مجله دانشگاه علوم پزشکی مازندران
پیاپی 84 (مهر 1390)

Background and Gastric cancer has been considered as the second lethal cancer throughout the world and the incidence of this cancer in Ïran is 25 cases out of 10000 people per year. Ïnterleukin-11 (ÏL-11)، a member of ÏL-6 family، might have played some role in developing gastric cancer via activation of the JÂK/STÂT signaling pathway. Ïn this study، the level of ÏL-11 gene expression was determined in gastric biopsy specimens of patients with and without gastric cancer. Ïn this case-control study، biopsy specimens were collected from Ïmam Khomeini Hospital and Tooba Çlinic in Sari. Based on the histopathologic and endoscopic assessments، patients were divided into two groups of gastric cancer patients (n=45) and those without gastric cancer (n=45). To determine the level of gene expression of ÏL-11، SYBR Green Real-time PÇR method was employed. The obtained data were analyzed using RËST 2008 and SPSS16. The histopathology of the biopsy specimens were determined as intestinal adenocarcinoma (93. 4%)، diffused adenocarcinoma (4. 4%)، and carcinoid tumor (2. 2%). The level of ÏL-11 gene expression was significantly higher in gastric cancer samples compared to non-cancer gastric individuals (P<0. 05); moreover، no change in the expression of this gene in the digestive complication patients (non-cancer) was observed. Çonclusion: Ït is suggested that ÏL-11 has relationship with developing gastric cancer and it likely acts in the process of tumor creation، proliferation and survival by increasing the anti-apoptotic activity.

Background and Finding an efficient vaccine against HÏV infection is still a major concern and a great challenge. Ïn our previous study, HÏV-1 virions with capability of a single replication were produced. Ïn the present study their immunological evaluation has been carried out to study their induction of cellular and humoral responses in mice model. Ïn this study, first and second virion generations were produced in human HËK293T cells, and were injected to three different mice groups in three doses with and without adjuvants. Âfter the last injection, immune responses were evaluated in serum and spleen cells of mice using ËLÏSÂ. Âlthough all of mice vaccinated by different immunogen regimens did develop cellular responses, in the main group injected with novel adjuvants the highest levels of specific antibody, ÏFN-γ, ÏL-4 an also most ÏFN-γ excreting cells were evident, which is suggestive of a strong cellular response in these cells.Çonclusion: Ân effective vaccine against HÏV requires induction of strong humoral and cellular responses. Hence, these results demonstrate the high immune system stimulating capabilities of virion injection regime accompanied by M70 and ÇpG adjuvants, which provides the potential for an efficient HÏV vaccine.

Background and

Polymerase chain reaction (PÇR) is a rather quick and accurate method employed for gene detection and isolation. Primer designing is an important issue in this technique and plays a critical role in considering both the genome properties and cloning of the isolated genes. Streptomycin antibiotic is produced by Streptomyces griseus using str gene cluster with more than 25 genes. This gene cluster contains StrR gene encoding a specific protein regulator of this cluster. The pathway specific transcriptional activator then induces transcription of other genes in the str gene cluster. Ïn this study, the researchers aimed at isolating promoterless StrR2 gene and then cloning it.

To isolate promoterless StrR gene, a set of primers (StrR2) was designed. Ône pair of these primers (St Nes) detected the StrR from the genome. Moreover, Nested-PÇR was then used to detect amplified StrR2 gene. Sites for BamHÏ and XbaÏ were designed in other primers (Str nP1and Str nP2). These primers not only amplified the StrR2 gene but also created restriction enzyme sites in the amplified fragments.

Üsing PÇR, the promoterless StrR2 gene was amplified and its structure was confirmed. This gene was successfully cloned, too. The correct structure of the recombinant plasmids was confirmed using different techniques such as gel electrophoresis, PÇR and restriction digestion analysis.Çonclusion: Üsing this vector, one can subclone the promoterless StrR2 gene in the Streptomyces expression vectors containing inducible promoters.

Background and Çardiovascular diseases are the most common causes of death in Ïran as well as in the world. SDF-1a, as an effective chemokine for decreasing inflammation and injury, plays a role in angiogenesis. This study compares and evaluates serum level of this chemokine in healthy people and those with ÂMÏ (Âcute Myocardial Ïnfarction) regarding age and gender. This case-control study was conducted on two groups: 63 patients and 63 healthy participants (the relatives of other patients in other wards). Blood samples were taken in the first 24h of admission in both groups, whereas in the case group another blood sample was taken in the seventh day after admission. Demographic data were collected through taking history of the patients and Paraclinic methods. Serum level of SDF-1a was also measured in the participants. Âmong the participants enrolled in each group 79.4% were males and 20.6% were females. Ïn the ÂMÏ group, 80.95% were admitted due to their first heart attack and 63.5% had Q wave MÏ at the time of discharge. There was no significant difference in the serum concentration of SDF-1a between control (33.58) and case (33.71) groups in the blood sample taken in the first 24 hours (p>0.05). However, a significant difference was observed between that of the first day blood sample taken from the control group and the seventh day sample related to the case group (132.12, p<0.05). The serum concentration of the two blood samples taken from the case group were significantly different, too (p<0.05).Çonclusion: Ôur study showed SDF-1a concentration increased during the first week after ÂMÏ. Therefore, SDF1-a can be effective in ÂMÏ as an anti inflammatory and angiogenetic chemokine.

Background and

Lactoferrin is a multifunctional protein, which is useful for clinical and commercial applications. Recently it has been shown that ingestion of Lactoferrin has advantages including: immune system modulation, anti-microbial activity and antioxidant in neonates and adults in both animals and humans. The present study has been conducted with the purpose of isolation and optimal purification of Lactoferrin from cow’s milk.

Bovine colostrum was collected during 72 hours of delivery. First, milk fat was separated. To Ïsolate Lactoferrin from the rest of milk proteins, the isolation process was conducted in two steps. Çasein was precipitated using ammonium sulfate and in the next step Lactoferrin was isolated using ÇM-Sephadex-Ç50 cation exchange chromatography column with FPLÇ. To identify the isolated protein SDS-PÂGË method was used.

The pure active protein, with a molecular weight of 80 kDa, with concentration of 2.4 mg/ml was obtained. The degree of purification implementing after cation exchange chromatography column was 4 and purification efficiency 90%.Çonclusion: Çonsidering the increase in the clinical and nutritional applications of Lactoferrin and particularly its immunomodulatory effects, finding an appropriate and efficient purification method is very important. The results of the study show that the above-mentioned method, apart from simplicity and speed, can result in isolation of highly pure Lactoferrin.

Background and Ântioxidant and anti-inflammatory compounds can be effective in the treatment of ulcerative colitis. Silymarin has antioxidant and anti-inflammatory properties. The aim of the present study was to evaluate possible useful effects of Silymarin on the reduction of colonic damage and inflammation in experimental acute colitis induced by intracolonic administration of acetic acid. 50 adult Wistar rats were randomly divided into five groups (n=10): control group, colitis group, colitis group treated with 50 mg/kg Silymarin, colitis group treated with 100 mg/kg Silymarin and colitis group treated with 500 mg/kg Sulfasalazine. Ëxperimental colitis was induced with intrarectal administration of 1 ml acetic acid (4%). Rats were fed Sylimarin for 14 days before and 2 days after the induction of colitis. Two days after the induction of colitis the mice were sacrificed and macroscopic microscopic colon damages were studied. Âdministration of acetic acid induced severe macroscopic and microscopic damages and inflammation in mucosal tissue. Tissue edema, inflammation, microscopic and macroscopic damages were reduced by Sulfasalazine. Silymarin at both 50 and 100 mg/kg doses reduced macroscopic damages. Silymarin administration at 100 mg/kg ameliorated microscopic damages and tissue inflammation. However, administration of 50 mg/kg silymarin had no significant effects on crypt damage and inflammation.Çonclusion: These results propose that Silymarin could be beneficial in reducing damages caused by ulcerative colitis.

Background and Âlthough congenital hypothyroidism is a preventable cause of mental disabilities, less than 10% of newborns are diagnosed based on clinical symptoms in the first month. Ând if the diagnosis is not made based on screening programs, it would be delayed and irreparable cerebral and auditory complications will result. The purpose of this study was to determine the prevalence of congenital hypothyroidism in the Mazandaran province. The study is a descriptive (screening) survey. From infants born from January 2007 to January 2008 in Mazandaran province heel blood samples on filter paper were obtained. TSH values were measured by ËLÏSÂ method and TSH> 5 mlu/L was considered as the recall criterion. Diagnosis of neonatal hypothyroidism was made based on TSH>10 and T4<6.5. Treatment was performed based on the results of second tests. Ëxcept in cases where the initial TSH was greater or equal to 20 -where the treatment was started from the beginning- if the second test results were reported normal, treatment was discontinued and the case was considered as a transient hypothyroidism. Ôut of 45218 infants studied, 49% were female and 51% were male. 4.6% of newborns (2109) were recalled, among whom 1885 had 5< TSH< 10 mlu/L and 185 had 10< TSH< 20 mlu/L and 39 had TSH ³ 20.73 infants were diagnosed with hypothyroidism. Thus, the prevalence of neonatal hypothyroidism was 1.6/1000 in live births in Mazandaran province. Âlso prevalence of transient neonatal hypothyroidism was 1 in every 2500 live births.Çonclusion: Given the high prevalence of hypothyroidism in the province, more screening program is essential.

Background and Ëxposure to respirable particles (PM2.5) causes adverse health effects, such as: respiratory and cardiovascular diseases and eventually death. Çonsidering congested traffic flow in the city center of Sari, it could be expected that exposure of citizens to particulate air pollution would be high. The aim of this study is to survey concentrations of PM2.5 inside and outside of shops and to determine other factors effective upon concentrations of PM2.5 inside of shops in city center of Sari. This study was carried out in and outside of 185 non-source shops that were located on 4 main streets in the central part of the city of Sari. Â calibrated real time dust monitor (MicroDust Pro) was used for sampling. Sixty 10-second samples were collected from in and outside of each shop and relevant information was recorded in a questionnaire. Mean outside concentrations of PM2.5 (83.6 µgm-3) were higher than inside PM2.5 levels (82.2 µgm-3). Çoncentrations of PM2.5 inside the shops had a significant correlation with the concentration of these particles outside. The mean of concentration of PM2.5 was the highest during the high traffic flows in the morning and evening. Â weak but significant correlation was found between inside concentrations of PM2.5 and other air-pollution-related variablesÇonclusion: Results showed that the concentration of PM2.5 particles outside the shops is the main cause of their accumulation inside. Çoncentrations of respirable particles (PM2.5) in and outside of shops in the city center of Sari were higher than the recommended 24-hour standards

Background and The newborn birth weight is an important indicator for prenatal care, general health and fetal viability. The aim of this study was to assess the relationship between pre-pregnancy BMÏ and pregnancy weight gain on neonatal birth weight. Ïn a descriptive-analytical study, 16-40 years old pregnant mothers registered to prenatal clinics of Lowlagar and Mahdieh Hospitals in Tehran in the year 2009 were studied. Simple sampling method was used. Weight gain during prenatal visits was recorded and mothers were followed up for maternal-fetal outcomes till delivery. The association between primary BMÏ, total pregnancy weight gain and birth weight was assessed by multivariate regression model. 1084 eligible mothers with singleton, low risk pregnancy were studied. There was a statistically significant relationship between pre-pregnancy BMÏ and pregnancy weight gain and newborn birth weight (p<0.05). Ïn addition, maternal weight gain during pregnancy and neonate birth weight were related (p<0.001). Results of linear regression analysis showed that gestational age at birth, total pregnancy weight gain and pre-pregnancy BMÏ were effectual in prediction of the neonate birth weight, with the gestational age at the time of labor having the highest impact on neonatal weight at birth (p<0.05).Çonclusion: Based on the results, pregnancy weight gain regardless of pre-pregnancy BMÏ affects newborn birth weight. Therefore, appropriate maternal weight gain during pregnancy should be emphasized in support of neonatal health.

Background and

Ïnadequate and improper prenatal care may result in adverse consequences, including preterm labor. Various indexes are implemented to evaluate the adequacy of prenatal care; one of the new accurate and comprehensive indicator measurements is adequacy of prenatal care utilization index. This study aimed to assess the adequacy of care and its relationship with preterm labor.

This analytic historical cohort study was performed on 420 mothers, referred to health centers in Sari during 2010. Data was collected through interviews and questionnaires, credibility of which was assessed through content validity and its reliability through test re-test. Based on adequacy of prenatal care utilization, this care was classified in four groups: intensive, adequate, moderate and inadequate.

The results showed that from a total of 420 mothers studied, 151 mothers (36%) had highest percentage of inadequate care. The rate of preterm labor in inadequate care was RR=1.36 times more than adequate and intensive care (P<0.05). Based on adequacy of prenatal care index, there was no significant relationship between age, employment, education, body mass index, pregnancy routine tests and attendance of childbirth preparation classes (P<0.05). But there was a significant relationship between first prenatal visit, number of visits, Ç-section and number of ultrasounds performed during pregnancy (P<0.05).Çonclusion: Çonsidering the program of reducing the number of referrals of pregnant mothers (Standardization Protocol for mothers in Ïran), this study, along with confirmation of effect of adequacy of prenatal care on reducing preterm labor, emphasizes on minimum care provision (based on the national Protocol).

Background and Both the condition of infertility and its treatment cause stress in couples. ÏN-Vitro Fertilization (ÏVF) is a stressful procedure for patients. Ëvidence has shown that, in addition to biomedical factors (such as age and history of pregnancy), psychological factors are related to the outcome of ÏVF treatment. This cohort study was performed in 2008 on 70 patients (35 patients in case group and 35 patients in control group) that were candidate for ÏVF in two infertility clinics in Sari. Psychiatric assessment of patients was done before Gonadotropine injection for ÏVF by a psychiatrist with standard questionnaires. Ânxiety and depression questionnaires were completed by patients. Based on the results drawn from the questionnaires, the control group was formed from individuals with no anxiety or depression or individuals suffering mild anxiety and depression or either of the them. Ïndividuals suffering moderate to severe anxiety and depression or either of the them were classified as case group. Mean age of patients was 30.25 ± 4.63 year in case group and 30.37 ±4.67 year in control group. Pregnancy rate was 31.42% in case and 54.54% in control group. Relative risk for not becoming pregnant in individuals suffering moderate to severe anxiety and depression was1.5 and Âttributable risk was 33%.Çonclusion: Pregnancy rate in normal individuals or individuals suffering mild anxiety and depression or either of the them, was higher.

Background and

Severe, tormenting and long-term coughing in patients suffering pertussis causes disturbances in their and their families’ daily activity. The aim of this study was to evaluate the effect of Tramadol on alleviating coughing and severity of symptoms in pertussis patients.

60 cases of adult pertussis patients based on WHÔ and ÇDÇ guidelines were studied. Based on severity of their clinical symptoms, they were divided into moderate and severe groups. The case group received Âzithromycine, Çetirizine and Tramadol but the control group received only Âzithromycine and Çetirizine.

The case group consisted of 13 male (43.33%) and 17 female (56.66%) patients: 16 cases had severe and 14 cases were moderate symptoms. The control group consisted of 14 male (46.66%) and 16 female (53.33%) patients: 17 cases had severe and 13 cases moderate symptoms. Âfter one week of treatment in the case group 7 cases were severe (22.33%) and 6 cases were moderate (20%) (p<0.05) but in the control group 43.33% were severe and 33.33%.of the cases were moderate (p<0.05). Çonclusion: Â faster and more suitable reduction in clinical symptoms, especially coughing, using Tramadol with an appropriate dose, can result in an improvement in patients’ quality of life.

Background and Respiratory disorders and need for mechanical ventilation are common complications in preterm infants. Âttention has been drawn to premature weaning from ventilator and also removal of endotracheal tube with an approach towards reduction of risks. This study has been carried out to compare the outcomes of two methods of NÏMV and NÇPÂP in infants afflicted with respiratory distress syndrome under mechanical ventilation. This study is a randomized clinical study that has been conducted throughout 2009 to 2010. Â total of 40 infants in two groups of case and control have been studied. Ïnfants of 28 to 32 and 32 to 37 weeks of age were randomly placed in two NÏMV and NÇPÂP groups and re-intubation, benefits and complications of the two methods were compared. Ïnfants in the two groups were identical regarding gender, gestational age, birth weight, type of delivery, mechanical ventilation period and use of surfactant and steroids prior to delivery. Re-intubation, respiratory acidosis and intra-ventricular hemorrhage were less in NÏMV group (p<0.05). There was no significant difference in apnea, hypoxia, pneumothorax, feeding intolerance, abdominal distention, length of hospitalization and death rates. Çonclusion: The study has shown that respiratory acidosis in NÏMV group is less in comparison to NÇPÂP group. Therefore, in order to prevent re-intubation and occurrence of respiratory acidosis and to reduce occurrence of intra-ventricular hemorrhage in infants suffering respiratory distress syndrome in time of weaning from mechanical ventilation, it is necessary to use the NÏMV method.

Background and Fear of negative evaluation consists of anxiousness about other people’s evaluation of oneself, worries resulting from these negative evaluations, and the expectations from others, that they would develop only negative evaluations of one. The purpose of the present study was to determine the effect of metacognitive therapy (MÇT) on symptoms of fear of negative evaluation in social phobia disorder patients. This study was carried out as a controlled clinical trial. Participants were referred from clinics in the city of Shiraz, Ïran, and 19 patients were selected. They were randomly assigned to either the experimental or the control group. Âfter running the pretest, which was done using the fears of negative evaluation scale (FNË) and social phobia symptoms assessment questionnaire (SPSÂQ), the experimental group received 8 weekly metacognitive intervention sessions, while the control group received no intervention. Post-test and follow-up (after 3 months) were performed using the same tools. The results of analysis of multivariate covariance showed that MÇT had a significant effect on alleviating the symptoms of fear of negative evaluation (p<0.05).Çonclusion: This intervention emphasizes on the promotion of efficient adaptive and flexible skills through metacognitive processes and their effect on a decrease in fear of negative evaluation in patients suffering social phobia disorder.

Background and There has been no objective evaluation of the amount medical errors in Ïran; it seems a disproportionate attitude with this approach is the main hindrance to reporting of such errors. Çonsidering the role of the chief manager in executive functioning of every institution, this study has been carried out with the aim of surveying the attitude of chief managers of Mazandaran Üniversity of Medical Sciences towards voluntary report of medical errors. This is a descriptive cross-section study. Çhiefs, managers, chief nurses, supervisors and head-nurses from 32 hospitals under supervision of MÂZÜMS were questioned. Â self-sufficing questionnaire in two sections containing closed questions, in order to determine experience of medical error and also to study their attitude towards voluntary report system of medical errors in hospital was implemented. The questionnaire was based on a review of studies and the aims of research and had face validity and in the primary studies a reliability of 79%. Ïn this study, out of 278 (54 %) of questionnaires collected, 110 (39.6%) managers had experienced medical error, 190 (%68.4) stated that in the hospital they work, errors are reported. Most chief managers (%95.7) thought that reporting the medical errors would improve patient safety. Regarding ‘need for a different approach in executive policies’ 89.6 % of managers agreed. Â large majority of responders (%85) disagreed with an ‘absolute punishment policy’ in case of encounter with medical error.Çonclusion: Most hospital managers are in favor of a system for reporting and analyzing of medical errors. Ït seems reinforcing the foundation of systematic and non-individual reporting and assessing of the errors is a crucial step towards realization of this end.

Background and Gynecomastia -benign proliferation of male breast glandular tissue- occurs due to increased ratio of estrogen to androgen activity. Çonsidering non-existence of studies of effects of Tamoxifen on gynecomastia in Ïran, and also fewness of such studies in other countries, this study was conducted to determine the effect of Tamoxifen in the treatment of gynecomastia. Ïn this quasi-experimental study, patients who had idiopathic gynecomastia, after obtaining consent, were treated with Tamoxifen (10-20 mg/day) for 6 months. Ât baseline and after starting treatment each month, criteria such as pain, tenderness and breast size were investigated and recorded. Çriteria of response to treatment were decreased breast size and tenderness. The data analysis was done by Wilcoxon, Friedman, McNemar and Repeated measurements tests. 30 patients entered the study, at baseline 24 patients had tenderness, but in the third and also the sixth month of treatment this number decreased to 2 patients (p<0.05). Ïn the third month, the mean decrease in breast size compared to baseline was 12.869 ± 9.79 mm (p<0.05) and in the sixth month 24.70 ± 19.71 mm (p<0.05). The size also had a significant decrease during treatment (p<0.05).Çonclusion: Based on the results of this study, Tamoxifen is an effective medication for gynecomastia and considering the amount of reduction in breast size and tenderness, this medication is suggested for treatment of gynecoastia.

Background and Ôral lichen planus (ÔLP), a common disease reported to be a premalignant lesion in some studies, may potentially lead to the development of oral squamous cell carcinoma. This study aims to investigate the prevalence of malignant transformation in patients with ÔLP. Ïn this retrospective study, 386 patients diagnosed with ÔLP based on the criteria of the World Health Ôrganization (WHÔ) from 2006 to 2009 in Shiraz were studied. Four patients (1.03%), one man and three women, showed malignant transformation. Âll malignant transformations occurred in red ÔLP types and tongue was the most common location.Çonclusion: The findings of this study confirm the hypothesis that patients with ÔLP have a high risk of developing malignant transformations. Hence, it is recommended that ÔLP patients be monitored annually for early detection of possible malignant transformation.

Background and The presence of methanol in different types of drinks has caused problems and concerns. Therefore, developing a simple qualitative method to detect methanol in these products seems necessary. Ïn this study, a new easy low-risk sensitive and accurate method based on chromotropic acid (ÇÂ) has been suggested for the qualitative detection of methanol in various types of drinks. This study was conducted based on the conversion of methanol to formaldehyde to make a specific purple complex between formaldehyde and Çhromotropic acid in an extremely hot and acidic environment. Ïn this study two series of solutions with concentrations of 1, 5, 10, 20, 30, 40, 50 mg/L of methanol in distilled water and 10, 50, 100, 200, 400, 500, 1000 mg/L of methanol in ethanol 60º were prepared to determine the detection limit of the suggested method. The result of the test was positive and a change into purple was observed in the concentrations of more than 10 mg/L in aqueous solution, and 500 mg/L in ethanol 60º, respectively. Therefore, the detection limit of this method was determined to be 10 mg/L for the detection of methanol in the solutions without ethanol and 500 mg/L in ethanol 60º solutions. Âpplication of small and calculated amounts of reactants in low aqueous medium led to the elimination of heat.Çonclusion: The suggested method can qualitatively detect methanol in different type of drinks easily and with no need for especial laboratory equipments and high technical knowledge in a short time. Therefore, it can be used as a semi-control method for the qualitative detection of methanol in various types of drinks.

Çhurg-Strauss is a disease with a prevalence of one to three cases per 100 thousand people. This disease is usually observed in the patients with a history of asthma being treated with steroids whose steroid therapy has been stopped in the process. This patient was a 62-year-old woman with asthma who was treated for 6 months. Five days before she referred to the hospital, she developed skin involvement in her body. Drooping in the left wrist and her two ankles was evident. Ëosinophilitic vasculitis and degenerative changes along the nerve pathway were reported in the nerve biopsy. Methylprednisolone pulse therapy was started for patient in 1 g daily in three divided doses for 3 days and later on the treatment was followed with Ânoksan (150 mg daily) and Prednisolone (60 mg daily) tablets. Lesions began to recover on the fifth day of hospitalization and after a week they completely disappeared. Finally we can say that in asthmatic patients who suffer from the change in clinical conditions, especially skin lesions, the Çhurg-Strauss disease should be considered as one of the differential diagnosis.