فهرست مطالب

Medical Sciences - Volume:44 Issue:6, 2019
  • Volume:44 Issue:6, 2019
  • تاریخ انتشار: 1398/08/10
  • تعداد عناوین: 10
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  • Negar Varaa, Saeed Azandeh *, Zahra Khodabandeh, Anneh Mohammad Gharravi Pages 437-448

    There are several differentiation methods for mesenchymal stem cells (MSCs) into hepatocyte-like cell. Investigators reported various hepatic differentiation protocols such as modifying culturing conditions or using various growth factors/cytokines. In this literature review, we compared different MSCs extraction and isolation protocols from Wharton’s jelly (WJ) and explored various MSCs differentiation methods. Various protocols have been recommended for MSCs isolated from WJ, such as enzymatic, enzymatic-explant, and explant methods. In the explant method, valuable time is wasted, but the cost and biological contaminations are reduced and the number of isolated cells is high. However, other features, such as immune phenotype and multiline-age differentiation capacity, do not differ from other methods. There are also several differentiation methods for hepatocyte-like cell including the induction of MSC by cytokines and growth factors, and the differentiation of MSC in 2- and 3-dimensional matrix (2D and 3D). Among several cytokines, hepatocyte growth factor (HGF) and fibroblast growth factor (FGF) are essential. In the early stage of the differentiation, 2D culture is useful, and in the development stage, 3D culture system with HGF and FGF cytokines are more effective in the process of differentiation. Some studies have used 3D culture system in biocompatible scaffolds, such as alginate, collagen, gelatin, and peptide-Gly-Leu-amide (PGLA).In conclusion, Wharton’s jelly-Mesenchymal stem cells (WJ-MSCs) can be considered as an appropriate source for hepatocyte differentiation. Moreover, we introduced the explant method as the most effective protocol. This review attempted to highlight factors in hepatocyte differentiation, but the most effective protocol is not still unknown.

    Keywords: Cell differentiation, Mesenchymal stromal cells, Umbilical cord, Wharton jelly, hepatocytes
  • Seyed Ebrahim Ahmadi, Hassan Rafiey, Homeira Sajjadi *, Farhad Nosratinejad Pages 449-456
    Background
    Global and Iranian statistics indicate a rise in the newly emerging phenomenon of voluntary childlessness as a permanent status among couples. Childlessness is one of the main challenges of modern society. In Iran, studies on the process of voluntary permanent childlessness are scarce. The present study aimed to investigate the causes and underlying factors of voluntary childlessness and to provide an explanatory model of this phenomenon among Iranian couples.
    Methods
    The present qualitative study was conducted using the grounded theory approach proposed by Strauss and Corbin. Married couples from Tehran (Iran) with no infertility problems who chose to be permanently childless were invited to take part in this research. Theoretical saturation was reached after 33 semi-structured in-depth interviews.
    Results
    Based on the results, the causal conditions of childlessness included the high-risk society and adverse experiences. Contextual and intervening conditions included social problems, social support, transitional society, natural resources, social presence of women, and marriage age. The strategies and interactions observed in childless couples included the suppression of feelings, conflicts, rationality, and malingering. The core phenomenon was individualism.
    Conclusion
    Increased social problems and reduced social support endanger a society in transition toward modernity. Individualists resort to permanent childlessness by suppressing parental feelings, overcoming doubts about childbearing, and becoming nonchalant by running away from child-rearing responsibilities. Such people may resort to child adoption or to have pets in order to cope with loneliness.
    Keywords: Reproductive behaviors, Voluntary childlessness, Grounded theory, Individualism
  • Mehrdad Mohammadi, Kia Nouri, Mahdavi *, Abbas Barzegar Pages 457-464
    Background

    The incidence of renal hemorrhage during percutaneous nephrolithotomy (PCNL) is high. We sought to evaluate the effects of tranexamic acid (TXA) on bleeding and hemoglobin levels of patients with staghorn calculi treated with PCNL.

    Methods

    In a double-blind clinical trial, 120 patients with staghorn calculi candidated for PCNL in Alzahra Hospital between January 2014 and November 2017, Isfahan, Iran, were classified into two groups in terms of the stone size (>4 cm and

    Results

    The mean volume of blood loss was significantly higher in the control group patients than in those receiving TXA, in both stone-size categories (P<0.001). There was no significant difference in the postoperative hemoglobin level between the intervention and control groups, in both stone-size categories (P=0.26 and P=0.10, respectively). In addition, the mean volume of blood loss increased significantly with an increase in the operative duration (P<0.001).

    Conclusion

    TXA reduced the risk of bleeding during and after PCNL and attenuated the drop in the hemoglobin level in the postoperative period. Longer operative procedures were associated with an increase in the bleeding volume. Trial Registration Number: IRCT20180209038673N1

    Keywords: Tranexamic acid, Staghorn calculus, Bleeding, Hemoglobin
  • Hossein Faramarzi *, Maryam Nasiri, Mahmood Khosravi, Abouzar Keshavarzi, Ahmad Reza Rezaei Ardakani Pages 465-473
    Background
    Human brucellosis is widespread in Fars province. The present study aimed to investigate the effect of climate on its incidence and determine the areas prone to the infection.
    Methods
    Monthly meteorological data and the incidence rate of human brucellosis during 2009-2015 were collected and their correlation was studied using Pearson’s correlation coefficient. Additionally, the multiple regression method and multi-layer perceptron neural network model were used to predict the incidence of human brucellosis. In order to analyze the data SPSS software (version 16.0), MATLAB software (version 8.1), and GIS software (version 10.4) were used.
    Results
    Pearson’s regression analysis, on a monthly basis, showed a significant indirect correlation between the incidence of human brucellosis (with a time lag of up to 5 months) and climatic parameters (minimum temperature: -0.72 and evaporation: -0.73) in Abadeh (Fars, Iran). Moreover, there was a significant direct correlation (P<0.001) between the incidence of human brucellosis and the maximum relative humidity (+0.67) and rainfall (+0.48). The incidence of human brucellosis in Abadeh was predicted by using artificial neural network models (4 layers, 4 neurons in each layer), the Levenberg-Marquardt training algorithm, and Sigmoid transfer function. It was determined that a correlation rate of 0.89 in the training level and 0.8 in the test level (with the lowest error rate) were the best values in multi-layer perceptron modeling.
    Conclusion
    Climatic parameters are important factors in determining the incidence rate of human brucellosis in Fars province. Climate conditions provide a favorable environment for the spread of human brucellosis in this area.
    Keywords: Brucellosis, Fars province, Climatic Parameters, Artificial neural networks
  • Carbin Joseph Danny Darlington *, Sathasivam Suresh Kumar, Sadasivan Jagdish, Magadi Gopalakrishna Sridhar Pages 474-482
    Background

    The impact of diabetic foot infections is enormous in India. Studies on vitamin D levels in diabetes mellitus foot infections are scarce. The primary objective of the present study was to compare the serum vitamin D level between diabetics with foot infections and those without foot infections and the secondary objective was to assess the association between the vitamin D level and the severity of foot infections and outcomes.

    Methods

    The study included 176 type 2 diabetics who attended Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India, between September 2012 and June 2014. The serum vitamin D level was measured for 88 diabetics with foot infections (Group 1) and 88 without foot infections (Group 2) using the ELISA 25OH vitamin D DIAsource kit (DIAsource ImmunoAssays S.A., Belgium) and compared. Both groups were followed up for 6 months for outcomes. The qualitative variables were analyzed using the χ2 test and the quantitative variables using the Student t test. The statistical analyses were performed using SPSS, version 17.0. A P value of less than 0.05 was considered significant.

    Results

    The mean serum vitamin D level was not significantly different between the two groups (P=0.306). Among the patients in Group 1 who either required amputations or died, 97.44% had subnormal vitamin D levels in contrast to 59.18% in those who were grafted or achieved wound healing (P=0.001). Among those who achieved wound healing within 6 months, 78.9% had normal vitamin D levels (P=0.0006).

    Conclusion

    The study found no significant difference in the serum level of vitamin D between diabetics with and without foot infections. However, vitamin D deficiency was associated with a poor outcome in diabetics with foot infections.

    Keywords: Amputations, Diabetic foot, Vitamin D deficiency
  • Kiran R. Kharat, Arun S. Kharat * Pages 483-492
    Background

    Calotropis gigantea (family: Asclepiadaceae) has been known to contain cardiac glycosides. The C. gigantea extracts have been reported as cytotoxic to a few cancer cell lines. The present study was designed to examine the effect of Calotropis gigantea methanolic extract (CGME) on the growth and apoptosis in human breast carcinoma cell line (MCF-7 cells).

    Methods

    The study was conducted in Aurangabad (India) from 16 February to 10 June 2015. CGME treated MCF-7 cells were analyzed for growth inhibition and apoptosis. The exhibition of phosphatidylserine was analyzed with the Annexin-V Fluorescein isothiocyanate flow cytometry (FITC) method. Accumulated poly-caspases were determined with carboxyfluorescein poly-caspase assay, Apo-BrdU™ tunnel assay for DNA fragmentation and pro/anti-apoptotic gene expression with real-time polymerase chain reaction. The high-performance liquid chromatography analysis indicated the presence of two unknown cardenolides along with known cardenolides such as calactin, calatropagenin, usharin, afroside, calatoxin, and gamphoside. The Kruskal-Wallis and Wilcoxon tests (GraphPad Prism version 7.0) were used for statistical analyses.

    Results

    Upon treatment with 40 µg/ml CGME, about 56.9% of the cell population underwent apoptosis. Compared to paclitaxel, the accumulation of active caspases in CGME treated with MCF-7 cells was found to be dose-dependent, whereas the G2/M cell cycle arrest was time-dependent. The Apo-BrdU™ tunnel assay confirmed that CGME treatment caused DNA fragmentation and RT-PCR analyses indicated elevated transcription for pro-apoptotic gene expression. Kruskal-Wallis test results were significant; Bcl-2 (P=0.00193), Bak-1 (P=0.00021), and Bax (P=0.0019).

    Conclusion

    CGME treatment caused the accumulation of phosphatidylserine on the cell membrane, recruitment of poly-caspases, DNA fragmentation, and enhanced transcription of pro-apoptotic gene expression.

    Keywords: Calotropis, apoptosis, Caspases, Apocynaceae
  • Ali Hosseini, Fatemeh Amiri, Fereshteh Khalighi, Amaneh Mohammadi Roushandeh, Yoshikazu Kuwahara, Hamed Bashiri, Mehryar Habibi Roudkenar * Pages 493-500
    Background
    Due to oxidative stress, hypoxia, and serum deprivation, a large percentage of mesenchymal stem cells (MSCs) die in the early stages of transplantation. The present study aimed to address whether induction or inhibition of autophagy would affect the viability of MSCs after exposure to oxidative stress.
    Methods
    MSCs were isolated from umbilical cord tissue using the Ficoll gradient method. pCMV-GFP-LC-3 plasmid containing GFP-tagged LC3 was transfected into MSCs to assay autophagy level in these valuable cells. The four study groups were: MSC-LC3-Rapa, MSC-LC3-3MA, MSCs without any transfection, and MSC-GFP-LC3 (control groups). To induce autophagy, the MSC-GFP-LC3 was treated with different concentrations of Rapa for 24 hours and named MSC-LC3-Rapa. To inhibit autophagy in MSC-GFP-LC3, these cells were cultured in the presence of 3MA for 24 hours and named MSC-LC3-3MA. Non-treated MSC-GFP-LC3 and MSCs were considered as control groups. MSCs were exposed to lethal doses of H2O2 followed by cell viability evaluation with the water-soluble tetrazolium salt assay method. The data were analyzed with SPSS version 18.0 using one-way ANOVA test. P
    Results
    The results revealed that the enhancement of autophagy in MSC-LC3-Rapa sensitized them against oxidative stress (P=0.0006) and inhibition of autophagy in MSC-LC3-3MA led to resistance against oxidative stress (P=0.0003).
    Conclusion
    Inhibition of autophagy, as a non-genetic engineering method, in MSCs enhances cell viability following exposure to the oxidative stress. This may provide a novel strategy to promote the efficiency of MSC-based cell therapy for clinical applications.
    Keywords: Mesenchymal stromal cells, Autophagy, Oxidative stress, Sirolimus, 3-methyladenine
  • Donya Firoozi, Ali Akbar Nekooeian, Nader Tanideh, Zohreh Mazloom *, Maral Mokhtari, Mohsen Mohammadi Sartang Pages 501-510
    Background
    Ulcerative colitis is an inflammatory disease with indefinite treatment. The present study aimed to assess the anti-inflammatory and antioxidant effects of Carum copticum L. (CC) extract on induced colitis in rats.
    Methods
    Sixty male rats were randomly divided into six groups (n=10 per group). Acetic acid-induced colitis rats were orally administered with doses of 100, 200, and 400 mg/kg CC extract, and 100 mg/kg sulfasalazine for seven consecutive days, respectively. Colonic biopsies were taken to measure histopathological parameters as well as the tumor necrosis factor (TNF-α), interleukin-6 (IL-6), myeloperoxidase (MPO), malondialdehyde (MDA), and glutathione (GSH). Data analysis was performed using the one-way ANOVA and Tukey’s test for normally distributed data. Kruskal-Wallis test followed by Dunn’s test was used for non-normally distributed data. The analysis was performed at P≤0.05 using SigmaStat software (version 10.0).
    Results
    The control colitis group had a significantly higher total colitis index (P=0.01), TNF-α (P=0.01), IL-6 (P=0.01), MPO (P=0.01), and MDA (P=0.01); and lower GSH (P=0.01) than those of the sham group. The colitis group receiving a dose of 200 mg/kg/day CC extract had a significantly lower total colitis index (P=0.01), TNF-α (P=0.01), IL-6 (P=0.01), MPO (P=0.01), and MDA (P=0.01); and higher GSH (P=0.01) than those of the control colitis group. The colitis group receiving a dose of 200 mg/kg/day CC extract had a significantly lower total colitis index (P=0.04), TNF-α (P=0.03), IL-6 (P=0.04), MPO (P=0.03), and MDA (P=0.03); and higher GSH (P=0.01) than those of the colitis group receiving sulfasalazine.
    Conclusion
    The present study revealed that CC extract had healing effects on colitis, possibly due to its antioxidant and anti-inflammatory properties.
    Keywords: Colitis, Ulcerative, Rats, Cytokines, Antioxidants, Anti-Inflammatory agents
  • Maryam Nasimi, Arghavan Azizpour, Azita Nikoo, Robabeh Abedini, Safoura Shakoei * Pages 511-514

    Bowen’s disease (BD) is a non-melanoma skin cancer with several histological subtypes. Herein we describe a case of a 35-year-old woman with a 4-cm diameter crusted plaque on the parietal scalp region. She had the lesion for 2 years. It had previously been histologically diagnosed as pemphigus vulgaris and only treated with a topical cream. The lesion progressively became thicker and larger. A new biopsy showed atypical cell proliferation through the whole thickness of the epidermis and follicular epithelium, with dermal microinvasion along with acantholysis and clear cell formation. The patient underwent total lesion excision (1 cm margin) with the diagnosis of both acantholytic and pagetoid subtypes of BD and dermal microinvasion. We describe a rare case of a young female patient with both subtypes of BD present in one lesion on an area not exposed to the sunlight. The lesion was initially misdiagnosed as pemphigus vulgaris.

    Keywords: Bowen’s disease, Pemphigus, Keratin-7, Skin neoplasms, Acantholysis
  • Seyed Mokhtar Esmaeilnejad Ganji, Behnam Baghianimoghadam * Pages 515-518

    Implantation metastasis occurs when tumor seeds into a wound or tissue by a significant amount of viable tumor cells. Here we describe the case of a 30-year-old man suffering from pain and swelling of the foot, which was misdiagnosed as a bone cyst. Surgery was performed involving curettage followed by bone grafting. After surgical pathology, the exact diagnosis was revealed as the synovial sarcoma (SS) of the foot. Implantation metastasis of SS in the iliac region, the grafting site, occurred 9 months post-surgery. Although there are a few reports on implantation metastasis of other types of tumoral lesions, to the best of our knowledge, we describe seeding of this type of tumor for the first time. Similar to other studies, we recommend that tumor surgeries should be carried out in a special setting to prevent any spread to or contamination of other sites by the tumor.

    Keywords: Sarcoma, Synovial, Neoplasm seeding, Medical errors