مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و ششم شماره 4 (پیاپی 112، مهر و آبان 1393)

Fungal keratitis is known as an important underlying cause for ocular morbidity. Microbial keratitis is responsible for up to 30% of the prevalence of blindness in less developed societies. The aim of this study was to determine the fungal species in corneal scraping specimens that have been prepared from patient’s suspected corneal fungal infection and have been sent to Mycology Laboratory in Faculty of Medicine in Tabriz. In a cross-sectional study, 30 specimens of corneal scarping of patients, suspected with corneal fungal infection were collected. The specimens were examined by using KoH 10% and were cultured in Sabouraud Dextrose Agar (S) and Mycosel Agar without actidioun. Positive yeast samples were identified using the API32C kits, produce germ tube and chlamydoconidia. Morphology of colony, microscopic examination, and slid culture of species were used for identification of mold fungi. Men had infectious more than women (ratio: 2/1) in our study. 12 (40%) cases were positive in direct examination and 9 (30%) cases were positive in two both direct and culture methods. Fusarium, Aspergillus, Candida albicans and Curvularia were isolated from corneal ulcers specimens. Fungal keratitis remains a diagnostic and therapeutic challenge to the ophthalmologist. Direct examination, by using KOH can be a most important, simple and sensitive test for diagnosis. In this study direct examination with KOH was 10% positive results than culture method. Fusarium and Aspergillus were common isolates in corneal ulcers specimens.

Placental Growth Factor (PlGF) is a member of Vascular Endothelial Growth Factors (VEGF) family, which is involved in several pathologic processes, including the growth and spread of malignancies. PlGF promote cancer metastasis by controlling the MMP (Matrix metalloproteinase) activity. In the present study, we investigate the correlation between the expression of PlGF and matrix metalloproteinase enzymes activity in human Adenocarcinoma Gastric Cell (AGC). Methods and Materials: Human AGC were treated with 20, 40 and 80 picomol concentrations small interfering RNA (siRNA) related to PlGF mRNA for24, 48 and 72 hours. Then MMP-2 and MMP-9 enzymatic activity was measured by gelatin zymography test. The gelatin zymography results indicated that the activity of MMP2&9 was fully inhibited in AGC which were treated with various concentrations of PlGF-siRNA for 24 hours. Our results also showed that in cells were treated with PlGF-siRNA for 48 hours the activity of MMP2 and MMP 9 were decreased (but not fully inhibited). According to this study reduction of PlGF gene expression may prevents MMP2/9 activity in AGC. These data suggest that PlGF may function up stream of MMP in gastric adenocarcinoma cells. Probably PlGF effect on cancer cell metastasis via regulation activity of MMPs.

Microorganisms are known as an important biocatalysts for green chemistry which can be used beneficially for production of medically and pharmaceutically important compounds such as the bromine and paraxanthine through caffeine biotransformation. The aim of this study was to determine the bacterial subtypes which are able to use as a new biocatalyst for the synthesis of high-value added dimethylxanthines from caffeine as low-cost substrate. In this experimental study, twenty-one bacterial strains isolated according to their ability to degrade caffeine using enrichment technique. Primary screening was performed by Thin Layer Chromatography (TLC). The selected strain characterized based on phenotypic analysis and also amplification of 16S rDNA gene. Biotransformation mixtures were quantified for produced methylxanthines by High Performance Liquid Chromatography (HPLC) technique. Among the 21caffeine-degrading bacterial cultures, the resting cells of B. subtilis strain CTB04 are reported to be able to convert caffeine into the bromine and paraxanthine. The results showed that the strain CTB04 was capable of converting 2.5 g/l of caffeine to 1.35 g/l paraxanthine with molar yield (58.2%) and 0.66 g/l of the bromine with a 28.4% molar yield after 96 h biotransformation. There was a dual approach for bioremediation of the toxic caffeine from environment and a way for the production of pharmaceutically dimethylxanthines such as the bromine and paraxanthine as well.

Arrhythmia is known as a common complication of most major surgeries. The reduction in the Serum level of Mg+2 during the peri-operation period plays an important role in prevention of arrhythmias through stabilization of cell membrane. The aim of this study was to investigate the use of prophylactic magnesium sulphate in treating arrhythmias that may occur following coronary bypass grafting operations. In this randomized double blinded clinical trial study, the population consisted of 174 consecutive patients undergoing the Coronary Artery Bypass Grafting (CABG). 87 patients given 3 g of magnesium sulphate (MgSO4) [20 ml = 24.32 mEq/L Mg+2] in 100 cc of isotonic 0.9% solution over 2 hours intravenously at the following times: 12 hours prior to the operation, immediately following the operation, and on postoperative days 1, 2, and 3 (Group 1). Another group including 87 patients given 100 cc. isotonic 0.9% as placebo, during the same time periods (control group). In the postoperative period, the magnesium values reduced in control Group and increased in case group due to its injection. Arrhythmia prevalence was reduced significantly in favor of magnesium group (P= 0.013). The two groups showed no significant differences in other operative or postoperative measurements. No side effects of the drugs were observed. Prophylactic use of magnesium sulphate is effective at preventing arrhythmia that may occur following coronary by-pass operations. Magnesium sulphate should be used in prophylactic treatment since it may decrease arrhythmia at low doses. If arrhythmia should occur despite this treatment, intervention with amiodarone may be preferable.

Breast cancer is the most common malignancy; meanwhile, finding molecular markers to identify it in the early stages, might be helpful in this regard. Overexpression of TP73 gene is frequent in cancers. TP73 is expressed in multiple variants with either tumor suppressor or oncogenic function. This study was performed to evaluate the association between the expression of tumor suppressor TAp73 and oncogenic ΔNp73 variants and breast tumorigenesis. In this experimental study, 60 specimens (30 tumoral and 30 marginal tissues) were examined by RT-PCR technique and the semi-quantitative data were converted to quantitative data using UV-tech software. Overexpression of TAp73 and ΔNp73 was observed in 80% and 43.3% of tumors, respectively. A direct significant correlation was found between the expression level of both variants in tumors (P=0.01) that indicates co-upregulation of them in tumor tissues. A significant difference was found in the expression level of TAp73 between tumor and marginal tissues (P=0.001) but the difference in the expression level of ΔNp73, was not significant (P=0.92). There was not any significant difference in the expression level of studied variants between the early and the late stage tumors (P>0.05). Overexpression of TAp73 is a marker for the detection of malignant breast tumors. Co-upregulation of TAp73 and ΔNp73 is also a hallmark of malignant epithelial cells of the breast. Overexpression of TAp73 is involved in tumorigenesis via the overexpression of ΔNp73. So, overexpression of tumor suppressor TAp73 can indirectly cause breast tumorigenesis.

In the industrial world everyone is unavoidably exposed to ambient Electromagnetic Field (EMF) generated from various technical and household appliances. The aim of this study was to investigate the diminishing effects of Allium cepa on uterus cell injury induced by EMF. In this experimental study, 40 rat were selected and kept for one week in quarantine and 20 rats subdivided to two groups were exposed to 40 Hz (non-ionizing radiation, 0.1 tesla) for 6 weeks, one of this exposed group received 3cc /Rat Allium cepa juice, other experimental group just received only 3cc/Rat Allium cepa,the control group just received 3cc water by gavage method. The materials were processed and observed apoptosis under a light microscope by tunel method. In the experimental rats apoptotic cells showed significantly increased in EMF groups, but in exposed group that received Allium cepa,apoptotic cells and serum MDA were decreased and SOD was increased respectively (P<0.05). since in this study EMF could be induces cell injury on uterus tissue, using 3 cc Allium cepa juice has antioxidative effects on uterus tissue by reduced apoptosis.

Diabetic neuropathy is one of the most common complications of diabetes mellitus, which is associated with a decrease in the synthesis and transport of neurotrophins. The aim of the present study was to investigate the effect of endurance training on gene expression of Nerve Growth Factor (NGF) in the motor spinal cord of rats with diabetic neuropathy. In this basic-experimental study, 16 adult male Wistar rats with the mean weight of 326/3±8/4 gr, randomly cathegorized into the four groups (n=4 in each group): diabetic control, diabetic training, healthy control and healthy training. For inducing diabetic neuropathy, after twelve hours of food deprivation, intraperitonealinjection of STZ solution (45 mg/Kg) method was used. Two weeks after STZ injection, the endurance training protocol was performed for six weeks and twenty-four hours after the last training session, rats were sacrificed. Gene expression of NGF in rats spinal motor segments were measured with Real time-Pcr technique and the 2-ΔΔCT method. The two way ANOVA was used for statistical study.The levels of NGFmRNA were significantly decreased in the motor segment of spinal cord after diabetes (P=0.038), while the endurance training resulted in modified levels of NGF closed to the normal value. Also, in comparsion with diabetic control, training led to significant decrease in blood glucose levels in diabetic training group (P=0.0001). Endurance training after diabetic neuropathy can maintain NGF levels in the normal range. These results suggest that the beneficial therapeutic effects of training after diabetic neuropathy and other neurodegenerative disease might also be atributed to the modulation of NGF.

Acute leukemia is the most common childhood malignancy, which accounts for approximately one-third of all pediatric cancers; meanwhile, Acute Lymphoblastic Leukemia (ALL) constituted about 75% of pediatric acute leukemias. Common constitutional symptoms include fever, faitugs, pallor bone pain and disruption of normal hematopoesis. Immonophenotyping by flow cytometry is performed to further characterization of ALL subtypes. This study was designed and performed in order to determine the Immunophenotypically Subtypes of Acute Lymphoblastic Leukemia in children in Azerbaijan region. This study was performed as a cross- sectional descriptive survey. The population under concern contained children suffering from ALL who were admitted to Tabriz Children Hospital during 2003- 2008. Data required for this survey was worked out by the researchers from patient’s files in the hospital. All of 150 patients with ALL who had complete file data were enrolled in this study, 84 were males (56%) and 66 were females (44%). The patient’s mean age was 6.62± 4.03 years. The mean hemoglobin and platelet count were 8/76 ± 2/45 gr /dl and 116000 ± 10720 mm3, respectively. The most prevalent immonopeonotype was pre-Bcell and the least one was mixed type. Epidemologic distribution of blood parameters and some clinical signs also ALL immonophenotype in Easte Azerbaijan are compatible with other studies in other parts of the world.

Pneumonia is caused by a range of microorganisms. The incidence of bacterial pneumonia can be divided into two categories: hospital-acquired pneumonia and community-acquired pneumonia. Community acquired Pneumonia is a related leading cause in different populations. Staphylococcus aureus and Klebsiella pneumonia are the most common cause of hospital-acquired pneumonia, and Streptococcus pneumonia and mycobacterium tuberculosis are Cause of community-acquired pneumonia. The aim of this was to investigate the common causative factors of respiratory tract infections include Streptococcus pneumonia, Staphylococcus aureus, Klebsiella pneumonia and mycobacterium tuberculosis using multiplex PCR was the main aim of this study. This study was experimental development. Multiplex PCR is a rapid, accurate molecular method for the simultaneous detection of two or more specific genes in a reaction.In this study, multiplex PCR method for simultaneous detection in the genome-specific sequences leading causes of pneumonia (Streptococcus pneumonia, mycobacterium tuberculosis, Staphylococcus aurous and Klebsiella pneumonia) was done. Specific genes that we chose in this study were: ply (pneumolysin) for Streptococcus pneumonia, nuc (thermonuclease) for the staphylococcus aureus, gyrA (gyrase A) for Klebsiella pneumoniae and pncA gene for Mycobacterium tuberculosis, also the 16s ribosomal gene was used as a positive control. After set-up procedure and observing specific bands, sequencing was confirmed the accuracy of observed bands.Our results showed that the detection of Streptococcus pneumoniae, Staphylococcus aureus, Klebsiellapneumoniae and Mycobacterium tuberculosis in a Multiplex PCR reaction is possible. In fact, this method can be used for direct and simultaneous detection of these agents in the respiratory specimens.

Infection is known as a major challenge for a burn team to deal with; meanwhile, it’s responsible for almost 75% of the burn death. The main underlying cause of this problem is because of this fact that the environment at the site of the wound is ideal for the proliferation of infecting organisms. The aim of this study was to investigate the causative microorganisms and antimicrobial resistance profiles of the isolated microorganisms in patients hospitalized at the burn ICU of Zareh hospital, Sari, Iran. All of the 100 patients who were hospitalized at the burn unit were enrolled in this prospective cross sectional study. Demographic, clinical data, including sex, age, total burned surface area were collected for each patient. Laboratory specimens included wound discharge, tissue debridements, tracheal tube and Centeral Venus Presher (CVP). Environmental specimens were also collected from patient’s room including medical instatements located in the room. Conventional microbiologic tests were performed for isolation and identification of burn infections causative organisms and to detect antibiotic sensitivity by disc agar diffusion method. Two hundred and twenty six different microorganisms isolated were collected from the 615 samples including 280 swabs, 35 tissue biopsies, 100 urine samples, 100 bloods, 50 CVP samples and 50 endotracheal specimens. Acintobacter baumannii was the most prevalent bacterium isolated. 550 samples of patients’ environment were also studied. Regarding antibiotic sensitivity of the isolated bacteria over 90% of Acintobacter baumannii isolates were resistant to amikacin, gentamicin, piperacillin/ tazobactam, ceftazidime and cefepime. The highest susceptibility was observed for tobramycin (58.2 %) and imipenem (41.9 %). The most common type of burn was flash injury. Nearly 60% of participants were aged from 21 to 40 years. Acintobacter baumannii was the most prevalent bacterium causing infection. Detection of high levels of antibiotic resistance in our Acintobacter baumannii and other medically important isolated bacteria underlines need for continuous surveillance of burn infections and developing strategies for antimicrobial resistance control.

Gastrointestinal (GI) complains are common in hemodialysis patients. More than 80% of patients undergoing regular dialysis have similar complaints, such as dyspepsia. Moreover, the rate of GI bleeding is high in patients with chronic renal failure comparing with normal population. Peptic ulcer disease in non-dialysis patients is associated with two main factors: a) Helicobacter Pylori (H.P) infection and b) use of Non Steroidal Anti Inflammatory Drugs (NSAIDs(. The incidence rate of H.P infection in patient undergoing regular dialysis is controversial. The aim of this study was to evaluate the response to the H.P eradication therapy among patients undergoing dialysis. In this analytical study, 100 people with chronic dyspepsia with normal renal function and 80 dialyzed patients who were kidney transplant candidates with the inclusion criteria underwent upper GI endoscopy. H.P infections in those who had a positive rapid urease test or positive histology for Helicobacter and nominated for H.P treatment were enrolled. These patients received triple therapy against H.P for 2 weeks followed by 2 weeks received PPI and 4 weeks after cessation of treatment, Eradication was assessed by urease breath test (UBT). The successful eradication was found in 87% and 84% of the dialysis and control groups, respectively. Both dialysis group and the control group, who received furazolidone, had 100% eradication. In dialysis patients. From 54 patients who received clarithromycin, 81.5% have been successful in. H.P eradication. In the control group, 67 patients who received clarithromycin 76.1% have been successful in. H.P eradication. Eradication of H.P in dialysis and control groups showed no significant differences. Meanwhile the frequency of eradication with furazolidone was significantly more than clarithromycin.

Type D personality is related to poor coronary heart disease prognosis, but there is no standard for assessing this Type of personality. The purpose of this study was to examine the reliability and validity of the Persian version of 14-item Type D personality scale (DS14) among coronary heart disease patients.Methods and Materials: 198 coronary heart disease patients participated in study, thereforre, they all filled out the Persian version of DS14, and SF-36 Questionnaire. SPSS 17.0 software was used for data analyses and P-value<.05 was considered as statistically significant. Cronbach’s alpha was used to examine the internal consistency of the DS14. In order to determine validity of DS14, it was compared to SF-36. With the standardized cut-off of NA≥10 and SI ≥10, 65.1% of the coronary heart disease patients in Iran were defined as having a Type D personality. The Cronbach's α coefficient for the negative affectivity (NA) and social inhibition (SI) subscales were 0.79 and 0.56, respectively, for the coronary heart disease patients. High internal consistency of Cronbach's alpha coefficient has been found to be 0.83 in patients for DS14 scale. Good convergent validity was shown by the expected correlations type D personality and depression (P<0.001), Interfere with daily activities (P=0.003), Fatigue (P=0.004), Nervousness (P<0.001). The Persian DS14 was a valid and reliable tool for identifying Type D personality. Patients with coronary heart disease showed higher rate of type D personality. Therefore, identifying Type D personality is important in clinical research and practice in cardiovascular disease.

Chronic Myelogenous Leukemia (CML) is a clonal pluripotent hematopoietic stem cell disorder which increases the number of abnormal white blood cells. Recently, Quinazoline derivatives have been considered for cancer treatment. The objective of this study was to determine the cytotoxicity and apoptosis effects of the new Quinazoline derivatives on K562 cell line, CML. Methods and Materials: The colorimetric MTT test was used to evaluate cytotoxicity of these compounds. The K562 cells were seeded in 96-well plates at 2×104 cells/well and treated with various concentrations (100-300μM) of the Quinazoline compounds (4t-CHQ، 4-CHQ and 4-CPQ) for 24, 48 and 72 h. Inverted and fluorescent microscopy were used to evaluate the morphological changes and apoptosis. Apoptosis was also confirmed by DNA fragmentation assay. The results showed that the Quinazoline compounds cause cell death in a dose- and time-dependent manner. 4t-CHQ، 4-CHQ and 4-CPQ were found to be highly active cell proliferation inhibitor with IC50 values of 200, 280 and 280 μM, respectively. Given that the basic structures of these compounds, the compound with a reactive group showed stronger cytotoxic activity. The results indicated that structure and function of these compounds are related to each other. Fluorescent microscopy and DNA fragmentation assay was confirmed apoptosis cell death in K562 cells after 48 h of treatment with the compounds. Base on these results, the new Quinazoline derivatives can be proposed as effective agents for more investigation in the field of chemotherapy.

Diabetic wound is a common complication of diabetes. The aim of this study was to evaluate the effects of topical application of Lotus corniculatus hydroalcoholic extract on cutaneous wound healing in diabetic rats induced by streptozocin (STZ) in comparison with Phenytoin ointment in rat.Methods and Materials: In this interventional experimental study, male Wistar rats (250±20 g) were divided randomly to normal and diabetic groups. Diabetes was induced by intraperitoneal injection of STZ (60 mg/kg). After anesthesia, full thickness skin of upper dorsal part of rats removed in 2cm2 area. 24 hours after operation, wound in each animal treated once daily with L. corniculatus hydroalcoholic extract (40%) or phenytoin ointment (1%) in normal and diabetic group. Control group received no treatment. Wound surface area measured until 24th postoperative days. The time required for complete healing was also recorded. The progress of wound healing in diabetic animals was slower than in normal animals, and also healing effect of L. corniculatus extract compared with controls and normal Phenytoin and diabetic test groups was significant (p<0.001). Topical application of L. corniculatus might be accelerate the wound healing after seven day and it was comparable to phenytoin cream in diabetes-related complications.

Vitamin D is a group of sterol compounds and a liposoluble vitamin that has major role in the matrix of cartilage and bones. Food fortification with liposoluble vitamin is not straightforward, because of this vitamins is poorly dispersible in aqueous systems such as beverages. The encapsulation of nutraceutical compounds in lipid-based carrier systems, ¬like nanoliposomes, is effective in the preservation of their native properties during storage. The objective of the present study was to prepare vitamin D3 nanoliposomes, characterization, and stability studies of prepared formulation. In this experimental study, the nanoliposomes containing vitamin D3 were prepared from -various quantities of lecithin and cholesterol (60-0), (50-10), (40-20), (30-30) by thin-film hydration¬-sonication method. Various testes such as zeta-potential, turbidity and rheology were carried out to determine physicochemical properties of liposomes. The physical stability of the prepared formulations, evaluated by measuring the average particle size and the remaining vitamin D3 in nanoliposomes during storage, over 30 days at 4¬˚C. Zeta-potential results showed that inclusion of cholesterol in liposome caused to increase of negative zeta-potential from -29 to -42.9 mv. The samples containing cholesterol showed no significant changes in mean diameter volume and the amount of vitamin loaded liposome, during this period. The incorporation of cholesterol into the phospholipid bilayer increased the turbidity. All liposome samples showed Newtonian behavior at all concentration of lecithin- cholesterol. The applied method in this study has been efficient method for encapsulation of vitamin D3, reduction of size in the nonometric range, a narrow size distribution, physical stability and else properties.