مجله علوم پزشکی رازی
سال شانزدهم شماره 12 (پیاپی 69، اسفند 1388)

With regard to the reported biological effects of different frequencies of ELF as window effect and also the use of 217 Hz frequencies as modulating radiofrequency waves of 900 MHz in global system for mobile(GSM), the purpose of this study was to investigate the effect of magnetic field of 217 Hz frequency on the growth of tumor cells. Forty-nine male mice of Balb/c race aged 6-8 weeks were randomly divided into 7 groups (3 test groups, 3 sham groups, and a control group), and 100%, 75%, and 30% of minimum required cells in order to cause tumor were subcutaneously injected into them respectively. On the second day after injecting cells, test groups were exposed to the homogenous field of a pair of Helmholtz Coil for 150 minutes every day for 19 successive days. The formation of tumors was observed after 6-10 days. On the twentieth day of the experiment, the mice were anesthetized and the tumors were extracted.Tissue samples were also gathered for histological comparison. This study was conducted experimentally and one-way ANOVA and SPSS-12 software were used to analyze and compare the weight and size of tumors in test groups in relation to sham groups. The study revealed that there was a significant difference (p<0.05) between test and sham groups regarding the size and weight of tumors. In terms of tumor formation, there was a significant difference between test and sham groups,too. Histological comparison did not show a significant difference regarding mitosis and metastasis into other organs. However, mitosis in test groups was higher in comparison to sham groups, which is indicative of the presence of more active tumors in these groups. In addition, test group's tumors had larger necrosis areas. The obtained results of this study show that exposure to pulsed 217 Hz magnetic field can increase the development of the fibrosarcoma tumors in Balb/c mice, which is indicative of window effect according to the reports about other EFL frequencies.

Despite the frequency with which IBS is encountered in clinical practice, it remains an important medical problem for both health care providers and patients. Unfortunately,so far no single treatment option has been effective for managing IBS.Therefore, we decided to evaluate the effects of Plantagel on relieving IBS symptoms.Patients and This double-blind clinical study was conducted from April 2006 to December 2007. 70 patients with diarrhea predominant IBS (IBS-D) enrolled in our study.The subjects were divided into two equal groups of 35. First, all the participants were monitored for two weeks prior to drug administration.Then 35 patients in the study group received Plantagel and 35 patients in the control group received placebo for two weeks. The patients were called at the end of the second week of treatment period and 3 weeks after the end of treatment in order to evaluate the clinical severity of IBS symptoms.SPSS software v.15, paired t-test, Chi-square and independent sample t-test were used to analyze the data. The entire study population improved significantly over 2 weeks of treatment in terms of all studied parameters. However, severity of bloating, feeling of incomplete emptying, presence of mucous in stool and urgency tended to decrease further in Plantagel group in comparison with placebo group.Three weeks after completion of the course of treatment, severity of abdominal pain, frequency of defecation, bloating and urgency returned to primary levels in placebo group and the benefits of treatment diminished over time in this group,while the severity of all symptoms in Plantagel group statistically improved compared with before treatment. The present study is the first clinical trial to evaluate the effects of Plantago Major on IBS-D symptoms. Our study demonstrated that Plantagel is effective in the management of IBS-D symptoms and its effects last 3 weeks after completion of treatment. According to these findings, IBS-D patients can use Plantagel intermittently to improve their complaints and decrease treatment costs.

Multiple sclerosis(MS) is the most common inflammatory disease of central nervous system which is caused by an autoimmune process leading to destruction of myelin sheath. In this disease, CD4+ T–lymphocytes, mostly of TH1 phenotype, play important roles in destruction of neuronal tissues. Because of the probable etiologic participation of EBV virus in immunopathogenesis of MS, the aim of this study was to evaluate the relationship between serum levels of anti-Epstein Barr virus antibodies and production of TH1 and TH2 cytokines.Patients and A descriptive study was performed on 68 MS patients in different stages of the disease and 20 healthy individuals. Blood samples were taken and plasma levels of anti-EBNA-1 and VCA antibodies were determined by ELISA method. Then, peripheral blood mononuclear cells (PBMC) were isolated by Ficoll Hipaque separation and stimulated with PHA in optimal culture conditions. Concentrations of IFN-γ, IL-12 and IL-4 in culture supernatants were then measured by ELISA. Statistical analysis was performed by using SPSS version 16. Mann-Whitney, t-test,and Pearson correlation coefficient were used to compare the variables and find the correlation between them. P<0.005 was considered statistically significant. The mean levels of anti EBNA-1 and VCA antibodies were significantly higher in patients compared to controls (P=0.04, P=0.001 respectively). Concentrations of IFN-γ, IL-4 and IL-12 were also significantly higher in MS patients than healthy individuals (P=0.001, P=0.005, p=0.002 respectively). Although the ratios of IFN-γ to IL-4 and IL-12 to IL-4 were higher in MS patients than healthy individuals, this increase did not reach a significant level (P>0.05). A statistically significant correlation was found between anti EBNA-1 and VCA antibodies and IL-12 production (P =0.02, r=0.27& P=0.04, r=0.25 respectively) whereas no significant correlation was found between these antibodies and production of IFN-γ and IL-4 in MS patients. The significant correlation between the level of anti-Epstein Barr virus antibodies and IL-12 production in MS patients implies the probable role of this cytokine in skewing immune responses toward TH1 phenotype. It is possible that this putative viral agent in combination with other etiological agents is involved in the etiology and progression of the disease.

Psoriasis is a common chronic inflammatory skin disease that affects 1-3% of the world's population. It can cause significant distress to the patient and ultimately the reduction of the patient's life quality. From the clinical perspective, it can create bright, red, elevated, and scaly plaques. Psoriasis is now recognized as a T-cell mediated disease with epidermal hyperplasia being a consequence of the activation of the immune system and cytokines release. No definite cure has been found for this lesion and existing treatments have high rates of relapse. Further recognition of immunopathogenesis and cytokines contributing to the severity of the disease can help to discover more specific and efficient treatments for this disease.The aim of the present study is to determine the relationship between serum levels of cytokines secreted from Th1 and Th2 cells, IL8 and ICAM-1 and psoriasis severity based on PASI in order to distinguish the possible role of cytokines in the immunopathogenesis of psoriasis.Patients and This study was performed on 40 patients with psoriasis vulgaris referred to Rasool-e- Akram Hospital between 2007 and 2008. In order to determine the severity of the disease based on PASI, each patient was examined clinically. Then 3 cc of vein blood sample was taken and serum sample was separated through centrifuge and stored at -70°C until the final examination. Next, through ELIZA method, serum levels of the above-mentioned cytokines were measured and by using Spearman correlation coefficient, the relationship between serum levels of the above-mentioned cytokines and the severity of the disease was evaluated. According to this study, there is a meaningful statistical relationship between the serum level of interferon ɣ (p=0.001, r=0.50), interleukine 8(p=0.018, r=0.37), and ICAM-1 (P=0.047, R=0.31) and the severity of psoriasis based on PASI. However, such a relationship was not observed between the serum level of interleukine 4 and the severity of the disease (p=0.24, r=0.18). Based on our study, interferone ɣ, interleukine 8, and ICAM-1 are related to the severity of psoriasis. Therefore, the treatments which selectively target the above-mentioned cytokines, are more reliable and efficient. It is strongly recommended that further studies and researches be conducted to investigate the effects of the above-mentioned biological treatments on psoriasis.

Low back pain and lordosis are among the most frequent complaints of pregnancy, and one of the methods to reduce them is physical exercise. The purpose of the present study is to evaluate the effect of exercise on low back pain severity and lordosis in pregnant women.Patients and A randomized clinical trial was performed on 30 pregnant women with a gestational age of 16 weeks who had low back pain.The patients were randomly assigned into two groups. In the case group (n=15) exercise and in the control group (n=15) nothing was done. To find the severity of back pain, the pregnant women were asked to fill in Roland-Morris questionnaire once at the beginning of the study and again in the 20th and 24th weeks of pregnancy. Lordosis was measured by a flexible ruler at the beginning of the study and again in the 20th and 24th weeks of pregnancy. Statistical analysis was performed using SPSS v.11. Paired t-test and Student's t-test were used to compare the results. P value less than 0.05 was considered significant. In comparison with the control group, the case group showed a significant reduction in the severity of back pain 2 months after intervention (26.13± 2.41 VS 31.93 ±4.9, P=0.001), and the reduction in the intensity of back pain 2 months after intervention was less in the control group than the case group (-3.42± 0.44 VS 17.76± 0.936, P= 0.001). In both groups, lordosis was significantly increased (40.26± 7.1 VS 42.6±7.16, P=0.001 in the case group, and 39.63±5.21 VS 41.9±5.84, P=0.001 in the control group), but the rate of increase was higher in the control group. Exercise may be a good method to reduce low back pain and lordosis in pregnant women.

Angiogenesis has an important role in the progression and metastasis of breast cancer and is a predictor of patient's survival. This process is regulated by vascular endothelial growth factors (VEGF). The purpose of the present study is to determine the angiogenesis process through the evaluation of the relationship between MVD and VEGF based on immunohistochemistry in patients with invasive breast carcinoma and study their correlation with grading, staging, age, lymph node involvement and biomarkers including estrogen receptor(ER), progestron receptor (PR), Ki-67, HER2 and P53.Patients and In this analytical cross-sectional study, after searching among paraffin embedded blocks in Pathology Ward of Hazrat Rasool-e-Akram and Atieh hospitals between 2004 and 2007, 74 blocks were included in the study and immunohistochemistry staining for biomarkers VEGF and CD31 were done, and the results were compared with ER, PR, Ki-67, HER2 and P53, age, lymph node involvement, histologic grade, and stage. Demographic information was gathered from the patient's files. Data was analyzed by SPSS v.12 software. The mean age of the patients was 49.4±11.94 years.The mean of CD31 was between 5.6 and 106.6(37.39±17.95) and the median of CD31 was 34.3, which was assumed as cut-off. Based on this value, 37cases(52.1%) were considered as low MVD and 34 cases(47.9%) as high MVD. 57 cases (7%) were VEGF positive and 17 cases (23%) were VEGF negative. Between mean MVD and VEGF was a significant correlation (Spearman r=0.24 and P=0.041), which means VEGF as an angiogenesis factor plays a role in increasing MVD. There was no significant relation between VEGF and MVD and age, histologic grade, nuclear grade, lymph node involvement, tumor size, stage, ER, PR, HER2/Neu, Ki-67 and P53. Based on the results of this study, VEGF plays a role in promoting angiogenesis. With respect to the results of this study, there is no significant relationship between VEGF and MVD and histopathological prognostic factors, age, and biomarkers of ER, PR, HER2/Neu, Ki-67 and P53.

Stable and unstable angina and acute MI happen due to atherosclerosis of coronary artery. The purpose of this study is comparing the level of LP(a) with LDL-C, VLDL-C and HDL-C in patients with MI and unstable angina.Patients and This cross-sectional study was performed on patients suffering from MI or unstable angina who were admitted to Yahyanejad Hospital in Babol between 2006 and 2007.The patients were divided into MI group and unstable angina group based on the positive or negative result of troponin test. After lipid profile test, information was recorded in a questionnaire. Then the data were analyzed by spss14, Chi-square and t-test. p<0.05 was considered significant. Among 218 patients in this study, 188 patients suffered from unstable angina and 30 patients suffered from MI.The mean of serum lipids was: LDL-C= 145.19±3.05, VLDL-C= 30.89±1.48, Lp(a)= 65.15±5.31, TG= 154.41±7.41, CHOL= 221.41±3.68,and HDL-C= 44.48±0.69. Comparing the means of serum lipids in both groups of MI and unstable angina revealed a significant difference between levels of LDL-C, Lp(a), cholesterol, and HDL-C (p<0.05), but in terms of VLDL-C and TG the difference was not significant (p>0.05). It can be concluded that a significant correlation exists between LDL-C, cholesterol, low HDL and high Lp(a) in patients with unstable angina and AMI.

Post-operative pain is a frequent complication after surgery which can increase the risk of other post-operation complications and also the duration of hospital stay. In this study, we have tried to assess the effect of rectal diclofenac as pre-emptive analgesia to reduce post-operative pain after ophthalmic surgeries(vitrectomy).Patients and This study was designed and performed as a double-blind clinical trial. The patients who were candidates for vitrectomy in Rasool-e-Akram Hospital were included in the study according to some exclusion and inclusion criteria and divided into two groups of diclofenac and control. In diclofenac group,patients received a single dose of 100mg 2 hours before surgery.The pain scores were assessed in recovery room,4 and 12 hours after vitrectomy using the visual analogue scale(VAS). To compare qualitative and quantitative data of the two groups, provided that normal distribution existed, we used Chi-square test for qualitative variables and t-test for quantitative variables. Also, in order to determine confounding factors exactly and assess the effect of time, multiple regression analysis was used. A total of 97 patients were divided into two groups:51 persons in diclofenac group and 46 persons in the control group. The mean of pain intensity at the 4th hour after surgery in diclofenac group was lower than the control group(p<0.001). Pain intensity at the12th hour after surgery in diclofenac group was 2± 0.6 and in the control group was 3.3±0.8, which was statistically lower in diclofenac group than the control group(p<0.001). Multiple regression analysis revealed that two factors,i.e. increasing age and using diclofenac, were effective in reducing pain(p<0.05). Single dose of rectal diclofenac as pre-emptive analgesia is effective in reducing post-vitrectomy pain.