فهرست مطالب

Medical Sciences - Volume:45 Issue:1, 2020
  • Volume:45 Issue:1, 2020
  • تاریخ انتشار: 1398/10/11
  • تعداد عناوین: 10
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  • Page 1
  • Nasrin Abolhasanpour, Sakineh Hajebrahimi, Abbas Ebrahimi Kalan, Ahmad Mehdipour, Hanieh Salehi Pourmehr * Pages 2-15

    Neurogenic bladder (NGB) secondary to spinal cord injury (SCI) is accompanied with several complications such as urinary tract deterioration, urinary incontinence, and consequently lower quality of life (QoL), significant morbidities, and occasionally death. Current therapeutic methods have some side effects and there is no treatment for the upper urinary tract injuries. Stem cell therapy is a promising method for treating this condition. However, the best timing and the best route of its transplantation have not yet been determined. Animal models of SCI, especially in rats, are the most commonly used method for evaluating the efficacy of cell therapy in NGB improvement, and the most common assessment method is the urodynamic studies (UDS). However, there are variations in the range of UDS parameters among the published studies. The current review aimed to discuss the effect of stem cell transplantation on bladder dysfunction recovery based on urodynamic parameters after SCI in rats. For this purpose, the cell source, doses, the route of administration, and the complete UDS equipment and its parameters were summarized in SCI models in rats. In some urodynamic test results, to some extent, an improvement in the lower urinary system function was observed in each treatment group. However, this improvement was far from full functional recovery. The average cell dose was about 1 million cells in every injected site. In most studies, the stem cells (SCs) were transplanted 9 days after the injury using PE-50 and PE-60. Many researchers have recommended further experimental and clinical studies to confirm this treatment modality.

    Keywords: Urodynamic, Spinal cord injuries, Urinary bladder, Neurogenic, Stem cell transplantation
  • Honeyeh Karami, Khodabakhsh Karami, Morteza Abdullatif Khafaie, Shahla Zahednejad, Ali Asghar Arastoo * Pages 16-22
    Background
    Vision plays an important role in supporting efficient locomotion. The present study aimed to measure the physiological cost index (PCI) and some kinematic parameters of preferred walking and jogging in blind and sighted students.
    Methods
    A cross-sectional study was conducted among blind (n=18) and sighted (n=27) students aged 8-16 years. The following parameters were measured during a standard test procedure: step length (meter), cadence (steps/min), mean speed (meter/min), and the PCI of preferred walking (PCIW) and jogging (PCIJ) over a distance of 100 meters.
    Results
    Univariate linear regression analysis revealed that the weight of an individual as well as the test duration were significant predictors of heart rate (HR) and PCI. Overall, the PCI (beats/meter) of sighted (PCIW=0.22±0.08 and PCIJ=0.24±0.07) and blind students (PCIW=0.27±0.07 and PCIJ=0.31±0.08) were significantly different (all P≤0.05). In addition, the speed of preferred walking (PW) in sighted students was significantly higher than that of the blind students (67±8 versus 62.8±9 m/min; all P≤0.05), while this difference was insignificant in jogging mode (105±9 versus 102±11 m/min).
    Conclusion
    Although the blind students were familiar with the ambient environment and the walking route, they demonstrated a different pattern of PW and jogging modes with respect to kinematic parameters. We also demonstrated that the blind students spent more energy (i.e., PCI) to achieve a lower or equal gait kinematics compared to the sighted students.
    Keywords: Walking, Jogging, Students, Physiological cost index, Kinematic parameters
  • Mohammad Reza Malekjamshidi, Hengameh Zandi, Fereshteh Eftekhar * Pages 23-31
    Background
    Community-acquired infections by multidrug-resistant (MDR), extended-spectrum β-lactamase (ESBL) producing Klebsiella species (Klebsiella spp.) is of major concern worldwide. Antibiotic resistance, production of extended-spectrum β-lactamases (ESBLs), and carbapenemases, as well as the presence of classes 1, 2, and 3 integrons in outpatient isolates of Klebsiella collected from Yazd central laboratory, Yazd, Iran.
    Methods
    We collected 250 Klebsiella isolates from Yazd central laboratory between August 2015 and October 2017. Antibiotic susceptibility was determined against 18 antibiotics by disc diffusion, and multidrug-resistant isolates were tested for ESBL production by the phenotypic confirmatory test according to CLSI 2017 protocols. The amplification of β-lactamase genes blaSHV, blaTEM, blaCTX-M, blaOXA-48, blaKPC, and blaNDM, classes 1, 2, and 3 integrase genes, was carried out using specific primers and polymerase chain reaction (PCR).
    Results
    Of the 250 Klebsiella outpatient isolates, 3.6% were K. oxytoca and the rest were K. pneumoniae. Disc diffusion showed that 21 (8.4%) isolates were MDR, 19 (90.4%) of which were ESBL producers including one K. oxytoca. The most prevalent β-lactamase gene was blaSHV followed by blaTEM and blaCTX-M, but blaOXA-48, blaKPC, and blaNDM were not detected. Class 1 integron was detected in 18 out of 21 MDR isolates (85.7%), but classes 2 and 3 were not observed. Two isolates were resistant to carbapenems and harbored blaSHV, blaTEM, and blaCTX-M, as well as class 1 integron.
    Conclusion
    ESBL production and the presence of multiple β-lactamase genes in MDR community isolates of Klebsiella spp. can have significant implications in terms of the spread of these opportunistic pathogens.
    Keywords: Klebsiella, Outpatients, Integrons, Drug resistance, microbial
  • Parisa Farzad, Reza Rahimi, Soltan Ahmad Ebrahimi, Frough Aghajani, Zahra Mousavi, Parvaneh Najafizadeh * Pages 32-40
    Background
    Antiepileptic drugs, such as sodium valproate (SV), are teratogenic as their usage by the pregnant mother has been associated with an increased risk of major congenital abnormalities in the fetus. In this study, the effects of voluntary exercise and prenatal exposure to SV on learning, memory, and anxiety in rats’ offspring are investigated.
    Methods
    In the present study, 70 female albino Wistar rats (200-240g) were used. The rats were categorized in seven groups: 1 and 2, pregnant rats with exposure to SV (10 mg/kg/day i.p) 3 and 4, pregnant rats with exposure to SV (20 mg/kg/day i.p) 5 and 6, pregnant rats with exposure to normal saline (0.4 ml/day i.p) and 7, pregnant rats with exposure to lamotrigine (20 mg/kg/day i.p). The even and odd groups were sedentary and voluntary exercise groups, respectively. Learning and memory were tested in male offspring using shuttle-box; anxiety was tested by elevated plus-maze (each group n=12). Statistical analyses were performed using the one-way ANOVA (the Tukey test) and/or two-way ANOVA on rank.
    Results
    The results showed that voluntary exercise in male rats caused improvement of latency and duration time in the dark box compared to sedentary groups (P=0.004). Moreover, the group administrated with 10 mg/kg SV showed better learning capability than the group administrated with 20 mg/kg SV. Voluntary exercise could also improve anxiety (P=0.001).
    Conclusion
    This study indicated that exercise could increase learning capacity and improve memories in rats’ offspring whose mothers were exposed to SV. Voluntary exercise could improve anxiety too, and the effect was dose-dependent.
    Keywords: Exercise, Valproate sodium, Epilepsy, Pregnancy
  • Azadeh Khalili, Shohreh Alipour, Mohammad Fathalipour, Azar Purkhosrow, Elaheh Mashghoolozekr, Gholamreza Bayat, Ali Akbar Nekooeian * Pages 41-49
    Background
    Liposomes constitute a promising drug delivery vehicle, and are believed to improve drugs’ effectiveness. This study was aimed to compare antihypertensive and vascular modifying activities of liposomal and non-liposomal forms of ascorbic acid.
    Methods
    Forty-nine male Sprague-Dawley rats were randomly divided into seven groups (n=7): A sham vehicle-receiving (Sham-veh), hypertensive (HTN), vehicle-receiving hypertensive (HTN-Veh), two liposomal Ascorbic acid-treated hypertensive at 50 or 100 mg/kg/day (LVC-50 and LVC-100), and two non-liposomal Ascorbic acid-treated hypertensive at 50 or 100 mg/kg/day (VC-50 and VC-100). Systolic blood pressure (SBP) and heart rate (HR) were measured weekly; after 4 weeks, dose-responses to phenylephrine (PE) in the absence and presence of nitro-L-arginine methyl ester (L-NAME), acetylcholine (Ach), and sodium nitroprusside (SNP) were obtained on aortic rings. Data were analyzed with one-way ANOVA and Duncan’s multiple range test at a P value of <0.05 using Sigmastat statistical software.
    Results
    Compared to the non-liposomal form, the liposomal one was associated with more prominent effects on the final SBP. Both forms of Ascorbic acid decreased SBP dose-dependently. The basal and stimulated release of Nitric Oxide (NO) was significantly recovered by both forms of Ascorbic acid. The PE maximal responses were not significantly different between the liposomal and non-liposomal groups (P=0.08). Although the Emax of Ach-relaxation response was not different in two preparation forms, Ach-relaxation response induced a lower concentration of the liposomal form of Ascorbic acid (P=0.03)
    Conclusion
    The liposomal Ascorbic acid exhibited relaxation activity in significantly lower concentrations. The observed effects were partly mediated by the increased basal release of NO.
    Keywords: liposomes, Ascorbic Acid, Rats, Hypertension, Nitric oxide
  • Saeid Afshar, Abdolazim Sedighi Pashaki, Rezvan Najafi, Safoora Nikzad, Razieh Amini, Nooshin Shabab, Omid Khiabanchian, Hamid Tanzadehpanah, Massoud Saidijam * Pages 50-58
    Background
    Usually, chemoradiotherapy can be used for the treatment of locally advanced colorectal cancer (CRC) before surgery. On the other hand, some studies have shown that fractional radiation of tumor cells leads to chemoresistance. The aim of this study was to evaluate the chemoresistance of radioresistant sub-line (RR sub-line).
    Methods
    This study was done in Hamadan University of Medical Sciences in 2017-2018. MTT assay and sub-G1 fraction analysis by flow cytometry were used to evaluate cross-resistance of RR sub-line to gefitinib and regorafenib. Real-time PCR was used to investigate the role of four miRNAs and their target genes in the cross-resistance of RR sub-line. The t test and repeated measures test were used for the assessment of statistical significance between groups.
    Results
    The IC50 of gefitinib and regorafenib for RR sub-line were significantly higher than those of the parental cell line. On the other hand, the resistance index of RR sub-line for gefitinib and regorafenib were 1.92 and 1.44, respectively. The sub-G1 fraction of RR sub-line following treatment with gefitinib and regorafenib was significantly lower than that of the parental cell line (P=0.012 and P=0.038, respectively). The expression of miR-9, Let-7e, and Let-7b in RRsub-line was significantly lower than that of the parental cell line. However, NRAS, IGF1R, NFKB1, and CCND1 found to be upregulated in RR sub-line in comparison with the parental cell line.
    Conclusion
    We can conclude that the acquired RR sub-line was cross-resistance to gefitinib and regorafenib. Furthermore, miR-9/NFKB1, let-7b/CCND1, let-7e/NRAS, and IGF1R played essential roles in the chemoradioresistance of CRC.
    Keywords: Colorectal neoplasms, Drug Resistance, MicroRNAs, Gefitinib, Regorafenib
  • Shokofeh Rahmani, Jamileh Saberzadeh, Mohammad Ali Takhshid * Pages 59-66
    Background
    Aluminum (Al) exposure is among the environmental risk factors that may involve in the pathogenesis of neurodegenerative diseases. Oxidative stress has a critical role in the Al-induced toxicity. Saffron is a plant with potent radical scavenging and anti-oxidative properties. This investigation was designed to evaluate the possible protective effects of saffron extract (SE) on aluminum maltolate (Almal)-induced oxidative stress and apoptosis in PC12 cell line.
    Methods
    In this in vitro study, PC12 cells were divided into four groups including control, Almal (500 µM), Almal+SE (50 μg/ml), and Almal+SE (100 μg/ml). After 48 hours of treatment with Almal in the absence and presence of SE, cell viability and apoptosis were determined using MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) assay and Annexin V flow cytometry, respectively. Catalase activity was determined as an index of oxidative stress. Statistical analyses were performed using one-way ANOVA (SPSS version 16.0). P<0.05 was accepted as a statistically significant difference between groups.
    Results
    Almal decreased the PC12 cells viability dose-dependently (IC50=500µM). Co-treatment of 50 and 100 μg/ml of SE with 500 µM of Al increased cell viability to 79% (P=0.04) and 86% (P=0.02) of the control group, respectively. Al also increased PC12 cells apoptosis and catalase activity to 37 and 2.7 folds of those of the control group (P<0.001 and =0.001respectively). 100 μg/ml of SE blunted the effects of Al on the increased cell apoptosis (P=0.02) and changes in the catalase activity (P=0.003).
    Conclusion
    SE has protective effects against Al-induced apoptosis and oxidative stress and may possess therapeutic values in the treatment of Al-neurotoxicity.
    Keywords: Aluminum maltolate, Crocus, PC12 cells, apoptosis, Oxidative stress
  • Alireza Tabibkhooei, Arash Fattahi *, Ali Rostami Pages 67-72

    Hemangioblastoma (HB) in the supratentorial region of the brain is rare and only a few cases are reported on intraventricular HB. HB of the lateral ventricles is even rarer. We present a case of a 30-year-old man with generalized tonic clonic seizures. The brain computed tomography showed a 5.5 cm heterogeneous mass extending into both lateral ventricles with partial enhancement. Based on the size and imaging features, we present the fourth documented case of a large solitary intraventricular HB. Our approach to this unique case and some treatment complexities are also described.Considering the rarity of the case and the patient’s imaging features, the present study provides a better understanding of HB and recommends HB to be considered in the differential diagnosis of masses in the lateral ventricles. In addition, some preventable pitfalls in the treatment of such complex cases are described.

    Keywords: Hemangioblastoma, Solitary, Lateral ventricle, Magnetic Resonance Imaging, Hydrocephalus, Seizure
  • Narjes Saberi, Farshad Gholipour * Pages 73-75

    Labial adhesion (LA) is a rare clinical entity in postmenopausal women. Estrogen deficiency and lack of sexual activity are probable contributing causes. Voiding dysfunction due to LA is even rarer in postmenopausal women, and only a few studies have previously reported such occurrence. A 62-year-old virgin postmenopausal woman presented to the Al-Zahra Hospital (Isfahan, Iran) with a 5-year history of voiding dysfunction and recurrent urinary tract infection. Despite multiple medical visits, no genital examination was ever performed by a medical practitioner, mainly due to the patient’s refusal to be examined by a male physician. On physical examination, we observed extensive LA with only a small opening. Surgical separation of the labia was performed and subsequently, the urinary tract symptoms were completely resolved. Herein, we present a case of LA causing urinary problems in a virgin postmenopausal woman. The case underlines the importance of the genital examination of female patients with urinary tract symptoms.

    Keywords: Female genitalia, Urinary Tract Infection, Physical examination, Postmenopause, Lower urinary tract symptoms