مجله دانشکده پزشکی اصفهان
پیاپی 241 (هفته سوم امرداد 1392)

Acute myeloid leukemia (AML) is clinically، cytogenetically، and molecularly heterogeneous. Advances in molecular research have greatly improved our understanding of the leukemogenesis in AML. Programmed cell death-4 (PDCD4) is a novel tumor suppressor that inhibits neoplastic transformation and tumor progression and invasion by suppressing activator protein (AP) -1 activation and protein translation. In the present study، we examined the PDCD4 expression levels in de novo AML and investigated correlation between altered expression of PDCD4 with patients’ clinical characteristics. Peripheral blood samples were collected from 56 patients with AML at the time of diagnosis and also، 10 healthy individuals. Quantification of PDCD4 mRNA expression by Real Time Quantitative PCR was performed. Mann-Whitney U test was used to compare PDCD4 expression differences among healthy and AML samples. PDCD4 mRNA expression was significantly diminished in patients with AML at diagnosis in comparison to the PB as normal samples (P < 0. 001). We observed a statistically lower expression in AML-M5 subtype in comparison to other AML subtypes (P = 0. 028). We have not found any significant correlation between PDCD4 expression level and clinical parameters of patients. Also، no significant correlation between the expression levels of PDCD4 and complete remission after induction therapy was observed. Our results shown that، like many epithelial cancers، the down-regulation of PDCD4 expression also occurs in AML.

Doxorubicin is used for treatment of different types of cancer including breast cancer. However، there are various side effects such as cardiotoxicity. Using a suitable drug delivery system such as polymeric micelles containing doxorubicin may reduce these effects. Micelles were prepared by direct dissolution method. After optimization according to their particle size، zeta potential، polydispersity index، loading efficiency and release of doxorubicin، micelles were used for further tests of cytotoxicity on MCF-7 cell line by 3- (4،5-Dimethylthiazol-2-yl) -2،5 diphenyltetrazolium bromide (MTT) assay. The optimum targeted micelles with particle size of 419 ± 38 nm، zeta potential of -13. 3 ± 1. 2 mv، polydispersity index of 0. 45 ± 0. 019، loading efficiency of 93. 5 ± 2. 7 percent and drug release efficiency of 29. 03 ± 3. 7 percent in different concentrations of 0. 21، 0. 26، 0. 34، 47. 0 and 0. 78 μM showed higher cytotoxicity than blank micelles and free drug. Pluronic F127-poly (methyl vinyl ether-alt-maleic acid) micelles showed more cytotoxicity than free drug against MCF-7 cell line.

Sternal ulcer infections have a great importance and complexity following coronary artery bypass graft (CABG) surgery. Although this kind of infection has a low prevalence but the complications are severe. The purpose of this study was to determine the type of microorganism and antibacterial resistance in sternal wound infections following CABG surgery in Shahid Chamran hospital in Isfahan، Iran، from 2009 to 2012.

In this descriptive and analytical study، 275 cases of CABG operation were entered. Sternal wound secretion samples of suspected patients were cultured and the type of the causative bacteria were determined. Also، antibiogram test was done on the grown strains and antibacterial resistance patterns were determined.

Of 275 CABG surgeries، 13 cultured sternal wound samples showed positive bacterial colonization. The types of bacterial samples were Staphylococcus epidermidis، Klebsiella، Escherichia coli and Pseudomonas in four، four، three and two cases، respectively. The mean age of patients with and without sternal ulcer infection had no specific differences (P = 0. 43). The differences of sex distribution between the case and control group was not statistically significant (P = 0. 31)، but having diabetes was significantly different between the groups (P < 0. 01). Aortic clamping time and body mass index (BMI) showed no significant differences between the groups (P > 0. 05).

The incidence of sternal infection in patients undergone CABG surgery in this study was moderate compared to other studies; this is influenced by several factors including host، staff relating، environmental and medical equipments factors. Therefore، it is necessary to implement preventive measures at the time of hospitalization and provide appropriate educational programs and preventive methods for staff، patients and their families.

In 2009، the novel H1N1 virus pandemic appeared with the ability of transmitting from human to human. In our country، the epidemic occurred between 2009 and 2010. This study assessed the epidemiology of patients with H1N1 influenza and its risk factors، also، needing care in intensive care units، and the prevalence of death. In a cross-sectional study، all the patients with influenza H1N1 admitted to Al-zahra medical center (Isfahan، Iran) during the epidemic period were entered. Demographic characteristics، clinical symptoms، laboratory and radiological findings، and underlying diseases were recorded. The data were analyzed by chi-square، One-way ANOVA and t tests. 74 women and 76 men with H1N1 influenza were admitted. Fever (87%)، cough (76%)، and dyspnea (48. 7%) were the most common clinical findings and lymphopenia (48. 3%) was the most common paraclinical finding. 28% of patients needed ventilation support and 23 (15. 3%) were died. The neurological symptoms (OR = 5. 83)، lymphopenia (OR = 2. 87) and infiltration in the chest X-ray (OR = 1. 67) were effective factors in increasing need for admission to the intensive care unit. The most prevalent risk factors for death were neurologic symptoms (OR = 17. 04)، abdominal pain (OR = 5. 60)، increased creatinine kinase (OR = 4. 89)، respiratory distress (OR = 3. 67) and lymphopenia (OR = 2. 27). According to our findings، neurological symptoms، lymphopenia، infiltration in the chest X-ray، abdominal pain، increased creatinine kinase (OR = 4. 89)، and respiratory distress are very critical sign and symptoms which should be carefully considered in patients with H1N1 Influenza.

A cell requires energy to do its work. Mitochondria are the energy-producing machines of the cell. Uncoupling proteins (UCPs) located in the inner mitochondrial membrane cause a proton leak from the intermembrane space to the matrix. Clearly، the changes in the proton gradient across the inner membrane affect ATP production. In this paper، the role of these proteins in different tissues as well as peripheral and central nervous tissues has been reviewed. This study has reviewed 63 publications explaining the various functions of UCPs in different tissues using PubMed، Elsevier، NCBI and EBSCO databases. Several studies have shown that UCPs، based on the type of tissue، change the cell activity. Studies related to UCPs roles in the nervous system are mostly restricted to the in-vitro situations; thus more investigation seems to be needed to reveal the UCPs actions in the in-vivo conditions of physiologic and pathologic studies. These studies potentially can open some new therapeutic strategies and hopes to cure neurodegenerative diseases.