Acta Medica Iranica
Volume:44 Issue: 5, Sep-Oct 2006

Cancer cell-stromal cell interaction plays a crucial role in the growth and invasion of tumor cells of various organs. It has been recently suggested that adipocytes and preadipocytes, two specific types of stromal cells, affect the biological behavior of variety of breast cancer cell lines. In spite of few investigations, there is a controversy in the literatures about the effects of adipocytes and preadipocytes on tumor growth. In this study, we compared the proliferation of MCF-7 breast-cancer cell line in culture with or without presence of primary isolated human adipocytes and preadipocytes by MTT colorimetric assay in 2, 4 and 6 days of culture experiments. Human adipocytes increased the proliferation of MCF-7 cells in the co-culture about 8.6%, 12% and 12% more than MCF-7 monoculture in 2, 4 and 6 days after cell culture respectively. Human preadipocytes decreased the proliferation of MCF-7 cells in the co-culture about 7.7%, 16.9% and 21% lesser than MCF-7 cell monoculture in 2, 4 and 6 days after cell culture, respectively. Proliferation of MCF-7 cells in co- culture with adipocytes were 17.7%, 35% and 42% more than MCF-7 cells in co-culture with preadipocytes after 2, 4 and 6 days of culture, respectively. We concluded that human adipocytes increase the proliferation of MCF-7 breast cancer cell line but human preadipocytes inhibit proliferation of MCF-7 breast cancer cell line.

Biological effects extracorporeal shock wave lithotripsy (ESWL) is not precisely known. We have evaluated two urinary enzymes activity N-acetyl-B-D-glucosamine (NAG) and alanine amino peptidase (AAP) before and after unilateral ESWL as markers for renal parenchymal damage. Forty eight patients with kidney stones (mean age 39) who had presented for the first time or at least one year after their previous lithotripsy underwent ESWL. Urinary specimens were collected before and after first, third and seventh days of lithotripsy and NAG, AAP were evaluated. These enzymes displayed the greatest activity 24 hours after ESWL with significant difference compared to the control group, (P < 0.05 versus 0.02). Elevation of urinary enzymes activity correlated with stone size particularly stones larger than 2 cm. These data suggest that there is some tubular and parenchymal damage induced by ESWL that needs time to get improved. The higher urinary enzyme activity in patients with larger stones (> 2 cm) is probably related to injury resulting from passage of smaller stones, produced after lithotripsy of a large stone, and it is suggested that these patients are treated with a safer procedure.

The lethality of pulsed ultra-violet (UV) rich light for the inactivation of pathogenic bacteria has been investigated. A low pressure xenon filled flash lamps that produced UV intensities have been used. The pulsed operation of the system enable the release of electrical energy stored in the capacitor into the flash lamp within a short time and produces the high current and high peak power required for emitting the intense UV flash. The flash frequency was adjusted to one pulse per second. Several types of bacteria were investigated for their susceptibility to pulsed UV illumination. The treated bacterial populations were reduced and determined by direct viable counts. Among the tested bacteria Pseudomonas aeruginosa was the most susceptible to the pulsed UV- light with a 8 log10 cfu/ml reduction after 11 pulses, while the spores of Bacillus megaterium was the most resistant and only 4 log10 cfu/ml reduction achieved after 50 pulses of illumination. The results of this study demonstrated that pulsed UV- light technology could be used as an effective method for the inactivation, of pathogenic bacteria in different environments such as drinking water.

Tranexamic acid is now used on a routine basis for on-pump coronary artery bypass grafting (CABG). We assessed the hemostatic effects of tranexamic acid to decrease bleeding tendency and transfusion requirements in patients undergoing off-pump coronary artery bypass surgery (OPCAB). A total of 66 patients were enrolled to elective OPCAB in a double-blind, prospective randomized study. Of these, 33 patients received tranexamic acid (15 mg/kg before the infusion of heparin and 15 mg/kg after protamin infusion), and 33 patients received only saline. Preoperative hematologic variables, postoperative bleeding and allogeneic transfusions were considered. D-dimer plasma levels were also evaluated to monitor the activation of fibrinolysis. Postoperative bleeding was significantly lower in the tranexamic acid group compared with the control group (320 ± 38 mL vs. 480 ± 75 mL at 12 hour, P < 0.001). The tranexamic acid group had significantly lesser need for allogeneic blood products (0.46 units/patients vs. 0.94 units/patients, P < 0.001). They had also lower post-operative D-dimer plasma levels. No postoperative thrombotic complications were observed in either group. The defective hemostasis occurs even in the OPCABG. Tranexamic acid effectively reduces postoperative blood loss and the need for allogeneic blood products after OPCAB is decreased.

Pain in neonates can be associated with various risks and it seems essential to find a simple and acceptable method for relieving pain. Pharmacologic agents are not recommended in neonates for pain relief in minor procedures but orally administered glucose solution is found to be effective. The objective of this study was to assess the efficacy of oral 30% glucose during intramuscular injection in term neonates. Sixty-four healthy term neonates were recruited for this study during 1 month. The inclusion criteria were gestational age 37-42 weeks, birth weight 2500-4000 gr, and Apgar score > 7. The intervention consists of administration of either 2 ml of oral 30% glucose or 2ml of sterile water 2 minutes before injection. The primary out come measure was the cumulative Neonatal Infant Pain Scale (NIPS) score at 3 minutes after injection. Thirty-two neonates received 30% glucose and 32 neonates received sterile water. The cumulative NIPS score at 3 minutes after injection for neonates given 30% glucose was significantly (P = 0.000) lower than for neonates given sterile water. The heart rate immediately after injection for neonates given 30% glucose was significantly (P = 0.002) lower than for neonates given sterile water. Oral 30% glucose given 2 minutes before injection was effective in reducing neonatal pain following injection. It is a simple, safe and fast acting analgesic and should be considered for minor invasive procedures in term neonates.

To minimize the risk of embolic events, several protection strategies have been introduced. We have evaluated the short-term outcome of patients who underwent carotid stenting with the routine use of cerebral protection devices. In our center, 36 successful carotid stenting procedures (of 38 attempted) were performed in 37 patients (23 men; age mean [SD] 667 years). Cerebral protection involved distal filter devices (n = 36). The protection device was positioned successfully in 36 of the 38 attempted vessels. Neurologic complications included 1 major stroke and 1 minor stroke and there wasd 1 sudden cardiac death. The rate of stroke or death was 2 for symptomatic lesions and 1 for asymptomatic lesions, and 2 in patients aged < 80 years and 1 in those aged 80 years. Protection device-related vascular complications were mild spasm occurring after 3 procedures (8%) but none led to neurologic complications. There were another four cardiogenic deaths in 30 day follow up. In this uncontrolled study, routine cerebral protection during carotid artery stenting was technically feasible and clinically safe. The incidence of major neurologic complications in this study was lower than in previous reports of carotid artery stenting without cerebral protection.

There are reports from different countries that some types of glaucoma are associated with blood groups. This cross-sectional study was performed on 400 glaucomatous patients [100 patients in each group of Primary open angle glaucoma (POAG), chronic angle closure glaucoma (CACG), pseudoexfoliative glaucoma (PEXG) and primary congenital glaucoma (PCG)] and 400 blood donors as control group to assess the association between blood groups and glaucoma. All patients underwent ABO and Rh blood group testing. The prevalence of blood group A was 30% in the control group, 27% in POAG, 33% in CACA, 38% in PEXG and 36% in PCG. The prevalence of blood group B was 24% in the control group, 19% in POAG, 20% in CACG, 15% in PEXG and 34% in PCG (P < 0.025). The prevalence of blood group AB was 8% in the control group, 9% in POAG, 5% in CACG, 12% in PEXG, and 8% in PCG. The prevalence of blood group O was 38% in the control group, 45% in POAC, 42% in CACG, 35% in PEXG and 22% in PCG (P < 0.001). The prevalence of Rh+ was 88% in the control group, 84% in POAG, 87% in CACG, 86% in PEXG and 87% in PCG. Compared to control group, blood group B was more prevalent and blood group O was less prevalent in PCG. There was no association between other types of blood groups (ABO and Rh) and PCG. There was no association between blood groups (ABO and Rh) and other types of glaucoma.

Abstract- Studies of the epidemiology of civilian vascular trauma in developing countries are rather few. This is a prospective study of our experience with vascular trauma in a referral university hospital in Tehran, Iran. The aim was to study the etiology, pattern of injuries and the mortality and morbidity rates due to vascular trauma in our population. In this cross-sectional study, all trauma patients suspicious of having vascular injuries who were admitted to Sina Hospital between March 2002 and May 2003 were included. Among 123 studied cases, there were 109 males and 14 females.Blunt injuries were more common than penetrating ones (56.1% vs. 43.9%). The most common anatomical site of vascular injuries had been knee and lower leg. In fact, cases with lower extremities vascular trauma were twice as common as those with vascular trauma in upper limbs (59.1% vs. 27.3%). The commonest injured vessels were popliteal artery followed by femoral artery. Arterial repair with graft interposition was done in 23 cases and bypass graft in 13 cases. Procedures on veins were performed in 24 cases. Five patients (4.06%) died and in 3 cases the patients died because of non-vascular reasons. The present study allows an understanding of the epidemiology of vascular trauma in the one of the major trauma centers in the metropolitan city of Tehran. The majority of our cases were young males sustaining vascular injuries due to road traffic accidents or being stabbed with knives. It also has important implications for vascular injury prevention in our community.

The seasonal and diurnal variations in the incidence of hypertension, cerebrovascular accident, coronary heart disease were well documented, but the relation between season and daytime on the onset of aneurysmal subarachnoid hemorrhage (ASAH) was a subject of controversy. In the present study we aimed to evaluate the role of season of year and diurnal changes on the onset of ASAH. The time was categorized into two intervals of daytime and night time. Also patients were evaluated in two age groups of  60 and under 60. There were 107 files of patients with definite diagnosis of ASAH. The main common symptom was headache (88.8%). 52.2% of patients were referred to the hospital in day time and 45.8% were in night time, and the difference was not statistically significant. Moreover, the frequency of ASAH in winter and falls was about 51.4% and that of summer and spring was 45.6% and the difference was not significant. Seasonal frequency in patients with or without hypertension, cigarette smoking or both was not also statistically different. seasonal and diurnal variation didn’t show considerable effect on the onset of ASAH in our study. Even this effect was not observed in hypertensive patients. However, we need other researches on a larger sample of patients considering the influence of hypertension in relation to season and daytime in the onset of ASAH.

Mycotic infections have been commonly encountered in patients with hematological malignancies. The current study seeks the prevalence of actinomycete infection in patients suffering from blood cells malignancies. A hundred and fifty patients with some kinds of blood cells dyscrasia who underwent the bone marrow aspiration were recruited. In addition to the diagnostic work up, samples were examined for the presence of actinomycete infections. Twenty one samples were positive for actinomycete infections. All of them were infected by Actinomyces naeslundii. All the positive patients were categorized in malignant groups, acute myelocytic leukemia, chronic myelocytic leukemia, and lymphoma and myelodysplastic syndrome. High incidence of actinomycete infections in the present study population was interesting. These results can also be suggestive of a pre-malignancy role for the actinomycosis.

Adenoviruses are one of the most important etiological agents of serious gastroenteritis among infants and young children. Fecal specimens from patients with an acute gastroenteritis were evaluated for the presence of adenovirus (Ad40, 41) from April 2002 to February 2004. During the study, 1052 samples were collected from children under the age of 5 years in six educational and therapeutic pediatric centers. The specimens were tested for adenovirus (Ad40, 41) by EIA technique in the Virology Department of Pasteur Institute of Iran. Adenoviruses (Ad40, 41) were detected from 27(2.6%) samples, but were not detected in 150 samples of healthy control group. In this study the highest rate of adenovirus was found in children aged 6 to 12 months (40.7%), but the male to female ratio inpatients was approximately equal. Adenovirus (Ad40, 41) infections peaked in the winter as 48.1% was detected from December to March. There were a statistically significant difference between age and infection (P < 0.001), also between season with adenovirus (Ad40, 41) infection (P = 0.005). Breast-feeding had a protective action against adenovirus (Ad40, 41) infection. This study revealed that enteric adenovirus (Ad40, 41) is an etiological agent of acute gastroenteritis among children in Tehran.

Intrathecal administration of midazolam has been reported to have antinociceptive action, and to be an effective analgesic agent. In this prospective double-blind study we aimed to evaluate the postoperative effects of intrathecal midazolam with lidocaine following perineal operation. Forty patients were randomly allocated to two groups: 20 patients in the control group received 2 ml of 5% heavy lidocaine plus 0.4 ml of 0.9% saline intrathecally; 20 patients in the midazolam group received 2 ml of 5% heavy lidocaine plus 0.4 ml of 0.5% midazolam. Duration of analgesia was significantly greater in the midazolam group (7  1 hours) compared to the control group (1.5  0.5 hours).

Idiopathic hypercalciuria is a leading cause of frequency-dysuria syndrome in childhood. Different modes of inheritance have been suggested in this disease. This article presents the occurrence of idiopathic hypercalciuria in all children of two families. In the first family, a 5.5 year old girl with a history of renal stones and dysuria due to hypercalciuria, had two involved brothers and one sister. In the second family, hypercalciuria and medullary nephrocalcinosis were detected in two siblings who were admitted for polyuria and dysuria. Idiopathic type of hypercalciuria was diagnosed in these two families by normal laboratory exams and exclusion of other causes of normocalcemic hypercalciuria. According to the involvement of all offsprings (both sexes) in these two families, it is suggested that idiopathic hypercalciuria is an autosomal dominant disease with complete penetration.