مجله دانشکده پزشکی اصفهان
پیاپی 559 (هفته سوم اسفند 1398)

The purpose of this study was to determine the effect of pretreatment of aerobic training on stress and inflammatory indices [heat shock protein-70 (HSP70), superoxide dismutase (SOD), malondialdehyde (MDA) and C-reactive protein (CRP)] induced by doxorubicin in lung tissue of aging male rats.

16 male rats were randomly divided into aging + doxorubicin (AD) and aging + doxorubicin + training (ADT) groups. The training group ran on a treadmill for three weeks at speeds of 15-17 m/minute for 25-39 minutes and five sessions a week. Subjects received doxorubicin (20 mg/kg) 24 hours after the last training session. The biopsy was taken 48 hours later. Data were analyzed using one-way ANOVA and Scheffe post hoc test via SPSS software.

Three weeks of the aerobic training only resulted in a significant increase of HSP70 and SOD, and decrease of MDA in the lung tissue in the training group compared to the control group.

Doing exercises before treatment with doxorubicin appear to be effective in elderly people, probably due to changes in the protective proteins of the cell in inhibiting or reducing oxidative damage.

Brachytherapy is used to treat cancer in a short distance with radiation from the radionuclide sources located inside the capsule. This type of treatment is directly treated with direct irradiation, in or near the treatment area; then the dose is continuously delivered to the tumor. In protocol of TG-43, we use air kerma strength, dose rate constant, radial dose function, and anisotropy function to calculate the distribution of doses around any linear source. The purpose of this study was to calculate and obtain dosimetric parameters for the cobalt-60 source, using the Geant4 code, and comparing with the reference calculations of the BEBIG cobalt source.

By using Geant4 code, cobalt source and water phantom were simulated for dosimetry calculations. The average energy of gamma rays in simulation was considered for gamma rays from cobalt-60 source.

The results of simulation performed by Monte Carlo Geant4 method was obtained in the form of dose distribution curves and important parameters in the dosimetry of brachytherapy, according to protocol recommendations of TG-43U1 with low error percentage. Moreover, dosimetric quantities including air kerma intensity, radial dose function, two-dimensional anisotropy function for angles of 0 to 90 degrees, dose rate constant, and optical density reduction were calculated. Dose rate constant was obtained as equal to 1.086 ± 0.003 cGyh-1</sup>U-1</sup>.

Calculations performed with the Geant4 code show a good agreement after comparing with BEBIG cobalt reference data. Dosimetric parameters obtained from the simulation based on the TG-43U1 protocol can be used in brachytherapy treatment design software.

Cutaneous leishmaniasis is an infectious disease caused by the protozoa of Leishmania genus, which cause serious public health issues in endemic regions across 80 countries. The disease outcome is influenced by interaction between the parasite and immune system of its human host. Here, we report two cases of unusual and </em>drug-resistant cutaneous leishmaniasis as an initial presentation of the underlying lymphoproliferative disorder.

Case Report:

Case 1 was a 43-year-old man with a history of cutaneous leishmaniasis presenting with an ulcerated and indurated plaque in proximity to the right eye along with ectropion, with multiple recurrences and resistance to multiple treatment plans. After multiple evaluations and hospitalizations, the patient was diagnosed with acute lymphoblastic leukemia (ALL). Case 2 was a 51-year-old man with a history of cutaneous leishmaniasis primarily presenting with an ulcerative papular lesion located on right forearm. The lesion was resistant to treatment, and two new ulcerated and indurated lesions appeared on the left ear and right zygoma with multiple recurrences and resistance to treatmen. During the course of treatment and further evaluations, chronic lymphocytic leukemia (CLL) was diagnosed.

This case report presents ALL and CLL as possible underlying causes for resistance and recurrences in cutaneous leishmaniasis. Giving special attention to the patients’ signs and symptoms, as well as a thorough physical examination with proper paraclinical evaluations in patients with treatment failure, can be the key to identify underlying disorders.