Journal of Kerman University of Medical Sciences
Volume:27 Issue: 4, Jul Aug 2020

Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity. Despite some improvements in treatment, the survival rate is still very low, mainly due to the possible development of secondary malignancy or metastasis. Clinical and pathological features as well as molecular biomarkers might predict the recurrence.In recent years, many studies have been carried out on molecular biomarkers that can predict the prognosis of OSCC. One of these markers is the epidermal growth factor receptor (EGFR), which has led to different results. The aim of this study was to determine EGFR level in OSCC and to analyze its correlation with clinicopathological features.

A total of 62 paraffin-embedded samples from OSCC patients treated in the oncology department of the Omid Hospital in the city of Mashhad, Iran were selected and EGFR staining was performed. The clinical and histopathological data were extracted from the medical records.

EGFR expression was positive in 98.4% of the cases. There was a significant difference between EGFR expression in the tumor and control cases in terms of cellularity and intensity (p˂0.001 and p=0.004, respectively). No statistically significant correlation was observed between EGFR and clinicopathological parameters. There was also no significant relationship between the cellularity and intensity expression of EGFR and patient survival (p=0.92 and p=0.42, respectively).

In view of the high EGFR expression in squamous cell carcinoma, further studies on the role of EGFR in cell processes such as proliferation, angiogenesis and differentiation of the tumor are recommended.

Cardiac rehabilitation program (CRP) is a useful method of modifying cardiovascular risk factors, improving life expectancy and quality of life in patients with ischemic heart disease (IHD). The present study was conducted to evaluate the effects of cardiac rehabilitation on the pulmonary artery systolic pressure (PASP) and left ventricular end-diastolic pressure (LVEDP).
This Quasi-experimental study with pretest-posttest design was conducted on 80 patients with IHD who had participated in CRP after undergoing coronary artery bypass graft (CABG) surgery. Echocardiography was performed before the beginning of CRP (the 1st session) and at the end of the rehabilitation sessions, and ventricular function indices (ejection fraction), PASP (using the tricuspid regurgitation velocity), and LVEDP (using Nagueh formula: 1.24×E/e´+1.9) were measured.
Ejection fraction (EF) was changed from 49.3 ± 7.8 before rehabilitation to 50.7 ± 7.4 after rehabilitation, which was a statistically significant difference (P=0.003). The pulmonary artery systolic pressure altered from 30.3 ± 8.4 before rehabilitation to 27.3 ± 6.6 after rehabilitation. The left ventricular end-diastolic pressure (LVEDP) changed from 10.5 ± 3.7 before rehabilitation to 9.1 ± 2.9 after rehabilitation, which was a statistically significant difference (P= 0.000).
According to the results, LVEDP and PASP in patients with IHD who underwent CABGs decreased after cardiac rehabilitation.

Metabolic flexibility is the capacity of a system to adjust fuel (primarily glucose and fatty acids) oxidation based on nutrient availability. Pyruvate Dehydrogenase Kinase 4 (PDK4) is one of the main enzymes that play a critical role in metabolic flexibility. In current study, we examined PDK4 inhibition along with exercise training (ET) on the gene expression of Estrogen related-receptor alpha (ERRα), medium-chain acyl-CoA dehydrogenase (MCAD), carnitine palmitoyl transferase-1b (CPT-1b), peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), PDK4 and citrate synthase (CS) in skeletal muscle.

Sixty-four male Wistar rats (8 week-old) were randomly divided into 8 groups (n=8); 1- untreated control, 2- STZ-induced diabetic, 3- PDK4 inhibition, 4- endurance training (ET), 5- diabetic + PDK4 inhibition, 6- diabetic + ET, 7- PDK4 inhibition + ET, and 8- diabetic +ET + PDK4 inhibition. ERRα, MCAD, CPT-1b, PGC-1α, PDK4 and CS genes expressions were measured by Real-Time PCR and quantified by 2-ΔΔCt method.

ERRα, MCAD, CPT-1b, PGC-1α, PDK4, and CS expressions were significantly higher in non-diabetic+ Endurance Training group compared to the control group. The expressions of CPT-1b, MCAD and CS genes were significantly lower in the non-diabetic+ endurance training/PDK4 inhibition compared to the non-diabetic+ endurance training group, and the expressions of ERRα, CPT-1b and MCAD were significantly lower in the diabetic + PDK4 inhibition group compared to the diabetic group.

In sum, PDK4 inhibition has negative effects on lipid metabolism in healthy rats, but in animals with diabetes, PDK4 inhibition can be used for improving lipid metabolism (over-expression of CS and PGC-1α).

Differentiation of Embryonic Stem Cells into Oocyte-like cells in vitro is challenging. Successful derivation of oocyte from stem cells can provide an alternative source for curing ovogenesis problems. The current study aims to demonstrate a new protocol with two different types of media for differentiating embryonic stem cells (ESCs) into oocyte-like cells (OLCs).

After culturing mouse ESCs, embryoid bodies (EBs) were generated from ESCs by hanging drop (HD) method. To final differentiation of oocyte-like cells (OLCs), the EBs were cultured in two different types of media for 12 days (first 7 days EBs were cultured in in vitro maturation diluted in Granulose Cell- Conditioned Medium and Follicular Fluid [1:1:1] followed by 5 days of culture in in vitro maturation diluted in uterine condition medium [1:1] ).

According tothe MTT test, the viability rate increased in the experimental group compared to the control EBs cultured alone. Expression of Oct4, as a pluripotency marker, decreased during the differentiation process of EBs in the experimental group. Co-culturing of EBs with our mentioned protocol increased germ cell markers (Stella and Mvh) and increased Oocyte-specific markers (ZP1, Figα and GDF9).

Our study introduces a promising in vitro protocol for achieving successful oogenesis through creating interactions of EBs with granulosa cells and uterine condition medium.

Lichen planus is an autoimmune disorder and is associated with other autoimmune diseases. There is, however, little evidence of the association of oral lichen planus with celiac disease. The aim of this work was to investigate, for the first time, such an association in patients in the city of Mashhad, Iran.
This case-control study was performed during October 2017 to March 2018 in the department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Mashhad University of Medical Sciences, in Iran. All participants were evaluated for Anti-TTG (IgA) and Total IgA, and in some cases for Anti-TTG IgG. Data were analyzed using SPSS software v.20.
A total of 96 subjects were considered in the study; 32 in the case group, and the rest in the control group. The mean value of Anti-TTG IgA was 0.12 ± 1.51 Au/ml in the oral lichen planus group, while it was 0.57 ± 1.20 Au/ml in the control group with no significant difference (P=0.167). The mean value of the Total IgA was 134.96 ± 42.86 mg/dl in the lichen planus group, and it was 129.85 ± 55.28 mg/dl in the control group, as they differ negligibly either (P=0.639). Moreover, celiac disease was not present in the population.
We showed that there was no celiac disease present in the oral lichen planus patients as well as healthy subjects. Further studies are required to imply or to rule out the association of oral lichen planus and celiac disease.

Troxerutin has antioxidant and anti-inflammatory properties and in this study, its antioxidant effect on the reduction of oxidative stress induced by ischemia-reperfusion sciatic nerve injury was investigated.
In this study, 64 male rats were randomly divided into 8 groups as follows: 1- IR2: ischemia (3 hours) and reperfusion (2 days), 2- Trox+IR2: ischemia (3 hours) and reperfusion (2 days), 3- IR7: ischemia (3 hours) and reperfusion (7 days), 4- Trox+IR7: ischemia (3 hours) and reperfusion (7 days), 5- IR14: ischemia (3 hours) and reperfusion (14 days), 6- Trox+IR14: ischemia (3 hours) and reperfusion (14 days), 7- IR28: ischemia (3 hours) and reperfusion (28 days), 8- Trox+IR28: ischemia (3 hours) and reperfusion (28 days). The rats received 150 mg/kg troxerutin in one injection (single dose). After separation of serum, biochemical parameters of the serums such as NO, PON1, CAT, and GPX were measured.
Troxerutin significantly increased the GPX and PON1 levels in groups that their reperfusion time was 2 and 14 days (P<0.05). There was no significant difference in the levels of NO and CAT between the groups received troxerutin and control groups (P>0.05).
Troxerutin relatively decreased the oxidative stress in the sciatic nerve ischemia-reperfusion injury by increasing the level of antioxidant enzymes.

Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. In the present study, the effect of Boswellia serrata (BS) on improvement of memory impairment in patients with MCI was investigated.

In this single-center randomized double-blind placebo-controlled clinical trial study, 118 patients with mild cognitive impairment (MCI) were included and randomly divided into two groups (case and control). Control group (n=59) received BS 300 mg/kg body weight twice a day and control group (n=59) received placebo for a period of three and six months. Montreal Cognitive Assessment (MoCA) test for detecting cognitive impairment was done at baseline, three and six months after the intervention.

A significant difference was reported in the MoCA mean score between the groups after three months (24.64 vs. 22.83) and six months of the intervention (25.22 vs. 22.7). Memory item had the greatest impact on the average final score (P≤0.0001).

BS has a significant effect on the improvement of memory impairment in patients with MCI. Further studies are required with higher doses of BS and longer duration of treatment to assess the effects of BS on memory of patients with MCI.

While anti-Müllerian hormone (AMH) level allows quantitative evaluation of ovarian reserve, its predictive value for live births following assisted reproductive technology cycles has remained controversial. The aim of the present study was to assess the importance of AMH in predicting live birth following intrauterine insemination (IUI) in the case of low or very low ovarian reserve.
In this retrospective cohort study, 123 patients with AMH≤1 ng/ml, who underwent a total of 137 IUI cycles were enrolled and evaluated for live birth rate. Patients were divided into two groups based on serum AMH levels: group 1 with low level of AMH (0.4-1 ng/ml, n=83, cycles: 95) and group 2 with very low level of AMH (≤0.4 ng/ml, n=40, cycles: 42). The results were compared between the two groups. Main outcome was the pregnancy rate.
The rates of biochemical pregnancy, clinical pregnancy and live birth in all patients were 11%, 8% and 7.3%, respectively. The two groups showed no significant difference in the rates of biochemical pregnancy (10.4% vs. 14.3%, p=0.3), clinical pregnancy (6.3% vs. 11.9%, p=0.2) and live birth (6.3% vs. 9.8%, p=0.5). In univariate regression analysis, baseline characteristics and ovarian stimulation parameters showed no significant relationship with the rates of pregnancy and live birth.
In women with AMH≤1 ng/ml, serum levels of AMH did not appear to reflect pregnancy outcomes and live births following IUI. It can be concluded that in women with low or very low levels of AMH, there is chance of pregnancy, and live birth following IUI.

Kawasaki disease is an acute inflammatory disorder of medium-sized arteries that predominantly affects cardiac coronary arteries and children under the age of 5 years. Cardiac involvement usually happens later than 10 days after the onset of illness. Most of cardiac complications are coronary artery abnormalities (ectasia or aneurysms) and subclinical myocarditis. Clinical myocarditis (symptomatic congestive heart failure), pericarditis, valvulitis and pericardial effusion, as well as pancarditis are rare. This paper reports a 5-year-old boy who had heart failure (ejection fraction 48%) in the acute stage of Kawasaki disease and pericarditis. He was admitted to the hospital following 3 days of continuous fever, bilateral cervical adenopathy and dominant right side neck of torticollis. The results of physical examination after 5 days showed typical Kawasaki disease. Cardiac examination also revealed cardiac murmur and gallop rhythm. In laboratory tests, mild liver dysfunction, hypoproteinemia and hyponatremia were discovered. During hospitalization, troponin levels were positive. The patient was treated with oral high dose aspirin (100 mg/kg/d), two doses of intravenous immunoglobulin (IVIG 2 gm/kg) and three pulses of methylprednisolone. Two weeks later, cardiac evolvements were improved without further complications. The patient exhibited dramatically clinical recovery and was healthy after 8 weeks of follow-up. This case indicates that Lymph-node-first presentation of Kawasaki disease could be examined in children with Kawasaki disease who exhibit symptoms of congestive cardiac failure, pericardial effusion and pericarditis during the acute phase of the disease.