مجله دانشکده پزشکی اصفهان
پیاپی 481 (هفته اول امرداد 1395)

The study aimed to evaluate imposed radiation dose and normal tissue complications probability (NTCP) of two common treatment plans of supraclavicular nodes, anterior-posterior (AP) field and parallel opposed fields (POFs) which are widely used in tangential treatment plans for patients with mastectomy.
The stated methods were planned on the computed tomography (CT) scan images of a chest phantom, using TiGRT treatment planning system (TPS). Then, the normal tissue complications probability values were estimated using dose-volume histogram (DVH) data of the plans. According to the plans, the phantom was irradiated with 6 and 15 MV photon beams of a Siemens Primus linac. Dose measurements were also done using thermoluminescence dosimeters.
Findings: The mean ± standard deviation (SD) dose to ipsilateral lung (P = 0.045) and heart (P = 0.078) for tangential beams with a single anterior-posterior field (35.42 ± 2.84 and 28.73 ± 3.17 percent, respectively) was significantly lower compared to tangential beams with parallel opposed fields (49.36 ± 2.35 and 30.41 ± 3.77 percent, respectively). In addition, the normal tissue complications probability values of ipsilateral lung and heart for tangential beams with anterior-posterior field (4% and 3%, respectively) was lower compared to tangential with parallel opposed fields (6% and 4%, respectively).
It is considered that irradiating supraclavicular nodes with an anterior-posterior field is more suitable technique compared to parallel opposed fields, due to lower imposed dose, and also lower normal tissue complications probability to ipsilateral lung and heart of the patients.

Medical students, especially whom enter to clinical courses, are in high exposure of Mycobacterium tuberculosis responsible for tuberculosis (TB). This emphasizes the need to evaluate the condition of exposure to tuberculosis in this population.
In this cross-sectional descriptive study, changes in tuberculin skin test (TST) was evaluated among 140 interns in Isfahan University of Medical Sciences (IUMS), Iran, during the years 2016-2017. Purified protein derivative (PPD) was injected into the medial side of forearm. After 72 hours, the diameter of induration was measured. 10 mm of induration and higher was considered as positive. 1 year later, the tuberculin skin test was repeated. The results from the first and second tuberculin skin tests were compared and analyzed. Demographic information was recorded.
Findings: 46.4% of examined population were men. In first tuberculin skin test, 8 cases (5.7%), and in second test, 10 cases (7.1%) were positive. 2 cases of test conversion were found. Mean induration size among all interns was 2.82 and 3.17 mm in first and second tuberculin skin tests, respectively. In both tests, men had significantly more positive results.
In this study, 2 test conversion cases were found. As these interns will have more exposure in their educational and professional future, it needs to perform useful plans to control and prevent transmission of tuberculosis.

Using clomipramine, as a serotonin-reuptake inhibitor, is associated with unwanted side effects such as reproductive disorders. In this study, the effect of clomipramine on spermatogenesis process, and testosterone, follicle stimulating, luteinizing hormones was assessed in laboratory male rats.
24 male rats (aged 7 to 8 weeks, weighing 25-30 g) were selected and randomly divided into 4 equal groups including three treatment groups and one placebo group. The placebo group received normal saline, and the treatment groups received 3, 6, and 12 mg/kg body weight of clomipramine for 20 days, intraperitoneally. At the end, blood sampling was performed to test the level of testosterone, follicle stimulating, and luteinizing hormone. The histological assessments were conducted using hematoxylin-eosin staining, and by a microscope equipped with a digital camera. Data were analyzed using one-way ANOVA and Duncan tests.
Findings: The mean levels of testosterone, follicle stimulating, and luteinizing hormone in treatment groups were not significantly different compared to placebo group (P > 0.050 for all). The mean number of spermatogonia cells, spermatocytes, and spermatids, as well as the thickness and diameter of seminiferous tubules in the treatment group was significantly lower than the placebo group (P Using clomipramine, especially at high doses, can disrupt the spermatogenesis process, as well as decreasing the diameter and thickness of seminiferous tubule in testis tissue. All of these changes suggest that the application of clomipramine may reduce fertility in males.

Cerium oxide nanoparticles, or nanoceria, as radioprotectors can play an important role in reducing complication of ionizing radiation. The aim of this study was to reduce the mortality of normal lung cells against 6-MV photon beams by using nanoceria; so that through identifying optimal concentration of nanoceria, it could be used in radiation therapy.
Nanoceria suspensions were sterilized with 70% ethyl alcohol. In order to optimize the nanoparticles distribution in aqueous medium, suspension was shaken by vortex for 3 minutes. Then, the sonication was performed for 2 hours using ultrasound sonicator. MRC-5 cells were cultured in Dulbecco's modified eagle medium/F12 (DMEM/F12) medium, and placed in a high-humidity incubator at 37 °C. To determine the non-toxic concentration, the cells were treated with serial concentrations of 5, 10, 30, 50, 70, 90, 110, 150, 200, 250, and 300 µM of nanoceria. Quantitative radio-protection effect of nanoceria was performed in non-toxic concentrations against 6-MV X-ray with doses of 20, 40, 60, 80, and 100 cGy.
Findings: The concentration of 70 μM and low concentrations did not have toxicity for MRC-5 cells. The mean cell viability (%) in this concentration of nanoceria was 89.4 ± 2.6 percent. MRC-5 cells at presence of 70 µM anoceria had significant radiation protection against radiation doses of 40, 80, and 100 cGy compared to the control group.
Using cerium oxide nanoparticles can increase the precision of treatment, and reduce secondary effects of radiotherapy.

The aim of this study was to evaluate the correlation between endoscopic and histological findings of esophageal and gastric biopsies in patients referred to Imam Hussein hospital, Isfahan, Iran, during the years 2014-2015.
In this retrospective study, the endoscopic and histological findings of 243 patients were collected, and classified using the site of biopsy (esophageal or gastric) and the diagnostic findings (eosinophilic esophagitis, esophagitis and ulcer in esophagus, gastritis, nodularity, and gastric follicle and erosion). The age range of the enrolled patients was 1 month to 16 years. In order to find the correlation between endoscopic and histological findings, chi-square, t, and one-way ANOVA tests were performed using SPSS software.
Findings: For the esophagus, the positive endoscopic and histologic findings were 117 (48.1%) and 86 (35.4%) cases, respectively. While, for the stomach the positive endoscopic and histologic findings were 157 (64.6%) and 145 (59.7%) cases, respectively. The sensitivity and specificity of the esophagus endoscopic findings were 73.3% and 51.3%, respectively [Area under curve (AUC) = 0.623; P = 0.002]. There were also significant for the stomach findings (AUC = 0.576; P = 0.043).
Concordance between endoscopic and histologic findings of the esophagus was stronger compared to the stomach.