نشریه پژوهش در پزشکی
سال چهل و ششم شماره 4 (پیاپی 184، زمستان 1401)

Pituitary adenomas account for 12-15 % of intracranial neoplasms. Visual impairment is usually the most common objective symptom in these tumors. Diffusion Tensor Imaging (DTI) is a non– invasive MRI that illustrates the white matter pathways. In the current study, our goal was to use DTI to quantitatively assessthe visual impairment and to predict visual improvement.

In this before and after treatment study, the total of 20 patients with pituitary macroadenoma who complained of visual impairment underwent ETSS surgery between 2018 and2021. Conventional MRI, DTI and Neuroophthalmological examination were performed for 20 patients intwo periods: preoperative and 3 months after surgery. We evaluated the effects of tumor size, duration of symptoms, and age on visual improvement.

The total of 20 patients including nine (45%) women and eleven (55%) men. The meanean age of the patients was 39 ± 13 yearsrangingranged from 16 to 60 years. The mean tumor size was 9.24 ±4.59 mm3 ranging from 4.02 to 21.03 mm3. The mean symptoms duration was 18.6 ± 12.9 weeks. All patients with visual field analysis by mean deviation (MD) on Humphrey visual chart showed visual recovery.
The FA and MD parameters in DTI showed both improvement and reduction of myelin axon damages. The degree of mean deviation was significantly correlated with the Fractional anisotropy (FA) (P-value<0.05) but not with mean diffusivity in DTI analysis.

The present study showed that DTI could be implicated as a tool for quantitative assessment of visual impairment and invisual field defects, in particular. According to the findings, between two parameters of fractional anisotropy and mean diffusivity, FA is most closely related to tumor size and visual field defects. FA before surgery could be used as a measure to predict the extent of visual improvement after ETSS surgery.

Functional magnetic resonance imaging (fMRI) has been widely used for pre-neurosurgical planning and may eventually become a routine pre- surgical imaging modality. The validity of fMRI for the clinical application depends on various factors such as proper task selection, correct statistical analysis, and threshold setting with appropriate patient cooperation. To compare the potential of five functional magnetic resonance imaging (fMRI) language paradigms in activating language areas in Persian-speaking volunteers in order to optimize these tasks for clinically useful protocol.

16 healthy right-handed Persian-speaking volunteers were studied. Each individual performed five tasks during the fMRI scan: word generation (WG), object naming (ON), word reading (WR), word production (WP), and reverse word reading (RWR). In the current study's first phase, each task's ability to activate classical language areas was assessed using group analysis. In addition, the lateralization index (LI) for each subject-task was calculated and compared. In the second phase, the optimized protocol was assessed on 40 patients with different types of brain mass lesions or hippocampal sclerosis to assess the role of appropriate patient selection for achieving a reliable fMRI result.

We found that WP, RWR, and WG robustly activated language-related areas in the dominant hemisphere. ON and WR failed to sufficiently delineate these activation areas. The highest activation intensities in the frontal lobe (including Broca's area) were seen with WP, whereas RWR showed the highest LI among all examined tasks. In the patient population, we found that accurate and reproducible fMRI strongly depends on the patient’s cooperation. In present study, we observed that a pre-test mock fMRI session held by a radiologist might help to predict which patients are more or less suitable candidates for fMRI.

Our results demonstrated that the Persian version of WG and newly presented WP and RWR tasks could be reliably used for the localization of language-related areas in Persian speakers. This type of language evaluation also can be used in the pre-surgical planning of neurosurgical procedures in the Persian population. We recommend the application of WP and RWR in routine clinical practice to avoid significant morbidities after brain lesion surgery.

Spermatogonial stem cells have the ability to self-renewal and differentiation and can transmit genetic traits to the next generation. Therefore, establishing an appropriate culture medium for this cell line is important. The aim of this study was to determine the effect of different concentrations of L-arginine on sheep spermatogonial stem cells colony formation in-vitro.

An experimental study was conducted. Each treatment was replicated five times. Spermatogonial cells were isolated from prepubertal lamb’s testis using two-step enzymatic digestion. The cells were cultured for ten days in six groups. In the control group, a simple culture of spermatogonial cells was performed in DMEM containing 1% antibiotics and 5% FBS. In the treatment groups 1, 2, 3, 4, and 5 different concentrations of L-arginine (50, 100, 200, 500, and 1000 μmol/L), was added to the culture medium, respectively. The culture media were changed every three days. Identification of cells was confirmed by immunocytochemical staining against PGP9.5 and PLZF antigens. Immediately after isolation, the percentage of cells viability, number, and surface area of colonies formed on the 4th, 7th, and 10th days after the culture, were assessed by an inverted microscope. Data were analyzed using one- way ANOVA test. P<0.05 was considered statistically significant.

The findings indicated that the viability rate of spermatogonial cells after isolation was 89.28 ± 1.4%. Isolated cells expressed PGP9.5 and PLZF antigens. Also, on day 10 after culture and in treatment 4 (200 μmol/L L- arginine); the number (160.8 ± 21.1) and surface area (5.4 ± 1.3) spermatogonial cells colonies had a significant increase compared to other groups (P<0.05).

It seems that the addition of L- arginine at a dose of 200 μmol/L has a positive effect on the induction of spermatogonial stem cells colonization and can provide an appropriate culture medium in vitro.

With increasing age, degenerative changes in testicular tissue can be seen along with a decrease in sperm quality. Among the factors that have a toxic effect on sperm quality is the increase of oxygen free radicals by cadmium chloride, the low amount of which is necessary for sperm to acquire fertility. Nanoselenium as a strong antioxidant is able to neutralize free radicals. The aim of this study was to investigate the effect of nanoselenium on oxidative status in cadmium chloride induced infertility in adult male Wistar rats.

In this experimental study, 48 adults male Wistar rats were randomly divided into eight groups including: healthy, experimentally healthy, receiving nanoselenium (0.05, 0.1, 0.2 mg/kg body weight), infertile control, receiving cadmium chloride, experimental infertile Cadmium chloride,and nano- selenium recipients (0.05, 0.1, 0.2 mg/kg body weight). The duration of treatment was 30 days. At the end of the treatment, the animals were anesthetized and the testicular tissue of the rats was removed immediately. The testes were homogenized and malondialdehyde (MDA), levels and activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) enzymes were measured. Finally,The results were analyzed using two-way ANOVA.

The results of the present study showed that the amount of MDA in the group treated with cadmium chloride increased significantly compared to the control group (3.88 ± 0.34) (p˂0.05). The results also indicated that the antioxidant power of testicular tissue in the group treated with cadmium chloride was significantly reduced compared to the healthy control group (p˂0.05).Moreover, nanoselenium treatment in infertile animals at doses of 0.1 and 0.2 mg/kg improved the oxidative stress parameters compared to the infertile control group.

It seems that nanoselenium, as a strong antioxidant, can inhibit the destructive effects of cadmium chloride on lipid peroxidation and the antioxidant power of testicular tissue.

Non- alcoholic fatty liver disease is characterized by fat deposition in liver cells and, if not controlled, may cause fibrosis, cirrhosis, and cell destruction of the liver. Sports activity is one of the contributing factors in the recovery of non-alcoholic fatty liver patients. The aim of this study was to investigate the effect of eight weeks of high- intensity interval training (HIIT) on serum levels of adiponectin, irisin, and lipid profile in women with non- alcoholic fatty liver disease.

In this experimental clinical trial, 25 women with non-alcoholic fatty liver disease with an age range of    30-50 years were selected as a statistical sample based on the inclusion criteria and randomly divided into two exercise groups (13 people) and control groups (12 people). Intense interval training was performed for 8 weeks (four sessions per week and each session lasting 48 to 60 minutes). Blood samples were taken before and after the test to measure the levels of adiponectin, irisin, and lipid profile. Statistical analysis of the data was done using independent t- test and correlated t- test using spss21 software at a significance level of p<0.05.

The results showed that after training intervention, the serum levels of adiponectin (p= 0.049), irisin  (p= 0.004), and HDL (p= 0.005) significantly increased, and LDL (p= 0.001), TG (p= 0.001), TC (p= 0.001) had a significant decrease in the exercise group compared to the control group (p≥0.05).

Considering the positive effects of HIIT on serum levels of irisin, adiponectin, and lipid profile in patients with non- alcoholic fatty liver, it seems that these exercises can be recommended as a non- pharmacological treatment to improve these patients.

unpleasant sensory pain associated with tissue, and Neurological pain in MS is related to the central nervous system. The quality of life is also a multidimensional intrinsic factor that affects a person's physical and mental condition. The aim of this study was to investigate the effect of eight weeks of exercise in water, land, and the combination of water and land by the Burdenko method on pain and quality of life in women with MS.

In the present clinical trial study, 31 women with MS in the age range of 30-50 years and EDSS < 4.5 were divided into three groups in different training environments by the Burdenko method for 12 weeks. Pain rate was measured by the Visual Analogue Scale (VAS), and quality of life was measured by the Short Form 36 Health Survey (SF-36). The results of the Kruskal- Wallis test at the error level of 0.05.

Our findings showed no significant difference between the three training intervention groups in the pre- test in the variables of pain and quality of life (P > 0.05). In order to investigate the effectiveness of exercises in reducing pain and increasing the quality of life in different training environments, before and after comparisons were made. The paired Wilcoxon test showed that in each training group, there was a significant decrease in pain and a significant increase in quality of life compared to the pre-test (P < 0.05). Also, post- test demonstratedthat there is no significant difference in pain and quality of life between the three types of training environments using the Kruskal- Wallis’s test (P > 0.05).

All of these training environments including water, land, and water-land combined, can be effective in reducing pain and increasing the physical and mental quality of MS patients. Also, there is no significant difference between various training environments, and patients could benefit from any training environment available for them.

Obesity and gaining weight lead to dysfunction in adipose tissue metabolism, reduced blood flow, and increased hypoxia. On the other hand, exercise training has been identified as complementary medicine, convenient and efficient. This study aimed to compare the effects of eight weeks of high- intensity interval training (HIIT) and low- intensity continuous training (LIET) on the expression of HIF-1α and FSP27 genes in adipose tissue of overweight male rats. This study was conducted in 1399 at Royan Biotechnology Research Institute in Isfahan city.

In the present experimental study, 40 male Wistar rats weighing 155.4 ± 24.6 g were randomly divided into four groups at five weeks of age. The control group, HIIT and LIET, consumed high- fat food for 16 weeks, and the sham group consumed standard food. The HIIT group performed high- intensity exercise, and the LIET group performed low- intensity exercise. Finally, the expression of HIF-1α and the FSP27 gene of adipose tissue isolated from mice were measured by real- time PCR.

There was a significant difference in the expression of HIF-1α and FSP27 between the study groups (P= 0.001). The expression of the HIF-1α gene in the HIIT group (P= 0.003) and LIET group (P= 0.001) decreased by 3.3- fold compared to the control group. Also, the expression level of FSP27 between the control group and HIIT group (P= 0.016) and LIET (P= 0.042) decreased by 0.3 fold.

A high- fat diet has significantly increased the weight of rats and caused obesity. Moreover,  high- intensity and low- intensity endurance training decreased the expression level of the HIF-1α and FSP27 in adipose tissue. Furthermore, these training protocols improved the metabolism and function of adipocyte fat drop.

Inflammation is the immune system’s primary response to harmful stimuli. The aim of this study was to evaluate the effect of ethanolic extract of mentha pulegium on the expression of pro- inflammatory mediators of iNOS and NF-κB in mononuclear cells isolated from human peripheral blood activated with lipopolysaccharide.

In this experimental study, mononuclear cells of 12 individuals with no history of specific disease were used. In the first group: PBS buffer was added to the culture media. Group 2: Lipopolysaccharide was used to stimulate inflammation at a concentration of 10 ng/ ml (19). Group 3: After stimulation with lipopolysaccharide, a concentration of 10 μg / ml ethanolic extract of mentha pulegium was used in the culture medium. Group 4: After stimulation with lipopolysaccharide, a concentration of 30 μg / ml ethanolic extract of mentha pulegium was used. Group 5: After stimulation with lipopolysaccharide, a concentration of 60 μg / ml ethanolic extract of mentha pulegium was used. Then, the expression of iNOS and NF-KB pro- inflammatory mediators in different groups wasmeasured. Data analysis was performed using SPSS software with one-way ANOVA analysis and Tukey supplementary test.

The results of the present study showedthat the expression of NF-κB gene in the second group (1.09 ± 0.14) significantly increased compared to the first group (P˂0.05). Moreover, NF-κB gene expression was significantly lower in the third group (0.48 ± 0.09), the fourth group (0.54 ± 0.13), and the fifth group (0.66 ± 0.24) compared to the second group (P˂0.05).In addition,, iNOS gene expression in the second group (1.14 ± 0.22) showed a significant increase compared to the first group (P˂0.05). The expression of iNOS gene in the third group (0.35 ± 0.24) and the fourth group (0.29 ± 0.07) was not significantly different from the second group (P˂0.05).

The results of the present study indicated that the Ethanolic extract of mentha pulegium has  anti- inflammatory effects and can be effective in altering the expression of pro- inflammatory mediators iNOS and     NF-κB in mononuclear cells isolated from human peripheral blood activated with lipopolysaccharide.

Although the degeneration of nucleus pulposus cells (NPCs) is one of the main causes of intervertebral disc degeneration, the molecular complications of this disease have yet to be clarified. The ability of stem cells to differentiate into different types of cells, especially NPCs, has attracted much attention. This study aimed to investigate the role of genes with differential expressions in stem cell differentiation into NPCs and to identify the salient signaling pathways involved. Since there has not been an extensive study on the important genes of NPC cell differentiation, it is necessary to investigate this process.  

RNA- sequencing raw files of stem cell samples and differentiated NPCs with the accession number GSE122429 from the GEO database. The samples were analyzed, and genes with differential expressions were isolated in the R programming language with the Limma package via logarithmic fold changes (logFC) ≠3 and adjusted   P-values < 0.05. Functional analysis was conducted on the signaling pathways and biological processes of the differentially expressed genes using the Enrichr database.

In NPCs, 170 genes were upregulated, and 102 genes were downregulated. The functional analysis revealed that the differentially expressed genes were mostly involved in the extracellular matrix organization, collagen organization, and positive cellular processes. The study of signaling pathways identified the neural crest differentiation pathway as the most significant pathway in the evaluated samples. Considering logFC ≠3, overexpression was detected in MSX2, OLIG3, WNT3A, TWIST1, PAX3, RHOB, CDH6, COL2A1, CDH1, ZIC1, PMP22, SNAI2, and MSX1, all of which are involved in the neural crest differentiation pathway.

Our results should expand the knowledge of the molecular pathways involved in stem cell differentiation into NPCs and proffer new clues to the treatment of intervertebral disc degeneration. Nonetheless, more detailed molecular studies are needed to determine the reliable biomarkers of NPCs

Polycystic ovary syndrome (PCOS) is associated with an increased cardiovascular disease (CVD) risk. Pdis and QTdis are simple and useful electrocardiographic markers that may be used in the prediction of the risk of adverse cardiovascular events in PCOS patients. The main purpose of present study was to evaluate the effect of eight weeks of moderate-intensity aerobic training (MICT) on Pdis and QTdis as biomarkers of adverse cardiovascular events in women with PCOS.

30 females with PCOS aged between 18 and 40 years were randomly dividedinto an eight- week MICT anda control group. The MICT program included eight weekly sessions (three sessions a week). Electrocardiography was performed the day before the intervenion, and 48 hours after the last exercise session. A cardiologist evaluated all parameter measurementsst. Statistical analysis was conductedby tes t-test using SPSS software (version 23). P less than 0.05 was considered statistically significant.

After the eight- week intervention, a significant reduction in QTdis, QTcdis, weight, and BMI was observed in the MICT group (p˂0.01) but not in the control group (P>0.05). Regarding Pdis, no significant changewas observed before and after intervention in both groups (P>0.05).

These findings demonstrated that eight weeks of MICT in PCOS patients could be prescribed to prevent adverse cardiovascular events in women with PCOS.

Diabetes is a group of metabolic disorders that affect the structure and function of other organs in the body, such as the myocardium, and is referred to as cardiomyopathy. However, due to the role of exercise in preventing and treating diabetes complications, the present study was performed to determine the effect of diabetes and high- intensity interval training (HIIT) on tissue expression of miRNA-1 and miRNA-21 in the left ventricle of diabetic male rats.

In this experimental study, twenty adult Wistar male rats were selected and randomly divided into two groups: diabetic and diabetic with HIIT (T) protocols. Accordingly, the rats underwent the HIIT program on smart electronic tape recorders for eight weeks, five days a week. HIIT training was performed with an intensity of 90-85% of maximum speed 6-12 times for 2 minutes and with 3-minute active rest intervals with an intensity of 30% VO2max. At the end of the study contract, all rats were anesthetized and operated on 48 hours after the last intervention without a painless method to determine changes in miR-1 and miR-21 gene expression by real-time PCR in left ventricular tissue.

The results showed that the quantitative relative expression of miRNA-1 in the HIIT + diabetes group was (0.00005 ± 0.000001) and diabetes control (0.00018 ± 0.000005). The Quantitative relative expression of miRNA-21 in the HIIT + diabetes group was (0.00025 ± 0.000001) and in the diabetes control group (0.00011 ± 0.000016). Eight weeks of HIIT training significantly increased the relative expression of miRNA-21 and decreased the expression of miRNA-1 in diabetic rats (P < 0.05). In contrast, the results showed that after eight weeks of diabetes, the relative expression of miRNA-21 decreased significantly, and the expression of miRNA-1 increased (P < 0.05).

Based on the results of this study, it seems that miRNA-210 can be used as an indicator to assess the adaptations associated with exercise training.

The aim of the present study is to compare two types of aerobic exercise on stem cell mobilization, WBC, and admission durationbefore autologous transplantation. Cancer is a malignancythat causes an uncontrollable growth in the cellreplication. Transplantation of hematopoietic stem cells is required for the treatment of many malignant and non- malignant blood diseases. In hematopoietic stem cell transplantation, patients' hematopoietic cells are removed and replaced with stem cells. The success of the transplantation depends largely on the amountof stem cells. The higher the number of cells, the sooner recovery happens.

In a quasi- experimental applied study, 60 patients in the age range of 22-69 years admitted to Taleghani Hospital were randomly selected and assigned into 3 groups of 20 members (continuous aerobic, discontinuous aerobic, and control group). The aerobic exercise program was performed for 7 consecutive days of mobilization period including walking on a treadmill (according to the patient's ability) continuously and discontinuously for 30 minutes in the morning and afternoon, taking into account the perceived effort. Blood samples were taken in the mornings before and after mobilization, and the CD34-MNC and WBC levels were counted as absolute. Days of admission were counted after discharge. Chi-square test, analysis of covariance (ANCOA), and multiple comparison test were used for statistical analysis. The p-value of 0 ≤ 0.05 was considered significant.

Moderate- intensity continuous and discontinuous aerobic activity increases the number of CD34- MNC and WBC countin all 3 groups and decreases the days of admission in the continuous group. . Moreover,the amount of CD34 and MNC cells in the continuous aerobic activity group was significantly higher than in the discontinuous aerobic activity group. (This case has been published in an article in English that is mentioned in the references). However, WBC count was not significantly different between the continuous and discontinuous groups. Finally, the days of admission in continous group were less than the discontinuos group (P≤0.05).

Moderate- intensity continuous and discontinuous aerobic exercise significantly increases hematopoietic stem cells. The admission period in thecontinous group was less than the discontinuos group. However, the increasing rate of cell count and the decreasing rate of admission period in the continuous group were higher than the discontinuous group. Due to the role of these cells in the transplantation our findings could contribute to a higher rate of success.

Congenital hypothyroidism results from abnormal structure, position, or hormone production of the thyroid gland. Since common genetic and developmental pathways exist, congenital heart disease may accompany it.

In this cross- sectional descriptive study, 75 children with congenital hypothyroidism were evaluated by echocardiography using the census method. They had been detected during the national screening program of neonates; the diagnosis had been documented then. Patients with Down syndrome, low birth weight, and less than 1-month age were excluded from the study. Mean and standard deviations for quantitative variants and frequency for qualitative variants were applied.  Student’s test- test, Pearson’s chi- square, and correlation index were used for data analysis.

Congenital heart disease was detected in 20% of these hypothyroid children, including 12% atrial septal defect, 4% atrial and ventricular septal defects, and 4% mitral valve prolapse. Patent foramen ovale was detected in 21 children. No cardiac abnormality was reported in 52% of children. Gestational age and birth weight were significantly lower in the congenital heart disease group (P=0.000).

Congenital heart disease is relatively prevalent in Iranian children with congenital hypothyroidism. We recommended cardiac evaluation for all hypothyroidism cases detected by the national screening program

People with social phobia have lower self- esteem than normal people. A common treatment and intervention for this problem is stress management based on the cognitive- behavioral approach. For this purpose, in the present study, we aimed to determine the effectiveness of cognitive- behavioral stress management training on the self-esteem of students struggling social phobia.

The present study is an experimental design with a pretest-posttest and control group. 32 students with social phobia were selected with the highest score in the social phobia inventory (SPIN) through available sampling. After homogenization, the research sample was divided into experimental and control groups, and using the social phobia inventory (SPIN) and self- esteem rating scale (SERS) were assessed before and after the intervention. The experimental group underwent cognitive- behavioral stress management training for ten weekly sessions and the control group was waiting. The obtained results were analyzed using descriptive statistics and U Mann Whitney by SPSS software.

In current study, 16 people were in the experimental group and 16 people in the control group (all members were female). None of the students left the intervention. U Mann Whitney showed that by controlling the differences between the two groups before the study, there was a significant difference between the final score of the experimental group compared to the control group. Cognitive- behavioral stress management training increased overall self- esteem from 17.05 ± 84.62 to 24.13 ± 243.68 (P < 0.001) and decreased social phobia from 6.99 ± 53.56 to 2.4 ± 47.5 (P < 0.001) in the experimental group.

It seems that the cognitive- behavioral stress management method can be used as an effective skill in treating students' social phobias.

Renal fibrosis, with multiple aetiologies, is the typical pathological symptomof almost all chronic Kidney diseases and the most reliable indicator of CKD progression to end- stage renal failure. Kidney disease affects a variety of kidney cells and compartments and causes the spread of fibrosis called glomerulosclerosis, interstitial fibrosis, atherosclerosis, and perivascular fibrosis. Many cellular and molecular mechanisms are involved in the development of kidney fibrosis. Kidney disease affects a variety of existing cells and the compartment of the kidney and causes a variety of fibrosis called glomerulosclerosis, interstitial fibrosis, atherosclerosis, and perivascular fibrosis.

In this study, a comprehensive review of the cellular and molecular pathways involved in renal fibrosis, along with drug therapy and cell therapy used to improve the disease, by searching the databases of Scopus, PubMed, and Google Scholar was performed from 2010 to 2022.

Findings from studies showed that optimal cell therapy methods have fewer side effects than drug therapy. Due to the type of fibrosis involved in the kidney, it will be possible to repair it using stem cells. TGFB1 signaling seems to play an important role in the development of renal fibrosis, and drugs used to improve renal fibrosis often address the importance of the TGFB1 signaling pathway, which in addition to the relative improvement of the disease, has many side effects.: The use of cell therapy in the treatmentof chronic kidny fibrosis has more appropriate effects and fewer side effects than drug therapy, and mesenchymal stem cells are the most suitable candidates for transplantation.

Uterine perforation occurs when an instrument passes or IUD )Intera uterine devices) through the uterus wall and can result in visceral Injury, hemorrhage, and infection.Due to greater magnification and accuracy and other advantages of laparoscopic surgery, such as shorter hospital stay, less pain and bleeding, and faster return to work, we use laparoscopy to remove IUD from different places in the abdominal cavity. Intestinal and omentum herniation from the port site is a rare complication of laparoscopy.
The purpose of presentarticle is to investigate a case of IUD exit from the rectum by laparoscopy. This surgery was accompanied by a rare case of exit of the omentum and bowel from the 5 mm left lateral trocar site when the drain was exited

A 26 years old woman from Bouseher, with a history of two cesarean section, received an       intra- uterine device (IUD) for contraception 10 daysafter delivery. Vaginal sonography confirmed a lack of IUD in the uterine cavity. Pelvic X-ray showed IUD near the right ovary. In laparoscopy, the adhesion of the rectum and right ovary was detached, IUD was removed from the site of adhesion of rectum and right ovary, and then rectum was repaired. During drain extraction, we noticed that the bowel and omentum were herniated from the 5 mm left lateral port site. After injection of local anesthesia and extension of the port site, the bowel and omentum were inverted in to the peritoneal cavity, and the fascia was repaired.

Immigrant IUDs should be removed whenever identified. The laparoscopic procedure is a safe and suitable method for most intra-abdominal migration.