مجله دانشکده پزشکی اصفهان
پیاپی 221 (هفته سوم اسفند 1391)

Eukaryotic release factor 3 (eRF3) is known as a polypeptide chain releasing factor in the translation process. It is necessary for G1 to S phase transition (GSPT1). Recent studies have demonstrated that this protein may have a potential role in development of cancer. The purpose of this study was to investigate the tri-nucleotide polymorphism (GGC) in eRF3a/GSPT1 exon 1 gene and to identify its association with risk of breast cancer in Isfahan، Iran. This study was conducted on 250 women with breast cancer and 250 healthy women. DNA was extracted from peripheral blood and amplified by polymerase chain reaction (PCR). Finally، polyacrylamide gel electrophoresis was used to detect GGC polymorphism. Four alleles including 7، 10، 11 and 12 repetitions of GGC were found. GGC10 was the most common allele between patients and controls. Women who carried GGC12 allele (odds ratio = 2. 9068، confidence interval = 1. 0308-8. 0196) and those who are homozygous for GGC7 (odds ratio = 5. 0816، confidence interval = 0. 5894-43. 8133) of eRF3a/GSPT1 gene were at significantly higher risk for developing breast cancer. This was the first Iranian study to identify the distribution، allelic frequency، and various genotypes of eRF3a/GSPT1 gene. We found the homozygous occurrence of the longest and the shortest allele of this gene to increase the risk for breast cancer among women in Isfahan.

Helicobacter pylori infection is common in children and causes a number of diseases including peptic ulcers، iron deficiency anemia، decreased growth rate، and gastrointestinal cancer. This study assessed the effects of various factors on the incidence of Helicobacter pylori infection and the relations of the infection with iron deficiency anemia and children’s growth. We also compared gastrointestinal symptoms in children with Helicobacter pylori infection and healthy children. This study was conducted on 99 children who referred to the endoscopy unit of Alzahra Hospital (Isfahan، Iran) during 2010-11. Cultures of endoscopic specimens were obtained and complete blood counts were performed. The demographic، economic، and social risk factors for acquiring Helicobacter pylori infection were recorded. Symptoms of peptic ulcer disease were also collected using a questionnaire. Among children with Helicobacter pylori infection (n = 31)، the prevalence of smoking parents، keeping pets at home، family history of dyspepsia، shared bedroom، and family size of greater than four was 6. 0%، 9. 0%، 12. 5%، 69. 0%، and 75. 0%، respectively. Seven Helicobacter pylori-infected children (22. 6%) and eight healthy children (11. 9%) were anemic (P = 0. 14). Given the high prevalence and treatment costs of Helicobacter pylori infection، further studies are warranted to determine its risk factors. On the other hand، inconsistencies in the results of previous studies about the association of anemia and Helicobacter pylori infection necessitate more studies in this field.

Controlling postoperative pain and its complications is a major issue in postoperative care and plays an important role in accelerating the recovery of patients. The present research compared the effects of ketamine alone and in combination with metoclopramide on postoperative pain.

This double-blind clinical trial was conducted on patients undergoing septorhinoplasty at Alzahra Hospital (Isfahan، Iran) in 2012. Patients were divided into two groups to intravenously receive either 10 mg metoclopramide combined with 0. 3 mg/kg ketamine or only 0. 3 mg/kg ketamine five minutes before the incision. Pain (based on a visual analogue scale)، vomiting، the required amount of morphine، and the side effects were evaluated in the two groups.

The two groups had a significant difference in pain intensity (P = 0. 028) and mean morphine consumption (P < 0. 001) 30 minutes-24 hours after the operation. There were also significant differences between the two groups in the incidence of nausea and vomiting during the 6th-12th postoperative hours (P = 0. 048 and 0. 035، respectively).

Combination of ketamine and metoclopramide was more effective than ketamine alone in reducing pain after septorhinoplasty. Therefore، the use of this combination is recommended in the absence of contraindications.

Organic acidurias (or organic acidemias) are a group of inherited metabolic disorders usually caused by loss or lack of the activity of one enzyme in the catabolic pathway of amino acids، fatty acids، carbohydrates، cholesterol، biogenic amines، nucleic acids، and steroids. Accurate and early diagnosis and follow-up of these disorders are very important in prevention of permanent damage of the nervous system، mental retardation، and death. Pathological changes in normal catabolism of these compounds are usually reflected in patient''s urinary organic acid profile. These changes can be identified by analysis of urinary organic acids using gas chromatography-mass spectrometry (GC-MS). Since each disease usually has a unique profile، the disorders can be identified by this method. The analysis of urinary organic acids is not currently performed in Iran and samples are sent abroad for such evaluations. However، timely diagnosis and follow-up of these disorders requires accurate determination of normal ranges and profile of urinary organic acids in healthy populations. Genetic and environmental factors and dietary habits can affect the concentration of urinary organic acids. Therefore، data about each population has to be collected separately. The absence of such data in Iran necessitates assessments in the country.

Asialoglycoprotein receptors are among the most important over-expressed receptors in hepatocellular carcinoma (HepG2). Decorating drug carrier to specific ligands of these receptors can enhance their absorption to cells and elevate their permeability to hepatoma cells. This can reduce the side effects of the drug in nonspecific tissues and enhance drug efficiency. The aim of the present work was to evaluate the cytotoxicity of doxorubicin-loaded mixed micelles of galactosylated Pluronic F127/L122 on HepG2 cells. Galactosylated Pluronic F127 was synthesized. Doxorubicin-loaded nano-sized micelles were prepared by direct dissolution method. Based on particle size، zeta potential، polydispersity index، loading efficiency and release efficiency of doxorubicin from nano-sized micelles، optimized micelles were used for cytotoxicity test on HepG2 cells by 3- (4،5-dimethythiazol-2-yl) -2،5-diphenyl tetrazolium bromide (MTT) assay. The optimum targeted nano-sized micelles had particle size of 197. 9 ± 2. 1 nm، zeta potential of 18. 6 mv، polydispersity index of 0. 308 ± 0. 058، loading efficiency of 78. 3 ± 0. 3%، and drug release efficiency of 32. 5 ± 0. 5% (until the third hour). Nano-sized micelles loaded with doxorubicin in concentrations of 0. 2، 0. 8، 3، 6 μM caused significantly higher cytotoxicity compared to non-targeted nano-sized micelles and free doxorubicin. Mixed targeted nano-sized micelles of galactosylated Pluronic F127 and Pluronic L122 loaded with doxorubicin showed more efficiency and specificity to toxicity against HepG2 cells than non-targeted nanoparticles and free drug.

Cutaneous leishmaniasis is an endemic disease in Iran. Pentavalent antimonial drugs have been the first line of therapy in cutaneous leishmaniasis for many years. However، the cure rate of these agents is still not favorable. This study was carried out to compare the effects of topical trichloroacetic acid 50% in combination with glucantime، intralesional glucantime plus fractional laser، and glucantime alone on cutaneous leishmaniasis. A total of 90 patients were randomly divided into three groups of 30 to be treated with intralesional injection of meglumine antimoniate (glucantime)، a combination of topical trichloroacetic acid 50% and glucantime، or a combination of fractional laser and glucantime. Complete cure rate and changes in sizes of lesions and scars were assessed and compared between groups. The mean duration of treatment was 6. 1 ± 2. 1 weeks in all patients (range: 2-12 weeks) and 6. 8 ± 1. 7، 5. 2 ± 1. 0، and 6. 3 ± 3. 0 weeks in glucantime، topical trichloroacetic acid plus glucantime، and fractional laser plus glucantime groups، respectively (P = 0. 011). The mean score of scars was 3. 7 ± 0. 6، 3. 6 ± 0. 8، and 6. 3 ± 0. 7 in the above-mentioned groups (P < 0. 001). Compared to glucantime alone، the combination of intralesional glucantime and trichloroacetic acid 50% or fractional laser had significantly higher and faster cure rate in patients with cutaneous leishmaniasis.

Leishmania is a genus of trypanosomatid protozoa which causes a wide spectrum of diseases ranging from a self-healing cutaneous lesion to a vital visceral form of the disease. Although various experimental Leishmania vaccines have been prepared in different parts of the world، only a few of first generation vaccines have reached to human trials. Killed Leishmania major (KLM) and autoclaved Leishmania major (ALM) have been tested in human volunteers in Iran and other countries. We evaluated protein contents of KLM and ALM and fresh Leishmania major using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Leishmania major (MRHO/IR/75/ER) was isolated from infected BALB/c mice and cultured in Novy-MacNeal-Nicolle medium. It was then subcultured in Roswell Park Memorial Institute (RPMI) 1640 medium supplemented with fetal calf serum 20%. ALM and KLM were prepared by Razi Vaccine and Serum Institute of Iran. Electrophoresis of the two antigens and freshly cultured Leishmania major promastigotes was performed and their protein contents were compared using SDS-PAGE. The results of electrophoresis showed numerous bands from more than 100 kilodalton (kD) to less than 10 kD. KLM bands were found to be similar to freshly cultured intact Leishmania major (except for 57 and 24 kD bands). ALM contained two very close bands (71 kD) which were not seen in KLM or fresh Leishmania major. Identification and purification of protective immunogens in crude antigens and detection of their stability are essential in production of an effective vaccine.