Iranian Journal Of Pathology
Volume:4 Issue: 2, spring 2009

Carcinogenesis is a multistep process characterized by the gradual accumulation of genetic changesthat ultimately lead to cancer. These genetic mutations can impart limitless replicative potential tothe cancer cells making them immortal. Telomeres are repeat nucleotide sequence TTAGGG thatare present at the end of chromosomes. Its functions are to protect the chromosomal ends and toensure that these ends are not recognized as DNA strand break by the polymerase enzyme. Theyalso act as a clock like mechanism to count the number of times a cell divides. These telomeresare maintained in the cell by an enzyme called as telomerase. The function of telomerase enzymeis to protect the cells from telomere erosion and senescence. Thus, the cell can become immortaland replicate forever. This is called as the canonical function of telomerase. Normally telomeraseis present in stem cells, germ cells and blood cells only and the somatic cells usually do not expresstelomerase. However, a very high concentration of telomerase has been identified in various cancercells. A few years back it was observed that low levels of telomerase are present in the S phase ofcell cycle of somatic cells at levels that are not sufficient to maintain telomeres lengths. Additionallyit was observed that ectopic expression of telomerase causes stem cell division, mobilization andmigration, increased wound repair and an increased tumor burden. Based on these facts it hasbeen deduced that telomerase has at least one non-canonical and elongation-independent function.Both canonical and non-canonical functions of telomerase are considered to play important roles indevelopment and progression of tumorogensis.

The aim of this study was to compare the screening performance ofa new modified liquid-based cytology method (Liquiprep™) with conventional PAP smear (CP) ina low risk population, using colposcopy followed by histology as “gold standard”.Patients and This cross-sectional study was performed on random referred specimensto a general gynecological clinic in Tehran, during 20 months by a split-sample method. In bothCP and Liquiprep™ group, all positive and 10% of negative results of smears were followed bycolposcopy. A biopsy was taken whenever any atypical transformation zone seen. Sensitivity,specificity, negative and positive predictive values (PV), and overall accuracy of both methods wereanalyzed in relation to histology. A total of 1265 patients were analyzed by two methods. In 158 (12.5%) of cases histologicaldiagnosis was made. Liquiprep™ samples (94.7%) were more adequate than CP (92.1%). Therewas not any low or high-grade squamous intraepithelial lesion (SIL). Atypical squamous cell ofundetermined significance (ASC-US) was diagnosed more with CP than with Liquiprep™ (1.43%vs. 0.79%) while pathologically 60% of ASC-US in Liquiprep™ and 16.6% in CP had degrees ofSIL. The Liquiprep™ had a significantly higher sensitivity (83% vs. 66%) and positive PV (83%vs. 33%) than the CP to detect SIL at histology but the difference in specificity was non significant(98% vs. 86%). This study confirms the superiority of the Liquiprep™ method to detect cervicallesions in a low risk population.

Some of the human papillomaviruses (HPVs) can infect genitaltracts and are sometimes associated with anogenital tract cancers. HPVs induced cervical cancersthrough the expression of E6 and E7 genes by inactivating the tumor suppressor proteins. In thisstudy, E6 and E7 genes were chosen in order to construct an expression vector which is able toexpress target proteins.Patients and This experimental investigation was performed in Virology Departmentof Tarbiat Modares University. An expression vector containing human papillomavirus type 16 E6and E7 genes was constructed. The accuracy of the plasmid was confirmed by polymerase chainreaction (PCR) and restriction enzyme analysis. The construct was transfected into the eukaryoticcells and its ability for protein production was confirmed by Western blotting. The colonies containing desired plasmid have the fragment about 995 bp. For confirmingthe ability of the construct for protein production in eukaryotic cells, Western blotting was doneusing the lyses-cells as antigen and they showed the desired bands using monoclonal antibodies. The designed vector can consider as a based vaccine for construction a therapeuticvaccine in suitable vectors for gene therapy in order to administration in Iranian patients withcervical cancer.

The outcome of hepatitis B virus (HBV) infection may be influencedby host factors like Human Leukocyte Antigen (HLA). We have investigated HLA-A and DRB1alleles in patients with persistent hepatitis B infection compared to subjects who had spontaneouslyrecovered from HBV infection. To complete the findings of this study we performed another surveyin certain HLA alleles that were significantly related to the outcome of HBV infection. The currentstudy aimed to determine association between HBV infection outcome and HLA-A and DRB1genotyping in North part of Iran.Patients and Ninety-four HBV infected patients were enrolled in this cross sectionalstudy. First HLA-A and DRB1 alleles were analyzed by using low resolution PCR sequence-specificprimer(PCR-SSP) and then we used high resolution PCR-SSP method for subtyping HLA-A*33and DRB1*13 alleles which were significantly related to the outcome of HBV infection. HLA-A*33 allele was significantly higher in persistent group than recovered groupand sub typing showed HLA-A*3303 in 75% and HLA-A*3301 in 25% of cases. HLA-DRB1*13allele was significantly lower in persistent group than in recovered group and its subtypes wereDRB1*1301 in 66.7% and DRB1*1303 in 33.3% of subjects. Host HLA polymorphism is an important factor to determining the outcome ofHBV infection. HLA-A*3303 and DRB1*1301 were the predominant subtypes of HLA-A*33 andDRB1*13 alleles in Iranian HBV infected patients.

Bacterial meningitis is an important cause of mortality and longtermneural morbidity. Immediate diagnosis and treatment are necessary in appropriate time. Thisstudy was designed in Afzalipour Hospital in Kerman to evaluate meningitis causes, frequency andCSF laboratory changes.Patients and In this retrograde descriptive study from September 2003 to September2005, documents of all the hospitalized patients with diagnosed meningitis in Afzalipour Hospital ofKerman, southeast of Iran were studied. During this period, 126 patients were hospitalized. The age average was 15.2 ± 5.2 yr.Males were more than females (69% vs 31%) & 64% were children. Majority of patients wereadmitted in winter (42.9%) followed by spring (31%). 9.5% had viral meningitis. 89.5% of patientswith bacterial meningitis had negative CSF culture. Positive culture included 6 cases of H.influenzaetype B, 3 cases of pneumococcal and 3 cases of meningococcal. Average level of glucose in CSF inpositive culture group was less than negative culture group (22.5mg/dl vs 53.5mg/dl). All positiveculture patients had pro>100mg/dl and WBC>1000/mm3. 10.5% of patients had positive culture, which might suggest that there were someerrors in microbial cultures done in this hospital. More prevalence of meningitis in children wassimilar to other studies. The most common cause was H.influenzae, so Iranian children vaccinationshould be considered.

Presence of hepatitis B core antibody (anti-HBc) in the absenceof hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) is defined, asisolated anti-HBc. little is known about the clinical significance of the isolated anti-HBc in hepatitisB virus (HBV) infections. The aim of this study was to assess the significance of anti-HBc as the onlymarker of HBV infection in high risk patients.Patients and In this cross-sectional study, 395 patients including 289 patients onchronic hemodialysis (HD) and 106 HIV infected subjects were enrolled. HBsAg, anti-HBs, anti-HBc, Hepatitis C antibody (anti-HCV) and Alanine aminotransferase (ALT) levels were tested in allsubjects. The presence of HBV-DNA was determined quantitatively in plasma samples of patientswith isolated anti-HBc by real-time PCR. Of 395 patients, 40 (10.13%, 95% CI, 7.1%-13.1%) had isolated anti-HBc. HBV-DNAwas detectable in 12 of 40 patients (30%, 95% CI, 15.8%-44.2%) who had isolated anti-HBc. Our study showed that detection of isolated anti-HBc could reflect unrecognizedHBV infection; hence, screening of these patients is useful to preventing of HBV transmission.

The Fallopian tube plays an essential role in tubal transport ofboth gametes and embryos and successful pregnancy. We assessed the histomorphological effect ofsmoking on the fallopian tubes in rats, in this study.Patients and Twelve female rats were divided to two groups as subjects (n=7) andcontrols (n=5). They have been exposed to smoke four times daily for 4 weeks. The histomorphologicaleffect of smoking on the fallopian tubes was assessed by H&E. The findings were hydrosalpinx in two cases and inflammation in one of them. Therewas no reduction in the number of either the ciliated cells or the cilia. The findings did not confirm our theory regarding smoking effect on the fallopiantubes’ tissue. Further studies with electronic microscope are recommended.

Littoral cell angioma is a splenic vascular tumor of splenic sinus lining cells that is consideredbenign in general. This report describes a case of littoral cell angioma with no malignant histologicalfeatures. The lesion is composed of anastomosing vascular channels resembling splenic sinus; theyare lined by endothelial cells which show mitotic activity very rare. Immunohistochemically, thetumor cells were positive for both endothelial (Factor VIII-AG, CD34) and histiocytic markers (KP1or CD68). The morphologic and immunohistochemical findings in this tumor confirm the presenceof dual (endothelial / histiocytic) characteristics of the reticuloendothelial cells lining the splenicsinus, justifying the term littoral cell angioma.

Anderson-Fabry disease is a rare inherited X-linked lysosomal storage disease caused by deficiencyof the enzyme alpha-galactosidase A. Hereby we report a 39 year old male that presented withproteinuria and edema. Histopathologic, immunofluorescence and ultrastractural examination ofrenal tissue were in favor of Fabry disease in associate with IgA nephropathy. Fabry’s diseaseassociated with IgA nephropathy apparently is extremely rare, and the present case is among fewreported cases in literature.

Chronic granulomatous disease (CGD) is a rare inherited disorder characterized by inabilityof phagocytes to generate oxygen radicals needed for intracellular killing of phagocyticmicroorganisms. We report a 2.5-year-old Iranian female with multiple liver abscesses. Shewas admitted in surgical ward because of abdominal pain and fever for one month durationthat had no response to conventional antibiotic treatment. The results of laboratory tests were:WBC=17000, Neutrophils=82%, lymph=17%, ESR=100. Other tests except nitroblue tetrazolium(NBT) and dihydrorhodamine (DHR) tests were negative and according to these two tests the finaldiagnosis was CGD. Supportive care along with recombinant interferon γ and oral trimethoprimsulfamethoxazolefor prophylaxis of infections started. Now after 18 months she is alive and healthy.Any patient with recurrent or unusual lymphadenitis, hepatic abscesses, osteomyelitis at multiplesites, a family history of recurrent infections, or unusual infections with catalase positive organisms,like S. aureus, requires evaluation for CGD.