مجله دانشکده پزشکی اصفهان
پیاپی 373 (هفته اول اردی بهشت 1395)

Cartilage injuries are the leading cause of disability in the elderly in developed countries. In addition, articular cartilage has a limited ability to repair. Current treatment methods for cartilage tissue injuries lead to fibrous tissue formation. Cell therapy is a treatment in which stem cells using tissue engineering can be differentiated into chondrocytes by using growth factors and scaffolds. Since growth factors such as transforming growth factor beta1 (TGF-β) leads to hypertrophy of cartilage chondrocytes tissue and many scaffolds are weak in terms of mechanics and stability, it is essential to achieve the appropriate scaffolds and inducing factors. Studies have shown that fibrin alginate scaffold is appropriate in terms of mechanical and stability and piascledine increases the cartilage-specific genes expression. Therefore, in this study the chondrogenic effect of TGF-β1 and piascledine on adipose derived stem cells in fibrin alginate scaffold was compared and evaluated.
Fat samples were obtained from three persons. Adipose derived stem cells (ADSCs) was extracted from adipose tissue and proliferated. Then the cells were transferred to the fibrin alginate scaffold and the cells were cultured for 21 days under the influence of the induction medium. The rate of proliferation and survival of cells was evaluated by [3 (4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium-bromide] MTT method and the rate of gene expression of Aggrecan and Collagen II and X was evaluated with Real-time polymerase chain reaction (Real-Time PCR) method.
Findings: The results showed that proliferation rate and survival of cells in a fibrin alginate scaffold in the group containing Piascledine increased compared to the other groups, but this increase is not significant (P> 0.050). Also, Piascledine increased collagen II gene expression (P Piascledine was found as a proper effective inducer in chondrogenic differentiation of human adipose derived stem cells cultured in fibrin alginate scaffold.

Retina is the innermost tissue in human eye which sends visual information to the brain by means of optic nerve. Designing an intra-retinal layer segmentation method which can detect the retina surfaces properly in the presence of noise and lack of contrast is an important step in ophthalmology. In this study the combination of morphological component analysis (MCA) and dynamic programming (DP) is used automatically for segmentation of optical coherence tomography (OCT) images.
Data set for this study was 55 samples which were taken from normal people by Topcon OCT-1000. This study had two phases. In MCA phase the image dictionary was created by clustering with eigenvalues (k-SVD), and then the image was decomposed to cartoon and texture parts by selecting proper bases. In the second phase segmentation was done by the dynamic programming (DP) method on cartoon part and the retinal pigment epithelium (RPE), Verhoeff's memberane (VM), outer segment layer (OSL), inner collagenous layer (ICL), inner synaptic layer (ISL), and outer limiting membrane (OLM) layers were detected.
Findings: Comparing the obtained results with gold standard (manual segmentation) shows that minimum error belongs to OSL surface and its error in the form of mean ± SD (standard derivation) is 0.030 ± 0.167. For other surfaces the error is calculated in this way from left to right for RPE, VM, ICL, ISL, OLM: 0.66 ± 0.33, -0.59 ± 0.31, -1.00 ± 0.49, -1.72 ± 0.61, -1.05 ± 0.51.
MCA in combination with DP can work as an automatic method for six lower intra retina layer's segmentation with acceptable accuracy. One of the main advantages of this method is omitting preprocessing phase for segmentation.

Nontuberculosis Mycobacterium (NTM) is the most common bacterium transferred to human from cow milk and products. The presence of these bacteria in the cow's milk stands as a public health concern particularly among those individuals consuming raw milk and dairy products. In this study the determination of 16S rRNA gene sequence method was used in order to evaluate the amount of Non tuberculosis Mycobacterium incidence and determine its types in milk samples gathered from Isfahan province.
The cetyltrimethylammonium bromide (CTAB) and phenol chloroform were used for DNA extraction in isolates recognized as Non tuberculosis Mycobacterium, then using designed primers, 16S rRNA polymerase chain reaction was done and the types were determined after sequencing.
Findings: 9 cultures, out of 119 samples gathered from Isfahan farms, were recognized positive in which 8 samples had M. fortuitum and one of them was M. gordonae.
NTM incidence was 8.6% in evaluated milk samples. By using polymerase chain reaction (PCR) with 16SrRNA and sequencing, the fortuitum isolate type I incidence was 88.9% and Gordonae type III incidence was 11.1%. PCR method and sequencing of 16S rRNA gene which were used in this study are able to recognize isolates up to 100%.

Previous studies showed that managed surveillance and treatment have a considerable effect on decreasing the mortality and morbidity in head trauma patients. But there isn’t a validated guideline in Iran. Thus, the aim of this study was nativation of diagnosis, treatment and clinical prevention of head trauma guideline for using in Isfahan hospitals.
In a cross sectional study, 6 validated guidelines for management of head trauma were studied and the most important head lines were extracted and then, attitude of resident and attends of treatment groups including neurosurgery, anesthesia and emergency medicine was given and the agreement between treatment group and guideline was analyzed.
Findings: In this study, six guidelines were studied and attitude of 78 persons of treatment group of head trauma including 30 persons from emergency medicine ward, 28 persons from neurosurgery ward and 20 persons from anesthesiology ward were compared with the guidelines. The mean ± SD of enter viewed staff was 15.0 ± 2.7 (range: 8-20) and based on that, attitude of 14(17.9%) had excellent agreement, 34 43.6%) had good agreement, 27(34.6%) had acceptable agreement and 3(3.8%) had weak agreement with the guide lines.
According to the results of this study, management of head trauma treatment is not programmed and in several stages was not approved and this practice may lead to higher risk of morbidity and mortality and additive hospital cost. So, treatment methods, surveillance and treatment of head trauma patients must be revised.

The aim of this study was to evaluate the effect of arm position during coronary artery bypass surgery on neuropathic symptoms and nerve conduction velocity (NCV) of the upper extremity nerves in diabetic patients.
In this clinical trial, 20 patients with diabetes, who were candidates for open heart surgery, were divided randomly into control and experimental group. During the operation, patient’s arm was positioned at 90 degree abduction and at the sides of the body in the experimental and control group, respectively. Electrodiagnostic tests including assessing amplitude and conduction velocity of sensory and motor nerves of radial, median and ulnar of left hand was performed. Physical examination was also done for checking the numbness and Paresthesia in both hands.
Findings: The Comparison of the changes for mean of amplitude and NCV of radial, median and ulnar nerves showed significant change in the control group after operation (P Arm abduction at 90 degrees reduces the axonal injury of the ulnar sensory fibers during coronary artery bypass graft surgery.