Solitary Langerhans cell histiocytosis of the sternum in a 21-year-old woman

Children are more likely to develop Langerhans cell histiocytosis (LCH), a rare disorder with an unknown cause. LCH often invades skeletal systems, while it has occasionally been seen in the sternum or ribs. The best course of treatment for single-site, skeletal LCH is yet unknown. We present an instance of sternal LCH with adult onset. By fusing and reconstructing chest computed tomography, it was possible to determine the extent of surrounding soft tissue invasion. Because LCH is so uncommon, it could be challenging to recall when we see a sternal lesion. Adult Patients who arrive with anterior chest discomfort and an osteolytic sternal lesion should include LCH on their differential diagnosis list.

Effect of atorvastatin on serum periostin and blood eosinophils in asthma - a placebo-controlled randomized clinical trial

Objective

To investigate the effect of atorvastatin on serum periostin level and blood eosinophil count in patients with asthma.

Methods

Patients diagnosed with asthma were enrolled and randomised into an intervention or placebo group, to receive 40 mg atorvastatin or similar placebo, daily, for 8 weeks. Spirometry was performed at baseline, and at the end of weeks 4 and 8; patients also provided blood samples and completed an asthma control test (ACT) at baseline and at the end of week 8. Primary study outcomes were blood eosinophil count and serum periostin levels.

Results

Eighty patients completed the study (40 per group). Mean ACT scores were similar between the intervention and placebo groups at baseline (17.95 ± 3.75 versus 17.98 ± 3.77, respectively), and improved in the intervention group (19.88 ± 3.28), but remained unchanged in the placebo group (18.6 ± 3.26) during the treatment period. No statistically significant differences in spirometric changes, blood eosinophil count or serum periostin levels were observed between the groups during the treatment period.

Conclusion

Spirometric parameters and inflammatory markers did not change significantly in response to atorvastatin treatment, and did not differ between the placebo and intervention groups.

Measuring Staff Satisfaction in Transportation System using AHP Method under Uncertainty

One of the most important challenges in today world is the transportation and satisfaction of this system. Measuring satisfaction in transportation has been done quantitatively so far and, more importantly, the measurement process has not usually been scientific. This study aimed at an accurate scientific measurement. Because of ambiguity, this paper discusses how to use the intuitionistic fuzzy method, in which both membership and non-membership functions were expressed. Therefore, initially, considering the results of previous researches, as well as studying the references and standards, the characteristics and basic criteria, a researcher-made questionnaire with a reliability of 0.95 was first performed and then the weights were determined using the AHP intuitionistic fuzzy method. After performing the above steps, the intuitionistic fuzzy satisfaction value was calculated at different levels and using the method, the final number of satisfaction was defuzzified.

Aloe Vera; A new treatment for atrophic vaginitis, A randomized double-blinded controlled trial

AIM OF THE STUDY

Vaginal atrophy is of the most common problems during menopause with significant psychosocial and medical consequences. Estrogen as an approved therapy for vaginal atrophy can be associated with adverse effects and several contraindications in menopause patients. The aim is to compare the effect of Aloe Vera vaginal cream with commercially available estrogen vaginal cream for management of vaginal atrophy in menopause females.

MATERIALS AND METHODS

This is a double-blinded randomized controlled trial on 60menopause female with complaints of vaginal atrophy symptoms. Subjects were randomly allocated in two groups of 30 patients, named as estrogen and Aloe Vera groups. Vaginal health index (VHI), maturity value (MV), vaginal cytologic smear, transvaginal sonography (TVS) and severity of symptoms related to vaginal atrophy were assessed before and after 6-weeks of vaginal cream administration.

RESULTS

Comparison of MV before and after treatment revealed that superficial cells were significantly increased after administration of both vaginal cream (6.67 VS 54.33 in Aloe Vera group; 4.33 VS 59.67 in estrogen group). In addition, VHI (13.83 vs 20.13 in Aloe Vera group; 13.97 vs 19.93 in estrogen group) and symptoms of vaginal atrophy (3.63 vs 1.10 in Aloe Vera group; 3.90 vs 0.66 in estrogen groups) were also significantly improved after treatment in both groups. There was no significant difference between groups after treatment except for fluid volume with a superiority in Aloe Vera group (P-value = 0.004) CONCLUSION: Aloe Vera vaginal cream can be as effective as estrogen vaginal cream in the management of vaginal atrophy in menopause females.

Comparing scraping cytology with touch imprint cytology and frozen section analysis in the intraoperative diagnosis of sentinel lymph node metastasis in breast cancer

BACKGROUND

Breast cancer is a common cancer in the female population. Sentinel lymph node (SLN) in breast cancer patients can be evaluated by different methods including intraoperative frozen section analysis (FSA), touch imprint cytology (TIC), and scraping cytology (SC). In this study, in addition to investigating TIC and FSA, we focused on SC to evaluate the diagnostic value of this almost new method.

MATERIALS AND METHODS

In this retrospective study, the quadrantectomy and sentinel lymph node resection of 150 specimens with mammography and core needle biopsy-confirmed breast cancer were examined. Of the 150 participants, 77 and 73 had negative and positive results for the permanent pathology of SLN metastasis, respectively. Intra-operative FSA, TIC, and SC for SLN were performed for the patients and all were confirmed by permanent pathology.

RESULTS

All the specimens were taken from females aged between 25 and 82 years. The sensitivity and specificity of TIC, FS, and SC were 73% and 50%, 92.6% and 50%, and 92.1% and 50%, respectively. Among the three techniques, TIC had the lowest positive and negative predictive values. However, FS had the highest positive predictive value whereas SC had the highest negative predictive value.

CONCLUSION

In addition to FS and TIC as rapid, cost-effective, and reliable diagnostic methods in SLN metastasis, SC is an acceptable and highly sensitive method. A combination of these methods may provide a more favorable diagnostic value for SLN assessment in breast cancer patients.

Primary Pure Squamous Cell Carcinoma of Kidney Associated with Multiple Stag Horn Stones

Primary Squamous cell carcinoma (SCC) of the kidney is rarely reported in the literature. It is usually associated with renal stone, and due to lack of clinical symptoms and radiological diagnostic features, patients often present at the late stages of the disease. We reported a 59-year-old woman presented with a longstanding history of flank pain and hematuria. Imaging techniques revealed enlargement of the right kidney associated with multiple staghorn stones. The patient subsequently underwent right radical nephrectomy, and histopathological examination of the mass revealed well-differentiated keratinized squamous cell carcinoma. There was no primary source for her SCC. Although the primary SCC of the kidney is a rare entity, it should be considered in patients with longstanding renal calculi, particularly for large staghorn stones of renal pelvis. On the other hand, conventional imaging could not detect this type of malignancy. In most cases, CT and MRI play an essential role in the diagnosis of such tumors.

Interferometric optical testing to discriminate benign and malignant brain tumors

When normal cells suffer from the malignant disease, changes occur in cellular size and structure, and their constituents. These changes can affect the biological response of cells and tissues. Conventional hematoxylin and eosin staining, which is the gold standard of tumor diagnosis provide a very detailed view of the tissue by staining cell structures to diagnose a disease based on the deformation of the cells. However, this study shows changes in cells and tissues structure due to malignant diseases can also affect the optical properties. The purpose of this research was to assess and compare these effects to identify benign and malignant brain tissues from each other. Various samples of adult human brain tissues were studied using Mach-Zehnder interferometer as an optical method and using the Fourier transform method as an analytical process. The formed interference patterns of benign and malignant brain tumors were investigated to obtain the phase distribution of tumors. The obtained information demonstrated that the phase distribution of malignant brain tissues was different from benign brain tissues. The phase distribution approximately ranged from 10 to 120 rad for benign samples and from 10 to 160 rad for malignant samples. Moreover, the average of unwrapped phase distribution was 63.79 and 85.69 rad in benign and malignant samples, respectively. This results indicated that the proposed laser-based technique, Mach-Zehnder interferometer method, can be used as an auxiliary procedure along with histological techniques to identify benign and malignant brain tumors from each other. It is suggested that the unwrapped phase distribution of tissues be considered as an optical property for differentiating various brain tumors.

Ameliorative role of aspirin in paraquat-induced lung toxicity via mitochondrial mechanisms

Paraquat (PQ) has accounted for numerous suicide attempts in developing countries. Aspirin (ASA) as an adjuvant treatment in PQ poisoning has an ameliorative role. And, it's uncoupling of mitochondrial oxidative phosphorylation role has been well established. The current study aimed at examining the aspirin mechanism on lung mitochondria of rats exposed to PQ. Male rats were randomly allocated in five groups: Control group, PQ group (50 mg/kg; orally, only on the first day), and PQ + ASA (100, 200, and 400 mg/kg; i.p.) groups for 3 weeks. Mitochondrial indices and respiratory chain-complex activities were determined. PQ induced lung interstitial fibrosis; however, ASA (400 mg/kg) led to decrease in this abnormal alteration. In comparison with PQ group, complex II and IV activity, and adenosine triphosphate content in ASA groups had significantly increased; however, reactive oxygen species production, mitochondrial membrane permeabilization, and mitochondrial swelling were significantly reduced. In conclusion, aspirin can alleviate lung injury induced by PQ poisoning by improving mitochondrial dynamics.

Population structures of Leishmania infantum and Leishmania tropica the causative agents of kala-azar in Southwest Iran

Visceral leishmaniasis (VL) is endemic in Iran and is caused predominantly by Leishmania infantum, but L. tropica is emerging as an important cause. We studied the intra-species population structure of Leishmania spp. causing VL in southwest Iran by sequence analysis of the internal transcribed spacer (ITS) 1 of DNA samples from 29 bone marrow aspiration smears. L. infantum (n = 25) and L. tropica (n = 4) were identified, consisting of 10 and three ITS1 sequence types (STs), respectively. Compared to GenBank ITS1 STs, our L. infantum parasites displayed high heterogeneity but less heterogeneity compared than northwest Iranian isolates. VL affects mostly nomadic populations in southwest Iran, and their mobility may explain partly the L. infantum heterogeneity. The VL causing L. tropica was also genetically heterogeneous but genetically indistinguishable from L. tropica strains causing anthroponotic cutaneous leishmaniasis from southwest Iran.

Exacerbated liver injury of antithyroid drugs in endotoxin-treated mice

Drug-induced liver injury is a major concern in clinical studies as well as in post-marketing surveillance. Previous evidence suggested that drug exposure during periods of inflammation could increase an individual's susceptibility to drug hepatoxicity. The antithyroid drugs, methimazole (MMI) and propylthiouracil (PTU) can cause adverse reactions in patients, with liver as a usual target. We tested the hypothesis that MMI and PTU could be rendered hepatotoxic in animals undergoing a modest inflammation. Mice were treated with a nonhepatotoxic dose of LPS (100 µg/kg, i.p) or its vehicle. Nonhepatotoxic doses of MMI (10, 25 and 50 mg/kg, oral) and PTU (10, 25 and 50 mg/kg, oral) were administered two hours after LPS treatment. It was found that liver injury was evident only in animals received both drug and LPS, as estimated by increases in serum alanine aminotransferase (ALT), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and TNF-α. An increase in liver myeloperoxidase (MPO) enzyme activity and tissue lipid peroxidation (LPO) in addition of liver glutathione (GSH) depletion were also detected in LPS and antithyroid drugs cotreated animals. Furthermore, histopathological changes including, endotheliitis, fatty changes, severe inflammatory cells infiltration (hepatitis) and sinusoidal congestion were detected in liver tissue. Methyl palmitate (2 g/kg, i.v, 44 hours before LPS), as a macrophage suppressor, significantly alleviated antithyroids hepatotoxicity in LPS-treated animals. The results indicate a synergistic liver injury from antithyroid drugs and bacterial lipopolysaccharide coexposure.

Prognostic Value of HLA-G in Malignant Liver and Pancreas Lesions

BACKGROUND

Human leukocyte antigen (HLA)-G is a nonclassical HLA class I molecule with modulatory effects on NK and T cells. Because HLA-G expression is frequently detected in different solid tumors, it may be involved in tumor immune evasion.

OBJECTIVE

This study was designed to elucidate the prognostic value of HLA-G in hepatocellular carcinoma (HCC) and pancreatic adenocarcinoma (PADC). The influence of hepatitis B virus (HBV) infection on HLA-G expression was also evaluated in patients with HCC.

METHODS

HLA-G expression was investigated in tumor tissues from patients with HCC (n=74) or PADC (n=42) with immunohistochemical techniques. The presence of HBV genome was also examined in HCC tumor tissues by PCR.

RESULTS

HLA-G expression was detected in 66% of PADC and in 31% of HCC samples. In contrast to HCC, HLA-G overexpression was associated with advanced stages and grades in PADC. HBV genome was detected in 31% of HCC samples but we found no correlation between HLA-G expression and the presence of HBV genome in these tumors.

CONCLUSION

Our findings showed that HLA-G overexpression in tumor tissue correlated with poor prognosis in PADC. HLA-G expression is apparently affected by the patient's genetic background and other epigenetic factors rather than by HBV infection.

Efficacy of Bronchial Washing and Brushing Cytology in the Diagnosis of Non-Neoplastic Lung Diseases

Flexible fiberoptic bronchoscopy is often the initial technique for diagnosis of lung and bronchial tumors. Many studies have shown the high accuracy rate of bronchial washing and brushing cytology in the evaluation of neoplastic and non-neoplastic bronchopulmonary lesions. The aim of this study is to emphasize the value of the bronchial cytologic findings for diagnosis of non-neoplastic bronchopulmonary lesions. In a cross-sectional study, we retrieved all cases with bronchial washing and brushing cytology from 21 Mach 2014 to 21 December 2015. The slides of 100 patients with negative cytological reports were reviewed and concomitantly correlated with history, physical examination, clinical and pathologic documents. The cases with insufficient clinical and pathological diagnostic documents were rejected. The results classified in subgroups according to final diagnosis and cytological findings were discussed. We evaluated 100 cases that were previously had negative cytological reports.60 cases were male, and 40 cases were female with male to female ratio: 6/4. The age range was between 21 to 88 with the mean age of 57 years. Regarding lung cancer, 31% of cases were false negative. Causes of these falsely negative reports were been errors in screening, low cellularity, unsatisfactory smears and poor fixation. 23% were known cases of tuberculosis with some cytological findings including inflammation, necrotic calcified deposits, multinucleated giant cell and reserve cell hyperplasia. 19% were pneumonic patients with smears demonstrating inflammation, curschmann's spiral and reserve cell hyperplasia. Other non-neoplastic cases included in this study were asthma, granulomatous inflammation, rheumatoid arthritis, sarcoidosis, Wegener, SLE, heart failure, hydatid cyst, interstitial lung disease, and end stage renal disease. Cytological specimens from patients underwent bronchoscopic washing and brushing should be carefully examined. In situations with negative cytologic results, correlation with history, imaging and biopsy specimen is mandatory.

Umbelliprenin induced both anti-inflammatory and regulatory cytokines in C57/BL6 mice

Objective(s):

Umbelliprenin is a prenyloxy-coumarin with pharmacologically polyvalent activity. Several studies have shown Several studies have been shown its anti-inflammatory, anti-tumor, antioxidant, and antigenotoxic activities. However, the exact mechanism of action of this compound on the immune response has not yet been shown. Here, we investigated umbelliprenin effects on the predominance of Th1 and Th2 responses in normal C57/BL6 mice.

Materials and Methods:

Umbelliprenin (2.5 mg/200 µl IP) were administered to six C57/BL6 mice every other day for 8 days. Paraffin and PBS-injected mice were enrolled as solvent and control groups, respectively (n=6 mice/group). IL-10, IFN-γ, and IL-4 levels were determined in sera and also in splenocytes culture supernatants in the presence of Con A (3 µg/ml) after 72 hr. H&E staining of paraffin embedded blocks was performed for lung and liver tissues of mice.

Results:

Umbelliprenin could significantly increase the secretion of IFN-γ and IL-4 in sera and IL-10 in splenocytes cultures. Comparison of IFN-γ/IL-4 in the sera and splenocytes culture supernatants showed lower ratios in umbelliprenin treated mice than in solvent and untreated groups.

Conclusion:

The in vivo study showed that umbelliprenin could induce anti-inflammatory responses via the predominance of Th2 cells and some regulatory responses in C57/BL6 mice.

Hesperidin as Radioprotector against Radiation-induced Lung Damage in Rat: A Histopathological Study

Reactive oxygen species (ROS) are generated by ionizing radiation, and one of the organs commonly affected by ROS is the lung. Radiation-induced lung injury including pneumonia and lung fibrosis is a dose-limiting factor in radiotherapy (RT) of patients with thorax irradiation. Administration of antioxidants has been proved to protect against ROS. The present study was aimed to assess the protective effect of hesperidin (HES) against radiation-induced lung injury of male rats. Fifty rats were divided into three groups. G1: Received no HES and radiation (sham). G2: Underwent γ-irradiation to the thorax. G3: Received HES and underwent γ-irradiation. The rats were exposed to a single dose of 18 Gy using cobalt-60 unit and were administered HES (100 mg/kg) for 7 days before irradiation. Histopathological analysis was performed 24 h and 8 weeks after RT. Histopathological results in 24 h showed radiation-induced inflammation and presence of more inflammatory cells as compared to G1 (P < 0.05). Administration of HES significantly decreased such an effect when compared to G2 (P < 0.05). Histopathological evaluation in 8 weeks showed a significant increase in mast cells, inflammation, inflammatory cells, alveolar thickness, vascular thickness, pulmonary edema, and fibrosis in G2 when compared to G1 (P < 0.05). HES significantly decreased inflammatory response, fibrosis, and mast cells when compared to G2 (P < 0.05). Administration of HES resulted in decreased radiation pneumonitis and radiation fibrosis in the lung tissue. Thus, the present study showed HES to be an efficient radioprotector against radiation-induced damage in the lung of tissue rats.

Concurrent Inflammation Augments Antimalarial Drugs-Induced Liver Injury in Rats

Purpose: Accumulating evidence suggests that drug exposure during a modest inflammation induced by bacterial lipopolysaccharide (LPS) might increase the risk of drug-induced liver injury. The current investigation was designed to test if antimalarial drugs hepatotoxicity is augmented in LPS‑treated animals. Methods: Rats were pre-treated with LPS (100 µg/kg, i.p). Afterward, non-hepatotoxic doses of amodiaquine (25, 50 and 100 mg/kg, oral) and chloroquine (25, 50 and 100 mg/kg, oral) were administered. Results: Interestingly, liver injury was evident only in animals treated with both drug and LPS as estimated by pathological changes in serum biochemistry (ALT, AST, LDH, and TNF-α), and liver tissue (severe hepatitis, endotheliitis, and sinusoidal congestion). An increase in liver myeloperoxidase enzyme activity, lipid peroxidation, and protein carbonylation, along with tissue glutathione depletion were also detected in LPS and drug co-treated animals. Conclusion: Antimalarial drugs rendered hepatotoxic in animals undergoing a modest inflammation. These results indicate a synergistic liver injury from co-exposure to antimalarial drugs and inflammation.

Radioprotective effects of hesperidin on oxidative damages and histopathological changes induced by X-irradiation in rats heart tissue

This study was carried out to evaluate radioprotective effects of hesperidin (HES) administration before the irradiation on the cardiac oxidative stress and histopathological changes in an experimental rat model. The cardiovascular complications of radiation exposure cause morbidity and mortality in patients who received radiotherapy. HES, an antioxidant flavonoid found in citrus fruits, suggests the protection against the tissue damage. Fifty-eight rats were divided into four groups: Group 1 received phosphate buffered saline (PBS) and sham radiation; Group 2, HES and sham radiation; Group 3, PBS and radiation; and Group 4, HES and radiation. The rats were exposed to single dose of 18 Gy of 6 MV X-ray. One hundred milligrams per kilogram doses of HES was administered for 7 days before irradiation. The estimation of superoxide dismutase (SOD), malondialdehyde (MDA), and histopathological analyses was performed at 24 h and 8 weeks after radiation exposure. The irradiation of chest area resulted in an elevated MDA level and decreased SOD activity. Moreover, long-term pathological lesions of radiation were inflammation, fibrosis, the increased number of mast cells and macrophages, and development of plaque, vascular leakage, myocardial degeneration, and myocyte necrosis. Although the administration of HES decreases inflammation, fibrosis, mast cell and macrophage numbers, and myocyte necrosis, it did not result in reduced thrombus, myocardium degeneration, and vascular leakage. In conclusion, these results suggest that HES can perform a radioprotection action. The protective effect of HES may be attributable to its immunomodulatory effects and free radical-scavenging properties.

Evaluating Radioprotective Effect of Hesperidin on Acute Radiation Damage in the Lung Tissue of Rats

BACKGROUND

Oxidative stress plays an important role in the pathogenesis and progression of γ-irradiation-induced cellular damage, Lung is a radiosensitive organ and its damage is a dose-limiting factor in radiotherapy. The administration of dietary antioxidants has been suggested to protect against the succeeding tissue damage. The present study aimed to evaluate the radioprotective efficacy of Hesperidin (HES) against γ-irradiation-induced tissue damage in the lung of male rats.

MATERIALS AND METHODS

Thirty two rats were divided into four groups. Rats in Group 1 received PBS and underwent sham irradiation. Rats in Group 2 received HES and underwent sham irradiation. Rats in Group 3 received PBS and underwent γ-irradiation. Rats in Group 4 received HES and underwent γ-irradiation. These rats were exposed to γ-radiation 18 Gy using a single fraction cobalt-60 unit, and were administered HES (100 mg/kg/d, b.w, orally) for 7 days prior to irradiation. Rats in each group were sacrificed 24 hours after radiotherapy (RT) for the determination of superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA) and histopathological evaluations.

RESULTS

Compared to group 1, the level of SOD and GSH significantly decreased and MDA level significantly increased in group 3 at 24 h following irradiation, (p=0.001, p<0.001, p=0.001), respectively. A statistically significant difference in all parameters was observed for rats in group 4 as compared to group 3 (p<0.05). Histopathological results 24 hours after RT showed that radiation has increased inflammation, lymphocyte, macrophage and neutrophil compared to group 1 ( p<0.0125). Oral administration of HES before RT significantly decreased macrophage and neutrophil when compared to group 3 (p<0.0125), but partly there was inflammation and lymphocyte that indicated there was no significant difference when compared to group 3 (p>0.0125).

CONCLUSION

Oral administration of HES was found to offer protection against γ-irradiation- induced pulmonary damage and oxidative stress in rats, probably by exerting a protective effect against inflammatory disorders via its free radical scavenging and membrane stabilizing ability.

Myxoma Immediately above the Junction of the Inferior Vena Cava and the Right Atrium: A Rare Cause of Budd-Chiari Syndrome

The Budd-Chiari syndrome (BCS) is a rare disorder caused by the obstruction of the hepatic veins or the inferior vena cava (IVC) at the suprahepatic level. This syndrome is developed by either hepatic vein thrombosis or mechanical venous obstruction and leads to centrilobular hepatic congestion with the subsequent development of fibrosis and cirrhosis. Intracardiac tumors have been rarely reported as a cause of the BCS. These tumors usually originate from the atrial septum. Very rarely, they arise either from the junction of the IVC and the right atrium or from the Eustachian valve. There are a few case reports in the literature where atrial tumors have caused the BCS. In these cases, the tumors were malignant, and the patients died shortly after being diagnosed. We describe a 71-year-old female patient who presented with a 3-month history of abdominal pain and protrusion. On physical examination, blood pressure and pulse rate were normal. Jugular venous pressure was about 10 cm. Cardiac examination revealed a systolic murmur, grade IV/VI, in the left sternal border without radiation. Echocardiography showed a large mass (about 6×4 cm) in the right atrium with close contact to the origin of the IVC, obstructing it. Cardiac magnetic resonance imaging, with and without gadolinium, also confirmed the diagnosis. The patient underwent surgery, and the myxoma was removed. The tumor was a large solid mass, 5×4 cm in size, which originated immediately above the entrance of the IVC. The patient is in good condition 1 year afterward. We emphasize that atrial myxomas should be considered in the differential diagnosis of tumors that cause chronic BCS.

Renal capsule for augmentation cystoplasty in canine model: a favorable biomaterial?

PURPOSE

To evaluate effectiveness of canine renal capsule for augmentation cystoplasty.

MATERIALS AND METHODS

Ten adult dogs participated in this study. After induction of anesthesia each animal underwent bed side urodynamic study, bladder capacity and bladder pressure was recorded. Then via mid line incision abdominal cavity was entered, right kidney was identified and its capsule was dissected. Bladder augmentation was done by anastomosing the renal capsule to the bladder. After 6 months bed side urodynamic study was performed again and changes in bladder volume and pressure were recorded. Then the animals were sacrificed and the augmented bladders were sent for histopathology evaluation.

RESULTS

Mean maximum anatomic bladder capacity before cystoplasty was 334.00±11.40cc which increased to 488.00±14.83cc post-operatively (p=0.039). Mean anatomic bladder pressure before cystoplasty was 19.00±1.58cmH2O which decreased to 12.60±1.14cmH2O post-operatively (p=0.039). Histopathology evaluation revealed epithelialization of the renal capsule with urothelium without evidence of fibrosis, collagen deposits or contracture.

CONCLUSIONS

Our data shows that renal capsule is a favorable biomaterial for bladder augmentation in a canine model.

[Significant association between nonsyndromic cleft lip with or without cleft palate and IRF6rs2235371 polymorphism in Iranian familiar population]

According to previous studies the IRF6rs2235371 polymorphism is a risk factor for NSCL/P in different populations. However our recent study revealed no correlation between IRF6rs642961 and NSCL/P in our population. In the present study we have investigated the relationship between IRF6rs2235371 and NSCL/P in same group to determine whether IRF6rs2235371 is a risk factor in our population as well. We analyzed the IRF6rs2235371 genotype in a subset of the Iranian population using the Polymerase Chain Reaction technique. The PCR products were digested with DpnII. Chi-square test was applied to analyze the obtained result. The patients were supplied by the Cleft Lip and Palate Clinic of the Isfahan University of Medical Science. A clinician ascertained the non-syndromic status of all patients and that no clefting drugs, ethanol or smoking were abused during pregnancy. The control group was selected from unaffected subjects with no history of NSCL/P in their families. 107 patients from 107 Iranian unrelated families and 100 controls were screened. There was a significant association between the IRF6rs2235371 genotype sand an increased NSCL/P risk. Our data indicates that the IRF6rs2235371 variation can increase the risk of NSCL/P in the Iranian population. This result is in contrast with the results of our recent study on the correlation between the IRF6rs642961 polymorphism and NSCL/P in the same group.

Inhibition of CEA release from epithelial cells by lipid A of Gram-negative bacteria

A number of bacterial species, both pathogenic and non-pathogenic, use the human CEACAM family members as receptors for internalization into epithelial cells. The GPI-linked CEA and CEACAM6 might play a role in the innate immune defense, protecting the colon from microbial invasion. Previous studies showed that CEA is released from epithelial cells by an endogenous GPI-PLD enzyme. GPI-PLD activity was reported to be inhibited by several synthetic and natural forms of lipid A. We hypothesized that CEA engagement by Gram-negative bacteria might attenuate CEA release from epithelial cells and that this might facilitate bacterial colonization. We tested the hypothesis by examining the effect of Escherichia coli on CEA release from colorectal cancer cells in a co-culture experiment. A subconfluent monolayer culture of colorectal cancer cells (LS-180, Caco-2 and HT29/219) was incubated with E. coli. While there was a significant reduction in CEA secretion from LS-180 and HT29/219 cells, we found only a small reduction of CEA shedding from Caco-2 cells compared to the level from the untreated control cells. Furthermore, lipid A treatment of LS-180 cells inhibited CEA release from the cells in a dosedependent manner. Western blot analysis of total lysates showed that CEA expression levels in cells co-cultured with bacteria did not differ from those in untreated control cells. These results suggest that lipid A of Gram-negative bacteria might play a role in preventing the release of CEA from mucosal surfaces and promote mucosal colonization by bacteria.

Healing effect of pistacia atlantica fruit oil extract in acetic Acid-induced colitis in rats

BACKGROUND

Considering the anti-oxidant properties of Pistacia atlantica and lack of data regarding its efficacy in the treatment of ulcerative colitis, this study aims at investigating the effect of the Pistacia atlantica fruit extract in treating experimentally induced colitis in a rat model.

METHODS

Seventy male Sprague-Dawley rats (weighing 220±20 g) were used. All rats fasted 24 hours before the experimental procedure. The rats were randomly divided into 7 groups, each containing 10 induced colitis with 2ml acetic acid (3%). Group 1 (Asacol), group 2 (base gel) and group 7 (without treatment) were assigned as control groups. Group 3 (300 mg/ml) and group 4 (600 mg/ml) received Pistacia atlantica fruit orally. Group 5 (10% gel) and group 6 (20% gel) received Pistacia atlantica in the form of gel as enema. Macroscopic, histopathological examination and MDA measurement were carried out.

RESULTS

All groups revealed significant macroscopic healing in comparison with group 7 (P<0.001). Regarding microscopic findings in the treatment groups compared with group 7, the latter group differed significantly with groups 1, 2, 4 and 6 (P<0.001). There was a significant statistical difference in MDA scores of the seven treatment groups (F(5,54)=76.61, P<0.001). Post-hoc comparisons indicated that the mean±SD score of Asacol treated group (1.57±0.045) was not significantly different from groups 4 (1.62±0.024) and 6 (1.58±0.028).

CONCLUSION

Our study showed that a high dose of Pistacia atlantica fruit oil extract, administered orally and rectally can improve colitis physiologically and pathologically in a rat model, and may be efficient for ulcerative colitis.

Assessing two methods of repair of duodenal defects, jejunal serosal patch and jejunal pedicled flap, (an experimental animal study)

OBJECTIVE

To evaluate the outcomes of jejunal serosal patch and jejunal pedicled flap procedures for the repair of duodenal injuries.

METHODS

The experimental animal-model study was conducted at Shiraz University of Medical Sciences, Iran, in February 2013. Ten mixed-breed male dogs were selected and randomly divided into groups A and B. After general anaesthesia, a large duodenal defect was created in all animals. The defect was repaired with jejunal pedicled flap in group A and jejunal serosal patch in group B. Microscopic healing was scored according to epithelialisation, collagenisation, inflammation, ulcer and necrosis of samples. Kolmogorov-Smirnov and independent t-test were used to indicate normal distributions of data and statistical differences between the two groups respectively.

RESULTS

The weight of the animals ranged between 23 and 37 kg and the age range was 12-16 months. All dogs survived the procedures. Anastomotic leakage, intra-abdominal abscess or intestinal obstructions were not detected in gross examination. Healing score was significantly higher in the group A than group B (p < 0.011). However, in terms of surgical findings, no significant difference was detected between the groups (p > 0.05).

CONCLUSION

Applying jejunal pedicled flap for repairing large duodenal defects would lead to better histologic outcomes compared to jejunal serosal patch in dogs.

A new method to repair recto-vaginal fistula: Use of human amniotic membrane in an animal model

BACKGROUND

Recto-vaginal fistula is primarily one of the co-morbidities of vaginal delivery. These patients suffer from persistent malodor vaginal discharge. Various surgical techniques have been employed by surgeons in the course of time. This is the first trial of applying Human Amniotic Membrane (HAM) as a bio-prosthesis in repairing recto-vaginal fistula.

MATERIALS AND METHODS

In a prospective animal study, 8 mixed-breed female dogs weighing 23-27 kg with the age of 12-18 months were selected. They were randomly divided into two groups for standard recto-vaginal fistula repair and fistula repair with human amniotic membrane. The Kruskal-Wallis and Mann Whitney tests were performed to indicate statistical differences.

RESULTS

After 6 weeks, fistulas were evaluated both grossly and microscopically. In gross examination, there were no difference between the two groups and healing of fistula seemed to have been occurred in all dogs expect for one which had a persistent patent fistulous tract. Microscopic healing was scored according to epithelialization, collagenization inflammation, ulcer and necrosis of samples. Healing score was significantly higher in the HAM group than the standard group (P = 0.029).

CONCLUSION

Our findings revealed that using HAM as a bio-prosthesis to repair recto-vaginal fistula would result in better surgical and histological outcomes comparing to simple repair.

Histopathological changes in rabbit gastric mucosa after chronic exposure to pickled vegetables: an experimental study

Gastric cancer (GC) is very common in Iran. Daily consumption of pickled vegetables is a routine dietary habit in most areas of Iran. Because pickled vegetables have been associated with GC it can be of importance to study the relationship between the two. We have therefore studied the histo-morphological effects of pickled vegetables on the Rabbit gastric mucosa. Forty and twenty healthy male rabbits were respectively allocated in the experimental and control groups. The rabbits were fed freely with pickled (experimental group) and fresh vegetables (control group) for 1 yr. The gastric mucosa of rabbits was examined and the results were compared. In addition to all the rabbits of the control group, 14 rabbits (35%) of the experimental group had normal gastric mucosa. The rest showed abnormal changes including atypia-so called indefinite for dysplasia-in 10 (25%), low-grade dysplasia in 14 (35%), and high-grade dysplasia in 2 (5%). The analysis showed significant difference between results of the 2 groups (P < 0.001). Daily consumption of pickled vegetables can produce atypical and dysplastic changes in the gastric mucosa. Such preneoplastic changes can potentially transform to gastric carcinoma. This process could be prevented by reduction or cessation of daily pickled food consumption.

The effect of creatine supplementation on muscle fatigue and physiological indices following intermittent swimming bouts

We evaluated the effect of Creatine (Cr) supplementation on muscle fatigue and physiological indices after intermittent swimming bouts in trained swimmers. Sixteen healthy non-elite swimmers (19±4 years, 75±12 kg) were randomly assigned into two groups of either Cr supplementation or placebo and performed six repeated sprints swimming bouts of 50-m departing every 120 seconds. The Cr group was supplemented 4 times a day for 6 days. Blood lactate, Creatine Kinase (CK), creatinine, heart rate, best repeated sprint (RSb) and mean repeated sprint (RSm) times, and percentage of speed decrement (%Dec) were measured at the various phases of swimming bouts. Repeated measure ANOVA and independent t-student tests showed CK and blood lactate concentration increased gradually after the third and sixth swimming bouts. % Dec in Cr group was significantly lower after 3rd swimming bout, also heart rate in Cr group was associated with lower increase in HR mean (P<0.05) compared to placebo. These results suggest that Cr supplementation may improve swimming performance and reduce increased blood lactate levels following intermittent sprint swimming bouts. In conclusion Cr supplementation in trained swimmers may improve anaerobic performance and heart rate variations independent of the effect of intensive sprint swimming bouts.

The interactive effects of exercise type and environment temperature on HSP72 in active females

The purpose of this study was to determine the effects of endurance and/ or weight training in normal and/ or moderate heat environments on heat shock protein (HSP72) response in active young females. Forty-five healthy active female (21±3 year, 61.4±10.2 kg, VO2max 37.2±5.3 mL/kg/min) were randomLy assigned into five groups; endurance training+normal heat (ET+NH), endurance training+moderate heat (ET+MH), weight training+normal heat (WT+NH), weight training+moderate heat (WT+MH) and heat group (HG). The training protocols include treadmill running to exhaustion on a treadmill at %65-75 V02max in the ET+NH and ET+MH groups and 4 sets of eccentric actions of elbow flexors (two sets with %50 and two sets with %60 1RM) in the WT+NH and WT+MH groups. Fasting blood samples were collected from non-dominant arm at three phases; consist of rest (baseline) and mid-test and 30 min after the training protocols. Endurance training and/ or weight training, in particularly, in the moderate heat ambient resulted in an increase in the HSP72, creatin kinase (CK) and cortisol values, as compared to ET+NH and WT+NH groups and the mid-test and baseline phases. However, the HSP72 and CK concentrations significantly increased in WT+ NH group, as compared to ET+NH group. Furthermore, WT+MH group showed significant increase in HSP72 levels, as compared to ET+ NH group. These findings suggest the muscle damage related to factors such as; exercise type, environment temperature and increase in exercise-induced body temperature.

Endurance exercise training and diferuloyl methane supplement: changes in neurotrophic factor and oxidative stress induced by lead in rat brain

Lead is a highly neurotoxic agent that particularly affects the developing central nervous system. In the current study we investigated the neuroprotective effects of exercise training and/or diferuloyl methane (DM) supplement, which is known as curcumin, on lead acetate-induced neurotoxicity in the rat hippocampus. Sixty rats were randomly divided into six groups: 1) lead acetate, 2) DM supplement, 3) endurance training, 4) training+ DM supplement, 5) sham and 6) base. The rats in the training groups performed treadmill running consisting of 15 to 22 m · min(-1) for 25 to 64 min, 5 times a week for 8 weeks. All groups except sham received lead acetate (20 mg · kg(-1)), whereas the sham group received DM solvent. In addition, the DM and training + DM groups received DM solution (30 mg · kg(-1)) intraperitoneally. Chronic administration of lead acetate resulted in a significant increase in the malondialdehyde (MDA) in plasma, but not in the hippocampus. In addition, it led to significantly decreased brain-derived neurotrophic factor (BDNF) in the hippocampus and total antioxidant capacity (TAC) levels, as compared to the sham group. Treadmill running, DM supplementation, or both resulted in a significant decrease in MDA levels and significantly increased BDNF and TAC levels, as compared to the lead acetate group. These results provide a rationale for an inhibitory role of DM supplement and regular exercise in the attenuation of lead-induced neurotoxicity.

Primary pure squamous cell carcinoma of gallbladder presenting as acute cholecystitis

Squamous cell carcinoma of the gallbladder is rare and constitutes only 0.5-3% of all malignancies of this organ. Most of the reported cases have had a component of adenocarcinoma. We report a 70-year-old man who presented with acute onset right upper quadrant pain. He operated on based on a presumptive diagnosis of acute cholecystitis according to clinical and ultrasonographic findings. Histopathological examination of the infiltrating mass of the gallbladder revealed well differentiated keratinized squamous cell carcinoma invading full wall thickness. Thorough evaluations revealed no other primary site for the tumor. Pure primary squamous cell carcinoma of the gallbladder is rarely reported. Clinicians and pathologists must be aware of its vague clinical presentations.

Use of fine needle aspiration cytology in the diagnosis of cutaneous leishmaniasis: a comparison with the conventional scraping method

Cutaneous leishmaniasis is endemic in Iran. Scraping smears are widely used and fine needle aspiration (FNA) cytology is now attracting more attention. Both methods were performed on the clinically suspected cases in our study. Smears were stained using Giemsa. We compared the sensitivity, specificity and some other aspects of these two methods. Of our 400 patients, 346 had specimens that were positive for leishman body, and of these 328 were detected using both methods. However, 42 cases were confirmed positive by FNA cytology and 18 as a result of scraping smears. There was a significant difference between the two methods in the detection of leishman body and microgranuloma, slide background and patient comfort. The sensitivity of FNA cytology was greater even though the specificity was the same. Our study confirmed the advantages of FNA cytology as a reliable method for the diagnosis of cutaneous leishmaniasis.

An epidemiological and clinical study on scorpionism in hospitalized children in khuzestan, iran

BACKGROUND

Scorpion sting is a public health problem in Khuzestan, South-West Iran. The aims of the current study were to monitor the hospitalized children, due to scorpion sting, and releasing more clinical and epidemiologic data related to scorpionism in this Province.

METHODS

In this retrospective study, the data of scorpion sting victims, among the hospitalized children in Abuzar Children Hospital of Ahvaz Jundi Shapur University of Medical Sciences, was analyzed from the points of epidemiological and clinical aspects in 2006.

RESULTS

The scorpion species of 18 files out of 57 were recognized accurately, using Farzanpay's keyof Iranian scorpions, as Androctonus crassicauda (Scorpionida: Buthidae) and Hemiscorpious lepturus (Scorpionida: Hemiscorpiidae).

CONCLUSION

The most scorpionism emergencies among the children in the Khuzestan should be paid to those species. However, H. lepturus sting emergencies are in the top of attention among the children.

Seroprevalence of hepatitis B in Nahavand, Islamic Republic of Iran

We determined the seroprevalence of hepatitis B in Nahavand in a sample of 1824 subjects > 5 years in 2002. Face-to-face interviews were conducted and blood samples taken. The association between risk factor and hepatitis B was assessed using logistic regression. The prevalence of HBsAg positive cases was 2.3%, and HBcAb and HBsAb were isolated in 7.8% and 11.6% of the participants respectively; 11.9% were positive for both HBcAb and HBsAb. History of surgery and imprisonment were the major risk factors for infection with odds ratios of 2.14 (95% CI: 1.22-3.05) and 3.57 (95% CI: 1.68-5.4) respectively.

Cytologic findings of medulloblastoma in crush smears

OBJECTIVE

To describe the cytologic findings of medulloblastomas on intraoperative crush preparation smears and compare them with the findings of other central nervous system tumors.

STUDY DESIGN

The intraoperative crush preparation smears of 19 cases of medulloblastoma were studied (6 undifferentiated type and 13 well-differentiated type). The findings were compared with those of a control group consisting of 31 astrocytomas, 22 ependymomas, 18 oligodendrogliomas, 27 meningiomas, 17 schwannomas, 17 pituitary adenomas, 3 lymphomas, 5 hemangioblastomas, 5 chordomas and 11 metastatic tumors.

RESULTS

Medulloblastomas revealed clusters and isolated small, round malignant cells with hyperchromatic nuclei and indistinct cytoplasm. Typical Homer-Wright rosettes were seen in the well-differentiated type, but they were poorly formed in the undifferentiated type. Tumor cannibalism, target inclusions, cytoplasmic vacuoles and prominent multiple nucleoli were noticed frequently in the undifferentiated type. The control group (metastatic tumors and high grade astrocytomas) rarely showed tumor cannibalism or multiple nucleoli.

CONCLUSION

Smears of the undifferentiated type of medulloblastomas frequently revealed tumor cannibalism, cytoplasmic vacuoles, target inclusions and prominent multiple nucleoli. These findings have been rarely reported. The prognosis of the undifferentiated type of medulloblastoma was poor.

Ménière disease caused by an anomalous vein of the vestibular aqueduct

The precise cause of Ménière disease remains unclear. Multiple causes have been proposed with most experimental evidence pointing to impaired fluid resorption by the endolymphatic duct and sac as the final common pathway in development of hydrops. We report a unique case of Ménière disease secondary to compression of the endolymphatic duct and sac by an anomalous vein of the vestibular aqueduct. The resulting mechanical obstruction led to excessive accumulation of endolymph with clinical signs of Ménière disease. We review the literature and discuss proposed pathogenesis of disease. The finding of this anomalous vein provides further evidence that anatomical obstruction of the endolymphatic duct and sac may lead to Ménière-like symptoms. This unique example of an anatomical variant offers additional insight into the pathophysiology of endolymphatic hydrops.

Effect of diabetes on the healing process of synthetic grafts implanted in dogs: a preliminary study

The deleterious effects of diabetes in peripheral vascular surgery and blood access are generally considered to be associated with the greater failure rate of vascular prostheses. To understand better these phenomena, we investigated the healing characteristics of an ePTFE graft in dogs. The animals were made diabetic after total pancreatectomy and the grafts implanted for scheduled periods of 24 h, 48 h, 1 wk and 1 month, either as thoracic (series I) or abdominal (series II) aortic substitutes. The same implantations were performed in non-diabetic dogs used as controls. The luminal surfaces of grafts implanted in diabetic dogs, either as thoracic or abdominal bypasses, proved to be more invaded by platelets as a result of the blood's increased platelet aggregation properties. The presence of endothelial-like cells spreading over the pannus after 1 month implantation was strikingly different in diabetic versus non-diabetic dogs. In the first group, the cells were fragile and less abundant, whereas in the second they were more adhesive, elongated and orientated in the direction of the blood flow.