مجله دانشکده پزشکی اصفهان
پیاپی 286 (هفته سوم تیر 1393)

Acute myeloid leukemia (AML) is a heterogeneous group of hematologic malignancies with great variability in the pathogenesis and clinical course. DNA methylation of CpG islands within the promoters of specific genes may play roles in tumor initiation and progression. Secreted frizzled-related proteins (SFRPs) are negative regulator of the Wnt signaling pathway. In the present study, we compared the methylation status of SFRP1 and SFRP2 genes promoter in patients with AML and healthy individuals. In peripheral blood from 43 patients afflicted with de novo AML and 25 healthy controls, isolated DNA was treated with sodium bisulfite and analyzed by methylation-specific polymerase chain reaction (MSP) with primers specific for methylated and unmethylated promoter sequences of the SFRP1 and SFRP2 genes. We used Mann-Whitney u-tests to investigate the correlation between SFRP1 and SFRP2 genes hypermethylation and clinical parameters. The frequency of aberrant hypermethylation of SFRP1 and SFRP2 genes promoter in patients with AML was determined 30.2% (13/43) and 20.9% (9/43), respectively. In addition, for all subjects in control group, methylation of SFRP1 and SFRP2 genes promoter were negative. Patients with M0 subtype of FAB-AML had the highest incidence of hypermethylation of SFRP1 (P = 0.028) and SFRP2 (P = 0.004) genes promoter. The present study showed that, like many solid tumors, SFRPs genes methylation also occurs in AML. Therefore, the methylation of these genes may play a role in leukemogenesis initiation.

Health sector reform (HSR) has done in the Islamic Republic of Iran (I. R. Iran) as family physician program, in rural areas and urban regions of bellow-20-thousands population from 2005. The aim of this study was comparing the main reproductive health indicators before and after implementation of family physician program. In a trend study in 2012, we analyzed the reproductive health indices from 2001 to 2011 comparing indices in two intervals, 4 years prior and 6 years after introducing the family physician program in the Isfahan province, Iran. In the rural areas of Iran, personal, social and health data are collected on each person in the community covered by health houses and then are collected by health centers in which family physicians teams are presented. Afterward, data are gathered and assessed in district health centers. These data had been drawn from vital data software. This software existed in every Deputy Director at the District Health Centers. We assessed indicators such as neonatal mortality rate (NMR), infant mortality rate (IMR), under-5-year mortality rate (U5MR), and the percentage of the deliveries carried out by skilled attendance in hospital. The NMR decreased from 13.35 per 1000 live births to 8.8. The IMR decreased from 17.86 per 1000 live births to 14.2. The U5MR decreased from 21.06 per 1000 live births to 17.4. Following family physician program measurements, the main reproductive health indices such as NMR, IMR and U5MR have been decreased markedly in rural areas of the Isfahan province.

According to the progress of microscopic imaging technology and suitable image processing techniques in the past decade, there is a tendency to use computer for automatic diagnosis of microscopic diseases. Automatic border detection is one of the most important steps in computer diagnosis that accuracy and specificity of the subsequent steps crucially depends on it. Microscopic images are colored to be seen more accurate and easier; after coloring, the image artifacts increases, so the boundary detection of objects is very important in order to find the exact feature extraction. In this study, leishman bodies existed in microscopic images taken from bone marrow samples of patients with visceral leishmaniasis underwent automatic-segmentatio using Otsu and Savoulla thresholding methods besides K-means clustering method. For data acquisition, a digital camera (Sony DSC-H9) coupled on an optical microscope (Olampus-CH40RF200) were used. Proposed method was tested on 20 images. For automatic diagnosis of the leishman bodies from all found objects, some geometric features like eccentricity, area ratio, roundness and solidity and some texture features like mean, variance, smoothness, third moment, uniformity and entropy were extracted. Found objects were classified into healthy and non-healthy groups using Feed-Forward Neural Network classifier. To find the best mode for each method, a comparison were made and determined that using stage 5 for Otsu, threshold 0.1 for Sauvola and 5 clusters for k-means had minimum automatic boundary extraction error. After compartment of obtained result with specialist, we found that Sauvolla method had minimum error of border detection, and Otsu method was more accurate for automatic detection of leishman bodies.

Osteoarthritis is a degenerative disease caused by damage or trauma to articular cartilage, leading to pain, brittleness, limitation of joint motions and swelling of the tissue. Cartilage damage is common in older people and also athletes. Chondrocytes dedifferentiate in monolayer culture. Tissue engineering involves the use of scaffold to maintain the differentiation of the cells. In this study, maintaining chondrogenic differentiation of the chondrocytes within the pure silk fibroin (SF) and silk fibroin- chondroitin sulfate- alginate (SF-CHS-SA) was compared. Pure SF and SF-CHS-SA scaffolds were prepared through lyophilization. The microstructures of the scaffolds were studied by scanning electron microscopy (SEM). Chondrocytes were isolated from the articular cartilage tissue of rabbit and were cultured within the prepared scaffolds for 14 days. The percentage of chondrocytes viability was measured using 3-(5,4-dimethythiazol-2-yl)-5,2-diphenyltetrazolium bromide (MTT) assay, using extract of the scaffolds. Glycosaminoglycan (GAG) secretion and gene expression of collagen II were studied using alcian blue staining and real time polymerase chain reaction (real time-PCR), respectively. SEM showed that the composite scaffold had higher interconnected pores and pure SF scaffold had mainly closed pores. Results of the MTT assay confirmed no cytotoxicity of the prepared scaffolds. GAG secretion and collagen II expression were significantly higher in the SF-CHS-SA scaffold than the pure SF scaffold (P < 0.05). The SF-CHS-SA scaffold is a much more suitable substrate for maintaining differentiation of the chondrocytes than pure SF scaffold or monolayer culture of chondrocytes.

In the issue No. 247 (October 2013) of Journal of Isfahan Medical School, an interesting article entitled “Survival time and recurrent rate in patients with rectum cancer” was reported by Sanei et al. That study was one of the largest reports of rectal cancer from Iran. It provided valuable information regarding the characteristics and oncologic outcomes of the patients with rectal cancer in Isfahan province. Furthermore, 2 other recently published reports from the Tehran and Shiraz investigated the characteristics, prognostic factors and survival of patients with rectal cancer. These two recently published articles specifically focused on the total number and ratio of positive identified lymph nodes, or surgical techniques used in patients with rectal cancer. Sanei et al. did not provide information regarding the total number and ratio of positive identified lymph nodes. Inadequate lymph node evaluation is a common problem in patients with colorectal cancer. The higher number of identified lymph nodes is a favorable prognostic factor and associated with improved disease-free and overall survival in node negative colorectal cancer. On the other hand, higher lymph node ratio is a poor prognostic indicator for overall and/or disease free survival in node positive (stage III) colorectal cancer. Multicenter and national studies are warranted to identify the clinical characteristics and survival of patients with rectal cancer.