Acta Medica Iranica
Volume:60 Issue: 2, Feb 2022

A predominant challenge in the discovery approach to curative leukemia is investigating the effect of mesenchymal stem cells (MSCs) on leukemic cells. We aimed to investigate the role of MSCs in targeting telomerase enzyme and consequently telomere length of leukemic cells. For this purpose, the KG1 cell as leukemia cell line was co-cultured with MSCs in the trans-well system. After seven days of co-culture, KG1 cells were collected, and telomerase activity, telomere length, and hTERT gene expression were analyzed by PCR-ELISA TRAP assay and real-time PCR, respectively. Also, the potentially involved ERK pathway was analyzed at gene and protein levels by real time PCR and flow cytometry, respectively. It was found that MSCs caused a significant decrease in telomerase activity, telomere length, and hTERT gene expression. The following results showed that MSCs resulted in a significant decrease in the ERK expression levels. It can be concluded that the co-culture of MSCs with KG1 cells be involved in the telomerase targeting via ERK signaling pathways. This study concluded that the co-culture of MSCs with AML leukemic cells could secrete a significant amount of cytokines that cause to inhibit the proliferation of AML cell lines via ERK signaling pathway. The recognition of cytokines as well as growth factors involved in the anti-proliferative effect of MSCs requires further investigation. This effect as a therapeutic strategy could be considered in the basic experimental studies.

Thyroid nodule elastography has been exceedingly used for the differentiation of benign and malignant nodules. Determination of confounding factors of the results of sonoelastography in thyroid nodules when assessing the probability of malignancy is an issue of importance, and this matter needs further research. In this study, the contributing factors to the results of strain sonoelastography in cases of thyroid nodules were assessed in order to help the clinicians for better management and decision making. In this diagnostic study in Taleghani Hospital, Tehran, Iran, in 2018 and 2019, a total of 92 consecutive patients with thyroid nodules were assessed by grayscale ultrasound and strain sonoelastogaphy, and the contributing factors to the results of sonoelastography were determined according to low and high malignancy probability elasticity scores. The results in this study demonstrated that there were 57 cases (62%) with low probability scores and 35 patients (38%) with high probability scores according to strain sonoelastogaphy. The patient’s age and nodule grayscale characteristics such as shape, echogenicity, margin, composition, size, and calcification were not related to sonoelastography results (P>0.05). This study showed that results of sonoelastography are not related to demographic factors and gray-scale sonographic features of the nodules.

Accumulating evidence suggests the potential use of chloroquine, an anti-malaria medication, as a neuroprotective agent. Moreover, several studies have reported that the endogenous opioids and nitric oxide (NO) may mediate the chloroquine’s effects. In the present study, effects of chloroquine on hyoscine-induced memory impairment were assessed. Furthermore, the possible involvements of opioids and NO were evaluated. Chloroquine was administered intraperitonially (i.p.) at doses of 0.1, 0.5, 1, 3, 10, and 20 mg/kg to hyoscine-treated (1mg/kg, i.p.) mice, and the spatial and fear memories were evaluated using Y-maze and passive-avoidance tasks, respectively. Also, to provide further evidence about chloroquine’s mechanism of action, the opioid receptors and the NO production were blocked using two nonselective antagonist’s naltrexone and L-NAME, respectively. Chloroquine at doses of  0.5, 10 and 20 mg/kg furtherly damaged the impaired memory of hyoscine-treated mice and at doses of 10 and 20 mg/kg impaired the memory of saline-treated mice in the passive-avoidance task. Additionally, chloroquine at doses of 0.5 and 1 mg/kg improved the spatial memory in hyoscine-treated mice in Y-maze test. In addition, naltrexone (3 mg/kg) reversed the neuroprotective effect of chloroquine (1 mg/kg) in hyoscine-treated mice in Y-maze task. It could be concluded that chloroquine at low doses may improve cognitive performances by involving the opioid receptors; as a result, blocking the opioid receptors may reverse chloroquine’s neuroprotective effect. Notably, chloroquine at high doses did not improve the memory and in combination with hyoscine, it caused even more damage to the long-term memory.

Vimentin is a cellular marker that has recently been considered in the prognosis of colorectal cancer (CRC), and its expression appears to indicate increased malignancy. The aim of this study was to investigate the expression of vimentin in CRC patients and its association with prognostic factors. This retrospective study was performed on CRC patients who had undergone colectomy at Imam Khomeini Hospital, Ahvaz, Iran, in 2019 and 2020. Data around the microscopic degree of the tumor differentiation and the status of lymph node involvement were extracted from the patients' pathology reports. Immunohistochemistry staining for vimentin was performed on biopsy specimens, and its expression was assessed and compared in both CRC specimens and normal colon tissues. Appropriate statistics were used with P<0.05 considered as statistically significant. Out of 31 CRC patients, vimentin expression was moderate-positive in 20 (64.5%) and strong-positive in 11 patients (35.5%). Mean percentage of stained cells, the intensity of staining, and vimentin expression in the immunohistochemistry evaluations had no significant relationship with tumor grade and tumor invasion rate (P>0.05), but they showed a significant relationship with lymph node involvement (P<0.05) and mean percentage of stained cells, the intensity of staining, and expression of vimentin marker increased with increasing lymph node involvement. In the normal tissue samples, 5 out of 30 samples showed weak-to-moderate vimentin expression. Vimentin expression was significantly associated with lymph node involvement; however, further studies with larger sample sizes are required to determine its probable association with other prognostic variables.

The aim of this non-randomized clinical trial was to evaluate tumor outcomes and subjective quality of voice following radiotherapy and partial laryngectomy in early-stage glottic laryngeal cancers. Non-Randomized Clinical Trial. Otolaryngology and radiation oncology clinics of Imam Khomeini (an affiliated hospital of Tehran University of Medical Sciences) and Amir Aalam Hospitals. Fifteen patients with early-stage glottic laryngeal carcinoma were admitted to the otolaryngology clinic, divided into two treatment groups: radiotherapy and partial laryngectomy. Of the total 50 patients, 25 had a partial laryngectomy and 25 radiotherapies. The comparison of the average of the Voice Handicap Index (VHI) showed significant improvement of vocal quality after treatment for both partial laryngectomy and radiotherapy (P<0.0001 for both). But there was no significant difference in VHI mean scores between the two treatment groups (patients treated by partial laryngectomy and radiotherapy). Short- and long-term complication was higher in patients undergoing surgery than radiotherapy group (P<0.0001). With regard to oncological outcome after one and eight-year after treatment, no differences were observed in the two treatment groups; there was a significant relationship between smoking cessation and recurrence of disease in the partial laryngectomy treatment group (P=0.012). There was no significant difference in voice quality and life expectancy of patients operated on using open surgery and patients treated with radiotherapy in this series. Open surgery may have more noticeable complications than radiotherapy.

Thyroid hormones play an important role in several metabolic pathways including glucose and lipid metabolism and may cause metabolic syndrome. Both hypothyroidism and metabolic syndrome are common in Syrian population. This study was done to evaluate the metabolic syndrome in two types of hypothyroidism and the effect of TSH levels on its occurrence. A retrospective cross-sectional study was performed of 91 patients with overt hypothyroidism, 31 patients with subclinical hypothyroidism without clinical symptoms and 53 controls without thyroid disorders. Metabolic syndrome was defined as per International Diabetes Federation(IDF) criteria which are defined as central obesity based on race- and gender-specific WC cutoffs (Waist circumference (WC) ≥ 94cm for male , WC ≥ 80cm for female) plus any two of the following four parameters: (Raised triglycerides: ≥150 mg/dl (1.7 mmol/l) or history of specific treatment for this lipid abnormality, Reduced HDL cholesterol: < 40 mg/dl (1.03 mmol/l) in males and < 50 mg/dl (1.29 mmol/l) in females or history of specific treatment for this lipid abnormality, Raised blood pressure: systolic BP ≥130 mm Hg or diastolic BP ≥85 mm Hg or on treatment for previously diagnosed hypertension and Raised FPG: ≥ 100 mg/dl or previously diagnosed type 2 Diabetes mellitus In conclusion, our study showed significant association between overt hypothyroidism and metabolic syndrome. It also revealed that TSH level over 2.5 uIU‎/ml significantly increases the risk of the metabolic syndrome.

Diabetes mellitus (DM) is a chronic disease caused by pancreas failure in processing or producing enough insulin in the body. An estimated 20-40% of people with DM will experience complications of kidney failure. DM patients who experience complications of kidney failure should undergo hemodialysis (HD) therapy. This study aims to assess the survival time of DM patients with HD at Rumah Sakit Islam (RSI) Jemursari, Surabaya, Indonesia, in 2016-2019. The study used secondary data in the form of electronic medical records of DM patients with HD who were registered at RSI Jemursari from 2016 to 2019. Survival analysis with the Kaplan Meier and Cox Regression methods is used as data analysis. The data were 126 DM patients with HD. DM patients with the majority of HDs have the following criteria: over than 50-year-old, male, housewives, having previous hypertension and heart disease records, having no previous lung disease records. The average survival time of DM patients with HD is 182 weeks. Subjects with the criteria as follows: male patients, working, having previous hypertension records, having no previous lung and heart disease records, have a higher survival time. Age has a significant effect (P=0.004) on the survival of DM patients with HD. The risk of patients' death increases by 1.07 times as the age increase by one year.

Knee osteoarthritis (OA) is a common osteoarticular disease. Its prevalence increases with age, as well as the coexistence of other chronic diseases. Recent research has revealed an association between OA and cardiovascular diseases. However, the association between knee OA and comorbidities has not been fully studied. Therefore, the purpose of this study was to investigate the association between knee OA and comorbidities. In this cross-sectional study, patients with knee OA were enrolled. Sociodemographic data, as well as comorbidities, were collected. Grading of knee OA was performed using the Kellgren-Lawrence (KL) grading system. The functional impact of knee OA was assessed by KOOS-Physical Function Shortform (KOOS-PS). This study assessed 104 patients with knee OA (10 men and 94 women). The mean age was 65.83±11.08 years. Mean VAS pain was 6.56±1.72. Mean KOOS-PS was 15.58±6.73. Up to 81 patients (77.9%) had severe knee OA, according to the KL grading system. Comorbidity was noted in 92 cases (88%). The most frequent comorbidities were obesity (62.5%), hypertension (61.5%), and dyslipidemia (43.3%). Comorbidities in knee OA were associated with age (P=0.04), axial deviation in the sagittal plane (P=0.01), neuropathic pain component (P=0.02), and VAS pain (P=0.04). Our study also showed a significant correlation between comorbidities and structural grading of knee OA (P=0.04). However, comorbidities were not correlated with the KOOS-PS score (P=0.06). The accumulation of comorbidities is significantly associated with higher intensity scores in knee OA. Physicians should additionally pay close attention to the prevention and treatment of comorbidities in the routine management of OA.

We describe the case of a 7-year-old boy who presented with suprasternal swelling. The chest computed tomography scan showed a large mass of mediastinum. Biopsy from the mediastinal mass was performed. Histologic and immunohistochemistry findings were consistent with Langerhans cell histiocytosis [LCH]. LCH should also be considered in the differential diagnosis of anterior mediastinal tumor in children.

Ever since the new coronavirus has become the cause of the COVID-19 pandemic, it has manifested with unknown and new presentations. In this report, we are presenting a 46-year-old female infected with COVID-19 (confirmed by RT-PCR nasal swab test) and a known case of Diabetes mellites type 2 who had a history of ICU admission due to COVID-19 with uncontrolled diabetes mellites. In the second admission after recovery, she had blurred vision. Fundus examination revealed multiple yellow-white well-demarcated nonpigmented masses. Diagnosis of the multiple subretinal abscesses was confirmed. KOH-Calcofluor staining of vitreous fluid was negative for fungal infections of the eye. No polymorphonuclear leukocytes (PMN), epithelial cells nor any organisms were detected. The patient was treated with an injection of the intravitreal Amphotericin B 10 µg/0.1cc.  To our knowledge, the presented case is the first case of the subretinal abscess after covid-19 infection.