مجله دانشکده پزشکی اصفهان
پیاپی 396 (هفته چهارم مهر 1395)

Metastasis is an advanced stage of cancer in which tumor cells are removed from the primary tumor and migrate to other areas of the body and develop a new mass by high replication. Animal models could be applied to evaluate metastasis along with a metastatic and appropriate cell line. Carcinoma 4T1 cell line is a metastatic cell line with excessive cell proliferation and invasion up to the liver, lungs, brain and lymph nodes.
By injection of about 5 ´ 105 4T1 cells to BALB/c mice, primary tumor was developed. Rate of tumor growth, survival and other morphologic symptoms were checked and recorded. To study the metastasis process, liver, lung and brain tissues were separated and the pathological status was studied following hematoxylin/eosin dye staining.
Findings: The primary tumor growth was increased significantly. The survival rate in mice with breast cancer was decreased to maximum in 7-8 weeks. Liver and lung tissues were metastatic with necrosis and infiltration of numerous cancer cells while metastasis was not observed in brain tissue.
In this model, high proliferation of cancer cells in mice was in association with a sharp decline in survival rate as well as lung and liver tissues metastasis. Metastasis to the brain cells might be accomplished by injection of more 4T1 cells and presumably occurs in a longer period.

Hodgkin’s disease is a special type of lymphoma or cancer that is associated with the abnormal growth of cells in the lymphatic system. The purpose of this study was to investigate different methods of radiotherapy in women with Hodgkin’s disease who need radiotherapy. Due to the presence of sensitive organs in this area, and secondary disease and cancers after radiotherapy, the importance of reviewing various treatment plans, is outstanding.
The data of computed tomography (CT) scan for 18 women with Hodgkin’s disease with mediastinal involvement were used. In next step, contouring all sensitive organs inside the field and the involved volume was done, using treatment planning system of Seyedoshohada Hospital, Isfahan, Iran. Then, the comparisons between the anterior-posterior/posterior- anterior (AP/PA) common treatment with the energy of 6 and 18 Mv and the four-field techniques with different weights were performed.
Findings: The maximum dose reached to the breast was reduced to 33%, compared to the current parallel-opposite technique, in the four- filed technique. On the other hand, the four- filed technique caused an increase of about 2.8 times in the average dose, due to the side-fields. The mean dose reached to the treatment volume was 100-102 percent in the 2-field technique and 99.5 percent in the four-filed technique.
For women with Hodgkin’s disease with mediastinal involvement, using the two-field technique with 18 Mv photon weighing 1.5 of anterior and 0.5 of posterior, showed better results compared to the 6 photon. The use of the 4-field technique led to a decrease of V20 value for the whole lung and the average dose received by esophagus and aorta and spinal cord, and V30 value for the heart.

Kawasaki disease is an acute and self-limited vasculitis which has unknown etiology. Cardiovascular disorders (CVDs) are the most common serious complication of this disease. The main aim of this study was the evaluation of early- and late-onset cardiovascular disorders and related risk factors in children with Kawasaki disease.
This historical cohort study was conducted among 85 patients with Kawasaki disease. Echocardiography was performed in all the patients. Besides, medical documents of all the patients were evaluated. Patients were divided in groups with and without early- and late-onset cardiovascular disorders and then, statistical analysis was performed on data.
Findings: The most common early- and late-onset cardiovascular disorders were mitral regurgitation (45.9%) and tricuspid regurgitation (20%), respectively. In logistic regression analysis, patients which received second dose of intravenous immunoglobulin (IVIG) showed significantly higher risk of early-onset cardiovascular disorders (OR: 2.81, 95%CI: 1.05-7.51). In addition, patients who had cardiovascular disorders in onset of the disease showed higher risk for late-onset cardiovascular disorders (OR: 7.23, 95%CI: 1.95-26.8).
In this study, it was shown that patients who received second dose of IVIG were on higher risk for early onset cardiovascular disorders. Suffering of cardiovascular disorders in initial phase of the disease was proposed as risk factor for late onset these disorders. For better evaluation, studies with larger sample size and prospective design are suggested.

There were few researches indicating the association between irritable bowel syndrome (IBS) and obesity. This study aimed toassess the association of IBS with obesity and abdominal obesity.
During this cross-sectional study, 4763 Iranian adults filled out self-administered questionnaires on demographics and IBS. Data on self-reported height, weight and waist circumference were used to calculate body mass index and abdominal obesity. The prevalence and symptom frequency of IBS and its subtypes was evaluated in each subgroup. Modified Persian version of ROME III questionnaire was applied for this purpose.
Findings: We found that IBS was more prevalent in individuals with abdominal obesity compared with normal individuals (25% vs. 18%). Additionally, these people had a greater probability to have frequent symptoms even after adjustment for potential confounders although control for these factors attenuated this relationship (OR: 1.30, 95%CI: 1.04-1.63). IBS-Mixed was also observed to have more symptom frequency in people with abdominal obesity (OR: 2.71, 95%CI: 1.09-6.72). No significant association was observed between IBS and different BMI categories although obese people had a greater probability to be affected by IBS-Diarrhea (OR: 1.51, 95%CI: 0.98-2.30). Besides, we showed that overweight people reported more frequent symptoms of IBS-Diarrhea (OR: 2.51, 95%CI: 1.24-5.08).
Obesity whether in general or abdominal was associated with symptom frequency rather than prevalence of IBS in this group of adults. In addition, this association was more prominent between obesity and IBS-Diarrhea subtype.

microRNAs are non-coding RNAs that modulate different types of cellular processes like differentiation and cell death. Hitherto several studies have been done to determine the expression profile of microRNAs in patients with multiple sclerosis (MS) to obtain appropriate biomarkers. In previous studies, it was found that miR-145 was over-expressed. This up-regulation was in patients who did not start taking medicine. Therefore, in this study we assessed the effect of beta interferon on the expression of this microRNA in patients with multiple sclerosis.
We evaluated the expression pattern of miR-145 in 15 patients who did not start taking medicine and called treatment naive, in 15 patients who were under treatment and also 15 healthy people using real-time polymerase chain reaction method.
Findings: The expression level of miR-145 in treatment naive patients was 3.9 fold of healthy people (P = 0.005), whereas expression level of this microRNA between healthy people and under treatment patients was not significantly different.
Down-regulation of miR-145 in under-treatment patients to the extent of healthy people suggests that probably, this microRNA could be used as predictive biomarker.