Iranian Journal of Medical Sciences
Volume:32 Issue: 1, Mar 2007

Vol. 32, No. 1, March 2007 Mutations of p53 Gene in Skin Cancers: a Case Control Study Abstract: Abstract Intrapulmonary vascular abnormalities associated with liver cirrhosis may result in intrapulmonary right-to-left shunt and hypoxemia. The aim of this study was to use contrast enhanced echocardiography to detect intrapulmonary vascular abnormalities in patients with liver cirrhosis candidates for liver transplantation. One hundred and two adult patients underwent contrast enhanced echocardiography to determine the prevalence of intrapulmonary right-to-left shunt and its relationship to the severity of hepatic disease, arterial oxygenation, and spider angioma. The rate of patients with positive and negative contrast enhanced echocardiography was 44% and 56%, respectively. There was no significant difference in age, sex, or etiology of liver cirrhosis in patients with and without intrapulmonary shunt. Patients with intrapulmonary right-to-left shunt had more severe hepatic disease compared with those without shunt (Child-Pugh score 12±2 vs 8±2). There was significant difference in the partial arterial oxygen pressure (PaO2) values in patients with grade 3+ to 4+ left ventricular opacification by microbubbles compared with those without evidence of intrapulmonary right-to-left shunt (64±6 vs 82±10 mmHg). Twenty eight of the patients with intrapulmonary right-to-left shunt had cutaneous spider angioma. The findings suggest that there was a significant relation between severity of liver cirrhosis and presence of intrapulmonary right-to-left shunt or severity of hypoxemia. The data also indicate that cirrhotic patients with cutaneous spider angioma most likely have the shunt. Authors: M. Zamirian, A. Aslani Key words: Mutation,p53 gene,skin cancers The most frequently mutated tumor suppressor gene found in human cancer is p53. In a normal situation, p53 is activated upon the induction of DNA damage to either arrest the cell cycle or to induce apoptosis. However, when mutated, p53 is no longer able to properly accomplish these functions. The aim of this study was to investigate the expression of p53 gene in cases of skin cancers and compare those with control subjects. The expression of P53 gene was investigated in samples form 62 patients who diagnosed as having various skin cancers including 41 basal cell carcinoma, 15 squamous cell carcinomas, 5 malignant melanoma, and one basosquamous carcinoma using immunohistochemistry method. The control group comprised 20 samples from patients with benign skin diseases. Data were analyzed using t and Chi-Square tests. The ratios of p53 mutations in different skin malignancies comprised of 28/41 basal cell carcinoma, 9/15 squamous cell carcinoma, 1/1 of basosquamous carcinoma, and 1/5 of malignant melanoma as well as 3/20 of control group. Statistically significant differences from the control group were found in the ratios of p53 mutations in cases of basal and squamous cell carcinomas. However, the ratio of p53 mutations in malignant melanoma was not significantly different from that of the control group. Our findings suggest that mutations of p53 gene may contribute to the persistence of cancer cells and development of basal and squamous cell carcinomas.

Abstract Intrapulmonary vascular abnormalities associated with liver cirrhosis may result in intrapulmonary right-to-left shunt and hypoxemia. The aim of this study was to use contrast enhanced echocardiography to detect intrapulmonary vascular abnormalities in patients with liver cirrhosis candidates for liver transplantation. One hundred and two adult patients underwent contrast enhanced echocardiography to determine the prevalence of intrapulmonary right-to-left shunt and its relationship to the severity of hepatic disease, arterial oxygenation, and spider angioma. The rate of patients with positive and negative contrast enhanced echocardiography was 44% and 56%, respectively. There was no significant difference in age, sex, or etiology of liver cirrhosis in patients with and without intrapulmonary shunt. Patients with intrapulmonary right-to-left shunt had more severe hepatic disease compared with those without shunt (Child-Pugh score 12±2 vs 8±2). There was significant difference in the partial arterial oxygen pressure (PaO2) values in patients with grade 3+ to 4+ left ventricular opacification by microbubbles compared with those without evidence of intrapulmonary right-to-left shunt (64±6 vs 82±10 mmHg). Twenty eight of the patients with intrapulmonary right-to-left shunt had cutaneous spider angioma. The findings suggest that there was a significant relation between severity of liver cirrhosis and presence of intrapulmonary right-to-left shunt or severity of hypoxemia. The data also indicate that cirrhotic patients with cutaneous spider angioma most likely have the shunt.

Urinary tract infection in children may cause renal scar formation, which can be prevented by early and appropriate treatment. Recent studies showed that single daily injection of gentamycin can produce best effect without increasing the side effects. The aim of this study was to evaluate the rate of renal scar formation when new regime (every other day gentamicin injection) used for treatment of urinary tract infection. Forty eight Sprague Dawley rats were infected by inoculation of 0.1 ml Uropathogenic E.coli suspension (109/ml) to their left kidneys. The rats were divided into four groups after 24 hours. Gentamicin was administrated intraperitoneally at dosages of 10mg/kg (daily), 10mg/kg every other day or 20mg/kg every other day to the first three groups. The fourth group did not receive any antibiotic. Renal scar formation was evaluated by histology and responses were evaluated by counting colony forming units (CFU)/ml of homogenized kidney tissue and percentage of sterile kidneys. Evaluation of all sections showed that 0-30% of interstitial tissues had scar formation. The results showed no significant difference in scar formation between the first three groups, but showed mild to moderate scar formation in the fourth group. It was concluded that 10mg/kg or 20mg/kg of gentamicin usage in every other day interval dose did not increase the risk of renal scar formation while it had appropriate efficiency.

The role of Renin Angiotensin System (RAS) in ischemic/reperfusion (I/R) injuries is not fully elucidated. Furthermore, it is not clear whether inhibition of RAS by Angiotensin-Converting Enzyme (ACE) inhibitors has beneficial effects in terms of protecting the brain from I/R injuries. In this study enalapril is used as an ACE inhibitor to evaluate the role of RAS in I/R injuries in the rat. ACE inhibition was performed one hour before induction of ischemia using a single IP injection of 0.03 mg/kg or 0.1 mg/kg enalapril in the rats. Transient focal cerebral ischemia was induced by 60 min occlusion of the middle cerebral artery followed by reperfusion. Neurological deficit score (NDS) test was performed 24 hours after the start of reperfusion. Finally the animals were sacrificed under deep anesthesia, the brain removed and prepared for the evaluation of cortical and striatal infarction volumes using Triphenyltetrazolium chloride staining method. Pre-ischemic inhibition of ACE with non-hypotensive dose of enalapril (0.03mg/kg) significantly reduced cortical and striatal infarction volumes of ischemic rats by 41.6% and 52.7% respectively with concomitant improvements in NDS. However, no improvement was observed when ACE inhibition accompanied with arterial hypotension. In the rat model of transient focal cerebral ischemia, ACE inhibition seems to reduce the severity of I/R injuries. Therefore, it is plausible to conclude that renin-angiotensin-system may participate in ischemic/reperfusion injuries.

Chronic idiopathic urticaria is defined as urticaria, which lasts for more than 8 weeks and has no apparent etiology. The aim of this study was to examine the causal role of Helicobacter pylori infection in chronic idiopathic urticaria. Fifty-six patients with chronic idiopathic urticaria and a negative response to skin prick test for common aeroallergens were selected. They were examined for H pylori infection using a serologic test and urea breath test, and were divided into three groups. The first group included H pylori-positive patients (n=23), who did receive eradication regimen for two weeks. The second group comprised of H pylori-positive patients (n=15), who did not have the indications for anti H pylori treatment, and were not treated. The third group included H pylori-negative patients (n=18), who received no treatment. The patients were studied for signs and severity of urticaria. In the first group, urticaria improved partially and completely in 74% (n=17) of cases. In the second group, urticaria did not improve in 60% (n=9), and improved partially in 40% (n= 6) of cases. In the third group, urticaria did not improve in 61% (n=11), and improved partially in 39% (n=7) of cases. Patients, who had a higher titer of urea breath test and longer period of symptomatic urticaria, had better response than the others. The findings suggest that anti-H Pylori treatment is significantly effective in the treatment of chronic idiopathic urticaria. H Pylori eradication can be suggested as a method for treating urticaria, if the urea breath test is positive.

New Pressor Protein (NPP) is a human plasma enzyme structurally related to b–fragment of activated factor XІІ (β-FXIIa). The objective of the present study was to investigate the effects of NPP and β-FXIIa on systolic blood pressure and heart rate in bilateral nephrectomized rats. Forty male Wistar rats (250-300 g) were sham-operated or bilaterally nephrectomized under anesthesia with a combination of halothane, nitrous oxide and oxygen. Twenty four hours later under anesthesia with Inactin (100 mg/kg), they were ganglion blocked (pentolinium tartrate; 19.2 mg/kg), and their systolic blood pressure and heart rate were measured before and after intravenous administration of captopril (2.5 mg/kg), NPP (20μl plasma equivalent) or purified β-FXIIa (300 ng/kg). NPP raised the systolic blood pressure by 31±2 mmHg and heart rate by 19±2 bpm in sham-operated rats. Captopril caused systolic blood pressure and heart rate to increase significantly by 64±7 mmHg and 107±9 bpm, respectively in response to NPP. In bilateral nephrectomized rats, NPP raised systolic blood pressure by 57±6 mmHg and heart rate by 70±13 bpm in the absence of captopril, which were not significantly different from those (46±3 mmHg and 75±8 beats/min) in the presence of captopril. This study shows that the effects of NPP and β-fragment of factor XІІ on systolic blood pressure and heart rate are similar, suggestive of a functional relationship between them. The findings might suggest that the potentiation effect of captopril in sham-operated or bilaterally nephrectomized rats is primarily expressed via renal enzymes

A number of drugs are used to control opioid withdrawal symptoms during detoxification. Tramadol, as a partial opioid agonist, has been widely used to manage acute and chronic pains. The present study was designed to assess the effectiveness of tramadol in methadone-assisted detoxification. In a double-blind randomized clinical trial 72 opioid-dependent patients as defined by 4th edition of the Diagnostic and Statistical Manual of Mental Disorders were assigned to two groups receiving methadone (15 mg/day) or tramadol (560 mg/day). Patients in both groups received clonidine and oxazepam. The severity of withdrawal symptoms was assessed at the baseline and 7 times every other day onward using the Short Opioid Withdrawal Scale (SOWS). Mean scores of total withdrawal symptoms on days 13th and 15th were significantly higher in the methadone group than in the tramadol group (16.2±9.5 vs 9.5±7.5 and 15.2±10.6 vs 8.5±6.9). On day 15th, the patients in methadone group showed significantly more severe psychological symptoms (5.8± 4.1 vs 4.3± 4.2). In the methadone group mean score of psychological symptoms was higher on day 15th compared with the first day (15.2±10.6 vs 9.7±8.7). Drowsiness and sweating were significantly more in patients in methadone group than in tramadol group. Tramadol can be used effectively as a substitute drug in opioid-assisted detoxification, particularly in patients with low to moderate dose opioid dependency.

Makhaarej Al-Horouf, the study of speech sounds by Avicenna is a valuable piece of work in the study of speech sounds, which was written about ten centuries ago. It contains six chapters on sound, anatomy of vocal tract, and phonetics. It is amazing to find that Avicenna’s explanations are congruent with the findings of modern scholarship in relevant topics. The study was intended to compare Avicenna’s explanations on the anatomy of the vocal tract to today’s modern advancements. Avicenna describes three cartilages of the larynx, which are known in our time as thyroid, cricoid, and epiglottis (or maybe arytenoids) as well as many of the muscles of the larynx and the tongue. The findings show that Avicenna’s explanations of the anatomy of vocal tract are comparable to today''s knowledge on the subject. They also indicate that the study of Makhaarej Al-Horouf and other ancient works would be beneficial in the investigation of the history and development of science around the world.