مجله دانشکده پزشکی اصفهان
پیاپی 179 (هفته اول اردیبهشت 1390)

Heat shock proteins (HSPs) are a large family of proteins with different molecular weights and differ­ent intracellular localizations. These proteins such as Hsp70 and gp96 have a critical role in presentation of major histocompatibility complex class I (MHC-I)-restricted antigens and induction of CD8+ T cells (TCD8+) responses. These surprising immunological characteristics of HSPs are now the basis for a number of clinical trials for cancer vaccination. We studied two tumor cell lines, i.e. erythroleukemia (K562) and human prostatic carcinoma (LNcap), in order to determine the best temperature that induces the optimized HSP induction. Each cell line was heated at 3 different temperatures (41, 42, and 43ºC) for 1 hour and then incubated at 37ºC for 3, 6, and 12 hours. HSP70 production and gp96 expression were determined through flow cytometry using a commercially available enzyme-linked immunosorbent assay (ELISA) kit and monoclonal anti gp96, respectively. Our results showed that the optimum temperature and incubation time for HSP70 and gp96 induction in K562 and LNcap were 43ºC for 3 hours and 43ºC for 12 hours, respectively. Our results revealed that the temperature and post-heating incubation period need to be optimized for each tumor cell line before using in HSP-based tumor vaccine.

Microsatellites are the short tandem repeat regions in eukaryotic genome whose polymorphisms have an association with some population genetic properties and also some diseases. In this study, we aimed to investigate the gene polymorphism of tumor necrosis factor alpha (TNF-α) of human leukocyte antigen (HLA) locus in native population of Southern Iran. This cross-sectional descriptive study was performed on 50 peripheral blood samples of native Southern Iranians. Allelic polymorphisms of TNF-α were studied using specialized primers. Statistical analyses were computed by SPSS and Popgene software programs. Polymorphism evaluations showed that all 13 typical alleles of TNF-α were present in this Iranian group. TNF-α*3 and TNF-α*4 were the most prevalent alleles with frequencies of 0.24 and. 016, respectively. On the other hand, TNF-α*1 and TNF-α*2 were the rarest alleles with frequency of 0.02. In addition, the differences between the frequencies of alleles and the studied population were significant (P < 0.05). HLA microsatellites can be useful in identifying the relation between gene polymorphism of TNF and genetic diseases in different parts of Iran. Then can also be beneficial in preparing the first Iranian STR gene database.

There is evidence that a significant proportion of people living with HIV (PLWH) still practice unsafe sex and this remains a challenge for HIV prevention. Since some manuals can have positive effects on condom use among the high risk population, this qualitative study explored perceptions of Iranian PLWH regarding such manuals. In-depth, semi-structured interviews were held with a purposively selected group of PLWH recruited from three HIV care clinics in Tehran, Iran. Overall, 34 individuals including 26 HIV positive patients (22 males and 4 females) were interviewed. In addition, 5 healthcare workers and 3 wives of HIV-patients were also interviewed. All interviews were recorded and typed, and the codes were extracted after reviewing them several times. Data was analyzed using the content analysis approach. Participants pointed to the internal and external stimuli. Conscience was the most important internal stimulus. The most influential external stimuli included mass media, consulting with health care providers, communication with friends, and training. Although external stimuli such as the media can have a significant role in the adoption of safe behaviors and preventing sexual transmission of AIDS, focusing on internal stimuli may also be of high importance.

Cesarean section is one of the common surgeries among women with a current rate of 14-15% in western societies. However, the rates are much higher in Iran. Acute postoperative pain is one of the recognized complications after cesarean section. Uncontrolled postoperative pain may interfere with breast-feeding. It might also affect the emotional relation between newborn and mother. This study was designed to compare the effects of indomethacin, diclofenac sodium, and acetaminophen suppositories on opioid usage after cesarean section in Alavi Hospital, Ardabil, Iran. In this triple-blind clinical trial, 120 ASA I-II candidates of cesarean with spinal anesthesia were randomly divided into 4 groups of 30. Acetaminophen, indomethacin, and diclofenac were used after the operation in the first, second, and third groups, respectively. The dosage was repeated every 6 hours and opioid usage was compared during the first 24 hours after the surgery. The fourth group was considered as the control group and received placebo suppository. Opioid was also used when required (PRN). The severity of pain was recorded based on a visual analogue scale (VAS). In case of severe pain (VAS > 5), 0.5 mg/kg intramuscular pethidine was prescribed. The data was analyzed in SPSS using analytical statistics such as analysis of variance (ANOVA), chi-square test and Tukey's post hoc test. There were no statistically significant differences between the groups in baseline data. There were statistically significant differences between the control group and other groups in pain scores 1, 12, and 24 hours after the operation. Groups receiving acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), i.e. indomethacin and diclofenac, were significantly different in pain scores 12 and 24 hours after the operation. The three intervention groups received the first dose of pethidine much later than the control group and the distance for both NSAIDs (diclofenac and indomethacin) was significantly longer (P < 0.001). Indomethacin, diclofenac, and acetaminophen significantly reduced the amount of pethidine usage during the first 24 hours after the surgery compared to the control group. This reduction was more in indomethacin and diclofenac groups compared to acetaminophen group (P = 0.001). Considering the significant reduction in pain scores and opioid usage especially in indomethacin and diclofenac groups in comparison with the control group, it is suggested to prescribe indomethacin and diclofenac for post cesarean section analgesia.

Diabetes mellitus is the most prevalent metabolic disorder worldwide with many subsequent medical complications. An important complication of diabetes is microalbuminuria which is a major indication for development of diabetic nephropathy. The prevalence of diabetic nephropathy in type 2 diabetic patients has been estimated to be 47%. Since the disorder initiates with microalbuminuria, its early detection and prevention are vital. On the other hand, helicobacter pylori infection is more common in diabetic patients due to their low immune tolerance. The vacA positive genotype is reported to be effective in microalbuminuria development in type 2 diabetic patients. In this study, we investigated the relation between H. pylori vacA and microalbuminuria in type 2 diabetic patients. This study included 88 type 2 diabetic patients among whom 60 had microalbuminuria. Stool samples were collected from all patients and DNA was extracted using QiaAmp Stool DNA Extraction Minikit. In order to detect H. pylori infection, a nested polymerase chain reaction (PCR) protocol was developed and all H. pylori positive samples were genotyped for cagA positivity. Overall, 16 patients (18.2%) were detected to be H. pylori positive out of whom 12 had microalbuminuria (75%). VacA positivity was detected in one patient without microalbuminuria. We could not establish a relationship between vacA positivity and microalbuminuria in the studied type 2 diabetic patients.