مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و دوم شماره 6 (پیاپی 92، بهمن و اسفند 1396)

The goal of radiotherapy is delivering enough dose to the tumor and the lowest dose to the organ at risks (OAR). The aim of this study was to evaluate the received dose and homogenous dose in the target volume. Also we evaluated the dose received by the heart and lung during the treatment of breast cancer by using tangential wedge beam technique.
Material and Twenty patients with left sided breast cancer and conserved breast were divided into two groups: patients with large breasts and patients with small breasts. Treatment design was performed by Iso -gary software The Dose Volume Histograms (DVHs) was used to measure the doses received by the target volume, heart and lungs.
Dose homogeneity index (DHI) was equal for both groups. Homogeneity index (HI) of small breasts was lower significantly (p=0.001) and the dose distribution was better. The percentage of heart and lung involvement in the patients with big breasts at all dose levels was more but the difference wasn’t significant.
HI for target volume and dose received by organs at risks were higher in the patients with big breasts. Therefore treatment planning for the patients with bigger breasts needs more attention. Also calculation of evaluation indexes is more essential for these patients. Doses received by the heart and lung were compatible with standard levels and also the radiation risk for the heart and lung was within the acceptable level.

The orofacial malformations are among the most common congenital abnormalities of the head and face. Treatment of such patients aims at proportionate growth of the head and face as well as normal speaking and hearing. The objective of this study was to assess the hearing status and the frequency of chronic otitis media by audiological evaluations in the cleft palate patients with or without cleft lip. In the Euro-cleft project, audiometry and tympanometry are considered as necessary tests to evaluate hearing. Since there is a huge statistical difference in the results of the treatment of such patients in different geographical regions, record and assessment of the status of the treatment of the patients during the course of treatment, based on the specified standard records, in every center is necessary.
Material and

In this cross sectional study, we assessed the hearing status of 200 non-syndromic patients (110 boys and 90 girls). The mean age of the patients was 1.5±1.03 years. Based on clinical ear examination, tympanometry and auditory brain response (ABR) were performed at appropriate age for every patient.

According to the results of ABR 5.8% of the ears were normal, 54% had mild hearing loss (20-40 db), and 40.3% had moderate or severe hearing loss. In general, we detected hearing impairment in 94.2% of the patients.
The result of tympanometry revealed type B tymapanogram in 89.8%, type C in 3.7% and type A in 6.6% of the patients. After clinical examination, we found that insertion of V.T. is needed for 92.2% of the patients and, there was no difference between the girls and boys in this regard in both age groups of below and above one year old.

Considering the high incidence of conductive hearing loss in cleft palate patients and necessity of better understanding of hearing and middle ear problems, similar studies in the future, with comparison of their results in different medical centers in Iran and other countries can lead to development of new treatment methods in regard to primary surgeries of palate and ENT care.

Since proteasome is strongly considered to be involved in the development and progression of a wide variety of hematological malignancies in particular, multiple myeloma, blockage of this hemostasis system with different types of proteasome inhibitors seems to be a promising way of treatment for multiple myeloma. In this study, we investigated the effect of Kyprolis, a new irreversible proteasome inhibitor (PI), on the survival rate of multiple myeloma -derived KMM-1 cell line.
Material and To evaluate whether inhibition of proteasome using Kyprolis could exert cytotoxic effect in multiple myeloma, KMM-1 cells were cultured with different concentrations (25-150 nM) of the inhibitor for 24 and 48 hours. Then trypan blue exclusion assay, MTT assay, flocytometric cell cycle analysis were performed and we evaluated gene expression changes associated with apoptosis.
The results of this study demonstrated that Kyprolis induced both cytotoxic and anti-proliferative effects on KMM-1 cells. This inhibitor is able to reduce the cell survival and metabolic activity in a dose- and also time-dependent manner (p ≤ 0.001). Moreover, we found that Kyprolis increased cell population in G1 phase of cell cycle to 52.33% probably through up-regulation of p73 gene expression (p ≤ 0.05). Exposing multiple myeloma cells to this proteasome inhibitor also led to induction of apoptosis probably through alterations in the gene expression of pro- and anti-apoptotic related genes (p ≤ 0.05).
The results of this study clearly indicated that Kyprolis had anti-tumor activity against KMM-1 cells.

Lead is one of the environmental pollutants that enters the nervous system and leads to neurological disorders such as depression and anxiety. Cinnamon (Cinnamomum verum) has antioxidant, anti-inflammatory and neuro-protective properties. The purpose of this study was to investigate the effect of cinnamon hydroalcoholic extracts on the level of anxiety and depression in male rats receiving lead acetate.
Material and 32 male Wistar rats were divided into: 1) control 2) cinnamon 3) Lead and 4) lead-cinnamon groups. The 2nd and 4th groups received 200 mg/kg of cinnamon extracts for 30 consecutive days and at the same period, rats of the 3rd and 4th groups received 100 mg/kg of lead acetate. At the end of the period we used elevated plus maze test to investigate anxiety, and forced swimming test to assess depression in the rats.
In elevated plus maze test, percentages of OAE and OAT significantly decreased in the lead group compared to those in the control group (P It is concluded that cinnamon extract has anti-anxiety and anti-depressant effects on the rats receiving lead acetate.

Rheumatoid arthritis (RA) is an autoimmune disease. It seems that the function of regulatory T cells (Tregs) is compromised in RA. Foxp3 is a critical transcription factor of these cells. The aim of this study was to determine the relationship of vitamin D plasma level with Foxp3 gene expression in the patients with RA.
Material and 18 untreated RA patients and 41 healthy people participated in this study. Plasma levels of vitamin D were measured by competitive ELISA method. Foxp3 gene expression was also determined by using realtime PCR technique.
The expression of Foxp3 gene was significantly lower in RA patients compared to that in the healthy controls (p We found low levels of vitamin D could not affect the expression of Foxp3 gene. It seems that vitamin D deficiency cannot be considered as an effective environmental factor in the pathogenesis of RA.

Enterohemorrhagic Escherichia coli (EHEC) cause a wide spectrum of infections, such as diarrhea, hemorrhagic colitis and hemolytic–uremic syndrome. Considering the risks associated with antibiotic therapy against EHEC infection, vaccines can be a promising method for prevention of infections. Recombinant chimeric proteins containing multiple immunogens could induce immunity against bacterial infections. The aim of this study was to evaluate immunogenecity of trivalent chimeric antigen EspA -Stx2b -Intimin against E.coli O157 H7 infection.
Material and In this descriptive-laboratory study,recombinant chimeric protein was expressed in E.coli BL21 DE3 by use of IPTG. The protein expression was evaluated by SDS-PAGE and western blotting analysis. The recombinant protein was purified using Ni–NTA affinity chromatography. The immunization was conducted in mice with purified protein and antibody titers were determined by ELISA. Following immunization, mice were infected with E.coli O157:H7 and evaluated for bacterial shedding and mortality. Using SPSS software, statistical analysis was performed by Duncan's test and T-test.
The protein was expressed in E.coli BL21 (DE3) and SDS-PAGE analysis showed expression of recombinant protein with molecular weight of 63kD. Western blot analysis confirmed presence of chimeric protein. ELISA results showed that immunogenic properties of chimeric protein induced humoral response to EspA, intimin and Stx2b. Bacterial shedding in immunized mice decreased to 102 cfu/ml and mortality rate was reduced to 60%.
The results showed that the chimeric protein induced humoral response and protected the mice against E.coli O157:H7.

Cartilage disorders may deteriorate following oxidative stress injuries affecting mature chondrocytes. Meantime, mesenchymal stem cells (MSCs) can differentiate into chondrocytes in the presence of oxidative conditions and act as a source of compensation for injured chondrocytes. The present study aimed to investigate the effect of H2O2 on MSCs differentiation into chondrocytes in order to cast light on the dual roles of oxidative stress in the pathogenesis of diseases.
Human mesenchymal stem cells were isolated from abdominal adipose tissue of three different donors and cultured in the presence of 50 mM H2O2 in order to differentiate into chondrocytes. We determined cell viability by tetrazolium assay and measured reactive oxygen species (ROS) level by flow cytometry. Presence of glycoseaminoglycans was confirmed by safranin staining.
The percentage of cells containing ROS was significantly higher in the cells treated with hydrogen peroxide (29.2% ± 1) compared to that in the untreated control cells (7.7% ± 1.4). A significant increase in glycoseaminoglycan content was observed in H2O2 treated cells compared to that in the control cells both on the 9th day (treated: 1.57×104 ± 0.1 vs control: 0.91×104 ± 0.09) and 21st day (treated: 2.87×104 ± 0.2 vs control: 0.96×104 ± 0.07). In addition, comparison of glycoseaminoglycan content on the 9th and 21st days showed a significantly higher content in both treated and control cells on the 21st day (p Hydrogen peroxide resulted in increased differentiation of adipose tissue-derived MSCs into chondrocytes. Therefore, we concluded that, oxidative stress had positive role in the induction of chondrocyte differentiation.

Pseudomonas aeruginosa is one of the most important causes of nosocomial infections and septicemia in patients with burn and cystic fibrosis. It is found in water and wet soil. PhzM and PvdA are virulence genes involved in the production of two iron carriers, pyoverdine and pyocyanin. Considering the importance of virulence genes in the bacteria, determination of the frequency of these genes in clinical and environmental samples has shown an increasing trend. The aim of this study was to investigate the prevalence of virulence genes in pseudomonas aeruginosa isolated from infected patients.
Material and

Clinical samples were obtained from the patients referring to Kermanshah hospitals. After isolation and identification of Pseudomonas aeruginosa strains, DNA extraction was performed by Sina Kit gene and the presence of genes evaluated by PCR. Data were analyzed by using SPSS v20 software.

Among 106 strains, 34 (32.07%) and 47 (44.33%) strains were positive for pvdA and phzM genes, respectively. The logistic regression analysis revealed significant correlations between the presence of pvda gene and samples of urine (p

We found moderate prevalence rates for phzM and pvdA virulence genes in pseudomonas aeruginosa isolated from Kermanshah hospitals.

Widespread use of Chromium and their compounds in many industries, including plating, steel production, and wood protection and tanning leather, can result in the discharge of large amounts of pollutants to receiving waters, leading to toxic effects on human health and the environment. The aim of this study was to determine the efficiency of the photocatalytic process to remove Chromium in the presence of organic matter from the aqueous medium by using nanoparticles of TiO2 synthesized by sol gel.

This was an experimental study. After nanoparticle synthesis, we used FTIR, SEM, XRD for analysis of nanoparticles. The photocatalytic process for Chromium removal was performed using a discrete stream reactor and Uv light bulb with 30 watts intensity. Then, the effects of independent variables, including pH, concentration of nanoparticles, contact time and the presence of interfering organic matters such as phenol, EDTA, CCl4, methanol and humic acid on the efficiency of the removal of Chromium in an aqueous medium were evaluated.

The results showed efficiency of Chromium removal increased after decreasing pH. Also, increasing the concentration of nanoparticles and contact time led to increased removal efficiency. We found reduced removal efficiency after increasing concentrations of the pollutants. Removal efficiency of Chromium increased in the presence of EDTA, but methanol, phenol, humic acid, and carbon tetrachloride reduced its removal efficiency.

Photocatalytic oxidation with titanium oxide nanoparticles synthesized by sol-gel method can be an effective way for removal of Chromium from aqueous medium.

Tobacco use in various ways such as cigarettes, hookahs, and nas is one of the most important and preventable factors in illness, disability and premature death in the world. Considering the importance of hookah consumption and its impact on the health of people in the community, studies in this regard will be significant. In this regard, the aim of present study was to determine the levels of heavy metals (zinc (Zn), copper (Cu), lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg)) in the tobacco and hookah water used in cafes in Sanandaj city in 2017.
Material and In this descriptive-analytical (cross sectional) study, two popular and common brands of hookah tobacco were selected in Sanandaj (Crystal and Palm), and each of the brands was evaluated for three flavors (dassib, lemon, and mint). A total of 36 tobacco samples (before and after use) and 36 samples of water (before and after use) were investigated. The samples were prepared by acid digestion and finally, the concentrations of metals (Zn, Cu, Pb, Cd, As, and Hg) was measured by atomic absorption.
The results of this study showed that the highest and lowest concentrations of metals were related to Zn (11/05 µg/g) and As (1/35 µg/g) respectively. In general, according to the results, the order of the metals was Zn > Cu > Pb > Cd > As. The results showed that there was a significant difference between Pb in burnt and unburned tobacco, and Pb in burnt tobacco is more than unburned tobacco. In contrast, no difference in the mean of the other metals before and after use has not been made. The results of comparison of metals before and after the use of hookahs in hookah water showed that there was a significant difference in Cu, Zn, and Pb. Moreover, there is no significant difference between the two brands in terms of metals as well as the different taste of the tobacco (p> 0/05).
The results of this study showed that the concentration of metals in tobacco samples distributed in Sanandaj was higher than the standards of WHO. The values indicated were high levels of metals in aromatic tobacco samples, which also require more attention to protect people's health and ways to reduce tobacco use.

Dermatomyositis in a rare inflammatory disease with incidence rates between 0.5 and 0.99 per 100.000. Its relationship with some cancers such as breast, lung and ovary is well established. It can be the first or one of the presenting features of ovarian cancer. Dermatomyositis is a rare paraneoplastic syndrome which has a very rare association with ovarian cancer. Here we report association of dermatomyositis as a paraneoplastic syndrome with ovarian cancer.
Material and A 40 year old woman referred with scattered rash and pruritus espcially in extensor surfaces, myalgia and weakness from 40 days prior to referral. Bilateral ovarian cancer was diagnosed during follow up period.
We should consider the likelihood of underlying malignancies in the patients with dermatomyositis. Because, in case of malignancy different therapeutic measures should be considered.

Hobnail hemangioma ( targetoid hemosiderotic hemangioma( is a benign vascular tumor that is usually characterized as a papule with an ecchymotic halo on the periphery. It is usually seen in young adults and most commonly affects limbs. The lesion is seen equally in both sexes. This vascular tumor is rare in the world and, according to our acknowledge, only one case has been reported in Iran. In this case report, we described the second case of targetoid hemosiderotic hemangioma.
Material and The patient is an 8 years old boy with a targetoid asymptomatic red popular lesion on his lower leg from 5 years ago .The lesion was completely excised. Skin biopsy showed dilated vascular spaces with hobnail endothelial cells in the superficial dermis accompanied with narrower vessels in the deep dermis which was compatible with targetoid hemosiderotic hemangioma. In a follow up period of three years the lesion did not recur.
Distinction between targetoid hemosiderotic hemangioma and malignant skin lesions such as melanoma, Kaposi sarcoma and angiosarcoma is necessary. Thus, knowledge of clinical picture and pathology of this lesion can prevent unnecessary aggressive procedures.