مجله دانشکده پزشکی اصفهان
پیاپی 445 (هفته اول آبان 1396)

Hyponatremia is known to be a marker of poor prognosis in many diseases. Peritonitis is the most common complication and the leading cause of mortality in patients under peritoneal dialysis. Therefore, we aimed to investigate the effect of hyponatremia on prognosis of peritoneal dialysis patients with peritonitis.
In this case-control study, we selected 30 peritoneal dialysis patients with peritonitis and hyponatremia and also 30 peritoneal dialysis patients with peritonitis and normal serum levels of Na as control group. Mortality rate, hospitalization, and relapse of peritonitis were assessed as outcomes of the study. In addition, the demographic and laboratory characteristics, and pathogens of peritonitis were analyzed.
Findings: There were no significant differences in duration of dialysis, pathogens of peritonitis, and residual kidney function before and after peritonitis between the two groups (P > 0.05). Furthermore, comparison of the outcomes between the two groups revealed that there were no significant differences in mortality rate, hospitalization, and relapse of peritonitis (P 0.05). Acute phase protein levels in patients who died were higher than patients who continued their treatment (P = 0.02).
Serum level of Na during peritonitis is not an independent predicting factor of mortality, hospitalization, and relapse of peritonitis in patients with peritoneal dialysis-related peritonitis. However, further studies would be required to demonstrate the exact role of Na in prognosis of peritoneal dialysis-related peritonitis.

Candida vaginitis is one of the most common opportunistic fungal infections and 75% of women struggle at least once with this infection during their lifetime. The purpose of this study was to compare the results of two phenotypic and molecular methods in the diagnosis of candida vaginitis.
In this study, 125 vaginal samplings were done by two sterilized swabs from suspected patients to vaginal candidiasis. The direct experiment performed by preparing two staining slides, one with Gimsa and the second with 10% Potassium hydroxide (KOH). For culturing, Sabouraud dextrose agar with chloramphenicol (SC), corn meal agar (CMA) and Chromagar candida were used. At first, the isolates were identified by microscopic observation and creation of specific color on Chromagar and chlamydoconidia on CMA culture media. For molecular methods, the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was also used with MspI enzyme.
Findings: Out of the 125 samples, 53 (42%) were positive in terms of vaginal candidiasis in both methods. Isolated species were as Candida albicans 46 isolates (87%), Candida glabrata 5 isolates (9%) and Candida kruise 2 isolates (4%).
In present study, Candida albicans, like most studies, diagnosed as the most frequent species. This study shows the high frequency of vaginal candidiasis. Therefore, due to the similarity of the results in both methods and considering the lack of sufficient and advanced molecular facilities in deprived areas, using phenotypic tests is recommended.

Respiratory distress syndrome (RDS) is one of the most common causes of mortality in premature neonates and its prevalence is about one percent of all births worldwide. Zinc deficiency causes serious complications, such as low birth weight, intrauterine growth restriction, and disruption in many vital organs such as the respiratory system. Therefore, in this study, we aimed to compare the zinc level in umbilical cord blood among premature neonates with RDS and healthy neonates.
In this case-control study, 40 preterm neonates with RDS were selected as case group and also 40 healthy neonates were selected as control group. After delivery and after cord clamping, a sample of blood from the umbilical artery was collected. All experiments were performed by an operator and by an automatic analyzer.
Findings: The mean zinc level in umbilical cord blood was 96.67 ± 16.45 and 109.07 ± 21.49 mmol/l in the patient and control groups, respectively (P = 0.005). There was a positive and significant association between the zinc level in umbilical cord blood and the age of the neonates (r = 0.23, P = 0.030). Similarly, a significant positive association was found between the weight of the neonates and the zinc level in umbilical cord blood (r = 0.22, P = 0.040).
The zinc level was significantly lower in infants with RDS than healthy neonates. Therefore, the improvement of zinc status in premature neonates may reduce the risk of RDS.

Head and neck tumors in children have been reported and compared to similar tumors in adults; these tumors reveal significant differences in histological and clinical conditions and treatments. Malignancies of head and neck in children have been the subject of a few studies and the major problem in the conclusion of these studies is the lack of same or similar parameters in them. This study aimed to determine the frequency of head and neck neoplasms in age group less than 20 years in Isfahan City, Iran, during a 10-year period.
In this retrospective descriptive study, files related to patients with head and neck malignancies, holding in department of oral and maxillofacial pathology of Isfahan Dentistry School and archive of three related hospital in Isfahan City (Alzahra, Seiedoshohada, and Kashani) were studied. All the data were extracted and analyzed using chi-square statistical test at the significant level of P Findings: From all 143 cases, 86 cases were girls and 57 were boys. Thyroid (papillary) carcinoma with 60 cases and nasopharyngeal and cervical lymph nodes lymphoma with 35 cases were the most common malignancies. Distribution of patients according to the type of malignancy a significant difference between the first and second 5-year periods (P = 0.020).
Results show that the most common malignant lesions such as thyroid carcinoma and nasopharyngeal lymphoma were similar to previous studies. In addition, the prevalence of thyroid carcinoma was 5 times more among the girls and the prevalence of nasopharyngeal and lymph nodes lymphoma was 2 times more among the boys; these results were similar to other previous studies, too.

Coagulation factor 7 (FVII) is a vitamin-k-dependent serine protease with an essential role in initiation of extrinsic pathway of coagulation cascade. Extrinsic pathway is the major mechanism of clot formation in physiologic conditions. Congenital deficiency of FVII is a recessively inherited bleeding disorder caused by F7 gene mutations. The use of recombinant FVII is a therapeutic intervention for treatment of FVII deficiency and hemophilia diseases. The first step of production of recombinant FVII is cloning of F7 gene in an appropriate expression vector and transfection of the vector into cells capable of efficient processing of the expressed protein.
Complete human F7 cDNA was isolated from HepG2 cell using real-time polymerase chain reaction (RT-PCR) method. The cDNA was inserted into pcDNA3.1/neo expression vector and CHO-K1 cells were transiently transfected with the resulting construct. After transfection, in order to study the expression of recombinant FVII, conditioned medium of the cells was collected and coagulant activity and antigen level of FVII was assessed using one-stage PT-based and the enzyme-linked immunosorbent assay (ELISA) methods, respectively.
Findings: The recombinant FVII was expressed in CHO-K1 cells successfully and had appropriate coagulant activity.
In this study, we produced functional recombinant coagulation factor 7 with coagulant activity. This suggests that the pcDNA3.1/neo is a suitable vector for expression of FVII protein in mammalian cells and CHO-K1 cells exert correct and efficient post-translational processes on FVII protein and can be used to produce recombinant FVII protein.

There are various techniques for treatment of male infertility, nowadays. At the beginning, evaluations are performed to determine the cause of infertility and the treatment. These include advanced molecular evaluations and assessment of sperm parameters. There is no study investigating the relationship between sperm parameters as an elementary index of male infertility, and DNA methylation as an important epigenetic mechanism with rat sperm ubiquitination, so far. The aim of this study was to evaluate the motility, morphology, DNA methylation, and ubiquitination in rat sperm and to determine the relationship between them.
First, 10 male mature rats were kept in experimental condition for 9 weeks (one cycle of spermatogenesis). After sacrificing, their semen samples were used to determine the sperm parameters and smear preparation. Through prepared smear and immunofluorescence assay, percentage of ubiquitinationed and methylated sperm were determined and finally, the correlation coefficient between them was calculated.
Findings: There was no significant correlation between the ubiquitination and DNA methylation. However, there was an inverse and significant correlation between the percentage of ubiquitination and morphological abnormalities in spermatozoa (P Ubiquitination, as one of the important molecular processes, prevents the participation of defective sperm in fertilization, and transmission of disorders to next generation. DNA methylation and ubiquitination affect sperm chromatin, but these two processes act in an independent manner.

Myocardial infarction (MI) is one of the most important health problems around the world. Increased parathyroid hormone (PTH) following MI causes significant improvement in myocardial performance. On the other hand, the imbalance between matrix metalloproteinases (MMPs) and tissue inhibitor metalloproteinases (TIMPs) causes major health problems like sudden cardiac death. In this study, we tried to investigate the correlation between serum post-MI PTH levels with MMP-9 or TIMP-1.
62 patients diagnosed with MI were enrolled the study between 2016 and 2017 as well as 6 normal persons as control group. Blood sample was collected 72 hours after MI and serum was separated. Serum levels of TIMP-1, MMP-9, and PTH were measured using the enzyme-linked immunosorbent assay (ELISA) assay kit.
Findings: The serum levels of MMP-9 (8.07 ± 4.30 ng/ml) and PTH (61.94 ± 40.44 pg/ml) were significantly increased versus the control group (2.83 ± 0.44 ng/ml and 30.93 ± 6.59 pg/ml, respectively). The serum level of TIMP-1 (6.21 ± 1.36 ng/ml) increased compared to the control group (5.60 ± 0.57 ng/ml), but the difference between them was not statistically significant. In total, statistical analysis showed that there was no significant correlation between the increased level of serum PTH with those of MMP-9 or TIMP-1.
These results proposed that PTH and MMP-9 or TIMP-1 are independent factors in post-MI events.