in the patients with and without coronary artery disease were 21. 8±11. 6 pg/dl، 23. 2±11. 5 pg/dl (P=0. 427) respectively.

Our study showed association between CACS and CAD that was statistically significant while no relationship was found between PTH، CACS and CAD.

Renal transplantation is the treatment of choice in patients with end-stage renal disease. Urinary tract infection (UTI) is one of the most common complications after renal transplantation and it has serious consequences. The aim of this study was assessing UTIs in renal transplanted patients and evaluation of risk factors associated with post-transplant UTI. In this prospective study، 173 patients (48 hospitalized patients and 125 outpatients) were enrolled in this study. These renal transplant recipients evaluated for bacterial urinary tract infection in urology research center at Sina Hospital. After collecting urine samples from symptomatic and asymptomatic patients، urinalysis and colony count were performed. Identification of bacteria was performed by routine microbiological tests in the Department of Pathobiology، School of Public Health، Tehran، Iran، in 2011. UTI was observed in 47 patients and the most prevalent microorganism was Escherichia coli (E. coli) 18 (38. 2%). Nearly 71% of UTI cases were diagnosed during the first three months post transplantation. Risk factors for post transplant UTI were female gender، age، length of hospitalization and diabetes mellitus. Female patients were more susceptible than males (OR=0. 50 and P=0. 047) to infection. There were no significant difference between diabetes mellitus and UTI. Most of the isolated bacteria were susceptible to imipenem and resistant to tetracycline and trimethoprim- sulfamethoxazole. Our study confirmed that bacterial infections remain as the most common infectious complication in the early post-transplant period، and antibiogram rather than empirical treatment is needed to find the best effective antibiotics. Moreover، risk factors such as female gender، increased age and length of hospitalization are predisposing factors to increased urinary tract infection in renal transplantation.

Today، a CT scan examination play an important role in disease diagnosis and thus allocates a significant dose of medical X-ray examinations. One of the important principles in the use of ionizing radiations is to observe radiation protection principles. Evaluating patient''s absorbed dose and implementing the strategies for reducing dose are prior in safety issues. To achieve this purpose، sufficient studies should be performed in this regard. Therefore، patient''s absorbed dose and the factors affecting have been studied in this research. This study aims to present and develop an acceptable level of absorbed dose in CT scan examinations.

Diagnostic reference dose level in the adult age group (older than 15 years) has been studied in eleven CT scan centers in Tehran. For this purpose، CT scan examinations prevalent in above-mentioned centers were chosen and Weighted Computed Tomography dose index (CTDIw) and dose length product (DLP) parameters were studied. Standard phantoms with 16 and 32 diameters of Polymethylmethacrylate (PMMA) origin have been used in the centers for CT scan calibration process. CTDIw third quartile has been considered as the diagnostic reference dose level (DRL).

Rate of diagnostic reference dose in the adult age group (older than 15 years) for the head، sinus، lungs، abdomen and pelvis are 50. 87، 38. 27، 8. 05 and 9. 11 mg، respectively. Dose measurements made in this survey have been used to set up local DRLs and can be used as a template for national DRLs.

Value of diagnostic reference dose for the head examinations is more than the other parts and diagnostic reference dose in Tehran city in the Adult age group and the protocols compared is less than national reference dose.

Ovarian mucinous borderline tumors are divided into two morphologic groups: endocervical-like and intestinal type. Most endocervical adenocarcinomas exhibit mucinous and/or endometrioid differentiation، they infrequently metastasize to the ovaries but may simulate primary ovarian tumors (both atypical proliferative or borderline and carcinoma). In patients with mucinous adenocarcinoma in the abdominal cavity، caution should be exercised in interpreting the possible primary site of the tumor on the basis of the immunohistochemical profiles. The presence of human papillomavirus (HPV) DNA is assessed to determine whether the ovarian neoplasms were metastases or primary independent neoplasm. Approximately 90% of endocervical adenocarcinomas are related to high-risk human papillomavirus (hr-HPV) with the remainder being unrelated to HPV. Both types metastasize to the ovaries very infrequently. Ovarian endocervical-type (mullerian) mucinous tumors and tumors composed of a mixture of endocervical-type mucinous، serous endometrioid، squamous، and indifferent cells with abundant eosinophilic cytoplasm reported to date have been primarily limited to borderline and micro invasive types. We report a-36-yr old woman with adenocarcinomas of uterine cervix who also had ovarian mucinous borderline tumor. The patient presented with abnormal uterine bleeding and lower abdominal pain. She had a history of uterine cervix polyps. Pelvic ultrasound showed a right adnexal mass and a large cervical size. Histological diagnosis in uterine cervix biopsy revealed adenocarcinoma of cervix. Radical hysterectomy type III with bilateral salpingo-oophorectomy was performed. Histological finding in adnexal mass revealed borderline mucinous tissue of ovarian tumor. Testing for HPV DNA in the tumoral tissue was negative. This confirms that the ovarian tumor is not metastatic from endocervical adenocarcinoma. We conclude that in a patient with tumors that involve two organs، complete diagnostic investigation should be done to distinguish the primary origin. The factors that affect cell proliferation، can probably have synchronous effects on the two similar cells.

Eating the egg of Echinococcus granulosus tapeworm in vegetables contaminated with dog''s fecal material is the main cause of hydatid cyst. The most common involved organ is liver and the second are lungs. Spinal involvement especially primary involvement of paravertebral soft tissue without vertebral and extradural involvement is very rare. We report a case with paravertebral hydatid cyst without vertebral involvement. A 61 years old man patient resident of Torbatjam، Khorasan Razavi provience، was admitted to our department complaining a mass in back from six years ago. In physical examination he had several right paravertebral masses. MRI reveals a huge multilocular mass in the right paraspinal from T1 to L5 that is accompanied by ribs erosion without destruction. Operation was performed and the cyst was completely removed while contained several liquid-filled cysts، the hydatid-like cysts. Pathological findings were confirmed the diagnosis. Albendazole (10mg/kg) was prescribed post-operatively for six months. Recurrence has not occurred after two years follow up. Hydatid disease is a major infectious disease that is a main problem in many countries. In some articles paravertebral involvement without vertebral and extradural involvement is reported but primary paravertebral involvement with hydatid cyst is very rare. In this case we report paravertebral without vertebral involvement and the patient did not show any sign of spinal and vertebral pressure. In spite of the fact that hydatid cyst involves liver and lungs more than other organs، it can involve any organ and this point should be taken into consideration especially in the endemic areas.